If you are experiencing symptoms on a ketogenic diet then it may be solved by increasing your electrolyte intake. As the body begins to burn fat instead of glucose for energy there can be rapid water loss. With this we can also lose a lot of salt and minerals. Our nutrient intake will likely change as well. With keto there is less of a need for some nutrients but others are essential. For certain health conditions it can be helpful to track nutrients especially at the beginning or if symptoms arise. I’ll go over what to watch for with keto and some of the most common imbalances I see.
Mental Clarity: the Gut-Brain Axis
Healthy fats are excellent for brain health. One of the benefits of keto is that people do feel a reduction in brain fog. Before keto there can be a build up of endotoxins in our body. If there is dysbiosis in the gut these toxins get released each time we eat. Toxins like lipopolysaccharide (LPS) begin to circulate. The body responds by launching an inflammatory response.
The gut is meant to be a friendly place so when chronic inflammation occurs in there nothing really works. Nutrient absorption, gut lining integrity and post-biotic production of short-chain fatty acids are inhibited. But keto takes out many of the foods that irritate the gut and intermittent fasting helps to stave off these toxins. This reduces the inflammatory response and things calm down. And certain probiotic strains can actually be used to kill off some of these endotoxins.
Having variety in the types of fats you eat is important. EPA and DHA are especially important for brain health. If there is a lot of LPS then olive oil is better than coconut oil. Variety in fats is helpful for maintaining a diverse gut microbiome. Carb cycling using resistant starches, like cooked and cooled white rice or potatoes, also feeds the beneficial bacteria. Prebiotics do this as well and I strongly suggest using these as part of your supplement plan during keto.
Fats also help with absorption of nutrients. But by far the most benefit we see is the regulation of metabolism and a reduction in insulin resistance. This calms cortisol and also reduces inflammation. Stable blood sugar helps with energy, mental clarity and focus. So let’s talk a little more about nutrients.
Eat More of These & Less of These
As a fat burner you may need less vitamin C because glucose competes with vitamin C. Similarly the metabolic pathways for carbohydrates require more B vitamins. That means in a lower carb state the need for certain b vitamins will be less.
However, many people who eat keto are consuming significantly less nutrients. The way around this is to eat your way into keto with lots of low carb nutrient dense foods. Examples of these include broccoli, green onion, asparagus, kale, spinach and carrots. As long as you are tracking your protein intake and getting enough of grass-fed meats, wild fish and some shellfish or organ meats you should be fine. An app like cronometer is excellent for tracking micro nutrients as well as making sure your carb count is low.
What About Nuts, Seeds & Dairy
Well these can be good for some people and bad for others. Anyone with an autoimmune conditions needs to check if their symptoms become worse with these. Lectins can be irritating to the gut and lactose or casein in dairy is a common, cross-reactive allergen.
On the up-side, these are nutrient dense foods full of good fats. Some nuts can also be higher in carbohydrate so be cautious. Dairy is highly palatable so it is easy to overeat and may raise LDL (low density lipoprotein). It’s really meant to be a side-note or a condiment type of food.
Electrolytes & Salts
If keto is working well for you in general but some symptoms have popped up then increase your electrolytes. Keto flu is the term given to describe feeling yucky during the adaptive phase. Symptoms that you haven’t had for awhile can also emerge. People with thyroid or adrenal issues may see an exacerbation in symptoms. While electrolytes won’t fix these issues, it may curb a flare. Bone broth is a good source of electrolytes as long as you tolerate histamines & glutamate.
Ensure that your salt intake is also adequate. Sodium follows a U-shaped curve and most people are scared to reach the high end but the slope is much steeper at the low end. Any salt is ok to use as long as your electrolytes have a good profile of nutrients. I prefer pink salt in my kitchen and it could be because it’s pink!
Seasonal Affective Disorder is Real
Millions of people experience the winter blues. This type of depression is known as SADD. There are several interventions that can help and even reverse SADD. Winter is an excellent time to get extra support either from a therapist, a peer group or a functional medicine practitioner who can help optimize your health.
7 Tips You Can Begin Now
Let me know which of these helps you the most.
- Get outside between 10 am and 2 pm everyday. Bright light exposure triggers our brain and endocrine system creating a cascade that helps your body thrive. Aim for at least 20 – 30 minutes everyday. It doesn’t have to be sunny out to get the benefit of midday exposure to daylight.
- A lower carbohydrate diet makes sense in the winter because we generally slow down a bit. People who experience SADD tend to feel better when they focus on other foods in the winter. Simply focusing on microbiota accessible carbs (MAC’s) supports both gut health and mood. These come in the form of roots and tubers. They are the traditional foods we would gather in the fall and store in the winter.
- Eat Fish. The DHA in fish supports healthy brain function whereas the EPA keeps inflammation down. Research shows that consuming fish several times a week is better in the long-term than supplementing with fish oil. Just eat real food and take cod liver oil as an excellent source of Vitamin D.
- Tend to your gut health. The gut-brain axis is key. Brain-fog is usually caused by an imbalance in the gut. Eat fermentable fibers and avoid alcohol as it can increase intestinal permeability. This can set off an immune response and increase inflammation which contributes to depression.
- Neurotransmitters are produced in the gut. Depending on what kind of depression your experience you may benefit from specific dietary or supplement support while treating the gut. Melatonin is affected adversely by bright light at night. It works with serotonin to regulate the sleep/wake cycle.
- Get moving. Exercise feels good. Serotonin is one of the neurotransmitters that we know increases when we move. Choose activities that you enjoy and try new ones that are more suited for the season.
- Reflect. The winter is an excellent time to cultivate creativity and develop a gratitude or meditation practice. Enjoy warm drinks, cozy fires and enough social time to balance out the stillness.
Lab Tests Can Provide Important Insight for Treatment
For my patients, I want to see their vitamin D status especially if they have been supplementing. This is a standard blood test. Vitamin D can be problematic if too high or too low. I also like to see a urine organic acids test to see how neurotransmitter production is functioning. Basic gut testing always helps whether or not there are gut symptoms. Cortisol, melatonin and inflammatory markers like cross-reactive protein also give important insight when it comes to treating the root cause of depression.
Optimizing methylation can help with depression, allergies and asthma. A recent meta analysis showed “consistently lower methylation levels observed at all associated loci across childhood from age 4 to 16 years in participants with asthma.” The findings of this meta analysis suggest that further investigation of epigenetics is warranted. This means a focus on how genes expressed.
Our health is not determined by our genes. Diet, environment and lifestyle are more important than we think.
I see women in clinic nearly everyday who are very low in specific nutrients. This can have far reaching effects on methylation. The cause is often a vegetarian or vegan diet that they are choosing because they believe it is more healthy.
Specific genetic variations or SNP’s (single nucleotide polymorphisms) can inhibit methylation. You may have heard of MTHFR. It’s one of the most commonly talked about gene mutations. It relates specifically to methyl folate. The enzyme needed to make this nutrient active is inhibited. Ensuring you have a folate rich diet is the epigenetic part. We need 2-3 servings at least. I say this because if you are a poor methylator you may benefit from more.
Chris Masterjohn, Phd has a handy phrase to help us remember where to find folate. The 3 L’s are Leafy greens, legumes and liver. One serving is 100 grams so we need between 200 and 300 grams per day of:
- Cooked vegetables. Fresh and local is important. Use the water that you cook them in.
- Double the amount if you are measuring raw vegetables.
- Wash veggies before cutting, blending.
- Folate degrades in frozen veggies so avoid any freezing or frozen products.
- Liver can be weighed before cooking.
- Legumes need to be soaked, rinsed and then cooked.
- Buying sprouted legumes and pressure cooking speeds the process.
