Things to Consider Before Getting the Flu Vaccine

By Dr. Mercola

Did you know that during the 2012-2013 flu season, the flu vaccine's effectiveness was found to be just 56 percent across all age groups reviewed by the CDC —in essence, the statistical equivalent of a coin toss. In seniors, aged 65 and over, the US flu vaccines were only nine percent effective.
The 'gold standard' of independent scientific evaluation and analysis, the Cochrane Database Review, has issued no less than five reports between 2006 and 2010, all of which decimate the myth that flu vaccinations are “the most effective flu prevention method” available.
In average conditions, when a flu vaccine at least partially matches the circulating virus, 100 people need to be vaccinated in order to avoid just ONE set of influenza symptoms, according to Cochrane’s findings.
Yet as another flu season approaches, all these facts are wholly ignored by conventional medicine and media alike, and you’ll certainly never see them mentioned in any flu vaccine promotion campaign.
Unfortunately, in addition to the fact they may not be nearly as effective as advertised, flu vaccines can, and do, cause harm. The featured video is a potent reminder of what vaccine damage can look like, and why it’s so important to make well-informed decisions about all vaccinations, including “routine” ones.


While death and complete disability from a flu vaccine may be rare, so is dying from the flu itself. So I strongly recommend weighing the risk of suffering a debilitating side effect of the flu vaccine relative to the more likely potential of spending a week in bed with the flu.
Remember, most deaths attributed to influenza are actually due to bacterial pneumonia, and these days, bacterial pneumonia can be effectively treated with advanced medical care and therapies like respirators and parenteral antibiotics.
Also, it is important to remember that only about 20 percent of all influenza-like illness that occurs every year is actually associated with influenza viruses because many types of respiratory illnesses with flu-like symptoms can be mistaken for influenza. About 80 percent of cases of suspected influenza sent to the CDC for analysis lab test negative for type A or type B influenza.

Vaccine Choices Abound This Year...

This season, your choice of flu vaccine is more diverse than ever. The US Food and Drug Administration (FDA) recently approved several new flu vaccines, including trivalent (three strain) and quadrivalent (four strain) vaccines. As reported in Time Magazine¹ last month, available choices this year will include:

Standard three-strain flu vaccine. This year’s version includes influenza strains H1N1 and H3N2, and an influenza B virus	Egg-free vaccine (FluBlok), in which the influenza virus’ were grown in caterpillar cells instead of chicken eggs
Quadrivalent, or four-strain vaccine, which includes two A class of viruses and two from the B class, which tends to cause illness primarily in young children	High-dose vaccines, promoted for seniors aged 65 and over
Nasal spray, called FluMist. This year it will contain four strains opposed to three, matching the quadrivalent injection	Intradermal vaccine, promoted for those afraid of needles. The vaccine is delivered through a panel of micro-needles rather than a single needle

Universal ‘Flu Vaccine’ May Already Exist—In the Form of Vitamin D

Scientists are also inching ever closer to the creation of a “universal” flu vaccine— one that would protect against all forms of influenza. One hypothetical universal vaccine type targets so-called “stalk antibodies.” However, recent research in pigs has raised a huge red flag, calling into question the validity of this hypothesis, as it appears such a vaccine might actually magnify the impact of some strains of the virus and cause more severe disease.
Another universal vaccine being developed by the pharmaceutical company Sanofi is based on the finding² that people who have more virus-killing immune cells, known as CD8 T cells, either don’t get sick or experience only mild flu symptoms. The idea behind this vaccine is that by stimulating your body to produce more CD8 T cells, it may protect you from getting the flu, or at least from having severe symptoms.
However, while the drug company researchers brag that they know how to use a vaccine to stimulate the immune system to produce more CD8 T cells, they fail to mention that vitamin D is also known to have a direct immune-modulating effect on CD8 T cells. This was revealed in a study³ published three years ago. Other research has proposed that deprivation of sunlight and vitamin D at higher latitudes worsens CD8 T-cell deficiency.⁴ So, it may be, then, that a ‘universal flu vaccine’ doesn’t need to be created at all because it essentially already exists in the form of vitamin D!

Research Proves Vitamin D Is a Potent Weapon Against Influenza

Robert Edgar Hope-Simpson was one of the first to discover the link between a deficiency in solar radiation and seasonal influenza. Then, in 2006, the journal Epidemiology and Infection⁵ published Dr. John Cannell’s paper "Epidemic Influenza and Vitamin D,"⁶ which presents the hypothesis that influenza is little more than a symptom of vitamin D deficiency.
Clearly, just because you’re exposed to a virus does not automatically mean that you will get sick. On the contrary, studies⁷ have shown that even in people without any antibodies against a particular virus, the majority do not develop any symptoms at all when directly exposed in experiments.
The fact of the matter is that if your immune system is operating optimally, your chances of contracting a cold or flu-like illness or influenza are very slim. Vitamin D is an important player in overall healthy immune function, but it’s also an effective antimicrobial agent in its own right, producing 200 to 300 different antimicrobial peptides in your body that kill bacteria, viruses and fungi. So optimizing your vitamin D levels will help combat viruses in more ways than one.
Dr. Cannell followed up on his hypothesis with another study published in the Virology Journal⁸ in 2008, and his findings were again confirmed in 2009—this time by the largest and most nationally representative study of its kind to date, involving about 19,000 Americans. That same year (2009), it was discovered that almost two-thirds of the children who died from H1N1 swine flu complications had underlying health problems such as  epilepsy, cerebral palsy, or other neurodevelopmental disorders. Neurological and immune disorders have been associated with childhood vitamin D deficiency, which could also have made the children  more susceptible to swine flu complications.
A 2010 study⁹ that didn't get any widespread attention also demonstrated the effectiveness of vitamin D as a preventive strategy against influenza. In fact, children taking just 1,200 IUs of vitamin D3 per day, which is considered a low dose, were shown to be 42 percent less likely to come down with the flu. I firmly believe that optimizing your vitamin D levels is the single most important and least expensive action you can take to help strengthen immune function and protect against getting sick during the flu season, and would STRONGLY urge you to have your vitamin D level monitored to confirm your levels are therapeutic at 50-70 ng/ml year-round.

