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Problems with the Pill

There is no doubt that the birth control pill was a huge player in the feminist revolution. First released in 1960, the pill allowed women to delay pregnancy and focus on their career, transforming the lives of women and society. While the pill may be a political powerhouse, and be effective at preventing pregnancy, my belief is that it is being overprescribed, and women are under-educated on the impact that the pill can have on their health.

This article will share some of the concerns that I, as a naturopathic doctor and women’s health expert, have regarding the pill. The purpose is not to convince you to give up the pill, but to empower you with information so that you can make an informed choice as to whether this medication is the right choice for you.

Problems with the Pill

  1. The Pill Depletes Nutrients

One of the biggest problems with the pill is the nutrient deficiencies that result from use. From B vitamins to essential minerals, the pill changes the absorption, utilization and metabolism of a number of different nutrients. These nutrient depletions are the underlying cause of many of the negative side effects of the pill – things like weight gain, moodiness, fatigue and blood clots. You can read all about the nutritional problems with the pill in this article.

  1. Weight gain

The estrogen in birth control pills can cause an increased appetite and fluid retention, leading to weight gain, especially in the first few months on the pill. Long term weight gain on the pill is more likely due to the decreased levels of B vitamins, necessary for carbohydrate and fat metabolism (i.e. burning fat for energy).

  1. No glory for our guts

The pill is known to alter the balance of healthy bacteria in our guts. Estrogen affects gut permeability (a risk factor for autoimmune disease) and bacteria balance, a condition known as dysbiosis. Healthy bacteria are incredibly important for our overall health – especially our immune, mood and digestive health. The pill has been linked to symptoms of gas, bloating, IBS, and an increased risk of Crohn’s disease in women with a family history of the digestive condition.

The change in healthy bacteria balance, combined with the estrogen in the pill, also makes women more susceptible to vaginal and digestive yeast infections. If you get frequent or recurrent yeast infections, or significant gas or bloating symptoms, consider if your pill may be part of the problem.

  1. Moodiness

Any woman can tell you that hormones can have a significant impact on your mood. The rises and dips in estrogen and progesterone that occur over a woman’s monthly cycle can lead to moods and behaviours that foster relationships, encourage sexual intimacy, and make women weepy, emotional and volatile. While some women on the pill notice very little difference in their mood states, other women find their normal emotional states become heightened in intensity and more difficult to manage. The reasons for this are very individual – some women don’t tolerate the high levels of estrogen and others find the high progesterone problematic. In either case, if the pill makes you moody switching to another pill is unlikely to help.

  1. Blood clots

Possibly the most well known side effect of the pill, the risk of blood clots is highest in women who are obese, are smokers or who have a family history of blood clots. The estrogen in the birth control pill is the most likely culprit, increasing the production of clotting factors and increasing a woman’s risk of blood clots by three-to-four fold. Deficiencies of key nutrients can also contribute to an increased risk of blood clots, most notably vitamin B6, vitamin E and magnesium – all of which are depleted by the pill.

  1. Thin endometrial lining

The endometrial (or uterine) lining is necessary for a successful implantation and pregnancy. In women wanting to have a family, long term use of oral birth control pills could thin the endometrial lining, leading to difficulty conceiving or maintaining a pregnancy. The underlying cause of this change is thought to be a down-regulation of estrogen receptors in the uterus, resulting from long term use of synthetic progesterone. The upside to this situation, is that this same mechanism is thought to be the reason why the pill reduces the risk of endometrial cancer.

  1. No sex drive

Never mind a thin endometrial lining if you can’t get up the urge to have sex at all. Many women report a low libido as a major issue they have with taking the pill. The pill lowers androgens and the lowered testosterone is likely responsible for the lack of sex drive. Around ovulation women typically experience a small, but significant, testosterone surge, causing them to seek out sex. On the pill you don’t experience this testosterone surge and your urge for sex can all but dry up. On a positive note – this decrease in testosterone is the reason why the pill can improve acne. But there are other ways to clear acne than giving up your lusty libido.

  1. Ignoring Mr. Right

Some of the most intriguing research on the pill surrounds a woman’s decision making around possible partners. Women who are on the pill tend to be attracted to more masculine, macho men with more ‘manly’ physical characteristics, and ignore men with softer, more ‘feminine’ features. Dr. Julie Holland, in her book Moody Bitches, refers to this as the “dad-or-cad” dilemma – women on the pill are more likely to be attracted to the bad-boy, rather than the more sensitive man who may be more acceptable as a long term partner and father to her children. Dr. Holland suggests it might be a good idea to get off the pill if you’re entering the dating pool, to prevent later regrets!

