Edwin Y. Endo, OD Optometrists, Associates & Interns

We are the leading Provider in Eye Care and highly regarded professional Optometry establishment in honolulu for the entire family where Quality eye exams are Affordable with Excellence. Diplomate,  Board Certified Optometrists, Eye Doctor near you

header photo

alt     alt         alt              alt    alt        alt            

Natural Allergy Relief


Stuffy nose, watering, itchy eyes and dry mouth — these are just a few of the annoying symptoms of seasonal allergies. For many, allergies are more than annoying; they can seriously affect the quality of life.

But treating allergies isn’t always simple. Some medications come with side effectsthat are nearly as annoying as the symptoms themselves, and others just don’t work as well as we might hope. These natural allergy relief options could replace or support any current treatment options.

Natural options, including quercetin, butterbur, vitamin C and probiotics, may present allergy sufferers with the opportunity to manage symptoms without medication. Additionally, these options could be used to support an existing treatment plan if care is taken to avoid interactions. Let’s take a closer look at the science behind these claims.


Found in foods like apples, berries and grapes, along with onions and broccoli, quercetin is a natural antihistamine. In 2016, researchers documented its effects on allergies in the journal Molecules. Specifically, this nutrient acts to reduce inflammation and affects the immune system in a way that can improve allergic responses and asthma symptoms, even among those allergic to peanuts.

In addition to loading up on foods high in quercetin, taking a 500mg supplement is also an option for individuals hoping to improve their allergy symptoms. Green teas also contain this natural allergy remedy.


Found in marshes, butterbur is a plant-derived supplement can be taken in pill or oil form to improve allergy symptoms. 

According to the National Center for Complementary and Integrative Health, butterbur can be safely used to improve the symptoms of hay feverCaution: This supplement should only be taken under the direction of a healthcare provider since it can cause allergic reactions in certain individuals. 

Vitamin C

Vitamin C has been said to address the oxidative stress that plays a big role in environmental allergies, according to a 2018 study in the Journal of International Medical Research. More specifically, an antioxidant known as ascorbate keeps inflammation levels low, but individuals with allergies have been found to have low levels of ascorbate.

Taken intravenously, vitamin C was found to improve allergy symptoms in the study’s participants. At this time, giving patients a high dose of vitamin C isn’t common practice, but this research calls for clinical trials in the future. That being said, an earlier study suggested supplementing with 2 grams daily to help manage symptoms of allergies.


A healthy gut seems to have a widespread effect on human health and allergies are not excluded from convincing reasons to include probiotics in your diet. In 2017, researchers connected supplementation with three specific strains — lactobacillus, bifidobacterium bifidum and bifidobacterium longum — with improved quality of life for individuals suffering with allergies.

Probiotics can be purchased as a supplement and it is possible to find strain-specific choices. Adding fermented foods, like sauerkraut and kombucha, is another good way to increase dietary intake of these gut-friendly bacterias.

Allergies can be so much more than a nuisance. If your current treatment options aren’t working for you, talk with your healthcare provider about making adjustments to medications, exploring options like allergy shots, and experimenting with natural remedies until you find relief.

Copyright 2019,


People Who Wake up Early May Be at Risk




A new study shows a possible correlation between waking times and major cardiovascular events, such as heart attack and stroke. In fact, those who routinely wake up too early may be at a greater risk of dying from a sudden cardiovascular event than those who get the proper amount of sleep. Sleeping too much may also increase cardiovascular risks. So it's important to get the right amount of sleep. And, unfortunately, people are finding it increasingly difficult to get a good night's sleep. A 24-hour economy combined with an overload of responsibilities and an unending pressure to perform has left many sleep-deprived. 

Study Links Waking Early with Cardiovascular Risk

study conducted by the University College London Institute of Cardiovascular Science found that white Europeans were 1.3 times more likely to die from a cardiovascular event than South Asians and African-Caribbeans when they woke up too early. The study followed more than 4,000 people and found that those who regularly woke up earlier than intended or those who woke up feeling tired were at a higher risk of dying from a cardiovascular event.

