Published June 12, 2019 By Adam Lowenstein

Dr. Lowenstein: Hi, and welcome to the Headache 360 Podcast. I’m your host, Dr. Adam Lowenstein. Again, what we’re doing here is trying to take a 360 degree view of headache and migraine pain. As such, some of you will know that I am a migraine and headache surgeon. I do nerve decompression, but people usually get to me after seeing many, many other different types of caregivers. What we’re going to try and do is talk to these types of caregivers so you can get some ideas of what they do and what opportunities might be out there.

Dr. Lowenstein: Today I have a very special guest. Amy Kilian is a Certified Nutritional Therapy counselor that I work with at my Center in Denver. She enjoys working with headache patients. We’re going to talk about some different things that we can do as headache suffers to both find some relief but also maybe to help avoid dealing with pain in the first place. Welcome Amy.

Amy Kilian: Thank you so much. Thank you for having me.

Dr. Lowenstein: So, let’s start off with a most simple thing like, what does a Nutritional Therapist do?

Amy Kilian: So, very common question, and it is different than a Registered Dietician. So, in nutritional therapy we focus primarily on working with the body and to bring balance to the body through a primarily nutritionally-dense whole-food-based diet. So, I’m not a dietician in a sense that I’m going to make you eat from the food pyramid and kind of give you the Standard American Diet approach to things. So, I do a lot of background history with my patients and take a pretty detailed medical history, have them do a nutritional assessment questionnaire before they come in, which Dr. Lowenstein has taken. It’s pretty involved.

Dr. Lowenstein: It is pretty involved. It took some time and some thought, actually, to do it.

Amy Kilian: Ask a lot of questions, so I analyze that. I do a food diary with my patients for about 10 days to two weeks prior to them coming in and then just kind of focus on them as an individual. Bio-individuality is a big buzz phrase in the nutritional therapy world, because we do see each person as individual. There is no one-size-fits-all approach with this, and it really is working with each individual person to kind of bring them balance.

Dr. Lowenstein: So that site that you had me go to where … It was like 18 pages of questions.

Amy Kilian: Yeah, it’s a lot.

Dr. Lowenstein: It was like 300 … I looked up and looked at the number of questions I’d answered and it was incredible. But, it talks about everything from joint pain to headaches to bloating to … It was really impressively involved. So, you’re dealing with lots of different, I don’t want to say disease processes, but physical troubles of patients?

Amy Kilian: Yeah, I kind of look at the entire body system. One of the the things with nutritional therapy is it is based on a nutritionally dense whole-food properly prepared diet. Because, in the basic level if our systems are not functioning correctly a lot of things just aren’t going to work. So, making sure that digestion is working from the top down, you have a healthy gut. All of those things are going to make a difference in if I’m going to offer you supplementation. If you don’t have a healthy gut and you’re not digesting your food properly, you could be taking all the supplements in the world and they’re not really going to be making much of a difference.

Dr. Lowenstein: Do you ever order like tests to see … My friend that I was talking to just went to the doctor and found out that she’s highly Vitamin D deficient, because she wears a lot of sunscreen apparently, which it is what it is. But, would you send somebody for tests to find out a deficiency?

Amy Kilian: If I saw something on their NAQ that came back as being extremely-

Dr. Lowenstein: Neck is the?

Amy Kilian: The Nutritional Assessment Questionnaire.

Dr. Lowenstein: Not neck.

Amy Kilian: NAQ.

Dr. Lowenstein: Okay, because-

Amy Kilian: NAQ, the N-A-Q.

Dr. Lowenstein: Got it. Okay, N-A-Q.

Amy Kilian: Nutritional Assessment. So, if I saw something that was really out of balance, yes, I would either recommend that they follow up with their primary care provider, or if it was something that they were working with another specialist on already, and that’s something that’s really important. Most of the people who come to me are either referred by a specialist, another physician, a friend who is someone who’s worked we me in the past. So, I really need to know what’s going on with that provider, as well. If it’s something I need to send them back to that provider for, like checking thyroid levels or hormone levels, sending them back to their endocrinologist, making sure that they’re monitoring those things, as well.

