Screening Our Sunscreens for Potential Endocrine Disruptors

Recent research about sunscreens had questioned their safety. The FDA is in charge of regulating products and claims that sunscreen manufacturers make and the last time they were reviewed claims and efficacy was in the 1970’s. Labeling is expected to change for next summer. So what are the current problems associated with some sunscreens and what do consumers do for now until greater regulation and review takes place?

Let’s take a look at one potential problem and that is the chemicals in sunscreen. Oxybenzone is commonly used in sunscreens and may actually be very problematic. In addition to being known to produce free radicals (also known as pro-oxidants), recent research done on fish actually found that oxybenzone can have endocrine disrupting estrogenic effects as well. In this study, the researchers took two different groups of fish. When exposed to high levels of oxybenzone, the fish’s blood levels of estrogen was 75 times greater than those fish not exposed to oxybenzone. Researchers also evaluated the reproductive success of the fish. The ability of females to produce viable eggs was significantly lower after just 7 days of exposure and the number of fertilized eggs that ended up hatching was also significantly lower. This research suggests that there may be an estrogen like activity of the chemical oxybenzone and may alter normal hormonal function.

Knowing this information, what are safe ingredients in sunscreens? Look for sunscreens that are mineral based and contain either zinc oxide or titanium dioxide as the main sun protective ingredients. According to the environmental working group, Mexoryl SX is another good option, but it’s sold in very few formulations. Tinosorb S and M could be great solutions but are not yet available in the U.S. Sunscreens with avobenzone are also okay.

Label reading can also be a hurdle when selecting a sunscreen. SPF measures a sunscreen's ability to prevent sunburn, which is caused by ultraviolet B (UVB) light. If your skin would normally burn after 10 minutes in the sun, for example, wearing an SPF 15 sunscreen would theoretically allow you to stay in the sun for 150 minutes (10 x 15) without burning. This means that the person should re-apply after 2.5 hours in the sun. Scientists now also know that ultraviolet A (UVA) is a major cause of aging and also contributes to skin cancer. SPF can be misleading because products with less than SPF 15 might not protect against the UVA effects, but may prevent sunburn. There is little data if products greater than SPF 50 provide any additional benefit. A tan offers the equivalent protection to a sunscreen with SPF 3 or 4. A white long sleeve tee is SPF 7 and dark, heavy denim has an SPF of 1,700.

To learn more about chemical components of sunscreen, take a look at environmental working group’s 2011 sunscreen report. This group reports on the health effects of chemicals in our environment. Their online resource allows you to see how your current sunscreen (makeup, moisturizer or lip balm) ranks and gives their recommendation for the safest products to use. It actually breaks down all the ingredients in a product so you can see how each may be influencing your health.

It’s difficult to talk about the sun without talking about vitamin D. You need at least 20 minutes of full body sun exposure between the hours of 10 am until 2 pm  to make your daily allowance of vitamin D. Darker skinned individuals may need up to one hour. Anything over SPF 8 blocks the body’s ability to make vitamin D. So you can see the problem here-- many people burn with just 10 minutes in the sun and we want to protect our skin from damaging rays. This is where the importance of taking supplemental vitamin D comes in to play. Vitamin D deficiency is very common in Wisconsin and individual need is widely variable. I have seen similar body and age matched patients need anywhere from 2000 units a day to 10,000 units a day to get to an optimal blood vitamin D levels. Vitamin D is an easy blood test that your doctor can to o that you can ensure that you are getting the correct supplemental amount of D.

Here are the key take home points:

1. Avoid oxybenzone. Look for mineral lotion sunscreen with zinc oxide or titanium dioxide.
2. Look for full spectrum: UVA (A for Aging) and UVB (B for Burn) with at least SPF 15.
3. Consider that most sunscreens are water resistant at best, waterproof claims are not well substantiated, and therefore you need to re-apply every few hours. Clothing and shade are likely the best bets for complete protection from the sun.
4. Wait about 20 min after going outside before applying sunscreen or take supplemental vitamin D and have your levels checked.

