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Female Hair Loss: Lab Testing

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

Laboratory Testing for Female Hair Loss

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

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

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

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

Female Hair Loss – Printable PDF

Disclaimer

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

 

Gratitude Goodies

Every year at the Integrative Health Institute, we celebrate our anniversary by celebrating you – our community – the reason we are able to do what we do.  You are the motivation that brings us to work every day.  You are the fire behind our passion for health care.  And so we thank you!

This year I celebrated our #IHIgratitude party by making my favourite healthy vegan snack – protein power balls! We’re calling them Gratitude Goodies and the recipes are below.

Ginger Coconut Gratitude Goodies

1 cup dates (soaked)
1 cup mixed raw almonds and cashews (soaked)
1 scoop Vega vanilla protein powder
1 tbsp coconut oil
1 tbsp grated fresh ginger
1/2 cup unsweetened coconut

Soak dates and nuts for 10 minutes in warm (not boiling) water.  Drain and place in food processor.  Pulse to mix.  Add protein powder, coconut oil and ginger.  Blend in food processor until desired consistency (I like a bit of crunch so I don’t puree until smooth).  Form balls and roll in coconut.

Mexican Hot Chocolate Gratitude Goodies

1 cup dates (soaked)
1 cup mixed raw almonds and cashews (soaked)
1 scoop Vega vanilla protein powder
1 tbsp coconut oil
1 tbsp raw cacao nibs
1/4 cup Mexican hot chocolate powder (I used the one from Soma Chocolatiers)

Soak dates and nuts for 10 minutes in warm (not boiling) water.  Drain and place in food processor.  Pulse to mix.  Add protein powder, coconut oil and cacao nibs.  Blend in food processor until desired consistency (I like a bit of crunch so I don’t puree until smooth).  Form balls and roll in powdered chocolate.

The Uterine Fibroid Diet

“The food you eat can either be the safest and most powerful form of medicine, or the slowest form of poison” ~ Ann Wigmore

Below are listed some suggestions for ways food can be your medicine in the treatment of uterine fibroids. These recommendations will optimize nutrient levels, support detoxification and balance estrogen levels – all important treatment goals for improving health and managing the symptoms of uterine fibroids.

Fibroid Diet: Foods to Avoid

  1. Alcohol

Alcohol can alter estrogen metabolismAlcohol can wreak havoc on hormone balance. Consuming even moderate levels of alcohol can increase circulating estrogen levels in the body, impacting the progression of uterine fibroids and increasing the risk of endometrial cancer. Alcohol also interferes with the body’s ability to absorb and utilize B vitamins, nutrients that are essential for proper estrogen detoxification in the liver. Avoid alcohol or drink only small amounts infrequently.

  1. Refined sugar

Sugar is another culprit that can increase estrogen levels. Consumption of sugar in the form of fruit is fine, but eliminating all sources of refined sugars can help to improve hormone balance.

  1. Saturated fats

A diet high in saturated fats is associated with high circulating blood estrogen levels. Found predominantly in dairy products (cream, cheese, butter, ghee), fatty meats (beef, pork), processed and fried foods.   Limit or eliminate these foods from your diet and instead choose healthy polyunsaturated fats from olive oil, flaxseed oil, avocado, nuts and seeds.

  1. Avoid the use of plastic

Plastics are an abundant source of hormone disrupting chemicals. These chemicals have similar molecular structures to estrogen, and are able to bind to estrogen receptors resulting in an increased estrogen effect in the body. To minimize the risk avoid using plastic food storage containers and never heat food in a plastic container.

Fibroid Diet: Foods to Enjoy

  1. Increase dietary fiberHealthy whole grains

    A diet low in fiber is associated with elevated estrogen levels, which has been demonstrated to increase the risk of endometrial cancer. A diet high in fiber also helps to improve elimination of estrogen by encouraging healthy and regular bowel movements.
    Focus on healthy whole-food based fibers: fruits, vegetables and whole grains and limit processed and refined grains (breads, crackers, muffins, etc.)

  1. Consume whole grains

Whole grains are a rich source of fiber and one of the best sources for B vitamins. B vitamins are essential for healthy detoxification of hormones, including estrogen.
Choose whole grains that retain the entire grain: brown rice, wild rice, oats, quinoa, buckwheat, millet, rye, amaranth

  1. Eat tomatoes and an abundance of fruits and vegetables

Fruits and vegetables are excellent sources of antioxidants and fiber. Lycopene, a compound found in yellow, orange and fruits and vegetables (especially tomatoes) has been shown to have potential in decreasing the size of uterine fibroids.
Cooked and canned tomato sauces are the richest sources of lycopene. Consume 6-10 servings of whole fruit and vegetables per day.

