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Is my IBS actually SIBO?

Gas, bloating, abdominal pain, diarrhea, constipation – present to your medical doctor with any of these symptoms and you’ll likely get a diagnosis of IBS – irritable bowel syndrome. But what if it’s more than that? What if rather than having a cranky digestive tract you actually have a bacterial imbalance in your small intestines? What if you have SIBO?

What is SIBO?

SIBO stands for small intestine bacterial overgrowth, a condition where abnormally large numbers of bacteria (both the good and bad kind) are present in the small intestine. SIBO is a very common cause of IBS-like symptoms – studies have shown SIBO to be involved in between 50-84% of IBS cases. More importantly, when treated for SIBO, a 75% reduction in IBS symptoms has been found. For people who have been suffering for years (or decades!) with IBS symptoms, a proper diagnosis of SIBO can be life-changing.

Symptoms

While most people who experience digestive issues are given a diagnosis of IBS, the symptoms of SIBO are so similar that I recommend every patient who has been told they have IBS be tested for SIBO. Symptoms of IBS include:

  • Gas and bloating (often causing visible distention of the abdomen)
  • Flatulence (farting) and belching (burping)
  • Abdominal pain, cramping or general discomfort
  • Constipation or diarrhea (or both!)
  • Heartburn
  • Nausea
  • Nutrient deficiencies (due to malabsorption – vitamin D, B12, K)

The bacterial overgrowth in SIBO can cause significant gas and bloating – if you are experiencing severe gas or bloating, SIBO testing should be considered. With healthy normal bacteria levels, a single ounce of milk will cause about 50cc of gas to be created. With SIBO, that same amount of milk will cause up to 5000cc of gas to be created! And that gas has to go somewhere – filling the intestines and causing pain, or being released as gas and burping.

Many conditions may also be associated with SIBO, with the additional symptoms of those conditions being present. Some of those conditions include:

  • Hypothyroidism
  • Gallstones
  • Crohn’s disease and inflammatory bowel disease
  • Lactose intolerance
  • Diverticulitis/ diverticulosis
  • Fibromyalgia
  • Chronic pancreatitis
  • Lactose intolerance
  • Celiac disease
  • Restless leg syndrome
  • Rosacea
  • Diabetes

What Causes SIBO?

In our bodies we support a population of around 300 trillion bacteria. Living mostly on our skin and in our large intestine, these bacteria are powerful supporters of healthy human function. Producing vitamins like vitamin K and B12, producing neurotransmitters like serotonin, and regulating the function of our immune system – these bacteria are essential for optimal health.

SIBO occurs when the bacteria that should be in our large intestine migrate upwards into our small intestine. There they produce gases and disrupt nutrient absorption, leading the symptoms often attributed to IBS.

There are some specific triggers that can lead to this movement of bacteria into the small intestine. Some of those triggers include:

  • A stomach flu or food poisoning
  • Low stomach acid (or use of antacids)
  • Prior bowel surgery
  • Use of antibiotics (especially multiple courses)
  • Moderate or high alcohol consumption (greater than one drink per day for women or two drinks per day for men)
  • Use of birth control pills

One of the organisms involved in SIBO, Methanobrevivacter smithii has been linked to obesity in humans

Clues to SIBO

There are some clues that your IBS may in fact be SIBO. If you answer “yes” to any of these questions, you should invest in SIBO testing now.

  1. Did your digestive symptoms start, or become worse, after a bout of the stomach flu?
  2. Have you experienced short term improvement in your symptoms after taking an antibiotic?
  3. Do your symptoms get worse when taking a probiotic or prebiotic supplement?
  4. Does eating a high fiber diet worsen constipation or IBS symptoms?
  5. Do you have celiac disease that has not sufficiently improved following a gluten-free diet?
  6. Have you been diagnosed with an iron deficiency, despite having an iron rich diet?
  7. Do you have IBS symptoms and take antacids more than once per month (including Tums, Rolaids, Nexxium or Prilosec)?
  8. Do you experience gas that has a strong “rotten-egg” odour?

Diagnosis

The overgrowth of bacteria seen in SIBO can be identified through a breath test. The bacteria produce high amounts of hydrogen, hydrogen sulfide, or methane gas. These gases are not produced by human cells, but only through the action of bacteria on carbohydrates in our intestines.

The most common (and effective) test for SIBO is a combined hydrogen/methane breath test. This test is readily available from your Naturopathic Doctor. This is the only test for SIBO – stool tests will not help to diagnose SIBO.

Next steps

If you suspect you may have SIBO, you should see your Naturopath for appropriate testing. Once a diagnosis has been made you can embark on a treatment plan that may finally resolve your symptoms and get you back on the path to optimal health.

The treatment of SIBO is multifaceted and individualized for each person. Some of the key areas we focus on are supporting small intestine motility, optimizing digestive acids and enzymes, healing the lining of the digestive tract, eradicating biofilm and promoting healthy bacterial balance in the large intestine. Addressing the lifestyle and diet for long term prevention of recurrence is also important. Discontinuing medications, like antacids and proton pump inhibitors that encourage SIBO must also be considered.

You don’t have to continue to suffer. Digestive health is essential for optimal health. Get yourself tested, and get on the path to wellness today.

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.

MTHFR in Mental Health

MTHFR is an essential component of human health, one that you may not have heard of, but you likely will be hearing more about it in the future.