The Best Way to Optimize Your Vitamin D Levels

Research on vitamin D is moving forward swiftly, so you’d be well advised to stay on top of the latest developments as recommendations are refined and updated. I will cover the latest developments here, so you may want to share this article with your peers.
Sun exposure is by far the best way to optimize your vitamin D levels as your body has built-in “fail-safe” mechanisms that help prevent detrimental side effects from occurring. Vitamin D from sunlight acts as a pro-hormone, rapidly converting in your skin into 25-hydroxyvitamin D, or vitamin D3. A viable alternative is to use a safe tanning bed, i.e. one that has an electronic ballast, opposed to a magnetic one.
Sun exposure may also be more beneficial due to the fact that when your skin is exposed to sunlight, it produces cholesterol sulfate, which is important for optimal brain and heart function. Cholesterol sulfate also appears to play an important role in reducing LDL cholesterol, which is associated with cardiovascular disease. So there’s more to gain by getting sun exposure than “just” protecting yourself against influenza and flu-like illness.
The problem, of course, is that it can be difficult to get enough sun exposure, especially during winter months when you need it the most. Last year, I created a video to help you determine if you can get enough vitamin D from sun exposure in your area at different times of the year.
If you decide to take supplements to boost your vitamin D levels, based on the latest investigations by Carole Baggerly, director of GrassrootsHealth, the average adult dose required to reach healthy vitamin D levels is around 8,000 IUs of vitamin D per day. For children, many experts agree they need about 35 IUs of vitamin D per pound of body weight. Here, it’s important to remember that if you’re taking high-dose vitamin D supplements, you ALSO need to take vitamin K2, and monitor your levels via blood testing to ensure that they’re within the optimal range.

Diet and Sleep Are Also Important Factors

Besides vitamin D, addressing your diet and sleep pattern can go a long way toward warding off the flu. When it comes to diet, perhaps the most important factor is to avoid processed foods and sugar (especially fructose), as sugar decreases the function of your immune system almost immediately. Be aware that sugar (typically in the form of high fructose corn syrup) is present in foods you may not suspect, like ketchup and fruit juice. A high-sugar diet will also decimate your beneficial bacteria and feed the pathogenic yeast and viruses. Clearly, if you are sick, or specifically want to reduce your chances of getting sick, then sugar is the last thing you should be eating.
It’s important to remember that the bacteria in your gut have enormous control of your immune response. In addition to avoiding processed food and sugar, you’d be wise to add in fermented foods on a regular basis, which will help reseed your gut with a wide array of beneficial bacteria.
Sleep is another important factor. Just like it becomes harder for you to get your daily tasks done if you're tired, if your body is overly fatigued it will be harder for it to fight the flu. Be sure to check out my article "Guide to a Good Night's Sleep" for some great tips to help you get quality rest.

Other Strategies to Protect Yourself Against the Flu Without Vaccination

If you want to avoid a serious case of influenza, you need to focus on maintaining a robust and well-functioning immune system. As mentioned, I believe optimizing your vitamin D levels is one of the most potent preventive strategies available, followed by diet and sleep. There are other factors that can come into play too, of course. The following guidelines will also act in concert to support your immune system:

• Have Effective Tools to Address Stress. We all face some stress every day, but if stress becomes overwhelming then your body will be less able to fight off the flu and other illness. If you feel that stress is taking a toll on your health, consider using an energy psychology tool such as the Emotional Freedom Technique, which is remarkably effective in relieving stress associated with all kinds of events, from work to family to trauma.
• Get Regular Exercise. When you exercise, you increase your circulation and your blood flow throughout your body. The components of your immune system are also better circulated, which means your immune system has a better chance of finding an illness before it spreads. Be sure to stay hydrated – drink plenty of fluids, especially water. However, it would be wise to radically reduce the intensity of your workouts while you are sick. No Peak Fitness exercises until you are better.
• Take a High-Quality Source of Animal-Based Omega-3 Fats. Increase your intake of healthy and essential fats like the omega-3 found in krill oil, which is crucial for maintaining health. It is also vitally important to avoid damaged omega-6 oils that are trans fats and in processed foods as it will seriously damage your immune response.
• Wash Your Hands. Washing your hands will decrease your likelihood of spreading a virus to your nose, mouth or other people. Be sure you don't use antibacterial soap for this – antibacterial soaps are completely unnecessary, and they cause far more harm than good. Instead, identify a simple chemical-free soap that you can switch your family to.
• Tried and True Hygiene Measures. In addition to washing your hands regularly, cover your mouth and nose when you cough or sneeze. If possible, avoid close contact with those who are sick and, if you are sick, avoid close contact with those who are well.
• Use Natural Immune-Boosters. Examples include oil of oregano and garlic, both of which offer effective protection against bacteria, viruses, and protozoa in your body. And unlike pharmaceutical antibiotics, they do not appear to lead to resistance.
• Avoid Hospitals. I'd recommend you stay away from hospitals unless you're having an emergency and need expert medical care, as hospitals are prime breeding grounds for infections of all kinds. The best place to get plenty of rest and recover from illness that is not life-threatening is usually in the comfort of your own home.

Protect Your Right to Informed Consent and Defend Vaccine Exemptions

With all the uncertainty surrounding the safety and efficacy of vaccines, it's critical to protect your right to informed consent to vaccination and fight to protect and expand vaccine exemptions in state public health laws. The best way to do this is to get personally involved with your state legislators and the leaders in your community.

THINK GLOBALLY, ACT LOCALLY.
Mass vaccination policies are made at the federal level but vaccine laws are made at the state level. It is at the state level where your action to protect your vaccine choice rights can have the greatest impact. It is critical for EVERYONE to get involved now in standing up for the legal right to make vaccine choices in America because those choices are being threatened by lobbyists representing drug companies, medical trade associations and public health officials, who are trying to persuade legislators to strip all vaccine exemptions from public health laws.
Signing up for NVIC's free Advocacy Portal at www.NVICAdvocacy.org gives you immediate, easy access to your own state legislators on your Smart Phone or computer so you can make your voice heard. You will be kept up-to-date on the latest state bills threatening your vaccine choices and get practical, useful information to help you become an effective vaccine choice advocate in your own community. Also, when national vaccine issues come up, you will have the up-to-date information and call to action items you need at your fingertips..
So please, as your first step, sign up for the NVIC Advocacy Portal.

