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The Most Important Test for Preventing Miscarriage

Pregnancy is one of the most significant women’s health topics – we spend our teens and early 20’s avoiding pregnancy, and many of us spend our 30’s and early 40’s trying to get pregnant.  And once a woman is pregnant, we want to ensure a healthy pregnancy with the outcome of a happy, healthy baby.

Lack of Lab Testing

In Ontario, where I run my women’s health practice, the standard of care is for women to receive only very basic testing when they discover they are pregnant.  Women are screened for sexually transmitted illnesses (chlamydia, gonorrhea, syphilis), public health testing (rubella), blood type and Rh factor.  But few women are screened for one of the most common, and preventable, causes of miscarriage – one that can be easily identified and often has no symptoms. 

Comprehensive Testing

The one test I insist all women in my practice have at the first sign of pregnancy is a comprehensive thyroid panel.  The thyroid gland, sitting in your throat near your voice box, is one of the most important hormone producing gland in your body.  Thyroid hormones are essential for metabolism – creating energy in our cells to meet the demands of our body.  In pregnancy we need to be able to make a lot of energy – making a whole new human is hard work! 

In pregnancy our requirements for thyroid hormones increase – and if our body isn’t able to meet that demand, the result can be early pregnancy loss (miscarriage).  We can identify women who may be at risk for this by running a simple TSH (thyroid stimulating hormone) test and treating women who fall outside the normal range with thyroid replacement hormones during pregnancy. 

But TSH isn’t the only important thyroid test for a pregnant woman.  Testing thyroid antibodies, especially anti TPO antibody is also essential for preventing miscarriage.  Thyroid autoimmune disease is the most common autoimmune disease in women who are in their childbearing years – impacting up to 15% of women.  Many of these women have no symptoms of thyroid disease and their TSH levels are totally normal.

Having TPO antibodies however, is a major risk factor for miscarriage.  There is a strong association with TPO antibodies and miscarriage, preterm delivery, and other negative outcomes in pregnancy (such as low birth weight and smaller head circumference). 

Getting Tested

Despite all the evidence, known to doctors since the 1990s, comprehensive thyroid testing still isn’t available as a screening test for most women in early pregnancy. But that shouldn’t stop you from seeking it out. Available from your Naturopathic Doctor for under a hundred dollars, this test could make all the difference in your pregnancy. And since this cause of miscarriage is completely treatable, I encourage you to have the test done as soon as possible after you discover you are pregnant. Miscarriage is all too common already, I don’t want any more women to have miscarriages that could be prevented.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.


Going Grey

Purple, blue, red, pink – bright vibrant hair colours are all the rage these days!  But grey?  Is anyone really excited to see those grey hairs popping up?  Why are they there, and what can we do about it?  The answers may surprise you.

Aging Grey

Our hair follicles contain cells that make pigment, called melanin.  This melanin gives your hair its distinct colour.  As we age, these pigment cells start to die off and new hairs grow in lighter – in an array of shades from grey to silver and white.  Once that pigment cell is dead, it won’t come back – the hairs growing from that follicle will never be coloured again. 

And aging is inevitable.  Dermatologists often quote the 50-50-50 Rule – 50% of the population will be 50% grey by 50 years of age.  However, it differs for everyone.  It seems that white people tend to start going grey in their 30s, Asians in their late 30s and black people in their mid-40s. 

Grandma Was Great, and Grey

But it’s mostly your genes that determine how early you go grey – and how quickly!  (Thanks Mum.)  If your parents went grey early, it’s more likely that you will too.

Premature Greying

Genetic or otherwise, premature greying happens.  If you go grey 10 years earlier than the average person does, feel free to complain about it!  You can consider it premature if your hair is going grey before:

  • 20 years old if you’re white
  • 25 years old if you’re Asian
  • 30 years old if you’re black

Contributing to the Grey

There are health concerns that can contribute to grey hair.  If you’re convinced it’s not all in your genes, look at these factors to see if they are adding to your silver streaks.

  1. Lack of vitamin B12 – common in vegans and vegetarians
  2. Vitamin D deficiency – common in northern climates, especially during the winter months
  3. Low calcium – from poor intake or a parathyroid dysfunction, low levels are associated with premature greying
  4. Low iron levels – more common in women and vegans and vegetarians, low levels can contribute to greying and to hair loss
  5. Thyroid hormone imbalance – more common in women, impacting up to 1 in 6 women
  6. Vitiligo – an autoimmune disease that destroys pigment making cells
  7. Copper imbalance – copper can boost the production of melanin, the compound that gives hair its colour.  But don’t just start taking it – copper needs to be carefully balanced with zinc or it can cause mood swings, depression and anxiety.
  8. Smoking – smokers are much more likely to go grey before 30 years of age – 2 ½ times more likely!

What To Do About Grey Hair

Dye it or don’t, but whatever you do don’t pluck it!  Or at least don’t make a habit of it!  Repeatedly plucking hairs can damage the hair follicle and result in kinkier, less healthy hair growing in. 

Hair is made mostly of protein, so foods that are high in proteins are essential for healthy hair.  Nutrients like iron, calcium, zinc, vitamin D, omega 3 fatty acids, B12 and B6 have also been found to support hair health.  Some vegetarians and vegans, and people with digestive issues, may have difficulty getting enough of these from their food and might want to look at taking targeted supplements. 

Eating every 4-5 hours may also help to support hair health.  Hair is not considered an essential tissue by the body, and research suggests that if we go too long between meals the energy available to non-essential tissues could be reduced and could impact hair health. 

Consider having your nutrient levels tested to see if they are negatively impacting your healthy hair. And meet with a Naturopathic Doctor to discuss your diet if you feel like it could use a boost as well!

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Hormones and Hair Loss

One of my favourite/ least favourite stories to tell is how I became a Naturopathic Doctor.  I was in my late teens, finishing my last year of high school, when I began losing my hair.  What was happening to my thick full hair?? It was falling out more and more, but my doctors assured me I “still had lots of hair”, as if that was what mattered.  I was not taken seriously – whether because I was a teen girl, or because my doctors didn’t see how much hair I was losing every day, it didn’t matter.  My hair loss was destroying my self confidence and I was convinced it meant something was wrong.

