18 Mar

50 Ways to Leave Your Doctor (Ok Only Four)

in /by

One day, I ran into a patient, a long term patient whom I had been treating since he turned 40. He was now on his mid-50s and I realized I had not seen him in the office for ages.
While perception is reality, I chose to verify my instincts and checked the computer system. It turns out he had not been to the office for more than a year and there were electronic records from other physicians in his file.

The patient had obviously switched practices, but I was left wondering why?

Relationships are complicated and the one you have with your physician is no exception.

And despite rumors to the contrary, doctors are humans. We also have feelings.

Often patients fail to realize the connection we make with our patients, particularly those who have been under our care for extended periods of time. Sometimes we treat multi-generations of family members only to find one day they are no longer coming to our office for medical care.

As a patient, you have the right to leave a medical practice and find another. Your level of comfort with the physician and his staff as well as confidence in the quality of medical care is crucial.

And sometimes you may choose to leave for no reason at all. My goal is not to force you to stay but rather to share some professional ways to give your physician, “The Pink Slip.”

Here are my guidelines for professional “uncoupling”:

  • Bring it up! If something is amiss, let the physician know. While not every situation can be remediated, awareness is helpful.
  • Communicate. If you are unhappy and would like to switch practices, have a face-to- face conversation. Your feedback can only help our practice.
  • Tell a staff member. If you are unhappy or plan on switching practices and are uncomfortable sharing information with the physician, tell the office manager, medical assistant, nurse practitioner, physician’s assistant or front desk person and ask the individual to share the info with the doctor.
  • Send a letter or note directly to the doctor with the reason for your request. There is no need for a dramatic breakup. Just express your concerns in a calm and businesslike manner. Most docs find the info helpful, even if they find it hard to hear.

As physicians, there are some things are in our power to change. Others are not. If numerous patients are unhappy with a staff member, I prefer to know about it. Often I am unaware of the front desk dynamics because I am in the back office providing care. If poor bedside manner is problematic, it’s beneficial for me to know. If you simply moved away from the practice, allow me to wish you luck in your new location.

But some expectations are unrealistic. I cannot put you on an anti-biotic without seeing you or prescribe narcotics over the phone. I also cannot always control the wait time. It’s hard to estimate how many minutes to allocate to each patient. Things come up. But if the wait time is excessive, I would like to know.
In the process of saying goodbye, ask for a copy of your medical records. And have the physician renew your prescriptions so you don’t run out before the switch. Those two steps will ensure a smooth transition.

Trust me. I am a doctor.

01 Jan

Blown Away by the Common Cold?

in /by

Piffle! It’s only a sniffle!

No I did not make that one up.

Piffle! It’s only a sniffle! is the name of a famous children’s play. So famous in fact that Sex in the City Actress Kim Cattrall claims playing the role of a cold germ was a formative experience in her acting career.

But a cold is no child’s play.

It can start as a tickle in your nose, a scratchy throat, a subtle cough, a bothersome headache or a feeling of utter exhaustion.

Little invaders called viruses affect your mucosa, which are the linings of your airways. This process alerts your immune system that something is about to go down, big time and your immune system starts mounting an attack on these unwanted pests. In this process, chemicals are being secreted which help recruit or flag down and activate the various parts of the immune system. These substances are what cause your runny nose, cough and the all too pervasive snot and phlegm.

There are no official stages for a cold. Each cold is individual and follows its own path. Some last for hours, others for days or even weeks.

There is some evidence that topical zinc, like branded ZICAM® which coats your nasal or oral mucosa, may reduce the severity and duration of the symptoms. Other remedies that have anecdotal evidence for either masking symptoms or reducing the severity include elderberries, aged garlic, high doses of Vitamin C and D and good old-fashioned chicken soup.

But nothing beats rest, fluid, TLC and time.

