Vitamin D/Sunshine #46

Susan Fekety:

program and I would say that at least half of the people that I see who are Mainerse are grossly, clinically deficient in Vitamin D. It shocked me when I started testing.

Dr. Bethany Hays:

Well, I think there are unique places in the United States that draw healers. I don't know why that is, but it's just there are little nodules of great healing that happen in a number of places around the country and Maine is one of them.

Rhonda Nordstrom:

If you're eating well with foods that are high in calcium and you're getting a little bit of sunshine every day, you know your skin's going to be that much healthier, your whole body's going to be that much healthier, and you're going to have more resistance to UV damage.

Dr. Lisa Belisle:

Hello, this is Dr. Lisa Belisle and you are listening to the Dr. Lisa Radio Hour and Podcast Show Number 46, Vitamin D and Sunshine, airing for the first time on July 29, 2012 on WLOB and WPEI radio Portland, Maine. And today's show is one that Genevieve and I wanted to put in the works. For quite a long time. We waited till the summer because it seemed like the right time to do it, but we've been talking about it for a long time. Hi Genevieve. Hi Lisa. Yeah, I think it's been in the news the lack of vitamin D, that people are vitamin D deficient far more often than we think they are. And it's all very relevant. But why do you think vitamin D is important? Lisa well, we know that vitamin D has been linked to first of all, vitamin D isn't really a vitamin. I mean, it's been considered a fat soluble vitamin, A, D, E and K for a long time considered one of the vitamins. But it's not really a vitamin. It's more like A hormone. And as a hormone, it actually has an impact on multiple systems in the body. So it has an impact on our ability to prevent cancer. It has an impact on our mental well being, our emotional states. It really, it's connected to everything. And it's very interesting that the vitamin D connection kind of connects us back out to the universe. I mean, we know that the food that we eat, that impacts the insides of our bodies, and we know the air we breathe impacts the insides of our bodies. But now we know the sunshine does, too. And it's not just about getting a tan. It's true. And I think that that sort of symbolizes everything that you and I are about and our theory of wellness, which is. It's all connected. Yes, it is all connected. And one of the reasons I began studying traditional Chinese medicine and acupuncture several years back was because understand that. And they look at the body as a whole system. In fact, ayurvedic medicine does the same thing. So when I do an evaluation of somebody in my practice, they'll come in and I actually look at their skin and I talk to them about their whole body and I talk about their skin issues, but I talk to them about everything. And in traditional Chinese medicine, the skin is actually a manifestation of the lung. And it's something that kind of gets rid of toxins. It gets rid of things that our body no longer needs. And if you think about it, when you sweat, you're getting rid of, you're helping your body cool off, but you're also getting rid of things that your body doesn't need. So it is all connected. That's interesting. I mean, I know that the skin breathes, but I never really made that connection between the lungs breathing and the skin breathing. Yeah. And children have a lot, if you think about. And this is one of the things I've thought about a lot because I have three kids. You know, anything that you put on your kids, it gets absorbed into their little bodies and they have a lot of skin. So they're absorbing. Anything you put on them that you might put on yourself, they're absorbing to a much greater degree. And they also, their skin is very kind of thin. So this is, you know, it's interesting. And they're also impacted by the sunshine and vitamin D. Well, I'm excited about this show because I think it's going to tell everyone out there how vitamin D acts in your body. And that's a great indicator of one small thing that makes a big change in your health and your Wellness. It is going to be a good show, a really good show. Those of you who are listening are in for a treat. We have Susan Feketty, formerly of True north, who has been talking about vitamin D and functional medicine for a long time. She's the owner of Healthy Living Healthcare in Falmouth. We also have one of the co founders of true north, Dr. Bethany Hayes, who happens to be somebody that I trained with when I was at Maine Medical Center. She is a former obstetrician. She's sort of legendary around here. She is, yes. And we have in addition Rhonda Nordstrom who is a spa owner out of Rockland. But she's a pretty high powered spa owner actually. She's created her own safe Skin care line, Healthy Skin Care line, including safe sunscreen. So we think that this is going to be a pretty great lineup for those of you who are listening. So we hope that you'll continue to tune in. The Dr. Lisa Radio Hour and Podcast is pleased to be sponsored by the University of New England. As part of our collaboration, we offer a weekly segment we call Wellness Innovations. This week's Wellness Innovation is about a study that shows that low vitamin D in the diet increases the stroke risk in Japanese Americans. Japanese American men who did not eat foods rich in vitamin D had a higher risk of stroke later in life, according to the results of a 34 year study reported in Stroke, an American Heart association journal. Vitamin D is an essential nutrient that helps prevent rickets in children and severe bone loss in adults, and researchers believe it has the potential to lower the risk of a host of diseases, including cancer and diabetes. Sunlight is generally the greatest source, but synthesizing vitamin D from the sun gets more difficult as we age, so older people are advised to eat more foods rich in vitamin D or take supplements. Good sources include fortified milk and breakfast cereals, fatty fish and egg yolks. Stroke ranks fourth among the leading causes of death in the United States. New or recurrent strokes strike about 795,000Americans annually, researchers said. It is unclear whether the results could be applied to different ethnic groups or to women, but it is important to note that previous studies have focused on blood concentrations of vitamin D, while this investigation used dietary intake. For more information on this wellness innovation, which came to us through Eureka alert.org visit drlisabelisle.com for more information on the University of New England, visit une.edu.