A Familiar Story

Of course, it did mean something was wrong.  For myself, it was a combination of low iron (which I talk about as a root cause of hair loss) and significant stress.  And this loss of trust in the conventional medical community led me to change my plans from becoming a Medical Doctor to becoming a Naturopathic Doctor.

I’d like to think my story is unique.  But I’ve come to see that it is not.  Many women (and teen girls) come to my practice with similar stories.  Being dismissed and told that their hair loss is not a significant symptom.  Being told that it is normal.  Or having little to no testing done to identify the underlying cause of hair loss. 

I may not be able to help all of the millions of women who experience hair loss, but I hope by sharing my story, and some of my expertise, that I may be able to impact some. 

Hormones and Hair Loss

Hair loss can happen to a woman at any age, and while it may be more common as we get older, that doesn’t mean that it is a normal occurrence at any age.  Keep in mind – common is not the same as normal!  In this article I’m going to focus on the hormonal causes of hair loss, some of the most common causes I see in my practice.  In order to properly diagnose your hair loss, be sure to use the Hair Loss Lab Testing Checklist and get to the root cause. 

Thyroid Imbalances

Your thyroid is a small but mighty gland located in your neck, near your voice box.  The primary role of the thyroid is to encourage energy production by the body.  When the thyroid isn’t functioning optimally, there can be consequences throughout the body, including the hair.  Hair loss can occur with too little thyroid hormone (hypothyroidism) or too much (hyperthyroidism).  A condition known as alopecia areata is also linked to autoimmune thyroid disease, or Hashimoto’s thyroiditis

Conventional testing for thyroid function is not always adequate to identify an underlying thyroid condition.  If you suspect your thyroid may be contributing to your hair loss, get a comprehensive thyroid panel completed with your Naturopathic Doctor, functional medicine doctor or MD.  This test will look beyond TSH and test for free T3, free T4 and thyroid antibodies. 

Testosterone Overload

One of the most common causes of hair loss in women and men, high levels of testosterone can lead to hair loss, especially at the frontal hairline and the top of the head.  While typically thought of as a man’s hormone, women produce testosterone as well.  The real issue isn’t testosterone specifically, but a metabolite of testosterone called dihydrotestosterone, or DHT.  This form of testosterone is much more powerful than regular testosterone and binds strongly to hair follicles on the scalp, face, back and chest – leading to hair loss on the scalp, and acne on the face, back and chest. 

Many women can have lab testing for testosterone that looks normal, but DHT levels may still be high.  It is important to have both these hormones tested, especially if you have other signs of high androgens such as acne or irregular periods, or have been diagnosed with PCOS

Low Progesterone

Progesterone is a damn important hormone.  The natural balancer to both estrogen and testosterone, many hormonal imbalances are a result of low progesterone.  Progesterone is able to block testosterone from accessing receptors, preventing it from leading to hair loss.  Progesterone is also the reason women’s hair grows so thick and healthy during pregnancy! 

The three times in a woman’s life when low progesterone are most common are:

  1. If she is using the birth control pill.  On the pill you do not ovulate, and do not produce progesterone (the synthetic progestins in the pill are not the same thing)
  2. If she has PCOS and does not ovulate
  3. As she ages.  Progesterone production drops through your 30s and many women in their 40s are not making enough to balance their estrogen and testosterone levels.  Women in menopause make hardly any progesterone at all. 

Stress is another common cause of progesterone deficiency, as the body will steal all the available progesterone to make cortisol, our body’s main stress hormone. 

Insulin and Blood Sugar Imbalances

No hormone acts on the body in isolation.  They all influence each other.  Insulin, the hormone produced to encourage our cells to take up sugar and regulate the levels of sugar in our blood, can have an impact on hair loss when it is imbalanced.

When your diet is too high in refined or processed carbohydrates, your cells can become resistant to insulin, causing higher circulating levels of blood sugar.  When this occurs your ovaries can become resistant as well, an imbalance which disrupts healthy ovulation and causes your ovaries to produce more testosterone and DHT. 

Stress and Cortisol

You may pull your hair out when you are stressed, or stress may cause it to fall out.  Stress can cause increased or decreased cortisol levels, both of which can contribute to hair loss.  Excessive stress can also cause your hair to enter its telogen, or hair fall phase, prematurely.  This will often result in hair loss 2-3 months after the stressful event. 

High cortisol will also deplete progesterone and allow for more testosterone to bind to hair follicles, which can further exacerbate hair loss.  If you have significant stress, consider what changes need to be made to help lessen your stress, and explore whether cortisol testing may help to reverse and resolve your hair loss.

Stopping Hair Loss

Understanding the hormonal causes of hair loss for women is just the first step.  To get to the root cause of your hair loss comprehensive testing is almost always necessary.  The problem is that many doctors don’t take hair loss seriously (I know from my personal experience!).  You may need to pay out of pocket to get the level of testing that you need, but in the end, that knowledge can help you put an end to your hair loss and allow you to regain not only your hair, but balance your hormones and give you your quality of life back.

Selected References

Ohnemus U, Uenalan M, Inzunza J, Gustafsson JA, Paus R. The hair follicle as an estrogen target and source. Endoc Rev. 206;27(6):677-706. https://www.ncbi.nlm.nih.gov/pubmed/16877675

Ohnemus U, Uenalan M, Inzunza J, Gustafsson JA, Paus R. The hair follicle as an estrogen target and source. Endoc Rev. 206;27(6):677-706. https://www.ncbi.nlm.nih.gov/pubmed/16877675

Randall VA. Androgens and hair growth. Dermatol Ther. 2008;21(5):314-28. https://www.ncbi.nlm.nih.gov/pubmed/18844710

Randall VA. Hormonal regulation of hair follicles exhibits a biological paradox. Semin Cell Dev Biol. 2007;18(2):274-85. https://www.ncbi.nlm.nih.gov/pubmed/17379547

Levy LL, Emer JJ. Female pattern alopecia: current perspectives. Int J Womens Health. 2013;5:541-556. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769411/

Disclaimer

The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed health care provider.  Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem. 

