Food, Glorious Food

Posted by Jennie Ann Freiman MD on

With the exception of the last hundred or so years… the time when science promised to outperform nature… humans relied on food both as a source of nutrients and for its ability to prevent illness. History repeats.
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Normal Isn't Always Good Enough

Posted by Jennie Ann Freiman MD on

“Normal” is often not good enough, especially when it comes to health. We consider something “normal” if it’s an accurate statistical representation of a given outcome. In the case of standard laboratory testing, generally normal results do not necessarily equate to optimal outcome for the individual. Until personalized medicine (tailoring diagnosis and treatment to each patient) is fully realized, it makes sense to scrutinize current laboratory reference ranges defined as “normal.” Frequently, we can do better.

These are three important examples of tests whose normal results are linked to specific (avoidable) disease states:

Thyroid health: Thyroid-stimulating hormone (TSH) is the standard screening test for assessing thyroid function. Most laboratories (and doctors) accept a range of 0.4-5.5mIU/L as normal, despite overwhelming evidence that adverse health outcomes are linked to TSH above 2.0, even when thyroid hormones (T3 and T4) are normal. Health conditions associated with a TSH in the upper half of normal include an increase in blood lipids, cardiovascular disease and mortality, fracture (and low bone mineral density, especially in post-menopausal women), male and female infertility, complications of pregnancy (miscarriage, preterm labor), mood disorders, dementia, and autoimmune thyroiditis (Hashimoto’s disease). Experts have known about the increase risks of high-normal TSH for over two decades, but so far this awareness hasn’t led to a revised consensus for diagnosis and treatment. One recent recommendation for evaluating thyroid disease involves screening with a combination of TSH, free T3 and T4, and consideration of the individual’s clinical status. Redrawing the lines of “normal” to the narrower 0.4-2.0 mIU/L range for TSH would cause millions of Americans to suddenly be diagnosed as hypothyroid, creating an unwelcome burden for insurance companies.

Vitamin D3: Vitamin D plays an important role in both skeletal and non-skeletal health. Public health recommendations for sun-avoidance, successful in protecting against skin cancer, contributed to epidemic levels of vitamin D deficiency in the general population. The lower end of the common laboratory “normal” range of 20-50ng/mL is not optimal. Insufficient vitamin D3 is associated with an increase in fracture, cancer, and cardiovascular, autoimmune and neurodegenerative disorders. The Vitamin D Council recommends 50ng/mL as the ideal level. Prudent sun exposure and vitamin D intake by diet and/or supplements to reach this level is strongly recommended. Note: Levels of vitamin D above 100ng/mL are too high and pose health risks.

Homocysteine And Vitamin B12: Homocysteine is commonly tested as a marker for cardiovascular health but its relationship to cognitive impairment and Alzheimer’s disease should be considered in assessing normal reference ranges. Homocysteine reflects the status of vitamins B12, B6 and folate, all of which are key to optimizing mental function. The normal range for homocysteine in women is <10.4 umol/L and in men, <11.4 umol/L. Clinical studies find that homocysteine levels at the high end of normal are linked to a 1.15 to 2.5 relative risk for dementia. Optimal homocysteine is less than 7.2 umol/L. Similarly, normal vitamin B12 levels of 200-1100pg/mL are associated with dementia at the lower end of 200-400pg/mL. Homocysteine, B12, B6 and folate can be improved by diet and supplements.

Optimizing health is the best insurance policy for resilience against disease. Take steps that make a difference.


Disclaimer: This article was created for informational purposes only, is not intended to provide medical advice, diagnosis or treatment and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Views expressed here do not necessarily reflect those of Oobroo™ Inc or its staff.

References available on request: email


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This Year, Skip The Flu

Posted by Jennie Ann Freiman MD on

February just started, yet the 2017-2018 flu season has already recorded the highest level of infection since the swine flu pandemic of 2009. Nationwide, the flu has many hospitals at “surge capacity,” the limit of their ability to handle a sizable uptick in the number of people needing urgent care. H3N2, the main flu strain, is highly contagious, virulent and deadly. The flu vaccine is only 10% effective against H3N2, so preventive measures are the best hope for staying safe.

