Skip to main content

Natural Treatment Options for PUPPPS

 

PUPPPS may sound like a cute acronym, but ask any pregnant woman who has experienced it and you will soon realize this condition is anything but cute.

PUPPPS stands for pruritic urticarial papules and plaques of pregnancy.  This translates to “itchy, allergy-like rash during pregnancy”.  PUPPPS is a hive-like rash that occurs in around 1 in 200 women during pregnancy.  The rash is itchy and most commonly starts on the abdomen and may spread to the legs, feet, arms, chest and neck but usually does not occur on the face.

We don’t know why some women develop PUPPPS during pregnancy but it most often begins in stretch marks and is more common in women with significant skin stretching. Women with large fundal measurements and those who are carrying large babies or twins and triplets are at greater risk.

Interestingly there is a higher rate of PUPPPS in women carrying boys. Statistics have shown that bw-pregnant-window70% of women with PUPPPS deliver boys. Researchers think this may be due to male DNA interacting with the mother’s body, leading to irritation.

The good news is that PUPPPS, aside from causing itching and irritation, has no long term negative effects on either the mother or the baby and tends to resolve on its own within a week of delivery.

Most treatments for PUPPPS involve hydrating the skin and keeping the mother comfortable.  Certain antihistamines may also be tried.  From a Naturopathic perspective, we focus on decreasing the allergic response of the immune system, supporting the detoxification properties of the liver, decreasing inflammation and helping to clear and possible underlying causes.

6 Natural Treatment Options for PUPPPS

  1. Increase vegetable consumption and vegetable juice consumption

To optimize liver function by supplying healthy antioxidants and cholagogues (plant based compounds that support optimal liver function). Ideal vegetables are dark green leafy vegetables, beets, carrots, broccoli, cauliflower, bok choy, brussels sprouts, kale and kohlrabi

Also increase consumption of canned tomatoes for the lycopene content, an excellent antioxidant and member of the beta carotene family – but be sure to choose organic canned tomatoes to decrease exposure to BPA. Glass containers are even better.

  1. High quality omega 3 rich oils

TomatoesOmega 3 fatty acids, such as those found in flax seeds, chia seeds, salmon and fish oil supplements help to improve the fluidity of skin membranes, decreasing the potential for stretch marks. Omega 3 fatty acids are also anti-inflammatory and can help to decrease the production of inflammatory mediators, decreasing redness and itching in skin rashes.

Consume omega-3 rich foods such as ground flax seeds and chia seeds daily. Consume omega 3 rich fish (those that are safe in pregnancy include salmon, tilapia, cod and Pollock) at least two to three times per week. An omega 3 rich fish oil supplement may also be recommended by your Naturopathic Doctor.

  1. Moisturize the skin with a soothing moisturizer

    Coconut oil is a safe choice for pregnancy and is highly moisturizing. Chickweed ointment is another stellar choice as chickweed is a natural antihistamine and can greatly reduce itching sensations.

  1. Dandelion Root (Taraxacum officinalis)

    allergy_dandelion medicineAnother highly effective treatment for PUPPPS. Dandelion acts as a hepatic and cholagogue – it enhances the function of the liver and gallbladder, clearing inflammation and congestion through that system. It is highly indicated for chronic skin eruptions, especially those that are hot, red or itchy.

    Dandelion is available as a tea (which will have diuretic effects) or as a capsule. For PUPPPS I usually recommend starting with a tea and introducing a supplement if needed.

  1. Milk thistle (Silybum marianum)

    Mike thistle is a liver supportive treatment that can be used to enhance the actions of dandelion root or on it’s own. It is effective in increasing the secretion and flow of bile from the liver and gall bladder. Milk thistle also promotes milk secretion and is encouraged for breast-feeding mothers.

  1. Avoid food sensitivities

    There is some research suggesting a correlation between food sensitivity (especially dairy) and PUPPPS. Consider food sensitivity testing or elimination diets to address symptoms.

PUPPPS can be a difficult condition to life with, and with the support of naturopathic medicine you may not need to!  Gentle and safe natural treatments are available.  Speak with your Naturopathic Doctor today to put together a plan.

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 PCOS Diet

A nutritious diet is the cornerstone of health – a foundation on which we can build healthy choices and behaviours. In no condition is this more true than polycystic ovarian syndrome. Choosing the right foods for PCOS and avoiding others can be enough for many women to balance their hormones and decrease symptoms of PCOS. And there are no harmful side effects – just the benefits of a healthy diet and vibrantly healthy lifestyle.

The PCOS Diet – What to Avoid

  1. Refined grains

Breads, bagels, muffins, crackers, pasta – all the many forms of refined grains that are common in the western diet, should be avoided in women with PCOS. These high glycemic-index foods quickly raise blood sugar levels and can lead to insulin resistance – a condition where your cells no longer respond to insulin. This is thought to be one of the underlying hormonal imbalances in PCOS.

  1. Refined sugars

Fighting Sugar AddictionSugars found in cookies, cakes, candies, sodas and sweetened beverages can wreak havoc on your hormones in a similar way to refined grains. Best to leave these foods out of your diet entirely and instead opt for naturally sweet fruits to nourish your sweet tooth.

  1. Alcohol

Alcohol is one of the most hormonally devastating things we can put in our body. Not only is it made of mostly sugar (and in PCOS we know what sugar can do to our insulin response!) it also prevents the liver from being able to effectively process and eliminate excess hormones. Women with PCOS also have an increased risk of non-alcoholic fatty liver disease. Limit alcohol consumption to red wine, have no more than one serving per day and don’t have it every day.

  1. Red meat

Red meats are high in saturated fats and contribute to inflammation. Saturated fats can also lead to increased estrogen levels. I recommend limiting red meat to lean cuts of grass-fed, hormone free meat and consuming it no more often than 1-2 times per week.

  1. Dairy

Dairy is a significant source of inflammation, unhealthy saturated fats and should be avoided by women with PCOS. Additionally, dairy increases the production of insulin-like growth factor (IGF) which is known to negatively impact ovulation in PCOS. Rather than reducing dairy, you should consider avoiding it all together to help manage your PCOS.

The PCOS Diet – What to Enjoy

  1. Vegetables and fruits

Eat food

The foundation of the PCOS diet is a plant-based diet. Vegetables, fruits, beans and legumes, nuts and seeds are provide the body with essential nutrients and fiber. Soluble fiber such as that found in apples, carrots, cabbage, whole grains such as oatmeal, and beans and legumes, can lower insulin production and support hormone balance in PCOS.

  1. Proteins

Healthy proteins are an absolute necessity for women with PCOS. While dairy and red meat are not recommended, plant based proteins like nuts, seeds, beans, lentils and legumes are encouraged. Other healthy proteins like turkey, chicken breast, eggs and fish should also be emphasized. For most women with PCOS, a daily intake of 60-80g of protein per day is recommended.

  1. Wild salmon

An excellent source of protein, wild salmon is also rich in omega-3 fatty acids. Omega 3s improve insulin response and blood sugar metabolism and studies have shown lower circulating testosterone levels in women who supplement with omega 3s. Choose wild caught salmon and other cold water fish two to three times per week and incorporate other healthy sources of omega 3s such as walnuts and flax seeds into your diet.

