A Functional Medicine Practitioner-Designed Postpartum Recovery Plan (For Mom & Baby)
It’s hard to believe my baby girl is coming up on 5 months old already!
All the mamas out there know… the postpartum period is a whirlwind!
Not only are you adjusting to taking care of baby, but your body is undergoing massive changes (just as big as during pregnancy!)
And you’re sleeping less, nursing (literally nourishing an entire other human with YOUR body!), and might even be going back to work around the 3-month mark if you’re in the U.S.
It’s a lot! That’s why I think your postpartum recovery plan is just as important as what you do before and during pregnancy (if not more important!)
Today I want to share my go-to supplements that I’ve used in my own postpartum recovery and first months of motherhood - I hope they help you as much as they have helped me over the past few months.
What I’m Taking For Postpartum Recovery & Surviving New Motherhood
Here’s a quick rundown of my daily supplement routine since giving birth. (Remember that this is what was appropriate for me, and may not be exactly right for you! Book a free consult with my team to learn more about customizing supplement plans for you).
#1 A good prenatal multivitamin
There’s nothing that depletes your body of nutrients quite like growing another human and then nursing them! You need the extra nutrients in a good prenatal just as much after birth as you do before.
I like Designs For Health Prenatal Pro because it contains chromium and other important micronutrients. Because I have a family history and personal tendency toward diabetes (and dealt with gestational diabetes), I specifically chose a prenatal that contains chromium. Research suggests that chromium can help lower fasting blood sugar and insulin levels.
#2 Magnesium
Magnesium - for everything! Magnesium has so many benefits…. But it’s especially good for mitochondrial energy, maintaining your calm, supporting healthy sleep, hormone support, and insulin signaling. I use Magnesium Buffered Chelate Glycinate by Designs for Health.
#3 Mushroom blend
I use a mushroom blend with reishi, cordyceps, and lions mane called Host Defense Stamets 7.
Mushrooms have so many benefits! Lion's mane helps with brain health, stress and anxiety, and diabetes prevention and management.
Cordyceps can help protect mitochondria and therefore have anti-aging benefits. And with how little sleep I’m getting, I definitely feel like I need the help! Contact me to learn more about mushrooms and breastfeeding.
#4 Adaptogens
Adaptogenic herbs (like goji berry, maca root, ginseng, and more) support adrenal health and mitochondrial function. With all the stress of a new baby and the limited sleep, adaptogens can be really useful. I use “The One” from Quicksilver Scientific.
#5 Flax seed meal
I have PCOS (Polycystic Ovarian Syndrome) and as a result my hormones need extra support to stay in balance. I personally tend toward estrogen dominance (not all women with PCOS do - so be sure to get your hormone levels tested with a practitioner!)
Flax seed meal has a “bad reputation” as an estrogenic food but the truth is that flax seed meal can help with estrogen detox, keeping the body’s hormone levels in better balance if you’re estrogen dominant like I am. I eat a couple tablespoons of ground flax daily.
#6 Probiotic & prebiotic
I rotate through 3 probiotics to keep my gut healthy: FloraMyces, Klaire Therbiotic, and MegaSporeBiotic.
I’m also taking a daily prebiotic. Prebiotics are indigestible fibers that act as food for the bacteria in the gut. I use MegaPreBiotic.
The probiotic and prebiotic are for my health - but also for baby girls’! Right now, my daughter’s microbiome is still “under construction”and is strongly influenced by who she has contact with - namely her dad and I. Moms transfer bacteria to baby through kissing, cuddling, and (most importantly) breastfeeding. That’s why gut health is even more of a priority right now than usual.
#7 Natural toothpaste & mouth rinse
Your oral microbiome seeds your gut microbiome, and with as much as my daughter open mouth kisses me and all the germs we pass back and forth, I’m doing everything I can to support a healthy microbiome body-wide. Research has shown that baby’s oral microbiome continues to develop up to 1 year.
I use PerioBiotic toothpaste from Designs for Health and Dentalicidin Mouth Rinse from BioBotanical Research.
Why I’m Passionate About Breastfeeding
I’m also taking supplements that have made breastfeeding easier and confer benefits to baby through breastmilk. I promise I’ll share all those with you - but first I want to cover why I’m so passionate about breastfeeding.
My intention is to breastfeed my daughter past one year - what’s called extended breastfeeding. That’s because there are so many benefits to breastfeeding:
- Breastfeeding prevents autoimmunity - research has shown being breastfed is associated with a lower incidence of diabetes, celiac disease, multiple sclerosis and asthma
- Breastfeeding builds a stronger immune system and may even help prevent development of disease later in life
- Breastfeeding boosts the brain - this study showed it improved cognitive development and this one showed those breastfed for 6+ months had better test results in school
And with my history of gestational diabetes and tendency toward high blood sugar, it was important to me that breastfeeding decreases the risk of diabetes in mom AND baby and especially helps prevent Type 2 diabetes for moms who had gestational diabetes.
That doesn’t cover even a fraction of all the health benefits of breastfeeding for mom and baby… not to mention the emotional and mental benefits.
While I understand that breastfeeding isn’t possible for all new moms, I highly recommend it… and if you’re struggling with low supply, keep reading for some of the solutions that made breastfeeding work for me.
Breastmilk Boosters
I struggled with low supply from day 1 (largely as a result of hormone disruption caused by my PCOS) - but luckily I found a few solutions that helped get my supply up to normal. If you’re a fellow PCOS sister, I hope you’ll consider these ideas.
#1 Myo-Inositol
Myo-inositol is a natural substance, found in plants and animals, which helps to regulate insulin in a similar way to metformin and may be useful for mothers with PCOS who are dealing with low supply.
It’s a major ingredient in breast milk and taking it supplementally can help boost breast milk production and increase baby’s brain health.
#2 Metformin
Metformin is a prescription drug that can help lower blood sugar to boost supply. It doesn’t work for all women - but if it helps you, it’s a powerful tool that’s safe for baby. Metformin is considered low-risk for baby.
The dosage starts at 500 mg, but talk to your doctor (you’ll need a prescription) to find what’s right for you.
For anyone nervous about using metformin: you should know this what what finally increased my supply to nearly normal levels!
I also take therapeutic levels of Fenugreek, Goat’s Rue, Moringa, and Shatavari-- all proven to improve milk production and flow safely. While different women will have different degrees of response to these herbs, they are generally safe to try. It can take up to 2 full weeks to notice a shift in supply or flow.
What I’m Taking For Baby’s Benefit
Nursing mamas aren’t just a milk machine... But everything you take in is transferred to your breast milk. And when that milk is baby’s only source of nutrition for 6 months, you want it to be as good as possible!
A healthy and diverse diet with more-than-enough calories is step one to make the best milk, but I also am using these supplements for “milk enhancement.”
#1 Lugol’s iodine
Pregnancy requires higher levels of iodine, and research has shown women who are iodine deficient in pregnancy and postpartum are more likely to have children with neurological and psychological deficits like attention deficit disorders and lower IQ.
Since I don’t eat iodized salt or iodine-rich foods regularly, I use 2 drops of 2% Lugol’s iodine solution daily.
#2 Calcium
Here’s a wild breastfeeding fact: if you’re not taking in sufficient dietary calcium while breastfeeding, your body will leech calcium from your bones to supply calcium in your breastmilk!
I don’t want to feed my baby my own bones - so I supplement with calcium to make sure I have adequate supply for both of us.
#3 DHA
The omega-3 fatty acid DHA is one of the most important nutrients for a healthy baby. It’s critical for healthy brain development plus vision and memory.
Lots of research has shown that supplementing with DHA can increase DHA levels in breastmilk and lead to better health outcomes for baby, so I use Nordic Natural Prenatal DHA.
#4 Coconut oil
Coconut oil is one of my favorite sources of healthy fat - and eating it regularly can increase lauric and caprylic acid content in breastmilk. Lauric and caprylic acid are powerful antimicrobials that can help strengthen your baby’s immune system and keep them healthy.
Studies have shown eating 3 tablespoons at a meal can significantly increase levels, so I aim for 3 tablespoons in my daily smoothie.
#5 Liver and organ powder
Liver and other organ meats are on the best sources of important nutrients like choline… but most of us are deficient! Choline is particularly important for healthy brain and memory development, so it’s important for breastfeeding moms to get enough.
I use a powdered form of organ meats made by Ancestral Supplements and try to eat 2 pasture-raised eggs (the yolks are a great source of choline!). Use code BRIEW10 at checkout for a 10% discount!
What To Give Baby
Right now, all baby girl gets is milk, milk, and more milk!
That’s all infants less than 6 months of age need - it’s the perfect food.
The only supplement I give to her is Klaire Therbiotic Infant 4 times a week to support her healthy microbiome development. I give this to her either on my nipple by dampening the skin with a little milk and then dabbing the powder on there, or, by mixing it in a bottle of milk, when she takes a bottle.
She’s getting her Vitamin D through my milk; you must take 5000 IU or more daily to accomplish this--test first to make sure that dose is safe for you.
That’s it!
Your Postpartum Recovery Strategy
As a hormone specialist, I’ve always loved working with moms in the postpartum period - but as a mom myself now, I have a profound respect for all my mom clients!
If you’re pregnant now, hope to be soon, or are in the postpartum period now, I’d love to support you in finding your own postpartum recovery strategy, tailored to your unique needs.
Book a free 15 minute consult with my team by clicking here. During the consult, we’ll talk about your experiences and needs and start on a strategy for long-term wellness, together.
To your health,
Brie
P.S. Are you interested in hearing more about my motherhood journey? Be sure to check out my Instagram where I share candid pics and commentary!
Everything You Need To Know About Candida Overgrowth (Part 3)
In Part 1 of this series, I covered what Candida is (and isn’t) and how it could be present in your body. In Part 2, I covered the symptoms and root causes. Today, we’re going to talk testing for and treatment of Candida.
So, you’ve read Parts 1 and 2 of this series. You understand what Candida overgrowth is, and (I hope!) you even understand HOW it can cause so many systemic symptoms.
And if you’ve made it here to Part 3, you probably suspect that chronic Candida overgrowth is something you could be dealing with.
Today, I want to share how I work with patients in my clinic who present with Candida symptoms. I hope this is helpful to you - and please don’t forget that I’m here for you! My passion in life is supporting women through health challenges like Candida overgrowth so they can overcome them and get on with the stuff that really matters in life!
If you want to learn more, book a free 15 minute consult with my team by clicking here.
Testing For Candida Overgrowth
“Don’t guess, test” is one of my mantras for life.
There are some instances where guessing is perfectly fine - but when it comes to something as vital as your health, why mess around??
Testing is more accurate and affordable than ever before. It ensures we know exactly what we’re dealing with - and aren’t wasting time, money, and energy on the wrong treatments.
With a condition as diverse as Candida overgrowth, testing is especially important. The same symptoms could be caused by hormone imbalances, gut dysbiosis, HPA axis issue, SIBO and more… so bottom line: don’t guess, test!
In my clinic I use a few different tests (depending on the patient).
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- Stool Tests - not all stool tests can pick up Candida, but advanced ones like the GI-Maps and Genova GI-Effects can. I like to order a comprehensive stool test on all my patients because it can reveal a ton about your overall health - not just candida!
- Organic Acids Panel - This test (I like the Organix test from Genova) looks for D-arabinitol, a specific marker for invasive candidiasis. Some other organic acids panels look for arabinose as a marker instead, but I don’t like those, as they can easily give false positives based on what you’re eating. Organic acids tests are another of my favorite tests because of the breadth of information they can provide (and they’re totally non-invasive!)
- Blood testing - antibodies in your blood can show past or current level of candida overgrowth… but can’t tell you which. (I rarely use blood testing).
- Culture sample - you can take scrapings from the vaginal mucosa, vulva, oral cavity, etc and culture it to identify candida. (Again, I don’t usually use this testing myself).
And this is important - be sure you test BEFORE you complete any treatment for candida. If you’ve recently treated candida, your test will probably come back negative - but that doesn’t mean you don’t have any remaining yeast - especially if it is invasive.
Before You Go Any Further...
When you have Candida overgrowth, your white blood cells produce antibodies to fight the candida called IgE immunoglobulins, which also cause allergic reactions.
More IgE is made every time you have another yeast infection flare. When the IgE reacts against the Candida, it causes the release of histamine. Histamine makes your blood vessels dilate and can cause swelling, redness, itching, and burning (in super fun places like the vagina, sinus, and gut).
When you treat the candida, killing it causes the yeast to release antigens, causing an increase in IgE… which means more histamine symptoms (itching, burning, redness).
Basically - all of this was to say: you’re very likely to experience die-off symptoms when you treat candida!
The bummer is that this WHOLE process weakens your immunity. The increased levels of histamine suppress your white blood cell mediated immunity and inhibit the production of T cells.
This means that supporting your immune system during Candida treatment is absolutely necessary! You must protect and support immunity ON TOP of changing your diet, using antifungals, and doing leaky gut repair.
Don’t forget your immune system in this process!
How I Treat Candida Overgrowth
Step #1: Clean Up Your Microbiome
Before you treat Candida, you need to clean up other gut infections. A stool test can identify which bacteria overgrowths or parasites you’re dealing with. If you don’t get a handle on this first, your Candida treatment won’t be effective!
Probiotics and prebiotics can also help. Lactobacilli bacteria can inhibit the growth of candida albicans (I like the Femecology formula by Vitanica). Both oral supplementation and vaginal use can help.
Step #2: Adapt Your Diet
Most people don’t need to go on a super-restrictive, very low-sugar diet - but most people do need to make SOME changes.
A yeast-free, carbohydrate restricted diet alone won’t cure candida overgrowth. In a study of those with chronic candida, diet and anti-fungals was shown to be the most effective treatment (compared to diet and antibiotics, or diet alone). In fact, antibiotics and diet combined had the WORST outcomes!
For my patients, I recommend:
- 80 grams or less of carbohydrates daily (avoiding refined and processed carbs entirely)
- Avoid dairy (except ghee, butter, and some cheeses)
- Avoid yeast in foods (like kombucha, alcohol, and apple cider vinegar)
- Avoid all refined sugar
- Avoid alcohol
Step #3: Antifungals
To get rid of Candida overgrowth, you must use an antifungal that can kill the yeast overgrowth.
In certain cases, I have seen clients gain greater success by combining natural antifungals with prescription antifungals like Nystatin or Difllucan, for limited periods through the extended herbal treatment period. Nystatin is not absorbed outside of the gut (it is local, not systemic), so it’s a good choice. Most systemic antifungals (like Diflucan) can cause elevations in liver enzymes. If you’re using a systemic antifungal, you need to have liver testing before starting and every 2 weeks of treatment.
But there’s also plenty of evidence that Candida is becoming resistant to antifungal drugs - just like bacteria are becoming resistant to antibiotics. Yikes!
That’s why, I always use a well rounded botanical protocol alongside prescription antifungals to help prevent resistance.
The 2 keys to remember when using natural products like garlic, caprylic acid, undecylenic acid, lauric acid from coconut, lactoferrin, propolis, specific enzymes, and essential oils like oregano and cinnamon:
- Treat long enough! 7-10 days of treatment is not enough. It might clear some symptoms - but you need at least 8 weeks of treatment (sometimes more) to truly clear Candida overgrowth.
- Use the right dosage! If you take natural products in the wrong amounts, you won’t only not get better - but you risk damaging your microbiome. Don’t mistakenly believe they are safe at any dose because they are natural--I’m looking at you, oregano! I highly recommend working with a professional (like me) to get the right doses.
Step #4: Hyphae Interrupters
Remember the “roots” Candida can grow called hyphae? A good Candida protocol should also include something to help hyphae release from the gut wall.
In my practice, I like to use undecylenic acid. It’s a fatty acid obtained from castor bean, and it helps disembed hyphae from the intestinal wall.
Treating Tough Cases
Truthfully, I think every case of Candida is a “tough case.” Most of my patients need the specialized support I can provide after working with Candida overgrowth for years to get better.
For those with repeat vaginal Candida, monthly mid-cycle treatment can help (alongside systemic treatment). We use vaginal treatments for 3 days, and often for 3 more days prior to the start of your period, for 3-9 months to help stop the yeast cycle.
And for those with a history of Candida, we take preventative measures if they have to use antibiotics, corticosteroids, PPIs, or are following an elemental diet (as a treatment for SIBO). Preventative antifungals can help keep Candida at bay!
Need Help With Candida?
We’ve covered a LOT in these 3 articles (make sure you read parts 1 and 2 as well!) and I know you might be feeling overwhelmed.
Are you uncertain if Candida overgrowth could be an issue for you? Not sure what the next step should be? I get it!
My job as a clinician is to take all this complicated stuff and make it easy for you to get better. No more confusion, just results.
I’d love to work with you. Don’t be shy - book a free 15-minute consult with my team. It’s a no-obligation way to see if we can help you. I hope to chat with you soon!
Everything You Need To Know About Candida Overgrowth (Part 2)
In Part 1 of this series, I covered what Candida is (and isn’t) and how it could be present in your body. In Part 2, we’re going to cover the symptoms and root causes. Be sure to look for Part 3 (all about how I treat Candida in my practice!).
Sugar cravings, brain fog, joint pain, fatigue… these are just some of the nonspecific symptoms often attributed to chronic Candida overgrowth.
But the problem is these same, ambiguous symptoms can be caused by multiple conditions! So how do you know if a Candida diagnosis is really something you should pursue?
Today, I’m going to dig into the symptoms that send up red flags for Candida in my practice - and I promise, it’s a lot more than “exhausted mom craves dark chocolate before bed!”
I’m also going to talk about the risk factors and root causes that make a Candida overgrowth more likely.
Here, There, Everywhere: Candida Symptoms
The most striking characteristic of Candida is its complexity. While no two people with chronic Candida may have the *exact same* symptoms, they will all have a variety of seemingly unrelated symptoms - ranging from “annoying” to “life-altering.”
Here are just some of the places you might have Candida-related symptoms:
- Central nervous system,
- Gastrointestinal tract (digestive)
- Genitourinary tract
- Endocrine glands
- Skin
- Muscles and joints
- Respiratory system
How could one condition cause so many different symptoms?
How Candida Can Mess With Your Whole Body
This gets kind of complicated, so I’m going to try and make it as simple as possible to understand.
Candida can produce acetaldehyde and ethanol (AKA the same compound we drink in alcohol!) when the yeast in the gut ferment sugar and carbs. In fact, Candida can produce so much ethanol, it can cause your blood alcohol level to rise and make you drunk. (This phenomenon is called Auto-Brewery Syndrome).
Then, when the ethanol or acetaldehyde is oxidized, it requires that Nicotinamide adenine dinucleotide (NAD) be changed from its oxidized form (NAD+) to its reduced form (NADH). It’s basically like drinking a 6-pack daily - but without the fun part!
(You may have heard about NAD as an anti-aging supplement. NAD is a really important cofactor and levels reduce over time, as we age. Some promising research suggests that raising NAD levels can reverse mitochondrial damage - aka the effects of aging!)
OK, here’s what all this means: chronic Candida causes the production of a bunch of alcohol inside your body. To get rid of the alcohol, NAD+ is converted to NADH. Over time, this leads to lower levels of NAD+ in the body - and that can lead to a cascade of symptoms.
Low NAD+ levels are linked to chronic illnesses like diabetes, heart disease, Alzheimer’s vision loss, and premature aging. Higher levels of NADH can lead to less mitochondrial energy production, lower levels of serotonin, and problems metabolizing proteins, fats, and carbs.
But that’s not all...
Acetaldehyde produced by Candida can also impact the membranes inside your body. Membranes are the outer layers of cells and act as “gatekeepers” of your cells - keeping bad stuff out, letting good stuff in, and transmitting messages.
When this happens to the cells in your gut, you develop “leaky gut” - aka increased intestinal permeability. Leaky gut causes by Candida can further complicate the symptoms caused by Candida.
If You Have Candida, You Might Also Have…
Here are some of the most common symptoms of Candida I see in my clinic:
- Sugar cravings - yes, this one is “overplayed” but real! Candida will send signals along the gut-brain axis to make you crave more sugar.
- Allergies - Candida releases chemical mediators like histamine, leukotrienes, and prostaglandins that all lower your body’s white blood cells’ effectiveness. You might have rhinitis, chronic hives (urticaria), or asthma. Candida can also cause chronic stuffiness.
- Inflammatory Bowel Disease - individuals with high Candida burdens appear to be more prone to intestinal inflammatory diseases.
- Carpal Tunnel Syndrome - this occurs as an effect of acetaldehyde.
- Formaldehyde Sensitivity - formaldehyde is processed through the same detox pathways as acetaldehyde, and with that system overburdened, you may have trouble detoxing formaldehyde.
- Histamine sensitivity and intolerance - again, histamines are processed through same detox pathways as acetaldehyde. This can lead to food intolerances, rashes, and hives.
- Central Nervous System Symptoms - especially common is trouble with short-term memory, a result of acetaldehyde lowering the availability of acetylcholine (an important neurotransmitter)
- Rashes - dermatitis, psoriasis, eczema, hives, jock itch, diaper rash are all common symptoms. Especially on nails, in skin folds, and in the area of the groin or genitals.
Root Causes & Risk Factors for Candida
There’s no way I could cover every potential symptom of Candida, but if you read anything on the above list that was a little too familiar, keep on reading.
Now it’s time to talk about the most common risk factors and underlying causes for Candida overgrowth.
This is a BIG list, but I’m taking the time to write them all out because most people have multiple predisposing factors - and for each one you have, the likelihood of Candida becoming a problem for you increases.
Risk factors are cumulative. That means, the more times you take antibiotics (for example), the more the ratio between opportunistic yeast and good bacteria shifts. Eventually, Candida levels will rise above a threshold and symptoms develop.
#1: Antibiotics or Steroid Use
The number one cause of Candida overgrowth is prolonged use of antibiotics (especially broad spectrum). The worst offenders are penicillin, clindamycin, vancomycin, metronidazole, Cipro, keflex, zithromax, augmentin, bactrim and erythromycin.
These drugs kill both aerobic bacteria and anaerobic bacteria. Anaerobes help prevent yeast colonization by inhibiting the ability of Candida to adhere to the gut wall. They can also lead to decreased digestive secretions and altered pH.
Corticosteroids work by suppressing the immune system, so it’s understandable why can predispose to yeast!
#2: Hormone Changes
Any change in hormone levels put you an increased risk for Candida overgrowth:
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- Oral contraceptive use has been shown to increase Candida in the oral microbiome , which leads to the gut (in fact, studies show that just brushing teeth 3 x daily reduced levels of Candida in the stool!)
- Estrogen replacement therapy (for any reason)
- Pregnancy not only causes increased levels of estrogen - but also causes natural immunosuppression and increased cortisol levels to keep the mother’s immune system from attacking the fetus. This creates an ideal environment for Candida to take hold!
#3: Diet
Candida thrives on a diet rich in glucose - the simple sugar found in foods like bread, pasta, and refined sugar. Dietary glucose is necessary to start the process of candida invading tissues.
But please know: this doesn’t mean the answer to Candida is simply a zero-sugar diet! More on this in Part 3!
Diabetes and high blood sugar also put you at increased risk for Candida overgrowth.
Finally, alcoholism - or even just frequent alcohol use - increases risk of Candida. Beer, wine, and other fermented alcohols promote Candida colonization, and all alcohol inflames the gut lining, making you more prone to inflammation, dysbiosis, and leaky gut.
