The Smart Drug You're Already on and How You Can Upgrade

There was a time when I woke up naturally, having slept plenty and felt rejuvenated.  My body was alive and my mind felt sharp. I was young and had limited responsibilities. I had the focus of a laser beam and carried out necessary tasks with ease. I attacked the day with vigor and had the mental stamina to stay awake and productive until midnight.  It was glorious.  It's also only a memory.  

I had children.  Two of them.  And they broke me. 

They have stolen leisure and among other things, the ability to eat meals at their intended temperature. My life with children takes constant effort and frankly, I don't always feel up to the task. My natural level of continuous vigilance lasts somewhere between 1-4 hours depending on the intensity of the task, but my day is 14-18 hours long. 

So how does one power through 14-18 hour days with clarity and avoid distractions that derail one's progress? Smart drugs may be the answer. In fact, most of you are probably already on a powerful smart drug and you may not even know it. 

CAFFEINE

There are many things I want to do during the course of my day, but the one thing I have to do every morning is have my coffee. Coffee upregulates a protein called Nrf2 which is responsible for the regulation of antioxidants and protects against oxidative damage caused by inflammation. Coffee also contains caffeine, the smart drug no one knew they were on. Alone, caffeine has positive effects on wakefulness, concentration and mood. To get extra benefit, pair it with the amino acid, L-theanine which is naturally found in green tea. They work synergistically and can further enhance alertness, attention and task-switching. L-theanine can also create an inhibitory effect in the brain to combat jitteriness, and sleeplessness. 

Mastered your coffee intake? Maybe it's time to upgrade.

Smart Drug Upgrades: Nootropics 

Smart Drugs can be broken down into two basic categories: Cognitive Enhancers and Nootropics. There's a lot of information available on nootropics and cognitive enhancers. Like anything of any interest, it can be controversial and you'll find mixed data and the need for more research. This lag in documented research leaves a big open space for self-experimentation. Before you order a slew of capsules online, safety first. 

A nootropic can be considered a cognitive enhancer, but the reverse is not necessarily true. Some cognitive enhancers have the potential for addiction, tolerance, and negative side effects. In order to qualify as a nootropic, a compound needs to meet some pretty rigid criteria: 

• it must provide memory enhancement
• increased efficacy of neuronal firing
• improved brain function particularly under disruptive conditions
• offer neuroprotective qualities
• be non-toxic with few-no side effects.

This generally means, nootropics are considered to be extremely safe for personal use. 

RACETAMS

Piracetam was first manufactured in 1964 by a chemist in Belgium. It's essentially the father of all the other racetams and as a group, they have been utilized for the purpose of enhancing focus, retention, memory formation, creativity and neuronal recruitment. They all work a little differently and have different uses and half-lives. The mechanism of action is still relatively unknown, but the racetams are considered to be some of the safest compounds for cognitive enhancement available. These compounds can be taken alone or in a "stack" meaning you've combined a racetam with other compounds, like amino acids or certain botanicals in an effort to synergistically enhance the effects of them all.

PQQ

Pyrroloquinoline quinone is a cofactor that potentially confers protective qualities to the brain and the heart. It primarily performs its function on mitochondria, an abundant organelle found in most cells and among other things, they are primarily responsible for energy production. PQQ works by activating cell signaling pathways directly involved in cellular energy metabolism, development, and function. Not only does it protect mitochondria from oxidative damage, but it also promotes spontaneous generation of mitochondria. 

Cognitive Enhancers that are not Nootropics

If you already on rotating stacks and manipulating your daily nootropic regimen, but still feeling the need for extra oomph, you're entering the "caution-required-zone" and leaving the safety of nootropics behind. Increasing the risk can mean increasing the reward, but you have to be sure you're playing with a full deck. See a knowledgeable physician for a thorough health assessment. The following compounds should not be experimented with unless you are in truly excellent health as confirmed with recent blood tests and physical exams. 

NICOTINE

Not just for smokers anymore. If you're tired, nicotine will make you more alert.  If you're anxious, nicotine will calm you down. There is no other drug that performs in such a disparate way and it has a fascinating impact on behavior. It can improve selective and sustained attention and also decreases distraction. Further, it can increase pre-attentional processing which is a subconscious ability to detect new information.