Share Your Story with the Media and People You Know

If you or a family member has suffered a serious vaccine reaction, injury or death, please talk about it. If we don't share information and experiences with each other, everybody feels alone and afraid to speak up. Write a letter to the editor if you have a different perspective on a vaccine story that appears in your local newspaper. Make a call in to a radio talk show that is only presenting one side of the vaccine story.
I must be frank with you; you have to be brave because you might be strongly criticized for daring to talk about the "other side" of the vaccine story. Be prepared for it and have the courage to not back down. Only by sharing our perspective and what we know to be true about vaccination will the public conversation about vaccination open up so people are not afraid to talk about it.
We cannot allow the drug companies and medical trade associations funded by drug companies or public health officials promoting forced use of a growing list of vaccines to dominate the conversation about vaccination. The vaccine injured cannot be swept under the carpet and treated like nothing more than "statistically acceptable collateral damage" of national one-size-fits-all mandatory vaccination policies that put way too many people at risk for injury and death. We shouldn't be treating people like guinea pigs instead of human beings.

Internet Resources Where You Can Learn More

I encourage you to visit the following web pages on the National Vaccine Information Center (NVIC) website at www.NVIC.org:

• NVIC Memorial for Vaccine Victims: View descriptions and photos of children and adults, who have suffered vaccine reactions, injuries and deaths. If you or your child experiences an adverse vaccine event, please consider posting and sharing your story here.
• If You Vaccinate, Ask 8 Questions: Learn how to recognize vaccine reaction symptoms and prevent vaccine injuries.
• Vaccine Freedom Wall: View or post descriptions of harassment and sanctions by doctors, employers, school and health officials for making independent vaccine choices.

Connect with Your Doctor or Find a New One That Will Listen and Care

If your pediatrician or doctor refuses to provide medical care to you or your child unless you agree to get vaccines you don't want, I strongly encourage you to have the courage to find another doctor. Harassment, intimidation, and refusal of medical care is becoming the modus operandi of the medical establishment in an effort to stop the change in attitude of many parents about vaccinations after they become truly educated about health and vaccination.
However, there is hope.
At least 15 percent of young doctors recently polled admit that they're starting to adopt a more individualized approach to vaccinations in direct response to the vaccine safety concerns of parents. It is good news that there is a growing number of smart young doctors, who prefer to work as partners with parents in making personalized vaccine decisions for children, including delaying vaccinations or giving children fewer vaccines on the same day or continuing to provide medical care for those families, who decline use of one or more vaccines.
So take the time to locate a doctor, who treats you with compassion and respect and is willing to work with you to do what is right for your child.

3 Surprizing Ways To Lose Weight

1) Stop eating less and exercising more and instead eat less and exercise less OR eat more and exercise more. 
 
You may not be aware, but the "eat less and exercise more" model has never been proven as a long-term solution to weight loss. Sure it works for some in the short run, but research shows 95% of people gain the weight back and 66% of those individuals end up fatter!

The first step to burning belly fat, or any fat for that matter, is breaking this "eat less, exercise more" habit. It is easy to do, just mimic your great grandparents OR your favorite athlete. Both of these groups of people met the two requirements for weight loss, a calorie deficit and hormonal balance, by following a different approach.

In the case of your grandparents, they ate less and exercised less.  This created natural metabolic balance and a calorie deficit making weight loss easy.

In the case of your favorite athlete, they ate more and exercised more. This too creates a calorie deficit and hormonal balance.

So choose which approach best suits you.  How do you know if you got it right? Your body will tell you.  If your hunger is low, energy is stable, cravings absent AND you are losing fat, you got it right.

2) Combat the stress hormone cortisol with leisure walking.

When many people think of fat burning exercise, they think of high intensity sprinting, jogging or other types of activity that stress the body and burn calories.  These types of exercise are great, but you also need to do something to help the body rest, recover and restore itself.

Slow leisurely walking (less than 3mph) is great at this.  This activity has been shown to dramatically lower cortisol and it is the only activity that does not cause increased hunger and cravings in most.

Walk for 60 minutes on all or most days as a start.  This should not even be seen as exercise, but rather necessity.

3) Get some R&R

Walking is one of the best forms of R&R, but there are other things that lower cortisol. Laughter, time with loved ones, playing with pets, physical affection, massage, hot baths and showers, sauna and spa time, naps and meditation.

Take time throughout the week to do things that help you rest and recover. Make sure you do this at least 3 times per week to start.

- Article by Metabolic Effect

A BIG Mistake You Could be Making in Your Workouts That’s Costing You Results

By: Nia Shanks

“I’m not getting the results I expected and that I think I should be seeing.”

“Are you working hard on each exercise? Are you using a challenging load and constantly improving your performance?”

“Yep. I don’t know what’s wrong. I’ve been following the program as written without any changes.”
We were walking towards the free weight area of the gym to begin our workouts. I started my warm-up and she began her first exercise – barbell back squats.

As I was doing weighted push-ups and inverted rows, she kept squatting away. Between my sets I’d watch her squat; her form looked excellent but she appeared to still be warming up.
After I completed all of my sets for push-ups and rows, I noticed her stripping off the weight plates.

“Are you done squatting?” I asked curiously.

“Yep. All done with squats. I did 4×6 today.”

“Ummm. I think I know why you’re not getting the results you’re after.” She gave me a puzzled look and I continued. “All of your ’work sets’ looked like nothing more than a warm-up. The weight definitely wasn’t challenging because I noticed your eyes wondering during each set so you definitely weren’t focused, and it looked like you could’ve done at least 10 or more reps on every set.”

“But . . . I’m doing it.”

“Yeah, well, you’re not doing it optimally. And that’s why you’re not getting results.”
We proceeded to put more weight on the bar and she slowly worked up to a heavier set. She ended up with 20 more pounds on the bar then she had on her final set of squats a few minutes earlier.
I stood by as she did 6 reps with the new, heavier, more challenging work weight. And still with picture perfect form on every rep.

After she completed the set and racked the bar, she stood silent. Finally she spoke, ”Wow. I can definitely tell the difference. I actually had to focus on every single rep. I didn’t know I was that strong either!” she exclaimed. “I had no idea I could squat that much.”
I’ve witnessed this over and over throughout my strength training career. And it’s costing people results.

That’s the one super simple tweak that will give you better results – make sure you’re using a challenging weight for your exercises. Don’t use a weight for 6 reps that you could easily do for 12 or more. (Note – exceptions include deloads and explosive exercises).

Always make sure you’re using proper form on every single rep, but be sure to challenge yourself. You should have to focus intently on the task at hand. You should have to work hard. Over time, you should be doing more reps with the same weight, adding weight to the bar, or in the case of bodyweight exercises — doing a more challenging variation.

