Today I had a new patient who has survived breast cancer. She mentioned that her high stress job and poor diet may have contributed to her becoming sick. Many of my patients are aware that these are important factors to living a healthy life. However, despite our best efforts illness can still show up. And its not our fault.
We Are Not In Control
The most powerful grassroots health movement of our time is the 12 steps or other peer support groups. Why is this? These groups are based on giving up the illusion that we are in control and can do it alone. Surrendering to this makes us more receptive. We can then access our own inner wisdom and invite help from others who are struggling in similar ways.
There are many factors that influence our health that we have limited control over. From environmental pollution to whether or not we were breastfed and even how our grandparents lived all weigh in. It can be difficult to accept this lack of control and it pushes us to face the reality of death. Oftentimes those who come into contact with their mortality begin to live more fully.
Getting sick does not mean that we somehow failed. That we “didn’t get it right.” When I met with my patient today I emphasized all her strengths. Her willingness and honesty about slipping back into old habits now that she is back at work is remarkable. But what is more remarkable is that she’s at work at all and that she loves what she does!
Accepting that we’re not in full control doesn’t mean that we don’t take care of ourselves. But we can release the guilt and shame that would otherwise come with a chronic illness or disease. This helps us respond appropriately. This patient told me how she will only work with people who are also committed to health and creating a positive work environment.
Self-compassion, kindness and empathy is what cancer survivors or survivors of any kind deserve. Somehow its easy to forget in our culture. I see and hear the words ‘don’t play the victim’ or ‘you need to take responsibility’. This often comes out of people’s own discomfort and is a reaction fueled by fear, anger or blame. Five young women around me are breast cancer survivors. These women are warriors and ought to be honoured for their strength.
So, what does it mean to take responsibility for your health while recognizing that you’re not in full control of it?
The most popular form of birth control in the industrialized world is the pill. Ninety-nine per cent of women have used this synthetic hormonal contraceptive at one time. Despite evidence indicating there are health risks associated with it, one-quarter of women using non-permanent forms of birth control choose the pill. Other options used are the patch, implants, injectables, vaginal rings, condoms and IUD’s. Ten percent use fertility awareness methods. Vasectomies make up 13%.
The pill depletes our healthy gut bacteria and can cause yeast overgrowth or other infections. Dysbiosis in the gut has been linked to migraines, fibromyalgia, endometriosis, psoriasis, depression & even infertility. Often women who have been on the pill for years can have trouble conceiving.
To metabolize hormonal contraceptives, the liver requires extra B vitamins, vitamin C, magnesium and zinc. If your diet is poor & your digestion is inhibited then you won’t have these essential nutrients available to you. Other health issues are likely to arise.
The pill is prescribed commonly for many reasons including fibroids, pain, PCOS, skin issues, PMS and heavy cycles. Its often paired with an anti-depressant for mood issues. Evidence indicates that most women know the pill affects their whole body. One of the main negative side effects is on mood.
I’m part of that 1% who never took the pill. So what have I done instead?
Get to Know Your Cycle
Strengthening your natural menstrual cycle is an excellent way to optimize your health in general. If you want energy, a libido and the ability to get pregnant then track your cycle. Maybe you simply want to enjoy sex without fear of harming your body. I know a master herbalist with teenage daughters who agrees with this approach. We don’t want to suppress the body’s wisdom. We want to get to know it, respect it & work with it.
There are 3 simple ways to know when you ovulate: waking temperature, cervical position and cervical mucus. The last two require that you to be intimate with your body. Learn how to contact your cervix. Notice the monthly discharge that comes with feeling aroused or a sensation in the ovaries which some women experience. Temperature can be charted by technology. I suggest trying all these methods & relying on two.
The Lady Comp takes your temperature and tracks your cycle. This device will chart what is happening for your fertility. It lets you know with a simple red, green or yellow light. On the green days you don’t have to worry at all. Our fertile window is about 6 days so the rest of the month will be in the green meaning good to go.
The longer you use it the more data you have. There is a six hour window in the morning to take you temperature but it has to be taken upon waking. Any movement or activity will alter your temperature.
There are many devices and apps available to make tracking temperature easier. This is just one that also offers a fertility aspect.
Fertility and Influencing Gender
If a baby is what you want then you can get the baby version of Lady Comp. It allows you to turn it to the best time to make babies and how to optimize your chance of having a boy or a girl. It can do this b/c male sperm move faster and female sperm last longer.
Risks associated with Contraception
Estrogen dominance, blood clots, osteoporosis and cancers are all associated with long-term use of hormonal contraception. I’m not going to go into detail about this but have a look at this research for more information.
The copper IUD can lead to chronic inflammation and deplete the body of zinc because zinc balances copper. It can also have a negative impact on gall bladder function.
Many of my colleagues agree that this era of birth control use on a massive scale will be looked back on as a very strange time in the history of women’s health.
Get Your Sexual Partner(s) On Board
Thirteen percent of men choose to have a vasectomy. The rest of them can get on board with understanding women’s cycles. The best partner knows his partner’s cycle better than she does. This allows her to relax, feel safe and enjoy herself.
