Carolina Total Wellness - Carolina Total Wellness

April 1, 2019May 20, 2019

How to Support Optimal Stomach Acid for Good Digestion

842 stomach acid

When we go to the doctor with symptoms of acid reflux, gas, bloating and heartburn, typically the diagnosis of high stomach acid is based purely on symptoms — not a lab test for stomach acid levels — resulting in a prescription for antacids, histamine type 2 receptor agonists (H2 blockers), Proton Pump Inhibitors (PPIs), or even surgery.

For many people, these drugs only worsen the problem.

Antacids reduce stomach acid temporarily, then more acid is automatically produced to bring the stomach back to its intended pH level. This only treats the temporary symptoms and does nothing to fix the actual problem.

H2 blockers block a substance in the body that encourages acid production in the stomach. They work more slowly than antacids and are intended to last for longer periods of time. On the down side, they stop production of pepsin, a digestive enzyme necessary for breaking down protein.

Proton pump inhibitors permanently block an enzyme that tells your stomach to produce acid.

All of these methods are linked to serious side effects and can even contribute to the root causes of continued chronic low stomach acid and other serious health conditions.

5 Ways to test stomach acid levels

Because hypochlorhydria isn’t well known to most patients, many never trace it back to their chronic health condition and they continue to suffer.

The good news is multiple options exist for testing stomach acid levels, which will help you create a clear game plan for remedying the situation at its foundation.

1. Gastric acid secretion test. Highly invasive and expensive, this test is typically done if a patient is diagnosed with a stomach ulcer. It can be helpful to track if anti-ulcer medication is working and to see if material from the intestines is coming back into the stomach.

2. The Heidelberg Stomach Acid Test. Considered the gold standard test for hypochlorhydria, a small capsule with a radio transmitter is ingested to measure the pH of the stomach as you drink a solution with baking soda (reduces acidity). The baking soda will naturally neutralize the HCL in the stomach. If the body does not return it to normal, it’s a sign of hypochlorhydria.

This test provides a graph showing your specific stomach response to the baking soda challenge, and can help determine if you have hypochlorhydria, hyperchlorhydria (high acid), or achlorhydria (complete lack of acid). At a cost of about $350, this test is not covered by most insurance plans.

3. CBC and CMP. These are common factors on a metabolic blood panel, typically covered by insurance. A skilled clinician can diagnose hypochlorhydria by taking into account these lab results in combination with your symptoms.

4. Betaine HCl challenge. An at-home test considered to be quite reliable, however false positives are possible, so it’s recommended to repeat the test three times. The betaine HCl costs about $20. If you have low stomach acid, you can then take it to help restore your HCl levels.

Buy Betaine HCl with pepsin.
Eat a high-protein meal containing at least 6 ounces of meat (veggies are allowed with this).
In the middle of the meal (not the beginning) take one betaine HCl pill.
Finish the meal and observe what happens.

Possible outcomes:

1. You notice no symptoms. This is likely a sign of low stomach acid.

2. Indigestion. Burning, heat, or heaviness in your chest likely indicate adequate stomach acid levels.

It is recommended to repeat the betaine HCl challenge two or three times to confirm your results. Three positive tests are a good indication of low stomach acid.

False positives are possible if:

You consume too little protein. A low protein meal doesn’t require much acid, so the betaine HCl can cause too much increase in acid.
You took the capsule before the meal, which can cause indigestion.
You have esophageal sphincter dysfunction. A hiatal hernia or poor esophageal sphincter tone can cause increased indigestion symptoms. Rule this out with a medical exam if you suspect it.

5. Baking soda stomach acid test. While not as accurate as the above tests, this is a free at-home test you can use to get an indication of your stomach acid levels. The results can vary from person to person depending on interpretation of the results. Some use it as a baseline measure and to track changes over time.

First thing in the morning, before eating or drinking anything:

Mix ¼ tsp baking soda in 4 to 6 ounces of cold water.
Drink the baking soda solution.
Time how long it takes for a burp to occur. Time it for up to 5 minutes

If you have not burped within five minutes, it may be a sign of insufficient stomach acid. Early and repeated burping may be due to too much stomach acid (do not to confuse this with small burps from swallowing air when drinking the solution). Any burping after 3 minutes is an indication of low stomach acid levels.

Associated tests

Low stomach acid can be associated with other health issues that have far-reaching consequences. If you suspect low stomach acid, ask our office about testing for the following:

B12 levels: Intrinsic factor is a glycoprotein in the stomach necessary for absorption of vitamin B12. When stomach acid is too low, intrinsic factor can’t do its job. This results in vitamin B12 deficiency, which is a serious health concern.

Homocysteine levels: Stomach acid is important for proper absorption of vitamin B12, a key factor in methylation that keeps inflammatory homocysteine at the right levels. When B12 is low, homocysteine elevates.

Supporting healthy stomach acid

Eat protein foods at the beginning of your meal to stimulate the digestive enzymes necessary for digesting protein.

Chew thoroughly. This is one of the most important parts of digestion. Food proteins need to be broken down to be properly digested.

