Author: Dr. Yuliya Klopouh

Is your sunscreen safe ?

March 2017 Health Letter
by Yuliya Klopouh, Pharm.D –

As summer slowly rolls out, we’ll soon be finding ourselves enjoying warm ocean breeze or relaxing at the neighborhood pool.  Wherever we are during those hot and steamy summer days, we must use sun protection to avoid harmful and damaging Ultra Violet (UV) Rays.

Each year in the U.S. over 5.4 million cases of nonmelanoma skin cancer are treated in more than 3.3 million people.1The incidence of malignant melanoma, the most dangerous form of the disease, is escalating. Effective sunscreens are crucial to use in children and adults.  But Environmental Working Group (EWG’s) investigation reveals that they may be hard to find.

Each year EWG releases reports on their guide to sunscreens.  As EWG reports,

“After 34-year process of reviewing sunscreen safety and efficacy, the U.S. Food and Drug Administration has implemented enforceable rules on sunscreen marketing and UVA protection. The FDA allows American sunscreen makers to claim their products are “broad spectrum,” even though many offer much poorer UVA protection than sunscreens sold in other countries. Based on the products in our 2016 database, EWG estimates that about half of all beach and sport sunscreens could not be sold in Europe because they provide inadequate UVA protection. Manufacturers there voluntarily comply with a European Commission recommendation that all sunscreens provide meaningful UVA protection in relation to SPF. FDA rules do not bar products with sky-high SPFs that prevent sunburn but leave users at risk of UVA-related skin damage.”2

Does your sunscreen work?  Is it safe for your and your child’s health?

Astoundingly, 2 of 5 brand-name sunscreens (brands including Neutrogena, Rite Aid, Target) either don’t protect skin from sun damage, contain hazardous chemicals, or both.
Here are some disconcerting statistics:

74 sunscreens with SPFs from 55-100+ might tempt you to stay out longer in the sun, but they block just 1-2% more sunburn rays than an SPF 30 sunscreen.

Hundreds of all-day moisturizers advertise SPF protection, but 1 in 5 offers little protection from harmful UVA rays.   Most sunscreens protect from UVB, or sunburn radiation. Higher SPFs indicate more protection. Far fewer brands contain ingredients that block UVA radiation, even though a growing number of studies show it is even more harmful than UVB radiation. UVA radiation hastens the progression of skin cancer, suppresses the immune system, and ages the skin over time.

Despite the increased use of UVA filters, 1 in 11 products confers dangerously low levels of UVA protection.  FDA does not require that sunscreens guard against UVA radiation.

Some sunscreens break down well before the day’s end. Nearly 40% of products on the market contain ingredients that may be unstable alone or in combination, raising questions about whether these products last as long as the label says. FDA has not proposed requirements for sunscreen stability.

Questionable product claims are widespread. Many products on the market carry claims that are considered “unacceptable” or misleading under FDA’s draft sunscreen safety standards. Claims like “all day protection,” “mild as water,” and “blocks all harmful rays” are not true, yet are found on bottles.   The analysis of products performed by the EWG showed that about 38% of sunscreens were labeled with one or more terms that FDA has said are indicative of a misbranded product, terms that are “unacceptable,” or terms that could “mislead consumers by inducing a false sense of security”.  These include “chemical-free,” “non-chemical,” “help prevent skin damage,” as well as terms like “sunblock,” “reflects,” “shields,” “protects,” “filters,” “screens,” “sun’s rays,” “sun’s harmful rays,” and all SPF designations greater than 50.

Until FDA sets an effective date for these standards, industry is free to use hyped claims.

Some sunscreens absorb into the blood and raise safety concerns. The review of the literature shows that some sunscreen ingredients absorb into the blood, and some are linked to toxic effects. Some release skin-damaging free radicals in sunlight, some could disrupt hormone systems, several are strongly linked to allergic reactions, and others may build up in the body or the environment. FDA has not established rigorous safety standards for sunscreen ingredients that fully examines these effects.

Here is a GUIDE to Safe Use of Sunscreens:

1) Read the Label!
2)  Sunblock should contain at least 7% of zinc oxide or titanium dioxide for broad spectrum protection.
3)  Purchase new sunscreen every year
4) Wear Reputable SPF Lip Balm- Lip cancer is most common on the bottom lip where sun exposure is most direct. Two out of 5 lip balms with SPF offer poor UVA protection.  Make sure you use the right one.
5) Avoid Oxybenzone or Benzophenone-3.  These harmful ingredients cause skin irritation, allergies, and hormone problems.

6) Avoid spray and powder sunscreens: inhaling sunscreens can pose extra risks and cause toxicities
7) Avoid Fragrance.  It can cause allergies, reproductive problems, eczema, and dermatitis.
8)  Do not use sunscreen with added bug repellent since you can get excessive amount of pesticide in your body.  Apply repellant at least 15 minutes after sunscreen to cut down on the pesticide soaking through the skin.

9)  Assure protection against both: UVA and UVB Rays:  Remember, SPF only protects against UVB rays, which are the rays within the ultraviolet spectrum that allow your body to produce vitamin D in your skin. However, the most destructive and damaging rays are the UVA rays.  They cause skin damage and cancer.  Therefore, it is paramount to have a sunscreen that protects against UVA and UVB rays.

In summary, only several sunscreens live up to their advertising claims, and the federal government is powerless to control them. Obtain your sun blocking agents from the Health Provider who can assure you of the quality and safety of the product.