Dr. Lisa Belisle:

Today on the Dr. Lisa Radio Hour and Podcast, our topic is Vitamin D and Sunshine. And the person we've chosen to come in as our first guest is somebody who knows a lot about vitamin D and sunshine. She spent a lot of time thinking about this and the relationship between nutrition, vitamin D and health. We're talking today with Susan Feketty, who is the owner of Healthy Living Healthcare, a new practice for human powered healthcare in Falmouth, Maine, and a Yale educated advanced practice nurse and midwife. Previously at Women to Women and True North Health Center, Susan has offered women's healthcare, healthy lifestyle counseling and customized nutrition solutions in the Portland area since 1995. You've been thinking about this a long time, Susan. Thanks for coming in and sharing your knowledge.

Susan Fekety:

It's a total joy to be here. So thanks for inviting me. I really appreciate it.

Dr. Lisa Belisle:

Susan, your approach to healthcare came about first through your exposure to what I would call traditional medicine. Traditional Western medicine, I should say. Tell us a little bit about your background and why did this send you in the direction of this healthy living practice.

Susan Fekety:

So I'm going to actually skip back to even a little bit before my education began to tell you the fact that I'm a product of a medical family. My dad's a doctor, my mother's a nurse. They met in the hospital. That kind of longstanding atmosphere around medicine and health sort of is where I grew up. I chose to become a midwife back in the 19 early 1980s because I was very passionate about women's health and also felt from a healthcare policy approach that it was really important to focus on prevention, which is what midwives do, and focus on supporting people's ability to understand what they can do for themselves, which is to me a hallmark of the nursing tradition and of the midwifery tradition. So as a midwife, my primary tools were, although I was educated around the things that we use in Western conventional medicine, because you need to understand that to be a safe obstetrical provider, what we specialized in as nurse midwives was learning how to support the physiologic process of pregnancy, labor, fertility, and the whole woman's health spectrum. And working with pregnant women, you're not going to be prescribing medications. You need to learn how to use other things. And so we were educated in using primarily nutrition and lifestyle therapies to prevent and resolve the common complications of pregnancy and also to develop a vigilance around what are the very early signs of trouble that you can see so you don't need to wait for the big disaster to occur and then you need to use rescue medicine. So my philosophy really is based on the idea that it's easier to stay out of trouble than to get out of trouble. And what I found over the years is that there is a depth and richness in that that puts the potency for health maintenance back in the hands of humans, back in the hands of people on a day to day basis. And as I look at the healthcare system right now, to me, like that's the only way things are going to change is with day to day information that people can use comfortably, themselves supported, educated, science based, but more on a one to one each day basis. What do we learn about ourselves?

Dr. Lisa Belisle:

It seems like vitamin D is actually a perfect topic. With that in mind, why has vitamin D become so important in the last 10 years?

Susan Fekety:

It's fascinating the way that the vitamin D and sunshine, which we really need to link them together, the history of that, the awareness of that problem, you may remember reading or listeners may remember reading or hear about or seeing photographs of back in around Victorian turn of the century, they would have solariums and people in the tubercular hospitals would be taken out on those little lounge chairs and put in the sunshine and wondered why are they doing that? If we know that sunshine causes cancer, what was up with that? But that was around the time when a guy actually won a Nobel Prize for identity. The health benefits of sun exposure, which in the times when people were becoming more industrialized, living in cities, the air was full of soot, a lot of people didn't get sun exposure. And yet different epidemiological studies identified that sunshine exposure was really important for human health. And so it was a part of health care. Then there was the discovery that a lot of children were developing rickets. I remember learning about that in midwifery school as a thing that, oh well, you're never going to see that. And you may have had the same experience. Lisa oh, rickets, yeah, that's something that happened a long time ago, but we're all over that with vitamin D fortified milk. Well, we're starting to see rickets back again. And the rickets is a bone deformity that we see in small children where they get bow legs and their bones actually form abnormally. And one of the things we're discovering, what we know is that rickets is a symptom, a very severe symptom of profound vitamin D deficiency, usually in combination with deficiency of calcium and vitamin D and calcium really always need to come together. So over recent years, more and more research has been done about vitamin D. And it's evolved from being a thing that we learned about as the cause of rickets. And I remember hearing about pelvic deformities in women who lived in Arab countries who wore purda and never got in the sunshine, would get deformed pelvises that it was really difficult to deliver babies through. And I thought I would never encounter it in my practice. Suddenly, as people started to understand more the connection between human beings and the natural world around them, we realize this is radical, that we started to understand that sunshine, vitamin D and calcium metabolism are actually essential for a lot of things.

Rhonda Nordstrom:

So.

