Your thyroid is a master gland at the base of your neck which helps control your metabolism. If your thyroid function is sub-optimal (on the low side), you may experience symptoms such as fatigue, difficulty losing weight, depression, foggy thinking, hair loss, cold extremities, and feeling burned out. This could be the case even if your thyroid tests look “normal” by conventional standards.
If your thyroid hormones are truly out of the “normal ranges”, you will most likely be prescribed Synthroid or levothyroxine, which is a synthetic form of the thyroid hormone, T4. However, this T4 needs to be converted into the active thyroid hormone, free T3. Many patients that I see have T4 levels that look fine or even on the high side of normal, but they still have symptoms. Giving them more T4 won’t help! We need to promote the proper conversion of T4 into T3, and some patients do better when we switch them from Synthroid to Desiccated Thyroid (which contains a little active T3 in it).
So, here are 5 ways to help improve that T4 to T3 conversion, in order to boost your metabolism!
1) Get enough sleep
If you aren’t getting enough sleep, you aren’t giving your body a chance to produce enough Growth Hormone (produced in your slumber). Growth Hormone increases that T4 to T3 conversion. If you’re having trouble sleeping, you could also have a melatonin deficiency, a hormone which you produce when it is dark and which helps make you sleepy. Melatonin is also needed for proper T4 to T3 conversion.
2) Get adequate protein in your diet
Protein is essential as a building block for tissue repair and proper enzyme function in your body. The average person needs about 60-70 grams of protein per day. You can get this from lean protein sources such as fish, chicken, eggs, nuts, hemp hearts and other seeds, and legumes (however, if you have an autoimmune thyroid issue, some of these may not be recommended). Avoid soy protein sources, especially the non-fermented ones, as they can slow down thyroid function. Enough protein in the diet helps build muscle, decreases fat storage, improves satiety, decreases cravings for sweets, and helps burn more calories.
3) Balance your blood sugar
Foods high in sugar or refined carbohydrates (found in processed foods, white flour, fluffy breads, bagels, and most baked goods) spike up your blood sugar, which leads to insulin being released to help bring the sugar into your cells. Guess what insulin does… It decreases the conversion of T4 into T3, resulting in less active thyroid hormone! Eating a mostly plant-based, unprocessed diet, with adequate amounts of protein, helps to balance blood sugar levels, keeping them more steady and avoiding the big insulin-triggering spikes.
4) Decrease stress
Chronic stress leads to the production of the stress hormone cortisol. Cortisol interferes with proper metabolism in several different ways. First of all, it decreases the conversion of T4 into T3. It also shunts some of the T4 away from producing T3, and into producing reverse T3 instead. Reverse T3 functions as a brake on metabolism! Also, chronic stress decreases the ability of insulin to effectively bring sugar into the cells, leading to more insulin being needed for the same effect (insulin resistance)!
5) Optimize essential nutrients and vitamins (especially selenium, iodine, zinc, iron, Vitamin A, Vitamin B12, Vitamin D)
These essential nutrients are very important for producing enough thyroid hormone, and some are also useful if there is an autoimmune thyroid issue such as Hashimoto’s thyroiditis. Work with a naturopathic doctor to ensure you have optimal levels of these, supplementing when necessary. It is possible to take too much of these too, so make sure you’re taking the right amounts for you!
Still feeling sluggish and having trouble losing weight? I can help!
Working with a naturopathic doctor can help you eliminate the guesswork, get some testing done, and approach your goal in an individualized and systematic way. There are so many factors as play regarding metabolism, many of which I did not mention here. Come on in for a visit, and we’ll get you started on a program tailored for you!
Bray GA, Smith SR, de Jonge L, Xie H, Rood J, Martin CK, Most M, Brock C, Mancuso S, Redman LM. Effect of dietary protein content on weight gain, energy expenditure, and body composition during overeating: a randomized controlled trial. JAMA. 2012 Jan 4;307(1):47-55.
Image from 123RF.com, Copyright: <a href='https://www.123rf.com/profile_magone'>magone / 123RF Stock Photo</a>
Scott, TD, Speidel, K. (2017). Essential Elements of Prescription Hormone Compounding. LP3 Network. Conference 2017 Apr 29-30.
We have all heard about probiotics, and how good they are for us. We have probiotic yoghurts, fermented foods, kefir, and probiotic gum easily available to us. After taking antibiotics, many of us know that it’s a good idea to replenish our good bacteria and load up on probiotics. As a naturopathic doctor, a recommendation for a good quality daily probiotic is very common for most of my patients.
However, there is a subpopulation of my patients for which this is NOT a good idea. At least, not initially. These patients actually have an overgrowth of bacteria in the small intestine, and giving them probiotics can actually make them worse if we don’t treat the underlying condition first.
Most of these patients have already been diagnosed with Irritable Bowel Syndrome (IBS). However, the diagnosis of IBS doesn’t actually tell them what is causing it, just that their bowel is irritable and that they most likely don’t have a more serious condition. Since I have started testing for it, I have found that many of my IBS patients actually have Small Intestinal Bacterial Overgrowth (SIBO) as the underlying condition. Furthermore, even if you have a diagnosis of Celiac disease, Colitis, or Crohn's, you may still have SIBO: those with these conditions actually have a 3-fold increased risk of developing SIBO, because of all of the gut inflammation, and its effect on the nervous system surrounding the digestive tract.
