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What you should know about decreasing or discontinuing PPIs – acid blocking medicine

This blog was inspired by one of my patients who, after taking Nexium, an acid-blocking medication for a couple of weeks, came to see me terrified by the potential side effects.Basically, she wanted to discontinue it as soon as possible but in a safe way.

From the perspective of integrative medicine, the problem with GERD is not that there is too much acid, but that the acid is in the esophagus rather than the stomach. PPIs block the secretion of acid, thus eliminating symptoms, but they do not address the underlying problem of regurgitation of the gastric lumen contents into the esophagus. In other words, PPIs don’t cure GERD; they only treat the symptoms so remember that acid-reducing medication is designed for symptom control. Your goal should be to take the least potent medication at the lowest dose to control your symptoms.

Here are few important points to consider:

  • PPIs medications (most potent, but takes 48-72 hours to have its effect)-Nexium, Protonix
  • H2 blockers (less potent/quicker to act than PPIs)-Zantac
  • Acid neutralizers (least potent/provide immediate relief of heartburn)
  • reflux symptoms are so closely tied to lifestyle choices in people with mild/moderate GERD or any other stomach problems this process is most effective when combined with smart lifestyle changes. Remember that adjusting your lifestyle and controlling your weight can help reduce your need for medications.
  • Do not stop your medicine for acid reflux at once. Making changes gradually will help you avoid rebound symptoms that may be worse than your actual baseline.
  • PPIs long-term use may lead to serious complications, including increased risk for pneumonia and Clostridium difficile, and decreased absorption of vitamin B12, calcium, magnesium, and iron.Recent evidence is now questioning the connection between PPIs and kidney injuries.
  • Despite these potential complications, PPIs are recommended in many circumstances, such as preventing gastrointestinal bleeding in elderly patients on NSAIDs. As with other medications, physicians need to balance the risks and benefits of PPIs, depending on the condition. They should also bear in mind that many patients are on PPIs with no good indication.

How to wean off your dose of acid reflux medication

The basic goals are to gradually move from:

  • PPIs down to H2 blockers down to antacids,
  • Wean off a high dose down to low dose,
  • Frequent use to less frequent use.

Key points to remember:

  • Don’t go too fast. It takes time for your body to adjust to the changes you are making, so wait at least two weeks between significant changes.
  • Stop making changes if your symptoms worsen beyond your satisfaction.
  • At the end of the day, a “take it when you need it” strategy is best, whether that is antacids (best), H2 blockers, or the occasional PP
  • Remove any possible triggers like acidic foods and pay attention to lifestyle changes: tobacco cessation, weight loss, propping the head of the bed 4-6 inches, eating meals several hours before lying down, eating smaller meals and stress management.
  • Repair your digestive tract:  various herbs, and supplements before and during the weaning off period. Some of the helpful botanicals: chamomile, DGL(a type of licorice), marshmallow tea, slippery elm. Add a good quality probiotic few weeks prior to discontinuing the medication.
  • Rebalance your nervous system-stress is a well-known risk factor for increased acid production and the return of symptoms. Consider acupuncture, meditation or moderate intensity exercise.

Remember, any changes to your medication should be done in consultation with your physician!


Living with pain? Learn about an alternative, non-invasive treatment

Research Confirms Steroid Injections Are Not a Long‐term Back Pain Solution

A recent study published in the Annals of Internal Medicine* confirms that steroid injections can only give temporary relief to sufferers of low back pain and sciatica. Investigators from France focused on 135 patients with back pain who received initial relief from their pain after a single steroid injection. However the randomized controlled trial showed the effect decreased over time and at twelve months, there was no difference in pain levels between the control group and those who had received the corticosteroid shot.

Dr. Byron Schneider, of Vanderbilt University School of Medicine in Nashville, noted there are many different causes of back pain. In this study, the patients suffered from chronic back pain, he pointed out. “Patients with chronic lower back [pain] probably have more than one cause of their pain, which may be why the good results they found at one month weren’t there a year later,” said Schneider, an assistant professor of physical medicine and rehabilitation.

Unfortunately, this category of patients has often exhausted conventional physical therapy, chiropractic manipulation, and pain medication‐ which bring the risk of addiction and other serious health concerns. This can lead to a sense of hopelessness, desperation and, of course, surgery.

