Navigating the supplement section at the health food store

Having gone to health food stores since I was a kid and working in them I feel a duty to offer some guidance on navigating the endless shelves of pills, liquids, tinctures and snake oil. I even managed a supplement department once, so I know what I'm talking about here.

There are many kinds of health food and supplement stores. Many have their hearts in the right place, but mostly they are there as a business. Some stores are fueled by an overwhelming need to help people and their staff has been working there a long time with little turn over, though this is somewhat rare. Old ideas about health often become entrenched in these places (strong laxative cleanses, vegan diets, coral calcium or candida anyone), that may have little bearing on current states of research or knowledge. Some stores sell supplements simply because that's where the money is and it has come to be expected at places that sell the natural and organic lifestyle. And some jump on any bandwagon and customers are at the mercy of whatever recent product training the staff has had. Usually you have a mix. One thing to remember is that these stores usually pay only a little above minimum wage, attract a young workforce, and may require very little in education about health or natural healing. This is a problem when you have a $7 billion dollar a year and rising natural health industry and many many people looking for holistic health. Undoubtedly people come into the stores looking for a magic bullet, a magic pill that will cure their woes. They want whatever the Great and Powerful Oz has recommended that week on TV. This leads to allopathic style recommendations of take this for that. Experienced practitioners and healers can become jaded in this kind of environment because it doesn't take into account the individual person. Businesses love it  because people come back for more. Some people spend more on their monthly supplements than food to the tune of hundreds of dollars (because they can't afford to eat well (WTF!!!)).

Another issue that the public doesn't seem to understand is that many stores have rules about what people can say about a product, the same rules that apply to how the products can market themselves. A person in the store cannot legally say that something works. This is important to remember. If you ask this question you probably feel like everyone is giving you the runaround about products. They are, but you are backing them into a legal corner. Some stores don't care and staff will say all kinds of things about a product that would make the FDA fume. Both styles are something to watch out for.

I think I'll just break down some of my recommendations before I get fuming about the current state of the industry. I can't write when I'm fuming. part of my recommendations have to do with products, but most of it is about how to avoid purchasing unnecessary items that magically show up in your basket and you have no idea why you bought it when you get home.

1. Health foods stores offer the most staff help in the biggest money makers for the store: the wellness department, and the cookie aisle. The one aisle that can make the biggest difference in your health usually only has a person stocking and usually cannot offer much in the way of nutrition or cooking advice. The produce section is poorly manned in any store because it is usually a profit drain on the store. Up to 50% of the produce gets thrown away. They order too much so it makes the store look lush and healthy. It's grocery green-washing. Wellness products are confusing so people need help putting the most expensive ones in their carts. Cookies and snacks basically sell themselves, but you might need help finding the ones you want.

2. If it's in your hand there is 30-50% that you will buy it. This is the standard product training rhetoric that everyone in sales has been told. I'm not sure why it happens, but it's true. Avoid taking whatever you're being handed until you can look at the product in peace. Or take it but remember the aforementioned sales tactic. Make your own decision. Take notes if you have too.

3. Either the sales person has a personal history with a product or issue and they are honestly recommending something, they are health practitioners who keep up to date on research and products and think they have a winner, they just received a training on the product so they like talking about it because they got free stuff, the product is new and they recently read the label, or the store has told the staff to push the product. Trying to parse this all out is daunting. By asking about people's personal experience with a product you can hopefully avoid new product enthusiasm. Also, by asking pointed questions like "Do you know of any good research on this?" "What do people repeatedly come back for and say really has helped their arthritis/IBS/acne/eczema etc..." or "what good reports from customers have you heard from this product?" If they don't know they probably don't have a healing relationship with their customers and it might be best to talk to someone else. Also feel free to ask about what training they have had in natural health. If it's just store training, specifically from product reps, the likelihood is that the training was geared more towards the bottom line that your health.

