Congestive Heart Failure: A Functional Medicine Approach

[Oversight regarding root causes] leaves aging individuals exposed to the ravages of unchecked heart attack risk factors such as excess homocysteine, insufficient vitamin D, and hormone imbalance & deficiency. This deadly oversight is a fundamental reason cardiovascular disease continues to plague so many Americans (Faloon 2009).1

In contrast to the relatively unimpressive conventional treatment options for heart failure patients, a major breakthrough in heart failure research came in 2013 with the presentation of early results of the Q-SYMBIO coenzyme Q10 (CoQ10) trial. This groundbreaking ten-year study provides strong support for a recommendation made by Life Extension many years prior in the context of heart failure. This exciting trial showed that CoQ10 supplementation significantly improves survival even for patients with severe Class III or IV heart failure while dramatically reducing incidence of hospitalization. Specifically, heart failure patients who took 100 mg of CoQ10 three times daily were significantly less likely to have a major cardiovascular event and significantly less likely to die from any cause during the study period compared to control subjects (Mortensen 2013).

Dietary and nutritional interventions have been valuable. “Vitamin B4 is water soluble and is needed in order for the organs and the body to function properly. Vitamin B4 should be included in a healthy daily diet by eating the types of foods that contain this complex vitamin. Bananas, oranges and apples contain vitamin B4, and so do vegetables with green leaves, such as spinach and mustard greens. Herbs that contain vitamin B4 include cloves, hawthorn, jojoba, sage, yucca, ginger and golden seal.”

Clearly, although ‘healing’ is the common goal, western (conventional) and functional (integrative) medicine have two separate approaches.  Conventional addresses symptoms as they present, using pharmaceuticals; functional addresses systems as root causes, and leans towards lifestyle, rather than medications as a first line of treatment.   According to functional medicine, “[m]ost pharmaceutical drugs work by blocking, poisoning, or inhibiting the body’s biochemical pathways.   As an alternative, functional medicine employees the use of nutrients that support the body’s biochemistry to help boost deficiencies that are the cause of the medical condition.  Rather than fighting the symptoms, functional medicine focuses on attacking the cause.”

Chiropractic medicine recognizes there is hope for people suffering from congestive heart failure.  According to Dr. Grisanti, “To be quite honest, when I first started in practice I was like most people thinking that there was no way a disease like congestive heart failure and a host of other diseases (you will learn about) could be reversed. The best I hoped for was at best just to slow down the progressive deterioration of heart failure patients.  To my surprise and the surprise of thousands of people, the more nutrient deficiencies that were identified and fixed, the healthier people became. Of course this is just the beginning of improving the health of people with heart failure.”

Along with common sense lifestyle modifications including diet, exercise, modest alcohol intake etc., Dr. Hyman offers: “. . . supplements can dramatically improve cardiovascular health. Take a good multi-vitamin/mineral along with a purified fish oil supplement that contains 1000 to 2000 milligrams a day of EPA/DHA. (You might need higher doses if you have low HDL and high triglycerides.) I also recommend a fiber supplement such as PGX (Konjac fiber or gluccomanan) to lower cholesterol and balance blood sugar levels.” 5







Lifestyle Tools That Become Lifelong, Lifesaving Gifts

The proper lifestyle tools become lifelong, lifesaving gifts. Caring for young children compels us to create a healthful environment. We begin to put greater thought into balancing sleep/wake schedules, exercise, diet, the air our youngsters breathe and the surfaces they touch. So how can we be sure we are making the right choices? One way is to hear the claims and then weigh the evidence.  It helps to choose educated professionals with whom we share common values.  The following article draws evidence-based data from the perspective of prevention, functional medicine & systems-based approaches to healing.

Why is sleep so important for our children?  Until the age of about 5, the human body generally requires between 12-13 hours of sleep a day; astonishing to some – well known by others.  During sleep, the brain and body develop.  Less than 11 hours of sleep a night during this crucial developmental stage may severely impact the child, with negative life long implications. Throughout the life span, sleep requirements may change.  Click here to read more about recommended upper and lower limits of sleep from birth to 25 years of age.

What are the recommendations regarding exercise for our children?  The 21st century brings with it the recognition that a sedentary lifestyle correlates highly with deterioration of the cardiovascular system. Specifically, the more we sit, the greater our chances of developing blood clots, obesity and poor posture – all of which stress the heart. Fortunately, even if we have fallen into couch potato patterns, or have otherwise become addicted to our laptops, once we begin to work more physical activity into our daily routine, we can reverse the premature aging of our cardiovascular system.  What a blessing to be able to help our children avoid the sedentary habits that can drive them to an early grave.

Two essential questions might pop into one’s mind: (1) How much exercise is really necessary for the human body?  and (2) How much physical activity do children really need in order to define theirs as a heart-healthy lifestyle?  For these answers we turn to the experts. The American Heart Association (AHA) recommends at least an hour (60 minutes – which can be divided into two 30-minute intervals) of exercise a day for children over the age of two. Click here  to see what the AHA concludes regarding health implications for our children.