Don’t forget to enjoy the sun!  It’s a powerful source of Vitamin D!  Apply safe sunscreen if you are spending most of your day outside and on the sensitive areas of your face.  However, applying sunscreen every time you are out in the sun will block the production of so much needed vitamin D (sunshine hormone, as it’s also referred to).  Research had demonstrated on multiple occasions that optimal levels of vitamin D are protective against many types of cancer, including pancreatic, breast, ovarian, skin, and lung cancers.

Be an EDUCATED consumer!  Protect yourself and your loved ones.

Stay Healthy,

Dr. Yuliya Klopouh


  1. Rogers HW, Weinstock MA, Feldman SR, Coldiron BM. Incidence estimate of nonmelanoma skin cancer (keratinocyte carcinomas) in the US population, 2012. JAMA Dermatol 2015; 151(10):1081-1086.
  2. Environmental Working Group May 2016



Coenzyme Q10

The Benefits of Coenzyme Q10 | by Yuliya Klopouh, Pharm. D. | Nutrition Consultations in Baltimore, MD: The nutrient Coenzyme Q10 (CoQ10) is a powerful antioxidant that is essential to cellular energy production and is found in every cell of the body. Because our body must have energy available to perform even the simplest operation, CoQ10 is essential for the body’s cells, tissues and organs.

CoQ10 levels are reported to decrease with age and to be low in patients with some chronic diseases such as heart conditions, muscular dystrophies, Parkinson’s disease, cancer, diabetes, and HIV/AIDS. Some prescription drugs may also lower CoQ10 levels.  What are the benefits of CoQ10?  Who needs to take this nutritional supplement?

Every adult needs CoQ10!

There is so much we need to know about heart disease, how to prevent and treat it effectively.  But first, we should discuss the role of one important nutrient that is beneficial to the heart in so many ways- coenzyme Q10 (CoQ10).

CoQ10 is also called ubiquinone, a name that signifies its ubiquitous (widespread) distribution in the human body. CoQ10 is used by the body to transform food into adenosine triphosphate (ATP), the energy on which the body runs.

Aging is the major reason for a deficiency, since the liver loses its ability to synthesize CoQ10 as a person grows older. Poor eating habits and unhealthy life styles, stress and infection also affect the body’s ability to produce adequate amounts of CoQ10.  The benefits of using CoQ10 can translate into increased energy, improvement of heart function, inhibition of gum and dental disorders, a balanced immune system and possible life

The greatest need for this enzyme is in the heart and liver, which accounts for its positive effects on cardiovascular disorders.

Below are the list of some disease states in which CoQ10 has been studied and showed to be beneficial.

Heart failure: Several studies demonstrated benefits of coenzyme Q10 in people who have been diagnosed with chronic heart failure (with or without cardiomyopathy), including transplant recipients. Although the results are promising, further research is needed.

High blood pressure (Hypertension): Several studies suggested that supplementation with coenzyme Q10 may lower systolic and diastolic blood pressure in patients with hypertension.  It has been hypothesized that coenzyme Q10 deficiency is a cause of high blood pressure.

Alzheimer’s disease: Recent studies suggest that coenzyme Q10 may slow the progression of dementia associated with Alzheimer’s disease.

Disease of gums (Periodontal disease): Coenzyme Q10 has been successfully used in the treatment of gum disease. Early evidence suggests that coenzyme Q10 may decrease pus formation, redness, bleeding, pain and swelling of the gums.

Chronic kidney disease: Coenzyme Q10 has been proposed as a possible therapy for treating chronic kidney failure. Preliminary evidence suggests that coenzyme Q10 may improve kidney function and reduce the need for chronic dialysis.

High cholesterol: Levels of CoQ10 tend to be lower in people with high cholesterol compared to healthy individuals of the same age. In addition, certain cholesterol-lowering drugs called statins (such as atorvastatin, cerivastatin, lovastatin, pravastatin, simvastatin) appear to deplete natural levels of CoQ10 in the body.

Pharmaceutical companies that market statin drugs should consider including the described CoQ10 potential depletion in their drug information materials provided to physicians and pharmacists, and they should encourage patients to consult their physician and pharmacist for appropriate supplementation.

Taking CoQ10 supplements can correct the deficiency caused by statin medications without affecting the medication’s positive effects on cholesterol levels.

 Diabetes: CoQ10 supplements may improve heart health and blood sugar and help manage high cholesterol and high blood pressure in individuals with diabetes. High blood pressure, high cholesterol, and heart disease are all common problems associated with diabetes. Despite some concern that CoQ10 may cause a sudden and dramatic drop in blood sugar (called hypoglycemia), two recent clinical studies of people with diabetes given CoQ10, 200 mg 2 times daily, showed no hypoglycemic response.

Available Supplements: Coenzyme Q10 is available as a supplement in several forms, including soft gel capsules, liposome tincture, hardshell capsules, and tablets. CoQ10 is also added to various cosmetics.

How to take it:  For adults 19 years and older, the recommended dose range for CoQ10 supplementation is 30 – 200 mg daily.  You should  consult your health provider for specific dosing recommendations.  They will depend on the medical condition being addressed and current medications or supplements you are taking.  Coenzyme Q10 is fat soluble ; therefore it should be taken with a meal containing fat for optimal absorption. Also, taking coenzyme Q10 at night may help with the body’s ability to use it.

A powerful antioxidant, CoQ10 can protect proteins, LDL-cholesterol (bad cholesterol), and mitochondrial DNA from oxidative damage. Due to its major role in the production of cellular energy, and as an antioxidant, CoQ10 can aid in the body’s response to a host of health diseases including heart disease, cancer, gum diseases, aging, neuro-degenerative diseases, and muscular dystrophy.