As if that wasn’t enough, another study found that women on the pill tend to seek out men with more genetic similarities to themselves, increasing their risk of miscarriage and genetic issues in their offspring. Women off the pill tend to choose men that are more genetically dissimilar – a pairing that tends to result in healthy pregnancies, happier relationships, more satisfying sex, and an increased likelihood of female orgasm.

  1. Masks symptoms

One of my biggest concerns with the pill is that it is used by conventional doctors as a band-aid for every female reproductive issue. Got PCOS? Take the pill! Got endometriosis? Take the pill! Got fibroids? Take the pill! PMS or menstrual cramps? Take the pill! Perimenopausal? You get the pill too! In no way does the pill address the underlying issues of these women’s health issues. The pill just provides a steady state of synthetic hormones, suppressing and masking the symptoms of the underlying imbalance. When you get off the pill you are no better than when you started – but you are older. And if you want to try and start a family you still have to address the underlying imbalance. The use of the pill as a way to suppress and deny the imbalances in women’s hormones is a disservice to women and I deplore it.

  1. The pill is a carcinogen

Ok. I get it, this sounds scary. But it’s true. The International Agency for Research on Cancer includes oral birth control pills as a carcinogen on its list of known human carcinogens. Studies have shown that birth control pills can increase the risk of breast cancer, cervical cancer and liver cancer. It can reduce your risk of ovarian and endometrial cancers, however. In general I’d suggest using the pill for as short a duration as possible and consider other forms of contraception for the majority of your reproductive years.

We have to keep in mind that the pill is not without problems. It contains synthetic hormones at levels much higher than our body produces on its own. Some of the side effects like acne, breast tenderness, or moodiness might be manageable, but I think women need to be empowered with knowledge to decide if the pill is the right choice for them.

If you have concerns about using the pill, want to balance your hormones naturally, or discuss natural forms of non-hormonal contraception, book an appointment now. Your hormones are in your hands – strive for hormone harmony!

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.

 

Nutritional Needs of Teens

There is a lot of growth during the teen years.  Emotional growth, intellectual growth, spiritual growth and, of course, physical growth.  All of this growing can be exhausting (this is one of the reasons teens need so much sleep!) It also means that nutritional needs are increased to support all this growth and change.

Teens need over 2 litres of water daily

The teen years are second only to pregnancy and lactation for high nutrient requirements.  The best way to ensure you are getting all of these nutrients is to eat a diverse diet high in different coloured fruits and vegetables, whole grains (such as brown rice, quinoa, barley, and millet), legumes and beans, lean meats (or alternatives) and low fat dairy (or alternatives).

Below are two charts on micronutrient (vitamins and minerals) and macronutrient (protein, carbohydrate, fats, water) nutritional needs.  Values given are daily requirements.

Micronutrient_Needs_Teens

*Vitamin D requirements are higher in Canada from October to May due to inadequate sun exposure during the winter.

**Any female who is sexually active should be taking an additional 400mcg daily to prevent birth defects if pregnancy occurs

Macronutrient_Needs_Teens

Remember: these reference values are for normal, apparently healthy individuals eating a mixed North American diet. An individual may have individual physiological, health, or lifestyle characteristics that may require different intakes of specific nutrients.

If you are concerned you are not getting enough nutrients in your diet consider a high quality multivitamin-mineral supplement to meet your needs.  It is better to take a supplement to meet your needs than to deprive your body of the building blocks it needs to grow and maintain health through your teens and beyond.

References:

Health Canada Dietary Reference Intake Tables.  Available online at: http://www.hc-sc.gc.ca/fn-an/nutrition/reference/table/index-eng.php http://www.hc-sc.gc.ca/fn-an/nutrition/reference/table/index-eng.php

Low Testosterone in Men: Supportive Supplements

Many otherwise healthy men are suffering with low testosterone levels.  Testosterone is an important hormone for male sexual health, but also mood, energy, muscle strength, bone density and many many other functions in the body.

Testosterone levels decline with age, and men of this generation are producing up to one-quarter less than their grandfathers.

Symptoms of low testosterone are variable but may include:

  • Low libido
  • Erectile dysfunction
  • Depression and low mood
  • Brain fog and reduced mental functioning
  • Osteoporosis
  • Reduced muscle mass
  • Infertility and low sperm count

Low testosterone levels can be identified on blood or salivary panels. If you think you may have low testosterone, ask your doctor for a test.