How can I get my child moving?  Once we define the questions and find the answers, we then need to be able to implement. Easier said than done. If you are interested in encouraging the next generation to form healthy lifestyle habits, you are in the company of a growing number of caregivers on the lookout for creative tips on how to physically engage children and young adults who are otherwise flooded with sedentary technological activities. Click here for ten heart healthy ideas.

While cardiovascular exercises are essential for several systems – including circulatory, skeletal and respiratory, stretching exercises are also important. In fact, stretching may be one of the most important interventions for athletes, when the goal is to keep the body limber. Remember: flexibility is what helps protect against soft tissue injuries (i.e. sprains and strains) during sports activities. This is a huge point to keep in mind for adolescents. Click here for some valuable interventions.

Yoga is another important approach.  When done properly, yoga helps more than just ligaments, tendons and joints. Well appreciated by adults who value balance of mind, body and spirit, yoga is able to be enjoyed by children as young as two years of age. If you think your child might be interested, click here for a few child-friendly poses.

Building a strong mind & body involves physical exercise (noted earlier), and well balanced nutrition.  Most people understand the impact of calcium, Vitamin D and other popularly advertised nutrients on the body; however, few people are aware of the role these play in brain development. In fact, most are unfamiliar with the tremendous impact of nutrition, in general, on such diagnoses as ADHD, IBS and other issues that involve a variety of organ systems. Learn more by clicking here.  Young children require on-target intervention in order to maximize their potential as they grow.

When it comes to the air we breathe, we usually consider air ‘quality’ – and there are several interventions (including plants – click here for a few examples of air filtering plants, and here for additional information) that can help. HEPA air filters are generally considered safe and effective, whereas the ‘ionic air purifier’ technology is becoming less respected by environmental groups. Click here to learn about HEPA filters.

Flu, Humidity and Vitamin D. Low humidity sets the stage for the transmission of airborne viruses, including the ‘flu’ virus (especially in winter months). When the dry air season combines with low levels of Vitamin D, the body’s immunity is low enough to permit the flu to multiply and make us sick. This is why in the north eastern United States, when the air is driest (beginning February, when the body’s Vitamin D stores are lowest after 5 months of sunshine deprivation), we understand ‘this is flu season’ . . . and flu shots become recommended by conventional practitioners, beginning in November. For those who are either unable to take the flu shot (i.e. if you ever had Guillain-Barre Syndrome  ) or if you simply choose not to have it for any other reason, there are ways to boost your immune system to avoid the flu.  Click here for recommendations.  With or without a respiratory illness, in addition to drinking enough water each day, humidification of household air is important  to keep the eyes, nasal passages, lips, mouth and throat hydrated.

How can I humidify my home?  When the winter weather makes the air outside cold and dry, whether you heat your home with electricity, oil, gas or a wood burning stove, the air inside your home is just as dry – and needs to be humidified. Plants can help. Depending on the type of plants you have, watering more often might help. Gardeners usually advise against ‘misting’ leaves – but that also depends on the plant.  Click here  for additional creative ideas on how to humidify your home. Humidifiers are also a popular intervention during winter months.  To learn more about how to choose a humidifier, click here.

How else can I protect my family during the dry winter, flu-season months?  Giving the immune system the proper tools to protect our children is FAR more effective than trying to kill or destroy any/every ‘germ’ (virus, bacteria, fungus) with which they may come into contact. In fact, research shows that children exposed to allergens (including animal dander, mice & even roaches!) in the first year of life have less respiratory issues than those who are raised in a more ‘sterile’ environment. Choosing non-toxic cleaning products for all surfaces – including wood, is a challenge; however, it is well worth the effort if you are interested in preserving our earth for future generations.  Here are some tips on how to keep your home environment earth friendly:  click here.

Ask your child’s pediatrician or pediatric nurse practitioner about how you can boost your child’s immune system using foods, fluids, and dietary supplements. Although these are ‘over-the-counter’ there are important reasons why it is best to consider your child’s unique body, metabolism, growth pattern and genetic make-up before selecting foods, herbs and supplements. Your wellness provider can help.

Here’s to healthful choices for you and your entire family! ~Dr. Iankowitz

Caring For Aging Parents

When caring for aging parents, we do our best to offer effective, loving, on-target interventions to address their many needs. Sometimes we move them into our home or we relocate into theirs – for as long as we can. When it becomes clear that your parent requires more attention, time, skill and/or expertise than you can offer, a tremendous amount of guilt may distract from making timely choices for the next ‘must-be-taken’ step. Getting out from under that cloud of harsh self-judgment begins with re-framing the worn-out phrase: “You can do anything you set your mind to” so that it accurately reflects the human condition.  In other words, if you have done everything reasonably within your power (short of taking a home health-aide course, joining a gym to build muscles in order to physically rise to the task at hand – you get the idea), it becomes essential to temper the quoted statement above to: “You can do anything you put your mind to – within reason.” This takes into consideration personal resources including but not limited to: money, time, logistics & energy demand.