Dr. Lowenstein: Got it. All right. So, as far as headaches and migraines, occipital neuralgia, what’s your approach to those kind of patients? How does dietary issues … What’s the right word? … affect these processes?

Amy Kilian: Yeah, so I think the biggest thing with migraine or headache sufferers is helping them really believe that what they’re eating could be causing some of their pain, or at least contributing to it, or worsening it. Sometimes people don’t always see that connection. We have become very disconnected from our food. A lot of people are really disconnected from eating, so they tend to think of it as a task or a job that they don’t really see that lasting impact on their body and how their body functions. So, that’s the biggest hurdle first, is like convincing them that
changing their diet …

Dr. Lowenstein: It could matter.

Amy Kilian: might really affect … Yeah.

Amy Kilian: Their health. That’s typically through finding what their trigger foods may be. As most of your listeners probably understand what trigger foods are. They’re pretty well talked about with migraines. Also, balancing out blood sugars throughout the day. That’s something people who even who just have regular headaches definitely could be hugely improved by monitoring their blood sugar, making sure they’re not dehydrated.

Dr. Lowenstein: When you monitor blood sugar you’re just talking about just by feel, or you actually, is there some way that you’re having actually people monitor blood sugar?

Amy Kilian: If someone has other kind of co-contributing factors I might have them actually do finger sticks.

Dr. Lowenstein: Oh, okay.

Amy Kilian: Actually monitor, just to make sure that we’re making positive progress. Because, again, people get very disconnected from how they’re feeling, especially if they’ve been feeling a certain way for a long amount of time. So, helping them see that like they are crashing, even though they may not feel like their blood sugar is dropping, to kind of show them that pattern and getting it back to where we’d like it to be to help them stay stable. Also then showing them what impact the foods they’re eating have on that ability for their blood sugar to stay balanced throughout the day. That making good food choices is actually going to help your blood sugar stay stable for an extended period of time, even beyond meals. That’s where like meal timing and nutrient timing becomes more important, and those are kind of more advanced things with food intake.

Dr. Lowenstein: I say that because I know that I don’t do what I should do, …

Amy Kilian: It’s hard for… yeah.

Dr. Lowenstein: … but I try. So, this NAQ, N-A-Q, thing I was actually really impressed. There’s a lot of headache diaries out there, but the way that this is such a great food diary, and talks about how you feel, your mood, and your physical, your pain level, I think it makes things really much easier to coordinate that way. I’m assuming … This NAQ … Since I operate on the neck I keep on thinking neck instead of NAQ. So this website is something that you access once you access someone like you?

Amy Kilian: Correct. So, I enter my patient’s initial information and send them essentially an invitation to take the NAQ, and then there might other to do tasks for them, meaning filling out their emotions diary, their intake paperwork, which is pretty involved. I ask a lot of questions on intake. My initial intake with someone is usually at least two hours long, like when we actually meet the first time. Because it’s a lot to go over. A lot of things … Epigenetics is also something that I’m very passionate about and really to me plays a big role in our health overall.

Dr. Lowenstein: Do you want to explain a little what that word means.

Amy Kilian: What epigenetics means?

Dr. Lowenstein: Yes.

Amy Kilian: So, epigenetics is just basically the science, or the study, of how our genes are expressing. They’re very much impacted by our daily activities. So, DNA is constantly replicating and as it does like little things can happen, like SNPs is kind of what they’re called, little changes, little ways that those genes are methylating can be affected. Food can have a bit impact on those, but, so can things that happened to you a long time ago that have just kind of stayed in that cycle of replication. So, being on antibiotics for an extended period of time as a young person.

Dr. Lowenstein: I saw that was in the … It asks like about having mono and all these things that-

Amy Kilian: Epstein-Barr.

Dr. Lowenstein: Yeah, like everybody had in college, I think, right?