Banishing Breast Tenderness

A woman’s relationship with her breasts can be… complicated.  I should know. I had comic book heroine sized breasts up until a breast reduction after weaning my youngest child.  At that time breast tenderness was just a part of my day-to-day life.  That experience has given me a lot of compassion for women who experience breast pain.  This article is what I am giving back – hope for those women who suffer with pain, and a plan to overcome it.  Take back your ta-tas. 

Breast Tenderness Types

There are typically two types of breast pain – cyclical and noncyclical.  Cyclical breast pain is associated with your period, most often starting a few days (to weeks) before your period and stopping during or just after your period ends. 

Noncyclical pain doesn’t happen just around your period but can happen at any time.  It can be caused by pregnancy, breastfeeding, trauma or injury to the breast, pain from the muscles around the breast, or simply from having large breasts.  It can also be caused by medications, including birth control pills, antibiotics, and antidepressants. 

Most of this article will talk about how to overcome cyclical pain, but women with noncyclical pain can benefit from following these recommendations as well.

Is it Breast Cancer??

No.  It mostly likely is not breast cancer.  Breast pain is not typically linked to breast cancer, and having breast pain does not put you at higher risk of developing breast cancer. 

But don’t hesitate to see your doctor for a second opinion and a breast exam.  Especially if you have symptoms like heat in a specific area of your breast, a fixed/ non-moving breast lump, or changes to your skin on your breast. 

Why Do My Breasts Hurt?

The most common cause of breast pain is your hormones.  Specifically a condition known as estrogen dominance.  Estrogen is the hormone that causes breast tissue to develop in puberty, and throughout our adult lives our breasts continue to respond to estrogen stimulation.  During the week before your period estrogen and progesterone levels can become imbalanced, leading to breast pain.  This is worsened by an overburden of estrogen in our bodies, which we’ll discuss in a moment.  

Breast pain can also be more common in women who have fibrocystic breasts.  As women age her breast tissue is replaced by fat (a process known as involution).  This leads to the formation of breast cysts and fibrous tissue – and a more lumpy breast texture.  Fibrocystic breasts don’t always cause pain, but they can.  Especially as these lumps get bigger leading up to your period. 

Banishing Breast Pain: An Empowered Woman’s Guide

Experiencing breast pain is not a normal part of a woman’s life.  If you have tender breasts, try to understand why your body has developed this symptom – is it a hormonal imbalance? Are you stressed? Are you tired? Are you taking time for self-care? Is your diet and exercise up to your standards?  Once you’ve taken stock of your life, put the recommendations below into action for 2-3 months and see how much of an impact you can have on your health – you’ll be amazed at how powerful you are. 

1.Eliminate Estrogen Dominance

I’ve talked extensively about estrogen dominance elsewhere but it really is an incredibly common concern for women.  Estrogen is an important hormone for women’s health, but our levels are far higher than our systems can manage.  Increased estrogen production in our bodies from excess body fat, stress and poor diets, combined with estrogen-like chemicals in the environment (known as xenoestrogens), and terrible detoxification and elimination from alcohol consumption, low fiber diets and insufficient vegetable intake has left women living a veritable estrogen soup.   

The consequences of estrogen dominance are huge.  PMS, mood changes, low libido, sugar cravings, brain fog, crazy periods, and breast tenderness are common.  So what should we do about it?

Eliminating estrogen dominance is a huge issue in women’s health.  But luckily there are some action steps you can take now to address this hormone imbalance, and reduce your breast pain.

  • Reduce stress
  • Eat a high fiber diet – consider having 2 tbsp of ground flax seeds per day in addition to lots of healthy leafy green and rainbow vegetables
  • Eliminate excess body fat – a lot of women don’t realize that fat cells can make estrogen, so if you’re more than 15 lbs overweight, consider talking to your Naturopathic Doctor about how to achieve your healthiest body weight
  • Avoid plastics, pesticides and other sources of environmental estrogens.  Drink water and eat out of non-plastic containers.  And never microwave plastic!
  • Limit intake of dairy products

2. Detox Like a Champ

Reducing how much estrogen your body makes/ intakes is an excellent first step in banishing breast pain.  Now we move to the next step – supporting your liver in detoxifying that estrogen!  Your liver needs to take all the estrogen circulating in your body and convert it into a compound that you can eliminate (we’ll cover that in the next step!)  For effective detoxification we need to make sure we have adequate nutrients, especially the B vitamins and trace minerals.  We also want to ensure we’re not overwhelming our liver with excess alcohol intake, pain medications or other pharmaceutical medications.  One of the best things you can do to support your liver is not drink alcohol.  Risky alcohol consumption for women is anything more than one drink per day. 

To support your liver, be sure to eat lots of leafy green vegetables.  Bitter greens like kale, dandelion greens, endive or chicory are especially helpful for the liver.  You can also consider liver supportive supplements like dandelion root, turmeric, artichoke, greater celandine and milk thistle to up your detox game.

3. Master Your BMs

You can be a super-star detoxifier, but if you aren’t having daily bowel movements you are not going to be able to balance your hormones are reduce your breast pain.  Our excess hormones are eliminated in our poop – if you aren’t having healthy daily poops you are going to end up recycling a lot of that estrogen and having to detoxify it all over again.

Best bets for mastering your BMs are a high fiber diet, a regular intake of healthy probiotic bacteria – either through supplements or fermented foods, and potentially a magnesium supplement.  Magnesium citrate or bisglycinate can help to get you regular while you focus on improving your diet.  Studies suggest between 200-600mg of magnesium can help by drawing more water into your stool and promoting regular BMs.

