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SAD Stands for Season Affective Disorder
Steve Irsfeld RPh • December 4, 2024

The Sun is a part of our happiness.  ☀️ 

Season Affective Disorder

I was wandering around the pharmacy today, trying to develop a topic for today’s article. One of my friendly staff suggested I write about Seasonal Affective Disorder, commonly known as SAD because she had received several calls about it over the last few days. SAD is a topic I have not written about but a concern in our area, so here goes.

SAD is a type of depression that occurs during certain times of the year. Most often, people experience it in the fall and winter months when the days become shorter and there is less natural sunlight. SAD can affect anyone, but it is more common in those who live in areas far from the equator, like North Dakota, where daylight hours are more drastically reduced during winter. Understanding the background of this disorder and its signs and symptoms can help those affected find relief and manage their condition.

The exact causes of SAD are not fully understood, but scientists believe it is linked to changes in sunlight exposure. During the fall and winter months, reduced sunlight can disrupt the body’s internal clock, also known as the circadian rhythm. This disruption can lead to fatigue, sadness, and a lack of motivation.

Another factor is the brain chemical serotonin, which helps regulate mood. Reduced sunlight may cause a drop in serotonin levels, contributing to feelings of depression. Additionally, the change in light can affect the body’s production of melatonin, a hormone that helps regulate sleep. Increased melatonin levels during the darker months can make people feel sluggish and tired.

Genetics and family history may also play a role. If someone has a family member with depression or SAD, they may be more likely to develop the disorder themselves.

Seasonal Affective Disorder can manifest in several ways, depending on the individual. The symptoms can range from mild to severe, interfering with daily life and relationships. While many of the symptoms overlap with those of major depression, they are linked to a specific time of the year.

Common Symptoms Include:
• People with SAD often report persistent sadness or a low mood, which can be especially noticeable during the fall and winter months when the disorder is most prevalent.
• Hobbies or activities that once brought joy may no longer seem enjoyable or worth pursuing.
• Fatigue and lack of energy are hallmark symptoms of SAD. Even after a full night’s sleep, individuals may feel exhausted and have difficulty performing daily tasks.
• People with SAD may experience oversleeping (hypersomnia) or difficulty staying awake during the day. Others may struggle with insomnia or poor sleep quality.
• Many crave carbohydrates or comfort foods, leading to weight gain during winter.
• SAD can make it hard to focus on work, school, or personal tasks, further adding to feelings of frustration and helplessness.
In severe cases, SAD can lead to deep feelings of despair and may even include thoughts of self-harm or suicide. If these thoughts occur, immediate professional help is critical.

Although SAD is most often associated with winter, some individuals experience a less common form of the disorder during the spring and summer months. Known as summer-pattern SAD, this type may include symptoms like insomnia, decreased appetite, anxiety, and restlessness.

Several factors increase the likelihood of developing SAD. Women are more likely to be diagnosed with the disorder than men, although men tend to have more severe symptoms when they are affected. Young adults and teenagers are also at higher risk compared to older adults. Living in regions with long winters or frequent cloudy weather, such as northern parts of the U.S., Canada, or northern Europe, can also make SAD more likely.

Recognizing the signs of SAD is the first step toward managing the disorder. Left untreated, SAD can significantly impact mental health, relationships, and overall quality of life. 

Traditional treatment options for SAD include light therapy and medications. Light therapy involves sitting near a special light box that mimics natural sunlight. This helps regulate the body’s internal clock and improve mood. Light therapy is usually done in the morning for 20-30 minutes daily.

Practitioners may also prescribe antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs). These help balance brain chemicals linked to mood. Sometimes, counseling or cognitive behavioral therapy (CBT) is recommended to help patients manage negative thoughts and develop healthier habits.

Other non-conventional treatment options include exercise. Regular physical activity, especially outdoors, can improve mood by increasing the release of feel-good chemicals like endorphins. Even on cloudy days, getting outside for a walk or jog can provide exposure to natural light, which may help regulate your body’s internal clock.

If exercise is not your thing yet, you would still like to benefit from an increase in endorphins. A compounded medication like low-dose naltrexone can trick the body into making more of these energy-producing chemicals.

Another approach is dietary changes and supplements. Foods rich in omega-3 fatty acids, like salmon and walnuts, may help improve mood. When these foods are unavailable, taking omega-3 fish oil in supplement form is always an option.