Amy Kilian: Right.

Dr. Lowenstein: I had mono. But, I was answering that question going, gosh, how’s that going to have affected what

Amy Kilian: What’s happening now.

Dr. Lowenstein: I’m eating now. Can you make specific recommendations about what I can do nutritionally now based on prior exposure to antibiotics?

Amy Kilian: Yes, absolutely. The same thing with people who have a lot of dental work who might have old metal fillings.

Dr. Lowenstein: Oh sure.

Amy Kilian: Those can be impacting their health, like that heavy metal leeching into their body can definitely be having a lasting affect, even if they’ve had some of them taken out. They can still cause a lot of problems. Kind of your body takes a while to readjust. Like it’s constantly changing but at the same time like damage that’s done can take a long time to come out of. That’s why we say with people, nutrition is the long game. It’s not a quick fix. It’s going to take time to see improvements in your health through nutrition. Other times that’s not the case. Now, someone comes to me in extreme distress and they’re eating the worst-case scenario Standard American Diet, and they follow all my recommendations and they change everything, yeah like a month later they’ll come in and be great.

Dr. Lowenstein: Okay, so wait a second. So, you’re equating the worst case scenario with the Standard American Diet, those are the same things?

Amy Kilian: Yes.

Dr. Lowenstein: Yeah, so one of the things it asked was like do I eat junk food? Did it say fast food or junk food?

Amy Kilian: Fast food and then yeah-

Dr. Lowenstein: So, I’ve been kind of wondering what qualifies. Like In-N-Out Burger is that fast food? Because it was pretty fast. I took my kids to In-N-Out last week for the first time in their lives. They’re seven and four, and they had never been to In-N-Out Burger. We never go to McDonald’s or whatever. But, sometimes you crave a Big Mac and it is what it is. But, it is interesting to me to note that a great number of people are eating this what you call worst-case scenario, and eating a lot of saturated fats and just stuff that we know is not necessarily the best for us, but it can be hard to find time to eat well.

Amy Kilian: It can, and that’s where education comes into play. A lot of people weren’t taught these habits by their parents, especially a newer generation of people. I was fortunate enough to grow up with hippie parents. My mom was like grinding her own flour, and there was no fast food in the town I grew up in. I didn’t have that even as an option to me until I was an adult and had left home. So, I get that my childhood was unique in that sense and very different from what your average person is experiencing now. Even just life is hectic. We make choices that are right in front of us. We don’t always think long-term. Dr. Lowenstein: 12:25 Fair enough. All right. So, rotating back around to headache
stuff, if you have somebody who comes in and their primary concern is their head, how do you go about thinking about what
to offer them, aside from the things we’ve talked about. They don’t have a trigger that they know of.

Amy Kilian: So, then I’d probably start with what are some of the common triggers and get them to start slowly eliminating those and see how they feel. Again, these are probably things you’re going to eliminate for a month and then reassess how you feel. So, it’s not like you can take out your aged cheeses, let’s say, or any of those histamine-containing foods for a day and then like, Oh, great, I didn’t get a headache today. That must be it. It takes a while, and sometimes it’s just certain variations of those things, or in combination. If you’re eating a wine and cheese platter with some cured meats, maybe not the best combo …

Dr. Lowenstein: Right, right, right.

Amy Kilian: … together.

Dr. Lowenstein: It’s interesting also that some foods seem to help some people and hurt other people, so I think epigenetics issues and treating everybody as an individual, which is something that is, I don’t think, done enough in healthcare these days. Of course, you know this is how I go about my practice, as well. But, for example wine. So, red wine … Interestingly, white wine used to make me extraordinarily ill, like throwing up kind of just and nobody understood it, because everybody always equates that with red wine. Apparently I grew out of it, because now I can drink white wine, but red wine gives me flares of my occipital neuralgia and my headaches. That’s a common trigger, as we know. I was seeing patients just earlier today, and one of the guys I was talking to about triggers I said. You know I want
patients to come in with really bad pain so I can do nerve blocks and improve their pain, and he didn’t have a lot of pain. So I said, Can you come back and maybe go out the night before, have a lot of wine.