These strategies help:

Wash hands often, with plain soap and water. Prevent flaking and dry skin (a portal of entry for germs) by moisturizing with organic coconut oil after washing. If soap and water are not available, alcohol (i.e. vodka) or a few drops of organic lavender essential oil are effective, non-toxic hand sanitizers.

Avoid touching your face (eyes, nose, mouth), which spreads germs. No hands in the mouth, including nail biting. On average, the hand-face connection happens 16 times an hour!

Don’t share eating or drinking utensils, even if the person isn’t obviously sick, because flu has an incubation period of 1 - 4 days before symptoms show.

Use a neti pot or daily nasal syringe bulb rinse to flush out viruses and secretions that trap them. Buy a saline nasal rinse or make your own by combining 3 teaspoons of iodide-free salt plus 1 teaspoon of baking soda in 1 cup of distilled water.

Avoid areas in which air is re-circulated, such as shopping malls, locker rooms, long term care facilities, hospitals, mass transit and airplanes.

Sanitize surfaces, including doorknobs, handles, staircase rails, phones, computer keyboards, remote controls, faucets, water fountains, gym equipment, elevator buttons and anything that many people touch throughout the day. Viruses can live on surfaces for more than 24 hours. No sanitizer available? Grab surfaces with your hand wrapped in a tissue or paper towel.

Avoid close contact with those who are sick: sleep in separate bedrooms, don’t share towels.

Slowly breathe out until 10 feet away from anyone coughing or sneezing to avoid inhaling contaminated air.

Strengthen your immune system with lifestyle factors that make a difference: get enough good sleep, exercise regularly, reduce stress, eat real, organic food.

Up your intake of organic herbs and spices with known anti-viral activity, including oregano, onion, turmeric, ginger, (crushed, raw) garlic. Organic supplements are available.

These foods/nutrients have been scientifically shown to reduce the incidence of flu:

  • Vitamin D: practice prudent sun exposure and/or take a vitamin D3 supplement to optimize blood levels to 50 – 70 ng/ml.
  • Green or black tea: 1 -5 cups daily.
  • Probiotic foods: live culture yogurt, kefir, kombucha, natto, pickles, sauerkraut, kimchi, miso, tempeh. Organic supplements are available.
  • Mushrooms: consume daily, shiitake and maitake are the best. Organic supplements are available.

The flu season commonly extends through May, so commit to these measures over the long haul. Why combat the flu when you can just skip it?


Disclaimer: This article was created for informational purposes only, is not intended to provide medical advice, diagnosis or treatment and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Views expressed here do not necessarily reflect those of Oobroo™ Inc or its staff.

References available on request: email

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Brain Fog: It's All In Your Head

Posted by Jennie Ann Freiman MD on

Brain fog is commonly recognized as a cluster of symptoms that include forgetfulness, confusion, trouble concentrating, and a distracted, almost out-of-body sense of detachment. It can be linked to the use of medication (chemo-brain), health conditions (fibro-fog, lupus-fog, thyroid-fog and others) and/or lifestyle-related. In all cases, brain fog is not a medically or psychologically recognized diagnosis, which makes it hard for patients to be taken seriously by their health care providers. Doctors traditionally confirm a diagnosis with “hard” evidence, objective findings supported by lab tests, rather than subjective complaints and symptoms. Finally, things are changing: the recent use of neuroimaging gives credence to what those experiencing brain fog have always known: the sense of living in a cloud is very real. Brain fog objectively falls within the spectrum of cognitive impairment. Imaging studies show the foggy brain is challenged both by physical defects and subpar performance.

CT and MRI scans are useful for evaluating brain structure, assessing its physical state. PET, SPECT and fMRI (functional MRI) show the brain in action, how it functions in terms of blood flow, metabolic activity and oxygen use. fMRI maps brain activity in areas responsible for memory formation, decision-making, language, emotion and pain, among others. The foggy brain has some combination of physical and functional gaps that translate to reduced mental function, distraction, and difficulty communicating, coping, and interacting socially. Day-to-day living and quality of life suffer.