  1. Cinnamon

CinnamonSpices are an amazing way to increase antioxidants in your diet, and cinnamon is especially useful for women with PCOS because it can help to regulate blood sugar. Sprinkle it on apples, oats or quinoa in the morning, add it to teas and use it in flavourful stews or curries.

  1. Pumpkin seeds

    These zinc-rich seeds help to lower testosterone levels and are an easy, high protein snack to enjoy every day!

  2. Green tea

Studies have shown that green tea extract helps to improve the response of cells to insulin, as well as lower insulin levels. Consider drinking a few cups of green tea daily – or better yet, have some matcha to get a big nutritional benefit!

  1. Spearmint tea

Spearmint tea for PCOSAs little as two cups of spearmint tea per day for a month can lower testosterone levels and improve symptoms of abnormal hair growth (hirsutism) in women with PCOS. A must for all women with polycystic ovarian syndrome!

  1. Broccoli

Cabbage, cauliflower, bok choy, broccoli, kohl rabi, kale – these brassica vegetables are a source of indole-3-carbinole, a compound thought to support the detoxification and breakdown of hormones in the liver.

  1. Walnuts

Researchers have found that consuming 1/3 cup of walnuts per day for six weeks can reduce testosterone levels, improve insulin sensitivity, and improve fatty acid status in the body. Combine these with your pumpkin seeds for a satisfying afternoon snack!

  1. Leafy greens

Spinach, kale, arugula and all the amazing variety of leafy greens are good sources of vitamin B6 – a nutrient necessary for balancing prolactin levels – a hormone that is often elevated in PCOS. Greens are also high in calcium, a mineral necessary for healthy ovulation. One more great reason to get those greens!

I hope you will embrace the PCOS diet – you really can heal your body through food medicine. If you need more support or guidance, contact me to book a free 15 minute consultation and together we can find your vibrant 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.

Select References

Kaur, Sat Dharam. The complete natural medicine guide to women’s health. Toronto. Robert Rose Inc. 2005.

Hudson, Tori. Women’s encyclopedia of natural medicine. Los Angeles. Keats publishing. 2007.

The Endometriosis Diet

Niels H. Lauersen, MD says in his seminal book Getting Pregnant that endometriosis is “one of the most devastating, if not frustrating, of all gynecological ills”. 1 in 10 women suffer from the pains and frustrations of endometriosis, and there is no cure.

Despite this lack of cure, there is a lot that can be done to decrease the painful symptoms of endometriosis, prevent worsening of the endometrial growths, and support future fertility.

The first step in managing your endometriosis is to follow the Endometriosis Diet.

The Endometriosis Diet

The purpose of the Endometriosis Diet is multiple:

You can start the Endometriosis Diet soon after diagnosis, or at any time. This diet can help control the growth of endometriosis that has already appeared, decrease pain and other symptoms and in some cases prevent endometriosis from occurring at all.

Endometriosis Diet: Foods to Avoid

  1. Avoid alcohol

Alcohol depletes B vitamins that are necessary for hormone detoxification. It also has estrogen-like effects on the body and can worsen endometriosis symptoms.

  1. Avoid refined sugarFighting Sugar Addiction

Sugar is another culprit that can increase estrogen levels. It is also known to negatively impact immune function. Fruit is fine, but avoid all sources of refined sugars.

  1. Avoid caffeine

Women consuming two cups of coffee per day have twice the risk of developing endometriosis.

  1. Avoid red meat, especially grain-fed

Red meat is a rich source of arachidonic acid – which promotes production of inflammatory prostaglandins and increases inflammation and pain. Additionally, cattle and pigs fed grains treated with pesticides tend to concentrate these hormone-disrupting chemicals in their fat and muscle tissues. Consumption of these meats is a leading source of human exposure to organochlorines.

  1. Avoid dairy products

Dairy products are another potential source of hormone-disrupting chemicals, like the organochlorines. Organochlorines also impact the function of the immune system, weakening natural killer (NK) cell activity. Additionally, high fat dairy products may promote estrogen dominance, accelerating the growth of endometriosis.

  1. Avoid gluten

A 2012 study started 200 women with endometriosis on a gluten-free diet. 75% of the women reported an improvement in pain and none reported an increase in pain. All patients reported improved vitality and general health as well.

  1. Avoid refined and hydrogenated oils

Refined and hydrogenated vegetable oils contain omega 6 fatty acids that compete for absorption with anti-inflammatory omega 3s. Avoid canola, safflower, sunflower and so-called “vegetable” oils.

  1. Limit eggsFertile Cervical Fluid Testing

Eggs are a source of arachidonic acid and their consumption should be minimized.

  1. Limit peanuts

Another rich source of arachidonic acid. Healthier nuts include almonds, hazelnuts, pistachios, walnuts and cashews.

     10.  Avoid food sensitivities

Food sensitivities can contribute to inflammation, intestinal permeability and immune system disturbances. Food sensitivities are very individual – blood testing is generally recommended to identify what foods may causing negative effects in your body.

Endometriosis Diet: Foods to Enjoy

  1. Organic fruits and vegetables

Fruits and vegetables provide fiber that support healthy digestive function as well as nutrients to support immune function, detoxification and decrease inflammation. Women who consume two servings of fruit per day have a 20% decreased risk of endometriosis. Selecting organic fruits and vegetables will minimize intake of pesticides that disrupt hormone function.

  1. Vegetarian proteins

almonds are a source of calciumWomen who eat a vegetarian diet excrete 2-3 times more estrogen in their feces and have half as much estrogen in their blood as meat-eaters. Focusing on eating soy, almonds and other nuts and nut butters, beans, lentils and legumes.

  1. Fish

Fish, especially cold-water fish like salmon and mackerel, are a rich source of anti-inflammatory omega 3 fatty acids. Two servings per week is the ideal recommendation – more than this can result in undesirable exposure to PCBs and other environmental contaminants.

  1. Flax seeds

Another rich source of omega 3s, ground flax seeds also contain lignans that provide an ideal source of fiber to support digestion and healthy bacteria balance.

  1. Cabbage family vegetables

brussels sprouts are goitrogenicThe Brassica (cabbage) family of vegetables support detoxification and encourage a healthy estrogen balance by favouring production of the less active form of estrogen. Consume broccoli, brussels sprouts, cabbage, kale, kohl rabi and cauliflower regularly to reap these benefits.

  1. Leafy green vegetables

Leafy green vegetables provide key minerals for detoxification and support liver function. Frequent consumption of leafy greens (two servings per day) has been shown to significantly decrease the incidence of endometriosis.

  1. Onions, garlic and leeks

These vegetables contain organosulfur compounds that enhance immune function and induce enzymes that detoxify the liver. They are also rich sources of quercetin, a bioflavonoid that stimulates the immune system and decreases inflammation.

