Garcinia Cambogia Medication Interactions, Contraindications, Safety, Effectiveness and Use in Pregnancy and Lactation.

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Garcinia cambogia (Malabar tamarind) is a fruit tree found in the evergreen and semi-evergreen forests of southwest India. The fruit of this tree resembles a small pumpkin and comes in a red, orange, or yellow variety. This fruit ripens during the rainy season, and the rind contains large amounts of hydroxycitric acid (HCA). The dried fruit rinds have been used for centuries as a flavoring agent.  

 

In Ayurvedic medicine, Garcinia is used to promote general health. It has also been used for rheumatism and bowel symptoms — an oral rinse containing G. cambogia has been used by veterinarians to treat mouth diseases in cattle.

 

HCA, which is related to citric acid, is a common ingredient in weight loss products. G. cambogia is available as a weight-loss supplement, either alone or mixed with other ingredients.   

 

Garcinia Cambogia Dose

Doses of Garcinia cambogia extract in clinical trials ranged from 1500 to 4667 mg per day. The supplement offered by Sunshine Nutraceuticals contains 700 mg Garcinia cambogia extract, and the recommended dose is one capsule by mouth twice daily 20-30 minutes before a meal with eight ounces of water.

Garcia Cambogia Side Effects

Side effects of Garcinia Cambogia are generally mild and include:

  • Dry mouth
  • Headache
  • Diarrhea
  • Dizziness
  • Nausea

Since Garcinia Cambogia is not centrally active, it should not cause anxiety, hypertension, or problems with sleep. 

Garcinia Cambogia in Pregnancy and Lactation

In my professional opinion, Garcinia cambogia should not be used by pregnant women or those who are breast-feeding. We do not have sufficient evidence to assure its safety; therefore, the risks outweigh the benefits.

 

Garcinia Cambogia Medication Interactions

Antidepressant Drugs and Serotonergic drugs

There has been a case report of serotonin syndrome being caused by a combination of Garcinia extract and escitalopram (Lexapro). The patient was re-challenged with sertraline (Zoloft) and again experienced serotonin syndrome.1

For this reason, caution should be exercised when taking G. Cambogia with any antidepressant medication. Monitor for signs and symptoms of serotonin syndrome.  These include:

  • Headache
  • Agitation
  • Restlessness
  • Confusion
  • Shivering
  • Increased heart rate
  • High blood pressure
  • Dilated pupils
  • Loss of muscle coordination
  • Muscle rigidity
  • Muscle Twitching
  • Heavy sweating
  • Diarrhea
  • Goose bumps

Serotonin syndrome may also occur when G. Cambogia is taken with other drugs that have serotonergic properties such as:

  • Tramadol (Ultram)
  • Pentazocine (Talwin)
  • Dextromethorphan (present in some OTC cough and cold preparations) 

Anti-diabetic agents

G. cambogia may increase the hypoglycemic effects of anti-diabetic agents. It is suggested that blood sugars be closely monitored when using both Garcinia and anti-diabetic medications. 

Statins and other hepatotoxic medications

There was a case report of rhabdomyolysis being caused following the ingestion of an herbal medicine containing G. Cambogia.2Caution is recommended when administering statins with other medications which may cause rhabdomyolysis.

Use caution when combining Garcinia with other drugs that negatively affect the liver. Some examples include

  • Acetaminophen (Tylenol)
  • Amiodarone (Cordarone)
  • Carbamazepine (Tegretol)
  • Isoniazid (INH)
  • Methotrexate (Rheumatrex)

Safety of Garcinia Cambogia

According to the TRC Natural Medicines Research Collaboration, Garcinia Cambogia gets a “possibly unsafe” grade. This is due to numerous case reports of liver toxicity. Most of these reports were the result of combination products that included G. Cambogia as one of the ingredients. There were at least two reports where the patient was taking Garcinia alone. Although the casualty was likely or probable, this is still concerning.

 

Effectiveness of Garcinia Cambogia

Obesity

There is conflicting evidence regarding the effects of Garcinia on treating obesity. Some studies show a significant weight loss while others do not. As mentioned in some of my previous posts, I prefer to consult meta-analyses when available. One such study was published by Onakpoya, et al in 2011 in the Journal of Obesity. 

 

The investigators of this meta-analysis did not believe the studies were of sufficient length to assess the effects of HCA on body weight. These studies ranged from two to twelve weeks. There were also different strains of Garcinia used in the studies. We are unsure what impact this might have on bioavailability. 

 

Finally, there was a difference in caloric intake in the various studies. 

 

Calories eaten ranged from 1,000 kcal, to as high as 3,009 kcal per day. This would certainly have an impact on weight loss.

 

The conclusion of this meta-analysis was that Garcinia extracts generate weight loss on the short term. 

 

They point out that the effect is small, and is not statistically significant when only rigorous random controlled trials are considered.3

Garcinia Cambogia Contraindications

The only known contraindication at this time, according to Lexicomp (accessed 1/12/2020), is a known allergy or hypersensitivity to any components of Garcinia Cambogia.

After researching Garcinia cambogia, many questions remain. 

Can this supplement be effective for weight loss long-term?

Does Garcinia cambogia cause liver damage or contribute to increased liver enzymes in some patients?

Is this supplement safe and effective?

The answers to the above questions cannot be answered until new research is available.  The current studies were of insufficient length and not well designed.  The liver damage side effect must be examined more closely before I can recommend starting this supplement for weight loss.

As I have explained in the past, the best way to lose weight is to eat whole foods, avoid fast food, drink plenty of water, and exercise.  You will feel substantially better if you follow these simple rules.  Supplements can help reduce hunger but exercise and proper food intake will get you much better results. 

At this time, my recommendation is to use Garcinia cambogia only if you have had success with it in the past.  If you have had no negative effects and have lost weight, it may be a reasonable option.

 

I will continue to research this supplement.  As new research is available, I will decide whether to keep it, or remove it from our product line.

If you want a safer alternative, I recommend our Keto Ultra supplement.  This contains raspberry ketones, African mango, green tea extract, caffeine, apple cider vinegar, kelp and grape seed extract.  You can order this supplement below.

Our goal is to give our readers the best information available to live a happy, healthy lifestyle.  Sometimes, the information I present to you will not be positive.  I want to remain unbiased with regard to the products I offer for sale.  If you have any questions, please click on the link next to my picture below to send a message.  I will respond!

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Elderberry for Flu Prevention, Safety in Pregnancy, Drug Interactions, and More…

I am excited to be able to introduce an elderberry supplement into the Sunshine Nutraceutical product line.  Elderberry is a purple berry produced by the European elder tree, a shrub which grows up to ten meters tall.  Elder flowers and berries have been used as medicines and flavorings for centuries and are especially popular as potent cold and flu remedies.  These common ailments have few treatments and can be annoying and even deadly in certain individuals.  Elderberries have been utilized to treat various health conditions including diabetes, gingivitis, inflammation, acne, and more. This post will concentrate on the evidence available for the use of elderberries as a nutraceutical agent.

Elderberry for Colds, Flu and Bacterial Infections

Probably the most common use for elderberry is as a treatment for upper respiratory infections.  Colds and influenza are prevalent especially during the winter months and are often treated with over-the-counter medications to combat symptoms and at times antibiotics are prescribed.  Both colds and the flu are caused by viruses.   Antibiotics are ineffective in the treatment of viral infections.  Taking antibiotics unnecessarily can lead to resistant bacteria so it is important to use antibiotics only when they are indicated.  No antibiotic is 100% effective and, if a resistant bacterial strain begins to multiply, it can be difficult to treat the infection.

The real question is whether elderberry will help with upper respiratory symptoms.  I know plenty of individuals who swear it works.  Before adding the elderberry product to my line, I did some research.  I located a meta-analysis published in February of 2019.  I have mentioned in previous posts that I like meta-analyses because they have a larger sample size and are generally more accurate than single studies. 

This meta-analysis showed that elderberry supplements, when taken at the onset of respiratory symptoms, substantially reduced symptom duration compared to a control group.  The investigators concluded that elderberry supplementation reduced influenza virus symptoms substantially more effectively than the upper respiratory symptoms caused by the common cold.  It should be noted that this meta-analysis included only one study on elderberry supplementation for the common cold.1

Elderberries neutralize hemagglutinin spikes found on the surfaces of some viruses.  This prevents the viruses from piercing cell walls or entering the cell to replicate.  If the viruses are unable to replicate, they cannot spread.2

Elderberries can also increase the antibodies produced by our bodies against the influenza virus.  This indicates elderberries may actually be able to prevent the flu from occurring.3

A study published in the BMC Complementary & Alternative Medicine Journal in 2011 concluded that elderberry liquid extract was effective against human pathogenic bacteria and influenza viruses.  Many patients develop bacterial infections when ill with the influenza virus.  Elderberry may prove to be helpful in fighting both the influenza virus as well as bacterial infections during outbreaks.4

Elderberry for Treatment and Prevention of Cancer

A study published in 2007 found extracts of the fruits of both the European elderberry (Sambucus nigra) and American elderberry (Sambucus Canadensis), demonstrated anti-initiation and anti-promotion properties.  This may prove to be useful in fighting cancer in the future.  However, more studies need to be conducted on this subject 5

 

 

Elderberry as an Antioxidant

Elderberry may act to protect the body against oxidative stress.  Elderberry has been proven to be an antioxidant and free radical scavenger in vitro (outside the body).  It has antioxidant activity comparable to other highly antioxidant fruits such as blueberry and chokeberry.6

Elderberry Effect on Obesity, Diabetes and Inflammation

Obesity is the result of excessive adipose tissue growth.  This can happen through two different mechanisms; Hypertrophy, which is the expansion of existing fat cells, and hyperplasia, which is the addition of new fat cells. 