Talk about fertility, family planning and why you do or don’t want a baby. Fertility is an integral part of sexuality. A woman’s ovulatory cycle can be a fun part of your sex life.
Let me know what you think! I’d love to hear from you.
Unfortunately, the distorted body image of that has been sold to us for decades does harm. Disordered eating takes different forms. It disconnects us from the felt sense of being embodied, of being alive and sensual.
The newest eating disorder is orthorexia or a preoccupation with specialized diets. It can be linked with other eating disorders and often goes along with body dysmorphia.
Orthorexia & Social Connection
Body image and disordered eating emerges with many of my patients. What I am noticing is the shame around it about this has lifted. How refreshing! A study showed that people find support for orthorexia online. Talking about the disorder helps people find their way back to healthy eating. Social support is key to being at ease in your skin.
Information helps too. A restricted or special diet is not the end goal. With an elimination diet we can know within a month which foods are causing a problem. Usually there are just one or two. Once removed the body’s resilience kicks it up and deeper healing can happen.
Food is an important part of social connection. The health benefits of feeling relaxed and connected to a community are as important. This can be even more important, at times, than what you eat.
Women Know Their Bodies
Establishing trust with my patients is important. Many people have had negative experiences in the medical system. Their power or wishes weren’t heard or respected. Yesterday I had a young person explain that her gynaecologist wouldn’t offer a diagnostic procedure if she didn’t first take oral contraceptives (OCP). She knows that the OCP has negative health consequences for her. No other option was offered. She left feeling defeated.
Having options and feeling heard are crucial aspects of mental health and well-being. Another patient explained to me that she can’t change her diet for various reasons. I understand why. Later I asked her why she was feeling better. She shared that she had tried a few of the suggestions we had talked about. It was going ok and the results felt good.
Being in a body can feel good. Its meant to. Media has not only created a monster out of branding body shape and size. It also has hyper sexualized certain aspects of being. By doing this it has diminished the erotic nature of simply being alive. The felt sense of being alive and connected is naturally pleasurable.
I see a trends in my work and orthorexia is one of them. Yet each person I work with is unique. Having more time with patients is important. In this way we get to know one another. It can be empowering and enjoyable all at once.
People who engage in regular movement or meditation are less likely to get sick during the winter months. Getting outside during daylight helps your circadian rhythm and vitamin D levels. Good sleep supports immunity and prevents colds. Here are 15 ways you can sleep better this season! Prevent getting sick so you can have more time with your loved ones.
Devour These Delicious Delicacies
This is the time of year to build your defences. Boost these in your diet. Enjoy this season more!
Colostrum: By providing immune cells directly, colostrum encourages the body’s resilience to external viruses. Milk that comes from mammals during the first 72 hrs of their baby’s life that is particularly high in antibodies.
Ginger: There is plenty of scientific research supporting the use of ginger in several pathogenic conditions. This is one of the most used herbs world-wide,
Vitamin C: This powerful nutrient contributes to immune defence by supporting various cellular functions of both the innate and adaptive immune system. It protects against environmental oxidative stress. 42% of people do not eat enough Vitamin C.
Fish Oil: Much of your immune system is housed in your gut. Research indicates that DHA (docosahexaenoic acid) in fish oil helps gut immunity by supporting B cell function. DHA is also one of the major building blocks of the brain. This omega-3 fatty acid is critical at all ages of life for optimal brain health. It is preventative against SADD.
Probiotics:Probiotics are living microorganisms that are found in the gut. They play an important role in regulation of host immune response. We are learning everyday how to best target symptoms with strain specific probiotics that are more likely to adhere to the gut lining.
Zinc: This nutrient is well documented as a source of immune support. Foods that are highest in zinc include oysters, crab and red meat. Nuts, seeds, legumes, avocados, berries and apricots also have zinc.
Echinacea: The active substances that help support cellular immunity are phenols and alkylamides. You know you have a potent product if it makes your tongue tingle.
Mushrooms: These work as antioxidants and immunomodulatory. Mushrooms such as Reishi (Ganoderma lucidum), Shiitake (Lentinus edodes), and Turkey tail (Colorus versicolor) protect immune cells.
Vitamin D Deserves Special Recognition
Low vitamin D levels may be one of the key reasons why acute respiratory infections are common during winter and spring. According to a recent study published in the British Medical Journal, vitamin D plays a critical role in enhancing immunity against viral, acute respiratory infections. Cod liver oil is an excellent way to increase your family’s intake of vitamin D. For prevention of diabetes type I and type II it is essential to optimize your vitamin D levels. The blood marker you can ask for from your doctor is 25-OH-D.
And Finally My Favourite: Beta Glucans
Beta glucans are highly branched polysaccharides that are non-caloric and impart an immune benefit. These prebiotic foods are mainly found in fungi (mushrooms and yeast) and grains (oats).