- Some people can’t tolerate legumes even if they are prepared in these ways.
Methylation contributes to detoxification of foreign chemicals and heavy metals. The liver is where most of this happens. What is really fascinating is our cells are constantly adapting to the the demands of their environment. Methylation is one of the key players that assists with this process.
This explains why how some people exposed to certain toxins feel little effect while others may be debilitated.
Methylation & the Brain
Proper methylation helps keep your brain flexible and focused. It prevents negative thought patterns from taking over. Associations between poor methylation and alzheimers have been researched.
Decreased methyl folate production is common. There are up to 30 different kinds of MTHFR genetic variations making it difficult to convert folate into its active form,L-methylfolate. Mania, mental illness and depression are linked to some of these mutations.
Allergies & Histamine Intolerance
When you are methylating well your body is getting rid of histamines. At the root of most allergic reactions is an overload of histamine causing what some call a histamine response. In the scientific literature this is called mast cell activation syndrome (MCAT). Mast cells mediate immunity and inflammation. Methylating poorly contributes to MCAT. Triggers like chronic stress and trauma can be triggers for MCAT.
Eat these key nutrients
- Folate or Vitamin B9 requires 2 -3 servings per day of dark leafy greens, sprouted legumes or liver. This essential nutrient cannot by synthesized in the body so must be ingested. L-methylfolate is the active form that can cross the blood-brain barrier. One key function of folate is to help produce serotonin, dopamine and norepinephrine.
- B12 needs to eaten frequently. We can only absorb in a day what is required for that day. Aim for 4-8 grams of liver, 8 grams of clams/oysters, 375 grams of animal protein, 3 glasses of milk or 3 ounces of cheese. Research is being done to assess if nori and chantrelle/shitake mushrooms can provide B12 but this is not yet conclusive. In general vegans/vegetarians are at high risk for B12 deficiency. This is a serious health concern.
- Choline: Egg yolks are an excellent source of choline especially if they are soft. One egg yolk has the same amount of choline as 50 grams of liver or 200 grams of nuts. Two or three egg yolks per day meet our need but don’t eat 600 grams of nuts. Cruciferous veggies are another source as is lecithin. If you are supplementing try alpha GPC or TMJ.
- Glycine: I’ve written at length about glycine. Basically we need 1-2 grams of glycine rich collagen for every 150 grams of protein we eat. You can also supplement with gelatin or have a high protein bone broth as your source of glycine
Who is at higher risk?
Anyone over the age of 65 needs to monitor these nutrients. If you have a history of ulcers or gastritis you also are at higher risk for deficiency. Vegetarians and vegans also need to be careful. Poor absorption can indicate the need for supplementation but generally its best to get these essential nutrients from food.
Remember methylation can be the missing link in your health. I want you feeling your best.
Our brains adapt to early life experiences by creating imprints. We have many imprints both positive and negative that become part of how we see the world. The interesting part is our brains can change. The brain’s ability to reorganize and form new neural connections is called neuroplasticity. Our nerve cells can adjust their activities in response to new situations or to changes in the environment. Here’s what you need to know in order to do this.
Our brains are wired to remember the dangerous or overwhelming experiences. This is part of a mechanism to protect and help with survival. The term used to describe it is negativity bias.
Trauma is any event that we hold onto because at the time we weren’t able to integrate it. This happens to everyone. And yet we don’t need to live in a constant state of heightened stress because of it.
The idea of ‘positive thinking’ has always felt suspicious to me. Underneath there is often a simmering of unmet needs. How do we address this? Beginning with ourselves and experimenting with our own experience is what seems to work best.
Gender & Sexuality
Gender is a rich place to explore this topic of how the brain orients itself. Just yesterday a man dropped by to inquire about my work. As he was leaving he scanned my body in a way that is very familiar. We all look at each other all the time but there is a way that a man does this to a woman that is rude given the circumstances.
I’ve learned from transgendered friends that this type of gaze is well known. Being observed and questioned about their gender or sexuality can cause significant activation of the stress response. The ability to regulate and reduce the impact of our negativity bias becomes more difficult. Our culture needs to shift to allow more people to be at ease.
Neuroplasticity tells us that we can train the brain to regulate itself. It is possible. The cascade of positivity extends far beyond ourselves. I’ll explain how this happens.
Body-centred mindfulness training or loving self-compassion are the foundations. Knowing the body and training ourselves to notice when we begin to get overwhelmed is stage one.
Stage two is noticing what is not overwhelming. Seeing anything in the environment that is easy to integrate brings us into a different part of our brain. This part is deactivated. It sees more clearly and can enjoy the beauty of the world more.
Stage three is looking at other people from this appreciative lens. This part can happen spontaneously and we also can train to do it more often. A gaze that sees another person with curiousity is kind. This type of gaze only looks deeply at another when the foundation or motivation is heart-centred. What this means is the judging, critical or activated brain is not running the show.
We can attune better to others and know what is appropriate if we are regulated ourselves. We can also listen to another’s experience without overlaying our own. This is an innate response. I see kids do it all the time on their own. It certainly helps when it is modelled to them.
Glycine is the Amino Acid that Gives
Without knowing it, glycine is helping your body every day with muscle repair, cognitive function, metabolic health, and immunity. This amino acid assists in breaking down glycogen, fat and other nutrients to be used as energy at the cellular level. When it comes to aging gracefully it plays a role with the important antioxidant glutathione as well as the human growth hormone.
In the brain glycine acts as neurotransmitter in a similar way to GABA. It is in fact released with GABA to calm or inhibit parts of the central nervous system. Glycine modulates excitatory neurotransmissions as well, meaning that it can go both ways. This unique neurotransmitter helps with sleep, memory, mental performance, stress, anxiety and even severe mental illness. As a preventative measure for everything from fatigue to stroke this is a powerful supplement.
For stabilizing blood sugar research shows a significant benefit with 5 grams of glycine before each meal so 15 grams per day. This amount would be difficult to get in either bone broth or collagen. You’d need two full servings of collagen to get 5 grams of glycine. With metabolic issues sky rocketing glycine can be an excellent therapeutic aid.
Anyone who over methylates can benefit from glycine because it buffers excess methyl groups. Methylation is a biochemical process that has an impact on B vitamin status. Without adequate B vitamins the body will generate less glycine. Another problem that can happen is that glycine can produce oxalates instead. This causes a different kind of pain in the joints and can lead to kidney stones.
By restoring gut health you also support immunity. This is one of the far reaching benefits of glycine. Given that digestive disorders and autoimmune conditions have reached epidemic proportions it’s worth ensuring you are getting enough glycine.
Where to Get Your Glycine
I mentioned above a few reasons to take glycine in its free form and how it can be difficult to get a therapeutic dose otherwise. Collagen loading is one way to bring up the balance in the body. This means taking high doses for a few weeks.
One of the reasons bone broth has finally received so much attention is due to this amino acid along with proline and arginine. However its difficult to know what dose you are getting when you make bone broth yourself. If you purchase both broth and the label tells how much protein there is per serving then the amount of glycine is a 3:10 ration. So you get 3 grams of glycine per 10 grams of protein.
Both collagen and bone broth can be taken for maintenance. Testing B vitamins, metabolism and neurotransmitters through organic acids testing will let you know what is needed.
Types of Collagen: How to choose?
Grass-fed, bovine sources of collagen provide both type 1 and 3. What this means is that it targets muscle growth as well as the joints, skin, hair and nails. This is because Type 3 has proline which supports creatine production.