Don’t be afraid to get out of your comfort zone and challenge yourself (just be safe, of course). You’ll see, and feel, the difference.

If want a structured, detailed workout that will challenge you and ultimately allow you to build the body you want, click HERE Now to find the best workout for you depending on your personal goals (fat loss, sculpt sexy muscle, get stronger, or just look absolutely awesome).

What Causes Cellutlite and How To Fix It

by Jade Teta ND, CSCS

What is cellulite?

What Causes Cellulite and how do I fix it?
The two most frequent topics we get asked about are belly fat and lower body fat (specifically What Causes Cellulite).

In this blog I want to attack the issue of lower body fat and address the “what causes cellulite and getting rid of cellulite” issue particularly. I can’t tell you how often I have been asked this question in how many different ways: What causes cellulite? How do you get rid of cellulite? And is it even possible to get rid of cellulite?

Cellulite is really the combination of two factors, fat and collagen fibers. The problem is that this fat and collagen is a little different than the fat and collagen found on a man’s body and even different than fat found on different areas of the female physique.



What causes cellulite?

Compared to men, women have collagen fibers in their lower body that run vertically up and down like a picket fence. This straight up and down distribution of collagen fibers is the major reason females get cellulite and men don’t. (estimates are 90% of women have some degree of cellulite compared to 10% of men). The superficial collagen of men forms more of a mesh. If women have the picket fence distribution of collagen, men have the “chain link fence” distribution. Where women’s fibers run up and down, male fibers crisscross.

This is important because the vertical distribution of female collagen fibers, more prevalent in the female lower body, form a sort of pocket in which fat cells then grow (see the picture above).  As the fat cells grow in size they are essentially corralled in and packed tightly together by the collagen fibers. Picture a Nerf football stuffed in between links in the fence. This tight packing of fat inside the “collagen pockets” creates the characteristic puckering and dimpling of cellulite. If you are still having trouble picturing this, imagine filling your pockets stuffed full with marbles and rub your hand along the outside. Feel the bumpy protruding marbles? That gives you an idea of what I am talking about.

Get rid of cellulite

One of the things many women wonder is how come some women have cellulite and others don’t?  And how come some overweight women don’t have as much cellulite as some skinny women? These are great questions and underscore the need to move beyond the simple fat loss models many experts cling to. Cellulite is not just an issue of gaining fat or losing fat, it is an issue of doing something to address both fat loss and collagen strength and health.

The reason some women get cellulite and some women don’t has a ton to do with genetics. Some women have collagen fibers that are more like a man’s (a picket fence & chain link hybrid), and some have extreme versions of the vertical distribution. So, getting rid of cellulite is perfectly possible for some women and far more difficult for others. However, no matter the genetic luck of the draw, the appearance of cellulite can always be improved upon.

There are ways to address the collagen issue, but none of them are very good. I will get to that in a minute. First, lets talk about the other aspect of cellulite, the fat.

Female lower body fat


The fat in the lower body of women is also different than that in men.  Women have about 9 times more alpha-adrenergic receptors associated with their fat tissue compared to beta-adrenergic receptors. Adrenergic receptors are bound by the body’s most potent fat burning hormones catecholamines (adrenaline and noradrenaline for our UK peeps and epinephrine and norepinephrine for us here in the US).

When the catecholamines interact with beta-receptors fat is released from fat cells. When they bind to alpha-receptors fat release is drastically slowed. I know I may be losing the non-science folks, so just think B for beta=burn and A for alpha=anti-burn.

You can thank the hormone estrogen for the large amount of alpha-receptors in the lower body of women compared to men. Interestingly, the study of transgender populations, those undergoing hormone therapy to transition from female to more male like, or from male to more female like, has taught us a ton about hormones and their impact on where we store fat. Studies, and working clinically with these populations give us the first hints of the female hormones and how they impact where fat is stored.  Males undergoing heavy estrogen and progesterone therapy will see increased fat deposition around the lower body and yes, increased prevalence of cellulite as well.

What this means for women is that when they lose weight they will often lose weight faster from the upper body (bust, waist and arms) compared to the lower body (hips, thighs and butt). If you or anyone you know has ever gone into one of those marathon running programs and realized they were losing every where except their hips and butt, you know exactly what I am talking about.

A few other things
That is the double whammy of cellulite. Vertical collagen fibers combined with a tendency to store fat primarily in the lower body and a more difficult time losing it is what causes cellulite.

But, that is not the end of the story because another prevalent aspect of the fat tissue in the lower body for women (also in the love handles of men) is the issue of blood flow.  This fat is relatively hypoxic, which means it is starving for oxygen.  This is because the prevalence of alpha-receptors along with the poor blood vessel perfusion means it does not get as much blood supply.  This is in contrast to the very oxygen satisfied belly fat (one of the reason why middle belly fat is often the first thing to go in weight loss programs in both men and women).

The other issue is that there is pretty much a direct association of muscle with its fascial lining (the connective tissue sheath that lines muscle) and the collagen tissue in the skin.  This means that well developed muscles have the ability to impact the tightness and tone of the connective tissue in the skin.  This is one of the reasons weight lifting tightens the body even when weight is not lost. When you think cellulite exercises, think weight training.

The fix
Now the question is how to get rid of cellulite or how to reduce cellulite?  Can you “burn cellulite”? Well, sort of.  You can certainly burn the fat part of it, but that is only part of the issue, as any skinny girl who has suffered from cellulite will tell you.  The collagen issue is much more tricky and controversial.

The truth of the matter is to get rid of cellulite really takes a more nuanced approach than just losing lower body fat.  And, I am going to be honest with you, it is not easy. What I can say with certainty is that even those with the worst cellulite can substantially reduce its appearance.  I address this in my clinic with what I call the 4 F’s (fat, fibers, flow, and firm)

• Fat. Burn the fat.

The first thing to do to get rid of cellulite is to burn the fat.  To do this you need to do what you can to block or bypass the alpha-adrenergic receptors in the lower body.  This can be done through a very low carb diet along with smart supplementation. Carbohydrates are the major simulators of the hormone insulin and insulin is a promoter of alpha-adrenergic receptor activity.  So, lower the carbs and you lower the insulin and suppress the action of the alpha-adrenergic receptors speeding fat release from the lower body. Now the speed of lower body fat release is more in line with the upper body.