White Europeans showed the most elevated risk. However, other ethnic groups also had an elevated risk, so this study should alarm everyone. Sleep quality did not seem to be a factor, according to the study.

Why People Aren't Sleeping Long Enough

A 2013 GALLUP poll revealed that 40% of people in the U.S. fall short when it comes to getting the recommended amount of sleep. Approximately 26% only get six hours of sleep, while 14% get five hours or less. But why? Why are Americans not getting enough sleep?

According to the poll, those who got the least amount of sleep had several things in common: they were employed, employed but considered low-income and had children. This all lends credence to the belief that life and responsibilities are increasingly getting in the way of a good night’s sleep. Additionally, the trend toward the 24-7 gig economy and the rising cost of living is putting even more pressure on sleep-deprived individuals.

As these don't seem to be going away anytime soon, we collected some research on sleep to try to help if the above is concerning.

How to Get the Perfect Amount of Sleep

The National Sleep Foundation recommends getting 7 to 9 hours of sleep per night, depending on age and a body’s individual needs. Those who feel groggy despite getting 8 hours of sleep may need to bump it up to nine.

It's also important to practice good sleep hygiene to get the most out of the hours devoted to sleep. Ideally, we should all go to bed and wake up at the same time each day to help prevent tossing and turning. Do not nap during the day. Get regular exercise, and take steps to make the sleep environment as comfortable as possible.

It turns out that sleep, whether too little or too much of it, may adversely affect cardiovascular health and raise the risk of sudden death caused by a cardiovascular event. For this reason, it's vital to get the recommended 7 to 9 hours of sleep on a regular basis. And if these tips don't help, visit a doctor and consider a sleep study because more than feeling rested may be at stake.

Copyright 2019,

European Academy of Neurology Guideline on Trigeminal Neuralgia European Journal of Neurology:

Visual Deficits and Dysfunctions Associated With Traumatic Brain Injury Optometry and Vision Science: Official Publication of the American Academy of Optometry



  • This systematic review and meta-analysis of 22 publications found that the most prevalent visual disturbances resulting from traumatic brain injury (TBI) are accommodative dysfunction (42.8%) and convergence insufficiency (36.3%). Mild TBI was associated with visual field loss in patients at the rate of 6.6%, with 0% cases of loss in visual acuity. However, moderate to severe TBI was associated with visual field loss in patients at the rate of 39.8%, along with loss in visual acuity in 3.2% cases.
  • Assessing visual acuity alone may not be enough to determine visual disturbances after TBI, and clinicians should assess accommodative and vergence functioning as well as visual fields in these patients.

– Kathleen Freeman, OD, FAAO

The Power of a Smile


Smiling, not the kind where you've been asked to smile by some schmoozy guy, but the act of it—the lift the corners, feel the boost kind of smile (even if you don't mean it) is actually beneficial to your well-being and can help improve our outlook on life. It turns out that this simple action not only makes us feel better in reality, but it's infectious and can make other people feel at ease in our presence, too. If boosting others isn't reason enough to smile, research has also found that smiling may help lower your blood pressure and heart rate.

Smiling may have more power than we realize. Besides helping other people feel at ease in our presence, there are actually health benefits that come from unleashing a smile. Discover why it's a practice you should start today, even if you have to fake it at first.

The Health Benefits Behind Smiling

Smiling may be good for heart health. The practice can reduce stress and may help lower blood pressure. A study found that individuals who smiled after taking part in a stressful activity had lower heart rates than their non-smiling counterparts.

Surprisingly, researchers also found that smiles did not have to be genuine to be of value. Although those who expressed genuine smiles did have lower heart rates after stressful activities, everyone who smiled benefited in comparison to those who kept a neutral expression. This tells us that just the mere act of smiling can have an effect on the body's stress response, even if the person secretly felt unsure about smiling.