It’s hard to totally prevent catching colds. Eating well, exercising and getting enough sleep are crucial components of building immunity. Washing hands is key, particularly after shaking hands with someone. And equally as important, refrain from touching your eyes and your face.

Sharing is not caring when it comes to colds so it’s best to be courteous when you are sick and refrain from shaking hands and spreading the love. Stay at home for a day or two. It does your body good and keeps the virus from spreading.

Because cold are from hundreds of different viruses, a cold vaccine is not on the horizon. So for the time being, grin and bear it…and cough it out.

It will eventually go away.

01 Oct

Is there hope for Dead Butt Syndrome?

in , /by

Is there hope for Dead Butt Syndrome? Five Pro Tips to Revive Your Gluteus Medius

Let me start by saying that Dead Butt Syndrome is real. It even has a formal medical term, Gluteal Amnesia.

But before I go into the details let me share with you a little anatomy.

There are three gluteus muscles. Most of us are familiar with the gluteus maximus which is located in our buttocks and is responsible for the movement of our thigh and him.

What is Gluteal Amnesia?

Gluteal Amnesia, also referred to colloquially as dead butt syndrome, refers to a condition where the tendons of the gluteus medius (another one of the three muscles) becomes inflamed. The result is pain in your lower back, hip or knee.

This condition occurs in distance runners where the repetitive nature of their exercise can lead to tightness in the hip flexors, even more so in those who do not add weight training to their running routine.

There is also the belief that as we have evolved from a labor-intensive to a corporate sedentary lifestyle, many people are developing gluteal amnesia because we park out butts in our chairs all day. This leads to tight hip flexors and weak glute muscles. Poor posture contributes to the lack of glute activation. As a result, activities normally performed by the gluteus medius are now being performed by the hamstrings and lower back muscles. When your glute muscle loses strengths, it causes an imbalance leaving the other muscle groups to compensate. Pain is your body trying to compensate for the imbalance.

The good news is this condition is reversible but only by “working your butt off (pun intended.)

Here are five exercises recommended byJustinSeedman, a South Florida ACE Certified Personal Trainer, Health Coach, and founder of JustinFit, a concierge in-home personal training company, to revive and reverse dead butt syndrome:

  1. The Squat is a foundational exercise incorporated in many fitness programs targeting the lower body including the glutes.
    How to perform the perfect squat:

    • Stand with your feet shoulder-width apart.
    • Sit back and down like you’re sitting into an imaginary chair. Allow your lower back to arch slightly as you descend.
    • Lower your level until your thighs are as parallel to the floor if possible.
    • Keep your knees over your ankles.
    • Press your weight back into your heels.
    • Push through your heels to bring yourself back to the starting position.

    Perform 2-3 sets of 10 reps

    Tip: Use your couch. Don’t sit on the sofa but use it as a target as to how low to go. Hold a kettlebell or dumbbell to increase the difficulty of this exercise.

  2. Lunges are another first exercise for targeting the glutes. The lunge compliments the squat in a fitness program they are especially popular because they are easy on the back. Contrary to the squat the lunge allows a person to keep their back straight and chest lifted, placing less strain on the back.
    • Stand tall with feet hip-width apart.
    • Take a long step forward with the left leg landing with the heel first one the floor.
    • Lower body until left thigh is parallel to the floor and left shin is vertical.
    • Don’t allow your left knee to go past the left toe.
    • Press into the left heel to drive back up to starting position.
    • Repeat on the other side.
    • Perform two sets of 10-15 reps, alternative legs for an extra challenge.

    Tip: For anyone facing difficulty balancing hold on to a stationary object when performing the lunge. Hold a kettlebell or dumbbells to increase the difficulty of this exercise.

  3. Take your lunge to the next level with Step-Ups. This exercise combines the movement of the lunge with stepping upward on to a bench. This is another move that effectively targets the lower body especially the glutes, quadriceps, and hamstrings.
    • Begin with right foot on a bench.
    • Press through your right heel as you step up onto the bench.
    • Step up onto the bench with your left foot.
    • Return to the starting position by stepping down with the right foot, then the left, so both feet are on the floor.