The oxidative stress caused by an increase in fat tissue leads to obesity-related comorbidities including insulin resistance, diabetes, cancer and heart disease.7

The accumulation of fat in hypertropic adipose tissue associated with obesity leads to oxidative stress and chronic inflammation.8

A recent study found an extract of the elderberry fruit (EDB) was able to decrease reactive oxygen species (ROS) in hypertrophic adipocytes suggesting an antioxidant action.  This may be a potential protective mechanism against obesity risk factors such as insulin resistance and chronic inflammation. 

This study also suggested that the anti-obesity and anti-diabetic effect of EDB may be due to inhibition of dietary sugar and fat absorption from the GI tract.9

Some evidence suggests polyphenols from several berry fruits can inhibit digestive enzymes which are responsible for the hydrolysis necessary for absorption of dietary lipids and carbohydrates.10

Zielinska-Wasielica et al. cited the following in their study published in August of 2019:

Results of the study indicate that Sambucus nigra fruit extract may offer substantial preventive and therapeutic potential for the treatment of obesity and obesity-related disorders, accompanied by oxidative stress, inflammation and insulin resistance. Moreover, the extract can inhibit digestive enzyme activity, and consequently, significantly reduce the intestinal absorption of dietary lipids and carbohydrates, which is an effective strategy for the prevention and treatment of obesity and metabolic comorbidities.11

Contraindications

No contraindications to elderberry have been identified.

Side Effects

Consuming uncooked leaves, stems, or berries can lead to cyanide toxicity, which may cause vomiting and diarrhea. Commercial preparations generally do not cause adverse effects at prescribed dosages.

Pregnancy and Lactation

I do not recommend taking an elderberry supplement if you are pregnant or breast feeding as there are not enough studies confirming safety in infants and small children. For this reason, I recommend reserving the use of elderberry supplements to those over the age of eighteen.

Elderberry Drug Interactions

Although drug interactions with elderberry are not well-documented, exercise caution when taking the following:

  •  Insulin
  •  Blood pressure lowering   medications  Chemotherapeutic agents
  •  Laxatives
  •  Theophylline
  •  Caffeine (Elderberry may   inhibit the enzyme that   metabolizes theophylline   and   caffeine). 12
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Our Elderberry Product

Sunshine Nutraceuticals has a brand-new elderberry product that contains 600 mg of elderberry extract per capsule. This supplement is designed to be taken twice daily 20-30 minutes prior to a meal with eight ounces of water. I DO NOT recommend taking this product if you are pregnant, breast feeding or under eighteen years of age. If you have a known medical condition, consult your physician or pharmacist prior to taking supplements containing elderberry.

Michael Brown pictured with Final Thought written

I expected to find a lot of information on elderberry for the treatment of colds and flu. After all, this is why many utilize this supplement and praise its effectiveness. What I didn’t expect was that elderberry has positive effects on diabetes, insulin resistance, and inflammation. We all know about the positive effects of blueberries as an antioxidant. It appears elderberries are not just good as a flavoring agent

and food source, but also possess medicinal properties beyond treatment of upper respiratory tract infections. As with all nutraceuticals, more studies are needed to determine the exact mechanism of action of the benefits of the elderberry. In the future, we may be able to isolate the active compounds from this plant, and use it not only to treat colds and the flu, but to prevent cancer, help fight insulin resistance, and more.

I firmly believe that, as a society, we under-utilize the natural substances provided to us in favor of chemicals which may help treat diseases but not without serious side effects. If we eat right, exercise, and spend time concentrating on our health, we may be able to avoid ingesting harmful chemicals. I know this sounds odd coming from a pharmacist, but this is the conclusion I have come to. Prescription drugs are absolutely necessary in some circumstances, but with the right lifestyle, we can limit our exposure to them.

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Lemon Mist Cheesecake

Initial Ingredients

Lemon is one of the favorite flavors in our house. I use lemon for all different kinds of food but cheesecake is a guilty pleasure that I allow myself to eat on special occasions. The nice think about this recipe is it has very few ingredients. This can be assembled fairly quickly but it does have to bake for almost an hour. You then have to let it cool and refrigerate it for several hours prior to serving.

I always set out all of the ingredients needed prior to cooking or baking anything. I do this primarily to be sure I have everything I need before starting. It is a real drag to get halfway through a recipe and discover you are missing a key ingredient. In this recipe, all ingredients are key.

Preheat your oven to 325 degrees F.

The first step is to prepare the crust. Place 25-30 lemon wafer cookies into a food processor and turn them into crumbs as shown. Add 1/4 cup of melted butter and mix until well blended. Press into the bottom of a greased 9-inch springform pan and place in the freezer while preparing the filling.

To prepare the filling, process the cream cheese and sugar in a food processor until smooth. Add the eggs one at a time and scrape the sides of the bowl. Add the lemon juice, lemon zest, and vanilla until blended.

Pour the filling into the frozen crust. smooth mixture evenly in pan. Place the cheesecake into a turkey bag and place it in a large roasting pan containing approximately 3 inches of preheated water. Be very careful when placing the cheesecake into the water bath. This is the best method I have found to keep the cheesecake from cracking. If you aren’t worried about this, you can bake the cheesecake without the water bath. Bake in a preheated 325-degree oven for 55 minutes or until the center of the cheesecake jiggles slightly when the pan is tapped.

Remove cheesecake from the water bath and place on a wire rack to cool for two hours. Be VERY careful when removing the cheesecake from the water bath. Take your time to avoid getting burned. After the cheesecake has cooled, cover with plastic wrap and place in the refrigerator for at least six hours prior to serving.

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Lemon Mist Cheesecake

Best Lemon Cheesecake
Prep Time30 minutes
Active Time55 minutes
Total Time1 hour 25 minutes
Course: Dessert
Keyword: cheesecake
Yield: 10 Servings
Author: sunshineneutraceuticals
Cost: $14

Equipment

  • Spring Form Pan
  • Plastic juicer
  • Large Roasting Pan for Water Bath
  • Oven turkey bags
  • Food processor with a metal blade
  • Wooden Spoon
  • rubber spatula
  • Knife for slicing lemon

Materials

  • 1 1/2 cups Nilla Lemon Cookies
  • 1/4 cup Unsalted melted butter
  • 3 eggs, Large
  • 1 cup Granulated sugar
  • 4 8 oz Cream cheese, softened
  • 1 lemon
  • 1 tsp vanilla extract

Instructions

  • Collect all necessary ingredients needed to make the cheesecake.
    Ingredients for lemon mist cheesecake
  • Place 25-30 lemon Nilla Wafer cookies into a food processor fitted with a metal blade.
    lemon cookies in food processor
  • Process the cookies until fine crumbs form.
    lemon cooke crumbs
  • Place 1/4 cup unsalted butter in microwave and heat until melted. Add melted butter to cookie crumbs. Mix until blended.
    1/4 cup butter
  • Press cookie crumb mixture evenly into the bottom of a 9-inch greased springform pan and place it into the freezer.
    cooke crust
  • Clean out the food processor bowl and add the cream cheese and sugar into the clean bowl. Process until smooth.
    cream cheese and sugar
  • Add cracked eggs one at a time mixing until just blended.
    3 cracked eggs
  • Zest one lemon, cut it in half and juice it using the hand juicer.
    lemons and juicer
  • add the lemon juice, lemon zest, and vanilla to the cream cheese mixture and mix until just blended.
    lemon zest and juice of one lemon
  • Pour final cheesecake mixture evenly into frozen crust.
    cheesecake prior to baking
  • Place cheesecake into a turkey oven bag. Place this into a preheated water bath and cook in a 325 degrees F oven for 55 minutes or until the center of the cheesecake just jiggles.
    cheesecake in turkey bag
  • Carefully remove the cheesecake from the water bath and place on a wire rack to cool for two hours. Cover with plastic wrap and refrigerate for at least six hours prior to serving.
    cooked cheesecake

Michael Brown in Lab Coat with arms crossed
Michael J. Brown, RPh, BCPS, BCPP
Owner Sunshine Nutraceuticals

The Cyclical Ketogenic Diet and Beta-Hydroxybutyrate (BHB) Salts

The ketogenic diet is one of the most popular weight-loss strategies today because those who stay on the diet are able to lose weight and keep it off.   It works by limiting carbohydrates.  The traditional ketogenic diet consists of approximately 75% of calories as fat, 20% as protein, and only 5% carbohydrates.  This results in a daily carbohydrate intake of around 50 grams.  With the amount of carbs being limited, the body becomes more efficient at breaking down fat into ketones for energy.

The body uses two main sources of fuel; glucose and ketones.  Glucose is obtained when the body breaks down carbohydrates including sugars.  The energy obtained from glucose makes one feel energetic initially but often leads to “crashing” soon after, causing hunger and weakness.  If more carbohydrates are ingested than can be used by the body, the excess is stored as glycogen in the muscles and liver.  When glycogen stores are full, the excess glucose is stored as fat.