Yuliya Klopouh, Pharm.D.
The Orpheus Clinic
Baltimore, MD

Phone: (443) 854-4673

Questions regarding your health should be directed to your primary care doctor.
Statements on this website have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.

Top 10 Medications That Deplete Your Body of Essential Nutrients

There are about 900 drugs and fixed-drug combinations used in US today.  Almost 400 prescription medications can deplete specific nutrients.

We are taking prescription drugs in increasing numbers.  Nearly 50 % of American adults take at least one prescription medication, and nearly 20 % take 3 or more.

But are we healthier because of it? Are these new drugs really improvements over older versions? While we hear daily of new drug miracles, more often, it’s the latest debacle: Baycol, a drug for lowering cholesterol, withdrawn from the market because of deaths and transplants due to severe liver damage; Vioxx, for arthritis, withdrawn because of heart disease-related complications.

Among the most ignored side effects, which are quite common and can be life threatening, are nutrient depletions. Most medications will rob your body of essential nutrients.

What can You do to prevent these detrimental side effects of the prescriptions medications?

Top 10 Drug- Induced Nutrient Deficiencies

Blood Sugar Control Medications

(Oral Anti-diabetic Drugs), such as Metformin (Clucophage® and Glucovance®)

This drug is the most popular oral anti-diabetic drug in America. This drug works by enhancing the action of insulin and reducing the blood sugar.

Nutrients depleted: Metformin depletes Vitamin B12 and Folic Acid. It reduces a substance called intrinsic factor in the stomach, which is needed for a good absorption of B12 by the small intestine. The longer the drug had been used and the higher the dose, the greater the drop in B12.  Metformin may also deplete the body of the antioxidant and cardiovascular protector coenzyme Q10.

Supplements needed:  Take vitamin B12 ( 200-1,000 mcg, Folic acid 400-800 mcg, and CoQ10 30-200 mg

Drugs for High Cholesterol

(Cholesterol-Lowering Medications), such as Statins: Lipitor®, Zocor®, Crestor®, and Pravachol®

At this time, about 36 million Americans have cholesterol counts high enough to make them candidates for statin therapy. The guidelines for safe cholesterol levels continue to change so that more and more people are prescribed these medicines at higher and higher doses
Statins reduce “bad” LDL cholesterol and raise “good” HDL cholesterol.

Nutrient Depleted: Statins deplete the body of CoQ10, causing severe side effects. The consequences of this deficiency are broad. It can translate to:

a) Heart Failure: Deficiency in CoQ10 makes the heart less able to do its job, leading to Congestive Heart Failure (CHF). CHF happens when the heart becomes too weak to efficiently pump blood through the whole cardiovascular system. Blood backs up and fluid accumulates in the lungs and throughout the body. Every year more and more people die from CHF. Could CoQ10 depletion from statin therapy have played a role in this dramatic increase?

In fact, CoQ10 is considered to be the most valuable nutrient in patients with heart failure. Studies have shown increased risk of heart failure in statin users, and this is likely related to the CoQ10-depleting effect of the drugs. It’s essential to add the nutrient back in to help avoid this serious weakening of the heart’s pumping power.

b) Muscle Pain and Weakness: this side effect is an obvious sign of CoQ10 depletion.

The good news is that CoQ10 is easy to supplement. In addition to protecting you against these side effects, this nutrient will improve your overall health as well. To learn more about CoQ10, click here.

Needed Supplement: Take 100-300 mg of CoQ10

Drugs for Hypertension  

Beta-Blockers: atenolol (Tenormin®), metoprolol (Lopressor, Toprol-XL®), and propranolol (Inderal®)

Beta-Blockers are one of the oldest and safest classes of antihypertensive drugs. They lower blood pressure by reducing the force and speed of the heartbeat.

Nutrients Depleted: Beta Blockers deplete CoQ10 and reduce production of a hormone called Melatonin. By blocking beta receptors, these medications may also block the action of an enzyme needed to make this hormone, which is produced at nightfall and promotes sound sleep.

Needed Supplement: Take 100-300mg of CoQ10.

Furosemide (Lasix®) and Hydrochlorothiazide (HCTZ®

This class of drugs is used to reduce Blood pressure by moving fluid out of the body by an action on the kidney.

Nutrients depleted: These drugs deplete Calcium, magnesium, potassium, vitamins C, B1 and B6, and Zinc.

Needed Supplements: Take a well-balanced, complete multivitamin supplement containing key nutrients and Calcium (1,000mg).

Drugs for Heartburn and Acid Reflux

Antacids (Maalox, Mylanta), H2 blockers (Pepcid®, Zantac®), Proton Pump Inhibitors (PPIs) – Nexium®, Prevacid®, Protonix®, and Aciphex®

These drugs are powerful acid-reducing medications. They reduce stomach acid and cause lots of side effects related to acid blockade. Several studies have shown that the use of acid-suppressing drugs us linked to increased risk of certain type of pneumonia. Why would this be?
Stomach acid kills all kind of bacteria, viruses, and other microorganisms that could cause dangerous diseases if let to pass further in the body. Suppressing acid production, then, reduces this natural bodily defense against hazardous “bugs”. Protein digestion is also impaired in patients taking Antacids and PPIs. They may benefit from the supplementation of pre-digested protein, such as Whey protein.

Nutrients depleted: Acid suppressing medications deplete vitamin B12 (thus, cause anemia), vitamin D, and calcium.