Limit liquid intake during meals until at least 30 minutes after a meal to allow for proper stomach acid production, pathogen sterilization, and protein metabolism.

Stay hydrated between meals to support proper gut motility; this pushes the contents of the intestines out of the body instead of back into the stomach. This is very important for those who are prone to SIBO.

Betaine hydrochloride supplements help support healthy gut function and safely restore normal gastric acidity. (Do not confuse betaine HCl with anhydrous betaine, a methyl-donor nutrient taken to control homocysteine levels.)

Always take the betaine HCL either half-way through the meal or right at the end of the meal. Taking it before a meal may create a false experience of heartburn and can turn off stomach acid production for this meal. Caution: Do not take HCL if you are taking any NSAIDs such as ibuprofen, Tylenol, or aspirin.

HCl with pepsin. Add these to your diet when you consume protein. When you feel warmth in your stomach, that means you are taking enough. Then back it down a notch and monitor your response. Some people need one capsule, others need more as everyone is unique.

Pepsin. Typically used in conjunction with HCl, pepsin is considered very safe when administered to assist digestion.

Digestive enzymes help to break down food proteins. Make sure to get a high-quality blend.

Apple cider vinegar. One tablespoon in a bit of water right before a meal can help with digestion.

Fermented foods such as sauerkraut, kimchi, pickles, pickled ginger, and water kefir contain organic acids, enzymes and probiotics to assist with proper digestion. They are also anti-microbial and fight H. pylori, arch enemy of stomach acid production.

Taking the time to improve your stomach acid levels will make a huge difference in your symptoms and quality of life. Please contact my office for more help.

March 25, 2019May 20, 2019

Statins Raise Diabetes Risk: What to Do Instead of Drugs

841 statins raise diabetes risk

You’ve been told you need to lower your cholesterol, but did you know taking a statin could raise your risk of type 2 diabetes? A recent study of almost 9,000 people in their 60s showed that statin use increased the risk of diabetes by almost 40 percent. Statin use was also associated with a higher risk for elevated blood sugar and insulin resistance (pre-diabetes). While the brand of statin subjects took didn’t seem to matter, risk was higher in overweight and obese subjects.

Given the risks associated with high blood sugar, insulin resistance, and diabetes, this study highlights further problems with statin use for a condition that is typically well managed through functional medicine protocols. High blood sugar and diabetes raise your risk for many chronic health disorders, including dementia and Alzheimer’s.

This isn’t the first study to link statins with an increased risk of type 2 diabetes. Previous research has found a 50 percent increased risk of diabetes in female users.

Statins most commonly prescribed drugs

Statins are among the most commonly prescribed drugs, accounting for more than $20 billion of spending a year. About one in four Americans over 40 takes statins, with that number having increased by almost 80 percent in the last two decades. Side effects include muscle weakness and wasting, headaches, difficulty sleeping, and dizziness.

Statins do not address the underlying cause of high cholesterol

Although statins lower cholesterol, they do not address the underlying cause of high cholesterol in most people, which is typically inflammation (some people have a genetic disorder that causes very high cholesterol). The body uses cholesterol to patch up damage in the arteries caused by inflammation. In fact, research shows inflammation is the primary cause of heart attacks and strokes, not high cholesterol.

Considering the following facts about cholesterol and heart disease:

75 percent of people who have heart attacks have normal cholesterol.
Older patients with low cholesterol have a higher risk of death than those with higher cholesterol.
Populations in other countries with higher cholesterol than Americans have less heart disease.

Hypothyroidism, a condition estimated to affect more than 20 million Americans, raises cholesterol. Many find a gluten-free diet lowers cholesterol, as gluten is inflammatory for so many people.

Research also shows diets low in fat and high in carbohydrates increase the “bad” form of LDL (there are two to look at) and decrease the protective HDL.

Lowering cholesterol through functional medicine

Using functional medicine is a highly effective way to lower cholesterol naturally. This is because functional medicine identifies and manages the root cause of a problem versus using a drug to block symptoms.

Management includes an anti-inflammatory diet, exercise, nutritional support, and finding out causes of inflammation. These may include low thyroid function, autoimmune disease, bacterial or viral infections, leaky gut, poor blood-sugar handling, or other chronic health issues.

In fact, high cholesterol is more often tied to a diet too high processed carbohydrates and sugars, not fat. Sugar and refined carbs, including processed white foods, drive good cholesterol down and triglycerides up. It causes low density small particles that encourage the dangerous buildup of arterial plaque. This can lead to not only heart disease but also insulin resistance or “pre-diabetes.” Sugar, not dietary fat, is the bigger cause of most heart attacks.

However, the type of fat you eat matters too. Trans fats, or hydrogenated fats, promote dangerous types of cholesterol, while omega-3 fats and monounsaturated fats improve the healthy types of cholesterol.

Measuring cholesterol players

Cholesterol is found in every cell and helps produce cell membranes, vitamin D, and hormones. It’s also necessary for good neurological function.

