Transcription of Vitamin D/Sunshine #46
Speaker 1: You are listening to the Dr. Lisa Radio Hour and Podcast recorded at the studios of Maine Magazine in Portland, Maine and broadcast on 13.10 Am Portland, streaming live each week at 11:00 AM on wlobradio.com. Show summaries are available at doctorlisa.org, download and become a podcast subscriber of Dr. Lisa Belisle through iTunes. See the Dr. Lisa website or Facebook page for details.
Speaker 1: The Dr. Lisa Radio Hour and Podcast is made possible with the support of the following generous sponsors: Maine Magazine, Mike Lepage and Beth Franklin at Re/ Max Heritage, Robin Hodgskin, Morgan Stanley Smith Barney, Dr. John Herzog of Orthopedics Specialist in Falmouth Maine, BOOTH, UNE the University of New England and Tom Shepard of Shepard Financial.
Dr. Lisa: Hello, this is Dr. Lisa Belisle and you are listening to the Dr. Lisa Radio Hour and Podcast, show number #46, Vitamin D and Sunshine, airing for the first time on July 29th 2012 on WLOB and WPEI radio Portland, Maine. Today’s show is one that Genevieve and I wanted to put in the works for quite a long time. We waited till the summer because it seemed like the right time to do it but we’ve been talking about it for a very long time. Hi Genevieve.
Genevieve: Hi Lisa. Yeah I think it’s been in the news, the lack of vitamin D, that people are vitamin D deficient far more often than we think they are and it’s all very relevant but why do you think vitamin D is important Lisa?
Dr. Lisa: Well, we know that vitamin D has been linked to … first of all vitamin D really isn’t a vitamin. I mean it’s been considered a fat soluble vitamin A, D, E and K for a long time considered one of the vitamins but it’s not really a vitamin, it’s more like a hormone. As a hormone it actually has an impact on multiple systems in the body. So it has an impact on our ability to prevent cancer, it has an impact on our mental wellbeing, our emotional state, it really … it’s connected to everything and it’s very interesting that the vitamin D connection kind of connects us back out to the universe. I mean we know that the food that we eat, that impacts the insides of our bodies and we know the air we breathe impacts the insides of our bodies but now we know that sunshine does too and it’s not just about getting a tan.
Genevieve: It’s true and I think that that sort of symbolizes everything that you and I are about and our theory of wellness which is it’s all connected.
Dr. Lisa: Yes, it is all connected. One of the reasons I began studying traditional Chinese medicine and acupuncture several years back was because they understand that and they look at the body as a whole system. In fact, traditional Western medicine does the same thing. When I do an evaluation of somebody in my practice, they’ll come in and I actually look at their skin and I talk to them about their whole body and I talk to them about their skin issues but I talk to them about everything.
In traditional Chinese medicine, the skin is actually a manifestation of the lung and it’s something that kind of gets rid of toxins, it gets rid of things that our body no longer needs. If you think about it when you sweat, you’re getting rid of your … you’re helping your body cool off but you’re also getting rid of things that your body doesn’t need so it is all connected.
Genevieve: That’s interesting, I never real … I mean I know that the skin breathes but I never really made that connection between the lungs breathing and the skin breathing.
Dr. Lisa: Yeah and children have a lot … if you think about it, and this is one of the things I’ve thought about a lot because I have three kids. Anything that you put on your kids, it gets absorbed into their little bodies and they have a lot of skin so they’re absorbing anything you put on them that you might put on yourself, they’re absorbing to a much greater degree. They also … their skin is also very kind of thin so this is interesting. They’re also impacted by the sunshine and vitamin D.
Genevieve: Well, I’m excited about this show because I think it’s going to tell everyone out there how vitamin D acts in your body. That’s a great indicator of one small thing that makes a big change in your health and your wellness.
Dr. Lisa: It is going to be a good show, a really good show, those of you who are listening are in for a treat. We have Susan Fekety, formally of True North who has been talking about vitamin D and functional medicine for a long time and she’s the owner of Healthy Living Health Care in Falmouth. We also have one of the co-founders of True North, Dr. Bethany Hays who happens to be somebody that I trained with when I was at Maine Medical Center. She is the former obstetrician.
Genevieve: She’s sort of legendary around here.
Dr. Lisa: She is, yes and we have in addition Rhonda Nordstrom who is a spa owner out of Rockland but she’s a pretty high powered spa owner actually. She’s created her own safe skincare line, healthy skincare line including safe sunscreen. So we think that this is going to be a pretty great line up for those of you who are listening so we hope that you’ll continue to tune in.
Speaker: The Dr. Lisa Radio Hour and Podcast is pleased to be sponsored by the University of New England. As part of our collaboration, we offer a weekly segment we call wellness innovations. This week’s wellness innovation is about a study that shows that low vitamin D in the diet increases the stroke risk in Japanese-Americans. Japanese-American men who do not eat foods rich in vitamin D had a higher risk of stroke later in life according to the results of a 34 year study reported in stroke an American Heart Association journal.
Vitamin D is an essential nutrient that helps prevent rickets in children and severe bone loss in adults. Researchers believe it has the potential to lower the risk of a host of diseases including cancer and diabetes. Sunlight is generally the greatest source but synthesizing vitamin D from the sun gets more difficult as we age. So older people are advised to eat more foods rich in vitamin D or take supplements. Good sources include fortified milk and breakfast cereals, fatty fish and egg yolks.