    Perform 2-3 sets of 10-15 reps, alternative legs for an extra challenge. Hold a kettlebell or dumbbells to increase the difficulty of this exercise.

    Tip: This exercise can be performed using a sturdy chair if you don’t have a bench.

  4. The Hip Press is one the most beneficial exercise improving mobility and strength in hips and glutes.
    • Begin by laying on your back with your knees bend and heels and feet flat on the ground.
    • Keep your hands palms down, with your arms flat.
    • Press through your palms and heels, engaging your glutes, and lift your hips upwards.
    • Hold for 1-3 deep breathes.
    • Slowly lower back toward the ground.
    • Perform 2-3 sets of 10-15 reps

    Tip: At the peak of the movement there should be a straight line from your knees to your shoulders.

  5.  Lateral Band Walks are widely considered by personal trainers to one of the best booty exercises. To perform this exercise, you’ll need a set of Minibands. They can easily be purchased from the sporting goods section of Target or on Amazon.
    • Place a resistance band slightly below your knees.
    • Begin standing with feet hip width.
    • Squat approximately halfway down.
    • Step sideways with your right foot onto your heel rather than your toes.
    • Keep tension in the band as you bring your left leg slowly toward your right, returning to the starting position.
    • Perform 1-2 Sets of 20-30 reps

    Tip: Place bands over clothing to avoid irritation for the band

The best way to avoid developing this syndrome?

If you are a runner, add weight training to your routine. And if a sedentary lifestyle is the culprit, take breaks, walk around and stretch. Vary your work routine by alternating between sitting and standing to perform your office related tasks.

The effort may seem like a pain in the butt but the results may be maximus.

01 Sep

My Wife is Hot. The Room Is Cold:  Whose Perception is Reality?

in , /by

My Wife is Hot. The Room Is Cold:  Whose Perception is Reality?

 Men are from Mars. Woman are from Venus. When it comes to body temperature, perception is actually reality.

There are generally three factors that affect your perception. The first is your tolerance. Moving to Florida affects your ability to handle the cold while moving to Alaska will affect your ability to handle heat.

The second is body fat which provides insulation. The more body fat, the greater your insulation. Brown Fat is also responsible for regulating your body temperature.Your body burns brown fat to make heat. This is why there is a theory that if you expose yourself to cold temperatures, you will increase your weight loss.

The third is your body’s ability to conserve and regulate core temperature.The hypothalamus in your brain helps regulate your body temperature by triggering changes to the sweat glands and muscles. The body can then increase or decrease the amount of heat lost.

Body temperature is also regulated by our arterial and vascular systems by causing vasoconstriction or vasodilatation. Vasoconstriction is the narrowing of the blood vessels resulting from contraction of the muscular wall of the vessels, in particular the large arteries and small arterioles. When you dilate your vessels, you allow more blood to go to your arms and legs, which will cool you down. When you vasoconstrict, you maintain the core temperature because you have less blood exposed to the external environment. Sweat also helps cool you down and radiate heat. Your innate ability to control your vascular ability and your sweating will control your ability to cool down or stay warm.

Those factors coupled with hormones and metabolism will give everyone their individual experience. Excessive thyroid hormones, testosterone, epinephrine, norepinephrine and dopamine will raise your body temperature. Lack of estrogen will also make you feel hotter.

Which is why your wife is hot.

Researchers have also found that women may have up to 9x more complaints of cold hands and feet. But that is probably due to hormonal imbalance, metabolism and body fat.

That explains why your wife is cold.