Dr. Lowenstein: Interestingly, he said, Yeah, he can drink as much wine as he wants. It doesn’t do anything to him. So, it does seem that individualizing everybody’s triggers is a difficult thing. You’d hope that all headaches are caused by X. Don’t take X anymore. Everybody’s headache is going to go away, but that’s not the case.

Amy Kilian: It’s not the case. There are definitely foods that for some people are helpful, caffeine being one of the key ones. Everybody knows Excedrin for Migraines has caffeine in it. Caffeine can sometimes make a headache go away. But in excess, or for some people even small amounts, can be very triggering. So, a lot of that, too, for me, as a Nutritional Therapist, comes back to how’s your gut? How are you digesting? How are you processing these things? How’s your toxic load? Are you really overloaded with environmental stuff that you need to get your liver functioning better, making sure you have good bile production. Are you actually functioning well?

Amy Kilian: Because I think … One of the questions on the NAQ is if wine makes you very hung over. The reason I ask that is not related to headaches. It’s actually related to how your liver processes those specific types of components of alcohol. Again, some people come in and like everything triggers them. You’ve probably seen that, too, with some of your patients. Like everything’s a trigger. So maybe we need to figure out what is truly a trigger by getting rid of these things and slowly re-
introducing some of them.

Dr. Lowenstein: So, you basically have people go on a very like a bland kind of
non-exotic diet and than slowly reintroduce … Kind of like
people with allergies, right?

Amy Kilian: Yes, similar to an allergy protocol. You know, and at the same time working on making them healthier overall, dealing with what some of their other issues might be. Rarely is the world in a bubble, right?

Dr. Lowenstein: Right, right, right.

Amy Kilian: Rarely does someone have just one thing. So, this might be our
main thing like migraines, right. Got to get these under control,
but at the same time like what else is maybe happening in your
life that we can improve and hopefully improve everything else
at the same time.

Dr. Lowenstein: Got it.

Amy Kilian: So, cutting out those things. Another thing, too, I’m going to look at, specifically related to what I get back on their nutritional assessment, is looking where there mineral levels are, vitamin and mineral levels, because there are definitely some key nutritional deficiencies that can trigger headaches in people, B12 being a big one. Folate, magnesium are definitely things I’m going to want to make sure are optimized. Again, ironically enough, high magnesium food, dark chocolate, also may be a trigger for some people, dark chocolate.

Dr. Lowenstein: Yep, and chocolate is a frequent one, but interestingly a lot of our patients are on magnesium supplements. I tried that at one
point and it makes you feel … Have you ever taken high dose of

Amy Kilian: It’s hard.

Dr. Lowenstein: Yeah, it makes you feel pretty weird to do. I couldn’t tolerate it and I stopped doing it, as well. But, clearly a magnesium deficiency is a well-known issue with headache patients. So supplement-wise is there certain things that you think patients should try to optimize their situation?

Amy Kilian: Yes, absolutely. Any of these … Just as a reminder to anyone who’s listening, you should definitely clear these with your doctor first before you start taking tons of supplements.

Dr. Lowenstein: Yes, I always like to include a disclaimer here within the podcast that nothing we’re talking about is specific to any one case and so the point of all of our podcasts here are to increase information and a knowledge base, but supplying people with this information for them to go back to talk to their providers and get a good therapy, individualized therapy, for them. So, please don’t start taking a tremendous amount of magnesium
just because you heard that that’s something that’s done.

Amy Kilian: Supplements are the same way. I treat supplements like I would treat food, essentially, like it’s a nutritional supplement, you should start slow, reassess and only take something that’s actually making a difference. If it’s not and it’s not … Obviously this is not medications, this is supplements. They’re supplemental. You should not need to be on these for life, so re-assessing. B12 is a big one. Riboflavin … Which everyone has probably associated with like the smell of Cheerios. There’s a lot of B vitamins in packaged cereals, make your urine turn bright yellow. … is a really good one. B vitamins are going to help with nerve conduction, with muscle contraction. So, again, if your headaches come from more of a tension base, or you’re getting irregular muscle firing, like making sure B vitamins are optimized is going to be really, really good.