One study showed that 9g of beta glucans from brewer’s yeast taken for 16 weeks was able to reduce the number of cold infections by 25% and the symptom score of those who got infected by 15% (1)
Fungal beta glucans have a stronger effect on immune response. Beta glucans from oats have a more potent anti-lipidemic effect. My store is nearly stocked with some of the best formulas for supporting your health long-term. Stay tuned for its launch soon!
As we enter a new era in Canada, it’s important to look at what’s happening in other places. Medical marijuana is legal in the majority of states in the USA. It is also legal in Australia although it is much more difficult to get. The supply is limited and there are no dispensaries. Medical marijuana in general doesn’t make it accessible to most people. Finding a doctor who will prescribe it isn’t always easy. Only a limited number of conditions are approved. What medical marijuana does is increase quality because the product is lab tested.
Recreational use is legal in Canada and in nine states of the US. This designation makes it much easier to obtain and quality can be determined by the consumer. In these states we find labs creating cleaner products that are free of fungus, pesticides, bacteria and chemicals. We can also get specific amounts of CBD:THC which allows is important for targeting specific symptoms. I’m looking forward to these kinds of labs emerging in Canada. At this time we can’t import across the border safely. It can be hit or miss what you get from a dispensary.
CBD For Pain
Medical marijuana is antispasmodic. Women who experience intractable pain during their cycle, CBD can help relax the muscles. It also dampens the communication from the pain receptors to the brain. What people report is still feeling the pain but it doesn’t bother them in the same way. This is important because the body can begin to heal when the pain response is lower.
Medical marijuana is anti-inflammatory. Therefore we see an improvement other symptoms as well. The side effects of other anti-inflammatories and pain medications can be severe. Not to mention that many of the stronger pain killers are habit forming and can result in overdose. I had a patient yesterday with a severe back spasm. The hospital denied him pain medication. NSAIDs don’t work for him because they are hard on the gut. He suffers from gastritis. He has no history of addiction to opiods. So why was he denied?
Another patient of mine had suffered with endometriosis for years. CBD was the only pain medication that helped her function. Once her pain was down she was able to make important decisions about her health, her career and her family.
Why does it work? How to take it?
The endocannabinoid system is part of our body. It’s a modulatory system that affects brain, endocrine, and immune tissues. Our body has endocannabinoid receptors. We produce chemicals naturally that are very similar to the chemical cascade of what occurs when we take CBD.
Smoking causes harm. Vaporization is a good alternative as are oils or tinctures. Suppositories can be excellent for severe abdominal and pelvic pain. Women who suffer from pain during intercourse are experiencing relief. But again we need to have standardized products. I have had two patients who experienced high anxiety and paranoia using products from a dispensary.
Endocannabinoids appears to play a very important regulatory role in the secretion of hormones related to reproductive functions and response to stress.
Women are using CBD for symptoms associated with PMS including painful periods, anxiety and insomnia. During perimenopause and menopause women are experiencing relief by using CBD particularly for insomnia and anxiety.
Pregnancy and Breastfeeding
There are only a few small studies on the subject of use in pregnancy. The results show a propensity towards pre-term labour and delivery. They also showed use over 20 days during pregnancy may result in lower birth weight. It is difficult to do clinical trials during pregnancy but this limited evidence shows that caution is warranted. Use during breastfeeding exposes the infant so the benefits need to be weighed carefully against the benefits.
One circumstance where more research could be valuable is when nausea/vomiting during pregnancy are extreme. Given that malnutrition of both mother and fetus is a concern, careful administration of CBD likely offers less risk than other medications that are used in this circumstance.
Dr. Rachna Patel is an expert in use of medical marijuana. Her website is an excellent resource.
In the last decade, oral contraceptive usage has dropped. This suggests a collective desire to regain control of our bodies and health. Many women report headaches, weight gain, mood issues and a host of other symptoms from taking the pill.
What is replacing the Pill?
Last time I visited a sexual health clinic I was pleasantly surprised to see the fertility awareness method (FAM) included on the intake form. FAM has not always been an accepted form of contraception. This was the first time I’ve seen it alongside the IUD and hormonal birth control.
I have never taken oral contraceptives. Not once although it seems like such an easy option. My mom told me how they work. This encouraged me to explore other options. When I asked about FAM and the IUD in my 20’s I was laughed at by clinicians. That’s putting it lightly. The sexual health clinics were somewhat coercive. If I wasn’t there to get the pill why had I come? I had read Taking Charge of Your Fertility and was getting to know my body.
Research,Technology & Men
Today there are a number of new books on the subject. There are also cycle-monitoring apps and social media groups devoted to fertility awareness. Packed with research, these offer accessible information. Learning what’s normal is a big deal. Then we can get support about what’s happening with our menstrual cycles.
In the 90’s, the intrauterine device (IUD) wasn’t offered to women prior to giving birth. Now women can choose the copper or Mirena IUD whether or not they have children. These devices can be disruptive in other ways but work well for some women who want to avoid the side effects that come with the pill. The Mirena has hormones and a woman may still lose her cycle. With the copper its important to monitor your zinc: copper balance. Some women also experience gall bladder issues or other pain along with a heavier cycle.