When we measure cholesterol, we are measuring LDL and HDL. These are small packages of fat and protein that help move cholesterol throughout the body.

High-density lipoprotein — HDL

This is considered “good” cholesterol. It helps removes excess arterial plaque.

Low-density lipoprotein — LDL

This is considered “bad” cholesterol. It can form plaque that narrows the arteries and makes them less flexible (atherosclerosis).

Triglycerides

High levels of this dangerous fat are linked to heart disease and diabetes. Levels rise from eating too many sugars and processed carbs, as well as from smoking, physical inactivity, excessive drinking and being overweight.

Lipoprotein (a) or Lp(a)

Lp(a) is made up of an LDL part plus a protein (apoprotein a). Elevated Lp(a) levels are a strong risk for heart disease.

When testing cholesterol, please pay attention to:

Levels of HDL “good” cholesterol versus LDL “bad” cholesterol
Triglyceride levels
The ratio of triglycerides to HDL
The ratio of total cholesterol to HDL

Inflammation promotes heart disease

Systemic inflammation is a primary factor in heart disease and most chronic health disorders. A diet high in sugars and processed carbs, a sedentary lifestyle, smoking, excessive drinking, chronic stress, gut infections, unmanaged autoimmunity, and chronic infections are all causes of chronic inflammation. People with elevated systemic inflammation, which is measured by a blood marker called C-reactive protein (CRP) have a higher risk for heart disease than those with high cholesterol. Also, normal cholesterol is not protective for those with high CRP.

By addressing the cause of high cholesterol not only do you avoid the dangerous risks and unpleasant side effects of statins, but also you journey into your golden years with improved energy and well being.

March 18, 2019May 20, 2019

Pregnancy and Postpartum can Trigger Hypothyroidism

840 pregnancy and Hashimoto s

For many women, the onset of their hypothyroid symptoms began either during pregnancy or just after. Most of these women went on to be diagnosed with Hashimoto’s, an autoimmune disease that attacks and destroys the thyroid gland. Pregnancy often triggers Hashimoto’s due to normal shifts in immunity that cause an already beleaguered immune system to tip out of control and begin attacking the thyroid gland.

Factors that can contribute to developing Hashimoto’s around pregnancy or childbirth include shifts in immune function during the third trimester, shifts in immune function postpartum, the dramatic shifts in hormone function, genetic tendency, and the exacerbation of existing disorders such as blood sugar imbalances, food intolerances, gut infections, and other autoimmune diseases (which may or may not be diagnosed).

How pregnancy can trigger Hashimoto’s hypothyroidism

Women make up the vast majority of people struggling with autoimmune diseases, about 75 percent. Researchers suggest this is because women have more complex hormonal systems that involve more fluctuations; hormone and immune function are closely tied. Hormone imbalances are a major contributor to chronic inflammation that can trigger autoimmunity.

Pregnancy simply exacerbates these fluctuations and underlying imbalances.

Shifts in immune function during and after pregnancy can trigger autoimmune disease

Women experience major immune shifts towards the end of pregnancy and then again immediately after birth. These are natural shifts designed to help protect the baby.

During the third trimester, a pregnant woman’s immune system becomes more heavily weighted toward what is called the TH-2 system. This arm of the immune system is the delayed immune reaction that produces antibodies that identify a foreign invader a short while after it enters the body. This response allows the body to recognize the invader in the future.

After the baby is born, a woman’s body then becomes more TH-1 dominant. This is the arm of the immune system that reacts immediately to a foreign invader, such as with swelling and pus around a splinter.

Most people who either already have an autoimmune disease or are at high risk of developing one are overly dominant in either the TH-1 or TH-2 arms of the immune system.

The immune swings that pregnancy and childbirth cause tip an already imbalanced immune system into full expression of an autoimmune disease such as Hashimoto’s hypothyroidism.

Pregnancy and pituitary function

Although about 90 percent of hypothyroid cases are caused by Hashimoto’s, some cases are caused by chronic stress. As any mom can tell you, pregnancy and childbirth can bring inordinate amounts of stress.

Extreme or chronic stress depresses function of the pituitary gland. The pituitary gland is a small gland at the base of the brain that is like a control tower for the body’s hormones, telling the various glands throughout the body how much hormone to secrete in response to external and internal cues.

Chronic stress overwhelms the pituitary gland and depresses its function. As a result, the pituitary falters at its job of telling the body’s hormone glands to secrete hormones. In the case of the thyroid gland, this means it doesn’t tell it to release enough thyroid hormone.

This not only causes tiredness and other hypothyroid symptoms, but it can also explain postpartum depression in some women.

