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What is Holism? - the person as a whole / the innate ability to heal individualism / client-centered / terrain theory / meeting halfway upstream thinking / why? / root causes / mechanisms & processes elegance / obstacles to cure docere / empowerment / teaching @marrmedicine | evokemedicine.com What is Holism? - the person as a whole / the innate ability to heal individualism / client-centered / terrain theory / meeting halfway upstream thinking / why? / root causes / mechanisms & processes elegance / obstacles to cure docere / empowerment / teaching @marrmedicine | evokemedicine.com “it is much more important to know what sort of person has a disease, than what sort of disease a person has” William Osler, MD, Founder, Johns Hopkins Hospital @marrmedicine | evokemedicine.com Brain Fog to Brain Power finding the Cognitive Edge Maximize your brainpower, memory & speed of thought Be more creative & think outside the box Be your absolute best - physically, mentally, emotionally, socially Climb the corporate ladder, lead a company Balance work, play & family @marrmedicine | evokemedicine.com Dr. Jason Marr, Naturopathic Doctor - Using evidence-based, integrative & functional medicine, I work with urban professionals to prevent, overcome & address adrenal dysfunction, optimize body & brain function, so that they can do what they want to do, and achieve their goals. @marrmedicine | evokemedicine.com Know Your Speaker: Dr. Jason Marr, BScH, ND - Bachelor of Science degree in Kinesiology w/ Honours - Honours Thesis: Imagery Training in Elite Athletes University of Waterloo, Waterloo, ON St. Francis Xavier University, Antigonish, NS - Naturopathic Doctor - Canadian College of Naturopathic Medicine, Toronto, ON @marrmedicine | evokemedicine.com Evoke Integrative Medicine Ltd.: Naturopathic Doctor & Director - Practice focused on: - - Adrenal Dysfunction Brain Medicine Sports & Injury Rehabilitation Corporate Wellness Competitive & Elite Athletes Modalities: - Diet & Lifestyle Counselling Nutraceutical & Orthomolecular Medicine Herbal / Botanical Medicine Acupuncture & Intramuscular Stimulation (IMS) Low-Level (Cold) Laser Therapy @marrmedicine | evokemedicine.com Institute of Holistic Nutrition (IHN): Instructor - Nutritional Pathology Applied Endocrinology Lab Diagnostics in Clinical Practice Nutritional Fundamentals for Health (NFH), Genuine Health: - Medical Consultant @marrmedicine | evokemedicine.com Proactive vs. Preventive: Preventive: Doing something to stop something bad from happening Proactive: Doing something to get maximize/optimize your health - Outcomes: - Increased energy, motivation, libido, physical & mental abilities Improved memory, focus, concentration & speed of thought Improved creativity & problem solving skills Increased productivity & opportunity @marrmedicine | evokemedicine.com Optimizing Brain Function: - Memory / short-term, long-term Focus & Concentration / seeing through the crowd Brain Fog / the haze Speed of Thought / reaction time Mood / anxiety, depression Low Libido / motivation / “burnout” / overtraining Creativity / foresight / thinking outside the box @marrmedicine | evokemedicine.com • Brain Diseases/Disorders - Alzheimer’s Disease - Multiple Sclerosis - Parkinson’s Disease - Dementia - Stroke - Anxiety, Depression - Other Mental Disorders @EvokeIM | evokemedicine.com @DrMarrND | drmarr.com @marrmedicine | evokemedicine.com • Sub-acute & Sub-chronic Conditions - Adrenal Dysfunction - (Brain) Fatigue / “Burnout” / Overload - Declining memory, focus, concentration - Lowered libido, motivation - Insomnia @EvokeIM | evokemedicine.com @DrMarrND | drmarr.com @marrmedicine | evokemedicine.com Your Brain Needs Fuel: - Oxygen Glucose @marrmedicine | evokemedicine.com Your Brain Needs Fuel: - Oxygen - Glucose - Glucose @marrmedicine | evokemedicine.com Brain Fuel Requires Blood Delivery: Delivery of oxygen & glucose is dependent on : - blood flow to the brain healthy blood (rule out anemia, esp. iron & b12 deficiencies) ability to minimize physical/physiological/chemical damage to the brain tissues caused by using oxygen and glucose as energy sources crossing a healthy blood-brain barrier - inflammation oxidative stress & free radicals @marrmedicine | evokemedicine.com Brain Function Requires Neurotransmitters: Neurotransmitters are chemicals that transfer messages between neurons and from neurons to organs and tissues: - - Dopamine / energy, voltage, power, pleasure Acetylcholine / youth, memory, speed - GABA / control, calm, rhythm Serotonin / mood, sleep, rest @marrmedicine | evokemedicine.com @marrmedicine | evokemedicine.com What are the Adrenals? - Small pyramid-shaped glands - - Sit atop each kidney, mid-lower back/flank Adrenals secrete: - Cortisol Epinephrine (Adrenaline) & Norepinephrine (Noradrenaline) @marrmedicine | evokemedicine.com Sympathetic Response: - Fight or Flight: - The adrenals are designed to provide us with a short, massive boost of energy to save your life when under stress (car on fire, sabre-toothed tiger). @marrmedicine | evokemedicine.com @marrmedicine | evokemedicine.com @marrmedicine | evokemedicine.com @marrmedicine | evokemedicine.com @marrmedicine | evokemedicine.com stress @marrmedicine | evokemedicine.com anxiety @marrmedicine | evokemedicine.com worry @marrmedicine | evokemedicine.com grief @marrmedicine | evokemedicine.com Real-life Stress: - Physical / trauma Psychological / emotional / social - financial/money/employment marital/relationship/family negative attitudes & beliefs, fear, worry, grief @marrmedicine | evokemedicine.com Real-life Stress: - Physiological / biochemical - - lack of, or excessive exercise & overexertion, infection stimulant use, lack of sleep, lack of routine anemia (iron & b12 insufficiencies) hypothyroidism Environmental / Terrain - nutritional / nutrient inadequacies, caffeine, sugar, simple carbs food allergies/sensitivities/intolerances toxins / heavy metals, smoking, drugs, etc. @marrmedicine | evokemedicine.com The body does not differentiate stresses: - Stresses are additive & cumulative - - A single event, or repeated events may cause changes in health The body can become “primed” or “stuck” in a sympathetic state (ie. “overdrive”) Adrenal “Fatigue” (Adrenal Dysfunction) @marrmedicine | evokemedicine.com Cortisol is not the devil you think it is… @marrmedicine | evokemedicine.com Hormones Associated with the Adrenals: - Cortisol: - Anti-inflammatory Increases metabolism of carbohydrates, proteins & fats for energy Decrease white blood cell action & formation - - (depresses the immune system) Cortisol has rhythm: - Stress disrupts cortisol’s diurnal, routine, circadian release Generally, should be highest around 5-7am, taper throughout the day @marrmedicine | evokemedicine.com Hormones Associated with the Adrenals: - Epinephrine & Norepinephrine: - - Increase heart rate Increase blood pressure Increase respiration rate (more oxygen) Shunt blood to peripheral tissues (esp. brain, heart, lungs, muscles) Shunt blood away from visceral organs, digestive system Remember: The Brain Needs Fuel! @marrmedicine | evokemedicine.com Signs & Symptoms of Adrenal Dysregulation: Syndrome: A collection of signs & symptoms forming a pattern -You don’t have to have all the signs/ symptoms to “have” adrenal fatigue, nor does any one sign/symptoms define the issue. Fatigue / low energy / lethargy - - difficulty waking up (unrestful sleep), not really awake until 10am < around mid-late afternoon (esp. 3-5pm) > after dinner or 11pm (second wind, delaying bedtime, vicious circle) Lack of motivation / anhedonia / low libido Feeling “stuck” / depression / anxiety