Once the decision has been made to include others in the journey, in consideration of the health and well being of you as well as your loved one(s), the ‘next step’ might include bringing a professional caregiver onto your wellness team. When searching for reputable in-home attendants, it is optimal to get word-of-mouth recommendations from friends or other family members who have experienced the journey before. If personal recommendations are not available, you can tap into online resources (such as  If the ‘next step’ for your situation includes relocating your parent to a long term care facility, and no personal recommendations are available, then checking out resources for their on-site reputation becomes a viable alternative. You might find this resource helpful:  click here.

What if you have a particular location in mind?  For example, if geographic location to facilitate visits is a priority, choosing a facility that falls within your target radius may be done by searching online by the name of the state you have in mind.  For example, if seeking information about reputable facilities in Pennsylvania, you might check out this link: click here.   It might help to become familiar with terminology so that you can best address your particular needs; for example, your parent might need help with medication, bathing and eating. You may or may not need to consider memory support (dementia) in terms of hands-on ratio of care-givers at a particular facility; click here to learn more about how to meet your needs for your aging parent.

There are many additional considerations including but not limited to financial concerns, informing close friends or family, (as well as deciding whether or not to include the parent about whom you are concerned and/or those family & friends) in the decision-making process. This bring us to what may be, for some, the most significant concern; specifically, that which involves informing the aging parent of the ‘next-step’ process. Bringing a social worker or other well trained mental health professional on board at this tender time might be helpful – especially if your parent slips in and out of awareness. You might require more support than the parent for whom relocation and increased care is being planned. If your parent is relatively well oriented, then involving your parent – if that person is capable of decision-making, may provide a valuable bonding experience for all involved.

Decisions made out of sincere concern and love are very different from the “dumping” label we tend to give ourselves when considering long term care for aging and/or otherwise incapacitated loved ones.  In addition, the various elements of self-inflicted guilt you have mastered might be dissolved if your parent expresses awareness and agreement with the logic of the ‘next-step’ – whether it involves bringing an additional caregiver onto the team, or moving to a reputable facility in order to best meet the needs of all involved.

Whether the discussion happens in advance or at the time of need, it is best to have a few hints and tips in your back pocket. If you are fortunate enough to have parents who are alert, oriented and able to have this important discussion, click here for a few tips. Additional helpful pointers may be found at the following link:  click here.

Life is filled with lessons – some of which are learned more easily than others.  Try to learn from every experience, and find ways to let yourself off the hook when guilt distracts you from joy.  It is a difficult time for all involved.  Engaging a mental health professional yourself might assist in your journey back to centering your balance of mind, body and spirit. Remember, every family member is affected by this milestone.  Try to be kind and gentle with yourself and with each other.  Life is precious and there are always blessings to count.  Here’s to your best health.  ~Dr. Iankowitz

Refilling the EMPTY-NEST with Dignity & Grace

Reframing expectations once the kids return home is key to maintaining sanity.  When your 24 year old is preparing to launch into his or her career, but not yet able to make ends meet on the entry-level salary (even though there is a prestigious Master’s degree on the resume), the desire for independence on the part of the young adult might clash with the desire for ‘freedom from children’ on the part of the parents.  Add to this mix aging grandparents – both hard of hearing, one of whom suffers with vascular dementia, and the other in a massive state of denial about all that is happening.

So what can YOU do if you are a member of the sandwich generation – surrounded in your home by YOUR kids as well as YOUR (or your spouse’s) parent(s)?   Two main goals to establish:  COMMUNICATION & BOUNDARIES.

  1. COMMUNICATION: Open communication about expectations regarding computer use, showering, and meals
    • If sharing computers, get passwords and internet security protection (the LAST thing you need is a computer virus – especially if you share WiFi or actual laptops)
    • Timing of showering needs to be considered – especially if one or more people need to go to work, and also in case washing machine or dishwasher interfere.
    • Are there food sensitivities or preferences? Is there medication that requires refrigeration? Will you each purchase your own food? Does more than one person enjoy cooking? Will the microwave, countertops and/or stove or oven be shared?
      • Consider assigning space in the refrigerator & freezer for special needs.
      • Perhaps you need a schedule of who eats when (the elders may require meals earlier or snacks more often; work schedules often dictate who will eat together and who will eat alone).
      • Is there room at the kitchen table for everyone at once?
  1. BOUNDARIES: Parents who are accustomed to being the ‘back-up’ either emotionally, health wise or financially, may find it difficult to separate with clearly defined boundaries.  Here are a few points to consider:
    1. Privacy: If the master bedroom shares a wall with the bathroom used by the adult child, and you hear the toilet flush in the middle of the night – assume all is well unless your child knocks on your bedroom door. If you were awakened and have difficulty getting back to sleep, wait until morning or later in the day to bring it up.  Nobody needs a confrontation in the wee hours of the morning.
    2. Responsibility: Don’t assume your adult child needs money whenever s/he leaves the house. Stop yourself from asking how much s/he has in the wallet whenever heading out.
    3. Laundry: Assume your adult child does his/her own laundry. By request, of course, a few additional garments may be added on occasion to your load – but don’t make this a habit.
    4. Food shopping: This blends communication with boundaries. Establish rules that suit your family rhythm and stick to them until a new conversation helps reestablish guidelines.