4. If a product is never in stock, it doesn't mean it's good. Sometimes it does, but usually it means there was a media blitz on the product. Just blame Oz. Products with staying power are usually well stocked and don't usually go on back-order. This is not true of botanicals however. Herbs have to be grown. They are not synthesized in a lab. Sometimes demand outpaces supply. Sometimes there is a bad growing season or drying season. It's hard to know. Sometimes prices go up because half the worldwide crop was lost. This happens and not much can be done about it, so be nice to the salesperson who probably has no idea why they can't get holy basil (holy basil is awesome by the way).

5. Go when the staff isn't stressed out. Remember the making close to minimum wage thing. Ok, it's usually somewhere between minimum and living wage ($8-$15 depending on experience), but still not enough to feel financial security. In the early morning there are opening duties and lots of things to do. The staff might still be waking up, or had a harrowing commute, or be hungover. Give them a minute to warm up before going into all your health and life problems. The lunch rush can get particularly busy and the staff might not get to take their breaks until it is over. This is not the time to go if you need particular help with something or want to discuss an issue. At the store I worked for all we had time for was pointing to a shelf and checking out the long line. If you're in a hurry there is not much they can do to help you choose a good product for you. They will probably just point to a best seller. If you go at quieter times of day they can ask personal questions, refer to resource books, ask co-workers for input and it is a much more fulfilling experience for all.

6. If you have a particularly bad intractable chronic or rare illness you can't expect staff to know anything about it. The more information you can offer the better your experience will be. Maybe you won't find help or relief that day, but maybe you will. Alter your expectations. You don't want to fluster the person helping you because they may start recommending all kinds of products out of panic and overwhelm.

7. Not all products are safe or effective. It could be unsafe because you have a certain health concern, thyroid disease or a heart condition for instance, or a certain form of a nutrient is basically inert. The good stuff often costs more. Ask about the different forms of things on the shelf. If whoever is helping you doesn't know the answer, look it up on your smartphone. It's harder to know or look up information about nutraceuticals and health conditions. There is often conflicting data, no data whatsoever, or changes in standard treatment recommendations. The internet is a big place and tends to have someone spouting every possible answer to every question. Reference books go out of date, and not all books are well researched. It's better to do your research before you get to the store. At least know about your current health state.

8. It is your responsibility to know what you have, what you've taken before that has worked for you, and what you're trying to achieve. Product labels and formulas change all the time so it is good to know the details. Some people have trouble with the personal responsibility bit. Natural Health is work, and it involves taking care of the factors which are in your ability to control. If you yield that control to someone else, especially someone who doesn't have any stake in your health (a paid practitioner has a real interest in helping you, someone just working in a wellness department does not) you will end up with a basket of crap, taking 22 pills a day, and not feeling any better or worse, feeling better but not knowing why or which one. I have a story of a customer who came regularly to the store I worked at. She was probably in her 60's and she was coming in for thyroid issues and she wanted herbs. I hadn't worked with her before so I asked her what thyroid issue she had.

"I don't know," she said.

 "Ok. What are your symptoms then?" I asked trying to parse out what was going on.

 She snipped "I don't want to tell you. I just want the herbs the other lady gave me!"

"Ok. We can do that. Are they working? What did she give you?" I asked.

"I don't know if they're working! They're green!" She was almost yelling at this point.

I calmly told her that it is her responsibility to know her illness, symptoms, and what she's taking. I can't help her if she can't help herself. Oh man. She was fuming after that. Stormed out of the store and she even tried to get me fired!

I realize that a lot of my tips come down to personal responsibility. But that's really the only way I know to keep from being taken for a ride.

Migraines and Anger

Like many people, I suffer from migraines. Mine aren't out of control or completely debilitating anymore. This could be for many reasons such as diet and lifestyle changes, or the more prosaic getting older and having my hormonal milieu change. One thing I have always noticed is a correlation between sugar and my migraines. Eating too much to regularly increases the occurrence for me. Natural sugars like fruit, honey, or sucanat tend to be ok, but white sugar and HFCS seem to set me off. I don't know if the fact that they are frequently GMO plays a role in that, but I suspect it does. I have also noticed a correlation between sugar and uncontrollable anger outbursts. I never really put them together before. I had always assumed that it was the sugar that lead to the anger and irritability, not the migraines themselves.