You can learn about lifestyle approaches to improving low testosterone levels here, or read on to learn how specific nutritional and botanical supplements can increase your testosterone and get you back to feeling vibrantly healthy.

Nutritional Supplements

Zinc

The most important nutrient for male health, even a slight deficiency in zinc can lead to lower testosterone levels and decrease sperm counts. It is estimated that 80% of men are not getting the daily recommended intake of zinc (11mg). Good food sources are nuts, pumpkin seeds and whole grains. Take supplements only under the care of a qualified naturopathic doctor – taking too much zinc can be toxic to sperm and result in infertility. Taking zinc with folic acid has also been shown to be more effective at balancing hormones and sperm production than either alone.

Astaxanthin

This carotenoid molecule (less well-known than it’s cousin beta carotene), is isolated from algae.  Astaxanthin has been found to increase testosterone levels and sperm health after three months of supplementation. It has stellar antioxidant properties and is safe for most men.

Botanical Supplements

Mucuna pruriens

A traditional Ayurvedic herb, mucuna is able to balance the entire cascade of male hormone balance from the production of GnRH in the hypothalamus all the way to testosterone production in the testes. Human and animal studies have shown increases in sperm count and increased testosterone. It also has been found to decrease reports of stress and decreased stress hormone (cortisol) production.

Tongkat Ali

Eurycoma longifolia Jack, or Tongkat Ali, is a traditional Malaysian botanical medicine. We don’t know exactly how it works, but studies have demonstrated increases in hormones, including testosterone as well as increased libido and sperm count.

Withania somnifera

Ashwaganda, an excellent adaptogenic botanical, has been found in studies to improve sperm counts, hormone balance and testosterone levels. This botanical is best indicated for men with stress in addition to low testosterone levels.

Tribulus terrestris

A botanical with a long history of use for improving male virility, muscle strength and sexual potency. Tribulus is thought to enhance production of lutenizing hormone, leading to an increase in testosterone production. Studies have found daily supplementation can improve hormone parameters after as little as one month.

As with all supplements, supervision by an experienced and qualified Naturopathic Doctor is recommended to ensure safe and effective use.  Natural remedies may be natural, but they are not without side effects and potential interactions.  Your ND will help you find your ideal 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.

 

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.

A Male Prenatal?

We all recognize the importance of prenatal supplements for women.  But can men benefit too?  Women are encouraged to take a nutritional supplement for at least three months before getting pregnant and I think men should do the same!

Nutrients for Male Fertility

Certain nutrients are needed for the production and protection of sperm.  Making sure that men have enough of these key nutrients can improve sperm count, sperm motility and the percentage of healthy sperm.

Vitamin C and E

Antioxidants for male fertilityVitamins C and E are antioxidants – they protect the body from damage done by reactive oxygen species (ROS or ‘free radicals’).  Sperm are especially sensitive to damage by ROS.  This is why semen contains high amounts of vitamin C and other antioxidants, to protect the sperm from ROS damage.

A diet that is deficient in antioxidant rich fruits and vegetables can lead to lower sperm count, poor motility and more abnormally shaped sperm.

However, you can get too much of a good thing.  Excess doses of vitamin C and E can have pro-oxidant effects – leading to oxidative damage rather than preventing it.  Working with a Naturopathic Doctor can help you determine your optimum dose for fertility.

Selenium

Supplements for Male Fertility

Another antioxidant, selenium deficiency is associated with poor male fertility.  Selenium supports sperm production and supplementation can improve sperm motility and sperm count.

As with vitamin C and E, too much selenium can cause adverse effects.  It is best used in combination with other antioxidants at low dose, or as a food-based nutrient.              

Folic acid

Normally associated with female fertility, men can benefit from folic acid supplementation as well.  Folic acid is necessary for DNA synthesis and the protection of DNA during sperm production.

It has been suggested that supplementing men with folic acid may decrease miscarriage rate by decreasing genetic mutations.

Zinc

No single nutrient has a greater impact on male reproduction than zinc.  Zinc is necessary for folic acid absorption and metabolism, testosterone production, formation and maturation of sperm and fertilization.

The scary thing is that 79% of men are not consuming even the recommended daily allowance (RDA) of zinc.  Most men who are considering fatherhood could benefit from a zinc supplement.

But as with so many things, you can have too much of a good thing.  Excess intake of trace minerals like zinc can lead to pro-oxidant effects.