4. Target Your Diet

Inflammation can be a major contributing factor to pain in our bodies, and our breasts are no exception.  By reducing inflammation in our diet we can significantly improve breast pain.

The ideal diet for breast pain is pretty much what you’d expect.  Eat more vegetables, lots of healthy plant based proteins, fish, leafy greens and healthy fats.  Limit or eliminate sugar, alcohol and dairy.  Coffee, especially at high amounts (more than 1-2 cups per day) can also contribute to inflammation and pain, so check in with yourself and see if you’re overdoing the drip. 

Adding in healthy fats and phytoestrogens will also help with hormone balance.  Flax seeds are a superstar for this – they contain omega 3 fats, healthy fiber and phytoestrogen lignans which bind to estrogen receptors and prevent other stronger estrogens from binding.  Flaxseeds – the overachiever of the seed family. 

5. Support with Supplements

You cannot supplement your way out of a terrible diet.  But there are absolutely some supplements than can help reduce breast pain, especially over the first few months while you are making the lifestyle and diet changes that will help you remain pain-free. 

EPO for breast pain

Vitamin E has been found in studies to reduce cyclic breast pain, especially when combined with evening primrose oil (EPO).  A fat-soluble nutrient, vitamin E reduces inflammation and acts as an antioxidant in our cells.  EPO is often used as a source of pregnenolone, the precursor hormone to progesterone, which is essential to balance the effects of estrogen in the body.  600IU of vitamin E with 2-3 grams of EPO is a typical dose. 

B vitamins are necessary for liver detoxification and can be taken as a simple B complex supplement.  Vegans and vegetarians in particular should be considering a B complex containing vitamin B12.

Iodine is another nutrient essential for breast health and low levels have been associated with the development of lumpy fibrocystic breasts.  Rates of iodine deficiency are incredibly common, and you should discuss with your ND whether or not you should test your levels.  A multivitamin supplement will provide you with some essential iodine, or seaweed snacks are a great food source. 

Chaste tree, or Vitex agnus-castus, is hands-down my favourite botanical supplement for cyclic breast pain.  Also used to reduce painful periods and PMS mood changes, chaste tree can be a game-changer for women with miserable premenstrual symptoms.  Talk to your ND to ensure this is a good choice for you. 

Taking Back Your Ta-Tas

My philosophy of women’s health is “No More Meh”.  You don’t have to accept symptoms of breast tenderness, mood changes and low libido.  You don’t have to feel exhausted and overwhelmed.  You are a force of nature.  You are a damn goddess.  Own it. 

If you want to work together, drop me a line via email or Facebook or follow me on Instagram. I’d love to meet you. 

Disclaimer

The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed health care provider.  Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem. 

Select References

Pruthi S, Wahner-Roedler DL, Torkelson CJ, et al. Vitamin E and evening primrose oil for management of cyclical mastalgia: a randomized pilot study. Altern Med Rev. 2010;15(1):59-67. https://www.ncbi.nlm.nih.gov/pubmed/20359269

Mirghafourvand M, Mohammad-Alizadeh-Charandabi S, Ahmadpour P, Javadzadeh Y. Effects of Vitex agnus and flaxseed on cyclic mastalgia: a randomized controlled trial. Complement Ther Med. 2016;24:90-95. https://www.ncbi.nlm.nih.gov/pubmed/26860808

How to Select a Naturopathic Doctor

I believe that women need the medicine that Naturopathic Doctors offer.  I believe that giving women the knowledge they need to make healthy decisions for their health, and the health of their families, is one of the most powerful ways we can empower women. This is the entire reason my website exists – to share knowledge and empower women.

But I can’t be everywhere.  And I can’t treat everyone.  As a Naturopathic Doctor I am a regulated health care professional and can only practice in jurisdictions where I am licensed (Ontario, Canada).  Every week I receive emails from people across Canada and around the world who want to find someone like me.  The great news is that there are many wonderful Naturopathic Doctors out there who are making huge impacts on the health of their community.  And you can find one in your area.

How to Select a Naturopathic Doctor

The Basics

1. Do they have a degree in Naturopathic Medicine?

In North America there are only seven accredited schools where a Naturopathic Doctor can obtain a degree.  Only two of these are in Canada.  You can check the schools on the website for the Council for Naturopathic Medical Education (CNME).

2. Are they licensed to practice in the province or state where you live?

Naturopathic Medicine is not regulated the same in every province or state.  In fact, only 5 provinces (Ontario, British Columbia, Alberta, Saskatchewan and Manitoba) currently regulate Naturopathic Doctors.  Many states in the USA also regulate Naturopathic Medicine, while others are still seeking regulation.  (Click here to check if your state is regulated).

Regulation is important to ensure the safety of the public – if you are in a regulated area only see a Naturopathic Doctor who is licensed to practice in that area.  If you are not, consider finding a Naturopathic Doctor who is licensed to practice in a regulated area.

The Right Fit

3. Do they have a practice focus? 

Naturopathic Doctors are primary care physicians – trained to support a wide variety of health care conditions and concerns.  However, many Naturopaths choose to focus their practice on treating a specific concern or population.  Ask your potential ND if they have a practice focus and see if it is inline with the concerns you are seeking care for.  You don’t want to see a cancer-focused Naturopathic Doctor if you are seeking care for PCOS.

4. Do they have any additional certifications or training?

The education of Naturopathic Doctors should not end when they graduate from naturopathic medical school.  There are additional certifications and associations that Naturopathic Doctors can obtain that can enhance the services they offer.  Examples include bio-identical hormone prescribing, IV micronutrient therapy, perinatal, cancer, or pediatric associations.

The Best Practices

5. What types of assessments or testing do they offer in their practice?

One of the core tenets of Naturopathic Medicine is to treat the root cause.  How is your Naturopathic Doctor going to help to uncover the root cause of your symptoms?  Do they offer the highest level of functional tests in addition to standard blood tests? Do they do mostly energetic testing?  Will they review lab tests from your Medical Doctor? How do they decide what tests may be necessary for you?