Needed Supplements: Vitamin B12, Whey Protein Supplement, Calcium (1,000- 1,200mg), Omega-3 fatty acids (1,000-2,000 mg), high quality, broad spectrum probiotic

Prescription medications for Constipation

Mineral Oil, Lactulose (Enulose®), Miralax and Senna (Senokot®)

These products work mostly by helping retain water in the stool and increasing the motility of the GI tract to remove stool from the body. None of these drugs are recommended for any more than short-term use, and can cause diarrhea, nausea, and black, tarry stools

Nutrients depleted: Fat Soluble Vitamins: A, D, E, and K. Also, deplete Vitamin B12, Calcium, Iron and Zinc.
It is believed that many Americans are borderline Zinc deficient, drugs or no drugs, and even a small depletion can worsen preexisting deficiency. Symptoms of low Zinc level are: acne, joint pain, menstrual problems, poor immunity, and brittle hair.

Needed Supplements:  Broad Spectrum Probiotic (daily), Omega-3 fatty acids (1,000 mg), Calcium (1,000-2,000 mg) and 500mg of Magnesium, Zinc (25-50mg)


Selective Serotonin Reuptake Inhibitors (SSRIs): Celexa®, Lexapro®, Zoloft®, Paxil® and Prozac®

SSRIs are the most commonly prescribed class of antidepressants. They work by making serotonin more available in the synapse; so instead of being picked by the cell and broken down, the serotonin molecule gets to connect with the same receptor several times. The net effect is an increase of the neurotransmitter’s feel-good effects.

SSRIs cause multiple side effects and nutrients depletions.

Nutrients depleted: Melatonin- based on human studies, melatonin changes after antidepressant use may be due to pharmacological action of SSRIs on melatonin secretion. SSRIs are also known to deplete sodium which may lead to severe neurological changes.

Needed supplements: Well-balanced Multivitamin/Mineral, specifically, group-B vitamins, Co Q10- 100-300 mg daily, Folic Acid 800mcg daily,   SAMe (S-adenosyl methionine) – 200mg twice daily, Omega-3 fatty acids (1,000 mg daily)

Drugs for Birth Control

Oral Contraceptives are highly effective, no doubt, but they increase the risk of breast and cervical cancers and of cervical dysplasia, the precancerous condition the doctor looks for when doing a Pap smear.  Oral contraceptives also increase the risk of heart attacks and blood clots.  Low sex drive on the pill?  It’s caused by low testosterone which in turn, is caused by synthetic hormones.  Depression on the pill?  It’s due to depletion of vitamins C and B6, needed to make neurotransmitters.

Nutrients Depleted:  Calcium, Folic Acid, Magnesium, Vitamins B2, B6, B12, vitamin C, and Zinc

Needed Supplements:   Calcium1,000-1,200 mg daily

Folic acid 400-800 mcg daily and Magnesium 400-600 mg daily, Well Balanced/complete Multivitamin /Mineral preparation containing sufficient amounts of B vitamins (B1, B2, B6 and B12) as well as vitamin C (1,000 mg) and Zinc (25-50 mg)


(Augmentin®, Keflex®, Cipro®, Bactrim®, etc)

More often than not, lots of people these days rely on antibiotics as “magic bullet” for recovery. While in some situations, the use of antibiotics is appropriate and clinically justified, in other situations they are simply not necessary and often given to people just to “prevent secondary infection”. In the process of taking antibiotics without a true indication, you replete your body of several important nutrients, known as “good” probiotic bacteria that help maintain immunity and gastrointestinal health.
Nutrients Depleted: Biotin, Inositol, ALL major vitamins (water and fat soluble), calcium, folic acid (especially, Bactrim®) and potassium (mostly, Augmentin® and Keflex®)

Needed Supplements:the doses of magnesium, iron, calcium, and potassium contained in a good multivitamin should cover your needs for these nutrients during a course of antibiotic therapy.  You may need to restore other nutrient depletions by taking the following:
B-Complex vitamins,
Inositol (100-1,000mg),
Probiotics (choose the products that contain at least one billion live organisms per daily dose). Antibiotics kill beneficial bacteria. Therefore, you must replenish these “good” bacteria to prevent future infections and GI problems.

Pain Medications

(Tylenol®, Percocet®, Motrin®, Naproxen®,  Indocin®)

Acetaminophen (Tylenol) is a drug that reduces pain.  It is implicated in tens of thousands of cases of liver damage, including around 450 deaths, every year, and is the single largest contributing factor to liver failure that requires liver transplants.

This drug is included in many multi-drug, over-the-counter (OTC) combinations, and taking even slightly more than the recommended amount can seriously damage your liver.

Nutrients Depleted:  Folic Acid (Motrin, Naproxen), Vitamin C, Zinc, and Glutathione (that prevents liver damage)

Needed Nutrients:

N-Acetyl-Cysteine- 600-1200 mg (precursor to glutathione) can prevent liver damage

Vitamin C > 3 g/day extends protective effects of N-acetyl-cysteine

Selenium  200 mcg/day

Osteoporosis Medications

(Fosamax®, Actonel®)

These medications are called bisphosphonates.  They are widely prescribed to prevent and treat osteoporosis and to prevent fractures.  Fosamax and Actonel slow bone loss.
Nutrients depleted: Because bisphosphonates push calcium into the bones, blood levels of this mineral, which also plays a role in muscle contraction and relaxation, can be depleted if dietary intake is too low. Essentially, these bone- building drugs have a calcium-depleting effect.