Men and women contribute equally to fertility – you each give your DNA to your baby.  Put your best DNA forward and consider seeing a Naturopathic Doctor who can recommend a male prenatal supplement to optimize your fertility, and the health of the next generation.

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.

 

Alopecia Areata – The Naturopathic Approach

Hair loss can be a devastating symptom for men and women alike.  When it happens during adolescence or young adulthood it can be even more so.  Alopecia areata, a type of hair loss that affects up to 0.2% of the population (that’s over 50 000 people in Toronto alone) most often starts in people under 20 years of age.

Men and women suffer equally from alopecia areata and it occurs in all ethnic groups.  While we don’t know exactly what causes alopecia areata the evidence suggests it is an autoimmune condition with genetics and environmental factors contributing to its onset.

DIAGNOSIS of ALOPECIA AREATA

Alopecia areata has a characteristic appearance of well-defined round or oval areas of hair loss.  Typically occurring on the scalp, the circular patches of hair loss are free from scarring and the skin is not discoloured.  Around the patch of hair loss some hairs will have an “exclamation point” appearance showing signs of the abnormal transition of the hair through it’s growth phase.

While alopecia areata usually occurs as defined patches on the scalp, alopecia totalis occurs when there is  total loss of the scalp hair and alopecia universalis refers to loss of all hair on the scalp and body.

Diagnosis of alopecia areata should consist of a detailed history, a thorough clinical examination and appropriate laboratory testing.   Markers of inflammation and nutritional status should be included in any blood work to identify potential contributing factors in the onset and development of alopecia areata.

TREATMENT of ALOPECIA AREATA

Treatment of alopecia areata is difficult to assess because spontaneous recovery and hair regrowth occurs within 6 to 12 months for more than half of all patients.  However, recurrence is high so efforts should be made to determine the underlying cause of alopecia areata and treat accordingly.

While many things can contribute to the development of alopecia areata research suggests that some of the most significant factors are:

  • Stress (physical or emotional)
  • Hormone fluctuations
  • Infectious diseases or illnesses
  • Autoimmune conditions
  • Pre-existing health conditions such as celiac disease, ulcerative colitis, psoriasis, multiple sclerosis, vitiligo and lupus
  • Nutritional deficiencies – especially zinc and iron
crisp bread
Seeds are a good source of zinc.

As a Naturopathic Doctor my focus is on uncovering potential imbalances that may be contributing to the development of disease.  With alopecia areata there are often multiple factors that must be addressed – nutrient deficient diets, stress, poor immune function and hormone imbalances being the most common.

Potential natural treatments depend on individual needs – unfortunately there is no one diet or supplement that can cure alopecia areata.  The best course of action is to understand your health – what are the potential causes of your hair loss and how can they be addressed through dietary, nutritional and supplemental support.

To learn more about my individualized approach to hair loss, book a complimentary 15 minute meet-and-greet.  Learn how you can improve your health today.

References:

  1. Shapiro J. Hair Loss in Women. N Engl J Med. 2007;357:1620-1630.
  2. Springer K, Brown M, Stulberg DL. Common hair loss disorders. Am Fam Physician. 2003;68(1):93-102.
  3. Tosti A. Diseases of hair and nails. In: Goldman L, Schafer AI eds. Goldman’s Cecil Medicine. 24th ed. Philadelphia, PA: Mosby Elsevier; 2012:chap 450.
  4. Alkhalifah A, Alsantali A, Wang E, McElwee KJ, Shapiro J. Alopecia areata update part I. Clinical picture, histopathology and pathogenesis. J Am Acad Dermatol. 2010;62(2):177-188.
  5. Brajac I, Tkalcic M, Dragojevic DM, Gruber F. Roles of stress, stress perception and trait-anxiety in the onset and course of alopecia areata. J Dermatol 2003;30:871-878.
  6. Harries MJ, Sun J, Paus R, King LE Jr. Management of alopecia areata. BMJ. 2010;341:c3671.
  7. Rushton DH. Nutritional factors and hair loss.  Clin Exp Dermatol. 2002;27(5):396-404. Trost LB, Bergfeld WF, Calogeras E. The diagnosis and treatment of iron deficiency and its potential relationship to hair loss.  J Am Acad Dermatol. 2006;54(5):824-844.
  8. Park H, Woo Kim C, Seok Kim S, Wook Park C.  The therapeutic effect and the changed serum zinc level after zinc supplementation in alopecia areata patients who had a low serum zinc level. Ann Dermatol. 2009;21(2)142-146.