If there isn’t enough glycogen or glucose available to provide energy, ketones are utilized.  This energy source is steadier and doesn’t lead to cravings or the crash that often occurs with glucose.   The traditional ketogenic diet is not without adverse effects.  Two of these side effects are discussed below.

 

The Keto Flu

The keto flu can happen during the first couple weeks of starting the diet.  This is your body’s response to changing from glucose to ketones for energy.  The keto flu symptoms are:

  • Nausea
  • Stomach cramps
  • Chills
  • Muscle cramps or aches
  • Irritability
  • Sore throat
  • Poor sleep
  • Trouble concentrating

 

These symptoms typically start twenty-four to forty-eight hours after beginning the diet.  The more your diet was previously high in refined sugars and carbohydrates, the more severe these symptoms will likely be.

Keto Breath

Another common side effect of the keto diet is keto breath.  This “bad breath” symptom will be experience by most people who put their body into ketosis.   It can occur during the first week and is the result of acetone being released from the body.  This side effect is often accompanied by a metallic taste in the mouth and should go away when the body becomes accustomed to being in ketosis. Until this happens, there are some steps that can be taken to help with this pesky problem.

  • Carry Breath Mints: You may not be able to get rid of the acetone on your breath, but you can mask it with breath mints. Sugar-free mints are preferred.
  • Drink More Water: Drinking more water causes more ketones to be released from the body in the urine resulting in less elimination by breathing. Drinking water has other health benefits as well that I have discussed in previous posts.
  • Brush Teeth Frequently: This is another simple strategy to help keep your breath fresh.

The Cyclical Ketogenic Diet (CKD)

The cyclical ketogenic diet is a variation of the ketogenic diet where you follow the 50 gm/day carb diet for 5-6 days per week followed by a higher carb diet for 1-2 days.  This variation is a popular tactic for those trying to build muscle and improve exercise performance as the higher carb days or “refeeding days” replete glucose reserves.  This is important as glycogen is what the body uses for energy during workouts.  These “carbohydrate days” will give your body the glucose it needs during workouts while reaping the benefits of ketosis.

This type of diet has many benefits.  If you don’t ever get to eat carbohydrates, you may feel deprived of some of your favorite tasting food.  The CKD allows you to enjoy these foods one or two days per week.  The body needs carbohydrates to function properly and carb loading keeps the body functioning smoothly. 

The microbiome of the gut will be healthier if you eat more carbs.  This leads to a better functioning gut-brain axis which provides several benefits.   

The keto flu and keto breath are usually less severe with CKD. 

It is important to be selective in the carbohydrates you consume during the CKG.  Try to eat fruit, lentils, sweet potatoes, rice and oatmeal, limiting fat intake during your carbohydrate days.  This is important as the body is only able to utilize one energy source at a time.  Since glucose is the preferred energy source, excess fat consumed during these days will be stored as body fat.  The goal should be to burn all of the glycogen consumed during the refeeding days so ketones are used as energy the rest of the week.

 

One Benefit of CKD - A Higher Level of Anabolic Hormones

Testosterone

 

Testosterone is one of the most important hormones for muscle growth.  A high fat diet increases the concentration of testosterone in the blood.  It has been shown that diets with less than 20% fats can inhibit testosterone production.  This is especially true when compared to diets containing 40% fat. 1

A study by Wang et al. showed a low-fat diet decreased testosterone levels by 12%. 2

A low fat diet decreases the level of testosterone in the bloodstream which, in turn, may lead to a decrease in muscle-building capability.

 

Growth Hormone

Growth hormone (GH) also known as somatotropin or human growth hormone (HGH), stimulates growth and the reproduction and regeneration of cells.  Low levels of this hormone may increase risk of disease and increase body fat. 3

Carbohydrates and sugar increase insulin levels.  More insulin leads to less HGH so reducing carbohydrates in the diet may help to increase human growth hormone. 4

5

 

Insulin-like growth factor 1 (IGF-1)

The deficiency of Insulin-like growth factor 1 (IGF-1) is associated with metabolic syndrome.  Metabolic syndrome leads to insulin resistance, increased glucose levels, impaired lipid profile, cardiovascular disease and obesity.  All of these effects are undesirable.  The ketogenic diet increases IGF-1 which may lessen the chances of contracting metabolic syndrome and the negative effects described above. 6

A Great Supplement For Keto Dieters

If there isn’t enough glycogen or glucose available to provide energy, ketones are utilized.  This happens even when we consume a regular diet during the night as we sleep.  As mentioned above, this energy source is steadier and doesn’t lead to cravings or the crash that often occurs with glucose.  There are three ketone bodies.  These are acetoacetate, BHB, and acetone.   Beta-hydroxybutyrate is a great energy source when eating a ketogenic diet.  When glucose is limited, mental concentration can be negatively affected. 7

BHB salt supplements can be used when energy levels are low while on the ketogenic diet. 

Michael Brown pictured with Final Thought written

The ketogenic diet has become very popular.  This diet works by forcing the body to break down fat for energy.  For those who work out, the cyclical ketogenic diet is likely a better option.  This diet allows for one to two days per week of carbohydrate loading to build up glycogen stores for quick energy supply during physical exertion.  It is important to eat “clean” carbohydrates rather than junk food.  Remember when carb loading to avoid too many fat calories because the body can only utilize one energy source at a time.  Finally, consider utilizing BHB salts for energy during the beginning of your keto diet and anytime you feel sluggish.  This supplement can get you over the hump without resorting to eating too many carbohydrates.  If you have any questions regarding the ketogenic or cyclical ketogenic diet, please feel free to contact me.  If I don’t know the answer to your question, I will research it and get back to you as soon as possible.  Thank you for reading my post.

 

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Ashwagandha Withanolides: Uses, Side Effects, and Contraindications

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Ashwagandha, or Withania somnifera is an evergreen shrub that grows in hot, dry climates.  This herb is very popular in India and the Middle East.  The shrub produces small greenish-yellow flowers as well as fleshy fruit which is orange-red when ripe.  Ashwagandha is sometimes called “winter cherry”.

Ashwaghanda has been utilized in Ayurvedic medicine.  This “whole-body” healing system was developed in India more than 3000 years ago.  It is used as a Rasayana which is an herbal or metallic substance that increases happiness and helps promote a youthful mental and physical condition.  Withania is the most prominent ayurvedic Rasayana herb and is given to small children as well as middle-aged and elderly in hopes of increasing longevity. Ashwagandha supplements are most commonly recommended for energy enhancement and to boost exercise performance. 1

Withania somnifera contains a group of pharmaceutically active steroidal lactones known as withanolides.  These withanolides are believed to have many positive medical effects including antimicrobial, anti-inflammatory and anti-cancer properties. 2

The word ashwagandha translates to “smells like a horse”.   It not only smells like a horse but is also thought to give those who ingest it the power of a horse.  Ashwagandha is also known as Indian ginseng, even though it is generally used for its calming and anti-stress properties whereas ginseng supports energy and stamina. 3

Ashwagandha and Cognition

Cognition is a complicated process and is performed by our brain.  It includes thinking, communicating, problem solving, memory, judgement, processing information from our senses and more.   It is not surprising that many are interested in obtaining substances which improve cognition.  These substances are known as nootropics.  As we get older, our cognition tends to decline.  A study by Sing-Manoux et.al found this decline often begins between 45 and 55 years of age. 4

A double-blind, placebo-controlled study was performed on a group of subjects with mild cognitive impairment (MCI).  This is a state between normal cognitive aging and dementia.  These people have memory deficits but not to the extent that activities of daily living are adversely affected.  A total of fifty adults were randomized to receive either 300 mg Ashwagandha root extract in capsule form, twice daily, for eight weeks or a placebo. 

The researchers concluded that “Ashwagandha (Withania somnifera) may be useful in enhancing immediate and general memory, executive function, attention, and information processing speed in people with MCI, with few adverse effects.” 5

The Anxiety Formula available in our Sunshine Store contains Ashwagandha.  This is a supplement I consume daily to keep me focused and to clear my mind.  I have had great success with this supplement and have had no adverse effects occurring with its use.  You can order this supplement by clicking the box shown below.

Ashwagandha and Obsessive Compulsive Disorder (OCD)

Obsessive compulsive disorder (OCD) is a mental illness where the patient to suffers from obsessive, intrusive thoughts.  These thoughts may lead the patient to clean continuously or constantly check light switches to be sure they are off, etc.  This disorder can cause distress to the point that it affects daily functioning.   Selective serotonin reuptake inhibitors (SSRIs) are the medications most commonly used for OCD.  Unfortunately, SSRIs are only mildly effective in treating OCD. 6

7

8

9

A study conducted in 2016 showed Ashwagandha was more effective than placebo in improving Y-BOCS scores in patients with a diagnosis of OCD.  Y-BOCS is the standard test for assessing the frequency and severity of OCD symptoms.  Thirty patients were randomized into two groups and Y-BOCS scores were evaluated in both groups at baseline and after six weeks of treatment.  The treatment group received an evaporated root extract of Ashwagandha obtained from Iran.  Each capsule contained either 30mg of root extract and lactose to a total weight of 250mg, or lactose only (placebo).  The treatment group had Y-BOCS scores improve by 8 units, whereas the placebo group only improved by 2 units.  This was a statistically significant difference. 10

Ashwagandha and Blood Sugar Levels in Schizophrenia

I work as a psychiatric pharmacist so I am concerned about the effects of antipsychotic agents on blood sugar.  A small study was published in the Indian Journal of Pharmacology in 2013.  This study was designed to assess the ability of Ashwagandha to decrease blood sugar levels in schizophrenic patients who were receiving second-generation antipsychotic medications.