One of my favorite supplements is vitamin D, which is often recommended since lower levels of this vitamin are common during the winter and can affect mood. Where we live in relation to the potency of the sun and our inability to get enough sun with the cold weather makes vitamin D a necessity in the winter month of ND. Remember that omega-3 and vitamin D levels can be easily tested to ensure you are at an optimal level. 

Mindfulness and meditation practices can also help. Techniques like deep breathing, yoga, and guided meditations reduce stress and promote relaxation, helping to counter the anxiety or sadness that can accompany SAD. 

Some people find relief through aromatherapy. Essential oils like lavender and citrus are believed to boost mood and energy. Using a diffuser or adding a few drops to a bath can provide calming effects.

While not replacements for professional care, these alternative treatments can complement traditional approaches and provide additional relief. Anyone experiencing severe symptoms should consult a healthcare professional to find the right balance of treatments.

While the changing seasons can be beautiful, they can also bring challenges. Knowing how they affect your mental health can make all the difference in facing those challenges head-on.

Stop by or call the pharmacy for more information on options to help deal with SAD during winter. Please visit my website at www.irsfeldpharmacy.com to find this and other archived articles in the blog section. 

 Until next time, be vigilant about your health!!

By Steve Irsfeld RPh January 15, 2025
Hydroxyapatite Many of you have seen our posts on Facebook or read the last article I wrote on detoxing however there is another side of the toxin equation and that is toxin avoidance. Cleaning up your environment and limiting exposure of toxins. One are I have focused on is selfcare, which has a ton of chemicals in many of the products we use every day. I have been using a clean toothpaste for a while now, but my recently retired dental hygienist offered me a couple of options to consider, with each of these options containing the active ingredient hydroxyapatite (HA). Today’s article is an overview HA and its use in the areas of dentistry and bone support. Hydroxyapatite is a naturally occurring mineral that plays a vital role in the human body, especially in our teeth and bones. It is a form of calcium phosphate with the chemical formula Ca₅(PO₄)₃(OH). This mineral is known for its hardness and biocompatibility, making it essential for maintaining strong teeth and bones. Hydroxyapatite is a key component of tooth enamel and bone mineral, providing structural support and protection against damage. Hydroxyapatite was first identified in 1808 by a German chemist named Berzelius. It was initially discovered in rocks and later recognized as a crucial part of human skeletal tissue. The word "apatite" comes from the Greek word "apatē," meaning deceit, as the mineral was often mistaken for other stones due to its varying appearance. Over time, researchers began to study the properties of hydroxyapatite more closely, leading to its use in medical and dental fields. By the mid-20th century, synthetic hydroxyapatite was developed for various applications, including bone grafting and dental care. Hydroxyapatite is a major component of tooth enamel, the outermost protective layer of teeth. Enamel is the hardest substance in the human body, primarily composed of hydroxyapatite crystals. These crystals give teeth their strength and ability to withstand chewing forces. However, enamel can become damaged due to acidic foods, poor oral hygiene, and bacterial activity, leading to tooth decay and cavities. Hydroxyapatite has gained attention in modern dentistry as a natural way to protect and repair tooth enamel. Benefits for Dental Health: Remineralization: Hydroxyapatite can help repair minor enamel damage by depositing calcium and phosphate ions back into the enamel structure, reversing early stages of tooth decay. Plaque Reduction: Studies show that hydroxyapatite can reduce bacterial adhesion on teeth, lowering the risk of plaque formation and gum disease. Whitening: Hydroxyapatite can gently polish teeth without the harsh abrasives found in some whitening products. Sensitivity Relief: It can help reduce tooth sensitivity by sealing exposed dentin tubules, which are microscopic channels leading to the tooth nerve. Hydroxyapatite is commonly used in toothpaste and mouth rinses due to these benefits. Some natural and fluoride-free toothpaste options use hydroxyapatite as the primary protective agent. Hydroxyapatite also plays a crucial role in bone health as it makes up about 70% of bone material by weight. Bones require both strength and flexibility to support the body and protect vital organs. Hydroxyapatite provides the hardness and density bones need to fulfill these functions. In the medical field, hydroxyapatite is used in orthopedic procedures and bone repair treatments. Since it is similar to the body's natural bone mineral, synthetic hydroxyapatite can be safely used in surgeries and treatments. Benefits for Bone Health: Bone Grafts: Synthetic hydroxyapatite is often used in