  1. High fiber foods

High fiber foods are incredibly important for endometriosis because they support the optimal balance of friendly bacteria in the digestive tract. Friendly bacteria support the elimination of estrogen in the feces. Focus on fiber in the form of vegetables, fruits and whole grains such as barley, quinoa, millet, brown and wild rice.

  1. Fermented foods

Fermented foods support estrogen balance by providing a food source of friendly bacteria. Olives, pickles, sauerkraut, kimchi, miso, tempeh and kombucha are excellent, delicious options.

Spices contribute to health     10. Spices

Spices such as ginger and turmeric are powerful anti-inflammatories and also support liver detoxification. Use them liberally throughout the day.

Far More Than Food

Following the Endometriosis Diet is going to improve more than just your endometriosis symptoms. It will likely improve your overall health and vitality as well. This is a healthy, whole-foods based diet that can help you feel great, inside and out.

Diet isn’t the only important aspect of endometriosis treatment. Other articles on this website cover Understanding Endometriosis, Acupuncture for Endometriosis, Endometriosis and the Immune System, Endometriosis and Infertility, Endometriosis in Adolescence and Naturopathic Treatment of Endometriosis. Read on, and if you’re ready to take a well-rounded, holistic approach to your endometriosis, feel free to book an initial consultation to get started.

References

Hudson, Tori. Women’s Encyclopedia of Natural Medicine. New York: McGraw Hill, 2008.

Lauersen, Niels H and Bouchez, Collette. Getting Pregnant. New York: Fireside, 2000.

Lewis, Randine. The Infertility Cure. New York: Little, Brown and Company, 2004.

Gluten-free diet: a new strategy for management of endometriosis related symptoms? Minerva Chir. 2012 Dec:67(6):499-504.

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.

Naturopathic Medicine and Endometriosis

Endometriosis is a chronic condition affecting millions of Canadian women. It can begin at any age between the teens and 40s and impacts between 10-15% of women in these age groups.

There is no cure for endometriosis, but Naturopathic Medicine can offer women with this condition hope for improved hormone balance, decreased pain and support for fertility.

Prior to reading this article, I suggest you check out Understanding Endometriosis to learn how to recognize the symptoms of endometriosis and the underlying imbalances that lead to this frustrating condition.

Naturopathic Treatments for Endometriosis

A Naturopathic treatment plan for endometriosis will be highly individualized to each person, addressing their unique lifestyle, dietary and symptom needs. The treatment goals vary person to person, but always include a combination of the following:

  • Normalize the function of the immune system
  • Balance hormones
  • Support liver detoxification of hormones
  • Reduce and block pro-inflammatory chemicals produced by the body
  • Support the large intestine and microbiome (healthy bacteria)
  • Decrease stress

Vitamin CBy addressing these underlying imbalances in endometriosis Naturopathic Doctors can improve the overall health of women with endometriosis, decrease or eliminate symptoms of endometriosis and address the underlying cause of endometriosis.

Normalize Immune Function

There are many nutrients involved in healthy immune function. One of the largest categories of immune supportive nutrients are the antioxidants. Nutrients like vitamin C, beta carotene, vitamin E and selenium all enhance immune function and can be used to support endometriosis treatment. Many of these nutrients also decrease inflammation and can improve pain associated with endometriosis.

Vitamin D, an incredibly important nutrient for Canadians, has profound impacts on endometriosis. Vitamin D regulates cell growth and differentiation in endometriosis, enhances macrophage action and decreases inflammation. Vitamin D supplementation has been found in studies to reduce the weight of endometriosis lesions as well.

Balance Hormones

hormone balanceEndometriosis is a hormonally responsive condition – the growth of the endometrial lesions occurs under the influence of estrogen – so balancing hormone levels is an important treatment goal for all women with endometriosis.

Phytoestrogens, such as lentils, flax seeds and soy, can bind to estrogen receptors and have a less potent effect than our body’s own estrogen. When these phytoestrogens are bound to receptors they displace our own estrogen resulting in a lower estrogen effect overall. These foods should be incorporated into our diet daily for optimal hormone balancing effects.

Indole-3-carbinole and DIM (di-indolylmethane) from brassica vegetables are also estrogen regulating supplements that act much like phytoestrogens by binding estrogen receptors and decreasing our body’s estrogen response. Your Naturopathic Doctor may recommend these supplements, or recommend increasing consumption of broccoli, cauliflower, cabbage and brussels sprouts for hormone balancing in endometriosis.

Reduce Inflammation

Grapes are a source of resveratrolMany of the most profoundly effective treatments for endometriosis work by reducing inflammation in the body. Pycnogenol, a pine bark extract, has anti-inflammatory, immune supportive and anti-growth properties. Studies have shown significant improvements in pain symptoms in women using pycnogenol.

Resveratrol, a substance found in the skin of grapes, is especially beneficial for women with endometriosis and infertility. Resveratrol can decrease inflammation, reduce proliferation of endometrial lesions and protect eggs from the effects of aging.

N-acetyl cysteine (NAC) is one of the most promising treatments for endometriosis. Studies have found immune function improvements (increases in T regulatory cells, decreases in TNF-alpha), significant decreases in inflammation (including increases in glutathione – a cellular anti-inflammatory) as well as reduces in the size of existing endometrial lesions.

Support Liver Detoxification

The liver is essential for hormone balance as it is where our body detoxifies estrogen and prepares it for elimination. B vitamins are necessary for this function, allowing the liver to more efficiently inactivate and process estrogen.

Nutrients known as lipotropics also promote liver function by promoting the flow of fat and bile (containing estrogen for elimination) out of the body through the large intestines. Choline, betaine, methionine and dandelion are all prime examples of lipotropics that can be used to enhance liver detoxification in endometriosis.

oatmealSupport Large Intestines and Healthy Bacteria

Our body eliminates estrogen by attaching it to a carrier molecule (glucuronic acid) and excreting it through the bile into the stool. Unfriendly bacteria in the large intestines can prevent our ability to eliminate estrogen by breaking this bond between estrogen and it’s carrier. This estrogen is then recycled back into our body, resulting in higher circulating levels of estrogen.

We can modify this action, and support healthy hormone levels, by following the Endometriosis Diet which emphasizes healthy fiber and avoidance of unhealthy fats. Probiotic supplements can also be used in some cases to encourage healthy bacteria balance.

Decrease Stress

Stress occurs frequently in our fast-paced society, but we know that unhealthy levels of stress, or poor adaptation to stress is linked to decreased immune function and may trigger the kind of biochemical imbalances that lead to endometriosis. Studies have demonstrated that endometriosis grows more rapidly, or recurs faster and in greater quantities, during times of extreme emotional stress.

Breathing exercises, physical exercise, yoga, meditation, mindfulness, good quality sleep and adaptogenic herbs and supplements can decrease your stress response and help you to manage your endometriosis, naturally.

Not All Nutrients Are Beneficial

Just because it’s natural, does not mean it’s safe. It is strongly recommended to consult with a Naturopathic Doctor to develop a safe and effective endometriosis plan that will address your concerns and give you the best chances for success.

