Your Annual Physical Just Isn't Enough

“What?? How could she be sick? She just had her annual physical and everything was fine!”

It may seem perfectly logical when somebody says this, but here’s the surprising truth: Neither the standard annual physical exam, nor the routine blood tests associated with it, have ever been shown to make a measurable difference in helping people detect life-threatening diseases at an early stage.  

If you’re shocked by this, you’re hardly alone. Although in many cases disease can be halted or reversed if detected in the early stages, the most intentional thing that most of us do to protect ourselves is to go for our annual checkup. And sadly, that annual physical won't keep you from getting sick, or help you live longer -- at least according to every study ever done on the subject. Luckily, the answer isn’t simply to despair, or sit idly by and wait for illness to develop.    

The human body is capable of healing itself. When we are exposed to stress (think radiation, toxins in our air and water, tobacco smoke, certain drugs, ozone, charred foods, etc.) that stress damages our cells. That cellular stress is called oxidative stress, and it is the very thing that triggers aging and illness.  Yes, you heard that correctly - oxidative stress is exactly what makes you age, and get sick.  

The only way to prevent oxidative stress is with something called an antioxidant.  Some antioxidants are found in our diet, and some our made in our cells.  If, in addition to maintaining healthy levels of your own antioxidants, you also eat a diet high in the food-based antioxidants below, it is the cellular equivalent of doubling your defense budget.  

The ones that are made in our cells are:

  • glutathione

  • CoQ10

  • alpha lipoic acid

  • catalase

  • superoxide dismutase (SOD)

The ones that are found in our diet are:

  • vitamin C

  • vitamin E

  • carotenoids (carrots, sweet potatoes, cantaloupe, dark leafy greens, broccoli, peas)

  • polyphenols (ginger, dark chocolate, cloves, elderberry, raspberries, blackberries)

But that leaves us with a million-dollar question: If our body's are so capable of fighting disease, why do we still get sick? Simply put, when the sheer volume of stress surpasses the bodies ability to heal itself and recover, the scale tip over (and not in your favor). You can picture it like a game of Jenga – when all of the pieces are together and the tower is complete (your body at full capacity) it takes a whack to knock it over. But once a whole bunch of blocks have been pulled out (your body under extreme stress), just breathing the wrong way can send the tower toppling.

It probably won’t surprise you to hear the usual suspects that stress the body and rob it of its self-healing ability: inadequate sleep, emotional stress, untreated depression, immobilization, and exposure to toxic substances like pesticides, some medications, food dye, artificial sweeteners, or even plastic..

Scary? Well, sure, it can be. But my hope is that this information will empower you and encourage you to take your control back. Knowing that there are highly sophisticated systems in place in your body to fight disease is the first step to regaining your health. The second step is to shore up your defenses by testing your antioxidant levels and correcting any deficiencies through diet and supplements.  This type of specialty testing is available through Functional Medicine, an approach to care that is rapidly disrupting the entire healthcare industry in its approach. Functional Medicine physicians test for cellular levels of antioxidants and create customized plans to improve them.  Not something you were offered during your last physical, right?  

While it might be tempting to just take a boatload of antioxidants in supplement form as opposed to precisely measuring and carefully replenishing them, there is good evidence that too much of a good thing… well, it might not be a good thing at all (actually, it might be plain dangerous).

Once you've tested your antioxidant levels and brought them up to a healthy range, it is critical to remove any toxic substances from your body that might currently be making you sick. There are now tests available that can check your levels of heavy metals, pesticides, BPA, phthalates, parabens, VOC's,  and PCBs.  If your levels are abnormally elevated, which is pretty common given the sheer number of chemicals we are exposed to every day, a Functional Medicine physician can then create a plan to remove them from your body once and for all.  Flushing cancer-causing chemicals from the body will help prevent depletion of your antioxidants, which ultimately means preventing disease.  

After increasing your antioxidant levels and flushing out disease-inducing chemicals, taking a thoughtful look at your lifestyle from the perspective of inflammatory triggers is next.  This means really focusing on sleep, exercise, diet, and your overall happiness as a means of maintaining or restoring health.  

It is easy to see why these lifestyle factors are the focus of most health advice. However, science has come much further than this.  If it is as simple as eating well and exercising, why do people who do both still get cancer?  While looking at the triggers for disease, and the mechanisms that worsen or progress it, there is no smoking gun.  

All sickness begins with health.  It is a spectrum, and it is multi-factorial.  There is a widespread belief that one day a switch gets flipped and you go from being well to being sick.  Everything we know about science and medicine actually refutes this and instead validates that illness begins at the cellular level.  