6. Do they incorporate evidence based information and research into their treatment plans? 

The body of research on naturopathic medicine is growing every single day.  How does your Naturopathic Doctor stay up to date on research in their practice?  Do they incorporate both modern research and traditional knowledge into their treatment plans?  Patients are often surprised by the amount of research we can provide on the treatments we are suggesting for their care!

7. Will they work integratively together with your current health care team?

Integrative Medicine is choosing the best of all forms of medicine with the sole purpose of improving patient outcomes.  ~ Dr. Lisa

I think the medicine of the future will be more patient-centered, with all different types of health care providers working together to improve the health of individuals and their families.  I love working with Medical Doctors, physiotherapists, psychotherapists, nurse practitioners, chiropractors, osteopaths, massage therapists, and many other health professionals.  I truly believe this approach benefits everyone, most importantly my patients.

8. What types of therapies do they use in their practice?

Naturopathic Doctors are trained in a number of different therapies, from acupuncture to herbal medicine, nutritional supplementation and homeopathy.  What therapies does your Naturopath use, and why?  Personally I don’t use a lot of homeopathy in my practice because there isn’t a vast body of research supporting its use.  I focus on the research based treatments of nutritional and botanical medicines.  Discuss what your Naturopath is using and see if it resonates with what you’re looking for.

9. How much experience does the Naturopathic Doctor have?

There are many more important considerations than the number of years a doctor has been in practice, but it is something to discuss when meeting a Naturopath for the first time.  You don’t necessarily want to be someone’s first patient with your health concern.

10. Do you trust them, feel listened to, and comfortable with them?

In my mind, this is one of the most important considerations.  Ideally you are building a long term relationship with your Naturopathic Doctor.  Consider the so-called “soft traits” like personality, approachability, empathy and trust when deciding on your Naturopath.  This can be the make or break factor in selecting your ND, and I encourage you to trust your gut.

To make things easy for you, I’ve made a pdf with all these suggestions.  Bring it along when meeting your Naturopathic Doctor for the first time.  Most NDs offer a free 10-15 minute meet and greet appointment – I highly recommend taking them up on this.  Take the time to choose the best ND for you, and you will benefit immensely from the investment!

How to Select an ND

Disclaimer

The advice provided in this article is for informational purposes only.  It is meant to augment and not replace consultation with a licensed health care provider.  Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

 

 

Hormone Harmony during Breastfeeding

Going through my pregnancies with my two sons, and supporting hundreds of women in my practice through their pregnancies and beyond, I am always interested in the information that is given to pregnant women and what that says about what our society deems important.

Women going through pregnancy know a lot – they know what to eat, what to avoid, when their baby develops eyelashes (32 weeks) and what position to sleep in. They know how to track contractions, how often to breastfeed and the best positions for breastfeeding.

What women know very little about is what is happening in their own bodies. What the hormonal changes that occur during pregnancy, breastfeeding and the postnatal stage mean for their own energy, emotions and health.

This article is here to close that gap – to help women understand the hormonal changes that occur during breastfeeding and when that hormone balance is normal, and when to seek support when it is not.

Breastfeeding Hormones

Breastfeeding is associated with production of two specific hormones: prolactin and oxytocin. These two hormones allow for peak production of breastmilk as well as bonding with your new babe. Let’s look at each one in more detail.

Prolactin

Prolactin, or “pro-lactation hormone” is produced during breastfeeding to increase breast milk supply. Levels rise for almost an hour after the baby begins to feed, encouraging the alveoli in the breasts to make milk.

But that is not all prolactin does. In fact, not just breastfeeding parents produce it – all parents produce it. Prolactin is a calming and relaxing hormone that decreases progesterone and testosterone production in both parents. It can cause mothers to feel deep relaxation (and sometimes deep fatigue) during breastfeeding and for some time after.

Interestingly, prolactin is also released during sexual intimacy, counteracting the effects of dopamine (which is associated with sexual arousal) and resulting in a sensation of gratification and calm. With high circulating levels of prolactin during the breastfeeding stage, there is often less sex drive – your body feels like it’s already in the afterglow, and your libido is no where to be seen.

Oxytocin

Mostly commonly referred to as the “love hormone”, oxytocin is released to encourage let down during breastfeeding. Oxytocin increases bonding and is produced in both parents during cuddling and intimate contact – with both the baby and with each other. Oxytocin levels are highest during new relationships, such as with your brand new baby, and while baby is breastfeeding.

Most of the time we respond to oxytocin in positive ways – it feels good to be awash in these bonding hormones. But it isn’t this way for all women. Some women are very sensitive to such high levels of oxytocin and feel more anxious, irritable or overwhelmed while breastfeeding.

Women’s Hormones in Breastfeeding

It is no surprise that women’s hormones fluctuate a lot in the time after pregnancy – after all, those hormones that helped to sustain the pregnancy are now dropping off (quickly!) to pre-pregnancy levels. How a woman feels in the months, and years, after her baby is born has a lot to do with the balance of her hormones.

Estrogen

Estrogen levels can hit menopausal levels for the months after giving birth – and for some women they stay low throughout the time she is breastfeeding. Low estrogen levels can cause mood swings, irritability, hot flashes and night sweats as well as vaginal dryness, tenderness and discomfort during sexual intercourse. Low estrogen can also zap your desire for sexual intimacy (let alone how dry your lady garden is…) Using a water-based lubricant, and engaging in foreplay can help to overcome some of these low estrogen issues, but if the concern persists, talk to your ND about a low dose topical estriol cream.

Low estrogen can also contribute to an increased incidence of yeast infections, especially in women who are prone to them. If this happens, talk to your Naturopathic Doctor about treatments that are safe during breastfeeding.

Progesterone

Progesterone – “pro-gestation hormone” is at sky-high levels during pregnancy and it can feel like a rollercoaster free fall when you return to pre-pregnancy baselines in the weeks after delivery. Prolactin production suppresses ovulation, especially during the first six months after delivery, and with no ovulation progesterone production is incredibly low.