Stroke ranks fourth among the leading causes of death in the United States. New or recurrent strokes strike about 795,000 Americans annually. Researchers said it is unclear whether the results could be applied to different ethnic groups or to women but it is important to note that previous studies have focused on blood concentrations of vitamin D while this investigation use dietary intake. For more information on this wellness innovation which came to us through eurekalert.org, visit doctorlisa.org. For more information on the University of New England, visit une.edu.
Speaker: This portion of the Dr. Lisa Radio Hour and Podcast has been brought to you by the University of New England, UNE. An innovative Health Sciences University grounded in the liberal arts. UNE is the number one educator of health professionals in Maine. Learn more about the University of New England at une.edu.
Dr. Lisa: Sitting on the Dr. Lisa Radio Hour and Podcast, our topic is Vitamin D and Sunshine and the person we chose to come in as our first guest is somebody who knows a lot about vitamin D and sunshine, she spent a lot of time thinking about this and the relationship between nutrition, vitamin D and health. We’re talking today with Susan Fekety who is the owner of Healthy Living Health Care. A new practice for human powered health care in Falmouth, Maine and a Yale educated practiced nurse and midwife previously at Women to Women and True North Health Center. Susan has offered women’s health care, healthy lifestyle counseling and customized nutrition solutions in the Portland area since 1995. You’ve been thinking about this a long time Susan, thanks for coming in and sharing your knowledge.
Susan: It’s a total joy to be here so thanks for inviting me, I really appreciate it.
Dr. Lisa: Susan, your approach to health care came about first through your exposure to what I would call traditional western medicine, I should say. Tell us a little bit about your background and why did this send you in the direction of this healthy living practice?
Susan: So I might actually skip back to you in a little bit before my education began to tell you the fact that I’m a product of a medical family. My dad’s a doctor, my mother’s a nurse and that … that kind of long standing atmosphere around medicine and health is sort of is where I grew up. I chose to become a midwife back in the early 1980’s because I was very passionate about women’s health and also felt from a healthcare policy approach that it was really important to focus on prevention which is what midwives do and focus on supporting people’s ability to understand what they can do for themselves, which is to me a hallmark of the nursing tradition and of the midwifery tradition.
So as a midwife, my primary tools were … although I was educated around the things that we use in western conventional medicine because you need to understand that to be a safe obstetrical provider. What we specialized in as nurse midwives was learning how to support the physiologic process of pregnancy labor, fertility and the whole women’s health spectrum. Working with pregnant women, you’re not going to be prescribing medications, you need to learn how to use other things and so we were educated in using primarily nutritional lifestyle therapies to prevent and resolve the common complications of pregnancy, and also to develop a vigilant around what are the very early signs of trouble that you can see so you don’t need to wait for the big disaster to occur and then you need to use rescue medicine.
So my philosophy really is based on the idea that it’s easier to stay out of trouble than to get out of trouble. What I found over the years is that there is a depth in richness in that that puts the potency for health maintenance back in the hands of humans, back in the hands of people on a day to day basis. As I look at the health care system right now, to me that’s the only way that things are going to change is with day to day information that people can use comfortably themselves. Supported, educated science based but more on a one to one each day basis, what do we learn about ourselves.
Dr. Lisa: It seems like vitamin D is actually a perfect topic with that in mind. Why has vitamin D become so important in the last 10 years?
Susan: It’s fascinating in the way that the vitamin D and sunshine which we really need to link them together, the way … the history of that, the awareness of that problem. You may remember reading or listeners may remember reading or hear about or seen photographs of, back in around Victorian turn of the century, they would have solariums. Now, people in the tubercular hospitals would be taken out on those little lounge tiers and put in the sunshine and wondered, why are they doing that? If we know that sunshine causes cancer what was up with that.
But that was around the time when a guy actually won a Nobel prize for identifying the health benefits of sun exposure which in the times when people where becoming more industrialized, living in cities, the air was full of soot. A lot of people didn’t get sun exposure and yet different epidemiological studies identified that sunshine exposure was really important for human health and so it was the part of health care. Then there was the discovery that a lot of children were developing rickets.
I remember learning about that in midwifery school and saying that, “You’re never going to see that,” and you may have had the same experience Lisa rickets, yeah that’s something that happened a long time ago. We’re all over that with vitamin D fortified milk. Well, we’re starting to see rickets back again and rickets is a bone deformity that we see in small children when they get bow-legs so their bones actually form abnormally. One of the things were discoverable, what we know is that rickets is the symptom, a very sever symptom, of profound vitamin D deficiency usually in combination with deficiency of calcium and vitamin D and calcium really always need to come together.
So over recent years, more and more research has been done about vitamin D and it’s evolved from being the thing that we learned about as the cause of rickets. I remember hearing about pelvic deformities in women who lived in Arab countries who wore purdah and never got enough sunshine, would get deformed pelvises that it was really difficult to deliver babies through and I thought I would never encounter in my practice.
Suddenly, as people started to understand more the connection between human beings and the natural world around them we realized this is radical, that we started to understand that sunshine vitamin D and calcium metabolism are actually essential for a lot of things. So there was this ground slow of new research that actually found that rather than what they used to think which is vitamin D was made in the kidney, that actually vitamin D is made on our skin and everyday and that we’re designed to do that. In fact, if we think about how our genetics, how our body developed, we were designed to be running round naked on the African veldt and being in the sunshine all day, every day.
That’s what our genes kind of want and have as familiar. We live in the United States, we’re inside most of the time, we’re avoiding the sun when we are outside, we’re smearing ourselves with sunscreen, we’re putting on a hat for long and phobic and so there’s the whole new epidemic of vitamin D deficiency because people are sunshine phobic. As more research has been done, I would say in the past five to 10 years about vitamin D physiology, we’re starting to discover that the vitamin D-calcium link is really important but it’s only a tiny piece of what we’re really learning.
