Do Supplements Really Help?

But My Doctor Recommended I Take Supplements

I recently discussed taking probiotics with my primary care doctor (I have IBS). Because we’re both doctors we discussed the data on probiotics and the fact that she recommends the brand of probiotics her patients with IBS recommend to her. There’s nothing wrong with this, but it’s important to understand why your doctor is recommending supplements to you and based on what data. In case you were wondering so far, there’s no clear, reliable medical data that shows whether or not probiotics work for IBS.

Why I Want To Talk About Supplements

As a cardiologist many of my patients take supplements for various reasons: they want to live longer, lose weight, prevent heart disease, etc. There’s a lot of information out there about the benefits of supplements. But it’s not all good. I’ve even had the rare patient have a heart attack from supplements. In my experience “extra energy” supplements are sometimes too much energy for your heart. I want you to know the information that I know and I use when I recommend supplements to my patients or take them myself.

Who Should Try Supplements?

In my opinion, there are a few reasons you should consider taking supplements.

The first reason is that you have a medical condition, like celiac disease, which may not let you absorb nutrients properly.

The second reason is that you’re not getting enough vitamins and minerals from the food you eat. I was vegetarian in my 20s because I thought I would eat more fruits and vegetables. In reality, I ended up eating a lot of pizza, pasta, and bread. So I started taking a multivitamin because most days I was only eating one serving of fruits and/or vegetables.

Since then I’ve learned a lot about eating healthy. If you’re eating a balanced diet, it’s unlikely you’re going to have a shortage of minerals or vitamins. If you’re concerned, you can check with your medical provider. Most nutritional deficiencies will show up on blood tests.

The third reason you should consider supplements is if you have a medical condition like anxiety and you’ve already tried everything else, medications, therapy, meditation, and yoga, and nothing has worked out for you. Then you should consider trying supplements.

Supplements Are Natural So What’s Wrong with Taking Them?

The most important thing you should know about supplements is that the FDA doesn’t regulate them. This means there could be anything in the pills you get, from the ginseng root it claims to have in it to plain sugar or even caffeine, or both because sugar and caffeine make you feel good. Like “Wow! That ginseng root really does make me feel better!”

The best case scenario is it does have ginseng root in it. The worst case scenario is that it has something in it that you didn’t want to have in your body or that it interacts with something else you’re taking. The worst worst case scenario is it kills you.

The odds of supplements killing you are low, but you might think that if one person dies from a supplement, it gets pulled from the market. My best guestimate would be closer to 20 people need to die before something gets pulled from the market. Why? Because when you think about it, most people taking supplements are usually taking more than one. So when something goes wrong, it’s hard to pinpoint which supplement caused the problem, until many people taking the same supplement die.

The Best Way To Try Supplements

The best reliable source of information on supplement verification that I’m aware of is the United States of Pharmacopeia Convention (USP). Supplement products the USP have verified are marked with a USP stamp. I have no affiliation with them, but this is what I recommend to my own family.

Also, I recommend you stick with the same manufacturer once you start a supplement as there can be substantial variation from one manufacturer to another. You should only try one new supplement at a time so you can tell if it’s helping and/or causing side effects. Prescription medications can take anywhere from one day to three months for you to get the full effect. I recommend you try one supplement for up to three months to get an idea of if it’s working for you and if there are any side effects.

Again I think you should try supplements as a last resort because eating a well-balanced diet is the best way to keep your body healthy and there are many things like yoga and meditation that can help you feel better without putting anything extra in your body.

Originally published on Medium September 22, 2017.

Lose Weight So You Can Fit Into Your Clothes

Recently my friend told me about how she’s frustrated that half the clothes in her closet don’t fit. She has two wardrobes: one for her skinnier self and one for her heavier self. Losing weight is on her to do list, she tries to eat healthy, and she works out, but it just doesn’t seem to be happening. What’s she doing wrong?

Sugar Is Your #1 Frenemy

If you’re like most women, sugar is keeping you from getting the body you want. You know that sugar makes you fat, it makes you tired, and it makes you hangry all day. So why aren’t you doing anything about it? No matter how hard you try, you just can’t seem to cut back on sugar.

I understand, I’ve struggled with it myself. And with all the sugary treats at the office and the “I’ll just have one bite of dessert, ok maybe I’ll just have the whole thing” splurges on the weekend, it can seem impossible.

How Can You Detox From Sugar?

So what can you do about it? You basically have 2 options. You could try quitting sugar cold turkey. I’ve actually tried this and felt like I was going through sugar withdrawal – hot flashes, mood swings, trouble sleeping, and more. I don’t recommend this if you have a job or friends or a life. You may not have any left by the time you’re done and also no ice cream sandwiches.

I recommend the 2nd option. Start by decreasing your sugar intake by roughly 10%, that’s what worked for me. Then reevaluate and see how you feel. If you feel awful, back up and just cut your sugar intake by 5%.