It’s important to understand that stress doesn’t just mean bad traffic or a demanding job. Many women enter into pregnancy already under enormous stressors they may not be aware of:

Leaky gut or gut infections
Blood sugar that is either too low (hypoglycemia) or too high (insulin resistance)
Undiagnosed food intolerances such as gluten sensitivity or celiac disease
Hormonal imbalances
Undiagnosed brain dysfunctions, such as from an old brain injury, brain inflammation caused by poor diet, or PTSD or CPTSD
Sensitivity to chemicals or over exposure to chemicals
Poor liver detoxification
Undiagnosed chronic bacterial, viral, parasitic, or fungal infections

Are you at risk? Check your TPO and TGB antibodies before pregnancy

It’s not a bad idea to screen for risk for Hashimoto’s before conceiving. You can do this by testing TPO and TGB antibodies. Many people have autoimmune mechanisms already in place that not advanced enough to cause symptoms. However, a big shock to the body such as pregnancy can be the tipping point to send you over the edge into autoimmune expression.

If you have Hashimoto’s in your family, other autoimmune diseases in your family, or you suffer from other inflammatory conditions, it pays to screen for your risk before pregnancy. This gives you an opportunity to use functional medicine strategies to slow down or send into remission your autoimmune condition.

Studies show that women with no thyroid symptoms but positive blood serum TPO antibodies have a 25 percent higher risk for developing an autoimmune response to their thyroid.

Reducing the risk of autism, allergies, eczema, and more in your baby

Using functional medicine to manage autoimmunity or heightened risk for autoimmunity is not only good for the mother’s health, but also for that of her child. Children born to mothers with autoimmunity such as Hashimoto’s show increased risk for varying health disorders, including autism spectrum disorder, eczema, asthma, food allergies, and food intolerances.

Researchers have increasingly found that autoimmune disorders underlie many cases of autism, which is caused by an autoimmune attack against the brain in these children. Whether it’s autism or other immune disorders, children born to mothers with imbalanced immune systems may be more vulnerable to environmental triggers that can tip them over into full blown autoimmunity.

Triggers can include food intolerances, blood sugar imbalances, or toxic chemicals introduced into the bloodstream.

Of course, no one willingly or knowingly brings these hardships onto themselves or their children, but in today’s world the modern immune system faces significant burdens. Going into pregnancy knowing how to manage and minimize the impact of those burdens on the body can help minimize the risk. If you already developed Hashimoto’s during pregnancy or after childbirth, understanding why you did can help you better manage it.

Ask my office for help addressing the root cause of your Hashimoto’s hypothyroidism.

March 11, 2019May 20, 2019

Pollutants Lower Sperm Counts

839 pollutants lower sperm counts

Infertility has been a growing problem over the last three decades, with most of the attention focused on women’s reproduction. However, 40 to 50 percent of cases of infertility are caused by male infertility. Research shows sperm quality has dropped by 50 percent in the last 80 years. Sperm quality of dogs has also declined sharply over recent years.

Now, a recent study shows common pollutants in the environment and in the foods we eat affect male fertility.

The British study looked at the
effects of two common pollutants on the sperm of both men and dogs. For this
study they studied a common plasticizer that is ubiquitous in our environment
and the industrial chemical polychlorinated biphenyl 153, which, though banned,
is still abundant in our foods and the environment.

They found that when sperm is
exposed to both these chemicals at levels found in the environment it damaged
the sperm. They reduced sperm motility and fragmented DNA in the sperm. Male
infertility is linked to DNA fragmentation in sperm.

Many studies link pollutants to poor sperm quality

The declining rates of sperm quality since the rise of industrialization are no surprise; other studies show links.

For instance, past research has shown that environmental pollutants not only impact male fertility but also raise the risk of testicular cancer. Poor sperm quality has even been linked to the chemical exposure of a man’s mother prior to his birth.

Also, chemicals called “endocrine disrupters” have long been shown to impact male fertility. That’s because they mimic human hormones — the female hormone estrogen primarily, thus throwing male hormones off balance.

Again, it’s the chemicals in plastics that are to blame for skewing male hormones and promoting infertility.

Low sperm counts and poor sperm quality have also been linked to benzenes, toluene, xylene, pesticides, herbicides, organic solvents, painting materials, and heavy metals.

Sugars and processed carbs impact male fertility

While industrial pollutants take their toll, so does a dietary pollutant that is a staple of the modern American diet: foods high in sugar and processed carbohydrates that spike blood sugar
and insulin levels.

Eating a diet high in these blood sugar-spiking ingredients triggers a man’s body to over produce estrogen. This not only gives him more feminine characteristics but also impacts his
fertility.

Symptoms of too much estrogen in men include:

Low libido
Decrease or loss of morning erections, fullness of erections, and the ability to maintain erections
Mental fatigue and poor concentration
Depression
Lack of motivation
Decrease in physical stamina
Infertility

Men with excess estrogen also often have high cholesterol and triglycerides, insulin resistance, elevated blood pressure, abdominal weight gain, the development of “breasts” and “hips,”
and varicose veins or hemorrhoids. Some men even have hot flashes thanks to
high estrogen.

A variety of factors are shown to contribute to estrogen dominance in men, including estrogen mimicking chemicals in pesticides and environmental chemicals, poor essential fatty acid status
(too much omega 6 fatty acids and not enough omega 3), gut infections, and poor liver detoxification.

However, the most common cause is the effect of a high-carbohydrate diet on overall health.