Important note: You and your spouse deserve your own special protected time away from the circus – and this needs to be scheduled in.

  • If finances permit an extravagant getaway – go for it GUILT-FREE, as long as you effectively hand off all responsibilities (including mail, care of the dog/ cat/gold-fish . . . you get the idea) and provide emergency contact information – get up and GO when you need that very essential self-care.
  • If time and money are not readily available, create a safe space in your home – off limits to all, to give yourselves that uninterrupted time/space. If physical space is an issue, try taking a walk, going to a movie or just getting OUT together – once a week. It may also be helpful to make an effort to go to bed an hour early during the week to just catch up, watch the news or a favorite comedy or movie on television . . . or just cuddle & relax in the silence you create for yourselves.

Keep unspoken ‘assumptions’ to a minimum, self-reflect often, and take lots of deep breaths to keep yourself on track.  This is a learning experience for ALL of you, simultaneously.

One of my favorite quotes (paraphrased here) is by Vivian Greene, and it goes something like this:  Life is not about waiting for the storm to pass; it’s about learning to dance in the rain.  So here’s to your successful adventure through life, and to all those deep breaths to which you are about to treat yourself.  ~Dr. Iankowitz


If you have hints and tips to share, I invite you to add your wisdom from either personal experience or observation.   ~Dr. Iankowitz

Words That Distract From Wellness: DIET & EXERCISE

You are on the right track if you say,   “NO – NEVER – NOT ME!” in response to the popular misinterpretation of these two words:  DIET  &   EXERCISE

Diet, if misinterpreted as

  • Self-deprivation on any level
  • Separation anxiety as if saying good-bye to something you love and look forward to – as in losing a friend
  • Being forced
    • against your will to give up pleasure
    • to eat or drink something that is upsetting to you

Exercise, if interpreted as

  • Physical torture, pain, or discomfort on any level of mind/body/spirit
  • An unpleasant task

Once you get out from under the distractions and misinterpretations, you are able to get hold of YOUR intention and YOUR idea of a wonderful, healing journey going forward.

It Is Time To Heal

MINDFULNESS exercise: How does one get hold of personal INTENTION & begin to choreograph a healing journey in three (3) simple steps?

  1. Look up the true definition of “diet” and “exercise” in the dictionary
  2. Observe YOUR choices and patterns over a two week period
  3. Document your observations (#2) paired with your mood, energy, general health, sleep pattern

The recognition of the role of mindfulness (following steps #1-3, above) is a life changing experience, as it reintroduces you to the body you are walking around in during your time on earth.

After the first two weeks, as you review the mindfulness documentation, you begin to awaken to the messages your body gives you every day – several times a day. This new friendship begins as any other – with the first step as ‘earning trust’.  Choose a support system (can be a friend, a group you join [i.e. Weight Watchers] or a trusted wellness professional).

Earning the trust of YOUR own body begins with mindfulness, compromise & open communication. Establishing your personal healing path requires loyalty, honesty & a willingness to let go of energy that no longer serves you (i.e. sucks energy, depresses your mood, creates anxiety & physical discomfort), as you adopt new, positive healing energy that fills your life with joy.

If you decide that you need or want some support or professional guidance to facilitate this part of your healing adventure, feel free to call (917) 716-6802  for a free 20-minute consultation. Dr. Iankowitz can outline an appropriate direction for you which may include an appointment with her and/or a list of foods to add or avoid, a few stretches to consider working into your daily routine and/or recommendations for additional licensed, certified health providers skilled in acupuncture, herbs, energy healing, chiropractics etc.  Today is the first day of the rest of your wellness journey.  Embrace it with gratitude and positive energy.


When The Foods You Love Don’t Love You Back

You may very well know how to balance your mind, body and spirit. Your diet and nutrition might work well for you, and your weight might be exactly where you want it to be. It is possible that you have no joint pain, your muscles are strong, and you are flexible, well rested and generally centered.  Perhaps you meditate several times a week, self-reflect and have reached that point in life where you feel confident, excited, gratitude & joy on a daily basis, and you even pay your blessings forward whenever possible.  Namaste.  If, however, you are still working diligently to fulfill your potential and master the art of ‘balance & joy’ then take a few seconds to view the video (a 9-second long ‘stay-cation’)  and then, please read on.