One of the most important changes that is occurring is men taking more of an active role in fertility and contraception. I presented at a conference a couple years ago and was speaking to this. A master herbalist was following me on stage. I invited him into the question and answer portion of my talk.
Supporting women’s menstrual cycle is a way to prevent unwanted pregnancy. He explained that he knew exactly when his wife was ovulating. Instead of showing his daughters what herbs prevent pregnancy, he shows them how to normalize and track their cycle. It is encouraging to have male allies in this important work. Men are getting on board with cycle tracking. This allows women to relax and enjoy their bodies more.
‘A Women’s Health Epidemic’
This shift comes at a time when our collective hormonal health seems to be getting worse. Experts know this is largely a result of our modern lifestyle. High stress, environmental toxins like xenoestrogens and a diet high in processed food are all factors. Then there is a lack of research and focus on women’s health. Conventional medicine rarely tests hormones. Invasive interventions are offered before gathering basic information that directly relate with women’s symptoms.
“I absolutely believe we are in a women’s health epidemic,” Nicole Jardim, a New York-based hormone expert.“I believe that there are a number of different reasons why that’s occurring right now. Most of them can be attributed to the fact we live in a crazy modern society. Women have super-human expectations of themselves. Other people have them too.” This creates a lot of pressure and stress.
Jardim is a nutritionist and holistic health coach specializing in hormonal and reproductive health. She says that electronic addiction and poor nutrition wreak havoc on women’s bodies.
“Combine that with the insane stress so much of us are under, our lack of sleep and I think we have a perfect storm for hormone imbalance,” she adds.
All the Same Root Cause
Ninety percent of women experience difficulty with PMS now. Polycystic ovarian syndrome, breast cancer and difficultly with menopause are not as separate as they first seem. Underlying all of them is a lifestyle and environment that is mismatched with our bodies.
We can shift this culture by learning to adapt and care for ourselves differently. Enough meditation and rest is important. Choosing medical marijuana instead of harmful pain medications is another step we can take. Getting thorough hormone testing is also very empowering.
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.
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.
Research shows that young children are adversely affected by indoor lighting at night. Just one hour of bright light exposure before bedtime suppressed the children’s melatonin by 88 percent. This study isn’t even looking at electronic use, and a significant negative response was found. We know the higher intensity blue light coming from screens causes even more disruption.
Bright artificial light exposure at night suppresses melatonin production. The negative health effects include fatigue, behaviour issues, compromised immunity and elevated blood sugar.
Serotonin is the precursor to melatonin. Both help regulate inflammation and pain. Chronic inflammatory disorders including depression may be influenced by low melatonin. Melatonin is also an important antioxidant.
Amber coloured light bulbs and side lighting can be used in the evening to support melatonin. Dimmer switches can help as well. Nightlights ought to be warm coloured and used in bathrooms as opposed to bedrooms. Digital alarm clocks, and other sources of artificial light should be removed from bedrooms. Blackout curtains may be necessary. Restricting children’s use of electronic use especially before bed is important.
Parents feel more distracted parenting when using their phones. Studies show this impairs their sense of connection with their children. The group of parents who did not use phones while parenting had an increased sense of meaning from this time.
Play as an Antidote to Anxiety
Screens take away from play time, interrupt time for reflection and time for boredom which is an important aspect of creativity.
The disappearance of play is a major contributor to the growth of anxiety disorders amongst adolescents. Play helps kids learn social and emotional skills. It also develops the ability to take risks and think abstractly.
Half of children will have a mood or behaviour disorder by the time they are 18. Anxiety affects 32% of young people. Time spent on social media means a decline in contribution to their home environment and in their communities.
Cultivating the 3 ‘C’s’
Connection – cuddling, tickling, holding young children. Older children need the same connection although it may look different.
Communication – asking questions, finding out how they feel and what they spend their time doing. Ask them how screen time feels different from other activities?
Capability building – help them grow to be capable human beings who are learning skills to self-regulate.
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.
Collagen helps to balance the branch chain amino acids in our bodies. This has far reaching effects. Many of you understand the importance of balancing healthy fats to ensure you get enough omega 3’s. There is a similar balance when it comes to amino acids. Most of us get too much methionine and not enough glycine. Glycine can be taken on its own or consumed in either bone broth or collagen.
The reason I love collagen is because of convenience. I make bone broth but not as often as I need to consume it. Collagen is convenient. It can be added to my morning matcha, power balls or an afternoon workout drink.
Grace & Beauty
Collagen nourishes all of our connective tissue. Its great for anyone who wants a faster recovery time post workout or is experiencing tendon or joint pain. Connective tissue includes skin, hair and nails. You may notice collagen being marketed as a beauty aid. Certainly when we are pain free and nourished, we have a healthy glow.
Adequate amounts of glycine also supports phase two of liver detoxification. This is often sluggish due to the modern lifestyle and the high stress that comes with it. We can talk about this from an evolutionary standpoint and it makes a lot of sense. We evolved eating a wide variety of foods that included some fish and animals. We valued these sources of nutrient dense food by eating everything. This gave us a balance of amino acids that nature provides.