This study found a significant improvement in both fasting blood glucose and serum triglyceride levels in the Withania group as compared to the placebo group.  More studies with a larger sample size are needed to establish safety and efficacy of this treatment option. 11

Ashwagandha for Pain and Inflammation

Pain relief has become more difficult in the wake of the opiate crisis.  Many physicians are not willing to prescribe opiates for chronic pain due to the recent guidelines which recommend against this practice.  Unfortunately, other drug classes, such as non-steroidal anti-inflammatory agents (NSAIDs), also can be detrimental, especially if taken over an extended period of time.  Pain can be debilitating for some. It can lead to problems sleeping, decreased mood, and reduced work performance.

A study was performed to see what effects a single 1000 mg dose of Withania somnifera would have on mechanical pain.   In this study a device was set up to measure pain threshold as well as pain tolerance force and time.  The researchers found Withania somnifera increased pain threshold and pain tolerance force and time as compared to placebo.  No adverse effects were reported in this study. 12

W. somnifera has also demonstrated analgesic and antipyretic effects in rat models. A study was done comparing Ashwagandha root powder to indomethacin. This study showed the root powder was able to curb the inflammatory response without causing damage to the GI tract of the rats. 13

 

Ashwagandha for Stress, Anxiety and Cortisol Levels

Ashwagandha is probably most known for its effects as an adaptogen.  These substances (adaptogens) are able to help the body combat physical, chemical, and biological stress.  A study published in 2012 included 64 people who had a history of chronic stress.  These subjects were randomly assigned to two groups.  The treatment group received 300mg Ashwagandha root extract in capsule form twice daily for 60 days.  The other group, placebos.

On day 60, the treatment group displayed a significant reduction in all stress assessment scales relative to the placebo group.   Serum cortisol levels were also substantially reduced in the treatment group.  Cortisol is the body’s main stress hormone.  Increased cortisol levels can be an indication of increased stress. 14

Ashwagandha as a Cancer Treatment

Scientists have been searching for a cure for cancer for many years.  Most of the medications available to treat various cancer types come with a long list of life-changing side effects.  Ashwagandha root extract was first shown to decrease cancer incidence experimentally in vivo in 1967. 15

This has led to an increasing interest in Withania for both cancer treatment as well as prevention.

We know that the carcinogenic process is prolonged.  Is there a way to prevent cancer?  In 1976, the idea of chemoprevention was presented by Michael Sporn. 16

The definition of chemoprevention is the use of natural, synthetic, biological or chemical agents to reverse, suppress, or prevent the process of carcinogenesis.  This has become an increasingly popular area of research.  Natural substances and nutraceuticals are getting a closer look.  Sulforaphane derived from vegetables such as broccoli for prostate cancer and turmeric for colorectal cancer prevention are examples of studies currently under way.

Breast Cancer

A study using mice that were predisposed to developing breast cancer showed a 33% reduction in tumor formation when being fed a diet containing 750mg/kg of Withania root extract for 10 months. 17

Hepatocellular Cancer

Cancer of the liver is aggressive and has a poor response rate to traditional cancer therapies. 18

A study, published in the Journal of International Medical Research in 2018, concluded the water extract of Withania somnifera is a powerful antioxidant and has anticancer effects on HepG2 cells.  They suggest it may be a favorable treatment for hepatocellular carcinoma and should be confirmed in animal studies. 19

There are barriers to using Withania for chemoprotection.  This plant only thrives under specific environmental conditions and is relatively slow growing.  There is also variability in the alkaloids and withanolides produced by each plant, as well as different parts of the plant (leaves vs roots).  This variability requires standardization of the active components of the preparation.  Care must also be taken to not over-utilize fertilizers and pesticides when growing Ashwagandha. 20

Ashwagandha Contraindications

Although Ashwagandha is considered safe for most individuals, there are three groups of people who should avoid it. 

  • Those with hormone-sensitive prostate cancer: Ashwagandha may increase testosterone levels, therefore, it should not be consumed by these patients. 21
  • Those who take benzodiazepines, barbiturates, or anticonvulsants: Ashwagandha may have a sedative effect, as well as effects on GABA, so it should not be used in these patients. 22
  • Pregnant women: Ashwagandha may induce abortion at higher doses. 23

Ashwagandha Side Effects

Ashwagandha has very few side effects when utilized in normal doses.  A study using Sprague-Dawley rats did show some sedation, ptosis and ataxia 15-20 minutes after administering Withania but this was a very large dose 1-2g/kg. 24

Michael Brown pictured with Final Thought written

Ashwaganda is one of the most prized herbs used in Ayurvedic medicine.  This herb contains many substances, including withanolides, which seem to be effective for a wide range of ailments. 

Ashwaganda has been shown to possess chemopreventive as well as chemotherapeutic properties.  Research is being done to assess its use for the prevention and treatment for certain types of cancer.  Ashwagandha has been used for thousands of years in India for its calming and anti-stress effects. 

There is also some evidence to suggest Ashwagandha can improve cognition, help with pain and inflammation and lower blood sugar levels.

This herb may also have a positive effect on certain neurogenerative diseases such as Alzheimer’s disease, Parkinson’s disease, and Huntington’s disease. 25I believe Ashwagandha is a valuable herb which will be more widely utilized as information from clinical trials becomes available.  This herb has few side effects and is well tolerated.  It is one of the ingredients in the Sunshine Sleep Aid as well as our Anxiety Formula, and I also have a single ingredient Ashwagandha product as well.

Please contact me with any questions.  This has been a complex subject to research and there is much more to learn.  It does give me hope for the future of cancer treatment in the United States.  As always, live a happy, healthy life and most of all, stay happy!

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Blissfulness – My Secrets To Happiness

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Is there a secret to happiness?

Why am I always sad?

What can I do to improve my mood?

Is there hope for a happy tomorrow?

We all want to be happy. There is no emotion more sought after than happiness. It is surprising to me that, although we all want it, most of us do not take the time to research ways to obtain happiness. What if I told you it isn’t that hard to achieve? I am going to ask you to read this post, commit to trying some of the simple exercises outlined, and spend some time each day working on your happiness.   

 

I made happiness one of my New Year’s resolutions a few years back. I bought some books, read them, and tried to make Mike a happier person. It was well worth the effort. It has been life-changing for me.   

My goal is to make all of my readers happier and healthier. I hope you enjoy what you are about to learn. 

Practice Mindfulness

Start to be more conscious of your surroundings. Enjoy the beauty of nature and pay attention to the pleasant colors and smells you encounter during the day. Smile as you realize how blessed you are to be part of this gorgeous planet. Be aware of your surroundings without judging. 

 

Spend more time concentrating on the positive aspects of your day. Take a few minutes each day to focus on your breathing. Use this time to relax and relieve any stress you may be feeling. Be aware of your senses by watching a bird in flight, feeling the warmth of the sun on your face, tasting and appreciating fresh water.

 

Being mindful helps put things in perspective. It may help change the way you think. Make it a priority to practice this several times daily. Set the alarm on your phone to remind you. This is the first step to the new you! 

Re-Frame Perceived "Negative" Circumstances and Smile

Have you heard the quote 

 

“If it won’t matter in five years, don’t spend more than five minutes being upset about it”?

 

This little tidbit can save you from countless hours of frustration and decreased mood. There are many things beyond our control. I used to get very upset about traffic and, to be honest, still do at times. I have tried to start using this time in a positive way. 

 

You can, too, by listening to your favorite song or downloading some books to listen to. Always remember, things could be a lot worse. If you can turn negative situations into positive ones, happiness will be more plentiful in your life. 

 

If you have no control over what is happening to you, try to find a positive spin to it. This can take practice, but it can improve your level of happiness.  

 

Force yourself to smile in times of sadness. This helps in two different ways. First, your brain perceives you as being happy when you are smiling. Secondly, people who are around you will tend to smile back. This helps reinforce a positive mood. Try it, smiling works! 

Eat Whole Foods

The main thing I learned while on the Whole30 diet was that if you eat only whole foods, you will feel much better. Your diet has more to do with how you feel than you might think as it can affect your entire body in many ways. If you read my post on the Gut-Brain Axis, you already know how important this is. 

 

I am not advocating staying on a restricted diet such as the Whole30 forever, but try to consume more whole foods and less processed foods. Stay away from fast food, drink a lot of water, and try to get several servings of fruits and vegetables each day. A little planning goes a long way. 

 

You really are what you eat in more ways than one. If you want to know how much better you can feel, try the Whole30 diet. It is not easy but will give you an appreciation of how better eating choices can improve various aspects of your life. I highly recommend the Whole30 experience! 

Happiness Elements

I have written about happiness elements several times. We are all different. What makes me happy likely will not make you as happy.

 

I am going to give you a simple exercise. Take some time to think about the five things that make you the happiest. These can be people, places, activities, etc. Do not list material things on this list.

 

After you have identified your five happiness elements, devise a strategy to spend more time experiencing them. This one small activity can boost your mood. The more time you spend with the elements that make you happy, the better! This seems simple, but many of us don’t take advantage of it.

 

Most of us are happy spending time with the people and pets we love. Dogs, especially, will give you unconditional love. They can make a difference in your mood. I believe strongly in this process as it has helped me in my quest for happiness. 