Susan Fekety:

So there was this groundswell of new research that actually found that rather than what they used to think, which is vitamin D was made in the kidney, that actually vitamin D is made in our skin every day and that we're designed to do that. In fact, if we think about how our genetics, how our bodies developed, we were designed to be running around naked on the African veldt and being in the sunshine all day every day. That's what our genes kind of want and have as familiar. We live in the United States. We're inside most of the time, we're avoiding the sun. When we are outside, we're smearing ourselves with sunscreen, we're putting on the hats, the long and phobic. And so there's this whole new epidemic of vitamin D deficiency because people are sunshine phobic. So as more research has been done, I would say in the past five to 10 years about vitamin D physiology, we're starting to discover that the vitamin D calcium link is really important. But it's only a tiny piece of what we're really learning. Suddenly we're discovering that vitamin D physiology has to do with cardiovascular health. It has to do with cancer prevention. Breast cancer, prostate cancer, colon cancer are the most numerically dramatic forms of cancer. But vitamin D is like, oh my goodness, we can work with that. It has to do with mood. It's Vitamin D is a cofactor for neurotransmitter signaling. So we have an epidemic of depression, people taking serotonin reuptake inhibitors. And what we're starting to discover is there's probably a proportion of those people who it's not a serotonin deficiency they have. It's a vitamin D deficiency that's showing up as a serotonin problem. And you can Make a long list of healthcare challenges that people live with and suffer with every day that can be related, at the very least, theoretically and probably in actuality to problems with vitamin D just because of the American lifestyle that brings us indoors and away from the sun, or if we're living in a place where we don't get a lot of natural sun exposure like Maine.

Dr. Lisa Belisle:

But this makes the dermatologists crazy.

Susan Fekety:

It makes them crazy. People throw books at one another, at conferences about this issue because there is. We know that the non melanoma skin cancers are caused by direct sun exposure on the skin. I mean, that was proved, I think, in the 1940s with farmers who would get basal cell skin carcinoma and squamous cell carcinomas on the parts of their bodies that were exposed to the sun when they were out working. The research that I read shows that those same populations, interestingly enough, had lower cancer, lower rates of the melan, the ones that are really that we think of as much more life threatening than the non melanoma skin cancers. And the thinking among the vitamin D experts that I'm reading is that it's actually that same sun exposure that may give them small non life threatening skin cancers, but prevent them from getting those big bad melanomas which oddly enough seem to occur in the places that aren't exposed to the sun anyway. So what's up with that? It's a big mystery. But when the people who are researching vitamin D start talking sensible sun exposure and going out in the sun for 10 or 15 minutes a couple of times a week without sunscreen, the dermatologists go nuts. There's also the wrinkling issue which a lot of people are really concerned about. And you know, photo aging of the skin is a reality. And a lot of people.

Dr. Lisa Belisle:

But we're not talking about the bad old days that I remember where you'd smear yourself with baby oil and put a tin foil in your record album cover.

Susan Fekety:

No, but didn't we do that? You're too young to have done that. Yeah. So no, we're not talking about those bad all day. So we're talking about just a few minutes pre redness. You never want to get burned, A because it hurts, but B, because you know it's bad for your skin. But this is just enough to turn on your physiologic vitamin D synthesis mechanism that we're all designed to get a little bit of all the time, which is why we're hungry for it, I think.

Dr. Lisa Belisle:

Well, it is interesting that people seem much Happier when the sun comes out. All of my patients that come in on sunny days, they're like, oh, I don't even know if I need to see you because I feel so good. And I say, you know, that's all good. Put some needles in you anyway. Do a little acupuncture. Just keep that good energy going. They come and see me on cloudy days and they say, I don't know why I feel so bad. So anybody who doesn't recognize that there is a link between mood and sunshine maybe isn't paying very close attention.

Susan Fekety:

Yeah. And the biochemist would say that's the serotonin mechanism, that's the neurotransmitter mechanism of vitamin D. I think there's also some really complex and elegant physiology that has to do with just light in the brain, in the eye, having a favorable effect on mood. But when the folks who identified seasonal affective disorder started to do that research that was groundbreaking, even though intuitively many of us had sort of known that winter was a dark time. But that makes me want to touch on the thing that I think is really important. We are designed to have cycles of light and dark and seasonally and during the day. And one of the things that I think is really important that many of us have gotten away from to our health detriment is attending to or even noticing that natural cyclicity. Right. We're in our offices working on the computer while it's a sunny day outside. We're up late at night with the television on, and that's affecting our. Our sleep cycling in the morning. We get up, we get in the car, we go to the office. We're missing that light and dark cycling which, you know, in every tradition of medicine, experience.

Dr. Lisa Belisle:

Another really important thing for human bodies to experience is the right type of food. And I know this is an important part of your practice. You're also in practice with Dr. Peter Knight, who's a naturopath. I know that food is very important to him. Is there a relationship between vitamin D and food?