Glycine is a neurotransmitter as well! It has the ability to be both excitatory and inhibitory, meaning it can function both to stimulate brain and nervous system activity, or to quiet it. Let’s put a few things together.
Calms the brain
Helps us sleep deeply to support repair
Supports organ function especially the liver which cleans our blood at night
Liver also regulates all emotions. When it’s not functioning optimally, we tend to feel frustrated or angry. When the liver is well we are able to grow in a direction that feels right
Grace is a feeling of ease with how life is. This comes with a happy liver
Strong Bones Long Term
There is more collagen in our bones than calcium. Remember this applies also to our skin, joints, ligaments and hair. If you haven’t taken collagen before you can try taking it up to three times a day. Ideally we’d have 30% of our protein from collagen rich foods.
Blood Sugar & Hormones
Protein can stabilize blood sugar so collagen can be an excellent way to support a higher protein intake. Collagen is a great way to increase the cascade of dopamine first thing in the morning. Patients report a huge benefit from beginning their day with a warm, protein rich breakfast.
If you aren’t a breakfast person collagen in your hot morning drink can suffice. For hormone health this is a much better choice. I often see people using caffeine and fat to suppress their normal morning appetite. It works for awhile but then hormone and lipid markers start to go out of range. Symptoms can include afternoon crashes, late night hunger, brain fog, thyroid problems and insulin resistance.
To begin with, its won’t get easier because what you think you want happens. Its not about getting a raise, a new partner or losing that extra weight. Life can be effortless by focusing away from what we think and towards what is. Stability and trust grow as we meditate. Then we naturally stop bracing against reality and allow more to emerge without it overwhelming us. Life begins to unfold in a very different and really surprising way. More intimacy, focus and inspiration can occur spontaneously.
Meditation Is Provocative
Things arise when we meditate. The purpose of meditation is to notice whatever this is. Grief, numbness, agitation and a wide range of thoughts will show up. These are the places we don’t have space for in our daily lives. This is why they end up taking over at inconvenient moments.
Have you ever over-reacted? Did you take the time to figure out why?
We hold onto a vast amounts of unlived experience until we start sitting. Giving these aspects of ourselves a place to breathe, we discover a life with a lot more ease. Stronger bonds, more success and greater health are just some of the other welcome side benefits.
“But I don’t have time to meditate!”
Meditation lets us get more done by doing less. Strange, huh? Is it hard to believe that doing nothing creates more efficiency? Let me explain why and how this works. When we slow down we begin to notice how much tension there is. Bracing against reality requires a LOT of energy. When we learn to feel this, there is a natural letting it go. In its wake a sense of freedom emerges.
Not giving into every impulse and habitual tendency helps us develop stability. With this stability, life emerges with more power. Sounds pretty good huh? Well its not all good. Some of it hurts and we need to be willing to embrace this as well. The key to a full life is developing fearlessness. It takes training and a willingness to be uncomfortable. This is why its called warrior training.
“I must be doing it wrong because I don’t feel relaxed.”
When you sit down to meditate relaxation may not be what you feel. This means you are doing it right. Relaxation is only one aspect of meditation. The point is to just notice what is there.
We just closed another week long retreat. On the last day two participants spoke in the group about discovering parts of themselves they didn’t like. Through meditation they had become familiar with these forgotten parts and befriended them. This made it easy to share. I was struck by the lack of shame they expressed when speaking to a large group about these shadowy aspects.
I saw my doctor yesterday. We spoke a little about meditation. He had just read a book about it. Patients of his would benefit he said but he didn’t know how to get them started. I told him that’s my job. Within the current system, doctors and nurses don’t have the time to offer these tools. I know because I talk with them. Most of my friends who work in the system choose remote locations simply because they have more time with their patients.
My doctor and I have sons who are the same age. I told him how much more I enjoy parenting when I have meditated. I also find every other aspect of life more fulfilling including the time I have with patients. The best thing he could do, I said, is meditate himself.
The fascinating thing about being human is that we have a ripple effect that is much wider than we know. When we transform, even just a little , everyone around us feels it. What is happening is our second veil or early habitual trauma is lifting. This allows us to see, feel, sense and love more. The strength is palpable. We also can receive love more and accomplish more simply because we aren’t constantly inhibiting ourselves.
Birth control or oral contraceptive pills are given out for everything. If you have unexplained heavy cycles, skin issues or experience PMS (pre-menstrual syndrome) your doctor will likely prescribe birth control. Why is this a problem? It masks what it going on underneath. Our cycles give us a ton of information about our bodies and our health.
Birth Control Messes Up the Gut
Yeast and fungal infections increase as soon as six months after beginning the pill. Often women are on the pill for many years but don’t put the two together. Chronic yeast infections lower immunity and are a stress on the body.