For some patients, surgery is appropriate‐ once all other conservative means have been pursued. “For chronic pain, physicians need to address the musculoskeletal reasons that cause the hurt, but also other reasons that patients may be experiencing pain,” Schneider said.

More and more spine specialists (medical, osteopathic and chiropractic) are offering IDD Therapy® oscillation decompression, a means of circumventing the surgical route utilizing a computer directed treatment device that performs targeted segmental mobilization. The system delivers gentle, highly accurate dynamic energy to the spine which helps restore normal spinal function, increase hydration of the disc and in many cases can retract a disc bulge (as seen in post-treatment MRI’s).

IDD Therapy® treatment provides primary care providers another resource for their patients in need of back pain relief and can help them to return to their former activities they once thought they could no longer do.

*Nguyen C, Boutron I, Baron G, Sanchez K, Palazzo C, Benchimol R, et al. Intradiscal Glucocorticoid Injection for Patients With Chronic Low Back Pain Associated With Active Discopathy: A Randomized Trial. Ann Intern Med.2017 Apr 18,166(8):547-556.

The above blog was written by our colleagues at Disc&Spine Center, they are the leading Atlanta area non-surgical treatment center for spinal disc injuries.Their treatment can improve disc metabolism and provide neuromuscular re-education to soft-tissue structures.Call 404-843-3040 and review your case with Dr. Miller!


Do Safer Cosmetics Really Matter?

This is a beautiful and sincere blog written by Maria Angelova my close friend and founder of Rebellious Intl- a company dedicated to wellness through exercise, aromatherapy, and safe cosmetics.Enjoy her blog and check out her website for more information.

NOTE: The below blog may contain information that some may find disturbing.

Do safer cosmetics really matter? In light of what I know and now my work, yes, they do. I have found myself lately in great conversations with friends on the topic. I try really hard to not be that annoying friend that always talks about ingredient safety. I often bite my tongue and sometimes it’s easier than others. I can truthfully say that I get a lot more excited about a friend or loved one using a pure essential oil or cleaner cosmetic product than for the sale.

Several recent conversations prompted this blog. It is never my intent to scare people; it is always my intent to offer information and make people think.

In one scenario, I shared the Closing Presentation: Gregg Renfrew, Founder & CEO Leadership Summit Keynote 2017 with a friend. This is the note she sent back:

“Mary, once again, thank you for sending the link to this video. This was super informative and inspiring. I realize more and more how very little I know about all the chemicals and ingredients that go into my cosmetics. Now I am researching parabens, sulfates, you name it….this is super helpful.”

Several days later, the same friend:

I was checking my skincare and was amazed….my day cream, body cream have parabens….[X] brand has parabens. I can’t believe it! I am just getting rid of everything now.”

This is what I consider a huge success – I made someone aware and that resulted in action on her behalf. Did she buy Beautycounter from me? No, at least not yet, she is doing her research. I appreciate people like that!

Scenario 2: A very close friend of mine made the statement:

“I just don’t want to have wrinkles, I don’t care what I put on my skin.”

There was a big lump in my throat after that statement. I love this girl; she is one of my best friends. Deep breath. I didn’t say anything but let me tell you what went through my head.

What I really wanted to ask her is:

Have you ever seen anyone go through or die of cancer?

If I had to guess, it would be no. I have. I have seen a perfectly healthy man who ate right, worked out, was happy, etc., etc. be gone from my life in a year and a half. That man was my dad. He died at 48. I witnessed his frustration having a hair fall into his food when he lost it, jumped out of his chair, grabbed the electric razor and asked me to shave all of his hair….that was one of the effects his chemo had. He loved to eat….but then said everything tasted like metal….that was another side effect of chemo.

He managed greatly through his first round of chemo but then cancer came back and spread out quickly. It impacted his brain. I remember me complaining about something small and his response was: “I can’t do the little things, I am not the same person, soon I will be gone and I will no longer be a burden.”

I remember the day when they marked dad’s face with markers to target radiation area. He left the facility with the marks on his face. He got home and took a cotton swab with rubbing alcohol and started rubbing hard and jittery to take it off; he was trying to look calm but by his movements and the look on his face, I knew he wasn’t.

I remember vividly his last days begging the nurse for an overdose to end the pain. We begged him not to do it.

I was barely 19. I went through all that trying to be his rock, to stay positive and to have faith that somehow his cancer will go away. He wasn’t of the lucky ones.