In those already genetically prone to alcoholism, research has suggested that Candida overgrowth (and the Auto-Brewery syndrome it can cause) can even lead to a Candida-perpetuated form of alcoholism. (Other research has also established the connection between intestinal fungal overgrowth and alcoholic liver disease.)
#4: Nutrient Deficiency
Nutrient deficiency goes hand-in-hand with some of the other risk factors listed here. Low stomach acid (which can be caused by antibiotic use, stress, antacids, or PPI drugs) can cause incomplete digestion of the food you eat.
Poor diet (like too much sugar or refined carbs, and not enough fruits and veggies) can lead to nutrient deficiency, too.
Iron, zinc, and biotin deficiency are all risk factors. Both too much and too little iron (anemia) can predispose you to Candida. Iron stimulates yeast overgrowth, but low iron can interfere with the white blood cell’s ability to function and fight infection.
#5: Environmental Factors
Pesticides like glyphosate have been shown to disrupt the microbiome, reducing beneficial bacteria that help to protect you from Candida overgrowth.
High levels of stress dysregulate the HPA Axis, and can cause abnormally low or high cortisol levels. We know stress is associated with an increased risk of vaginal Candida - and I suspect if we studied it, we’d find it also tracks with gut Candida.
#6: Gut Health
If you already have altered bowel flora - aka dysbiosis - you’re at increased risk for Candida.
Overgrowths of H. pylori and Streptococcus facilitate Candida overgrowth.
This is why it’s so important to treat those other bacterial overgrowths and gut dysbiosis alongside Candida. If you’re trying to clear Candida without addressing overall gut health, it’s like chasing your own tail! (More to come on this topic in Part 3).
#7: Impaired Immunity or Underlying Disease States
If you have Candida, overgrowth, it’s a major sign your immunity is decreased. Likewise, if you have known decreased immunity, you’re at increased risk of Candida.
Conditions like thyroid dysfunction and diabetes can also predispose you to Candida overgrowth.
Start Counting…
Most people have multiple risk factors and symptoms for Candida overgrowth. If you count up all your symptoms and potential risk factors, what number do you come up with?
If you have more than one or two, be sure you read Part 3 of this series, where we’re going to discuss how you can find out if you actually have Candida overgrowth - and if you do, what to do about it!
I’ll share the tests and protocols I use with patients in my own practice - so don’t miss Part 3!
Everything You Need To Know About Candida Overgrowth (Part 1)
Depending on who you ask, Candida overgrowth is either entirely made up or the root of all disease.
Some experts claim as much as 90% of people have chronic candida overgrowth and it causes a gamut of health issues from weight gain to cancer. Others say it’s only an issue in acute cases like oral thrush or vaginal yeast infections (which can be easily treated and eradicated).
So what’s the truth?
As with most things, the truth is somewhere in the middle. Chronic candida is a research-backed condition, but that doesn’t mean everything you’ve heard about it is true.
As a functional medicine practitioner, I’m interested equally in what the research has shown and what my patients are experiencing. In this series, I’m going to share everything I know—both from research and anecdotal experience—about candida overgrowth with you.
This will be a multi-part blog post. Today, we’re going to focus on what Candida is (and isn’t) and how it presents.
Part 1: What The Heck Is Candida?
First of all, you need to know that 99% percent of the time, when you hear “Candida,” it refers to Candida albicans.
Other species do exist (C. glabrata, C. krusei, C. tropicalis and C. parapsilosis for example) but C. albicans is the most common. For the rest of this post, know that I’m talking about C. albicans when I say “Candida.”
OK—moving on.
Candida is normally a commensal fungus that lives in your oral, gastrointestinal, and genital tracts and is part of the “world of microorganisms” that live inside your body and make up the microbiome.
“Commensal” means that Candida gets nutrients from you without causing any harm. Your body recognizes the Candida as a “friendly” fungus and doesn’t mount an immune response against it.
As a commensal fungus, Candida is very common: approximately 80% of healthy people have commensal Candida living in their mouths, guts, and vaginas. In fact, it’s completely normal for Candida colonization of the vagina to increase in puberty as hormonal shifts make the vagina even more hospitable to fungal growth.
The main point is: Candida isn’t all bad! For most people, it’s just part of a healthy microbiome.
But that can change when Candida shifts from “commensal” to “pathogenic.”
Here’s What Happens When Candida Breaks Bad
Under specific conditions, Candida can shift from it’s normal commensal state to a pathogenic state, overgrow, and cause symptoms.
This happens in two ways:
#1 Candida Changes Form
Under certain circumstances (like a change in temperature or acidity) Candida can go through a process called “morphogenesis” and change form from one your body recognizes as friendly to one it sees as an enemy. The result is an immune response from your body toward the new form of candida. This is also when candida can grow “roots” - aka hyphae - and start burrowing into intracellular space.
#2 Your Body Starts Reacting To Candida
The Candida doesn’t always have to change form for a response to happen. In vulvovaginal candidiasis (vaginal yeast infection), the Candida that’s normally present in the vagina doesn’t necessarily change form (although that can also happen) - but the tissue of the vagina creates an immune response against the Candida.
This means that the symptoms are caused both by Candida changing form AND your body changing how it reacts to the Candida.
Acute vs. Chronic Candida Overgrowth
Acute Candida overgrowth is called candidiasis. This is the typical vaginal yeast infection or oral thrush, but can also cause infections in the esophagus and intestines.
The acute form results in an overgrowth of yeast on mucosal surfaces (like your mouth and vagina), but that’s not all. During active infection, Candida can grow hyphae, which are like roots that can burrow into intracellular spaces. With hyphae, Candida can invade deeper tissues and grow inside the epithelial cells. There, they release products of fermentation and enzymes that kill the tissue cells. The result are the white patches that characterize candidiasis (the white is actually dead cells, not clumps of Candida colonies!).
Acute candidiasis is often treated with a short course of antifungal drugs or herbals. But if the treatment is incomplete, the yeast in the epithelial cells won’t be totally eradicated… leading to chronic Candida overgrowth symptoms.
In the chronic form, the Candida is inside the epithelial cells, instead of just on the surface of the cells. The yeast is “dormant” but still releasing antigens that trigger inflammation, and can result in red and inflamed tissues.
The low-grade inflammation caused by chronic Candida can cause pain, tenderness, burning, and more. This is especially common with vaginal yeast infections.
A Closer Look At Vaginal Yeast Infections
About 75% of women will be diagnosed with a vaginal yeast infection at least once in their lives, and Candida is the cause of about 40% of all vaginitis cases. A vaginal yeast infection is probably the most common type of acute Candida overgrowth or candidiasis.
They’re most common in women of reproductive age because they have higher estrogen levels - and estrogen promotes yeast in the vaginal tissues. (Side note: this is also why oral contraceptives increase your risk of yeast infections—they contain synthetic estrogen. More on this to come!)
The symptoms are all too familiar to most women: Itching, redness, burning, white discharge, painful intercourse, yeasty odor, and painful intercourse from tissue irritation. It can also lead to vaginitis and urinary tract infections (UTIs).
The worst part, however, is that yeast infections can become a vicious cycle for women, as the antibiotics used to treat UTIs and vaginitis make women MORE susceptible to yeast infections recurring.
We know that repeat infections can lead to vulvodynia (vaginal pain and tissue irritation) that makes sex painful and everyday activities (like wearing yoga pants and using tampons) uncomfortable. The vulvodynia may very well be caused by the low-grade inflammation of chronic Candida leading to irritated vaginal tissue cells.
But complications from vaginal yeast infections are just one way candida overgrowth can impact your life.
In Part 2 of this series, I’m going to dig into the symptoms chronic candida can cause—and I’m going wayyy beyond just “sugar cravings!” You’ll also learn what the risk factors and predisposing conditions for Candida are.
Recap: Candida Overgrowth
Because this is an intense topic, I want to give a really quick recap before we wrap up this first part of the series.
Here are the main points:
- “Candida” usually refers to Candida albicans
- Candida is a normal, healthy yeast (type of fungus) that lives in about 80% of peoples’ microbiomes
- In certain circumstances, candida can overgrow and change form, causing two types of Candida overgrowth problems:
- #1 Acute Candida Infections - like vaginal yeast infections and oral thrush
- #2 Chronic Candida Overgrowth - low-level, long-lasting candida overgrowth, often a result of incomplete treatment of an acute infection
OK—that’s all for now! I’ll see you back here for Part 2, where we’ll go over the symptoms and root causes of Candida overgrowth in-depth!
My Not-So-Glowing Pregnancy Truth: How I Wound Up With Gestational Diabetes (And What I’m Doing About It)
I’ve been really lucky to enjoy every moment of my pregnancy so far. I feel good. I’ll even say I’m “glowing”! I’m so excited to become a mom and really enjoying the journey.
But my pregnancy joy hit a bump in the road after my 26-week appointment.
If you’re a mama-to-be or already have kiddos, you know what happens at the 26-week appointment: testing for gestational diabetes.
My OB and I decided that instead of traditional testing (more on that later) I could test my blood sugar at home.
I’ve never had fasting glucose above 90, so gestational diabetes wasn’t even on my radar. I was stunned when my fasting glucose was 114!
After testing my blood sugar a couple more times, I called my OB. She confirmed what I already knew: I met the clinical requirements for a gestational diabetes diagnosis!
So much for “glowing”...
But, I believe EVERYTHING happens for a reason…
Why I’m Grateful I Have Gestational Diabetes
I know it sounds a little out there… but at then end of the day I’m actually grateful for this diagnosis.
I hope I can remove some of the stigma around gestational diabetes.
A GD diagnosis doesn’t mean you’re doing anything wrong. You can still have a happy, healthy pregnancy.
But I also think it’s high time we take a hard look at the usual suggestions for moms with GD. As I’ll share in this post, what most doctors recommend isn’t the only option.
I’m going to share:
- What gestational diabetes is
- Testing for GD (and the alternative to traditional testing)
- Who gets gestational diabetes and why (you’ll be surprised by this one)
- What you can do to manage it (and exactly what I’m doing)
What Is Gestational Diabetes?
Gestational diabetes is basically just high blood sugar that develops (or is first noticed) during pregnancy.
Even women who have 100% normal blood glucose readings before pregnancy can develop gestational diabetes.
Why?
During pregnancy, the placenta, which connects your baby to your blood supply for nutrients and clearing waste, produces high levels of various other hormones. Almost all of these hormones impair the action of insulin in your cells, raising your blood sugar.
Modest elevation of blood sugar after meals is normal during pregnancy. The bigger your baby grows, the more of these insulin-blocking hormones your placenta produces - which is why gestational diabetes is more likely to present in 2nd and 3rd trimester.
Gestational diabetes is diagnosed when fasting glucose is above 100 - but it’s ideal to have it stay at 90 or below. Post-prandial (after meals) glucose above 130 at any time also suggests GD.
Sometime gestational diabetes is called “carbohydrate intolerance” because it’s high levels of carbohydrates that trigger the high blood sugar.
Why Gestational Diabetes Is A Problem
While slightly elevated blood sugar is a normal thing in pregnancy, gestational diabetes is NOT something you should ignore.
If it’s not addressed GD can cause serious issues for mom and baby:
- Baby can grow too large (think 9 pounds and up)
- Increased risk of preterm birth
- Increased risk of respiratory distress syndrome for baby
- Increased risk of preeclampsia for mom (high blood pressure)
- Increased risk of Type 2 Diabetes down the road for mom AND baby
All of these risks can be mitigated if gestational diabetes is discovered and managed - that’s why all women should be screened for gestational diabetes.
Most cases of gestational diabetes can be managed with diet and exercise alone - but some women do need insulin, as well.
How Do I Know If I Have Gestational Diabetes?
EVERY woman should be screened for gestational diabetes. But we don’t all have to be tested the same way.
The most common test for gestational diabetes is called 3-hour glucose tolerance testing. It works like this: you go to the doctor fasting and have your blood sugar tested. Next, you drink a solution that contains 75 grams of fructose. Then, you’ll have your blood sugar tested every hour for 3 hours after.
My main issue with 3-hour glucose tolerance testing (besides drinking that nasty solution) is this: Who actually consumes 75 grams of sugar in one sitting?
I certainly don’t!
Unless you’re guzzling soda or supersized slushies, you’re probably not taking in this much sugar at once, either. It’s the equivalent of 2 large pancakes with syrup - but even if you DID eat the pancakes, you’d have the fat, fiber, and protein in the rest of the meal slowing your absorption of the sugar into your bloodstream.
Because I don’t eat much refined sugar, I didn’t think this type of testing was ideal for me. I asked my OB if I could test my own blood sugar (fasting and post-meal) at home with my glucometer instead and she agreed.
(Side note: my OB is awesome. Every woman deserves a pregnancy care team they trust. Don’t be afraid to try out a couple different doctors until you find a team that listens, makes you feel heard and understand, and is responsive to YOUR wants. That doesn’t mean they’ll always say yes to what you want - but they should be willing to consider your requests.)
My Test Results
The next day I ran my fasting glucose…..yikes…106?
Pre-pregnancy, I’d never had fasting blood sugar above 90!
Post-meal, I tested at 127 - then later it rose to 141. I knew that wasn’t good.
The next day, my fasting was 114.
(Remember - GD is diagnosed when fasting glucose is above 100 and post-meal rises above 130).
The results were a shock to me - especially because I’d been following a lower-carb, Paleo/keto style diet. In pregnancy, I’d increased my carbs a little - think a gluten free waffle with almond butter, a teaspoon of honey in my tea, or a slice of gluten free bread once a day.
Pregnancy cravings are real - but it’s not like I was eating pints of ice cream or loaves of bread. How could I have gestational diabetes?
Risk Factors For Gestational Diabetes
Once I took a deep breath, I reminded myself of what I already knew:
Even women with totally normal fasting glucose and good general glucose control can wind up with gestational diabetes in pregnancy.
It wasn’t my diet, but my genetics that put me at increased risk for GD:
#1 I have Polycystic Ovarian Syndrome (PCOS) —this leaves me already more prone to insulin resistance
#2 I have a family history of Type 2 Diabetes - and my mom had gestational diabetes in her pregnancy
#3 I’m non-white. Scientists aren’t sure why, but non-white people have an increased risk of gestational diabetes
Being overweight is also a risk factor for gestational diabetes, but not one that I have personally.
Once I accepted that I had GD, I shifted to action mode: how was I going to manage this so I didn’t need insulin injections?
The Normal Treatment For Gestational Diabetes
The standard recommendations for managing GD is a diet high in complex carbs - about 175 grams per day.
Suggested sources of complex carbs are bananas, whole grains, fruit, rice, and oats.
You’ll also need to monitor your blood sugar 4-7 times per day with a glucometer at home.
Many women are even required to meet with a dietitian to help implement these changes (my insurance required this).
If these diet changes can’t manage your blood sugar, the next step is insulin injections.
As a functional medicine practitioner, these recommendations didn’t jibe with me.
What made more sense to me: a modified keto diet and closely monitoring my blood sugar (plus getting gentle exercise - like walking - every day).
My OB agreed that as long as I could keep my fasting glucose under 100 (preferably under 90) and my post-meal under 120, I could do what worked for me.
An Alternative Way To Manage Gestational Diabetes
A modified keto diet (aka low carb) makes sense for managing gestational diabetes because it is carbohydrates that cause the rise in blood sugar.
Eat less carbs and your blood sugar won’t rise as high. It’s pretty simple (and intuitive).
While I’d like to take credit for the idea of using a modified keto diet to manage gestational diabetes, it was actually Dr. Lois Jovanic. Dr. Jovanic is one the the foremost experts on diabetes in pregnancy and previous director and chief scientific officer of the Sansum Diabetes Research Center.
Here’s what she has to say about the standard recommendations:
“Honestly, 175 g of carbohydrate is stupid! Women should be going as low as it takes to keep their blood sugar regularly under 90 mg/dl (5 mmol/L). Women ask me, ‘Do I have to eat carbohydrates?’ and I say, ‘No you do not!’ If you do eat carbohydrates [with GD], you will have to have insulin. It is that simple.”
Nutritional ketosis is actually a natural state for pregnant women: pregnant women have higher circulating blood ketones than non-pregnant women.
So why is the standard recommendation to eat 175 grams of carbs per day?
It’s because of a misguided fear of diabetic ketoacidosis in pregnant women. One sign of diabetic ketoacidosis is high levels of ketones in the urine - but that doesn’t mean that ketosis and ketoacidosis are the same thing.
Some experts even suggest that having circulating ketone is not only normal and safe, but supportive to optimal fetal neurologic and brain development.
What To Eat When You Have Gestational Diabetes
No matter what diet you’re eating, the MOST important thing is to regularly test your blood sugar levels to ensure they stay in the normal ranges. Both too high and too low are dangerous for growing baby - so test regularly.
Testing 4 -7 times a day is a good place to start. Test when you wake up (fasting) and then after each meal. If you blood sugar rises too high after a meal, that’s a sign you ate too many carbohydrates at that meal.
Secondly, it’s important to eat adequate calories and to not go long periods of time between meals. If you’re not eating enough or going too long between meals, you’re more likely to have problems managing your glucose levels.
Dr. Jovanic also recommend avoiding what she calls “naked carbs” or eating carbohydrate-rich foods all by themselves. Instead, pair carbs with fat and protein to slow absorption. (I.e. a handful of crackers by itself vs. crackers with nut butter).
Getting exercise every day also helps manage blood sugar levels.
What I’m Eating Now
Here’s a peek into what a day of eating looks like for me:
Breakfast: 2 eggs with a sprinkle of shredded pasture raised cheese, cooked in pasture raised butter. Topped with a small avocado and a handful of sliced cherry tomatoes. Rasa herbal Koffee with a splash of grass-fed whole cream and a scoop of collagen.
Lunch: steamed veggies (broccoli, cauliflower, zucchini) with tahini sauce and poached salmon.
Snack: chicken liver pate on celery sticks
Dinner: Homemade Tom Kha soup with veggies, chicken, coconut milk, lime juice, coconut aminos, fish sauce, and green curry paste –yum!!
One last important change I made: adding in late night protein, right before bed.
When I first switched to low carb meals, my post-meal glucose dropped right into line. But my fasting glucose in the morning was still too high. Why? It was because of something called the “Dawn Phenomenon.”
The Dawn Phenomenon occurs when your fast overnight (for me, it was 12+ hours between my dinner and breakfast). The extended fast would kick my body into gluconeogenesis, causing my morning fasting glucose to spike (usually between 99 and 106).
Increasing my evening protein (instead of half a chicken breast, I’d eat a whole one) and adding a tablespoon of psyllium husk to help slow glycemic uptake both did the trick: as soon as I made those changes, my fasting glucose dropped below 90 and stayed there.
My Gestational Diabetes Journey (And My Goal In Sharing This)
For now, eating a modified keto diet, exercising, and testing my glucose levels 4-7x times a day is working to manage my gestational diabetes.
My OB and I are both verrrry happy with my results and that I don’t need to use insulin shots. (And I’m sure baby boy is too!)
As my pregnancy progresses, I might need to switch things up: adding a bit more carbs in or dropping my levels down. Regular glucose testing will help me know what to do.
My goal in sharing this information is to help remove the stigma around gestational diabetes and bring light to an alternative way of managing GD that might work better for you.
But keep baby’s safety first in mind: if you have GD, you should talk with your doctor before making any changes to your treatment plan.
Have a doc who’s unwilling to even consider an alternative to the standard recommendations? It might be time to find a doctor who is willing to work with you.
Hang in there, mama! I know how scary a gestational diabetes diagnosis can be - but I also know you can manage it and keep on glowing.
If this resonates with you, I’d be honored to have you book a 20-minute consult with my team. These consults are totally free and a chance for us to share how we are trained to help you!
→ Learn more and book a free consult with my team here.
How To Treat Depression & Anxiety Holistically - Part Two
In Part One of this series, I delved into the fact that depression and anxiety are not problems of JUST the brain or JUST the body. There is a definite mind-body connection, and the best treatments (and prevention) for depression and anxiety treat both. I also started going into the root causes – everything from childhood trauma to candida – and the solutions that might be able to help you. If you haven't read Part One yet, click here to go back and check it out!
Lots of people think “holistic” = “natural” or “alternative.”
But that’s not actually what holistic means!
A “holistic” approach looks at a person as a whole. Rather than seeing each part of the person - say their digestive system, or hormones, or mental health - as separate entities, holistic medicine views them all as interconnected.
(Sometimes, that does mean we use natural and alternative approaches to healing.)
But it always means that we’re looking at YOU as a whole person and not just a set of symptoms or a diagnosis.
I think that’s so important to make clear as I dive into the 2nd part of my series on treating depression and anxiety holistically.
Today, I’m going to explore how environmental exposure to toxins and hormone imbalances can play a role in depression and anxiety. It might seem crazy to think your detox pathways or PCOS could be related to depression or anxiety - but they can! Today I’ll explain exactly how and what you can do about it.
If you haven’t read Part 1 of my series, go HERE and read it first! Then come back and dig into Part 2!
What Toxins Are (And Aren’t)
Toxins is one of those words that gets thrown around a lot. But what does it really mean?
A toxin is any chemical or compound that has noxious or harmful effects on living organisms.
Toxins can come from outside us (our environment) but they can also be generated internally. For example, our hormones can become toxins if they stick around too long. They must all be “detoxified” - broken down and cleared from the body in order to make room for new fresh hormones to be produced. We also produce toxins in the gut.
But, the major source of toxins is the outside environment.
We have THOUSANDS of toxin exposures every single day. Here are just some of the most common ones:
- Smog in the air we breathe
- Touching receipts coated with chemicals
- Pesticide residue on food
- Prescription medicine contamination in drinking water
- Hair & beauty products made with dangerous chemicals
The EPA estimates that in 2014, 4 billion pounds of toxic chemical waste was released into the air, water or placed in some type of land disposal in the U.S.
(And they consider this an IMPROVEMENT over the 4.7 billion pounds released in 2002!)
It’s likely that at least 25% of the United States population is dealing with heavy metal poisoning, too.
And while our body is equipped to deal with toxins (that’s what our liver is for!) the amount of toxic exposure humans have today is overwhelming. That’s why so many people's detox systems are overburdened. We can’t detox at a rate fast enough to keep up with all the toxins coming in!
This leads to fatigue, allergies, skin reactions, accelerated aging, autoimmunity, brain fog, yeast and bacterial overgrowths, and… increased depression and anxiety.
How Toxins Mess With Our Brains
The brain is a powerful and vulnerable organ.
The brain is made of nearly 60% fat. And that’s a problem - because many chemicals and toxins are fat soluble (including the nefarious heavy metals!).
The brain is so susceptible to toxin damage that there’s a specific name for toxins that negatively impact the brain neurons’ function: neurotoxins.
Neurotoxin exposure is a direct cause of depression and anxiety because they cause neurotransmitter dysfunction and inflame the brain.
This creates problems with brain signaling.
Neurons work by secreting specific brain chemicals (primarily serotonin and dopamine) out of the end of one neuron (called vesicle) into the space between the neurons (called the synapse).
Ideally, these chemicals are taken up by the receptor sites on the next neuron meant to receive the message. When that happens, a response signal is stimulated, and it continues on down the line to next neuron. If too much of any one brain chemical is released, it should be reabsorbed into the storage vesicles. This is called reuptake.
It’s sort of like your neurons are all playing a game of telephone.
But when toxins get in the way, the game gets messed up. The next neuron can’t hear the message clearly and passes it on wrong - or maybe not at all.