Additionally, some nutrients may negatively impact endometriosis. L-carnitine, an amino acid, was shown in one study to induce a condition resembling endometriosis with accompanying infertility when give to young female mice. We are not sure of the impact this may have on humans, but a cautious approach is recommended.

Treating Endometriosis

Understanding EndometriosisTo take a fully empowered, knowledgeable approach to your endometriosis I recommend you read the other articles written by Dr. Lisa Watson, ND on endometriosis: Understanding Endometriosis, The Endometriosis Diet, Endometriosis and the Immune System, Acupuncture and Endometriosis and Endometriosis and Infertility.  If you are ready to take the next step, book a complimentary 15 minute meet-and-greet appointment with Dr. Watson, or book an initial consultation.  You can feel better! Get started now.

References

Hudson, Tori. Women’s Encyclopedia of Natural Medicine. New York: McGraw Hill, 2008.

Lauersen, Niels H and Bouchez, Collette. Getting Pregnant. New York: Fireside, 2000.

Lewis, Randine. The Infertility Cure. New York: Little, Brown and Company, 2004.

Kohama T, et al. Effect of French maritime pine bark extract on endometriosis as compared with leuprorelin acetate. Journal of Reproductive Medicine; 2007:52(8),703-8

Vassiliadis S, Athanassakis I. A “conditionally essential” nutrient, L-carnitine, as a primary suspect in endometriosis. Fertil Steril. 2011 Jun 30;95(8):2759-60.

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.

Blood Clots in Pregnancy

The risk of developing blood clots is increased during, and after, pregnancy. There are additional risk factors which may increase development of blood clots during pregnancy.

  • A history of blood clots
  • A genetic disposition to blood clots (such as Factor V Leiden)
  • Obesity
  • Long distance travel
  • Prolonged bed rest
  • Carrying multiple babies
  • Advanced maternal age
  • Pre-existing medical conditions.

If you are at risk for blood clots during pregnancy, there are some precautions you should take.

Common sense precautions that reduce the risk of clotting for all pregnant women

  1. Stay hydrated at all times.Water
  2. If you must be sitting for a long period of time, elevate your feet. Even a little bit can take pressure off the backs of your thighs. Get up every hour or two and stretch, walk around, get your blood moving.
  3. Eat a healthy diet with plenty of protein, B-vitamins, folic acid, magnesium and salt. Everything you do to support a healthy blood volume will reduce the risk of abnormal clotting.
  4. Get appropriate amounts of vitamin C, vitamin E and essential fatty acids. Everything you do that promotes healthy blood vessels and tissues will reduce the risk of abnormal clotting.
  5. Don’t overdo calcium. Make sure that your calcium intake is appropriately balanced with magnesium. Too much calcium can impede placental function with calcifications and increase the tendency of blood to clot. When the balance tips in favor of calcium, the balance may also tip in favor of clotting. Get enough, but not too much.
  6. Get moderate exercise every day or every other day. Ideal exercises include walking, swimming, low-impact or water aerobics, basically any low-impact exercise that gets the blood moving and the muscles contracting. Exercise improves circulation, and anything you do that improves circulation will reduce the risk of abnormal clotting.

There are also some natural foods and remedies that can decrease the risk of clotting. Discuss these with your Naturopathic Doctor to determine if they are appropriate for you during your pregnancy.

Naturopathic Prevention of Blood Clots in Pregnancy

  1. garlicGarlic – garlic has a distinct and potent anticoagulant effect. It can be grated fresh onto quinoa or rice, made into garlic butter, added at the last minute to spaghetti sauce. Epidemiological studies have shown garlic to significantly increase serum fibrinolytic activity in humans (breaking down of clots and preventing clot formation). Garlic oil and raw garlic are both effective for this purpose.  The increase in fibrinolysis occurs within the first 6 hours after ingestion and continues for up to 12 hours.
  2. Ginger – similar to garlic and onion, ginger is an inhibitor of platelet aggregation. However, ginger’s effects have been shown to be much more powerful. Ginger inhibits thromboxane formation, pro-aggregatory prostaglandins and significantly reduces platelet lipid peroxide formation – all of which contribute to clot formation.       In one study gingerol compounds and their derivatives were more potent antiplatelet agents than aspirin. In addition to acting on platelets, ginger also promotes fibrinolysis. Ginger promotes bile production and should not be used by those with gall bladder disease.ginger
  3. Purple Grape Juice – juice because the juice is made from the whole fruit, including seeds, and the seeds contain potent anticoagulants as well. Purple because much of the anticoagulant action comes from components in the skins of purple grapes. White grape juice does NOT have the same effect. Use 100% grape, not a blend or cocktail. Two cups a day were used in one study that found purple grape juice to be more effective than aspirin.
  4. Ginkgo biloba – Ginkgo is a very potent anticoagulant. It reduces the “stickiness” of blood and improves circulation. For pregnant women it would only be advisable for those who have actually been diagnosed with a clotting disorder, and should only be used under supervision of a Naturopathic Doctor. Gingko exerts its cardiovascular effects by regulating blood vessel tone, dilating blood vessels and inhibiting platelet aggregation, adhesion and degranulation.
  5. Bilberry – well-known for its antioxidant properties, bilberry is also a cardioprotective herb that protects and strengthens the capillaries. The flavonoids in bilberry (anthocyanosides) also have significant antiaggregation effects on platelets.
  6. pillsB vitamins and folic acid – B vitamins (especially B6, B12 and inositol) and folic acid decrease homocysteine levels. Elevated homocysteine levels increase the risk of clot formation. Pregnancy increases the body’s demands for B vitamins and folic acid. Likewise, birth control pills tend to deplete the body of these nutrients.
  7. Omega 3 fatty acids or fish oils – fish oils decrease production of clot forming substances and enhance the production of platelet anti-aggregatory substances. These action play an important role in decreasing inflammation and clot formation. EPA supplementation is most important for preventing clot formation (thrombosis).

 

Photo Credit: phalinn via Compfight cc

Five Key Nutrients for Headaches

Key Nutrients for HeadacheAlmost half of all adults suffer from headaches and the mental, emotional and physical impacts of headaches are often under recognized and under-treated by medical professionals.

The majority (90%) of headaches are vascular or tension-type, or a mixture of the two. Vascular headaches include both migraines and cluster headaches. The remaining 10% of headaches are due to other conditions such as trauma, dental pain, visual strain, TMJ disorders, neck disorders, sinus inflammation or tumours.

As a Naturopathic Doctor it is important that each person with a headache receive an appropriate intake and assessment to determine underlying causes and precipitating factors impacting their headaches.

In addition to understanding the possible causes of headache, understanding the impact of five key nutrients on headaches allows your Naturopath to assess your diet and recommend supplements where needed.

Magnesium

Low levels of magnesium are typically found in patients with vascular (migraine and cluster headache) and tension type Black beans proteinheadaches. Increasing dietary magnesium, or using a magnesium supplement can decrease the pain associated with magnesium.

Magnesium also acts as a muscle relaxant and can decrease the tension associated with tension headaches.

Foods that are rich in magnesium include pumpkin and sesame seeds, leafy green vegetables, soy beans, black beans, quinoa, cashews, squash, brown rice, barley, millet and oats.