So, what might be some indications that you might have SIBO?
5 Key Clues That May Indicate SIBO
1) Bloated all the time
You may start off the day with a relatively flat stomach, but as the day progresses, you go up a few sizes and may look pregnant! This might happen no matter what you eat. Or, you may have identified a few foods that make things worse, but even when you avoid them, you still get some digestive symptoms.
2) You feel worse with high fibre and/or sugary foods
A diet high in fibre can lead to increased fermentation of food by bacteria in the small and large intestines, and if you already have an overgrowth of bacteria, you can imagine that this could lead to increased gas. Sugary foods, and/or foods high in certain types of carbohydrates (high FODMAPs foods), also feed the bacterial overgrowth, and can worsen symptoms. And it’s not just bloating that you could experience. Depending on the predominant type of bacteria present, hydrogen-producing of methane producting, you could also experience diarrhea and/or constipation, or even heartburn.
3) You have a history of bacterial gastroenteritis
If you’ve had a bad stomach bug, or haven’t been well after “traveller’s diarrhea”, this may have set off the fine balance in your gut and contribute to SIBO. You may have also been put on strong antibiotics, which can kill off some of your good bacteria and allowed less beneficial bacteria to thrive.
4) Your thyroid is sluggish
You may have been diagnosed with hypothyroidism, or have sub-laboratory hypothyroidism (your thyroid function may not be slow enough to be prescribed Synthroid for it, but you have symptoms). Either of these can slow down your digestive system and the transit time down the digestive tract, allowing bacteria more time to ferment it.
5) Taking probiotics makes you worse
This makes sense, as, if you have an overgrowth of bacteria in the small intestine, populating with more bacteria, even the “beneficial” ones, could make things worse. Not everyone with SIBO gets worse with probiotics, but most SIBO patients don’t feel significantly better on them if we don’t get rid of the overgrowth first and make sure that the sweeping function (migrating motor complex) of the small intestine is working properly beforehand.
Does this sound like you?
Have you been struggling with ongoing digestive issues but haven’t had a breakthrough yet? Come on in for an assessment, and we’ll see if testing for SIBO would be a good idea for you!
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Khangura, P. (2017). Superseding SIBO. Webinar 2017 May 13.
You’re feeling overwhelmed, your body doesn’t listen to you anymore, you’re exhausted but you can’t sleep, you’re gaining weight around the belly, and you have your suspicions that chronic stress is to blame. You may have read my previous blog about adrenal fatigue, and figured that your adrenal glands are likely getting exhausted from working overtime to help you cope in a stressful world.
But the symptoms of adrenal fatigue are wide and varied. How can you test and find out how healthy your adrenal glands really are? Furthermore, how do you find out which stage of adrenal fatigue you may be in?
I use a ranked questionnaire shared by Dr. Tara Scott and Dr. Ken Spiedel at a conference I recently attended, which uses symptom severity and an algorithm to figure out your most predominant hormone imbalances. While this is not a fool-proof test, it allows us to get an idea of what are most likely to be your top 3 hormone imbalances. The results from this simple questionnaire tend to correlate well with the results from hormone testing, helping direct further objective testing. It can help us identify if most of your symptoms are likely from too high cortisol, too low cortisol, both, or something else altogether.
During a physical exam, there are a few specific tests I can do that indicate if you are likely in Stage 3 adrenal fatigue, where your cortisol production goes down. The first test looks at your pupil’s reaction to light. I shine a light in your eye, and see if you can maintain your pupil’s constriction for a short period of time. If you can’t, or your pupil closes and then opens in this time frame, this is one possible indication that your adrenal glands are fatigued, as it correlates with your adrenaline levels (also produced by the adrenal glands).
The second test I do in-office is checking your blood pressure lying down, and then standing up (called orthostatic blood pressure). Generally, when you get up, you should be able to bring your blood pressure up by about 10 points within one minute. If it stays the same or goes down, it could be a sign of hypoadrenia. Again, other factors can affect this, including medications that you’re on.
This test will likely be positive (blood pressure will stay the same or go down when you get up) if you are in Stage 3 adrenal fatigue. However, if you’re in Stage 1 or Stage 2, or even early Stage 3 adrenal fatigue, this test may still look normal.
Salivary Hormone Testing
Salivary hormone testing for cortisol and its precursor, DHEA, is the preferred method for testing adrenal function. Cortisol is the main hormone produced by the adrenal glands during chronic stress. There are several advantages of this method over doing a blood test for cortisol:
1) Salivary testing avoids falsely elevating cortisol levels from doing a blood draw. Pricking or lancing has been shown to increase cortisol levels just because of the anxiety the procedure causes for many people, whereas spitting into a tube in the comfort of your own home usually does not.
2) Salivary testing can be done several times throughout the day, allowing us to see the normal (or abnormal) daily variation of cortisol. Blood is not convenient to test more than once during the day. However, cortisol levels usually are highest in the morning, and then decrease during the rest of the day. Seeing where your levels fall at 4 different time points allows us to more accurately assess which stage of adrenal hypo-functioning you may be in.
