Blog - Gil Winkelman ND

The Amazing Effectiveness of Holistic Treatment for OCD

October 5, 2023 by Dr. Gil Winkelman Leave a Comment

In over 15 years of working as a Naturopathic Physician, I have seen many patients with obsessive-compulsive disorder (OCD) or OCD traits. I can tell you that holistic treatment for OCD works extremely well. What is OCD? And what types of natural remedies for OCD are effective? The Walsh Protocol is highly effective. But before I get into that, let us explore what OCD is.

What is OCD?

OCD is a pattern of unwanted thoughts and obsessions leading to repetitive behaviors (compulsions). These compulsions and thoughts interfere with daily activities. In extreme cases, very dark thoughts accompany the behaviors. Regardless, the person suffers extreme distress and anxiety. (OCD is a subset of anxiety.)

One can try to stop the obsessions or compulsions but that often serves to increase the distress and anxiety. Performing the acts is an attempt to relieve the stress. The thoughts come back even when ignored, leading to more ritualistic behavior and the cycle of OCD.

Often, OCD revolved around a theme, such as a fear of germ contamination. To ease the fear, the compulsion starts. In this example, compulsive hand washing is even to the point of sore or chapped hands.

If you have OCD, holistic treatment for the condition exists. Before we explore treatments, I want to discuss the symptoms in more detail.

Symptoms of OCD

Obsessive-compulsive disorder usually includes both obsessions and compulsions. But it is also possible to have one without the other. Some people cannot see that their obsessions or compulsions are excessive. What is excessive? Anything that interferes with your daily routine, social, academic, or work functioning. It is important to distinguish OCD from perfectionism. Perfectionism is the desire for something to be flawless. Recently, I had my car detailed. My friend joked about the detailed that it’s a good way to channel his OCD. And while he worked really hard to make my car perfect while spending hours cleaning it, he didn’t obsess about the things who couldn’t get perfect. He just moved on. Thoughts about actual problems in your life, or liking things arranged particularly, are not necessarily OCD thoughts. It’s when these actions and thoughts interfere with your life that it is a problem. Let’s dive into the difference between obsessions and compulsions.

Obsession symptoms

OCD obsessions appear as recurring thoughts, urges, or images that cause distress. One may try to ignore them or use a ritual to remove them. Typically, these obsessions intrude when attempting to do something else.

Some examples of obsessive themes include:

Fear of contamination or dirt
Uncertainty intolerance
Needing things orderly and symmetrical
Aggressive or horrific thoughts about losing control and harming yourself or others
Unwanted thoughts, including aggression, or sexual or religious subjects
Needing to perform a task to prevent something bad from happening.

Examples of obsession signs and symptoms include:

Doubting if they locked the door or turned off the stove
Intense stress when objects aren’t orderly or facing a certain way
Images of driving your car into a crowd of people
Thoughts about shouting obscenities or acting inappropriately in public
Unpleasant sexual images
Avoidance of situations that can trigger obsessions, such as shaking hands

Compulsion symptoms

OCD compulsions are repetitive behaviors one feels driven to perform to reduce anxiety. Engaging in compulsions brings temporary relief but rarely pleasure. One invents the rituals or rules to control anxiety, but is rarely realistic or related to the problem.

Compulsions typically have themes such as:

Washing and cleaning even until the skin becomes raw.
Repeatedly checking locks and that the stove is turned off.
Counting in specific patterns
Orderliness
Following a strict routine
Demanding reassurance

Severity varies

OCD usually begins in the teen or young adult years, though signs of it appear in childhood. A gradual increase of symptoms occurs as people age, and sometimes the obsessions and compulsions change. Symptoms worsen with increased stress and can be disabling.

Holistic Treatment for OCD

Now that we have explored what OCD is, how is it treated? When I think holistically, I consider various approaches to treat the condition, not just medication. Many people find benefit from a mix of psychotherapy, the Walsh Protocol, neurofeedback, and/or Naturopathic care. Let’s explore each of these.

Psychotherapy for OCD

Cognitive-behavioral therapy (CBT) is effective for many people with OCD. One type is called exposure and response prevention (ERP). In ERP therapy, you gradually face fears and learn to resist rituals. ERP takes effort and practice, but improves one’s life quality if effective.