Cigarettes, however, still remain dangerous and cancer-causing. Luckily, the aggressive surge to quit smoking has inspired a new class of products—the nicotine replacement therapies (NRTs). These products deliver a consistent and metered dose of isolated nicotine. When choosing this drug for cognitive enhancement, low dose nicotine can be quite useful. 

Remember, nicotine is one of the most addictive drugs in the world and certainly not without it's side effects, particularly for those with certain conditions or predispositions. Be sure you understand the risks, before you attempt to get the benefits. 

MODAFINIL

Modafinil is a pharmaceutical that requires a prescription from a physician. As of 2012, modafinil is the only approved "go drug" utilized by the Air Force to keep pilots alert. It is considered a wakefulness-promoting agent (eugeroic), but is not a direct stimulant like adderall or methylphenidate.  This distinction is important since it makes modafinil much less addictive and carries less potential for side effects and abuse.

It's prescribed for fatigue associated with severe sleep apnea or for individuals who have Shift Work Disorder (SWD). SWD is a term applied to individuals who are fatigued or have difficulty with staying awake due to unnatural schedules, particularly those that compete with circadian rhythm. Modafinil is a weak dopamine reuptake inhibitor and has positive effects on sustained energy, mood, learning and working memory.

It won't increase your IQ, but—if you have SWD—it can certainly make you more productive and less distracted when you're on it. Modafinil does confer the risk of a potentially dangerous, albeit rare, rash. If you're sensitive to NSAIDs, you may be sensitive to this drug. 

Sum It Up

For the right people, smart drugs may be the answer to boosting cognitive performance. When used judiciously by informed individuals, I think they are wonderful tools. This is a (very) brief overview of cognitive enhancers. Before you begin, see a qualified physician who can confirm your health and help you navigate this world. Nothing can change for the better if you're still battling poor metabolic function and dietary sabotage.

Get it together. Get smart. Get healthy. Then get smarter. 

A Hack For Cheat Days

I love the picture associated with this post.  It's a beautiful board of cheese and bread and it makes an appearance at every event I attend.  What it really looks like is a big plate of "nope". That's because all I see is a big plate of gluten and casein, the proteins found in wheat and dairy respectively.  For a lot of people, this plate is not to be feared, but for some it's just a window into a world of bloating, gas, discomfort, and an array of digestive complaints that follow.  As a result, many people choose to avoid these foods all together.  

I am one of those people.  I should say: I do not have celiac disease, or any type of true food allergy or an autoimmune condition. If you have any of those concerns, the rest of this post will not pertain to you and a more thoughtful and careful discussion should be had. I fall into the category of people who have an "intolerance". I don't notice an issue with gluten, personally, but I avoid it for general health.  I suppose I should count myself lucky that when I foray into the land of dairy, I only experience a temporary abdominal discomfort, but I don't like being uncomfortable and like any sane human, I try to avoid things that make me uncomfortable. 

For the most part, I avoid discomfort by avoiding "nope plates".  They come in many disguises. Bagel and cream cheese spreads--nope. Lasagna--hot, melting pile of nope. Nachos--gluten free, but topped with multiple kinds of nope. The problem is that I have a deep desire to eat all those things. By this point, you should know my purse is a veritable dispensary of ailment-solvers. That's where one of my favorite products comes in. 

Similase GFCF is a product made by my favorite company, Integrative Therapeutics. It contains a combination of enzymes and dipeptidyl peptidase IV (DPP IV) that assist the digestive process especially when it concerns gluten and dairy. If the blatant choice to try the newest Salt and Straw flavor does you in, or even just minor contamination from eating out at a restaurant, you should keep this product handy. Buy it from the shop if you've tortured yourself for too long and are ready to indulge in something delicious. Take two with just before your meal and enjoy yourself. 

You deserve it. 

My secret weapon to preventing hangovers

Drinking is part of our culture, especially here in Portland.  We drink to network, celebrate, drown our sorrows, or simply because we really do want to try every tap option at Bailey's.  Whatever the reason we drink, the next morning always comes to soon, too brightly and way too loudly. For some people, creating a 2-3 drink limit allows for indulgence and hangover prevention simultaneously.  It's a reasonable plan and a worthy endeavor, but there are exceptions to this rule like weddings, or your birthday, or Fridays. 