Dr. Lowenstein: But don’t overdose on Cheerios. That’s not the thing to do.

Amy Kilian: No. Right. You have terrible weird urine and … Yeah, so I would recommend 400 mg a day is plenty of B2, and you do want to make sure that you’re getting really high quality B vitamin because if not you’re not going to get a lot of benefit from it. You’re just going to excrete it.

Amy Kilian: Coenzyme Q10 was popular years and years ago for its heart benefit. You know, it was one of those supplements that got really popular in the 90s. I feel like everyone was like, Oh, my gosh, CoQ10 for heart health. It was even in some skin care because, again, it is key to conduction of neurologic function essentially, specifically in heart tissue, like it helps those electrical impulses travel. So, it’s very rare to have side effects, which is why it’s considered a really safe supplement, but CoQ10 is definitely one that I would recommend.

Dr. Lowenstein: It’s also used for memory, right?

Amy Kilian: Yep. It is and, again, because of it’s ability to kind of help with those firings.

Dr. Lowenstein: Neuroconduction.

Amy Kilian: So, that one’s a good one. Magnesium we’ve kind of talked about. It can have some laxative effect, so I definitely don’t recommend that people start taking large amounts of magnesium first thing in the morning. Definitely take it at night. It’s good for muscle relaxation, too. A lot of people take it to sleep. Again, it’s going to help with kind of regulating muscle contraction and muscle firing, which is why if you’re taking a lot of it you’re going to feel kind of weird.

Dr. Lowenstein: It makes you feel like you’re burning kind of, at least that’s what it did to me.

Amy Kilian: Give you kind of the tingles?

Dr. Lowenstein: Yes, exactly.

Amy Kilian: The burning tingles? Yeah, magnesium’s one I actually people, if they can, to get from food sources. I don’t jump to supplementation with magnesium, specifically because it is easy to get through food. There’s a lot of high magnesium foods, and also there is topical sprays which I like people to use, too.

Dr. Lowenstein: Really?

Amy Kilian: Instead of taking a pill you spray it on the bottom of your feet at night.

Dr. Lowenstein: Why the bottom of your feet?

Amy Kilian: It absorbs it kind of at more regulated manner and it …

Dr. Lowenstein: Really?

Amy Kilian: … can sting. Yeah, like you felt burning when you took it, it can sting sensitive skin.

Dr. Lowenstein: All right.

Amy Kilian: The bottom of our feet are pretty

Dr. Lowenstein: Is that just with magnesium, or are there spray on-

Amy Kilian: There are other topicals.

Dr. Lowenstein: Are there?

Amy Kilian: Yeah, there actually are a lot of topicals I recommend because of the way that they’re processed preferentially if you put them on topically versus orally. You know, our bodies when we take something orally it is going to be broken down through a process of digestion, and there’s a lot of acid involved in that and neutralization that you may not want to have happen with that supplement.

Amy Kilian: It’s like glutathione is a big one. If I’m ever supplementing somebody with glutathione, which for people who are big into methylation are going to understand glutathione is kind of the master controller of all of that, always as a topical cream only.

Dr. Lowenstein: Huh. All right.

Amy Kilian: So, magnesium I would recommend eat some dark chocolate if it doesn’t trigger you. Some nuts, Brazil nuts, specifically, are really high in magnesium. They’re also really good for men in general. They’re really healthy for testosterone levels. Legumes, pumpkin, pumpkin seeds are all really high in magnesium.

Dr. Lowenstein: All right.