3) Salivary testing allows us to identify the level of cortisol that is actually getting to your tissues, where it acts (the active cortisol). Blood levels usually use very large “normal” ranges, and include both bound (inactive) and free (active) cortisol.
Blood Levels of Cortisol
As mentioned above, this is not the preferred method. But, if we want to screen out more serious conditions of the adrenal glands, such as Addison’s Disease (extremely low adrenal function) or Cushing’s Syndrome (abnormally high cortisol), blood tests could be used.
Ready To Test?
If you suspect your adrenals are near or at burnout, or you are under chronic stress, don’t delay in pursuing treatment with a naturopathic doctor. The health of the adrenal glands is intertwined with that of so many hormones, so make sure you take care of these little soldiers before they’re too exhausted to take care of you!
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Rocky Mountain Analytical (2014). Adrenal Function Panel: Clinical Information for Professionals. January 2014.
Scott, TD, Speidel, K. (2017). Essential Elements of Prescription Hormone Compounding. LP3 Network. Conference 2017 Apr 29-30.
We all deal with stress. Stressors such as losses, job interviews, presentations, medical diagnoses, lack of sleep, job and home life balance, or challenging relationships can make us feel overwhelmed. Our bodies should be able to deal with these stressors, for a short period of time. And that’s the key: for a short period of time. The problem is, most of us are chronically stressed!
How Heavy Is The Burden You Carry?
You’ve probably heard of the analogy of holding a glass of water. Hold it for a minute, and it feels light. Hold it for an hour, and your arm will start to ache. Hold it for a day, and your arm will be numb and the glass will feel unbearably heavy. We often don’t remember to put the glass down until it’s too late. Until we have seen the repercussions on our body, mediated primarily by our adrenal glands, these little soldiers that sit on top of our kidneys, trying to fight for us.
Fight Or Flight
Your adrenal glands perceive any form of stress, whether it is a physical, emotional, environmental, biochemical, or spiritual stress, and respond the same way: by trying to produce either adrenaline (short-term) or cortisol (long-term). They are responsible for our fight or flight response: when our body assesses its environment and deems it unsafe, it prepares us for battle, getting our blood pumping, shifting our resources away from digestion and into our muscles and brain so that we can run from danger or fight it head on. But if this goes on for a long period of time, we will get exhausted, as it’s just not sustainable.
How Chronic Stress Affected Me
When I graduated from naturopathic medicine, and shortly after writing my licensing exams, my adrenal glands were in rough shape. I had pushed myself through medical school, but once the stressor was over, it was difficult for me to peel myself off the couch or do any exercise at all. I had survived on insufficient sleep, caffeine, deadlines, and willpower, but in the process, my digestion was a mess, and I was constantly battling fatigue throughout the day. Any new stressor made me feel overwhelmed. Luckily, as a new naturopathic doctor, I knew that my adrenal glands were in need of some tender loving care. I was probably near burnout. It took me a good year before I felt a lot better, and a few years more before I felt better than I had years before, during my undergraduate and naturopathic medical school studies.
You don’t need to be near breaking point before realizing that your adrenal glands need some help, and that stress is affecting your body in various ways. It’s best to catch it in the early stages, when it’s easier to shift back to balance.
Adrenal Fatigue Stages
You may have heard of the term “adrenal fatigue” (or adrenal insufficiency, hypoadrenia) from naturopathic doctors and integrative medical doctors. This term really refers to an older concept founded on Dr. Hans Selye’s research (a Canadian endocrinologist), called “General Adaptation Syndrome”. If we are under stress for long enough, we move through the different stages of adaptation to chronic stress, from the alarm stage, to the exhaustion stage. At the end of the exhaustion stage is burnout. You don’t want to get to the exhaustion stage if you can prevent it!
Stage 1 – Alarm
In this initial alarm stage, the body panics a little and tries to mobilize its resources. You might have a temporary decreased resistance to stress as your body starts to produce more cortisol to deal with the chronic stress, and you mobilize your energy sources from fat and muscle. Some people will lose weight in this stage.
Stage 2 – Resistance
In this stage, the adrenal glands actually grow in size as they try and keep producing more cortisol. But the high cortisol will wreak havoc on the body. Symptoms of high cortisol include:
-feeling tired but wired
-anxiety and nervousness; heart palpitations
-depressed mood; irritability; mood swings
-brain fog, confusion; memory problems; decreased concentration
-decreased sex drive
-hot flashes; night sweats
-weight gain around the middle
-more frequent colds and flus
Stage 3 – Exhaustion
In this stage, the adrenal glands can’t keep up with the production of cortisol and eventually cortisol production goes down. Any added stressor will be more difficult to deal with, as your resilience goes down. While cortisol levels fluctuate throughout the day, your highest levels of cortisol should be in the morning. Morning cortisol levels are also the last ones to drop in hypo-functioning adrenals. Cortisol helps keep us alert. So if you are having trouble peeling yourself out of bed, and you have late afternoon energy crashes, you may be in this stage.