The parts of the animal that are often wasted are used to make collagen. Grass-fed, pasture raised animals supports a healthy ecosystem in ways that industrial agriculture can’t. The benefits to humans consuming small amounts of ethically raised animal products is well known. This is especially key for those with compromised digestive health or autoimmunity. For recovery from injury, surgery or to alleviate the damaging side effects of some medications it can be considered medicine. Women who are pregnant, breastfeeding and caring for small children benefit as well.
Collagen harvested from fish can also be very nourishing and done ethically. However marine collagen has a higher price point. If its not then likely this is because the source is farmed fish. The bioavailability will therefore be compromised as the molecules are larger and therefore less absorbable. Well sourced marine collagen contains only Type 1 collagen which is the most bioavailable and often marketed for beauty reasons.
Type 2 collagen from chicken sources is especially rich in cartilage. For anyone taking MSM and glucosamine this may be a replacement especially if you try a higher dose.
Optimal Health & Hormones
I mentioned the human growth hormone (HGH). By building up and breaking down muscle we actually stimulate a cascade of positive physiological responses in the body that keep us feeling and looking great. I like to think of collagen and glycine as supporting an active lifestyle and optimal health. The liver loves glycine and the liver is what helps balance other hormones.
Here are all the ways that glycine supports your to feel your best:
- Energizes: whether you suffer from chronic fatigue or are an athlete this nutrient improves energy
- Metabolism: balancing blood sugar is key to metabolic health and weight maintenance
- Muscle growth: for those who have lost muscle mass from illness or are enjoying the benefits of strength training
- Sleep and Nerves: glycine has a positive, regulating effect on the central nervous system
- Digestion: helps repair the gut by helping form the two key elements required for this which are gelatin and collagen
- Aging: as a powerful antioxidant it prevents cellular damage and can slow the various ways that aging shows up
- Immunity: by improving gut health we improve immunity
- Injury repair: this includes post-birth or surgery, joint or ligament injuries and harmful side-effects of medications
Have You Heard of Psychobiotics?
The microbes in our gut have far reaching psychological effects. In 2013 there was a ground breaking study proving that depressed mice were positively affected by a strain specific probiotic. Around the same time, the term ‘psychobiotic’ was used to describe a notable change in the character of rats who received a fecal transplant. Gut psychology has gained continuous footing since then.
Five years later we have much more reliable data that includes human trials. What we know is the effects are gradual. It takes 3 to 4 weeks to see results. This is why I begin with a 30 day reset and all my new patients sign on for at least a two month Case Review.
Will any Probiotic Work?
Good quality probiotics will adhere to the gut more effectively and therefore will stay longer which we want.
Information on the effectiveness of specific strains of probiotics for certain conditions is now available. I’m enjoying seeing the results of adding these to treatment strategies for people suffering from anxiety, eczema, chronic constipation or diarrhea.
Some strains can be disruptive in certain conditions. If you react to a product it may be that your specific type of gut imbalance is why. This is why single strains can be good. Also look for not only the genus and species but also the number after it. You know it is excellent quality if the company is able to show this.
Strain Specific for Mental Health & Even Sleep Deprivation
Here are a few examples from the research:
Lactobacillus casei shirota helps with mood but not with anger or anxiety.
Bifidobacterium longum and lactobacillus helveticus can be used to treat anger, depression, anxiety and perception of pain.
Bifidobacterum longum 1714 reduces feelings of stress.
Bifidobacterium bifidum reduces stress in those who are chronically sleep deprived.
Making These Available
One of the biggest challenges is finding products for people that are good quality. Patients often bring in a bag of supplements bought at Costco or online that are not going to help them. What are the problems?
- Not absorbable: either they are in a tablet or the form of the nutrient is not bioavailable. In some cases this can be harmful.
- Expired: buying online through Amazon or other large distributors can mean that the product has been sitting around for awhile.
- Cross contamination: A popular probiotic was recently recalled by the FDA. Licensed practitioners were told to return the product due to cross contamination. If you buy from a 3rd party you risk missing recalls like this.
- Too many things at once: Often products have too many ingredients and not good quality of what is needed. You body may get more benefit from less.
I’ve been researching this for ages. Despite the many reasons not to set up a store, I am committed to providing excellent quality products to people who need them. It will make taking care of yourself much easier!
Stay in touch & I’ll keep you posted! Many of these products can’t be found easily & they are what I use with my patients because they work. I want you to be able to access reliable support when you need it.
If you would like to download my free ebook ‘Gut Health for Hormones’, sign up for my email list! Sign up is located at the bottom of the page and in the sidebar.
Suppressing symptoms with pharmaceuticals to treat high blood pressure or cholesterol means missing the investigation as to why these are high in the first place.
We know that blood sugar issues and metabolic syndrome contribute to heart disease. In fact there are multiple factors that affect heart health and its worth looking into because often these can be treated and pharmaceuticals can be avoided along with the side effects.
Low cholesterol is known to contribute to disease and death in those with brain disorders and with mental health problems. Low levels are also dangerous for women and the elderly but we rarely hear about this. Conventional medicine is still treating cholesterol as though it is the problem when we know it is not. This obviously leads to more problems.
Cholesterol is carried on lipoproteins. Science used to believe that it was the concentration of cholesterol on these particles that led to CVD but recent studies have disproven this. Damage to arterial walls occurs not by the cholesterol carried in these particles but by there being too many particles in the blood at once particularly LDL particles.
Those who are at highest risk of heart disease may have normal or low cholesterol but high LDL particles. If one of these people only has their cholesterol tested it may seem that they are in the clear. Those with high LDL-C but low LDL-P are still given statins to lower cholesterol and these drugs have some of the worst side effects.
Our body needs a certain amount of cholesterol. LDL-P carry both cholesterol and triglycerides. When there are more trigycerides then there is less room to carry cholesterol and so more LDL-P are produced. Checking triglyceride levels is crucial as is looking at thyroid health as this can also increase the LDL-P. Thyroid hormone increases LDL receptors. It is also involved with cholesterol production in the liver and cholesterol absorption in the intestines.
Speaking of intestines would you be surprised if I told you there is a link between the markers we’ve been talking about and gut infections? Cholesterol, LDL-P, tryglycerides and low HDL are all linked with H. Pylori infection to name one culprit. In fact treating the gut can result in lowered LDL-P with no other interventions.
Soluable Fiber: Plant Food
Want to improve your life span and quality of life? Soluable fiber increases clearance of LDL, improves insulin sensitivity and binds to cholesterol. It is found in most root veggies, some that grow above ground and in some fruit.
Healthy Fats and Good Chocolate
Macadamia nuts, almonds and olive oil provide excellent sources of good monounsaturated fat. Dark chocolate lowers blood sugar and LDL. It also improves insulin sensitivity.
CoQ10 and Polyphenols
Organ meats and vegetables have plentiful anti-oxidants. They along with polyphenols are protective. Eating a range of colorful vegetables, spices and teas are provides enough and supplementing from reputable companies is also good.
Fish is better than Statins?
Once study showed that eating cold water fatty fish was more effective at reducing death than Statin drugs. The benefits of consuming enough EPA, DHA and long chain omega 3 fats has several benefits to cardiovascular health. Keep in mind that recent studies show that fish is better than fish oil.
Sleep and Move
Of course having fun, feeling connected and enjoying life are crucial for heart health. Sleep duration needs to be between 7-9 hours per night for adults. College age, adolescents and children require more sleep. Devices have no place in the bedroom as the light exposure interferes with the suprachiastmic mechanism in the brain and is disruptive to deep sleep cycling.
Brain health is influenced by many factors and we know there are a few habits that support long term function.
The inflammatory cytokine model of depression shows the influence diet has on cognitive function. Omega 6 oils are linked to depression and are pro-inflammatory. One in four adults experience mental illness in the US and the standard American diet is high in omega 6 oils. (1) Depression is increasing at an alarming rate of 20% each year.