The toxins (and the inflammation caused by them) block the receptor sites on the neurons from taking up the chemicals - aka “hearing the message.” Your neurons don’t get the signal.
And that means you don’t feel the effects of serotonin or dopamine, because they aren’t able to do their job.
Then, the serotonin and dopamine that should have been taken up start building up in the synapse.
Your body goes into action: it knows it can’t let too much of these chemicals accumulate. It starts creating enzymes to break down the serotonin and dopamine that are stuck in synapse.
The end result? Your reserves of serotonin and dopamine are lowered.
Depression and anxiety are both a result of the receptor sites in your brain being “shut down” and the lowered serotonin and dopamine this ultimately causes.
Signs Your Detox System is Overburdened and Needs Help
If you’re dealing with symptoms of depression or anxiety, it’s a sign your detox systems could be overburdened - along with these other signs:
- Memory, concentration, and focus problems
- ADD or ADHD
- Skin problems (acne, eczema, psoriasis, hives, rashes)
- Fatigue
- Overeating & food cravings
- Autoimmune conditions
- Feeling chronically flu-like
- Yeast overgrowth (Candida)
- Bacterial overgrowth (SIBO)
- Food intolerances
But - all of these symptoms can be related to OTHER problems as well - which is why it’s so important to get accurate lab testing, and not just guess at a diagnosis based on symptoms.
Here’s what I commonly see with my patients:
A patient with depression or anxiety will also have digestive tract infections or dysbiosis, yeast overgrowth, or food intolerances.
These promote inflammation in the gut, and the inflammatory cytokines circulate in the blood and travel into the brain across the blood brain barrier, impacting brain function.
(What do I do to help? Glad you asked! After testing, I use specific amino acids like 5-HTP, tyrosine, and GABA, plus nutrient cofactors to deal with shut-down receptor sites and neurotransmitter deficiency. At the same time, I’m addressing underlying root causes of the gut infections.)
How To Address Depression & Anxiety Related To Toxin Exposure
The solution to depression and anxiety caused by toxin exposure is to address the cause of the inflammation: those toxins!
That means limiting exposure as much as you can: get a water filter, air purifier, buy organic, switch to natural beauty products, etc.
From there, I start by enhancing detoxification pathways with nutrient protocols, hydration, herbs, saunas, skin brushing, and lymphatic system support so the toxins can be broken down and excreted from the body.
Next, I use lab testing to identify where in the detox pathway things are getting gummed up. Is your Phase 1 or Phase 2 liver detox malfunctioning? Proper testing can tell us!
I also use Organic Acids Testing and Heavy Metals testing to see exactly what toxins you’re dealing with.
I have to give a warning here: you MUST be careful when doing detox work. It can be dangerous to stimulate detox and have the body suddenly dump toxins from storage into circulation.
It’s never good to detox someone who still has a leaky gut or gut issues - and it can make your gut issues get worse.
You shouldn’t feel sick when detoxing - this usually indicates pulling toxins out of storage faster than your body can clear them.
An experienced practitioner can help you detox safely.
Depression, Anxiety & Hormones
I’ve saved the best (worst?) for last: hormones!
On some level, almost all depression & anxiety is related to hormone imbalances.
Neuroscientists at the National Institute of Mental Health have even stated that most depression in the United States is caused or contributed to by HPA-axis dysregulation (also called adrenal fatigue) and hormone imbalances.
The most important players for depression and anxiety are cortisol, DHEA, testosterone, estrogen, and progesterone. Together they can trigger a biochemically-induced depression.
Cortisol Dysfunction
Cortisol is a stress hormone that’s has to be just right. Too high or too low, and you can have lots of problems. But it’s tricky because your cortisol levels shouldn’t be steady throughout the day: they should follow a predictable arc of rising quickly in the morning when you’re exposed to light and slowly lowering throughout the day.
(That’s why cortisol problems can be easily overlooked! You can’t just look at one reading - you need to look at both levels throughout the day, and the rate at which they rise and fall to get the complete picture of cortisol health.)
Low cortisol levels are related to depression - and in particular, are linked to postpartum depression. Low CAR response (the rise of cortisol first thing in the morning) can also be related to depression.
But - high cortisol (especially high at nighttime) is also related to depression - both high and low levels can cause similar symptoms. Again - that’s why you must have accurate testing!
What messes up cortisol levels?
The big triggers for cortisol imbalances are are sustained and chronic stress! It can be mental OR physical stress - anything from a stressful job, being a super-busy new mom, or over-exercising can wreak havoc on cortisol levels.
Sex Hormones Imbalances
Progesterone, estrogen, and testosterone are the primary sex hormones - but they can also have a huge impact on mental health and depression and anxiety in particular.
Here are just a few of the many ways sex hormones can directly impact mental health:
Progesterone helps balance blood sugar levels. Remember - the brain is dependent on adequate glucose to function. Low progesterone levels can lower the supply of glucose available to the brain. This decrease in "brain fuel" contributes to the most common psychological and emotional symptoms of PMS like:
- Irritability
- Rage
- Depression
- Tension
- Anxiety
- Confusion
- Fatigue
- Memory lapses and loss
- Inability to concentrate
- Decreased stress tolerance
Estrogen and progesterone also have a strong effect on the neurotransmitters involved in mood regulation:
- Progesterone binds GABA receptors (which decreases anxiety and depression)
- Progesterone raises serotonin hormone levels in brain
- Estrogen increases dopamine activity in the brain
That means, any change in hormone levels (even subtle ones!) can contribute to psychological symptoms.
Unfortunately, the treatment given to many women who do experience mood symptoms with their monthly cycle is the hormonal birth control pill.
This drives me crazy as it only compounds the problem!
Birth control pills deplete the body of essential vitamins and minerals like folate, b vitamins, and magnesium - all of which are involved in the synthesis of chemicals for brain health (among other things!).
This can result in intensified depression, anxiety and PMS! A number of studies have linked depression with the use of oral contraception.
Studies have also indicated that using the Pill for extended periods of time can alter the gut microbiome, especially predisposing users to candida overgrowth and other bacterial and fungal issues.
The nutrient deficiencies that are induced by the Pill are largely due to the influence on the gut microbes, where many of these nutrients are synthesized. (So again, many of these issues point back to the gut - make sure you read Part 1 of this series!)
But that’s not all…
Thyroid Problems
Every cell in your body has receptors for thyroid hormone - including the brain!
(That should give you a clue to how essential a healthy thyroid is for overall well-being!)
Thyroid hormone makes progesterone receptors more sensitive. This means that low thyroid hormone can mimic the symptoms of low progesterone. (Remember the fun PMS stuff we talked about in the previous section??)
Low thyroid hormone can also directly impact neurotransmitter levels. It can cause low dopamine levels - which translates to lack of motivation, drive, and willpower.
Taking Control Of Anxiety & Depression
No matter what root cause (or causes) of depression and anxiety you’re dealing with, there are certain steps you take with your diet and lifestyle to help alleviate symptoms.
For some of my clients, just making lifestyle and diet changes is enough to completely alleviate symptoms of depression and anxiety! Here are some things to try in all the major categories:
Eat:
- Eat plenty of healthy fats (like avocado, coconut, and olive oil)
- Avoid processed foods and excessive sugar
- Some people can benefit from removing dairy & gluten
- Choose organic foods (especially the Dirty Dozen)
- Aim for 10 servings of fruits & veggies per day
- Focus on eating for balanced blood sugar (avoiding processed carbs!)
Move:
- Exercise has been shown to be as effective in most cases as antidepressant drugs for alleviating depression
- Find what works for you and what you ENJOY doing
- If you haven’t been exercising regularly, just start with 20-30 minute walks daily
Sleep:
- Turn off screens 1 hour before bedtime
- Schedule enough time for enough hours (8 hours or more)
- Sleep in a dark room, with the temperature slightly cooler
Stress:
- Active stress management is something I recommend for ALL my clients (no matter what health concern they have)
- Meditation, yoga, tai chi or qi gong, making art, dance, journaling are some of my favorite options for managing stress
- Making a conscious decision to “switch” from fight-or-flight mode to rest-and-digest mode
- Consider working with a counselor or therapist - especially if unresolved emotional issues are a factor for you
Next Steps For Treating Anxiety & Depression
After reading Part 1 and Part 2 of this series, you might be feeling a little overwhelmed.
It seems like you could have hormone issues, toxin exposure, gut issues, and maybe yeast overgrowth, too! (Plus there’s definitely some past trauma lurking that needs to be dealt with….)
As one of my mentors in Chinese medical school used to say: “You are entitled to more than one problem at the same time!”
The truth is that while some people have one primary cause, the majority of depression or anxiety cases is due to a “perfect storm” of factors.
Everything we’ve discussed in this series can be interrelated:
- Having dysregulated cortisol levels can not only contribute to changes in the brain and brain chemistry, but can alter the way the immune system operates, leaving us more prone to inflammation and more vulnerable to infections in the gut
- Having a leaky gut from food intolerances or infections will affect the brain directly, but will also be a major contributor to detox system overwhelm
- Having low thyroid function can cause symptoms of low progesterone
The complex way all these systems interacts means one thing: you don’t want to go this alone!
I really believe everyone should have a trusted practitioner by their side, guiding them through the process of healing.
The right practitioner (trained in a holistic approach like Functional Medicine) can untangle the strings of depression and anxiety and get back to feeling like yourself!
If this resonates with you, I’d be honored to have you book a 20-minute consult with my team. These consults are totally free and a chance for us to share how we are trained to help you!
→ Learn more and book a free consult with my team here.
How To Treat Depression & Anxiety Holistically - Part One
Butterflies in your stomach before a first date. Sweaty palms before asking your boss for a raise. Grief when your dog dies. Crying over a breakup.
These are all normal and healthy moments of nervousness and sadness.
But then there’s a shift….
Laying awake at night with a pit in your stomach… when tomorrow’s just another Tuesday. Overwhelming sadness when everything is going OK. A feeling of despair you can’t shake…
These are signs of a more serious issue: anxiety and depression.
If you’ve ever experienced anxiety or depression, you’re currently dealing with them, or are supporting someone you love with one of these conditions all you care about is getting rid of them.
But it’s not always simple. Anxiety and depression are multifaceted issues. And that’s where the problem starts.
Doctors and practitioners want to put you onto one 2 paths:
- Treat the brain. This is everything from antidepressants and anti-anxiety meds to talk therapy with a psychologist. On this path, anxiety and depression are seen purely as a mental health issue - so treatment focuses on your brain.
- Treat the body. On this path, anxiety and depression are seen as symptom of a problem somewhere else in the body. Treatment often focuses on changing your diet (especially avoiding certain foods) and adding in exercise.
This gets me so frustrated!
Like nearly EVERY health condition, depression and anxiety are not problems of JUST the brain or JUST the body. There is a definite mind-body connection, and the best treatments (and prevention) for depression and anxiety treat both.
In this series, I want to do some real talk about anxiety and depression. We’re going to dig into the root causes - everything from childhood trauma to candida - and the solutions that might be able to help you.
Nothing is off limits and I’m not going to vilify any one kind of treatment.
I hope this can be an open and honest discussion about anxiety and depression like you’ve never experienced before.
Trauma, Circumstance, and Perception in Anxiety and Depression
Before I dive into some of coexisting conditions I see around anxiety and depression (and the steps you can take to help treat it), I want to make a very important distinction. While I believe (and the research shows) things like compromised gut health and hormone imbalance can cause anxiety and depression, it’s not the case for everyone.
Trauma, circumstance and perception can all be root causes of anxiety and depression.
And even if eating a blood-sugar balancing diet DOES help you manage anxiety and depression, it doesn’t mean that your anxiety was just caused by eating too much junk food. The trauma was real. This is a very sensitive issue, so I want to make sure this is clear.
Here’s what I see a lot in my practice: when a woman has co-existing conditions like leaky gut or a hormonal imbalance, when trauma happens (and it happens to almost all of us to varying degrees), it’s more likely that the temporary stress of the trauma develops into the long-term problems of anxiety and depression.
How you perceive trauma is important too. What qualifies as a trauma to one person wouldn’t be for another person - and neither one is right or wrong. Your perception is YOUR perception. But, you can learn tools that can help change the way you perceive things.
(It’s the difference between seeing your mother-in-law’s comments as a personal attack against you or just a manifestation of her own insecurities that you can brush off.)
If you’re equipped with self-care practices and coping mechanisms before the trauma happens, you’re much more likely to avoid depression and anxiety.
This is where “treating the brain” is so important.
For those of you who are dealing with past trauma or very difficult circumstances, I’d suggest looking into EMDR and Brainspotting in addition to everything else I lay out in this post.
- EMDR is shorthand for Eye Movement Desensitization and Reprocessing. It’s a kind of psychotherapy that combines aspects of traditional talk therapy with eye stimulus. Research has shown it helps you process through trauma much faster than talk therapy alone (think the work of 8 years of talk therapy in just a few EMDR sessions). It’s a recognized treatment by the World health Organization, the Department of Defense, and the American psychiatric Association. Learn more about it and find a clinician here.
- Brainspotting is a therapeutic tool that can be used in conjunction with other forms of therapy. It works by accessing the autonomic and limbics within the central nervous system to help work through traumas - especially those that are not in the conscious mind (and therefore hard to talk about and treat). Learn more about Brainspotting and find a clinician here.
And I encourage everyone - whether or not they’re dealing with anxiety and depression - to get started on the inner-work that makes you more resilient to trauma. It can be as simple as beginning a meditation practice or finding a counselor.
A note on antidepressants and anti-anxiety medications: I believe antidepressants and antianxiety medications can be life saving for some people. They also have serious side effects and address the symptoms over the root cause. No one other than you and your doctor can decide if medication is the right step for you. But, whether or not you use medication as part of your treatment, I encourage you to explore treating the coexisting conditions and root causes I share about in this post.
Gut Health and Depression
When I hear about depression and anxiety, I immediately think about gut health. I rarely (I mean rarely!) see a patient with symptoms of depression and anxiety who doesn’t have some sort of gut health problems.
And intuitively, it makes sense. We feel our emotions in our guts just as much as we feel them in our mind - the “stomach in your throat” feeling, butterflies in the stomach, a “gut punch” when you get bad news, needing to go to the bathroom when you’re anxious or nervous.
We also know that 90% of the body’s serotonin is actually produced in the gut - not the brain - and that other important mood chemicals are made in the gut, too.
Irritable Bowel Syndrome (IBS) is also closely associated with depression and anxiety.
In my practice, I see 2 kinds of gut health problems contributing to anxiety and depression over and over again: leaky gut and candida overgrowth.
How Leaky Gut Leads To Depression & Anxiety
One of the most famous studies on gut health and depression was conducted in 2008: “The gut-brain barrier in major depression.”
This study is famous (and still cited all the time) because the researchers made some amazing discoveries.
First, they concluded that “There is evidence that depression is accompanied by an activation of the inflammatory response system and that proinflammatory cytokines and lipopolysaccharide (LPS) may induce depressive symptoms.”
In layman’s terms, that means:
- Inflammation is one cause of depression
- There is evidence that leaky gut may cause symptoms of depression
The study measured antibodies produced by the body’s immune system against lipopolysaccharides (LPS) in depressed patients and in controls (without symptoms of depression). LPS are large molecules of dead cell wall of the gram-negative enterobacteria - also called endotoxins. LPS should NOT be in the bloodstream. If LPS are present in the bloodstream, it means the tight junction of the gut have become loose (aka leaky gut).
The researchers found that the immune markers against the LPS bacteria in the gut were much higher in depressed patients than in the control group.
This means that the depressed group had more leaky gut and gut microbiome dysbiosis than the control group.
In fact, researchers concluded that patients with major depression should be tested for leaky gut. (And I’d argue, anyone with any symptoms of depression or anxiety - not just major depression!)
What causes leaky gut?
LPS are dead bacterial cell walls - and generally having high levels of them in the bloodstream indicates dysbiotic flora in the gut in addition to leaky gut. This can too much of the wrong bacteria, too little of the right bacteria, or too much or too little bacteria in the wrong place.
Leaky gut can also be caused by parasites, SIBO (Small Intestine Bacterial Overgrowth), yeast overgrowth (more on that to come), and untreated food sensitivities and intolerances.
Food sensitivity symptoms are usually an immune system response to foods we eat. The reaction creates inflammatory compounds that get into the bloodstream, circulate, and can create anxiety, brain fog, depresion, and fatigue.
Low nutrient status can also contribute to depression. When food isn’t properly absorbed in the gut (due to dysbiosis or leaky gut) the body doesn’t have the “nutritional building blocks” like amino acids, folate, vitamin B6 and more it needs to create the chemicals to control mood. This can cause depression and anxiety.
Yeast Overgrowth, Depression
Other than leaky gut, the most common gut health problem I see in relation to anxiety and depression is candida overgrowth. Candida is a kind of yeast that almost all people have present in their body. Candida is responsible for thrush in babies and yeast infections in women. In normal amounts it is healthy - but it’s when it overgrows that it causes problems. And the way candida impacts depression is especially interesting!
Candida is a yeast - which means it produces alcohol (ethanol) and acetaldehyde (the chemical responsible for the main symptoms of hangovers!) Both these chemicals are toxins to the body.
In a normal healthy person, (who hasn’t been drinking!), there should be little to no alcohol in the bloodstream. But if that person has an overgrowth of Candida, the alcohol produced by the yeast is entering the bloodstream - we call this “auto brewery syndrome” and it literally makes you drunk.
In a study conducted by doctors at Biolab in London, UK, a number of chronically unwell patients were tested for blood ethanol levels an hour after ingesting a sugar solution. The study found the patients consistently had high blood levels of ethanol which the researchers concluded came from small intestinal yeast overgrowth.
And - even worse - when candida is well established, it transform into the fungal form its branching (hyphae) “feet” can penetrate the intestinal wall.This creates literal holes in the gut, enhancing leaky gut syndrome and allowing more alcohol and acetaldehyde into the bloodstream.
What does that do to you?
Ethanol metabolism…
- Interferes with energy metabolism; this results in fatigue & muscle aches
- Causes hypoglycemia or "low blood sugar"
- Creates nutritional deficiencies
Then the ethanol is converted into acetaldehyde which…
- Is responsible for most of the symptoms of a hangover
- Causes dilation of blood vessels in the brain which result in the characteristic severe headaches
- Is toxic and inflammatory to the brain’s neurons
- Binds glutathione - the body's main antioxidant - thus increasing oxidative stress and allowing free radicals to damage cells throughout the body. Without enough glutathione, the liver can’t detox properly
- Increases the release of adrenaline, causing heart palpitations, anxiety etc. Panic attacks become more common.
What causes candida to overgrow?
All of these factors make your body more hospitable to the overgrowth of candida:
- Antibiotics
- Oral contraceptive pills
- High sugar/starch alcohol diets
- Stress
- Having other GI infections, or
- Having immunosuppression related to adrenal fatigue
Candida overgrowth can be treated - but the root cause that began the overgrowth must also be addressed!
Action Steps For Healing Gut Issues
The first step to healing gut issues is to find out exactly what is going on.
I don’t like to “guess and check.” For patients in my clinic, I always start with specific stool tests for parasites, dysbiosis, and yeast overgrowth. For SIBO, I test using a lactulose breath test.
Once we identify exactly what issues are occuring, we tackle them - treating parasites and pathogens, and then using diet and supplements to heal leaky gut. Gut mucosa heal rapidly when the aggravating factors are resolved! On average, my patients see big changes in as little as 3 weeks.
Coming Up: Hormones & Toxins
I hope reading Part 1 of this post has left you feeling empowered - and maybe even hopeful. If gut issues are contributing to your anxiety and depression, treating them can help you take a big step forward.
In Part 2 of this post, I’m going to address two other major factors in anxiety and depression: exposure to toxins and hormone imbalances. There’s still a lot left to cover!
I’m passionate about helping women uncover the root causes of their health problems and address them naturally. If you’re dealing with anxiety or depression, I’d love for you to book a free 20-minute root cause symptom analysis consultation with my team. These appointments are TOTALLY free, and there’s no obligation to book any further appointments. See what time slots we have open here.
The REAL Meaning Behind Adult Acne (And How To Get Rid of It For Good)- Part Two
In Part One of this post, I explained the link between PCOS and adult acne. I also explained why PCOS is misunderstood and underdiagnosed. If you haven’t read it yet, make sure you go back and read Part One here. In Part Two, I’ll explain how I help women address adult acne and PCOS in my clinic.
How I Help Women With Adult Acne
Whether or not you have a clinical diagnosis of PCOS, adult acne is almost always related to hormone imbalance. In my clinic, I use a multi-faceted approach to treating hormone imbalances.
Step 1 is always proper testing to determine exactly what type of hormone imbalance you’re dealing with - there is no “one size fits all” treatment, so proper testing is critical to healing. Every woman I work with recieves a customized plan for healing based on her test results, symptoms, and lifestyle - but there are some general recommendations I start with for many women:
- Optimize Your Diet For Hormone Health
- Nurture Your Microbiome
- Lower Stress
- Promote Ovulation
- The Right Skin Care Routine
Optimize Your Diet For Hormone Health
You don’t need to go on a no-carb diet or severely restrict to optimize your diet for healthy hormones (in fact, that is probably the worst thing you can do!). Start with balancing your blood sugar and insulin. Almost all women with PCOS (regardless of weight) show some signs of insulin resistance.
You can counteract this and get back to healthy blood sugar by:
- Optimizing the amounts and types of carbs you eat. (It’s not about cutting carbs completely. Instead, eat more whole-food carbs, fewer processed carbs.)
- Moving more! It doesn’t have to be in the gym - walk more, hike, dance, swim, just stay active throughout the day.
- Using key supplements. The exact supplements and doses matter, so work with a pro to add in things like inositols, d-pinitol, curcumin, chromium, and berberine - if they are right for you.
Key nutrients for healing acne are:
- Vitamin A - natural sources are cod liver oil, liver, pastured egg yolks.
- Zinc - zinc has been shown to clear acne as effectively as antibiotics! It also interacts positively with Vitamin A. Dietary sources are organ meats, beef and lamb, oysters and scallops.
- Omega-3 fats - These fats are anti-inflammatory and reduce your skin’s reactivity to UV light, too. EPA and DHA are the best sources - find them in fatty fish or a high-quality supplement.
You should also consider cutting dairy from your diet. I don’t like to make blanket dietary suggestions, but for women with acne and PCOS, cutting dairy is almost always helpful.
Here’s why: there is a hormone in milk (from cows, goats, sheep, and camels) called insulin-like growth factor-1 (IGF-1) which mimics insulin in our body. IGF-1 is a growth hormone (which makes sense, as milk is for baby animals!).
In most people, a little dairy here and there can be well-tolerated - humans have a binding protein for IGF-1 that inactivates it. But for women with PCOS or hormonal imbalance who already are likely to be insulin-resistant or have high insulin, the added burden of IGF-1 can be a problem. This is amplified because women with PCOS have LESS of the binding protein for IGF-1 and higher IGF-a levels than other people do, too. And the ovaries of women with PCOS are more sensitive to IGF-1 (and other growth hormones), too.
IGF-1 can also cause your ovaries to overproduce testosterone (an androgen) - which is something we’re trying to minimize.
Not only all of that - but IGF-1 also increases sebum production and inflammation in the skin - sebum is oil on your skin - and encourages new cell growth. As new cells grow, old ones die and are shed.This means more oil and old skin cells potentially clogging pores and causing acne.
