sexual wellness

Dude, Where’s My Orgasm?!: Unpacking Sexual Wellness In Perimenopause

Today I’m unpacking a topic that doesn’t get the attention it deserves: sexual wellness during perimenopause. While this is a powerful time in our lives, it can come with a lot of changes that make us feel like those orgasms we once had are now a thing of the past. 

What’s worse than searching for our former sensuality is we’re often told by doctors, “That’s common at your age,” and sent on our way without a solution, wishing we hadn’t taken our turn-on for granted. 

But here’s the thing: sexual wellness is not a luxury reserved for our younger selves. It’s an essential part of our health and wellbeing in all stages of womanhood: even perimenopause, menopause, and beyond. Pleasure is our birthright, ladies, and together we’re going to reclaim it!

 

Understanding the Link Between Hormones and Sexual Pleasure 

Perimenopause brings a lot of hormonal fluctuations as our bodies prepare for menopause. But there’s more to it than hot flashes and mood swings: hormones like estrogen, progesterone, and testosterone can have a significant impact on our sexual health and intimacy leaving us with reduced sensation, discomfort, or no desire to “do it” in the first place. 

If you're facing any of these challenges, you’re not alone–over 40% of perimenopausal women report sexual dysfunction. And sexual dysfunction isn’t just lacking the drive to get down–it can mean having trouble at any of the four stages of sexual response: 

  1. Desire: Lasting anywhere from minutes to hours, desire is when the body begins to prepare for sexual activity in response to thoughts or sensations by increasing blood flow to the vaginal area.
  2. Arousal: The Lubrication of the vagina and swelling of the clitoris that began in the Desire stage intensified in the Arousal stage.
  3. Orgasm: During orgasm, or climax, pelvic muscles contract and tension is released.
  4. Resolution: This is when muscles begin to relax, heart rate slows, and the body returns to its unaroused state.

The good news? These issues can often be addressed, bringing you back to a place of sexual satisfaction. Before we talk about how to address them, though, let’s take a look at what’s causing these unwanted changes.

 

Decreased Sensitivity and Sensation 

Estrogen plays a vital role in maintaining vaginal lubrication and blood flow. As estrogen levels begin to drop during menopause, women may experience decreased sensitivity and sensation, particularly in the clitoris. This can lead to orgasms that are less intense, more difficult to achieve, or are even non-existent. So if you’re feeling like someone “turned down the volume” on your orgasms or they’re completely MIA, estrogen may be to blame. 

 

Discomfort

Estrogen is also responsible for overall vaginal tissue health. Decreasing estrogen can lead to vaginal atrophy: thinning and inflammation of the vaginal walls, along with vaginal dryness. All of this can contribute to discomfort, irritation, and pain during sex. 

 

Low Sex Drive 

We can’t place all the blame on estrogen for trouble in the bedroom, though. Progesterone and testosterone can also start to decline during menopause, bringing your mood and–you guessed it–libido right down with them. 

 

A Holistic Approach to Rediscovering Sexual Pleasure In Perimenopause

So, what can we do to relight the fire and restore intimacy? Here’s where to start:

  • Address Hormone Imbalances: Just as I emphasized the significance of hormone balance for skin health, the same applies to your sexual health. Comprehensive hormone testing is key to addressing imbalances. The DUTCH panel can give invaluable insight into your hormone levels and guide a personalized protocol to restore balance.

 

  • Nurture Your Gut: Surprisingly, gut health also impacts sexual health. A healthy gut supports nutrient absorption, including essential vitamins and minerals crucial for hormone production and overall well-being. Prioritize a diverse, nourishing diet and consider probiotics to support your gut microbiome.

 

  • Manage Stress & Boost Adrenals: Chronic stress can negatively impact adrenal and sex hormone levels–and can make-or-break the feeling of being “in the mood”. The stress hormone cortisol can also reduce estrogen, leading to decreased sensitivity in the vagina and clitoris. To support adrenal health and balance cortisol levels, practice stress-reduction techniques like mindfulness, meditation, or gentle exercise. In addition, shoot for 8 hours of sleep each night. If you have ongoing signs of HPA Axis imbalance (constant fatigue, feeling “wired but tired”, trouble falling or staying asleep, or a poor stress response) talk with your Functional Medicine provider about running a DUTCH Adrenal panel to get a customized repair protocol.

 

  • Embrace Self-Care and Connection: We talked about how self-care is essential for healthy skin, but it's equally vital for your sexual well-being. Prioritize time for relaxation, self-exploration, and connection with your partner to enhance intimacy. Share your experiences, concerns, and desires with your partner to build trust and understanding as you navigate perimenopause.

 

  • Explore New Avenues: As our bodies evolve, so can our desires and interests. Embrace this opportunity to explore new ways of intimacy and sensuality, whether through mindfulness practices, tantra, or simply trying something new with your partner. Studies have shown that women in their 40s and 50s tend to become more independent, confident, and decisive, and less self-critical. They also generally feel better in their own skin and more comfortable with who they are, which can lead to new levels of sexual confidence and willingness to explore what they actually find pleasurable. Give it a try! Who knows, you might discover ways of connecting that bring you to new levels of intimacy and satisfaction.

 

  • Address Trauma: If you’ve been affected by trauma, please know that you are not alone. Any experience with trauma–not just sexual trauma–can cause issues with sexual function. Addressing your trauma with a qualified professional is the first step to resolving any sexual challenges you may be facing.

 

Here are some other great treatment options to consider:

  • Topical DHEA: Julva, a topical DHEA cream, can help rejuvenate vaginal tissue and support sexual health. It’s generally safe when used as directed, but always consult your healthcare provider–especially if you’ve had breast cancer. A recent study found that the use of vaginal DHEA in women after breast cancer treatment did result in increased hormone concentrations, though the levels were still within the lower postmenopausal hormone range.
  • Topical Estriol or Estradiol: Topical estriol or estradiol can increase clitoral sensitivity, improve vaginal tissue health, and prevent or treat atrophy. Estriol is a safer alternative to estradiol, and is just as effective. One study found that hormone levels remained unchanged after a 12-week treatment with 0.005% estriol vaginal gel in postmenopausal women with early hormone receptor-positive breast cancer. These results support the safety of 0.005% estriol vaginal gel for the treatment of vulvovaginal atrophy symptoms in women who have had breast cancer. While low-dose, locally applied estrogen can be a safe option, hormone levels should be closely monitored by your healthcare provider while using topical creams through testing like the DUTCH Sex Hormone Panel.
  • Pelvic Floor Physical Therapy : If you haven’t seen a pelvic floor physical therapist, now might be the time! Pelvic floor therapists are trained physical therapists who specialize in treating pelvic floor dysfunction. The pelvic floor refers to the muscles supporting the reproductive, urinary, and bowel organs. If you’ve ever given birth (vaginally or via cesarean), you should be assessed by a pelvic floor physical therapist. This type of therapy isn’t just for women who have given birth, though–it can be highly effective in treating pelvic pain, urinary and bowel problems, pelvic organ prolapse, sexual dysfunction, and more. In fact, research supports the use of pelvic floor physical therapy as a minimally invasive, first-line treatment for pelvic issues–including sexual dysfunction. 
  • Perifit: Ever think you’d get to play video games with your vagina? Perifit is a device similar to a sex toy that uses video game technology to help visualize, measure, and strengthen your pelvic floor muscles. It can help restore sexual function and pleasure and reduce incontinence. Not to mention, it’s fun and addictive!
  • Joylux vFit - Red Light Therapy: Red light therapy isn’t just for anti-aging skin treatments–it can also work wonders for vaginal health! vFit by Joylux is a non-invasive red light therapy device designed to improve vaginal moisture, tissue resilience, sensitivity, sensation, and sexual satisfaction in just three 10-12 minute sessions a week. Painless and hormone-free, vFit is easy to use from the comfort of your home. Some women see results in as little as 3 weeks! For faster and more complete results, Joylux offers a $99 upgrade to the vFit Gold Device that includes a 32% increase in power and 2 additional minutes of treatment time. You can access this upgrade and accelerate your results for free by purchasing through our office! For more information, contact us today. Contact our office for more information if you’re interested in the vFit–we can get you free access to the upgrade!
  • Bonafide Ristela: Ristela is a plant-based, hormone-free supplement formulated to improve orgasm and overall sexual satisfaction by increasing blood-flow to the vaginal area. After just two months of taking Ristela, 75% of women reported an increase in both physical arousal and sexual satisfaction, and 74% reported an increase in orgasm!

 

Other Factors Contributing to Sexual Dysfunction

It’s important to note a few other factors, not necessarily related to perimenopause, that can contribute to sexual dysfunction. Here are some common situations to consider, and how to address them. 

  • Clitoral Atrophy: Clitoral atrophy is when the clitoris shrinks in size and loses sensation due to impaired blood flow to the area, menopause, or having a hysterectomy. In the case of clitoral atrophy, the saying “use it or lose it” may actually come into play! Masturbation and exercises can help redirect blood flow to the clitoris, which can help in certain cases with clitoral atrophy. Don’t be afraid to ask your doctor about hormone therapy–estrogen may also be helpful.

 

  • Pelvic Organ Prolapse: Pelvic organ prolapse is a condition where one of the pelvic organs (most commonly the uterus or bladder) drops down into the vagina. This is common and not life threatening, but can significantly impact quality of life, sometimes causing symptoms like painful intercourse and decreased vaginal sensation. Other symptoms may include a feeling of fullness in the vagina, urinary problems, and feeling or seeing a lump inside or coming out of the vagina. If you think you’re dealing with pelvic organ prolapse, get evaluated by your doctor. Surgery isn’t the only option–he or she may recommend pelvic floor physical therapy, hormone therapy, or a vaginal pessary (a flexible device inserted into the vagina designed to support the areas affected by the prolapse).

 

  • Childbirth: Scarring and weakened pelvic muscles after childbirth can contribute to decreased sensation or discomfort during intercourse. This is extremely common, but can be addressed. Talk with your functional medicine provider, doctor, or pelvic floor physical therapist for recommendations.

 

Empower Your Perimenopausal Sexual Health

Perimenopause doesn't mean your nights between the sheets are over. Sexual wellness and satisfaction are an essential part of your health and happiness today and everyday! 

OPTION 1 My goal is to support you on this journey, helping you rediscover your vitality and sexual pleasure along the way. If you’re ready to embrace this phase of life with confidence, schedule a 15 minute call to learn more about how I can help guide you. 

OPTION 2 If you’re ready to embrace this phase of life without hormonal symptoms dragging you down, come learn more about our new program, The Reverse Age Method. 

This group coaching program is compassionately designed for women in perimenopause who want to stop menopausal weight gain, supercharge their energy, boost brainpower, and support glowing, vibrant skin. Oh yeah…and have great sex! Join us today.


menopause

Harnessing the Power of Hormones: Menopause, Weight Management, and Beyond

As women navigate the winding path of perimenopause and enter the world of menopause, a whole gamut of changes start to occur within their bodies. These changes are mostly driven by shifts in hormone levels, most notably, the decline in estrogen. One area of our health that takes a significant hit during this time is weight management. It’s as if an internal switch has been flicked, and suddenly, maintaining a steady weight becomes a challenge. Who’s body is this? When did these jeans get too small? 

 But why does this happen? And is there anything we can do about it?

 

Estrogen, Appetite, and Weight

Estrogen, one of the primary female sex hormones, performs numerous functions beyond its role in reproductive health. It is intricately linked with our metabolic health, affecting how our cells convert glucose into energy.

During the perimenopausal transition, estrogen levels decline, leading to what we could call a "temporary energy crisis". Our cells find it harder to convert glucose into energy, which can trigger increased appetite, hot flashes, and night sweats. The latter can disrupt sleep, which can then further exacerbate these symptoms. This combination of physical discomfort and heightened appetite often leads to overeating or binge eating, contributing to weight gain.

 

The Glucose-Ketone Transition

As estrogen levels decrease, our bodies need to adapt to this new metabolic environment. The hormone estradiol, a form of estrogen, usually increases glucose sensitivity by enhancing the ability of mitochondria (the powerhouses of our cells) to turn glucose into energy.

With the decline in estrogen levels, our cells have to switch from burning glucose to burning ketones. This switch requires a certain degree of "metabolic flexibility". If the brain can adapt to a higher ketone state, the symptoms should be temporary. However, if the body cannot adapt due to whole-body insulin resistance, this can potentially lead to more serious conditions such as dementia.

What Are Ketones?

Ketones are produced in the liver from the breakdown of fats. This production occurs in the absence of glucose, which comes from sugars and carbohydrates. This process can occur overnight, during fasting, or when we eat meals that are primarily made up of proteins and fats, without adding more than 5 grams of carbohydrates.

 

Embracing Metabolic Flexibility for a Healthier Perimenopause

Metabolic flexibility is your body's ability to switch between using glucose or ketones as a fuel source. This flexibility is essential, especially during the perimenopause transition, as it allows your body to adapt to changing hormone levels and efficiently use available energy sources.

When your body can seamlessly shift from glucose to ketones, you can experience fewer menopausal symptoms, improved energy levels, and better weight management. Here are some strategies that can enhance your metabolic flexibility:

Dietary Approaches

The foods we consume play a crucial role in how our bodies metabolize energy. Specific types of diets can enhance metabolic flexibility by optimizing your body's ability to switch between glucose and ketones.

Low-Carbohydrate, High-Fat Diets (LCHF)

These diets, such as the ketogenic diet, are designed to shift your body's primary fuel source from glucose to ketones. By reducing carbohydrate intake and increasing healthy fats, you can stimulate your liver to produce ketones more efficiently, promoting metabolic flexibility.

Mediterranean Diet

This diet emphasizes fruits, vegetables, whole grains, legumes, and healthy fats, like olive oil and fatty fish. It's rich in nutrients that support metabolic health and can enhance insulin sensitivity, a crucial aspect of metabolic flexibility.

 

Fasting

Intermittent fasting, whether it's time-restricted eating or alternate-day fasting, gives your body a break from processing food. This pause allows your body to deplete its glucose stores and start producing and using ketones, increasing metabolic flexibility.

 

Resistance Training

Physical activity, especially resistance or strength training, can boost your metabolic flexibility by enhancing insulin sensitivity and promoting muscle growth. Having more muscle mass means your body can store more glucose, thus reducing the likelihood of insulin resistance.

 

Lifestyle Steps

Implementing simple lifestyle changes can also greatly enhance your metabolic flexibility.

Adequate Sleep

Sleep deprivation can lead to insulin resistance, impairing your metabolic flexibility. Aim for 7-9 hours of quality sleep per night.

Stress Management

Chronic stress can negatively impact your metabolic health, including your body's ability to switch between fuel sources. Regular mindfulness practices, like yoga or meditation, can help manage stress levels.

Empower your journey through perimenopause by improving your metabolic flexibility. Our group program integrates these dietary, physical activity, and lifestyle approaches, providing a comprehensive plan to help you navigate this transition with grace and strength.

Why wait? Book a discovery call with us today. It’s time to take control of your health and embrace a brighter, leaner, and more energetic you during perimenopause and beyond.

 

Your Path to a Healthy Perimenopause

Understanding these complex processes is the first step towards taking control of your health during perimenopause and beyond. There are ways to navigate these changes and manage the symptoms effectively.

The transition into menopause should not equate to giving up on your health goals. This is a time for empowerment, for harnessing the change and using it to propel yourself into a phase of increased longevity, youthful skin, solid energy, a fiercely sharp brain, and a lean body.

Our group program is designed specifically for women in perimenopause who want to 'reverse-age'. Our scientifically-backed strategies will help you adapt to the hormonal changes, improve your metabolic flexibility, and help you avoid weight gain. Better yet, we understand that your body is not identical to the next woman’s body and metabolism, and we utilize state of the art lab testing to personalize your protocol for longevity optimization and reclaiming your body, energy, mind, and beautiful skin. 

I encourage you to take this journey with us. Book a discovery call today, and let’s work together to not just weather the menopausal transition, but to thrive through it. Embrace this change as an opportunity to become the best version of yourself. Because you deserve nothing less.


Unlocking the Secrets of Hormonal Changes and Conquering Menopausal Weight Gain

Aisha, a client of mine,  is an energetic and dynamic woman in the prime of her life. At 49 years young, she's a loving mother and a dedicated business owner, juggling life's demands with grace and determination. When I met with her last week, she expressed feeling increasingly frustrated as she’s noticing changes in her body that she never expected. Despite sticking to her tried-and-true diet and lifelong exercise routines that once worked like magic, she's now facing the reality of having to buy a size up in jeans because her old ones no longer fit. This unexpected shift has left her questioning what's happening and longing for answers. If you’re having a similar experience (or want to learn how to avoid it!) read on– I’ll share with you exactly how I broke it down for her so that  you can have the knowledge of exactly what steps to take charge of your own body as you navigate these hormonal changes.

 

Hormonal Changes During Menopause

Menopause is a natural phase in a woman's life when her ovaries gradually produce fewer hormones, leading to the end of menstruation. Two key hormones involved in this process are estrogen and androgen (think “male” hormones like Testosterone and its precursor DHEA).  During perimenopause, the 15 year  lead up to menopause, a reduction in estrogen and a relative increase in circulating androgen occur. These hormonal shifts can influence body composition, muscle mass, and the distribution of fat within our bodies.

 A 2021 journal publication  titled "Changes in Energy Metabolism and Lipid Metabolic Abnormalities Underlying Weight Gain in Postmenopausal Women"  breaks down this physiological cascade in detail.  This study focused on understanding how our body's energy and fat processing change during menopause. During menopause, many women tend to gain weight, and to redistribute fat around the abdomen, and this research aimed to figure out why it happens. First let’s look at the roles these hormones play with fat storage:

  1. Estrogen: Estrogen is a critical hormone that plays many roles in our bodies. One of its essential functions is to regulate fat distribution. Before menopause, estrogen levels are higher, and this helps to keep fat stored in subcutaneous (under the skin) areas rather than visceral (around organs) regions.
  2. Androgen: Androgens are another group of hormones, often referred to as the "male hormone," though they are  present in women too. (Androgens typically refer to testosterone, DHEA, and their metabolites). During menopause, as estrogen levels decrease, the relative balance of hormones shifts, leading to a relatively higher level of androgen in the body. This shift can contribute to changes in body composition, such as increased fat accumulation in the abdominal area.

The relative balance of estrogen and androgen is crucial in maintaining a healthy body composition and metabolism. When estrogen levels decline during menopause, it disrupts this balance. As a result visceral fat lipolysis increases and Beta oxidation decreases.   Let’s break down what each of those are and what they mean for you:

Visceral Fat Lipolysis

To explain this, let's imagine fat in our body like tiny little storage units. Visceral fat is a specific type of fat that surrounds our internal organs, like the liver and intestines. When we talk about "lipolysis," it means the process of breaking down these fat storage units to release the stored fat as energy. During menopause, there's an increased breakdown of this visceral fat, which can lead to an excess of fatty acids floating around in our bodies. When Visceral Fat Lipolysis increases, due to falling estrogen levels, the body tends to break down more visceral fat through a process called "lipolysis." This means that the stored fat around our organs is released into the bloodstream as fatty acids. Studies show that having consistently elevated circulating levels of fatty acids in the bloodstream can lead to insulin resistance.

Beta Oxidation

Beta oxidation is like a special team within our body that helps convert these released fatty acids into energy for us to use.Normally, the body efficiently converts these released fatty acids into energy through "beta oxidation." But during menopause, the team's performance can be affected because of certain hormonal changes, like a decrease in estrogen. As a result, these released fatty acids may not get converted into energy efficiently, and they end up staying as fat in our bodies, especially in the belly area.