The 21st Century has fast forwarded us into the technological era where focus is on external communication.

  • We can face time with people thousands of miles away at the touch of a button. This brings us closer to those we miss and love.
  • Computer savvy has trumped traditional ‘wisdom’ since grandparents are, for the first time in human history, consulting with grandchildren for THEIR advice on how to . . . . .

. . . and yet, there is indeed a downside which needs to be returned to the ‘right-side-up’ position if the human race is to be left in the hands of a healthy next generation.

We are what we eat; what if food is toxic?

At the current rate, if present day focus remains unrefined, and the rampant neglect of essential issues remain unaddressed, the next generation (which is already suffering) will suffer an even greater impact, not to mention the generation following that . . .

        . . . I prefer to address what CAN be done – rather than consequences if we don’t.

We need to

Becoming aware of poisons that are avoidable is key.  The State of Maine, for example, has taken a huge step in requiring manufacturers of paints and cleaning products to give the consumer a ‘heads-up’ by insisting that they list toxic ingredients in their products.  Click here for a sample list.  We all deserve to know what is in the products we bring into our home – especially if we have vulnerable children who depend on us to keep them safe.

Once aware of the toxins, you can make informed decisions about how exposed you wish to be.  You get to pick and choose your poison – in the very real sense of the phrase.  Again, YOUR body is indeed designed to handle occasional toxins – but if you deliberately (or neglectfully) overload your organ systems, the result is often illness that is directly related to imbalance you created.

Let me say this again: The healthy human body is able to clean and filter air it breathes, food it eats, and fluid it drinks.

We are designed to purify and detoxify ALL SORTS of pollutants.  The problems arise when we either overload the human body with unnecessary toxins (i.e. alcohol for the liver; fuel exhaust for the lungs) AND/OR we have an organ that is compromised (illness etc. which may decrease that organ’s ability to keep the human body safe).

If you have healthy organs, a liver that is not unduly burdened, and lungs and kidneys that work generally well, chances are good that with careful selection of healthful food, air and water, you will continue to be able to efficiently filter the occasion toxins that leak into the soda or are delivered to your gut by the burger you crave a few times a month. However, if your organs are compromised, the filtering system becomes a bigger deal and impacts the body on a bigger scale.

When the body is off balance, all sorts of labels (aka: diagnoses) are offered by health care providers.  The bottom line is simply that there are a few diagnoses which are 100% preventable and, even once diagnosed: 100% reversible.  An example of two of these: obesity & insulin resistance (type 2 diabetes).  In fact, these labels often represent imbalance that MIGHT be related to TOXINS rather than just diet!  Think about it.  Talk to your doctor.

Toxins from plastic bottles (i.e. phthalates – click here for details) are found in foods as well – and they are KNOWN to cause hormonal disruption.  This is a HUGE awakening.  It takes the ‘fault’ and ‘guilt’ out of these organ system issues . . . and that helps SOME people reconsider the effort they are willing to put into healing their body as a whole.

Speak with YOUR holistic, integrative or functional medicine health care provider about the possible benefit YOU might derive from interventions that detoxify YOUR body (especially liver and kidneys) so that YOU can live a cleaner life, set a healthful example, and leave a legacy of balance and positive energy for future generations.

Wishing you goodness & healing,

~ Dr. Nancy Iankowitz

ABOUT THE AUTHOR:  Dr. Iankowitz is an ANCC Board Certified Family Nurse Practitioner who takes an integrative/ functional medical approach to facilitating wellness. As Founder and Director of Holistic and Integrative Healing LLC, she joins each patient along his/her unique healing adventure, embracing a mind/body/spirit patient-centered journey. To maintain her own spiritual center, Dr. Iankowitz plays chess & enjoys nature. As founder and owner of Universe’Secretary, she writes children’s stories, essays and inspirational books of poetry and philosophy.

You Are Probably Dehydrated If . . .

. . . your lips are cracked/ you lick them often AND/OR you

  • Are constipated
  • Have dry skin
  • Notice your urine is darker than straw (and you haven’t been taking supplements – such as Vitamin B)
  • Think you are hungry all the time (If so, try this: drink 8 ounces of clear water before reaching for between meal snacks)

                                                          . . . the list goes on . . . 

What is YOUR body telling you?    “Please drink more water!” (That’s what). It surprises many to learn that dehydration is as concerning in the winter as it is in the summer – but for different reasons.  During summer months we think about heat stroke, fainting and other life threatening consequences; but, the dry winter air (especially in the northeast US) contributes to the spread of the flu and other viruses that spread by coughing and sneezing. Isn’t this worthy of our attention? The symptoms of dehydration in the winter are also potentially dangerous. How many people know that drinking WATER is among the first recommendations when we want to bring down a fever?  Ask any pediatrician.

