Winter into Spring 2010   

"Support for Your Healthy Lifestyle"

Susan Fekety, RN, MSN, CNM

In this issue:
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Holy cow, I know it's the middle of February but I have spring fever already! I love this time of seeds under the earth stirring invisibly -- I can't see them sending shoots up yet but I know they're there, and trust fully that there is action happening in preparation for whatever magic will be bursting forth. Please enjoy this issue -- and take a moment to notice what's fun, new, and wakening up in YOU?

Be nice to your body --

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"IODINE: The Trace Mineral that Proves We Come from the Sea"

If you've been to my office recently you may have noticed the vintage advertisements I have taped to my office door. I bought a box lot of old Hygeia magazines from the 1920s at an auction a couple of years ago. Surprisingly (well, maybe not!) many of the health themes that were "up" then are still "up" now, like the connection between adequate dietary fiber and full human potential, or the value of sunbathing and cod liver oil for Vitamin D.

One of the ads is for a medicine called Iodostarine, made by Hoffman-LaRoche. These chocolate tablets each contained 10 mg of iodine, and children were supposed to take one tablet a week to prevent "the goiter menace." Goiter is an enlargement of the thyroid gland, and back in the early part of the twentieth century they were pretty common. (Go ahead and type "goiter" into Google Images -- wow! Yikes!)

Here's the back-story on menacing goiters. When you don't have enough iodine coming in from your diet, your thyroid gland can't make all the thyroid hormones your body needs and you can become hypo-(low)-thyroid. In order to pick up the slack, the gland actually grows bigger and bigger in the hope of cranking out more and more hormones -- kind of an endocrine version of the Incredible Hulk. (Your precious miraculous body works valiantly every day to help you.)

Iodine deficiency is not just a cosmetic problem. Having your thyroid be out of whack can make you very ill and feel very lousy: tired, cold, depressed, irregular periods, overweight, constipated even. Not that there are a lot of people walking around Maine with goiters, but I do see a lot of under-functioning thyroids in my practice; hypothyroidism is very under-diagnosed in women, particularly those over 35. We just think we're getting old and figure we have to live with it.

Iodine is found primarily in seafood and sea vegetables, but it's not terribly abundant in foods that come from the land. It's not TOTALLY unavailable from non-watery sources, but it is a whole lot less concentrated in soil so it doesn't generally make it into plants or the animals who consume them. Land-locked places (like my home state of Michigan and the upper US Midwest in general) tend to have iodine-deficient soils, as do mid-continent areas around the world. Years ago, this was referred to as the "goiter belt." (If you looked at the Google Images, you might be troubled by the notion of having a belt of goiters -- I sure am.)

Iodine has a lot of functions in your body -- so the further away you get from the ocean, the tougher you may have it. From an evolutionary perspective, this is pretty interesting, don't you think? (We are supposed to live on the beach! I knew it!)

Also, it looks like countries where people naturally get a lot of iodine in their diets (Japan, Iceland) have much lower rates of breast cancer than we do in the US, and there is sensible speculation that there's an important connection here. Natural medicine practitioners have used iodine therapy for years to treat fibrocystic breast disease, and there is a lot of research interest in the cancer-iodine connection. Keep your ear to the ground on this one -- looks to me like iodine will be the next important nutrient to come to our attention, now that we're finally all over Vitamin D. (You've had yours tested, right?)

The Recommended Daily Allowance (RDA) for iodine is really low -- 150 mcg a day for adult women, and 220-290 mcg for women who are pregnant or nursing. But still, a lot of people were not getting this much, and the goiter menace triggered the routine iodization of salt and flour too (did you know that?) so if you ate a slice of bread you got the minimum amount right there. (Did you know that iodized salt was introduced in my home state of Michigan? I didn't. And did you know that there is a huge salt mine under Detroit? Heard about this as a kid, but I never visited them. Run by women -- check it out at

The conventional wisdom is that it's hard NOT to get the RDA for iodine if you eat pretty much any sort of food and sprinkle some iodized salt onto it from time to time. (I even read somewhere that you can breathe iodine in -- from car exhaust. Please do not try this.) Most multivitamins contain a small amount of iodine, too.

So you may be surprised to hear that the most recent data we have available from the population screening program called the National Health and Nutrition Examination Survey (NHANES) suggest that iodine deficiency is surprisingly common in the US, even though iodized salt has been used for a long time. Last time around (2003 to 2004), NHANES found that about 10% of Americans, and 15% of women of childbearing age, are deficient in iodine. That's a lot!

This is of particular concern because one result of iodine deficiency is an increased risk for having a baby with congenital hypothyroidism, or cretinism. Not just a nasty schoolyard slur you may remember from your childhood, this is a preventable disorder of fetal/neonatal brain and body development that can result when pregnant moms are low on iodine. One of the (many) reasons you'd want to have a health visit BEFORE you get pregnant is to check in on your thyroid function and make sure you're getting the micronutrients you need before you conceive, like folic acid and iodine, and that your thyroid function is normal.