Neurofeedback for OCD

Neurofeedback shows great promise to treat OCD. Many patients report having less severe symptoms following neurofeedback sessions. During neurofeedback, we first map the brain by placing sensors on the scalp. The map directs treatment of OCD by showing which areas of the brain may be most affected. Depending upon the type of neurofeedback system and severity of symptoms, most practitioners treat 1-3 times per week. I like to start with weekly sessions to better monitor how the treatment takes.

Walsh Protocol for OCD

The Walsh Protocol is a highly effective holistic treatment for OCD. When I first started using the Walsh Protocol, we thought OCD was strictly a methylation issue. It turns out that OCD may also have an element related to NMDA receptors too. The beauty of the approach is that knowing the biosubtype allows us to determine the treatment plan for the NMDA receptor, too. Patients with OCD typically have issues with memory extinction. By affecting the NMDA receptor, supplements can help ease symptoms. Many patients report having fewer disturbing thoughts or compulsions.

Naturopathic Treatments for OCD

OCD and other mental illness may be related to high levels of inflammation in the body. Natural treatments like bio-therapeutic drainage, supplements, gut balancing, and hydrotherapy can reduce inflammation and lower oxidative stress in the body. While these treatments do not always immediately resolve the problem, they do improve overall health. One aspect of OCD that I am integrating into my practice is looking at trauma. Trauma affects many areas of the body but particularly the mitochondria. Changes in the mitochondria cause a myriad of downstream effects on glial cells (the helpers of neurons), methylation, oxidative stress, and so forth. In fact, mitochondria may be an important aspect of all health problems. This approach can help can not only help OCD but likely prevent other conditions too.

How to Get Holistic Treatment for OCD

Curious to get treatment for OCD. Contact me today to schedule an appointment. I’m excited to share what I have learned and help you or your loved one struggling with OCD. Call my office today at 808-726-2772 or use the schedule now form.

How Do I Know If I have Trauma

April 4, 2023 by Dr. Gil Winkelman Leave a Comment

How Do I Know If I Have Trauma

When you think about trauma, do you think about accidents and child abuse? Trauma may be the biggest health issue that isn’t recognized. It touches our lives in so many ways. Traumatic events vary as do people’s responses to events that we deem scary. How do I know if I have trauma is a common question I get from patients.

To start, we need to define what trauma is. Trauma is any event that occurs where the nervous system gets activated but doesn’t reset. I explain the details in another post. But the basics are this. Something happens that causes us to be on alert. Our sympathetic nervous amps up, causing our heart to race, pupils to dilate, and glucose gets mobilized so we can fight or flee. (This is the fight/flight response.) When the danger passes, ideally, your system calms down. Say you have a near miss accident while driving. In milliseconds, you respond to the threat so you can react to the situation. At the last minute, you swerve to avoid the wreck. Some people pull over after this type of experience to calm themselves. They may shake, scream, or somehow discharge the pent up energy. But what if you don’t do that? Sometimes, that event leads to what I’m calling trauma. The energy gets stuck. And that energy can affect mind, body, and spirit.

Examples of Trauma

What are some examples of trauma? Surgeries, poorly performed procedures, accidents, and adverse childhood experiences such as bullying at school or verbal or physical abuse are examples of trauma. But many times, the event is one we never considered traumatic because we rationalized it away. For example, many patients never considered a surgery traumatic because the procedure went well. But the body responds as though there is a threat. People remember little from the time they were preverbal (around 2 years of age). If anything happened, your body might remember it, but you would have no recall of the event. Finally, there is evidence that some trauma is epigenetic. This means that we may experience situations as traumatic because one of our ancestors passed that to us. You can read more about this in my report.You can read more about this in my report.

How trauma affects mind, body, and spirt?

Before I answer that question, we need to discuss shame and trauma. Shame is a form of developmental trauma. It leads to a similar type of avoidance. If your arm hurts, you don’t move it around. If you have a psychological wound, you don’t poke at it. Regardless if you are aware of trauma, it affects your mind, body, and spirit. How? Below is a list of typical reactions people have both right away or ones that are delayed.

