Healthy Concepts
Dr. Amy Nussbaum Schubbe

Dr. Amy Nussbaum Schubbe

Dr. Amy Nussbaum Schubbe is a board-certified chiropractor who has been helping families achieve better health for 25 years. She is certified in functional medicine, nutritional counseling and is a certified gluten practitioner. She is on the Fox Valley Celiac Board and counsels newly diagnosed Celiac and gluten sensitive patients. She also has additional training from the Hashimoto Institute.Her office is located at Nussbaum Chiropractic, 873 N. Casaloma Drive in Appleton. Call 920-734-2400 to get started on a better path to health!

Wednesday, 31 January 2018 19:54

How to make 2018 great

As we flip the calendar to the New Year many people turn their aspirations inward to improve their health going forward. Today we will delve into considerations for the New Year and make it great!

1. Choose foods wisely. The Environmental Working Group website has a list of the “clean 15” and the “dirty dozen.” Fruits and vegetables on the dirty dozen list should be purchased organically due to the heavy pesticide residue, which does not contribute to overall good health. For the produce on the clean 15 list, you can save your grocery pennies and buy non-organic as there is not significant spray detected or there is a protective peel or rind surrounding the fruit or vegetable that can be removed before eating. Another recommendation is to eat with seasons to vary your produce choices to incorporate more nutrients. Unfortunately the average American eats only 15 foods — over and over and over again potentially leading to food sensitivities.

2. Exercise. In my practice I commonly see patients who regularly incorporate cardio into their fitness routine. Unfortunately strength training and flexibility often take a back seat to cardio but are equally important. I am in favor of group, or individual training, as it can be helpful for an instructor to observe and critique the clients form and posture, in addition to simply making it more fun. I have also seen positive results with step counters in my patients trying to incorporate more motion in their day and to keep moving. Motion is the body’s lotion so get up and start moving!

3. Consider nutrient testing. There are specialty labs using a simple blood draw that can evaluate if one has nutritional deficiencies, which can be corrected with supplementation. Our population in Wisconsin is especially susceptible to vitamin D deficiency as we have many days where the sun is too far away to absorb adequate vitamin D effectively through our skin. Supplementation can prove helpful to correct imbalances. I also like evaluating B vitamin status, as this vitamin complex helps us deal with stressors, which are plentiful in our daily lives.

4. Cultivate or immerse yourself in a new activity or hobby. Below is a list of three common traits of people who live to 100 years of age.

  1. They are lean.
  2. They don’t smoke.
  3. They have hobbies.

Hobbies, especially in retirement, are important when transitioning from the work place to retirement. It is great brain food, to learn something new, which helps develop new neuronal pathways, and as a bonus, it is good to tap into your inner creativity.

Try to incorporate some helpful tips from this article and make it a great 2018!

Tuesday, 31 October 2017 16:53

Overall health picture

In my practice I have both chiropractic patients as well as nutrition/functional medicine patients. Often times with my nutritional/functional medicine patients we do specific lab testing to determine levels of certain vitamins, minerals and nutrients. If patients are not interested in getting a full nutritional work-up we often recommend the following nutrients to help provide a better picture of their overall health.

1. Vitamin D. As we live in a northern climate where the sun doesn’t shine consistently, adequate levels of vitamin D are important. We get vitamin D from the sun, which is absorbed through our skin. Vitamin D is helpful in reducing our aches and pains and helps boost our immune system. It also helps reduce anxiety and depression. One local lab uses the range of 30-100 to measure this important vitamin with the sweet spot being 60-80 in nutrition circles. We can get 15 to 20,000 IU in 20 minutes of sunshine without sunscreen. Populations north of Atlanta, Georgia frequently suffer from vitamin D deficiency. With the increased use of sunscreen, we block this important vitamin and therefore supplementation can be quite important. Nursing mothers are also encouraged to supplement with vitamin D for their infant.