Amy Kilian: That’s where I like to go. The two that are, again, a little more challenging and I would definitely not recommend taking these without working with your doctor. Butterbur is an herb. It has been studied and it has been shown really helpful for reducing migraines. It’s something that can have a really extremely rare toxic side effect on the liver, so that’s why you want to make sure that your liver is really healthy before you take it. Anyone who has any type of compromised liver function should absolutely not take Butterbur in any form. Pregnant women should also avoid it. It’s very rare but there is an optimal dosage, and they did studies with 50-75 mg and they found that for some people 50 mg did absolutely nothing; 75 mg was hugely helpful. Anything more than that, and you run the risk of some toxicity. So, it;’s one that people need to be really careful with.

Dr. Lowenstein: Good. Think of that like as a medication.

Amy Kilian: I would think of that as a medication. That’s the thing with supplements, though, you can buy this online.

Dr. Lowenstein: But it doesn’t mean that you should.

Amy Kilian: It doesn’t mean you should. The other one is Feverfew. Feverfew is actually good for allergies. A lot of people take it for allergies.

Dr. Lowenstein: I can’t say I’ve ever even heard …

Amy Kilian: Feverfew.

Dr. Lowenstein: … the word Feverfew.

Amy Kilian: Yeah, it’s a plant. It’s a flower. It’s great in tea. It’s actually a really good tea, because there again you’re getting a more diluted dosage of it. But it’s been proven helpful for reducing the severity of migraines. It can have a blood thinning effect, and you should never consume it raw, which most people probably don’t have that ability to go forage their own herbs. But, it can have a little bit of a blood thinning effect so, obviously, if you’re going to be having surgery soon you need to stop it. Make sure, again, just tell your doctor the supplements you’re taking because they can impact things like surgery.

Dr. Lowenstein: Yeah. We always, and this is one of the challenging things … We always have all of our patients ten days before surgery stop taking anything that’s not prescribed by a doctor and just eat good food. Some of these supplements have side effects that, frankly, you just don’t think of and it’s better safe than sorry. This is a little off topic, but supplements are not extraordinarily regulated.

Amy Kilian: They’re not regulated at all in most cases.

Dr. Lowenstein: So, when you’re recommending supplements, do you go down to talk to Johnny on the corner over there, or do you go to Whole Foods, and we are not endorsed by anybody, but …

Amy Kilian: It would be awesome if we were, though.

Dr. Lowenstein: … here in Colorado we have … Well, there you go, maybe one day. Vitamin Cottage, these local places. What do you tell people where to source their stuff?

Amy Kilian: So, for people who are working me I actually work with a company called Biotics, so it is pharmaceutical grade supplements, so the supplements that I can get through Biotics are, obviously, going to be my top choice. Now, if something is a bit unusual I do have online sources that I usually recommend. If it’s something simple like, Go pick up some Feverfew tea, that you get at Whole Foods at Vitamin Cottage. But, I don’t generally recommend those just because people tend to get overwhelmed by the options there, so I’ll usually give my clients a specific recommendation like, "Get this specific product.

Dr. Lowenstein: Again treating all of this kind of stuff like medicine.

Amy Kilian: To me it is. I know exactly what’s in it. I also know what else they’re taking. With the supplements from Biotics, there are a lot of combinations of things. There might be some glandulars in them. There might be a lot of other things that might interact. So, if someone’s taking their supplements, and other supplements that I haven’t seen or looked at … You know, supplements can be very overdosed like meaning the dosage is more than what you need, not meaning you’re going to die of an overdose, but meaning they’re dosed too high.

Dr. Lowenstein: I see.

Amy Kilian: Especially in combination with other things. They might just add, they might be just adding vitamin C into a supplement for no good reason.

Dr. Lowenstein: Filler.

Amy Kilian: Right. Or vitamin E. It’s kind of junk vitamin but you still want to make sure that you’re not combining stuff together that shouldn’t be.

Dr. Lowenstein: Got it. Okay. All right, well, so I’m sure you have people also coming in with specific disease, that’s a strong word, illnesses and they also have headaches. You also probably have healthy people that come in with headaches. You probably also just have people with normal things like hormone changes. That’s a question that I get asked a lot. A lot of people have headaches associated with hormone fluctuations. Do you work with those kinds of situations, as well?

