You hear that familiar wheeze or cough although you barely did any exercise. You may have just gone up a set of stairs, stepped out into the cold, or emptied out the dust compartment of the vacuum cleaner. Here it goes again, you think, as you reach for your inhaler…
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
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.
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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
You may have heard of the term “detox”, but don’t really know what it entails. It may conjure up images of juicing or cayenne pepper cleanses, starvation diets, or even drug and alcohol addiction centres. This is NOT what I’ll be talking about today. I’ll be talking about metabolic detoxification: how you can maximize your own body’s cellular detoxification capabilities so that you can clean up the inside of your body and feel your best!
You probably don’t think twice about cleaning up your outside: you brush your teeth, take a shower, wash your hair, cut your nails, etc. But what about the inside of your body? How does it deal with the onslaught of industrial chemicals, pesticides, hormone disruptors, heavy metals, and other substances that are foreign to it? How does it get rid of internal toxins, such as metabolic waste products, immune reactions to food, free radicals, and fermentation products from unhealthy gut bacteria?
Detoxification – What Is It?
Luckily, our bodies have a built-in detoxification system that helps us get rid of the toxins we are exposed to. We are constantly detoxifying through this mechanism every second of our lives! However, just relying on that and going on your merry way is often not enough. “De-toxification” literally means to remove toxins, and in today’s society, we are exposed to more and more industrial chemicals, plastics, and hormone disruptors than ever before which “clog up” our detoxification mechanisms. A study done in 2009 found that the 10 minority ethnic group babies tested (this was a US study) were born with up to 232 toxic chemicals in their umbilical cord (EWG, 2009)! This number is likely higher than the average Canadian newborn, but showcases just how our toxicity is getting passed on to the next generation.
In wholistic and integrative medicine, detoxification refers to a healing method used to improve physiological function by eliminating existing toxins, avoiding new toxins (as much as possible), and supporting the organs of elimination (primarily the liver, the gut, and the kidneys).
The liver modifies and packages the toxins into forms that can leave the body, either by getting packaged into bile to leave through the gut, or made water soluble to leave through the kidneys. If any main detoxification organ system gets “clogged up”, this puts undue strain on our other primary detox organs, as well as our secondary detox organs (the skin, lymphatic system, and lungs).
Could You Benefit From a Detox?
If you’re living and breathing in our 21st century world, eating out of plastic containers, taking (or have a history of taking) birth control pills and various pharmaceutical drugs long-term, planning to get pregnant, eating primarily non-organic food, or using perfumed products and cosmetics, chances are you’ve accumulated some of these toxins in your system and could benefit from a detox!
Here are some additional symptoms that could be associated with an elevated toxic burden:
-chronic digestive issues
This is not an exhaustive list, since toxins can have various side effects, depending on the nature of the toxins. When shouldn’t you detox? If you’re pregnant, have compromised liver or kidney function, and with some chronic diseases, a detox is likely not the right avenue for you at this time.
What Foods Can Help with Detoxification?
The liver is the primary processing plant in the body for sorting and getting rid of toxins. Most detoxification programs will include foods (and supplements) that help with both Phase 1 (modifying) and Phase 2 (packaging for elimination) detoxification enzymes in the liver. Phase 1 reactions often end up creating a more toxic bi-product, so you want Phase 2 enzymes to be working efficiently to get rid of it. While I won’t go into supplements here, you can start including more of these beneficial foods into your diet today (Hodges, 2015)!
Phase 1 supporting foods: lemons, dark green leafy vegetables, cruciferous vegetables, oranges, tangerines
-Pro tip: If you can’t tolerate much caffeine, you may have slow Phase 1 detox enzymes since they break down caffeine.
Phase 2 supporting foods: cruciferous veggies, legumes, adequate lean protein, turmeric, green tea, raspberries, blueberries
-Pro tip: If you have multiple chemical sensitivities, you may have a buildup of Phase 1 metabolites, either from too quick Phase 1 enzymes, too slow Phase 2 enzymes, or both.
What Does a Typical Detox Program Entail?