 

40 Vegan Calcium Sources

We all know that calcium is an essential mineral that is used by the body to build and maintain healthy bones and teeth.  But did you know that calcium is also used for blood clotting, nerve conduction, muscle contraction, regulation of enzymes and cell membrane function?  That is one useful mineral!

If we aren’t consuming enough calcium in our diet, our body will take the calcium it needs from our bones – leading to osteomalacia (softening of the bones) and, along with other factors, to osteoporosis.  If children don’t consume adequate calcium they will not have healthy bone mineralization which can lead to rickets and lifelong low bone mineral density.

Calcium and a vegan diet

One of the concerns people express when they learn I’m raising my children as vegetarians is “how are they getting calcium if they aren’t drinking milk?”.  It’s impressive how well the dairy industry has marketed milk as the only dietary source of calcium!  But there are many plant-based sources of calcium – and it’s not hard to reach your daily calcium needs by eating these common (and delicious!) foods – usually just 2-4 servings a day is more than enough.

Daily Recommended Allowance of Calcium 

Calcium requirements

To enhance absorption of calcium, you should also make sure you are getting enough vitamin D.  That means 20 minutes of direct sunlight every day from May-October and a daily vitamin D supplement during Canadian winters (November to April).  Inadequate stomach acid also reduces calcium absorption.  Discuss with your Naturopathic Doctor whether this may be an issue for you.

40 Vegan Sources of Calcium

Vegetables (per cup)Green leafy vegetables are a source of vegan iron

Bok choy (cooked) – 330 mg
Kale – 180mg
Bean sprouts – 320 mg
Spinach (cooked) – 250 mg
Collard greens (cooked) – 260 mg
Mustard greens (cooked) – 100 mg
Turnip greens (cooked) – 200 mg
Swiss chard (cooked) – 100 mg
Seaweed (Wakame) – 120mg
Okra – 130 mg
Broccoli – 45 mg
Fennel – 45 mg
Artichoke – 55 mg
Celery – 40 mg
Leeks – 55 mg

Nuts, nut butters and seeds

Almonds (1/4 cup) – 95 mg
Brazil nuts (1/4 cup) – 55 mg
Hazelnuts (1/4 cup) – 55 mg
Almond butter (1 tbsp) – 43 mg
Sesame seeds (1 tbsp) – 63 mg
Tahini (1 tbsp) – 65 mg

Grains

Cereals (calcium fortified, ½ cup) – 250 to 500 mg
Amaranth (cooked, ½ cup) – 135 mg
Brown rice (cooked, 1 cup) – 50 mg
Quinoa (cooked, 1 cup) – 80 mg

Legumes and beans

Chickpeas (cooked, 1 cup) – 80 mg
Pinto beans (cooked, 1 cup) – 75 mg
Soy beans (cooked, 1 cup) – 200 mg
Tofu (soft or firm, 4 oz) – 120 – 400mg
Tempeh (1 cup) – 150 mg
Navy beans (1 cup) – 110 mg
White beans (cooked, 1 cup) – 140 mg

Fruit (per cup)

Figs (dried) – 300 mg
Apricots (dried) – 75mg
Kiwi – 60mg
Rhubarb (cooked) – 350 mg
Orange – 70 mg
Prunes – 75 mg
Blackberries – 40 mg

Miscellaneous

Blackstrap molasses (1 tbsp) – 135 mg

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.

References:

Health Canada.  Vitamin D and Calcium: Updated Dietary Reference Intakes. http://www.hc-sc.gc.ca/fn-an/nutrition/vitamin/vita-d-eng.php.  Accessed January 31, 2012

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.

Tea and Iron Deficiency

Tea (Camellia sinensis) is one of the most commonly consumed drinks on the planet and is highly respected for its many health promoting properties.  To name a few, tea is:

  • antioxidant
  • anti-inflammatory
  • probiotic (promotes healthy intestinal bacteria)
  • antimicrobial – antiviral, antibacterial and anti-protozoal
  • anti-mutagenic
  • anti-carcinogenic

However, tea can have a significant negative impact on our health as well.   Green tea, black tea, and some herbal teas (such as peppermint) can contribute to iron deficiency. The polyphenols in tea (the same compounds that give tea – especially green tea – many of its health promoting properties) bind to iron and prevent the body from absorbing it.

When tea is consumed at the same time as iron-rich foods the absorption of iron is decreased by as much as 26%.  This impact on absorption is only a concern with non-heme iron, or plant based iron and is not seen with heme-iron (animal-based iron.)  This leaves vegans and vegetarians at greatest risk for the negative effects of this interaction.