Amy Kilian: Yes. I work a lot with women’s health. Again, I’m really passionate about epigenetics, which has a lot to do with like preconception nutrition. So I do work with a lot of women who are still in that menstruation age but then also post menopause. Very common for women to have complaints about headaches around menstruation. It’s typically a deficiency of some sort. So whether that is an iron deficiency, some type of anemia, or they’re magnesium deficient. Magnesium is a big one that I’ll supplement for women around their period. It helps with cramps because it’s a muscle relaxer so it helps with cramps, but it also helps with the headaches typically. Something that’s really … I still do see way more of than I wish I did was people who are eating a very low-fat diet. I always try to encourage my patients to do an oil change, so we want to cut out all industrial seed oils …

Dr. Lowenstein: Oil change. I like that.

Amy Kilian: and really focus on getting healthful oils back into our diet. Women, specifically, tend to become afraid of fat in some way still, not as much as they were in the 90s and early 2000s, but it’s still out there, that women are eating a very low fat, a very low quality fat diet.

Dr. Lowenstein: And fat’s so important. It’s important not only for what it does, but it’s also a very important carrier. There are certain nutrients that we call lipophilic, meaning that they get absorbed better in the presence of fat. Cutting fat out … Correct me if I’m wrong, because this is not my area, since I was studying it in undergrad school a long, long time ago. But, you’re not only losing the benefits of beneficial fat but you’re also potentially malnourishing yourself through other things.

Amy Kilian: That’s absolutely correct. All of our cells have a phospholipid bilayer, meaning that they have a little fatty shell on them. So, you kind of think of it as building a house. You’re basically building your body all the time, so if you’re giving it cheap, nasty, processed oils to build that phospholipid bilayer, every single cell. Our brains are made primarily of fat. So, you’re giving it nasty fries that have been put through canola oil that’s been used a 1000 times, or you’re getting salmon and walnuts, things that your body knows what to do with and can build this beautiful phospholipid bilayer around all your cells and keep your brain healthy and your heart healthy.

Dr. Lowenstein: Everything is more stable that way as well.

Amy Kilian: Much more stable, and your body knows what to do with those things. The other thing that happens with these bad oils, is your body uses them because it has no choice, but they have a tendency to glycate, meaning they can basically they get sticky so sugar molecules start sticking to them and it makes that layer around the cell nonfunctional, so nothing good gets in or out. It’s not helping. You’re going to be low in energy. Your mitochondria is not going to be giving you good energy if you’re eating these really bad oils. So, for women, especially menstruating women, especially women who are wanting to conceive, absolutely getting high-quality fats in your diet is so key. Egg yolks, essential fatty acids, evening primrose oil, things that are going to nourish your body.

Dr. Lowenstein: Right. So I’ve got two questions as we kind of come towards our close. I’ll ask both of them. When, number one, should somebody suffering from headache think about seeing a nutritional therapist, or somebody who is going to enhance that part of their diet? Then, more generally speaking, because it seems like you can help people who are having trouble with their period, or getting frequently ill, or … One of those things on this NAQ was, Have I gotten sick in the last two years? I mean, I’ve got kids in preschool. I was thinking, wait did that say would I get sick in the last two years or the last two weeks? Because I get sick all the time, because the kids bring stuff home. Does that mean I’m malnourished. When should somebody start to see somebody like you?

Amy Kilian: I mean, I think everybody should work with a nutritional therapist. I mean, obviously that’s what I do so I see the value in it, but if you’ve never really works with someone on your nutrition you’re absolutely going to benefit from it. Now, people who are suffering from headaches, again, like I said in the very beginning, they may not see that link that, Hey, what I’m eating, Even simple things like, I’m eating too much citrus. It can be something simple that’s triggering your headaches to be worse. Now, is it going to be the cure? Maybe not, but can we help monitor your symptoms and help prevent some of your suffering and get your body functioning better? Absolutely, 100%, especially if you are going to undergoing surgery. If you’re doing surgeries, Dr. Lowenstein, you want to be as healthy as possible going into it. So, working with a nutritional therapist prior is going to help a lot.