We typically can’t avoid our daily exposures to car exhaust, but we do have a tool that we can use daily to reduce our toxin exposure: our fork and what we put at the end of it! A typical detox program will:
-Reduce overall pesticide exposure by emphasizing organic foods
-Eliminate processed foods, sugar, alcohol, and minimize if not eliminate coffee to decrease unnecessary burden on the liver
-Remove known or typical food sensitivities that increase inflammation in the body
-Emphasize organic and nutritious foods that support Phase 1 and Phase 2 detoxification in the liver, as well as include liver-supporting supplements
-Emphasize lots of water and fluids to support kidney detoxification
-Include high fiber foods, probiotics, and gut healing supplements to allow the bowels to eliminate toxins adequately
There are various levels of detoxification. Have you ever started cleaning one area of your house, only to realize that other areas needed cleaning too? Once you’ve mastered the food level, you can look into decreasing toxin exposure from plastics, cosmetics, stress hormones, or other areas, if needed. Regular moderate exercise helps keep the lymphatic system running smoothly, improves overall health, and decreases stress hormones. But there’s no need to overwhelm yourself. Start with one small aspect, and you will already reap the benefits!
What About Detox Reactions?
Have you ever set out to deep clean a room in your house, only to be overwhelmed with the sheer number of items that are uprooted and need to be sorted in the process? A similar thing can happen when you are doing a detox, usually within the first 2-4 days. As your body tries to detoxify, you may feel like you are getting a flu, with body aches or headaches. Not everyone gets these symptoms, but if you do, it usually only lasts a day or two. If it lasts longer, your ND can advise you on how you can minimize your symptoms. However, just like cleaning up your room, the temporary discomfort is well worth it!
Do You Have 7 Days?
If you’ve been reading this and realizing that you can benefit from a detox, I’d like to invite you to join my 7 Day Detox program. It’s just 7 days of your life to get you feeling the benefits of a detox! Take a sneak peek here. I’d love for you join my growing list of patients who are taking advantage of this to kick-start their health! If an intense detox is not for you, that’s no problem either. I’ve done slower detoxes with patients for years with just as many benefits – it just takes a little longer to get there.
For those of you interested in my 7 Day Detox program, find out more about this revolutionary program here!
EWG Public Affairs (2009). Toxic Chemicals Found In Minority Cord Blood. Retrieved from: http://www.ewg.org/news/news-releases/2009/12/02/toxic-chemicals-found-minority-cord-blood
Hodges, R.E, and Minich, D.M. (2015). Modulation of Metabolic Detoxification Pathways Using Foods and Food-Derived Components: A Scientific Review with Clinical Application, J Nutr Metab, 2015: 760689.
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Fatigue is a very common concern that patients come to see me for in my practice. A lot of the time, patients have had a standard workup done with their medical doctor, but were told everything came back as “normal”.
You may find yourself in the same situation. You know you could feel better, but you don’t know what you can do about it. So, you keep dragging yourself from one day to the next with just barely enough energy to get through the day. Chances are, you CAN get better, and a naturopathic doctor can help you figure out what needs to change.
We all feel tired once in a while. If you’re wondering if your level of energy is normal or not, here are some signs that things could be better:
Of course, there are some basic lifestyle factors that can lead to fatigue. These are things that you would easily be able to identify yourself, like lack of sleep, a diet of highly processed food, or lack of exercise (which you may not be able to bring yourself to do if you are feeling very run down). What I’ll share with you today are the top 7 causes that I take into account when assessing a patient with longstanding fatigue. Keep in mind that there are many other causes. If these show up as optimal for you, then I’ll keep digging to find the cause of your fatigue.
#1 – Iron Deficiency OR Iron Overload
Most women who have regular menstrual cycles have sub-optimal iron levels. Furthermore, those who eat vegan or vegetarian diets are at greater risk of an iron deficiency. Even if you are not anemic (where iron levels drop to a minimum), you can still feel low in energy if your storage level of iron (ferretin) is sub-optimal. I generally aim for ferretin to be in the 60-80 range for women. Note that you could be in the “normal” levels with levels of ferretin as low as 10, but obviously you wouldn’t be feeling your best!
Before you go ahead and start supplementing with iron, do get your ferretin levels checked. It is possible to take too much iron, which can cause all kinds of problems long-term. Some people feel unwell because their body stores too much iron, a condition called hemochromatosis. I’ve seen this issue more commonly in men than in women, but it can happen in either.
#2 – Vitamin Deficiencies, Especially VitB12 And VitD
A Vitamin B12 deficiency is very common in vegans and vegetarians, so if you are eating little to no animal protein, you are probably deficient. However, even if you do eat meat regularly, it is possible to be B12 deficient. This can be due to problems assimilating the B12 from your diet due to issues such as malabsorption, food sensitivities, or low stomach acid. As well, if you are prone to depression or anxiety, you may need higher levels of B12.