Needed Supplements: Take complete Multivitamin /Mineral containing calcium, magnesium, boron, vitamin D and vitamin K to ensure that you have enough of these minerals to fulfill all their roles in the body. Any woman approaching or at menopause should use these supplements, plus a couple more to really get ahead of the curve and prevent osteoporosis.

Every young woman needs to be aware that her young years are crucial for building optimal bone mass. Studies have shown that a significant percentage of young women are already at risk for developing osteoporosis later in life because they have failed to build up their bones. Exercise, calcium/magnesium/vitamin D, and a good diet, are crucial in the teens and early twenties.

In conclusion

Be aware of the power of prescription medications, both to heal and to harm.  By educating yourself about possible nutrient depletions, you will be in the best position to take advantage of the positive effects that medications can provide for you.

In addition, by supplementing accordingly, beyond just the level of the depletions, you will be giving yourself a chance for true healing and optimal health.  You deserve it!



The “New Way” of Eating and Living Healthy: Intermittent Fasting.

How many times have you heard of the advice to eat five or six small meals a day in order to stay healthy and loose weight?  We have all been taught not to miss breakfast ( ever!) as it is the most important meal of the day.

This is old news; and today its nothing but a myth. It was believed that eating small meals throughout the day keeps our metabolism “revved up” and facilitates weight loss.  However, there is little evidence to support this way of thinking.  In fact, “eating many small meals a day” has negative implications.  When people are told to eat many small meals a day, wheat they actually tend to do is “eat something all the time”.  It is of no coincidence that this way of “eating” led to skyrocketing rate of obesity in our country and the world overall.   The other major misconception that led to increased rate of obesity was the government’s “low-fat” dietary recommendations that led to over consumption of carbohydrates that caused insulin resistance and as a consequence became root cause for majority of inflammatory diseases such as diabetes and hypertension to name a few.

The time has come to explore the opposite idea: regularly allowing greater-than-normal amounts of time to pass between meals, a practice known as “intermittent fasting,” or IF.

The basic essence of IF is to enjoy better health via repeatedly fasting for longer periods than is typical on a daily breakfast-lunch-dinner schedule. There are multiple scenarios on how to accomplish it. Some proponents skip breakfast; others, dinner. Others fast all day every other day, every third day, once per week, or once per month. But what unites all these methods is the following concept: fasting means abstaining from solid food; all sensible IF plans allow hydration with water, tea or other no- or low-calorie beverages.)

What are the benefits of Fasting?

  • Fasting increases Insulin and leptin sensitivity thus reducing the risk of chronic diseases such as diabetes and hypertension
  • It allows your metabolism to be “fat adapted”- increases your energy by burning stored fat
  • It also stimulated production of ghrelin (satiety hormone)- and prevents overeating
  • Intermittent Fasting reduces your Triglycerides levels and decreases risk of heart disease
  • Reduces body Inflammation
  • Helps loose weight and maintain it long term.
  • Exercising in a fasting state can help preserve muscle and prevent muscle aging.

Fasting periods also help eliminate toxins left by dead and damaged cells, a process known as autophagy. A failure of autophagy to keep up with accumulated cellular debris is believed by many scientists to be one of the major causes of the chronic diseases associated with aging.

Occasional fasting also seems to boost activity and growth of certain types of cells, especially neurons. This phenomenon explains sharper memory and cognition in people who consider intermittent fasting.

Points to consider when implementing Intermittent Fasting (IF)

  • There are many ways to do it. Some people find it easy to consider Every other Day Diet – meaning not eating every other day at all, or consuming about 500 kcal / day on a fasting day.  You would eat at libidum on non fasting day.  This way of fasting allows full hydration on fasting days ( tea, unsweetened coffee, water)
  • More practical way of intermittent fasting is Fasting for 16-18 hours/ day. This may be accomplished by delaying eating after awakening.  This type of fasting I practice myself.  I recommend to skip breakfast and eat your first meal of the day at lunch/dinner time within six to eight hours window frame and make your last meal of the day 3 hours prior to bed time
  • Fasting will help shift your metabolism to fat-burning mode.
  • It is best to exercise in the fasting state. However, consider supplementing with whey protein drink as you recovery drink/meal.
  • Quality of food you consume is just (if not more) important is the timing of food consumption. It is not recommended to consider intermittent fasting if your diet consists of processed refined foods (fast food).  It is PARAMOUNT to exclude refined carbohydrates, sugar/fructose and grains!
  • Pay close attention to how you feel and don’t take any changes in the way you feel or your energy levels lightly. You need to consult your health provider if you are diabetic, pregnant or breastfeeding.


I think there is an evidence for the health benefits of IF!   Getting hungry now and then is clearly a healthy thing to do as long as overall caloric intake stays high enough to maintain a healthy weight. (Fasting, like every other healthy activity, must be done sensibly and in moderation.) Many people who follow IF regimes report both physical and mental benefits, including improved energy and concentration, better sleep, and an overall feeling of well-being.

Let me know if I can help you create an effective eating plan and schedule.

Best of Health,
Dr. Yuliya Klopouh


© 2015 Yuliya Klopouh, The Orpheus Clinic. All Rights Reserved. Questions regarding your health should be directed to your primary care doctor. *Statements on this website have not been evaluated by the Food and Drug Administration.These products are not intended to diagnose, treat, cure or prevent any disease.