Susan Fekety:

There is. Although interestingly, if you look at the food sources of vitamin D, there aren't a whole lot. And so that's one of the things that makes us think that indeed our bodies are designed to connect up with sunlight. And many people end up supplementing sort of as their hedge around that food sources of vitamin D. Oily fish, Wild Alaskan salmon is going to be one of your best sources. Atlantic farm raised salmon isn't going to get a lot of vitamin D because of the nature of the food that they ingest. So if you can see sockeye salmon, which is starting to come into the markets now, that's a really wonderful thing. I'm a big fan of sardines. I used to hate them, but I've learned how to prepare them so that they taste good to me now. But sardines are a good source of natural vitamin D. Mackerel. I've never eaten it, I've never enjoyed it, but it's one of the oily fish on the list. So oily fish is one of the primary natural sources of vitamin D. There's a writer too that talks about how for northern dwellers who didn't have a lot of sunshine in their latitude, one of the primary evolutionary benefits for them was discovering how to fish for the fish that had the vitamin D that helped them survive through Norwegian winters, Finnish winters, so that they could get the vitamin D. I think that's a really cool story. But anyway, so oily fish is one of the primary sources and the next most common one is, oddly enough, mushrooms. Fungi have the ability to synthesize the vitamin D. And when you eat mushrooms, you're going to get a little bit of vitamin D. Is it as much as you would probably pick up in a supplement? No. But mushrooms are good for us on so many levels that that's one additional way to get more in. I have to tell you, I've got a lot of patients. I say mushrooms. They look at me like when I say star sardines. But mushrooms are another source. Porcini and shiitake mushrooms, I think have the highest quantities of vitamin D. So you can make a beautiful ragu, say of spinach and mushrooms and garlic and onions and have that as your side dish instead of a pile of rice. And you're ahead on a lot of levels.

Dr. Lisa Belisle:

What about cod liver oil?

Susan Fekety:

So in my I meant to bring this today. In my office I have this page I pulled out of a 1929 health magazine and it's a picture of a toddler aged boy with his teddy bear sitting on the bed of A sun lamp and he's got a sun lamp on him, he's got little aviator goggles on and they're coming at him with a teaspoonful of cod liver oil. So that's an ancient way, ancient, culturally ancient way to get vitamin D into us. And that was recognized as that was the way to do it was because it fish, oily fish like cod tend to have vitamin D. And so when the connection was made to rickets and other health benefits, everybody's grandmother or mother would send them to cod liver oil. Moi, even the purified stuff, I don't like it. I don't like the feel of eating a teaspoonful of oil. Many people rely on cod liver oil though to get their vitamin D. The thing about cod liver oil is it's got to be purified because that's high on the aquatic food chain, the fatty part of any fish. So purity is really important if you're going to use cod liver oil. The challenge around cod liver oil is when you get what we think of as a therapeutic dose or the amount of vitamin D that you would typically want to do. You usually have to take several teaspoons full. And the kicker to that is vitamin D naturally contains a hefty dose of vitamin A preformed retinol, which is the fat soluble form of vitamin A. Vitamin A in high doses can run you into biological trouble. So I tend to not rely on cod liver oil and don't recommend it to people as a vitamin D source. Plus there are so many other easier ways to get vitamin D in that I tend to not like to do that. But the vitamin A, the high doses of vitamin A issue, I think it's a little bit challenging. So I tend to not recommend that so much.

Dr. Lisa Belisle:

Now vitamin D is also in vitamin D fortified milk and other types of milk products. I didn't hear dairy coming out as one of the recommendations. I don't personally recommend it to my patients. How do you feel about dairy?

Susan Fekety:

Well, suddenly we're in a culture where the food culture is fortifying everything with everything that they think we have read about that we want and will trigger on omega 3 fortified orange juice, vitamin D fortified milk. That was the primary way that D has been gotten into us. A glass of milk is probably going to have 100 international units of vitamin D in it. And if you think about even the Institute of Medicine recommendation for daily supplementation with vitamin D at 600 IU's for an adult, that's not a whole lot. So you can get some There. But for many people, as you point out, the downside of dairy products sort of militates against using milk as your vitamin D source, although it's one way that people do get it and it should be counted when you're assessing your personal intake, say over the course of a day. But I think for most people it's easiest to actually use a supplement rather than vitamin D supplemented something. If that's easy for you, that's totally wonderful. You just have to do a little bit more complex math, I think, to track the quantities for that.

Dr. Lisa Belisle:

I have a question for someone who's taking a vitamin D supplement who knows that their levels are low and they're taking a high supplement, should they be careful with sunbathing?

Susan Fekety:

Everybody should be careful with sunbathing, but it's hard. You know what, I can't really answer that question because I don't know how low is low and I don't know how high is high. So this is one of the areas where I think our natural tendency to try to treat a supplement like an over the counter medicine can kind of run us into trouble. And it really helps to have somebody to support us to sort of figure out what's the right strategy for each of us. You know, we have a tendency to look on the Internet and find this and you can go in the health food store and get some fairly high dose stuff. And that's not the right recipe for everybody. It's the right recipe for some, but particularly with high dose vitamin D. And by that I mean something on the order of 10,000 international units in one capsule. I watch my patients who are using those very carefully and monitor their levels over time to make sure we don't destabilize them. So it's. So that's one of those it depends kind of things. I mean, I think one of the messages that I would want listeners to get about vitamin D is that it is one of those things where more than none is really good. More than more than more can really run you into trouble. It's like anything saturated fat, you got to have some to survive. Too much, it's going to gum up your works and make you not healthy. So vitamin D is one of those things too. There are some people who metabolize vitamin D in a unique way and really should have somebody supporting them to do that and sensible fashion. That's why I'm a big advocate of checking levels. You know, I think a lot of folks think, oh, well, if I'm, if I've got some in my multivitamin and I'm drinking a glass of milk and I've got the fortified orange juice. That should be enough. And, you know, the reality is it's probably not.