Symptoms of low progesterone can include anxiety, depression, mood swings, low libido, and insomnia. Many clinicians believe that low progesterone is a contributing factor to the development of post-partum depression in some women. There are many available treatments for post-partum depression, if you are concerned that you may have PPD, talk to your Naturopathic Doctor right away.

Testosterone

Produced mainly by the ovaries, but also in the adrenal glands, testosterone levels are also low in breastfeeding women. Testosterone can contribute to sexual desire, as well as sexual response. Low levels can impact mood, focus and libido.

Beyond Hormones

The months after giving birth are a challenging time for everyone. My take home message here is that while lack of sleep, and an exhausting schedule are huge factors in the way women feel during the months and years of breastfeeding, there are also hormonal influences at play that need to be considered.

If you have been feeling off, feeling exhausted, or have mood swings or low moods don’t just attribute it to the busy-ness of having a baby – talk to someone about how you can support your hormones and restore your hormone harmony throughout breastfeeding.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

The Empowered Woman’s Guide to HSV

Oh herpes. No one wants you. But with 2/3 of people under age 50 having some form of herpes, a lot of women are dealing with this unwanted guest in their lady garden. And herpes isn’t going anywhere – once you have the herpes virus, you always have the herpes virus. Herpes is one of the types of virus that is able to remain in a hidden state in our bodies (called “latent” infection) and pop out when we least want it to.

Types of Herpes

There are two types of herpes simplex virus – HSV-1 and HSV-2. HSV-1 is the virus associated with most cold sores. HSV-2 is the one associated with genital herpes. However their location doesn’t really matter – you can have HSV-1 on your genitals, and while relatively rare, you can also have HSV-2 around your mouth.

How to Get Herpes

Now no one wants to get herpes, but honestly it is hard to avoid. HSV-1 and -2 are transmitted by physical contact, kissing or sexual intimacy. As one of the most common sexually transmitted infections, exposure rates are very high. To avoid exposure to HSV use condoms or dental dams when having sexual contact, and avoid direct contact during known outbreaks in a partner.

While HSV-2 is commonly transmitted sexually, it can infect the mouth as well through oral sex. Most cases of HSV-1 are contracted during childhood, but can also occur sexually. HSV-1 and -2 can both also be passed along to infants during childbirth.

Symptoms of HSV

Many people recognize the symptoms of cold sores – a watery blister near the lip (or sometimes the nose) or in the mucous membranes of the mouth. As the blister heals it forms a characteristic scab.

But herpes can also be completely silent – many people have HSV infections and never know it. This contributes to the high rates of exposure to HSV – it can be passed on even if no active blisters or sores are present.

Symptoms of an outbreak can also cause some symptoms such as tingling, burning or flu-like symptoms before the blisters appear. It is important to avoid direct contact with a partner during these times (use a condom or dental dam).

The first contact with the virus will cause the primary outbreak – usually with symptoms showing up between 2-21 days after contact. Typically this outbreak is more severe and can last longer than subsequent outbreaks.

Triggering Future Outbreaks

Any number of different triggers can lead to the resurgence of the herpes virus. Things that compromise your immune function – like lack of sleep, stress, poor diet and alcohol consumption are common triggers. Other triggers may be sun exposure, excessive heat, skin irritation or other local infections.

Diagnosing HSV

The best test is a simple swab, done in your doctor’s office soon after the onset of the blisters. It can take up to a week for results to come back, so treatment is often started if the symptoms and appearance are consistent with a herpes infection.

There are blood tests available as well that can be used if HSV is suspected.

An Empowered Approach to Treating HSV

My first step in treating HSV in women is to offer assurance. You are practically a unicorn if you have never had HSV – most people in Canada do have it (and remember, once you’ve had it you always have it). It is a virus like any other and we need to let go of some of the negative connotations around contracting HSV.

Second, there are antiviral medications available that can help to lessen the severity of an outbreak and lower the chances of passing HSV to a partner. While I don’t advocate for on going use of these medications, they can be used judiciously in women who are looking for short term support.

Of course, as a naturopathic doctor, my focus is on empowering women to make choices for their health based on knowledge and informed by science. So I like to emphasize what we, as women, can do to help control HSV and prevent outbreaks.

St. John’s Wort – most commonly known as a treatment for depression, Hypericum perforatum (St. John’s Wort) also has powerful antiviral properties that are effective against herpes viruses. Typically taken at higher doses for 1-2 weeks, then decreasing to a lower or maintenance dose.

Lysine – one of the more well-known treatments for HSV, lysine is an amino acid that helps to stabilize the virus and prevent reactivation. It is most often taken daily to prevent outbreaks. Many doctors also suggest consuming more lysine in the diet, and avoiding arginine – this balance supports the immune system in it’s work. Below you’ll find a list of foods high in lysine (enjoy lots of these!) and foods high in arginine (limit these).

Lemon Balm – topical lemon balm is stellar at soothing and supporting the healing of cold sores and genital herpes. It is applied directly to the lesions once or twice per day during an outbreak.

Coriolus Mushrooms – mushrooms pack one hell of a punch when it comes to optimizing our immune system. Coriolus mushrooms in particular have been found to optimize immune function and support the immune system in it’s battle against viruses. I suggest taking mushrooms regularly to support your immune function.

Empowered Steps

If you are struggling with recurrent HSV outbreaks, or this is your first outbreak, I hope that you feel more knowledgeable after reading this article. As always, I suggest that you work with a qualified Naturopathic Doctor to put together a plan that approaches all aspects of your health, and the health of your lady garden. If you’d like to work with me, I am happily taking new patients in my women’s health focused practice in Toronto. You can book here.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

The Empowered Woman’s Guide to Vaginal pH Testing

In teaching my patients to provide empowered care for their lady garden, I have emphasized the importance of a healthy vaginal pH. So how do you know if your pH is optimal? You test it of course!