MTHFR is an acronym for a gene – methylenetetrahydrofolate reductase. This gene produces an enzyme essential for human health – methylenetetrahydrofolate (MTHF). It has been estimated that somewhere between 30-85% of humans carry a mutation, or SNP (single nucleotide polymorphism) in this gene. This can lead to minimal changes in the function of this gene, or significant changes that can drastically impact health. Our current best guess is that between 6-14% of caucasians, 2% of African descent, and up to 21% of Hispanics have a severe mutation.

MTHFR in Mental Health

One of the essential functions of MTHFR is to produce neurotransmitters. Individuals with MTHFR mutations may be more at risk of developing one of the many mental health conditions associated with MTHFR:

  • depression
  • bipolar disorder
  • attention-deficit hyperactivity disorder (ADHD)
  • schizophrenia
  • autism
  • addiction
  • anxiety

The neurotransmitters produced during the MTHFR cycle, in particular serotonin, dopamine, norepinephrine and melatonin, have important mood stabilizing effects. The decreased function of the MTHFR cycle in people with a MTHFR mutation can lead to lower levels of these neurotransmitters, increasing the risk of developing a mental health condition.

MTHFR and Anti-Depressants

In addition to increasing the odds of developing a mental health condition, an MTHFR defect can also alter the ability of a person to respond to antidepressant medications. A higher rate of non-responsiveness and/or adverse effects has been found in people with an MTHFR mutation.

MTHFR Testing

If you suspect you may have an MTHFR defect the only way to know for sure is to do a genetic test that will identify if you have a mutation in this important gene at one of two locations – known as C667T or A1298C. If you have a single mutation in one location (inherited from one parent) you have a “heterozygous” mutation – if you have two mutations in one location (inherited from both parents) then you have a “homozygous” mutation, which is generally more severe. If you have two mutations in both locations then you have a “compound homozygous” mutation, the most severe.

What to do about MTHFR

The most important thing to do about MTHFR is to support the normal function of this enzyme pathway with essential nutrients. This pathway (methylenetetrahydrofolate reductase) produces folate as one of it’s primary actions. Folate, vitamin B9, can be taken as a supplement and reduce the negative effects seen with MTHFR mutations. Avoiding things that can interfere with folate is also important – digestive diseases, poor diet, alcohol consumption and some medications (include the birth control pill). Additionally, avoiding synthetic folic acid, found mostly in processed foods (like bread, crackers and cereals), is also important as the folic acid can slow down the MTHFR cycle further.

In addition to taking a folate supplement, focusing on a healthy diet is essential for managing MTHFR. Folate comes from foliage – so eating your leafy greens, broccoli and beans can provide folate in your daily diet.

Treating MTHFR can be complex. Working with a qualified practitioner, well-versed in MTHFR is essential to improve your health and support your mind and body.

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 in PMS

Welcome to the first installment of the “Hormone Harmony” series. In this series I’ll be exploring some of the most common states of female hormone imbalance, how your hormones can explain your symptoms, and some simple hormone hacks to help bring your body back into a state of hormone harmony.

Premenstrual Syndrome (PMS)

While a definition of PMS may not be necessary if you are reading this (it’s likely you’ve had first hand experience), I will try to give one that encompasses exactly what PMS is.

PMS is a recurrent set of physical and/or behavioural symptoms that occurs 7-14 days before a period and negatively impacts some aspect of a woman’s life

There have been over 150 (seriously!) symptoms of PMS identified. Some of the most common include:

  • Low energy
  • Mood changes – anger, crying, irritability, anxiety, depression, bitchiness
  • Food cravings
  • Headache
  • Low sex drive
  • Breast tenderness
  • Digestive upset – constipation, bloating, diarrhea, gas
  • Difficulty sleeping

Unfortunately we don’t really know what causes some women to experience PMS more than other women. But hormone imbalances are a common proposed cause, and in my practice I see balancing hormones as the most important means of decreasing symptoms of PMS.

Hormone Imbalances in PMS

The relationship between estrogen and progesterone is one of the most important hormone balances in a woman’s body. Imbalance in estrogen and progesterone levels is thought to be the primary cause of PMS.

Estrogen is produced throughout the month by the ovaries, adrenal glands and fat cells. It main action is growth – growth of breast tissue in puberty, and growth of the endometrial lining in the uterus during menstrual cycles.

Progesterone is produced during the second half of the menstrual cycle – after ovulation – by the ovaries.  Progesterone helps to balance the effects of estrogen and prepare the uterus for a possible pregnancy.

A too high estrogen level, or a too low progesterone level is thought to be the most likely cause of PMS symptoms in most women. This state, commonly called “estrogen dominance” is the most common hormone imbalance in women between the ages of 15 and 50. Estrogen dominance is becoming more common in North America due to increasing exposure to xenoestrogens (chemicals in our environment that mimic estrogen), high rates of obesity, decreased ability of our livers to detoxify and overwhelming amounts of stress.

The important thing to remember with PMS and hormone balance is that it is the relationship and balance of estrogen and progesterone that leads to symptoms. You may have normal levels of estrogen, but if your progesterone is low you will still experience symptoms. Progesterone levels are low in women who do not ovulate, and in those with significant stress (your body will convert progesterone into cortisol, leaving you deficient in much-needed progesterone).

Hormone Hacks for PMS

If you are a woman experiencing PMS, taking charge of your hormones and getting them into balance can make a huge difference in your quality of life. Below are some simple Hormone Hacks to get you started.

  1. Follow the PMS diet

There have been some significant findings in the diets of women who suffer from significant PMS. Compared to women who do not have PMS they eat 275% more sugar, 79% more dairy and 62% more refined carbohydrates. Avoiding these foods – and instead choosing fruits, vegetables, whole grains and healthy proteins – can diminish PMS symptoms significantly and promote healthy hormone balance.