bone grafting procedures to promote bone regeneration. It serves as a scaffold where new bone cells can grow. Fracture Healing: Hydroxyapatite-based materials can assist in healing bone fractures by providing structural support while natural bone tissue regenerates. Osteoporosis Treatment : Some treatments for osteoporosis use hydroxyapatite to increase bone density and reduce fracture risk. Research has consistently shown the effectiveness of hydroxyapatite in both dental and bone health applications. Dental Health : A 2019 study published in the Journal of Clinical Dentistry compared hydroxyapatite toothpaste to fluoride toothpaste and found both equally effective in preventing cavities and re-mineralizing enamel. Bone Health : A 2020 study in the Journal of Materials Science: Materials in Medicine demonstrated that hydroxyapatite-coated implants improved bone growth and integration in patients undergoing joint replacement surgeries. Biocompatibility: A review in the International Journal of Nanomedicine highlighted hydroxyapatite's biocompatibility and safety, emphasizing its use in both dental and orthopedic fields without adverse effects. Fluoride has long been the standard in dental care for preventing cavities and strengthening teeth. However, hydroxyapatite offers a natural alternative with some unique advantages. Hydroxyapatite is non-toxic , even if swallowed, making it a safer option for children and individuals concerned about fluoride toxicity. Clinical studies have shown hydroxyapatite to be as effective as fluoride in preventing cavities and re-mineralizing teeth. While fluoride strengthens enamel by forming a fluorapatite layer, hydroxyapatite works by directly integrating with the enamel structure. Many of the products we recommend for bone support contain microcrystalline hydroxyapatite concentrate (MCHC). The reason we recommend this is because there are no published studies that show that calcium alone will regenerate lost bone density; only stop the bone loss where it is caught, and/or accelerate bone healing, post-fracture. The MCHC is the only natural substance documented to regenerate lost bone, (even in post-menopausal women), also MCHC has been documented to accelerate recovery, assisting the body's repair naturally, (in the case of a fracture and / or bone loss). Hydroxyapatite is a remarkable mineral with a long history of use in dental and bone health . Its ability to strengthen tooth enamel, reduce sensitivity, and promote bone healing makes it invaluable in modern healthcare. As scientific research continues, hydroxyapatite is likely to gain even more prominence as a natural, effective solution for maintaining strong teeth and bones. We would love to have you join our detox journey. Please reach out to my staff at the pharmacy, as they would be more than willing to help you out at 701-483-4858. All my articles can be found online at our website, www.irsfeldpharmacy.com . My podcast, "The Irsfeld Pharmacy Optimal You Podcast," can also be accessed through the website. Until next time, be vigilant about your health!!
By Steve Irsfeld RPh January 8, 2025
The start of any year often begins with resolution and even though we are already a week into the New Year, it’s not too late to propose another option. When you think about a resolution, the focus is usually to make a change or do something to better improve our quality of life. Most often resolutions revolve around health and exercise but today I am going to talk about the Core Four and why, if you don’t take a dietary supplement, it can provide great benefit in overall health. A common question I hear at the pharmacy is, “I don’t take any vitamins, so where should I start?” That is an excellent question for two reasons; first, it is an indication that the patient is interested in bettering their health, and secondly, that they see value with supplements helping in that change. The keyword in that last statement is value. The definition of value is; the importance, worth, or usefulness of something. Another word that fits into this conversation is quality. I have written articles on value and quality in the past, and they are essential attributes when choosing a supplement that you will be taking for many years to come. You get what you pay for in this arena. The answer to their great question about where to start is quite simple, and we refer to it as the core 4. We call it “foundational nutrition” because it is the foundation of health, and without a strong foundation, the structure or body can easily crumble. The four supplements that comprise the Core 4 are Multivitamin/mineral, Vitamin D, Omega 3 Fatty Acids, and Probiotics. Below is an explanation of the Core 4, along with a way to monitor levels in your body. Multivitamin: This is to fill in the gaps that our diets don’t meet. It is well documented that our food supply does not contain the same amount of nutrients as it did 40-50 years ago, and that is if we are eating a balanced diet. The goal is optimal health and providing nutrients is essential for making that happen. A micronutrient test can look at the levels of critical nutrients, and the cost is $400 Vitamin D: This is formed when your skin is exposed to sunlight. Unfortunately, we live too far from the equator to allow the sun to make this happen year around. If it’s warm enough in April, the sun is potent enough, and getting 10-15 minutes of exposure should cover us until about mid-September. That means that we won’t be getting our daily dose of Vitamin D for 6-7 months out of the year. It only makes sense for us to supplement, and if you are like me, my tan usually comes from the fluorescent lights of the pharmacy. 