When a man consistently eats a diet that is high in starchy and sugary foods, such as sweets, bread, pasta, rice, potatoes, soda, and sweet coffee drinks, this chronically over produces
insulin in order to low high blood sugar.

This type of diet triggers an enzyme called aromatase, which synthesizes estrogen. The constant activity of aromatase also leads to insulin resistance—when insulin cannot escort glucose
into the cells—which causes hormonal imbalances.

Addressing excess estrogen in men

Don’t be fooled into thinking using testosterone gel is the way around high estrogen. Thanks to aromatase, the additional testosterone will simply be converted into estrogen too. The excess
testosterone can also cause testosterone resistance, which makes symptoms of low testosterone worse. Instead, a hormone panel that includes levels of testosterone and estrogen will reveal the mechanisms of the imbalance and what the best course of action is for you.

Functional medicine strategies for male infertility

While we can’t rid the environment of pollutants, we can minimize our exposure and help buffer our bodies. In addition to replacing toxic items in your home, body care, house cleaning, and
diet with non-toxic alternatives, you can also help your body by supporting your liver detoxification, antioxidant glutathione status, and body’s stress handling abilities.

It’s also vital to use diet and lifestyle changes to support healthy testosterone levels. Ask my office about functional medicine therapies to support healthy male testosterone and fertility.

March 4, 2019May 20, 2019

New Study Shows Processed Foods Shorten Your Life

838 processed foods shorten life

A new study shows regularly eating processed foods — the staple of most western diets — can shorten your life. In functional medicine, we know from the published research that a diet based on processed foods also will significantly increase your chances of suffering from chronic disease. Common chronic diseases tied to diet include diabetes, obesity, heart disease, autoimmune diseases, high blood pressure, dementia, and Alzheimer’s.

The study was conducted in France and published in the JAMA Internal Medicine journal. It tracked almost 45,000 adults, most of them in their late 50s at the start of the study. Researchers followed the health and the diet of the subjects over a period of eight years.

On average, the subjects derived about a third of their calories from processed foods. The processed foods researchers looked at included the following:

Instant noodles
Instant soups
Breakfast cereals
Energy bars and drinks
Chicken nuggets
Ready-made meals and snacks
Packaged snack foods
Any foods made using industrial processing

During the course of the study, more than 600 subjects died, primarily from cancer and cardiovascular disease.

In looking at the deaths, the researchers adjusted for general health, socioeconomic status, and influencing behaviors, and compliance with a healthy diet.

However, even after all that, they still found that every 10 percent increase in consuming processed foods was linked with a 14 percent higher chance of early death.

Why eating a lot of processed foods leads to chronic disease and earlier death

In considering the link of processed foods to risk of earlier death, the authors suggest the following possibilities:

High-temperature processing may form contaminants. High-heat food processing can alter protein structures so that the body sees them as inflammatory. In functional medicine we know that high temperatures also make industrial oils used in food processing toxic to the brain and body.

Additives may be carcinogenic. Food additives are synthetic chemicals that are foreign to the human body. Chemical food additives bind with food proteins to create new molecules that the immune system recognizes as an invader. Many synthetic chemicals are also simply difficult for the body to metabolize and eliminate, thus raising inflammation and the toxic burden. Many additives have also been linked to brain-based symptoms and disorder. Simply put, food is no place for synthetic chemicals that have little safety vetting.

Packaging of prepared foods can lead to contamination. The industrial nature of the packaging process can introduce harmful toxins into the food itself. Also, if you are gluten-free, eating packaged foods is always a crap shoot as they are most likely contaminated with gluten due to multiple foods being processed on the same equipment.

What we know about processed foods in functional medicine

Those were the concerns listed by the researchers. In functional medicine we are aware of other reasons processed foods cause chronic disease and raise the risk of an early death.

Industrial oils. The brain is made of primarily fat and the fats you eat determine the health of your brain. The oils used in food processing are industrial seed oils that are generally rancid due to their very unstable molecular structure. These oils contribute to poor neuron structure and integrity and thus cause overall brain health to suffer. They are also generally inflammatory. Additionally, processed foods that contain hydrogenated fats are especially problematic for the brain and body and linked with cognitive decline, heart disease, and inflammation.

Poor fatty acid ratio. The oils used in processed foods are very high in omega 6 fatty acids. Human health requires a ratio of omega 6 to omega 3 fatty acids (such as from nuts and cold-water fish) of at least 4:1 though 1:1 is even better. Sadly, most Americans eat a ratio of 25:1 thanks to processed foods. In other words, way too much omega 6. This puts the body in an inflammatory state that promotes obesity and chronic disease.

Too many processed carbohydrates. One of the biggest promoters of chronic disease and dementia is unstable blood sugar from eating a diet too high in processed carbohydrates. Processed and packaged foods are predominantly grain-based and/or sugary and very high in carbs. This sends blood sugar on a tail spin every time you eat them, promoting inflammation and the chronic disease process.