The Functional Medicine approach also begins at the cellular level, and then it expands from there to ultimately address our day-to-day lifestyle choices that either keep us well or make us sick.  This new paradigm ensures that the patient is no longer in the passenger seat.  This new paradigm helps you to reclaim your health, your vitality, and your control.  

Allison Fox, M.D.

The Straight Buzz on Coffee

I've noticed an intriguing phenomenon over the last several years that I've fondly nicknamed coffee shame.  What is coffee shame?  Thewell-intentioned, but typically misguided, guilt or remorse over one’s coffee consumption.

As I obtain my patients’ full medical and social history, their alcohol, exercise, and green vegetable "habits" rarely seem to provoke the kinds of explanations their coffee consumption so frequently does. "I know I should be drinking less", "I tried so hard to give it up, but I just couldn't do it", and "I've been doing half-caff, that's better, right?"-just a handful of the disclaimers that patients tend to lead in with.  

All of this coffee shame, combined perhaps with my personal love for the age-old brew, has prompted me to attempt to set the record straight.  In the wise words of Clark Gable, “I never laugh until I’ve had my coffee.”  So here are some facts about coffee to smile about. The proven benefits of low to moderate coffee consumption are plentiful.  I have listed them below for you.  Of note, low to moderate is defined as less than three eight-ounce cups per day.

Benefits:

  • Increase in alertness and ability to concentrate

  • Decreased risk of Parkinson's disease

  • Slightly lower or delayed risk of Alzheimer's disease

  • Decreased risk of Type 2 Diabetes

  • Improvement in acute headache symptoms

  • Modest decrease in constipation symptoms

  • Decreased risk of alcoholic cirrhosis

  • Slowed progression of liver disease in those with advanced Hepatitis C

  • Reduced risk of gout

  • Decreased risk of liver cancer

With all of these incredible potential benefits that low to moderate coffee consumption can have, are there downsides?  Well, just like anything that is enjoyable, there are.  The downsides can include:

  • Difficulty sleeping

  • Increased anxiety and agitation

  • Increased risk of cardiac arrhythmias and cardiac events in those that are susceptible

  • Physical and/or psychological tolerance or dependence on caffeine

  • Caffeine withdrawal symptoms in those that are tolerant or dependent

  • Mild elevation in cholesterol when consuming unfiltered coffee (e.g. French press, espresso)

  • Slowed growth and even potential risk of miscarriage or preterm birth when consumed in pregnancy (the studies are mixed on this so always ask your OB)

When I explain all of this to my coffee-loving patients, I usually tell them that there are two magic numbers to keep in mind. Those numbers are two and twelve. Try to keep your coffee consumption to two eight-ounce cups per day, and drink those two cups before twelve o'clock noon.  Pushing the limits of what is considered safe intake of anything is never a good idea, and drinking caffeine of any kind in the afternoon often leads to problems sleeping.  I do have several patients that I recommend stop drinking coffee altogether for various health reasons, so it is extremely important to always check in with your doctor before assuming that your cup of joe is a safe habit.  

Allison Fox, M.D.

Top 5 Misconceptions About HPV

1. “Once you have HPV, you have it for life.”

Not at all! If your immune system is healthy, you can get rid of the infection for good. It may take a little time, but by taking appropriate steps, you will again test negative for HPV.

2. “I had the HPV vaccine, I can’t catch the virus.”

Despite the HPV vaccine being highly effective at preventing certain strains of HPV, it absolutely does not protect you from every strain out there. You can get the HPV vaccine and still get HPV, I’ve seen it happen many times.

3. “Condoms protect you against all STDs, including HPV.”

This is a dangerous misconception. HPV is a virus that is spread through skin to skin contact. While condoms are clearly extremely important in the prevention of most STD's, they only reduce the risk of HPV spread.  In other words, you can use them 100% consistently and correctly and still get HPV.

4. “After a colposcopy removed the damaged cells, the virus is gone.”

The colposcopy procedure removes the cells of your cervix that have been damaged by HPV. However, the virus itself lives throughout your body, which is where my diet and lifestyle recommendations come in. A healthy immune system will help clear the virus up from your body for good.

5. “Older women don’t need Paps, they are for women of childbearing age.”

One in 4 cases of cervical cancer occurs in women over the age of 65. Forty one percent of cervical cancer deaths also occur in this age range. While every woman does not need a Pap every year, every woman does need a visit to see their physician to discuss their personal risk and decide on the best plan.

Allison Fox, M.D.