Neuroimaging studies support these conditions:

Chemo-brain: Up to 1/3 of people who undergo chemotherapy experience some version of brain fog, which can be short term or long lasting. It’s hard to know exactly how many people are affected because cognitive reserve can compensate for loss of mental function, which causes the real incidence of brain fog to be underestimated. For breast cancer treatment, the most studied form of chemotherapy-related cognitive impairment, rates are as high as 40% and higher in the case of women treated before menopause. MRI findings include total brain shrinkage, especially in the hippocampus, the memory center. PET scans show changes in brain metabolism, with less energy use in areas responsible for planning and prioritizing. fMRIs detect reduced blood flow to and through the brain and less brain connections, commonly resulting in distraction and weakened verbal memory.

Fibro-fog: Brain fog is one of the most common complaints with fibromyalgia, a complex disorder of generalized and widespread pain, fatigue and reduced function. The same holds true for chronic fatigue syndrome. Both conditions are tough to pinpoint and tend to be diagnosed by exclusion, defaulted to when nothing else explains the findings. Common laboratory tests are not useful in these cases. On MRI, fibro-fog is characterized by structural defects in gray matter, the brain’s cells and their connections. Neuroinflammation and alterations in brain patterns for pain signaling are seen on fMRI. fMRI findings are so specific that researchers believe they have uncovered a potential neurophysiologic “signature,” objective brain patterns unique to fibromyalgia. These results await further scientific confirmation. Stanford investigators report a specific neuroimaging signature has also been found for chronic fatigue syndrome and, in the future, may be valuable as a biomarker of that condition.

Thyroid-fog (also known as “cold brain syndrome”): Thyroid hormone is essential for normal brain development and function, so it’s no surprise that when lacking, cognitive performance is impaired. Neuroimaging studies in hypothyroidism show decreased brain connections and metabolic alterations in multiple areas involved in learning, memory, attention and mood. A 2014 study found that adults with significant hypothyroidism experience impaired driving similar to driving under the influence of alcohol. Study subjects were tested on a driving simulator, confirming impaired function that risks both personal and public health. When the thyroid doesn’t work, energy production is lowered. In the brain, less energy means less function.

Lupus-fog: Neuroinflammation is behind much of the physical and functional limitations found in this, rheumatoid arthritis, and other auto-immune disorders. The main neuroimaging correlates for lupus relate to fatigue, mood disturbances (especially depression) and fuzzy mental function.

Some quick tips for brain fog:

  • Identify, and if possible eliminate, any medication, prescription and over-the-counter, known to be linked to cognitive impairment, including cholesterol-lowering statins, sleeping pills and anticholinergic allergy and acid reflux drugs.
  • Seek treatment for associated medical conditions, in addition to those listed above, including depression, menopause, hepatitis C and lyme disease.
  • Address lifestyle contributors including stress, sleep disturbance, heavy metal and other environmental toxins, food allergies and additives, nutritional deficiencies, and lack of exercise.
  • Anti-inflammatory supplements and cognitive behavioral therapy are helpful interventions. 

Summary: There are distinct differences in the structure and function of the healthy brain vs. the foggy brain. Brain fog is real, and yes, objective studies show it’s all in your head.

Disclaimer: This article was created for informational purposes only, is not intended to provide medical advice, diagnosis or treatment and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Views expressed here do not necessarily reflect those of Oobroo™ Inc or its staff.

References available on request: email

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5 Easy-To-Keep New Year Resolutions

Posted by Jennie Ann Freiman MD on

If 2018 is typical, new year resolutions made while reveling in the closing days of 2017 will quickly fall by the wayside as real life draws each of us into its web of never-ending demands and obligations. To match intent with success, commit to small changes that promise big results. If wellness made the cut in your plans (it should have!), these five, easy-to-adopt-and-stick-to new year resolutions will make a real difference: 

1. Time-Restricted Eating (TRE): Weight Loss And So Much More

Losing weight is a popular favorite for the new year, but how to get there? Calorie restriction and the self deprivation demanded in most diet plans dooms them to failure, but luckily, there is a better way. Confining food intake to a 12 hour window takes advantage of a metabolic state that burns stored fat. TRE is a user-friendly, scientifically-validated approach with many health bonuses, making it a great choice whether or not weight loss is the goal. TRE lowers systemic inflammation, the root of all illness, and reduces oxidative stress, the damage caused by harmful free radicals. Combining TRE with high quality (organic, unprocessed), nutrient-dense food is one-two punch against obesity and chronic illness. Sticking to TRE is surprisingly easy. For example, finish dinner and all food intake by 7:30PM and don’t eat again until 7:30AM, a plan that extends the overnight fast that naturally occurs during sleep. Zero calorie drinks including water, black coffee and tea are allowed during the fast, making it that much easier to accomplish. TRE doesn't interfere with socializing or going out to dinner, and taking an occasional break for a day or two to enjoy an eating binge doesn't harm the plan long term. Since the benefits of TRE are directly related to the length of time fasting, a longer fast is better. Skipping breakfast and delaying the first meal until lunch, confining food to an 8 hour window (the 16:8 program, 16 hours off food, 8 hours on) is ideal. Start with 12 hours, any extension is a bonus.