Insulin Resistance

Additionally, the hormonal changes can also contribute to insulin resistance. Insulin is a hormone that helps regulate blood sugar levels. Increased levels of circulating fatty acids can lead to insulin resistance, where our body's cells become less responsive to insulin's actions. This can hinder the body's ability to use glucose for energy, resulting in higher blood sugar levels.

Metabolic Rate

Furthermore, these hormonal shifts can impact the body's overall metabolic rate, which is the speed at which our body burns calories for energy. A decrease in estrogen can also  lower the metabolic rate, by upregulating genes that promote fat storage, leading to potential weight gain.

In summary, hormonal changes during menopause, particularly the decrease in estrogen and relative increase in androgen, play a vital role in altering body composition and metabolism. These changes can lead to increased visceral fat lipolysis, impaired beta oxidation, insulin resistance, and a lower metabolic rate, all contributing to menopausal weight gain, especially around the belly area. Understanding these hormonal shifts is crucial for developing personalized approaches to support women's health and well-being during this natural phase of life. Seeking guidance from healthcare professionals can help navigate this journey with better insight and make informed decisions for a healthier future.

 

So, What Does it all Mean? 

In simple terms, this study found that hormonal changes during menopause  may lead to an increase in abdominal fat storage and increased tendency to develop insulin resistance, even without changes in diet and lifestyle. However, with informed steps, this challenge can be tackled effectively.

Clinically, I have found four main steps that are essential to preventing or reversing the weight creep up many women experience:

 

Step 1: Optimizing Nutrition

1. Low Carb Diet Variations:

Exploring lower carb diet variations can be a game-changer for women’s bodies. By focusing on nutrient-dense, low carb foods, we can stabilize blood sugar levels and support your body's metabolism. It's essential to find the right balance that suits your individual needs, ensuring she gets enough energy for your activity level while still managing carbohydrate intake.

2. Timing of Carbohydrates:

Timing plays a vital role in optimizing how your body processes carbohydrates. Consuming carbs closer to physical activity allows your body to use them more efficiently as fuel for her workouts. This helps prevent excessive storage of carbohydrates as fat and maximizes their energy benefits.

3. Intermittent Fasting: A Powerful Tool for Menopausal Women

Intermittent fasting involves cycling between periods of eating and fasting, allowing the body to tap into its natural rhythms and optimize various physiological processes, and can be a valuable tool when used in the right way, at the right time. The benefits of Intermittent Fasting for Menopausal Women include:

Hormonal Balance: Intermittent fasting has shown promise in helping to balance hormone levels in menopausal women. By allowing the body to experience periods of fasting, insulin sensitivity can improve, which in turn positively impacts the balance of sex hormones and adrenal hormones.

Insulin Regulation: As menopausal women often face an increased risk of insulin resistance, intermittent fasting can be a powerful strategy. It helps regulate blood sugar levels, reducing the likelihood of insulin resistance and supporting overall metabolic health.

Weight Management: Intermittent fasting can assist menopausal women in managing their weight. By promoting fat burning during fasting periods and limiting calorie intake, it can help shed excess weight and support a healthy body composition.

Cellular Repair and Longevity: Intermittent fasting triggers a process called autophagy, where cells remove damaged components and repair themselves. This process supports cellular health and has been linked to potential longevity benefits.

Enhanced Energy: By optimizing insulin sensitivity and cellular repair, intermittent fasting can lead to increased energy levels and improved overall well-being.

While intermittent fasting can offer numerous benefits for menopausal women, it's essential to approach this practice mindfully. As we navigate this new aspect of your journey, it's crucial to listen to your body and make adjustments as needed. Consulting with a trusted expert ensures that intermittent fasting becomes a positive and supportive addition to your health journey.

4. Resistance Training for Muscle Building:

Incorporating resistance training into your routine can do wonders for your body composition. Building lean muscle mass through strength training boosts metabolism and increases insulin sensitivity. As you put on muscle, your body becomes more effective at using insulin to control blood sugar levels.

 The Role of Muscle and Insulin: Muscles are like little powerhouses in our bodies. When you engage in resistance training, your muscles become more responsive to insulin, allowing them to efficiently use glucose for energy. This reduces the risk of insulin resistance, a condition where cells don't respond well to insulin's signals, leading to elevated blood sugar levels.

Boosting Mitochondrial Function: Mitochondria are like tiny energy factories within our cells, and they play a crucial role in energy production. By engaging in resistance training and maintaining a balanced diet, you can enhance your mitochondrial function, leading to improved energy levels and overall metabolic health. 

 

Action Steps: Working with a Trusted Expert 

Functional Medicine testing to optimize hormones and cellular metabolism can take diet and lifestyle efforts to the next level in terms of getting results.  By running hormone testing, you can gain valuable insights into hormone levels, including sex hormones, adrenal hormones, insulin, and other hormones related to metabolism. This personalized approach allows you to tailor interventions that optimize your hormonal balance.

Reprogramming optimal mitochondrial function. We use Organic Acid testing to assess your personal level of mitochondrial efficiency and levels of oxidative stress. We can also gain insights into precisely the nutrients or approaches your body can best use to rehab any shortcomings to optimize mitochondrial function and ultimately your longevity and wellspan/playspan! By addressing any imbalances and providing targeted interventions, you can unlock her body's potential for renewed energy and vitality.

Remember, this phase of your journey is an invitation to embrace the power within and discover the incredible potential of your body! Embracing this specialized approach to healthcare empowers us to restore hormonal balance and optimize overall well-being. 

If you’re interested in learning more, schedule a free 15 minute call by clicking here. We offer different programs for every need and budget, and would love to help you find the support that’s a perfect fit for you.

 

 


stress

Understanding the Link Between Stress and Perimenopause

Stress - we’re all living with it.

And you don’t need me to tell you stress isn’t great for your health…

But for women in or near perimenopause, stress deserves special mention. Research has shown chronic stress actually worsens the hormonal symptoms of perimenopause, like hot flashes and PMS - as well as weight gain, decreased sex drive, and overall feelings of wellbeing.

But as we all know, “getting rid of” stress really isn’t an option. As a long-time health practitioner, my goal isn’t to help my clients eliminate stress, but rather teach them strategies to better manage stress. 

This is especially important during the perimenopause transition, when we are already in a hormonal shift and have less “wiggle room” to manage things like stress, blood sugar imbalances, and inflammation from hidden infections. 

But I’m not just talking about starting a meditation practice or saying no to that extra project at work. Targeted use of the right bioidentical hormones, herbs, and adrenal support supplements can help your body handle stress better, and help you transition through menopause seamlessly. 

Today, let’s explore what stress and menopause do to the body on a hormonal level - and what we can do to better support the body for more energy, less hormonal symptoms, and a better life. 

 

How Stress Impacts Your Hormones

When I say “hormones” I don’t just mean your sex hormones like testosterone, estrogen, and progesterone. I’m also talking about adrenal hormones like cortisol and DHEA, which play a role in controlling your sex hormones as well. 

During perimenopause, hormone levels fluctuate, and it's fluctuating hormones that can cause symptoms like hot flashes, mood swings, and weight gain. Research shows that stress only intensifies this. 

Stress triggers the release of cortisol. This is good, as cortisol is the “fight or flight” hormone that helps us respond to danger. But when stress is on-going, it can lead to an on-going state of elevated cortisol. Elevated cortisol in turn depletes the hormone DHEA, which is already in a natural state of decline as we age. 

Low DHEA is a problem for anyone, but especially for perimenopausal women because DHEA is a precursor to both testosterone and estrogen. Low levels of DHEA can therefore cause low levels of both testosterone and estrogen, intensifying the already changing hormone levels during this time. 

 

Low DHEA & The Pregnenolone Steal

So far, we’ve covered how stress can lead to elevated cortisol, which causes lower levels of DHEA. Because DHEA is a precursor for testosterone and estrogen, it can impact sex hormones.

But why does elevated cortisol deplete DHEA? That’s thanks to a process commonly called the “Pregnenolone Steal.” 

The basic premise of the pregnenolone steal is that pregnenolone  - a hormone produced by the adrenal gland - is a precursor for both cortisol and DHEA. When stress is high, the body reacts by producing more and more cortisol, “stealing” all the pregnenolone and leaving none for DHEA production.

That’s a bit of an oversimplification, though. There’s not just one pool of pregnenolone that gets depleted. In reality, pregnenolone is in the mitochondria of each of the cells. Rather than thinking about pregnenolone being stolen, it's more that the body prioritizes some pathways of hormone production that are about survival (cortisol), over reproductive hormones.

That being said, no matter “how” it happens, the decrease in sex hormone production this causes is particularly inopportune during the perimenopause years, when we are already hormonally in shift. It can make it seem like we are more sensitive to stress, or that it takes less stress to cause a noticeable change in how we look and feel. Coexisting issues like blood sugar imbalance or hidden infections - which are other common triggers for cortisol release - might suddenly become a bigger problem, too. 

 

Perimenopause and Low DHEA Symptoms

If you’re dealing with stress related hormone dysfunction on top of perimenopause symptoms, you might feel like you’ve got the worst perimenopause of anyone you know. It can cause an intensification of already-known symptoms like:

  • Hot flashes
  • Night sweats
  • Decreased sex drive (low libido)
  • Decreased sexual pleasure
  • Weight gain/ weight loss resistance
  • Poor sleep
  • Increased cravings
  • Mood disturbances (depression, anxiety, etc.)
  • Low energy
  • Overall lack of wellbeing

So that’s the “bad news.” Now let’s talk about the good news - all the things you can do to help rebalance hormones, support your body’s stress response, and get back to feeling like yourself. 

In fact, after 1-2 months on a customized plan based on your hormone test results, most of my clients see a 75% or more reduction in symptoms. 

 

Can Hormone Therapy Help Low DHEA and Perimenopause? 

For a deep dive into using bioidentical hormones safely during perimenopause, see my blog here. 

But in addition to sex hormone replacement therapy, supplementing with hormones like DHEA can be an option too. 

When used appropriately - and well monitored - DHEA is a safe way to help increase low testosterone in peri-and menopausal women. (It’s especially great for women with some types of hair loss, too!)

But, DHEA needs to be used carefully. Androgen dominance (too much testosterone) can be a main driver for the development or worsening of insulin resistance in perimenopause. 

That’s why I always recommend testing before starting DHEA (even if it is available over the counter where you live) and on-going monitoring. I recommend a comprehensive hormone panel like the DUTCH test. 

In the clinic, we also use pregnenolone supplementation when using DHEA. This helps with two main problems with DHEA supplementation. First, it can help offset the tendency of DHEA to lower cortisol levels, which can be a problem if someone is already dealing with low HPA output. 

Secondly, DHEA has a tendency to put weight on some people, or cause water retention. Adding pregnenolone can prevent this tendency. 

 

Active Stress Management and Supplements

Supplementing with hormones is just one part of the puzzle - just as, if not more, important are complementary lifestyle practices that help manage stress. 

I make a custom plan for each of my clients, but some of the techniques we use include:

  • Optimizing sleep hygiene (no blue light before bed, etc.)
  • Introducing movement (finding an exercise you actually enjoy– and prioritizing muscle building over cardio)
  • Circadian alignment (going to bed and rising with the sunset/sunrise)
  • Balancing blood sugar and increasing protein intake
  • Eliminating/reducing alcohol and processed sugar 

Active stress management - like qi gong, walks in nature, meditation in any form, making time for art, getting involved in your community, and spending time with friends and loved ones  - are also key. 

And then of course there are the issues that you can control - like your relationships, overall task burden, time management, ability to delegate and ask for support, and cutting out toxic people or activities. 

These steps can help you eliminate what stress you can and better tolerate the stress you have to live with. 

A final piece of the puzzle are adaptogenic herbs and herbs for supplement symptoms. As a long-time Traditional Chinese Medicine practitioner, I’ve seen the incredible power of herbs for transforming health. But, as with all powerful tools, they should only be used after adequate testing or practitioner diagnosis has identified the imbalances that exist. 

 

Look and Feel Your Best in Perimenopause

Perimenopause has a reputation as the worst time in a woman's life… but it doesn’t have to be that way!

With the right support, you can not just survive perimenopause - but actually enjoy the transition and step confidently into a new chapter in your life. 

You don’t have to accept weight gain, low sex drive and lack of pleasure, hot flashes, mood swings, cravings, irritability, and all the other common symptoms of perimenopause. 

My passion is guiding women through this change, helping to support their body’s unique needs, and watching them thrive in this phase of life!

If you’re interested in learning more, schedule a free 15 minute call by clicking here. We offer different programs for every need and budget, and would love to help you find the support that’s a perfect fit for you. 


Skin

Skin from Within: A Unique Approach to Anti-Aging Skin Care

If there is one thing we all can agree on it’s this: we want younger looking skin!

And judging by the myriad face creams, facials, lasers, and injectables on the market, most of us are willing to spend time and a lot of money to get it.

But if you’ve tried a few of these products (or procedures) you’ve likely been underwhelmed. Even the very expensive treatments don’t have the kind of results most people want and expect.

And as a long-time functional medicine practitioner and acupuncturist, I can explain exactly why…

These treatments only go skin deep. 

If you want the kind of radical results that get everyone asking “What are you doing differently?!” you absolutely must address your skin’s aging from the inside out. 

We need to go beyond topical treatments and take a look at what is happening on a cellular level to actually change the way your skin looks as it regenerates itself. To do this, we need to talk about your mitochondria. 

Stick with me - today I will explain what your mitochondria are (in a simple way) and how you can help them function better for younger looking skin from the outside in, no 27-step skincare regimen required!

 

How the Mitochondria Give You Youthful Skin

Mitochondria are one part of the many cells that make up your entire body. You might remember from high school biology that the mitochondria are like the batteries that charge up your cells. Mitochondria churn out ATP (Adenosine triphosphate), the fuel your cells use for energy. 

Research has shown that mitochondria become less efficient as we age. When researchers looked at mitochondria in skin cells from young, middle-aged, and older patients, they found mitochondria function was lower in middle-aged adults and even lower in the older group. 

The lower mitochondrial function left the aging skin cells more vulnerable to the effects of damaging compounds known as reactive oxygen species (ROS)—otherwise known as free radicals. Free radicals damage the skin cells, leading to a dry, wrinkly outer layer and premature aging over time.  

On the other hand, robust mitochondrial action helps protect skin from damage and recover quickly - think of the way a kid’s skin heals after a cut. That's why, as we age and mitochondrial function naturally decreases, we start to see fine lines, wrinkles, sagginess, and discoloration set in. 

 

Protecting Your Skin From The Sun

One HUGE source of skin damage throughout life is UV radiation from the sun. The problem is twofold. First, too much sun exposure weakens the mitochondria and the energy production in skin cells sputters out. This changes the skin—and not in a good way. The sun damage leads to premature skin aging. 

But in addition to this, the mitochondria—when they’re working well—serve as nature’s sunscreen helping to protect your skin from sun damage even when it is exposed. That’s why it can feel like all the sun damage from you teens and twenties finally appeared when you turned 30!

 

How To Have Beautiful Skin 

The healthiest thing you can do for your skin is to rejuvenate your mitochondrial health.  One of the best ways to do this is with a powerhouse nutrient called NAD+ (nicotinamide adenine dinucleotide). Your mitochondria use NAD+ in order to make ATP. Without enough NAD+, your cells can’t create the ATP that provides the energy to defend against free radicals, which leads to skin damage. 

Plenty of NAD+ equals plenty of ATP, which in turn results in gorgeous skin. Since NAD+ levels drop with age, an NAD supplement is an important part of aging skin care. 

NAD+ also boosts levels of sirtuins, a family of proteins that can protect your skin against inflammation. Redness and puffiness are signs your sirtuin levels may have taken a nosedive. Scientists call this inflammaging, meaning the inflammation that happens as you age.  

Keeping the mitochondria happy and healthy by using NAD+ also can lengthen your telomeres. These are caps at the end of your chromosomes, just like the caps at the end of your shoelaces that keep them from unraveling.

As you age, your telomeres grow shorter. UV radiation from the sun also shortens telomeres in the skin. The more you can do to protect your telomeres, the healthier your skin will look. 

The best bet? Use NAD+ both orally and topically on your skin itself. An oral NAD supplement will include nicotinamide riboside or nicotinamide mononucleotide. In addition, there’s a liposomal NAD+ product, and NAD+ is also included in Thorne Collagen Plus, along with other skin healthy ingredients.

 

Other Mitochondrial Support Supplements

You’ve probably noticed that many topical skin health product contain antioxidants like vitamins C and E and coenzyme Q10. Antioxidants like these help to protect the mitochondria from free radical damage. 

But just using these antioxidants topically misses the mark - it’s when used internally that they can have the greatest anti-aging effect. 

However, you don’t want to just start popping tons of mitochondrial support supplements - it’s better to work with a functional medicine practitioner who can isolate the nutrients you’re low in and focus on those.

Having said that, here are some mitochondrial rejuvenators worth talking about with your provider. Each of these supplements either protect the skin against stress, act as antioxidants and defend against too many damaging ROS, and soothe inflammation. 

  • Adaptogens 
  • Alpha lipoic acid 
  • Coenzyme Q10 
  • Curcumin
  • Probiotics 
  • Carnitine 
  • Glutathione 
  • Magnesium 
  • Omega-3 fatty acids
  • Vitamin B12 
  • Vitamin C 
  • Zinc 

 

Avoid Things That Damage the Mitochondria

You might have noticed that when you don’t get a good night’s sleep, your skin suffers. Or when you’re going through a lot of stress your skin lacks that healthy glow. Think about how much older presidents look when they leave office compared to when they first took over one of the most stressful jobs around. 

Lack of sleep and stress can spell trouble for the mitochondria. In fact, their impact on the mitochondria may be the reason why each of these things can get in the way of healthy looking skin. 

The sex hormone estrogen also protects the mitochondria at the same time as it keeps the skin looking young, so as levels start to decline with premenopause, the mitochondria can suffer. This is why it’s a good idea to work with a functional medicine provider to balance hormone levels.

Toxins are another source of mitochondrial damage. Toxins are all over the place: in your food, your water, the air you breathe. We’ll talk more about the role of toxins in mitochondrial health in an upcoming blog post. 

 

The Secret to Gorgeous Skin

Want skin that looks and feels younger and healthier? As a functional medicine provider, I can help you maintain your youthful appearance by ordering the right tests and then choosing the right supplements. That’s why I invite you to reach out to me for a free 15-minute troubleshooting call to find out the best course of action for you. We’ll start there, and if you come on board as a client, I’ll order a full lab work-up. Our strategy is to give you healthy skin from within so your good-health glow will turn heads wherever you go.


Mold Toxicity

What Is Mold Toxicity or Mycotoxin Illness?

Did you know you might have an unwanted house guest? 

Sometimes, that “guest” sends out a musty odor, so you know it’s there. 

Other times, there are no obvious signs of your visitor’s presence.

In fact, the problem may not have originated in your current home. Your unwanted visitor might have hitched a ride with you when you moved from one place to another.  

This visitor is a real troublemaker.

I’m talking about mold. Gross, right? Especially when you discover that it can colonize more than just your house—it can also colonize you

Mold can wreak havoc on your health. If you suffer from brain fog, fatigue, acne, light sensitivity, sleep problems, or headaches—or one or more of the other symptoms listed later in this article—your unwanted guest could be to blame. 

When mold makes you sick, it’s called mold toxicity, mold illness, or mycotoxin illness. 

 

My Personal Experience with Mold

I’m deeply interested in mold toxicity right now. Why? During a recent storm, my neighbor’s hose froze and ruptured. The trouble began when it thawed out, and the water saturated the ground between our homes. Some of that water leaked into my basement—an area already susceptible to mold because it’s foundation is 100 years old. 