Ironically, folks who are working hard to eat well may be at increased risk for dietary iodine deficiency. How not fair is that? If you're avoiding fish, either for ethical reasons or because the idea of mercury contamination is (appropriately) repellent to you, you're missing our primary dietary source of naturally-occurring iodine. If you're avoiding salt in general, and/or consuming only un-iodized sea salt, you're missing the added iodine your friends might be getting. And unless you have a significant sushi habit, or like to make sea vegetable dishes regularly (see my recipe for Arame-Carrot Saute, below) -- you might be low on this nutrient, too.

If that's not bad enough, it's starting to look like other chemicals commonly found in our daily lives (chlorine, fluoride, bromine, and rocket fuel) can get in the way of the iodine doing its job in our bodies. For instance, flours are now often brominated instead of iodinated, and bromine fits on cell receptors where iodine would like to be. The way some people put away white bread, pretzels, cookies, and bagels makes me wonder if there's a link between bread and obesity that is completely unrelated to the quick conversion of wheat flour into sugars. So please consider brominated flour yet another reason to get your carbohydrates from plants instead of processed foods. And at the risk of being branded one of those conspiracy theory cranks, I will say that I think drinking filtered, non-fluoridated water would be preferred from the perspective of optimal thyroid function. I won't even start on the rocket fuel angle.

By now, you are probably desperate to get going on taking some extra iodine. Hold your horses, please. There's an important thing for you to know before you go crashing out to the health food store to pick up some iodine supplements: iodine deficiency can be bad -- but iodine excess can be even worse. Too much iodine can actually cause your body to create antibodies that attack your thyroid gland and cause you to become hypothyroid (low thyroid) even if you weren't before. So don't fall into the trap of thinking that it's cool to chow down on "thyroid support" supplements to help you get peppy and lose weight -- tempting though that might be. Iodine is one of those good and necessary things -- AND it's worth working with a practitioner who knows a lot about it. (I'm learning!)

Here's my thinking about iodine: first, certainly keep it on your radar screen. You can get iodized sea salt, and you ought to choose that if you can for your routine cooking and table salt. If you are just out of the habit of having fish or shellfish a couple times a week, consider changing that -- just be sure to select the cleanest fish sources you can find.

My favorite solution is to bring some sea vegetables to the table -- this is Mother Nature's natural packaging, and it comes in a bowl, not a pill bottle. If you're not into snacking on sushi nori, you might gather some seaweed sprinkles and start using them as a salt substitute. Maine Coast Sea Vegetables makes a nice version that comes in a little shaker bottle. Speaking of these folks -- if you haven't tried their Sea Chips, you've missed out -- though they are a high-impact carbohydrate food, if you decide you're going to take an excursion into tortilla-chip-land, this would be the brand to try. (And no, they're not paying me to say that!) Made of organic corn, they have powdered sea vegetables instead of salt on them and they are Yum-O. Most health food stores around here stock these, and I think you can also order them online.

One final note: Depending on where you live, you might decide to harvest sea vegetables yourself on the beach -- I'm not sure I'd do that, frankly, though there is always a simple earthy delight in gathering food yourself. Why not? These super-foods apparently super-concentrate pollutants (A little arsenic with your kelp! ewww!) that may be present in the water where they grow. So I'd recommend that unless you consider the pertinent body of water to be wildly pristine, get your sea veggies at the store and always choose organic. Plenty of good choices there, and a little goes a long way!

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Monthly Open House Events Carrying on into Spring!

I have been really enjoying my monthly Open Houses introducing True North's premiere nutrition and lifestyle tune up program called FirstLine Therapy®.

Spending an hour or so informally sharing experiences and answering the questions you, your friends, family, or co-workers might have about this uniquely powerful health-positive program, while enjoying some delicious nutritious snacks like Dr. Pete's Outrageous Orange-Basil Hummus, has become a highlight of my month.

If you've been thinking about FirstLine Therapy®, or just know it's time to take better care of yourself but aren't sure where to begin, or you just have questions like "So, what's different about this from every OTHER 'diet' I've been on for twenty years?" and "How do I get started anyway?" and "What is this weird test you do on me?" grab a friend and let's make it a date!

I'll keep your invitation open for the first Thursday of every month from 6:30 to 7:30 pm. RSVP to 781-4488 is nice but not necessary. We meet in the True North Living Room, 202 US Route One, Suite 200, Falmouth, Maine. Upcoming dates are April 1, May 6, and June 3. (We're skipping March -- I'll be away!)

(I will continue to offer free 15-minute informational visits in the office, but if daytimes are not convenient for you, let's meet over appetizers!)

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GREAT BOOKS: (and sort of a rant)

We recently slid through a delicious long weekend around Valentine's Day, and around that time it seemed as though (maybe just in my imagination) a record number of women came into my office saying they were troubled by a near-total lack of interest in sex. Hot red negligee, champagne, and chocolate? Not so much.