At this stage, you may have symptoms of both low and high cortisol all at once. Symptoms of low cortisol include:
-burned out feeling
-cold body temperature; cold extremities
-cravings for sweets and/or salt
-joint pains; muscle pains
-low blood pressure
At the end of naturopathic school, I was definitely into Stage 3. Luckily, there are things we can do to help you deal with the stress and rebuild the health of your adrenal glands.
Do you need to put your glass down?
Do you think you might suffer from adrenal fatigue? In my next blog, I will discuss testing methods for assessing the health of your adrenal glands, so that you can know which stage you’re in and we can treat more specifically based on your needs.
But if you’ve read this and think you’re in the later stages based on your symptoms, don’t wait! Come on in for a visit, and I’d be happy to help you start to feel better. And don’t forget to put your glass down!
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Selye, H. (1998). A Syndrome Produced By Diverse Nocuous Agents. Journal of Neuropsychiatry, Spring 1998; 10(2): 230-231.
Scott, TD, Speidel, K. (2017). Essential Elements of Prescription Hormone Compounding. LP3 Network. Conference 2017 Apr 29-30.
The connection between liver health and the skin is well-known, especially in serious liver diseases. For example, a yellowing of the skin is seen with liver cirrhosis, a condition in which scarring replaces normal functioning liver tissue. Pruritis, or skin itching, can also be associated with liver disease.
The reason? The liver is one of the major detoxification organs in the body. It filters the blood and processes, breaks down, and packages major toxins (metabolites, alcohol, caffeine, medications, hormones, environmental pollutants) that your body is exposed to, in order to either make them more usable by the body, or to eliminate them. If this “processing plant” is overburdened and starts to work more sluggishly, the toxins need to go somewhere. Often, in an attempt of the body to get rid of them, many will end up in the skin, a secondary organ of elimination, and also our largest detoxification organ. Even if you don’t have a serious liver disease, your liver enzymes may not be working as optimally as they could, with repercussions showing up elsewhere, such as your skin.
Therefore, in order to have healthy-looking skin, you want to make sure that your primary organs of detoxification are working properly.
Supporting Your Primary Organs of Detoxification
Our primary organs of detoxification include the liver, the intestines, and the kidneys.
1) Drink Enough Water
You can support kidney detoxification by drinking a sufficient amount of water, typically about 2L a day for the average person (preferably mostly away from meals to prevent diluting your digestive enzymes too much). As a rule of thumb, you should be drinking about half your body weight (in lbs) in ounces (i.e. for a 150 pound person, 150/2 = 75 oz, or roughly 9 cups). This helps you eliminate water-soluble toxins from your body, with the added bonus of plumping up your skin and decreasing the visibility of wrinkles.
2) Clean Up Your Diet
Reduce foods in your diet that will put more burden on your digestive system and on your liver. This includes processed food and sugar, alcohol, caffeine, and food sensitivities. If you’re not sure about your food sensitivities, book an appointment and I’ll run a simple lab test or help you identify them through an elimination diet. You’ll also want to include foods that help improve liver function, including leafy green vegetables, cruciferous vegetables, berries, turmeric, and sufficient protein.
3) Take Probiotics
Probiotics are essential for a healthy gut and immune system. They can be obtained from fermented foods in the diet, but this can be problematic since many people with skin conditions cannot tolerate cow’s dairy, including regular yoghurt. An alternative yoghurt, such as sheep or goat yoghurt, could be an option if they are better tolerated. However, probiotic supplements may be your best option. With supplements, we can be specific about which strains of probiotics we are using, as each strain has a slightly different effect on the immune system. For example, I use a different blend with a patient with acne versus someone suffering from an autoimmune condition such as psoriasis.
4) Drink Lemon Water
One simple addition you can try at home that gently supports liver function is starting the day with a large glass of lemon water (about 500mL of water with the juice of about ¼ of a lemon). You’ll want to wait about half an hour before having your breakfast afterwards. Again, you don’t want to dilute your digestive enzymes!
5) Use Nutraceuticals To Support Liver Detoxification
With many skin conditions, including acne and eczema, I see the fastest improvement when we include some liver supporting herbs and nutrients into the treatment plan. These can include high quality, concentrated extracts of milk thistle, dandelion, turmeric, B vitamins, and other nutraceuticals. Because these supplements can interfere with medications you are taking, or could have side-effects, work with a naturopathic doctor who can recommend the best avenue for you, monitor your progress, and modify your treatment plan if necessary. A word of caution: liver supporting herbs can initially worsen a skin condition, especially if the intestines are not working well, or if you start too much, too quickly.
Do you want healthy, glowing skin from the inside out? Then making sure that your body’s primary organs of detoxification are working to your full advantage is extremely important. I can help you identify your food sensitivities, heal your digestive system, and support proper liver detoxification through an individualized program tailored to your specific needs.
If you’ve dealt with a skin condition, such as acne or eczema, you’ve probably tried a series of different skin regimens to help improve your skin. I know what it’s like. I’ve been there, struggling with eczema, which ultimately led me to a career change from biochemical research to naturopathic medicine. You see, no matter how much I diligently used my cortisone creams and moisturizers, it kept coming back, and I knew I needed to look deeper for the answers. I found the answers were not merely skin deep. The answers were in my gut!