I woke up on Christmas morning to the sound of water trickling in the basement and spent the day shop-vacuuming up over 30 gallons of water as it flowed down the inside of the dry wall and out across the flooring (and under it!) from under the baseboard. A demo team came pretty quickly to remove the Pergo and linoleum, and parts of the drywall– the bigger problem was that once those were pulled out, there was clear evidence of pre-existing water damage and mold on the surfaces.  I immediately had an industrial grade HEPA air filter installed to vent the basement air to the outside as a temporary solution until I could get all the mold removed.

Uh, oh! It was clearly time to take aggressive action or my health, and that of my family, could suffer. 

I plan to run mycotoxin testing on myself and journal the results, so stay tuned for updates on my progress. For now, let’s talk about mycotoxin illness and how it may impact your health. 

 

What Is Mold Illness?

Mold is a fungus that’s usually found outdoors, but sometimes it can lurk in your home, office, or even your car or child’s school. When mold invades a water-damaged indoor area, watch out! It can cause mold illness, and you may dismiss the symptoms without realizing they’re causing many of your most bothersome health problems.  

Buildings aren’t the only source of mold exposure, though. Did you know that mold can grow inside breast implants in some women?

Mold releases odorless mycotoxins into the air, which can really do a number on your health. Exposure to mycotoxins can cause mold toxicity, also known as mycotoxin illness or mold illness. 

Likewise, mold creates other troublemakers known as volatile organic compounds (VOCs). If you notice a musty odor in a water-damaged area, these VOCs are to blame. And if you can smell them—and even when you can’t—you can inhale or swallow them. In some cases, mold can colonize your body, causing you to pump out mycotoxins from within.

Exposure to mycotoxins can trigger chronic inflammatory response syndrome—CIRS, for short. CIRS kickstarts excessive inflammation, which can impact pretty much any organ in the body. CIRS symptoms are the same as those caused by mycotoxins since CIRS is often the culprit behind mold toxicity.

Even in small amounts, mycotoxins and VOCs can harm the body. In fact, they’re considered carcinogens. They create a high level of damaging oxidative stress, which in turn harms the mitochondria of your cells. Think of mitochondria as the powerplant of your cells that fuel your body with energy. If you have a hard time getting out of bed in the morning and are dragging all day, your mitochondria could need some tender loving care.

It's important to remember that mold toxicity and mold allergy are completely different things. During mold allergies, your immune system reacts to mold spores. The result? A runny nose and itchy, watery eyes, etc. 

Mold toxicity often affects more than just your sinuses and lungs, and it causes symptoms that can be mistakenly attributed to some other trigger.

 

Symptoms of Mold Sickness

Different types of mycotoxins can each cause specific symptoms. For example, the mycotoxin ochratoxin A leads to problems with brain or nerve function and may cause nerve pain or a  hormone imbalance. This mycotoxin also attacks your immune system.

Whether or not you feel ill varies greatly. Even in the same environment, you may feel sick while your coworker or spouse feels just fine. 

So, what causes those reactions? You can thank your genes for an increased vulnerability to mold. Nearly 25% of people living in the U.S. are genetically susceptible to mold toxicity. If you’re one of them, your immune system doesn’t identify and eliminate the mycotoxins as easily as other people’s systems do, so the toxins build up in your body. 

There are more than 100 mold illness symptoms. I can’t list all of them here, but some of the most common ones include:Common Symptoms of Mold Sickness

  • Abdominal pain
  • Anxiety
  • Asthma (new-onset or worsening)
  • Autoimmune disorders
  • Bloating
  • Brain fog
  • Chemical sensitivity (symptoms that occur when exposed to chemicals or fragrances)
  • Depression
  • Diarrhea
  • Digestive problems, like irritable bowel syndrome (IBS)
  • Dizziness
  • Fatigue
  • Headaches
  • Irritability
  • Joint pain or stiffness
  • Leaky gut
  • Memory loss
  • Mood swings
  • Muscle pain
  • Nausea and vomiting
  • Poor immunity
  • Sensitivity to bright light
  • Sinus problems
  • Skin irritation or rashes
  • Skin sensitivity, even to light touch
  • Sleep problems or night sweats
  • Sore throat
  • Thyroid problems
  • Tremors
  • Urinary incontinence
  • Weight gain

 

Your Brain on Mycotoxins

Ochratoxin, the most common mold mycotoxin, greatly reduces dopamine levels, especially in areas of the brain linked to Parkinson’s disease. In addition to Parkinson’s disease, over time, mold toxicity puts you at risk for:

  • Alzheimer’s disease
  • Amyotrophic lateral sclerosis (ALS, also known as Lou Gehrig’s disease)
  • Autism
  • Multiple sclerosis 

 

Tests for Mold Exposure

Just because you don’t live in a warm, humid part of the world doesn’t mean your home is safe from the problem. Mold can occur anywhere. Studies show that half of the buildings in North America may have water damage

If you have mold toxicity symptoms, don’t write them off because your house is a new build or you can’t smell anything musty. Testing for mold is your best bet. 

Because mold can also colonize your body—and especially your gastrointestinal tract—the problem might not even be in your current residence or office. Your previous home or workplace could be to blame. Mold can catch a ride on things like papers, books, and even your clothes. This means it can travel with you from place to place. 

Here’s how to test your home for mold: use a do-it-yourself (DIY) mold testing kit, such as this one as a starting place. Want another option? Use a professional home inspector. I love We Inspect, but you can also find mold testing professionals in your area through the National Association of Mold Remediators and Inspectors (NAMRI).

You can also work with a functional medicine provider who will use a mold toxicity urine or stool test to detect the presence of mycotoxins in your body and help you create a personalized protocol to remove them. 

 

Treating Mold Toxicity

Once you’re certain that you’ve been exposed to mold, how do you kick mold illness to the curb? I use this five-step approach:

  1. Ditch mold exposure either by moving or thoroughly treating and/or revamping your home or office. If you move, be careful what you bring with you. Mold can contaminate furniture, documents, books/bindings, clothing, and fabric. 
  2. Have your functional medicine provider order baseline mycotoxin urine, and sinus testing to gauge your level of exposure. Stool testing for fungal dysbiosis is also encouraged. Your provider can recommend natural antifungals to kill any mold colonizing the GI tract, lungs, or sinuses. 
  3. After six weeks of treatment, your functional medicine provider should retest your mycotoxin levels. If mycotoxins are still present, you may need to try a new antifungal treatment or increase the dosage.
  4. Help the body chase away the mycotoxins. Using natural binders and using products to boost bile production can help pull mycotoxins out of the body. Liposomal glutathione is a great choice for removing residual mycotoxins. Mold toxicity seriously decreases glutathione levels. As your body’s major antioxidant, glutathione fights the oxidative stress caused by mold. In some cases, you might need to sweat the mold toxins out of your body using an infrared sauna or sauna blanket. Be sure to hydrate and poop one to three times per day.
  5. Support your mitochondria and energy as well as insulin levels and hormone balance. 

 

Feel Better by Fighting Off Fungus

Is mold toxicity causing your sickness, fatigue, or other health problems? As a functional medicine provider, I’ll find out the answer to that question. The process begins with a free 15-minute troubleshooting call. From there, I can order the right mold toxicity tests and interpret the results to find out whether we need to take steps to get rid of your mold exposure and treat your mold illness. I’ll develop a treatment plan to help you feel more energetic, clear-headed, and better overall. Sign up for a call today, so you can feel like your old self again.


Toxin Exposure

Is Toxin Exposure Aging You Faster?

Is Toxin Exposure Aging You Faster?

Are you looking in the mirror every day and wondering how you can turn back the clock?

You’re in the prime of your life, but you are noticing wrinkles and fine lines where there used to be none.

You can’t seem to squeeze into your favorite jeans.

You feel an energy dip in the afternoon when you want to be present to your kids.

It seems like your mind has lost its sharp edge.

Your muscles are less toned, even when you double-down on your workouts. 

After tackling work and home life, does it feel like you have nothing left over for your own enjoyment?

Unfortunately, you’re not imagining things. It’s real. Your cells are aging. You are aging. But it doesn’t have to be that way. Because you can turn back the clock. 

I’m inviting you to get off the aging train. Keep reading to find out one of the most important steps you can take to slow the aging process. You can hold on to that youthful glow -and turn heads- now and well into your golden years.

 

Look and Feel Younger 

Did you know that your biological age can be much younger than your chronological age?

Your chronological age is based on how many birthdays you’ve celebrated. Your biological age is based upon how old your cells think they are and how they feel. By turning back the clock on your biological age, you will no longer be a prisoner to your chronological age.

Here’s an example of young biological age… 

I’ve taken up social dancing recently, a type called Casino that is from Cuba. Dance is a huge piece of how I stay younger. Dance brings me joy. 

When we’re joyful, our cortisol levels are more balanced, our hormones are more balanced, our body functions better and we have more oxytocin, a love hormone that plays a role in social bonding.  

Dancing is good for my health. I’m a better person when dance is part of my regular weekly routine. 

A couple of weeks ago when I was out dancing, I saw a woman in her mid- to late 70s. Not only was she the life of the party, she was even getting down on the dance floor with the lead singer of the band! She was the poster child for someone who has a young biological age

I will be doing something right if I’m her age and have her energy and her outlook and her mood! I just looked at her and thought #lifegoals. 

The point is: there are a lot of ways to be 75 or 80 years old. She’s found what feeds her soul. She found her place, her happy spot. Her chronological age might be chasing 80, but her biological age was much younger.

So what does dancing have to do with environmental toxins? You see, exposure to toxins is one of the most common things that cause our biological age to skyrocket. Your youthfulness—or your biological age—is an equation. You can slow down aging with things that bring you joy, a healthy diet, nutrients, building muscle mass, and more. You can speed up aging with stress, toxins, poor diet choices, drinking, staying up late, smoking, working out too much, radiation, and more. 

Toxin exposure can make you look and feel older. Toxins trigger inflammation, damage DNA, shorten telomeres, and get in the way of healthy mitochondrial function.  

The good news? There are ways to measure your toxin exposure and to detox your body. Let’s take a deep dive into how toxins age you faster. You’ll find out what you can do to kick toxins to the curb so you can feel and look more youthful.  

 

Lead and Mercury and BPA, Oh My!

Everywhere you go and everything you do exposes you to toxins. They’re found everywhere from canned food to cash register receipts to some personal care products, children’s jewelry and toys, vinyl flooring, dust, and soil. Toxins lurk in the water you drink, the air you breathe, and the food you eat. 

For example, lead—a chemical linked to heart disease and other health problems—is found in many places including:

  • Electrical cords including Christmas tree lights
  • Houses painted (and toys made) prior to 1978
  • Imported candies and food
  • Lead-glazed ceramics, china, leaded crystal, and pewter
  • Some folk medicines, ayurvedic medicines, and cosmetics
  • Some children’s jewelry and toys.   

This article isn’t meant to go into detail about each and every toxin. Just know that toxins are out there and we’re exposed to them from the time we’re in the womb. 

But don’t let this discourage you because there are ways to decrease your toxic burden. I will discuss more on how to detox later in this article.

 

 A Telomere’s Worst Enemy

One reason why toxins age the body is because of their impact on telomeres. The genetic blueprint of our bodies is encoded on double-stranded DNA molecules called chromosomes. Telomeres are protective caps on the ends of chromosomes that make it possible for cells to divide without scrambling that important DNA information. Telomeres are often compared to those hard sections at the end of shoelaces that stop them from unraveling. 

Telomeres grow shorter and shorter each time cells divide. Eventually telomeres get so short that cells can no longer divide, and instead they die. 

What does telomere shortening mean for your body? The shorter your telomeres, the greater the chance you’ll feel and look older. Short telomeres are linked to a whole host of age-related problems, whether we’re talking about cancer, immune system and memory problems, inflammation and all the diseases that go with it, or skin wrinkling. 

Toxins are basically out to get your telomeres. For example, every time you touch a cash register receipt or eat food out of a plastic container or can that’s not BPA-free, your telomeres will need to duck and cover because they might get a hefty dose of bisphenol-A (BPA). Even low-doses of this toxin speed up telomere shortening.  

Likewise, lead exposure damages telomeres.  This is an important way in which toxins age you faster.

 

How Toxins Do Their Dirty Work

Environmental toxins damage the mitochondria, the powerhouses that fuel our cells and give them energy to keep working their best. When toxins hurt the mitochondria, cells are injured and stressed, creating molecules that are pro-inflammatory and speed up aging.  

Normally, inflammation benefits the body because it helps the body recognize and fight off infections or address naturally occurring damage to our tissues. This type of inflammation is low-grade and should have a beginning, middle, and end. 

We have systems in our body that understand when the inflammation is needed and should resolve it in the same way firefighters strive to put out a wildfire before it gets out of control.  

But when toxins damage our mitochondria, the checks and balances that the body usually puts in place to stop inflammation from spiraling out of control stop working. 

The result? Inflammation rages out of control and goes on and on, causing a shift in the immune system and leading to more tissue damage, cellular aging, and chronic inflammatory diseases. For example, it can cause the immune system to attack itself, causing autoimmune disease. 

 

Are You Suffering from Inflammaging?

As we grow older or are exposed to damaging substances like toxins, inflammation ramps up in the body like a fire that hasn’t been put out. Damaged mitochondria from toxin exposure create pro-inflammatory molecules, which can speed up aging. 

Scientists coined a term for the inflammation that goes into overdrive when we age. It’s known as “inflammaging.” Aging plus inflammation is not pretty. It puts you at greater risk for many diseases that disable the elderly including heart disease, diabetes, and dementia. Out-of-control inflammaging can also cause wrinkles to pop up on your face, and you can say goodbye to your youthful appearance.  

There’s another damaging process called oxidative stress, which goes hand in hand with inflammation. Reactive oxygen species (ROS) are the culprits behind oxidative stress. Some oxidative stress is healthy, but too much of it hurts your body. That’s why people take antioxidants—to protect themselves against too much oxidative stress. 

Oxidative stress builds up in your body for many reasons, but toxin exposure is one of the most common. 

 

Where Are Toxins Lurking?

Toxins are made by harmful bacteria in the gut and those in the water supply. We also can get exposed to toxins when we eat or drink, especially food that’s not organic or when we drink too much alcohol.  

We breathe air and dust that contain toxins (such as mycotoxins from mold), which enter the lungs, travel into the mucous membranes in the sinuses, and drip into the throat. When we swallow, the toxins end up in the gut. 

If your cells are exposed to lots of toxins—and heavy metals are some of the worst offenders—production of reactive oxygen species goes into overdrive and damages the mitochondria and weakens your body’s ability to protect you. 

If the toxic burden is too high your mitochondria can’t repair themselves, which means the mitochondria can’t make enough ATP, the energy molecule that fuels your cells. The result? Feeling tired and dragging as you perform your daily responsibilities.  

 

How Your Body Protects You Against Toxins

So what happens when you’re exposed to these toxins? Nrf2 to the rescue! The Nrf2 pathway in your body soothes inflammation and boosts your body’s production of antioxidants. 

Aging, toxins, and infections weaken the Nrf2 pathway, which is why it’s important to increase levels of this powerful protein. I’ll talk more about a substance that activates the Nrf2 pathway later in this article, so you’ll be armed and ready to defend yourself against rapid aging.

 

Testing for Toxins

The good news? We can measure our toxin exposures by using a number of blood tests such as:

  • Genova ION test to measure levels of the antioxidant glutathione, oxidative stress, and different liver detox pathways 
  • Testing for mycotoxins, or toxins from mold (Mycotox Panel by Great Plains Laboratory)
  • Heavy metals testing (Mercury Tri-Test & Blood Metals Panel Quicksilver Scientific test) 
  • Environmental toxin burden panels (Great Plains Laboratory ENVIRO-Tox Panel). 

 

How to Detox Your Body from Toxins

You don’t have to put up with a toxic brew of chemicals that harm your health and age you faster. Here are some ways to detox your body or avoid toxin exposure in the first place. These strategies can slow aging and lead to younger looking skin and a healthier body.   

  • Use an Infrared Sauna. Pull toxins out of your body by sweating them out using an infrared sauna or infrared sauna blanket. 
  • Dry Brushing. This method is thought to open pores and promotes sweating to release toxins through the skin.
  • Install a Good Water Filter. To purify the water supply, use a water filter not only in the kitchen but also in the bathroom so you don’t breathe in (or bathe in) toxins while you shower.  
  • Eat Organic Food. To reduce your toxin exposure in the first place, eat organic food. Researchers have found that people eating an organic diet have lower levels of pesticides in their urine samples.
  • Promote Bile Flow. After the liver detoxifies toxins, the byproduct is removed from the body through bile, which is excreted in the intestines. Make sure you’re pooping daily. If not, try eating more fiber, taking a magnesium supplement, and addressing other root causes of constipation
  • Drink Lots of Water and Liquids. You’ll need to drink enough water or other healthy liquids like herbal tea to keep toxins moving through the kidneys and out through the body. 
  • Support the Nrf2 Pathway. Sulforaphane, which is found in broccoli, is an Nrf2 activator. It’s a good idea to eat lots of this vegetable to reduce inflammation and oxidative stress and to keep the mitochondria healthy. Just make sure you choose the organic variety in order not to expose yourself to even more toxins. Healthcare practitioners may offer supplements that contain other Nrf2 supportive combinations of herbs and nutrients.
  • Keep Your Mitochondria Happy. NAD+ is just one supplement that I use in my clinical practice to support mitochondria health. You can read more about this nifty nutrient here:
  • Take a Prebiotic and Probiotic. These can protect your gut against bacterial-produced toxins. I recommend Megaprebiotic and Megaspore.

 

Other Factors That Can Make You Look and Feel Older Than You Are

Many factors besides environmental toxin exposure can age you faster. These include:

  • How you sleep or don’t sleep
  • Ongoing infections in the gut or bacteria-related toxins known as endotoxins
  • Smoking cigarettes
  • Solar radiation
  • Eating too many processed and artificial foods
  • Not spending enough time in nature
  • Being under a lot of stress
  • Ongoing psychoemotional challenges (experiencing trauma)

All of those things impact how fast or slow we age, more so than the number of years you have on the planet. They’re the driving force behind whether you’re going to be dancing salsa when you’re in your 80s or too tired to get off the couch. 

 

How to Slow Aging with My Help 

Are toxins causing you to age faster? That’s what we will find out if you choose to reach out to me for a free 15-minute troubleshooting call. As a functional medicine provider, I can order the right tests and interpret the results to find out which toxins are damaging your telomeres and mitochondria. Then I’ll develop a treatment plan to detox your body and give you a more youthful appearance, increased energy levels, and a sharp memory—to name just a few healthy aging benefits. Sign up for a call today, so you can feel and look years younger. 

 


health coach

What is a Functional Medicine Health Coach?

As a Functional Medicine Health Coach, I combine my training and knowledge of Functional Medicine principles and approaches with my expertise in coaching psychology, behavior change and more. My work is aimed at empowering people to take charge of their health, and guide them to make lasting, sustainable changes to optimize their wellbeing.

In my years of working in Functional Medicine, I witnessed a gap that some people experienced. While these folks invested their time and money into meeting with highly qualified practitioners who provided them with very comprehensive treatment plans, they couldn’t figure out how to take that plan and make it work in their lives. They understood the directives they were supposed to follow to get healthier, but they couldn’t figure out how to go about doing it. This gap often resulted in frustration and struggle, impeding their success in reaching their goals for improved health.

This spurred me to create a Functional Medicine Health Coaching practice to address the need for support and guidance on 1.) how to implement treatment protocols, along with 2.) how to make Lifestyle changes that would successfully lead to reaching goals, and 3.) how to cultivate potential for greater fulfillment and wellbeing in life.

 

What does Functional Medicine Health Coaching offer me?