Other pathogenic bacteria become opportunistic and inhibit the absorption of critical nutrients like B12, vitamin K and folate. A B12 deficiency has several symptoms including:
Nerve problems like numbness or tingling, muscle weakness, and problems walking
Mental problems like depression, memory loss, or behavioural changes
A B12 deficiency can result in irreversible symptoms if left untreated.
Vitamin K is responsible for transporting calcium to the bone and therefore is important for preventing osteoporosis later in life. It also plays a role in blood clotting which is one of the more serious health concerns with taking the pill.
Low folate can have a genetic factor and is implicated in:
Poor immune function; frequently getting sick
Chronic low energy
Poor digestion; issues like constipation, bloating and IBS
Developmental problems of the brain and spinal cord of the fetus during pregnancy
Canker sores in the mouth and a tender, swollen tongue
Changes in mood, including irritability
Premature gray hair
Our Hormones & Gut Work Together
Estrogens increase peristalsis (movement of the intestines) and pain sensitivity. If you have gut symptoms you may notice more cramping and diarrhea when estrogen spikes and drops. This happens twice. Once before ovulation and again before menstruation.
Progesterone, on the other hand, slows peristalsis. This is why women experience bloating with PMS when progesterone naturally increases. It also peaks in the first and third trimesters of pregnancy and is the cause of constipation. Who knew?!
When there is an imbalance in gut flora, peristalsis plays an important role in recovering. We don’t want the bacteria hanging around where they shouldn’t. This rhythmic motion ensures that bacteria don’t colonize the small intestine where we absorb our nutrients.
Why Not Test?
If you want to know why your cycle is heavy then you’ll want to test. Often estrogen dominance causes heavy cycles but so can a weak digestive system. It can and often is both. Heavy cycles quickly lead to iron deficiency, fatigue and anxiety. Testing lets us see where the imbalance is and what to do about it. By testing we also prevent other, more complex problems later.
The other option is to take the pill and hope for the best. Women are offered the pill along with an anti-depressant. With a few dietary and lifestyle tweaks a lot can normalize even before test results come in. Then we go deeper.
Sex & Other Risk Factors
Women are often told about the increased risk of blood clots and strokes when taking the pill. But these more common and chronic symptoms aren’t discussed.
If you are taking birth control to avoid pregnancy what other options are recommended?
Get to know when you ovulate. A barrier method or abstaining can work during this time. Exploring sex without intercourse during ovulation is also an option. Men who know their female partner’s cycle can take responsibility for birth control too. These men are often the best lovers. The Fem Cap and copper IUD which are excellent options for some women. The Fem Cap requires a spermicide lubricant. Find a natural option. They do exist. The copper IUD can result in a zinc-copper imbalance and gall bladder or liver issues.
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.
An ancestral approach is much more than a diet. Let’s start with a handful of startling facts from the industrial world:
1 out of 6 children in the industrial world has a developmental delay
an infant as young as 1 has been diagnosed and treated with an anti-psychotic medication
depression is the number one disability in adult populations
40 million have an anxiety disorder
40 thousand suicides a year in the US alone
This is crazy! A disconnect has happened. It has led to an epidemic of chronic disease that is new. The effect on our children is most concerning. How we are living is undermining our health and particularly the ability of our brain function.
What are the solutions? I asked this many years ago as I watched a friend develop schizophrenia. Diet changes help him a lot but the medications he was on were debilitating. Unfortunately meds are given more weight than diet in conventional medicine. And yes they are crucial at certain points. Limiting them is also very important.
A new patient in my clinic today was told that stress, diet and lifestyle have no role in her fibroids. Since the medication she was given didn’t work surgery has been suggested. Unfortunately these are the only tools doctors have. Patients are left knowing that changes are needed but not knowing what to do.
Intuitively I knew what was needed when I became ill and it wasn’t medication. When I found my doctor and mentor he reminded me of what I already knew. This information is in our bones. He learned medicine in an oral tradition and so he shared his knowledge in this way. We need this kind of human connection. As a First Nations man he talked about how we are all indigenous. We all come from the same earth. Tuning into our bodies and the genetic wisdom etched in our DNA is what reconnects us. Its how we heal.
So yes, this is more than a diet. The ancestral approach includes how we relate to all aspects of being human. Most people have a nature deficit. A lack of intimacy, play and pleasure have been replaced with screen time. Light exposure is raising our stress levels while good stress like exercise, learning and new experiences are being put aside. We need these homeotic stressors to adapt.
“Cultivate strength of spirit.” Leni Wylliams
Leni Wylliams was one of my dance teachers when I was young. Do you remember the words of someone you looked up to? This phrase stayed with me. Physical training and art strengthen our spirit. Being immersed in nature helps us relax into being human. Meditation allows us to live with confidence and dignity. Anything that assists you in turning towards life, even the painful parts, is what keeps you well. Life is not about avoiding the storms, but about making sure we have the resiliency to endure them.
Noticing where we draw strength from is important. What in your early years taught you to trust life? Growing up on a farm and having a brilliant, stay-at-home mother gave me a good start. At the time infant formula was being pushed and she didn’t buy into it so I was breastfed. She taught me to honour the female body and to be skeptical of oral contraception. She’s fabulous. I pursued Functional Medicine because of how she raised me. Listening to women and children is another way we can revolutionize the medical system.