2. Sauna Bathing: Heat Is Good Stress

Known as the “poor man’s pharmacy,” regular sauna bathing is roughly equivalent to moderate intensity exercise, reducing all-cause mortality and benefitting cardiovascular and brain health. Healthy heat lowers blood pressure, total cholesterol, LDL (“bad”) cholesterol and triglycerides, raises HDL (“good”) cholesterol, and reduces the incidence of Alzheimer’s disease and dementia. Sauna benefits are directly related to frequency of use: while once weekly promotes wellness, partaking 4 - 7 times each week is optimal. Camaraderie, relaxation, stress reduction, and disconnecting from technology are some of the ways sauna promotes wellness.

3. Side Sleeping: Position Yourself For Wellness

A good night’s sleep is key for both a sound body and a sound mind, yet the American sleep diet keeps getting stricter. Apart from time asleep, ideally a restful 7 - 9 hours, position influences the restorative value reaped in the land of nod. Supine (flat on your back) sleep is linked to snoring, sleep apnea and teeth grinding, and because it’s related to the lowest blood oxygenation of all sleep poses, it’s harmful to chronic lung and heart conditions. Prone (face down) sleep is an orthopedic no-no that worsens neck and back pain. Lateral (side) sleeping is the ideal posture. Curling up in the fetal position allows you to breath easier, reduces heartburn (left side), improves blood pressure (right side) and helps the brain optimize its overnight housekeeping function, clearing out cerebral waste linked to neurodegenerative diseases including Alzheimer’s and Parkinson’s. Pillow props that prevent rolling onto the back help maintain side sleeping.

4. Daily Salad: This One-A-Day Keeps The Doctor Away

Think of it as a multivitamin in a bowl: eating a diverse, colorful organic salad every day is a smart and delicious way to consume a nutrient rich powerhouse untainted by chemicals and artificial fillers and colors typical of one-a-day supplements. One salad serving daily, a key pillar of the MIND diet, improves memory and slows cognitive decline by an amount equivalent to being 11 years younger in brain age. Regular salad consumption also lowers the incidence of heart attack and metabolic syndrome. Salad dressing made with healthy fats such as olive oil and/or including avocado and other healthy fat foods in the mix, improves absorption of fat-soluble nutrients and vitamins such as beta-carotene, lutein, and vitamins E and A.

5. Talk To A Stranger: Small Talk, Big Effects

Civil inattention, the ability to navigate among strangers while maintaining anonymity, is standard operating procedure for modern life, but maybe it shouldn’t be. Humans are social animals in need of engagement, a skill whose loss has been accelerated by digital technologies that isolate us while defining anyone as little as one click away as being a “friend.” The world is full of opportunities to engage others and reap emotional, psychological and physical benefits. Whether it’s during the daily commute, grocery shopping, or walking the dog,  connecting with others increases happiness and pays it forward: the joy of connection is contagious. Being neighborly banks cardiac prosperity, reducing heart attack risk and increasing the use of preventative health care services. Expose yourself to new perspectives, fresh ideas, invite opportunities, network, get out of your comfort zone. Next time, when you need a ride, choose UberPOOL over UberX.

You don’t always have to think big: many small steps create a butterfly effect of wellness.

Wishing you and yours a very happy, healthy and well-thy 2018.


Disclaimer: This article was created for informational purposes only, is not intended to provide medical advice, diagnosis or treatment and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Views expressed here do not necessarily reflect those of Oobroo™ Inc or its staff.


TRE: and PMC 4255155 

Sauna bathing: and 27932366

Side sleeping: and PMC5310097

Daily salad: and 26779528

Talk to strangers: and 28214249


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