Studies show that people have much greater success in creating positive, long- lasting changes when they have the support and guidance of a professional wellness coach. Coaching improves the efficiency of your journey and ensures a greater outcome achieved. Athletes and high-performance professionals wouldn’t think of trying to achieve their goals without the guidance of a coach.

What can you expect from Functional Medicine Health Coaching?

  • Mentorship and guidance
  • Education
  • An objective perspective 
  • Opportunity for self-discovery and growth 
  • Strategies to support habit changes 
  • Empowerment to change and progress
  • Tools to support motivation
  • Accountability 
  • Individualized action plans, and much more… 

These would be difficult to access if trying to do this alone. 

* My personal style blends knowledge and science with intuition and wisdom derived from many years of working with patients in healthcare. I employ many holistic tools, modalities and techniques based on individual needs and presentation.

 

Get Support from a Functional Medicine Health Coach

Functional Medicine Health Coaching is useful whenever you’re attempting to make changes in habits and patterns aimed at improving the quality of your wellbeing. Taking steps to upgrade Lifestyle habits is an investment in your health.  Simple changes can lead to huge strides in feeling better, having more energy and vitality, improving the quality of your health, being more content in your life, and ultimately living with greater fulfillment.

What exactly are “Lifestyle Factors?” These are the choices you make every day that define how you live, impacting the quality of your health and your life.

There are nine pillars that lay the foundation for our health and well-being.  They include:  

  • Nutrition
  • Exercise and Movement
  • Sleep
  • Stress Management
  • Positive Relationships
  • Creativity
  • Meaning and Purpose 
  • Connection to Nature and Environment
  • Avoidance of Toxic Substances

 

If I’m working with a Functional Medicine healthcare provider, why do I need a coach?

Functional Medicine providers are highly skilled at identifying the root cause of your ailments and devise brilliant treatment plans to alleviate your condition. However, they commonly don’t have the bandwidth nor the skills to help guide you on how to make behavior changes or integrate treatment protocols into your life.

Collaboration with a Functional Health Coach expedites the process. When these two professions are employed in tandem, it creates a synergy that makes a recipe for success and the results are beyond impressive. 

Changing habits and patterns can be complicated. It becomes easier when you have someone who is knowledgeable on the nuances of your treatment plan - a coach to guide and educate you how to carry it out, support your motivation, provide accountability and help keep you on track.  Results are often accelerated, and more lasting levels of change are achieved. It’s your willingness and dedication to the process that brings the alchemy to fruition!

 

Meet Health Coach: Catherine Willows, RN, BA, FMC-HC, NBC-HWC

Catherine is a Registered Nurse and a seasoned healthcare professional with years of experience in a wide variety of clinical settings. Her long-standing passion for integrative and holistic health practices led her to studying and certifying in many holistic modalities, including herbalism, energy work, somatic therapies, and much more. This eventually led her to serving as a leader in the Obesity Prevention Initiatives in Chicago, and brought her to Functional Medicine where she worked as Clinical Services Director for Dr. Mark Hyman’s clinic, the UltraWellness Center. Catherine is a Functional Medicine Certified Health Coach, and a National Board-Certified Health and Wellness Coach.

 

If you really know me, you would know that…

I am dedicated to personal growth. I believe we’re all here to become our best version of ourselves. My purpose is dedicated toward helping others become their best version of themselves too!

I deeply value Creativity and Creative Expression. I believe everyone is inherently creative, even though many people have lost touch with it. Through Creativity, we have the opportunity to express our unique gifts in the world. I make it a practice to carve out space for Meditation, personal Freedom, Creativity and Inspiration - as these are essential to my wellbeing.

I love the arts. I love to engage in art-making, painting, fiber arts and more.

I love Nature - the Beauty of Nature - all its seasons and elements, plants and animals alike. I believe that the Essence of Nature has much to teach us about how to live in greater balance, and our individual health is intimately connected with the health of the planet.

I am a life-long learner with burning curiosity that drives me to continuously expand my knowledge in many areas of interest.

I enjoy riding my bike through the backroads of the Berkshires, kayaking, gardening and spending time with my Australian Shepherd.

 

If I could snap my fingers and be anywhere in the world, I would be

along the coast in Portugal I love to travel, and being seaside is one of my favorite places -  among natural beauty, in a place rich in culture and arts, with healthy food, a temperate climate zone, and a more easeful lifestyle.

 

New Functional Medicine Health Coach Program

Have you heard about my new group coaching program yet? This hour-long virtual gathering will be offered to current clients twice monthly and hosted by Catherine Willows. Its aim is to provide you with greater support in making lifestyle choices and habit changes to bring your health to a better place. Catherine’s next session is February 1st – get the full scoop here.


Mitochondria

Always Tired? It Could Be Your Mitochondria

Feeling tired and run down? Girlfriend, I know how frustrating it can be! But don’t accept low energy levels. You can reclaim your youthful energy and conquer the world. 

You can wake up refreshed, take care of your home, dominate at work, and crush it at the gym. 

And you won’t need three cups of coffee to feel that way!

What do you need to do to have boundless energy? Taking care of your mitochondria is at the top of the list. 

Mitochondrial health is the next big thing to think about in regards to getting back your youthful energy. More and more research is published every day on this cutting-edge topic, which is why mitochondrial support is a big part of my treatment for many patients.  

Since mitochondrial dysfunction is one of the most common causes of fatigue, this is one of the most important blog posts you’ll ever read.  

Mitochondria that aren’t working well can cause all sorts of problems, including weight gain, insulin resistance, skin aging, and much more. I’ll talk more about those problems in a series of blogs coming soon. 

Meanwhile, in this article, I’m going to dive into the ways that mitochondrial dysfunction can cause your energy levels to drop—and what you can do about it. 

 

What Are Mitochondria and How Do They Boost Your Energy?

Mitochondria are fascinating little structures. They’re the powerhouses of your cells, manufacturing energy that powers your entire body. 

The cellular fuel that mitochondria make is known as adenosine triphosphate, or ATP for short. Without ATP, your cells couldn’t work and you wouldn’t be able to function. With enough ATP, you’ll have lots of youthful energy.

Within each mitochondrion, there is an assembly line that takes proteins, carbohydrates, and fats derived from food, breaks them down, and manufactures ATP. Every cell in the body needs energy (ATP) to do its job. The heart, brain, liver, muscles, and kidneys are high in mitochondria because these organs need lots of energy to work.

When your mitochondria are humming happily along, you have lots of energy and feel like you can take on the world. 

 

Symptoms of Mitochondrial Fatigue

So how do you know if weak mitochondria are the cause of your low energy or other health problems? These symptoms will clue you in:

  • Fatigue in general
  • Weakness or lack of endurance during exercise
  • Excessive body pains or muscle aches after exercise
  • Longer than average exercise recovery or feeling wasted the day or two after exercise
  • Weight gain, slow metabolism, insulin resistance
  • Aging skin and rapid wrinkling
  • General all-over body pain, muscle weakness (myopathy)
  • Brain fog
  • Migraines
  • Anxiety and depression
  • Difficult to cope with stress

 

Your Mitochondria During Aging

As you age, the mitochondria can break down and not work as hard. The number of mitochondria actually decreases during aging. This means mitochondria make less ATP, so the body doesn’t make enough fuel to keep it running, just like a car that runs out of gas.

If you want to see young mitochondria in action, watch children run around a room or in the park. They’re little bundles of energy, fueled by their youthful mitochondria. 

Unfortunately, mitochondrial problems due to aging cause your body to make too many reactive oxygen species (ROS), also known as free radicals. These chemicals can harm your cells, creating a vicious cycle of yet more damage to the mitochondria. In addition, too many ROS smothers the creation of new mitochondria and stops the body from getting rid of damaged mitochondria. 

So what does it mean for you when your mitochondria get messed up during aging?  It drops your energy levels and you feel too tired to get things done.      

 

Other Reasons for Mitochondrial Problems

Besides aging, other factors can make the mitochondria scream out for help. These include:

  • Alcohol
  • Antibiotics
  • Environmental toxins
  • Hereditary factors
  • High-fructose corn syrup
  • Inadequate nutrients
  • Not enough physical activity
  • Overeating
  • Smoking
  • Statin drugs
  • Stress
  • Vegetable oils (high in omega-6 fatty acids)

 

How To Know If Your Mitochondria Are Healthy

Your functional medicine provider can order an organic acids test (OMX Metabolomics or the ION).  These tests will tell you whether your mitochondria are happy.

Your functional medicine doctor can also order a test to measure your telomere length. Telomeres are caps at the end of your chromosome—like the ends of shoelaces that keep them from unraveling. 

Telomeres become shorter and shorter with age. Your numerical age may not be the age your cells think they are. By measuring telomere length, you can get a good idea about your cellular age. 

Finally, testing adrenal function can let you know if your cortisol levels are off. High cortisol can block mitochondria function. 

 

A Secret To Keeping Your Mitochondria Healthy

One of the best ways to give your mitochondria some TLC? Make sure you have plenty of nicotinamide adenine dinucleotide (NAD+). 

Your mitochondria need NAD+ to make ATP and to fuel your energy levels. On the other hand, low levels of NAD+ can damage the mitochondria and make you feel like you just ran a marathon even if you haven’t gotten out of bed for the day. 

Low NAD+ also shortens your telomeres. Think of NAD+ as the “gas pump” you need to fill your cells’ “gas tank.”

Between the ages of 40 and 50, NAD+ levels drop to 50% of what they were when you were younger. In some organs and tissues, your NAD+ levels can drop by as much as 90% to 100%. This freefall in NAD+ means you’re not making as much ATP, which makes you feel like you’re running on empty.

Because your body needs NAD+ to make ATP, making sure you’re getting enough NAD+  ensures that all areas of your body are healthy including the adrenals, thyroid, brain, and circulatory system. For example, NAD+ protects the neurons in the brain by restoring mitochondrial health. This keeps your brain from feeling worn out. 

How do you raise NAD+ levels? You can take one of several different types of NAD+ supplements. I take it in a collagen product called Thorne Collagen Plus. It’s also available as liposomal NAD+. Many people use either a nicotinamide riboside or nicotinamide mononucleotide supplement to boost NAD+ levels. 

 

Other Mitochondrial Support Supplements

Many other supplements support mitochondrial health. Be sure to work with your functional medicine provider to find out which nutrients you really need. By ordering the right tests, your doctor can create a personalized and more effective protocol that includes supplements for mitochondrial support.

Here are the most common and effective mitochondria support supplements:  

  • Adaptogens – These are botanicals that help the body cope with stress. Stress can cause cortisol levels to go through the roof, and high cortisol is one of the mitochondria’s worst enemies. Stress also shortens telomeres.
  • Alpha lipoic acid – An antioxidant that encourages ATP production.
  • Coenzyme Q10 – An antioxidant that plays a crucial role in mitochondria’s ability to make ATP. CoQ10 is one of the mitochondria’s best friends. It stops the mitochondria from making too many reactive oxygen species (ROS). CoQ10 is the cornerstone of a mitochondrial support program.
  • Curcumin – Improves mitochondrial health by reducing inflammation.
  • Probiotics – Probiotics improve mitochondrial function and your body’s ability to make energy.
  • Carnitine – This amino acid boosts fatty acid metabolism in the mitochondria. Fatty acids are building blocks for ATP. 
  • Glutathione – An antioxidant involved in mitochondrial health. 
  • Magnesium – This mineral acts as an antioxidant in mitochondria, blocking the production of too many ROS and improving mitochondrial dysfunction. An organic acid test can tell you which type of magnesium your mitochondria need the most—for example, magnesium citrate.
  • Omega-3 fatty acids – These are an important component of the mitochondrial membrane.
  • Vitamin B12 – Your body needs enough of this vitamin to make energy.
  • Vitamin C – An antioxidant that promotes the production of carnitine, which in turn keeps your mitochondria in tip-top shape.
  • Zinc – Stops the mitochondria from making too many ROS.

 

Getting Rid of Chronic Fatigue and Mitochondrial Dysfunction

As a functional medicine provider, I can work with you to answer your question: “Why am I always so tired?” I’ll order the proper testing to see if your mitochondria need a boost. Then I’ll let you know what supplements to take and other steps that can get rid of your fatigue and make you more productive and full of energy.

I’ve successfully used this approach in many patients. That’s why I invite you to reach out to me for a free 15-minute troubleshooting call to find out the best course of action for you. We’ll start there, and if you come on board as a client, I’ll order a full lab work-up. 

The goal? To boost your energy levels, improve the health of your mitochondria, and give you the stamina to tackle life’s daily challenges. 


Gaining Weight

Weight Gain in your 40s

You’re eating the same as you always have, still getting the same amount of exercise… but your pants are suddenly tight.

Surprise! It’s menopause to blame… again.

Of course there are the night sweats, hot flashes, and mood swings, but gaining weight in menopause (or the 10 years leading up to it!)  is one of the most common (and dreaded) signs of this massive hormonal change. 

But like any other sign of menopause, just because it’s common, doesn’t mean it has to happen to you. 

The first step to preventing or reversing weight gain in peri-menopause is to understand why it happens on a chemical and hormonal level. 

From there, we can focus on holistic changes that don’t just make you drop a few pounds - they create an overall feeling of well-being, happiness, and health so you can thrive in this new season of life. Menopause doesn’t have to suck - I promise!

 

Why Do Women Gain Weight in Menopause?

Menopause isn’t just the end of your period - it’s a massive hormonal shift in your body, only comparable to puberty or pregnancy. As women, hormones are the ruler of almost everything that happens with our bodies, from our energy level to weight to mood. 

For a complete explanation of the hormonal changes that occur during menopause, read this blog.

Those hormone changes interact with the various mechanisms that control weight. (Yes, weight is about a lot more than just “calories in and calories out!”)

Here are just some of the mechanism involved in weight changes:

  • Gut Microbiome Dysbiosis
  • High cortisol (adrenal/nervous system issues)
  • Chronic inflammation
  • Thyroid disease
  • Insulin resistance and fatty liver
  • Medications
  • Lack of movement
  • Mitochondrial dysfunction
  • Hormonal changes

In menopause, the major hormonal change is first fluctuating and eventually lower levels of estrogen and progesterone. Those changes impact everything from glucose regulation to sleep, and those, in turn, impact weight.

In particular, the hormone changes of menopause can lead to increased belly fat. That increased belly fat can then fuel excess estrogen progesterone, intensifying the fluctuations that can lead to symptoms.

 

Sleep, Menopause, and Weight Gain

One well-known side effect of menopause are sleep problems - from trouble falling asleep to waking suddenly with night sweats. Research suggests that the sleep disturbances caused by menopause may also be at least partly to blame for the weight gain common in menopause. 

The fluctuating estrogen levels common during the menopausal shift can trigger increased appetite, hot flashes, and night sweats, impacting sleep quality. The late-night combination of increased hunger and inability to sleep is also a perfect set up for late-night binge eating. 

Even if your eating hasn’t changed, lack of sleep makes it harder to lose body fat, increases hunger and cravings for carbohydrate foods, and even inhibits muscle gain. Simply sleeping less may impact your body’s ability to manage glucose (blood sugar), promoting weight gain. In one observational study of over 150,000 women, those who had night sweats and hot flashes for a longer period of time (and therefore a longer period of disrupted sleep) also had a greater risk of developing diabetes - as much as 18% higher. 

But it’s not just disturbed sleep that can cause issues with glucose levels - the normal hormonal changes of menopause can wreak havoc on your blood sugar as well.

 

Blood Sugar and Gaining Weight In Menopause

For women, estrogen and progesterone levels impact how we maintain healthy blood sugar levels. Changes in your hormone levels can impact blood sugar and may even contribute to insulin resistance. 

Insulin resistance is when the body becomes desensitized to insulin, the hormone that controls blood sugar levels by acting like a key and “unlocking” cells so they can absorb sugar from the bloodstream. When insulin resistance occurs, the “key” stops working, and no matter how much insulin is present, it is unable to do its job. This creates a state of chronic elevated blood sugar, and can even lead to diabetes over time. Signs and symptoms of insulin resistance include weight gain (especially around the midsection), high triglycerides and LDL cholesterol, hypertension, gout, skin tags, and androgen excess, including PCOS.

Estrogen also plays a major role in the production of insulin, and can contribute to both insufficient and excess levels of insulin that contribute to insulin resistance. Estradiol, one type of estrogen, increases glucose sensitivity by enhancing the ability of the mitochondria to turn glucose into energy. Lower estrogen levels may then decrease glucose sensitivity, as well as impair the cells’ ability to convert glucose that has been absorbed into energy, causing a temporary energy crisis, even if enough glucose is being consumed. For you, this can feel like always being hungry, especially for carbs and sweets.

Progesterone, which has an anti-androgen effect, may also be protective against excessive insulin levels, as excess androgens stimulate the production of more insulin. (Overproduction of insulin is one aspect of insulin resistance.) When progesterone levels drop during menopause, this anti-androgen effect is lost. This is why hormone specialists like myself consider progesterone to be a weight loss hormone (just not artificial progestins, which can have the opposite effect).

These hormonal changes can result in elevated blood sugar and insulin resistance. In one study, hormone change symptoms like hot flashes were linked to both increased insulin resistance and higher blood sugar levels. In other research, women were less likely to experience hot flashes when blood sugar was elevated above normal, and more likely to experience them when fasting, showing the extremely complex relationship between menopause symptoms and blood sugar. 

In addition, as estrogen and progesterone levels decrease, it can lead to a state of testosterone dominance, which can also contribute to insulin resistance.

 

Ketones, Menopause, and Your Brain

Weight gain isn’t the only potential consequence of these changes. The brain’s primary fuel source is glucose, and the brain alone consumes more than 20% of the glucose in your bloodstream.

Because estrogen plays a role in the cells’ ability to burn glucose, when estrogen levels drop, cells must switch from burning glucose for fuel to burning ketones, and this may have an impact on brain function if the switch between the two fuel sources isn’t smooth. You might feel this as brain fog, forgetfulness, and fatigue.

To navigate this transition, the brain needs to get better at using ketones. And to do that, you need whole body insulin sensitivity and metabolic flexibility. Let’s talk about how you can achieve those goals.

 

How To Stop Menopause Weight Gain

The causes of weight gain in menopause are complex, so the solution needs to be multi-faceted. Here are just some of the suggestions I work with my own clients on:

 

Do Exercise You Love and Build More Muscle

Aim for 3-4 hours per week of muscle-building activity, as well as a mix of high intensity and steady state cardio. For a bonus, incorporate up to two fasted workout sessions per week. After you’ve exercised, refuel with 20-40 grams of protein in the hour after training.

 

Optimize What You Eat

I recommend a blood-sugar balancing diet, which typically involves lowering carb intake or rotating a keto-style diet with a moderate-carb-intake, mediterranean-style diet rich in above-ground veggies, polyunsaturated and unsaturated fats like olive oil, nuts and seeds, avocado, and leaner proteins. In general, your food should be anti-inflammatory and plant-forward, with a lot of veggies at every meal. Avoid liquid calories. 

 

Optimize When You Eat

A 10-12 hour eating window (followed by at least a 13 hour fast), and 3 meals without snacks is ideal for insulin sensitivity. Focus on eating protein at your first meal, and have it no later than 10 AM. Research suggests eating the biggest meal of the day at breakfast (instead of dinner) can also help promote weight loss.

 

Test For Food Intolerances

While not a factor for everyone, sometimes removing foods you’re intolerant of can reduce inflammation and clear the path for effortless weight loss. After testing revealed an intolerance, just removing eggs from my diet allowed me to lose 6 pounds without any other changes. 

 

Find Your Carb Sweet Spot

In general, menopausal women need fewer starchy foods than they did when they were younger. (I know, it isn’t fair!) Each individual has their own “sweet spot” for carb intake depending on activity levels and metabolism. Choose complex carbs, and aim for 30+ grams of fiber daily. Eat the bulk of your carbs during your most active part of the day or right after you exercise. 