Suddenly, we’re discovering that vitamin D physiology has to do with cardiovascular health. It has to do with cancer prevention, breast cancer, prostate cancer, colon cancer, the most numerically dramatic forms of cancer but vitamin D is like, oh my goodness we can work with that. It has to do with mood, vitamin D is a co-factor for neural transmitter signaling so we have an epidemic of depression.
People taking serotonin, we have take inhibitors and what we’re starting to discover there’s probably a proportion of those people who it’s not a serotonin deficiency they have, it’s a vitamin D deficiency such going up as a serotonin problem. You can make a long list of healthcare challenges that people live with and suffer with everyday that can be related at the very least, they’re radically and probably in actuality to problems with vitamin D just because of the American lifestyle that brings us indoors and away from the sun. Or if we’re living in a place where we don’t get a lot of natural sun exposure like Maine.
Dr. Lisa: But this makes the dermatologists crazy.
Susan: It makes them crazy. People throw books at one another at conferences about this issue because there is … we know that the non-melanoma skin cancers are caused by direct sun exposure on the skin. I mean that was proved I think in the 1940’s with farmers who would get basal cell skin carcinoma and squamous cell carcinoma on the parts of their bodies that were exposed to the sun when they were out working.
The research that I read shows that those same populations interestingly enough, had lower rates of the melanoma cancers, the ones that are really … that we think of as much more life threatening than the non-melanoma skin cancers. The thinking among the vitamin D experts that I’m reading is that … it’s actually that same sun exposure that make it some small non life threatening skin cancers but prevent them from getting those big bad melanomas which oddly enough seem to occur in the places that aren’t exposed to the sun anyway, so what’s up with that?
It’s a big mystery. But when the people who are researching vitamin D start talking about sensible sun exposure and going out in the sun for 10 or 15 minutes a couple of times a week without sunscreen, the dermatologists go nuts. There’s also the wrinkling issue which a lot of people are really concerned about and photo ageing of the skin is a reality and a lot of people …
Dr. Lisa: But we’re not talking about the bad old days that I remember where you’d smear yourself with baby oil and put a tin foil on your record album cover.
Susan: No but didn’t we do that, you’re too young to have done that!
Dr. Lisa: I did that.
Susan: So no we’re not talking about those bad old days. We’re talking about just a few minutes, pre-redness we never want to get burnt: a) because it hurts but b) because we know it’s bad for skin. But this is just enough to turn on your physiologic vitamin D synthesis mechanism that we’re all designed to get a little bit of all the time. Is why we’re hungry for it, I think.
Dr. Lisa: Well, it is interesting that people seem much happier when the sun comes up. All of my patients they come in on sunny days, they’re like, “I don’t even know if I need to see you because I feel so good.”
Susan: Exactly.
Dr. Lisa: That’s all good, let’s put some needles in you anyway, do a little acupuncture, just keep that good energy going. They come and see me on cloudy days and they say, “I don’t know why I feel so bad.” So if anybody doesn’t recognize that there’s a link between mood and sunshine maybe isn’t paying very close attention.
Susan: Attention, yeah. The biochemist would say that the serotonin mechanism, that’s the neural transmitter mechanism of vitamin D. I think there’s also some really complex and elegant physiology that has to do with just light in the brain, in the eye affecting … having a favorable effect on mood. But when folks who identified seasonal effective disorder started to do that research, that was ground breaking even though intuitively many of us had sort of known that, winter was the dark time.
But that makes me want to touch on the thing that I think I really important. We are designed to have cycles of light and dark, seasonally and during the day. One of the things that I think is really important that many of us have gotten away from to our health detriment is attending to or even noticing that natural cyclicity. We are in our offices working on the computer while it’s a sunny day outside. We’re up late at night with the television on and that’s affecting our sleep cycling. In the morning we get up, we get in the car, we go to the office, we’re missing that light and dark cycling which in every tradition of medicine experience.
Dr. Lisa: Another really important thing for human bodies to experience is the right type of food and I know this is an important part of your practice. You’re also in practice with Dr. Peter Knight who’s a naturopath, I know that food is very important to him. Is there a relationship between vitamin D and food?
Susan: There is although interestingly if you look at the food sources of vitamin D, there aren’t a whole lot. So that’s one of the things that makes us think that indeed our bodies are designed to connect up with sunlight and many people end up supplementing sort of their hedge around that. Food sources of vitamin D; oily fish, wild Alaskan salmon is going to be one of your best sources. Atlantic farm raised salmon isn’t going to get a lot of vitamin D because of the nature of the food that they ingest.
If you can see Sockeye salmon which is starting to come into the markets now, that’s a really wonderful thing. I’m a big fan of sardines, I use to hate them but I’ve learned how to prepare them so that they taste good to me now. But sardines are a good source of natural vitamin D. Mackerel, I’ve never eaten it, I’ve never enjoyed it but it’s one of the oily fish on the list. So oily fish is one of the primary natural sources of vitamin D.
There’s a writer too that talks about how for northern dwellers who didn’t have a lot of sunshine in their latitude, one of the primary evolutionary benefits for them was discovering how to fish for the fish that had the vitamin D that helped them survive through Norwegian winters, finish winter so that they could get the vitamin D. I think that’s a really cool story. Anyway, so oily fish is one of the primary sources.