  1. Cut the caffeine

No one wants to hear it, but drinking caffeine-containing beverages increases the severity of PMS. And those effects are worsened if you add sugar to your tea or coffee. So cut back, or cut it out all together if you want to decrease your PMS.

  1. Exercise

Women who exercise regularly have less PMS. Multiple studies have found this to be true, and the more frequently you exercise the better the boost. Exercise is known to decrease estrogen levels – so get out there and get moving.

  1. Get your nutrients in

Deficiencies in many nutrients have been found in women with PMS. Some notable ones include magnesium, vitamin B6, and zinc. All of these nutrients can be found in nuts and seeds – also known to be excellent sources of vegan protein.

  1. Get tested

Understanding your hormone imbalances can be incredibly valuable to managing symptoms like PMS. Testing your hormone levels will give you a clear understanding of what is happening in your body during a specific phase of your menstrual period. For PMS we test hormone levels (estrogen, progesterone and prolactin) about 7 days before your expected period.

  1. Herbal hormone balancers

There are some phenomenal hormone balancers in the world of herbal medicine. Vitex agnus-castus (also known as chaste berry) can improve progesterone levels, helping to balance estrogen dominance. Phytoestrogens, like those found in black cohosh, soy and flaxseeds, can also help to normalize estrogen levels by decreasing the action of our body’s own estrogen in favour of the milder estrogen signal from plant estrogens.

  1. Bioidentical progesterone

When all else fails in hormone balancing for PMS, your naturopathic doctor can prescribe low dose bioidentical progesterone in a cream that you can apply during the final weeks of your menstrual cycle. This will be helpful if your progesterone levels are low, or if your estrogen levels are high. Be sure your ND is qualified to prescribe bioidentical hormones, as additional training is required.

Don’t suffer with hormone imbalances like PMS.  You can achieve hormone harmony, and working with a Naturopathic Doctor can get you there.  Book an appointment, or a meet and greet now to find your personal balance.

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.           

Female Hair Loss: Lab Testing

My expertise in treating hair loss in women started with a personal experience of hair loss in my 20s. After being dismissed by my Medical Doctor who assured me it was “totally normal” I persisted in understanding why a healthy woman in her 20s would start losing hair.

Laboratory Testing for Female Hair Loss

As I discuss in my article, Getting to the Root of Female Hair Loss, treating hair loss can only be effective if you understand the root cause – why is a woman losing hair? Through laboratory testing an answer can often be found.

When I am working with women with hair loss I generally advocate for a tiered approach to lab testing for hair loss – starting with the most likely causes and progressing to the more complex.

For myself, the issue was an iron deficiency. By correcting that iron deficiency I was able to resolve my hair loss in under a year and it hasn’t recurred since.

Use the checklist below with your Medical Doctor or Naturopathic Doctor to determine the root cause of your hair loss. And if you’re ready to work with someone experienced in hair loss in women, get in touch and book an appointment today.

Female Hair Loss – Printable PDF

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.

 

Natural Treatments for Tinnitus

Tinnitus impacts nearly 400 000 Canadians and can severely impact the quality of life. Tinnitus is defined as the perception of sound without an external source. It may be described as a hissing, ringing, or whooshing noise.   Many individuals diagnosed with tinnitus are told that the condition is chronic, will never improve, and they will just have to learn to live with it.

While Naturopathic Medicine can not guarantee a successful treatment of tinnitus, there may be hope in some of the integrative treatments available.

Cause of Tinnitus

The exact underlying cause of tinnitus is not known. It can be associated with noise trauma (explosions, loud noises), physical trauma, post-inflammation, anxiety and other conditions. In many cases an underlying cause is not identified.

The symptoms of tinnitus may be processed by different parts of the brain than typical auditory pathways. The amygdala and limbic system – parts of the brain responsible for memory and emotions – seem to play a significant role in tinnitus.

Diagnosis of Tinnitus

Diagnosis of tinnitus is generally clinical – the presence of a reported noise with no external source. An audiologist assessment should also be performed. A contrast MRI is also a useful tool and can identify possible underlying causes of tinnitus. Blood work for autoimmune antibodies, vitamin B12, inflammatory markers (ESR), cholesterol levels, blood sugar levels, thyroid-stimulating hormone and comprehensive hormone testing can also provide useful information in identifying metabolic, hormonal, or autoimmune cases of tinnitus. Questionnaires can also be valuable in tracking progress with integrative treatment options.

Conventional Treatment Options

There are several different treatment options offered by qualified audiologists. Many involve sound therapy, masking, hearing aids or tinnitus retraining devices. A referral to an experienced audiologist is necessary for these treatments.

Correcting underlying causes of tinnitus will be helpful in a patient-by-patient basis. If the tinnitus is caused by a hormonal imbalance, such as thyroid disease, correcting the thyroid dysfunction can lead to resolution of symptoms. Antidepressants (impacting serotonin and/or dopamine) and GABA-enhancing medications have also been used in some individuals with success.

Naturopathic Treatment Options

While no guarantee of success exists in the treatment of tinnitus, the lack of conventional treatment options leads many people to seek out natural and integrative therapies. The majority of these options are safe and may provide some degree of relief to people suffering with tinnitus. Working with a knowledgeable Naturopathic Doctor is advised as these treatments may have side effects or interactions with other medications.