If you do only one thing: take Theracurmin HP

If you've ever been to a dinner or an event with me, you've probably gotten a sample of my favorite product. It's Theracurmin HP and made by a company I love and trust, Integrative Therapeutics. I give it out because if you're going to do nothing else, this product alone will drastically cut down hangover symptoms the next day. I literally use it every time I drink. Feel free to stop reading now and buy some Theracurmin HP.  Or continue on if you want to learn how it works and get some tips on how to control hangovers and understand why they happen.

Three primary causes of hangovers

There are several contributing factors. Veisalgia, the technical term for hangover (and the one I suggest using if you need to call out of work) can get severe if people really over do it. 

Hangover Cause #1: Acetylaldehyde 

It's gnarly. It's the metabolic breakdown product of alcohol ingestion and it's 30 times more toxic than the alcohol you drank.  This metabolite causes headache, nausea and vomiting and is responsible for light sensitivity.  Acetylaldehyde is toxic and toxic things create inflammation in the form of free radicals and increased inflammatory cytokines. 

Pro-tip: Remember Theracurmin HP, that product I love? This is where it does its best work. Theracurmin HP contains the chemical constituent curcumin derived from tumeric root and is specially designed to be more bioavaiable. Taking it early (2 capsules with your first drink) helps reduce inflammatory cytokines and acts as a free radical scavenger helping your body do the heavy detoxing. Find it by clicking on my supplement tab or on the link towards the top. 

HANGOVER CAUSE #2: DEHYDRATION

It's part of story.  Drinking alcohol inhibits the hormone antidiuretic hormone (ADH), thereby increasing urinary output. Having 4 drinks can cause the body to lose half and up to a liter of fluid. And if the fluid goes out, so do electrolytes.  This dehydration alone can cause nausea, and headache. These symptoms are difficult to chase in the morning so it's best to prepare in advance. 

Pro-tip: Drink water before you start your night.  If you're not peeing every 15-30 min before you start, you're already not putting your best foot forward.  Continue to drink 8oz of water after every 2 drinks and don't let up. 

Hangover Cause Factor #3: Glutamate Rebound

Alcohol is a central nervous system depressant.  It works by enhancing GABA effects on the brain.  GABA is an inhibitory neurotransmitter and when it's enhanced, it helps us feel relaxed, lowers our heart rate, and reduces our inhibitions. Remember high school physics: "for every action there is an equal and opposite reaction"?.  When your done consuming alcohol, your body rapidly tries to correct the neurotransmitter imbalance.  Glutamate's effects are suddenly in full swing. Unfortunately, you're trying to sleep and the brain is excited.  It wakes us up, can cause restlessness, and sensations of depression and anxiety.  

Pro-tip: N-acetyl cysteine (NAC) performs many tasks.  When broken down by the body, it turns into glutathione, a potent antioxidant helpful to aid alcohol detoxification and cysteine, a key ingredient in maintaining an appropriate balance of glutamate levels. Take the first one 30 min before you start drinking and pop one every 1-2 drinks until you've hit 1,800mg.  There's no more value to it after that. Look for it in the supplement tab. 

Finally, consider IV Therapy...and your drink choices

If you know you're about to go all in for an event or a series of events, come see me first and get some IV Therapy. Intravenous vitamins topped off with glutathione will set you up for a much better recovery, especially if you have multiple days of fun ahead. There's no better way to get active glutathione into your system since it's not very well absorbed orally and you'll prepare your body by providing it with everything necessary to detox. 

That being said: I'm a whiskey girl, myself, but the clear alcohols cause less of a hangover due to a significantly lower congeners, a group of chemicals that form during production and aging. Choose wisely especially if you need to be productive the next day.  

Lastly, I'm all about imbibing, except when it comes to driving after drinking.  Please pass on the alcohol or be sure to contact my friends at Uber or Lyft to get home safely!

The more blood work, the better

My patients are sometimes surprised at the number of tubes of blood I draw for testing. "Blood work" is a broad term for any laboratory test performed on the specimen of blood.  It is not, however, created equal. For performance assessment, functional blood work analysis (FBWA) is critical. 

Sometimes "blood work" is just a finger prick or a couple tubes drawn from a needle stick. But if you come to me it can be more like 10-15 tubes. "What?!", you ask?  More tubes means more tests and more test results give us more information. In this case, more information allows for a more detailed look at how the body is really performing under the stress of daily living.