The Brain and Smiling

The act of smiling releases feel-good-hormones, such as dopamine and endorphins. Serotonin is another mood elevator that is present, and it can act as an antidepressant. Every time you smile, these hormones are released, allowing you to get the benefit of a feel-good rush. It's suggested then, that even when you don't feel like smiling, doing so anyway may help improve your mood and change your overall outlook.


The Psychological Pull of Smiling

Smiling and sharing your smile with others can do wonders in just about any setting. There are theories that claim most people look their best when they smile. By smiling at strangers, we put our best foot forward. This could be especially helpful in the case of a first date or a job interview. Smiling shows others that we're friendly. Even if we don't actually engage with them, we could have a positive effect on someone's day, just by flashing them a smile.

Given that smiling can help make a positive difference in our day, especially following stressful activities, it makes sense that even if we have to fake it until we feel it, we can still improve our mood by passing on the positive feelings to everyone around us—and then absorbing them back in as they reflect back to us so that we all feel better.

Copyright 2019,

Is Adrenal Fatigue Real? And If so… Then What?


The term “adrenal fatigue” has gained recent popularity as one possible cause of an apparent epidemic of gut problems, sleep disturbances, anxiety and fatigue. But is it even real? What can you do if you’re suffering?

“Adrenal fatigue” is a term naturopaths use to describe the long-term effects of stress on the body. Symptoms include extreme fatigue, digestive issues, anxiety, insomnia and sweet or salty food cravings.

Is Adrenal Fatigue Real?

According to Endocrine News, the term “adrenal fatigue” comes from a naturopath named James L. Wilson, DC, ND, PhD. Wilson claims chronic stress can burn out the adrenal system, leading to a slew of symptoms.

Authorities note that there is an actual condition, known as chronic adrenal insufficiency, in which the adrenal glands become underactive. Fatigue is one symptom of the disorder— along with weight loss, nausea, vomiting, diarrhea, joint pain, low blood pressure and dry skin. But whereas chronic adrenal insufficiency can be confirmed through diagnostic testing, “adrenal fatigue” cannot.

So, What Is It?

Fatigue, insomnia, anxiety and digestive issues can result from a number of other health issues, including autoimmune diseases, anemia, infections and problems with the heart, liver or kidneys. These medical issues should be ruled out before your doctor considers other possibilities. But what if a physical exam and blood tests don’t offer any answers?

The symptoms attributed to adrenal fatigue also have strong similarities to fibromyalgia and depression. This would explain why self-care — improving diet, implementing more exercise, getting enough sleep and reducing stress — appears to have such a positive impact on patients’ symptoms. Both fibromyalgia and depression can cause profound fatigue, digestive issues, anxiety and insomnia, but both are also treatable.

Although research seems to indicate that this condition is based on one doctor's opinion rather than any substantiated studies, the symptoms and effects are certainly causing people to suffer. The way that these symptoms can be part of many different causes, may mean that those who accept a diagnosis of "adrenal fatigue" are not being treated for other conditions. It's probably best to continue testing and work to see what the true underlying cause is rather than to accept a fast diagnosis that may be being used in some cases as a catch-all.

Catch-all diagnoses can prevent people from getting care for other conditions, so we urge anyone who has these symptoms to please see a doctor. The answers are possible, but sometimes we have to be persistent.

Copyright 2019,


Autism, Epigenetics and Unconditional Love


Several clients have asked me what they can do before conception and during pregnancy to prevent autism in their future children. The short answer is that autism is not 100% preventable because there isn’t a way to erase all the risk factors altogether. However, there are modifiable nutritional and lifestyle factors (epigenetic variables) that can greatly reduce risk. Here is a summary of what I’ve learned and seen along the way through scientific articles, clinical experience and observation of the world around me. 

Epigenetics and Unconditional Love

It’s impossible to talk about autism risk without talking about epigenetics, and it’s impossible to talk about epigenetics without talking about unconditional love.

Epigenetics provides a lens to improve health and quality of life before conception even occurs. Don’t you just love the idea of leveraging the empowering aspects of epigenetics by starting wherever we are along the timeline and doing what we can to optimize our quality of life while being aware and appreciative of differences and uniqueness?