The next most common one is oddly enough mushrooms. Fungi have the ability to synthesis the vitamin D and when you eat mushrooms you’re going to get a little bit of vitamin D. Is it as much as you would probably pick up in a supplement? No, but mushrooms are good for us on so many levels that that’s one additional way to get more in. I have to tell you I’ve got a lot of patients I say mushroom sick kind of, they look at me like when I say sardines but mushrooms are another source, possini and shiitake mushrooms I think have the highest quantities of vitamin D. These would make a beautiful, salad of spinach and mushrooms and garlic and onions and have that as your side dish instead of a pile of rice and you’re ahead on a lot of levels.
Speaker 1: We will return to our interview after acknowledging the following generous sponsors Robin Hodgskin, senior Vice President and financial advisor at Morgan Stanley Smith Barney in Portland, Maine. For all your investment needs, call Robin Hodgskin at 207-771-0888. Investments and services are offered through Morgan Stanley Smith Barney LLC member SIPC and by BOOTH, accounting and business management services, payroll and book keeping. Business is done better with BOOTH, go to boothmaine.com for more information.
Dr. Lisa: What about cod liver oil?
Susan: So in my … I’m into old magazines in my office I have this page I pulled out of a 1929 health magazine and it’s a picture of a toddler aged boy with his teddy bear, sitting on the bed of a sun lamp, and he’s got a sun lamp, he’s got little aviator goggles on and they’re coming at him with a teaspoonful of cod liver oil. That’s an ancient way … ancient … culturally ancient way to get vitamin D into us and that was recognized as that was the way to do it because fish, oily fish like cod tend to have vitamin D in them.
So when the connection was made to rickets and other health benefits, everybody’s grandmother or mother would send to cod liver oil. Even the purified stuff, I don’t like it, I don’t like the feel of eating a teaspoonful of oil. Many people rely on cod liver oil though to get their vitamin D. The thing about cod liver oil is it’s got to be purified because that’s high on the aquatic food chain, the fatty part of any fish so purity is important if you’re going to use cod liver oil.
The challenge around cod liver oil is when you get, what we think of as a therapeutic dose or the amount of vitamin D that you would typically want to do, you usually had to take several teaspoons full. The kicker to that is vitamin D naturally contains a hefty dose of vitamin A, preformed retinol which is the fat soluble form of vitamin A. Vitamin A is high doses can run you into biological trouble. So I tend to not rely on cod liver oil and don’t recommend it to people as a vitamin D source plus there are so many other easier ways to get vitamin D in that I tend to not like to do that, but vitamin A the high doses of vitamin A issue I think is a little bit challenging so I tend to not recommend that so much.
Dr. Lisa: Now, vitamin D is also in Vitamin D fortified milk and other types of milk products. I didn’t hear dairy coming out as one of the recommendations, I don’t personally recommend it to my patients. How do you feel about dairy?
Susan: Well, suddenly we’re in a culture where the food culture is fortifying everything with everything that they think we have read about that we want and will trigger on: Omega3, fortified orange juice. Vitamin D fortified milk, that was the primary way that D hasn’t gotten into us. A glass of milk is probably going to have 100 international units of vitamin D in it and if you think about even the institute of medicine recommendation for daily supplementation with vitamin D at 600IUs for an adult, that’s not a whole lot.
So you can get some there but for many people as you point out the downside of dairy products, sort of militates against using milk as your vitamin D source although it’ one way that people do get it and it should be counted when you’re assessing your personal intake say over the course of the day. But I think for most people it’s easiest to actually use supplement rather than vitamin D supplemented something. If that’s easy for you, that’s totally wonderful, you just have to do a little bit more complex math, I think to track the quantities for that.
Dr. Lisa: I have a question for someone who’s taking a vitamin D supplement, who knows that their levels are low and they’re taking a high supplement, should they be careful with sunbathing?
Susan Fekety: Everybody should be careful with sunbathing but it’s hard … I can’t really answer that question because I don’t know how low is low and I don’t know how high is high. So this is one of the areas where I think our natural tendency to try to treat a supplement like an over the counter medicine can kind of run us into trouble and it really helps to have somebody to support us, to sort of figure out what’s the right strategy for each of us.
We have a tendency to look on the internet and find this and you can go in the health food store and get some fairly high dose stuff and that’s not the right recipe for everybody. It’s the right recipe for some but particularly with high dose vitamin D, and by that I mean something on the order of 10,000 international units in one capsule. I watch my patients who are using those very carefully and monitor their levels over time to make sure we don’t destabilize them. So that’s one of those it depends kind of things.
I think one of the messages that I would want listeners to get about vitamin D is that it is one of those things where more than none is really good, more than more than more can really run you into trouble. It’s like anything, saturated fat, you’ve got to have some to survive, too much is going to gum up your work and not you not healthy. So vitamin D is one of those things too, there’s people who metabolize vitamin D in a unique way and really should have somebody supporting them to do that in a sensible fashion. That’s why I’m a big advocate of checking levels. I think a lot of folks think, if I’ve got some of my multivitamin and I’m drinking a glass of milk and I’ve got the fortified orange juice, that should be enough and you know the reality is, it’s probably not.
Dr. Lisa: What are some of the symptoms of vitamin D deficiency aside from rickets?
Susan: Most people who are low in vitamin D actually have no idea which is why I’m a big advocate of testing. I’ve been testing pretty much everybody who comes into my clutches in my practice gets a vitamin D level because I believe that it’s now important. I would say at least half of the people that I see who are Mainers, are grossly clinically deficient in vitamin D and it shocked me when I started testing. Many of those people are not symptomatic at all but some of the subtle things that have been associated with vitamin D deficiency are some blues, whether they’re seasonal blues or just sort of a chronic feeling of being grumpy, premenstrual syndrome has been linked with vitamin D deficiency.