Vitamin D deficiency is also very common here in Canada. It is very rare for me to measure a patient’s blood levels and find them in the optimal range if they are not supplementing with at least a minimal amount of Vitamin D. Adequate Vitamin D not only helps with energy, but it also helps with hormone balance, immune system support, skin health, and cancer prevention. Most people need prescription levels (i.e. >1000 IU per day) of Vitamin D at least temporarily, and getting your blood levels measured helps to individualize that prescription for you.
#3 – Blood Sugar Imbalances
If you crave carbs or sugary snacks and need that cookie to get your energy back up, a blood sugar imbalance might be behind your fatigue. Sugary foods can bring your energy levels up, but only temporarily. This is soon followed by a crash in energy, which will have you reaching for another quick source of energy. Having more balanced meals with plenty of protein and vegetables can help you keep your energy more even throughout the day. You can test this out by seeing how you feel after pasta dish compared to how you feel after a hearty chicken salad.
#4 – Sub-Optimal Thyroid Function
Hypothyroidism is a condition in which the metabolism slows down, and people generally feel more fatigue. If you’ve been diagnosed with this, you know how it feels. However, even if your doctor measured your thyroid stimulating hormone (TSH) and it was within the normal range, it could be functioning sub-optimally. If you suspect this might be a problem, see my post about the thyroid here.
#5 – Food Sensitivities
Reactions to food can have local effects (such as digestive symptoms of bloating, gas, diarrhea, constipation), but they can also lead to systemic effects, such as brain fog and fatigue. Many patients notice more energy once they go on a detox or elimination diet that removes the most common food sensitivities at once. You can find out if food sensitivities are playing a role in your fatigue either through an elimination diet, or through IgG food sensitivity testing.
#6 - Adrenal Fatigue
If you’ve been under chronic stress for a while, chances are you have adrenal fatigue. Your adrenal glands are little glands that sit on top of your kidneys and help you deal with stress. For short-term stress, they produce adrenaline, but for longer-term stress, cortisol is the prevalent hormone. Your cortisol levels vary throughout the day, so the best way to measure the health of your adrenal glands is through a 4-point salivary adrenal test (taken at 4 times during the day). We typically also test for other hormones in females when running this test, as being chronically stressed can wreak havoc on your other hormones.
#7 - Depression
This one doesn’t have a lab test to rule it out, but careful questioning can help your doctor assess if depression might be causing your fatigue. In this case, the fatigue can be mental/emotional, and you may not feel motivated to do things that used to be enjoyable for you. There are questionnaires, such as the Beck Depression Inventory, that can help us see where you stand. If you do have symptoms of depression, a naturopathic doctor can also see if some of the above factors could be contributing to you feeling depressed.
These are just some of the most common causes of fatigue I have seen in practice. As you can see, finding and treating the cause of your fatigue is key – only then will you be able to see lasting improvement in your day to day energy!
Do you want to wake up in the morning with a spring in your step and energy to last throughout the day? If yes, then I invite you to start your journey towards thriving with me!
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I am seeing more and more patients in my practice affected by autoimmune disease. Some of the more common autoimmune diseases I encounter are Hashimoto’s thyroiditis (a form of hypothyroidism), Graves' disease (a form of hyperthyroidism), Celiac disease (a strong intolerance to gluten), psoriasis (autoimmunity affecting the skin) and rheumatoid arthritis (autoimmunity affecting the joints). There are also some conditions that are not commonly thought of as autoimmune, but may have an autoimmune component and therefore fall on the autoimmune spectrum, including eczema and endometriosis.
An interesting question to ask is: What do all these conditions have in common?
What Is Autoimmunity?
Autoimmunity literally means that your immune system is reacting to components of your own body as if they were foreign invaders! As your immune system develops during infancy, it is trained to differentiate self from non-self, so that it can accurately distinguish what can be harmful to you and what isn’t. Unfortunately, with autoimmunity, the immune system becomes confused and starts to attack self.
The 3 Major Contributors To Autoimmune Disease
Most people come and see a healthcare practitioner only after they have had symptoms of autoimmune disease for a while, making it difficult to pinpoint and study the origin of autoimmune disease. However, because of the growing incidence of autoimmune disease in North America, there has been more interest recently to study this in more depth. It has been found that there are 3 main triggers for autoimmune disease (Campbell, 2014; Ballantyne, 2013):
Various environmental factors can also trigger autoimmune disease. These include bacterial and viral infections (that result in the formation of autoantibodies because the bacteria or viruses’ proteins look similar to our own proteins), heavy metals, chemical toxicants, silicone breast implants, emotional stress, vitamin and nutrient deficiencies, and drugs (Campbell, 2014; Ballantyne, 2013; Myers, 2015).