How much water do you REALLY need to drink?  (Is there a quick, easy FORMULA?)


Your Weight Divided by ‘2’ = How Much Water You Need to Drink

It’s all over the news, especially during a heat wave (but sadly not as often – if at all, when we crank UP the heat in our homes). So what are the facts? Which beverages actually count towards your daily intake of water (and which DON’T?) Does tea count? YES. Beer? NOPE.  Soda? Not really. How about soup? It may – unless it’s ‘creamed’ . . .

For general information  click here.

The bare bones approach discussed in the news clip linked above is a good start, but fails to individualize the approach.  What if a person is living with diabetes or congestive heart failure?  What about people who suffer from lung or blood pressure issues? What if there are several daily medications in your regimen or you suffer from chronic constipation? Do these conditions impact the amount of water required?  ABSOLUTELY: YES. They most certainly do.

Each of these health issues forces us to individualize our approach to targeting ‘optimal water intake’.  Your primary health provider can help with this. When you bring the discussion up, be certain that all of your questions are answered.

Winter months are notorious for dry air.  Does humidification count towards water intake?  No, but it does help your overall health.  Ask your primary care provider for details and recommendations on a safe system for YOUR living environment.

The goal is to avoid dehydration.  Click here for signs of dehydration. (I am not promoting this product.  The web page gives good, easy-to-read information).  For a more scientific explanation about the mechanism of dehydration,  click here.

The truth is this:  the amount of water you need in order to sustain proper hydration depends on several factors including your body weight, exercise, and the environment (i.e. temperature, humidity).  There is no single across the board number – but there IS a ‘general rule’ you can follow if you are in relatively good health.

Always consult with your trusted health provider before implementing dramatic changes in your lifestyle – including diet, exercise, hydration, supplementation etc.

Your goal is to drink enough water so that all your body systems can work effectively – and this includes generating enough energy to walk, talk, listen and think clearly.

Bottom line to what YOU need: The two-step formula mentioned above (and illustrated below) is for healthy individuals who plan to spend the day sitting in a relaxing, 70 degree environment would be to take your weight (in pounds) and divide by two.  Then, take that number and put “ounces” after it.

This is what the QUICK & EASY TWO STEP FORMULA looks like:

Body weight: 120 pounds  .   .   .  divided by two = 60.  (Then divide ’60’ by ‘8’ to get number of glasses/day)

The number “60” represents the number of OUNCES of water you need to drink if you

  • are in good health
  • are not planning to exert yourself
  • will be in a relatively moist but not too humid 70 degree environment

To get the number of glasses of water, you then divide the # of ounces (in the above case: 60) by ‘8’. Therefore, a person who weighs 120 pounds would divide ’60’ by ‘8’ (that is the number of ounces in a full cup of liquid) which becomes an intake of water equal to about 7 or 8 glasses (each of 8 ounces) a day.  Click here for a more precise tool that takes other factors into consideration.

Note:  Keep in mind that ‘milk’ is considered a ‘solid’ and does not count towards your water intake. While teas, soups, fruits and vegetables may indeed help hydrate you, it is best to consume/drink these outside of the calculated target ounces.  So if you weigh 120 lbs., aim to drink 7-8 glasses (60 ounces) of clear water . . . and then eat your veggies etc. on top of that.

Here’s to your health!

Additional reading:

About the Author: Dr. Iankowitz is an ANCC board certified  advanced practice nurse, in private practice as founder and Director of Holistic and Integrative Healing LLC.  Dr. Iankowitz is the editor and author of several articles and books, and founder of Universe’Secretary.

Other posts by this author:

Safety in the Summer Sun

The more sun we get, the more potential Vitamin D we may manufacture; however, absorption is a key factor, and washing with soap after sunbathing has a lot to do with it. In fact, Vitamin D absorption from sun exposed skin is decrease if the exposed skin is washed with soap and water within the initial 48 hours after exposure.  (Click here to read what Dr. Mercola has to say). The body needs time to manufacture and then absorb the “Vitamin D” (which is really a hormone – ask your health provider for details). Dr. Cannell suggests that, depending on ‘when’ you bathe – that is, how long after your skin was exposed to sun, you can interfere with absorption of Vitamin D.  Click here to read the studies he cites.

As noted above “Vitamin D” is really a hormone. Unlike ‘vitamins’ which are supplied by food or supplements, ‘hormones’ are actually manufactured by the body. In order to get the most of that experience, MANY organ systems pitch in. In other words, ‘the body’ needs to work as a team. It takes a village to raise a child and it takes an entire body to get the benefits of sun exposure.

Vitamin D is necessary for a variety of reasons. It facilitates healthy bones, heart and more . . . and the Sun is our friend regarding inspiration to the body to produce it.  What role do sunscreens play in helping or hindering the process? These are important questions that have a wide range of answers, depending what schools of thought are followed. Your trusted health care provider is your best resource, especially when evidence-based research supports recommendations.