Riboflavin (Vitamin B2)

bell peppers are a source of riboflavinOne of the suspected underlying causes of migraine headaches is impaired mitochondrial function in the brain and in muscles. Riboflavin is necessary for the function of two enzymes involved in this process and can improve the energy reserves of the mitochondria without altering the excitability of neurons.

Riboflavin is used as a prevention for migraine headaches but will not change headache duration or intensity once it is occurring.

Food sources of riboflavin include soy beans, leafy green vegetables, yogurt, mushrooms, eggs, asparagus, almonds, turkey, broccoli, green beans, bell peppers, green peas and sea vegetables.

CoEnzyme Q10 (CoQ10, Ubiquinone)

Similar to riboflavin, CoQ10 also enhances the energy-related mitochondrial processes that are impaired in patients with migraine headaches. Taking a daily CoQ10 supplement can prevent migraines but will not impact a headache once it is occurring. Digestive upset can occur with CoQ10 supplements and they should only be taken under supervision by a Naturopathic Doctor.

Omega 3 Fatty Acids

Salmon is a source of omega 3 fatty acidsOne of the best things you can do for headaches is to increase your intake of omega-3 fatty acids. These essential fats, found in cold water fish and flax seeds, have many benefits for both vascular and tension headaches. Omega-3s are powerful anti-inflammatories, decreasing the production of inflammatory molecules in your body. They are also vasorelaxant and decrease platelet aggregation – two of the underlying physiological changes in migraine headaches.

Clinical studies have suggested that fish oil can reduce headache frequency dramatically as well and decreasing duration and severity.

Omega-3 supplements are readily available and food sources include flaxseeds, walnuts, sardines, salmon, soy beans, fortified eggs and grass fed beef.

Vitamin D

Many more Canadians are becoming aware of the importance of vitamin D. It is necessary for immune function, bone health, diabetes and cancer prevention. It is also required for the production and response to serotonin.

Serotonin is a neurotransmitter with multiple influences on headaches. Altered serotonin release is known to be one of the many physiological results of migraine headaches and low serotonin production, or low response to serotonin can decrease pain threshold.

All Canadians should be taking a vitamin D supplement during the winter months, but those suffering with headaches should be sure to have their vitamin D levels tested and take a supplement based on their individual needs. Often the recommended daily allowance (600-800IU) is inadequate for people suffering with headaches.

Putting It Together

Working with a Naturopathic Doctor is your best chance for successful management of headaches. Focusing on lifestyle, diet, exercise, nutrients and integrating other therapies such as massage therapy, chiropractic, osteopathy, acupuncture and botanical medicines can turn your life around and stop the headache cycle once and for all.

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.

Fish Consumption During Pregnancy

The U.S. Food and Drug Administration and the U.S. Environmental Protection Agency made headlines this month when they released guidelines on how much fish pregnant and breastfeeding women should consume.

While previously both the FDA and EPA recommended maximum amounts of fish that should be consumed by pregnant women, no minimum has ever been established.

The new recommendations are based on emerging evidence that fish are an abundant source of omega 3 fatty acids, and that these nutrients can have a “positive impact on growth and development as well as on general health” (Stephen Ostroff, MD).

Pregnant and breastfeeding women are now recommended to eat at least 8 ounces, and up to 12 ounces (2-3 servings) per week of varieties of fish that are low in mercury.

Fish that are known to be high in mercury and should be avoided by pregnant and breastfeeding women, as well as children are:

  • Tilefish
  • Shark
  • Swordfish
  • King mackerel
  • Albacore tuna (“white” tuna)
  • Marlin
  • Orange roughy
  • Escolar

Fish that is encouraged due to lower levels of mercury include:

  • Shrimp
  • Pollock
  • Salmon
  • Tilapia
  • Cod
  • Light tuna

Fish oil supplements that are analyzed for mercury levels are also safe for consumption in pregnancy and offer the same health benefits to mother and baby as eating fish.

Selected references

FDA Press Release: FDA and EPA issue draft updated advice for fish consumption

http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm397929.htm

Sea Choice: Healthy Recommendations
http://www.seachoice.org/seafood-recommendations/health-recommendations/

Health Canada: Mercury in Fish

http://www.hc-sc.gc.ca/fn-an/securit/chem-chim/environ/mercur/cons-adv-etud-eng.php

Health Canada: Fish Consumption Advisories

https://www.ec.gc.ca/mercure-mercury/default.asp?lang=En&n=DCBE5083-1

Getting Under Your Skin – Ten Natural Treatments for Psoriasis

Psoriasis is a common condition, affecting more than 50 000 people in Toronto alone.  Both men and women are equally impacted by psoriasis and more than one-third of people with psoriasis have a family member who also has it.

What is Psoriasis?

Psoriasis is a chronic, immune-mediated inflammatory condition that manifests as red, scaly skin rashes (known as “plaques”) that occur on the knees, elbows, scalp and other areas of the body.  The underlying issue that leads to psoriasis is immune activation of T-cells leading to release of inflammatory mediators and hyper-proliferation of keratinocytes.

Naturopathic Treatment of Psoriasis

Naturopathic treatment of psoriasis works to address the underlying causes of psoriasis – immune dysfunction and inflammation.  Correcting the imbalances that lead to psoriasis plaques and arthritis can significantly improve outcomes and promote optimal health.  Listed below are ten natural treatment options for psoriasis.

Ten Natural Treatment Options for Psoriasis

1. Anti-Inflammatory Diet

Food is a major source of inflammatory particles for our body.  Some foods promote inflammation, while other foods inhibit inflammation.  Foods that cause inflammation include: dairy, red meats, partially hydrogenated vegetable oils, safflower oil, canola oil and trans-fats.  These foods should be reduced or eliminated in the diet.

 Foods that reduce inflammation include the omega 3 fatty acids, many spices, and most fruits and vegetables.  A vegetarian diet, or diet rich in fruits and vegetables can decrease inflammation and symptoms of psoriasis.

 2. Identification and Elimination of Food Allergies and Sensitivities

In addition to foods that contain compounds known to lead to inflammation, individual food sensitivities or allergies can also cause inflammation.  Consuming foods that we have a sensitivity to leads to an immune response in our body, ultimately leading to inflammation.  Determining your food sensitivities and eliminating them can profoundly decrease the symptoms of psoriasis.  The most common food sensitivities found in people with psoriasis include gluten (wheat), eggs and dairy.

3. Healthy Weight LossBalance scale

People who are overweight tend to have worse symptoms of psoriasis, likely due to the increase in inflammation from insulin imbalance and the metabolic effects of being overweight.  Achieving and maintaining a healthy body weight is an important lifestyle goal for all people with psoriasis and something your Naturopathic Doctor can help you do in a healthy and long-lasting way.

 4. Manage Stress

Long term stress can deplete our body’s ability to produce cortisol, one of the most powerful natural anti-inflammatories in our body.  Psoriasis tends to worsen during times of stress – whether it is mental, emotional or physical stress.  Learning appropriate stress management skills, and using appropriate natural supplements to decrease the physical impacts of stress can be an effective way of managing psoriasis across your lifespan.