The Importance of Balance

Your vaginal pH is one of the most important factors contributing to the health and comfort of your lady garden. The pH of the vaginal tract is maintained by the healthy bacteria that live there – mostly Lactobacillus species. When the pH is out of balance this can lead to bacterial vaginosis (BV), yeast infections, and urinary tract infections.

If you are experiencing symptoms of itching, burning, discomfort or an unpleasant odour from your lady garden, a pH test can help you to determine the cause. And once you know the cause, an empowered woman can find the appropriate solution!

How to Test Vaginal pH

Testing your vaginal pH couldn’t be simpler. You purchase a pH test kit – it has to have a pretty narrow range to accurately assess the pH of the vaginal tract. This one is the one I recommend most – you can purchase it easily on Amazon.

To test the pH simply part the outer labia then apply a piece of the pH paper to the vaginal walls for a few seconds. You can then compare the colour of the pH paper to the packaging to determine your pH balance.  Choose the colour that most closely resembles the colour of the paper – it doesn’t have to be a perfect match, just a close match.

What the Results Mean

The pH of a healthy vaginal tract is slightly acidic – typically between 3.8 and 4.5.

A higher number (above 4.5) suggests a more alkaline environment – and is one of the most accurate ways of diagnosing BV. If your pH is high, you should skip the yeast infection treatments and instead start on the PATH to treating BV.

Yeast infections don’t typically change the pH of the lady garden. So if your pH is normal and you still have itching or discomfort, then a yeast infection is more likely your issue. If you don’t have typical symptoms of a yeast infection, speak with your Naturopathic Doctor about whether it may be cytolytic vaginosis, a condition associated with an overgrowth of Lactobacillus that can sometimes mimic a yeast infection.

Monitoring with pH

One of the best things you can do when you are learning to expertly tend to your lady garden is test your pH. If you have had a history of bacterial vaginosis in the past, using pH to monitor your balance, or to assess the impact of treatments, can be incredibly empowering. I suggest you try testing your vaginal pH at different times through your cycle, I recommend weekly, to get a sense of your pH balance throughout your hormonal cycle.

Seeking Support

If you test your vaginal pH and it is out of balance, I suggest you work with a qualified Naturopathic Doctor to regain your balance. The health of your lady garden is a reflection of your hormonal and bacterial health, and I want your health to be vibrant and amazing!

Selected Resources

Hemalatha R, Ramalaxmi BA, Sweta E, Balakrisna N, Mastromarino P. Evaluation of vaginal pH for detection of bacterial vaginosis. Indian J Med Res. 2013; 138(3):354-359

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

Phytoestrogens: Hormone Balance With Food

Phytoestrogens, or plant-based estrogens, are compounds found in our food that can bind to our estrogen receptors.  While a lot of confusion exists on the impact this has on our hormone health, I’m going to help you understand the amazing balancing effects of phytoestrogens, and tell you why you should consider having more of them in your diet.

Why Phytoestrogens are Important

In our bodies we have three sources for estrogen: the estrogen we make (also known as endogenous estrogen), the estrogen we eat (phytoestrogens) and the estrogen-like compounds we are exposed to in our environment (xenoestrogens).

Each of these estrogens can bind to an estrogen receptor and cause an estrogen-like effect.  The chemical estrogens, or xenoestrogens, from the pesticides, herbicides, personal care products and other chemicals in our body have a much stronger impact than that of our own home-made estrogen.  And the plant estrogens have a much weaker effect.

The Balancing Effects of Estrogen

With many women suffering from conditions of excess estrogen – like fibroids, PCOS, obesity and estrogen dominance as well as estrogen sensitive conditions like endometriosis, fibrocystic breasts and breast cancer – lowering their body burden of estrogen is important.  For women with high estrogen, consuming more very mildly estrogenic phytoestrogens can prevent the negative impact of exposure to their body’s own estrogens as well as the chemical estrogens from the environment.  When you have lots of plant estrogens in your body they occupy the estrogen receptor, causing a very small estrogen-like impact, but most importantly, they prevent other stronger estrogens from binding to that receptor.  This results in an overall lower estrogen state in the body.

Following along so far?  It gets better!

When women are suffering from low estrogen – due to hysterectomy or menopause, phytoestrogens can also be helpful.  When women is no longer producing her own estrogen in optimal amounts, the small amount of an estrogen effect from a phytoestrogen can help to boost her estrogen levels and diminish symptoms of low estrogen like hot flashes, night sweats, insomnia and mood swings.

Food Sources of Phytoestrogens

More than 300 different plants contain phytoestrogens. There are several subclasses of phytoestrogens, some of which are listed below.

Lignans – Vegetables, fruits, nuts, cereals, spices, seeds; especially flax seeds

Isoflavones – Spinach, fruits, clovers, peas, beans; especially soy

Flavones – Beans, green vegetables, fruits, nuts

Chalcones – Licorice root

Diterpenoids – Coffee

Triterpenoids – Licorice root, hops

Coumarins – Cabbage, peas, spinach, licorice, clover

To increase dietary sources of phytoestrogens, consider the following foods:

Flax seeds – the highest food source of phytoestrogens is flax seed and oils. The phytoestrogens in flax seeds are lignans. Lignans have antitumour, antioxidant, and weakly estrogenic and antiestrogenic characteristics. They have been found in studies to decrease vaginal dryness, hot flashes or night sweats in women with low estrogen symptoms.

Soy, edamame, tofu, tempeh – the best known phytoestrogen, soy, when consumed in the diet, is safe for women with symptoms of both high and low estrogen.  For hot flashes and night sweats, women who consume soy tend to have less symptoms than women who do not.  Other research suggests that increasing soy foods in the diet stabilizes bone density, decreases cholesterol levels and has a favourable effect on cardiovascular risk profiles in menopausal women

Beans: soybeans, tempeh, black beans, white beans, kidney beans, lentils, mung beans, coffee

Grains: wheat berry, oats, barley, rice, alfalfa, wheat germ

Seeds and nuts: flaxseed, sesame seeds, fenugreek

Vegetablesyams, carrots

Fruits: apples, pomegranates

Herbs and spices: Mint, licorice root, ginseng, hops, fennel, anise, red clover

Harmonizing Your Hormones

If you are interested in exploring more ways to balance your hormones naturally, book a free 15 minute meet and greet appointment with me to discuss how you can bring harmony to your hormones and fire up your health!