For all of these reasons I do recommend you try cutting out dairy if you’re dealing with PCOS or acne. Grass-fed butter and ghee are OK to keep in, as they are almost entirely fat and don’t contain much, if any, IGF-1.
Nurture Your Microbiome
A healthy microbiome is critical for both hormone health and lowering overall inflammation to help calm your skin.
The right gut flora is a main player in regulating your hormones, especially your estrogen levels. If you have too much of the wrong bacteria, the result can be increased estrogens in circulation.
Eating a whole-foods-based diet and taking probiotics are obvious ways to care for your microbiome - but if you’re already doing that and still having gut issues, I highly recommend advanced stool testing. Common gut infections like Blastocystis hominis, H. pylori, candida, and staph or strep overgrowth in the gut correlate to acne in patients. There is also a huge connection between Small Intestine Bacterial Overgrowth (SIBO), candida, and acne - especially rosacea.
Endotoxins released into the bloodstream by a leaky gut (aka increased intestinal permeability) are also a major cause of inflammation in the body and can impact the skin, too.
Lower Stress
This is the advice everyone hates - but it is the MOST important step toward achieving long-term health.
The reason people hate the advice to lower their stress is because they feel like most of their stressors are outside their control (bills, deadlines, work, family drama!) - but the truth is that there are many small steps you CAN control that can help reduce the burden of stress on your body.
Some simple but powerful things you can start doing right now:
- Get quality sleep - that means going to bed with 7-8 hours before you have to wake
- Avoid blue light after sunset - get the glasses, change the settings on your phone, and dim the lights inside
- Start a daily meditation/gratitude practice - just 5-10 minutes can set the tone for your entire day
Promote Ovulation
Supplementation should always be done only after proper testing and consulting with a practitioner. That being said, there are supplements that can support and promote ovulation that I use with my patients:
- Flaxseed and DIM to address excess estrogen
- Saw palmetto, reishi, pygeum, zinc, white peony/licorice, and green tea to slow the conversion of estrogen to testosterone
- Vitex (aka chasteberry) to support Hypothalamic-Pituitary-Ovarian signalling and progesterone production.
- Adrenal and thyroid support, as needed (this is why you need proper testing!)
The Right Skin Care Routine
A pimple here or there - or a bad breakout after you use a new face wash - is potentially a topical issue. That means it has to do with what you’re putting on to your skin from the outside, externally. But most cases of adult acne are more a result of internal imbalances (like we’ve been talking about in this article).
That being said, what you put on your skin still matters. Don’t use harsh products externally on your skin. Instead, try more simple options. I love:
- Mother Dirt spray (promotes a healthy skin bacteria)
- NERD skincare system
- Homemade masks with Manuka honey, tea tree oil, turmeric powder, and apple cider vinegar
This Is A Whole-Body Issue
I hope you take away this key point from this article: acne is a whole-body issue, not just a skin thing!
Whether you have PCOS or not, if you have adult acne, it is a sign that something isn’t working right in your body. From gut issues to hormone imbalances, there are multiple overlapping, underlying causes that could be causing your skin troubles.
But, I also hope you now understand that PCOS is underdiagnosed and misunderstood - and it could be affecting you.
Once I discovered that truth, I was finally on my way to #clearskineveryday (not to mention better moods, healthy monthly cycles, & healthier hair and nails!).
I’m passionate about helping women uncover the root causes of their health problems and address them naturally. If you’re dealing with adult acne, I’d love for you to book a free 20-minute root cause symptom analysis consultation with my team. These appointments are TOTALLY free, and there’s no obligation to book any further appointments. See what time slots we have open here.
The REAL Meaning Behind Adult Acne (And How To Get Rid of It For Good)- Part One
You wake up on the day of your dream-job interview, look in the mirror… and there it is, a big pimple on your chin.
You wish you could blame it on nerves, but the truth is that lately your skin is more broken out than it was when you were a teenager. You don’t know what else to try...
- You’re already spending tons of cash on facials and trips to the dermatologist
- You’ve tried every “miracle” regimen at Sephora
- You even tried cutting back on nights out with your girlfriends!
But here’s what you don’t know… what you think is just “annoying adult acne” might actually be more than that. It could be a sign you have Polycystic Ovarian Syndrome.
I know what you’re thinking - you’ve heard of PCOS and you couldn’t possibly have it! You have normal cycles (well, at least your birth control pill makes them seem normal), you’re not overweight (although you do feel like you carry a bit more weight than you should, given how active you are), and you don’t have any other symptoms (except the acne… and your hair is thinning a bit… and the need to wax your lip every month…).
Listen girl, I get it! When I found out I had PCOS, I was shocked. But it turns out, I actually had a pretty atypical case. And you might too.
Misinformation about what PCOS is and the symptoms it can cause let many women slip through the cracks and never get the diagnosis or treatment they deserve.
Adult acne isn’t normal, and it isn’t something you should have to deal with. Finding the root cause of your acne and addressing it can mean clear skin and better health (because acne is always a sign of a bigger problem). And even if you’re certain you don’t have PCOS, keep reading anyways - you may be surprised by what you learn!
What PCOS Is (And Isn’t)
The #1 misconception about PCOS is that it is simply a condition where cysts develop on the ovaries. So wrong. In fact, some women with PCOS don’t even have cystic ovaries!
PCOS is actually the most common type of hormone and metabolism imbalance. It affects 1 out of 10 women. (Yes, that number is the same as 10% - a huge amount.)
Based on the Rotterdam Criteria from 2003, there are 3 diagnostic criteria for PCOS - and to be formally diagnosed, you have to have at least 2:
- Confirmed androgen excess on labs or androgen excess symptoms
- Ovulatory dysfunction
- Multiple cysts on ovaries (PCOM) diagnosed via imaging ultrasound
If you have at least 2 of the 3 criteria above, your doctor can diagnose you with PCOS.
In 2018 PCOS diagnosis guidelines were updated by a combined counsel of the Australian National Health and Medical Research Council, European Society of Human Reproduction and Embryology, and American Society for Reproductive Medicine.
It was a HUGE step forward in the treatment and diagnosis of PCOS, since the new guidelines (finally!) took into account how different PCOS can be in different women.
Here are their new recommendations:
- Androgen excess can be diagnosed by measuring free testosterone or bioavailable total testosterone. However, elevations in the hormones Androstenedione and DHEAS can also indicate PCOS, even without elevated testosterone.
- When irregular menstrual cycles are present, a PCOS diagnosis should be considered. Irregular is defined as cycles less than 21 days, greater than 35 days, or less than 8 cycles per year. However, ovulatory dysfunction can still occur with regular cycles - this can be confirmed or ruled out with serum progesterone levels taken in the second half of the cycle.
- Ultrasound should not be used for the diagnosis of PCOS in those less than 8 years out from their first period, because many younger women have multifollicular ovaries, even without having PCOS.
The new diagnostic criteria don’t mention weight - and that’s because your weight is not part of the diagnosis for PCOS. Only 30% of people with PCOS are overweight or obese. And pain is not a symptom of PCOS, either.
What Does PCOS Do To You?
The hormone imbalance in PCOS creates problems with how the ovaries function, so the egg that should develop each month may not, or may not be released during ovulation (aka anovulation).
Some women think that if they aren’t actively trying to get pregnant, anovulation is no big deal - but regular ovulation is a sign your body is humming. Many women with PCOS also experience irregular cycles. Again - this is more than just a fertility problem (though it is that too!) A healthy period is a sign your overall health (physical & mental) is good
(Side note - if your doctor prescribed the pill to regulate your cycle, this is still a problem! More on that later, so keep reading).
But PCOS is about way more than just ovulation.
Excess Androgens Are The Real Cause of Adult Acne
Women with PCOS tend to have an excess of androgens. Androgens are male hormones, and an excess can mean high testosterone, high DHEA, or high metabolites of either.
Excess androgens are responsible for some of the most dreaded PCOS symptoms like:
- Acne (especially on the chin, jaw, and back)
- Male pattern hair loss/thinning
- Hirsutism (male-pattern hair growth, like on the face)
- Anger, irritability, mood swings
- Poor stress response
- Increased anxiety and depression
Not every woman with excess androgens has all of the above symptoms - and sometimes one symptom can be severe (like acne!) while other can be more mild (maybe just a bit more hair on your upper lip).
But pay attention here - hormones levels are complex! Many women with PCOS also have symptoms of high estrogen. It commonly happens like this: DHEA is high, but progesterone is low relative to estrogen levels. On top of that, many women have poor estrogen detox because their liver is overburdened.
How PCOS Presents in Real Women
Remember, every woman is unique - but there’s a common scenario I see in my clinic with women with PCOS. And - full disclosure - I was one of these women too!
Here’s a story I hear from a typical PCOS patient with acne in my clinic about her teenage years/early 20s:
- Her period came in her later teens (or never started naturally)….or started “on time” but then had irregular long windows between
- Acne started to develop and so did hair in places she didn’t want it --(like nipples, lip, chin, stomach)
- She may have been put on oral birth control pills to “regulate” her period and help deal with the acne
- And she might have been put on antibiotics like tetracycline or Accutane to further help control the acne
Sound familiar to you?
Then, as she aged into her 20s and 30s:
- As other women’s acne clears up, hers is getting worse than ever
- She may start to gain weight around her middle (even if she remains thin), or struggle to control her weight despite a healthy lifestyle
- Her hair might lose its luster and start to thin
- She may notice more anxiety and depression, trouble recovering from stress
And if she decides to stop taking the pill, here’s what usually happens:
- Her period takes a long time to return after stopping the pill - or it NEVER comes back
- Can’t conceive easily or without intervention
Not all of these symptoms are drastic (although some women do have very dramatic symptoms as a result of PCOS) - they can be subtle annoyances that hint at a bigger underlying problem.
What Not To Do If You Have PCOS & Acne
Most doctors - be they GPs, gynecologists, or dermatologists - only think of acne as a cosmetic issue. They often don’t make the link between acne and bigger issues like PCOS or hormone imbalance - especially if your other symptoms are mild or masked by the artificial hormones in the pill.
So, if you go see your doctor complaining about acne, you’ll probably be given one of these 3 things:
- Oral contraceptives (birth control pills)
- Antibiotics like tetracycline
- Medications like Accutane
While these meds might help short-term for some women, in the long-run they only make PCOS symptoms worse. Research has shown women with PCOS already have a less diverse microbiome than women without PCOS (and, that increasing microbiome diversity may be an essential part of treatment). The pill, Accutane, and antibiotics all only further damage the microbiome (especially when you’re taking them long term!)
Our microbiome (aka all the bacteria living in our gut) are critical for hormone biotransformation - that means they help produce and then clear out hormones. To have healthy hormones, (and clear skin) you’ve got to have a healthy gut - and taking any of these common acne meds can wreck your gut!
(It always comes back to the gut!)
Don’t Panic!
If you’re reading this and thinking you may have PCOS - or are nodding along because you were prescribed the Pill and antibiotics to treat your acne - please don’t panic!
Our bodies are so resilient, and there is a lot you can do to balance your hormones. In Part Two of this article, I’ll explain exactly what you CAN do and how I help women with acne, hormone imbalances, and PCOS in my clinic. Check out Part Two here.
Are Worms The Next Frontier of Health? Everything You Need to Know About Helminth Therapy
I talk a LOT about clearing infections and overgrowths - Small Intestine Bacterial Overgrowth (SIBO), yeast overgrowth (candida), and of course, killing parasites.
So I was shocked when I first heard about a new treatment idea for treating disease and healing damaged gut: worm therapy. Not clearing worms. Giving them to the patient, to help heal disease.
No, I’m not joking. It’s called helminth therapy - named for the type of organism used Hymenolepsis Diminuta Cysticeroids (HDCs). HDCs are the larval form of a very specific type of worm that help to restore immune tolerance and diversity to the microbiome when it’s been damaged.
I was really skeptical when I first heard about this. But then I heard a presentation given by one of my medical heros, Dr. Sidney Baker (former faculty member of Yale Medical School, founder of Defeat Autism Now! and Autism360.org, Linus Pauling Award recipient) and Dr. Yehuda Shoenfeld at the Institute for Functional Medicine conference in May 2018.
They shared the latest research and their experience using helminth therapy - and I went from skeptical to excited. I slowly introduced helminth therapy in my own practice and saw amazing results.
Here’s what I want you to do: suspend all your judgement for the next 10 minutes and read the rest of this post. I promise you’ll be surprised by what you learn - and I bet you’ll want to learn more about helminth therapy.
HDCs Aren’t Just Any Worms
HDCs are the larval form (aka an intermediate life stage between egg and worm) of a small helminth. Helminth grows naturally in grain beetles, which were a common part of our food supply up until about 100 years ago.
HDCs are not a parasite. By definition, a parasite causes harm to an organism - HDCs cause no harm. HDCs stay in the gut - they cannot breach the gut wall.
Really important: HDCs cannot colonize in humans. That means they’ll never go from larvae to worm in a human. For that same reason, HDCs can’t be passed from human to human either. They’re NOT contagious from person to person.
Using helminth therapy is completely different from something like taking a tapeworm from Mexico. It’s produced in sterile lab conditions (just like probiotics are) and carefully controlled.
How Are HDCs Produced - And How Do You Take Them?
Therapeutic HDCs are grown in sterile conditions in a lab - much the same way probiotics or yeast for brewing beer or culturing yogurt are.
First, the eggs are grown in rodents in the lab. If that makes you squeamish, keep in mind that these animals are kept in MUCH more humane & clean conditions than most farm animals! Then the eggs are taken and are bred into larvae in grain beetles which eat only oatmeal. The HDCs are harvested from the grain beetles and suspended in salt water.
HDCs are given orally (again, just like probiotics!) through the salt water solution. You’ll take a tiny vial (about the size of the tip of your pinky finger!) that holds the microscopic organisms. If you hold the vial up to the light, you can just barely see the HDCs as tiny white flecks.
Unlike probiotics - which can contain billions of CFUs per capsule - HDC are given in very precise, small amounts: most people start with 10 HDC per vial and work up to 30 HDC. Strong, therapeutic doses of up to 100 HDC every 2 weeks can be used, too.
If you do ingest HDCs, they can only stay in your body for about 2 weeks.
How Does Helminth Therapy Work?
This is the part that’s really exciting:
Helminth therapy works by promoting microbiome diversity and restoring immune tolerance.
Remember - our body isn’t sterile. Our microbiome is teeming with important bacteria and other organisms that help it function: both flora (like probiotics) and fauna (beneficial things like HDCs). When the gut microbiome doesn’t have enough diversity of both flora and fauna it can’t perform its functions properly.
Our gut microbiome teaches our immune cells how and when to function and it establishes our intestinal barrier (which keeps pathogens out of our bloodstream). Our immune cells are our body’s defense team. Immune tolerance is what our immune cells won’t react to. It’s our body’s bouncer waving something through.
Immune tolerance is a good thing! It means your body won’t wage war on the strawberries you ate, or cause you to sneeze and cough when you’re outside around pollen.
If you have decreased immune tolerance, you’re more likely to experience these conditions:
- Allergies (both seasonal and to foods)
- Eczema
- Asthma
- ALL autoimmune conditions (things like endometriosis, multiple sclerosis, lupus, rheumatoid arthritis, vitiligo, Hashimoto’s, alopecia, ulcerative colitis, Crohn’s and more)
Today, 50 million Americans have been diagnosed with an autoimmune disease. That’s up from 9 million in 1997. (Still a huge leap even when you factor in increased testing/awareness.)
Experts like Dr. Baker and Dr. Shoenfeld agree: the best way to treat ANY chronic illness is to restore immune tolerance.
What Makes Our Microbiome Diversity & Immune Tolerance Decrease?
Up until the very recent past (like the past 100 years) our microbiome diversity was supported naturally by our environment. People interacted more frequently and directly with nature: farming, foraging, etc. They also had less hygiene practice: no antibacterial soap or hand sanitizer.
Worms - both beneficial ones like HDCs and pathogenic ones - were also something more people had when we lived hunter-gatherer lifestyles. (These persist in hunter-gatherer groups like the Hadza tribe today - and they have the most robust and diverse microbiomes of anyone known on the planet… and virtually no IBS, UC, Crohn's, diabetes or other autoimmune disease!)
Other things in the modern world that damage our microbiome diversity:
- Antibiotic use (kill beneficial bacteria in the gut)
- PPIs (impair digestion and promote bacterial and fungal overgrowth)
- Birth control pills (kill beneficial bacteria in the gut and promote yeast)
- C-section births (prevent transfer of microbiome from mother to infant in the vaginal canal)
- Vitamin D deficiency (too much time indoors)
- Chronic stress (go-go-go cultural attitude)
- Contaminated/nutrient poor food (Standard American Diet!)
- Excessive hygiene practices (overuse of antibacterial cleaning agents)
How To Restore Microbiome Diversity & Immune Tolerance
Diet has the biggest influence of all factors on the health of our microbiota. Less diversity in your diet = less diverse gut bugs.
Step 1 has to be eating a nutrient-dense diverse diet with plenty of gut-nourishing foods: fiber, healthy fats, and protein.
Making changes to your lifestyle & hygiene practices is important too:
- Put down the antibacterial soap!
- Get out in nature and interact with the earth
- Get adequate sunlight or supplement with Vitamin D
- Eat fermented foods or supplement with a high quality probiotic
But if you already have all these steps dialed in and are still dealing with symptoms of decreased immune tolerance or chronic illness, helminth therapy that can increase diversity and immune tolerance may be the next step for you.
What The Research Shows About Helminth Therapy (And Results in MY Practice!)
- In the largest randomized control trial in history (!), 1 million children in India were dewormed by researchers who hypothesized it would lead to an improvement in general health. Instead, they found no significant effect on weight, death rate, or health. This drew into question the premise that all worm are always harmful…
- In a 2005 study, 29 patients with Crohn's disease (most of whom were non-responsive to pharmaceutical treatments) were treated with helminth therapy every 3 weeks for 24 weeks. At 24 weeks, 79.3% of the participants had responded favorably and 72.4% had completely reversed their Crohn’s disease!
- In this 2014 study, people with IBD (either ulcerative colitis or Celiac Disease) were treated with either helminth therapy or a placebo for 12 weeks. Although this study was too small and too short to be conclusive, 10% of those who received the helminth achieved remission (compared to 4% in the placebo group).
In my own practice, I’ve seen these results using helminth therapy:
- Normalization of thyroid labs
- Remission of Crohn’s and Ulcerative colitis (when symptoms have already been improved and other co-infections addressed)
- Improvement of GI symptoms (diarrhea, constipation, gas, bloating, etc.)
- Reduction of arthritis symptoms
- Improvement of inflammatory symptoms like skin rashes, insomnia, and mood/brain issues
- Reduction of histamine intolerance symptoms
Other practitioners have reported improvement in children with autism and people with multiple sclerosis.
Who Helminth Therapy Is (And Isn’t For)
There’s no magic potion in medicine that will cure all your problems (i’m sorry!).
If you’re not eating right, moving, finding joy, and managing your stress, helminth therapy won’t work for you.
But if you’ve already got those “core” practices in place and are still struggling (or just want to see how good you can feel!), helminth therapy could be beneficial for you.
Typically people take 6 doses of HDCS 2 weeks apart to initially evaluate if they are or are not going to have a beneficial response. Then, if no benefit is seen, they can increase the dose for. Risk is almost non-existent, and the potential benefits are huge.
(But, anyone on immunosuppressive drugs - like those used in some types of inflammatory bowel disease or other autoimmune diseases - shouldn’t take HDCs. The helminth therapy is not beneficial if your immune system is suppressed by medication.)
What Do You Think?
I am so glad you stayed with me.
I know that “worm therapy” sounds really weird at first- but the idea of taking probiotics was once weird, too! I’m a supporter of anything we can do to improve our gut health - because our gut health radiates out into every aspect of our being.
Want to learn more about helminth therapy (and potentially give it a try?) - book a free 15 minute consult with my team where we can create an action plan for you.
Want to get healthier but NOT ready to try HDCs? That’s OK too - I’d love to teach you about how else you can support your gut. Book a free 15 minute consult with my team here.
What Working With A Functional Medicine Practitioner Is Really Like (Patient Case Study)
You’ve been to the doctor. He runs some tests and he says nothing’s wrong.
But you know you’re not you right now. Maybe you’re dealing with digestive problems that have taken the fun out of eating. Every dinner out is a potential threat.
Or maybe it’s your hormones that seem off. Your once predictable cycle is suddenly erratic. You feel like you’re in puberty all over again.
Or maybe you’ve never had a happy gut or healthy hormones. The doctors have thrown up their hands. They can give you The Pill or suggest you try a fiber supplement, but that’s all they’ve got for you.
You’ve always trusted your doctor - but right now it feels like there is nothing they can do to help you.
Where do you turn?
This story is how so many women end up looking for a Functional Medicine Practitioner. I know it well, because this is my story, too.
What Is Functional Medicine?
Functional medicine is an evidence-based approach to health that focuses on finding the root cause of health problems. Functional medicine looks at the body as one system - meaning that is something is “wrong” in one area of the body, it is likely having an impact on other parts of the body, as well.
Functional medicine incorporates both Western and Eastern approaches - the latest technology and ancient wisdom.
The #1 misconception about Functional Medicine is that it denounces modern medicine in favor of healing crystals and water fasts. Not true!
Listen, I won’t knock anything until I try it - including crystals and fasting - but the majority of work I do with clients in my clinic is much different than that. You might not know that though, because you’ve never seen a FMP before!
What Is It Really Like To Work With A Functional Medicine Practitioner?
Today, I want to walk you through the process of working with a Functional Medicine Practitioner. I’ll share one of our amazing patient’s own journey (yes - including test results!) so that you can understand what it’s really like to work with a FMP.
Before anything else, I always do a free 15-20 minute prospective patient interview. This is just a chance for us to connect (without any pressure) and be certain we’re a good fit for working together. From there we’ll go to official first step: the case review appointment.
The case review is like a deep-dive interview. I want to know as much about you as possible. I might even ask some questions about your childhood! Here I’m looking for clues as to the root causes of what is troubling you now.
Next, we’ll order some testing - depending on your unique symptoms and history. I don’t want to waste your time or money, so we’ll only order the tests that are relevant for you.
Once test results are in, we’ll meet again to develop a treatment plan. You’ll implement the plan (usually diet & lifestyle changes, plus supplements) and we’ll have check-ins to see how you’re progressing and if we need to make tweaks to the plan.
Finally, we’ll re-test to check your progress. (This is the best way to know treatments are really working.)
I’m excited to share this story with you - let’s dig in!
Step 1: Marina’s Case Review
Marina met with Amelia, one of the clinicians who works in my practice, in January. At her first meeting, we learned a lot about her!
She was 22 and was working as a paramedic with her local fire department. She wanted to become a helicopter medic (how badass is that?) but was struggling with health problems that were holding her back. Digestive problems and brain fog were zapping her of the energy she needed to go back to school.
First, Marina told us about what was going on right now: serious digestive problems. She was having oily stool, undigested food in her stool, and couldn’t tolerate eating meat at all unless she took her “meat pill” - a prescription anticholinergic medication. The digestive problems were wearing her out, and she was dealing with brain fog.
Then we went back in time: when did her health problems start?
Marina told Amelia that when she was younger, she had developed a cyst on her heart. Her doctors had treated it with back-to-back rounds of antibiotics.
