Ask the Doctor: Memory Loss, Shouder Pain, Solving Low Blood Sodium Levels

Every month we ask top practitioners to address you health concerns. This month find solutions for memory loss, low blood sodium levels, and shoulder pain.


Recently I’ve had to go from my house to the car about three times before I can leave for work. I seem to be forgetting my phone, my coffee, and my other set of keys...sometimes even my computer! When I go to bed at night, I remember that one thing I was supposed to do, but forgot. Can you help me with some natural ways to boost my memory so I don’t feel so lost?
Many people feel a need to improve memory and recall, particularly if they have been misplacing items or forgetting things. In reality, though, making improvements in our ability to pay attention and focus is often what is needed to improve our ability to remember things.
One essential nutrient that has been shown to have an impact on brain function including attention—is citicoline or CDP choline. In recent studies it has been shown that daily supplementation with Cognizin (a specific brand of this nutritional supplement ingredient) improves attention capacity. Attention capacity refers to the brain processes that are related to the recognition and intake of new information. Results indicated that participants who were administered either the 250 mg or the 500 mg citicoline supplement showed significantly better attention capacity than participants who received placebo.
Cognizin citicoline provides a mechanism for the essential nutrient, choline, to be absorbed and available in the brain. While choline is found naturally in food, including eggs and meat, our bodies do not absorb choline very well as we age.
Citicoline is comprised of cytidine and choline and the presence of cytidine improves the absorption of choline in the brain. Brain imaging studies of Cognizin citicoline suggest it provides essential building blocks for energy production in the brain and improves focus, concentration and mood. Citicoline is also thought to increase release of brain neurotransmitters, such as dopamine, that are closely associated with cognitive function, particularly sustained attention and focus.

Question answered by Dr. Deborah Yurgelun-Todd, PhD, a professor of psychiatry at the University of Utah and director of cognitive neuroscience at the university’s Brain Institute.
I have severe pain in my left shoulder (rotator cuff). I do not want to have surgery if I can avoid it. However, it hurts to move it with any range of motion. What, if anything, can I do naturally to repair my shoulder from a bad tear in the rotator area? I have also heard that vitamin E helps prevent scar tissue from forming. Is that true?
The shoulder is the most mobile joint in the human body. Your body creates this incredible mobility through a series of muscles that surround the shoulder joint like the cuff on a shirt sleeve, hence the name “rotator cuff” to describe the shoulder muscles. The muscle most often injured is the supraspinatus, which runs over the top of the shoulder. This makes it painful to lift your arm away from the body, especially overhead.
Even if it hurts to move the arm, it is important to get some physical therapy to preserve the range of motion through gentle stretching and exercises.

Movement is essential to proper functioning of our bodies, so get a referral from your primary care doctor to see a trained physical therapist. Using and working the muscles represents the most natural way to heal muscle injury. If you stop moving the shoulder, you can develop a “frozen shoulder” where the muscles and tendons scar and severely limit shoulder movement. If the pain is too severe to allow you to participate in a rehabilitation program, you might consider a shoulder injection to reduce the inflammation in the shoulder first.
Another option to treat shoulder pain would be acupuncture. Studies are limited but there is some evidence that acupuncture may improve shoulder pain and function over the short term (2 to 4 weeks). It is a very safe form of alternative therapy, as well.
If you do need surgery to repair your shoulder, consider using guided imagery to prepare yourself before surgery. Studies show improved post-surgical outcomes with the use of guided imagery. Now, that’s harnessing the power of positive thinking!
In regards to your vitamin E question: Unfortunately, studies do not support either topical or oral vitamin E as effective therapies to prevent scar tissue from forming in the shoulder joint—or even to decrease scarring from a surgical wound post-operatively. So stick with the therapy and acupuncture, to aid the healing of your shoulder.
Question answered by Dr. Sue Park, MD, and Dr. Bernadette Clevenger,MD, who are both board certified in family medicine and practice at the HealthEast Grand Avenue Clinic in St. Paul, Minnesota. Clevenger is also board certified in holistic medicine and is pursuing certification mind body medicine.
Do you have any solutions to solving low blood sodium levels? My husband’s level remains at 133, the low end of normal is 135. He has greatly reduced the amount of fluids he drinks and adds either salt or bio-salt to his meals. This does not occur because he is a runner or because he is hot and sweats; it occurs all of the time with a fairly normal lifestyle. Could 133 just be a normal reading for him?
Hyponatremia, or low sodium, is a metabolic change that needs some medical detective work. When consistently low sodium levels appear in your blood work, it signals either a shift in kidney regulation or thirst center regulation. In addition, some medications can create this change.
Another factor is whether a person is severely dehydrated in certain circumstances, as this could depress the overall sodium in the body. Rehydrating with only water would aggravate the situation, so be sure to drink something more electrolytebalanced like coconut water. Gatorade is another commonly known rehydrating fluid, but it has a lot of high fructose corn syrup, and the gel packs can be good, too, but they have some salt and a lot of sugar.
The bottom line: find out the specific cause by working with a healthcare practitioner if your laboratory results are off.
Dr. Roberta Lee, MD, is the vice chair of the Department of Integrative Medicine at Beth Israel Medical Center, co-director of the Fellowship in Integrative Medicine, and author of The SuperStress Solution.