Gluten. Most packaged and processed foods are wheat-based and thus loaded with gluten. Many people have undiagnosed gluten sensitivity or celiac disease that keeps their body in a constant state of inflammation, thus promoting chronic disease. Gluten is linked with 55 diseases so far, most of them autoimmune.

Eating a whole foods diet with basic real-food ingredients is one of the best things you can do to turn your health around. For more advice on a whole foods diet, please contact my office.

February 26, 2019May 20, 2019

Gut Bacteria Play a Role in Anorexia and Other Eating Disorders

837 anorexia and gut microbiome

People with eating disorders such as anorexia simply do not experience hunger and satiety in the same way people who have a healthy relationship with food do. New research suggests that the composition of gut bacteria, or the gut microbiome, may play a role in the behavioral aspects of anorexia and eating disorders. For instance, previous research shows a connection between mood disorders such as depression and poor gut microbiome diversity. Less than half of people with eating disorders fully recover, showing that conventional treatments are failing untold numbers of people, the vast majority of them women.

The study showed that patients with anorexia had lower diversity of gut bacteria than healthy individuals. They also found that the less diverse the gut microbiome was the more depression and anxiety patients suffered. The researchers also found that as a patient with anorexia began eating again their gut bacteria diversity was partially restored, which in itself aided in recovery.

Alterations in the gut microbiome can affect how a person’s body functions, how they think, feel, and behave, and how they interact with others.

The gut microbiome is critical not only to regulating mood and behavior, it also plays a vital role in regulating metabolic function, appetite control, and weight.

A better understanding of the role of the gut microbiome in anorexia can help researchers forge new directions in treatment around determining target weight goals, how fast the anorexic patient should gain weight, and what type of diet the anorexic patient should follow to best support the brain’s role in eating disorder behaviors.

The researchers are now investigating whether targeted probiotics could ease the renourishment and refeeding phase of anorexia recovery — many patients struggle with gastric and abdominal distress when reintroducing foods. Customized probiotic therapy could also support the mental and emotional aspects of recovery from an eating disorder.

Gut bacteria targeted in eating disorders

Past research has also shown a link between the gut microbiome and eating disorders, which affect an estimated 5 to 10 percent of the population. A 2015 study from France showed gut bacteria plays a role in eating disorders.

The study looked at mice who had an inflammatory reaction to a protein made by gut bacteria. In essence, the mice responded to these bacteria as if it were an allergy or sensitivity. This immune response caused eating disorders in the mice.

The gut bacteria that triggered this reaction is very similar in structure to a hormone called alpha-Melanocyte-stimulating hormone (a-MSH). a-MSH is a satiety hormone that tells you when to feel full. When the immune system attacks the gut bacteria similar to a-MSH, it also attacks the a-MSH due to their structural similarity. This immune reaction can then dysregulate signals around feeding, energy usage, and anxiety.

When the immune system mistakenly attacks the body

This study is evidence of a “cross-reactive” immune reaction, in which the immune system confuses something in the body with something infectious and attacks both. This is a very common mechanism in autoimmune reactions, such as with Hashimoto’s hypothyroidism, type 1 diabetes, or multiple sclerosis.

The research suggests that some eating disorders may have an immune reaction driving the psychological disorder.

Tips on addressing eating disorders nutritionally

Although eating disorders are highly complicated and require intensive, sometimes multi-faceted therapeutic approaches, it’s still important to be mindful of nutritional strategies to support the brain and the gut microbiome:

Eliminate processed carbs and sugars as they trigger addictive tendencies metabolically.

Keep blood sugar stable to curbing cravings, food obsession, and relentless hunger. You may need to eat small, frequent meals that include protein initially.

Base your diet on plenty of vegetables and a wide, ever changing diversity of vegetables. This will increase the diversity of your gut microbiome, which promotes psychological health and stability.

Supporting your brain chemicals, or neurotransmitters. Neurotransmitters affect your mood, thoughts about yourself, behavior, energy levels, and other aspects of how you feel and function. For instance, you may need serotonin or dopamine support. Serotonin is the neurotransmitter that allows us to feel joy and stave off depression. Dopamine, on the other hand, is necessary to feel self-worth, motivation, and to not experience constant cravings. Both serotonin and dopamine have been shown to play a role in eating disorders. If you have been starving yourself, binging and purging, undereating, or affecting your diet in other ways due to an eating disorder, there is a strong possibility you may be deficient in either one or both of these important neurotransmitters.

Ask my office for more advice on how to support a healthier approach to balanced approach to recovering from eating disorders.

February 20, 2019May 20, 2019

How to Support Your Brain’s Happiness Chemical

836 serotonin basics

Many people take SSRI antidepressants for depression. However, it’s important to ask why you are feeling depression in the first place.

Many important research strides have been made linking chronic inflammation, poor gut health, gut bacteria, and general brain health with depression.

However, we still need healthy serotonin activity, the target of SSRIs, to feel good.

Do you have these symptoms of low serotonin?