 

Test For & Treat Insulin Resistance

Signs of insulin resistance include:

  • Waist measurement over 33 inches/85 CM
  • Elevated C-Reactive Protein (CRP)
  • High triglycerides and LDL
  • HBA1c above 5.6%
  • Continuous Glucose Monitor readings high (above 140)
  • HOMA-IR index
  • Fasting insulin above 5, especially above 10

For treatment, I like to use organic acid testing with my clients to personalize nutrients that influence insulin sensitivity, such as ALA, magnesium, chromium, bitter melon, cinnamon, and gymnema. Magnesium is one supplement I recommend to almost everyone. My favorite form is magnesium glycinate, which helps calm the brain and promotes better insulin sensitivity. 

 

Stabilize Estrogen

Test your estrogen levels and then use supplements like DIM, CDG, IC3, and phytoestrogen-rich foods like ground flaxseed to stabilize levels if estrogen is high. If estrogen is low, and you’re in perimenopause or early menopause - consider bioidentical replacement.

 

Use Hormone Replacement Therapy Strategically

Learn about the safety and efficacy of hormone replacement therapy, plus how I use it successfully with my clients, in this blog post. 

 

Get Enough Sleep

Make 7.5-8 hours of sleep a night a priority. If you’re struggling with insomnia, I can help with strategies for increasing melatonin and decreasing nighttime cortisol. Some easy places to start: turn off screens at least 1.5 hours before bed, and consider wearing blue-blocking glasses, too. 

 

Support Your Liver, Thyroid, and Gut

The liver and gut both play a major role in clearing out used estrogens. Lower estrogen levels can also negatively impact the gut microbiome and increase intestinal permeability. Check for signs of fatty liver, and if you aren’t pooping daily, let’s fix that. Test your thyroid function and support it with adequate levels of iodine, which also helps with hormone processing.

 

Get Expert Help for Gaining Weight in Menopause

Advice to just eat less and exercise more to lose weight gained in menopause misses the mark. Between fluctuating hormone levels, impaired sleep, and blood sugar changes, the causes of weight gain are complex. What you need is a holistic plan that addresses all aspects of weight gain so you can lose weight without starving yourself or feeling miserable. 

I mean it when I say that menopause doesn’t have to be a miserable process. Helping women navigate menopause while looking and feeling their best in my passion. If you’d like support, book a free consult with my team. We’ll start with a deep dive into your health history so we can understand the full picture of you. Then, we’ll develop a customized plan for supporting your health goals, and be with you every step of the way. 

 

>>> Book a FREE 15-Minute Consult to Discuss Your Health Goals Today


hair loss

The Causes of Hair Loss in Women

Your hair is your pride and joy, but lately you’ve noticed hair thinning or hair loss. 

It’s heartbreaking, I know. 

The bad news? There is never going to be “just take this supplement” kind of answer, because there are so many drivers behind hair loss in women.

The good news? By digging down to the root cause of the issue, in many cases you can have thicker, fuller hair once again. 

So what causes hair loss in women? Glad you asked. Because in this blog post, I’m going to answer that question and let you know the natural treatments for this common and frustrating problem.

 

Searching for Clues

When seeing a patient who complains of hair loss or hair thinning, I look at the symptom picture and history. 

Most importantly, I observe the type of hair loss. 

If the hair loss is patchy, it could signal autoimmune psoriasis. Patchy hair loss could also suggest alopecia areata, an autoimmune condition that causes hair loss. 

Overall thinning tends to be a sign of hormonal hair loss in women, which may be due to high cortisol and stress or estrogen or progesterone imbalances. Overall thinning could also be a symptom of nutrient deficiencies. 

 

What Causes Hair Loss in Women?

There are many reasons for hair loss in women. That’s why it’s important to work with a functional medicine provider to help you figure out the cause (or causes) of your hair loss. (more on functional medicine providers later). 

 

Menopause and Perimenopause

As many as 40% of women notice their hair thinning in the years before and during menopause. This isn’t a given. It’s not like it happens to everyone. But it’s common enough to include it in this blog post. 

Hair is vulnerable to falling out after a drop in estrogen and progesterone, which occurs during menopausal stages. When these hormones fall, hair may become thinner and grow more slowly.

 

Medications

A number of prescription drugs can cause hair loss or hair thinning. Here are a few of the common culprits:

  • Birth control pills
  • Chemotherapy
  • NSAIDS
  • Acne medications

 

Your DNA

Unfortunately, hereditary hair loss is the most common cause of hair loss and the one that is the most difficult to treat. This type of hair loss is typically gradual and involves a receding hairline and bald spots in men and a thinning of hair along the crown of the head in women.

 

Blood Sugar Issues

Elevated insulin levels in women can cause excessive production of male hormones, excess levels of free testosterone, or increased sensitivity to male hormones. Androgens are a group of sex hormones found in all genders, but men make more of them. Important for bone, muscle, sex drive, and sexual development, androgens include testosterone, androstenedione, dihydroepiandrosterone (DHEA), DHEA-sulfate, and dihydrotestosterone (DHT). 

When these male hormones go unusually high in women, it’s called hyperandrogenism and may promote acne, hair growth on the face, or a deep voice. It can cause hair loss at the front and sides, in the male pattern. Women with insulin resistance and/or polycystic ovary syndrome (PCOS), for example, typically have high levels of testosterone (or it’s metabolites) due to high insulin levels. These women are also prone to hair loss. 

But testosterone is not the big culprit behind hair loss, it is testosterone’s downstream metabolite- dihydrotestosterone - which is ultimately responsible for hair loss. Testosterone converts to DHT thanks to the enzyme, 5-alpha reductase. Many hair loss supplements try to block this enzyme.

If a woman or a man is insulin resistant, they produce more DHT. DHT can trigger the death of hair follicles. In fact, the main culprit behind hair loss is not testosterone itself but rather the level of DHT binding to receptors in hair follicles. 

 

Hormonal Hair Loss in Women

Imbalances in hormones can lead to hair loss. If any of the following hormones are out of whack, it could lead to losing hair:

  • Estrogen
  • Follicle stimulating hormone
  • Luteinizing Hormone
  • Progesterone
  • Prolactin
  • Testosterone

Another hormonal imbalance that can lead to hair loss is high cortisol levels, combined with low DHEA. High cortisol levels are the main reason why stress is involved in hair loss and thinning.  

Low levels of sex hormone binding globulin (SHBG) also can cause hair loss. SHBG is a protein that grabs on to excess hormones. If it is low and your free testosterone is high, your hair loss treatment should include both increasing SHBG and lowering testosterone by balancing all hormones.

 

Mercury and Other Toxins

Exposure to some heavy metals are to blame for certain cases of hair loss. Hair absorbs metals like a sponge and could affect hair growth. Exposure to these metals also cause symptoms like fatigue, depression, insomnia, irritability, and memory loss.

 

Thyroid Problems

The thyroid produces hormones that facilitate and regulate cell reproduction, so thyroid disorders—hypothyroidism and hyperthyroidism—can affect hair growth.

 

Nutrient Deficiencies or Excesses

Certain nutrient deficiencies—including riboflavin, biotin, folate, and vitamin B12—are  linked to hair loss. Micronutrients and macronutrients play an important role in follicle development and regulating immune cell function, which is involved in healthy hair growth. 

But don’t rush to load up on biotin for hair loss! Biotin levels that are too high, as in people who take biotin supplements, can harm the thyroid gland and interfere with thyroid lab tests. High biotin also can cause insomnia, digestion issues, skin rashes, and problems with insulin release.  If you’re going to supplement with biotin, I recommend a supplement that has lower levels of biotin such as Viviscal Pro Hair Health.

To prevent low levels of key nutrients, take a high-quality multivitamin daily and get checked regularly for nutrient deficiencies, including iron and ferritin levels.  You can also take a B vitamin complex to make sure you’re not deficient in any of the B vitamins linked to hair loss.

 

Autoimmune Issues

In autoimmunity, your immune system is triggered and mistakenly attacks a part of your body, a phenomenon called molecular mimicry. 

Alopecia can refer to a number of hair loss conditions, but relevant to the discussion on autoimmunity is alopecia areata, an autoimmune disease that causes the body’s immune system to attack hair follicles. In cases of autoimmune hair loss, we have to dig deep for the root causes of autoimmune disease to bring back hair growth.

 

Other Causes 

Other causes of hair loss in women include using harsh chemicals or hairstyles that pull on the hair a lot. Dieting and calorie restriction can cause hair thinning or hair loss. In addition, inflammation of any cause can lead to hair loss or thinning. What’s more, women often lose hair during the postpartum period. Read my blog post on postpartum and hair loss here

 

Case Study — Here’s How It Works

This is a recent hair loss case from my clinic. It is still in progress, but I’m including it to show you what it looks like to address the factors involved in hair loss. 

The client was a 48-year-old female. I’ll call her Jill. She had put on more weight around the middle, was on a low-carb diet, suffered from insomnia, and had rapid skin aging and hair loss. 

Jill’s first test with another practitioner showed she had low estrogen (estradiol), progesterone, and DHEA, as well as relatively high testosterone, although not out of range. The practitioner jumped to address her hormones, but not in a comprehensive way. She was given progesterone, no estradiol, and nothing was done to address her testosterone levels. The practitioner also did not evaluate insulin resistance or glucose sensitivity. 

The next test showed low estradiol, progesterone levels through the roof, and very high testosterone. This was likely due to the fact the practitioner had given her too high a DHEA dose, since the body converts DHEA to testosterone. 

When she began seeing me, her symptoms had become worse. I didn’t attempt to adjust her hormone protocol right away because it was designed by another provider and she wanted to wait before changing it. She gained more weight and was sleeping worse. Her skin aging also was worse, she had developed mild acne, and was moody and irritable. 

I was concerned about her very high hormone levels in relation to a very low estradiol. I tested her for blood sugar balance to see if it might be part of the mix. I thought stress and cortisol might also explain her hormone imbalances and hair loss.

I had her detox for three months to bring down her progesterone levels using herbal detox support to help the liver clear out the excess hormones and lower her SHBG. I also put her on herbal androgen blockers, which protect the body from too many circulating androgens. In addition, I focused on blood sugar control after finding out she was mildly insulin resistant. I tested her SHBG, gave her low-dose estradiol therapy, and began adrenal support. I had her stop taking DHEA at first because her levels were high, but added it back in at a much lower dose at six weeks, when her levels returned to normal.   

Hormonal balance is still on the radar. Jill will need progesterone at some point, and I plan on retesting her after the three months’ detox period. 

Jill’s making progress. She dropped eight pounds without changing her diet or activity level. She is sleeping better most nights.  Her skin has improved moisture and fullness. She still sometimes has a tough time falling asleep at some times of the month, but progesterone treatment should help with that. I anticipate her symptoms—including her hair loss—will resolve after we finish balancing her hormones and eliminating other causes such as insulin resistance. 

 

Helping You Pinpoint the Cause 

If you’re losing hair, it’s best to work with a functional medicine provider to identify the root cause of the problem. Toxins, hormonal imbalance, malnutrition, blood sugar issues, or an autoimmune process are just a few of the possibilities that must be ruled out. Your doctor can order the right tests to figure out the reason for your hair loss. Then he or she can recommend potential remedies.

As a functional medicine provider, I’ve successfully used this approach in many patients. That’s why I invite you to reach out to me for a free 15-minute troubleshooting call to find out the best course of action for you. If after the call you come on board as a patient, I’ll suggest ways to balance hormones and address other causes of hair loss. We’ll work together to revitalize your health and get back your magnificent mane of hair at the same time.


Pros and Cons of Hormone Replacement Therapy

Mood swings, hot flashes, nigh sweats, weight gain, loss of libido: these are just some of the most common “symptoms” of menopause. 

Is it any wonder most women dread this transition?

But what if there was a way to skirt menopauses negative side effects completely, and sail through this major change without sweating, screaming, or stress? According to some, the secret to making it through menopause is hormone replacement therapy (HRT). 

But is hormone replacement therapy right for you? Today, let’s talk what happens in the body on the hormonal and chemical level during perimenopuase and menopause, how hormone replacement can and can’t help, and options you have to support this transition even if you’re not interested in HRT.

 

Menopause vs. Perimenopause: What’s The Difference?

Menopause is defined as going 12 or more months without a menstrual cycle. Perimenopause is the time period - usually several years - leading up to menopause. It’s a transition period sometimes thought of as “puberty in reverse.”

The average age of menopause in the Untied States is 51, and perimenopause usually stars 4-10 years before that. For some women, perimenopause symptoms begin as early as age 35. And if you need another reason to quit, research has shown smokers reach menopause at a younger age than non-smokers. 

Perimenopause SymptomsPerimenopause symptoms include:

  • More frequent or heavier periods or missing or less frequent periods
  • Interrupted sleep
  • Low energy 
  • Night sweats/hot flashes
  • Weight gain
  • Change in texture of skin or hair 
  • Loss of muscle
  • Irritability and depression 
  • Anxiety
  • Lack of motivation
  • Dry skin
  • Sore muscles
  • Burning joints
  • Weakened bones
  • Lower libido and painful sex
  • Headaches
  • Onset or worsening of prolapse
  • Spotting between periods
  • Facial hair growth (especially on the chin)
  • Loss of hair (on the head)
  • Brain fog

Of course, not every woman has every symptom, and it’s not an overnight onslaught. Usually, the first signs of perimenopause are a slightly shortened cycle (think 21-24 days instead of 28) and an increase in PMS symptoms and irritability.

 

The Hormonal Changes That Cause Menopause

So what is actually happening in the body to cause everything from weight gain to hair loss? 

To start, let’s talk about the normal hormone cycle that occurs each month. It all starts in the brain when the hypothalamus signals the pituitary gland via gonadotropin-releasing hormone (GnRH). GnRH tells the pituitary gland to release luteinizing hormone (LH) and follicle-stimulating hormone (FSH). In turn, LH and FSH tell the ovaries it’s time to ovulate and release an egg from the follicle. Ovulation triggers the release of estrogen and progesterone. The release of estrogen and progesterone communicate back to the brain that the system has worked, creating a feedback loop.

During the reproductive years, GnRH is produced in a rhythmic cycle, leading to regular cycles. But as we age and enter perimenopause, the release of GnRH becomes more unpredictable. In addition, as we age the ovaries stop responding to LH, leading to erratic ovulation. Because ovulation is what triggers estrogen and progesterone, when ovulation becomes erratic, levels of these hormones drop.

This doesn't happen all at once, though: the changes are often up and down. At first, estrogen levels may shoot up high, then drop back down. Progesterone is only made via ovulation, so it may be irregular in the early stages of perimenopause before beginning a gradual decline. The decline of progesterone often occurs faster than estrogen, leading to temporary estrogen dominance in perimenopause, as well. 

The loss of progesterone affects the brain, GABA system, and HPA axis. Allopregnanolone, one type of progesterone, has a calming effect on the brain. Without adequate levels of it, sleep disturbances and reduced ability to cope with stress can occur. The loss of progesterone can also contribute to autoimmunity, especially Hashimoto's thyroiditis. And without the anti-androgenic effect of progesterone, excess androgens can stimulate insulin, contributing to insulin resistance.

In addition to these changes, testosterone, which is produced in the ovaries and adrenal gland, continues to be produced after menopause (though it peaks in the 20s). It is common to go through a phase in perimenopause where testosterone is high relative to estrogen and progesterone, causing symptoms like hair loss, central abdominal weight gain/body shape change, and the onset or worsening of insulin resistance. 

Some types of estrogen are produced outside the ovaries. Half of the body’s estrone (one type of estrogen) is made in the fat tissue and adrenal glands, and estrone becomes the predominant estrogen after menopause. This is good for bone density, brain tissue maintenance, and cardiovascular health - we need that estrone! This is why supporting adrenal health is so important  for making it through menopause with optimal hormone levels (more on that to come).

 

The 4 Stages of Perimenopause 

From a hormonal standpoint, I like to break perimenopause into 4 stages.

Stage 1: In this stage, estrogen is high, but progesterone levels have started to drop due to an increase in anovulatory cycles (when bleeding occurs and you have a “period” but your body doesn’t ovulate). The luteal phase is often shorter here, but periods might stay regular. 

Stage 2: In this phase, estrogen levels are still high but start to fluctuate, causing symptoms associated with estrogen withdrawal, such as hot flashes, migraines, and night sweats. Cycle lengths may vary by as much as 7 days. 

Stage 3: Stage 3 is marked by a significant increase in cycle length, going two or more months between cycles. The hormonal changes of Stage 2 remain and/or intensify, and estrogen remains high or rises and drops. 

Stage 4: This final stage is often a waiting game: will you get your period again, or are you officially in menopause for good? Estrogen levels are low, unless you get a surprise period, which can raise levels back up temporarily. 

 

Does Menopause Have to Be Miserable?

I could shout it from the rooftops: menopause is not a bad thing, and it doesn’t have to make you feel bad! If there is a menopause problem it’s simply that menopause and modern life are an evolutionary mismatch.

In comparison, the women of the remote Hadza tribe in Tanzania, who still practice hunting and gatherng as a subsistence pattern, don’t experience menopause the way American women do - in fact they report no symptoms associated with menopause, and don’t even have a name for this change. 

How can that be? Some of the most important factors might be that Hadza women:

  • Have robust gut microbiomes
  • Have a strong sense of community and purpose
  • Pre-menopausal women rest during their period
  • Post-menopausal women eat less and walk more than pre-menopuasal women
  • Spend more time pregnant and breastfeeding (and often transition directly from pregnancy/breastfeeding to perimenopause, softening the transition)
  • Eat a foraged, high fiber diet without aunty farmed or processed foods

Fortunately, we don’t have to move off the grid to adapt some of these practices to our own lifestyles and reap the benefits. More on my suggestions for how to do this to come.

 

Understanding Hormone Replacement Therapy for Menopause and Perimenopause Symptoms

Hormone replacement therapy is the use of topical or oral estrogen, progesterone, and sometimes testosterone to temporarily increase hormone levels, treat the symptoms of perimenopause, and improve overall well-being. 

Bioidentical hormone replacement therapy (B-HRT) is the use of replacement hormones that are identical to what the body produces. This is in contrast to the use of synthetic hormones, like those found in birth control pills. 

As early as the 1930s, women were given placenta as a form of estrogen replacement therapy. In the 1940s, Premarin, a drug made from the urine of pregnant horses, was developed as a HRT. In the 1970s, studies linked estrogen therapy to endometrial cancer, revealing the importance of including progesterone to prevent estrogen-driven cancers. 

From the 1960s to the 1990s, hormone replacement therapy grew in popularity. It was marketed as a way to stay youthful and feminine, and was widely used. But then, in the early 2000s, research showed HRT caused a slight increase in the risk of breast cancer, heart disease, stroke and blood clots.

 

Is Hormone Replacement Therapy Safe?

In 2002, a HRT trial was stopped early because of risks including a small increased risk of breast cancer, heart disease, stroke and blood clots, but fewer cases of hip fractures and colon cancer. This was followed by a 2003 report in the Lancet claiming the use of HRT increased the incidence of breast cancer, even though the data was not strong enough to document a clear harm. 

This incomplete information created a change in public opinion that remains today: many women are hesitant to use HRT, even though we now know how to use it safely. 

What we now know is that the most important factor for HRT safety is the age at which it is started. HRT is best started as young as possible, while in the perimenopausal window, and ideally continued for no more than 2 years beyond the last period. Starting HRT when older, or after the last period has occurred, increases the risk.

That’s why I’m glad you’re here reading this: if you want to start HRT, starting sooner is safer. But if you feel like you already missed your chance at HRT, and have now “aged out” - don’t give up hope. I have more suggestions for you at the end of this post. 