1. Protein and Fat
Supplementing with omega 3’s is an option, however quality is an issue. Keep in mind that grass-fed dairy, meat and pastured eggs all are high in omega 3’s whereas conventional varieties are much higher in omega 6’s. Cold water, fatty fish that is wild is an excellent source of omega 3 oils as well as the important fatty acids EPA and DHA. DHA has been shown to support brain function particularly in depression, bipolar disorder and ADHD . Comparatively, vegetarians and vegans ingest 30-60% less EPA and DHA.
Monounsaturated fats like cold pressed, extra virgin olive oil increase the production of ACTH which is an important neurotransmitter. All neurotransmitters are built from amino acids in the gut. Glycine, a component of bone broth, reduces psychotic episodes and improves cognition by acting as an inhibitory neurotransmitter. It will antagonize norepinephrine which helps regulate the stress response. Cholesterol nourishes the myelin sheath of the brain.
A staggering 30-40% of people do not respond to anti-depressants. One of the ways these function is to inhibit the stress response by lowering high cortisol levels. Although, it can’t be known if an individual has high, normal, or low cortisol without testing. As a result this may explain why so many don’t respond. Cortisol is anti-inflammatory and by lowering it without proper testing it could actually increase inflammation.
2. Caffeine has many benefits in moderation
Caffeine is known to exacerbate anxiety especially in the afternoon and evening. The resulting lack of sleep and improper light exposure disrupt circadian rhythm. Over 20% of people with insomnia develop depression. In addition, those at high risk are mother’s whose iron and fat intake is not optimal. Interestingly half the population are poor metabolizers of caffeine. There may be a link between those with a gluten intolerance.
3. Gut Health and Gluten
The number of people who have undetected celiac disease and non-celiac gluten sensitivity is growing. The connection between celiac disease and cognitive dysfunction has determined at least 22% of people are likely to experience both. An astonishing 57% of those with neurological dysfunction test positive for anti-gliadin antibodies. Clinically I’ve seen people who tested negative for gliadin which is the standard test and when I test other gluten specific antibodies they are positive. The disorders associated with gluten include: seizures, neuropathy, ADD, ADHD, autism, ataxia, anxiety, depression and schizophrenia.
Vegetarians and vegans are 68-83% deficient in B12. B12 deficiency is associated with alzheimer’s, dementia, cognitive decline, memory loss, depression, bipolar and psychosis. B12 absorption can be impaired by dysbiosis, leaky gut, inflammation, pernicious anemia which is autoimmune, alcohol, pharmaceuticals, low stomach acid and IBD.
Folate and B6 are needed for serotonin synthesis. Additionally, a deficiency of these also increases inflammatory homocysteine.
5. The Minerals: Zinc and Magnesium
Copper and zinc act as neurotransmitters in the brain. The ideal serum ratio is .7 copper – 1 zinc. Oxidative stress and inflammation reduce zinc and increase copper. Low zinc indicates inflammation.
Magnesium acts at the blood brain barrier to prevent stress hormones from entering the brain. Prevents anxiety and depression after a traumatic brain injury. Caffeine and stress in excess deplete magnesium. Too much calcium inhibits absorption. Calcium from food is enough for most people.
Magnesium is stored in our bones. Acid reflux, Crohn’s, colitis, kidney disease and alcoholism contribute to a deficiency. Proton pump inhibitors are used to treat reflux by masking the symptoms and these will also deplete the body of magnesium overtime.
The recommended dose between 500-700 mg/day. Food sources include: dark leafy greens, cacao, bananas, soaked nuts, seeds and legumes. Protein will be better absorbed with a diet higher in protein. Some pharaceuticals block absorption and create deficiency of magnesium including PPI’s, Lasix, digoxin, nitrofurantoin, anti-malaria drugs and bisphosphonates.
Symtoms and conditions associated with low levels include: muscle cramps, heart arrhythmias, tremors, headaches, acid reflux, increased risk of heart disease, hypertension, metabolic syndrome, type 2 diabetes, migraines, premenstrual tension syndrome, asthma and hypothyroidism.
I recommend magnesium gylcinate and suggest that people take one capsule at night along with eating a nutrient dense diet free of the phytates that bind magnesium. Loose stool results from too much and can be to help with occasional constipation. Taking magnesium before bed will help relax your muscles and supports good sleep.
CBD (cannabinoid) is a natural, safe, and effective. Its affect includes reducing inflammation, pain and seizures. There is evidence that it may inhibit cancer growth. It certainly helps with nausea and other side-effects of chemotherapy including loss of appetite. In my practice I have seen it work on insomnia caused by recalcitrant pain. I’ve had patients stop opiates and other damaging pain medications after decades of use.
What are the benefits of CBD?
In clinical studies there is evidence that CBD is effective in five areas.
- The most established benefit on relieving pain and inflammation. It does this without the serious side effects of opiate drugs and NSAIDS.
- Studies have also shown effectiveness with PTSD especially on veterans experiencing social anxiety. Its important to note that in a percent of the population CBD can also increase anxiety.
- CBD has successfully treated drug-resistant children who have epilepsy with non of the side-effects of traditional seizure medications. Anti-seizure meds come with the worst side-effects of any drugs.
- It works against viruses, fungi, and bacteria as an anti-microbial. Some studies suggest that it may even be effective against superbugs like MRSA and other anti-biotic resistant infections.
- CBD is anticarcinogenic. Several studies demonstrate that CBD is antiproliferative and proapoptotic. More research is needed but it may inhibit cancer cell migration and invasion.
How does CBD work?
All mammals have receptors for CBD. This is called the the endocannabinoid system. It regulates a variety of functions including mood, appetite, sleep, hormone production, and immune system response. For patients with autoimmunity causing pain I’ve seen excellent clinical results. This may be because of the link between the gut and autoimmune conditions.
Interestingly the gut, which is part of the nervous system, has many endocannabinoid receptors. This is why CBD can be a game changer for people with IBS, IBD, and other GI issues like nausea. This may be part of why it is such an effective remedies for insomnia.
What forms is it taken?
CBD is available in several different forms and ratios. THC is needed to activate the CBD but it can be a minute amount. The psychoactive component does not appeal to most patients I talk to (if not all). It can be purchased as capsules, liquid extracts, sprays, vapours and topical salves or creams. CBD taken internally is best for reducing pain and insomnia, whereas a topical is best for treating skin conditions and relieving musculoskeletal pain.
Is it legal? What other challenges are there?
CBD is generally well tolerated. There are however a few potential contraindications. Like some other botanicals CBD may interact adversely with pharmaceuticals. This is because it inhibits cytochrome P450. This enzyme in the liver metabolizes many drugs so it may increase the effects. A medical herbalist is trained in understanding which drugs are potentially affected and its important to discuss this with your prescribing doctor.
The potential that it may increase anxiety must be taken into account as well. A major issue right now in Canada, is that it is difficult to get a reliable source with the proper ratios. Legalization will hopefully lead to more standardization in products. The right ratio is important depending on what is presenting. I’ve had some patients respond very well 4:1 whereas others report uncomfortable psychoactive properties. This may be due to product inconsistency or individual response. 20:1 is more difficult to find but this is a much lower dose of THC and is indicated for neurological disorders.
We always start with a low dose and build up slowly. In the US patients can purchase these products from reputable labs and companies so they know what they are getting. It is legal in the US without a prescription. Within the next fews years I expect to see reliable sources.
As you many of you know I’ve been going on meditation retreats for many years. Recently I was the health person on a retreat where mould illness was affecting three people. Another member of our community is literally debilitated from mould illness so it’s quite frightening for those who have been recently diagnosed.