Effects of Trauma on Mind, body, Spirit

Immediate Emotional Reactions Numbness and detachment Anxiety and/or panic Guilt (Either survival guilt or guilt for causing the problem) Exhilaration as a result of surviving Anger Sadness Feeling helpless or out of control Feeling as though you are watching your self (depersonalization) Disorientation Denial Feeling constricted or overwhelmed	Delayed Emotional Reactions Irritability and/or hostility Depression Mood swings, instability Anxiety (e.g., phobia, generalized anxiety) Fear of trauma recurrence Grief reactions Shame Feeling extra vulnerable or seen Emotional detachment
Immediate Physical Reactions Nausea and/or gastrointestinal distress Sweating or shivering Faintness Muscle tremors or uncontrollable shaking Elevated heartbeat, respiration, and blood pressure Extreme fatigue or exhaustion Greater startle responses Depersonalization	Delayed Physical Reactions Sleep disturbances, nightmares Increased focus on and worry about body aches and painsd Appetite and digestive changes including nausea, gas, bloating, constipation, and diarrhea Lowered resistance to colds and infection Chronic fatigue Elevated cortisol levels Hyperarousal Long-term health effects to any body system including autoimmune disease
Immediate Cognitive Reactions Difficulty concentrating Rumination or racing thoughts (like replaying the traumatic event in your mind) Distortion of time and space (like everything happened in slow motion.) Memory problems or misremembering events Strong identification with victims	Delayed Cognitive Reactions Flashbacks/intrusive memory of event or worse memory Previous traumatic events are reactivated Self-blame Difficulty making decisions Magical thinking: belief that certain behaviors, including avoidant behavior, will protect against future trauma Belief that feelings or memories are dangerous Avoiding similar situations to the traumatic event Suicidal ideation
Immediate Behavioral Reactions Startled reaction Restlessness Sleep and appetite disturbances Difficulty expressing oneself Argumentative behavior Increased use of alcohol, drugs, and tobacco Withdrawal and apathy	Delayed Behavioral Reactions Avoidance of event reminders Easily startled Social relationship disturbances Decreased activity level Engagement in high-risk behaviors Increased use of alcohol, drugs, and tobacco Withdrawal and apathy
Immediate Existential Reactions Intense use of prayer Restoration of faith in the goodness of others (e.g., receiving help from others) Loss of self-efficacy Despair about humanity, particularly if the event was intentional Immediate disruption of life assumptions and predictability of life	Delayed Existential Reactions Questioning “Why me?” Increased cynicism, disillusionment Excessive self-confidence and risk-taking Loss of purpose Renewed faith Hopelessness Reestablishing priorities Redefining meaning and importance of life Reworking life’s assumptions to accommodate the trauma (e.g., buying a gun)

Adapted from Treatment Improvement Protocol (TIP) Series, No. 57. Center for Substance Abuse Treatment (US). Rockville (MD): Substance Abuse and Mental Health Services Administration (US); 2014

While many diagnoses fit these symptoms, the similarity to pyrrole disorder and/or autoimmune conditions jumped out at me. For a long time, we have suspected that pyroluria is a physiologic response to trauma. It may or may not be but in another post I will discuss how trauma directly affects the body.

Trauma clearly affects many aspects of our lives. Because it is an energy block, trauma can block our creative force, particularly if you don’t remember the trauma. It could limit your life in ways that you don’t understand. If you freeze when trying to do some forms of work, such as writing an article about trauma, you may not get a promotion. Or if you are afraid to fly, you won’t be able to go to business meetings, or a family reunion in Hawaii.

What to Do About Trauma?

What do you do about trauma if you realize that it exists in your life? For the moment, working with a therapist (or me) is the best option. Working with me is a great option if you have pyrrole disorder or other health issues happening. While taking vitamins won’t take the trauma away, it often makes the process easier. I am working on an online course. Join this new mailing list to learn more.

How to Cope with Pandemic Anxiety using Teletherapy

March 26, 2020 by Dr. Gil Winkelman 2 Comments

In the two weeks since I sent my last newsletter about teletherapy we have all experienced many changes. Many of us are sheltered in place. We are stuck at home, balancing work and children. We are unaccustomed to the constancy of family being around, while some feel very isolated. What to do? Before I give more information, I want to let you know that for people in Oregon and some in Hawaii, I can bill telemedicine visits to your insurance. That change is a huge step in the right direction. I do not know how long this will last. And obviously I cannot do neurofeedback. But I can help with many medical issues and provide counseling during this difficult time. One of the curious aspects of this virus is that people with underlying conditions such as diabetes, heart disease, and high blood pressure may be at greater risk to this virus. Naturopathic medicine has much to offer regarding treating these conditions.