As a side effect of the antibiotics, she developed neuralgias (a kind of nerve pain that causes severe pain) and vertigo. The vertigo led to 3 concussions in a row and she was ultimately diagnosed with a Traumatic Brain Injury (TBI).
It was at this time that the digestive problems started, too. Bloating, nausea, food intolerances, and fat malabsorption (which was causing the oily stool).
Her doctor told her the digestive symptoms were just Irritable Bowel Syndrome (IBS) and gave her the prescription for the “meat pill.” That was all he could offer.
6 years after the cyst on her heart, and Marina was still dealing with the repercussions of it. That’s how she came to see us.
Based on her history of antibiotic use and her current symptoms, we suspected Mishana was dealing with a gut infection. We suggested she start with a GI-MAP - a comprehensive stool analysis that can test for many gut infections at once.
Step 2: The Test Results Are In
Marina agreed to the test, and a few weeks later, results were in:
Marina tested positive for:
- C. difficile
- Enteroinvasive E. coli/Shigella
- Enterotoxigenic E. coli LT/ST
- Salmonella
- Entamoeba histolytica
- Enterococcus faecalis
- Streptococcus spp.
- Candida spp.
- Chilomastix mesnelli
- With relative elevations in other markers
You might be thinking these test results are crazy - but it actually isn’t that uncommon! Even in the United States, gut infections and parasites are fairly common. And if you have used antibiotics or have a compromised microbiome for some other reason (like you’ve been eating the Standard American Diet) you are more susceptible to picking up gut infections.
Why don’t doctors test for these infections?
Some Western-medicine doctors do - but many others don’t. They either wrongly believe that gut infections are unlikely or they think they are “non-symptomatic” infections - meaning they don’t cause problems, and don’t need to be treated.
In my experience, (both personally and with my patients) clearing gut infections makes a huge difference in how you feel.
For Marina, we started treatment with a prescription anti-parasitic, alongside a natural bacterial protocol. After she completed those treatments, we used a prescription anti-fungal. Finally, we completed a re-seeding protocol with both probiotics and prebiotics (the most important step after any type of clearing treatment!).
After treatment, I always recommend re-testing to be sure that all the infections have cleared. Feeling better is a great indicator that infections have cleared - but it can’t replace seeing the results on paper!
Step 3: The Second Test Results:
As you can see from the results - Marina was able to clear all her gut infections!
(Note: She did have some low beneficial flora that we worked on next.)
The results on paper back up what Marina experienced day to day: her digestion has improved. No more bloating or food intolerances.
Not just that, but after years of brain fog, Marina is finally thinking clearly again. She was even able to pass her paramedic cardiac program and enroll in medic school.
Now that the infections are cleared, Marina is working on improving her habits - especially around eating foods that support gut health and getting enough sleep - so that the infections don’t have a chance to come back. I’ll keep working with her to make sure she keeps improving.
It’s Black, White, & Gray
I like to say that I look for “black, white & gray” results with my clients.
I want the black and white stuff - the test results that prove the treatments we’re using are working. And I know those results are important to you, too.
But I also want the “gray” - I want to hear that you’re going out to dinner with your boyfriend and you don't get sick, that you’re finally able to be back in school, that you don’t have to press snooze five times every morning before you drag yourself out of bed.
For Marina, we definitely got the black and white and the gray - and I am so thrilled to see her thriving again after years of struggle.
I hope this has helped you understand what it really is like to work with a Functional Medicine Practitioner. And if you’re ready to take the next step forward in your health, I’d be honored to work with you. You can book a free prospective patient interview anytime here.
The Truth About Hormones & Your Sex Drive
Which of these best describes your sex drive?
“Want it, need it, gotta have it!”
“Could take it or leave it...” or
“Don’t even think about it!”
Whatever you answer, there’s no shame.
Women are pretty reluctant to say our libido (or lack thereof) is one of our top health concerns. But when I dig deep with the women I work one-on-one with in my clinic, I find that almost all of them are struggling with their sex drive.
And personally, when I was struggling with hormone imbalance, my sex drive was non-existent. I thought it was just “normal.” After all, as women we are conditioned to believe we should want sex less than men.
Truth: healthy women have robust sex drives!
Our libido isn’t just dictated by whether our partner brings home flowers or we’ve shaved our legs - it is controlled by a complex group of hormones and neurotransmitters. Too much or too little of one or another can cause our sex drive to dwindle away or get out of hand.
That means that if your libido is lacking, you don’t just need to try lighting candles or new lingerie (although if your sex drive is healthy, that would sound fun instead of like a chore!). Balancing your hormones can restore a healthy libido.
Today, I want to explain how your hormones impact your sex drive. I hope this information empowers you - and if you have more questions or need more support, please reach out to me!
What This Article Can’t Do
Before I dig in to all the juicy hormone info, there are a couple other things I want to get out in the open.
First, most of the research on hormones has been done based on cisgender, heterosexual people and in heterosexual relationships. More research on hormones in other populations is long overdue. If you’re outside this group, some of this information will apply to you and some of it won’t - but I’d love to support you in overcoming hormone issues one-on-one until more inclusive research is available.
Secondly - as you're reading this I know symptoms of too much or too little of various hormones are going to jump out at you. But know this: the only way to diagnose hormone imbalances is with proper testing! That means blood, saliva, and/or urine testing.
Treatment for hormone imbalance is highly individualized, and I always recommend anyone who suspects hormone imbalance work one-on-one with a trained practitioner like myself for accurate testing and treatment! At the end of the article, I’ll share about my favorite hormone tests.
OK - disclaimers done - let’s get to the good stuff!
Estrogen - “The Feminine Hormone”
Estrogen is the hormone we associate with women. It makes women softer - both emotionally and physically. Estrogen is responsible for women’s curves: breasts, hips, and more fat on the butt! In studies of heterosexual men, women with higher estrogen levels were rated as more attractive.
It also increases a woman’s receptive sex drive—the part that makes her interested and open to penetration. Estrogen says “Take me now!” Women with higher estrogen levels may have more of a seductive sex drive - they are more likely to be receptive to sex, more likely to flirt and give “I’m available” signals, than they are likely to initiate it.
Testosterone - “The Masculine Hormone”
What hormone causes horniness? Testosterone is the hormone associated with men - but healthy women have testosterone, too. It helps us build muscle and causes us to feel more competitive and aggressive. In the bedroom, testosterone makes us want to initiate sex and governs the drive for genital sex and orgasms. Women with higher testosterone levels tend to have more of an aggressive sex drive and are more likely to initiate sex than wait for a partner to start things up. Interestingly, some post menopausal women have relatively higher testosterone levels (as compared to other hormones like estrogen) and may notice more of an interest in initiating at this phase in their lives.
Testosterone makes us less interested in relationships and commitment and more likely to want time alone (that’s what the Man Cave is for!). Women with higher testosterone levels tend to masturbate more, too. Too much testosterone can make us feel irritable - but too little can make us feel depressed.
Dopamine - “The Pleasure Chemical”
Dopamine isn’t exactly a hormone - it’s actually a neurotransmitter. Dopamine helps us anticipate pleasure - therefore having the drive and motivation to take action. It’s dopamine that makes us anticipate that sex = pleasure.
People who are low in dopamine tend to seem “flat” - they lack interest, enthusiasm, and get-up-and-go.
Testosterone increases the activity of dopamine in our brains, so supplementing with testosterone is often prescribed for women with low libido. But in my experience, this rarely works - or at least not without other support - probably because the issue isn’t just low testosterone, but also low dopamine. (Just another reason why you have to test!)
DHEA - “The Master Hormone”
DHEA is our most abundant circulating hormone. It’s produced both in the Adrenal glands and in the brain, and most of our other hormones are derived from it. DHEA levels peak in our 20s and start to decline from there - faster for some than others based on factors like your genetics and stress. Oral contraceptives are also know to lower DHEA levels.
Ideally, I like to see DHEA levels on the higher end of the normal range because DHEA can:
- Lower risk of depression
- Provide better function in old age
- Protect against immune suppression when cortisol levels are high (from stress)
- Prevent osteoporosis
- Maintain muscle mass
And of course, DHEA plays a major role in sex drive, orgasms, and sex appeal. Higher levels of DHEA in women correlated with higher rates of sexual desirability in studies. Most of our pheromones are derived from DHEA - scents that in the animal world dictate attraction and mating. Pheromones are often what make us feel an “instant connection” or drawn to someone. When a woman complains of low libido, I always test her DHEA levels first!
In times of stress, DHEA levels decrease significantly -and this can cause a cascade of low hormones throughout your body, since most other hormones are derived from DHEA.
Oxytocin - “The Love Molecule”
Oxytocin is a molecule that is triggered by physical touch. Oxytocin levels increase if you hug, hold hands, have sex, hold a baby - and even if you look at a dog! Levels of oxytocin also spike when you’re aroused and when you orgasm - it’s also what causes the uterus to contract during orgasm. If you’re in love, just thinking about the person can make your oxytocin levels go up.
Oxytocin helps you bond and feel love. It’s especially important for maternal bonding, and oxytocin levels rise during breastfeeding. Higher levels of oxytocin both reduce stress and rational thought - making it easier to “fall in love.”
Progesterone - “The Cock Blocker”
Does progesterone increase libido? In my practice I call progesterone the cock-blocking, (or clam-jamming) hormone. Basically, progesterone stops your sex drive. The effect of progesterone on your sex drive is so powerful, monks used to take the herb Vitex (aka Chaste Tree Berry!) to promote progesterone production and block their sex drive. Progesterone actually numbs the erogenous zones, meaning you’re likely to have dull orgasm with more stimulation - or no orgasm at all.
Many women have high levels of progesterone because they take hormonal contraceptives. The birth control pill contains a synthetic form of progesterone called progestin. Great birth control, right? Just kill your sex drive completely!
Progesterone isn’t all bad though - it promotes maternal behavior and has a mild sedative effect. It can make you feel calm, happy, and that everything is a-okay.
Does ovulation make you horny? In the second half of the menstrual cycle (after ovulation), progesterone is naturally higher. That makes sense biologically - once you’ve ovulated, your body won’t drive you to sex for reproductive reasons. When natural progesterone is balanced with estrogen, the dip in sex drive isn’t as strong and some women don’t notice it at all. Others might just be more interested in cuddling rather than going for an orgasm.
Prolactin - “The Nursing Hormone”
Prolactin is mostly associated with lactating women - it is the hormone that triggers your milk to let down after birth. Prolactin also tends to lower your sex drive - that’s why, in general, women have less sex when they are breastfeeding. Depending on your estrogen levels, you might retain some “receptive” sex drive even when prolactin is higher.
Promoting dopamine opposes prolactin. So if your prolactin levels are high and you’re NOT breastfeeding, using dopamine-promoting herbs can help lower prolactin and improve your sex drive. The only way to accurately gauge your prolactin levels is with testing!
Serotonin - “The Happy Chemical”
Serotonin is dopamine’s partner - together they are the two main neurotransmitters in the brain. Serotonin can impact your sex drive whether it’s too high or too low. Certain medications (like SSRIs) can cause high levels of serotonin. Dieting and chronically low calories can cause low serotonin, too.
Very high levels of serotonin dull your sex drive. That's why SSRI antidepressants have lowered sex drive and delayed/weaker orgasms as a side effect.
Conversely, low levels of serotonin can magnify your sex drive. In people with depression, low serotonin levels can even lead to sex addiction. In women with low serotonin, orgasms happen faster and easier. Men with low serotonin ejaculate right away.
Your Menstrual Cycle - “The Conductor”
Your menstrual cycle is like the conductor of all these hormones and chemicals. As the cycle progresses, hormone levels naturally rise and fall, leading to a shift in your sex drive.
At the beginning of your cycle, all hormone levels are low. Mid-cycle, estrogen and testosterone both spike - leading to an increase in sex drive (you’ll be both more aggressive and receptive to sex).
Many women also notice their libido peaks right before they start their period, as progesterone is naturally falling relative to testosterone. Your genitals will be more sensitive and it’s easier to orgasm during progesterone withdrawal.
During menses, some women have an increased sex drive - again because progesterone is lower relative to testosterone. But because serotonin levels can also drop during this time you might be grouchy too. Grumpy and horny!
The natural shift in hormones throughout the month can explain why sometimes you want sex more for the cuddling, emotional bonding, and skin-to-skin contact, - and why other times you just want an orgasm without all the bells and whistles.
Your Hormones & Your Libido
Our sex drive is completely dependent on our hormones. And as you’ve learned in this article, it’s not as simple as “more testosterone makes you horny!” Balanced hormones are the key to a healthy sex drive.
If your sex drive isn’t how you’d like it to be - either too much or too little - looking at your hormone balance is a great place to start. I know you’re sick of hearing me say this by now, but the ONLY way to accurately diagnose hormone imbalance is with advanced testing. You never want to “guess and check” by starting treatments or supplements for what you “think” is the problem. This can cause even greater imbalances that take more time and work to resolve.
Over the years I’ve used blood and saliva hormone tests - but now I almost exclusively use the DUTCH hormone test. This test is a kit your practitioner orders and you complete at home. It uses dried urine (that’s what the D and U stand for in DUTCH) to accurately test various hormone levels. It’s more accurate than saliva testing, and much simpler than blood testing. You just pee on a stick, let it dry, and mail it back to the lab.
Once I know a patient’s hormone levels, we can work together to come up with a plan to balance them. I never share exact protocols publicly because I’ve never had 2 patients who needed the exact same treatment! Hormones really are that unique.
If this article has resonated with you and you think hormone imbalances could be at the root of your sex drive struggles, I hope you’ll book a free 20-minute exploration call with my team. There’s zero obligation, but we’ll dive deep into your issues and then share what we can do to help.
Having come out the other side of hormone imbalance, I can tell you - having my sex drive back is great! (And my husband loves it too.) I want the health and radiance that comes from balanced hormones for all women. Book a 20-minute call for free here!
My Top Travel Tips for A Healthy Gut
Traveling is one of my biggest passions. When I got married, we chose to do a destination ceremony and reception with all of our friends and family in Sayulita, Mexico, instead of a traditional wedding (no regrets there!).
Traveling hasn’t always been fun for me, though. When I was younger, I felt like EVERY time I traveled, I got sick. And I’m not talking about a cold, folks - I’m talking about the nemesis of every globetrotter: traveler’s diarrhea.
Traveler’s diarrhea, Montezuma’s revenge, Delhi/Bali belly - it’s all caused by food poisoning. And while it will definitely ruin your trip, it also has a more sinister side - food poisoning can cause lasting damage to your digestive system leading to a lifetime of #gutproblems.
Want to know how food poisoning can cause long-term digestive issues - and what I do to avoid traveler’s diarrhea (even in the most exotic locales!)? Keep reading!
(Not interested in the science? Skip here for my travel tips).
How Food Poisoning Can Wreck Your Gut Long Term
I can’t tell you how many patient in my clinic can trace their digestive symptoms back to a case of food poisoning. And the science backs them up! Food poisoning is a known cause of irritable Bowel Syndrome (IBS). IBS after food poisoning is called “post-infectious IBS.”
But this gets a little complex, so bear with me here...
IBS isn’t a disease - it’s a syndrome. That means it’s just a name for a group of symptoms (fun stuff like gas, bloating, diarrhea, constipation, and food intolerances). IBS is a diagnosis of exclusion, meaning your doctor will call your symptoms IBS when they can’t find any other cause for them.
For many people - perhaps as much as 60% - the actual cause of IBS symptoms is something called Small Intestine Bacterial Overgrowth (SIBO). SIBO occurs when bacteria that should be confined to the large intestine migrates up and into the small intestine. A healthy small intestine should have very little bacteria in it!
So how does bacteria get from the large intestine to the small to cause SIBO?
It’s usually do to a problem with the Migrating Motor Complex (MMC). The MMC is what creates movement in your intestines - called peristalsis - and moves food from your stomach down through your intestines and eventually out of your body.
So what can harm your MMC? The most common causes are chronic viruses like Lyme disease, structural abnormalities, high stress levels, and… food poisoning!
Stay with me here - food poisoning can cause your Migrating Motor Complex to malfunction. When the MMC malfunctions, bacteria can move from the large to small intestine and overgrow, causing SIBO - and SIBO is the cause for as much as 60% of IBS!
As you can see, it’s a complex chain of events - and that’s why for years doctors have missed the connection between IBS, SIBO, and food poisoning. Luckily they are catching up now.
Toxins & Autoimmune Responses
So how exactly does the food poisoning cause damage to the Migrating Motor Complex?
Common food poisoning bacterias like E. coli, salmonella, Campylobacter jejuni, and Shigella all produce a toxin called cytolethal distending toxin B. It sounds bad, doesn’t it?
Your body will start producing antibodies against the cytolethal distending toxin B. For some people, they’re able to fight it off over in a few days and move on without long-term problems, but for about 10% of us (raising my hand!) we can’t fight it off as quickly - and therefore we keep producing more and more antibodies.
These antibodies don’t just fight the cytolethal distending toxin B - they also reduce a kind of protein in our intestine called vinculin.
Vinculin is very important in the health of Migrating Motor Complex - vinculin is crucial for proper function of nerve cells in the gut that cause peristalsis. When the MMC isn’t functioning and movement of food through the gut is slowed down, bacteria can overgrow and cause SIBO - plus other symptoms like bloating and gas.
The good news is that your gut can recover vinculin over time. First, you need to heal the SIBO. But it’s also critically important that you don’t get food poisoning again. So if you already have some gut issues, don’t stop reading now!
Here’s What I Do To Avoid Traveler’s Diarrhea
The key to avoiding traveler’s diarrhea is being proactive - think about where you’re going, research, and prepare! There are supplements I take to prevent illness, supplements I bring with me for defense in case I start feeling sick, and hygiene practices I follow, too.
Supplements I Use When Traveling To Keep My Gut Happy
When I’m travelling, I always take a probiotic. My favorites are Floramyces (which contains the yeast Saccharomyces boulardii) or UltraFlora Acute Care (this one blends S. boulardii with Bifidobacterium and Lactobacillus). I take 1 capsule of either, 1-2 times daily.
I also take Biocidin Advanced Formula Liquid to help boost my immunity. I start with 3 drops per day and work up to 5-10 drops twice daily.
Finally, I always take an Adaptogen blend. Adaptogens are herbs that help mitigate the stress of traveling. Yes, traveling is fun - but it is also hard on our bodies! Moving through time zones, awkward sleep schedules, and even just enjoying all the “newness” are all registered as stress to our bodies. I like blends that contain herbs like rhodiola for emotional and mental stress and eleuthero for physical stamina. NanoMojo Liquid and HPA Axis Homeostasis are my two go-tos.
Don’t Eat That!
Hygiene practices are so important for avoiding traveler’s diarrhea.
I always carry hand sanitizer with me - but not the conventional kind! Commercial hand sanitizers are full of BPA and other chemicals. Instead I make my own from aloe vera gel with lavender and tea tree essential oils, plus some Silvercillin. If you don’t want to make your own, this is good alternative. And of course - wash your hands with hot soap and water whenever you can.
Only drink bottled water - and never get ice! (Yes, even on the plane and in fancy restaurants!)
Avoid salad and uncooked veggies - especially lettuce. Cooked veggies (and cooked, hot food in general) are better when traveling. Worried about missing your greens? I bring a greens powder with me and mix it with bottled water. This one is my favorite.
Make sure you wash any produce you buy. As tempting as it is, don’t eat fruit straight from the farmer’s market cart. Wash it with a non-toxic fruit and veggie disinfectant first!
When eating out, look for food carts and restaurants with long line and plenty of locals.
Do This If You Feel Something Coming On
The minute I start to feel “off” - fatigued, grumbling stomach, or even a headache - I switch from my prevention to my treatment protocol.
I up the Biocidin Liquid to 10 drops, 3x per day.
I double up the probiotic.
I add in Oregano Oil Gelcaps for several days - 2 caps 3x daily.
And if diarrhea strikes? I go to a classic Chinese remedy called Huang Lian Su. It’s a blend of berberine-containing herbs that always works for me. I use 4-5 tablets, 3-4 times daily.
Happy Trails To You!
I hope these suggestions helps ease your fears about traveler’s diarrhea - and allow you to travel the world without getting sick!
And if you think food poisoning is at the root of your SIBO or gut problems, I hope you’ll consider working one-on-one with me to get it resolved. There is hope for overcoming gut problems - even one you’ve had for years! You can book a free consult with my team anytime. We’d love to help you!
The Truth About Fertility Apps (And the Exact Ones I Use and Recommend)
In college, I tracked my periods on my wall calendar. A red dot (so subtle!) marked day 1 of my period. It wasn’t very advanced, but it was when I first started paying attention to my not-so-monthly cycle. Back then I also read paperbacks and kept a grocery list on a magnetic notepad on my fridge.
I don’t do any of those things anymore though because - hey, there’s an app for that!
If you’re like me, you keep everything on your phone now, and there are even some amazing fertility tracking apps you can get, too. These apps don’t just help you remember when you last got your period - the best ones can accurately predict when you'll ovulate each month. You can use that information to help you get (or not get) pregnant.
But not every fertility tracking app you can download is actually useful. Some really can help you predict when you’re ovulating, but others are no more sophisticated than my old red-dot method.
Let me explain how and what fertility trackers can and can’t do - and I’ll tell you which ones I use and recommend (even if you have PCOS or irregular periods!).
Why Should I Track My Cycle?
I recommend cycle tracking for all women. Your period is one of the biggest indicators of your overall health - but it’s also really sensitive to changes. Little changes in your cycle can be a clue of a bigger problem, even before any other symptoms show up.
Plus, being aware of your cycle gives you powerful information about your body. As you get more in tune with your cycle, you may even start basing some other patterns around it (like how you eat or your exercise throughout the month).
And of course, the obvious reason to track your cycle is to track your fertility (by knowing when you ovulate). This is not just for women who are trying to get pregnant - you can use this information to help you get pregnant more easily OR to avoid pregnancy without having to use hormonal birth control methods.
Yes - the right fertility tracking app can replace hormonal birth control if it is used correctly!
But if you’re going to rely on cycle tracking to predict your fertility, it’s critical that you use a reliable app - and they aren’t all created equal.
Calendar-Only Apps Can’t Tell You Enough
Unless you are simply trying to get a better sense of cycle length and variations, regular calendar based apps are useless for fertility detection. These are apps like “Period Tracker” that just ask you to track when your period begins and ends.
These apps base their estimation of your fertility on data from your prior cycles, assuming you have a 28-day cycle and Cycle-Day 14 ovulation. But the truth is that fewer than 10% of women actually do. Your cycle length can also vary from month to month. Because most women don’t have this cycle pattern, these apps cannot accurately tell you when you can and can’t conceive.
Which App Should I Use?
If you really want accurate results (and when it comes to getting pregnant or not, accuracy is key) you need a fertility tracker that does more than just count days.
After testing and trying them all, both myself and with my patients, there are three I recommend - one for people whose goal is avoiding pregnancy, and another two for those who are looking to conceive OR who have very irregular cycles (my PCOS sisters, this one is for you!)
Let me break them all down for you.
If You’re Trying To Avoid Pregnancy (And Or Get Pregnant & Have Regular Cycles)
If you want to track your cycle, get a better understanding of your fertile window and monthly rhythms, and/or avoid pregnancy, I think the Kindara Fertility Tracker is the simplest to use and has a great track record.
Kindara is an app that you use along with a basal thermometer (which gives temperature to the second decimal).All you need to do is remember to take your temperature using the thermometer every morning, right when you wake up, and enter that data into the app. You’ll also track changes in your cervical mucus.