I also have patients for whom mould is the number one issue affecting their health. It shows up in the lab work and correlates with the symptoms presenting. Most recently a young woman with high anxiety had mould exposure.
My son developed a chronic cough after moving in a home that had some water damage. We only stayed a few months but his symptoms have persisted for 3 years. This is how real mould exposure is. There was an article published by the Harvard Gazette last month which outlines the real costs of mould on productivity in the workplace. Framing it this way helps everyone take it seriously, because it is very serious.
What is mould and biotoxin illness? What can we do?
Dr. Shoemaker discovered a connection between a mysterious illness and a toxin produced called Pfiesteria found in the water of his patient population in the 90’s. He then linked similar illnesses to toxins from a variety of microorganisms and chemicals. Its now called CIRS (chronic inflammatory response syndrome).
Biotoxins that cause CIRS are encountered in water-damaged buildings and other places. They include (1):
- Bacteria (possibly including Borrelia, Babesia, and other organisms transmitted by tick bites)
- Actinomycetes (gram-positive bacteria from the order Actinomycetales)
- Mould spores
- Endotoxins (aka lipopolysaccharides, or LPS; cell wall components of gram-negative bacteria)
- Inflammagens (irritants that cause inflammation and edema)
- Beta-glucans (diverse group of polysaccharides)
- Hemolysins (exotoxins produced by bacteria capable of destroying cells)
- Microbial volatile organic compounds (mVOCs; organic compounds released by microorganisms when there is adequate food supply for such “secondary metabolite production”)
Most people become ill when exposed to sufficient levels of these biotoxins. Many recover once they are removed from exposure. Our detoxification system recognize theses toxins and eliminate them via the normal mechanisms.
Some people do not recover. Many of these have HLA (human leukocyte antigen) genes that prevents their bodies from recognizing and thus eliminate biotoxins. So the biotoxins remain in the body triggering a chronic, systemic inflammatory response. Roughly 25% of people have this genetic tendency. When there is a sufficient exposure and a triggering event then CIRS will develop. This event could be as simple as a cold or as complex as a Lyme disease. Dr. Shoemaker also estimates that 2% of the population are highly susceptible genetically to developing a multi-system, multi-symptom illness after prolonged or repeated exposure to biotoxins.
How Common is Biotoxin Exposure?
43% of buildings examined had active water damage and 85% had past water damage. Mould grows in a day or two after water damage.
Mould and other biotoxins can develop in buildings that are not water-damaged but have indoor humidity levels above 50 to 60 percent. Experts recommend maintaining indoor humidity levels between 30 and 50%.
Here’s how to improve indoor air quality (1):
- Fix plumbing leaks and other water problems as soon as possible. Dry all items completely.
- Scrub mold off hard surfaces with detergent and water and dry completely.
- Discard absorbent or porous materials, such as ceiling tiles and carpet, if they become moldy. Don’t paint or caulk moldy surfaces.
- Clean and repair roof gutters regularly.
- Keep air conditioning drip pans clean and the drain lines unobstructed and flowing properly.
- Make sure the ground slopes away from the building foundation, so that water does not enter or collect around the foundation.
- Keep indoor humidity between 30 and 50 percent. Measure it with a moisture meter available at most hardware stores. Venting bathrooms, dryers, and kitchens to the outside is important. Using air conditioners and de-humidifiers where needed and increasing ventilation including exhaust fans for cooking can help.
- Do not install carpeting in areas where moisture problems may develop (i.e., in a bathroom).
Air Filters can also be helpful. A HEPA filter that is capable of removing ultrafine particles like mold, dust, pet dander, VOCs, and even viruses from the air. These ultrafine particles represent 90 percent of all airborne pollution that you breathe. An air sanitizer can eliminate allergens, odors, mould, and germs.
CIRS commonly misdiagnosed as:
- Fatigue, weakness
- Post-exertional malaise
- Memory problems, difficulties with concentration
- Disorientation, confusion
- Vertigo, lightheadedness
- Muscle aches, cramping, joint pains without arthritis
- Hypersensitivity to bright light, blurred vision, burning or red eyes and tearing
- Cough, asthma-like illness, shortness of breath, chronic sinus congestion
- Unusual shortness of breath at rest
- Chronic abdominal problems including nausea, cramping, diarrhea
Removal From Exposure is often the hardest step
Mould inspectors are not using comprehensive, accurate testing methods. A visual inspection and air samples is not enough. Both of these methods can yield useful information, but more is required.
The first VCS test is available at Dr. Shoemaker’s website, Surviving Mold, at a cost of $15 USD. This is a Functional Visual Acuity Test (FACT) that uses a scoring algorithm to determine the likelihood that a patient is being adversely affected by biotoxin exposure. If it is positive, there is a 92 percent chance that the patient has CIRS. This test cannot be used to rule CIRS in or out on its own. A clinician trained by Dr. Shoemaker needs to be involved in the diagnosis and treatment of CIRS. He has a number of valuable resources on his website so please have a look. Another physician named Dr. Keith Berndston, has written a summary of CIRS.
I’m researching this largely due to my son’s presentation of chronic rhinitis and asthma. Luckily he has improved a lot these past few months. I changed his mattress and have him sleeping by a open window. These interventions may have been more important than the steroids offered by the specialist which I used in small amounts when he was in an acute stage and unable to breathe.
A CIRS diagnosis, like any diagnosis, is helpful if it changes treatment strategies. In this case finding a qualified practitioner is important. I do preliminary testing in my practice. for patients who have been exposed and are not responsive to other treatments further steps need to be taken. Opening detox pathways, looking into a genetic predisposition and removing people from exposure are always the first steps.
The Gut-Brain Connection
Infections and other imbalances in the gut result in an inflammatory response in the brain. The inflammatory cytokine theory is well established in the scientific literature and is being embraced as the number one cause of depression.
But what about anxiety? (more…)
Given the trends that we see in the general population towards a sedentary lifestyle it’s not surprising our kids are less active than ever before. What are the health implications exactly? What can we do to change this?
Do It Yourself
Kids pick up on everything so when they see us trying new things, being active, and getting outside they develop their own love of movement and learning. It’s predicted that our children are likely to have shorter life spans than us unless we make these changes.
A study published in the Scandinavian Journal of Medicine demonstrates that high physical activity has positive effects on children’s immunity and may decrease the risk of autoimmune disease. This research has significant implications for long-term health of kids given that autoimmunity is on the rise in younger populations.
Physical activity not only reduces the risk of autoimmunity in children but also decreases cardiovascular risk factors, improves lung function, enhances motor skill development, and increases defenses against inflammatory diseases.
Nature and Play
Humans need unstructured play time, adults included. Reconnecting with nature is one way we can improve our sense of well-being and enjoy some much needed play time. Digitally detoxifying is an important aspect of this. Having a few weeks every year where screens are turned off is crucial for recalibrating.
Lifestyle Medicine Your Liver
As it warms up its easier to get outside more and get moving. Discovering ways to stay active all year long is important for many reasons. Organ health is at the top of that list. Our livers do more for us than any other organ. Caring for it can be as easy as moving everyday. They love it when we are active for a few reasons:
- Movement gets blood flowing. Our liver stores and cleans our blood. Physical movement assists this.
- The liver is affected by stress. Exercise reduces this. Endorphins are released so we feel better & can focus.
- Digestion improves. When the liver is upset you won’t digest as well. Move and you’ll enjoy your downtime more!
- Late night eating interferes with the liver’s job of cleaning the blood. Exercise improves our daytime appetite and regulates blood sugar. Eating earlier means sleep is more restful.
- Excess hormones move through the liver as do toxins. We help this process along by moving our body.