Coming in third behind "overweight" and "tired," low libido is a heavy-hitter complaint in my practice, and I'd wager that any health practitioner who is fortunate enough to have the time to listen to women would agree. Sadly, our quick-fix culture has led women to seek (if not plead for) prescription remedies, such as testosterone, as though that's all it will take to help them get in the mood and back in balance sexually with a partner who wants to make love more than they do.

When, when are we going to get away from the crazy idea that we can just slap a dose of hormones into women and all will be well? Hormone therapies can be terrific and valuable when well chosen and carefully monitored, but testosterone therapy used unskillfully can carry long-term risks for women. Voice deepening, excess facial and body hair, clitoral enlargement, mood changes, acne: these don't necessarily go away, even after you stop the hormones. Your practitioner must be VERY delicate with this treatment. Just so you know -- it's not the greatest thing since white bread, even though it sounds like a great solution. Dang.

Libido is such a delicate, multifaceted little bird, it seems just wrong somehow to reduce it to being just about hormones, anyway. So many things will affect a woman's desire for sex, or her energy for it -- it's just not a linear formulaic thing. Still, sometimes a crummy libido IS about hormones -- so I want to remind you that your hormone levels and balance (or lack of it) absolutely will reflect your patterns of nutrition, lifestyle, and stress management. A floundering libido is a red flag that there's something really important out of whack for you. So we should maybe talk.

Great sex is a foundational human endeavor -- please don't give up on it, or decide that it's just not in the cards for you. One of the things I love about doing lifestyle counseling is when, after someone has gotten off the sluggish and sedentary, nutrient-poor, calorie-dense, stressed-out, and steamed-up rollercoaster so many of us are riding on, they tell me (either shyly or with overt delight) that their sex life has taken a distinct upswing and both they, and their partner, thinks that is just terrific. No drugs involved. I think that's really cool.

If you're wanting to tune up your libido and looking for inspiration, let me suggest two great new (well, relatively new) books from people I know and admire.

The Secret Pleasures of Menopause
by Christiane Northrup, MD. (Hay House, 2008)

If you know me, odds are you're familiar with my friend and colleague Chris Northrup -- and further odds are you will enjoy this book as much as her other bestsellers. Offering Chris' signature blend of insight, practicality, humor, and science, this book offers creative inspiration for great healthy sexuality at midlife and beyond. This book will get you up to speed on nature's turbo molecule, nitric oxide -- maybe your best biochemical friend. It's juicy and sassy and empowering and if you haven't read it yet, well -- you just should!

The Return of Desire: A Guide to Rediscovering your Sexual Passion
by Gina Ogden PhD. (Shambhala, 2008)

I first met Gina Ogden years ago when she came to Women to Women to do a workshop, and I've been a member of her fan club ever since. She recently visited True North (for yet another workshop,) and I was reminded how powerful and smart she is. Maybe her bestseller from 1994, "Women Who Love Sex," caught your eye. This is kind of a catchy title, but overall I think she's less well known than she should be.

A grounded, evolved sex therapist and researcher, Gina has opened the world's eyes to women's sexual experiences by actually talking to us -- imagine that. Her frame of reference is essentially feminine -- not "compare and contrast to what men do." Her way of identifying how women blend sexuality with spirituality, communication, and whole-life development is refreshing and powerful. This book has some profoundly authentic insights and new ways to think about sexual health for women -- plus it gives you some really pleasant homework assignments.

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Arame*-Carrot Saute
(side dish for four)

3-4 good sized carrots, peeled and sliced into circles or cut up into matchsticks (about 2 cups after you cut them up)
1 medium onion, cut into half-moons
1 oz. dried arame (this will pretty much fill a one-cup measure)
1 cup water
1 tablespoon grated fresh ginger
2 tablespoons tamari or soy sauce
1 teaspoon toasted sesame oil
1 tablespoon olive oil
Optional garnish: toasted sesame seeds, thinly sliced scallions

Cover the arame with the water and let it soak for 10 minutes. Drain.

Heat the olive oil in a large saute pan. Add the carrots, onions, and ginger and saute until the onions are translucent and the carrots are starting to brown -- about 5 minutes. Stir frequently.

Add the arame and saute for a couple more minutes, until the arame is tender. Add the soy sauce and sesame oil and stir to combine. Saute a couple more minutes until the flavors have blended.

Garnish, if desired, and serve hot.

*Arame is a mild-tasting sea vegetable that looks like black threads so it's a good choice for sea-vegetable novices. Combined with the orange of the carrots, this is a very pretty dish and would be particularly delightful on a Halloween table with people who are afraid of eating seaweed or anything that looks like skinny black worms. Have fun!

Download and print this recipe.

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"Something wonderful, fresh, and new is awakening inside me."

Download and print an 8-1/2" x 11" PDF of this affirmation.

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Be nice to your body --

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202 US Route 1, Falmouth, Maine 04105 | (207) 781-4488 |