One Minute Course in Mindfulness of Thought

"With perception, there is deception."

One of my favorite quotes from the eleven week class I recently completed titled, "Mindfulness in Everyday Life." To me this quote is helpful in understanding how our own preconceived notions, experiences and ideas can change the way we see the world. By recognizing our judgments and associations we might begin to see things differently or at least begin to be more conscious that are minds are deceiving us.  Things are never as they seem to be.

 

Becoming conscious of our minds deceptive and distracting nature is one way to  help reduce stress in everyday life. If instead of worrying about a particular topic, we simply recognize the worry and the feeling and body sensations that go along with it, we can actually reduce the worry. Here is an example: Say you have a fear of dogs. Whenever there is a dog in your presence, you get tense and your blood pressure rises (body sensations) and remember the dog that bit you as a child (association). Your mind tells you the situation is dangerous (judgment) and you feel fear (label). If you take the body sensation, association, judgment and labels and begin to think of them as visitors and as merely thoughts separate from your self, the worry can be lessened. Using the same example: a dog is in my presence and I can feel my body tense and blood pressure rise. The memory that I have as a child, is simply that, a memory. I realize that I am judging this situation based on my past experience and I feel a sensation, a visiting sensation that is not really a part of me, but a visitor.

This model can be applied to all sorts of worry-- paying the bills, getting to work on time, meeting with a supervisor, etc. and over time will help with overall stress reduction. Stress reduction can prevent many disease states and is a crucial component of wellness.

Letter to the Editor-- Printed!

Last month, Milwaukee Magazine featured a column titled “Best Holistic Healers” and had a section listing naturopathic practitioners. The column listed the professional association for naturopathic doctors as the American Naturopathic Medical Association. This organization represents folks that have trained at institutions that offer online, correspondence or otherwise abbreviated coursework in naturopathic medicine. In Wisconsin, where there is not yet a licensing law to regulate who can call themselves a naturopathic doctor, the consumer is left to decide what type of practitioner they prefer. In states with licensing laws, only those that have completed four year doctoral programs in naturopathic medicine may call themselves naturopathic doctors or naturopathic physicians. I decided to clarify this information by writing a letter to the editor of Milwaukee Magazine:

This was printed on page 10 of March's issue of Milwaukee Magazine! I am thrilled that my letter was considered important. Even more, I hope that subscribers of the magazine will read this letter and learn about the distinction that so badly needs to be made in Wisconsin. For me this is an example of how necessary education is to advancing the practice of naturopathic medicine and how important it is to speak up for what you know and believe in.

Best Holistic Healers in Milwaukee

This months issue of Milwaukee Magazine features a list of "Best Holistic Healers" in the Milwaukee area. It features two of the fantastic doctors I am working with, Dr. Michele Nickels and Dr. Bozena Simon. You can read an excerpt from the article here.

Getting to the REAL cause...

11-11—a triggering of remembrance, a time to look around you and see what is really happening, and time to reflect. Time for me to start writing again!

Recently I have been thinking a lot about a common concern in our office—heartburn. Heartburn is a problem for so many Americans. The cause of the problem is a matter of opinion. Conventional medicine says that there is too much acid and the elimination of acid will help the burning sensation and other symptoms of indigestion such as bloating and flatulence. Often acid suppression is not an effective way to eliminate the problems and symptoms increase and often worsen. Medications like histamine blockers and proton pump inhibitors are very good at doing their job and eliminating acid in the stomach. But what is the result of this suppression? Why would we make this nasty acid stuff if it’s just going to cause our stomach to hurt?

Taking a look at my anatomy and physiology book from my first year of medical school, I learned that the lower esophageal sphincter (where the esophagus and stomach connect) NEEDS acid to close completely. Without sufficient acid, there is transient relaxation of the sphincter, allowing stomach contents to backwash into the esophagus. Using this line of reasoning, it seems that the problem to treat in cases of heartburn may actually be too LITTLE acid, rather than too much.