2. Magnesium. Magnesium is an important mineral and is involved in over 300 biochemical processes in the body. It can be effective as an anti-inflammatory, muscle relaxer and can promote better sleep. It is found in green leafy vegetables, but unfortunately most Americans do not consume enough leafy greens. There are different forms of magnesium to consider. If one suffers from constipation, magnesium citrate can be of benefit. Otherwise magnesium glycinate or magnesium lactate is a good form if constipation is not an issue. Traditionally 200 - 400 mg in divided doses can be effective. Magnesium can also aid in the reduction of migraine headaches but the dose is typically higher. There are several forms, including a liquid form for patients who do not like to swallow tablets. Coffee drinkers are often deficient in this mineral as it can be depleted with increased consumption. The best test to evaluate adequate levels of magnesium is a red blood cell magnesium blood test. I also like this mineral for my athlete patients. People who experience muscle cramps might also notice some relief with this wonderful mineral. Epsom salts also contain magnesium. One to two cups per bath with a drop or two of an essential oil like lavendar can make for a better night’s sleep.

3. Probiotics. There has been increasing interest in probiotics for improved gut health. There are over 100 trillion bacteria in the gut — some good and some bad. There are many brands on the market. I prefer the refrigerated probiotics and suggest products in the billions. I will often rotate various types with my patients. If a patient doesn’t do well on a probiotic they may suffer from small intestinal bacterial overgrowth (SIBO), which I discussed in a previous article. A stool analysis can also give a snapshot of the microbiome to evaluate both diversity and abundance of bacteria.

4. Fish oil. Fish oil has many benefits and has an anti-inflammatory effect. It is important to get good fats in the diet and supplementation with various fish oils can be of benefit. A recommended dose is 1-3 grams a day. I also like to rotate fish oils every couple months. Fish oil is important for brain health and is also an anti-inflammatory for joint health.

If you are not feeling as good as you would like, you may be inflamed or have certain vitamin or nutritional deficiencies. We are happy to help you evaluate your nutritional needs. 

Thursday, 31 August 2017 02:43

What is SIBO?

Do you feel you have excessive bloating and maybe feel as though you need to wear a different pants size by the end of the day due to the bloating? Do you look like you are 6 months pregnant but are not? Do you have nutritional deficiencies in vitamin D and ferritin (iron storage) and have not been able to figure out why? Do you have seemingly excessive food sensitivities? Have you tried a probiotic and it seems to make your belly worse? Perhaps you might want to consider testing for SIBO. SIBO stands for small intestinal bacterial overgrowth.

This condition oftentimes presents as bloating after eating, in particular carbs, starchy foods and fiber. SIBO can account for up to 60 percent of irritable bowel syndrome symptoms. Some people with SIBO experience constipation while others will experience diarrhea, and some alternate between the two. With SIBO, bacteria from the large intestine back up into the small intestine where one usually doesn’t find large numbers of bacteria. These bacteria now in the small intestines, feed off of carbohydrates in your diet and ferment, giving off gas including methane, hydrogen and other gasses thus distending your belly and making you uncomfortable. A trigger for SIBO can be food poisoning, which harms the natural movement in the gut. 

The test for SIBO is a breath test collected at home six different times during the day over a three-hour period and then sent to the lab for analysis after drinking a solution of lactulose (a synthetic sugar). The lab will measure levels of both hydrogen and methane after this lactulose challenge. If excessive gas levels are demonstrated, your functional medicine practitioner can help you decide which treatment is appropriate for you to decrease intestinal gas. One can choose an herbal antibiotic, a traditional antibiotic, an elemental diet or a specific SIBO diet to decrease gas and bloating. Retesting is important to ensure the treatment is helping. Some people respond better to traditional treatment, while others fare better with a nutritional approach. 

After treating for SIBO, a low carbohydrate diet is often advised so the fermenting and bloating does not return. During treatment, there are certain exercises the patient performs to help the nervous system perform better.

If bloating is an issue for you, consider investigating SIBO. 