 5. Spice Up Your Life!

Literally! Many spices can be used to decrease inflammation and act as strong antioxidants, promoting healing of skin.  Specific spices that can decrease inflammation and help treat psoriasis include: turmeric, capsaicin (red pepper), cloves, ginger, cumin, anise, fennel, basil, rosemary and garlic.

6. Omega 3 Essential Fatty Acids

Essential Fatty AcidsOne of the most powerful treatments for all forms of inflammation, including psoriasis, is omega 3 fatty acids.  Omega 3s are essential fatty acids, our body can’t produce them and needs to get them from food.  Unfortunately our diets are rich in omega 6s (pro-inflammatory) and deficient in omega 3s (anti-inflammatory).

 Omega 3s have many impacts on the development of psoriasis.  They change the function of cell membranes, modify immune function decreasing overactivation, prevent blood supply from developing in psoriatic plaques and decrease inflammation throughout the body.

 Dietary sources of omega 3 fatty acids include cold water fish (mackerel, salmon, herring, sardines, albacore tuna), flaxseeds, walnuts, algae and hemp seeds.  Supplementing with higher doses of omega 3s is recommended for people with active psoriasis.

7. Vitamin D

People with psoriasis have lower levels of the active form of vitamin D in their blood streams.  At this point it’s not clear if this finding is a cause of psoriasis or a consequence.  It is known that psoriasis is much less common in areas of the world with higher vitamin D production – sunny and warm climates have a much lower incidence than cold climates.  UV phototherapy is another effective treatment for psoriasis that increases vitamin D levels but can have unwanted side effects.

 Supplementing with vitamin D, and using it topically is safe for most people with psoriasis.  A simple blood test is available that will tell you whether this treatment is right for you, talk to your Naturopathic Doctor about it today.

8. Bioactive Whey Protein

Emerging research has shown bioactive whey protein isolate to be a promising treatment for psoriasis.  Whey isolate has immune regulating effects due to the presence of growth factors, immunoglobulin’s and active peptides.  Taking this supplement twice daily showed significiant improvements in psoriasis skin plaques after just two months of use.

9. Curcumin Gel

While much of the healing for psoriasis depends on healing from the inside out, topical use of curcumin gel has been shown to be more effective than calcipotriol cream, one of the most common prescription medications for psoriasis.  After 2-6 weeks of daily use all patients had at least a 50% improvement in psoriasis plaques with half of patients having a 90% improvement.

aloe vera
Aloe vera gel

Curcumin gel works by reducing inflammation locally and in combination with other Naturopathic treatments can be an amazing treatment option for psoriasis.

10. Aloe Vera Gel

Another topical option for healing psoriasis, aloe vera gel is an incredibly gentle and safe treatment with good clinical results.  Not only is aloe vera calming to inflamed skin but it also promotes healthy regrowth of normal skin cells.  One study found an 82% improvement compared to placebo.

Psoriasis is a multi-faceted condition that stems from an imbalance in the immune system leading to inflammation and characteristic skin plaques.  Naturopathic Medicine offers treatment options that address the underlying imbalances and can result in profound improvements in overall health and lead to healthy, clear skin.

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.

Selected References

Calder PC. n-3 Polyunsaturated fatty acids, inflammation, and inflammatory diseases. Am J Clin Nutr 2006;83:1505S-1519S.

Chalmers RJ, Kirby B. Gluten and psoriasis. Br J Dermatol 2000;142:5-7.

Heng MC, Song MK, Harker J, Heng MK. Drug- induced suppression of phosphorylase kinase activity correlates with resolution of psoriasis as assessed by clinical, histological and immunohistochemical parameters. Br J Dermatol 2000;143:937-949.

Perez A, Raab R, Chen TC, et al. Safety and efficacy of oral calcitriol (1,25-dihydroxyvitamin D3) for the treatment of psoriasis. Br J Dermatol 1996;134:1070- 1078.

Pizzorno JE, Murray MT. Textbook of Natural Medicine. 3rd ed. St. Louis, MO: Churchill Livingstone; 2006.

Poulin Y, Bissonnette R, Juneau C, et al. XP-828L in the treatment of mild to moderate psoriasis: randomized, double-blind, placebo-controlled study. J Cutan Med Surg 2006;10:241-248.

Syed TA, Ahmad SA, Holt AH, et al. Management of psoriasis with Aloe vera extract in a hydrophilic cream: a placebo-controlled, double-blind study. Trop Med Int Health 1996;1:505-509.

Traub M, Marshall K. Psoriasis – Pathophysiology, Conventional and Alternative Approaches to Treatment. Alt Med Review. 2007;12(4).

Wolters M. Diet and psoriasis: experimental data and clinical evidence. Br J Dermatol 2005;153:706-714.

Adult ADHD – Diagnosis and Natural Treatment Options

Attention deficit and hyperactivity disorder (ADHD) is not just for kids.  Difficulty concentrating, inability to complete tasks, forgetfulness and other symptoms in adults can be due to ADHD.  ADHD can cause significant problems in adults, ranging from increased anxiety, depression, substance abuse, financial problems, poor job performance and social difficulties.

Diagnosis of adult ADHD is important and management of symptoms, through mainstream or Naturopathic treatments should be considered to improve quality of life for people with this condition.

Diagnosis of Adult ADHD

It is estimated that 4% of North American adults have ADHD, a disorder that is most commonly diagnosed in childhood and persists through adolescence and into adulthood.

Diagnosis of adult ADHD is very similar to that of children. Diagnosis requires confirmation of at least 6 ADHD traits within the inattentive or impulsive/ hyperactive categories, or in both.  Impairment must also be present within at least 2 life settings.  The Adult ADHD self report scale is also a useful tool for identifying adult ADHD.

DSM-IV Criteria for ADHD

      Inattention Symptoms

  1. Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities.
  2. Often has trouble keeping attention on tasks or other activities.
  3. Often does not seem to listen when spoken to directly.
  4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions).
  5. Often has trouble organizing activities.
  6. Often avoids, dislikes, or doesn’t want to do things that take a lot of mental effort for a long period of time (such as schoolwork or homework).
  7. Often loses things needed for tasks and activities (e.g. school assignments, pencils, books, or tools).
  8. Is often easily distracted.
  9. Is often forgetful in daily activities.

      Hyperactivity Symptoms

  1. Often fidgets with hands or feet or squirms in seat when sitting still is expected.
  2. Often gets up from seat when remaining in seat is expected.
  3. Often excessively runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless).
  4. Often has trouble doing leisure activities quietly.
  5. Is often “on the go” or often acts as if “driven by a motor”.
  6. Often talks excessively.

      Impulsivity Symptoms

  1. Often blurts out answers before questions have been finished.
  2. Often has trouble waiting one’s turn.
  3. Often interrupts or intrudes on others (e.g., butts into conversations or games).

Six or more of any of the above symptoms, persisting for at least 6 months to a point that causes disruption in daily activities and work performance is adequate for a diagnosis of adult ADHD.