Ginkgo biloba

One of the most commonly sold botanical medicines worldwide, ginkgo is used to increase blood flow to the head and treat symptoms of Alzheimer’s disease, dementia and vascular tinnitus. ginkgo has antioxidant, neuroprotective and platelet-inhibiting effects. Studies suggest that ginkgo may have a positive impact on patients with tinnitus, by increasing blood flow to the ear and may be especially useful in the elderly. The use of ginkgo may be limited by its interactions with medications, especially blood thinners, aspirin and seizure medications.

Zinc

Zinc is an essential mineral with significant actions in the central nervous system, including the hearing pathway, as well as in hormone production, enzyme function, and synthesis of DNA and RNA. Studies have suggested that zinc deficiency impacts between 2-69% of individuals with tinnitus. Giving zinc to individuals with tinnitus is a low risk intervention, and measuring serum zinc levels may identify those in greatest need for supplementation.

Melatonin

Melatonin, a hormone produced by the pineal gland during the night, regulates sleep/ wake cycles and acts as an antioxidant. Some studies have found that supplementing melatonin may improve tinnitus, especially in individuals with sleep disturbances. Melatonin may also help in individuals with stress by balancing cortisol production, another hormone often involved in tinnitus.

Vitamin B12

An important nutrient, and common deficiency, there have been studies showing a relationship between vitamin B12 deficiency and abnormal function of the hearing pathway. For every individual experiencing tinnitus, vitamin B12 levels should be assessed and optimal levels should be achieved through dietary and supplemental means.

Garlic

The flavourful garlic bulb is useful for many cardiovascular conditions. It has cholesterol-lowering effects, lowers blood pressure and can decrease blood clot formation. It may be useful for tinnitus by improving blood flow to the inner ear. There are no current studies on the use of garlic for tinnitus, but the possible benefits are evident.

Pycnogenol

Preliminary research suggests that the antioxidant, pycnogenol (pine bark extract) can decrease symptoms of tinnitus after one month of use. It is suspected that it’s influence on inflammation and the cardiovascular system may lead to improvements in tinnitus.

Hormone Modulation

Hormonal imbalances have been identified in many individuals experiencing tinnitus, with imbalance in the hypothalamus-pituitary-adrenal (HPA) axis being most common. This HPA axis is involved in the stress response, with abnormal cortisol production being a common feature. One study found that individuals with tinnitus had a blunted cortisol response after stressful events. Identifying and correcting underlying hormonal imbalance can improve tinnitus in some people, especially those with stress.

Acupuncture

Several studies have demonstrated improvement in tinnitus symptoms with acupuncture treatment. Improvements with acupuncture have not been found in all studies, and improvements may be short lived (average of 100 hours in one study). Acupuncture is a very safe treatment, with limited side effects and no interactions with medications. Administered by a qualified naturopathic doctor or acupuncturist, it may be a valuable option for the treatment of tinnitus.

Taking an integrative approach, managing stress and balancing your hormones may help to improve the symptoms of tinnitus, and also improve the quality of life of people suffering with tinnitus. To learn more, speak to a qualified Naturopathic Doctor.

References:

The sound of stress: blunted cortisol reactivity to psychosocial stress in tinnitus sufferers. Hébert S, Lupien SJ. Neurosci. Lett. – January 10, 2007; 411 (2); 138-42

Diagnostic value and clinical significance of stress hormones in patients with tinnitus. Kim DK, Chung DY, Bae SC, Park KH, Yeo SW, Park SN. Eur Arch Otorhinolaryngol – November 1, 2014; 271 (11); 2915-21

Hormones and the auditory system: A review of physiology and pathophysiology Neuroscience, 2008-06-02, Volume 153, Issue 4, Pages 881-900, Copyright © 2008

Complementary and Integrative Treatments for tinnitus Gregory S. Smith MD, Massi Romanelli-Gobbi BM, Elizabeth Gray-Karagrigoriou Au.D and Gregory J. Artz MD  Otolaryngologic Clinics of North America, The, 2013-06-01, Volume 46, Issue 3, Pages 389-408

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.

 

10 Tips to Treat PMS Naturally

PMS (premenstrual syndrome) sucks.  That’s not medical jargon, that’s just the way it is.  Once a month, up to three-quarters of women experience physical or emotional discomfort or pain which can last up to 14 days (two weeks!!).  Over 150 symptoms of PMS have been identified but the most common symptoms are:

Naturopathic treatment of PMS
There are over 150 symptoms associated with PMS
  • Decreased energy
  • Irritability, nervousness, anxiety and anger
  • Food cravings
  • Depression
  • Headache
  • Altered sex drive
  • Breast pain
  • Muscle aches and low back pain
  • Bloating
  • Diarrhea and/ or constipation
  • Swelling of the hands and feet
  • Trouble concentrating
  • Difficulty sleeping

What causes PMS?

Honestly, we don’t exactly know what causes PMS.   It’s most likely a combination of imbalances in our hormones, neurotransmitters and environment that leads to symptoms of PMS.

Balancing these diverse systems gives most women relief from their PMS symptoms.  It sometimes takes time to determine which treatment is right for you.  An experienced Naturopathic Doctor will be able to tailor an individualized plan to give you the best chance for success.

10 Tips to Treat PMS Naturally

1. Exercise

Exercise is important for your overall health, but it can also decrease symptoms of PMS.  Studies have shown again and again that women who engage in regular exercise have fewer PMS symptoms than women who do not.  And the exercise doesn’t need to be intense – it just needs to happen regularly (at least 3 times per week throughout the month).

Exercise is thought to reduce PMS symptoms by reducing estrogen levels, improving glucose tolerance and raising endorphin levels.  Aerobic exercise (swimming, cycling, running, etc), yoga or tai chi are all beneficial.