I came across an article that made me think about that. I wasn't intentionally doing any migraine research. By chance I somehow clicked a link I didn't notice, and as I worked through the slog of open tabs on my computer I came across it. It is neither a long article, nor a well referenced one, but it gives me something to ponder and observe.

Anger and irritability are some of the lesser-recognized symptoms of migraine disease. These symptoms are most often experienced during the prodome phase.

The prodome phase comes before the migraine attack itself and serves as a warning of an impending migraine attack. The prodome phase can start as early as 24 hours before the onset of a migraine attack.

This anger, impatience and irritability are some of the most often misunderstood aspects of migraine disease for family members and friends. We often do not realize these tendencies are related to our migraine attacks and cannot warn our loved ones of this, either. It is not uncommon for those closest to us to perceive us as having a bad or nasty attitude that comes out of nowhere. The reality is that it can be extremely difficult for us to control this tendency, especially when we haven’t yet made any association between these symptoms and our migraine attacks.

I tend to have intense sugar cravings before a migraine which generally doesn't make me feel great and I've recognized that eating certain kinds of sugars like table sugar or HFCS sometimes leads to anger bursts. Does it happen every time? No. Which is why I haven't made a connection to it before or tried to observe it. When it does happen I feel like my liver becomes irate and the energy springs forth suddenly. It is a very "HULK SMASH!!!" sensation for me. This is based in a TCM understanding of liver and anger, not necessarily a directly physiological one. Sugar and fructose have been implicated in liver damage and non-alcoholic fatty liver disease, so I think the concept of angry liver might deserve consideration. This is my personal story and only reflects my personal experience in my own body. I'm writing about it here so I don't forget to take the time to observe.

Migraines have many presentations in the body and how they appear is entirely dependent on your own constitution. That is one reason they are so hard to get under control. This post is not meant to diagnose anything. It is important to pay attention to our bodies and to learn about signs, triggers and everything else. It is a constant challenge as we are always changing. At one time in my life I had migraines 15-20 days out of a month. Now it is down to about 2 days with very little effort on my part. I even get other types of headaches now. Like I said at the beginning, this could be due to lifestyle or it could be internal hormonal changes as I've gotten older, or both. I suppose I will leave it at that for now.

Tips for staying healthy in the last few weeks of flu season

Much of what can be said about boosting the immune is based on lifestyle changes, such as eating whole nourishing foods, sleeping more, reducing stress, drinking less coffee/alcohol/soda, blah, blah, blah.... We all know about these changes we can make and how we should have started them back when we we born. But that's not where we are now, and even the person who does these things gets sick. What we can do is look at where we are at and make some easy modifications that can help.

Basically, the things that depress the immune system are the same things that tend to make our bodies feel off or even just kind of blah. These feelings are often dismissed as getting older and not being a teenager anymore. Fatigue, illness, poor nutrition, stress, pain, are all signs of poor health, not necessarily signs of the dreaded aging. What tends to happen is that all of these stressors quite literally slow and cool the body down. They weaken the immune system and all normal body functions. Body temperature needs to be robust to keep metabolic function active and to ward off disease. Most of recommendations and personal practices reflect this.

• Dress appropriately and comfortably for the weather and the inside temperatures where you live and work. Take specific care of the parts of your body that feel cold or stress most. If you have cold hands and feet take extra care that they are warm and protected. If you have neck or lower back pain (stress signs) take care to keep those areas warm, whether it's with a scarf or a longer jacket. Scarves are my favorite thing in the world! I have quite a collection. I will wear a warm one outside and a lighter one inside in the winter. I have been known to wear them in the summer as well because of too cold air conditioning. In TCM, illness often enters the body at the nape of the neck or via the kidney area, so protecting those areas and keeping them warm is important.