Natural  treatments that can be utilized to support relief from Acid Reflux

Many people  I know suffer from acid reflux,  particularly after consuming a heavy meal. This is a natural physiological process.  The problem begins when the symptoms start to occur more frequently.  It may indicate that you could have heartburn or what is also known, GERD (Gastroesophageal Reflux disease) or acid reflux. The phenomenon of acid reflux can be explained by the relaxed sphincter muscle in the esophagus, also described as the valve that separates the stomach from  the esophagus.  When this sphincter does not close completely, it allows the stomach acid to squirt upward into the esophagus, causing burning sensation due to irritation of esophagus by the acid.   What are the common symptoms of Acid Reflux? Burping,  burning  sensation in the stomach and chest , Trouble  swallowing,  sensation that you may have food lodged in your throat,  Unproductive  cough,  Bloating, Pain in  the chest (sometimes mistaken for a heart disease), Bad breath.

What  are the Possible Causes of Acid Reflux? Many people think that the problem of acid reflux resides in having  too much hydrochloric acid produced in the stomach.  Thus, they refer to anti-acids after each and every meal.  In reality, it is quite the opposite.

Stomach acid production decreases dramatically as people get older! We > seem to forget that having stomach acid is both necessary and normal.   Our body needs to have proper nutrition, however, to make the mucous lining that protects the stomach. Instead of giving your body what it
needds to heal, we sometimes make the mistake of turning off our stomach acid to solve the problem.
What happens when you turn off stomach acid?

Unfortunately, using anti-acid medications for an extended period of time causes 2 major problems:

1. With no acid in your stomach, your body is not able to optimally digest food (proteins, in particular) and you become nutritionally deficient. This makes it even harder for your stomach to make the mucous lining it needs to protect itself and can set you up for even more reflux.
2. When you take anti-acid medications, your body’s ability to make stomach acid is diminished.  As a result, it makes huge amounts of a hormone called Gastrin that stimulates stomach acid. Because of this, as soon as you stop your antacids, the stomach makes massive amounts of acid– which it cannot protect against. In essence, you become addicted to the antacids. It is no surprise that Prilosec, Nexium,
Zantac and other antacids are some of the biggest money making  pharmaceuticals!

What are the dietary and behavioral modifications that help alleviate acid reflux? Try to stay away from processed foods and fast foods. Instead eat a diet of natural and whole foods.   Apples can lower acid in the stomach.  Take a slice of apple prior to eating a meal.  This is a natural anti-reflux remedy.  Always eat dinner at least three hours prior to bedtime.   Try eating smaller meals and snacks instead of consuming large heavy meals. It requires much lower levels of acid to digest a smaller meal and it is easier on the stomach. Don’t lay down for 45 minutes to an hour after you eat. Put one to two tablespoons of unpasteurized apple cider vinegar in a glass of water and drink twice a day. This doesn’t always work for everybody but does work for many.   Avoid alcohol or drink only a small amount.  Avoid drinking coffee. Substitute with herbal tea (except for peppermint tea which can worsen the symptoms of indigestion). Avoid milk and dairy products since they can increase production of acid in the stomach and exacerbate acid reflux.

What are the Natural Remedies for Acid Reflux? An effective way to resolve your reflux and indigestion is by referring to the following:

1. The  digestion can be dramatically improved by taking the proper digestive enzymes. Drink warm liquids instead of cold while eating (cold temperatures inhibit digestive enzyme function). Long-term use of digestive enzymes can also dramatically improve your over-all health and wellbeing.
2. Avoid taking aspirin products, soft drinks (colas), and alcohol until your stomach heals and then use them in limited amounts.
3. Use remedies that help heal your stomach.  Using  Diglycyrrhizinated Licorice, or DGL licorice (must be the DGL  form as others can cause blood pressure  problems) can be very effective in resolving heartburn symptoms.   Research shows that it is as effective as Tagamet (anti-acid), but is healthy for you!  As DGL licorice helps to heal the stomach instead of just masking symptoms, it may take 3-4 weeks to see the results.  You can use your antacids during that time if you want.
4. In many patients, stomach infections (H. Pylori) can be a major cause of long-term indigestion. Most doctors treat this with Prilosec combined with 2-3 antibiotics used simultaneously. There are some better, natural alternatives for treatment of H. Pylori. Talk to your  Holistic Health Provider for more information.

Here are some Natural ways to cope with Heartburn or Acid Reflux:
Apple Cider Vinegar – This is the oldest remedy used to treat acid reflux.  Make sure you obtain certified organic, unpasteurized apple cider vinegar. Organic vinegar also contains minerals and enzymes that are not present in other vinegars because of over processing and overheating. ACV has been sed successfully by many people in alleviating symptoms of acid reflux.
Pickle Juice – Pickle juice is more of an emergency remedy when there is nothing else around to help.  It gives an immediate relief from acid reflux.
Orange Peel Extract – According to Dr. Jacob Teitelbaum research, it has been shown that nearly 90% of patients claimed relief in their acid reflux symptoms in two weeks from the time they started on orange
peel extract. It may possess anti-cancer activity as well.
Probiotics – Taking probiotics can help your acid reflux and intestinal problems by improving digestion.
Many other remedies are available as separate standing herbs. However, the best way to address acid reflux is to utilize the combination product which contains herbal remedies that work synergistically (together) to address the problem.  One such preparation is called GI Revive.  Lots of patients have tried this preparation with dramatic improvement in heartburn symptoms.  The main ingredient of GI Revive is DGL Licorice.  It possesses powerful anti-inflammatory actions as well as stomach rejuvenating and healing properties.