Naturopathic medicine has long taught that skin conditions need to be addressed through the health of the gut, and that the gut and the skin are intimately connected. When you think about it, the inside of your digestive system is like an internal continuation of your external skin. We now know that a huge part, about 80%, of your immune system lies in your gut, and that many skin conditions are associated with a dysregulation of the immune system. Your gut is your first line of defense against pathogens, and regulates your immune system’s response to different foods, toxins, and micro-organisms.
To have healthy skin from the inside out, you must first address the health of your gut! This is primarily how I address skin conditions in my practice, from the inside out, and I have seen great improvements in my patients’ skin conditions using this approach.
Skin Conditions Associated With Digestive Issues
If the link between digestive issues and skin conditions is real, we would expect to see a strong correlation between digestive diseases and skin conditions. And we do see this. For example:
-Acne rosacea, an inflammatory condition of the skin on the face, is associated with a higher prevalence of gastrointestinal complaints (including Celiac disease, Crohn’s Disease, Ulcerative Colitis, H. pylori infection, Small Intestinal Bacterial Overgrowth (SIBO), and Irritable Bowel Syndrome (IBS)) than in the general population (Egeberg et al., 2017).
-Eczema and other rashes have been associated with reactions to certain foods, including in a condition called Non-Celiac Gluten Sensitivity (Elli et al., 2015).
-Dermatitis herpetiformis is a skin condition found in ¼ of patients with Celiac disease (Kresser, 2012)
The Leaky Gut, Leaky Skin Connection
We now know that chronic inflammation and damage to the gut lining can lead to a state of intestinal hyperpermeability, where food particles and microbial toxins that shouldn’t get through do get through, leading to what we call a “leaky gut”. This damage could happen as a result of many things, including food sensitivities, genetically modified foods, an imbalance in gut flora (the microbes in the gut), infections, and chronic stress.
Many of these things worsen skin conditions as well. Stress not only impacts the gut barrier, it also makes the skin barrier more permeable, which is why you may experience a worsening of your skin condition when you are particularly stressed (Slominski, 2007). If the gut is leaky, this also influences the immunity of the skin, making it produce less protective anti-microbial peptides.
Another aspect of the gut-skin connection, which I will address in a later blog, has to do with detoxification. If the gut, a primary organ of detoxification, is compromised, then the body will try and detoxify through other means, including the secondary detoxification systems, which includes the skin.
Treating The Gut Improves The Skin
Treating skin conditions definitely requires a multi-faceted approach. However, in my practice and in my own personal experience with eczema, I have seen a tremendous improvement in skin conditions by addressing the health of the gut first and foremost. For example, including probiotics in the diet, either through fermented dairy or through probiotics, can significantly improve the severity of acne vulgaris. Treating SIBO in a patient with acne rosacea is likely to improve their rosacea symptoms. Removing gluten in the diet usually resolves dermatitis herpetiformis.
So why just stick to skin deep treatments when you can address the root cause(s) of your skin condition? Changing my diet and healing my leaky gut has been extremely important in helping me minimize my eczema. A similar approach has helped countless of my patients, and I’d love to help you too!
Egeberg A., Weinstock L.B., Thyssen E.P., Gislason G.H., Thyssen J.P. (2017). Rosacea and gastrointestinal disorders: a population-based cohort study. Br J Dermatol., 2017 Jan;176(1):100-106. doi: 10.1111/bjd.14930.
Elli L., Branchi F., Tomba C., Villalta D., Norsa L., Ferreti F., Roncoroni L., Bardella M.T. (2015). Diagnosis of gluten related disorders: Celiac disease, wheat allergy and non-celiac gluten sensitivity. World J Gastroenterol., 2015 Jun 21;21(23):7110-7119.doi: 10.3748/wjg.v21.i23.7110
Kresser C. (2012). The gut-skin connection: how altered gut function affects the skin. Chris Kresser. Retrieved from: https://chriskresser.com/the-gut-skin-connection-how-altered-gut-function-affects-the-skin/
Slominski A. (2007). A nervous breakdown in the skin: stress and the epidermal barrier. J Clin Invest. 2007 Nov 1; 117(11): 3166–3169. doi: 10.1172/JCI33508
We’re heading into the Christmas holidays, where parties, friends, and family abound, and gifts and hugs are shared. Unfortunately, these close quarters are also prime opportunities for the flu and other viruses to be shared among us. If our immune systems are compromised with our lack of sunlight at this time of the year (and therefore low Vitamin D), and further taxed by lack of sleep, stress, alcohol, sweets, dry heated environments, and lack of exercise, we can be more susceptible to coming down with the flu.
So what’s the scoop on Vitamin D, and can it help you prevent and/or treat the flu?
Low Vitamin D levels are associated with higher flu rates.
There are many studies showing that deficient levels of Vitamin D are associated with higher rates of flus and respiratory tract infections. Now, keep in mind that just because there is a correlation, it doesn’t mean that the lack of Vitamin D is actually causing the increase in flus, and it’s definitely not the only factor. But clinically, we do see that optimizing Vitamin D levels and correcting deficiencies generally decreases patients’ frequency of getting sick with the flu.