Do You Have to Use A Calorie Counter?

I know you hate calorie counters, I don’t know why. I love calorie counters and anything that involves numbers. But, if you hate calorie counters I’ll tell you what worked for me, so you don’t have to use one.

The easiest way to cut down on how much sugar you’re eating and not miss it is to start with making one small change to what you eat for breakfast Monday to Friday. If that’s too hard just start with one day, probably Friday, since you’ll have after work drinks with your coworkers and Sunday brunch with your friends to look forward to.

Change What You Eat for Breakfast

Breakfast during the week is usually the easiest meal to change because normally you’re in a hurry, so you’re less likely to miss what you don’t eat. Maybe right now you’re eating a banana because it’s easy to grab when you’re running late. Or maybe you’re eating oatmeal with a fruit topping because that seems healthy, right? But if you want to lose weight you’re going to have to push a little harder.

It’ll be worth it in the end because you’ll feel great and you’ll look Insta-worthy in every single picture! Ok, I can’t promise the last part, but you’ll definitely feel great and lose weight.

The Sugar Hiding in Plain Sight

The reason these aren’t the best options is because of the sugar. Fruit is healthy, but first thing in the morning it’s a lot of sugar too. Once you get your body used to the idea that it needs this much sugar, it’s going to crave sugar all day. You can try snacking on other things like a handful of almonds, but you can’t trick your body. It wants sugar.

So what should you do? Try my new Funfetti Cupcake Diet! Just kidding, there’s no Funfetti Cupcake Diet. I mean there is, but if it actually worked, you wouldn’t be reading this.

What Should You Eat For Breakfast?

So what should you really do? Well, you could eat oatmeal without any toppings on it, but why would you want to? I tried it, it tasted awful. Instead of making drastic changes that are going to be hard to maintain long term, start with small changes that you can realistically maintain.

For example, if you normally eat oatmeal with a banana and brown sugar on top, try putting in ½ the banana. See how it goes, see how you feel, and then go from there. Eventually, try to switch to a less sweet topping like walnuts or almonds.

Where’s the Fruit?

What about fruit? Aren’t you supposed to be eating fruit for [insert your favorite health and wellness words here]. Try moving fruit to later in the day, like for your afternoon snack or even better for your after dinner dessert instead of ice cream sandwiches.

What if you can’t miss your daily ice cream sandwich? Well then cut back on fruit short-term while you’re trying to lose weight. Eventually when you’re making continued progress towards your weight loss goals, then add fruit back in. The goal for adding fruit back in shouldn’t be 5 years from now. Set a short deadline, like 3 months, and then stick to it by telling someone you can count on to be your accountability partner about it.

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Do Natural Herbs Work For Anxiety?


If you’re someone who struggles with anxiety, it’s likely you’ve experimented with a few different treatments. You may have tried therapy but found that it’s too expensive to go every week. You might have tried anti-anxiety medications but suffered too many side effects to make it worth it. If this sounds familiar, you’re not alone; anxiety affects 40 million adults in the United States.

You may have also considered trying herbal supplements, but it can be hard to find reliable information about how they’re regulated and whether or not they’ll work. After all, herbs can cause both positive and negative symptoms — many of which haven’t been studied very well. But despite the limited data on herbal supplements, there are a few reliable studies out there that tested different herbs for anxiety relief. Here’s an overview of the medical data available from the last few years. Please consult your doctor or medical provider before trying any of these options:

1. Chamomile

Chamomile is one option that has been shown to reduce anxiety symptoms. In one study, a pharmaceutical-grade chamomile extract of 1,500 milligrams (a 500-milligram capsule three times a day) was shown to help reduce moderate to severe anxiety symptoms. Of note: Chamomile has been shown to interact with blood-thinning medications, so discuss this with your doctor if you’re on this type of medication.

2. Saffron

Although it’s mostly known as a culinary herb, saffron is another good option for taming anxiety and promoting mental and emotional balance. One study showed that 50-milligram saffron capsules twice a day helped significantly reduce anxiety.

3. Kava kava

Kava kava has been shown to reduce anxiety significantly in several studies but has also been linked to kidney and liver damage. The FDA recommends caution if you have existing liver or kidney disease, and never take kava kava with alcohol or other medications.

4. Oil Aromatherapy

Aromatherapy is another alternative to consider. And while data is limited, there is one study showing lavender oil aromatherapy helped patients with anxiety.

Also, some older trials have suggested that passionflower, St. John’s wort, and valerian have some efficacy, making them other options to consider if you’re going to try herbs.