Finally, I cannot stress enough the importance of weight loss as the major natural cure for acid reflux.   If you are currently at your ideal body weight then this section may not apply to you.  Overweight and obese people are much more likely to suffer from acid reflux, including nighttime acid reflux.   Taking herbal remedies for acid reflux, yet making no effort to change  the diet and to lose the extra weight, will bring poor results.

Avoiding fried and fatty foods is often recommended for people who suffer acid reflux. If you avoid these offending foods and eat several  small meals during the day, you will naturally lose weight and relieve  acid reflux.

These are only some of the possible natural cures for acid reflux. For more recommendations, talk to your Holistic Health Provider .

Disclaimer Please Read: Questions regarding your health should be directed to your primary care doctor. *Statements on this website have not been evaluated by the Food and Drug Administration. Any advice and any products are not intended to diagnose, treat, cure or prevent any disease.

Healthful water

According to medical and scientific literature, the healthy and natural state of human blood has a pH of 7.365, which is mildly alkaline. Even a slight deviation in this factor, particularly toward the acidic side of the pH scale, i.e., less than 7.0, can be accompanied by disease, even death. The body, in its wisdom, will balance its alkaline-acid state even at the cost of creating an imbalance in the mineral reserves of other tissues since the proper pH is so vital to health.

Unfortunately, we live in a toxic world that imposes overwhelming acidity on our body’s homeostasis. From the foods, water, and other liquids we consume containing damaging chemicals, to the air we breathe, to the stress we experience, our world and lifestyles have a large acidic impact on our health and well being in addition to the fact that many people are chronically dehydrated. Since we are primarily water beings comprised of approximately 75% water by weight, it follows that without adequate and healthful water, many unhealthy changes occur in our bodies at the cellular level. “Since the natural pH of a cell is primarily dependent upon proper hydration, as cells become dehydrated, the acid wastes inside the cell concentrate and the overall cellular pH becomes more acidic. Many of these acid wastes trapped inside the cell are positively charged, free radicals that damage the interior structures of the cell.” (Turning Back the Hands of Time, Dr. Peggy Parker, Simple Health Network, 2013, page 8.)

Ionized, alkaline water, also called restructured or hexagonal water created through an electrolysis process with specialized technology, is what Hiromi Shinya, M.D. terms “good water” that is necessary for the immune system to function properly. With water filtration in place as the first step, it is then the synergy of the three properties of ionized, alkaline water – high antioxidant capacity, alkalinity for oxygenation and pH balancing, and hexagonal structure for deep hydration and detoxification at the cellular level – that make it the high quality water that is the key component of health and maintenance of cellular function. In fact, Dr. Shinya identifies ionized, alkaline water to “be an invaluable aid in helping you to cleanse and revitalize your cells.” (The Rejuvenation Enzyme, Hiromi Shinya, M.D., Millichap Books, 2012, page 82.)

Cancer cells thrive in an acid environment, and they don’t do well when the body is more alkaline.”

We stress alkalinization, which is a big factor: Alkaline Water, and green powders (that contain wheat grass, rye, etc.). These substances alkalinize the body.”

You can never underestimate the importance of diet in beating cancer. It’s everything.”

(Comments of Dr. James Forsythe, Board Certified Oncologist quoted in a 3/29/14 lecture by Marianne Rosen, M.D., Charleston, SC)

Having one’s own ionizing system enables using refillable, BPA-free bottles to preserve and support health and save the environment while promoting toxic chemical-free living with the other waters to replace personal and household cleaning chemicals.  The article mentions average families spend $1000/year on bottled water . The bottled water industry is a $12-13 BILLION per year industry.

Bottled water is simply filtered, highly marketed tap water bottled in another place and shipped at great environmental cost all over the world (plastics and oil for production and shipping).

Many companies manufacture ionizing water filtration systems available for a variety of price ranges from moderate to expensive. Before purchasing, be diligent and read the online FAQ’s and online reviews associated with water filtration systems.

Disclaimer: Questions regarding your health should be directed to your primary care doctor. *Statements on this website have not been evaluated by the Food and Drug Administration.These products are not intended to diagnose, treat, cure or prevent any disease.

Osteoporosis and fracture prevention: Vitamin K1 and K2?

Do you know of anyone taking Fosamax®, Boniva®, Actonel®?  These are the most commonly prescribed drugs to treat osteoporosis and prevent fractures.

Concern among doctors and patients has arisen following recent media reports that cite a possible association between unusual and unexpected (atypical) fractures of the upper thigh bone and use of these drugs.  While the “judges” are yet to make their final verdict on the future use of these medications, we want to look at the scientifically proven and clinically effective alternative ways to address osteoporosis.

In addition to well-known Calcium and Magnesium supplements that must be used along with Vitamin D3 to prevent osteoporosis, the new evidence suggests the role of another vitamin in supporting bone health – Vitamin K2.  Vitamin K2 is found in meat, cheese and the Japanese food natto, to name a few sources.

There are two types of vitamin K:  K1 and K2.   They are very different in their activity and function. Vitamin K1, found in green leafy vegetables, is a fat-soluble vitamin involved in the production of coagulation factors, which are critical for stopping bleeding.  Therefore, when someone has been prescribed a blood thinner such as warfarin, they need to be careful not to take too much vitamin K1, as it will antagonize (reverse) the effect of drug.  Vitamin K2, on the other hand, works differently.  Vitamin K2 works by activating two important proteins. Without it, the transfer process of calcium from your arteries to your bone cannot occur, which raises your risk of arterial calcification.  Vitamin K2 “moves” calcium from arteries to bones, where it needs to be.