Dr. Lisa Belisle:

What are some of the symptoms of vitamin D deficiency, aside from rickets?

Susan Fekety:

Yeah. So most people who are low in vitamin D actually have no idea, which is why I'm a big advocate of testing. I've been testing pretty much everybody who comes into my clutches in my practice gets a vitamin D level because I believe that it's so important. And I would say that at least half of the people that I see who are Mainers are grossly, clinically deficient in vitamin D. It shocked me when I started testing so many of those people are not symptomatic at all. But some of the subtle things that have been associated with vitamin D deficiency are some blues, whether they're seasonal blues or just sort of a chronic feeling of being grumpy. Premenstrual syndrome has been linked with vitamin D deficiency. Certainly any disorder of bone metabolism, osteopenia, osteoporosis, Those folks are good candidates for at least being considered deficient in vitamin D. And that's usually a productive area of inquiry. There is some interesting research about whether some people who have been diagnosed with chronic fatigue or fibromyalgia are actually manifesting musculoskeletal symptoms that are due to vitamin D deficiency. And so that's not something that I work with a lot in my own practice, but I think that's very intriguing. What I notice when someone is replete with vitamin D who has been low is that they generally describe just sort of feeling a gentle lift in mood. I had one patient who put it, I just felt like there's more water under my boat now that my vitamin D level is up. So it's not a dramatic change in mood. It's not going to make you zippy, peppy, but it's just putting the body back into a place of balance where it probably should have been all along.

Dr. Lisa Belisle:

In your practice, in addition to seeing patients, you also offer educational programs. Describe some of these for the people who are listening and might be interested.

Susan Fekety:

Thanks for that invitation. Dr. Knight and I both love to teach and consider that one of our primary missions with the practice is offering a resource area for patients who want to learn more about how to care healthfully for their body. We have a large population of patients in this area who are what I think of as health questers. They go on the Internet, they're Googling this, they're looking up that they're reading lots of books, they have a lot of questions and are looking for a place where they can sort of lean in and trust the quality of the information that they're getting. And so I feel very dedicated to creating a place for that, for people. Dr. Knight and I have created a lecture series that we do one class a month called the Foundations for Healthy Living. Each month we focus on one foundational principle. This month it's eat real food. And the talk is on Thursday evening from 7 to 8 and it's free. And people can go on our website and get the schedule. He and I, we just love to talk about what we do. Dr. Knight teaches a monthly cooking class, although he's taken a pause for the summer. The last one was about how to use all the herbs that are going wild in your garden in culinary fashion. Let me tell you, our health center smelled so good that night. And most of many of the recipes that I use in my kitchen are ones that I've gotten from him because he's a really good cook, although he'd never tooed his own horn about that. But it's really important to create a place where people can come and learn, learn from one another. That's one of the things that is really important to me. I by nature tend not to be a top down kind of teacher, but love to get people with a common interest together to share what they're experiencing because that is a learning that you can't beat that. And we all, we all grow from that. So love to talk about what we do.

Dr. Lisa Belisle:

How do people find out more about the classes and your practice?

Susan Fekety:

Our schedule is online at our website, which is www.me as in Maine healthyliving.com and people can sign up for our news information mailing list, which is not spam. It's usually useful and it mentions upcoming classes, but the website is really the place to go.

Dr. Lisa Belisle:

Well, this has been very informative. I'm sure that our listeners will just this will just tap the surface of the information that they're going to want to find out about vitamin D and nutrition and health. So we thank you very much for coming in and talking to us today. We've been speaking with Susan Feketty, the owner of Healthy Living Health Care Practice for Human Powered Healthcare in Falmouth, Maine. Thank you for coming in.

Susan Fekety:

Thank you so much.

Dr. Lisa Belisle:

On today's Dr. Lisa Radio Hour and Podcast, we're discussing vitamin D and sunshine, and we thought there probably is no better person in Maine to come in and talk to us about vitamin D and vitamins than the founder of True north. And this is Dr. Bethany Hayes. Thank you for coming in today.

Dr. Bethany Hays:

Thank you for having me, Lisa.

Dr. Lisa Belisle:

Now you and I have this background. You've been since you were sort of in my life very early on as a resident, when you were teaching and delivering babies, and I delivered some babies with you. So you've been out there as a teacher for a while now. You've kind of jumped the jumped ship from OBGYN to functional medicine. Tell me what that is. What is functional medicine and why is it important to health?

Dr. Bethany Hays:

Well, functional medicine is upstream medicine. It's medicine in which we try to find the causes of people's symptoms and problems rather than just treating the symptoms with drugs and surgery. So we're really going upstream and asking people not to get in the water instead of throwing drugs and surgery at them as they go over the waterfall. And I think of it as the way health care should be done and the way medicine is going to be practiced in the future.

Dr. Lisa Belisle:

But you went from a very surgically oriented, sort of, I don't know, maybe skeptical field into this relatively new part of medicine. Why did you make that decision.