How to Cope with the Anxiety

What can you do to help yourself and your family? Here’s a list of the main items that I have compiled from looking at several studies about this, along with my experience of working from home for many years. Create a routine and stick to it! This is important even not in quarantine. We are creatures of habit in a lot of ways. Our bodies like consistency. I’m not suggesting that you have to do or eat the same thing every day. But going to bed and waking at the same time daily is good for our systems. It reduces stress and helps the adrenal glands be balanced. Lower stress means higher immunity. Another aspect of a regular sleep routine is it helps our bodies produce the proper amount of melatonin. It may be related to stress and cortisol levels, but higher melatonin levels also improves immunity. There are a few studies suggesting that melatonin levels that function properly help fight off coronavirus. (There have not been studies on supplements, only looking at melatonin in the body.) Every hour of sleep before midnight is like two hours after midnight to the body. I recommend going to bed by 10 PM. It can also help your weight too. Reframe your situation. Instead of thinking you are stuck inside the house, do projects you have not had time to complete. Always wanted to plant a garden? Get to it! Or maybe you wanted to explore an aspect of yourself. Whatever it is, you have time to do it now. Even if you are still working, most people will save commute time. (Not to mention getting ready for work time.) Use that extra few hours to do something you have wanted to do. Avoid the news. I know some have a morbid fascination with what’s going on. Or maybe there’s this unconscious belief that knowing what is going on will protect us. What is happening extends way beyond this outbreak. (I’ll write more about this later.) It is unlike anything we have faced in our lifetimes. But constantly going online and reading about what is going on is not good for anyone’s mental health. (I’m talking to you too, Facebook users!) The constant barrage of information is stress provoking even in good times. It’s super intense. Step away from the computer. Unless you’re watching funny cat videos. Keep things clean and decluttered at home. I have a confession to make. In the last three weeks, I have cleaned my house more times than I think I have in the last three years. Seriously! I have become a clean freak. And I have decluttered everything too. It is calming. I can think. I feel there is space to think. Start a quarantine ritual. This is odd I know. And it can be anything to meditating to journaling. Writing about what is happening can be super helpful for people. Use Video Chat and the phone to connect with friends. This is super important, particularly for teens. I think the most stressful thing for adolescents is the social isolation. Younger kids often miss their peers too. But they can talk on the phone or computer. (You can limit the time if that is appropriate. And limit social media.)

Kids and Relationship Issues

Signs of Stress in Kids. Along this line, if you have children there are definite signs of stress that may require help in this situation. Here’s a partial list:

In younger children, excessive crying or irritation.
Returning to outgrown behaviors (for example, toileting accidents or bedwetting).
Excessive worry or sadness.
Unhealthy eating or sleeping habits.
Irritability and “acting out” behaviors in teens.
Poor school performance or avoiding school (For those of you with closed schools, I’ve found that most kids want something to do to feel a little productive. So if they are avoiding everything, that could be a sign).
Difficulty with attention and concentration.
Avoidance of activities enjoyed in the past.
Unexplained headaches or body pain.
Use of alcohol, tobacco, or other drugs.

Take space. There was a tiktok video showing a cat upset that the humans were always at the house. My brother related to the cat. He works at home and found his family being shuttered with him to be stressful at first. And maybe others can relate. Take space for yourself and communicate to others around you. Explain calmly that you need time to yourself. NOTE: I will do a relationship workshop in the near-term. More on this later. Get outside if allowed by law. Being in nature is best, if you can and properly socially distance yourself. Having that time is necessary regardless. But this is a stressful time. Teletherapy for anxiety or just to talk. Get help when you need it. It’s so important to use professional help. As I mentioned, I provide services and can bill insurance for Oregon and Hawaii. But if you are in another state, telemedicine is required coverage now. Check with your healthcare provider because there are stipulations by different companies. But overall, there is help available. You can always call 808-726-2772 to schedule or ask about coverage.

The Advantages of Telemedicine Appointments: How to Get Care During an Outbreak

March 12, 2020 by Dr. Gil Winkelman Leave a Comment

With WHO declaring the Covid-19 a pandemic, we all must take precautions. By now you have received many emails about what to do to protect yourself. Social isolation, as best as possible, is one of them. That does not mean you cannot see the doctor. The advantages of telemedicine are clear right now. For many years, I have offered telemedicine appointments. I use HIPAA compliant software to allow me to do video consults with patients. For many people, this suffices to get their medical needs met. First, a quick reminder about how to protect yourself:

The CDC and the WHO recommend several basic measures to help prevent the spread of respiratory diseases such as Covid-19.