2.    Cut out sugar

Women who experience PMS have been reported to eat whopping 275% more refined sugar than women who do not get PMS symptoms.  Refined sugars deplete our magnesium levels, increase sodium and water retention and create imbalances in our insulin levels.  All of these processes have been linked to the development of PMS symptoms.

Eliminating refined sugar and limiting simple carbohydrates in favour of high fiber complex carbohydrates lowers blood levels of estrogen, improves magnesium levels and can significantly improve symptoms of PMS.   So cut out the cookies, cakes, bagels and breads in favour of oatmeal, popcorn, quinoa, brown rice and other fiber rich foods.

 3.    Eliminate caffeine

Caffeine consumption is associated with more and worse PMS symptoms.  Caffeine is linked especially to breast tenderness,anxiety, irritability and difficulty sleeping during PMS.  The impact is even worse when combined with sugar (pay attention all you Frappuccino drinkers!).  Eliminating caffeine, or limiting it during the premenstrual phase can improve PMS symptoms for a lot of women.

4.    Take a probiotic

Probiotics are not just for digestive health!  Having good bacteria in our intestines has wide ranging benefits for our health.  Healthy bacteria can decrease symptoms of PMS by increasing beta-glucuronidase enzyme activity and promoting estrogen excretion.

The best way to establish a healthy bacteria flora in your intestinal tract is to take a probiotic supplement.  Try for one with both Lactobacillus acidophilus and Bifidobacterium bifidum.  Taken with food, probiotics are extremely safe and have no negative side effects (you can experience bloating if you take too much – 1 to 10 billion is usually a safe amount).

 5.    Take a calcium and magnesium supplement

1k-7649 spinachThere is a direct relationship between calcium and estrogen.  Estrogen is involved in the absorption, metabolism and utilization of calcium in our bodies.  Clinical trials have found that both mood and physical symptoms of PMS are improved with daily calcium supplementation

Magnesium deficiency is a major concern and is seen in a majority of women with PMS.  Magnesium deficiency causes fatigue, irritability, mental confusion, menstrual cramps, insomnia, muscle aches and pains and heart beat irregularities.

Dietary sources of calcium include dark green leafy vegetables, dairy (cheese, yogurt, milk), tofu, and almonds.  Dietary sources of magnesium are similar and include green leafy vegetables, tofu, legumes, nuts, seeds and whole grains.  Calcium and magnesium supplements should be taken in the evening, away from iron supplements and thyroid medications.

6.    Take B vitamins

B vitamins are involved in hundreds of different processes in our bodies.  The liver uses various B vitamins to detoxify estrogen and allow our bodies to eliminate it.

Additionally, pyridoxine (vitamin B6) can ease symptoms of PMS by increasing production of the neurotransmitters serotonin and dopamine.  Low levels of these neurotransmitters have been suggested as a cause of many PMS symptoms including low energy, irritability and mood swings.

As if that wasn’t enough, B6 is also involved in transfer of magnesium into cells – without B6 magnesium wouldn’t be able to enter cells.  This is another reason why B vitamins, and especially B6 are so important in the relief of PMS symptoms.

7.    Dong Quai

Dong Quai (Angelica sinensis) is a traditional Chinese herb with thousands of years of use for imbalances in the female reproductive system.  It has been used for menopause, painful menstruation, no menstruation and as a uterine tonic.  Dong quai has phytoestrogenic properties and is best used for women who experience PMS symptoms in addition to painful menstruation.

 Dong quai is usually used from ovulation (day 14) until menstruation begins.  If you are also experiencing painful periods, continue it until your period stops.

 8.    Chaste tree

While best known as a treatment for menopause, chaste tree (Vitex agnus castus) is probably the single most important herb in the treatment of PMS.

The effects of chaste tree appear to be due to the impact it has on the hypothalamus and pituitary – the starting point for hormone production in the body.  As a result, chaste tree is able to normalize the secretion of many hormones, for instance, reducing prolactin levels and normalizing the estrogen to progesterone ratio.

Chaste tree is best taken daily throughout the menstrual cycle.  Studies have found it to be useful for almost all symptoms associated with PMS including irritability, mood swings, anger, anxiety, headache, and breast tenderness.

9.    Licorice

Licorice (Glycyrrhiza glabra) is an amazing herb!  It has been used in both Western and Eastern herbal medicine for thousands of years for a wide variety of ailments.  It also has impressive modern scientific research to back up its historical uses.

 Licorice is useful in the treatment of premenstrual syndrome because it lowers estrogen levels while simultaneously raising progesterone levels.  Licorice also blocks the hormone aldosterone, decreasing water retention.

 Licorice is usually taken from ovulation (day 14) until your period starts.  It should not be used if you have a history of kidney disease or high blood pressure.  You should be under the care of a Naturopathic Doctor while taking licorice.

10. See a Naturopathic Doctor

This is probably the best thing you can do to help manage your PMS symptoms.  Naturopathic Doctors are experts in correcting the underlying imbalances that lead to PMS symptoms.  Your unique set of symptoms will give an experienced ND a lot of information that can be used to individualize a treatment plan just for you.  NDs also can order comprehensive hormone panels that will identify imbalances in prolactin, estrogen, progesterone or testosterone that may be contributing to your symptoms.  You can find a licensed Naturopathic Doctor in your area by visiting the national association websites – CAND in Canada and AANP in the United States.

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.