Certainly, any disorder of bone metabolism, osteopenia, osteoporosis, those folks are good candidates for listing considered deficient in vitamin D and that’s usually a productive area of inquiry. There is some interesting research about whether some people who have been diagnosed with chronic fatigue or fibromyalgia are actually manifesting muscular cell symptoms due to vitamin D deficiency. So that’s not something that I work with a lot in my own practice but I think that’s very intriguing.
What I noticed when someone is deplete with vitamin D who has been low is that they generally describe just sort of feeling of gentle lift in mood. Like one patient who put it, “I just felt like there’s more water under my boat now that my vitamin D level was up.” So it’s not a dramatic change in mood, it’s not going to make you zippy, peppy but it’s just putting the body back into a place of balance where it probably should have been all along.
Dr. Lisa: In your practice in addition to seeing patients, you also offer educational programs. Describe some of these for the people who are listening and might be interested.
Susan: Thanks for that invitation. Peter … Dr. Knight and I both love to teach and consider that one of our primary missions with the practice is offering a resource area for patients who want to learn more about how to care healthily for their body. We have a large population of patients in this area who are what I think of as health questers. They go on the internet, they’re googling this, they’re looking up that, they’re reading lots of books, they have a lot of questions and are looking for a place where they can sort of lean in and trust the quality of the information that they’re getting and so I feel very dedicated to creating a place for that for people.
Dr. Knight and I have created a lecture series that we do one class a month called The Foundations for Healthy Living. Each month we focus on one foundational principle, this month it’s eat real food and the talk is on Thursday evening from seven to eight and it’ free and people can go on our website and get the schedule. He and I, we just love to talk about what we do, Dr. Knight teaches the monthly cooking class although he’s taken a pause for this summer. The last one was about how to use all the herbs that are growing wild in your garden in a culinary fashion.
Let me tell you, our health center smelled so good that night and most of … many of the recopies that I use in my kitchen are ones that I’ve gotten from him because he’s a really good cook, although he’d never toot his own horn about that. But it’s really important to create a place where people can come and learn, learn from one another that’s one of the things that’s really important to me. I by nature tend not to be a top down kind of teacher but love to get people with a common interest together to share what they’re experiencing because that is a learning that is …you can’t beat that and we all grow from that so love to talk about what we do.
Dr. Lisa: How do people find out more about the classes and your practice?
Susan: Our schedule is online at our website which is www.mehealthyliving.com and people can sign up for our news information mailing list which is not spam. It’s usually useful and mentions upcoming classes but the website is really the place to go.
Dr. Lisa: Well, this has been very informative. I’m sure that our listeners will just tap the surface of the information that they’re going to want to find out about vitamin D and nutrition and health so we thank you very much for coming in and talking to us today. We’ve been speaking with Susan Fekety, the owner of Healthy Living Health Care, a practice for human powered health care in Falmouth, Maine. Thank you for coming in.
Susan: Thank you so much.
Speaker 1: A chronic ache, sleepless nights, a feeling of something being not quite right. Treat the symptoms with traditional medications, feel better for a little while and continue with your busy days. But have you ever stopped to consider the, ‘what,’ that’s at the core of a health issue? Most times it goes much deeper than you think and when you don’t treat the root cause, the aches, the sleeplessness and not quite right come back. They don’t have to, you can take a step towards a healthier more splintered life.
Schedule an appointment with Dr. Lisa Belisle and learn how a practice that combines traditional medicine with eastern healing practices can put you on the right path to better living. For more information, call the body architect in Portland at 207-774-2196 or visit doctorlisa.org today. Healthy living is a journey, take the first step.
This segment of the DR. Lisa radio hour and podcast is brought to you by the following generous sponsors. Mike Lepage and Beth Franklin of Re/ Max Heritage in Yarmouth, Maine. Honesty and integrity can take you home, with Re/ Max Heritage, it’s your move. Learn more at rheritage.com and by Tom Shepard of Shepard Financial with offices in Yarmouth, Maine. The Shepard financial team is there to help you evolve with your money. For more information on Shepard Financials refreshing perspective on investing, please email [email protected].
Dr. Lisa: On today’s the Dr. Lisa Radio Hour and Podcast we’re discussing vitamin D and sunshine. And we thought there probably is no better person in Maine to come in and talk to us about vitamin D and vitamins than the founder of True North and this is Dr. Bethany Hays. Thank you for coming in today.
Dr. Bethany: Thank you for having me Lisa.
Dr. Lisa: Now you and I have this background, you’ve been … since you were sort of in my life very early on as a resident when you were teaching and delivering babies and I delivered some babies with you. So you’ve been out there as a teacher for a while, now you’ve kind of jumped ship from OB/GYN to functional medicine. Tell me what that is, what is functional medicine and why is it important to health?
Dr. Bethany: Well, functional medicine is upstream medicine. It’s medicine which we try to find the causes of people’s symptoms and problems rather than just treating the symptoms with drugs and surgery. So we’re really going upstream and asking people not to get in the water, instead of throwing drugs and surgery at them as they go over the waterfall. I think of it as the way healthcare should be done and the way medicine is going to be practiced in the future.
Dr. Lisa: But you went from a very surgically oriented sort of, I don’t know, maybe skeptical field into this relatively new part of medicine. Why did you make that decision?