CDC and WHO Guidelines

Wash your hands often for at least 20 seconds.
Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
Clean and disinfect frequently touched objects.
Stay home when you are sick.
AVOID touching your face.
DON’T travel if you have a fever and cough.

NOTE: Several surveys suggest that only 66% of Americans wash their hands regularly. This is problematic. Get in the habit of washing your hands. It could save your or someone else’s life.

The Advantage of Telemedicine Appointments While in Isolation

Second, if you are showing symptoms, isolate yourself right away. There is testing available, but they must perform the test in an outpatient setting. The test is a nasal, lung, or throat swap. Hawaii is setting up test centers for symptomatic patients. Oregon is rolling out drive through testing stations. Many clinics do not want patients to come if they are showing symptoms. My local Adventist Health outpatient clinic is asking people to stay home and call the advice line if they are sick. Why? Most offices do not have resources to handle infections disease.

And this is one of the biggest advantages of telemedicine. Most people infected with the coronavirus (or another virus) can be treated at home. While it is likely highly contagious and will be deadlier than the seasonal flu, it is self-limiting in the majority of cases. I can prescribe treatments via video (or instruct you what to do if it’s more serious.) Telemedicine appointments can help with the coronavirus (or other illness). There are many natural treatments body fight infections before needing hospitalization. And if you have other health concerns, telemedicine appointments helps avoid exposure.

If you wish to discuss your symptoms, or have any other issues that require medical help, please call my office to schedule a telemedicine appointment.

You can email me at info@askdrgil.com or call 808-726-2772.

How to Cure Hypothyroidism and Anxiety

January 24, 2020 by Dr. Gil Winkelman 19 Comments

In medicine, hypothyroidism and anxiety aren’t typically associated. It is usually depression associated with a low thyroid function and anxiety with high. But many of my patients found their anxiety disappear with proper thyroid function. Why is this? Could low thyroid be the answer to treatment-resistant anxiety? Many patients come to me taking thyroid but are not feeling better. Others presented with subclinical hypothyroid. Why is this? Let’s explore more about these issues. I should note that hormone interactions in the body are very complex. This article does not serve as a full primer but a short introduction.

Before jumping into the complexity of hormones, I want to review the scope of the problem. Anxiety occurs in 30-40% of patients with hypothyroid. They can also have irritability, depression, learning issues, and poor concentration.

The Causes of Hypothyroidism (and Anxiety)

Most research suggests that doctors should not give medications for depression and anxiety until they check thyroid levels. While I agree with the approach in theory, it’s not as simple as testing thyroid.
To understand the paradox of this problem, I want to explain a bit about the hypothalamic-pituitary axis (HPT). This may be technical but bear with me. The hypothalamus and pituitary are in the brain, controlling hormonal function in the body through different hormones. The hypothalamus produces Thyrotropin-releasing hormone (TRH) to signal the pituitary to make thyroid-stimulating hormone (TSH). TSH signals to the thyroid to produce T4 (Thyroxine) which is stored in the thyroid gland until the body needs to use it. When the body needs energy, T4 converts to T3 (Triiodothyronine).

Because T3 is so potent, the body only converts what it needs when it needs it and mostly inside the cell. T3 then crosses into the nucleus and started turning genes on. If you have listened to my podcast about methylation and epigenetics, there may be a connection here. Remember that everything you eat, drink, breathe, and experience can change your genetic expression. Specifically, high or low methyl may affect T3 binding at specific sites, thereby producing different results. The following are required for the thyroid to work:

Hypothalamic/pituitary function
Secretion of TSH
Thyroid function (secretion of T4)
Thyroid hormone transport into the cell
Conversion of T4 to T3
Receptor binding
Downstream activation

There are a lot of steps. I want you to remember this list because it will be important in a moment.
But the doctor said my thyroid levels were normal!
Both the tests for thyroid and their interpretation are problematic. Typically, most doctors only run a TSH to see if thyroid is functioning well. But many recent research studies suggest that TSH is a poor measure of thyroid function. Several studies concluded that looking at just TSH does not show how cells are utilizing thyroid.

Some doctors know this and also measure T4 to determine thyroid function. There are problems with this approach. First, both TSH and T4 measure supply of thyroid hormone. A normal TSH means that the pituitary receives the message from the hypothalamus to tell the thyroid to produce thyroid. When these numbers are normal, most likely, your thyroid is working. But often in hypothyroidism, the problem stems from somewhere further downstream from the gland. Look at the list above. There are four more steps below the level of the thyroid that can lead to hypothyroidism.