This is diametrically opposed to eugenics, which persecutes people who don’t meet some culturally defined standard of physical and/or mental “fitness.” If you’re getting ready to start or grow a family, step into a space where epigenetics and unconditional love are inextricably connected. It’s understandable if you’re afraid of having a child with autism, and to seek out a fool-proof way of preventing it.

However, there aren’t any guarantees. While you can lower the risk, you can’t completely eliminate it. Thus, unconditional love of your future child means openness to the idea that while you can give your child the best possible conditions, you can’t control everything. In other words, becoming a parent means embracing the unknowns and loving your child, no matter what. It means not blaming yourself if your child doesn’t meet your ideals or your family’s or your culture’s ideals. 

What are some of the risk factors for autism?

Autism is an incredibly complex and still poorly understood multi-factorial condition. We cannot fully prevent autism or any other widespread multi-factorial condition, but we can work on all of the modifiable variables within the list of known or suspected causative and contributing factors. There are likely combinations of factors from among the following that affect susceptibility to autism: 

  • Genetics
  • Epigenetics (environmental factors that alter the expression of DNA and can activate or de-activate latent susceptibilities)
  • Toxic exposures – please be aware that nobody can fully avoid them, and that we each have a unique sensitivity threshold
  • Immune dysregulation – autoimmune illnesses, and possibly some kinds of infections in utero
  • Folate need and/or methylation issues
  • Individual nutritional deficiencies and needs in mom and baby.

The Hypermobility-Autism Connection

Over the years, I've noticed in my nutritional therapy practice that there is an overlap both in individuals and in families between signs and symptoms associated with autism and those associated with joint hypermobility. For example, a lot of my female clients with Hypermobility Spectrum Disorder and/or hypermobile Ehlers-Danlos Syndrome have a child who is somewhere on the autism spectrum, and many of my clients with ASD are also hypermobile, or have a parent with hypermobility or a related condition, such as fibromyalgia. 

I’m not sure whether hypermobility is a causative factor for autism spectrum disorder, a downstream effect, or a bit of both. However, I've also noticed that my clients/families with hypermobility/ASD presentations tend to have issues with a combination of heavy metal toxicity and dysregulated essential minerals. I think that the poor digestive and immune function of people with hypermobility/ASD can be a set-up for the poor regulation of metals and minerals in the body, with repercussions for many areas of functional health. 

Putting it all together

While we can’t control all of the risk factors that might play into autism, there are many modifiable epigenetic factors that we can leverage in our environment, nutrition and lifestyle in order to reduce the risk. Nonetheless, all the wonderful work that goes into prevention efforts should always occur with a spirit of unconditional love rather than with the illusion of full control over the outcome.

Sara Russell is a Nutritional Therapy Practitioner who works remotely with clients worldwide, specializing in complex health conditions. Sara approaches each client’s health goals foundationally, from a root-cause-oriented, bio-individual and client-centered perspective. You can learn more about Sara’s work at

8/14/2019 7:00:00 AM
Sara Russell
Written By 
Sara Russell is a Nutritional Therapy Practitioner who works remotely with clients worldwide, specializing in complex health conditions. Sara approaches each client’s health goals foundationally, from a root-cause-oriented, bio-individual and client-centered perspective. You can learn more about Sara’s work at https://bu...

What is the Best Time of Day to Exercise?


Making time for exercise can be tough. For those who have carved out an hour of precious free time to hit the gym or head outside, the hope is that every minute will count. So here’s the big question. Will exercising in the morning or evening make a workout more effective? Preliminary research reveals some great suggestions but has some caveats, too. Here's the latest research linking time of day with optimum results.

Time of Day and Exercise: Is There a Link?

Getting a jump start on your workout first thing in the morning may seem like a good plan, but is it really? In July of 2019, research published in Cell Metabolism linked time of day to the effectiveness of the exercise. Specifically, the researchers in charge of the studies hoped to see if planning exercise based on body changes caused by hormones throughout the day could increase the benefits of physical activity.