Inability to deal with stress / easily surprised / scared or irritable Poor memory, focus, concentration, creativity & productivity @marrmedicine | evokemedicine.com Signs & Symptoms of Adrenal Dysregulation: cont’d: - Low immunity, poor wound healing or slow recovery from injury Low blood pressure & orthostatic hypotension - - dizzy/lightheaded/fainting Increased PMS symptoms/signs Need use of stimulants (ie. coffee) & Cravings for salt & salty foods Increased urination, thirst @marrmedicine | evokemedicine.com Possible Sequelae of Adrenal Fatigue: - (Reactive) hypoglycemia Allergies & asthma Arthritis & autoimmune disorders Decreased immunity (frequent colds/flus) Anxiety/depression, alcoholism, mental disorders Insomnia Chronic Fatigue Syndrome / Fibromyalgia Syndrome Type 2 Diabetes Mellitus & Impaired blood sugar regulation Infertility @marrmedicine | evokemedicine.com Stages of Adrenal Fatigue - Stage 1: Normal graded response & return to baseline Stage 2: “Tired & Wired”, “Overdrive” Stage 3: “Burnout”, “Overtraining” @marrmedicine | evokemedicine.com Wellness Options Boosting brain power & overcoming adrenal dysfunction please challenge your licensed and experienced healthcare provider for recommendations on how to choose the best, safest, most cost-effective supplements & herbs for you as an individual. natural health products are not always safe, particularly in combination with some medications and other supplements @marrmedicine | evokemedicine.com Physiological Mechanisms for Boosting Brain Power: - Address anemia & ensure optimal nutrient status Optimize blood health & metabolism, boost blood flow to the brain Balance & provide stable glucose in the blood Manage inflammation & oxidative stress Support neurotransmitter production Resolve underlying adrenal dysfunction @marrmedicine | evokemedicine.com Lifestyle First @marrmedicine | evokemedicine.com The Refuelling Doctrine: - The secret to maximizing productivity and performance isn’t all about working harder - It’s about rest. @marrmedicine | evokemedicine.com Improvements = Stress + Adaptation @marrmedicine | evokemedicine.com Routine, routine, routine: - Wake, eat, exercise, work, sleep Plan weekly/daily routines Train your body to know what to expect, and try not to surprise it. Compartmentalization @marrmedicine | evokemedicine.com Rest & Relaxation: Get adequate sleep & Honour your body: - - bodywork, sauna, bubble baths, low intensity exercise Mini-breaks 15mins horizontal downtime each day Ensure 2 rest days per week (no exercise) @marrmedicine | evokemedicine.com Brain Lifestyle Biohacks: - Exercise / Physical Activity & Deep Breathing - - Exercise drives blood flow to the brain but is also a stress on the body - Balance! Contrast hydrotherapy Reframing: The silver lining & finding the positive Imagery training & Imagery armour Neuroplasticity exercises - lumosity.com @marrmedicine | evokemedicine.com @marrmedicine | evokemedicine.com @marrmedicine | evokemedicine.com Eat good food. Mostly vegetables. With adequate protein. @marrmedicine | evokemedicine.com Diet does not equal nutrition: @marrmedicine | evokemedicine.com Diet does not equal nutrition: What you put into your mouth (digestive tract) is still dependent on: - Digestion Absorption Transport Metabolism Synergy @marrmedicine | evokemedicine.com Nutritional Considerations: Stabilize blood sugar & ensure protein adequacy (0.8 - 1.25g/kg body weight) - Protein (neurotransmitters require amino acids) & fiber adequacy Eliminate refined, fast, fried foods (esp. sugar) & simple carbohydrates Reduce or eliminate grains, especially wheat, limit fruits to 2-3 servings/day Anti-Inflammatory Diet - 4x more vegetables than everything else ensuring nutrient adequacies B-Vitamins & Iron-rich foods (rule out anemias) from meat & green leafy veggies Rule out food sensitivities (and allergies, intolerances) Essential Fatty Acids (esp. omega-3s) & healthy fats from fish, nuts/seeds, avocados @marrmedicine | evokemedicine.com Nootropics: “Smart drugs” - Enhance memory, cognitive performance and intelligence Increased memory, focus, motivation, attention @marrmedicine | evokemedicine.com @marrmedicine | evokemedicine.com Nootropics: Many are stimulants - eg. Caffeine, Ritalin/Concerta/Adderall - Nicotine L-theanine Phosphatidylserine (esp. with EPA & DHA) Adaptogenic herbs (Bacopa, Ginsengs, Gingko…) @marrmedicine | evokemedicine.com Nutraceuticals & Orthomolecular Medicine B-vitamins: - B5 as pantathenic acid B6 as pyridoxyl-5-phosphate and/or pyridoxine HCl B12 as methylcobalamin - Fish oils & Essential Fatty Acids: - 2000-3000mg per day of combined EPA & DHA 6:1 or higher ratio of EPA to DHA (but you still want some of both) - EPA is more anti-inflammatory, functional DHA is more structural @marrmedicine | evokemedicine.com Nutraceuticals & Orthomolecular Medicine Magnesium - Magnesium (bis)glycinate or taurate - - oxides, and even citrates are more likely to give you loose stools and do not absorb as well Antioxidants - Vitamin C +/- Bioflavonoids N-Acetyl-L-Carnitine (ALCAR) CoQ10 N-Acetyl-Cysteine (NAC) @marrmedicine | evokemedicine.com Nutraceuticals & Orthomolecular Medicine - For calming / cortisol excess: - GABA L-Theanine Phosphatidylserine (PS) @marrmedicine | evokemedicine.com Support Neurotransmiter Production: Adequate & Complete Protein: - Neurotransmitters are derived from amino acids, the building blocks of protein Vitamin B6 is a cofactor (pyridoxyl-5-phosphate and pyridoxine HCl) - Tyrosine, phenylalanine, gingko, rhodiola, caffeine/guarana, nicotine (dopamine) Choline (as GPC), conjugated linoleic acid (CLA), gingko (acetylcholine) GABA, L-Theanine, Phosphatidylserine, Kava, Passionflower, Scutellaria (GABA) Melatonin, L-Tryptophan or 5-HTP, St. John’s Wort (serotonin) - Amino acids including tyrosine, phenylalanine, alpha-GPC, tryptophan etc., are known to cross the blood brain barrier. @marrmedicine | evokemedicine.com Support Neurotransmiter Production: - B6 dependent enzymatic processes: phenylalanine > tyrosine > dopamine tryptophan > 5-HTP > serotonin > melatonin sources of phenylalanine & tryptophan > primarily meat. @marrmedicine | evokemedicine.com Herbal & Botanical Medicines - Adaptogens: - Korean ginseng / Panax Ginseng Siberian ginseng / Eleutherococcus Licorice root / Glycyrrhiza glabra Cordyceps mushroom / Cordyceps sinensis - Ashwagandha / Withania somnifera Rhodiola / Rhodiola rosea Skullcap / Scutellaria lateriflora or baicalensis Passionflower / Passiflora incarnata Reishi mushroom @marrmedicine | evokemedicine.com Herbal & Botanical Medicines - Blood Supporting & Antioxidant: - Gingko berries / Gingko biloba Rosemary / Rosmarinus officinalis Hawthorne berries / Crataegus oxycanthus @marrmedicine | evokemedicine.com Individualized Treatment: - Work with your qualified, licensed and experienced healthcare provider to tailor you treatment plan to your individual needs and ensure you are doing so safely given your personal medical history and current terrain. @marrmedicine | evokemedicine.com Additional Resources: - The Better Brain Book, David Perlmutter MD The Edge Effect, Eric Braverman MD Adrenal Fatigue, The 21st Century Stress Syndrome, James L. Wilson - Stay Tuned! - Overloaded - The Refuelling Doctrine, Dr. Jason Marr ND @marrmedicine | evokemedicine.com Thank You! Questions? Dr. Jason Marr, BScH, ND Evoke Integrative Medicine Ltd. / 1030 West Georgia St., Suite 312 evokemedicine.com I work with urban professionals and athletes to optimize brain & body and overcome adrenal dysfunction so that they can do what they want to do @MarrMedicine @EvokeIM facebook.com/DrMarrND facebook.com/EvokeIM @marrmedicine | evokemedicine.com