Why am I Anxious if I’m Hypothyroid?

You may wonder how this related to anxiety. The short answer is we don’t know. My best guess is that the sympathetic nervous system kicks in to speed up processes in the body. Adrenaline rushes over long periods leads to anxiety.

If you suffer from anxiety, depression, learning issues, or brain fog, it’s time to get your thyroid checked. There are better ways to test thyroid than just doing a TSH including taking your temperature or measuring other hormone in the body such as sex hormone binding globulin. This is what I do in my practice now instead of measuring just the thyroid levels. I am certified in Wilson’s Temperature Syndrome therapy, a novel approach to correct issues with thyroid conversion. In fact many people who were previously diagnosed with Hashimoto’s or other thyroid issues, regained healthy thyroid function after this treatment approach. Schedule with me if you want to learn more. Your path to feeling better is just around the corner.

The Simple Way to Cure Your Stubborn Migraine Symptoms

February 8, 2019 by Dr. Gil Winkelman 30 Comments

Migraine symptoms can be extremely painful. If you have never had one, you are lucky. Migraine symptoms consist of debilitating head pain, nausea, vomiting, and sensitivity to sounds and light. In extreme cases, one can feel weakness on one side of the body that can last minutes to days. Some people never get head pain; rather they have problems with vision such as an aura around everything (ocular migraine symptom), stomach pain (abdominal migraine), or some other unexplained phenomenon. An article in the Sunday NY Times provides a bit of a first person account of migraines. Natural migraine treatment requires us to know the cause. I have identified at least 9 different causes of migraines. Likely there are more than the nine. Let’s explore the causes of the migraines and possible treatments such as LENS Neurofeedback.

Before we jump into the categories of migraines, I just want to give a brief overview of the scope of the problem. Estimates vary between 10-20% of the US population suffers from migraine symptoms. It costs consumers approximately $12.7 billion a year in medical costs plus another $12 billion in missed workdays. People who suffer from migraine headaches make less money than people who don’t. Not only that, people who get migraines are at a greater risk of heart attack and stroke.

Traditional medicine manages migraines headache symptoms with polypharmacy, or the use of multiple drugs. While providing relief, many of this drugs have side effects too. Determining triggers can help reduce the frequency of migraines. Chocolate, alcohol, caffeine, menses and barometric changes are some of the common ones. A trigger creates a migraine but isn’t necessarily the cause. The cause though is what makes the trigger manifest into a migraine. Not everyone who eats chocolate gets a migraine. For those who are susceptible to migraines, chocolate can create one. By the cause, I mean what is it that allows a trigger to work. Stress and a lack of sleep may also affect people. The trigger though, isn’t the same as the cause. I work with people to help them understand triggers because it can bring relief. Then we find the underlying cause so they don’t get sick again. Many of my patients tolerate the thing that made them ill previously. They start to live their life more fully.

The Simple Way to Cure Your Migraine

Understanding the cause is the simple way to cure migraines. Finding the cause is not always so easy. Let’s explore some of the different causes.

Traumatic Brain Injury (TBI): One of the most common causes of migraines is previous head trauma. I discuss the details of head trauma in the last post. Head injury is common and can cause migraines. Even minor bumps on the head or whiplash injuries can add up and lead to headaches later in life. In the last post, I go over the treatments in this situation.

Female Hormonal Imbalances: Many women get migraines related to their menstrual cycle. The headaches can occur right before or when their menses start. While this can be its own cause, it is usually related to liver imbalances. Treatment requires balancing of the hormones first. Ensuring that the cycles are regular is the first thing I do in this case. More often than not, though, it requires looking at the liver.

Liver Imbalance: Liver imbalance is common for people with migraines. The liver clears toxins from the body, and hormones are no exception. But other imbalances can occur too. The inability to eat rich foods or drink alcohol without a problem maybe a sign of a liver issue. The way I describe this issue to patients is that their liver cells just aren’t working as liver cells. Naturopathic treatments remind the liver cells how to do their job. Our DNA is more of a blueprint than a hardcoding. The body has flexibility in what it produces. If the liver isn’t doing its job, it means it’s not producing the proper proteins to be doing its job. I use a variety of supplements that assist the liver and others that work to reset the epigenetic state. Gemmotherapy, homoepathy, and low dose botanicals can all help with the liver.