• Eat warming foods. This is not the time for a quick lunch of a sandwich or salad. You want warming, dare I say hot, foods to get your temperature up. Soups are awesome here, especially ones made with rich bone broth. If you can get Pho, do it. You can often find chili and various stews at cafes. Hot foods are easy on digestion so your body doesn't have to dedicate lots of resources and blood flow to break down your meal. Meals with hot sauce or wasabi are also appropriate here. Skipping meals will also cool you down so avoid doing that. 

• Drink hot things and not just coffee. Teas are wonderful and many have been shown to have antiviral effects (even you Lipton). You can go with what you have on hand with green or black tea, flavored, whatever. You can have hot ginger tea with lemon and honey. Use powdered ginger (1/4 -1/2 tsp) or fresh. Add a dash of cloves or cayenne. It warms you up and makes you sweat. Fever is how the body fights infections. If you're already warm you might not get sick if exposed or you may knock it out more quickly. If you already have an herbal tea stash add some elderflower to that ginger tea (AMAZING!), drink elderberry, peppermint, yarrow, monarda, echinacia, chai, reishi, astragalus.... But you already know this. The point is to drink something hot to warm you up and help to flush out any nasties that try to take up residence. Hot water also works. It helps the mucus membranes do their job. 

• On that note, stop drinking iced things! I know, they're delicious and it's a habit that's hard to break. But bundling up while drinking a smoothie is not really helping anything. You want a smoothie? Make it with thawed or fresh fruit without ice. Still delicious but not a cold rock to your stomach or immune system.

• If you can, sleep or rest a bit more. Everyone else is trying to give you the plague, so why not stay in instead of going out for drinks. If you do go out remember elementary school when we were all told not to share food or drinks. It's a good time to remember that. The vodka in your friend's drink won't be enough to prevent her from passing on her flu (that she's totally over) on to you. I don't care how delicious she says it is. 

• Hot showers and baths can make a difference. If you've been out in the world it is good to feel the heat and get the blood moving. It also helps to wash off anything that may have followed you home. I need to remind my husband of this one all the time: please at least wash your face and hands when you get home, and damn well before you get into bed with me! 

To sum it up, stop freezing your immune system and you'll have a better chance. If you get sick, stay home, stay warm, and take time to recover. Kind of boring advice in a world when everyone is looking for a magic bullet. They don't exist. Sorry. I wish taking elderberry elixir everyday was enough, but it's often not. I know because my whole family got sick this year. They were down for days with fevers and aches. Me, I followed my own advice and never felt more than blah, which says to me I got sick too but was able to clear it fast.

Good luck.

A few thoughts on this year's flu

As it seems like there is a particularly bad flu going around, I thought I would talk a little bit about it. I remember a few years back when H1N1 was going around there was a surge of energy going through the herbal community. Where conventional treatments seemed to have little to offer, our herbal treatments really seemed to help. Anecdotally this was a great validation for the herbal remedies we use in flu. Elderberry seemed like a champion and there was even some interesting research about elderberry extracts inhibiting flu replication by preventing viral binding to host cells. This year's flu has been particularly virulent. Part of the problem is the particular strain of Type A flu. It is the H3N2 strain and health care workers say it is making people far sicker than other types of influenza. From discussions with other herbalists, this seems to be quite true. Unfortunately our usual arsenal of elderberry and other herbs seem to be less effective against this year's strain. Why this is is unclear. Past research on elderberry and H3N2 strains have shown effectiveness against this type of flu.

Even if it isn't as effective against this particular strain of the flu, elderberry is still useful as an adjunct treatment. It's antimicrobial qualities are helpful at preventing the secondary infections that sometimes occur. Other useful herbs are boneset (which helps with the body aches), elderflower (for helping you through a healing fever), and peppermint to cool and soothe. Eating lots of garlic, onions, and ginger is also helpful for a variety of reasons. The best thing you can do for yourself is to rest. And I don't mean work from home. I mean to really convalesce and let your body do its important work of healing.