What is functional blood work analysis?

Functional blood work analysis (FBWA) relies on a complex series of genetic testing, lipid differentiation, inflammatory markers, reproductive and metabolic hormones, detailed thyroid information, complete blood counts, and nutrient assessment. I utilize Boston Heart Diagnostics and Quest to perform these tests in the Portland area. The difference between FBWA and the standard blood work offered by a conventional primary care physician is vast.

How is it different from conventional blood work?

Conventional blood testing in the absence of serious risk factors generally includes a complete blood count (CBC), comprehensive metabolic panel (CMP) and basic lipids. Further, the reports suggest that every result falls into one of two categories: "normal" or "abnormal".

This categorization helps doctors assign diagnosis coding: you either have diabetes, or you don't. You have anemia, or you don't. Treatment is given if you "have" something and treatment is not given if you don't. You see, without a diagnosis code, your treatment won't be covered by insurance, and if your blood result number doesn't support the diagnosis, you don't get treatment. 

FBWA throws out the idea that there are only these two categories.  There's a wide range of results and they all mean something. Careful review and understanding of each result gives me two very different meta categories: the results are "optimal" and "everything that isn't".  

Proof is in the pudding

Of course, pathology is important to identify and still very much on my radar, but even without an overt, diagnosable pathology, improvements in performance and function can be made. Risk factors for developing chronic disease can be controlled and even reversed. Physicians who use this method can identify warning signs and weaknesses earlier and intervene faster and often those interventions lead to noticeable improvements in sensations of fatigue, exercise performance, blood sugar regulation, and hormonal fluctuations. 

Blood draws of this nature are significant, but not even close to the amount of blood given during a blood donation.  Plus, we have a wonderful mobile phlebotomist who will happily come to your house for maximum comfort. They also cost more than conventional report, but it's a fraction of the cost of hospitalization due to heart attack or stroke. Results are available in about 2 weeks and printed in color with easy to understand graphics so you can compare your results easily over time. 

Want to see a more complete roadmap of your health's markers with functional blood work analysis? Reach out to me to get started.

 

 

Wtf is biohacking?

Whenever I tell people I specialize in biohacking, I am almost always met with a quizzical glance and the question I both expect and dread: what is biohacking?  The childish part of me wants to answer back: "If you have to ask, it really isn't for you".  Of course, that doesn't help either of us have a productive conversation, but to some extent, that answer wouldn't be entirely inappropriate.  

Biohacking is the process by which one takes control over their own biology.  It's not a quick-fix or a passive project.  It requires constant evaluation, objective assessment, rigorous documentation and a willingness to explore not only oneself, but everything around you.  People who know what biohacking is are already doing this to some extent.  They've accepted an active role in their own life and are aggressively working to improve their relationships.  I use the word "relationship" to refer to interpersonal relationships, yes, but also to refer to how you interact with food, sleep, stress, work, breathing, the environment.  The list goes on.  

Biohacking is, I daresay, a movement and if you've been swept up, you already know. That being said, tidal waves spare some people and there are others who know inherently it's possible to feel better, live more fully, become more productive, but something is preventing them and they can't identify the barrier. To those who have been missed or cannot identify their barriers, I'm here for you.  I'll help you fix it, but please don't be under the impression that it is a passive assignment, or that I can do it for you.  I can guide you and keep you safe and offer my opinion and my medical services, but I cannot convince you to go get it. 

So what's it take? Biohacking is multifaceted.  It takes time to manipulate every facet.  It would be unreasonable to expect to adjust all of them at once and probably best to approach it from whichever aspect most negatively impacts you.  For many people, that's health. Hacking health is huge.  We all have genetic predispositions.  Knowing what they are and how they're manifesting in our own bodies is a crucial piece of information and those pieces of information are actionable. I help people get those tests, interpret them and then adjust them.  I'm aggressive.  I like change and I like results.

Arguably, all biohacking falls into health.  Emotional health, relationship health, sleep health, food health, and environmental health all contribute to your productivity, efficiency and effectiveness. There are hacks for all these things. 

Full disclosure: biohacking is not comfortable.  It will challenge the beliefs you hold about yourself and any mis-information you've believed to be true for the last 20 years.  You may have to change your diet, get new favorite restaurants and it may even require you to get new friends. Nothing about that is easy, but I can tell you, it's all worth it.