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.

 

The Empowered Woman’s Guide to UTIs

This month I’m sharing some of my best advice on how to support and maintain a healthy lady garden. And no discussion on lady garden health would be complete without a mention of those miserable, burning, peeing-a-million-times-a-day UTIs.

Urinary Tract Infections

While men get UTIs as well, women are much more prone to getting urinary tract infections. This is due to a couple of unique things about the lady garden anatomy – the urethra is very close to two bacteria-filled environments, the vagina and the anus, and the urethra in women is much shorter, allowing a fast-track for bacteria to get into the urinary bladder.

Sex can also increase the incidence of UTIs in women because of, well, friction. If the bacteria in the vaginal tract are not healthily balanced those bad bacteria can be pushed into the urethra and lead to a UTI (this is why we are told to pee after sex ladies!)

Symptoms of UTIs

Most women are pretty fast to identify a UTI. There is no mistaking that burning sensation when you pee, as well as that urgent and frequent need to urinate – even when very little comes out each time. Other symptoms to pay attention to are: cloudy urine, pain in the lower back or lower abdomen, or fatigue, fever and chills. If you pain, fever or fatigue – get to your doctor – the infection may have moved into your kidneys which needs immediate attention.

An Empowered Approach to Treating UTIs

While most women are given an antibiotic for UTIs – a treatment which is absolutely necessary in some cases – many women can manage their UTIs quickly and easily with a more natural and empowered approach. There is much more to the treatment of UTIs than just killing off bacteria (those antibiotics will kill off both good and bad bacteria) – we also need to support the health of the lady garden and the immune system.

Lifestyle and Prevention

If you have ever had a UTI it is likely you have been given this advice, but it is so important that it is worth mentioning again. Follow these simple tips to prevent UTIs:

  1. Pee after having sex (to flush the urethra of any bacteria that may have gotten in there)
  2. Drink lots of water
  3. Pee often – don’t hold it in!
  4. Wipe from front to back
  5. Don’t use scented products on your lady garden
  6. Wear cotton underwear and loose fitting clothes

Diet to Prevent Bladder Irritation

Some foods can promote a bladder environment that makes it more likely for you to develop UTIs – and can make it harder to effective treat infections, leading to an increased likelihood of chronic or recurrent urinary tract infections (no thank you!)

Limit caffeine, refined sugar, white flour, alcohol, and food allergies to support the health of your bladder and reduce irritation. If you are a smoker, you should quit as well.

Get Hydrated

Another piece of obvious advice, the importance of hydration can NOT be underemphasized in the treatment of UTIs. I recommend drinking water like it is your day job when actively treating a UTI. But for prevention you should still drink at least 2 litres of water per day. Avoid fluids that contain caffeine and sugar, and stick instead with just plain water – or water with lemon if you’d like.

Keep Your pH Balanced

We talked a lot about the importance of pH balance in the lady garden in the BV and yeast infection articles, and pH balance is just as important for urinary tract infections. Our urine should be slightly acidic (like our lady garden!) which creates an environment that is inhospitable to those UTI-causing bacteria, like e. coli.

Vitamin C is one of the easiest and most effective ways to support the proper pH of the urine. During acute UTIs you can take higher doses of vitamin C (discuss your dose with your Naturopath), and for maintenance take 1-2g per day in divided doses (morning and evening).

Promote Healthy Bacteria

UTIs are caused by the presence of nasty bacteria – most often e. coli, in the urinary tract. Promoting healthy levels of beneficial bacteria, especially lactobacillus, will prevent there from being large colonies of e. coli in the vaginal tract, urinary tract and digestive tract. A daily probiotic supplement is absolutely recommended, and I will often recommend a topical probiotic to be applied to the lady garden during acute infection.

Clear Out the Urethra

We’ve all heard of using cranberry to treat UTIs, and there is evidence that this treatment will help. Cranberry contains a compound called proanthocyanidin that prevents bacteria from adhering to the walls of the urinary tract. This allows you to clear the bacteria much faster. For an acute infection you need to use unsweetened 100% cranberry juice and drink a good amount per day – up to 16 ounces, diluted in water.

Banish Bad Bacteria

There are some excellent natural plant-based treatments for killing off the bacteria that cause UTIs. I never recommend these in isolation – they need to be taken as part of an empowered treatment plan. Destroying bacteria alone will not adequately treat a UTI.

Uva ursi is a powerful antimicrobial that can be highly effective in eradicating bacteria, including e. coli. It is not for use in pregnancy, breastfeeding, children or for more than one week at a time.

Goldenseal is another excellent antimicrobial that is effective against e. coli. It can be used as a supplement, in a tea, or as a lady garden rinse after sexual activity.

Boost Immune Function

To support your immune system, be sure you are maintaining healthy vitamin D levels. Vitamin D is necessary for the production of antimicrobial peptides – our body’s own antibiotics. Supplementation with vitamin D has been found to be associated with a decreased incidence of UTIs. And since just about every Canadian is deficient from October to May, a daily supplement is necessary for most everyone.

Empowered and UTI-Free!

I hope you can now see all the many factors that go into treating and preventing UTIs.  Working with a Naturopathic Doctor can help you to individualize your plan – to be sure that you are taking all the necessary steps to be empowered in the care of your lady garden.  If you’d like to talk – drop me a line!  You can book a 15 minute meet and greet session, join me on Facebook or Instagram.  I’m thrilled to a part of your empowered journey.

Disclaimer

The advice provided in this article is for informational purposes only. It is meant to augment and not replace consultation with a licensed health care provider. Consultation with a Naturopathic Doctor or other primary care provider is recommended for anyone suffering from a health problem.