Surround Yourself with Positive, Happy People

If you can avoid hanging out with pessimistic, negative people, do it. The negativity will rub off on you.

 

We have all worked with this type of person. Everything is terrible, complaints never stop, and they wear you down.

 

If you do have to work with this personality type, remind them that their life isn’t that bad. Better yet, if they are that unhappy, maybe they should be doing something else. Life is too short to be miserable.

 

Perhaps you can be the catalyst that makes them change for the better.

 

It is known that optimists are happier than pessimists. It is possible to change your mindset to become more optimistic. Optimists also live longer. Always try to find the positive aspects of a situation.

 

When you start feeling pessimistic, practice the mindfulness techniques described above. It takes some work, but you can make yourself happier! 

Start A Gratitude Journal

One of the best perks of working on a psychiatry unit is getting tips from therapists. These professionals are always able to come up with a solution to any problem you might be facing. I was recently reminded of the benefits of a gratitude journal. Just thinking about the things you are grateful for can change your mood.

 

Each night before bed, write a few things in your journal that you are thankful for. This is also a good thing to discuss at the dinner table. Go around the table and have each person talk about something they were grateful for that day. Concentrating on the positive aspects of your life is a great mood booster.   

Money Only Takes You So Far

Studies show that money only increases happiness until you reach about $75,000 per year. This is likely because once basic needs are met, material things only make people happy for a brief period.

 

Many individuals who win the lottery fall back to their baseline happiness level within five years.

 

Most people believe being rich will make them happy but the studies do not support this notion. Think about how you felt when you bought a new car. It feels great at first, but over time, it is just a car. Read this sentence carefully;

 

 Money does not make you happy! 

 

There is an exception to this. If you give money to an organization you believe in, this can make you happy. More money only increases happiness after a point if you give it away!

 

Do not be fooled by the marketing of the large companies brainwashing you into thinking you need “stuff” to make you happy. Possessions lead to clutter, which increases anxiety! 

Help Those less Fortunate

Early in my career, I worked as a nuclear pharmacist. Our boss liked to hire delivery drivers that were retired. One of these drivers was born with no legs so he used ones made of wood and got around the best he could.

 

One summer day after work, I was walking to my car and saw this driver laying on the ground trying to change a flat tire on his car. His hair was all messed up, and his face was sweaty and dirty. Even though I was in a hurry, I had to help. I changed the tire for him. He was delighted with the help and thanked me many times.

 

I remember how that small act of kindness made me feel great. There is something about helping others that makes me happy. 

 

I think this is the main reason I enjoy working in healthcare. Not a day goes by that I don’t feel like I helped someone less fortunate than I. You don’t have to work in a hospital to do this. Make it a point to help someone daily. Something small like giving them directions, buying them a cup of coffee, or just asking how their day is going can make a wonderful difference in both your lives.   

Find a Job You Love

We spend a lot of time working and if you hate your job, being happy is going to be difficult. Remember, money only takes you so far on the happiness scale.

 

I love being a pharmacist. It is mentally challenging, and I help people daily. I work with psychiatric patients who have a difficult life. Many have dementia and assisting this population makes me feel good. 

 

My wife loves to stay at home with our kids. She enjoys taking them to ballet, basketball, horseback riding, and whatever activities they choose to be involved in. She is much more social than I am and likes to visit with the other parents. She would not do well with my job, and I would not do well with hers. We are two different people who enjoy various activities.

 

Even if the pay isn’t as good, find a job that makes you feel good. If you think you need more money, revisit the section on money above! 

Love Yourself

We were all put on this earth for a reason.  Look in the mirror each morning, and appreciate what you have to offer.  Self-esteem is a big part of happiness.  Others like to be around positive, confidant people.  Tell yourself that today is going to be a great day and do everything you can to make that happen.  Remember, optimism is one of the keys to happiness.  You are an awesome person and deserve to be happy.  Keep telling yourself this.   

 

Exercise and Stay in Shape

Keep yourself physically fit. Find an exercise routine you enjoy and stay active. You may enjoy playing tennis or racquetball, swimming, weight lifting, running, or basketball.

 

Exercise will release endorphins, which will improve mood. Staying in shape also enhances your view of yourself. If you are unhappy with your body, you are unlikely to be happy in general. You don’t have to look like a supermodel, but being in shape makes you feel better and improves overall health.

 

If you pick a form of exercise you enjoy, you are more likely to stick with it.   

Sunshine Store

Visit The Sunshine Store For Your Vitamins And Supplements

Unplug!

This is something I need to work on. If you can spend less time on electronic devices, and more time interacting with people in the oldfashioned way, you will likely be happier. Schedule some time each day to turn your cell phone, iPad, or tablet off and interact with your family and friends. Write a letter, read a book, exercise, take a walk. The world will still be there when you turn your phone back on. Many of us have become addicted to our electronics.   

Read My Anxiety Post

The last thing I am going to ask you to do is read my post on anxiety. Pay close attention to the section on thinking errors. This is one of the fastest, easiest ways to improve mood. Thinking errors will cause your mood to deteriorate. Once you learn how to detect thinking errors and practice dealing with them, you can train your mind to think differently. Follow the instructions in the anxiety post to train your brain to squash thinking errors. 

Michael Brown pictured with Final Thought written

Happiness is one of my favorite topics. I have spent many hours reading about it, talking about it, and trying different techniques to improve my mood. For me, spending some time alone, visiting the beach, and going to concerts are some of my happiness elements. Visiting the beach with my wife is my favorite.

 

I also enjoy spending time with my family, writing, playing music, and cooking. Helping people gives my life purpose. Caring for the poor and vulnerable is what I believe I was put on the earth to do.

 

I want to warn you that if you feel depressed often, don’t have energy, have problems sleeping or sleep too much, cry more than usual, or think about hurting yourself, you need to visit your physician.

 

Although this post is meant to help people live a happy life, depression is real and, at times, needs to be treated by a professional.

 

If you think you might be depressed, get help. Mood disorders are no different than any other disease. There are people who specialize in helping those who suffer from depression. 

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

Probiotics Gut-Brain Axis and Psychiatry

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Is it possible to treat mental health disorders by altering bacteria in the gut?

 

What is the Gut-Brain Axis?

 

Can the drugs we use to treat psychiatric disorders make patients worse by altering the bacteria living in the gut?

 

There have been many articles and studies published recently discussing the possible connection between the microflora of the gut and the progression of neuropsychiatric disorders. The bacteria in the gut are affected by many factors, including age, diet, exercise, health, and genetics. Medications can also alter gut bacteria. This post will explore the possible effects of the gut microbiome on various psychiatric disorders. 

 

The Gut-Brain Axis

The Gut-Brain Axis is a network of nerves, hormones, and immunological factors connecting the central nervous system (CNS) to the Gastrointestinal (GI) tract. It appears that the gut flora are involved in this system. An imbalance in the function and composition of these intestinal bacteria is associated with many disease states. 1

The microbes in the gut contain genes that perform metabolic functions. The metabolites resulting from these reactions can produce local effects in the GI environment or gut wall. These microbial metabolites may also be absorbed into the systemic circulation and exert their effects on other organs, including the brain.

It is now known that there is bidirectional communication between the gut and the brain. This communication network is known as the gut-brain axis. 2

Altered microflora of the gut has been associated with depression, other mood disorders, and neurodegenerative diseases. 3

4

 

5

It is known that patients with GI diseases often suffer from mental health issues. 6

7

 

8

 

9

We also know that approximately one-third of patients with irritable bowel syndrome (IBS) have depression. 10

In patients with functional gastrointestinal disorders (FGIDs), 36.5% have comorbid psychiatric disorders. The most common of these are general anxiety disorder and panic. 11

Effects of Medications on Gut Bacteria

Psychiatric medications are known to disrupt the microbiome of the gut. 12

Second-generation antipsychotics, such as olanzapine, change the balance of intestinal bacteria leading to obesity.

Antidepressants such as selective serotonin reuptake inhibitors (SSRIs) may inhibit Staphylococcus and Enterococcus growth. 13

 

14

 

15

The Belgian Flemish Gut Flora Project found both benzodiazepines and antidepressants affected microbiology. 16

The classes of non-antibiotic drugs that have the highest antimicrobial activity are antidepressants, antipsychotics, and benzodiazepines. 17

 

18

 

19

 

20

The drugs we use to treat these psychiatric disorders may be making the conditions worse by altering the composition of the gut flora.

It may be possible to treat psychiatric disorders with living microorganisms. The goal would be to re-establish the healthy flora in the gut resulting in an improved gut-brain axis relationship. This is a difficult subject to study because once ingested; the living organisms are subjected to many negative environmental factors, including digestive enzymes, competitive microorganisms, and pH changes. Despite this difficulty, studies have been done, resulting in positive outcomes. 

Gut-Brain Axis and Autism Spectrum Disorders

Autism spectrum disorders are developmental disorders that affect communication and behavior. This is known as a spectrum disorder because there is a wide variety of symptoms involved. Patients with autism have a difficult time communicating, may not respond to their name, and often do not find enjoyment in activities others enjoy. They may also display repetitive, stereotyped behaviors.

The exact cause of autism is not known, but children with ASD often suffer from GI symptoms that correlate with the severity of their disorder. Several studies have reported altered gut bacteria in patients with autism.    