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.
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.
I am lucky to have a few mentors in my life. Today I was sitting with one discussing a topic I’ve considered for awhile. This wisdom that comes from those who have lived a little longer is invaluable. They see patterns that I can’t.
What he revealed was a detail that I felt but wasn’t able to explain. When Eastern thought migrated to the West, certain concepts took root. Some were adopted in theory but not in practice. My mentor explained how the idea of taking responsibility for your life became another way to act aggressively with ourselves and others. The result is blame and often social isolation. This is not helpful yet it has infiltrated many ‘human potential’ movements. I’ve witnessed subtle ways where heart is said to be leading but isn’t.
When a concept arrives in a culture predisposed to self-hatred the result is blame.
Chogyam Trunpa Rinpoche is a meditation teacher who led the way in bringing meditation to the West. One of the most striking observations he had about westerners is the amount of self-aggression we have. This aggression shows up is in our lack of respect for our leaders and also our mothers. We tend to have more disdain than reverence for those people who have loved, taught and nurtured our society from its infancy. We focus on the degrading instead of the selfless and fearless qualities that these people undoubtedly had or have. Of course this reflects how we relate with ourselves.
What happens when we notice the fearless and resourceful qualities in ourselves?
It’s true that there is a lot wrong with our world. Yet there are human qualities that have always risen above the most difficult circumstances. There are those who shine brightly for others even as they face their own death. It is part of our innate or developmental call to act in ways that are of benefit to all. In Western psychology its self-actualization. So why not focus here?
The concept of ‘full responsibility’ can look like blaming the victim.
This is a story we know all too well. Last year’s ‘Me Too’ movement shed light on this tendency. Another example is hearing from parents who are blamed for their children’s health challenges. Looking a little deeper I almost always see a mother or father who is doing their absolute best in the face of very difficult circumstances. These children are so fortunate to have parents with this amount patience, strength and insight.
Blame, shame and guilt are woven into our culture so deeply that we need to notice how we approach the topic of responsibility. What my mentor shed light on today is that there are different types of suffering. Sometimes we can shift our response and it relieves the pain. Other times serious things happen and the appropriate response is simply to acknowledge this. By seeing the strength of spirit in those experiencing difficulty we alleviate some pain. Human compassion is capable of this. It requires that we put our ideas aside. I just returned from a week long retreat where we focused on awakening the heart. We always are beginning with ourselves.
Maitri is the word for self-compassion. This extends out to others in a way that isn’t about imposing any idea on a situation but simply being present to what is.
I see a patients every week with iron deficiency who don’t know it. Standard blood work isn’t enough. In this article I’ll explain why. There are several markers that help us understand why iron is low but again conventional medicine rarely tests these. Low iron can cause fatigue, anxiety, depression and insomnia just to name a few common symptoms.
“My doctor says its all in my head but I know it isn’t.”
Other symptoms of iron deficiency include palpitations, rapid heart rate, restless legs, infections, poor mental function brain fog and decreased tolerance for exercise. Athletic performance and capacity to work will be lower. This is because when iron is low it decreases oxygen availability and then myoglobin levels in muscle drops. Lactic acid builds up.
It can also be difficult to maintain proper body temperature. This can lead people to believe they have a thyroid problem. Brittle nails, sores around the mouth and loss of taste can occur. Iron deficiency happens prior to clinical anemia which is the final stage. Eight percent of premenopausal women are iron deficient but I’m guessing this number is more given the number of women I see who are undiagnosed. A quarter of those are anemic.
In clinic I listen carefully to my patients symptoms and teach them how to read their own signs. Iron deficiency is often visible in a person’s complexion, cuticles or tongue depending on what else is going on. Postural hypotension or feeling dizzy upon standing can be a tell-tale symptom.
Functional Medicine Solutions
That being said, I always want to see comprehensive lab work. This is the best way to know what is actually going on. Recently I suspected a patient to be low in iron but her lab work showed two parasitic infections with healthy iron stores. As we treated the gut infections, her complexion and energy changed rapidly.
Another patient had a chief complaint of anxiety and fatigue. This had been going on for 4 years, since the birth of her second child. Her ferritin was the lowest I’ve ever seen. She is in the final stage of iron deficiency and clinically anemic.
Why is ferritin not monitored more closely, especially in mothers?
In the final trimester before my son was born I was also anemic. My symptoms were so uncomfortable I would cry at night before bed knowing I faced another night without sleep and in pain. Restless legs and insomnia can be incredibly painful.
This could have been caught earlier and prevented. I was seeing a primary care provieder weekly so why was this missed? I trusted that my bloodwork was being monitored properly. My diet was excellent but at this stage more supplementation was needed. Once I began I felt better within a few days.
3 Stages of Iron Deficiency
There are three stages of iron deficiency. Iron stores are measured in ferritin. When ferritin is between 10 to 15 ng/mL there is deficiency but not exhaustion. During this stage, there may not be any symptoms that conventional medicine would recognize.