  1. Cabbage family vegetablesTomatoes on the vine

The 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. Soy and legumes

A diet rich in soy and vegetarian proteins like legumes has been shown to reduce the risk of endometrial cancer. Soy acts as an estrogen modulator, decreasing the action of high circulating estrogen. Choose organic, non-GMO soy products, like miso, tempeh, tofu and edamame and have one serving per day. Also increase other legumes such as beans, peas, chickpeas and lentils. 

  1. Flaxseed

The lignans found in flaxseed help to regulate estrogen levels and have been found in studies to have promise in decreasing the risk of cancer. One to two tablespoons of ground flaxseed per day will also provide a rich source of fiber and omega 3 fatty acids.

  1. Vegetarian diet

Women consuming a vegetarian diet have higher rates of estrogen detoxification and elimination. Vegetarian diets are rich in beans, legumes, fruits and vegetables. Eating a vegetarian diet even 60% of the time can make a big difference for hormone balance. 

  1. Soy is a vegetarian protein and source of ironIron rich foods

    Iron deficiency anemia is a common concern for women with fibroids. In a terrible catch-22, iron deficiency can make heavy menstrual bleeding associated with fibroids worse, leading to worsening iron deficiency. A supplement may be needed for some women, but consuming a diet rich in iron can be very important for women with uterine fibroids. Rich sources of iron include lentils, beans, soy, pumpkin seeds, nuts, raisins, fortified cereals, chicken, beef, turkey, oysters, shrimp and clams.

  1. Green tea

    One of the best foods for uterine fibroids is actually a beverage. Green tea is a rich source of polyphenols, especially epigallocatechin gallate (EGCG). These polyphenols have been shown to be protective against cancer, help to balance hormone levels, and promote detoxification. In one study green tea extract was found to decrease the size of uterine fibroids, improve the quality of life and improve iron deficiency associated with uterine fibroids. Drinking 2-3 cups per day is a great choice for all women with fibroids.

Diet is one of the best ways to support your body when you have uterine fibroids.  Your Naturopathic Doctor can also give you guidance on how to decrease pain, prevent progression of fibroids and decrease excessive bleeding during your periods.  Contact a naturopath today and start yourself on a journey of optimal health.

Selected References

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

Roshdy E, et al. Int J Womens Health. 2013;5:477-486.

 

Vegetarian 101 – Iron in the Vegetarian Diet

Iron is one of the most important minerals for health.  Iron is used to form hemoglobin which allows our red blood cells to carry oxygen to each and every cell in our body.  Iron deficiency is the most common nutrient deficiency worldwide with up to two billion people affected, mostly women and children, and affects omnivores and vegetarians alike.

Symptoms of Iron Deficiency

Iron deficiency generally develops slowly and symptoms often do not appear until anemia is severe, even though our cells are already suffering the consequences of inadequate iron.

Symptoms of iron deficiency are similar in all age groups and include:

iron in the vegetarian diet

  • Fatigue
  • Dizziness
  • Shortness of breath
  • Irritability
  • Pale skin
  • Sore tongue
  • Dark coloured stools
  • Frequent infections
  • Sensitivity to temperatures (cold or heat)
  • Pica (the desire to eat non-food substances – most commonly ice or dirt)

Vegetarians have no higher incidence of iron deficient anemia than the omnivore population, however there are some additional precautions vegetarians must take to ensure an adequate dietary intake of iron.

Absorption of Iron from the Diet

Green leafy vegetables are a source of vegan ironDietary sources of iron are either heme-based (from animal sources) or non-heme (vegetarian.)  Some foods (such as cereals and infant formulas) are also iron-enriched or iron-fortified – non-heme iron is used in these foods.

Although a vegetarian diet is likely to contain as much (or more) iron than an omnivorous diet, the non-heme iron in a vegetarian diet is substantially less available for absorption because of differences in the chemical form of iron and accompanying constituents that inhibit iron absorption (such as calcium, tannins and phytates).

Vegetarians need to consume approximately 80% more iron than indicated by the national Recommended Daily Intake (RDI) due to the decreased bioavailability.  Absorption of non-heme is estimated to be 10%, although more will be absorbed in cases of severe anemia.  By comparison the absorption of non-heme iron is approximately 18%.

Iron absorption can be enhanced by combining iron rich foods with a source of vitamin C, using iron cookware (especially for cooking acidic foods that solubize iron from the pan), sprouting grains and avoiding coffee, tea and red wine with meals.