Last but not least of the 3 known triggers is a leaky gut (aka increased intestinal permeability). This is perhaps THE most important trigger.
The current research suggests that leaky gut is a NECESSARY precursor to autoimmune disease! That means that, even if you have the genetic susceptibility and an environmental trigger but if your gut barrier is intact, you won’t develop autoimmune disease. Isn’t that great news?
The current research suggests that leaky gut is a NECESSARY precursor to autoimmune disease!
What Is “Leaky Gut”?
Your gut is a continuation of your skin inside of you, and as such, it functions as a barrier between the outside world and the inside world. Therefore, to work properly, it can’t just let anything through into the bloodstream. There are tight junctions between each cell of the gut lining preventing most things from reaching the bloodstream before they are properly digested. Also, a huge part of your immune system is found right within the tissues surrounding the gut, sampling what’s coming in and making sure it’s “safe”. Beyond your own cells, the beneficial bacteria in your gut are also essential for proper digestion and immunity, and also act as a line of defence to prevent pathogens from getting through.
When your gut barrier becomes compromised and hyperpermeable, it allows food particles and pathogens through which shouldn’t be there. A gut can become leaky through (Ballantyne, 2013):
What Can You Do To Help Repair A Leaky Gut?
Fortunately, there are many things you can do to help heal a leaky gut! It does require a lot of work, since no supplement can replace improving your diet and lifestyle. Avoiding some of the food triggers that damage the gut and replacing them with whole, unprocessed foods is extremely important for lasting changes. You can identify your food triggers through a specific elimination diet. IgG food sensitivity testing can also be helpful to guide you in avoiding foods that are causing the most damage in your case. Supplements to help eliminate toxins and heal the gut lining are also very important, but you need to eliminate the triggers first before supplements can do their job properly. Stool testing can identify if you have an imbalance in your good gut bacteria. Stress management is also critical in helping your gut heal. A chronic leaky gut can also lead to malabsorption of vital nutrients that are necessary to help your gut heal, so I often do some testing to target supplementation to what each specific patient needs. Re-inoculating the gut with specific probiotics is also very important.
I have seen many patients’ health improve after we implement an individualized protocol based on these principles. The changes can sometimes be very dramatic! If you are suffering from an autoimmune condition and are ready to make some diet and lifestyle changes, I invite you to come on in for an initial assessment. I’d love to help you!
Now, I’d like to hear from you!
What autoimmune condition have you struggled with? Have you seen dietary and lifestyle changes make an impact on your health? Can you identify with some of the triggers I’ve mentioned?
Ballantyne, S. (2013). The Paleo Approach: Reverse autoimmune disease and heal your body. Las Vegas, Nevada: Victory Belt Publishing.
Campbell, A. W. (2014). Autoimmunity and the Gut. Autoimmune Diseases, 2014, 1-12. doi:10.1155/2014/152428
Myers, A. (2015). The Autoimmune Solution: Prevent and reverse the full spectrum of inflammatory symptoms and diseases. New York, New York: Harper One.
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If you’re wandering down any typical grocery store, you will usually come across one isle or two promising “freedom” from some of the typical things most people eat: gluten-free, dairy-free, egg-free, soy-free, and the list goes on. You may have wondered if those foods are healthier, and if you should also be filling your grocery cart in that isle.
Food sensitivities and allergies are on the rise in North America. It’s hard to plan a kids’ party without someone having some dietary restrictions. So, what’s the difference between food sensitivities, intolerances, and allergies?
Most people with food allergies found out the hard way. They ate some peanuts and had difficulty breathing, or ate some strawberries and broke out in hives. These reactions are usually severe, and are mediated by a type of antibody called IgE (antibodies are produced in the body and attach to specific protein sequences that they recognize). If you went to an allergist and got pricks in your forearms, you were most likely tested for IgE reactions.
Symptoms of food allergies usually show up fast, usually starting within 15min of consuming the food, and can be quite severe. They are the type of food reaction that is usually immediate, and are associated with anaphylaxis. If you have a food allergy, you have to be very careful about avoiding even trace amounts of the food in question.