No longer finding joy, pleasure, or enthusiasm in life
Rage and anger
Depression
Depression related to lack of sunlight
No longer enjoy hobbies, favorite foods, friendships, or relationships
Unable to sleep deeply or feel rested from sleep
Life looks good on paper but doesn’t feel good

Light. The brain depends on sufficient light to manufacture serotonin, so being indoors all the time or in chronically dark or grey weather can affect serotonin activity.

Estrogen. In women an estrogen deficiency can lead to poor serotonin activity. This can explain why some women who are perimenopausal or post-menopausal experience depression.

Although it’s important to use functional medicine to address the cause of low estrogen, such as blood sugar or adrenal imbalances, some perimenopausal or post-menopausal women may still need bioidentical hormone replacement. In these situations, estrogen therapy can deplete the methyl donors necessary for serotonin synthesis, making it important to supplement with them: methyl B-12, SAMe, or MSM (methylsulfonylmethane).

Diet. Some nutritional advice will tell you to address low serotonin activity with foods high in tryptophan, a precursor amino acid to serotonin. However, clinically we really don’t see this work.

Better nutritional advice is to eat a diet that keeps blood sugar stable and does not inflame the gut or the body. This means avoiding sugar and processed carbohydrates, avoiding foods that trigger an immune response, and eating lots of diverse vegetables to foster healthy and diverse gut bacteria.

Blood sugar and gut inflammation. Unstable blood sugar — blood sugar that is either too low or too high — can significantly impact serotonin activity, leading to depression. The same goes for a diet that inflames the gut and the body.

Iron. Additionally, an iron is deficiency can cause low serotonin production. Things that can cause iron deficiency include iron anemia, celiac disease, leaky gut, heavy periods, parasites, over exercising, low stomach acid, hypothyroidism, and uterine fibroids.

Nutritional cofactors for serotonin activity

In addition to iron, nutrients serotonin synthesis requires include P-5-P (pyridoxal-5-phosphate), an active form of B-6, niacin, methyl B-12, folic acid, and magnesium.

Deficiencies in these cofactors are widespread due to how poorly most Americans eat.

Additionally, magnesium deficiencies can arise in those taking diuretics or athletes who over train.

Methyl donors such as methyl B-12 are important for the conversion of the amino acid 5-HTP to serotonin; people who take SSRI antidepressants for long periods of time deplete their methyl donors and P-5-P.

Those considering weaning off SSRIs may need to supplement with these cofactors to cover deficiencies acquired during use of the medication.

Supplements that support serotonin activity

The amino acids 5-HTP or tryptophan are precursors to serotonin. Tryptophan has been shown to more easily cross the blood-brain barrier than 5-HTP. Others prefer 5-HTP because it is only one step away from being converted to serotonin, whereas tryptophan is two steps away. Therefore, 5-HTP has more potential to boost serotonin levels. However, both work and taking both can cover your bases.

Both 5-HTP and tryptophan have been shown to be helpful in addressing depression, persistent nightmares, fibromyalgia, chronic headaches, migraines, and mood disorders.

Botanicals that increase receptor site sensitivity, ensure the breakdown of used serotonin, and provide necessary cofactors for serotonin production include St. John’s wort, SAMe, P-5-P (a form of B-6), niacinamide, magnesium citrate, methyl B-12, and folic acid.

Ask my office how we can help you support your brain serotonin activity so it can help you feel happier and enjoy life more.

February 18, 2019February 25, 2021

Peppermint Panna Cotta

Serves 4 if you’re lucky…

INGREDIENTS

1 can full fat coconut milk

4 Tbsp raw cacao powder

1 Tbsp Gelatin

2 Tbsp maple syrup (optional)

1 tsp peppermint extract

1 tsp vanilla extract

DIRECTIONS

Blend all ingredients until smooth and well combined.

Then let rest in blender for 5 minutes to allow gelatin to activate.

After 5 minutes blend on high for 1 minute and distribute into ramekins.

Place in fridge to set for 3-4 hours.

If desired, top with whipped cream or whipped coconut cream and a sprinkle of crushed organic candy cane.

February 11, 2019May 20, 2019

Is Chronic Stress Damaging You? Take a Salivary Cortisol Test to Find Out

835 adrenal salivary test

Many of us are too stressed out these days and this can have negative consequences on our bodies and brains, promoting chronic disease and rapid brain degeneration. If you’re concerned about the effects of stress on your body and how to manage it, an adrenal salivary test is an important ally. It can show you whether your stress hormone cortisol is too high or too low and whether this has affected your sleep-wake cycle, or circadian rhythm.

Symptoms of low adrenal hormones

Fatigue
Slow starter in the mornings
Crash in the afternoon
Crave sweets, caffeine, or nicotine to keep going
Prone to moodiness
Become shaky, light-headed, or irritable if go too long without eating
Wake up at 3 or 4 a.m.; inability to stay asleep
Become dizzy when move from sitting to standing

Symptoms of high adrenal hormones

Excess belly fat
Insulin resistance (high blood sugar)
Trouble falling asleep
Wake up not feeling rested
Women grow facial hair; men grow breasts
Polycystic ovarian syndrome (PCOS).