Current evidence suggests that there is a strong association between osteoporosis (not having enough calcium in your bones) and an increased risk of heart disease.  An increased intake of vitamin K2 could be a means of lowering the risk of osteoporosis, bone fractures and heart disease.

Make sure to optimize the levels of vitamin K2!  Next time you are to take calcium/magnesium supplement, don’t forget to pair it with Vitamin D and K2 for best health results.

Questions? Remember to ask your primary care physician, and please feel free to call me to make an appointment to optimize your health.


*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.



Does your exercise “H.I.I.T.” the mark?

High-intensity interval training is defined as any workout that includes intense bursts of activity, alternating with fixed periods of less-intense activity or even complete rest.  A good example of H.I.I.T. workout is running as fast as you can for 30 seconds and then walking briskly for 1-2 minutes. Repeat this 1.5 minutes interval seven times for about 10 minutes effective workout.

It sounds really simple to be effective, but recent research demonstrates that it’s all you need (done 3 times a week) to promote fat burning, build muscle and increase production of growth hormone (HGH) responsible for not only weight reduction but anti-aging effect as well!  H.I.I.T. is more effective than “jogging” on a treadmill for an hour.  It’s efficient and does not require going to the gym!

Any physical activity (biking, jump roping, swimming and running) that gets your heart rate up fast- is all you need.  In addition, studies show that H.I.I.T. improves insulin sensitivity and blood sugar control after just 2 weeks  training!

See these studies:

Bacteria that’s good for you? Probiotics are beneficial.

Probiotics are beneficial bacteria (sometimes referred to as “friendly germs”) that help maintain the health of the intestinal tract and aid in digestion. They also help keep potentially harmful organisms in the gut (harmful bacteria and yeasts) under control.

Probiotics should not be confused with prebiotics. Prebiotics are complex sugars (such as lactulose, lactitol, a variety of fructo-oligosaccharides, and inulin) that are used as fuel by the healthful bacteria to stimulate their growth and activity while suppressing the growth and activity of harmful organisms.

Probiotics are thought to work by colonizing the small intestine and crowding out disease-causing organisms, thereby restoring proper balance to the intestinal flora. They compete with harmful organisms for nutrients and may also produce substances that inhibit growth of harmful organisms in the gut.

Probiotic bacteria have been found to stimulate the body’s immune system. They may also aid in several gastrointestinal illnesses such as Inflammatory Bowel Disease, Antibiotic Associated Diarrhea (AAD), Clostridium difficile toxin-induced colitis, infectious diarrhea, hepatic encephalopathy, irritable bowel syndrome, and allergies.

Recent research indicates that gut microbiota influences metabolism in humans. Several studies show that antibiotic use in infancy increases body weight in later childhood, due to misbalance of good/bad bacteria in the gut that occurs after the course of antibiotic treatment.

Probiotics are emerging as a potential therapy for metabolic syndrome. Several human studies and multiple animal studies show promise for probiotics in reducing blood glucose levels or improving insulin sensitivity. It is becoming increasingly recognized that gut microbiota (beneficial bacteria in our gut) plays an important part regulating metabolism in humans. Nearly 100 trillion microbes in human gut coevolve with the human body and significantly influence human health. What’s fascinating is that “manipulation” of gut microbiota through the administration of prebiotics and probiotics could reduce intestinal low grade inflammation and improve gut barrier integrity, thus, ameliorating metabolic balance and promoting weight loss.


Dr. Klopouh’s suggestions: What you should know about Wheat, Dairy, and Meat

by Yuliya Klopouh, Pharm.D.

Here are some thoughts to consider when working toward a healthful diet:

1. Wheat (gluten). Gluten is a naturally-occurring protein compound found in many grain products such as wheat, barley, rye and oats. However, many people have difficulty absorbing it because they are sensitive to the protein. So that inexplicable feeling of tiredness or headache you get might be the result of your body trying to cope with excess gluten. Other people experience cramping, stomach pain, constipation or diarrhea; everyone reacts differently.

Unfortunately, whole wheat products contain gluten and won’t help relieve your symptoms. The good news is that you can buy many gluten-free products and baked goods at health food stores that are just as delicious. While all supermarkets carry corn and brown rice, many have now begun to carry quinoa, amaranth, gluten-free oats and more “exotic” alternatives to wheat.

2. Dairy (lactose, whey and casein). Lactose is found in all animal dairy products: milk and cheese from cows, goats and sheep. A baby needs milk during nursing stage (until 1-1.5 years old), after which time the pancreas can stop producing the lactase enzyme that breaks down lactose. Once this enzyme wanes, dairy products can become an allergen.

Many people who have dairy allergies suffer from gas, belching, constipation, acid reflux and diarrhea. However, casein is also an an allergen and excitotoxin (a chemical that overactivates nerve cells) and can produce anxiety and insomnia in many people. So that glass of milk before bedtime might actually be keeping you awake!

Fortunately, companies have made huge strides in improving the taste and texture of dairy alternatives. Organic, Non-G.M.O. soy and almond milk are both healthful and delicious. Some brands contain more calcium than regular cow milk. Likewise, you can find soy yogurts, cheese (casein-free) and even ice creams that many people enjoy just as much as their dairy alternatives.

3) Meat (animal protein of all kinds)- Limit meat in your diet to no more than 2 servings per week. It includes chicken, turkey and red meat. If possible, substitute it with fish or other sources of protein, such as eggs, tofu or tempeh. The following grains are great source of protein: Chia seeds and Quinoa. Use them in your daily diet and add to juices/smoothies, etc.