Gastrointestinal: This is distinct from a liver problem. Sometimes, there is a problem with the foods we eat because we aren’t digesting them. This could be due to food sensitivities causing GI distress. For reasons unknown, this can lead to migraines. Changes in the healthy flora in the intestines can lead to this issue. These organisms help protect the gut and allow us to digest food well. The reason why so many people react to so many foods is that the gut is too loose. Leaky gut is a real problem, and one of its symptoms is migraine. Small Intestinal Bacterial Overgrowth or SIBO can be the culprit too. Proper diagnosis of this problem starts with an elimination diet. If the problem isn’t completely resolved, then I run other tests. SIBO, Leaky Gut, Irritable Bowel Syndrome, and Crohn’s can all be causes of migraines. Treatment varies based on the diagnosis.

Hormonal: Other hormonal imbalances can lead to migraines. Adrenal imbalances causing rapid changes in cortisol or epinephrine can cause migraines. The adrenal gland is also responsible for instructing the liver to produce certain proteins. Sometimes the liver is fine but the adrenals aren’t directing it appropriately. Or the thyroid may be out of balance. An imbalance in either could disrupt sleep, and fatigue is a common trigger for migraines.

Metal Imbalance: This is a new one for me although the research about this is almost 30 years old. The main culprits here are Zinc and Copper. The body requires both metals for proper functioning. In general, Americans are low in zinc and high in copper. This may be due to the effects of food processing, but it is unclear why. High copper levels may cause both migraines and menstrual difficulties. It also exacerbates low zinc. Zinc supplementation has shown promise in research studies as a treatment for migraines. (Med Hypotheses. 2011 Jul;77(1):147-51. A new horizon into the pathobiology, etiology and treatment of migraine. Dillion, Singh, Lvall) Simple testing of blood and/or hair can help reveal this issue. Zinc supplementation can be effective for raising zinc levels. Vitamin E and other nutrients can lower copper levels.

Heavy Metals: Another issue with metals is the heavy variety. Mercury, cadmium, arsenic, and aluminum can all contribute to migraines. Heavy metals can come from a variety of sources, and often the headaches come on as the body is trying to get rid of them. Elimination of metals needs to be gradual to prevent severe symptoms. A simple mineral prescription can start to mobilize the offending metals out of the body. Headaches will be completely gone in months.

Inflammation: Inflammation is starting to gain traction as a cause of many different conditions. Recent publications have suggested that migraines may be inflammatory. What does this mean? Inflammation is the process the body uses to heal damage. It is to be a short-term activity to do so. Cells release hormones called cytokines that are signals to repair damage. These make us feel achy, sluggish, and depressed. For various reasons, the body sometimes gets into a chronic inflammatory state. This means that the entire body feels down, as if ill. In some people, the inflammation leads to headaches. The reasons aren’t completely clear. Treatment would consist of lowering inflammation in the body. This is probably a good idea for most people. An anti-inflammatory diet, omega-3’s (fish oil), and turmeric are simple ways to reduce inflammation.

Cardiovascular: Changes in arterial pressure may also contribute to migraines. In this situation the pain doesn’t start with stress but when there is relaxation. Patients get migraines on the weekend or on vacation. What is interesting is that some of these patients may have had asthma earlier in life. There appears to be changes in the autonomic nervous system affecting the arteries. Another issue that can arise is that the person with migraines has a small hole in their heart. We have no idea what the relationship is between the two and it is somewhat rare. Treatment here definitely varies depending upon the situation. Neurofeedback or biofeedback can be helpful to stabilize the nervous system.

Musculoskeletal Issues: TMJ, neck issues, and shoulder injuries can all cause migraine symptoms. I didn’t include this in the first iteration of the article and a chiropractor reminded me of this. We don’t know the exact mechanisms of this but there may be a stress or emotional component. Many patients find relief with physical adjustments, massage, and craniosacral therapy.

Emotional: Mental/emotional issues can cause migraines. And what comes first, is not clear. LENS Neurofeedback can be extremely useful for decreasing migraine symptoms (or even curing them entirely.) But for many people, simple exercises that reset the autonomic nervous system can improve people’s lives.