I did an event for cancer survivors with other wellness folks. As we were watching the parade of people moving down the street, one of the doctors said: “These people have gone through hell and back”. I believed her…..

Scenario 3, I was having a discussion on vendors with another wellness person. The vendor in question offered products with retinol – EWG Rating. Retinol is frequently used in anti-aging cosmetics. I was uneasy with the vendor choice. As the conversation kept going, she mentioned that we don’t want to have wings at the event because they aren’t healthy. I had to stop her! We are now conditioned to think about food and what we put IN our bodies. The personal care and cosmetic industry is where the food industry was 10 years ago. We still don’t think that what we put ON our bodies matters. But it does. Skin is our largest organ. Anything we put on the skin goes into the bloodstream and different body organs thus impacting our health.

We will never know why dad got cancer. My family was exposed to the Chernobyl accident. My dad and mom are also Ph.D.’s in Biochemistry and both worked with radioactive materials. It is believed my dad’s cancer was due to environmental toxins.

While there is nothing we can do about the air that we breathe, there are often small changes that can add up to make a big difference. Some of those changes, like switching to safer cosmetics, is easy to do. Other changes like eliminating air fresheners, plugins, dryer sheets, and so forth are also easy to do as well. Marketers won’t tell you that. You do not have to believe me either. Do your own research. Read. Empower yourself to make safer choices for you and your family. Also, believe me, my family isn’t making all the right choices and all the time either but we are trying. Absolutely not judging here.

I remember there was a blog a mom had written saying something like: “Let me put whatever products I want on my child”. I totally agree we are all entitled to choices. I know that any mom will make the best choice when it gets to her kids. I simply want to encourage more to be aware of what is in those products. I can assure you that once you read a couple of research papers on harmful ingredients, you will for sure think twice. I have been there. I was shocked by all the things I did ‘wrong’ when my daughter was little. But I know that I made the best choices in light of what I knew then. It just happens that now I know more.

All that said, if I happen to be that friend that asks you to please throw away the fragrance potpourri from your bathroom, please know that I am only doing it because I truly love ya and your family.

My parents taught me that I should not fall a victim of circumstances but that I should take lessons learned and turn them into opportunities. Yes, maybe I was traumatized by what we went through.

However, I can’t think of a better way to honor dad than to become part of a social movement aimed to raise awareness about environmental toxins. I can’t change what happened to my dad but hopefully, I can impact another family’s life. Yes, this is a very personal journey for me.  

P.S. I have stopped using fragrance candles. I have a few in case of electricity loss. We lost power for about 10 minutes yesterday; I lighted 4 candles for 10 minutes. This morning, I woke up with red dotted circles around my eyes – this is how my body now reacts to harmful ingredients. 4 candles, 10 minutes. Food for thought.

The New Integration

Fifteen years into her medical career, Dana Neacsu, M.D., had become frustrated with the way she and colleagues were treating patients.

“I started noticing how certain patients kept coming back,” she says. “You give them medications and the medications work for a while, but they still have the same problem down the road or sometime it’s even worse because they are having reactions to the medicines.”

Concerned that conventional medicine often had to do more with treating symptoms than getting to the root of the illness or teaching patients how to care for themselves, she decided to try a new approach. She left her position at one of Atlanta’s most prestigious hospitals for a fellowship with Dr. Andrew Weil at the University of Arizona. The Harvard-trained Dr. Weil is widely considered the father of integrative medicine – a field that combines complementary and alternative therapies with conventional medicine.

Read the full article here »

Worry to Wellness

worry to wellnessAlthough I see a variety of cases and patients every day, my passion remains women’s health- not just hormone replacement therapy for menopause but rather a continuum of care through to senior years, focusing as well on preventing cognitive and memory decline.
During my 15-year career as a physician I have seen it all. But there is a constellation of symptoms-I called it ‘’The Thief’’-that I see almost every day.

These unwanted symptoms seem to affect up to 90 percent of my patients and especially women. It starts usually with few things here and there-not feeling up to exercise, worrying too much about small things but, quickly enough, people are developing a sense of exhaustion, generalized anxiety, lack of energy which ultimately translates into digestive and hormonal problems and weight gain.
Once people get to that stage, the physical changes further affect their emotional state, even causing depression-a vicious cycle.

I think a possible explanation for a higher occurrence in females includes tendencies for women to set up high expectations, overexertion via multitasking and lack of needed social support especially during important moments like pregnancy or illness. Many times, I jokingly tell my patients’’ We need a support group just for being a woman!’’