 

Tuesday, 27 June 2017 00:03

Food sensitivities

In my last article I discussed gut health and the importance of the microbiome as it pertains to health, and the role in leaky gut or intestinal permeability. Today I would like to delve into food sensitivities as this can be a factor in pursuing improved gut health.

Food sensitivities are different than food allergies. Often times a food allergy can be much easier to uncover as the reaction to a particular food (think peanuts) is pretty quick and can be life threatening, requiring medical intervention. These patients often carry an EpiPen with them. This is an adverse reaction traditionally described as an IgE reaction, which is different than an IgA or an IgG reaction. One can think of the immune system like the armed forces, which has several branches like the Army, Navy, Air Force, Marines like IgE, IgM, IgA, IgG, etc.

Unlike the quick responsive IgE reaction food sensitivities tend to have a delayed reaction, which can be more difficult to figure out. Some clinicians favor an elimination diet while others, like myself, prefer to use specialty labs to look at the body’s immune response to commonly reactive foods. Depending on which lab is utilized you can have several foods tested to help uncover some culprits that can be driving a negative immune response and creating inflammation in the body. Common inflammatory foods include gluten, dairy, corn, egg and soy to name a few. Gluten is a protein found in wheat, barley and rye.

Celiac disease is an autoimmune disease, which is triggered by ingestion of gluten. According to The New England Journal of Medicine, “Celiac disease is one of the most common lifelong disorders in both Europe and the U.S.” The American Celiac Society says, “The majority of celiac patients have visited five or more doctors prior to diagnosis… taking an average of five to 10 years, after initial presentation, for celiac disease to be diagnosed.” Approximately 87 percent of celiac patients are undiagnosed. Gluten sensitivity is much more common than celiac disease and involves a different process with the end result the same: avoidance of gluten. Some symptoms of gluten sensitivity include joint pain, muscle pain, skin rashes, fatigue, headaches including migraines, brain fog, reflux and IBS just to name a few. Often, traditional blood work will demonstrate low vitamin D and iron due to absorption issues accompanying the sensitivities.

One should question why these values are low and consider further evaluation including food sensitivity to uncover the cause. Specialty labs such as Cyrex and Vibrant Wellness in California have some of the best testing for gluten sensitivity and additional foods as well as leaky gut or intestinal permeability. Celiac markers can be tested with your family doctor. Children can also be tested for gluten through a blood panel or a finger poke. According to the Journal of Attention Disorders, “All children clinically diagnosed with ADHD or their parents report a significant improvement in their behavior and functioning after 6 months on a gluten-free diet.”

If you are looking to uncover potential food sensitivities your functional medicine practitioner can help you start your journey to feeling better. We are here to help you get started. 

The gut or microbiome is becoming an increasing area of interest and study. It has been estimated that we have over 100 trillion bacteria in our gut. Wow! Lots of tiny but mighty creatures making up what is called the microbiome. As around 80 percent of our gut makes up our immune system, a healthy belly is in our best interest. The gut has also been called our second brain and has also been referenced as our “gut instinct.”

Did you know you have the same neurotransmitters in your gut as your brain and if your brain isn’t happy chances are your belly is not either? Newborns are first introduced to important bacteria as they enter the world via the vaginal canal and get bathed in bacteria, setting the stage for immune health. Cesarean section babies are at a disadvantage to this initial introduction. In some parts of the country OB docs swab the mom’s vaginal area and then wipe it on the newborn born via a C-section as they have less diverse bacteria initially. One might wonder if this could play a part in a C-section baby having more allergies and asthma.

A stool test can be a very useful tool in providing a snapshot of the milieu of the microbiome. This one- or three-day test can be performed at home and sent to the lab. Your practitioner can go over the results with you.

Consider the 5 ‘R’s when improving the function of the gut:

1. Removal. Often upon evaluating stool tests parasites and various pathogens are uncovered. Eliminating these stressors is one approach to achieving better belly health. There are many antimicrobial supplements to help target specific infections. Food sensitivities also play a large part in gut damage, especially gluten. Food sensitivity testing is a helpful avenue to pursue.