Here are a few tried and true tips to help align Venus with Mars:

    • Make sure to stay hydrated since hydration plays a role in heat maintenance. If you are better hydrated you can better control your body temperature.
    • Have your hormones, Iron and Vitamin B12 levels checked by your cardiologist. Deficiencies in Iron and B12 will make you feel cold.
    • Dress according to your body temperature. If you tend to be cold, layer up. If you tend to be hot, wear breathable fabrics.
    • Always cold? Put on more weight, keep active and try adding turmeric and curcumin to your diet to raise body temperature

When all else fails, turn down the air and pile on the blankets. It’s a small price to pay for aligning the planets.

01 Aug

Why Stopping Statins are Stupid

in , /by

Why Stopping Your Statins May Be Stupid

While the allure of alliteration is irresistible, the bottom line is stopping your statins on your own could be stupid.

Let me explain why.

Statins are a class of medicines used to lower LDL cholesterol, also known as the “bad cholesterol.”Many of the names are probably familiar to you such as Lipitor and Crestor.

There have been many studies touting the benefits of these medications which have been around for a half a century and have been credited for reducing overall cardiovascular risk and mortality.

These medications have been theorized to not only lower your bad cholesterol but may also have a pleiotropic effect. In other words, they may do more than just lower cholesterol. They may prevent oxidation of cholesterol particles which cause blockages. They may also stabilizeatherosclerotic plaque thereby reducing vascular disease. They can be lifesavers.

So why would patients stop a class of drugs which has so many benefits?

These medications, like any other, come with side effects. Some patients claim they have aches and pains. Another reason is cost. On a more serious levels, others go into muscle breakdown which can cause kidney failure and death.

There are many ways to alleviate the problem. Cold turkey is not one of them.

  • For muscle pains, you can start taking vitamin CoQ10 or Ubiquinol.
  • Maintaining good hydration is also helpful because it dilutes the drug toxins. Typically when patients complain of muscle pain, it is usually because they are dehydrated and taking a combination of medicines. So if you focus on proper hydration, often the muscle pains will be reduced or resolved.
  • Switching to a different statin, recommended by your doctor may be a good alternative as not all statins have the same side effects.

Here is the bottom line,

If you are having a problems with your statins, you should not go off by yourself.You can have a rebound effect and the chances of a heart attack or stroke is significantly higher. Trust me, I have seen it happen.

Instead, speak to your doctor who may change your medication or wean you from it in a way that will provide the least amount of damage and the best quality of life.

Together we can get to the heart of the matter.

01 Jul

To Salt or Not to Salt: Is Salt Good or Bad for You?

in /by

To Salt or Not to Salt: Is Salt Good or Bad for You?

We have sold salt short (say that three times fast).

Physicians have been admonishing patients to lay off the salt because it MAY increase blood pressure or cause pulmonary edema, leading to heart failure, shortness of breath and hospitalization.

However, this ubiquitous crystal is quite innocuous in individuals with normal blood pressure, kidneys and good heart health.

And unfortunately, the ban on salt has led in an increase in the number of people who are iodine deficient. Iodine is an essential mineral responsible for thyroid and hormone production. Without it, you can end with hormone deficiencies and fibrocystic breasts.

That’s why they iodized salt in the first place.

So, in the process of protecting the small segment of the population who could be harmed by salt, we have deprived a larger segment of iodine and a crystal which enhances our eating experience.

Now there are people for whom we prescribe salt.

They generally have low blood pressure, so low they become symptomatic. They get light headed, faint or fall. These peeps must take in extra salt to maintain proper volume and blood pressure, thereby preventing black out episodes.

So should you cut down on salt?

Ask your cardiologist. 

If your heart, kidneys and blood pressure are all within normal limits, then the answer will probably be no. If you are having hormone problems, thyroid problems or fibrocystic breast changes, have your iodine checked.

Now that’s my advice. Take it with a grain of salt.

01 Jun

When Germs Fly: The Germiest Place in the Bathroom

in , /by

When Germs Fly: The Germiest Place in the Bathroom

Many people consider toilet seats to be public enemy No. 1, aka the germiest place in the bathroom.