Food sensitivities are typically harder to pinpoint than food allergies, so many people go undiagnosed for years. They are delayed reactions to food mediated by a different type of antibody, IgG. Symptoms occur most commonly within the first day of eating a food, but can occur up to 3 days after. The symptoms of a food sensitivity tend to be more subtle than a food allergy. They can include:
-digestive issues (bloating, gas, diarrhea, constipation, etc.)
-feeling like food “just sits there” and doesn’t digest well
-difficulty losing weight
-skin issues (acne, eczema, psoriasis)
-behavioural issues in children
Food sensitivities can be identified either through an elimination diet, or through IgG food sensitivity testing. Many patients opt for IgG food sensitivity testing to get a more objective starting point of which foods to start eliminating. This involves a simple blood test that will look at the level of IgG produced with respect to 120-200 foods. However, food sensitivity testing is still controversial. It is not 100% accurate, must be interpreted in the light of what is going on with the patient, and possible cross-reactions (i.e. shellfish IgG can show up high in someone with a dust allergy because the body recognizes a similarity between them). False positives can occur if the patient has a condition referred to as leaky gut syndrome (where the bowels are hyper-permeable and allow too many undigested foods through). False negatives can occur if you have not been eating a certain food, so it is better to do the testing before you start eliminating foods from your diet.
In research studies, IgG-based elimination diets have been found to help with:
-both migraines and irritable bowel (Aydinlar et al., 2013)
-IBS (Drisko et al., 2006; Atkinson et al., 2004)
-Crohn’s disease (Bentz et al., 2010)
Despite the lack of conclusive research, I have found the test to be very clinically relevant in practice: most of my patients with the relevant symptoms improve quite dramatically when we remove their food sensitivities from their diet.
Reading through articles can be confusing, since the term “food sensitivities” and “food intolerances” is often used interchangeably. However, food intolerances are non immune-mediated reactions to food (no antibodies are involved). Typically, the body will lack something which will make it intolerant to a food. A common food intolerance is lactose intolerance, where one cannot tolerate lactose-containing dairy products because he/she lacks the lactase enzyme in the digestive tract necessary to break down lactose. With lactose intolerance, symptoms usually occur within 30min of consuming lactose, leading to stomach cramps, abdominal pain, and diarrhea.
An elimination diet can help identify both food sensitivities and food intolerances. It may take some further testing after that to identify if, for example, your reaction to dairy is due to a sensitivity or an intolerance.
What To Do About Them
Once you identify which foods are a problem for you, there are healthy and not-so-healthy ways to eliminate them from your diet. Many of the specialty foods free of common allergens/sensitivities are highly processed, and contain fillers, emulsifiers, and sugars to make the texture or flavour more similar to their regular counterparts. Your best bet is to stick with whole foods that are minimally processed most of the time, and only have the processed ones as an exceptional treat. You may also need additional supplements to help heal your gut barrier so that you can potentially tolerate your sensitivities more in the future.
Do you think you may have a reaction to a food you are consuming? If you have any questions or would like to get started on an elimination diet or IgG food sensitivity testing, please contact us and we'll help you out!
Atkinson W1, Sheldon TA, Shaath N, Whorwell PJ.Gut. Food elimination based on IgG antibodies in irritable bowel syndrome: a randomised controlled trial. Gut. 2004 Oct;53(10):1459-64.
Aydinlar EI1, Dikmen PY, Tiftikci A, Saruc M, Aksu M, Gunsoy HG, Tozun N. IgG-based elimination diet in migraine plus irritable bowel syndrome. Headache. 2013 Mar;53(3):514-25.
Bentz S1, Hausmann M, Piberger H, Kellermeier S, Paul S, Held L, Falk W, Obermeier F, Fried M, Schölmerich J, Rogler G Clinical relevance of IgG antibodies against food antigens in Crohn's disease: a double-blind cross-over diet intervention study. Digestion. 2010;81(4):252-64.
Drisko J1, Bischoff B, Hall M, McCallum R. Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probiotics. J Am Coll Nutr. 2006 Dec;25(6):514-22.
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Over the years, I have seen many patients who have been struggling with their weight in my Ottawa practice. Many have tried multiple strategies without lasting success before coming to see a naturopathic doctor. Trying to lose weight can be an emotional roller coaster, and is often not simply a matter of willpower and portion control. The only way to truly make a difference in the long run is to address the underlying cause(s) of weight gain.