A diagnosis of ADHD must also eliminate the possibility that the symptoms are due to another disorder such as a mood disorder, anxiety disorder, personality disorder, schizophrenia or other diagnosis.

What Causes ADHD?

Food dyes and additives may contribute to ADHD symptoms

No one knows what leads to ADHD in children or adults.  It is known that genetics plays a significant role in the development of ADHD – if your parents, siblings or children have ADHD you are more likely to have it as well.

Food allergies or sensitivities have also been suggested as a potential causative factor in the development of ADHD.  The Feingold diet has been used since the 1970s to treat ADHD by eliminating food additives, dyes and salicyclates.

Some research suggests that a gene affecting the transport of the neurotransmitter dopamine may be a factor.  This gene increases dopamine transport, leading to dopamine inactivation.  Less available dopamine can impair memory and some brain functions.

Researchers also suggest that norepinephrine (another neurotransmitter) may also have a role in ADHD.  Without sufficient norepinephrine the brain can’t respond fully to new stimuli.

Other researchers think that ADHD is just an imbalance in overall neurotransmitter activity.  Dopamine may be over-active when compared to norepinephrine, but under-active when compared to serotonin.  Ask your Naturopathic Doctor to give you a questionnaire to assess your individual neurotransmitter balance.

Natural Treatment Options for Adult ADHD

ADHD is usually treated with prescription stimulant medications.  Many people diagnosed with ADHD do not want to take these medications and seek out natural treatment options.  Luckily there are many highly effective treatment options available, and a comprehensive individualized approach to adult ADHD can diminish or eliminate many of the symptoms and promote lifelong health.

Food Allergy Elimination/ Feingold Diet

Allergies to food or food additives have been suggested as a causative agent for ADHD in children and adults.  The Feingold diet was the first of many diets to eliminate preservatives and dyes in food to manage symptoms of ADHD.  Eliminating known food allergens (identified through IgG or IgA blood tests) can also decrease severity of ADHD symptoms.

Balance Neurotransmitters

As discussed above, imbalances in neurotransmitters – both frank deficiencies (overall low levels) and relative deficiencies (low levels of one or more neurotransmitter related to another) can lead to symptoms of ADHD.  Stimulant medications, like Ritalin are used in ADHD to increase norepinephrine and dopamine activity in the brain.  However, these stimulants can have significant side effects such as decreased appetite, insomnia, and jitteriness.

Your Naturopathic Doctor can use a questionnaire to help identify your individual neurotransmitter balance and uncover deficiencies.  This information is used to tailor a treatment to balance your neurotransmitters and enhance your overall health without the negative side effects of stimulant medications.

Nutritional supplements are used to help balance levels of dopamine, serotonin, norepinephrine and acetylcholine.  SAMe (S-adenosyl-L-methionine), phosphatidylserine, L-carnitine, iron, B vitamins, and tyrosine all have been used in the treatment of adult ADHD to balance individual neurotransmitters.

Essential Fatty Acids

Essential fatty acids are just that – essential.  Our bodies need them, but can not produce them.  They must come from dietary sources.  Levels of omega-3 and omega-6 fatty acids have been shown to be lower in people with ADHD than in people without it.  Additionally, men need nearly three times the volume of daily essential fatty acids compared to women to function well.  This may be one reason why ADHD is more common in boys and men.

Fish oils are the preferred form of essential fatty acid supplements.  Various studies have shown that supplemental fish oil improves cognitive function, behaviour, hyperactivity, and inattentiveness in patients with ADHD.  Omega 3s are necessary for health and should be taken by all individuals with ADHD, both adults and children.

Zinc and Magnesium

Zinc and magnesium are two nutrients that appear in lower concentrations in people with ADHD.  Magnesium deficiency can mimic the symptoms of ADHD (hyperactivity, irritability, fatigue, difficulty sleeping, poor concentration, and restlessness).  Zinc has been shown in studies to improve response to ADHD therapies – natural or pharmaceutical.

Ginkgo biloba and American ginseng (Panax quinquefolius)

Ginkgo biloba

Ginkgo biloba increases blood flow to the brain and when combined with American ginseng has been shown to improve some symptoms of ADHD.  Research has suggested that the combination of these two botanicals is more useful than either one in isolation.

L-Theanine

A component in green tea, L-theanine is used to promote a state of calm alertness.  Suggested to be partially responsible for the calm seen in zen monks, it has a long history of use as a natural stimulant.

These, and other natural treatments can be effective in managing ADHD in adults when used properly.  It is not recommended that you attempt to self medicate with these treatments, but instead seek out the care of a knowledgeable Naturopathic Doctor who can individualize your treatment and support you through your journey to 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.

Selected References

American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Washington, DC, American Psychiatric Association, 2000.

Elia J, Ambrosini PJ, Rapoport JL. Treatment of attention-deficit-hyperactivity disorder. N Engl J Med 1999;340:780-8.

Kessler, R.C., Adler, L., Barkley, R., Biederman, J., et al. The prevalence and correlates of adult ADHD in the United States:  Results from the National Comorbidity Survey Replication.  Am Journal of Psychiatry (2006), 163:724-732.

Lyon MR, Cline JC, Totosy de Zepetnek J, et al. Effect of the herbal extract combination Panax quinquefolium and Ginkgo biloba on attention-deficit hyperactivity disorder: a pilot study. J Psychiatry Neurosci 2001;26:221-8.

Mitchell EA, Aman MG, Turbott SH, Manku M. Clinical characteristics and serum essential fatty acid levels in hyperactive children. Clin Pediatr (Phila) 1987;26:406-11.

Oades RD. Dopamine may be ‘hyper’ with respect to noradrenaline metabolism, but ‘hypo’ with respect to serotonin metabolism in children with attention-deficit hyperactivity disorder. Behav Brain Res 2002;130:97-102.

Shekim WO, Antun F, Hanna GL, et al. S-adenosyl-L-methionine (SAM) in adults with ADHD, RS: preliminary results from an open trial. Psychopharmacol Bull 1990;26:249-53.

The Essentials of Essential Fatty Acids

Essential fatty acids are just that – essential.  Our body can produce most of the fats it needs (such as cholesterol, saturated and unsaturated fatty acids), however it can not produce omega-3 or omega-6 fatty acids.  This makes them essential to consume in our diet.

Omega-6 fatty acids are found in the oils of seeds and grains, such as sunflower, safflower, soy and corn oils.   The average North American tends to consume adequate amounts of omega-6 fatty acids through their diet.

Omega-3 fatty acids are found in fish and fish oils, flax, walnuts and canola.  Omega-3 fatty acids have been shown in over 8000 studies to be important for human health and nutrition.  Omega-3s have a role in every stage of development from pregnancy and infancy through to elder adulthood.   The average North American diet does not provide adequate amounts of omega-3 fatty acids and most people would benefit from an omega-3 supplement.

The ABCs of EFAs

The language of essential fatty acids (also known as EFAs) can be confusing.  Knowing the basic ‘ABCs’ of the EFAs can simplify things and make selecting a supplement much easier.