Research by the CDC has shown that, when used perfectly, this method of birth control is 99.6% effective!
Kindara reports days to you as either fertile or not fertile, based on your temperature, past cycles, and cervical mucus. If you’re avoiding pregnancy, abstain or use a non-hormonal birth control method when you’re fertile.
At only $4.99/month (and with a free basic version, as well), the Kindara app is a great alternative to hormonal birth control and is a useful tool for tracking your fertility.
If You’re Trying to Get Pregnant - Or You Have Long or Irregular Cycles
If your goal is to get pregnant, or if you have PCOS or irregular cycles (whether you want to get pregnant or avoid pregnancy) I recommend both Oova and the new Priya.
Priya is a vaginal sensor that monitors temperature all day long. It’s a silicone ring that you can wear continuously for up to 29 days - or remove for up to three hours daily - that takes regular temperature readings.
Because it measures core temperature, and because it takes readings all day long, every 6 minutes, the resulting temperature data is much more accurate than taking a single, oral reading.
Priya is able to predict ovulation up to 2.5 days in advance of a LH surge on an ovulation urine test and data in trials suggests it is just as accurate as an ultrasound, which is the gold standard for ovulation testing!
If you have PCOS, or unexplained fertility, using Priya can unlock a huge piece of the puzzle. The same holds true if you have irregular cycles or irregular ovulation from any cause, and are either trying to conceive, or trying to avoid it. It also works if a woman is taking fertility treatments in the form of herbs or medications to promote ovulation.
And if you’re wondering if it’s safe to wear, I have you covered! My first question was about the potential for EMF exposure. What makes Priya cool is that it only connects to the device once an hour for a few minutes, and it’s at a very low power. You can also change the setting and have it connect even less often, 1-2x daily is all that’s needed, and you can remove it before connecting. It will still read and store your temperature, even when disconnected.
I also asked about the potential for biofilm buildup and vaginal microbiome disruption (which is a major issue with other vaginal rings, like Nuvaring). Priya is different because it's made from washable silicone. You can take it out every day and wash it, and it can be removed up to 3 hours per day and still be effective.
Priya is not yet available to the public, but I am testing it with my clients and loving the results. Sign up for pre-orders here.
Another Amazing Option - Especially for PCOS!
Along with Priya, I recommend Oova, which uses urine tests (think pee-on-a-stick pregnancy tests) to track fertility throughout the month instead of temperature. You order a kit with 15 tests, and enter test results into the app for lab-quality results.
Honestly, I love Oova. The technology was developed by a doctor who struggled with fertility herself, and it’s unlike anything else you can buy.
You’ve probably heard of LH tests (AKA Ovulation Predictor Kits) before: you can buy them at the drugstore, and until now they were the best option for at-home ovulation prediction. But the big problem is that LH - luteinizing hormone - is present in your urine all month, and it surges just before ovulation. All an LH test can tell you is that ovulation is coming in the 24 hours or so - and that depends on you taking it at the right time (too early or too late and you’ll miss the tell-tale surge). Plus, interpretation can be confusing: is today the strongest pink line? Was it yesterday? Will it be tomorrow?
If you’re trying to get pregnant, LH tests alone aren’t very helpful because your fertile window is actually 5 days up until you ovulate, and an LH test misses most of that. And, an LH surge doesn’t always mean that an egg has actually been released, as some women don’t release an egg every cycle.
Oova uses super-sensitive, nanotechnology LH tests along with progesterone tests to solve this problem. Progesterone levels rise when an egg is released from the follicle in the ovary where it has been growing. High progesterone levels are also necessary for the vascular development of endometrial lining, and to prevent shedding of the endometrial lining if you are pregnant. By tracking progesterone levels with LH, Oova gets a complete look at your cycle.
You’ll use the Oova tests - which are read by the app, so you don’t have to do any interpretation - to establish your hormonal baseline and then see the changes that indicate your fertile window. It can uncover your exact, unique cycle length, and confirm that ovulation has in fact occurred - so it’s ideal for women with irregular cycles or PCOS!
I love to pair Oova with Priya or Kindara data, too - especially for tricky, irregular cycles who are trying to conceive!
Learn more and get Oova here. Use code BWIH1 for 15% off your Oova order!
Can A Fertility Tracker Really Replace Other Forms of Birth Control?
Like I said before, I recommend tracking your cycle to all women - even if it’s just a simple calendar app for right now.
But the right fertility tracking app CAN replace other forms of birth control as long as you’re doing it the right way. Just like with the pill or condoms, user error is the biggest problem with using fertility tracking as a birth control method.
Before you get started, read all the instructions included with your fertility tracking app - and when in doubt, use a backup method like a condom. My favorite condoms are Sustain Natural Latex Condoms, which are nitrosomine-free (nitrosomine is is a carcinogen that is formed when latex is heated and formed). The rubber they use for manufacturing their latex is also non-GMO and fair trade, which is really significant with condoms, as child labor and harsh working conditions are a big issue in many rubber plantations world-wide.
Do You Track Your Fertility?
If you have experience with the Kindara, Priya, or Oova, I’d love to hear how it worked for you! Got another fertility tracking app you love? Leave a comment and let me know.
And if you’re not yet tracking your fertility but want to give it a try using one of the apps I recommend, save 15% on the Oova kit with code BWIH1!
Natural Cold & Flu Remedies
Natural Cold & Flu Remedies (from Chinese Medicine)
It starts in the last weeks of summer with the “back-to-school” cold. By the time fall is slowly starting to turn to winter, it can feel like cold and flu infections are lurking on every door knob and elevator button.
And the truth is, they are! School age kids get 6-8 colds on average per year, and adults get 2-4. Women get more colds than men - probably because they often have more contact with kids. That averages roughly 5.5 missed work days per person, and 150 million workdays missed nationwide, just due to the common cold virus.
But, you don’t have to get sick that often (or stay sick so long)! You can get through the fall and winter without sniffles, runny noses, hacking coughs, and more phlegm than you thought existed in the universe - and you can do it without prescription drugs or over-the-counter cough syrups.
Can You Treat a Cold or Flu Naturally?
Absolutely. If you catch it early enough, nutrients and herbs can cut a virus off before it takes hold. And if you don’t catch it in time to prevent it from taking root, holistic treatment works powerfully to decrease symptoms, shorten the duration, and prevent secondary infections (like bronchitis or pneumonia) from developing later.
And remember: antibiotics do not work for viral infections, so they have no use in treating the common cold. The only time you should use antibiotics is if a bacterial infection sets in on top of a cold or flu.
Herbs, on the other hand, can help treat both bacteria and viruses. One plant can contain thousands of phytochemicals - compounds that are antiviral, help to boost white blood cell sounds, and antibacterial can all be in the same herb! Carefully combining herbs, as has been done for thousands of years, can make them even more powerful!
Why I Use Chinese Medicine to Treat Colds & Flus
When patients (or myself!) come down with the common cold, I always go back to my roots in Chinese Herbal Medicine. Herbs have been used by Chinese Medicine practitioners for thousands of years to treat and prevent colds and flus.
In Chinese Medicine, the common cold is divided into six distinct stages that each have unique herbal treatments. Formulas to treat symptoms of each stage are carefully created with different herbs. Chinese medicine herbalists consider not just what stage of a cold you’re in, but also the properties of the herbs, temperatures, and how a person will interact with the herbs based on their own constitution.
These formulas can give you both quick, short-term relief (by treating your symptoms) as well as help you get better faster (by boosting your immune system).
To really customize an herbal formula to what stage of a cold you are at and your constitution, I would recommend an in-person consult. But even if you can’t see a Chinese Medicine practitioner like me in person, there are some general nutrient and herbal formulas that are balanced enough to be safe and effective in all generally healthy adults who are trying to fend off impending coughing and sneezing.
Prevention First
Hands down, the best way to fight a cold or flu is to not get sick in the first place!
It goes without saying that practising good hygiene is the first step - wash your hands with hot water and soap and cover your nose and mouth when you cough or sneeze. Eating a nutrient-dense diet, getting plenty of sleep, and regular exercise can also help keep your immune system strong so that you effortlessly fight off anything that comes your way.
But Chinese herbs can be a secret weapon in preventing colds, too. Herbs can help strengthen our immune systems and fight off colds before they take root.
My favourite formula for taking throughout cold and flu season to strengthen the immune system is Yu Ping Fen Wan. This traditional Chinese formula contains lots of Astragalus, an herb which helps to increase circulating white blood cell counts and increases cytokines in our immune system that help ward off viral infections. The brand I use calls this formula Astra C, and the dose for adults is 2 tabs 2-3 times daily through cold and flu season.
What If I’m Already Sick?
With any Chinese Medicine formula, the quicker you start to take it, the better results you can expect. Personally, I will sometimes take a few doses of the herbal formulas for the first stage of a cold if I have had significant exposure to someone who is currently sick, just to make sure I don’t come down with the same thing!
But even if you don’t catch it before symptoms set in, the sooner you start treatment, the faster you’ll feel better.
But I know what you’re thinking - the last thing you want to do when you already feel bad from a cold (and maybe have a husband with the man-flu and kids who need your attention, too) is try and decipher labels at a Chinese herb shop!
That’s why I recommend keeping some herbal formulas on hand during the winter months. These are tablets that you can keep in the cupboard, just like you would a bottle of cold syrup. That way, when a cold or flu strikes, you’re already prepared.
I have my exact cold and flu protocols
(yes, even the exact brands of herbs I use!) - the same ones I use for myself and my clients - all in one PDF. You can download a copy for free here
.
When To Get More Help
The common cold, and a low grade version of the annual flu virus, as common as they are, can still make you feel really bad.
Both colds and the flu can usually be treated at home, without needing to see a doctor.
The most common cold symptoms are:
- runny nose and sneezing
- sore throat
- sinus congestion
- mild headaches
- body aches
- chills
- low-grade fever
- generally feeling unwell
A cold should run its course within 7-10 days, in most adults. Herbal treatments (like the ones in my protocol) can help with these symptoms.
But if your symptoms progress to any of these, you should seek medical attention:
- If your fever rises above 101.3 or lasts for more than 5 days
- If your headache, ear, throat, or sinus pain becomes severe
- If you notice wheezing, or have asthma symptoms
- If you get a deep barking cough or bronchitis, especially if you start to feel worse several days into the virus, rather than better.
The influenza virus (aka the flu), has many of the same symptoms as a common cold virus, but it is more likely to include fever (which is frequently over 100 degrees), and tends to have a more abrupt onset. Body-aches are usually more pronounced, and it is not uncommon to also have digestive symptoms like vomiting or diarrhoea.
The flu takes up to 2 weeks to recover from. The warning signs for seeking medical attention are the same as with the common cold, but according the the Mayo clinic, additionally include:
- Difficulty breathing or shortness of breath
- Pain or pressure in the chest or abdomen
- Sudden dizziness
- Confusion
- Severe or persistent vomiting
- Flu-like symptoms that improve but then return with fever and worse cough
Feel Better Soon!
Hopefully you’re reading this article before you get hit with a nasty cold or flu - but if not, I hope you feel better soon! Grab a bowl of bone broth, bundle up, and try some of my cold and flu protocols here.
4 Crucial Steps for Mealtime that can make-or-break your digestion
When it comes to healing digestive issues, it’s certainly true that we need to test to identify and then treat any infections or dysbiosis that may be contributing.
But just as importantly, we need to optimize the environment of the gut. In order to develop infections or overgrowths, the environment has to be right. Otherwise, our healthy gut terrain is inhospitable to the “bad guys”, and nurturing to the “good guys”.
This mainly involves things like optimal digestive secretions (like stomach acid and pancreatic digestive enzymes) that set the pH and fully digest our food. This ensures that we both assimilate the nutrients contained in what we eat, but also prevents other organisms, like bacteria and yeast, from eating it instead.
Other secretions, like bile from our liver/gall bladder, are also super essential. Bile digests fat, but also is a powerful antimicrobial, and regulates the motility of our intestines.
Of all the digestive secretions, Stomach Acid might be the most important when it comes to resilience against infections. Stomach acid (called Hydrochloric Acid, or HCL) is like your first line of defense.
You may know that stomach acid’s main role is to break down the proteins we eat, so that we can absorb the smaller amino acid building blocks to use as nutrition.
But stomach acid is also antibacterial to undesirable strains because of the low pH environment that it creates.
Keeping food in the stomach long enough is critical for the action of stomach acid to control the populations infused into lower regions with each pulsatile release of chyme. This is because food needs to be exposed to stomach acid (HCL) long enough to kill bad bacteria, preventing them from proceeding on into the small intestine.
So, if you have super-rapid motility (this is common in people who have chronic diarrhea), your food may pass too quickly through the stomach and into the intestines, and not have enough exposure to HCL. This equals increased risk of infections, in addition to not enough nutrient digestion.
Due to…
- Stress
- Nutrient deficiencies
- Modern diet and lifestyle
- And even just natural aging!
it’s unfortunately very common for people to produce less than optimal amounts of stomach acid to meet the demands of food intake.
And…..we need enough HCL present to keep the stomach pH below 4 for the entire time the food we are digesting in the stomach. If this doesn’t happen…pathogenic microbes pass unharmed into the intestines where they can take residence! (hello SIBO and parasites!)
Here’s the most important thing I want you to learn today:
HOW we eat our meals is one of the most important factors in optimizing gut environment.
Just becoming aware of HOW we eat, is one of the biggest things you can do to change what is happening with your digestive secretions, and therefore, with your microbiome.
Chewing: Why is chewing your food so important in regards to this?
Yes, chewing breaks your food down into smaller pieces, increasing the surface area, so that digestive secretions in the stomach and small intestines (like pancreatic enzymes, bile, and stomach acid) can further break them down.
But….there are other not so obvious reasons!
Chewing exposes foods to enzymes in the saliva that break down the cell walls of gram positive bacteria, causing them to die.
This means that chewing adequately is really our first weapon against pathogens that might be entering with our food!
Being relaxed while eating: Stress is a big factor that leaves us more prone to getting opportunistic gut infections, because stress shuts down our digestive secretions.
When our brain thinks we need to run from the proverbial tiger, it focuses our body’s energy and attention on surviving NOW, and diverts it from activities that are about long term survival, like digesting our nutrients.
Stress also spikes our cortisol, and this suppresses our gut’s immune system big-time--for much the same reason. And the hormone that our brain uses to signal the adrenal glands to make more cortisol, CRH, can promote leaky gut.
Healthy Meal Hygiene for Healthy Gut Environment:
1) Focus on creating a state of overall calm before, during and after eating to encourage stomach acid and digestive enzyme secretion.
2) Chew adequately—more than you think….keep chewing!-- to reduce particle size and mix enzymes in the saliva.
3) Include balanced fats, carbohydrates and proteins in each meal to encourage food to stay in the stomach long enough.
4) Planning enough time for meals—not eating on the run—is critical, to help allow for parasympathetic (rest-and-digest) nervous system activity. This allows for proper secretion of digestive fluids. Otherwise, if our body thinks we are running from the hypothetical tiger, there’s no digestion being emphasized, and no secretions being made—“Ain’t nobody got time for that”!
Have any questions or comments on this?
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Why Your Gut Health and Microbiome Make-or-Break Your Hormone Balance
Acne worse than puberty, ten pounds that won’t budge, a period-induced mood swing that turns you into a totally different person-- these are sure signs your hormones are out of whack. The solution to hormone problems like these seems obvious: Fix your hormones.
But what if I told you that the first step to balanced, happy hormones (and clear skin, easy, regular periods, a healthy weight, and even-keeled moods) isn’t about estrogen, progesterone, or testosterone?
I’m going to let you in on a big secret about female hormones: They never break in isolation.
What does that mean? Simply that if something is not right with your hormones, it’s a sure sign that something ELSE is not working right in your body that is causing the hormone problems. If you’re having symptoms caused by imbalanced hormones, we have to do more than just treat the symptoms - and we even have to do more than just treat the hormone imbalance. (Prescribing artificial hormones is NOT the answer).
We have to go back even further and find out: What caused the hormone imbalance in the first place?
Finding and addressing the root cause of your hormone imbalance is the MOST important step to achieving hormone balance for life.
And 9 times out of 10, when we do the careful detective work to find the real root cause behind hormone imbalance, it’s actually related to gut health.
I know it sounds a little odd at first - but the health of our gut is actually closely tied to our hormone health. In this post, I’m going to explain the link between our gut and hormone health, and what you can do to optimize both.
The Gut-Hormone Dream Team
The gut and our hormones are meant to be in communication. They support each other and work together to make our body run smoothly. In fact, our intestinal cells have special receptors for hormones that allow them to detect hormonal shifts.
It’s intuitive that our hormone and gut interact, too - even women with symptom-free periods will report noticing slight changes in their bowel patterns before and during their menstrual cycle.
Both estrogen and progesterone impact gut motility & peristalsis - the rhythmic movement of the intestines that moves food from your stomach down through your intestines and eventually out of your body. Estrogen and progesterone play opposing roles in motility. Progesterone slows down motility in the gut by relaxing smooth muscle and slowing transit time (the time it takes for food to move out of your body). Even women without IBS or other digestive issues are more likely to feel mildly constipated, or just more “full” during the week prior to the period, when progesterone levels peak.
Estrogen, on the other hand, increases contractions of the smooth muscle in the intestines. When estrogen levels are just right, this helps keeps things moving. Estrogen also increases the diversity of your microbiome, which is a good thing for immune health. Estrogen levels drop off suddenly, twice, during a normal menstrual cycle: once right before ovulation, and again just prior to your period starting. This can cause spasm and fast motility in the digestive tract, which can cause diarrhea at these times (even in healthy women). For the same reason (sudden, dramatic drops in estrogen levels), this can also happen during perimenopause and menopause, too.
Pregnant women experience an increase in progesterone in early pregnancy and then again in the third trimester - this is responsible for the constipation so many women experience during pregnancy. The excess progesterone can also cause the sphincter in the upper GI tract to loosen, leading to heartburn and reflux.
When estrogen and progesterone are in balance, you’ll tend to have normal motility most of the time - neither constipation or diarrhea. (Unless you also have some gut infections like SIBO, Candida, or parasites….then you could still have constipation.)
The Estrobolome
Our gut and hormones do more than just “talk”-- your gut microbiome also regulates estrogen. The estrogen-regulating function of specific bacteria in the microbiome is called the “estrobolome.”
The estrobolome is really important to keeping healthy estrogen levels in the body -- but to understand why, you need to know how the estrogen cycle works. Here’s how it happens in a healthy system:
- Estrogen is produced in the ovaries (but also in the adrenal glands and adipose tissue to a lesser extent)
- Estrogens circulate in the blood, making their way to tissues in the breasts, brain, bones, uterus and elsewhere
- Eventually, the estrogens travel to the liver, where they are broken down and deactivated
- Detoxified estrogens are deposited in bile which is secreted into the intestines, and exits the body with the stool.
So, where does the gut come in? The gut - or more specifically, the estrobolome - regulates the amount of estrogens circulating in the bloodstream through the creation of β-glucuronidase, an enzyme which breaks down estrogen into to its “free”, or biologically active form.
But that isn’t all the gut does - it can also create its own estrogen, too!
Bacteria can manufacture estrogen-like compounds from foods that we eat. For example, lignans, found in plants like flax seeds, are converted into estrogen-like compounds when acted on by bacteria in the gut. On their own, they don’t have any hormonal properties, but once converted the can either promote uptake of our own more potent estrogens into receptor sites, or can compete for the same receptor sites,.
Newer research also suggests that the microbiome (and also specific types of probiotics) can produce its own estrogen and also signal glands around the body to produce it. We don’t yet fully understand exactly which strains of bacteria are responsible for all of these hormone modulating roles, but we do know that we want good overall proliferation, and greater species diversity.
When Things Go Wrong
The gut and your hormones are closely linked. You can see that both the gut and the hormone systems depend of each other to work properly - and when something goes wrong with either one, it spells trouble for the other.
Problems in the gut-hormone relationship usually start with the gut - but once the delicate balance is thrown off, it’s hard to know where to pin the blame. Imbalanced hormones cause gut problems, and gut problems cause imbalanced hormones.
Here are just some of the ways gut problems can lead to hormone imbalance:
Leaky Gut Syndrome: Leaky Gut Syndrome (aka Increased Intestinal Permeability) occurs when the tight junctions between cells in the intestine become “leaky” and allow toxins called LPS (which are fragments of dead bacterial cell walls) to pass from the intestine, into the bloodstream, and circulate through the body. It sounds crazy, but it’s actually common and causes a wide range of symptoms.
If you have leaky gut syndrome (with or without symptoms), you are more vulnerable to developing hormonal imbalances. Why? Because leaky gut causes widespread inflammation throughout the body. LPS is known to cause inflammation in any tissue that it comes into contact with, and in the ovaries, the result is suppressed progesterone production. (Women with higher levels of LPS in the blood had elevated markers of inflammation in fluid inside the ovary (follicular IL-6), and correspondingly low progesterone production.)
Studies show that infections, allergic reactions, being born by cesarean section, and even chronic stress can all cause inflammation in the gut, as well. And inflammatory conditions like obesity and inflammatory bowel disease are associated with disrupted menstrual cycles and infertility.
If you’re not having digestive symptoms like bloating, diarrhea, or constipation, you may think you don’t have leaky gut syndrome - but leaky gut may not show up as digestive symptoms, depending on the person. Even without digestive symptoms, the “silent” inflammation caused by leaky gut affects nearly every other aspect of health - especially our hormones.
Gut Dysbiosis: Your intestines are filled with trillions of bacteria, fungi, and even some viruses, that are all collaborating to keep your system running smooth and healthy. These bacterial cells and their genes are called your microbiome, and they live not just inside the intestines, but on every surface of your body, from your skin, to your eyes, your lungs, vaginal walls, and bladder. When the microbiome gets disturbed and the type or number of bacteria is damaged, we call it gut dysbiosis.
Along with your brain, your microbiome regulates the expression of your hormones, and can restrict or promote hormone production elsewhere in the body. The bacteria in your microbiome are like air-traffic control for hormones. In addition to signalling other glands in the body to dial up or down the volume on hormone production, your gut flora regulate hormone metabolism post-production, by either helping (or hindering) detoxification of already-used hormones, when they are being cleared from your system to make way for new fresh hormones.
To work properly, your microbiome needs the right bacteria, in the right amount. When the type or number of bacteria gets messed up (from something like poor diet & stress, an infection or parasite, or even just a course of antibiotics) your gut can no longer perform it’s hormone-regulating functions properly.
Increasing reactions to food, bloating, skin outbreaks, constipation, stubborn weight that won’t budge despite your best efforts, and even heavy periods— can all be signs that your microbiome is compromised and you’re unable to properly metabolize hormones like estrogen in the gut. Ultimately, this causes a build up of hormones in your system, which shows up as worsening of your PMS, period symptoms, or menopausal symptoms, and leaves you bloated and moody.
Estrobolome Dysfunction: Remember, the estrobolome are the specific bacteria in the microbiome responsible for regulating estrogen in the body through the production of the enzyme β-glucuronidase. Disruption of the estrobolome are really a type of dysbiosis. The estrobolome can be damaged in the same way the rest of the microbiome gets hurt: common triggers are stress, poor diet, and especially antibiotic use.