I am excited to share with you some of the key points I talked about in my recent “Wellness for Weight Loss” seminars at the Ottawa Public Library. These are my top 5 weight loss sabotagers that I screen for in patients who are having difficulty losing weight.
Top 5 Hidden Causes of Weight Gain
Despite the large amount of food available to us, most North Americans following the Standard American Diet (appropriately referred to as the “SAD” diet) are overfed but undernourished! This diet is low in essential nutrients that are needed for proper metabolism and hormone balance. Without these nutrients, we can experience hunger even while eating larger quantities of food, since the body is still starving for those nutrients. Eating a whole food, varied diet, high in vegetables and omega-3 fatty acids, can help decrease inflammation in the body and help with proper hormone balance.
2. Blood Sugar Imbalances
Some carbohydrates in foods convert to sugar in the bloodstream faster than others. To prevent excessive storage of blood sugar into fat, you want your blood sugar to stay tightly regulated, with no sharp rises or dips. This is because sharp rises in blood sugar triggers the release of insulin, a hormone that controls blood sugar levels and storage into fat. As long as insulin levels are high, you cannot burn fat from adipose tissue because your body is focusing on storing excess blood sugar into triglycerides and then into fat cells. Foods that are high in simple carbohydrates and low in protein and fibre will cause an initial spike in blood sugar, leading to an initial energy boost. However, this is short-lived and is quickly followed by a dip as the sugar is taken up into cells and stored, leading to low blood sugar, low energy, and hunger cravings. And what do we typically reach for when we are hungry and in a hurry? High carbohydrate foods, which just perpetuate the cycle! Keeping your blood sugar more even by eating the right foods can make a big difference.
3. Food Sensitivities
Many people have underlying food sensitivities which are causing inflammation in their body, hindering weight loss. Identifying and eliminating food sensitivities may decrease chronic inflammation which fuels obesity. Food sensitivities are delayed immune-mediated reactions to foods, which can occur anytime from eating the food and up to 72 hours after. The body can produce excessive amounts of a type of antibody called immunoglobulin G, or IgG, which recognizes and attaches to specific proteins in food particles. (This is different from the typical anaphylactic allergic reactions we hear about, which are mediated by a different type of antibody called IgE.) Common symptoms of food sensitivities include digestive issues (gas, bloating, constipation, diarrhea), feeling like food “just sits there”, foggy thinking, migraine headaches, fatigue, difficulty losing weight, or skin issues (acne, eczema, psoriasis). If you suspect that you might have a food sensitivity, a naturopathic doctor can help you identify problematic foods through IgG food sensitivity testing (blood test) or an elimination diet.
4. Chronic Stress
All of us go through stressful periods. Usually, we can recover after a short-term stress and go on with our lives. However, we often don’t realize the detrimental impact of long-term, chronic stress on our bodies. Our body deals with any long-term stress through the adrenal glands (“ad” means “near” and “renal” means “the region of the kidneys”), which produce cortisol. If you tend to gain weight in your mid-section, chances are chronic stress (or sugar imbalances) may be an issue. Over time, high cortisol leads to the breakdown of muscle mass (decreasing metabolic rate), decreased production of active thyroid hormone, depressed mood, cravings for sweets, fats, and salty food, and central weight gain. Learning stress management tools and using the appropriate nutritional supplementation can help you improve your metabolism and help you lose weight around the middle.
5. Thyroid Dysfunction
Optimal thyroid function is very important for anyone who is trying to lose weight. The thyroid controls metabolism and therefore weight. An underactive thyroid, or hypothyroidism, is associated with weight gain, depressed mood, cold intolerance, constipation, and many other symptoms. Think about what would happen in your body if you slowed down how quickly everything worked, and you could explain most symptoms of hypothyroidism. If you have symptoms but your thyroid has been tested and found to be “normal”, there still could be a problem with your thyroid. I look for optimal rather than normal levels in those patients, and often order a complete thyroid panel (TSH, fT3, fT4, TPO) to make sure everything is functioning as well as it could. As mentioned above, chronic stress can also impair the way thyroid hormone is used by the tissues, and may be a reason you could have symptoms when your lab tests appear normal.
So that’s it: 5 underlying causes of weight gain to look out for! Are there any that you think could apply to you? If you have been struggling with weight for some time and want to treat the underlying cause, come on in for a visit at my clinic!
Dr. Tamar Ferreira is a Naturopathic Doctor in Brampton, Ontario. Her areas of focus include digestive health, hormone balance, and skin conditions.