Abdominal adiposity. Apple bodies. My best friend was just lamenting to me about what she was calling her “meno-belly”. Another friend told me that she was going to “throw up” if she heard the term “visceral fat” again. Belly fat, also known as visceral fat, refers to the fat that accumulates around the abdomen and internal organs. Unlike subcutaneous fat, which is found just beneath the skin, visceral fat is deeper within the abdominal cavity and surrounds vital organs such as the liver, pancreas, and intestines. Excess visceral fat has been linked to an increased risk of various health problems, including type 2 diabetes, heart disease, and metabolic syndrome.

Overall, joint pain during perimenopause and menopause is multifactorial, with hormonal changes, changes in connective tissue, lifestyle factors, and underlying health conditions all playing a role. If you're experiencing significant joint pain or discomfort during perimenopause or menopause, it's essential to consult with a functional medicine healthcare professional for evaluation and management. They can help determine the underlying cause of your joint pain and recommend appropriate treatment options—a well-rounded approach that doesn’t leave you with an empty diagnosis and no realistic way through to better health.

Most of us in the functional medicine field are aware of the pop culture status of mushrooms. Various blends of mushroom “coffee” pop up in my Instagram feed all the time. Mudwatr—have it. Om—seen it. ClevrBlends—Chai is delicious but the Sleeptime is disgusting, IMHO. I recently decided that instead of a food-based blend, I would focus on taking Lion’s Mane at a daily therapeutic dose. This would be at least 100 mg a day. Lion's Mane mushroom (Hericium erinaceus) has gained attention for its potential cognitive benefits, including memory enhancement. In perimenopause and menopause, hormonal changes can affect memory and cognitive function (think: word recall or word finding or just feeling less sharp), Lion's Mane may offer some support.

Insulin resistance is a condition in which the cells in your body don't respond properly to insulin, a hormone produced by the pancreas that helps regulate blood sugar (glucose) levels. When cells become insulin resistant, they don't effectively absorb glucose from the bloodstream. Over time, this can contribute to the development of type 2 diabetes and other health issues like cardiovascular disease, fatty liver, decreased muscle mass, hormonal concerns, obesity and even osteoporosis (low bone density).

A functional medicine approach to migraine management is increasingly favored. At Tendwell, we manage many patients’ migraines and have provided relief where many thought it was impossible. An integrative and functional approach may include identifying and avoiding triggers, making lifestyle modifications, stress management, and using medications that target the specific aspects of migraines for an individual. If you're experiencing migraines, make an appointment today to find out about a Tendwell membership.

Chronic Inflammatory Response Syndrome (CIRS) is a condition that can occur in individuals with a genetic predisposition who are exposed to biotoxins. Sometimes people who have CIRS are referred to as “mold sensitive”. These humans make up more than 25% of the population and actually have genetic variations functional medicine doctors can test for. CIRS is a complex health condition that arises when the body's innate immune system responds abnormally after being exposed to these biotoxins-- especially those produced by toxic molds. Biotoxins are also produced by other creatures but for this article, we are focusing solely on mycotoxins and fungal toxins. People with CIRS genetics have bodies that struggle to eliminate mycotoxins effectively, leading to a chronic inflammatory response.

At our functional medicine practice, we specialize in perimenopause and migraines. With respect to migraines, we offer a more effective root-cause approach than in traditional medical practices. For many, the instinctive response to a migraine, involves reaching for medications like Ibuprofen or prescription pain medications. However, the regular use of such medications (two or more times a week) can pose risks to the stomach and intestines, as highlighted by recent FDA warnings citing an increased risk of heart attacks and strokes. Clearly, something else is needed. At Tendwell, we offer an individualized plan to tackle the causes of migraines and to help women navigate the perimenopausal period.

At Tendwell, we have many patients who are entering menopause. Recent advances in hormone therapies for menopause (“Menopausal Hormone Therapy”, “MH”, or “MHT”), also known as hormone replacement therapy (“HRT”), make it a great compliment to holistic and integrative approaches for women experiencing menopause. The decision to start MHT should be made in consultation with your Tendwell healthcare provider based on a thorough assessment of your individual health, medical history, and symptoms.

A CGM or continuous glucose monitor, is a small wearable device that you can place on the back of your arm. It allows you to view your glucose levels continuously and in real time.
CGMs were originally developed for use by patients with Type 1 or Type 2 diabetes. However, it has become clear that anyone can benefit from using a CGM, whether diabetic or not. In fact, a CGM can contribute greatly to overall well-being. Here’s how it works:

Understanding and managing the risk of genetic diseases is a crucial aspect of maintaining overall health. While we can't alter our genetic makeup, there are practical steps we can take to minimize the impact of genetic factors. This functional medicine blog explores key strategies for risk reduction, the role of genetic testing, and the holistic approach of functional medicine.