Dr. Bethany: Well, I was trained like most physicians to first of all do no harm and as I got into my medical practice, I found myself not needing that requirement. So I began looking for who had the best outcome and the best results and my first step into this field was actually to pay attention to what midwives do because they were the ones who had the best outcomes in terms of normal birth. That led me into complementary and alternative medicine where there were ways to take care of people that weren’t as caustic, weren’t as dangerous as some of the drugs.
Then I found functional medicine which completely satisfied my need to understand things all the way down to the molecules. And so I … it’s not that I don’t love the surgical subspecialty but I found that when I practiced functional medicine, there wasn’t any surgery to do. So I ended up giving up surgery because I didn’t think I was doing it often enough to keep my skill set up and so here I am doing sort of outpatient medicine, helping people stay healthy.
Dr. Lisa: And you’re doing outpatient medicine at a very special place in Falmouth, True North, which has now been around for a decade to your credit and to the credit of people at True North. What is True North for those people who are listening, who aren’t aware?
Dr. Bethany: Well, True North is a non-profit 501C3 and we’re in experiment to see if health care can be done differently. So we’re trying to help people stay healthy and to provide people with a kind of healthcare which we think we’re not getting as often now because of the pressure on physicians to see lots and lots of people in a very short period of time. So at True North, all of our practitioners work together to help people get healthy. But we take the time that’s needed to really understand and listen to you and then figure out what’s going on upstream and help you to stop those problems.
Dr. Lisa: Speaking of upstream, let’s talk about vitamin D, I mean we’re talking about up and the sunshine and vitamin D, this has become very hot. Well, sunshine again, hot topic in the last few years. Why has it become important and what didn’t we know about it before that’s now emerged?
Dr. Bethany: Well, I think for a long time we thought vitamin D was just involved in preventing rickets which is a bone disease. Now, we’re finding that vitamin D is actually more than it is a vitamin, it is a hormone that is intimately involved with many, many processes in our body that keep us healthy. So vitamin D is involved in the immune system and how the immune system functions keeping your immune system from getting overactive. Overactive immune systems cause inflammation which is really one of the major causes of lots of downstream illnesses that we think of as related to ageing.
Vitamin D is critically important in brain function so we know that vitamin D is involved with Alzheimer’s and multiple sclerosis. There are a bunch of diseases that we now know we see more often in people who live in the far north. So people who live up here in Maine have some of these diseases more often than folks who live down in the sunshine. The question is, what do we do to keep healthy vitamin D levels when we live up here?
Dr. Lisa: I know interestingly that functional medicine was talking about vitamin D 10 years ago, eight years ago, right around when True North was founded, at the molecular level. Way before this conversation started happening in mainstream medicine.
Dr. Bethany: Yeah that’s one of the great things about functional medicine is they’re really out on the leading edge of the research and trying to get that research to clinicians faster. We know that a lot of the research that’s coming out doesn’t get to doctors for … well, the New England journal said an average of 17 years. There’re actually a number of things that didn’t get to doctors for 30 years so functional medicine is working hard to get that information to physicians earlier.
Dr. Lisa: Now vitamins A, D, E and K, they’re all fat soluble vitamins which means that we can’t pee them out … we can’t … if we take too much of them, they can’t be excreted.
Dr. Bethany: That’s right.
Dr. Lisa: What are the dangers associated with too much vitamin D?
Dr. Bethany: Well, if you get too much vitamin D, it causes calcium to be deposited in places you don’t want calcium. Like for instance, in your kidneys, to produce kidney stones or in your blood vessels to produce hardening of the arteries. So it is important to know your vitamin D level, to not overdose yourself with vitamin D. There’s some tricks to that that are going to require some intelligence on the part of people who are taking vitamin D and people who are prescribing it. For instance, if you have a very activated immune system such as people with autoimmune disease for instance. Then you can actually be activating vitamin D and have a relatively low 25-hydroxy vitamin D which is the form we test but have a very high activated vitamin D level. This could be dangerous.
Dr. Lisa: How do people find out what their vitamin D levels are?
Dr. Bethany: Well, it takes a blood test and you can come to True North and order that blood test on yourself and take the information back to your physician. We have a program called Patient Directive Lab. One of the patient directive labs that we’re offering is a 25-hydroxy vitamin D. If you get that test done at True North, you’ll get a letter from me explaining your results and asking you whether you’d like to have that information go to your doctor.
Dr. Lisa: Give me examples of other types of tests you think everybody should know the answer to.
Dr. Bethany: Well, right now we’re also doing HSCRP which is a marker for inflammation. As I said earlier, inflammation is something that we know is involved with lots of the disease of ageing. Another test that we’re doing is homocysteine and homocysteine is a test which gives you information about your B vitamins status. Homocysteine is associated with associated with heart disease and Alzheimer’s and a number of other illnesses. We think it’s something you should know about, do you need more B vitamins. Since most people don’t get enough vegetables, they’re not getting enough B vitamin and we want them to know that so they can change their behaviors.
Dr. Lisa: Just switching gear a little bit, I believe you’re from Texas, is that right?
Dr. Bethany: I am, do you hear that accent?
Dr. Lisa: I just came back from Texas where I did a little grandchild therapy and why Maine, why come here, why stay here? I mean Maine is a place where obviously we don’t have as much sunshine as you do so.