If the estrobolome bacteria become overgrown, the result is too much beta-glucuronidase being made. This causes already-detoxified estrogen to be reabsorbed and recirculated, in really high levels. This leads to a state of estrogen dominance. And estrogen dominance creates all kinds of chaos - PMS, cramps, fibroids and cysts, endometriosis, PCOS, heavy bleeding, infertility, a zapped sex drive, and weight gain. And of course, it can increase the risk of certain types of breast and uterine cancers.
And while it’s clear that we don’t want gut bacteria producing too much beta-glucuronidase enzyme, we actually don’t want them under-producing it either! When women have extremely low microbial diversity or even just extremely low levels of bacteria in the gut (think: excessive antibiotic use), the decrease in beta-glucuronidase causes a reduction in circulating free estrogens. Excess estrogen isn’t a good thing, but insufficient estrogen levels, especially in post-menopausal women, isn’t good for our health either! Estrogen is critical for maintaining healthy brain cognition, bone density, gut health, and cardiovascular health.
It isn’t just these gut problems that could be causing your hormone issues. The gut-hormone connection is a two-way street: here are some of the ways imbalanced hormones can wreak havoc on your gut health:
- Gallstones - women get gallstones twice as often as men! Estradiol (one of the types of estrogen) increases cholesterol levels in bile produced in the liver. (Cholesterol is the building block of our reproductive hormones, so when they are detoxified and broken down, cholesterol is released.) This increased saturation slows bile flow, which can lead to more stone formation.
- Leaky Gut - While inflammation caused by leaky gut can lead to hormone imbalances, low estrogen levels can also contribute to leaky gut. The epithelial layer of the intestinal wall needs estrogen to and keep it healthy and elastic. Leaky gut has been associated development of food sensitivities, autoimmune diseases, weight gain, acne, depression and anxiety, as well as almost every chronic illness you can think of.
- IBS - researchers know that estrogen and progesterone levels have an impact on the development of IBS (Irritable Bowel Syndrome). Symptoms of IBS include diarrhea, constipation, bloating, pain, and food intolerances.
Here’s the bottom line: if you want healthy hormones, you have to fix your gut!
Healthy Gut, Healthy Hormones
We know that we need a healthy gut to get healthy hormones - but what messed up your gut in the first place?
It’s a fair question, and not always easy to unravel. These are the most common causes for gut problems I see in my clinic - but there are many more (and most people have more than one contributing!)
Antibiotics: A single dose of the antibiotic Augmentin can kill off up to 90% of your gut flora - and most people are prescribed a 5-day course! Gut flora will regrow, (although it can take up to a year) but what types take hold and flourish impacts every aspect of our health. Generally we lose lactic-acid-producing species (like L. Acidophilus) first. This causes pH to go up in the intestines. Good colonic bacteria flourish in a more acidic environment, so in a less acidic environment, unfavorable strains can grow.
Toxins: Pesticides, herbicides, glyphosate from GMO corn and other foods, environmental chemicals, infections, and even stress can negatively shift the microbiome.
Diet: Eating a diet low in fermentable fibers and resistant starches (found in veggies, fruits, nuts, seeds, legumes, and grains) will also decrease bacterial diversity. Dairy, sugar, and gluten are major culprits in promoting bacterial imbalances.
The Pill: Contraceptive pills damage your microbiome as much as antibiotics do! The pill is known to promote candida overgrowth and SIBO (small intestine bacterial overgrowth) as well. Recent research has linked oral contraceptive use to development of inflammatory bowel diseases such as Crohn's Disease and Ulcerative Colitis, too.
The good news is there is a lot we can do to support better gut health - leading to better hormone health.
The best ways to support a healthy microbiome for healthy hormones, is through a diverse whole food diet, optimizing digestion, and taking steps to lower inflammation.
- Eat fermented foods - Sauerkraut, yogurt, kefir, kombucha, etc.
- Eat prebiotics/fiber - Found in root vegetables, flax seed, psyllium, beans, seeds, nuts, fruits and veggies. Women who eat more fibers from plants clear greater levels of estrogen in their stool.
- Take probiotics - In particular, Lactobacillus Acidophilus helps lower beta-glucuronidase!
- Optimize the environment of your digestive tract so good bacteria flourish there - This is similar to prepping the soil in your garden beds. Digestive secretions like pancreatic enzymes, stomach acid, and bile help optimize the conditions in the gut to promote the desirable bacteria. Taking these supplementally if you are deficient can help prime the gut for healthy colonization.
Get Your Gut & Hormones Humming
Every woman’s health is unique - but if a woman is having hormone symptoms, it almost always comes back to gut health! Heavy periods, adult acne, and PMS may not seem like they are related to your gut, but they so often are! That’s why I always test and treat the gut alongside hormone balance problems in my clinic.
Remember, our hormones don’t break in isolation! It’s almost always a sign of a problem somewhere else in the body. If you are struggling with your hormones, don’t forget to consider your gut health!
I hope this article and my suggestions for optimizing gut health help you. Need more help unraveling the root cause of your hormone issues? Want to run the right testing, so that you can really know for certain, what’s going on with your hormones and gut? I love to help women like you get back to radiant health so they can live big! If you’re interested in learning more about how I do this, you can book a free 20-minute prospective patient call here.
Acid Reflux and Chronic Urinary Tract Infection; Totally 'Unrelated' Symptoms With the Same Root Cause?
One of the principles of Functional Medicine is finding and treating the “root cause.”
But sometimes, it isn’t as simple as finding one root cause and getting rid of it. Most of my clients have multiple health concerns - and multiple causes behind them. Helping them is about peeling back the layers and addressing each one as we go.
For my client Jane, peeling back the layers was exactly what we needed to do! She came in because she was experiencing tightness in her chest caused by acid reflux - and we wound up working through multiple gut infections, addressing vaginal dryness, and putting interstitial cystitis (a condition that causes chronic bladder pain like a urinary tract infection) into remission.
Every time we treated another “layer” Jane felt better than before.
Today, Jane wants to share her story in her own words. If you’re considering pursuing help with a Functional Medicine Practitioner like me, I hope this story helps you better understand the process of working with a practitioner.
Jane’s Story
About three years ago, I started dealing with some bloating. Then, I’d occasionally have constipation - not all the time, but enough that I noticed it. I had a colonoscopy and the results came back normal. I started taking a probiotic. The bloating and constipation just became kind of a general annoyance I was living with.
But then I started feeling tightness and pain in my chest. That was really scary. I went to the doctor right away, but the tightness and pain weren’t heart-related. That’s when I realized they were actually a digestive issue. I decided to go see a physician at my regular clinic, and they told me it was acid reflux, prescribed Prilosec, and referred me to a GI doctor.
Luckily I had read enough about Prilosec to know I didn’t want to take a proton-pump inhibitor. Instead, I decided to get a second opinion from a Functional Medicine Practitioner - that was Brie.
Working With Brie
From the start, Brie was very thorough. She took a really detailed history that helped me connect some dots about what had started all my digestive symptoms in the first place. The past summer, I’d had a urinary tract infection and taken a course of antibiotics. Then in the fall, I went traveled out of the country and had to take a course of the antibiotic Cipro for traveler’s diarrhea. That's when the bloating and constipation became worse and the other acid reflux symptoms started.
But she wasn’t just interested in the acid reflux - Brie asked questions about my overall health. When I told her I was experiencing vaginal dryness, urinary pain, and low libidio, she took me seriously. My doctor had diagnosed my with interstitial cystitis - basically pain in my reproductive organs for no reason.
Brie explained to me how the antibiotics had killed the good bacteria in my gut as well as the bad. She recommended stool testing and a breath test for Small Intestine Bacterial Overgrowth (SIBO), as well as hormone testing. She also recommended I cut out dairy and gluten temporarily to give my system a break, since those foods are common gut irritants. She also recommended some supplement that would soothe my gut and help with symptoms until we got the test results back. All this happened at our very first meeting!
The Test Results Came In
The test results came back a few weeks later - they showed low cortisol, low estrogen, H. pylori, low beneficial flora, and a few overgrown bacteria (citrobacter, pseudomonas). Plus, I had both methane and hydrogen type SIBO and was under-producing pancreatic enzymes.
It was a lot to take in and I was so glad I had Brie to help me understand what the results meant. She saw how everything was connected.
Brie explained that the H. pylori infection was likely causing the acid reflux, and that the SIBO was probably the cause of the constipation and the uti bloating. My hormone problems were tied in to all of it and causing the vaginal dryness, urinary pain, and low sex drive.
It was a relief to know there was a reason I was feeling the way I was feeling - especially because my symptoms had gone into a flare as we waited for the test results. I remember going to visit a friend for a few days and having to come home early because I was just so uncomfortable.
Brie started my on a supplement protocol for 6-8 weeks for both the H. pylori and the SIBO. I kept avoiding gluten & dairy, too.
After I finished the first supplement protocol, we re-tested. The H. pylori was gone! The SIBO levels had come down, but it wasn’t completely gone. On the second stool test, I also had positive results for some other common gut infections and parasites, including candida overgrowth. Brie explained that all of this was normal - the first protocol of supplements had helped destroy the “biofilm” - the protective cover the bad bacteria use to protect themselves and hide. With the biofilm gone now, we could see other parasites and better treat the SIBO, too.
By, then my acid reflux was totally gone and I was feeling pretty good gut-wise. But I was still struggling with the vaginal dryness and hormone symptoms. And, what I initially thought was a bladder infection turned out to be Interstitial Cystitis. The “UTI” pain didn’t respond to normal treatments, and the pain turned chronic. Can a UTI cause bloating and constipation?
Putting Interstitial Cystitis Into Remission
My hormone symptoms were slowly improving as my gut healed - but Brie also suggested using a plant-based bioidentical estrogen replacement. She also had me use vaginal DHEA, a vaginal probiotic, and some herbs. Those helped me feel better right away.
Brie also explained that two of the bad bacteria that the tests had shown were overgrown in my gut - proteus and citrobacter - were related to the Interstitial Cystitis, too. As we treated those, my symptoms disappeared completely.
Brie suggested I work with a pelvic floor therapist, too. That helped me relax some overly tight muscles that were contributing to the pain.
Changing My Diet
Brie suggested I follow a gluten and dairy-free, low-FODMAP diet. It helped me a lot in the beginning, but I was anxious to reintroduce more foods as soon as I could.
After a few months, I was able to reintroduce beans and some other legumes, which I hadn’t been able to tolerate for years, and I really missed. I am now back to eating all fruits and veggies, and I can even add in a little gluten here and there. That makes me feel good!
Where I Am Now
After working with Brie, I feel great for the first time in years.
I came to see her because of the acid reflux - but she opened my eyes to a lot of problems I had been writing off as “normal” or just “part of getting older.”
Gut-wise, I am feeling so much better now! After having given up gluten and dairy for years, I’m finally able to experiment with adding them back into my diet again now.
The interstitial cystitis pain is gone now, too. I didn’t realize how much the pain held me back from enjoying life - I even cancelled an overseas trip because of it!
I’m so happy to be where I am now with my health. I’m following a maintenance protocol now and continuing to meet with Brie occasionally to make sure I’m doing the right things moving forward.
Working with Brie has made a huge difference for me, and I wish more people could have access to it! I hope my story helps to spread the word.
Do You Need Help, Too?
Jane had amazing success - she cleared multiple gut parasites, fixed her digestion, reversed interstitial cystitis, and was even able to reintroduce foods she hadn’t eaten in years.
Why was she so successful? Because she dedicated herself to working through the process of Functional Medicine. She didn’t give up even when it got complicated - and neither did I!
I hope reading Jane’s story has helped you understand better understand the process of working with a Functional Medicine Practitioner like me.
If you’re inspired and ready to start your own journey, you can book a free, no-obligation Prospective Patient Interview with my team. During this 20-minute appointment, we’ll learn about you and discover if you’re a good fit for working with us.
We’re Hiring a Virtual Office Manager!
Hey, guess what!? We’re looking for a Virtual Office Manager to help us manage the every-day details of running our consulting practice. We currently have an absolutely brilliant team member in this role who will be moving onto bigger and better things in the fall.
This is a paid hourly contract position--you work from home and would probably start out as a 12-or-so hour per week role, with room for growth as we grow :-) That said, we are currently growing rapidly, and so the ideal candidate would have room and desire to grow into a 20-30 hour a week position over the next year.
We’re looking for someone who:
- Is highly organized, detail-oriented, and serious about organization and processes (like, you organize-your-closet-by-color-and-alphabetize-your-spices-type-organized). You probably have done event planning or bookkeeping because you’re good at logistics and details, and you like to write lists and work from a checklist at all times.
- Enjoys working alone most of the time. While you will be in communication with Brie and other team members, as well as with clients, regularly, the work you’ll be doing is typically alone. If you’re the type of person who likes to chit-chat with people and interact with friends a lot during your work day, this probably isn’t right for you.
- Has the flexibility to work at least 1-4 hours each day of the week (excluding Saturday and Sunday) - preferably split between the morning and late afternoon/evening. Certain tasks must be done on Friday of each week, requiring several hours.
- Knows their way around a computer, apps, and various cloud-based software. Thinks that “everything is figure-out-able”. Is “tech savvy” with things like Office, Google Docs, Excel sheets, scheduling, email, ordering things online, etc.
- Is extremely dependable... not the “This usually doesn’t happen, but it happened again” type.
- Doesn’t take things personally, have feelings hurt easily or get offended. Stays objective and likes to always use logic to make decisions. This trait is extremely important for the customer service aspect of this role. Many of our clients just don’t feel so good when they initially start working with us….as a result, they can be slightly less than patient, have a lot of questions, get a bit grouchy, or need things explained to them in more than one way. Having extra patience and compassion, and/or having had experience either recovering from health issues, or living with someone who has, is a plus here.
If you’re the type of person who likes “creative” work, where you interact with a lot of people in a lively physical environment and chit-chat at the coffee machine..... and deal with a lot of different types of complex challenges….. then this probably is NOT right for you. This is more of what we would call “organizer” work, and will require you to keep checklists and work through specific processes.
On the other hand... if you’re the type of person who loves organizing things, operating efficiently and using checklists, and basically becoming better and better at running through a pre-planned process, (or, having the vision to make suggestions for improving upon what we already have developed) then this might be perfect for you!
As the Virtual Office Manager, you’ll be ordering tests, ordering supplements, setting up new patient charts, processing orders, filing test results, etc. This role does involve interaction with our clients or customers via email on a daily basis.
No questions please.
To apply, click below and respond to the questions by WED 9/19.
We can’t wait to meet you! :)
How I healed from 6 years of severe insomnia-- and you can too!
It is estimated that up to 50% of adults in the US are affected by insomnia, with up to 60 million having chronic sleep trouble. Twenty percent of Americans report that they did not wake up feeling refreshed on any of the past seven days. These numbers are staggering, when you think about the incredible number of studies proving that adequate, good quality sleep is essential for disease prevention, mood, and brain function.
I went through a time in my 20’s where I simply couldn’t fall asleep. For hours, I would lay awake, tossing and turning, getting angry and frustrated at my increasing alertness. After a while frustration would turn to worry….. “how am I going to function tomorrow….I need to be up at 7 to make it to work/class/etc”, “Am I ever going to be able to fall asleep naturally again in my life?”
I seriously believed that I had forgotten how to do something that I had taken for granted my entire life up until that point. To just. Go. The. F. To. Sleep.
Sleep Matters
When my clients mention that their sleep is less than optimal, I take it seriously. No matter what the main health issue is, if you aren’t sleeping well, the body and mind just can’t repair fully. Lack of sleep makes us inflamed, stressed, shifts our hormones for the worse, and impairs blood sugar balance. Our levels of patience, concentration, and creativity suffer. That word or name we are grasping for remains elusive as we struggle to communicate our thoughts.
Studies show that we tend to make poor food choices the next day. Poor sleep can even lead to weight gain, without a change in diet. Difficulty falling asleep, or staying asleep, inevitably leads to being less than fully awake and refreshed during the daylight hours— for years; I felt like I was half of myself. And that’s no way to live.
Finding My Root Causes
Resolving my insomnia required a pleiotropic (multi-faceted) approach. Testing and supporting my adrenal hormones was the first step:
(This is a saliva panel from before I used the DUTCH Adrenal test for assessing the HPA axis in my practice. You can see that my morning cortisol was super high right when I woke up, suggesting that it had been high at night.)
However, it turned out that I also had three parasites and candida overgrowth causing inflammation, which had to be addressed before my adrenal hormones and bio-rhythms could repair. (And this was despite not having many digestive symptoms at the time!)
Test 1
Test 2
Test 3
The inflammatory compounds from parasites and yeast in my gut, were neurotoxins. Exposure to these in my bloodstream was creating inflammation and oxidative stress in my brain that contributed to sleep and memory problems.
And my progesterone levels were lower than my post-menopausal grandmother’s would have been! (Progesterone production takes a back seat to cortisol production when your body is reading that you are under constant stress... *or inflammation).
To make things worse, my estrogen was through the roof. This relative excess of estrogen to progesterone is called Estrogen Dominance , and can make life in a woman's body fell like...well...a pain in the ass! (Think PMS, breast swelling and tenderness, heavy menstrual bleeding, fibroids and cysts, or weight gain around the hips and thighs....oh, and did I mention insomnia?)
Addressing each of these issues, over a period of about a year, gradually brought about a shift in my insomnia. Even after the first month of treatment, sleep started to come easier and easier. And it just got better and better from there. I felt like I had gotten my life and myself back!
5 Steps to better sleep
Modern life, with our artificial lights, tablets and screens, digital notifications, and indoor living give our bodies the exact opposite of the signals we need to promote sleep. While testing and treating these or other underlying causes for any case of insomnia may be necessary in the long run, we just can’t “out-supplement” diet and lifestyle.
Taking steps to set yourself up for success during the day, and early evening, is essential for anyone who’s sleep is less than optimal. There are many things you can do on your own, to give your body and mind every chance of sinking into a deep, restful sleep, naturally.
Sleep Tips
Sleep is one of the most important aspects of improving hormone balance and repairing body systems, from the brain to the digestive tract. Here are additional tips to facilitate this process:
Tip 1: Train the brain to feel sleepy & awake at regular times:
- Set fixed times for bedtime and rise-and-shine- As much as possible, keep to this schedule, even on weekends, regardless of how much sleep you got the night before.
- Avoid daytime naps- as this reduces your sleep drive at night.
- Keep the lights off -If you have to get up during night to use the bathroom do not turn on the light. Use a small nightlight so that you can see enough to move safely.
- Sunlight Exposure- get at least 30 minutes per day, sunglass free. Even in a cloudy sky, the natural spectrum light is bright enough to trigger your brain with a powerful signal that it is daytime. Natural light exposure helps establish healthy sleep/wake hormonal rhythms—it has only been recently that we’ve spent the majority of our lives indoors, under artificial lights. It’s essential to do this in the morning, within the first hour of being awake. For any kind of insomnia, it’s best to wake and go to bed at the same time every day. However, if you wake at 7 AM most days, but 9 on weekend, set your daily time outside to be 9:15-9:45 to ensure consistency, grab a mug of tea, and head out the door.
Tip 2: Develop a strong mental association between your bedroom & sleep:
- Use the bedroom only for sleep (or sex)- don’t read or watch TV in bed.
- Get into bed only when you are sleepy- If you are unable to fall asleep, get up and go into another dimly lit room, rather than lying in bed awake.
Tip 3: Avoid being over-stimulated at bedtime:
- Avoid Alcohol – it may help you fall asleep, but all the sugar in the alcohol will cause a rapid rise and subsequent drop in your blood sugar which will cause you to wake up. Even low-sugar alcohols like vodka can disrupt your sleep pattern, causing lighter sleep or frequent waking. Avoid alcohol within 3 hours of bedtime, and avoid it completely if you are struggling with insomnia.
- Ditch the Caffeine- Did you know that even a morning cup of joe at 7 AM can disrupt your sleep? This is especially true in people who have genetic caffeine processing issues, due to gene SNPs such as COMT. The “caffeine kick-back effect” is more common than you would think! Avoid caffeine completely if you are having sleep problems. Avoid it after 2 PM as a general rule, even if you don’t suspect you are overly sensitive to its effects.
- Slow Mental activity -stop doing active mental work at least 1 hour prior to bedtime. This includes surfing the web, watching Netflix or movies, emailing, Facebooking, or texting. We all need wind-down activities to switch out of “doing” and “problem solving” mode. Earlier in the evening, meditation, yoga, books, audiobooks, and yes, at the very least, even watching a TV show or playing a game on your Ipad is fine (assuming you are using precautions to avoid blue-light listed below)—anything that helps you switch into relaxation mode and away from the whir of thoughts and pace associated with wakefulness.
- Get Moving!- Exercise at least 30-60 minutes every day. Even walking works.
- Avoid Blue light Exposure— Have you ever noticed that the light near the end of the day, around sunset, is naturally warmer with more reds and pinks? Blue light from screens inhibits melatonin production by signaling that it is day time. Our brains respond to dimmer light and warmer light by winding down activity, but you need at least 2 or more hours of these lighting conditions prior to bedtime for optimal relaxation.
- Install apps on electronic devices that dim blue light and use warmer spectrum tones, such as f.lux on Mac, Nightshift for iPhones, or Twilight on Android.
- Dial down the brightness on dimmer lights, screens, and digital devices.
- These apps do a fairly good job, but if you are more sensitive to light and the apps don’t cut it, also consider buying a pair of blue-blocking glasses (around $10-15—-yep, these come in a ton of super-groovy styles now that they’ve caught on). Some people even install amber-colored light bulbs such as these around the house.
Tip 4: Create an environment supportive to sleep.
Your room should be:
- Dark- cover LED lights on bedside clocks, consider blackout blinds. An eye-mask with cup shaped or curved nose pieces can work just as well.
- Cool- Your body naturally cools off when you sleep, and if your room is too hot, it can be hard for your body to give off its heat. Around -65°F is ideal for most people.
- Comfortable- use a comfortable mattress and pillow that is supportive to your neck, depending on your sleeping position. Consider using a “side sleeper” pillow for under your neck when sleeping on your side. Consider using a body pillow to hug and put between your knees to align your back and shoulders at night. I personally love the PharMeDoc C-shaped body pillow for side sleeping as it supports both neck and hips. Yes, it is marketed for pregnancy (and is a must have for pregnant women!)—but it’s great for non-pregnant people who like to sleep comfortably too!
- Quiet –Some people swear by reusable silicone earplugs like these for the best noise cancellation. I prefer the super soft foam kind so they aren’t uncomfortable. You can use them several times before they lose their “squish” and look a little grubby—then toss ‘em and grab a new pair. These plugs block out even my husband’s snoring on the loudest night!
- You can also use a white noise machine, if you don’t like the feeling of having something in your ears. Different people prefer different sounds. I don’t use one of these, but patients have told me good things about them.
Tip 5: Eating for healthy sleep
- Stop Munching- avoid being too full at bedtime. No food for at least three hours before sleep, unless you suffer from severe hypoglycemic issues.
- Don’t Under-eat: Hunger and low blood glucose can give you insomnia and can wake you up in the middle of the night. Most people’s bodies naturally help them to eat the right amount, but if you’ve been intentionally trying to lose weight, or restricted eating because of digestive or other health issues, your appetite signaling can easily get off, and so can your sense of what is enough food. If you’re not sure that you’re eating enough try this:
- Use an online calculator like this one to figure out your approximate caloric need.
- Use a food tracking app such as MyFitnessPal to keep track of your calories for a few days.