Dr. Bethany Hays:

Well, you know, I was trained, like most physicians, to first of all, do no harm. And as I got into my medical practice, I found myself not meeting that requirement. So I began looking for who had the best outcomes and the best results. And my first step into this field was actually to pay attention to what midwives do, because they were the ones who had the best outcomes in terms of normal birth. And that led me into complementary and alternative medicine, where there were ways to take care of people that weren't as caustic, weren't as dangerous as some of the drugs. And then I found functional medicine, which completely satisfied my need to understand things all the way down to the molecules. And so it's not that I don't love the surgical subspecialty, but I found that when I practiced functional medicine, there wasn't any surgery to do. So I ended up giving up surgery because I didn't think I was doing it often enough and to keep my skill set up. And so here I am doing sort of outpatient medicine and helping people stay healthy.

Dr. Lisa Belisle:

And you're doing outpatient medicine at a very special place in Falmouth, True north, which has now been around for a decade. To your credit and to the credit of people at True North. What is True north for those people who are listening, who aren't aware?

Dr. Bethany Hays:

Well, True north is a nonprofit, 501C3, and we're an experiment to see if health care can be done differently. So we're trying to help people stay healthy and to provide people with a kind of health care, which we think we're not getting as often now because of the pressure on physicians to see lots and lots of people in a very short period of time. So at True north, all of our practitioners work together to help people get healthy, but we take the time that's needed to really understand and listen to you and then figure out what's going on upstream and help you to solve those problems.

Dr. Lisa Belisle:

Speaking of upstream, let's talk about vitamin D. Great. I mean, we're talking about up and sunshine and vitamin D. This has become very hot. Well, sunshine again, hot topic in the last few years. Why has it become important and what didn't we know about it before that's now emerged?

Dr. Bethany Hays:

Well, I think for a long time, we thought vitamin D was just involved in preventing rickets, which is a bone disease. And now we're finding that vitamin D is actually more than it is a vitamin. It is a hormone that is intimately involved with many, many processes in our body that keep us healthy. So Vitamin D is involved in the immune system and how the immune system functions, keeping your immune system from getting overactive. And overactive immune systems cause inflammation, which is really one of the major causes of lots of downstream illnesses that we think of as related to aging. Vitamin D is critically important in brain function. So we know that vitamin D is involved with Alzheimer's and multiple sclerosis. And there are a bunch of diseases that we now know we see more often in people who live in the far north. So people who live up here in Maine have some of these diseases more often than folks who live down in the sunshine. And so the question is, what do we do to keep healthy vitamin D levels when we live up here?

Dr. Lisa Belisle:

I know for interestingly that functional medicine was talking about vitamin D 10 years ago, eight years ago, right around when True north was founded at the molecular level, way before this conversation started happening in mainstream medicine.

Dr. Bethany Hays:

Yeah, that's one of the great things about functional medicine is they're really out on the leading edge of the research and trying to get that research to clinicians faster. We know that a lot of the research that's coming out doesn't get to doctors for, well, the New England Journal said an average of 17 years. There are actually a number of things that didn't get to doctors for 30 years. So functional medicine is working hard to get that information to physicians earlier.

Dr. Lisa Belisle:

Now, vitamins A, D, E and K, they're all fat soluble vitamins, which means that we can't pee them out. You know, we can't. If we take too much of them, they can't be excreted.

Dr. Bethany Hays:

That's right.

Dr. Lisa Belisle:

What are the dangers associated with too much vitamin D?

Dr. Bethany Hays:

Well, if you get too much vitamin D, it causes calcium to be deposited in places you don't want calcium, like for instance, in your kidneys to produce kidney stones or in your blood vessels to produce hardening of the arteries. So it is important to know your vitamin D level to not overdose yourself with vitamin D. And there's some tricks to that that are going to require some intelligence on the part of people who are taking vitamin D and people who are prescribing it. For instance, if you have a very activated immune system, such as people with autoimmune disease, for instance, then you can actually be activating vitamin D and have a relatively low 25 hydroxy vitamin D, which is the form we test, but have a very high activated vitamin D level. This could be dangerous.

Dr. Lisa Belisle:

How do people find out what their vitamin D levels are?

Dr. Bethany Hays:

Well, it takes a blood test and you can come to True north and order that blood test on yourself and take the information back to your physician. We have a program called patient directed labs, and one of the patient directed labs that we're offering is a 25 hydroxy vitamin D. If you get that test done at True north, you'll get a letter from me explaining your results and asking you whether you'd like to have that information. Go to your doctor.

Dr. Lisa Belisle:

Give me some examples of other types of tests you think everybody should know the answer to.

Dr. Bethany Hays:

Well, right now we're also doing hscrp, which is a marker for inflammation. As I said earlier, inflammation is something that we know is involved with lots of the diseases of aging. Another test that we're doing is homocysteine. And homocysteine is a test which gives you information about your B vitamin status. Homocysteine is associated with heart disease and Alzheimer's and another number of other illnesses. And we think it's something you should know about. Do you need more B vitamins? Since most people don't get enough vegetables, they're not getting enough B vitamin, and we want them to know that so they can change their behaviors.

Dr. Lisa Belisle:

Just switching gears a little bit. I believe you're from Texas. Is that right?

Dr. Bethany Hays:

I am. Do you hear that accent? I just came back from Texas where I did a little grandchild therapy.