At the same time there are two very good supplements I use in my clinic that have mechanisms of action similar to the catecholamines (for the science nerds they turn on the intracellular activity of cyclic AMP, the same thing catecholamines do when they bind the adrenergic receptors). They basically allow us to bypass the adrenergic receptors all together and avoid activating the alpha receptors in the first place.  These are green tea extract (I use a 50% EGCG standardized product) and coleus forskohli (standardized to 20% forskolin).  Keep in mind these supplements will do little unless the carbohydrate intake of the diet is low.

There are also a few herb derived compounds that will directly block apha-adrenergic receptors. These include yohimbine, epinephrine and berberine.  Again, the major caveat here is:  THESE SUPPLEMENTS DO NOT WORK OUTSIDE OF A LOW INSULIN ENVIRONMENT!! I tell you that because insulin is a far more powerful promoter and controller of the adrenergic receptors than any supplement. So to work they need to be taken under a low carb state.  We have our own protocol on how we manage this, which I am not going to take the time to go into here.  I will give you one clinical pearl though. Keeping total carb intake under 100g for the day and exercising on an empty stomach using a mix of intervals, then weights and then following it with a long slow cardio session, like walking, is what delivers our best results.

• Fibers.

Strengthen and remodel the fibers.  This is the hardest part and while there are some “low tech” ways to accomplish this, your best results will come with combining the fat burning techniques above with some of the up and coming best cellulite treatments, which attempt to address the collagen issue through deep tissue stimulation including heat, vibration and light therapy. These cellulite treatments attempt to strengthen and reorganize the collagen through what is often referred to as “collagen remodeling”. It is currently debatable as to the impact and effect of these treatments, but for those who want the low-tech version, deep tissue massage and self-deep tissue massage (i.e. foam rolling) are options.

Clinically, some women swear by this, but given they were doing all the other things described here, the fact that I don’t yet have enough clinical evidence to say either way AND the fact that there is no research at all suggesting it works, makes this an unknown. One thing to note, pretty much any massage type treatment will reduce the appearance of cellulite for a short time given the ability of massage to move lymph and increase blood flow. This is constantly reported by the women we see in our clinic. We explain this as a temporary fluid distribution shift out of the subcutaneous tissue. It is believed fluid, like fat, accumulates in the collagen pockets and can increase the dimpling effect.  So, removing this fluid may decrease the appearance of dimpling and puckering. Knowing this is comforting to women who want a quick solution to decreasing the appearance of their cellulite. It is a short-lived effect however.

• Flow.

Increase blood flow to the lower body.  The major ways to increase blood flow to an area are to move that area and to heat that area.  Exercise does both and so does massage. Increased blood flow to an area means increased ability to move released fat to distant sites to be burned. Increased blood flow also is wonderful at removing fluid from the area and essential for the health and strength of the collagen fibers.. We use several techniques here. Hyperthermia (hot baths & sauna) and contrast hydrotherapy (alternating hot and cold applications). Many women are familiar with this through some of the hot and cold dipping pools utilized in many high end spas. These are surprisingly effective, at least in the short term appearance of cellulite. Clinically, these treatments create an almost immediate reduction in the appearance of cellulite likely due to the fluid effect mentioned above.

• Firm.

Firm or build the muscle underneath. The final piece, and probably the second most important, is the building of muscle. Weight training is the only form of exercise capable of strengthening muscle and tightening the connective tissues of the body and the only effective “cellulite exercises”. A lower body resistance-training program that focuses on muscle growth is essential here. Although, in some this requires more than just a blind weight lifting strategy. This is especially true in under-muscled thin women with cellulite. For best results for those with underdeveloped butt muscles, learning to activate the butt muscle appropriately is essential as failing to do so may result in disappointing results from weight training.

So, that’s it. Everything you wanted to know about getting rid of cellulite. I realize this is a lot and a bit technical at times, but hopefully it gives you some things to think about. Real quick here are the most important points in bullets:

• What causes cellulite? Cellulite is more than a fat issue it is a fat and a fiber issue
• Women get cellulite more than men because of the vertical distribution of their collagen fibers
• The dimpling and puckering that occurs in cellulite comes form the buildup of fat and fluid in these “collagen pockets”
• One of the reasons cellulite can look better some days and worse others is due mainly to fluid distribution shifts. Menses is often a time where this is evident
• Females have a difficult time losing fat from the lower body due to the unique physiology caused by their female hormones
• The alpha-adrenergic receptors can be blocked and bypassed using certain diet and supplement techniques
• The 4 F model allows you to understand what causes cellulite and how to get rid of cellulite or reduce it.

Fat Loss Foods? Is there such a thing?

by Jade Teta ND, CSCS

The term “fat loss foods” is showing up a lot lately and you may be wondering what the hell is meant by a “fat loss food”?

What Fat Loss Foods Really Are
There is no such thing as a food that burns fat. Fat loss foods don’t have magical fat burning properties.  The reason they are so good at helping with fat loss is because they do three things:

1. Control hunger. They make you full quickly and keep you full for longer because they are digested slowly.
2. Raise energy. Because they are digested slowly their nutrients are absorbed in a slow steady fashion. This gives a steady supply of fuel and raises energy levels.
3. Reduce cravings. Another benefit of the slow digestion, is balanced blood sugar.  This along with the sustained energy and reduced hunger means cravings are also lowered.

The Properties of Fat Loss Foods
Fat loss foods have specific properties that make them almost impossible to overeat. They are high in protein, high in fiber and high in water. These three factors are the most important elements in the satiety index, a measure of how well a food controls hunger.

It is wrong to think about some foods as “fat burners” and others as “fat storers” because the truth is if you eat too much of anything you are probably going to get fat. The point is no normal human can overeat fat loss foods! Lets face it, certain foods are very easy to overeat while others are almost impossible.

I love the example of a doughnut and chicken breast.  Both have the same number of calories (roughly 250).  I know plenty of people, myself included, who could eat 5 to 10 doughnuts at a meal. I am not sure I know anyone who would could eat 5 to 10 chicken breasts at one time, not to mention in one day.

The chicken breast is a fat loss food because eating it fills you up fast, will supply stable energy and makes it less likely you will crave more food later. Anyone who has ever eaten a few doughnuts for breakfast realizes almost the exact opposite effect…….they don’t keep you full for long, your energy usually crashes within 30 minutes and you will likely be craving something sweet again in a few short hours.