They are wrong. It’s actually the sink.

Studies at the University of Arizona in Tucson found that sinks are the greatest reservoir of germ colonies in restrooms, thanks in part to accumulationof water that become breeding grounds for tiny organisms. That’s why it’s important to not only wash your hands, but use paper towels to act as a barrier against bacterial transmission when turning on and off the faucet. Other areas of concern are the door handles and manual paper towel dispensers. Again use barrier methods in preventing transmission of germs.

Wash your hands but be cautious not to touch handles or other objects after washing. Let’s face it germs are everywhere. Some are even helpful, there is no escaping them. Be smart, be careful, but most of all, be reasonable.

But back to the toilet seat.

Research has shown that the toilet seat it is not a common way to transmit germs. Fact is disease causing organisms can only survive for a short period of time on the toilet seat, and would have to be transferred to you through an opening or cut on your lower body. Possible? Yes. But highly unlikely.

Interestingly another place that carries a high risk of germ transmission is the actual toilet stall. When you flush, a mist of water and germs gets sprayed up into the air. These germs can be deposited on your clothes, skin and inhaled.

So my best advice is after flushing, RUN!

When it comes to germs, you can run but you can’t hide. Here are some practical anti-germ practices:

  • Antibacterial soaps containing triclosan and hand sanitizers are great at what they were designed to do:kill a good percentage of germs. That being said, they should be used sparingly around the home and in the office as studies have shown they may not be as effective as we think in preventing disease and may even promote antibiotic resistance.
  • It is preferable not to leave your toothbrush near the toilet, especially if it an automatic or power flusher, since that is where the mist developers.
  • And while we are on the topic, never use the drinking glass in a hotel bathroom. Rumor has it they clean it with pledge or Windex.

And contrary to public perception, the germiest item in your house is not in the bathroom, but in the kitchen.

It is your sponge. The one you use to clean your dishes. How’s that for irony?

01 May

A Short Term Roadmap to a Long Term Healthy Lifestyle

in , /by

A Short Term Roadmap to a Long Term Healthy Lifestyle

Leading a healthy lifestyle does not mean being relegated to a lifetime of eating salads, crazy workouts and creating sleep charts.

Here are things you can do to get healthier in 14 days.

Let’s start with the least obvious one. 

There is evidence that strong relationships, whether romantic or familial, contribute to a healthy, happy and long life. Make partner time a priority, keep up with the family, schedule time for a Men’s (or Ladies) Night Out, join a book club, bird watching group or any organization or nonprofit where you will find like-minded people.

If nothing else feels comfortable, think of investing in a pet. A dog will give you no excuse not to exercise and walking your pet is a great way to meet other pet owners.

While it might be hard to make long lasting relationships in a short period of time, the process will get you on the phone, out of the house and break patterns of isolation.

On to our favorite health-style topic, food:  

Deprivation is a short term solution. Instead, I recommend a well-balanced approach toward food. Have a pat of butter, individual servings of eggs and even a sizzling, marbled rib steak.

Individual foods are not innately unhealthy.

Rather it is nutritional imbalances which can wreak havoc on our overall health.

Refrain from processed foods such as cakes, cookies and refined sugars, including fructose, corn syrup and bleach processed flour. Substitute frozen grapes or grill pineapple to bring out the natural sweetness instead of a cupcake.

Too hard to actively refrain from the things you love? Add instead.

Add a salad or green smoothie to your main meal and eat it before you consume the main course.   Being proactive and filling up with healthier options will stave off hunger, prevent overeating or partaking regularly in foods which are not good for our health.

Drink a glass of water before your meals. Often we think we are hungry when we are really thirsty.

Use a smaller plate at a party or all you can eat buffet. Try it in your house as well. You won’t feel so deprived and you will be on the road to a healthier lifestyle.

Avoid soda like the plague. Even the diet soda can wreak havoc with your body, stain your teeth, create sugar cravings and more. Phase it out slowly.