Dr. Lisa Belisle:

And why. Why Maine? Why come here? Why stay here? I mean, Maine is a place where obviously we don't have as much sunshine as you do. Oh, yeah.

Dr. Bethany Hays:

Well, I didn't calculate that in when I made the shift, but I came to Maine because I wanted to live in a place where it felt like I was on vacation all the time. You know, when you turn 40, you start asking questions like, well, who am I and why am I on the planet and what am I supposed to be doing here? And that led me to ask the question, where in my wildest dreams would I like to live? And Maine was one of those places. So when the job showed up here in Maine, I jumped ship and moved to Maine. I have not regretted that decision for one instant.

Dr. Lisa Belisle:

It seems as though you're not the only person who's drawn to Maine as a healer. Can you speak to why that might be? Do you have any thoughts?

Dr. Bethany Hays:

Well, I think there are unique places in the United States that draw healers. I don't know why that is, but it's just there are little nodules of great healing that happen in a number of places around the country, and Maine is one of them. For me, there is a dramatic shift that happens when I cross the bridge at Kittery. It's like, oh, I'm in Maine. I am home. This is a great place. And I see that shift with my children, with my mother. The Texans come up here in droves in the summer because they feel that extraordinary energy of this very beautiful place. And I think a place that is as beautiful as Maine is and where the population cares about that and takes care of it is a place where people are interested in healing and so healers gather there.

Dr. Lisa Belisle:

Well, and vitamin D is sort of a beautiful analogy of the individual and nature because nature actually provides the best source of vitamin D, isn't that right?

Dr. Bethany Hays:

It does. One of the important things to know about vitamin D is probably it takes a combination of vitamin D as a supplement which gets your vitamin D level up higher and then vitamin D from sunlight, which gives you forms of vitamin D that are particularly useful in our bodies. And so if you're a lifeguard, you know, you can get enough vitamin D from the sunshine. But most of us are working, so we're not outside all day long. So we really either need to make a concerted effort, which we should do in the wintertime up here to get out in overhead sun. It has to be noonday sun in the wintertime or to take a supplement. And then you need to know how much supplement to take. And that means you need to know what your vitamin D level is.

Dr. Lisa Belisle:

How do people find out more about self directed Labs, True north, the work that you're doing, vitamin D levels. What are good resources?

Dr. Bethany Hays:

Well, you can go online to our website at www.truenorthhealthcenter.org. you can call us on the telephone 781-4488. We'd be happy to give you information about our self directed lab and our Empower Me program at True north, which is really a program designed to help you learn how to keep yourself healthy and live a long, happy life.

Dr. Lisa Belisle:

And then if people, once they've done the self directed lab, if they'd like to have an appointment with one of your many practitioners, that's also an option as well.

Dr. Bethany Hays:

Absolutely, we'd be happy to help you out. We'd also be happy to give you information that you can take back to your own physician. But we do have some extraordinary physicians at True north that are doing fabulous work and there are a few of us that are practicing functional medicine and are particularly interested in this project of keeping people healthy.

Dr. Lisa Belisle:

Well, we've been very happy to have you here in the studio. You have much experience. Thank you for all the work you've done with True North. We've been speaking with Dr. Bethany Hayes, Co founder of True north in Falmouth, Maine. And I would like to say pioneer in the future of medicine as it stands functional medicine. Thank you for coming in today.

Dr. Bethany Hays:

Thanks so much, Lisa.

Dr. Lisa Belisle:

Today on the Dr. Lisa Radio Hour and Podcast, our show is discussing the topic of vitamin D and sunshine. And it's interesting because we've talked a lot, Genevieve and I, about vitamin D and the importance of it and the hormone and the feel good factor. But there is a very real influence on skin, skin damage and aging, which is what we're afraid of. And so there is a balance to be struck between being out in the sun and then putting sunscreen on. But how do you use sunscreen safely?

Rhonda Nordstrom:

Right.

Dr. Lisa Belisle:

Which is why we invited Rhonda Nordstrom from the Real Day Spa in Rock Lemine to come down and talk to us about this. Rhonda has 12 years of spa experience and actually has her own skincare line. So I've personally put the sunscreen that she's created on my skin. And I think you're quite the expert to come in and talk to us. So thank you, Rhonda.

Rhonda Nordstrom:

Thank you for inviting me. It's really exciting to be here.

Dr. Lisa Belisle:

Well, we're always happy to have people who have a broader view of health and wellness. And actually, when you were coming in, you were talking about the Environmental Working Group. Tell us, what's the relationship between the Environmental Working Group and things that we put on our skin?

Rhonda Nordstrom:

So I think that often people don't realize the harmful chemicals that might be in some of the ingredients that they put on their skin that they've bought at the pharmacy or whatever that tells them that they're protecting their skin. And then you find out that there's harmful chemicals in there. And a good resource to find out what chemicals might be harmful that you have in your skin care products is the Environmental Working Group. And their website is ewg.org and that's a great place to start with what is a safe sunscreen, because they'll tell you what to look for that is not healthy. And they also list, I think it's the top 10 or 20 safest sunscreens, including those that are good for children.

Dr. Lisa Belisle:

Rhonda, what are some things that people should be looking for in their sunscreens?