In July 2017, the North American Menopause Society (NAMS) relased thier positon after reviewing the data amassed from millions of women usign HRT over several decades, and concluded the benefits of HRT outweigh the risk for healthy women, when HRT is started at the proper age. They found that being obese or having 4 or more alcohlic drinks per week actually increased the risk of breast cancer more than the proper use of HRT. Women using HRT had a 4 in 1000 chance of breast cancers vs a 3 in 1000 chance in women not using HRT.

In addition, they found there was no increased risk of heart attacks in women using HRT as long as they started taking HRT within 10 years of their last period or started between the age of 50 and 59.

In particular, bioidentical hormones are safer than synthetic hormones. Bioidentical progesterone likely decreases the risk of breast cancer, whereas synthetic progestins increase the risk. If started early in perimenopause, bioidentical hormones are actually heart protective as opposed to a risk factor for heart disease.

 

Pros and Cons of Hormone Replacement Therapy

When used correctly, the benefits of hormone replacement therapy include:

  • Fewer hot flashes 
  • Improved insomnia & sleep disturbances
  • Improved anxiety & depression
  • Less brain fog
  • Fewer menopausal symtoms in general

The primary cons are the potential slightly increased risk of breast cancer and heart disease. 

When deciding to start hormone replacement therapy, there’s a lot to consider. Here’s some of what I go over with patients while developing a treatment plan:

  • Age and proximity to menopause (starting earlier is generally better)
  • History of breast cancer (self and family)
  • Genetic predisposition to hormonal cancers
  • Risk of cardiovascular disease (I screen for factor V and prothrombin in all patients before starting HRT)

The type of hormone therapy used matters, too. Options include pills, gels, creams, patches, troche, and liquids. While gels, creams, and patches are common , I actually prefer oral micronized progesterone, or, nanoliposomal topical serum. Most topical progesterones aren’t able to deliver a high enough dose to protect the uterine lining. In addition, there’s no “regular” rate of absorption for creams, gels, or patches. Each woman’s unique physiology determines how much and how fast she will absorb topical hormones. Topical progesterone can also be stored in the fat, then “dumped” by the body, leading to irregular levels in the blood, damaging the sensitive feedback loop in the brain. When used for longer periods of time, I’ve also seen fat-based topical progesterone build up to higher than physiologically normal levels, eventually causing progesterone receptor resistance, much like insulin resistance. When a woman has been using topical progesterone, has normal or even high levels when tested, but still has the symptoms of low progesterone, this is usually the reason.

Whatever form you choose, careful monitoring before, during and after use is an absolute must. After initial testing, hormones should be retested within 3 months of starting HRT to assess if levels need adjusting, as well as how estrogens are metabolized. Women often assume they need estrogen, but actually just need progesterone to start, as progesterone is often low relative to estrogen in early menopause. Progesterone can help with symptoms like night sweats and hot flashes just as much (if not more) than estrogen. When estrogen is needed, estradiol and estriol are both very safe when used in combination with progesterone.

hormone testing

I use the DUTCH Complete Estrogen metabolism test, and look to make 2-OH as high or higher than all types of estrogen and other metabolites, for optimal, safe metabolism. 

I also want 4-OH to be moderate to lower, at least not higher than 2-OH. 

 

Alternatives & Complements to Hormone Replacement Therapy

Ready to start hormone replacement therapy? You’ll get the best results when also addressing your glucose, gut, and adrenal health in check, while paying attention to your diet, exercise, social life, and life purpose.

But even if you decide against HRT, addressing these other aspects of your health can have a radical impact on how you feel during perimenopause and menopause.

Eat For Balanced Blood Sugar

Research has linked hot flashes to insulin resistance, finding that glucose levels and the degree of insulin resistance rose as the frequency of hot flashes rose. Glucose levels were 33% higher in women who reported hot flashes 1 to 5 days per week than in those who reported no hot flashes. In another study of 6,000 menopausal women, diets high in fat and sugar led to a 20-percent increase in hot flashes and night sweats. After working with hundreds of women in my clinic, I’ve found that the more stable we keep their glucose levels, the fewer menopause symptoms they have. 

>> Get my blog on eating for balanced blood sugar

Ditch Caffeine

There may be a link between caffeine use and certain menopause symptoms — namely, hot flashes and other symptoms related to the body's regulation of the diameter of blood vessels (vasomotor symptoms).

Avoid Spicy Foods

Like alcoholic beverages, spicy food causes vasodilation of the blood vessels, triggering hot flashes.

Eliminate or Reduce Alcohol 

Cut back on drinks to 2 or less per week. When you do drink, expect to see menopause symptms return that night. (And surprisingly, wine is usually worse than clear spirits in this case - so maybe go with the vodka soda!) Cutting alcohol and sugar completely eliminates or minimizes night sweats and hot flashes in most women I see. 

Exercise Regularly

Movement is always great, but it's most effective if you’ve been moving regularly in the time leading up to perimenopause, and then keep moving. Too much exercise or high intensity can actually trigger hot flashes because of the influence on blood flow to brain and skin and how the brain regulates body temperature. 

Do Active Stress Management Daily

This can look like meditation, relaxation tracks, or hypnosis. CBT has also been shown to be very effective, especially in women who can’t use HRT due to breast cancer. 

Support Gut Health

The gut plays a major role in the production and clearance of hormones. I always recommend a comprehensive gut health test and gut health practices like using a probiotic. 

Try Phytoestrogen Foods

In some cases, phytoestrogen-rich foods like soy and legumes can be helpful. 

Rehab Your Adrenals

Your adrenals are responsible for synthesizing appropriate levels of testosterone, progesterone, and estrogen in the perimenopause transition and beyond. Test your hormones with a DUTCH Complete panel and work with a practitioner who can create a customized protocol to rehab your adrenal hormone function. 

 

Get Personalized Help with Hormone Replacement Therapy & Menopause

If you’re entering perimenopause (or already in the thick of it), hormone replacement therapy can help ease the transition. But even if you’re not ready (or not interested in) HRT, using diet, lifestyle, and herbs can help significantly. Either way, you don’t have to just accept the night sweats, hot flashes, weight gain, and mood swings - we can help!

If you’re looking for support in menopause, perimenopause, HRT, or natural alternatives to HRT, click here to book a free consult with our team.

We’ve helped hundreds of women in this life transition, and we’d be honored to help you, too.

 


Blood Sugar

Eating for Balanced Blood Sugar

Every year, various diet theories make their way into popular view on the internet. “Everyone  should eat less fat”…. “Everyone should eat low carb”…. “Everyone should go Keto”….. it’s enough  to make your head spin! The truth is that we are all biologically and genetically unique, and there is no One Diet that is an  ideal match for everyone. That said there are some general principles that hold true across  various diet types, and one of those is the importance of maintaining balanced blood sugar

Keeping blood sugar levels stable is critical for hormone balance, lowering inflammation, and  optimizing energy levels throughout the day.

 

Why Balanced Blood Sugar Matters

When we eat carbohydrates, the body breaks them down into simple sugars called glucose. Glucose crosses from the small intestine into the bloodstream where it can be taken up by the mitochondria - the “powerhouses”of our cells - and converted into energy. This energy is called adenosine triphosphate (ATP). However, mitochondria have a limited capacity to convert glucose into ATP: they can only convert as much glucose into ATP as they can use. When more glucose is present than can be used by the mitochondria, it causes “glucose spikes” - also known as elevated blood sugar. To prevent glucose spikes,  one of two things happens to extra glucose circulating in the bloodstream: it is either converted by the hormone insulin into fat for storage, or into free radicals. 

Free radicals are small, unstable molecules that set off a chain reaction of oxidative stress, inflammation, and aging. Free radicals have the potential to create mutations in our DNA, “turning on” harmful genes and even leading to cancerous cell changes. Oxidative stress caused by free radicals is the main trigger for all types of chronic disease, such as heart disease, dementia and cognitive decline, type 2 diabetes, and accelerated aging of all tissues, including your skin. Free radical damage to mitochondria leads to a loss of endurance for exercise and handling situational stress. A diet that prevents free-radical-creating glucose spikes lowers oxidative stress and the resulting inflammation, thereby reducing the risk of any of these inflammation- based diseases. 

Insulin is the hormone that stashes away glucose that our mitochondria can’t make use of at the moment. Insulin is released when blood sugar levels rise. First, insulin pushes extra glucose into the cells of our muscles and liver to be stored as glycogen. But then, when it runs out of “closet space,” it turns excess glucose into fat and stores it in our fat reserves. When the muscles and liver run out of glycogen, they should be able to tap into fat stores to replenish themselves, causing weight loss. However, if insulin is present, our body is prevented from tapping into these reserves. If levels of glucose are kept stable, insulin levels stay steady, allowing the body to burn fat for energy, thereby decreasing weight. 

Excess levels of insulin contribute to adrenal stress, including hypoglycemia, by clearing glucose out of circulation and into fat cells to be stored for later use, causing blood glucose levels to drop. In order to normalize blood sugar, the adrenals  have to produce increased levels of cortisol and epinephrine. This often leads to long-term cortisol depletion and ultimately adrenal hormone dysfunction.  

The decline of a glucose spike back to normal levels also triggers cravings. Studies show that a decrease in glucose levels, even just a decrease of 1.1 mmol/L, leads to increased cravings for high calorie foods. This can lead to overeating. 

 

Short & Long-term Effects of Glucose Spikes

  • Cravings
  • Fatigue/chronic fatigue
  • Poor sleep (waking during the night)
  • Suppressed immune response/more vulnerability to viruses and bacterial infections
  • Exacerbation of hormonal hot flashes and night sweats (worse flashes = high levels of glucose and insulin in studies)
  • Increased likelihood of migraines
  • Memory and cognitive issues
  • Increased risk of Alzheimer’s and dementia
  • Acne and other inflammatory skin conditions
  • Arthritis and other inflammatory diseases
  • Increased cancer risk
  • Heart disease
  • Infertility and PCOS
  • Insulin resistance and Type 2 diabetes
  • Non-Alcoholic Fatty Liver Disease
  • More depressive episodes
  • Digestive symptoms like leaky gut, heartburn, acid reflux
  • Accelerated aging and more rapid formation of wrinkles

 

Normal Blood Sugar Levels

According to the American Diabetes Association (ADA), normal fasting blood sugar is below 100 mg/dL. Levels between 100-125 indicate pre-diabetes, and anything over 126 when fasting is considered diabetic. After eating (postprandial), the ADA considers 70-140 mg/dL to be normal.

But, what’s “normal” isn’t necessarily optimal. Fasting glucose can be “normal,” but you may still experience glucose spikes over 140 mg/dL throughout the day. Instead, I prefer to look for these signs of optimal blood glucose levels:

  • Fasting: 70-90 mg/dL
  • Postprandial: Below 120 with a return to pre-meal glucose levels within 2 hours (ideally below 100)

However, a single blood sugar reading taken alone is not the best way to gauge overall blood sugar health. Instead, I suggest continuous glucose monitoring.

 

Continuous Glucose Monitoring

A Continuous Glucose Monitor (CGM) is a small device that you wear on the back of your arm for two weeks. They are painless to insert, and once placed, monitor the amount of glucose in your tissues 24 hours a day, sending the data to an app on your smartphone. Though they were originally developed for people with diabetes who need multiple blood glucose readings a day, almost anyone can benefit from the convenience and multiple data points a CGM can provide. A CGM is the best way to understand how specific foods affect your body, and the impact that glucose shifts have on your mood, energy, sleep, inflammation, and more.

Those interested in continuous glucose monitoring may be able to obtain one by prescription from your general practitioner, especially if you’ve had a history of elevated HBA1c, fasting glucose levels, or labs that suggest diabetes, gestational diabetes, or pre-diabetes. Alternatively, you can request a prescription to be filled at a pharmacy of your choosing through the concierge service at www.pushhealth.com. Request the Abbott Freestyle Libre unless you have an actual diagnosis of Diabetes, in which case you should qualify for insurance coverage of the Dexcom G6 CGM, which is more accurate, but more expensive out of pocket.

There are many subscription platforms using CGM, as well. These services come with app interfaces with more bells and whistles, food tracking built in, and generally some type of interactive coaching service available through in-app messaging. January.ai, Nutrisense, and Levels are a few of the better known platforms offering this service. 

For more information on how CGMs work and directions on how to calibrate yours, read here.

 

Are Carbs Bad for Blood Sugar levels?

Since carbohydrates become the glucose that elevates blood sugar levels, it’s only natural to wonder if carbohydrates are something that should be avoided. But in actuality, it’s much more complicated than just “good” or “bad.”

Glucose is essential to life. In fact, in the absence of any glucose in the diet, the liver converts fat into usable glucose via a process called gluconeogenesis. We are also biologically programmed to love sweet tastes. In hunter-gatherer times, sweet flavor meant food was both safe and was rich in energy. Sweet tastes release dopamine in the brain, which registers as pleasurable, prompting us to seek more of it. We are literally designed to consume carbohydrates.

But, not all carbohydrates are created equally. Carbohydrates are made by plants during photosynthesis and consist of starches, fibers, and sugars, including glucose, fructose, and sucrose. These exist in different proportions in different plants: kale has lots of fiber and some starch, while cherries contain mostly sugars, and some fiber. The fiber in plants slows the absorption of the glucose. This is what nature intended. In modern times, we have learned first to breed plants for higher sugar content and sweetness, and then to extract sugar from the fiber in plants and use it to sweeten… everything! It is this that has led to chronic health problems and modern degenerative diseases, not carbohydrates themselves.

 

How Much Carbohydrate Should I Be Eating?

One of the most effective ways to prevent or reverse the excess production of insulin and  cortisol is to balance the amount of carbohydrates and proteins that are eaten with each meal.  The amount of carbohydrates that each person needs is highly individual, and is based on several  factors: size, activity level, being physiologically male vs female, and biochemical  individuality/genetics.  For example, an average sized woman who is moderately active, and not trying to lose  weight, might need 75-150 grams. If she’s training intensively, she might need closer to 200  grams, or more. An average sized man might need 150-200 grams, or up to 400 grams daily if  highly active. 

Proper macronutrient ratios (percentage of carb/fat/protein in the diet) vary by health goals as  well, for example weight loss vs mood stabilization vs maintaining a healthy pregnancy. Weight  loss is generally supported by lowering carbohydrate consumption, whereas some people with  insomnia, anxiety, or depression may be better served by slightly increasing carb consumption. If you are only eating 50 grams daily, and not sleeping well, or suffering from energy or mood  dips, consider increasing by increments of 25 grams daily up to 100 or 150 grams and noticing  what happens.  

The only way to know what is right for you is to experiment and observe how you feel.  Additionally, wearing a Continuous Glucose Monitor (CGM - discussed above), can provide a sense of your carbohydrate tolerance at various times of day. 

Beyond just the amount of carbs eaten, the type and way in which you eat carbs can also have a profound effect on blood sugar stability. 

 

A few simple guidelines: 

Include small  amounts (1/2 – 1 cup) of starchy veggies (such as root vegetables, squash, or tubers), 1-3 times  daily, depending on your personal carbohydrate need. Eliminate or minimize grains. If you do include grains, emphasize whole form, not  flours, as flours have a higher glycemic load and will raise blood sugar more rapidly, and to a  greater extent than their unprocessed counter-parts. 

Include proteins with each meal in a weighted ratio of at least 2:1 of carbohydrate to protein. 

Eat 15-20 grams/protein at each meal, unless directed otherwise by your healthcare provider based on specific health goals. This is approximately a palm-sized serving of fish,  chicken, or red meat, or 2-3 eggs. You can also get some protein in the form of nuts, seeds, and  legumes, just be aware of the carbohydrate load that beans naturally include. While this amount  may be fine for some people, for people with blood sugar control issues, beans may be better as  a condiment or salad topping. 

Eat as many green, and then multi-colored (red, yellow, orange and purple) veggies as possible  each day. Strive for 5-10 cups of veggies daily. 

Use extra virgin olive oil, coconut oil/coconut butter/coconut milk, ghee, flaxseed oil (do not  heat), macadamia nut oil, or avocado. Avoid canola oil and use seed oils sparingly. 

Eat 1-2 servings maximum of fruit daily. Always consume fruit with a protein or fat: nuts, nut butter, or  other fat/protein source. 

If you struggle with elevated blood sugar levels, do not snack between meals, and  instead eat at 3 specific times of day, or as your practitioner has recommended for you. 

 

How to Flatten Glucose Spikes

#1 Deconstruct your meal

Instead of grabbing a bite of this and a bite of that, try this: eat veggies first (especially above-ground veggies and anything leafy). The fiber in veggies slows the breakdown and absorption of glucose. After you finish your veggies, eat protein and fat next, as fat slows the absorption of sugar. Save the starchy component of your meal for last.

 

#2 Add greens to the beginning of every meal

In addition to eating your veggies first, add a small salad or veggie appetizer before the meal, such as spinach leaves with a few artichoke hearts and vinegar and olive oil. Alternately, roast some low carb veggies like cauliflower and broccoli in the oven and store in the fridge to have on hand. Or, try grabbing a few bites of fermented veggies like sauerkraut or kimchi: eating even just a few bites of these prior to your meal lowers glucose spikes.

 

#3 Stop counting calories

Not all calories are equal. Weight management and health have much more to do with keeping glucose stable (using these techniques) than with sticking to an arbitrary calorie goal.Conventional wisdom says adding oil and vinegar to your salad only adds calories, but in reality those extra calories will keep you full longer, rev up fat burning, blunt the absorption of starches in the rest of the meal, and ultimately contribute to weight loss!

 

#4 Prioritize a high protein, lower carbohydrate breakfast with plenty of healthy fats

Extra points for fiber from veggies!This will set you up for better glucose control and energy through the day, as we are more sensitive to sugars first thing in the morning after fasting. Plus destabilizing glucose first thing with a high-sugar breakfast makes it very hard to regain glucose stability later in the day. (One note: Avoid smoothies containing lots of blended fruit, as this breaks up the fiber, making the sugar in the fruit more available, yielding bigger glucose swings. Some smoothies easily spike blood glucose as high as drinking a can of soda!

 

#5 Consume vinegar before a meal

To blunt glucose spikes, dilute 1 teaspoon to 2 tablespoons of any unsweetened vinegar– most people enjoy Apple Cider Vinegar the most– in water and drink before eating. Adding vinegar can reduce glucose spikes as much as 20%. Not a vinegar fan? This blog lists many delicious drink recipes based around apple cider vinegar. 

 

#6 Move your body after you eat

With every movement we make, we burn glucose. If we stay still after a meal, glucose enters the bloodstream and then floods our cells and overwhelms our mitochondria. But, if we use our muscles as the glucose moves from the intestines into the blood, our mitochondria have a higher burning capacity and will use that glucose to make more ATP.  This makes a huge difference when tracked using a glucometer or CGM: just adding exercise after a meal significantly lowers glucose levels. For best results, move anytime in the hour after you finish a meal - but it doesn’t have to be a hardcore workout. Just 10 minutes of walking is helpful, and if you can’t go for a walk, doing squats, planks, or lifting something heavy works just as well. 

 

Sweet Foods & Dessert

If you’re going to eat dessert, the best time to eat it is at the end of a meal - meaning green starter, vinegar, then veggie, protein/fat, starches…..and then dessert. When snacking, opt for savory snacks whenever possible. Don’t eat carbs by themselves– always eat them with protein or fat beforehand. This includes fruit. 

Replace sweeteners with monk fruit, allulose, or stevia (if you tolerate and enjoy stevia) where possible. Better yet, go sweetener free for a period of time to “reset” your taste buds. Avoid sweeteners like sucralose, xylitol, aspartame, maltitol, and erythritol. 