Photo credits:

Creative Commons License Mislav Marohnić via Compfight

Creative Commons License Ed Yourdon via Compfight

Tim Hamilton via Compfight

Wheat Woes: Celiac disease, wheat allergy and gluten sensitivity

Many people are beginning to recognize the personal benefits of a gluten-free diet. For some individuals the simple avoidance of gluten (a protein in wheat, barley and rye) can improve or completely resolve symptoms of diarrhea, constipation, gas and bloating.

So what is the problem with gluten? Why are so many people benefiting from avoiding this specific protein? The answer is not that simple. In fact, there are three distinct medical diagnoses that may apply to people who improve on a gluten free diet.

Celiac Disease

Bread slicedCeliac disease is an autoimmune disease impacting about 1 in 100 people. In this condition the body is stimulated to produce auto-antibodies against the lining of the small intestine. These auto-antibodies are only produced in the presence of gluten in the diet. Celiac disease incidence has increased 5-fold in the past 40 years – a trend that is seen with a number of autoimmune conditions. Having celiac disease increases the risk for the development of other autoimmune conditions in your lifetime. The only treatment for celiac disease is lifelong avoidance of gluten.

Wheat Allergy

Wheat allergy results when the body produces an allergic reaction to gluten or another component of wheat. The allergic sequence is similar to other allergies, with the release of histamine from mast cells and basophils, triggered by immunoglobulin E (IgE) cross-linking. Symptoms of wheat allergy include redness, swelling, hives and other allergy-type symptoms. Wheat allergy is the rarest of the wheat-associated diagnoses with only 1 in 500 people being impacted.

Gluten Sensitivity

By far the most common diagnosis associated with wheat is gluten sensitivity. It is estimated to impact 1 in 10 people and is 6x more prevalent than celiac disease. The symptoms of gluten sensitivity include:

  • Abdominal pain (68%)Gluten Free Logo
  • Eczema or rash (40%)
  • Headache (35%)
  • Foggy mind (34%)
  • Diarrhea (33%)
  • Depression (20%)
  • Anemia (20%)
  • Numbness in legs, arms or fingers (20%)
  • Joint pain (11%)

Diagnosis of gluten sensitivity is typically a diagnosis of exclusion. If you test negative for celiac disease (auto-immune antibodies), negative for wheat allergy (IgE immunoglobulins) but still improve on a gluten free diet then you will likely receive a diagnosis of gluten sensitivity.

Food sensitivity testing, such as the IgG food sensitivity panel, can help to confirm a diagnosis of gluten sensitivity. It can also identify other food sensitivities which may be occurring simultaneously, such as a dairy, egg or nut sensitivity.

If you suspect you may be gluten sensitive, cut it out of your diet for at least three weeks and watch your symptoms for improvement. Or contact your Naturopathic Doctor to discuss comprehensive testing for celiac disease, wheat allergy and gluten sensitivity. Take charge of your health, and let go of your wheat woes!

Select references

Sapone A, Lammers KM, Casolaro V, et al. Divergence of gut permeability and mucosal immune gene expression in two gluten-associated conditions: celiac disease and gluten sensitivity. BMC Med. 2011;9:e23

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.

 

Hashimoto’s and Gluten

Gluten. It seems like everyone is talking about it. Books are lining shelves declaring the evils of this grain-based protein most of us have been eating for years. The grocery stores are full of “gluten-free” labels and gluten free bakeries are popping up in cities all across the country.

Gluten Free LogoWhy are we suddenly so aware of this protein? And what does it mean for people who have Hashimoto’s? Let me take you through some of the basics.

What is Gluten?

Gluten is a protein found in several different grains – wheat, barley, rye, spelt, kamut and triticale. It is a combination of two different proteins, gliadin and glutenin. Not all grains contain gluten and a gluten-free diet can still provide the essential nutrients found in these grains.

Autoimmunity

Hashimoto’s thyroiditis is an autoimmune condition where the immune system attacks and destroys the thyroid gland. It is, in essence, an immune condition with the thyroid being the unfortunate victim.

Autoimmune conditions are thought to develop when there are a combination of different factors. The three most commonly suggested factors are:

  • Genetic predisposition
  • A triggering event – this can be a nutrient deficiency, acute illness, chronic infection, dysbiosis, excess stress, food sensitivities or impaired detoxification
  • Increased intestinal hyperpermeability or “leaky gut”

The increased intestinal hyperpermeability, or “leaky gut” is where gluten becomes a major issue.

Leaky Gut

Keep outThe cells that line our digestive tract are joined at tight junctions – these close connections allow only the smallest particles of digested food to present to our immune system. Certain foods, like gluten, are more difficult for our enzymes to completely digest. These partially digested proteins, called peptides, can cause inflammation at the lining of the digestive tract, leading to damage of the tight junctions. When these tight junctions are compromised they become more permeable, or leaky, allowing larger molecules (peptides) to present to our immune system.

Once the immune system has been exposed to these large peptide molecules it may begin to produce antibodies against the peptides – an attempt to protect us from this foreign molecule.

The issue of autoimmunity, especially Hashimoto’s thyroiditis, occurs when the immune antibodies begin to circulate through our body, searching for the sequence of amino acids that make up the gluten peptide. The surface of the thyroid gland is made up of fats and proteins – and unfortunately the amino acid sequence of proteins on the surface of the thyroid is the same as the gliadin peptide in gluten. This results in the immune system destroying the thyroid gland, mistaking it for the component of gluten that triggered the response in the digestive tract.

Gluten and Food Sensitivities

wheat is a common food allergenIn my practice I recommend that all people diagnosed with Hashimoto’s thyroiditis eliminate gluten from their diet. However, leaky gut can be caused by, or lead to many other food sensitivities which can also have the same devastating effect on the thyroid gland, and other tissues in the body.