The research was gathered based on both mice and human participants, and the results suggested that working out in the evening may increase calories burned. That being said, the researchers were pretty clear that these are just preliminary findings and that more information is needed to make a definitive recommendation on when to workout.

Working Out for Better Sleep

Although evening workouts may seem appealing based on the above and the ability to head to the gym on the way home from work, those who have trouble sleeping might need to think twice about committing to an early evening workout. A lot of people are invigorated by exercise and will struggle to doze off when getting active before bed. Additionally, a person who is having trouble sleeping may have their circadian rhythms affected by evening workouts, exacerbating the problem. Getting outside and exercising early in the day could play a role in encouraging wakefulness in the morning and resetting circadian rhythms.

Ultimately, it's hoped that readers won't use this news as an excuse not to exercise if the morning is the only time available to them. The perfect time for exercise is whenever you can make it work without disrupting your sleep schedule. Some may find that early evening workouts are better suited to them, but it’s important to note that the best time of day to get moving is the one that you’ll be able to stick with over time. Consistency is most important when it comes to any workout plan.

Longitudinal Changes in the Peripapillary Retinal Nerve Fiber Layer Thickness of Patients With Type 2 Diabetes JAMA ophthalmology



  • Using spectral-domain OCT measures of peripapillary retinal nerve fiber layer (pRNFL), the authors found a reduction in the pRNFL thickness among control eyes, eyes of patients with diabetes without diabetic retinopathy (non-DR group), and eyes of patients with nonproliferative diabetic retinopathy (NPDR) over a period of 3 years. However, the annual rate of reduction of pRNFL thickness was 3.3 times faster in the NPDR group and 2.9 times faster in the non-DR group than in controls.
  • These findings should be considered by clinicians when evaluating the pRNFL for glaucoma or other optic nerve disease.

– Kathleen Freeman, OD, FAAO


Progressive reduction of pRNFL thickness was observed in healthy controls and patients with type 2 diabetes without and with DR; however, type 2 diabetes was associated with a greater loss of pRNFL regardless of whether DR was present. These findings suggest that pRNFL loss may occur in people with type 2 diabetes even in the absence of DR progression.


Artificially Sweetened Beverages, Stroke, and Dementia



  • The association between sugar- and artificially sweetened drink intake and risk for stroke or dementia was evaluated in the Framingham Heart Study Offspring cohort. After adjusting for multiple confounders, both recent intake and cumulative intake of artificially sweetened drinks were associated with significantly greater risks for ischemic stroke and dementia.

  • Similar associations were not found for sugar-sweetened drinks.

  • This study should not be taken as suggesting that sugar-sweetened beverages are okay. We know that too much sugar is associated with many negative outcomes, including obesity, dysbiosis, and metabolic dysfunction. But the study should lend some caution as to the safety of artificial sweeteners. One that has had the most controversy is aspartame.

    Aspartame is composed of 50% phenylalanine, 40% aspartic acid, and 10% methanol. One of several potentially toxic byproducts of aspartame is formaldehyde. Humphries et al summarized the potential cellular mechanisms aspartame has on the brain in the European Journal of Clinical Nutrition.1 They state that aspartame disturbs integrity of neuronal function, causes nerves to fire excessively, depletes ATP function in mitochondria, and causes dysfunction of the endothelium, leading to a compromised blood–brain barrier. The literature has mentioned concern for aspartame in relation to headaches, malignancies, and learning disabilities.

    This was an observational study and thus causation cannot be made. An additional caveat to keep in mind when interpreting the results of this study is that participants with diabetes, who are more likely to develop stroke and dementia, also consumed more artificially sweetened beverages. While the authors adjusted for diabetes in supplementary analyses, it is likely that residual confounding in both primary and supplementary analyses has not been eliminated.

    But this study is reminder that nature is smarter than we are. We are likely better off eating whole foods artfully combined by a good chef than a processed food put together by a biochemist.

View older posts »