Vitamin D supplementation has been studied in the context of preventing one kind of influenza, influenza A. It was found that supplementing with Vitamin D decreased influenza A flus in schoolchildren, with the added bonus of decreasing asthma rates in those susceptible (Urashima et al., 2010).
Optimize Your Vitamin D Levels
I frequently test my patients for their Vitamin D levels in the blood (25-0H Vitamin D), and very rarely are they adequate, even in those that are taking 1000-2000 IU of vitamin D on a daily basis! So often, if your levels were very deficient to start with, blindly taking the recommended intake won’t help very much. You also don't want to take too much and overdose!
The average blood level of Vitamin D in Canadians is below 75 nmol/L (the lower end of the “normal” range), and 1/3 of those people are likely quite deficient, with levels below 50 nmol/L. Levels in the winter are even lower than that! I aim not only for normal ranges, but optimal ranges for my patients. This usually requires prescription level doses of Vitamin D (>1000 IU a day), which I can prescribe. Getting your levels checked can allow me to dose your Vitamin D appropriately and safely, bringing your levels up quickly and efficiently. Vitamin D is also important for so many other things, including bone health, mood, and energy!
Treatment Of Flu With “The Vitamin D Hammer”
Most of us have come down with the flu at some point or another, and we know it can make us feel quite miserable. What if you could cut that misery short? Can Vitamin D help once you already have the flu?
There isn’t much research in the area. However, there is some evidence clinically from doctors who use high doses of Vitamin D that it can be very helpful. We’re not talking about 800-1000 IU a day in these instances, as this likely would be too little, too late for most people. Dr. Gerry Schwalfenberg, MD, and his colleague use very high doses of Vitamin D (we’re talking high prescription doses) at the onset of the flu for 2-3 days. They call this “the Vitamin D hammer”, flooding the body with Vitamin D short-term! With this protocol, they find that patients’ symptoms resolve within 48-72 hours, which is amazing considering that the usual flu will often last a week or more, and can be followed by feeling weak and rundown for a while still afterwards.
Do you want to minimize your chances of getting the flu? Then among your arsenal, a good personalized dose of Vitamin D would probably be a good idea. We can get you tested to optimize your levels, and include other immune-boosting measures and supplements into your treatment plan so that you keep up your energy and smile all winter long!
Schwalfenberg G. (2015). Vitamin D for influenza. Can Fam Physician, 2015 Jun; 61(6):507. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4463890/
Urashima M., Segawa T., Okazaki M., Kurihara M., Wada Y., and Ida H. (2010). Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr, 2010 May;91(5):1255-60. doi: 10.3945/ajcn.2009.29094. Epub 2010 Mar 10.
Dealing with the symptoms of irritable bowel syndrome (bloating, gas, diarrhea or constipation or both, a tender or painful abdomen, and a sensitive stomach) can be exhausting! If you are an IBS sufferer, you probably have tried several things in an attempt to manage your symptoms. The cause of IBS can be different for different people, so what may work for others may not work for you!
Here are 5 things you can begin doing now if you have IBS, which can start to get you on the right track to manage your symptoms.
1) Start a diet diary
Being aware of what you put in your body and how you react to your food can be an important first step to help you identify if specific foods are a trigger for your symptoms. Most IBS patients have IgG food sensitivities, which can lead to symptoms anytime from eating the food, up to 72hrs after. Write down everything you eat every day for a week, along with the timing of any symptoms you may have. Then, go back and highlight when you ate foods that tend to be triggers: wheat and gluten, cow’s dairy, eggs, soy, corn, yeast, and high FODMAPs foods. Can you see a pattern between what you eat and your symptoms?
If things get confusing, bring in your diet diary to your appointment with me, and we can discuss the best avenue to proceed with. Food sensitivity testing may be a good option, or my 7-Day Detox Program.
2) Take a good quality probiotic
Did you know that about 3lbs of your weight is due to the crucial bacteria that you carry around in your gut? These bacteria need to be in a fine balance in order to play their role in decreasing your reactions to foods, maintaining a good intestinal barrier, keeping your immune system strong and balanced, and even improving your mood! Each strain of probiotic has its own effects on the immune system, so formulas can get pretty specific. Most of the time, I usually recommend a probiotic blend that includes Lactobacillus acidophilus, Bifidobacterium longus, and Bifidobacterium lactis. If you feel worse on a probiotic, stop taking it and talk to a naturopathic doctor. It could be a sign of something that’s going on in your body, such as a dairy allergy, a FODMAPs sensitivity (depending on what is included in the probiotic), or an overgrowth of bacteria in the small intestine (SIBO).
3) Introduce a regular exercise routine
You may not feel like exercising if your IBS symptoms are severe, but if you can, start small but get moving! Exercise has been shown to significantly improve the quality of life of patients with IBS. Exercise helps keep your bowels regular, changes gas transit time in the intestines, improves mood, and overall makes people feel better! A regular exercise routine is good not only for IBS symptoms, but also for overall health. Why not give it a try?