What it takes to burn fat
To burn fat, you need two things, a caloric deficit and hormonal balance. I realize the term “hormonal balance” is extremely ambiguous, so I will explain just briefly.  Calories don’t control metabolism hormones do. If you are in a caloric deficit you will likely lose weight, but because hormones don’t control metabolism you may or may not be losing mostly fat.
Hormones control metabolism and when insulin, cortisol, leptin, catecholamines, thyroid and others that control fat metabolism are “balanced” (balanced meaning in the right amounts, ratios and able to interact correctly with their cell receptors), fat loss, not just weight loss, is the more likely outcome. Lowering calories can help you lose weight, but paying attention to hormones can make sure that weight is fat.

The final benefit of fat loss foods is more nutrition
The above distinction between caloric weight loss and hormonal fat loss explains why going on the Twinkie diet or the Starbucks diet can result in weight loss.  And with weight loss comes some fat reduction.  But, the real trick is are you eating in a way that is sustainable for you or not? If you are constantly hungry, have low energy and suffering uncontrollable cravings are you more or less likely to make a permanent lifestyle change?

This is no small matter. 95% of all people who go on calorie controlled weight loss diets fail to keep the weight off after 5 years.  66% of these dieters actually end up fatter than they were before they started the diet. It is now a well established fact that diets don’t work in large part because people simply can’t maintain them. It might be a good idea in theory, but a perfect plan that is impossible to do is not a perfect plan.

Fat loss foods control the very sensations that make dieting impossible for most and one hidden benefit is they are usually loaded with nutrition.  The foods with the highest proportions of protein, fiber and water happen to be vegetables, fruits and animal proteins. A diet containing these foods and eliminating all other foods, usually referred to as a “Paleodiet”, was also found in research to be more nutritious compared to a low fat high grain diet.

Eating more fat loss foods
Rather than worrying about eating less, a focus on fat loss foods in particular almost assures you can eat your fill and remain in a caloric deficit and hormonal balance that will result in both weight loss and fat loss. To help you get started, follow the 5 steps below:

1. At breakfast switch your cereals for either eggs, a protein shake or a leftover protein and vegetable from the night before
2. At lunch trade out your sandwich and replace it with a soup or salad that is mostly vegetables and or meat
3. For snacks lose the crackers, popcorn and candy and replace them with fruits, vegetables, animal protein, protein shakes or high protein dairy foods (Greek Yogurt, string cheese, etc)
4. Replace all beverages with water, unsweet tea or unsweet coffee.
5. Make sure you are eating frequent enough according to your needs.

Why Your Scale Can't Be Trusted

by Jade Teta

We talk a lot about the need to stop playing the weight loss game here at Metabolic Effect.  This is a game where the scale is used daily to judge the progress of a diet and exercise program. Measuring your weight alone tells you NOTHING about the quality of the weight you are losing.
How do you know if you are losing fat, water or worse muscle? If you are using just a scale you have no idea. Losing or gaining 5 pounds of fat over a weekend is physiologically impossible, but the scale has convinced many that it can happen. A significant portion of those playing the weight loss game believe the weight they lose or gain on a day to day basis is fat. And the popular media and weight loss experts do nothing to help them understand that not only is this not true, but it also is one of the major reasons they continue to suffer from yo-yo weight regain and can’t lose fat as they age.

Losing Muscle
I want to introduce you to my wife, Jill Coleman and my sister-in-law ,Dr Jillian Sarno Teta. They are both named Jillian, but we call my Jillian Jill and Keoni’s Jillian Jillian. Both are from Boston and are the same age distance from myself and Keoni. They are both past track athletes. And both are ridiculously fit women who lift weights, are professional physique competitors and fitness models. They are both wicked smaaaht (a reference to their Boston roots) and are Metabolic Effect team members. They play a key role in developing the ME lifestyle programs and systems.
I bring our two favorite women in the world up because these women have muscle and weigh more than anybody could guess.  A running joke in our family is to take them to the carnival or fair and find that guy that guesses weight. We always go home with an extra stuffed animal, because they always guess 10 to 20 pounds lighter.  Jill weighs 150 to 160 but they always guess in the 130s.  Jillian weighs in the 130-140s and they always guess in the 10 to 20 pounds lighter.  In other words, these two fit women look twenty pounds lighter than what they actually are because they have maintained their muscle. Their bodies are tight, toned and look much tinier than the scale might suggest.

I bring this up because one of the single most important mind-shifts to break is how much you weigh. Because if you are losing weight indiscriminately and shedding muscle instead of fat (which almost all dieters are), your metabolism is going to be in BIG trouble over the long run.
Muscle is absolutely essential for maintaining basal metabolic rate. Basal metabolic rate (BMR) accounts for over two thirds of the calories burned at rest and more than half of BMR can be accounted for by the amount muscle a person has (1). It was shown as far back as 1988 in the February issue of the New England Journal of medicine that a slowed BMR is a predictor of fat gain over the course of a 2-year period (2). In this study those with the slowest metabolic rate had a 4-fold increase in gaining 15 or more pounds over the next 2 years. This explains why 66% of individuals going on weight loss diets end up fatter 2 years later compared to when they started the diet (3)
So, lose muscle and you lose your metabolic potential!! And guess what is a great formula for losing muscle? The “eat less, exercise more” model. A low calorie diet combined with aerobic exercise is a solution that may make you smaller  for a short period of time, but will end up making you either flabbier or fatter in the long run and in a terrible position to make losing weight again that much more difficult, because you lost muscle along the way.

A study published in the Journal of the American College of Nutrition in April 1999 showed just how damaging the standard weight loss model can be on metabolic efficiency (4).  This study looked at a group of obese individuals who were put on a very low calorie diet and assigned to one of two exercise regimes. One group followed the popular aerobic exercise model (walking, biking, or jogging four times per week), while the second group did resistance training three times per week and no aerobic exercise.

At the end of the twelve-week study, both groups lost weight but the difference in muscle vs. fat loss was striking.  The aerobic group lost 37 pounds over the course of the study.  The resistance-training group lost 32 pounds. Of the 37 pounds lost by the aerobic group, 10 pounds of muscle was lost on average. In comparison, the resistance-training group lost fat exclusively and had no muscle loss. This had consequences on basal metabolic rate (BMR). At the conclusion of the study, the aerobic group was shown to be burning 210 fewer calories at rest per day while the resistance-training group actually increased their metabolism by 63 calories per day. No wonder yo-yo weight regain is such an issue.