A treatment protocol using a fecal transplant was administered to 18 children with ASD (ages 7–16 years). The protocol started with two weeks of antibiotics, followed by a bowel cleanse. The children were then given an extended fecal microbiota transplant (FMT) using a high initial dose followed by daily maintenance doses for 7-8 weeks. 

At the end of treatment, there was an 80% reduction of GI symptoms, as measured by the Gastrointestinal Symptom Rating Scale. This included a significant decrease in abdominal pain, indigestion, diarrhea, and constipation. These improvements were still evident eight weeks after treatment. The behavioral symptoms also improved significantly and also remained eight weeks post-treatment. This procedure seemed to be effective for both ASD symptoms as well as GI symptoms and continued long after treatment was completed. 21

Gut-Brain Axis and Bipolar Disorder

One study showed that patients with bipolar mania were twice as likely to have taken a recent course of antibiotics. 22

It has been suggested that treating bipolar patients with probiotics could help reduce hospitalizations. A small study found treating acutely manic patients with probiotics led to a decrease in the readmission rate. Dr. Faith Dickerson randomized 66 patients to receive a probiotic capsule or placebo for six months after hospitalization for mania. The probiotic, or placebo, were given in addition to the regular medication regimens. Of these 66 patients, 24 or 73% required rehospitalization, while only eight (24%) of the probiotic group was hospitalized. The probiotic patients who were admitted also had a shorter hospital stay than those treated with a placebo.

The probiotics used in this study were Bifidobacterium lactis (bb-12), and Lactobacillus rhamnosus (LGG). These strains are also found in breast milk. 23 

 

 

Gut-Brain Axis and Major Depressive Disorder (MDD)

It has been shown that mice raised in a sterile environment (germ-free mice) have an exaggerated response to stress. This can be reversed by inoculating these mice with feces in their early development. 24

 

This suggests that gut microbial stimulation helps to shape healthy brain development during the early stages of life. 25

 

A review published in 2017 in the Annals of General Psychiatry concluded that treatment with probiotics might improve MDD symptoms. The mechanism is likely a combination of serotonin availability as well as decreased inflammation. More comprehensive studies need to be completed to determine the utility of such a treatment in depression. At the present time, there is likely no harm in supplementing antidepressant medications with probiotics. 26

Psychobiotics

Psychobiotics are substances that alter the bacteria of the gut. These may be live bacteria (probiotics) or prebiotics. Prebiotics are compounds that change bacterial composition or activity when fermented in the digestive tract. 27

In a study of 55 healthy volunteers, subjects received either fermented milk containing Lactobacillus casei Shirota, or a placebo for three weeks. The study subjects falling into the bottom third of mood scores showed significant improvement as compared to the placebo group. There were no overall changes in mood in this study, which may suggest Lactobacillus has a ceiling effect. In other words, people who are already relatively happy may not have an increase in mood after ingesting the probiotic. 28

It is important to note that not all studies have shown benefits regarding probiotics. A recent review found little evidence of positive outcomes from these substances. 29

 

Michael Brown pictured with Final Thought written

The Gut-Brain Axis is a fascinating topic that deserves much more research. I believe we can all benefit from eating a healthy diet, exercise, and possibly probiotic supplementation.

The evidence suggests that gut bacteria are vital in helping to develop the brain at a very early stage of human development. It is also evident that many of the medications we use to treat mood disorders such as depression, anxiety, and bipolar disorder, have an effect on the microbiome of the gut.

In the future, we may be able to either successfully treat these disorders with specific bacterial agents, or supplement the healthy flora destroyed by the medications we employ to treat these maladies.

I do know that I benefitted from eating a whole food diet during my Whole30 experience. My mood improved; I slept better and was more alert and happier in general. I can’t be sure this has anything to do with the microbiome in my gut, but it is certainly possible. I hope you have learned something from this post. If you have any questions, please feel free to reach out to me.

 

In the next post, I plan to write about happiness. This is something I have been looking forward to. I want to share my secrets for staying happy and improving your mood. I think you will all enjoy it.

 

Have a great day, and stay healthy!

 

 

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Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

White Chocolate Raspberry Cheesecake

White Chocolate Raspberry Cheesecake

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.


Initial Ingredients for the white chocolate raspberry cheesecake

White chocolate raspberry cheesecake is one of my favorite sinful indulgences. I try not to go overboard but for Thanksgiving this year I decided to make one. Above you will see all the ingredients pictured that you will need for this. The cheesecake takes some work, but it is well worth it. I have made many cheesecakes and will share some of my secrets with you as I go through the recipe.

Pans needed for the water bath to cook the cheesecake

The first secret is pictured above. I use a water bath to cook the cheesecake. As you can see from the picture, the springform pan fits into the roasting pan. This helps keep the cheesecake from splitting. I have tried several methods, and this works the best. As you will see later, I also place the cheesecake into a turkey-sized oven bag before placing it into the water bath. The keeps water from getting into the cheesecake.

oreo crust crumbs

The first step is to make the crust. This is super simple. I use double-stuff Oreos for my crust. I used 22 cookies. Pulse the cookies in a food processor as shown above. I then melt 2 tablespoons of butter in the microwave. Add the melted butter to the cookie crumbs and mix with the food processor.

Crust ready for the freezer

Pour the cookie crumbs into a springform pan and press them into the bottom as evenly as possible as shown above. Place the pan and crust into the freezer while you prepare the filling.

In a food processor or mixer, add the cream cheese, sugar, salt, vanilla, and lemon juice and blend for 30 seconds. Scrape the sides of the bowl and mix for another 10 seconds.

Add eggs one at a time and blend just to incorporate after each egg. Do not over mix.

Add 2 inches of water to a saucepan. Place a metal bowl with a lip into the saucepan as shown above to create a double boiler. Turn on low heat to melt the white chocolate chips. Be sure to continuously stir the chips until they are completely melted.

Add the sour cream to the melted white chocolate to cool the chocolate down before mixing it into the batter. Add the sour cream mixture and raspberries to the batter and mix until blended.

 

Cheesecake in turkey bag ready to bake

Place the cheesecake in the turkey bag as shown above. Add 3 to 4 inches of water to the large roasting pan. I pre-heat the oven with the roasting pan and water. When the oven reaches 400 degrees, add the cheesecake to the water bath. Be very careful when doing this, the water will be hot. Cook the cheesecake at 400 degrees for ten minutes. Turn the oven down to 350 degrees and cook for another 55 minutes.

baked cheesecake

Take the cheesecake out of the water bath and remove the turkey bag. Let the cheesecake cool before covering it with plastic wrap and placing it into the refrigerator to cool. I prefer to refrigerate the cheesecake overnight.

White Chocolate Raspberry Cheesecake

A sinfully delicious dessert the whole family will love.

Prep Time 45 minutes
Cook Time 1 hour 5 minutes
Total Time 1 hour 50 minutes

Course Dessert

Servings 10
Calories 682 kcal

Equipment

  • 10" X 3" Springform Pan
  • Reynolds Kitchens Oven Bag – Turkey Size
  • Food processor or large mixer
  • Large Roasting Pan for Water Bath
  • Measuring Cups
  • large saucepan
  • metal bowl with lip for a double boiler
  • Wooden Spoon
  • rubber spatula

Ingredients

  

  • 4 eggs
  • 3 pkgs Cream Cheese 8 oz.
  • 1/2 cup granulated sugar
  • 1/2 tsp salt
  • 11 oz white chocolate chips
  • 1 tsp lemon juice
  • 1 tbsp vanilla extract
  • 1.5 cups sour cream
  • 2 cups fresh raspberries

Instructions

 

  • Set out all equipment and ingredients to be sure you have everything needed. This is always a good idea to prevent a bad surprise during the cooking process. Preheat oven to 400 degrees.
  • For best results, use a hot water bath to cook the cheesecake. I use a large roasting pan, a springform pan and Reynolds turkey bags to keep water out of the cheesecake. I have found this to be the best process to keep the cheesecake from cracking. Add 3-4 inches of water to the roasting pan and place it in the oven while the oven is pre-heating. You can add more water after placing the cheesecake into the bath if necessary.
  • In a food processor, pulse the Oreo cookies into crumbs. Add 2 tablespoons melted butter and mix until incorporated.
  • Press crumbs into a springform pan evenly as shown. Place pan in the freezer while preparing the filling.
  • Add cream cheese, sugar, salt, vanilla, and lemon juice to a food processor fitted with a metal blade and mix until blended. Scrape sides of the bowl with a rubber spatula.
  • When well mixed as shown, add eggs one at a time, and mix just until incorporated. Do not overmix.
  • This is how the filling should look after the addition of the 4 eggs.
  • Set up a double boiler. I use a large saucepan with 2 inches of water. and a metal bowl with a lip that fits the saucepan. See picture.
  • Place the metal bowl into the saucepan, add the chocolate chips, and stir constantly. Use low heat to slowly heat the water.
  • When the chocolate is completely melted, stir in the sour cream (I do this to cool the chocolate and add the mixture to the filling. Add the raspberries and mix until incorporated. It is important to not over mix!
  • The final filling should look like the picture.
  • Pour the filling into the springform pan containing the cooled crust. Carefully place the pan into a Reynolds turkey bag as shown. Open preheated oven and place wrapped pan into the water bath. Be sure the bag is folded up so water can not get into it. Be very careful not to burn yourself during this step. The oven, water bath, and pan will be VERY hot. Cook at 400 degrees for 10 minutes. After 10 minutes, turn the oven down to 350 degrees and cook for another 55 minutes. The cheesecake should jiggle just a little when moving.
  • Carefully remove the cheesecake from the water bath and turkey bag. Turn oven off and let the water cool before removing it to prevent and accidental burn. The cheesecake will look like the picture. Let the cheesecake cool on the counter for about an hour. Place plastic wrap over the cheesecake and refrigerate overnight.