4) Cut out lactose from your diet
Since lactose intolerance is common in people with IBS, and can be confused with IBS, try cutting out lactose in your diet for 1-2 weeks. That means trying lactose-free milk, yoghurt, cheese and other dairy products instead of the regular cow’s dairy products. If your symptoms resolve, then you’ve got your culprit, lactose! However, if your symptoms get better but aren’t completely gone, then you may be lactose intolerant but still have other things going on at the same time. Often times, patients with IBS cannot tolerate casein, a protein in milk products which is found in both regular and lactose-free dairy products.
5) Eat real food
Remove the processed and sugar-laden foods from your grocery cart, and instead shop mostly the perimeter of the grocery store, where the fresh produce is found (skip the bakery isle if it is found there too). That way, you will be eating nutritious food that is naturally high in fibre, and you’ll be avoiding the sugar which feeds unhealthy bacteria in the gut. If your digestive system is currently very sensitive, you may want to eat more liquid foods in the form of home-made soups, stews, or smoothies. Just keep in mind that you could react to some of the foods listed in Tip #1.
Starting to implement some of these tips should help you get some relief from your IBS symptoms. However, it’s always best to work with your naturopathic doctor if you want to feel better faster and avoid much of the guesswork. Some critical tests can really help pinpoint the treatment that you need, and specific naturopathic treatments and supplements can speed up your healing process.
Helping patients with IBS is a passion of mine. If you are ready to get lasting relief from your IBS symptoms, I’ll be delighted to help you!
Cuomo R., Andreozzi P., Zito F.P., Passananti V., De Carlo G., Sarnelli G. (2014). Irritable bowel syndrome and food interaction. World J Gastroenterol., 2014 Jul 21;20(27):8837-45. doi: 10.3748/wjg.v20.i27.8837.
Johannesson E., Simrén M., Strid H., Bajor A., and Sadik R. (2011). Physical activity improves symptoms in irritable bowel syndrome: a randomized controlled trial. Am J Gastroenterol., 2011 May;106(5):915-22. doi: 10.1038/ajg.2010.480. Epub 2011 Jan 4.
If you’ve been suffering from irritable bowel syndrome (IBS) and want to get to the bottom of your symptoms, there are some crucial tests that you may want to consider running through your naturopathic doctor. You’ve probably tried many different things already to help with your symptoms through trial and error, without significant or lasting relief. Testing eliminates much of the guesswork and helps us target our treatment so that you can get better faster!
During your initial visit with me, your medical history will give us a clue to what might be causing your symptoms. It could be one of the ones outlined in my previous blog. I’m giving you a list of the most common tests to consider, but most people only need to invest in one or two of these tests. By far, the most common test that I run with IBS patients is the first one, IgG Food Sensitivity Testing.
1) IgG Food Sensitivity Testing
This is a blood test that measures levels of IgG antibodies to 120-200 foods, depending on which panel we run. It allows us to identify objectively which foods are the most likely to be causing the most inflammation in your digestive system. If we run this test, you will receive a printout of which foods you reacted to highly, moderately, or not at all. If you end up having a large number of reactive foods, you most likely have a condition called leaky gut, where the intestinal barrier becomes excessively permeable, leading to reactions to many foods. Repairing that leaky gut through naturopathic treatments can often allow you to eventually bring more foods back into your diet.
2) Candida IgG Test
This is also a blood test, and can be added on to the IgG Food Sensitivity Test, or run on its own. It would be run if we suspect a yeast or Candida overgrowth which could contribute to IBS-like symptoms. If your results turn out positive, then we would treat the overgrowth with dietary changes and targeted supplements.
3) SIBO Breath Test
Unlike the two tests above, this test is a breath test. You are given a lactulose solution to drink, and at timed intervals, take breath samples in the comfort of your home. The lactulose feeds bacteria in your intestine, and they will then produce hydrogen and/or methane gases as they break the lactulose down. These are the gases that are measured in your breath. If unusually high levels of those gases are found in your samples, you probably have Small Intestinal Bacterial Overgrowth (SIBO), a common cause of IBS. There is a multi-step process to treat SIBO, but the good news is that it CAN be treated!
4) Comprehensive Stool Analysis (+/- Parasitology)
This test requires a stool sample, usually taken from 3 different bowel movements. It gives a comprehensive assessment of your digestive health, including which bacteria (beneficial and harmful) are present and their relative amounts, any yeast overgrowth, parasites, and other information on how well your digestive system is working. If we suspect parasites, this would be the test to run, but it can also be run if we suspect an imbalance in the beneficial bacteria in your digestive system, or if your digestive system is a mess.
If you’ve been suffering from IBS symptoms for a while, testing could be a lifesaver, preventing you years of trial and error with different supplements and medications!
Ready to start feeling better now? Book your initial visit with me today, and we’ll start investigating so that you can get to the bottom of your IBS.
Image from 123RF.com
In my last blog, I shared with you some background information about what a diagnosis of irritable bowel syndrome, or IBS, means. The symptoms and diagnosis are just the tip of the iceberg. The bottom line is, if you’ve been diagnosed with IBS, you will want to dig deeper in order to find out what is causing your symptoms, and modify the factors you CAN control in order to get your symptoms under control.