The difference in Functional Medicine is that we flag anything under 30 ng/mL. In this way we prevent stage two when iron stores become exhausted and ferritin drops below 10 ng/mL.
The final stage is when there is no iron in bone marrow stores. Red blood cell production and hemoglobin drop. Anemia is more obvious, and symptoms can become severe. Unfortunately, most clinicians in primary care settings don’t test iron or ferritin. They only look at hemoglobin, red blood cells, and MCV levels. This is why a lot of patients in stage one and stage two are being missed.
In fact, its fairly common that people are iron deficient for decades without knowing it. Iron deficiency affects 1.62 billion people worldwide. That’s 25% of our global population.
Functional medicine understands there is a connection between depression, anxiety, fatigue, insomnia and low iron. Observing a patient and feeling the pulse is often enough to suspect iron deficiency. This is part of my basic training.
We also know how to investigate the underlying cause. Is it simply lack of nutrient intake? How can we increase iron rich foods into the diet? What other lifestyle factors are contributing? Is there gut dysbiosis leading to malabsorption? Are there any infections that need to be cleared? Is the body shunting iron to protect from something more serious? Is heat masking some of the signs we check?
Ferritin is an acute-phase reactant that increases the inflammatory response much like C-reactive protein. This can be confusing and its why a comprehensive panel is important to have. This is especially when chronic pain or more complex conditions are present. So a patient can be iron deficient but their inflammation is raising ferritin. Seeing a normal value in the face of clinical anemia does happen. Functional testing catches this by looking deeper.
In many places people can order their own bloodwork but the interpretation is important. I ask patients to get copies of their labs so we can look over them together from a Functional perspective.
The spirit of ‘DIY’ or ‘do it yourself’ is a quality I admire in patients. I love working with people who are engaged in their health and want to understand what is at the root of what they are experiencing.
This phrase “soft heart, strong back” reminds me of how I aspire to be. Its a vison of communicating needs effectively without given into the social norms of doing more when its time to slow down and reconnect. In fact, research shows that productivity increases when real down time scheduled in.
Connected to the Heart
We live in a time of pushing through. Our culture encourages us to work more, sleep less and consume more. The consequences are that we end up trading in a meaningful life and shutting down our vitality. Damn.
Slowing down and connected to the body through meditation on a daily basis has a powerful cumulative effect. I’ll describe how to do it and why it works.
Concepts that Keep Us Stuck
We all have a map of reality. Its made up of concepts. For instance, what the word “healthy” means is a just a concept. Unless we take a look at this we can live our lives stuck in an old idea. These concepts have very little to do what we actually experience about our health or our body.
How is your experience of feeling healthy different than what you think about it?
What does your body feel like versus what you think you look like?
Mindfulness Transforms Concepts
Meditation offers an important way of looking at and feeling our life from the inside. This experience of our life is very different than how it looks from the outside.
To illustrate this, I’ll share a short story. I was engaged with a man who was very charming. He was well liked in his profession and in my community. I say ‘my community’ because after awhile I began to realize he had very few close friends of his own. Inwardly he experienced a lot of anxiety, insecurity and even panic attacks. He spent a lot of time putting on his outward appearance for work or social events. It was exhausting and literally consumed him.
Our life looked great from the outside but on the inside it was unbearable. I was living with a man who was not well and wouldn’t get help but somehow continued to function outwardly.
the Map versus the Territory
We can call our experience of reality, the territory. In contrast the map is what we think about reality. In my story the map was the idea of having a happy home, satisfying careers, hobbies and good friends. It has a strong allure, doesn’t it?
The territory was that I was living with a person who was not functioning and instead chose to control, threaten and depend on me for everything. Sadly this story is very common. There are many who struggle in similar circumstances.
Connecting with our actual experience is liberating. It can be enlivening and very joyful. For instance, the body is where we access intuition, relaxation and a wide array of sensations. A daily meditation practice creates room to experience and explore the true territory of our life. Here are 4 steps for connecting with your body and heart.
Find a comfortable position either sitting or laying down.
Place your hands on your lower belly or chest depending on what feels right for you today.
Put your awareness into your body. Notice sensation in your feet, sacrum, mid-back, elbows, shoulders & head.
Take all of it in and notice how your body naturally relaxes when we are receptive and listening.
Spend some time resting in the heart. Notice what is there without judging.
Being human is messy. We need a soft heart and a strong back so we can honour our experience rather than live in a map that isn’t really ours.
A deeper knowing emerges when we give ourselves time to reconnect with the real territory of our lives.. You may notice the map has taken over when you hear the same story over and over. It can be in our head or something we share with others. This story usually has little to do with what is actually happenng. It causes tremendous suffering as we relive painful events.
A mindfulness practice helps us see this. What’s more is that meditation allows us to let go of trauma stored in the body without needing to tell the story or understand the map. Simply by connecting with our bodies, hearts and the real territory of our lives, we can heal.