Vegetarian Food Sources of Iron

Food Amount Iron (mg)
Soybeans,cooked 1 cup

8.8

Blackstrap molasses 2 Tbsp

7.2

Lentils, cooked 1 cup

6.6

Spinach, cooked 1 cup

6.4

Tofu 4 ounces

6.4

Bagel, enriched 1 medium

6.4

Chickpeas, cooked 1 cup

4.7

Tempeh 1 cup

4.5

Lima beans, cooked 1 cup

4.5

Black-eyed peas, cooked 1 cup

4.3

Swiss chard, cooked 1 cup

4.0

Kidney beans, cooked 1 cup

3.9

Black beans, cooked 1 cup

3.6

Pinto beans, cooked 1 cup

3.6

Turnip greens, cooked 1 cup

3.2

Potato 1 large

3.2

Prune juice 8 ounces

3.0

Quinoa, cooked 1 cup

2.8

Beet greens, cooked 1 cup

2.7

Tahini 2 Tbsp

2.7

Veggie hot dog, iron-fortified 1 hot dog

2.7

Peas, cooked 1 cup

2.5

Cashews 1/4 cup

2.1

Bok choy, cooked 1 cup

1.8

Bulgur, cooked 1 cup

1.7

Raisins 1/2 cup

1.6

Apricots, dried 15 halves

1.4

Veggie burger, commercial 1 patty

1.4

Watermelon 1/8 medium

1.4

Almonds 1/4 cup

1.3

Kale, cooked 1 cup

1.2

Sunflower seeds 1/4 cup

1.2

Broccoli, cooked 1 cup

1.1

Millet, cooked 1 cup

1.1

Soy yogurt 6 ounces

1.1

Tomato juice 8 ounces

1.0

Sesame seeds 2 Tbsp

1.0

Brussels sprouts, cooked 1 cup

0.9

Sources: USDA Nutrient Database for Standard Reference, Release 24, 2011

Recommended Daily Intake and Supplementation

The RDI for iron is 80% higher for vegetarians and is dependent on your age.  Children, adolescents and pregnant women have increased needs due to the rapid growth seen during these ages.  The values below are for vegetarian people only and reflect the increased need for iron in this population

Daily recommended intake of dietary iron for vegetarians

Children are at risk for iron deficiencyInfants (0-2 years): 19mg per day
Children (3-11 years): 18mg per day
Adolescent girls (12-18): 27mg
Adolescent boys (12-18): 19mg
Adult women (19-50): 32mg
Adult men (19-50): 15mg
Pregnant women: 48mg
Seniors (>50): 14mg 

Iron supplements should only be taken if blood tests have shown evidence of an iron deficiency or decrease in iron storage levels. Research suggests that a daily iron supplement is best for treating low iron, however frequency may be decreased to once or twice per week for prevention of deficiency in people with a history of low iron.

Iron supplements should be taken away from other minerals (especially calcium) since these may decrease the absorption of iron.  A source of vitamin C (500mg capsule) is also recommended to enhance absorption each time an iron supplement is taken.

Ferrous fumarate and ferrous sulfate contain the highest amount of elemental iron per mg with ferrous gluconate containing the least.  Ferrous gluconate, ferrous fumarate and ferrous citrate are well tolerated with fewer digestive side effects reported.

Constipation, darkening of the stool and digestive upset are the main side effects seen with iron supplements.  Supplements should be continued for three months beyond the resolution of iron deficiency anemia to replenish body stores of iron.

If you suspect you may have an iron deficiency, seek a blood test from your Medical Doctor or Naturopathic Doctor.

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

Goddard AF, James MW, McIntyre AS, Scott BB. Guidelines for the management of iron deficiency anaemia. British Society of Gastroenterology. 2005

M Amit; Canadian Paediatric Society, Community Paediatrics Committee. Vegetarian diets in children and adolescents. Paediatr Child Health 2010;15(5):303-314.

Hunt JR.  Bioavailability of iron, zinc, and other trace minerals from vegetarian diets. Am J Clin Nutr 2003;78(suppl):633S–9S

Stoltzfus RJ, Dreyfuss ML. Guidelines for the Use of Iron Supplements to Prevent and Treat Iron Deficiency Anemia. International Nutritional Anemia Consultative Group (INACG)

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

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.

Surprise, It’s Vegan!

What do Oreo cookies, Ritz crackers, Sour patch kid candies and Heinz ketchup all have in common?  They are all vegan!

Embarking on a vegan diet can be a daunting task.  Most people assume that being a vegan means eating nothing but carrot sticks, blue-green algae and apple slices.  But, despite being by nature a ‘restrictive’ diet – it does not have to be a boring diet!

Ritz crackers - another vegan treat
Ritz crackers – another vegan treat

One of my favourite resources on vegan foods is from the People for Ethical Treatment of Animals (PETA).  Their “I Can’t Believe It’s Vegan” site lists hundreds of foods (snack foods, condiments, breakfast foods, baked goods, staples and more) that are ‘accidentally vegan’.

So if you are considering veganism but are unwilling to give up your Red Berries or your BBQ Ruffles – check out this website and discover all the potential indulgences that a vegan diet can include!

*The foods mentioned in this article may not be ‘healthy’ foods and should therefore be consumed in moderation!

Source: PETA – I Can’t Believe it’s Vegan.

http://www.peta.org/accidentallyVegan/default.asp