 

Sample Blood Sugar Balancing Menu 

Day 1:  

  • 8am breakfast: 2-3 egg scramble with 2-4 oz ground chicken or chicken sausage, chopped  spinach, onion, garlic, herbs, cooked in 1-2 TBS of grass-fed butter or ghee or coconut oil.  Ideally with a few bites of roasted broccoli from the fridge, beforehand. 
  • 11am snack if needed: 10 nuts or 1 TBS nut butter and 1 cup berries  
  • 1pm: leafy green salad with 2 cups of chopped veggies, hard-boiled egg, turkey or chicken  breast, and salad dressing of fresh lemon juice and EVOO  
  • 4pm snack if needed: turkey roll-up (2-3 turkey slices rolled around avocado and hummus)  
  • 6-7pm: oven roasted fish (coconut crusted salmon: rub salmon with olive oil, sea salt and pepper  and pat with flaked coconut. Bake at 375 for 20 minutes),1 cup of roasted butternut squash  cubes, and 1-2 cups of sautéed leafy greens with garlic.  Eat the greens first. 

Day 2:  

  • 8am: Clean protein smoothie w/ 2 cups super greens, 2 TBS tahini, cinnamon, and 1 cup of  berries blended in almond milk. Bonus: add 1 TBS of Paleo Fiber  
  • 11am: raw veggie sticks and guacamole  
  • 1pm: Lettuce wrapped lamb burger, leftover greens, 1/2 sweet potato with coconut butter  
  • 6-7 pm: shrimp fajitas (with 1-2 cassava coconut Siete Foods Tortillas) OR ground turkey lettuce tacos with organic pressure-cooked black beans . Eat the beans last! 

Day 3:  

  • 8am: chicken sausage, grated parsnip hash cooked in avocado oil, with spinach and avocado  11am: protein powder smoothie with 1 cup berries and almond milk.  
  • 1pm: coconut milk soup with chicken, side salad 
  • 4pm: handful of almonds  
  • 6-7pm: pesto chicken breast, braised red cabbage (slice cabbage and sauté in olive oil + chicken  broth), roasted beets in olive oil with rosemary. 
  • dessert/snack: dark chocolate (1-2 squares) with whipped coconut cream

 

Get Your Own Customized Plan

You have the power to take back control and help your body (and blood sugar) get back into balance.

For a customized plan, step-by-step support, and expert guidance, the first step is to book a free, no-obligation discovery call with my health team.

Learn about how we work with clients to achieve their unique health goals and help them step back into radiant health, so they can stop worrying about how they feel and start living a purposeful life.

> Book your free discovery call here

 

Check Out These Books for Further Reading

  1. The Glucose Revolution by Jessie Inchauspe
  2. Drop Acid by David Perlmutter 
  3. Unlocking the Keto Code: The Revolutionary New Science of Keto That Offers More Benefits Without Deprivation by Steven Gundry.

Insulin Sensitivity

Insulin Sensitivity and Gut Health—A Dynamic Duo

Do you want your skin to look smooth and youthful for as long as possible?

Do you want your brain to be sharp?

What about losing weight and maintaining a slender, sleek body?

These are just some of the reasons to care about keeping your insulin and blood sugar levels balanced—even if you don’t have prediabetes or diabetes. Yet, when many people hear about insulin sensitivity they think it’s only relevant to diabetics.

That couldn’t be more wrong. 

There are good reasons for everyone to care about how their body is handling insulin. And surprisingly, it’s your gut that plays a major role in keeping this blood-sugar-balancing hormone in control. 

If your gut is unhealthy, your body won’t handle insulin well, which means your blood sugar will get out of whack. 

 

What Is Insulin Sensitivity?

Insulin is a hormone that’s made when our blood sugar (glucose) levels rise. It pushes extra glucose into the cells of our muscles and liver, where it’s stored as glycogen. But when our muscles or liver run out of closet space to store the glucose, the excess is converted into fat and stored in our fat reserves. 

When muscles and the liver run out of glycogen they should be able to tap into fat stores to replenish themselves, causing weight loss. 

However, if insulin is present in excess amounts, it blocks your body from tapping into those reserves.

What causes high insulin levels? Usually the culprit is high blood glucose in the form of glucose spikes that often happen even in people without diabetes.  

Insulin sensitivity refers to the body’s ability to respond to the blood-sugar-lowering signals that insulin is broadcasting. If the body can’t respond to those signals, it starts making more and more insulin to try to “hear” what insulin is saying. Kind of like talking louder when someone can’t hear you. Reduced insulin sensitivity is known as insulin resistance. In other words, your body isn’t as sensitive to insulin anymore so it needs to make more and more.  

 

Why You Should Care About Insulin Sensitivity

Poor insulin sensitivity and glucose spikes are to blame for a number of health problems, not just diabetes. For example, they’re linked to:

  • Accelerated skin aging and more rapid development of wrinkles
  • Acne and other inflammatory skin conditions
  • Adrenal stress
  • Arthritis and other inflammatory diseases
  • Cravings
  • Depressive episodes
  • Digestive symptoms like leaky gut, heartburn, acid reflux
  • Fatigue/chronic fatigue
  • Heart disease
  • Increased cancer risk
  • Increased risk of Alzheimer’s disease and dementia
  • Infertility and polycystic ovary syndrome (PCOS)
  • Memory problems
  • Migraines
  • Non-alcoholic fatty liver disease (NAFLD)
  • Poor sleep (waking during the night)
  • Suppressed immune response
  • Type 2 diabetes
  • Worsening of hormonal hot flashes and night sweats

 

How The Gut Controls Insulin Sensitivity

Problems in the gut lead to problems with blood sugar and the way your body uses insulin. Usually people don’t connect the gut with insulin problems, but there is a HUGE connection between the two.

Here’s the deal: The gut affects insulin sensitivity in five ways. Some of these might sound kind of technical, but bear with me for a moment as I’ll explain them all in a minute.

  1. Leaky gut
  2. Endotoxemia 
  3. Production of short-chain fatty acids like butyrate
  4. Alterations in bile acid metabolism
  5. Effects on the secretion of gut hormones

The common denominator in all five of these factors is an imbalance in the gut microbiota. The gut microbiota are the little organisms that live in your intestines, both good and bad bacteria, viruses, and fungi. Scientists call an imbalance in the gut microbiota dysbiosis. Dysbiosis is common in diabetes, suggesting the gut microbiota and blood sugar problems are connected. In diabetes, levels of beneficial bacteria are decreased, whereas many harmful bacteria are increased. Small intestinal bacterial overgrowth is also common in diabetes.  

 

Leaky Gut

Gut microbiota dysbiosis can lead to leaky gut, otherwise known as increased intestinal permeability. Leaky gut is the name for what happens when a person’s intestinal lining is weakened. This weakened lining allows toxins and bacteria to slip through into the bloodstream, causing problems throughout the body. Leaky gut creates inflammation and reduces insulin sensitivity. There’s also a link between leaky gut and diabetes.  

 

Low-Grade Endotoxemia 

Bacteria in the body produce a type of toxin known as an endotoxin, primarily a bad guy known as LPS. It’s a component of bacterial cell walls found mostly in gram-negative bacteria. When LPS escapes the colon during leaky gut and becomes a fugitive on the run throughout the body, it triggers an inflammatory response known as endotoxemia. 

LPS also does a number on the way your body uses insulin. LPS triggers an inflammatory cascade in every type of tissue it comes into contact with in the body. In insulin receptors, this inflammation leads to reduced sensitivity to insulin—or—insulin resistance. 

Endotoxemia and leaky gut go hand in hand. Since the intestinal lining is weaker, it allows these toxins to escape into the bloodstream, causing problems that at first glance don’t seem as if they’re linked to the gut. 

 

Butyrate and Short-Chain Fatty Acids

Short-chain fatty acids like butyrate are important for gut health and insulin sensitivity. Bacteria in the gut, especially those that belong to the phylum Firmicutes, make butyrate. If your gut isn’t making enough butyrate it spells trouble for the way your body uses insulin. 

In studies of obese mice, butyrate supplementation increased insulin sensitivity and improved weight loss. Fasting blood glucose, fasting insulin, and insulin tolerance remained normal in mice given butyrate.

In humans, if there aren’t enough butyrate-producing bacteria, it boosts the risk of metabolic disorders like diabetes. 

Butyrate repairs the intestinal lining and reduces inflammation, helping to get rid of leaky gut, which in turn promotes healthy blood sugar levels.  

 

Bile Acid Metabolism

Another way in which the gut controls insulin sensitivity is by regulating the way the body produces bile acids, which stimulate insulin secretion. People with leaky gut don’t recirculate bile acids efficiently. So they wind up with bile acid deficiency over time, which leads to inefficient detoxification as well as changes in how your body regulates fat and carb digestion.

 

Secretion of Gut Hormones

A healthy gut equals healthy amounts of gut-derived metabolic hormones called glucagon-like peptides (GLP-1), which are linked to blood sugar balance. GLP-1 boosts insulin levels when there’s glucose in the blood, helping to push glucose into your cells to improve blood sugar levels.  

GLP-1 also keeps you feeling full and satisfied after eating so that you can stay away from desserts and other unhealthy foods.  

 

How To Know If You Have Blood Sugar Issues

One of the best ways to monitor your insulin and blood sugar levels is to work with a functional medicine provider, who will order lab tests. The lab tests to measure insulin sensitivity and blood glucose include:

  • Fasting glucose, optimal range 70 to 85
  • Fasting insulin, optimal below 5
  • Fasting uric acid, optimal less than 5.5
  • HBA1c (a measure of blood sugar control over time), optimal range 4.8 to 5.2

Also important: Finding out if your gut is healthy by using a stool test. I like the BiomeFX panel.

The second way to see how your body is coping with blood sugar is to monitor glucose spikes. Everybody has glucose spikes to a certain extent. But when insulin sensitivity is low, blood sugar spikes are often too high since insulin is unable to control your blood glucose. 

The best way to monitor glucose spikes is by using a glucose monitor for two to four weeks. Monitor readings should be 70 to 120 the majority of the time, but even more ideal is 70 to 100. Lots of people spike above 140, even if they’re not diabetic, but most of us shouldn’t be going over 120 most of the time.  

 

What To Do About Glucose Spikes and Reduce Insulin Sensitivity

Eat Foods That Support Butyrate and Probiotic Bacteria

The main goals of balancing blood sugar and insulin are to raise butyrate levels and to get rid of any gut microbiota imbalances. 

From a dietary perspective, there are certain foods you can eat to increase butyrate levels.

Butyrate foods include:

  • Apples
  • Leeks
  • Onions

To support a healthy gut microbiota, eating high-fiber foods rich in prebiotics is a good first step. These types of foods can also help butyrate-producing bacteria flourish. Research has shown that eating fermentable fiber was linked to an increase in the beneficial bacteria Bifidobacteria. This type of fiber also normalized LPS and improved glucose tolerance and insulin secretion, while reducing inflammation. 

Prebiotic foods include:

  • Apples
  • Beans
  • Bran
  • Chicory root
  • Garlic
  • Jerusalem artichoke
  • Oat bran 
  • Onions
  • Psyllium husk
  • Tomatoes

It’s also a good idea to limit sugar and saturated fat, since these can cause butyrate levels to tank. 

 

Butyrate Supplements and Other Solutions

Another way to increase butyrate levels is through using certain dietary supplements. In animal studies, giving mice butyrate supplements blocked the development of insulin resistance caused by eating a high-fat diet.

Probiotics containing Bacillus bacteria endospores such as MegaSporeBiotic can increase butyrate-producing bacteria in the gut. 

Certain supplements can also boost butyrate production directly. These include:

I have found that it’s possible to boost butyrate by 140% in four weeks using a combo of MegaSporeBiotic and MegaPre—which only feed selectively the keystone bacteria species, not the bad guys—along with MegaMucosa to heal and repair leaky gut with essential nutrients as building blocks.  

 

Balancing Blood Sugar By Improving Gut Health

I have seen so many patients experience an improvement in their health after addressing gut issues, restoring butyrate levels, and balancing insulin and blood sugar levels. They’ll often have improved energy, clearer skin, better sleep, less hot flashes, and many of their other health complaints go away. 

You’re going to have the greatest success working with a functional medicine provider who can tackle all the bases.  That’s why I invite you to reach out to me for a free 15-minute call to find out the best course of action for you. 

If after the call you come on board as a patient, I’ll order the right tests for you. Based on the results and your symptoms, I’ll start you on a protocol to balance blood sugar, improve your gut health, and help you look and feel your best. 


Ulcerative Colitis

How to Heal Ulcerative Colitis: A Case Study

If you have ulcerative colitis, this is a case study you’re going to want to read. It’s about a woman—I’ll call her Sherrie—who suffered from this condition for years—until we were able to make some real breakthroughs in her health. 

Ulcerative colitis is a type of inflammatory bowel disease (IBD), a disorder that also includes Crohn’s disease. People who have ulcerative colitis have an inflamed colon and rectum and ulcers on the intestinal lining. Living with IBD can be a roller coaster. Their symptoms worsen during flare-ups and their symptoms go away during periods of remission.

Doesn’t sound like much fun, does it?

Ulcerative colitis is often hard to put into remission. It can take time to pin down and treat the root cause. But I’ve found that ulcerative colitis responds well to functional medicine. Often, we can send its bags packing—or at least put it into a long-term remission.  

Such was the case for Sherrie. 

 

Sherrie’s Long-Term Battle With Ulcerative Colitis

When Sherrie first came to see me in January 2018, she had been diagnosed with ulcerative colitis nine years prior at the age of 25. Before developing symptoms, she’d had a stressful few years. She bought a house, got married, was finishing her bachelor’s degree, and became pregnant for the first time. 

After her initial diagnosis her symptoms were manageable for years. She responded well to the drugs offered her. Conventional doctors gave her prednisone and Lialda (mesalamine) to lower inflammation. Most of her ups and downs were during pregnancy when she had to get off her meds, and she’d get better when she went back on the drugs.

After her third child was born in 2013, she went into remission and didn’t need to take any UC medications for two to three years. Then she caught a cold while traveling and this turned into an ear infection. She took antibiotics, which led to a UC flare. In the two years before she contacted me, she never came out of the flare, which motivated her to seek my help. 

Sherrie suffered from bloody stool and watery, urgent diarrhea six to ten times per day.  She couldn’t leave her house for fear of not being near a bathroom when she had to go. 

She’d never been hospitalized, but the poor dear had only been in remission for a brief period since giving birth, she told me. Pregnancy and birth can cause an immune shift and had made her ulcerative colitis even more difficult to control.   

The lab work ordered by other doctors found:

  • Low iron and ferritin
  • Low vitamin D
  • Low potassium
  • Low hemoglobin (she was anemic from blood loss)
  • Monocytes and eosinophils very high (suggests a parasitic or other type of infection.)

When she first came to my clinic, she was already on a strict paleo diet. That by itself didn’t do any good. 

 

Treating Stress Hormone Imbalances

The first step? Treating Sherrie’s stress-response system. The hypothalamic-pituitary-adrenal axis (or HPA axis) regulates our circadian rhythm and our stress response. Chronic stress can really throw the HPA axis out of balance, which leads to hormone imbalances. It can cause the adrenal glands to pump out too much of the stress hormone cortisol. Some people call this “adrenal fatigue,” but it’s really a problem with the entire HPA axis.

As Sherrie tapered off the prednisone, I gave her a higher than normal dose of dehydroepiandrosterone (DHEA), a hormone produced by the adrenal glands. Because she had been under stress, her adrenal glands were likely worn out and weren’t making enough DHEA. 

In fact, every ulcerative colitis patient I’ve treated has had HPA axis dysregulation. So I typically always address this in my UC patients.  

And guess what? Her ulcerative colitis flare regressed for the first time in two years. She now had only minimal rectal bleeding and not every day. 

 

Candida and Intestinal Bugs

While dealing with Sherrie’s adrenals, I ordered a stool test that revealed she had high levels of the following bacteria and fungus:

  • Candida
  • Klebsiella
  • Prevotella
  • Proteus
  • Pseudomonas
  • Salmonella
  • Staphylococcus
  • Streptococcus

It didn’t surprise me that she had Candida overgrowth. The fact she had gotten worse after taking antibiotics for her ear infection was a BIG clue that fungal overgrowth played a role. Candida is a type of yeast that under the wrong conditions can turn into an invasive fungus in your body. 

Plus, we know from studies that almost all cases of ulcerative colitis involve the marriage between a fungal imbalance and a bacteria that either trigger immune dysfunction or worsen it. 

In mouse studies, Candida albicans can worsen inflammatory colitis. What’s more, the yeast Candida tropicalis teams up with certain bacteria like E. coli to form a monstrous biofilm larger than any created by just one or two of the species alone. A biofilm is a type of shield that bacteria and fungi can form to protect them from things like antibiotics. 

The stool test also detected the presence of an amoeba parasite known as Entamoeba coli. Although many people with this parasite don’t have any symptoms, high amounts are linked to loose stools, gas, and other GI complaints. Amoeba infections in general are also linked to IBD.   

Sherrie’s stool test also showed high levels of calprotectin, which is a marker of inflammation in the gut lining. A high calprotectin is a red flag for IBD. Her levels of secretory IgA (SIgA) were also high. SIgA lines your intestines and acts as a gatekeeper, keeping bacteria, parasites, and allergens out of your circulation. 

 

Fancy Footwork and Ulcerative Colitis

I began treating the parasitic infection, balancing the microbes in the intestines, and starting round one of Candida treatment.  However, we had to put the brakes on treating the Candida for a little while because before starting treatment for this fungus, Sherrie went into flare mode. 

There’s often a lot of fancy footwork needed to treat ulcerative colitis patients. Flares can happen due to stress, seasonal changes, and other reasons. We need to time treatments so that we’re not putting too much stress on the body during flares.   

Other issues that showed up in testing also needed attention. For example, her mitochondria—the powerhouses of the cells—were in trouble. This is likely because the Candida produced ammonia and acetaldehyde, both toxins to the mitochondria. She also had high levels of a damaging process known as oxidative stress due to the autoimmune process that had created a years-long raging fire in her body

Her glutathione levels had also tanked, so her body wasn’t making enough of this antioxidant to fight the oxidative stress. I included liposomal glutathione into her regimen.  

Here are some other strategies that worked:

  • Adding low-dose naltrexone, an anti-inflammatory drug shown to reduce symptom severity in IBD
  • Eating an anti-inflammatory diet and adding in foods like rice and some dairy
  • Gut-focused hypnotherapy for her post-traumatic stress disorder (PTSD) response when getting into her car. This was triggered by the fear of needing to poop and not being near a bathroom. This therapy and the progress we were making allowed her to travel far from home. 

 

Big Improvements in Ulcerative Colitis Symptoms, But More to Go 

By August 2018, Sherrie was the best she’d been in two years! 

In September 2018, I ordered another stool test and some other lab work. Some of her beneficial gut bacteria were low and her calprotectin levels were still high. At the same time, I ordered a food reactivity test. Based on that, I had her avoid eggs, wheat, lentils, peas, cashews, peanuts, tuna, and a few other foods.    

Her worst flares tended to happen between Thanksgiving and Christmas. My theory? Holiday stress combined with lack of sun and vitamin D contributed to these flares. I learned to give her proactive support heading into that time of year. 

Finally, for the first time, she was able to go through the holidays with only a minor flare. I gave her a Chinese herbal formula known as Yunnan Paiyao, which stopped the flare in three days. The Chinese herbs also firmed up her stool. 

In addition, I gave her pre- and probiotics and improved her detoxification and antioxidant levels. 

Ultimately, after a period of three steps forward and two steps back, she was able to endure the holidays with zero flares. 

By January through May 2019, she was better overall and her stool consistency improved, but she was still bleeding mildly.  