2. Reinoculate. Specific probiotics can feed our gut and help establish a better balance. Antibiotics, while important in fighting the bad bugs, can also damage the good bacteria. Taking a probiotic can support the good flora that gets knocked out with antibiotic use. There are several strains on the market, and your practitioner can help you determine which is best. Complex carbohydrates found in fruits and vegetables are slow to be digested and also feed our gut. Resistant starch can also improve irritable bowel syndrome (IBS). People on a gluten-free diet need to be extra vigilant about getting enough fiber. The bugs in our belly feed on this fiber and make nutrients that we need. Women in general need about 25 grams of fiber, and men about 30. Eating a wide variety of foods can boost your gut health. The average American eats the same 15 foods over and over again. Remember variety is the spice of life! Eating with the seasons can also help to rotate your foods. Remember when shopping to use the “Clean 15” and the “Dirty Dozen” rules when purchasing your fruits and veggies. With increasing pesticide use the dirty dozen foods should only be consumed if you purchase it organically and the Clean 15 foods you can save your pennies on due to low pesticide use or a thicker rind to absorb the deleterious spray. EWG.com is a great website to learn more when you have time.

3. Repair. There are various herbal products that help repair the gut lining such as L-glutamine, deglcyrrhizinated licorice aloe and arabinogalactans.

4. Restore and 5. Rebalance. Restoring includes daily exercise and returning to healthy eating habits.

If your belly is not as happy as it should be, consider seeing a functional medicine practitioner for evaluation and to help achieve better health.

Monday, 30 January 2017 17:46

Thyroid facts and pearls for recovery

Thirty million people suffer from hypothyroidism, which is approximately 10 percent of the population. This number is probably conservative. 25-50 percent of this thyroid population has been diagnosed. Hypothyroidism (underactive thyroid) is 8 times more prevalent in women than in men. Approximately 25 percent of women will develop hypothyroidism in their lifetime and 97 percent of hypothyroidism is an autoimmune disease called Hashimoto.

Hashimoto is named after a Japanese doctor. Most people suffering from thyroid issues don’t realize that the majority of the cases (97 percent) are actually autoimmune. Autoimmune disease is what happens when your immune system attacks various tissue and in the case of Hashimoto, the target is your thyroid. Your thyroid is a butterfly shaped organ weighing 60-100 grams. You shouldn’t be able to feel your thyroid gland, which is situated at the lower front part of your neck. Synthroid, which is used to treat an underactive thyroid, is the most commonly prescribed medication in the United States.

Signs and symptoms of an underactive thyroid include feeling cold, loss of the outer third of your eyebrows, coarse hair, fatigue, weight gain, dry cracking skin and foggy thinking. Conventional lab testing for hypothyroidism typically only tests your thyroid stimulating hormone (TSH), which is actually testing your pituitary function. Having a full thyroid panel can help uncover any glitches that can be helped through nutrition.

For example, your thyroid needs zinc, selenium, iron and iodine to convert T4 to T3, which is your active hormone. If one is deficient in one of these cofactors you can suffer from hypothyroid even if your TSH levels are within normal levels. Food sources of zinc include shellfish, beef and seeds. White spots on your fingernails can indicate potential zinc insufficiency as well as lack of smell. Red meat and spinach are a good source of iron as well as liver. Brazil nuts are a good source of selenium. Iodine is again found in shellfish, which isn’t readily consumed in the Midwest or the so called “goiter belt.” Another part of a thyroid panel helpful to include are antibodies.

Elevated antibodies can mean an autoimmune process is occurring. Your functional medicine practitioner can order a full thyroid panel including antibodies and make recommendations to get you back on a better path to health.

Tuesday, 26 May 2015 20:51

Book suggestions for better health

Often my patients ask me about books that provide tips for better health, so I thought this month I would pass along some of my favorite titles to delve into for beach reading this summer.