Acid is necessary for digestion! Without it, there is no breakdown and absorption of nutrients. It is often seen clinically that women with osteoporosis or osteopenia have a long history of using acid reducing medications. Calcium in food or supplements requires stomach acid to be absorbed as well as vitamin D. Taking Tums as a calcium source seems kind of pointless then—acid suppression and calcium all in one dose. Vitamin B12 specifically requires stomach acid to be absorbed as well. Malnutrition can result after long term use of acid reducing medications.

I saw a patient this week wanting to get off of her Nexium. This is not an easy thing to do. She called several times during the week in agony after slowly weaning the drug. We replaced her drug with a digestive enzyme, probiotics and amino acids and herbs to help heal the lining of her intestinal tract. After a week of pain, she finally felt better. Her sinus congestion, post nasal drip, headaches and constant cough went away, which are also symptoms associated with too little stomach acid.

As Thanksgiving nears and today we celebrate the hard work of our veterans, I think about the things that I am thankful for in my life. I am thankful to be continuing my education as a resident and to live in beautiful Wisconsin. I am blessed to have wonderful family and friends. I am thankful to live in America and for the men and women who serve our country. Most of all, I am thankful for my stomach that faithfully produces acid to keep me healthy and happy!

Study Break

I am about one month away from graduation and excited to know where I will be heading next! I was selected to be a resident at the  Integrative Family Wellness Center in Brookfield, Wisconsin. I am beyond excited to have the opportunity to continue my learning process as a resident for one year. And who knows-- it may turn into something more!

For now until August 4th I will be recalling all of the useful clinical skills I have learned and getting ready for my board exams. SO, if you have any study tips-- send them my way! Here's how I am keeping energized and healthy for boards:

• Eating small, frequent, high protein meals. High protein sustains the feeling of satiety longer and the amino acids will be used to build brain neurotransmitters.
• Taking a multi, fish oil, b-complex, vitamin D, and adrenal support. The adrenals help with the response to stress and heavily utilize the B vitamins as well as Vitamin C.
• Exercising daily-- Jillian Michaels is kicking my butt right now.
• Frequenting coffee shops-- I don't know if I consider this a "healthy" study habit, but it keeps the scenery interesting.
• Listening to theta brainwave music. Theta brainwaves are known to help memory, learning and mental clarity.
• Making time to relax and read something mindless. 
• Studying with friends. Helps my motivation and I always seem to learn something from them.

Here is a link to learn more about my program.

Herbal Energy

Spring has become my favorite season here in the desert. In lieu of my routine P90X DVD’s, I ventured out of my living room to get some fresh air. I took a hike up Piestewa Peak in Phoenix and noticed another one of my desert favorites, the Ocotillo, in bloom. Aside from its fun shape and beautiful flowers when blooming, it has some interesting medicinal properties. 

The long branches of this plant have sharp spines camouflaged by small green leaves. Historic Indian uses include placing the flowers and roots of ocotillo over wounds to stop bleeding. (Convenient that my steep hike was lined with this lovely plant!)  In botanical formulations in the clinic, the fresh bark tincture is used mainly as a lymphagogue. Lymphagogue botanicals promote the movement of the lymphatic fluid that helps with immune function and waste elimination. This class of botanicals can be further categorized by area of the body that it is known to have greatest effects. Ocotillo has an affinity for the pelvis and is therefore useful in conditions of stagnation such as constipation, hemorrhoids, fibroids or endometriosis. For example, I chose to include this botanical as a part of a formulation for a patient who had varicosities in her legs.

It is amazing to me that medicine is really all around us. I can imagine that I passed many plants on my hike that day that can be used medicinally. Often botanicals can have stereotypical uses like, “St. Johns Wort for depression,” but in reality the energetic and practical application of the plant is what gives it its unique characteristics and not always completely understood effects. Plant medicines are unique in that they often work slowly and gently to heal chronic conditions, but can be used in high does for short periods of time for acute conditions. Energetics are not easily explained properties of plant medicines, but rather to be experienced.   I am excited to have another botanical medicine rotation coming up on my next (AND FINAL!!!)  quarter of school where I will be able to learn and experience the energy of herbs!