Dr. Bethany: Yeah well, I didn’t calculate that in when I made the shift. But I came to Maine because I wanted to live in a place where it felt like I was on vacation all the time. When you turn 40 you start asking questions like, who am I? And why am I on the planet? What am I supposed to be doing here? And that lead me to ask the question, where in my wildest dreams would I like to live? And Maine was one of those places. So when the job showed up here in Maine, I jumped shipped and moved to Maine, I have not regretted that decision for one instant.
Dr. Lisa: It seems as though you’re not the only person who’s drawn to Maine. As a healer, can you speak to why that might be? Do you have any thoughts?
Dr. Bethany: Well, I think there are unique places in the United States that draw healers. I don’t know why that is but it’s just there are little nodules of great healing that happen in a number of places around the country and Maine is one of them. For me there is a dramatic shift that happens when I cross the bridge at Kittery, it’s like Maine, I am home, this is a great place. I see that shift with my children, with my mother, the Texans come up here in droves in the summer because they feel that extraordinary energy of this very beautiful place. I think a place that is as beautiful as Maine and where the population cares about that and takes care of it, is a place where people are interested in healing and so healers gather there.
Dr. Lisa: Vitamin D is sort of a beautiful analogy of the individual nature because nature actually provides the best source of vitamin D, isn’t that right?
Dr. Bethany: It does. One of the important things to know about vitamin D is probably it takes a combination of vitamin D as a supplement which gets your vitamin D level up higher and then vitamin from sunlight which gives you forms of vitamin D that are particularly useful in our bodies. So if you’re a lifeguard, you can get enough vitamin D from the sunshine but most of us are working, so we’re not outside all day long. So we really either need to make a concerted effort which we should do in the winter time up here to get out in overhead sun. It has to be noon day sun in the winter time or to take a supplement and then you need to know how much supplement to take and that means you need to know what your vitamin D level is.
Dr. Lisa: How do people find out more about self directive labs, True North, the work that you’re doing, vitamin D levels? What are good resources?
Dr. Bethany: Well, you can go online to our website at www.truenorthhealthcenter.org, you can call us on the telephone 7814488. We’d be happy to give you information about our self directive lab and our empowerME program at True North which is really a program designed to help you learn how to keep yourself healthy and live a long happy life.
Dr. Lisa: If people … once they’ve done this self directive lab, if they’d like to have an appointment with one of your many practitioners, that’s also an option as well?
Dr. Bethany: Absolutely, we’d be happy to help you out. We’d also be happy to give you information that you can take back to your own physician. But we do have some extraordinary physicians at True North that are doing fabulous work and there are a few of us that are practicing functional medicine and are particularly interested in this project of keeping people healthy.
Dr. Lisa: Well, we’ve been very happy to have you here in the studio. You have much experience, thank you for all the work you’ve done with True North. We’ve been speaking with Dr. Bethany Hays, co-founder of True North in Falmouth, Maine and I would like to say pioneer in the future of medicine as it stands, functional medicine. Thank you for coming in today.
Dr. Bethany: Thanks so much Lisa.
Speaker 1: We’ll return to our interview after acknowledging the following generous sponsor. Dr. John Herzog of Orthopedics Specialists in Falmouth, Maine. At Orthopedics Specialists, ultra sound technology is taken to the highest degree with state of the art ultra sound equipment. Small areas of tendinitis, muscle tears, ligaments, instability and arthritic conditions can be easily found during examination. For more information visit orthocareme.com or call 207-781-9077.
Dr. Lisa: Today on the Dr. Lisa radio hour and podcast, our show is discussing the topic of vitamin D and sunshine. It’s interesting because we’ve talked a lot, Genevieve and I about vitamin D and the importance of it and the hormone and the feel good factor but there is a very real influence on skin.
Genevieve: Skin damage and ageing which is what we’re afraid of and so there is a balance to be struck between being out in the sun and then putting sunscreen on. But how do you use sunscreen safely?
Dr. Lisa: Right. Which is why we invited Rhonda Nordstrom from the Rheal Day Spa in Rockland, Maine to come down and talk to us about this. Rhonda has 12 years of spa experience and actually has her own skincare line. I’ve personally put the sunscreen that she’s created on my skin and I think you’re quite the expert to come in and talk to us, thank you Rhonda.
Rhonda: Thank you for inviting me, it’s really exciting to be here.
Dr. Lisa: Well, we’re always to have people who have a broader view of health and wellness and actually when you were coming in, you were talking about the environmental working group. Tell us, what’s the relationship between the environmental working group and things that we put on our skin?
Rhonda: I think that often people don’t realize the harmful chemicals that might be in some of the ingredients that they put on their skin, that they bought at the pharmacy or whatever that tells them that they’re protecting their skin and then you find out that there’s harmful chemicals in there. A good resource to find out what chemicals might be harmful that you have in your skincare products is the environmental working group and their website is ewg.org and that’s a great place to start with what is a safe sunscreen. Because they’ll tell you what to look for that is not healthy and they also list the … I think it’s the top 10 or 20 safest sunscreens including those that are good for children.
Dr. Lisa: Rhonda, what are some things that people should be looking for in their sunscreens?
Rhonda: I believe that the most effective sunscreen and the safest sunscreen ingredient is titanium dioxide. You’ll often find zinc as well, zinc is the ingredient that turns your skin white and it’s not very user friendly so it’s very thick and it’s hard to put on. Titanium dioxide is a little more friendly and often they’re used together but the importance of using titanium dioxide or zinc is that they screen out both UVA and UVB rays.
I think that’s where the problem has come in for a lot of years as is that the … when the FGA first started the SPF rating, it was really what SPF stands for is how long can you be in the sun before you burn. But the burning rays are not the only rays that we need to be concerned with, the UVA rays which don’t physically burn us immediately or whatever, go more deeply into the skin and are more often linked to cancers.