Is there such a thing as a ‘safe’ sunscreen?  Great question.  I advise my patients to avoid eating, drinking, breathing and absorbing chemicals – as a general rule.  To protect skin from over-exposure, I strongly recommend

  • eating foods that facilitate protection (from the inside out),
  • seeking out shade when necessary,
  • wearing protective clothing, and
  • using sun screen sparingly.

Examples of protective foods:  green tea, carrots, red peppers, spinach and salmon (click here for details).  (A nutrient called ‘lutein’ is of tremendous protective value for the eyes as well as the skin.  Click here for details). Shade: umbrellas, hats, trees.  Clothing: light colored, cotton. choose fabrics specifically designed to protect your skin. Click here for details.

Topical sunscreens (i.e. creams, gels, lotions and sprays) should have as few ingredients as possible (unless they are organic and otherwise facilitate wellness) and, those they do have need to be non-toxic. I recommend products with the main ingredient: zinc, which provides evidence-based skin protection.

What about “SPF” ?  Don’t be fooled by “SPF” (sun protective factor) since the higher numbers don’t necessarily mean greater protection in the way you expect. Dr. Weil suggests that ‘SPF’ greater than 15 is not as protective as the public believes.  Click here for details on that.

An organization that keeps your safety in mind: The “EWG” (Environmental Working Group), based in Washington D.C. advocates for health-protective policies (click here for details). For an example of a sunscreen they recommend that is organic and fragrance-free click here.

Is there a website with information I can trust? For a wonderful, well researched list of products that meet these criteria, please click here.  It will take you to “” – and I encourage you to explore that website at your leisure for the many ideas Katherine shares about a wide variety off topics.

To summarize: Sun safety can be simple if you keep a few points in mind:

  • enrich your summer food & drink intake with recommended (sun protective) foods
  • get to know your body (fair skin with light hair & eyes tends to burn faster than darker skin with dark eyes & hair)
  • take special sun protective supplements during the summer months to decrease your tendency to burn

Here’s to a wonderful, safe, & healthy summer experience!  ~Dr. Iankowitz

Additional resources regarding

. . . The color of your eyes might suggest that a lutein supplement might help protect your skin AND eyes from sun damage. click here for details.

. . .  Sun exposure, Vitamin D, and types of supplementation (D2 vs. D3).  There are two major types of Vitamin D and they are NOT  ‘identical’ – read what Dr. Mercola has to share about this (valuable when choosing to supplement your Vitamin D on a daily or weekly basis with oral intake).

. . .  Heart health:   Does low Vitamin D3 negatively impact the heart?  –read more about how,  ” . . . Diabetes may predispose to an even greater risk of vitamin D deficiency because of bowel motility disturbances, fat mal-absorption and an association with celiac disease . . .”

. . . Foods rich in Vitamin D:   Vitamin D Fact sheet by the Institutes of Health – read about what foods are highest in Vitamin D (it isn’t only cod liver oil – although that’s a GREAT source!)

Vitamin D Dosing Recommendations from the Mayo Clinic – read about the amounts and kind of Vitamin D that have been used to address a variety of health concerns in adults (ages 18 and over).

Why is Vitamin D necessary at all?  – read what Dr. Andrew Weil has concluded.

Vitamin D2  is not a bio-available BUT might be ‘safer’. D2 (ergocalciferol) vs. D3 (cholecalciferol) 

Do YOU think this study used sufficient amounts of Vitamin D?  OR are the conclusions possibly erroneous, relation to this as a limitation?  

About the Author: Dr. Iankowitz is an ANCC board certified advanced practice nurse, in private practice as founder and Director of Holistic and Integrative Healing LLC.  Dr. Iankowitz is the editor and author of several articles and books, and founder of Universe’Secretary.

Other posts by this author:

Survival Guide When You Wear 3 Hats: Child, Parent & Grandparent

The day is Friday. Last night was typical. You were awakened at 1:00 AM & 3:30 AM by your bladder, then again at 4:00 AM by the cat. You finally fell asleep – then morning reminded you of your 5:30 AM appointment with the dishwasher, 7:30 AM meeting with the tea kettle and, since this is your Monday/Wednesday/Friday schedule, you have a tele-conference with your ‘work team’ (from your laptop) at 9:00 AM sharp. This would all be fine if you had recovered from the Tuesday/Thursday schedule which involved tending to your aging parent (rotating between health-related visits for deteriorating vision, hearing, skin & dental issues . . . etc), from which you had not yet reestablished your own internal balance. You take a deep breath, eagerly anticipating the delicious babysitting experience you look forward to on Saturday, when your grandchildren fill your life with joy – even though your daughter-in-law just informed you that she and your son are generously giving you that time with their precious children so they can seek marriage counseling that was long overdue.

You technically ‘work from home’ three days a week; thus, referenced by colleagues as one who is ‘living the dream.’