- If you’re under-eating, bumping up your calories may be the silver bullet solution to help you sleep deeper and fall asleep easier.
- Eat high nutrient foods, especially minerals: Mineral deficiencies (like calcium, magnesium or potassium) are a common factor with insomnia. The best way to ensure high nutrient content is to eat a variety foods each week, including fruits, lots of above ground veggies, root veggies and tubers of different colors, animal proteins, liver or other organ meat, seafood, and bone broth. If you don’t eat dairy be sure to get plenty of calcium containing leafy greens, and or herbs that are high in calcium to supplements, Many people need supplemental magnesium as well. Even on an otherwise healthy, whole foods, Paleo type diet, you can still have deficiencies of essential nutrients if you are eating the same foods day in and day out.
- Eat enough carbs: Carbs are super important for sleep, in several ways.
- You need dietary carbohydrate in order to produce melatonin in your brain. Melatonin counters cortisol, among other things. Without enough melatonin in your brain, sleep isn’t happening!
- People with Adrenal Fatigue may have insufficient cortisol levels to stabilize their blood sugar for long periods of time. I notice that people with low cortisol often suffer on low carbohydrate diets, because their body can’t shift into carb generation mode in the liver (which is where your body sources stored carbs between meals). When your blood sugar drops while you’re sleeping, adrenaline kicks in and you wake up out of a dead sleep, wondering what is going on. To avoid this, consume more of your carbs at your evening meal, close to bed time.
- Each person’s carbohydrate need varies widely based on activity level and baseline metabolic rate. It can also differ at different phases in life. Depending on age, gender, activity level, pregnancy status, and weight maintenance goals, people need anywhere from 50-350 grams daily. With sleep difficulty, I recommend that my clients not go below 75 grams daily. The only way to know what is right for you is to experiment and observe.
- Again, take activity level into consideration —if you are training for a triathalon, 50 grams per day is simply not going to cut it. If exercise looks like a walk to the mailbox daily, you aren’t going to need above 150 grams. Adjust these levels until you find the right fit for you.
Tip 6: Develop An evening ritual helps prepare your body/mind for sleep.
Here are some possibilities to choose from:
- Journal- If you are someone who lays awake thinking of your to do list, get it all out on paper before-hand. Planning for the next day by writing a brief list can help short-circuit the mental spinning. Alternately, write down what you are grateful for that day, or journal. Consciously release and hurts or resentments you are feeling.
- Have a cup of herbal tea (e.g. “Sleepy Time”)
- Have a bath with Epsom salts—start with 1 cup in a warm (but not overly hot) bath. Add relaxing essential oils like lavender, chamomile, sandalwood, or vetiver if you enjoy these.
- Use a diffuser in your bedroom & use lavender essential oil before bed.
- Do some gentle stretching, or yoga. I personally love using my foam roller to roll out kinks and knots.
- Try progressive muscle relaxation--this has been shown to help reset cortisol rhythm. There are many version of this available on Youtube, such as this one.
- Do “4-7-8” breathing:
- Breathe in through nose for 4 counts
- Hold your breath for 7 counts
- Exhale through mouth for 8 counts
- This combination of count ratio slows heart rate and relaxes the sympathetic nervous system.
Do the same ritual every night, as you are training your body and mind to unwind from the day and giving it the message that it’s time for sleep.
Tip 7: Supplement Support:
Ideally, supplements should only be used after the above steps are being taken consistently. But tossing and turning night after night can really put a damper on your mood, not to mention your glucose control, sugar cravings, weight, hormone balance, and overall health. There is no one sleep supplement that works for everyone, and these are just several recommendations that are generally safe for people to experiment with on their own.
If you are still struggling, work with your practitioner to identify key issues that are at play with your insomnia, such as hormone imbalances, parasites, inflammation, neurotransmitter issues, toxicity, sleep apnea, or other causes.
Consider:
- L-Theanine- 200-400 mg
- Magnesium- up to 1200 mg, in divided doses daily. Use the chelated forms for best tolerance.
- Liposomal CBD- 1ml-4ml before bed.
- Calming Herbs – Lemon balm, Passion flower, Valerian root (like this blend)
Looking for further help with improving your sleep? We'd love to help you!
Adrenal Fatigue Part 1: Stress and Your Symptoms--What Exactly IS Adrenal Fatigue?
This is Part 1 of an 8-part series about Adrenal Fatigue (HPA-Axis Dysregulation), how it relates to your health, how to know if it’s impacting you, and what you can do to fix it!
Last Sunday evening, I drove across town to meet up with a girlfriend. My husband Jacob and I had driven up the coast from our house in Santa Cruz, on highway 1, to go for a hike that morning. I had just gotten on the road to my friend’s house when I noticed my gas light was on. I drive a Honda Fit, and they never run out of gas. They get incredible mileage, so even when they are “out of gas”, you still have at least 20 miles.
On my way home, I was planning to stop to fill the tank, but decided I’d go first thing in the morning, and headed home instead. Big mistake.
The gas station is less than a mile from my house, but when I went the next morning, I was 100 yards away from it when my car….Slowly….Trudged…To..A. stop.
I was stuck in the middle lane during morning rush hour, people honking at me and yelling out their windows, with my hazard lights flashing, as I tried to push my car to the side of the road. How embarrassing! I haven’t done something like this since I was probably 16 years old!
It was another hour before I’d gotten my tank filled again and was on with my day, running late for my first appointment….sigh…
Not exactly how I wanted to spend my morning. As I rushed non-stop into my full schedule, I noticed that for the rest of the day I felt frazzled. Any capacity deal with an unexpected change of plans, or handle any conversation that required effort or patience went out the window. I wished that I’d had 10-minutes to meditate and re-center myself
When Jacob got home at the end of the day, he took one look at me and just laughed!
"Rough day, Babe?"
Luckily, after a warm bath, some gentle yoga, and a good night’s sleep, I woke up feeling refreshed and ready to charge Tuesday! But several years ago, when my adrenal hormones were on the fritz, a hectic day like Monday would have left me sleepless, exhausted, and stressed out for several days or more…..
It’s well established that all modern diseases and their symptoms are negatively impacted by chronic stress.
From PMS, to susceptibility to the common cold, to an increased tendency to develop chronic diseases like cancer and diabetes, stress clearly promotes the development and prevents healing of a multitude of health concerns.
If we feel stressed out all the time, the impact it has on our physiology can override the benefits that healthy nutrition and exercise provide to your body.
But what exactly is happening in your body when this occurs?
What Is Adrenal Fatigue?
There is a ton of misinformation about Adrenal Fatigue out there in Google-landia. Adrenal Fatigue is not a disease. It’s a syndrome that occurs as a consequence of chronic stress without relief, and is characterized by predictable symptoms like fatigue, poor mood swings, insulin resistance or low blood sugar swings, decreased sex drive, insomnia, increased susceptibility to colds and flus, and worsening PMS or menopausal symptoms. These are just a few of the signs that you might have imbalanced stress hormone levels.
Your adrenals are two small pyramid-shaped glands that sit on top of each of your kidneys. The adrenals are responsible for the production of several types of hormones—glucocorticoids, mineralocorticoids, and androgens. Cortisol, our main adrenal hormone, is made mostly in the adrenal cortex (some is also produced in the mitochondria of cells around the body). Cortisol is often referred to as our “stress hormone”—and it can get a bad rap. More aptly it could be called our “stress response” hormone—and, while we don’t want it to be super elevated for prolonged periods of time, it’s also not great for it to get overtly low.
In truth, cortisol (along with meltonin) is one of the primary hormones that establishes our circadian rhythm, or sleep and wake cycle, in response to cycles of light and darkness. We want cortisol to spike highest within the first 30 minutes of opening our eyes in the morning, and then to gradually taper off over the course of the day, hitting its lowest point in the evening when we naturally fall asleep.
We need a moderate amount of cortisol to circulate daily to maintain body tissues, provide energy, put out inflammation, and to serve other vital metabolic functions. When we get in to trouble is when we keep giving our body the message to pump out high levels all the time.
Chronically high cortisol leads to:
-Imbalanced female hormones
-Increased rates of depresssion
-Increased fat storage, especially spare tire, which is good if you are in a famine, in order to survive, but not good if you are trying to look good in that cute new bikini.
-Lower thyroid hormone function and production
-Overall tissue breakdown and poor repair of injuries
-Increased risk of heart attack and stroke
-Increased risk of cancer
-And those are just to name a few...
On labs, Adrenal Fatigue is characterized when the current level of hormones produced by your adrenal glands (like cortisol) are consistently above or below the optimal ranges, or, when the daily circadian rhythm is doing something other than it should be (like being high at night and low in the morning!).
But don’t be fooled. Just because it’s not a diagnosable “disease” doesn’t mean that it can’t have a profound effect on your wellbeing! In fact, Adrenal Fatigue is often an early-warning sign of increased vulnerability to a variety of diseases and conditions such as diabetes, depression, autoimmune disease, thyroid disorders, and more.
The good news is that Adrenal Fatigue is measurable and fixable!
A trained professional can guide you through diet and lifestyle improvements, along with the strategic use of supplement and herbal protocols, to help get you back on the path to wellness.
If you think you might have Adrenal fatigue, (also called "HPA-Axis Dysregulation"--but more about in the upcoming posts) let’s get on the phone and talk about it, so that I can support you!
Click Here for the next section in this series where we’ll talk about what it feels like to have imbalanced adrenal hormones.
Adrenal Fatigue/HPA-D Part 2: How Adrenal Fatigue Feels
This is Part 2 of an 8-part series about Adrenal Fatigue (HPA-Axis Dysregulation), how it relates to your health, how to know if it’s impacting you, and what you can do to fix it! To read more about the basics of Adrenal Fatigue, go to part 1, here.
The first time I ran adrenal testing on myself, I was completing my 4th year of Chinese Medicine School. After seeking help from all the best practitioners I knew (Acupuncturists, Herbalists, Ayurvedic practitioners, Nutritionists, and my gynecologist), I was desperately looking for answers to my intractable insomnia. A regular night looked like me getting in bed around 10:30 PM, and then laying awake, frustrated, anxious, and worried, until around 3 AM or later. Beside my bed was an arsenalt of herbs and supplements that at best, helped me fall asleep an hour or two earlier, some of the time.
I still had to be to clinic or class by 8 am most mornings, and prided myself on giving my all to my patients and my studies, and maintaining a workout schedule, even on 3-5 hours of sleep. After 3 years of this, I began to wonder if I was ever going to get a normal, full night of sleep again! It was my own personal kind of hell, and it had gone on waaaaay to long.
If you are living with “Adrenal Fatigue” (also called HPA-Axis dysregulation), you probably live what appears to be a normal life from the outside.
Most people can do the things they have always done and may not have any obvious signs of severe physical illness.
However, you’ll typically have a general overall feeling of burn-out, general fatigue, or a kind of flat tone to their previously vibrant lives. Or, you might not feel fatigued; instead you might feel constantly wired, or even have a hard time winding down at the end of the day.
These people often use mild stimulants like coffee to get themselves going in the morning, and keep themselves going throughout the day. In the more progressed cases, people can be so exhausted that it’s hard to get out of bed for more than a few hours per day.
Some Signs of Adrenal Fatigue Include:
- An overreaction to perceived stressors—like the pressure of writing a school paper.
- An increased susceptibility to colds, flus, and infections
- An inability to regulate blood sugar –getting shakey or spacey between meals.
- An extra 5 pounds of fat that you just can’t lose around your stomach, or 10+ that showed up out of no where and won’t budge no matter what you do!
- Feeling frazzled to the point of road rage, getting easily frustrated or overwhelmed, snapping at your partner or kids, or crying for no particular reason
- Feeling fatigued, especially if you wake up wanting to go back to bed
- Wanting to nap or snack between 3-5 pm—especially if you feel more alert and alive after 6 pm than you do all day
- Difficulty falling asleep or staying asleep
- Worsening PMS, or menopausal symptoms like hot flashes and night sweats
- Nonexistent or decreased sex drive
- Easy bruising, more easily injured, or prolonged healing time
- Lacking the same zest and drive for the things in life that used to drive you
- You want to exercise, but just can’t push it as hard, or, you feel achy or fatigued later.
- Low or high blood pressure
- Difficulty bouncing back from stress or illness
While none of the above symptoms are life-threatening in the immediate, left untreated, imbalanced cortisol levels can lead to chronic disease states down the road.
Some of the risks of untreated HPA-Axis Dysregulation/ Adrenal Fatigue are:
- Greater risk of diabetes
- Increased rates of autoimmune disease
- Increased risk of cancer
- Osteopenia or Osteoporosis
- Increased risk of Alzheimer’s
- Loss of muscle mass
- Increased rates of heart disease
- Greater chance of depression
- Higher overall inflammation.
HPA-Axis Dysregulation/ Adrenal fatigue is defined by abnormal levels or rhythms of cortisol, the main hormone produced by the adrenal glands in response to signaling from your brain. We’ll go into more depth about how this occurs, in my next post. Essentially, testing and treating adrenal hormone imbalances is not just important for feeling better now, it’s also critical for maintain long term health and well-being.
To read more about what happens in your body when stress activates your adrenal glands, click here to read Part 3.
Adrenal Fatigue Part 3: Adrenal Fatigue is actually a BRAIN problem!
This is Part 3 of an 8-part series about Adrenal Fatigue (HPA-Axis Dysregulation), how it relates to your health, how to know if it’s impacting you, and what you can do to fix it! Click here to read Part 1 and Part 2.
In the Parts 1 and 2, we talked about how adrenal fatigue (HPA-D) feels, and associated symptoms and disease states. But what is actually going on in our body when we experience stress, that leads to these changes and symptoms?
(warning: this post gets a bit more technical, so read on if you’re curious…or skip it and click here to get support)
How Your Adrenals and HPA-axis Work:
You are planting a garden outside of your hut, when a hungry bear and her 3 cubs stroll out of the forest. You know a hungry momma bear is not to be messed with.Your brain goes into“high alert” and, in a split second, you decide to run.
The shift into Fight-or-flight mode occurs because your brain perceives some type of danger or stressor.
This decision took you less than 2 seconds, but in that time, a complex chain of events occurred before you were able to get into Go-mode:
In a big game of physiological telephone, stress registers in the brain, where your hypothalamus signals the pituitary, which then signals the adrenals.
The adrenals release hormones into the blood stream that make their way to the brain. This is the negative feedback loop that lets the hypothalamus and pituitary know the message has been received and the job performed.
Depending on whether the brain is perceiving the level to be high enough to meet the demands of the stress, it will keep signaling the adrenals to produce more cortisol, or stop sending the hormonal signal so that the gland will know it has put out enough.
The stress response happens in 2 phases: First, we release catecholamines (adrenaline and noradrenaline) that prime your body to act immediately. Secondarily, these chemicals trigger a series of neurochemical processes that tell the adrenals, “It’s go time!”, meaning, please make some cortisol--NOW!
Cortisol’s main role here is to increase your heart rate and therefore blood flow to your arms and legs, for running. It also mobilizes glucose to fuel the action.
The flood of cortisol helps to increase your breathing rate, initiate sweating, dilate pupils. It also shuts down movement in your digestive tract, to make sure our muscles have enough fuel to run from the bear, remain alert and keep our bodies cool, among other things. The overall effect is to prioritize energy to the Central Nervous System, Cardiovascular, and musculo-skeletal systems, which are critical to survival in a life threatening situation.
The rest of the body’s systems, such as digestion and reproduction, which are more essential for long-term survival are temporarily reduced in activity.
Priming your body to go into fight-or-flight when under duress is just one of the many hats that Cortisol wears. Cortisol receptors are found on almost every cell in the body—that’s how critical it is to almost every aspect of our metabolism.
Modern Stress
Our bodies were designed to survive and even thrive in situations that are stressful in the short term. For most of our lives as a species, this might have looked like the situation above. It might have been caused by something equally stressful, like falling into a river and having to swim to shore. In situations like these, increased levels of cortisol and adrenaline produce the perfect physiological response to help save your life.
But in our modern industrialized world, we are exposed to a constant barrage of ongoing, sub-acute stress throughout the day. Fighting traffic, meeting work deadlines, parenting issues, relationship glitches, the mortgage, the bills, taxes, and an endless influx of text messages, phone calls, emails, and social media alerts, each add to our stress.
Then there are the stresses that don’t always feel immediately stressful, but that add to our overall stress levels in more subtle ways. These include: sitting all day, lack of exercise, overtraining without enough recovery time, skipping breakfast in favor of coffee, eating processed foods, staying up late to watch one more TV episode, or exposure to lots of artificial light after sunset.
When the stress state is prolonged, cortisol is maintained at higher than normal levels for extended periods of time. Excessive exposure to cortisol actually causes a catabolic metabolic—this causes body tissue breakdown, as opposed to growth and repair. High cortisol levels in the brain permanently burn-out nerve cells in our hippocampus, our center of emotion and memory. So, when stress is too intense, or goes on for too long, our brain down-regulates the production of cortisol, in a disrupted feedback loop.
This is why "Adrenal Fatigue" is more accurately described by the term "HPA-Axis Dysregulation" (Hypothalmus-Pituitary-Adrenal Axis). As the HPA-Axis dysregulation progresses, cortisol production often drops lower and lower, as does the production of other adrenal steroid hormones like DHEA.
Adrenal fatigue is actually a brain problem
When we talk about “adrenal fatigue” and “adrenal repair”, it can give the impression that something is wrong or damaged in the adrenal glands themselves. But issues stemming directly from the adrenal glands are truly only at hand in specific medically diagnosed disease states like Cushings or Addisons diseases.
A more accurate description of what adrenal fatigue really is, is the term HPA-Axis Dysfunction (hypothalamic-pituitary-adrenal dysfunction….say that 3 times fast!). This term describes the breakdown of the communication systems that these three glands use to talk to each other and regulate hormone production and rhythm every day.
The HPA Axis is our central stress response system. When your brain perceives that there is either something stressful or threatening in your environment (or if emotions run high), or if your blood glucose levels get low, or if you have high levels of inflammation, the hypothalamus shouts at the pituitary to do something about it. The pituitary in turn, signals the adrenal glands (by releasing a hormone called ACTH) to crank up the production line on cortisol, to help deal with the situation.
Normally, when the “stressor” is gone, the signaling quiets down, and cortisol levels should return to normal. But if the stress/inflammation/glucose problem is ongoing or severe, sometimes, the levels either stay high, or, alternately, shut down.
When you experience symptoms like fatigue, anxiety, insomnia, or foggy-brain due to imbalanced cortisol levels, it’s because of a breakdown in the signaling from the brain to your adrenal glands. In other words, the problem is in the software or programming, not in the hardware!
When we test with cutting-edge labs, and create treatment protocols, our aim is to reset the rhythm of the output of adrenal hormones. This process is dependent on restoring the feedback loops between the control centers in the brain.
After long term stress or inflammation, we adopt a new normal. Treatment to restore balance is a bit like restarting the computer and rebooting the software.
To learn more about how stress and adrenal hormone dysregulation can throw a wrench in your sex hormone balance (like estrogen, progesterone, and testosterone), continue on to Part 4.
Adrenal Fatigue Part 4: The “Cortisol Steal”—or, How Increased Stress Creates Female Hormone Imbalance
This is Part 4 of an 8-part series about Adrenal Fatigue (HPA-Axis Dysregulation), how it relates to your health, how to know if it’s impacting you, and what you can do to fix it! Click here to read Part one, Part two, and Part three.
Two days ago, I was getting my haircut, and I saw a picture of my hairdresser’s two adorable kids at her station. She told me she’d raised them herself, thankfully with some support from her mother and brother, and that her young daughter was quite a handful these days!
Then she shared with me that she felt like now that she had turned 43, her hormones were “making her crazy” all of a sudden—the other day, she’d snapped at 7 year old daughter about something that would never have been a big deal in the past. This type of short fuse was always worse right before her period was due, but lately, it seemed like her mood, energy, patience, and brain function shifted almost 2 whole weeks before hand! As she remembered it, her mother had gone through a horrible menopausal phase. In fact, she’d had a really tough relationship with her mother during that time because of it, and she was terrified that her menopause was going to turn her into a crazy person too!
I don’t know first-hand, but the stress of being a single parent, even with some close family nearby, just seems like it requires super-powers to withstand. It was no surprise to me that after years of stress, her reproductive hormones were taking a hit.
So how does stress impact our female reproductive hormones?
Our bodies make most of our adrenal hormones and some of our “reproductive hormones” like estrogen, progesterone, and testosterone from the same precursor horomone - pregnenolone.
Ordinarily, pregnenolone is transformed into a multitude of various hormones, in optimal ratios, every minute of every day. But the minute our body perceives it is under stress, it prioritizes cortisol production, at the expense of the other hormones.
This prioritization is elegantly designed. Progesterone, estrogen and testosterone are all hormones designed for the long-term reproductive survival of the species. Cortisol is about rescuing You, Now.
If your body receives a hormonal message that the external environment is threatening, or you’re in a famine and therefore in a fasted, hypoglycemic state, it’s probably not the best environment to bring a new baby into, right?
So, your body focuses its energy and resources on saving you, and diverts its “attention” away from making hormones that are specific to reproduction and other “non-essential” activities. This allows for the production of a huge amount of cortisol, but inhibits the production of virtually every other hormone. When the stress resolves, our brain stops sending the signal to increase cortisol production, and hormone levels return to normal…in theory.
Pregnenolone can convert down either of two main pathways:
- Conversion into progesterone, as a first step on the path to being converted into cortisol, and/or cortisone, our main anti-inflammatory hormone.
- It can be made into DHEA, which is the precursor to all of our sex-hormones.
When under stress, the body will decrease DHEA production and prioritize the cortisol production. While the majority of our reproductive hormones are produced in the ovaries and testes, roughly 30-40{0ace9f30246476cbe34912402cc70dd667071e9efa13e47cc458477e17894418} is produced in the adrenals. This amount significantly impacts the maintenance of the overall stable hormone levels in circulation.
But there are other ways that stress impacts our monthly hormone cycles as well! The HPA axis is closely related to the HPO (Hypothalamic-Pituitary-Ovarian) axis. Just like these glands in the brain have feedback loops and signaling systems that tell the adrenals what to do when, we also have telephone lines between the hypothalamus, pituitary, and ovaries.
High cortisol levels block the HPA axis at each step in the chain. High cortisol stops the secretion of the hormone that our Hypothalamus send to the pituitary (GnRH) that tells it to make LH and FSH. LH and FSH are the hormones that the pituitary makes in order to signal the ovaries to make estrogen and progesterone. When these are suppressed, the ovaries don’t get the message. And, to make matters worse, elevated cortisol levels also interfere directly with ovarian hormone production, which is the bottom line.
This system is meant to protect you, and ultimately, to help your body know when the situation is safe for reproduction. But this brilliant system isn’t built to cope with today’s messy, stress filled world. We used to live in villages where everyone shared the responsibilities of life, food, shelter, and survival. For most of the humans on the planet, most of the time, everyday life was pretty ho-hum, and big stresses only occurred from time to time. Now we’ve each become our own village, wearing all of the hats every day, in industrialized countries. Our lifestyle of convenience and high-speed access to everything may not be so convenient after all.
Worsening PMS, stronger menstrual cramps, increasing hot flashes and night sweats, or periods that go AWOL are some of the red flags that Adrenal Fatigue and stress may be causing female hormonal imbalances!
Read on in Part Five, about the types of Stress (it's not just emotional stress!) that can disrupt adrenal hormones!