Every person with an autoimmune condition, including Hashimoto’s should seriously consider having an IgG based food sensitivity panel done to identify their own sensitivities. Understanding the action of your immune system in your body is imperative to decreasing the overactivity of the immune system and preventing further damage to your body.

For more information on Naturopathic Medicine and Hashimoto’s Thyroiditis, please read the other articles on this website written by Dr. Lisa Watson, ND: Understanding Hashimoto’s, Hashimoto’s and Fertility, Naturopathic Treatments for Hashimoto’s. If you are ready to start on your path to healing your Hashimoto’s you can book an appointment with Dr. Lisa by following the links 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.

Select references

Carrocio A, D’Alcam A, Cavataio F, et al. Gastroenterology. High Proportions of People With Nonceliac Wheat Sensitivity Have Autoimmune Disease or Antinuclear Antibodies.2015 Sep;149(3):596-603.e1.

Fasano A, Shea-Donohue T. Mechanisms of Disease: the role of intestinal barrier function in the pathogenesis of gastrointestinal autoimmune diseases. Nature Clinical Practices. 2005 Sep:2(9):416-422.

 

Understanding Hashimoto’s Thyroiditis

Hypothyroidism is a common condition impacting women, with women between 5-8 times more likely to develop this condition than men. The most common cause of hypothyroidism in Canada and the US is Hashimoto’s thyroiditis.

What is Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis is an autoimmune condition in which the body’s own immune cells attack and destroy the thyroid gland resulting in decreased thyroid function (hypothyroidism). Hashimoto’s most often impacts young and middle aged women (20’s to 50’s) and can lead to permanent damage of the thyroid gland and lifelong hypothyroidism.

Symptoms of Hashimoto’s Thyroiditis

Hashimoto’s thyroiditis in it’s early stages is often silent with few to no symptoms. Some people experience a sense of fatigue or not feeling their best, but often do not seek medical care for these common symptoms.Winter hat

The symptoms of Hashimoto’s are indistinguishable from other forms of hypothyroidism:

  • Weight gain
  • Fatigue
  • Swelling
  • Muscle weakness
  • Constipation
  • Cold intolerance
  • Dry skin
  • Dry or brittle hair
  • Hair loss
  • Firm or nodular thyroid gland on palpation

Diagnosing Hashimoto’s Thyroiditis

All hypothyroidism is diagnosed using a thyroid stimulating hormone (TSH) level. TSH is produced in the pituitary gland and tells the thyroid gland to make thyroid hormones. If the TSH is too high, that means the thyroid is not working effectively and a diagnosis of hypothyroidism can be made.

In Hashimoto’s thyroiditis anti-thyroid antibodies (antithyroid peroxidase, antithyroglobulin) are commonly present. However they are rarely tested, despite the majority of hypothyroid cases being autoimmune in origin.

In my Naturopathic practice I always test for anti-thyroid antibodies to confirm Hashimoto’s and to monitor treatment.

Hashimoto’s and Autoimmunity

An autoimmune condition is any condition where the body’s immune system begins to attack the body’s own tissues rather than the viruses and bacteria it is designed to fight. Hashimoto’s thyroiditis occurs when the immune system attacks the thyroid gland. It is not in essence a thyroid condition, but an immune condition where the thyroid is the unfortunate victim.

Once a person develops one form of autoimmune condition they are more likely to develop others. The incidence of Hashimoto’s is higher in people with pre-existing autoimmune conditions such as celiac disease, rheumatoid arthritis, psoriasis, vitiligo and lupus.

Conventional Treatment of Hashimoto’s

Thyroid medicationConventional treatment of Hashimoto’s thyroiditis does not differ significantly from treatment of other forms of hypothyroidism. The main treatment is L-thyroxine (T4) taken daily in the morning. This T4 is then converted in the body to the active thyroid hormone, T3.

There are controversies regarding this treatment for Hashimoto’s thyroiditis. Studies have shown that combined use of T4 and T3 results in better relief of hypothyroid symptoms than T4 alone. This is accomplished by using a dessicated thyroid extract, prescribed to you by your Medical Doctor, endocrinologist or Naturopathic Doctor.

Another controversy in the treatment of Hashimoto’s is the lack of treatment targeted at the immune system. The use of L-thyroxine does not prevent or treat the inflammation and autoimmune destruction of the thyroid nor does it lower anti-thyroid antibodies.

Naturopathic Treatment of Hashimoto’s Thyroiditis

An experienced Naturopathic Doctor can be an amazing ally in the treatment of Hashimoto’s. Your ND can personalize a protocol that will address the root cause of your Hashimoto’s – an overactive immune system.

In Ontario your ND may be able to prescribe dessicated thyroid, provided they have obtained additional education and a license to prescribe.

Nutritional supplements, such as selenomethionine, may also be used to decrease autoimmune thyroid antibodies. Dietary support such as gluten avoidance, immunoglobulin food sensitivity testing, celiac testing, detoxification support, gut healing protocols and more can also be used to support the immune system and decrease over-reactivity.
More information on the Naturopathic treatment of Hashimoto’s Thyroiditis can be found in the following articles: Hashimoto’s and Gluten, Naturopathic Treatment of Hashimoto’s Thyroiditis, Hashimoto’s and Fertility.  You can also book an appointment with Dr. Lisa Watson, ND and get started on healing your Hashimoto’s now.

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.