Move to Improve Gut Health
This new research shows that regular exercise changes our gut flora independent of what we eat. Specifically, it increases levels of short-chain fatty acid-producing bacteria and SCFAs. SCFAs are bacterial metabolites that serve as fuel for epithelial or cells of the colon. They also modulate the inflammatory response, and improve insulin sensitivity.
Based on these effects, aerobic exercise may be a beneficial therapy for dysbiosis, insulin resistance, and diseases associated with chronic inflammation. Engage in aerobic exercise to optimize the composition of your gut microbiota and increase circulating levels of health-promoting SCFAs.
What about Anaerobic Exercise?
Resistance training is by far the most important kind of exercise to balance hormones, increase longevity and mobility. When we build up and break-down muscle fibre there is a cascade that occurs in the body. It will literally make you look and feel younger, stronger and more at ease with life.
Endurance exercise can raise cortisol and contribute to burn out in the long term. Weight lifting, on the other hand, triggers the human growth hormone and helps us adapt better to stress. It also makes us better fat burners while reducing our risk of insulin resistance. Other hormonal imbalances also start to level out. The good news is you need to train just a few times a week to get excellent health benefits. This time commitment is much less than most aerobic exercise regimes.
A Few Excellent Botanicals for the Liver
Chinese Thorax (bupleurum falcatum)
This herb supports both phases of liver detoxification. Its used for symptoms like depression, irritability, menstrual cramps, and headaches. More serious conditions like hepatitis C and cirrhosis also respond to schisandra partially because it also modulates the immune system. Good for those with autoimmunity.
Burdock root (arctium lappa)
Burdock is anti-inflammatory and detoxifying especially for the skin. Its used to treat skin conditions such as eczema, acne, and psoriasis. As a bitter, burdock stimulates the release of bile and digestive enzymes. It is can soothe the digestive tract and also act as a laxative in a higher dose.
Dandelion root (taraxacum officinale)
Dandelion root is similar to burdock root. It is specifically indicated to assist in resolving gallstones.
Milk Thistle (silybum marianum)
Milk thistle’s active compound is silymarin. This is protective and repairs liver tissue after exposure to environmental and food toxins. It is safe while breastfeeding, and also enhances the production of milk.
Schisandra (schisandra chinensis)
Schisandra has all 5 key flavours: sweet, salty, bitter, sour and pungent. It has been in used in China for thousands of years. Its protective and supports both of the two phases of liver detoxification so is also used in treatment of Hep C. Schisandra regulates blood glucose and cholesterol. It strengthens the immune system and calms the nervous system because of its adaptogenic properties. It’s also a cough suppressant.
Turmeric extract (curcuma longa)
Turmeric is anti-inflammatory and an anti-oxidant. It restores liver tissue, increases bile production, and has mild blood thinning properties. Ingesting it with a fat will enhance your body’s ability to absorb it. Turmeric’s active component is called curcumin. It is far more potent than the whole spice, and is widely used as a supplement for inflammatory conditions. Tumeric supports the liver, mood and cardiovascular health.
Immunity, Iron & Infections
- Bacteria love iron so your body will remove it from the blood and store it in the liver. This is why its important to check if anemia is due to chronic disease, iron deficiency or another cause.
- White blood cells are produced to destroy the bacteria and viruses as well as transport damaged and irritating tissues from the site of infection. Antibody production goes up exponentially.
- People experience appetite loss and fatigue in order to conserve energy for repair.
- Fevers occur for a good reason.
Why Fevers are SO Important
- Fevers indicate the body is fighting off an infection. It’s a symptom, not the root illness. A strong fever shows the body has a healthy immune response.
- Fevers raise heart rate, create lethargy and hallucinations. In children a fever may even produce convulsions.
- One in twenty children will experience what is known as a febrile seizure. These can last a few minutes but have no lasting or harmful effects.
Interestingly a high temperature does not result in convulsions more often than a lower one. Recently in my clinic a patient reported a febrile convulsion as part of their history. It resulted from the common cold combined with a hot, summer day and no noticeable fever.
Think Twice Before Intervening
I’m a parent of a young child. I understand the concerns that arise when our little ones are sick. When my son has a fever I enjoy how much it slows us down and reconnects us. I trust his body’s immune response is in full gear. The impulse to use medication to bring his fever down does come up and this winter I did give him a small dose one night. We were in Mexico at the time. It was very hot already so I was more concerned than I usually would be. What I noticed is the fever needed to come back to kick whatever it was he was fighting. I actually prolonged the length of time his immune system was in high gear.
Keep In Mind
A strong response from the immune system is a good sign. Chronic and recurrent infections happen when the immune system can’t rise above it. This kind of ongoing or low-grade illness can be exhausting and lead to other issues. I’m working on rolling out more information to help those with chronic symptoms recover and rebuild their immunity. Our immunity is housed in our gut. Much of this is based on new discoveries in the world of strain-specific probiotics so you can stop buying broad spectrum ones that don’t result in much.
There are 44 million people currently experiencing alzheimers or dementia worldwide. There are a number of steps you can take no matter where you are in life to prevent and even reverse memory problems.
- Regulate blood sugar. Processed foods reduce insulin sensitivity of your brain’s neurons. Dementia is now being called Diabetes Type 4 due to the surprising amount of evidence linking insulin resistance with it.
- Eat Real Food. Chocolate for their flavonols and spices for their polyphenols. Pastured eggs for choline and cholesterol. Cold water fish for DHA and omega 3 fatty acids. (Choose ocean wise for ethical harvesting practices and third party tested oils for quality.) Berries for their antioxidants and fermented foods for the gut
- Meditate daily. If you have had the pleasure to spend time with anyone who has meditated for years, you’ll already understand why meditation is so powerful. Science is mapping the changes to the brain that occurs when you meditate. I’ve witnessed profound changes on retreat in myself and in others.
- Sleep. Our bodies repair when we sleep. One night of sleep triggers an inflammatory response in the body. If you are having trouble sleeping it may be due to blood sugar dysregulation or other imbalances that can be addressed by digging in with a functional medicine practitioner.
- Specific supplementation which I’ll get into now.
Its important to understand that Alzheimer’s and related disorders (ADRD) begin long before symptoms do. By addressing steps 1-4 you are reducing your risk by as much as 50%. Women are affected more than men as we age, however there is a growing number of young men who experience memory problems earlier in life due to very high stress and insulin resistance. ADRD affects people on all levels; personally, socially and professionally. Evidence supports early prevention in reducing risks as much as 50%.
Nutraceuticals and Botanical Medicne for Cognitive Health:
- Resveratrol is a polyphenol with both anti oxidant and anti inflammatory properties. Researchers believe it has positive effects on the hippocampus. This is the area of the brain that is critical for memory, learning and mood. It also has been shown to improve cerebral blood flow. Four studies saw enhanced executive function and memory in health older adults who supplemented for a minimum of 14 weeks at a dose of 150-200 mg with both resversatrol and phytoestrogens.
- Phosphatidylserine helps to improve depressive symptoms, memory, and behaviour. It is an essential nutrient that is not found in the diet. It also regulates stress and is indicated when cortisol is high at doses between 100-500 mg.
- Choline in the form of alpha GPC or citicoline allows this ‘b vitamin’ to cross the blood brain barrier. This supports cognitive health by making more acetylcholine and other neurotransmitters.
- Omega-3 Fatty Acids in the form of cold-water fatty fish is best. Grass fed meat is also higher in omega 3’s. If you are supplementing with fish oil a range aim for around 2000 mg (combined EPA + DHA).
- Vitamin B12 found in organ meats and some shellfish. Methylcobalamin can be supplemented at 500 mcg.