5000IU/day is the adult dose that I recommend. You can test Vitamin D for as little as $50. Omega 3 Fatty Acids or Fish Oil: Unless you eat fish twice a week, you probably are not getting the necessary amount of omega 3 to help support cell structure. Omega 3’s are anti-inflammatory, essential for the brain, skin, and eyes, and have cardiovascular benefits. Omega 3’s are one of the few supplements that cost less to buy as a supplement than if you were going to get it from a food source. Dosing ranges from 1000 to 4000mg per day of EPA + DHA depending on the treatment plan. You can find these amounts under the supplemental Facts on the label. Testing your levels is an option and can be done for $75 Probiotics: It seems a bit weird that we would add bacteria to our systems, and good would come from it, but yes, that is the case. Having a healthy gut flora, the combination of bacteria, fungus, and viruses line our intestinal tract, affects so many things: immune system, skin conditions, aging, digestive disorders, mood, and brain function, weight gain, fatigue, and more. It is almost impossible to help anyone who is not feeling optimal if they have an unhealthy gut that remains unaddressed. Many companies will look at stool bacteria for under $200. As stated above, the Core 4 is foundational nutrition, and building a regimen off of that is where a personalized protocol comes into play. That protocol could include joint health, gut health, inflammation, stress, or immune health, to name a few Treating each patient as an individual needs to happen because we are unique. One of the challenges is meeting the patient where they are at in their health journey. Here are a few examples of that: • How often can they take their supplement? I can usually convince them that if they brush their teeth twice a day, they can take supplements twice a day, and I know this because I fall into this category. • What can they afford to spend on a regimen? Trying to work within the confines of this because if you bombard them with too much product they can’t afford, they can shut down and quit. • And lastly, what are their expectations? Regarding expectations, consider the following: “Your health is like a train speeding down the track at top speed. If you are in poor health, the train is going in the wrong direction. My job is to help you go from top speed, slowly decelerate until you come to a stop, change tracks, turn around, start moving, and get you back to top speed on the healthy track.” How long do you think it will take for this to happen? Today, you often expect to make that happen by just taking a magic pill. I hope I don’t burst anyone’s bubble, but that train analogy will not happen by simply taking a pill. It requires hard work and commitment, something very different than a magic pill, and it may cost you more than that perceived magic pill, but, in the end, you will be better off for it. Please stop by the pharmacy or call to schedule an appointment. Let us help you navigate the Core 4 or design a protocol to meet your needs. Please visit my website at www.irsfeldpharmacy.com to view this and other health-related articles in the blog section. Until next time, be vigilant about your health!!
By Steve Irsfeld RPh December 31, 2024
Group Detox--Let's talk this thru. Welcome to 2025. When I hear that number, it seems like yesterday we were talking about Y2K and how it would shut down the world. Well, here we are, and the world didn't get shut down with Y2K. I love the holidays and everything that goes with them, but if you are like me, you may have let the holidays get the best of you, and it's time to make some changes to "right the ship." I have a proposition for you: an invitation to join me and many of the Irsfeld Pharmacy employees in a group detox. You may be wondering what this entails. The detox is a 10-day program that uses specific detox products combined with a diet spelled out in the protocol. It is not a weight loss program, but most lose weight due to a clean diet and the removal of toxins. I like this protocol because it is only 10 days, and it is an excellent jump-start to getting you on a better path to improving overall health. The word "toxin" doesn't describe a specific class of compounds but rather something that can cause harm to our body. If you look up the definition, you will get this: A poisonous or harmful nonbiological substance, such as a pollutant. Toxins can also be a byproduct of a living cell or organism that, when released, can cause disease when introduced to the bodily tissue. The focus of this article will be on toxins as pollutants. Toxins can be detrimental to our systems. A growing body of literature suggests that there may be an association