Rhonda Nordstrom:

I believe that the most effective sunscreen and the safest sunscreen ingredient is titanium dioxide. You'll often find zinc as well. Zinc is the ingredient that turns your skin white and it's not very user friendly, so it's very thick and it's hard to put on. Titanium dioxide is a little more friendly and often they're used together. But the importance of using titanium dioxide or zinc is that they screen out both UVA and UVB rays. And that's, I think that's where the problem has come in for a lot of years is that when the FDA first started the SPF rating, it was really what SPF stands for is how long can you be in the sun before you burn. But the burning rays are not the only rays that we need to be concerned with. The UVA rays, which don't physically burn us immediately or whatever, go more deeply into the skin and are more often linked to cancers.

Dr. Lisa Belisle:

So there are issues besides burning and cancers. What are some of the things you see in the day spa? What types of things problems do people get when you spend too much time in the sun?

Rhonda Nordstrom:

Oh my goodness.

Dr. Lisa Belisle:

Oh, my goodness.

Rhonda Nordstrom:

You know, besides the obvious hyperpigmentation or dark spots all over the face that we all get, especially from the sun and from aging, some of it's just hardening of the skin and keratosis. I'm seeing some. So many people come in with little pieces of skin chunks taken out of their skin from visiting the doctor and having suspicious looking things taken out of their skin. So that's a huge downside there because all of a sudden you're not so beautiful anymore and you're certainly not healthy. But you know what? I'm also seeing premature aging and deep wrinkling and whatnot on women in the their early 40s. And that's really too young to be seeing that kind of aging.

Dr. Lisa Belisle:

So your suggestion then is to be very careful about the sunscreen that you choose, but be diligent about applying it.

Rhonda Nordstrom:

Absolutely. You have to reapply it. And if it says it's waterproof, no lotion that you put on your skin can be completely waterproof. So if you're swimming, you need to reapply. And I do believe that the FDA is coming out with new guidelines, or even maybe they're going to change laws that will require the sunscreen manufacturers to label appropriately, because maybe they're not all doing that now. They might say it's broad spectrum, but unless it has titanium dioxide or zinc in it, you're still getting the UVA as well as uvb.

Dr. Lisa Belisle:

We've been talking a lot about vitamin D, and one of the best ways to make vitamin D in your body is through sun exposure. So what's your recommendation for a safe level of sun exposure? And then when do you put the sunscreen on? There's a balance there.

Rhonda Nordstrom:

Yeah. I think first an early morning walk or run. If you're going to be outside playing early morning is best. And then if you're at the beach during peak hours, which is, I think it's 10 until 4 is the guideline. You need to be lathered up. You really do. And as far as vitamin D and sunshine and health, I think it's all a balance, just like with everything else in life. So if you're eating well with foods that are high in calcium and you're getting a little bit of sunshine every day, you know your skin's going to be that much healthier, your whole body is going to be that much healthier, and you're going to have more resistance to UV damage.

Dr. Lisa Belisle:

Where can we get your sunscreen, Rhonda?

Rhonda Nordstrom:

So far, just at realday Spa in Rockland. However, you can order it online through our website and or call us and we'd be glad to ship it. And I'd also like to make a little plug for facials because I think that so many people in the world think, and I hear it every day. I talk to somebody about, yeah, you should get a facial. And the response is, I'm a massage person. I challenge them and then they get it so it feels good and they get it that it's an intimate experience. It's really beautiful. However, it also helps with the health of the skin. And the healthier your skin is, the more resistant it is to aging and to damage from the sun.

Dr. Lisa Belisle:

And where can people learn more about your spa and your product and you?

Rhonda Nordstrom:

They can find out about us@realdayspa.com we're also on Facebook at RealDay Spa, and they can come visit us at 453 Main street in Rockland.

Dr. Lisa Belisle:

Very good. Well, thank you so much for coming down and spending time this morning talking with us about safe sunscreens. And I encourage all the people who are out there listening who might be in the mid coast region to stop in, maybe get some sunscreen, have a conversation with you Rhonda, or maybe call you up and order some online, see what you think. I've personally tried it. I know it's not like the old fashioned white stuff you put on your nose as a lifeguard. It really does sink in eventually and I It's definitely worth trying out. Thank you Lisa this is Dr. Lisa Belisle and you have been listening to the Dr. Lisa Radio Hour and Podcast Show Number 46, Vitamin D and Sunshine, airing for the first time on July 29, 2012 on WLOB and WPEI Radio Portland, Maine. Today's guests have included Susan Feketty from Healthy living health care, Dr. Bethany Hayes from True north, and Rhonda Nordstrom from the Real Day Spa in Rockland. We hope that you've gained a little bit of knowledge on the Vitamin D and Sunshine link. We know this continues to be a topic of great interest amongst medical researchers and as things evolve, we'll let you know what we think. For those of you who have suggestions for our show, please contact us on our Dr. Lisa Facebook page or send an email to infooctorlisabalial.com we appreciate those of you who have been supporting us from the very beginning. Now that we're 46 shows in. We also appreciate your letting our sponsors know how valuable they are to us in helping us create a healthier, more vibrant world. Thank you for being part of our and my world. May you have a bountiful life.

Dr. Lisa Belisle:

Sa.