As we cross solidly into the Fall season, some people’s allergies cease to bother them while others with indoor environmental allergies (dust, dust mites) are on the rise. Interestingly, having seasonal allergies may increase a person’s likelihood of having certain food allergies and vice versa. There are many potential cross-reactions with foods that should be considered when someone has environmental allergies. Oral allergy syndrome (OAS) is caused by cross reactivity between proteins in fresh fruits, vegetables and nuts with pollens. This syndrome occurs in a large number (up to 70 percent) of people with pollen allergy.

Thyroid dysfunction affects 1 in 7 people, most of whom are women. Development of a thyroid disorder can occur at many different moments in life but people often become aware of a thyroid issue when they are planning a pregnancy, actively pregnant, or experiencing a hormonal transition in perimenopause or menopause. Despite the prevalence of thyroid disorders, many primary care providers do not routinely screen for them. At Tendwell, we take a different more nuanced approach to thyroid assessment and treatment. In this functional medicine blog, I will discuss some of these approaches.

Depression and anxiety have many causes. These mental health issues can be thought of as analogous to pneumonia. Pneumonia can have many causes: viral, bacterial, fungal…each one in fact results in pneumonia but each one (viral pneumonia, bacterial pneumonia and fungal pneumonia) calls for different treatments based on its root cause. I think this way about depression and anxiety as well. There is no one size fits all approach. This is what a functional medicine approach is all about—rejecting the one-size-fits-all model and creating personalized medicine for each patient.

Recently, I had the pleasure of sitting down to chat with Dr. Isabelle Amigues, an integrative rheumatologist here in Denver, CO. She and I bonded over collaborative care, past lives in New York City, raising kids in this complicated world and, of course, holistic approaches to patient care.

With the turn of season to fall, it may be time to take a fresh look at your metabolic efficiency. With school restarted, holidays on the horizon and changes in routines and in the weather, there is no better time to check in with a functional medicine doctor in Denver or via telehealth to fine tune the inputs to your metabolism.

Winter is coming. This means taking stock and re-evaluating our vitamin and supplement routine. As the seasons change, we need to consider our old friend vitamin D3. I am often still surprised to see low levels of vitamin D in my patients, coming out of Summer. With all of this amazing sun in Denver, Colorado, why would a deficiency of vitamin D3 come up? Well, many people wear sunscreen—including myself. We want to protect our skin from sun damage and reduce our risk for skin cancer. Some people have darker skin tones and therefore more melanin in their skin. This means that they may require even more sun exposure in order to make adequate levels of vitamin D. Others may have genetic variations that predispose them to lower levels of vitamin D. Whatever the case, it is important to check your vitamin D status at least twice a year to see where you are at and find your ideal dosage.

Recently I gave a presentation discussing the intricate role of pharmaceuticals in modern healthcare, offering my functional medicine perspective about their benefits, limitations, potential interactions, and side effects. As more medications come to be prescribed for longer and longer, unexpected consequences may emerge. Certainly, I believe in using medicine when appropriate. There can be a synergy between traditional medicine and functional medicine approaches. But managing medication use should be done with more care than is commonly used by traditional medical practices. In our Denver functional medicine office, we take a deeper look at the potential interactions of medications, their long-term necessity, and many other factors.

The CYP1A2 gene variant refers to genetic variations in the CYP1A2 gene, which encodes the cytochrome P450 1A2 enzyme. This enzyme is responsible for metabolizing various substances, including caffeine, in the body. The two most common CYP1A2 gene variants are often referred to as "slow metabolizers" and "fast metabolizers." Here are some questions and answers about the gene:

Berberine is a bioactive compound found in several plants, including the roots, rhizomes, and bark of various herbs from the Berberis genus, such as Berberis vulgaris (barberry), Berberis aristata (tree turmeric), and Coptis chinensis (Chinese goldthread). It has been used in traditional medicine systems, particularly in Chinese and Ayurvedic medicine, for centuries due to its health benefits. In this blog, we discuss some of the benefits and a brief history of berberine's use in medicine.

At Tendwell, we love pets!! There is actually quite extensive research on the benefits of owning a cat. Cats have been domesticated for thousands of years, and they hold a special place in many people's hearts. In this blog we discuss some of the commonly researched benefits of owning a cat.