As for sleep….

Sleep seven to nine hours a night.

Studies have shown lack of sleep leads to obesity. And obesity is contraindicated for a healthy life style.

The best way to increase your sleeping hours is to go to bed 15 minutes earlier each night for 3- 4 days, then 30 minutes, then 45 until you get an extra hour of sleep.

If 15 minutes sounds overwhelming, try to go to bed ten or five minutes earlier. It may take you more than two weeks to improve your lifestyle, but after two weeks, you will have a routine.

Last but not least, let’s talk exercise. Exercise is good for your heart, mood (think of those endorphins), motivate you to eat healthier and will help you sleep. It’s a vicious but effective cycle.

Exercise is no longer optional. However the type of exercise is our choice.

There are no one size fits all exercise programs.

The type of activity is irrelevant. The only criteria are to push ourselves outside of our comfort zone and ramp up our heart rate.

Committing to an exercise program is probably the biggest challenge. If we are not currently working out, the best plan is to start small. Park in the back of the parking lot. Then set aside 15 minutes a week and engage in some form of physical activity. Buddy up, mark workout time on your calendar or hire a trainer. Only you will know how to motivate yourself.Of course consult your personal physician before beginning any exercise program.

And don’t forget sex. Turns out women who work out have more active sex lives. And while sex is not a major calorie burner, it is good for your brain, immune system, sleep, and more.

All important components for a healthier lifestyle.

Oh, and don’t forget to reward yourself…with anything but food.

01 Apr

Wonder bread was touted as “Building stronger bodies 12 ways.”

in , /by

Wonder bread was touted as “Building stronger bodies 12 ways.”

But with two grams of protein in each slice, I am not sure they were referring to the protein content.

Protein is an essential building block of bones, muscles and cartilage. Our body uses it to repair tissue and make enzymes Proteins are found throughout our body, skin, nails and hair and are important for sustaining optimal health.

So it is essential we consume protein on a daily basis.

But how much should we consume?

In a study done in the American Journal of Clinical Nutrition looking at adults ages 20 – 81 showed dietary requirements of protein didn’t differ much based on age group, though women need slightly less than men, roughly 0.8g/kg/day vs 1.0g/kg/day.

According to the 2015-2020 Dietary Guidelines for Healthy Americans, the recommended protein intake is 10-35% of total daily calories for both men and women at all age levels.

The amount of protein only varied for athletes, the sick or the wounded.Though it’s difficult to place athletes with malnourished individuals in the same category, it is your metabolic demands which can increase your protein needs beyond the normal limits.

And don’t eat your protein all at once.

The human body cannot absorb more than 25-30g of protein in one sitting; any remaining will go to waste. It is best to incorporate protein throughout the day instead of ingesting it in one meal. First of all, protein slows down the blood sugar uptake and offers a wonderful steady source of energy.Additionally, individual amino acids (the building blocks of proteins) have been shown to cause kidney damage, when taken in high doses.

Therefore protein should be taken in its natural form and the best protein sources are the ones you will actually eat.

As for the best ways to get protein into your diet, I reached out to South Florida Registered Dietitian and Licensed Nutritionist, Suzanne Fisher:

When we think of protein, the most popular are the animal based sources such as lean poultry, beef, pork, fish, seafood, eggs and dairy.

And it easy to find animal sources of protein to grab on the run. My favorites include hard boiled eggs, Greek yogurt, cottage cheese, canned tuna and salmon and turkey jerky

With a little careful planning it is possible to consume adequate protein from plant based sources such as soy, pea protein, legumes, nuts, seeds, whole grains and vegetables. Quick and accessible forms of plant protein include steamed edamame, unsalted roasted soy nuts, nuts and seeds.

Worried your family is not eating enough protein?