 

 

 

Healing Your Hormones: Progesterone Deficiency

Women’s health is both the focus of my naturopathic practice and a passion in my life. There is no topic I am more excited to talk about, read about and learn about. And within women’s health there is no more important topic than hormone balancing. Because hormones are the main factor that differentiates men from women across the lifespan.

In this series I will take you through the basics of some common hormone imbalances that occur in women – progesterone deficiency, estrogen deficiency, estrogen excess, low thyroid hormone, excess thyroid hormone and testosterone excess.

So whether you are just interested in learning more about hormones, or hoping to identify some of your own signs and symptoms in this series, read on and get ready to learn how to heal your hormones.

What is Progesterone?

The reproductive system in women has two main hormones – estrogen and progesterone. Progesterone is our “pro-gestation hormone” – it is produced in the ovaries after ovulation to prepare the uterus for pregnancy. It is also produced in small amounts in the adrenal glands and in large amounts by the placenta during pregnancy.

What Does Progesterone Do?

Hormone sleepProgesterone prepares the body for pregnancy by stimulating the production of proteins that prepare the uterine lining for implantation. Progesterone also regulates our menstrual cycle – if a pregnancy does not occur, progesterone levels drop off and a menstrual period will result.

Progesterone is much more than just a pregnancy support hormone. Receptors for this hormone are found in the brain, breasts, blood vessels, and bones, in addition to the receptors in the reproductive organs. Progesterone is the natural balancing agent for estrogen – preventing estrogen from producing too many growth-stimulating effects on our tissues.

Progesterone also has significant anti-anxiety and relaxing effects on the body. It helps our mind and body cope with stress and can promote healthy sleep.

Changes in Progesterone Hormone Balance

Production of progesterone peaks in our mid-reproductive years – around 25 years of age. After that age we see steady declines in progesterone production until perimenopause and menopause when production drops off almost entirely.

Women who do not experience regular periods, or women who are not ovulating typically have low levels of progesterone as well.

Symptoms of Progesterone Deficiency

Low levels of progesterone can lead to a vast number of symptoms. Many of the symptoms are not taken seriously by doctors or may be attributed to other causes (especially anxiety, depression, insomnia and PMS). But for a large number of women the real cause of symptoms is an imbalance in progesterone levels.

 Escalator hormone balanceSymptoms of Progesterone Deficiency

  • Premenstrual mood changes
  • Painful or lumpy breasts
  • Insomnia
  • Premenstrual headaches
  • Anxiety
  • Infertility
  • Recurrent miscarriage
  • Unexplained weight gain

The Progesterone Hormone Web

No hormone functions in isolation. Each hormone in our body interacts with other hormones for optimal balance. Progesterone interacts with a number of important hormones, a few of which are noted here:

Estrogen

Progesterone is the natural balancer to estrogen. When progesterone levels are deficient, we can see symptoms of estrogen dominance. These include the symptoms listed above but also:

  • heavy periods
  • fluid retention
  • foggy thinking
  • decreased sex drive

Cortisol

Progesterone is the direct precursor to the production of cortisol, our stress/survival hormone. If progesterone levels are low, our ability to cope with stress diminishes and we may develop anxiety, depression, insomnia or feel overwhelmed.

Thyroid Hormone

Thyroid hormones stimulate the production and release of progesterone from ovarian cells. Thyroid hormone also influences the formation of progesterone receptors on cells throughout the body. If your thyroid function is low (hypothyroidism) you may also be experiencing low progesterone levels.

Hormone Healing for Progesterone Deficiency

Yoga natureLaboratory testing is necessary for all women seeking treatment for progesterone deficiency. It is imperative to understand the balance in the different hormones before starting any type of hormone treatment.

A lifestyle approach to improving progesterone levels is the foundation for all other treatments. Decreasing stress levels, encouraging a healthy diet that provides adequate protein and healthy fats, and engaging in regular exercise are all important to balancing progesterone levels.

There are a vast number of nutrients, and plant-based botanical medicines that can influence the production of progesterone. Some women also choose bioidentical progesterone cream, which can be prescribed by Naturopathic Doctors in Ontario who have prescribing rights.

Vitamin B6

Necessary for appropriate ovulation and subsequent progesterone production. If you are deficient, you will likely also be deficient in progesterone. Excellent food sources include tuna, salmon, turkey, chicken, sweet potato, sunflower seeds and dark leafy greens.

Magnesium

Magnesium is necessary for detoxification of hormones, especially estrogen. If you are deficient in magnesium you may have higher circulating levels of estrogen, resulting in a relative progesterone deficiency. Food sources of magnesium include pumpkin seeds, leafy greens, soy beans, sunflower seeds, and beans.

Chaste berry (Vitex agnus-castus)

Chaste berry (or chaste tree) has been found to increase progesterone levels during the second half of the menstrual cycle. It can also help to balance other hormones such as prolactin. Your Naturopath can help you decide if chaste berry is right for you

Bioidentical progesterone cream

Bioidentical hormone replacement therapy (BHRT) uses hormones that are identical to those in your body to balance your hormones and relief symptoms of hormone imbalance. Bioidentical progesterone is made from wild yams or soybean and is typically applied in cream form during the second half of the menstrual cycle.

Transdermal progesterone results in effective absorption of progesterone and movement of progesterone to the target tissues – brain, uterus, breast and blood vessels – to decrease symptoms. It is typically used twice per day and dosages vary – your Naturopath will work with you and a compounding pharmacy to establish your proper balance of hormones.

Hormone imbalance is not in your head – it is in every cell in your body. If you think your hormones are out of balance, talk to an experienced and qualified Naturopathic Doctor to help you find your optimal balance.