Measure Fat Loss
So, hopefully you understand the futility of putting too much stock in the weight showing on your scale.  If the scale is going down, you better make sure you are losing fat, NOT muscle. If you are losing muscle you should brace yourself for the weight gain rebound that is sure to come, as well as a less efficient metabolism later.  This chronic dieting mindset and attachment to the scale may ironically be the very thing that has caused your metabolism to now be unresponsive to your attempts at body change.  The weight loss game is rigged against you, so please stop playing it.
To make sure you are losing fat and not muscle you need to measure fat loss. There are several good ways to do this in a lab setting (DEXA, Hydrostatic weighing, Air Displacment Plethysmography, etc). These get you as close to accurate body fat measures as possible. The problem is these methods are expensive, and not widely available.  If you are going to track fat loss you need something that is cheap, convenient and able to show you a general trend of fat loss versus water or muscle loss. Here are our favorite methods below.

1) Bio-electrical impedance: These machines can be held or stood on (you need bare feet and the standing modules are better than the handheld in our opinion). They push an electrical current into the body (you can’t feel it) and the machines measures the “impedance” or resistance to that current.  Water is a good conductor of electricity and fat is not.  Where is most of the water in the body? The Muscle.

So, this machine makes a best guess of how much muscle, versus water, versus fat you have based on the impedance value along with height and weight.  It takes these numbers and plugs them into regression equations based off of thousands of DEXA scan studies and generates a estimate of your actual body fat.

It is important to understand this is a hydration measuring device NOT a fat measuring device (meaning it does not measure fat directly but estimates it based on hydration) and because water fluctuates so greatly in the body (the reason you can gain or lose 5 pounds in a weekend) you have to know how to read them.  They are NOT accurate, but when used consistently at the same time, under the same conditions weekly they definitely show a trend of muscle loss or fat loss.

A couple hints with these machines about the way we use them

- Measure only 1 time per week

- Measure first thing Friday morning before eating or drinking anything.
subtract the water value from the muscle mass value (BTW muscle mass, also reported as fat free mass, is not really a measure for muscle but rather a measure for water, organ tissue, bone and muscle.  Organ and bone will not change significantly, so you are left with water and muscle. subtracting the water value from the fat free mass value will give you an indication of muscle gain or loss)

- Consider measures taken during menses as comparable to only other measures done during menses.
The first week of a low carb diet will artificially look as if you gained a significant amount of fat. This is because insulin makes you hold onto both sodium and glycogen.  When you go low carb, you will lower insulin quickly and lose glycogen and sodium and shed a significant amount of weight (it is all water). But since this water goes into the calculation for fat free mass or muscle mass it will artificially look as if you lost muscle and your body fat % will be reported on the machine as going up. In fact it did not. This is an artifact and will correct.  BTW, this is a good sign and an indication you are entering “fat burning mode”

- We use the Tanita Ironman Series and recommend unit BC 549
Optimal for women is between than 25%-15% body fat (my opinion)
Optimal for men is between 15% and 8% body fat (my opinion)

2) Weight and circumference: This is not a great method either, but it can be useful.  This looks at weight along with circumference measures.  If you sign-up for our newsletter (top of the page to the right) one of the first things we give you is the sheet we use for those who are not going to invest in a body composition monitor like the ones above. As you can imagine if you lose muscle, your measurements on a tape measure will still go down. You can lose muscle and still fit in your skinny jeans.  So, these are less than perfect ways to judge fat loss. But, this is definitely better than weight alone.

Here are some pointers:
- Women losing fat will usually see the waist and bust size drop.  The hips may not change as much because it is a heavily muscled area
- Men will notice waist size decrease significantly.
- Measure one time per week under the same conditions using a tape measure allows you to track specific areas.
- Firmness and tone of the body is a good indicator.  If you are losing weight and getting flabby you are likely losing muscle.  If you are losing weight and getting tighter, you are probably losing fat.

Skin Caliper Testing: If you work with a trainer this is our favorite method.  The issue is that this takes a skilled practitioner to do and the same person must do it on you every time for accuracy. It is still the most accurate of the three methods listed here and the most repeatable in my opinion.  IF you can get skin calipers done we recommend you do.

The Female Fat-Loss Formula

by Jade Teta ND, CSCS

Women are particularly drawn to the Metabolic Effect lifestyle, diet and exercise for hormonal fat loss.  Because women experience monthly hormone fluctuations through the menstrual cycle, they know from experience that hormones impact how they feel, function, and look.  They seem to intuitively get the fact that hormones play a role in determining whether they store fat or burn fat and where. Because we always get many questions about the science of hormonal fat burning in women, I thought I would cover it here as a brief primer on the subject. This is perhaps one of the most misunderstood of all topics in natural health.

There is no question that the female sex steroids dramatically impact how much and where on the body a women will store fat. The difference between men and women make this very clear.  Women usually have smaller waists and more fat storage on the hips, thighs and breasts. Estrogen and progesterone have much to do with this.  Estrogen is largely responsible for greater fat storage around the hips and thighs while both estrogen and progesterone impact larger breasts (Progesterone may be  more of an issue here…just ask a women who is pregnant, a very progesterone dominant time). Men, on the other hand, are usually much leaner through the arms and the legs and store more fat around the middle as a consequence of testosterone.

Estrogen:Progesterone Balance
Most women, and even many health care providers, are unaware of the issues related to estrogen and progesterone balance.  It is the ratio of these hormone one to another that determines the health impact and the fat-burning outcome.  Unfortunately there is no good way to test this since each women is unique and likely has an optimal estrogen to progesterone balance all her own.  Some hints this ratio may be off come from looking at the body and exploring symptoms.  Bigger hips and thighs with smaller breasts could suggest greater estrogen effects in a women.  The reverse, with larger breasts and smaller hips and thighs,  may indicate progesterone excess.  The menstrual cycle is the best place to look for clues.  The first two weeks of a woman’s cycle are an estrogen dominate time while the last two weeks are a progesterone dominant time.  PMS is a strong indication there is a progesterone deficiency relative to estrogen. Don’t get confused here, a relative deficiency is not the same as an absolute deficiency.  A woman can have higher than normal progesterone levels but still have a relative deficiency if estrogen levels are much higher in comparison.  Many women with low progesterone relative to estrogen will report feeling like a completely different person before ovulation (first two weeks of cycle) vs after ovulation (last two weeks of cycle), where they feel much worse. This ill feeling usually manifests as depression, breast tenderness, moodiness, fatigue, lack of motivation, bloating and other complaints.