Here are my favorite ways to add protein to your dinner or snack menu:

  • Hemp seeds supply 10 grams of complete protein in a 3 tbsp. serving. Sprinkle a few tablespoons of these versatile, nutrient dense seeds into yogurt parfaits, oatmeal, salads and smoothies.
  • Nutritional yeast is low in calories yet supplies 8 grams of protein per 1/4 cup.  It has a pleasant cheesy, nutty taste that pairs well with many foods. Add it to eggs, tomato sauce, stews, soup or as a popcorn topper.
  • Greek yogurt makes and excellent base for protein shakes. The yogurt lends itself to a creamier shake with the addition of 23 grams of protein per cup.
  • Roasted chickpeas are a great source of protein with 6g of protein per 1/4 cup serving.

The wide availability of protein sources offers each of us the unique opportunity to find healthy foods we like and enjoy the experience.

I generally recommend eating the protein first so you ingest the sufficient amount but be mindful of the experience.

Chew each bite slowly and savor the taste, flavor and consistency before moving on to the next one.

After all, your body is a temple which makes eating a holy and wonder-full experience.

01 Mar

Is the Ketogenic Diet Good or Bad for Your Heart Health?

in , /by

Is the Ketogenic Diet Good or Bad for Your Heart Health?

The premise high protein/high fat diets are bad for you is completely wrong.

And it all stems from an erroneous study performed by Minnesota Physiologist Ancel Keys called the Seven Countries Study. In that study, he correlated a high fat diet with a higher risk of cardiovascular disease. However, the study itself included more than 30 countries and Dr. Keys cherry-picked the data to fit his premise.

When you look at the data in totality, it was a higher carb diet which correlated with a higher risk of cardiovascular disease. That being said, not all fats are created equal. Good fats are avocado, coconut oil or nuts, aka anything which comes from nature. All saturated fats or hydrogenated oils, such as margarine or Crisco, are problematic for your cardiovascular health. There is little evidence this diet is deleterious to your health as long as the fats you choose are the heart healthy ones.

The high fat, low carbohydrate ketogenic diet was originally designed as a dietary alternative for seizure control in epileptic patients. The promise of fat loss turned the ketogenic diet into a quick weight loss solution. The theory behind a ketogenic diet is the body changes how it processes energy, switching preferred fuel to fat as opposed to carbohydrates. The body taps into stored fat, accelerating weight loss through a process called ketosis. This metabolic state causes your body to burn fat and its stored form, glycogen, preferentially over sugars.

The Good:

Research has found the ketogenic diet reduces appetite and dietary intake at a higher rate than traditional diets. The ketogenic diet has also shown some potential promise of improved glycemic control in Type 2 Diabetics.

Though Ketogenic diets are good at accomplishing weight loss, sustainability is its biggest challenge and many people have difficulty avoiding simple carbs such as pasta, rice, potatoes and alcohol for long periods of time.

The Bad:

The side effects offer additional challenges:

  • The process of changing body fuel from carbohydrate to fat can cause decreased serum sodium, leg cramps, constipation, decreased energy and headaches.
  • The keto-flu is a very real side effect as the body transitions to a ketogenic diet. Brain fog, fatigue dizziness and insomnia are common with the keto-flu. Symptoms usually subside within a few weeks. Easing into the ketogenic diet and maintaining adequate fluid and sodium intake can lessen symptoms.
  • Reduced fiber from fruit and vegetables can increase risk of constipation. Bowel changes may also occur as the body adjusts to dietary changes.
  • Reduced carbohydrate intake can increase risk of dehydration as increased water is released through more frequent urination. Consume adequate fluid (water is preferred) throughout the day. It is also recommended to add sea salt to food to maintain sodium levels. Adequate sodium may reduce risk of leg cramping, fatigue and headaches.

The Solution:

If you want to try a ketogenic diet, my best advice is to follow it for a short period of time, and then slowly reintroduce nutrient dense carbohydrates like sweet potatoes back into your diet.

There is no need to demonize potatoes, except for the “couch potato” variety.