If my patients want to try herbal supplements, I advise them to start with only one at a time and to stick with the same manufacturer, as there can be substantial variation. I also recommend keeping a journal to track of how you feel. Consider writing down a daily anxiety score from 1 to 10 when trying a new supplement and record any side effects you notice–positive or negative. Many prescription medications for anxiety take two to three months to get the full effect, so I would recommend you try supplements for the same length of time. If any unexpected symptoms occur, stop the supplement immediately and contact your medical provider.

Originally published on mindbodygreen July 18, 2017.

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Kicking Sugar Cravings to the Curb

I Used To Eat Oreos For Breakfast

I love sugar. Eight years ago I used to eat 100 Calories Oreos packs for breakfast. I thought this was relatively healthy after all only 100 calories sounds healthy, doesn’t it? Plus they’re prepackaged; I used to be always running late in the morning and also I had to stop at Starbucks for a mocha before I went to the hospital, so a fast breakfast was essential. Now I eat eggs in the morning, and the transition to breakfast with less sugar has changed my whole life in how much easier it has been for me to cut sugar during the rest of the day.

Why is that?

If you pay attention to it, you will probably notice that if you eat a lot of sugar early in the day, you will crave a lot of sugar all day. This has to do with the way your body regulates sugar. Once you establish a high steady state of glucose in your body, your body will want to maintain that. This is true for most people who have a sweet tooth. If you’re more of a savory or salty person, then this likely doesn’t apply to you.

What should you do?

When I first started cutting sugar in the morning, I felt awful. I’m pretty sure I feel more energetic after I have sugar, even more than if I have caffeine. If this is you too, it can be hard to cut sugar in the morning and still feel awake enough to go to work.

Feel better in the morning

One option I found that worked for me was to move my workout to the morning. Exercise can give you a similar kind of rush as sugar. This is because exercise increases endorphins and enkephalins which are both endogenous opioid peptides. This means they both work with the part of the brain associated with pleasure and pain. Although there’s not a lot of medical data to support this, anecdotally this why you hear people talking about having a runner’s high or being addicted to exercise.

What if you don’t have time to go to the gym in the morning?

Try doing a mini workout like jumping jacks at home and see if this is a good stand in. Alternatively, if you don’t like working out in the morning, you could try meditation as well. In studies, it has been shown to help with depression and anxiety. So if you feel depressed or anxious from not having sugar in the morning, it could help you too.

Or you could try caffeine

Adding some extra caffeine to your morning could work too. Caffeine is a stimulant for your central nervous system, so it will help you feel more alert. You can try adding an extra shot of espresso to your iced latte if you’re a coffee person.  

If you’re a chocolate person like me and are switching from having chocolate related sugar in the morning, you can try switching to dark chocolate which has substantially less sugar than anything with milk chocolate. Usually the higher the percentage of dark chocolate the less sugar and more caffeine is in it. Personally, I find anything over 70% cocoa to be too bitter to enjoy. I initially switched from 100 calorie Oreo packs to a nut mix with dark chocolate covered soy nuts.  Your longer term plan should be to stop all chocolate in the morning eventually as it still has some sugar in it.

Change your habits

I recommend you cut back on sugar gradually, so you don’t feel like you’re depriving yourself and you’re more like to keep the changes long term. For most people doing something more extreme like a one month sugar detox will work for something short term like getting fit before a wedding or similar event. But then after the wedding, you’ll go back to all the same bad eating habits, and you’ll balloon back up to your previous weight. And the next time you have to go to a wedding you’ll be in the same place all over again. If you learn how to change your habits or even just one habit, what you eat for breakfast, it will make keeping off the weight much easier.

Originally published on Northington Fitness & Nutrition July 17, 2017.


Will Yoga Help You Lose Weight?

Why does it seem like everyone and their cat is doing yoga?

Can Yoga Help You Lose Weight?

Not surprisingly yoga can help you improve your flexibility and balance. Why is this important? Because improving your flexibility and balance can help you improve your other workouts too. Yoga can also help you improve your strength. One study even showed it can help you increase your deadlift strength.

Yoga usually involves some type of meditation. So it can help you better deal with stress and anxiety. Also, people doing yoga feel like they have a better quality of life versus people who don’t.  This potentially can help you feel better all day. Personally, I had never had much luck with learning how to meditate until I started doing vinyasa yoga. My yoga teacher at the time always spent the last 5 minutes in class on meditation. And that’s how I started getting into meditation too. If you’ve been trying to figure out meditation too, yoga could be your back way into it.

What Can’t Yoga Help You With?

Yoga won’t help you improve your cardiovascular fitness, i.e it won’t help you get heart healthy or lose weight. Sad, I know, I’m a cardiologist. It also won’t help you live longer.

My opinion on why yoga doesn’t help you get heart healthy or lose weight is that most forms of yoga don’t increase your heart rate. However, I think that if your yoga is more rigorous and increases your heart rate it might help you get more heart healthy and help you lose weight. Unfortunately, there’s no great medical data for or against this idea right now.