Dr. Lowenstein: What should somebody look for in a nutritional therapist? We’re in Denver here, but somebody in Savannah, Georgia hears this and wants to do something like that, can they work with somebody remotely, or should they go look for somebody locally? If they’re looking around, what kind of person are they looking for?

Amy Kilian: Yeah, so the Nutritional Therapy Association is who I am certified through, and that’s who I would recommend looking for someone in your area. Now, it does not have to be someone in your area. My coaching can all be done through tele-medicine essentially, and that’s totally fine. Some people like having that one-on-one, kind of need that. Some providers only work that way, and that’s something you kind of need to decide for yourself, like do I need someone right in front of me. If so, you need to search for somebody within your zip code. So, looking for someone who is a Certified Nutritional Therapy Counselor or practitioner, those are going to be my recommendation. But then also looking for … Making sure that you vibe with that person, kind of understand like from a theory standpoint that they are who you want. Kind of the same thing you do when you look for a doctor.

Dr. Lowenstein: Make sure it’s somebody you’re comfortable with and who understands your goals.

Amy Kilian: Right, and who kind of gets your paradigm. Again, bio-individuality is really big. So, if you are interviewing therapists, nutritional therapists and they don’t maybe jive with how you kind of feel, that’s fine. Being open to what they are saying is always good, but if you have your own very strong beliefs and you don’t want to change those then finding someone who can work within your paradigm is going to be key.

Dr. Lowenstein: Okay. So, if somebody wants to reach out to you, how does that happen?

Amy Kilian: So, the best way to do that is either send me a message through Instagram, or just email me directly. My Instagram is Amy, A-M- Y, Gray. That’s my middle name NTC, like Nancy, Taylor, Charlie, Amy Gray NTC on Instagram. That’s really the best way to reach out to me. From there you can shoot me a direct message. You
can send me an email.

Dr. Lowenstein: Your middle name is Gray?

Amy Kilian: It is Gray, G-R-A-Y.

Dr. Lowenstein: Is that somebody’s-

Amy Kilian: It’s a family name. Amy Gray, yep.

Dr. Lowenstein: Interesting. See, I learned a lot today. I learned about Feverfew, which I didn’t know existed, and I learned Amy’s middle name, so yeah. Actually, I learned a lot more than that. So that was your Instagram handle. Your email?

Amy Kilian: Email is just Amy, A-M-Y, @jasonmartinmd. You can email to me, though, directly through Instagram, as well.

Dr. Lowenstein: Perfect. Yeah, so Dr. Martin is another plastic surgeon who some of you may know of. He’s got another fantastic video podcast that I highly recommend. He talks about a lot of different health issues, not necessarily … There’s one headache episode where he interviewed me, but it’s a really, really great podcast, not just for plastic surgery. It’s called Beauty and the Surgeon, so something to look for. Amy, thank you very, very, very much. I love discussions where I learn stuff, and this was certainly one of them.

Amy Kilian: Well, I hope it helps. Headaches are challenging but-

Dr. Lowenstein: We’re all fighting towards the same goal of reducing pain in these patients, and I think that a lot of what you do is helping, so that’s great. So, Thanks a lot. I would ask you all to consider subscribing. Again, as one of my previous discussions said, I am a well-trained surgeon; I am not a very trained podcast producer." So, I think there’s a button that you can push, a bell or something to remind you-

Amy Kilian: Subscribe button.

Dr. Lowenstein: Okay, so Amy knows more than I do. Remember that if you have questions please fee free to email to me at questions@headachesurgery.com and we’ll try and address them in future podcasts. So, again, thanks and thanks for listening and here’s to hoping that you have as little pain as possible.

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