Keyword cheesecake, white chocolate raspberry cheesecake

I hope you enjoy one of my favorite desserts. Please let me know if you have any questions or comments.

Michael J. Brown, RPh, BCPP, BCPS
Clinical Pharmacist
Owner – Sunshine Nutraceuticals LLC.

Electroconvulsive Shock Therapy Indications, History, Side Effects and More

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

Electroconvulsive therapy (ECT) is a medical treatment performed under anesthesia most commonly used for patients with treatment-resistant depression and catatonia. A generalized tonic-clonic seizure is induced utilizing a small electrical current applied to the head. This seizure lasts from 30-60 seconds. 

ECT is the most rapid and effective treatment available for geriatric patients with psychosis, depression, or bipolar disorder, according to research studies.1

Many believe ECT to be the most effective treatment for depression for all patients. 

This procedure has been a topic of controversy ever since Ken Kesey released “One Flew Over the Cuckoo’s Nest” in 1962. This book was made into a movie in 1975 starring Jack Nicholson and depicted ECT and lobotomies as a method of torture utilized in psychiatric hospitals. This did not sit well with the counterculture movement.

ECT is one of the safest procedures performed under general anesthesia, with only two to four deaths per 100,000 treatments. This is likely because ECT is a short procedure.

History of ECT

The first convulsive therapy was performed in Budapest in 1934 using pentylenetetrazole (Metrazol). Metrazol was used as a circulatory and respiratory stimulant but caused seizures in high doses. It was useful for depression as a convulsant, but side effects and uncontrolled seizures limited its use. 2

Ladislas Meduna gave an IM dose of camphor to a patient who had been in a catatonic stupor for four years in 1934. It is reported that two days after his fifth injection on February 10, 1934, the patient got out of bed, requested breakfast, got dressed, and began to talk. 3

A psychiatry professor, Dr. Ugo Cerletti, induced convulsions by applying electricity directly to the brain at the University of Rome in 1938. Dr. Cerletti achieved success with this method in patients with schizophrenia. 4

In 1938, Cerelli gave the first public presentation on ECT at the Medical Academy of Rome. By 1943, ECT was being used in America. Initially, it was used for schizophrenia, but over time ECT was utilized to treat most psychiatric disorders. After several years, ECT became a common treatment for depression with psychotic features as well as severe mania.

Antidepressants first began to appear in 1958 when an anti-tuberculosis drug, iproniazid (Marsilid), started to be used off-label for depression. This drug was eventually removed from the market due to safety concerns.

 In 1959 imipramine (Tofranil) was approved by the FDA for major depressive disorder (MDD). This was the first tricyclic antidepressant (TCA).

Although the psychiatric community had high hopes following the invention of the TCA’s, these drugs were not 100% effective, and they were associated with side effects. The use of ECT decreased by 46% between 1975-1980, but ECT began to increase in popularity during the 1980s. In the United States in 1980, 2.4% of all hospitalized psychiatric patients received ECT treatment. 5

ECT Safety

As discussed in the introduction, ECT is a safe procedure. Recent studies have suggested depression is associated with a loss of gray and white matter in different parts of the brain. This neurodegeneration is more prevalent in patients with a more extended history of depression, untreated depression, and a larger number of depressive episodes. This suggests rapid treatment of depression as achieved with ECT can reduce the risk of neuropathologic changes. 6

Postmortem studies of ECT patients who had the procedure done with modern techniques do not show brain damage resulting from the ECT itself. 7

ECT for Behavioral and Psychological Symptoms of Dementia (BPSD)

BPSD is a reality for most dementia patients and their families. This is a common reason for hospital admissions. Symptoms of BPSD include agitation, aggression, disinhibition, apathy, depression, sleep and appetite changes. 

There are no medications approved for dementia besides the anticholinesterase inhibitors and memantine. These drugs slow the progression of dementia but usually have little effect on BPSD. We use antipsychotics to treat these behaviors. Antipsychotic agents all have significant side effects associated with them and an FDA boxed warning for increased mortality risk in elderly patients.

A retrospective chart review of sixty elderly dementia patients with BPSD receiving ECT for agitation was published on September 23, 2019. They found ECT to be safe in their population and very effective in reducing agitation and decreasing the psychotropic pill burden as well. There are other hurdles one must consider when utilizing ECT for dementia patients. The largest is that of consent. Most dementia patients are not able to agree with an ECT procedure.

 

ECT for Catatonia

Catatonia is a condition in which the patient has a significant decrease in their reaction to the environment. Catatonic patients are often mute, appear to be in a stupor, and may demonstrate negativism or motor rigidity. 

The initial treatment for catatonia is benzodiazepines. Many catatonic patients initially respond to IV lorazepam. The conversion to oral lorazepam dosing can sometimes lead to rebound catatonia in which the IV form may need to be reintroduced, or the oral dose increased. 

If the patient does not respond to a benzodiazepine in 2 to 3 days, or if the symptoms are particularly malicious, ECT is the best treatment option. Electroconvulsive therapy works synergistically with benzodiazepines and is beneficial in up to 80% of patients. 8

ECT in Clozapine-Resistant Schizophrenia (CRS)

Clozapine remains the drug of choice for treatment-resistant schizophrenia. Because schizophrenia is a chronic debilitating disease, it is crucial to find effective treatment methods. Clozapine is superior to other antipsychotics with regards to improved social functioning, symptom improvement, and reduction of hospitalization and mortality. Unfortunately, clozapine does not work for every patient. In 2018, Wang et al. evaluated the safety and efficacy of using ECT in addition to clozapine in the treatment of CRS. This meta-analysis showed adding ECT to clozapine was superior to monotherapy. The main adverse effects suffered in these trials were memory impairment (24.2%) and headache (14.5%). These side effects were mostly mild and short-lived. 9

ECT VS. Antidepressant Medications

The FDA performed a systematic review and Meta-Analysis of randomized, controlled trials examining the effectiveness of ECT in 2011. They came to the following conclusions with regard to ECT and antidepressant medication.

  • Immediately to one-month post-ECT, there is conflicting evidence that ECT is more effective than antidepressant medications.
  • One-month post-ECT, conclusive evidence shows ECT to be more effective than antidepressant medication. 

 

ECT Delirium

There have been cases of delirium reported after ECT treatments. After medical causes are ruled out, delirium may be effectively managed by changing to unilateral ultra-brief pulse ECT with a greater interval between treatment sessions. 10

Lithium is one of our best treatments for bipolar disorder. It is often used for treatment-resistant major depressive disorder (MDD.) There are times when it is beneficial to use Lithium and ECT together as the combination of the two seems to be more effective than either treatment alone. A study published in August of 2019 found that patients treated with lithium and ECT during an inpatient stay had an 11.7 fold higher risk of delirium than those being treated with ECT alone. 11

Lithium should only be used in conjunction with ECT for severe cases or when the risk of suicide is high to prevent delirium.

ECT and Cognitive Function in Major Depression

A paper published in the Journal of Affective Disorders in 2019, discussed a prospective study following twenty-seven depressed patients before, and two years after ECT. The purpose was to measure remission rates as well as any cognitive changes that may be caused by ECT treatment. 

They found improved neurocognitive function two years after ECT regardless of remission status. The remission rate reached 62.9% at two years. The relapse rate was low; 22% relapsed before the six-week follow-up, and 7.4% between six months and two years after ECT. 12

Although the ECT methods were not uniform in this study, and the sample size was small, the results suggest ECT is beneficial in the treatment of depression without negatively affecting cognitive function.

ECT and Age

A study was done to compare various aspects of ECT on three different age groups:

Young (18-45 years)

Middle (46-64 years)

Old (>=65 years)

A total of 402 patients were evaluated the day before ECT and one-week after. 

One week after ECT, the middle and old age groups showed a significant improvement in the Mini-Mental State Examination (MMSE) score when compared to baseline. Rates of response were not statistically different in the three groups. There was also no difference in premature drop-out rates.

This study concluded ECT was a viable treatment for elderly patients with treatment-resistant depression. Rates of response were near 70%, and no life-threatening adverse events occurred. 13

ECT Contraindications

 

  • Elevated intracranial pressure.
  • Recent myocardial infarction.
  • Heart Failure.
  • Severe Hypertension.
  • Pheochromocytoma.
  • Risk of bleeding.
  • Unruptured aneurysm.
  • Recent stroke.

Side Effects of ECT

  • Memory loss
  • Confusion
  • Nausea
  • Headache
  • Muscle Pain
  • Complications from Anesthesia
Michael Brown pictured with Final Thought written

Electroconvulsive therapy can be a life-changing procedure for many patients. For those who do not experience relief from antidepressant medications, ECT can be their last hope. It is also useful in treatment-resistant catatonia, dementia with BPSD, and clozapine-resistant schizophrenia. 

This procedure has undergone many improvements over the years. No longer do patients have to worry about broken bones caused by seizures. Today, psychiatrists utilize neuromuscular blocking agents which confine seizure activity to the brain. 