These are some of the causes of migraine. Others exist, of course, but these are the ones that I see most commonly in my practice. As you can see, it is a complex problem, and just treating the symptoms won’t change the issue. Treating the underlying cause helps reduce the problem. If you or someone you love suffers from migraines, please call me. I have a Naturopathic practice in Portland but can work with people remotely using Skype or telemedicine. While my I delight in helping people. And maybe you too can one day be migraine free.

Flu, Dis-ease, and Balance

November 19, 2018 by Dr. Gil Winkelman 2 Comments

Dr. Gil adds that maintaining health should be no different during winter than during any other season. Ill health may manifest differently during the colder months than at other times of the year, but true vitality and wellness are reflected in many more measures than whether or not you develop an infection.

Staying healthy does not mean staying free of infection. The body needs tune-ups from time to time, which is something that infections provide. Acute illness is a way our bodies eliminate unhealthy cells and toxins.

But repeated infections, overly severe symptoms, and lingering illness are not signs of good health. Even without an infection, imbalances of mood, energy, focus, stress, sleep, and/or food cravings can be clues of disturbance in the body. Balancing these are important to be able to live life to the fullest.

When people ask me in November what they can do to avoid the flu, it’s akin to being concerned, in June, about how your bathing suit will look on you this summer. Good health is a daily process requiring constant acts. Consistently good diet, exercise, stress relief, and supplementation over months or years provides the most significant protection. That said, there are things we can do to help during the cold and flu season. Here are a few ideas to help.

Vitamin D supplementation is super important in the Pacific Northwest but likely everywhere in the winter. Testing levels can help determine how much is needed. Vitamin D helps boost immune function, and low levels may be related to immune suppression.
Vitamin A is an excellent anti-viral. Supplementation can help ward off infection.
A good quality probiotic (the “good bacteria” you’ve perhaps heard about), which balances immune function. Probiotics are also excellent for clearing excess hormones.
Zinc supplementation is essential for immunity. Most Americans are zinc deficient. Zinc balances many functions in the body including immune resistance. Without it, the body is at a critical disadvantage fighting infections.

A combination of these can help reduce your risk of illness and keep you healthy this holiday season. If you have tried these and still get sick a lot, call for a consultation.

What you Need to Know about Reactive Attachment Disorder

June 23, 2018 by Dr. Gil Winkelman Leave a Comment

Today we have a special guest on Ask Doctor Gil. Esther Prelog joins Dr. Gil to discuss Reactive Attachment Disorder or RAD. RAD is a more common than previously believed and presents some tricky aspects to treatment. There’s a lot of misinformation about RAD leading to misdiagnosis at times. While Dr. Gil works with the biochemical and neurological pieces of RAD, there is a definitely need for psychotherapy, trauma work, and emotional healing to recover. Starting treatment early is extremely important to improving outcomes.

The first workshop will focus on pyroluria. What is pyroluria? It’s a sign of oxidative stress that when it arises can lead to many physical and emotional issues. You can learn more about it here.

Dr. Gil also offers online consultations for most mental/emotional health issues including RAD, ODD, OCD, anxiety, depression, schizophrenia, and others.

How To Evaluate The Safety Of Sunscreens

June 23, 2018 by Dr. Gil Winkelman Leave a Comment

Summer is Coming! That means it’s time to slather on the sunscreen right? But are they all safe? Recently, the state of Hawaii banned certain sunscreens due to reef destruction. But it isn’t just reefs that are endangered by these chemicals. You are! On this episode of Ask Doctor Gil, Dr. Gil discusses the problems with some of the chemicals in sunscreens and why you need to avoid them.

The first workshop will focus on pyroluria. What is pyroluria? It’s a sign of oxidative stress that when it arises can lead to many physical and emotional issues. You can learn more about it here.

Dr. Gil also offers online consultations for most mental/emotional health issues including RAD, ODD, OCD, anxiety, depression, schizophrenia, and others.

Are Online Doctor Consultations Appropriate for You

June 19, 2018 by Dr. Gil Winkelman Leave a Comment

Dr. Gil offers telehealth services or Online Doctor Consultations. On today’s AskDrGil podcast, Dr. Gil explains why telemedicine might be appropriate for you and what the process is like.

The first workshop will focus on pyroluria. What is pyroluria? It’s a sign of oxidative stress that when it arises can lead to many physical and emotional issues. You can learn more about it here.

Dr. Gil also offers online consultations for most mental/emotional health issues including RAD, ODD, OCD, anxiety, depression, schizophrenia, and others.

The Amazing Effectiveness of Holistic Treatment for OCD

What is OCD?