Dr. Lisa: So there are issues besides burning and cancers, what are some of the things that you see in the day spa? What types of things, what problems do people get when they spend too much time in the sun?
Rhonda: Oh my goodness. Besides the obvious hyperpigmentation, or dark spots all over the face that we all get especially from the sun and from ageing so obvious just hardening of the skin and keratosis. I’m seeing so many people come in with little pieces of skin, chunks taken out of their skin from visiting a doctor and having suspicious looking things taken out of their skin. So that’s a huge downside there because all of a sudden you’re not so beautiful anymore and you’re certainly not healthy. I was also seeing premature ageing and deep wrinkling and what not on women in their early 40’s and that’s really too young to be seeing that kind of ageing.
Dr. Lisa: So your suggestion then is to be very careful of the sunscreen that you use but be diligent about applying it?
Rhonda: Absolutely, you have to reapply it and if it’s says it’s waterproof, I’m not saying no lotion that you put on your skin can be completely waterproof so is you’re swimming, you need to reapply. I do believe that the FDA is coming out with new guidelines or even maybe they’re going to change laws that will require the sunscreen manufactures to label appropriately because maybe they’re not all doing that now. They might say it’s broad spectrum but unless it has titanium oxide or zinc in it, you’re still getting UVA as well as UVB.
Dr. Lisa: We’ve been talking a lot about vitamin D and one of the best ways to make vitamin D in your body is through sun exposure. So what’s your recommendation for a safe level of sun exposure and then when do you put the sunscreen on? There’s a balance there.
Rhonda: Yeah I think first an early morning walk or run if you’re going to be outside playing early morning is best and then if you’re at the beach during peak hours which is I think is 10 until four, it’s the guideline, you need to be lathered up, you really do. As far as vitamin D and sunshine and health I think, it’s all a balance, right? Just like with everything else in life so if you’re eating well with foods that are high in calcium and you’re getting a little bit of sunshine every day, you’re skin’s going to be that much healthier, your whole body is going to be that much healthier and you’re going to have more resistance to UV damage.
Dr. Lisa: Where can we get your sunscreen Rhonda?
Rhonda: So far just at Rheal Day Spa in Rockland however, you can order it online through our website and or call us, we’d be glad to ship it. I’d also like to make just a little plug for facials because I think that so many people in the world think and I hear it every day, I’ve talked to some about it, “you know you should get a facial,” and their response is, “I’m a massage person.” I challenge them and then they get it, so it feels good and they get it, it’s an intimate experience, it’s really beautiful. However, it also helps with the health of the skin and the healthier your skin is the more resistant it is to ageing and to damage from the sun.
Dr. Lisa: And where can people learn more about your spa and your product and you?
Rhonda: They can find out about us on rhealdayspa.com, we’re also on Facebook at Rheal Day Spa and they can come visit us at 453 Maine Street in Rockland.
Dr. Lisa: Very good, well, thank you so much for coming down and spending time this morning talking with us about safe sunscreens and I encourage all the people who are out there listening who might be in the mid-coast region to stop in, maybe get some sunscreen, have a conversation with you Rhonda or maybe call you up and order some online, see what you think. I’ve personally tried it, it’s not like the old fashion white stuff you put on your nose as a lifeguard. It really does sink in eventually and is worth definitely trying out.
Rhonda: Thank you Lisa.
Dr. Lisa: This is Dr. Lisa Belisle and you have been listening to the Dr. Lisa radio hour and podcast, show number #46, vitamin and D and sunshine, airing for the first time on July 29th 2012 on WLOB and WPEI radio Portland, Maine. Today’s guests have included: Susan Fekety from Healthy Living Health Care, DR. Bethany Hays from True North and Rhonda Nordstrom from the Rheal Day Spa in Rockland. We hope that you’ve gained a little bit of knowledge on the vitamin D and sunshine link. We know this continues to be a topic of great interest amongst medical researchers and as things evolve we’ll let you know what we think.
For those of you who have suggestions for our show please contact us on our Dr. Lisa Facebook page or send an email to [email protected]. We appreciate those of you who have been supporting us from the very beginning, now that we’re 46 shows in. We also appreciate you letting our sponsors know how valuable they are to us in helping us create a healthier more vibrant world. Thank you for being part of our and my world, may you have a bountiful life.
Speaker 1: The Dr. Lisa Radio Hour and Podcast is made possible with the support of the following generous sponsors: Maine Magazine, Mike Lepage and Beth Franklin at Re/ Max Heritage, Robin Hodgskin at Morgan Stanley Smith Barney, Dr. John Herzog of Orthopedics Specialists in Falmouth Maine, BOOTH, UNE the University of New England and Tom Shepard of Shepard Financial.
The Dr. Lisa Radio Hour and Podcast is recorded in downtown Portland at the offices of Maine Magazine on 75 Market Street. It is produced by Kevin Thomas and Dr. Lisa Belisle. Editorial content produced by Genevieve Morgan, audio production and original music by John C. McCain, our assistant producer is Jane Pate. For more information on our hosts, production team, Main Magazine or any of the guests featured here today visit us at doctorlisa.org and tune in every Sunday at 11:00 AM for the Dr. Lisa Radio Hour on WLOB Portland Maine 13.10 Am, or streaming wlobradio.com. Show summaries are available at doctorlisa.org. Download and become a podcast subscriber of Dr. Lisa Belisle through iTunes, see the Dr. Lisa website or Facebook page for details.