Ask Again Later

The jury is still out on whether yoga improves your cognitive function, i.e. whether or not it helps improve your memory and focus. Some studies show it does, some studies show it doesn’t.

Part of the problem with knowing the benefits of yoga is that there are a limited number of studies on it. Many aspects of yoga haven’t been studied enough to really know whether or not it helps. Unlike medications which have big pharmaceutical companies funding all of their research, yoga studies don’t seem to have the same level of funding from the yoga industry. Maybe they’re all too busy doing downward dog.

New or New-ish to Yoga?

If you’re new to yoga and afraid of looking stupid in a class, you can try it out at home first. There are a lot of videos on YouTube. I like Tara Stiles’ videos (I have no affiliation with her) because she has a lot of short (15 minutes or less), beginner ones.

If you’re trying a class for the first time, start out with room temperature yoga. Usually, this will be a yoga class that doesn’t have Bikram in the title. The first time I tried Bikram yoga I had muscle spasms for the next few days, despite drinking lots of electrolytes and water. In my experience, the least crowded classes are usually mid-morning on weekdays. If you can, try to make it to one of those classes so you can get more one on one help from the teacher.

Although yoga probably won’t help you get your revenge body, it’s worth checking out because the balance, flexibility, and strength benefits should help you with your other workouts. The mental benefits can help you with your head game at work and in your personal life.

Originally published on Thrive Global June 23, 2017.

Your Friends Are Making You Fat



It’s Friday night, and you’re supposed to be grabbing dinner with your friends at that new pizza place. You know the one that’s supposed to be so cool you’d think you were in Brooklyn but the pizza is so authentic you’d think you were in Italy. Which makes you wonder – is there New York style pizza in Italy? Probably not, Italians are pizza snobs.

And then you remember – aren’t you supposed to be trying to lose weight? You already have three weddings and a long weekend at the beach on the schedule. Should you really be going out for another carb heavy dinner? You’re just going to spend half the night thinking “How many hours will I have to go to the gym to work off all these calories?” or “How little will I have to eat for the rest of the week to make up for all the damage I’m doing tonight?” But what else can you do? Skip out on dinner with your friends? It’s like no matter what you do you can’t win.

Whenever you go out to eat there’s always some cool new dish to try, like three layer pizza cake. Ok maybe not that, but other cool things. Or your friend just got a new job and orders a round of shots to celebrate; you can’t say no to that, can you? Pizza, ramen, dumplings and who wants to skip out on doughnuts? Not me, not you.

So how do you enjoy going out to eat with your friends and still lose weight when your friends want to try every cool new Korean BBQ place that opens up. The requirement to be a cool new place seems to be to have two options on the menu – dishes that will make you fat and dishes that will make you really fat. Is the restaurant industry plotting against you? Probably. Does it seem like they don’t want you to lose weight? They don’t; it’s not good for business.

You’re not going to stop hanging out with your friends. Your friends like going out to eat. You like going out to eat. And you’re definitely not skipping out on boozy brunch. You don’t have to. This is what you’re going to do instead – pick the right foods at the right time.

Let’s say you’re going out for pizza. This is what you order:
  • Start the night with the least sweet options.
  • Bone Dry wines are your best option because they have less sugar.
  • Red Wine – cabernet, pinot noir, syrah.
  • White Wine – sauvignon blanc, pinot grigio, chardonnay.
  • Order one appetizer per person. Most people order fewer appetizers because they think they won’t have room to eat the main but that’s actually good at a pizza place because the main is higher in carbs than the appetizers you’re going to pick.
  • Cold – olives, salumi, and cheeses.
  • Salads – salads with vegetables over fruit as fruits as a group have more sugar than vegetables.
  • Hot – brussel sprouts, meatballs, and artichokes.



Pick a pizza with at least 3 toppings – 1 cheese, 1 vegetable and 1 meat. The more toppings you put on your pizza, the more full you will be from each slice of pizza. The goal is to end up eating fewer pizza slices total so fewer carbs total.



Any and all – the goal is to be so full from Appetizers and Pizza that you only have room for a few bites.



I know what you’re thinking, who wants to be that really lame friend that says no to ordering garlic knots? I don’t want you to be that really lame friend. This is what you do instead:

Use The Judge Judy Script:

To be used to stop your friends from judging you for trying to get hotter.

Friend (the one that seems to eat half their weight in food every time you go out but still has a better body than you do): “Let’s order the garlic knots, the Yelp reviews say they’re supposed to be really good here.”

You: “Work was really busy, I just ate lunch an hour ago. Let’s order the [insert complicated name of artisanal salad of your choice] instead.”

Try this out the next time you’re out with friends and let me know what works and what doesn’t in the comments below.
Bagels, breweries, burgers – your friends are making you fat.
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