I also would like to mention that people can have various other symptoms-think headaches, overall achiness or brain fog- that are related to anxiety, so always pay attention to your body’s signals.

Getting to the bottom of this problem is not easy. It involves detailed testing including saliva-hormonal or nutrient testing in order to be able to design an adequate treatment plan. This is one area where functional medicine helps the most because there so many imbalances to address: is it the hormones imbalance (like adrenals or thyroid), the mitochondria(the little powerhouse we have in each cell that is producing energy), serious vitamin or mineral deficiency that slows down your body, or is it an imbalance of the neurotransmitters-the chemicals that are making neurons work?

The diagnosis, and of course the treatment, can be complex. For treatment, I think it is important to include nutrition changes, stress-reduction techniques and safe, therapeutic- grade supplements to correct those imbalances under the guidance of a skilled healthcare practitioner.

I always encourage my patients to take a close look around them and their environment, and to make safe, greener choices when they buy products-whether food, beauty or even for home.

I also believe in meeting people where they are when it comes to lifestyle changes- moderation and baby steps, and rewards as well! I also think it takes a village to get somebody healthy so I often work with a team of other practitioners including nutritionists, acupuncturists and health coaches.

A general wellness tip: Willpower is a finite product, so please don’t test it at 10 pm after a long stressful day at work by, for example, keeping unhealthy food in your fridge-there is a good chance you might lose that battle; many of us would.

Wishing you health and happiness,
Dana Neacsu

Article featured in Modern Luxury Medicine, Fall/Winter 2017

Thyroflex-find out if you have thyroid disease

Getting A Better Picture of Thyroid Disease With Thyroflex™


The thyroid is a small gland located in front of the neck and just below the larynx (voice box). Weighing less than an ounce, it is an important organ that maintains body metabolism. It produces two main hormones, L-thyroxine(Synthroid) and Tri-iodothyronine (Cytomel™), that influence every cell in your body. These hormones regulate the way your body uses fats and carbohydrates. They help to control your body temperature, your heart rate, the production of protein and the amount of calcium in the bones.

Thyroid problems are often misdiagnosed or under-diagnosed and therefore, not treated effectively, if at all. Research has documented that up to 80% of the population has some level of thyroid dysfunction; therefore, testing for thyroid health is very important for everyone. The standard blood tests done to test for thyroid disorders do not give a complete picture, and often do not provide an accurate reading, particularly with patients who have sub-clinical hypothyroidism.
Enter the Thyroflex machine-a reflex hammer connected to a laptop computer which measures the speed of the neurotransmitters and the reflex speed and integrates this information into a resting metabolic rate along with symptoms. We use the muscle of the forearm to test, a more convenient way to obtain a reflex while the patient is seated comfortable chair. A delayed reflex time is the finding that indicates low thyroid.
Doing a Thyroflex test is especially useful in those cases in which the TSH is paradoxically low even though

the patient has symptoms of low thyroid. (Note: a low TSH indicates a high thyroid function while a high TSH indicates low thyroid function)
If you have been told your thyroid labs results are normal but you don’t feel normal, check into Thyroflex testing soon!

Our practice is one of the few practices in the Atlanta area to offer Thyroflex™ testing. The Thyroflex is the only non-invasive diagnostic tool used to detect thyroid disorders at the cellular level. It is highly accurate, non-invasive, and cost-effective and allows us to tailor your hormonal replacement treatment.

Call our practice and find out more!

Emotional wellness & hormones





Join the second of our Wellness Series! Let’s talk about Emotional Wellness & Hormones!

Join Dr. Dana Neacsu and Maria Angelova for an informational session on the importance of emotional wellness.We will talk about the role hormones play in that perspective. We will discuss practical and alternative ways to help deal with daily life.You will learn how to stay balanced since emotional health is one of the pillars of wholesome wellness.

Dr. Neacsu is trained in both conventional and integrative/ functional medicine under Dr. Andrew Weill. She focuses on finding the root cause of illness.Her method utilizes various modalities to promote body’s natural healing mechanism and restore wellness. Maria is the founder of Rebellious Intl whose mission is lifestyle transformations through empowering body, mind, and spirit.

Look forward to seeing you at the event!

The Wellness Series is a series of events on a variety of wellness topics.We strive to bring you. practical advice, fun and social interaction!