between toxin exposure and some long-term health conditions, such as chronic fatigue syndrome, fibromyalgia, and atherosclerosis, along with many other chronic diseases and illnesses. Our bodies are amazing detoxifiers. However, some toxins can build up and be stored in our fat tissue. Eventually, if these toxins are left unchecked, they can be sources of inflammation, and as we know, inflammation can promote chronic disease and illnesses, as discussed above. Toxins can also affect our microbiome, the bacteria littering our intestinal tract, disrupting it, or killing it off. Knowing that toxins are in the environment is the first step in understanding that toxins are a problem. When our bodies deal with toxins, we have two options to consider: decreasing exposure to toxins and enhancing their removal. When reducing exposure, here are some common and not-so-common toxins that you might want to avoid: cash register receipt tape, non-organic fruits and vegetables, swordfish and tuna, electromagnetic fields (EMFs), and plastic. Self-care products are another source of everyday toxins. Estimates show that we are exposed to 127 toxins before we leave the house in the morning, and many of them involve things we spray and apply while standing in front of the mirror. Here are some products to consider avoiding: deodorant, lipstick, and antibacterial soap. The Environmental Working Group has a site called Skin Deep that can help you choose safe products for you and your family. Here is the site: https://www.ewg.org/skindeep/ The body's natural detoxification process occurs in three phases. Phase I: Reaction —The first phase of metabolic detoxification occurs when your body utilizes enzymes to turn toxins into free radicals. Free radicals commonly occur in our systems, and our bodies are designed to process them, but they are a problem when we have too many. In this conversion process, toxins are transformed into water-soluble molecules that are easier for our bodies to get rid of via our kidneys and eventually removed in our urine. Phase II: Neutralization —After phase I, some toxins can be more reactive and not easily removed via the kidneys. In Phase II, these toxins are attached to other water-soluble substances, making them easier to eliminate in the urine and bile. This process is called conjugation (connecting) and requires certain enzymes to make it happen. Phase III: Transportation - Transporters ensure that the water-soluble compounds created in the first two phases are excreted from your cells. Before this occurs, Phase III neutralizes the compounds, binds them with dietary fiber in the gut, and is excreted in our feces. Let me simplify the previous paragraphs. Toxins like fat and our tissue cell walls are made from fat; toxins can readily enter our cells. The more fat we have on our frame, the more toxins can be stored in this tissue. Detoxification is done by pulling toxins out of our tissue and making them water soluble in our liver through specific metabolic reactions. Once these toxins are water soluble, our bodies have an easier time eliminating them from our systems via our urine, sweat, and feces. Other things to consider to ensure the elimination systems are also working optimally include whether you are drinking enough water. Staying hydrated is essential to helping with toxin elimination. Do you have daily bowel movements? Detoxing for a constipated patient can make the person not feel very well. The toxins are removed in the gastrointestinal tract, and if a person is constipated, the toxins we are removing can be reabsorbed back into the system. Our bodies now reprocess those toxins along with the toxins we are freeing up. When detoxing, ideally, you would want a formula that has select liver-supporting nutrients and cofactors, including taurine, N-acetylcysteine (NAC), methylsulfonylmethane (MSM), medium-chain triglycerides (MCT), trimethylglycine (TMG), quercetin, curcumin, green tea extract, milk thistle extract, grape seed extract, and methyl folate, to name a few. These ingredients have been shown to support healthy phase I and phase II detoxification in the liver. You also want gut-friendly ingredients that support the GI tract and add plenty of fiber to help latch onto toxins for easy removal. Most detox products come in powder form that can be mixed with water to get all these ingredients. They are also available in capsules for those who don't like the shake format; however, you will need to take many capsules to get an appropriate dose. We have an excellent detox questionnaire that patients can take to evaluate their need for detox. The questionnaire is free, and it provides some excellent information based on your answers that you can act on. We would love to have you join our detox journey. Please reach out to my staff at the pharmacy, as they would be more than willing to help you out at 701-483-4858. All my articles can be found online at our website, www.irsfeldpharmacy.com . My podcast, "The Irsfeld Pharmacy Optimal You Podcast," can also be accessed through the website. Until next time, be vigilant about your health!!
By Steve Irsfeld RPh December 23, 2024
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