The studies support the use of ECT. I have personally viewed several treatments during my Pharmacy Directorship at a private psychiatric hospital in the late 1990s. The procedure is quick, mild, and most adverse reactions are the result of anesthesia. More importantly, ECT is an effective treatment for a vulnerable segment of our population.

As a society, it is our responsibility to take care of our mentally ill population. We should not have these patients living in tents on the side of the road in our major cities. Psychiatric patients are people like us who have a brain disorder. Remember, this can happen to anyone. Electroconvulsive therapy is not a punishment for bad behavior. It is an effective treatment for several debilitating conditions that are resistant to other, less invasive therapies.

If you have any questions or concerns, feel free to contact me. I will answer every message received.

Always strive to live a happy, healthy life.

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.

 

 

My Whole30 Summary

Disclosure:  This post may contain affiliate links, meaning, at no additional cost to you, I may earn a commission if you click on, or make a purchase through a third-party link.

What is the Whole30?
Should I try it?
Is it hard?
Will I lose weight?

Here is my Whole30 summary

 

I discovered the Whole30 while researching the best body detox plans for a recent blog post I was writing. I don’t like to make recommendations to my audience that I am not willing to try myself. That being said, I started the thirty-day program on October 15th, 2019. I was well aware that Halloween would be a bummer (no candy), but I wanted to do this. I set up a Google Doc on my phone and kept notes of what I ate and how I felt during the program. My starting weight was 188 pounds.

What is the Whole30

The Whole30 was created in 2009 by Melissa Hartwig. This is not a diet or a test of willpower, it’s a program designed to change the way you think about food. The basic premise is simple; some foods are not good for your body. Of course, many of these are the foods we crave the most. Eliminating all the “unhealthy” foods removes toxins from your body. Saying goodbye to the “sugar monster” is difficult at first, but as you will see, changes the way you feel. No fast food, no added sugar or sugar substitutes, and no cheese! This program changed the way I plan to eat going forward.


I have to admit I was skeptical.


What you will read in this post is what I went through during the thirty days. Some days were difficult. There was bickering at the dinner table. The kids missed “their food”. Don’t send me messages about child abuse, I did not make them stick to the program, but I didn’t make fancy Mexican and Italian dishes, either. Ashley looked at me one night and said, “I just want my food back”. These kids are not fans of fast food or restaurants, except sushi. They love daddy’s cooking.

Whole30 Rules

The rules seem very simple at first. The problem is there are almost no processed foods that don’t contain an ingredient you can’t have. You are much better off only eating fresh organic food. Fruits and vegetables will become your best friend. Here are the rules:

  • No added sugar or sugar substitutes of any kind. This includes honey and agave nectar.
  • No alcohol! This was the most natural rule for me.
  • No grains. No wheat, corn, rice, barley, oats, millet, quinoa, etc. This covers a lot of foods. I suggest referring to the Whole30 book for a complete list.
  • No Legumes. No beans, peas, chickpeas, lentils, or peanuts. That means no peanut butter. You can easily substitute almond butter or cashew butter — no soy of any kind or tofu, edamame, or tempeh. Soy sneaks into products almost as often as added sugar. Learn to read the labels.
  • No dairy. Another crushing blow to me. No cheese, milk, cream cheese, or sour cream. You can eat clarified butter, but I skipped it. I used olive oil and coconut oil for all of my cooking, a change I plan to continue.
  • No carrageenan, MSG, or added sulfites. Careful with dried fruits and sausage, be sure there are no sulfites added.
  • No junk foods or baked goods made with improved ingredients. This means you can’t make pancakes out of coconut flour. I will give you some suggestions for sweet snacks later in the post.
  • Do not weigh or measure yourself in any way during the program. Just before and after. This is to keep you from concentrating on your weight and missing other benefits.

Preparing for the Whole30

I am going to stress this step. Be sure you have an adequate supply of “Whole30 compliant” food in your house before you start. Do not try to wing it! I suggest stocking up on fresh fruits and vegetables, almonds, cashews, eggs, and other sources of protein. If you are vegan, you are in good shape, remember, no grains. There are a few bars you can use that I will get to later.

If you don’t prepare, you probably will fail.

One of the things we ate several times is various forms of curry. This is ideal because not only can you change up the vegetables, the turmeric in the curry is very good for your body. I suggest stocking up on curry powder.

Be ready to spend more time cooking and preparing meals. There are no drive-throughs in this plan. Give yourself an hour for dinner preparation each night. I will share ideas for meals later. My plan was to eat simple things during the day and make a healthy dinner at night.

Restaurants and the Whole30

My suggestion is to plan to stay away from restaurants for thirty days. We went out once, and it was extremely frustrating. There was almost nothing on the menu that fit the plan. It was a horrible experience and, if I do this again, I will prepare every meal myself. I am not a huge fan of restaurants anyway, so this isn’t a significant loss for me.

Whole30 Compliant Snack Bars

There are a few snack bars that are Whole30 compliant and I have listed a few here.  The most inexpensive ones I was able to find are pictured above.  Please note that all Larabars are not Whole30 compliant.  The ones listed above are fine but please read ingredients on anything processed prior to eating.

Some of the EPIC bars such as the one pictured are also Whole30 compliant.  Just a warning, this chicken one is spicy!  Be sure to check all labels because some I found had added sugar.

RX bars are also mostly compliant.  I would not suggest eating any of these bars often.  Just keep them on hand for emergency use.  It is much better to always eat whole foods.

A Few Whole30 Recipes I Used

I have added a few recipes to this post that my family ate during the Whole30 experience.  The first is a snack bar that is super easy to make and very good.  So good, in fact, I am still making these even after finishing the Whole30.  The second is a frittata where you could substitute virtually any vegetable that works with eggs.  The last is a curry recipe. As I said above, we ate a lot of curry during the Whole30 and you could use any vegetables or curry types for this. 

My Experience with the Whole30

My starting weight was 188 pounds on 10/15/19. The first day was excellent. In the morning, I had black coffee only. For lunch, I had cherry tomatoes, blackberries, and raspberries. This was my pattern, although some days, I added almonds or cashews and turkey or tuna to lunch. I skipped breakfast almost every day, which is typical for me. The first night I made chicken primavera from the Whole30 book for dinner.

Day two, I was tired and hungry. I made a spinach frittata for dinner. I am not a fan of eggs, but it was pretty good.

Day three was a good day. I had a false sense that the hard part was over, but I was very wrong. Spaghetti squash with marinara sauce, steamed broccoli, and chicken Italian from 365 was dinner.

Day four, I was sluggish in the AM, but the day got better.

On day five, Luke Combs came to Portland, and Cathy and I went to see him. It was a great concert, and I didn’t think much about food. I made pork meatballs and sweet potatoes with bell peppers, zucchini, and tomatoes in a red curry sauce.

Day six was the WORST day of all, especially in the evening. I ate a lot of food but I felt like my energy was depleted. I wasn’t sure if I could make it. Looking back, I’m glad I pushed through. I worked the evening shift and didn’t get home until after midnight.

Day seven, I slept until 10 am.  I had two poached eggs and stuffed peppers before leaving for work. The worst was over!

Day eight, even with five hours of sleep, I felt amazing all day. I had read about it, but guess what happened next?

Tiger blood

The Whole30 book says this should happen from day 16 to 27 but it occurred for me on day 9. I can’t explain this feeling, but it is terrific. I felt better than I have in years. I attribute it to being detoxed off of all the crap I had been eating. I won’t bore you with all the details of the rest of the days, but they all went pretty well. I did get a little tired of the same food towards the end. In the last couple of days, I wanted to change up the diet a little.

We had curry in one form or another nine different nights. I had it leftover at least twice. I would say one of the main things I learned is that curry is excellent and healthy.

Michael Brown pictured with Final Thought written

I woke up at 2 am on day 31 and weighed myself. I was down to 175.8 pounds, so in 30 days, I lost 12.2 pounds.

I am not sure if I would do this again, but it wasn’t terrible, especially after day six. I did feel great during the last couple of weeks.

My wife also lost weight but struggled at times to find compliant food to eat when I wasn’t around.  Her skin improved, and she experienced no migraine headaches during the thirty days.  

Cathy brought home a pizza for the kids on day 15. This was probably the hardest thing to ignore because it smelled delicious plus I was hungry. I had a few days that I had to pass on Krispy Kreme donuts and candy, as well. I thought I would miss Diet Coke more than I did, but I guess I missed Mexican and Italian food much more.

Here is what I plan to change as a result of this experience; I will continue to drink my coffee black and cut back on soda, I want to continue the habit of drinking a lot of water daily, and fresh fruit and vegetables will always be available. I plan to snack on them often. I will keep monitoring my weight and try to stay where I am currently.

If you are interested in what I ate the other days, feel free to send me a message. I kept track of my meals, so I’d be glad to share that with you. If you have any questions regarding my experience, feel free to ask.

I am creating a diet of my own that I will share will you in the next few months.  One of the new products I have enjoyed is available below.  Give it a try.  Who doesn’t like pizza?  This crust eliminates unnecessary carbs!

I am creating a diet of my own that I will share will you in the next few months.  One of the new products I have enjoyed is available below.  Give it a try.  Who doesn’t like pizza?  This crust eliminates unnecessary carbs!

Michael Brown in Lab Coat with arms crossed

Michael J. Brown, RPh, BCPS, BCPP

Mr. Brown is a Clinical Pharmacist specializing in pharmacotherapy and psychiatry.

Read Michael’s story here.

Feel free to send Michael a message using this link.