- N-Acetyl Cysteine reduces glutamate from the brain. This antioxidant is the precursor to glutathione.
- Acetyl L-Carnitine (ALCAR) is recommended dosage is 1000 – 2000 mg to support brain function.
- Curcumin Cook with raw turmeric root and supplement with 300 – 500 mg of curcumin.
- Ginkgo Biloba increases blood flow to the brain and reduce Alzheimer’s symptoms. It also increases short term memory recall. Check for interactions with medications before supplementing at 120 – 240 mg.
- Bacopa is a herb that improves memory and focus. Recommendation is 200 – 500 mg.
I don’t recommend starting on all of these on your own. Herbal and nutraceutical medicine is complex and like Functional Medicine its individualized. Deciding on a treatment course and plan has many factors. Its best to work with a practitioner to ensure you will be getting the most out of any supplements you purchase. Quality and duration are important factors. You also want to ensure you are absorbing them and not taking anything that isn’t going to improve your quality of life.
Modulating your gut flora has far-reaching benefits for your emotional and cognitive health says a study published by Trends in Neuroscience. This study uses the term psychobiotics to describe how prebiotics and probiotics affect the brain. The central nervous system (CNS) includes the brain and spinal cord. It connects with the gut via the enteric nervous system (ENS). Gut microbes produce metabolites that affect both organs negatively if there is dysbiosis or an imbalance in bacteria.
Probiotics Support Neurotransmitters & Reduce Inflammation
In animal studies, specific probiotic strains were used to treat anxiety and depression. Findings included an improved stress response, an increase in GABA (the calming neurotransmitter), more tryptophan (the precursor to seratonin) and less inflammatory cytokines.
Inflammation is known to be part of the pathogenesis of most depression. These cytokines travel along the gut-brain axis and can cross the BBB (blood, brain barrier). An increase in BBB permeability is associated with mental illness and alterations in neurotransmitters like serotonin. In human studies, specific probiotic strains have been used to decrease negative moods and improve the stress response within 30 days of use.
Prebiotics Reduce Stress & Support Emotional Regulation
Prebiotics like GOS (galactooligosaccharide) have anxiolytic (anti-anxiety) and antidepressant effects. When stress levels are too high we don’t function optimally. By reducing the cortisol awakening response (CAR) we can soften the impact of chronic stress. Hyper-vigilance is associated with depression and anxiety. Increased prebiotic intake is showing to have an impact on this.
“Psychobiotics were previously defined as live bacteria (probiotics) which, when ingested, confer mental health benefits through interactions with commensal gut bacteria. We expand this definition to encompass prebiotics, which enhance the growth of beneficial gut bacteria. We review probiotic and prebiotic effects on emotional, cognitive, systemic, and neural variables relevant to health and disease. We discuss gut–brain signalling mechanisms enabling psychobiotic effects…” This quote is from a study published this year.
Prebiotics are available in foods like onions, artichokes and asparagus to name a few. Find more information on the health benefits of both these and probiotics here. For periods of rebuilding I offer my patients GOS, beta-glucan, larch arabinogalactan and inulin. When infections are present prebiotics can exacerbate symptoms. In these cases there are other prebiotic fibres that can be used during treatment.
Functional Testing for the Gut-Brain Axis
Its important to see what is happening in the gut. In Functional Medicine we say, “why guess when you can test?”. Over and over I’m surprised by this medicine. Just last week one of my patients thought there were two recurrent infections happening in his body. It turned out it was just one thing that was causing all his symptoms and the lab work showed exactly what to treat. He’s already feeling better!
When mood is the predominant symptom I start with another test. It is an overview of thewhich the gut, nutrient status, toxic exposure and neurotransmitters. For mental health this test allows us to target treatment. I’ve used it to successfully support a suicidal patient and another with PTSD (post-traumatic stress disorder) from a brain injury. This is an excellent starting place if you are ready to feel more alive and well. For a limited time your initial 15 minute consult is free and will help us decide the best place to begin. Book in now!
What’s the Difference?
Symptoms like chronic yeast infections, brain fog and sugar cravings can indicate dysbiosis or an imbalance in the gut microbiome. About 20 years ago candida albicans began receiving a lot of attention. Some said to cause a long list of ailments. We’ve learned a lot since then and continue to learn more all the time. Endoscopies are not perfect but can show fungal overgrowth occurring in the small intestine. (SIFO). In out patient settings, we test the gut using stool and breath tests.
Candida albicans is one strain of bacteria residing in the colon and is part of a healthy colon when in balance. It can get out of balance. This can happen when there is a dybiosis of insufficiency meaning a lack of other bacteria. Often it occurs after antibiotics used especially if several rounds were used.
Keep in mind that high stress, poor diet and reactions to foods also trigger an imbalance in gut flora. Similarly a parasitic infection like giardia can trigger the onset of Celiac disease and non-celiac gluten sensitivity. This is why people go traveling and say their gut was never the same afterwards.
So what causes SIFO?
If you are on a very limited diet to manage symptoms that appear to be fungal overgrowth but your labs come out looking good we have to consider SIFO. There isn’t a breath test available for SIFO and it won’t show on stool tests. Certain antibodies can be used to detect it but this is not yet widely used. An organic acids test has markers that are more telling. This is what I end up using because it has a variety of other markers that are helpful for assessing the patient’s health status in general. Knowing what triggered the symptoms is important so reinfection can be avoided. There is a strong correlation between long-term use of proton pump inhibitors and SIFO. Low stomach acid means more pathogens make it into the small intestine.
Treatment can include both pharmaceuticals and botanicals. As far as botanicals go I use monolaurin, a concentrate of coconut oil, oregon grape root, berberines, caprylic acid or allicin and biofilm disruptors like NAC or Interfase Plus. Cycling antibiotics followed antifungals is what gastroenterologist Dr. Satish Rao suggests. This is because onset of fungal infection occurs after the good bacteria is killed off whether its in the small intestine or the colon.
Can diet help?
A lower carb diet rich in nutrients is a good starting place. There is some indication in the research that ketones can feed the overgrowth so use caution with this approach. Often people will know what triggers symptoms and these need to be avoided. Following treatment a period of rebuilding is key to ensure that the colon is functioning optimally. A prokinectic like 5-HTP or bitters encourage the migrating motor complex to prevent reinfection in the small intestine. If the ileocecal valve between the two bowels is inflamed we want to address this. Bacteria collect around these valves and take up residence where they shouldn’t. So inflammation and any immune issues also need to be addressed.
Keep in mind that candida albicans is different than candidiasis, which is a serious condition occurring in immune compromised people. Candidiasis requires immediate medical intervention.
What makes us hungry?
The neuroregulation of appetite is getting a lot of press these days. The epidemic of diabetes grows and even young people are suffering the effects of obesity. Researchers are hell-bent on finding solutions. Our bodies have a feedback loop that lets us know when we are full or are in need of fuel. If the mechanism is broken then we don’t know how to turn off. Like a car without brakes we are headed for disaster. For some people, anxiety leads to no appetite. How can we get our brain and gut working together again? Biochemist and health enthusiast Robb Wolf explains that we are ‘hardwired to eat’. Let’s reboot our culture and bodies to kickstart these innate processes which are our genetic foundation.
No Longer About Macronutrients
Low carb and ketosis is the new fad. For many this is not sustainable and often results in an exacerbation of symptoms. The last fad of low-fat may have led to this because we were all obsessed with whole grains. Worldwide we know there are people who thrive on all types of macronutrient ratios. Traditional Inuit consume very high fat diets and are well adapted to their environment. We know of cultures that ate honey for two months of the year and high carbs the rest of the time without suffering chronic disease like ours does.