ALA – alpha-linolenic acid.  An omega-3 fatty acid found in flax, walnuts and canola oil.  The other omega-3s (EPA and DHA) can be synthesized from this molecule.  The primary source of omega-3s for vegans.

DHA – docosahexaenoic acid.  An omega-3 fatty acid.  The richest source is fish and fish oil.  Especially important for the central nervous system, brain and eye.  Has anti-inflammatory effects in the body.

EPA – eicosapentaenoic acid.  An omega-3 fatty acid.  The richest source is fish and fish oil.  Important for mood and behaviour as well as anti-inflammatory effects.

GLA – gamma-linolenic acid.  An omega-6 fatty acid.  The richest sources are evening primrose oil, borage oil, and black currant oil.

LA – linoleic acid.  An omega-6 fatty acid.  Found in the oils of seeds and grains such as sunflower, safflower, soy and corn.   The other omega-6 fatty acids can be synthesized from this molecule.

Balancing 3s and 6s

In the body omega-3 and omega-6 fatty acids (ALA and LA) compete for the same enzymes to be converted into the health promoting long-chain omega 3s and 6s (DHA, EPA and GLA).  This is significant because the substances derived from the omega 3 fatty acids, EPA and DHA have opposite effects to the omega 6 derived substances.  EPA and DHA lead to eicosanoids that are anti-inflammatory, while the eicosanoids derived from GLA are pro-inflammatory.

High intake of dietary omega 6s can be detrimental to health by blocking enzyme conversion of the omega-3s to their active EPA and DHA form.  Maintaining an optimal ratio of omega-3s and omega-6s is essential for health.

The standard North American diet has a ratio of 20:1 omega-6s to omega-3s.  An ideal ratio is closer to 1:1 or 2:1.  Excess omega-6s have been implicated in thrombosis, vasoconstriction, inflammation, heart disease, autoimmune disease, rheumatoid arthritis, ulcerative colitis, multiple sclerosis, lupus, asthma, depression, and other chronic diseases.

Due to this imbalance in omega-3 and omega-6 fatty acids most people do not require an omega-6 supplement but could benefit from an omega-3 supplement to correct the essential fatty acid ratio.

The Benefits of Omega-3s

Higher intake of omega-3 fatty acids have numerous benefits and no disadvantages.  There are so many benefits of omega-3s that it is easiest to break down the benefits by system.   Unless otherwise indicated both EPA and DHA are recommended to achieve the listed benefit.

General Health

  • Improved mood and memory
  • Healthy metabolism
  • Bone strength
  • Healthy skin
  • Decreased inflammation
  • Better management of pain associated with arthritis, ankylosing spondylitis and back pain

Cardiovascular Health

  • Reduced triglycerides
  • Reduced blood pressure
  • Decrease inflammation in the heart and blood vessels
  • Decreased risk of angina, heart attack and stroke

Cognitive Health

DHA is important for development of the brain and nervous system in infants, and in the repair and protection of the nervous system from age-related damage.  DHA plays an important role in:

  • Development of fetal nervous system in utero
  • Improved cognitive function in infants, toddlers and children
  • Preventing dementia and Alzheimer’s in the elderly
  • Improving cognitive performance in the elderly

EPA (combined with DHA) has the greatest benefit for conditions of altered mood and behaviour including:

  • ADHD
  • Depression
  • Bipolar disorder
  • Schizophrenia

Pregnancy, Infancy and Breast Feeding

DHA is necessary for the proper development and functioning of the nervous system, brain, and eyes.  The fetus is dependent on the mother for DHA intake – which must be high enough to meet both the requirements of the fetus and the mother.  Improved DHA levels in mothers and their breast milk is associated with:

  • Improved fertility
  • Decreased risk of premature birth
  • Decreased risk of post-partum depression
  • Improved attention, focus, learning, intelligence and behaviour in children
  • Decreased risk of allergies in children
  • Improved immune development
  • Improved visual acuity

Eye Health

  • Decreased dryness
  • Decreased redness
  • Improved tear production
  • Decreased risk of age-related macular degeneration
  • Decreased risk of cataracts
  • Protection against age-related damage to the eyes

Essential Fatty Acid Supplements

For most people, the preferred form of essential fatty acid supplement is a fish oil supplement.  Vegans may use flax oil as an alternative, but will require higher doses because the conversion to EPA and DHA in the body is inefficient.

Select a fish oil supplement that is:

  • Made from small cold water fish (such as sardines and anchovies) or cod liver.
  • Fresh.  Fish oil can go rancid and should not be used beyond the listed best before date.
  • Adheres to high production standards and performs third-party testing for peroxide, heavy metals, dioxins, polychlorinated biphenyl (PCBs) and other contaminants.
  • Is sustainably harvested.  This means the fish used are not endangered, are not from overfished waters and 100% of fish that are harvested are used for human or animal consumption.

Fish oil doses are dependent on the levels of EPA and DHA and should be individualized according to your individual health requirements.  Speak to a Naturopathic Doctor to determine your ideal EPA and DHA ratio and dosage.  A basic maintenance dose for someone with no major health issues is approximately 500mg EPA and DHA daily.

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.

Selected References

Calder PC.  n-3 polyunsaturated fatty acids, inflammation, and inflammatory diseases.  Am J Clin Nutr 2006;83:1505S-1519S.

Deckelbaum RJ, Leaf A, Mozaffarian D, et al.  Conclusions and recommendations from the symposium, Beyond Cholesterol: Prevention and Treatment of Coronary Heart Disease with n-3 Fatty Acids.  Am J Clin Nutr 2008;87:2010S-2012S.

Freeman MP, Hibbeln JR, Wisner KL, et al.  Omega-3 fatty acids: evidence basis for treatment and future research in psychiatry.  J Clin Psychiatry 2006;67:1954-1967.

Goldberg RJ, Katz J.  A meta-analysis of the analgesic effects of omega-3 polyunsaturated fatty acid supplementation for inflammatory joint pain.  Pain 2007;129:210-223.

Helland IB, Smith L, Saarem K, et al.  Maternal supplementation with very-long-chain n-3 fatty acids during pregnancy and lactation augments children’s IQ at 4 years of age. Pediatrics 2003;111:e39-44.

Helland IB, Smith L, Blomen B, et al.  Effect of supplementing pregnant and lactating mothers with n-3 very-long-chain fatty acids on children’s IQ and body mass index at 7 years of age.  Pediatrics 2008;122:472-479.

Howe PR.  Dietary fats and hypertension: focus on fish oil.  Ann NY Acad Sci 1997;827:339-352.

Kris-Etherton PM, Harris WS, Appel LJ; American Heart Association.  Nutrition Committee.  Fish consumption, fish oil, omega-3 fatty acids, and cardiovascular disease.  Circulation 2002;106:2747-2757.

Saldeen P, Saldeen T.  Women and Omega-3 Fatty Acids.  Obstet Gynecol Surv 2004;59:722-730.

Simopoulos AP.  The importance of the omega-6/omega-3 fatty acid ratio in cardiovascular disease and other chronic diseases.  Exp Biol Med 2008;233:674-688.