In order to prevent iron deficiency it is recommended that green and black teas – including iced teas, not be consumed with a meal and that individuals at risk for iron deficiency (adolescents, pregnant women, vegetarians and vegans, menstruating women, and the elderly) be aware of the potential impact of tea on their iron status.

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.

Iron Deficiency in Children

Iron deficiency is the most common nutrient deficiency seen in children.  In adults the causes of iron deficiency tend to be pregnancy and menses (in women) and gastrointestinal bleeding (in men).  In children iron deficiency is most often due to dietary influences.

Dietary Influences on Iron Levels

Lentils are a vegan source of iron

The effects of diet on iron levels are well-known.  Eating a diet low in iron-rich foods will result in iron deficiency in all age groups.  The chart below shows foods that are rich in iron and should be included in a health-promoting diet.  Picky toddlers and school-aged children may develop iron deficiency due to an iron-poor diet.  However, a low iron diet is only one cause of iron deficiency in children.

The most common cause of iron deficiency in younger children (0-24 months) is over-consumption of cow’s milk.  The iron in cow’s milk is much less available for absorption than human milk.  Breastfeeding for the first 12-24months or using formulas fortified with iron are the simplest solutions for iron deficiency in young children.

Due to the high demand of a child’s body for iron (necessary for growth and development) and the possibility for long-term impacts of iron deficiency (poor growth, decreased intelligence and IQ) an iron deficient child must be treated quickly and appropriately.

Other Causes of Iron Deficiency

Malabsorption (the decreased ability to absorb iron from the diet) is a potential cause of iron deficiency in all age groups.  Malabsorption is most commonly seen in people with celiac disease (an inability to tolerate gluten-containing foods – such as wheat, rye, oats, barley, kamut and spelt) or in people with H. pylori colonization in their digestive tracts.  Absorption of iron is also of concern in vegetarians because the phytates in iron-rich plant foods can decrease absorption.

Genetic conditions can also be a potential cause of low iron.  If you have a family history of iron deficiency discuss this with your Naturopathic Doctor.

Symptoms of Iron Deficiency

The symptoms of iron deficiency in adults and children are similar:

  • Fatigue
  • Dizziness
  • Pale skin
  • Sore tongue
  • Dark coloured stools
  • Pica (the desire to eat non-food substances – most commonly ice or dirt)

Food Sources of Iron

Animal Sources(meat, fish, poultry, eggs, dairy) Plant Sources(legumes, nuts, grains, vegetables, fruit)
Excellent sources (containing at least 3.5mg of iron per serving)
  • Pork, chicken or beef liver
  • Beef kidney or beef heart
  • Clams, canned
  • Oysters, canned
  • Iron-fortified breakfast cereal (1 cup)
  • Instant oatmeal
  • Soybeans, white beans
  • Firm tofu
  • Lentils
  • Chickpeas
Good sources (containing 2.1 -3.4mg of iron per serving
  • Beef
  • Shrimp
  • Sardines
  • Pasta (1 cup)
  • Kidney, navy, pinto beans
  • Baked potato with skin on
  • Cooked spinach (1/2 cup)
Fair sources (containing 0.7 – 2.0mg of iron per serving)
  • Pork, ham, chicken, turkey, lamb
  • Crab, salmon, tuna
  • Eggs (2 large)

*Meat portions are 100g/ 3oz – approximately the size of a deck of cards

  • Split peas (3/4 cup)
  • Dried fruit – raisins, figs, dates (1/4 cup)
  • Almonds, cashews, mixed nuts (1/4 cup)

Treating Iron Deficiency in Children

Iron supplements are the most common cause of accidental poisoning in children so great care must be taken in the dosing and storage of iron supplements.  Before prescribing iron supplements a blood test must be done to confirm low iron levels.  Once iron deficiency has been established your Naturopathic Doctor will prescribe an iron supplement appropriate for your child’s needs.  Dosage of iron is determined by weight and the recommended dose must not be exceeded.

Iron dosage: 2mg/ kg body weight per day

Iron supplements are best absorbed on an empty stomach, but this may cause stomach upset in some children.  If that is the case, take the iron with food.  Taking iron with vitamin C or with an acidic meal (containing lemon juice or vinegar) will increase absorption.

Supplemental iron should be taken for three months, at which time blood tests should be repeated to check iron status.  Iron supplements should be continued for 3 months beyond the point where iron levels are found to be sufficient in order to replenish iron stores.

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.