Each person is unique and some tolerate carbs well while others get spikes in their blood glucose levels even when they consume cellular carbs with the fibres intact. These people require more protein and fat to stabilize their cortisol and bring down inflammation. Lower carb intake can work well for someone who is insulin resistant and has lower activity levels. It’s crucial that stress is well-managed to maintain stable blood sugar.
Eat Enough Of the Right Stuff
We know that highly processed carbs are a nightmare for many reasons. Gluten is part of this and the lack of fibre is the other part. A variety of fibres feed the gut microbiota, support clearance of excess hormones and is preventative for several diseases. Knowing what is enough for your body and choosing the right carbs is important. Another problem with refined carbs and sugars is that they creates an insatiable hunger. We are less likely to get the relaxed, dopamine rush that comes from a nutrient dense, higher protein meal.
Can you imagine overeating undressed potatoes or yams? What about if you add a bunch of fat and seasoning? Research around processed foods that are hyper palatable show that the brain is stimulated in ways that create addiction similar to cocaine and nicotine. When we eat very sweet food its the same and the craving for extreme salt is the body’s way to regain homeostasis. You can avoid the craving to overeat simply by staying in the middle ground of flavour sensation. It becomes really easy once you start reading labels and learning what those flavour additives do to your organs.
Roots and Shoots: The Real Superfoods
Roots veggies can be the baseline for our carb needs along with some fruit. Shoots include superfoods like green onions. The nutrient density and medicinal quality of this simple food is off the charts. Enjoy green onions over your morning breakfast meal along with some healthy fats. Make sure you have some protein and sauerkraut to get the lasting feeling of relaxed energy that these foods offer.
Social Contact and Mindfulness
Just a reminder of how crucial social support and contemplative practice are for health. The medical research on these subjects is overwhelming. I see this in clinic and when I assist on meditation retreats. In my own life these are game changers and were more important than what I ate in terms of recovering my vitality. This is why I teach classes on physiology, nutrition and meditation.
Chronic sinusitis is unbelievably common. This is a condition termed in the medical literature as chronic rhinosinusitis or CRS. My five year old son has some dry inflammation in his sinus cavity. When I’ve taken him to get it checked out conventional medicine offers a steroid spray. I know steroids are very drying and won’t help the underlying issue. It may even make things worse in the long run. (1)
My son wasn’t even diagnosed with CRS. Instead it was suggested that he is asthmatic. I was offered steroids yet again. Kids get sick often. This is how their immune systems develop. Of course I want to prevent anything serious from developing. So I did some research. Recurrent upper respiratory tract infections are associated with the same root cause as CRS. (2) Despite numerous research papers published on the topic doctors are failing to notice.
The Real Cause of CRS
Research is showing that CRS is related to biofilms. (3) Many people still believe it is a fungal infection is the underlying cause. Fungal CRS is easily diagnosed and is in fact quite rare. Why then is the fungal hypothesis still the first thing that comes to mind? I’ve had a patients who were convinced that they had a systemic fungal infection causing CRS but their labs denied this. Eosinophilic mucin is used to diagnose a local fungal infection so its easy to rule out.
What is a biofilm? Why do some people suffer more than others?
Biofilms are extracellular matrixes where bacteria live. They host pathogens by providing a way for them to share nutrients and DNA while providing protection from antibiotics. A biofilm we are all familiar with is plaque on teeth.
Biofilms seem to proliferate in people with compromised immune function. To strengthen immunity botanicals like astragalus and cordinopisis are safe, even for children. Vitamins A, C and D are essential. I recommend a buffered vitamin C along with a good quality cod liver oil for A and D.
Post surgery is another time when biofilms seem to proliferate. Extra care needs to be taken at these times. I have a protocol I give to patients for pre and post surgery to prevent issues.
Nasal Irrigation is the best way to affect local biofilms in the sinus cavity. PubMed suggests using baby shampoo. In a study 60% patients responded positively to this.
Xylitol is a natural agent that works against biofilms. It’s loved by even conventional dentists and hygienists. Unlike steroid sprays xylitol is not drying. In fact, it’s a lubricant allowing the body to clear pathogens with nasal mucus the way it usually does.
There is no research on using systemic biofilms however this would be an interesting area to explore. We know that the gut microbiome affects the skin and sex organ’s microbiomes. Therefore it makes sense that the nasal passage is also interconnected.
What about Fungal Infections?
Many patients ask about how to treat fungal infections on the skin, genitals and in the intestines. Once you have a clear diagnosis that this is actually what’s happening here are a few things you can try.
Biotin binds to a sugar called arabinose, which is produced by yeast. Arabinose forms pentosidine causing inflammation. This is seen in Alzheimer’s disease and autoimmune responses. Biotin is also an antifungal in a higher dose of 5mg.
Molybdenum helps convert a toxin called acetylaldehyde that is produced by fungal organisms. If the conversion to acetic acid doesn’t happen B6 gets blocked and several crucial biochemical don’t happen. Acetylaldehyde can react with neurotransmitters and cause pain.
Several herbs are beneficial but best to work with a medical herbalist. I’ll mentiona few of my favourites. Olive leaf, allicin, cardamon, black walnut and yerba mansa. Binders can also be helpful in clearing both toxins and fungal infections. I use chorella, modified citrus pectin and clay.
Many people try to starve out the bugs by avoiding carbs. This is not recommended as some research shows yeasts can thrive on ketones. Low carb diets can also lead to dysbiosis or an imbalance in the gut microbiome. This is why I focus on a long-term ancestral type diet with my patients.
A process that occurs in the body a billion times a second, is good to understand if you are interested in health.
Poor methylation can affect the brain, the gut, and the liver. This is just the beginning. Methylation repairs DNA, turns genes on and off, fights infection and gets rid of environmental toxins by way of the phase two detox pathway of the liver.
The Chemistry in a Nutshell
Methylation is a reaction that occurs when a molecule passes one methyl group to another. A methyl group is a carbon atom linked to three hydrogens.
Building and Balancing
For example, methylation is involved with building creatine, carnitine, CoQ10, phosphatidylcholine, melatonin, and many others. It controls sulfur metabolism and balances our glutathione needs, which I’ll talk more about later. Other sulfur metabolites like cysteine, taurine, and sulphate are also involved. Lessening oxidative stress is another way to describe how this functions in the body.
Cellular Energy Metabolism
Methylation influences the production of ATP, the fundamental energy unit of the cell. Remember mitochondria from biology? Nothing works well if the cell can’t produce ATP in the mitochondria. There just won’t be enough energy.
One of the main systems methylation effects is the production of neurotransmitters. Autism spectrum disorder, ADHD, depression and anxiety are all seen in combination with methylation issues.
Glutathione is one of the major molecules in the detoxification cycle. If you don’t methylate properly, you won’t be able to detoxify properly. Heavy metal toxins, pesticides and other environmental pollutants like mold will be harder to handle.
Lipopolysaccharide from leaky gut and other bacterial or gut pathogens will also be more difficult to manage. Ever wonder why one body can handle a level of toxic overload another can’t? This is likely why or at least a significant factor.
Histamine Intolerance? We call it Mast Cell Activation Syndrome
Methylation influences the breakdown of histamine in the gut. Have you heard people talk about histamine intolerance or mast cell activation syndrome? One of the potential underlying causes is poor methylation.
Regulation of gene expression is a big topic. I’ll dedicate my next article to it. Just briefly though, methylation controls the activation and silencing of genes.
How it works is a methyl group binds to the gene and this changes the way that a gene expresses itself. This is known as DNA methylation or epigenetics. It’s a mechanism that cells use to control gene expression and is getting a lot of press these days and for good reason. This confirms that diet and lifestyle has a massive influence on health and gene expression.