I’ve had countless patients go from having daily diarrhea and bloating to having happy bowels that no longer cause them daily anxiety and stress, once we find and treat the cause! This is a very personalized process, as what causes IBS for one person doesn’t necessarily cause it for another. Additionally, many times there is not just one cause, but a combination of factors that must be addressed.
When a patient comes in to see me with IBS, I have a running list of possible causes going through my mind, trying to fit the pieces of the puzzle together for that person as I listen to their particular story. Here are the top 5 causes of IBS that I consider. This list is by no means exhaustive! Working with a naturopathic doctor and ordering the appropriate testing will help you get long-lasting relief for your symptoms!
1) Food Sensitivities
Many patients’ IBS symptoms resolve or significantly improve after we identify specific problematic foods, either through IgG food sensitivity testing, or through an elimination diet. Food sensitivities can cause IBS symptoms since they increase inflammation in the gut and irritate the gut lining. It can be difficult to identify your food sensitivities just by keeping a diet diary, since you can notice digestive symptoms from a food up to 72hrs after eating it! The most common problematic foods tend to be gluten, dairy, eggs, corn, and soy.
2) Small Intestinal Bacterial Overgrowth (SIBO)
Bacteria can overgrow in the small intestine, as a result of many things, including lots of antibiotics, low stomach acid, and a dysfunction in the movement of muscles surrounding the intestines. It’s actually a very common cause of IBS, being present in from 35-80% of IBS cases! If your IBS symptoms come with lots of bloating, you’ve been on strong antibiotics or antacids, and probiotics make you feel worse, it might be a good idea to get tested for SIBO.
3) Lactose Intolerance
Many people figure this one out by trial and error, as drinking a glass of milk makes them run to the washroom within half an hour. However, many people go undiagnosed for years, as the symptoms can be just shrugged off as IBS. There is a test available for this as well, if you’re unsure.
4) Yeast Overgrowth
Just like bacteria can overgrow in the digestive system, so can yeast! Candida albicans is a yeast that is commonly found in the digestive tract in small amounts, but if the opportunity arises, it can overgrow and cause a variety of symptoms that can fall under the umbrella of IBS. The most typical triggers for Candida overgrowth are chronic antibiotic use and/or a diet high in sugar, but there are others, including chronic stress and the use of the birth control pill. If you’re a woman and have IBS symptoms along with frequent vaginal yeast infections, getting tested for Candida overgrowth would be an important step to find out if it’s causing your IBS symptoms.
5) FODMAPs Intolerance
FODMAPs foods are made up certain types of sugars and short chain carbohydrates that can be difficult to digest. The acronym stands for Fermentable-Oligosaccharide-Disaccharide-Monosaccharide-And-Polyols. Unlike food sensitivities that are due to a reaction to the protein portion of a food, in this case, you may be unable to break down and digest the carbohydrate portion of certain foods. Avoiding high FODMAPs foods has been shown to improve IBS symptoms. Sometimes, however, patients cannot tolerate these foods because they already have an overgrowth of certain bacteria or yeast which thrive on these foods and ferment them to create more gas! See how different causes can be related?
There are many other factors which cause or aggravate IBS, including chronic stress, low stomach acid, chronic use of certain analgesics, and a dysfunction in the action of the muscles surrounding your digestive tract (the migrating motor complex).
Do you want to get to the bottom of your IBS symptoms? In the next blog, I’ll be discussing in more detail about what crucial tests you should consider if you’ve been diagnosed with IBS.
Image from 123RF.com <a href='http://www.123rf.com/profile_oporkka'>oporkka / 123RF Stock Photo</a>
Atkinson, W., Sheldon, T.A., Shaath, N., and P.J. Whorwell. (2003). Food elimination based on IgG antibodies in irritable bowel syndrome: A randomized controlled trial. Gut, 53:1459–1464. http://gut.bmj.com/content/53/10/1459.full.pdf
Dainese R1, Casellas F, Mariné-Barjoan E, Vivinus-Nébot M, Schneider SM, Hébuterne X, Piche T. (2014). Perception of lactose intolerance in irritable bowel syndrome patients. Eur J Gastroenterol Hepatol., 2014 Oct;26(10):1167-7. https://www.ncbi.nlm.nih.gov/pubmed/25089542
Halmos EP1, Power VA2, Shepherd SJ2, Gibson PR3, Muir JG3.(2014). A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology, 2014 Jan;146(1):67-75.e5. https://www.ncbi.nlm.nih.gov/pubmed/24076059
Mann, N.S., and Limoges-Gonzales, M. (2009). The prevalence of small intestinal bacterial overgrowth in irritable bowel syndrome. Hepatogastroenterology, 2009 May-Jun;56(91-92):718-21. https://www.ncbi.nlm.nih.gov/pubmed/19621689
Dr. Tamar Ferreira is a Naturopathic Doctor in Ottawa, Ontario, with clinic locations in both Nepean and Orleans. Her areas of focus include digestive health, hormone balance, and skin conditions.
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