How to do an adrenal salivary test

To perform the adrenal salivary test, simply collect a small vial of saliva several times throughout the day using the vials in your test kit. The lab will then analyze your saliva for cortisol levels and how much cortisol you produce in the morning, afternoon, and evening. Do not something unusual or stressful on the day of your test.

It’s important to understand that low or high adrenal hormones usually don’t reflect a problem solely with the adrenal glands, two glands that sit atop each kidney and secrete adrenal hormones. Instead, chronic stress affects stress pathways in the brain, which start to dysfunction when stress is chronic.

It isn’t just being too busy, a bad job, a bad relationship, and so forth that cause chronic stress. Lesser known factors of chronic stress can include unstable blood sugar (usually from too many carbs), a chronic infection, leaky gut, or an autoimmune disease. Using second and third adrenal salivary tests allow you to track whether you’re successfully managing your condition; adrenal health should improve as these conditions resolve. If adrenal health does not improve, it means you must keep investigating to find out what is causing the body stress.

Measuring the sleep-wake cycle, or circadian rhythm

A sleep-wake cycle, or circadian rhythm, that is out of whack is one symptom of adrenal stress. If the circadian rhythm is normal, then cortisol is highest in the morning and lowest at night. This is what allows us to feel alert when we wake up and sleepy before bed. Many people with altered circadian rhythms notice they are more awake at night. Or they may notice an energy crash in the afternoon and being wide awake in the middle of the night.

The stages of stress

The adrenal salivary test measures circadian rhythm, the cortisol precursor hormones DHEA and 17 hydroxyprogesterone, and cortisol levels. It can tell you where you fall on the spectrum of adrenal fatigue to high adrenal hormones. People don’t necessarily progress from high adrenal hormone to low; adrenal function can jump back and forth between phases or stay stuck in one phase.

The adrenal salivary test also measures total secretory Ig antibodies, or (SIgA). Low SIgA levels reflect poor and dysfunctional immunity. If your SIgA levels are low, you are more prone to food intolerances, chemical sensitivities, autoimmune disease, infections, and other assaults on the immune system.

Ask my office about functional medicine protocols that can profoundly influence your adrenal health. We will also search for and manage the root causes of your adrenal stress.

February 4, 2019May 20, 2019

Test for Gluten Sensitivity if You Have Hashimoto’s

834 hashimotos and gluten

Numerous studies show a strong link between gluten intolerance and Hashimoto’s disease, an autoimmune disease that attacks the thyroid gland, causing hypothyroidism. This is because gluten has a molecular structure that closely resembles thyroid tissue — gluten sensitivity triggers an attack on the thyroid gland. Gluten (technically, the correct term is gliadin), is the protein found in wheat and wheat-like grains, such as spelt, kamut, rye, barley, triticale, and oats.

One of the immune system’s primary jobs is to protect the body from foreign invaders. Sometimes it may recognize a common food as a dangerous invader. When you eat that food throughout each day this can keep your immune system engaged in constant battle, making it hyper zealous, overly sensitive, and thus prone towards food sensitivities and autoimmunity.

Some people also have celiac disease, disease in which gluten triggers an autoimmune attack against the gut, the skin, or neurological tissue. Gluten sensitivity is more common than celiac disease, however, both show up in higher numbers in people with Hashimoto’s hypothyroidism.

If you have been diagnosed with hypothyroidism you should first test for Hashimoto’s by screening for TPO and TGB antibodies — the majority of hypothyroidism cases are caused by Hashimoto’s.

You should also screen for gluten intolerance or celiac disease given how common these conditions are in patients with Hashimoto’s. Likewise, people who discover they are gluten intolerant or have celiac disease should screen for Hashimoto’s.

It’s important to give up gluten completely if you have Hashimoto’s and gluten intolerance. Cheats and little bites are not ok as they trigger an immune response that ultimately destroys thyroid tissue. Also, it’s important to avoid foods that have been contaminated by gluten. Be careful when in a kitchen where gluten is used, with restaurant food, or with questionable packaged foods.

Cyrex Labs offers testing to identify gluten intolerance. However, sometimes the immune system can be so depleted that it produces too few antibodies to produce a positive test, even though you react to gluten. You can screen for this with a total immunoglobulin test.

However, given the evidence establishing a link between gluten intolerance and Hashimoto’s disease, you may be surprised how much better you feel by simply removing gluten from your diet as a start.

Many people have to remove other foods as well, such as dairy, eggs, or other grains. Following the autoimmune paleo diet for about a month and then reintroducing restricted foods one at a time every 72 hours can help you determine which foods trigger an inflammatory reaction in you.

Many people are able to put their hypothyroid symptoms into remission simply by following a diet that eliminates gluten and other trigger foods. Although autoimmune diseases such as Hashimoto’s can be successfully managed through diet and lifestyle strategies, it’s important to understand they can’t be cured. It’s just a matter of taming the immune system.

Ask my office for ways to manage your autoimmune Hashimoto’s hypothyroid condition.