“The Blue Zones” by author Dan Buettner is an easy read about places around the world where people regularly live to 100. This is a great book that looks at cultures in the world that have common traits for longevity. A follow-up to this book, called “The Blue Zone Solution” has just been released and is in line on my nightstand.

“Wheat Belly” by William Davis, M.D., a Milwaukee cardiologist, looks at the history of wheat and how eliminating this grain can provide improved function for several health disorders. In my office we frequently test patients for gluten sensitivity with Cyrex Labs Array 3 to uncover a gluten sensitivity and then counsel on how to proceed going gluten-free.

“Drug Muggers” by pharmacist Suzy Cohen delves into nutrient deficiencies that can develop after taking prescriptions and over-the-counter medications. She makes recommendations to replenish these nutrients. One “drug mugger” for many people is statin medication, which can lead to a CoQ10 deficiency, which is basically your body’s energy. She has other great titles and I especially like her healthy thyroid book, which explains the thyroid gland and its complexities in layman’s terms.

“The Autoimmune Solution” by Amy Meyers, M.D. and Functional Medicine practitioner, contains great information on preventing and reversing the increasing issue of autoimmune disease. Unfortunately, one out of six Americans will develop an autoimmune disease.

I hope you have a chance to read one or all of these titles this summer and call our office if you would like to seek help with nutrition, chiropractic or food sensitivity testing.


 

Monday, 27 April 2015 21:16

Adrenal health and stress

Modern women’s lifestyles can be stressful juggling family activities and workforce demands. Throw in a poor diet, excessive antibiotic use, ongoing screen time, smoking, indigestion, constipation, undiagnosed food sensitivities, insomnia, worry, etc., and one can spin one’s health into a downward spiral. Our adrenal glands are walnut shaped organs that sit on top of the kidneys close to the aorta. They secrete hormones that help our body deal with stress. The outer part of the adrenal gland is called the cortex and the inner part is the medulla. The adrenal medulla produces epinephrine and norepinephrine and the adrenal cortex produces cortisol, aldosterone, dehydroepiandrosterone (DHEA) and others. Unfortunately, if our adrenals continue to be chronically stressed a person can go into adrenal exhaustion and fatigue. Your functional medicine practitioner can help you uncover this health imbalance by taking saliva samples at different times of the day to evaluate cortisol, DHEA and other hormone production. The Adrenal Stress Index (ASI) is a saliva test that helps to differentiate and identify the level of adrenal function or dysfunction. After evaluating this circadian cycle, she or he can recommend supplements to help overcome this condition. Phosphatidalserine, licorice extract, ashwaganda and rhodiola are some nutritional supplements to be considered depending on the pattern of adrenal dysfunction on the ASI.

In addition to supplements, the following recommendations can be helpful.

  • Sleep. The body’s physical repair takes place at night. Without adequate rest the body cannot regenerate itself to deal with the stresses of the next day. A completely dark room is helpful to maximize melatonin production.
  • Identify stessors. Environmental toxins, gluten sensitivity, toxic emotions, virus and molds, side effects of medications are all possibilities.
  • Avoid coffee or caffeinated beverages. Coffee and tea act as stimulants and can interrupt sleep patterns if one consumes too much.
  • Exercise. Exercise is a great stress reducer and great oxygenator. It is helpful in reducing depression and improving blood glucose.
  • Eat breakfast. If you are low on sugar the adrenals are instructed to secrete cortisol to increase blood sugar and allow the body to function. It’s imperative to have a healthy breakfast soon after waking to prevent the body from playing catchup for the rest of the day.
  • Maintain glycemic control. An effective way to help reverse adrenal stress and improve hormone balance is to balance the amount of carbohydrates and proteins and fats that are eaten with each meal. Approximately 2 parts carbohydrate to 1 part protein is recommended to help maintain blood sugar balance.

A professional trained in functional medicine can help the individual test and address adrenal fatigue to achieve improved health. Lifestyle modification and specific nutritional supplements can then be recommended to achieving better health.


 

Subscribe Today
Community Partners Directory
Find a Newsstand
Community Calendar