The 21st century represents a wide variety of new experiences to each generation – including multiple ways of ‘commuting’ to work.  Whether your commute involves a train, plane, mass transit, car, rolling out of bed to your computer or phone, or a combination of the aforementioned, it is essential that you master the art of healthy boundary setting for your own personal well being.

Boundary setting is important in order to preserve your sanity. There are mini-mental stay-cations (i.e. listening to music, practicing yoga, deep breathing) which work wonders for many people. This approach enhances the living experience by facilitating circulation of oxygen throughout your body and relaxation of muscles – the internal environment.  But what about your external environment? Interruptions – visual as well as auditory impact us on a daily basis. Friends and strangers call day and night. Depending on your circumstances, you may actually be able to limit that communication portal, especially if your sleep is negatively impacted.

It might be of value to consider putting your cell phone on “airplane mode” at the same time each night – perhaps an hour or two before you plan to go to sleep, so that uninvited calls and texts don’t spill into your unwinding time and sleep schedule.  If you are able, you might benefit from setting your land-line telephone to “silent mode” as well – that is, if you have all those who might need to reach out to you living under your roof and/or otherwise within shouting distance in case of an emergency. This communication limiting intervention controls for robo-calls and other unwanted invasions of privacy – but you need to be mindful of keeping certain channels of communication open for the loved ones who may actually need you, especially if you are the ‘go-to’ person. When aging parents or adult children who are in and out of crisis don’t live under your roof, you might consider sharing the ‘on-call’ responsibility, if possible, with other friends or relatives, so that you can have one or more nights off during the week.

Ideally, you can work a 10-day vacation into your annual schedule to recharge your batteries and reestablish internal balance; however, this intervention is not always possible.

The sandwich generation is filled with adults between the ages of 45-70 who take care of aging parents at home while balancing their own roles as parent and grand-parent. Click here for some valuable recommendations.

If your job isn’t your dream career, and you find it a bit draining – but it is necessary in order to pay the bills (that is, when YOUR reality means what feeds your spirit can’t make ends meet), then you owe it to  yourself to nourish your soul with a hobby that does more than take the edge off . . . it must help you establish and maintain mind/body/spirit balance.  There are reasons why it is essential to maintain balance.  When out of balance, we are compromised – health wise. Susan Blum offers insights and tips regarding this topic. Click here to read her recommendations.

When your reality is that you simply can’t get away . . . Whether your constraints involve time, money, commitments or any number of other priorities, you can’t afford to permit your immune system to suffer.  A healthful diet – such as the paleo diet, may provide enough nutrients for your body throughout most of the year (click here to read more about how nutrition impacts your wellness); however, if your sleep is interrupted (click here to read about how sleep affects the immune system), anxiety or ‘monkey mind‘ distract you, or the season precludes adequate exposure to sunshine – you need to be mindful about including additional self care interventions (including vitamin supplementation) into your daily routine. Click here to learn about what Dr. Andrew Weil teaches regarding supplementation with vitamins, minerals and probiotics.

Does your work environment provide a window (to exercise your eyes) and full spectrum overhead lighting?  Or do you work in a cubicle under fluorescent lights? Although scientific evidence-based data are mixed regarding the value/benefit of exposure to full spectrum light (click here for recent data), you know your own body better than any study could predict; therefore, if YOU feel better after sunbathing – even if your exposure is limited to a few precious moments during a lunch break mid-day, then take the hint and catch those rays.

If you are you surrounded by toxic vibrations of any sort, you need to be especially mindful of the air and light around you. Amy Crawford shares some valuable insights regarding this subject.  Click here to read more.  When out of balance, we are more susceptible to illness. Deepak Chopra offers wonderful interventions.  Click here to read them.  During time of stress, consider asking your doctor about vitamin / mineral supplementation. These interventions are highly individualized, so self-treatment without educated guidance is not recommended.

The importance of self-care is tragically understated in today’s world. Take time out of your busy schedule – either once a day or a few times a week, to get back in touch with your true self.  Art, music, dance, meditation, exercise – or any other form of relaxation that permits your mind to take a deep, spiritually cleansing breath.  What makes you feel safe?  Figure it out and experience it. Whether it is learning about your chi points (click here for examples), experimenting with acupressure and chiropractic techniques (check these out click here with your doctor before trying at home) there are methods literally at your fingertips to help you along your wellness journey.

Learn how to read your body.  The body sends us messages every moment of every day. Click here to read about how to interpret what your body is telling you. When you feel a sniffle coming on or experience a morning sore throat, those are also messages – and easily remedied.  Click here to read more.

You owe it to your parents, children, grandchildren, colleagues and all who love and/or simply care about you to pay attention to your mind/ body/ spirit balance.  Help is out there.  Tap into your resources.This not only facilitates your own wellness journey, but it sets an excellent example for the next generation.