Estrogen, Progesterone and fat storage
Progesterone may be the most important hormone in keeping the waist of women smaller and giving the hour glass shape.  This is because progesterone and cortisol are antagonists to one another meaning they each block the action of each other.  Therefore, higher levels of progesterone may decrease cortisol’s action on the belly. However, high stress levels will impact progesterone for two reasons.  First, in the adrenal glands progesterone is used to make cortisol.  Many holistic physicians, including myself, believe progesterone derived from the ovaries can be used to increase cortisol production when needed.  This is called “progesterone steal” or “pregnenolone steal” and is used to describe a situation where the adrenal glands “steal”/use up pregnenolone (a precursor to progesterone) or progesterone to make the stress hormone cortisol.  Next, cortisol antagonizes progesterone’s action at its receptors thereby decreasing progesterone’s impact in the body.
Estrogen is a little different.  Estrogen may work to increase fat storage by up-regulating alpha adrenergic receptors in female fat depots around the hips and thighs.  Adrenergic receptors are like the gas and brake peddles on your car and work to accelrate or decrease fat usage.  Beta adrenergic receptors increase fat burning while alpha adrenergic receptors block it. The hips and thighs of a women have high amounts of alpha adrenergic receptors. This is the major reason it is so difficult for some women to lose fat from the hips and thighs.  Many women have plenty of fat to spare around that area but instead will become smaller in the torso and breast rather than the hips and thighs.

Estrogen increases alpha adrenergic receptor density while progesterone decreases it. Progesterone has also been shown to increase beta adrenergic receptors (so does testosterone). In this way, estrogen and progesterone work to influence the ability to burn fat and determine from which areas it will be taken from. This is an issue of hormone balance not calories and believe it or not, aerobic exercise makes this worse NOT better.  I will get to that in a minute. Estrogen is also a weak antagonist of thyroid hormone which is a major metabolic fat burning hormone. This is a major reason why women should work hard to decrease the effects of estrogen in their environment.  Many women are unaware, but the environment they live in is swimming with estrogen related compounds.  Plastics, coffee, pesticides, soy, and others contain chemicals that resemble human estrogen and act as weak estrogens in the body impacting a woman’s total estrogen load.

Women should not make the mistake of assuming estrogen is all bad.  Too often people want to put labels on biochemicals and hormones as if things are black and white, they are not.  Hormonal action needs to be within a range of function. Too high is not good, but neither is too low.  In addition, hormones behave differently depending on the balance of other hormones around with them.  It is the total hormonal influence that makes a difference.  Estrogen helps the body be more sensitive to insulin and has fat-loss and muscle building benefits in that regard.  As long as it is in balance with progesterone and other hormones it aids fat loss for women.  Likewise, while good testosterone levels in a women are beneficial, if it is too high and present with higher cortisol, estrogen and insulin it can lead to PCOS and masculinization causing increased hair growth and other negative effects women would prefer to avoid.

Working with female hormones
Perhaps the biggest mistake I see in my clinic and with my personal training clients is the way women approach body change.  Women are often duped into believing the low calorie diet and aerobic exercise myth.  This approach to weight loss rarely works and often creates damage to their body as a consequence. Here is why. As a women ages, as a consequence of stress or because of environmental estrogen mimicking compounds several things begin to occur.  First, the ovaries decrease their production of estrogen and progesterone potentially exacerbating an estrogen:progesterone imbalance. This is because there are many estrogen mimickers in our food and environment and fat cells continue to produce estrogen through an enzyme called aromatase present in fat cells. As a consequence the estrogen/progesterone balance begins to shift more towards estrogen. At the same time human growth hormone (HGH) levels decline and DHEA, a precursor to testosterone, is lowered. Together this creates the perfect storm for female related fat gain and most of it will occur in the middle.  DHEA, HGH and progesterone all act to keep a woman lean and block the storage of fat in the middle of her body. The tricky part is that a low calorie diet and a focus on aerobic exercise makes this worse because they do nothing to restore these powerful hormones and may actually increase the impact of cortisol only furthering the imbalanced hormonal effect in the long run.

Instead what women should be focused on is eating higher amounts of vegetables and “estrogen free protein” (a soy free and organic meat focused approach) and most importantly, weight train.  There are only three ways to reliably restore HGH in the body: sleep, adequate protein, and intense exercise using weights.  The current trend is for women to take up an aerobic exercise program, go on a low calorie vegetarian diet, and use stimulating “fat burning” supplements.  All of these choices are poor ways to reverse the underlying hormonal issues because they often interfere with sleep, adequate protein, and weight training. Weight training is perhaps the most important aspect of this and is critical for female health especially to stop the belly fat that accumulates during aging.  HGH is to women what testosterone is to men, it keeps them looking young, lean and firm. Ironically, most women avoid weight training opting instead for lower intensity walking or yoga.  They falsely believe this will give them the desired “look” of their younger years.  While these activities are exceedingly healthy they will not be adequate to generate the hormonal effect needed to raise HGH and DHEA.

The female fat-loss formula involves the following:

1. Decrease exposure to all estrogen related factors in the diet and environment.  Including plastic bottles, coffee, soy, pesticides, non-organic meats, sodas, etc.

2.Help the body deal with excess estrogen through natural detoxification.  This is done through increased intake of green tea, cruciferous veggies (broccoli, cauliflower, cabbage, etc), increased fiber, tailored supplementation, and decreased dairy and grain (yes, these cause excess release of insulin and will do little to protect female bones if eaten in excess)

3. Decrease insulin and cortisol effects by decreasing most grains and starches and replace with fruits and vegetables. Drink water (not out of plastic) and green tea and skip coffee and other beverages.

4. Supplement with Vitamin D, calcium, and Fish Oil (Krill oil is best for women), yes to protect bones, but more importantly to decrease catabolic inflammation and protect against heart disease and cancer.

5. Train with weights 3 to 5 times per week.  If you want to burn fat, decrease belly fat, build bone, improve mood, enhance strength, bolster self-esteem, tighten the body (it is the only way to do this) and decrease morbidity and mortality into old age nothing…NOTHING compares to weight lifting exercise. Walking is necessity NOT exercise. Everyone should walk as much as they can daily.
Talk to a holistic physician trained in restoring hormonal balance through the use of natural foods, herbs, hormone precursors, and bio-identical hormone replacement therapy.  Natural medicine has much more to offer in this arena than conventional medicine.  Conventional doctors know next to nothing about nutrition and even less about exercise.