So much progress, but there was still a root cause that had not been addressed. At this point, I ordered more testing, including a stool test that found the amoeba parasite Blastocystis. The testing also revealed problems digesting and using fats, so I had her take ox bile and a few other supplements. 

What’s more, her zinc levels were low. Zinc is critical for bowel repair and lowering inflammation. Selenium—a mineral critical for autoimmune health and the production of glutathione—was also low. 

The testing showed her oxidative stress levels were high and her detox abilities were overwhelmed.  Levels of the antioxidant glutathione were better, but still low. She still had some Candida

 

How To Stop An Ulcerative Colitis Flare-up

In July 2019, after a stressful event, Sherrie went into another flare. I put her on the Specific Carbohydrate Diet (SCD), a diet that’s free of sugar, grains, starch, and processed foods, which really helped. Butyrate enemas were also helpful. Butyrate is a short-chain fatty acid formed from the fermentation of dietary fiber in the colon. It is the main fuel the cells of our intestinal lining use for repair, and it is known to reduce ulcerative colitis symptoms.   

Even before our next appointment, as soon as Sherrie could feel a flare coming on, she immediately followed my advice for reducing a flare. It was a BIG win! She was learning how to manage and stop flares on her own. The flare stopped by August and by the fall she was the best she’d been in four years. 

She had another flare at the end of summer triggered by poison ivy while camping, but she was able to stop it within two to three days.   

By fall she was feeling amazing. She was having regular, twice daily bowel movements. There was no urgency and the stool was well-formed. At the same time, Sherrie was finishing round two of the Candida program.

From fall of 2019 to January 2020, Sherrie stayed in remission. Right after the holidays were over she had another flare, but she was able to stop the flare almost entirely on her own before our next appointment. Yay!  

We tested again. As you can see, this is a process of continually testing, treating, and modifying the protocol until we can get ahead of the disease process. Since her vitamin D levels were very low, I gave her a higher dose supplement. Her gut microbiome was also imbalanced with low levels of a type of bacteria known as Akkermansia. I focused on restoring levels of this important bacteria using specific prebiotics (pomegranate seed husk, matcha, greens powders, red powders for polyphenols, and acacia fiber) in order to repair her gut lining.   

She had only a mild flare in the winter of 2019-2020. This happened in February 2020 and drew out with occasional small amounts of blood until April. 

 

Can Mold Toxicity Cause Ulcerative Colitis?

After the flare in February 2020, we discussed some reasons why she kept having flares—and we had a breakthrough. 

I knew that there is a link between mycotoxins—toxins produced by mold—and ulcerative colitis. When no obvious lifestyle or nutrition factors could explain Sherrie’s UC flares, I started digging deeper into what might be bothering her in her environment- her house to be exact. The fact she got worse in winter when the environment was more moist also pointed toward mycotoxins as a possible cause. 

Even though her home was a new build she knew for certain there was periodically mold in her home. She and her husband often tried to clean it up. 

We tested Sherrie for mold and mycotoxins in April 2020. Many markers for mycotoxins were high. An inflammatory marker known as TNF-alpha was also elevated. 

Aha! Mold could definitely be the culprit.

She had her home inspected by a professional company that uses indoor mold testing and found the home was contaminated.

I started Sherrie on a treatment regimen for mycotoxins in July 2020 to proactively get her through her vulnerable period in late fall/winter.    

At first that strategy paid off. She felt great. Her stool was firm and she had no flares.

She took a break from the mycotoxin program and had a flare between Christmas and New Year’s 2021. She mostly recovered within a month. But since she was still having flares, I decided to retest her for mycotoxin markers in February 2021. 

That testing revealed she still had very high levels of the mycotoxin known as ochratoxin. Although these tests aren’t always 100% accurate, Sherrie’s lack of complete progress, her symptoms, and other markers suggested mold could be to blame. 

I put her on another round of the mold protocol, and she stayed well through August 2021. 

I ordered another mycotoxin test and it was much lower, although still high. This suggested she might be getting re-exposed.

Her husband had done some mold remediation on their home. But another round of indoor mold testing still showed the mold was off-the-charts positive. A mold-testing company found more mold in the utility room behind the water heater, in the shower caulking, and in the air. 

They had their home professionally remediated.

I then put Sherrie on another round of mold treatment. 

She had COVID-19 in November 2021 but did not experience a UC flare even though her body was under stress from the virus. This showed her intestines were getting stronger. 

 

Stopping Ulcerative Colitis in Its Tracks: Success at Last!

Sherrie had no UC flares through the winter of 2021—the first winter with no flares in nine years. Over the course of treatment, Sherrie would have long periods up to a year with no bleeding, but she might develop loose stools with blood for a few weeks and then go back into remission. But by 2022, she had gone a very long time with no visible blood in her stools. Now we were getting somewhere!

Her mold test came out clear. She felt great—high energy, no anxiety, and able to travel a lot in the winter and spring without fear.

At this point, I put her on a long-term program featuring antioxidants and pre- and probiotics. She’s taking minimal supplements and doing well.

Sherrie’s case shows that ulcerative colitis and inflammatory bowel disease respond well to a  functional medicine approach. In IBD, there are many overlapping root causes that must be identified, treated, and modified, all the while working around a person’s flare-ups. Over time, Sherrie and I figured out her triggers and she learned the tools to stop her flares before they started.  It may take some time, but ultimately a functional medicine practitioner can dig down to the root problem in order to heal ulcerative colitis.  

 

Heal Ulcerative Colitis with Functional Medicine

Like Sherrie, you can heal ulcerative colitis by working with a functional medicine practitioner. That’s why I invite you to reach out to me for a free 15-minute troubleshooting call to find out the best course of action for you. 

If after the call you come on board as a patient, I’ll order the right tests for you and start you on an anti-inflammatory protocol. The goal is to pinpoint your individual triggers and put ulcerative colitis in remission or cure ulcerative colitis altogether. 


Natural Solutions for Hypoglycemia, Hyperglycemia and Insulin Resistance

Do you reach for a snack when you feel your energy levels drop mid-afternoon? Or maybe you’re just the opposite: lunch makes you so sleepy, you feel like curling up under your desk for a nap?

I’m going to let you in on a little secret…

The only thing eating should make you feel is not hungry.

If meals either give or drain your energy, that’s a sure sign you’re dealing with blood sugar dysregulation such as hyperglycemia, hypoglycemia, and insulin resistance.

Unstable blood sugar causes everything from cravings to mood disorders. It can hold you hostage from your ideal weight, cause inflammation, and even impact fertility. Not to mention, it can be the start of blood-sugar related diseases like Type 2 diabetes and Alzheimer’s (which is sometimes called Type 3 diabetes!). 

On the other hand, stable blood sugar is the secret to reducing inflammation, having stable energy, better sleep, a better mood, and balanced hormones. I’ve even seen stable blood sugar have a positive impact on relationships (that’s why I always carry snacks for my toddler… and my husband!)

The bad news is that blood sugar issues are one of the most common problems I see in practice… but the great news is that there is an entire suite of things we can do to bring blood sugar back into balance. 

 

What Are Normal Blood Sugar Levels? 

Blood sugar is exactly what it sounds like: the amount of sugar in our blood. When we eat carbohydrates, they are broken down by the body into a simple sugar called glucose. Glucose crosses from the small intestine into the bloodstream where it can be taken up by the mitochondria - the “powerhouses''of our cells - and converted into energy, called adenosine triphosphate (ATP). 

This process is helped along by key hormones like insulin and glucagon. Insulin is released by the pancreas and helps lower blood sugar levels by allowing sugar to enter the mitochondria, as well as be stored in the liver and muscles as glycogen, or stored in fat. Glucagon works in the opposite direction: it helps free stored glucose to raise blood sugar levels when they drop too low.This give and take is extremely important, as the body thrives when blood sugar remains stable - not rising too high or dropping too low. 

When blood sugar levels are chronically low, it is called hypoglycemia. People with hypoglycemia often feel tired, anxious, or unfocused when they are hungry - and a meal helps energize them and allows them to focus. On the other hand, those with hyperglycemia (also called insulin resistance) have blood sugar levels that are too high. They feel tired after eating. Many people have symptoms of both hypo- and hyperglycemia at different times. 

According to the American Diabetes Association (ADA), normal fasting blood sugar is below 100 mg/dL. Levels between 100-125 indicate pre-diabetes, and anything over 126 when fasting is considered diabetic. After eating (postprandial), the ADA considers 70-140 mg/dL to be normal.

But, what’s “normal” isn’t necessarily optimal. Fasting glucose can be “normal,” but you may still experience glucose spikes over 140 mg/dL throughout the day. Instead, I prefer to look for these signs of optimal blood glucose levels:

  • Fasting: 70-90 mg/dL
  • Postprandial: Below 120 with a return to pre-meal glucose levels within 2 hours (ideally below 100)

(For how to find your blood sugar levels, see “Testing Your Blood Glucose and the Benefits of Continuous Glucose Monitoring” below.)

 

What Is Hypoglycemia and What Causes Hypoglycemia?

Hypoglycemia is low levels of blood sugar, generally less than 70 mg/dL when fasting. 

A Lactate dehydrogenase (LDH) level below 140 is also a sign of hypoglycemia.

Clinically, a person with hypoglycemia is often on the thinner side, and a “healthy” eater. However, they may skip meals (or just never feel hungry - only realizing they need to eat when they are shaky, foggy, or depressed), then have a mid-day crash, anxiety, and irritability. They often have strong sugar cravings in the afternoon or after dinner. When they do finally eat, they have improved energy and mental function-  but it doesn’t last long! They also often struggle to stay asleep, as they don’t have the necessary glycogen stores. 

The main complaints I see with hypoglycemia are:

  • Fatigue, especially an afternoon or mid-day crash, or between or after meals
  • Insomnia, trouble staying asleep or falling asleep
  • Mood swings
  • Anxiety
  • Depression
  • Hair thinning
  • Infertility and hormone imbalances
  • Impaired metabolism or weight gain

What causes hypoglycemia? The main culprits I see are a habit of missed meals, high-sugar snack, using caffeine or nicotine to suppress appetite, eating sweets or snacks instead of meals, and overtraining without properly replenishing glucose. 

Low blood sugar can also be the first step toward developing insulin resistance and hyperglycemia. Low blood sugar causes a stress response, where cortisol rises and catecholamine spikes, to “save'' low blood sugar, which can cause nervousness, shakiness, and anxiety. Catchelomanes also suppress appetite, masking hunger and leading to more hypoglycemia.

 

What Is Hyperglycemia and What Causes Hyperglycemia?

Hyperglycemia is elevated blood sugar levels, with a morning fasting glucose above 99 mg/dL (though I prefer to see it below 92!), and levels after meals rising above 140 mg/dL. It is also signaled by an HBA1c above 5.6, though this marker isn’t always accurate. Fasting insulin levels above 5 indicate mild hyperglycemia, while levels above 10 indicate pre-diabetic levels of hyperglycemia. 

If not addressed, hyperglycemia can intensify into diabetes, where fasting glucose is above 126,  HBA1c is above 7, and fasting insulin is above 20.

Clinically, people with hyperglycemia often complain that after they eat, they feel fatigued, have impaired mental function, and often crave sugar. Chronic inflammation is another hallmark of hyperglycemia, and may present as anything from chronic joint pain to acne to autoimmune disease. Frequent urination is another key sign of hyperglycemia I look for. Finally, those with hyperglycemia often have a very hard time exercising, but once they do, have notable improvements in energy levels. 

Hyperglycemia and insulin resistance are often used interchangeably. Hyperglycemia is simply the state of having high blood sugar - it could be a one-time thing due to a particularly high-carb or sugary meal. Insulin resistance, on the other hand, is a result of ongoing, sustained high blood sugar, which tells the pancreas to constantly make more insulin to help lower blood sugar levels back down. Over time, the body becomes less sensitive to elevated levels of insulin, and essentially “stops listening” - keeping blood sugar levels high.

 

What Are the Root Causes of Insulin Resistance?

Chronic stress, eating too many highly processed carbs, and lack of exercise all play a role in the development of hyperglycemia and insulin resistance. However, there are other factors at play that aren’t as simple to control as skipping the bun on your burger.

For instance, people with polycystic ovarian syndrome (PCOS) are genetically prone to be less insulin sensitive, even with a “perfect” diet.

In addition, the normal phases of the menstrual cycle can have a major impact on blood sugar levels. As progesterone rises in the week before your period starts, insulin resistance also increases, leading to elevated blood sugar levels. In addition, progesterone can also increase cravings for carbs and sugary foods, intensifying the problem. (It can also tank workout performance and hinder proper recovery!) On the other hand, estrogen, which rises during the follicular phase, actually increases insulin sensitivity. 

For these reasons, I recommend people workout harder and eat more whole-food carbs during the follicular phase, then reduce carbs and do lighter training in the luteal phase. Use the last week of your cycle as a recovery period, and prepare to bounce back hard right after your period ends.

 

Testing Your Blood Glucose and the Benefits of Continuous Glucose Monitoring

You might have some symptoms of hyper or hypoglycemia, but the only way to know for certain is with blood glucose monitoring. I recommend continuous glucose monitoring with a monitor like NutriSense. This little device is convenient, painless, doesn’t require any finger sticks, and gives you 24-hour-a-day data on your glucose levels. Plus, you can wear it during workouts, sleeping, and everything in between.

Continuous glucose monitoring allows you to see the impacts of everything you do on your blood sugar levels - these are just some of the things I like to pay attention to:

  • The types of carbs you eat whole food vs. processed)
  • Eating carbs with or without other foods
  • The time of day you eat carbs
  • Workouts
  • Sleep
  • Menstrual cycle
  • Stress
  • Meditation and stress management techniques

You can use this information to optimize your lifestyle for wellbeing and glucose control. You may have never guessed that eating an apple alone at 10 AM would give you a crazy blood sugar spike - but now that you know it does, you can make a point to pair it with almond butter. 

One other test I use with those with hyper or hypoglycemia concerns is the ION panel. This gives us a look at nutrient levels, so that we can make personalized supplement recommendations - like adding key blood-sugar control nutrients like magnesium, folate, and other B vitamins. 

Elevated levels of Pyruvate, L-Lactate, and/or B-Hydroxybutyrate on an organic acids panel (like the ION/Organix or the OMx) are also potential signs of impaired insulin metabolism. But, because other things - like a strict ketogenic diet or deficiencies of specific nutrients such as CoQ10, B1, or pantothenic acid - can cause elevations in these markers, I only consider them in the context of other symptoms or lab markers. 

 

Food, Fiber and Supplements to Help Stabilize Blood Sugar Levels

Fortunately, if your blood glucose levels aren’t stable, there is a lot you can do about it! 

First up, let’s talk about what you can do at meals. Start with a glass of water with 2 teaspoons of apple cider vinegar mixed in. Next, take a look at your plate. Start by eating the greens on your plate - and if there aren’t greens (ideally you’re having greens with every meal) - instead grab a serving of fiber like PureLean Fiber, or Glucomannan Caps if you are on the go (I prefer powder in water as it works better!).

Once you’ve had your greens/fiber, move on to eating your protein and fat. Make sure you’re prioritizing eating enough protein - especially early in the morning. Finally, go ahead and eat your carbs as the last component of your meal. Bonus points if you eat meals containing carbs earlier in the day, as most people are more insulin sensitive in the morning and early afternoon. (And avoid refined carbs and added sugars, in general). If you find that you’re sleepy after meals, it's simply a sign you ate too many carbs at one time. 

When you’re done eating, go for a walk. And if you don’t have time to walk, even just doing a few squats can really help. And when you’re done with dinner, be done, and skip those bedtime snacks. A 12-hour fast (from dinner to breakfast) is an easy goal to aim for. But just be aware: fasting longer than your body likes can actually backfire and drive cortisol levels up, so stick to 12-13 hours to start. If you’re not sure about the ideal fast length for your body, a continuous glucose monitor can help clue you in. 

Away from the table, actively minimizing stress is key. Stress causes increases in cortisol, and cortisol spikes also spike glucose. If you don’t believe me, just look at your continuous glucose monitor. My glucose has gone up during a couple’s therapy appointment! Sleep is also essential: getting less than 6 hours of sleep per night increases insulin resistance. 

I also encourage all my clients to fix any underlying gut health issues, especially an imbalanced microbiome. A lack of butyrate-producing bacteria decreases insulin sensitivity, which many of the proteolytic bacteria are gram-negative and contain pro-inflammatory LPS, which causes or  increases insulin resistance. 

Hormones play an important role, as well. In women, getting support for hormone balance early on in the peri-menopausal window (after around age 35 for most of us) is essential. Keeping levels of progesterone and estrogen adequate maintains insulin sensitivity. The decline in estrogen that eventually occurs can push up to 40% of women into pre-diabetes or diabetes at menopause. Alternately, having too much testosterone as a woman can make you more insulin resistant (like in many cases of PCOS). Progestin-containing birth control pills have the same effect, as they convert into androgen-like substances in the body. In men the opposite is true: too little testosterone can cause insulin resistance.

And finally, grab some weights: research has shown that building muscle is one of the best tools we have for improving insulin sensitivity. 

For my clients, I also like to create custom supplement plans utilizing these nutrients:

  • Alpha LIpoic Acid - one of the only substances actually known to recondition insulin receptors to make them more sensitive over time!
  • Vitamin B1 (Thiamine) - shown to improve glucose tolerance.
  • Chromium  - regulates and enhances the effects of insulin.
  • Myo-inositol and D-Chiro-Inositol- reduces glucose variability and improves fasting blood glucose.
  • Berberine - lowers blood sugar comparably to the drug Metformin, increasing insulin sensitivity and production.
  • Magnesium - low consumption of this mineral is associated with poorer blood sugar regulation and a higher risk of type 2 diabetes. 

Other herbs I use include fenugreek, cinnamon, bitter melon, pycnogenol, and gymnema, among others.  

 

Get Personalized Help with Your Blood Glucose Levels

 Whether you’re dealing with hyperglycemia or hypoglycemia, insulin resistance, or even a diagnosis like diabetes, you have the power to take back control and help your body (and blood sugar) get back into balance.

For a customized plan, step-by-step support, and expert guidance, the first step is to book a free, no-obligation discovery call with my health team.

Learn about how we work with clients to achieve their unique health goals and help them step back into radiant health, so they can stop worrying about how they feel and start living a purposeful life. 

>>> Book your free discovery call here


ibd

A Functional Medicine Practitioner’s Approach To Treating IBD

When a patient visits me for the first time with inflammatory bowel disease (IBD)—ulcerative colitis or Crohn’s—they’re usually in bad shape. 

They have abdominal pain and cramping, diarrhea, fatigue, and other problems, such as visible blood in the stool. 

In other words, they’re experiencing an IBD flare. 

People who suffer with ulcerative colitis or Crohn’s experience usually have flare-ups when symptoms are much worse, as well as periods of remission, when their symptoms go away. It can be frustrating and hard to have a “normal” life.

When patients come to me for IBD treatment, the first step is to get the patient out of the flare so we can focus on putting the IBD into remission- for good. 

In this blog post I’m going to dive into what I do to treat IBD naturally. We can get lasting remission without the use of medications, as seen in this real-life success story from one of my patients. But, first, a word of caution. 

Do NOT try this at home! 

There’s a very strategic order of operations. If you do any of the things I mention in this article in the wrong order, you can make yourself worse. 

Much worse. 

For example, if a patient is in a severe flare I might not throw betaine hydrochloride, a digestive aid, at them until later. If they take betaine hydrochloride during an IBD flare it can make things worse. 

That’s why it’s so important to work with a functional medicine provider. 

I can’t say it enough: If you have ulcerative colitis or Crohn’s, get yourself a good functional medicine practitioner.   

Okay, with that out of the way, let’s briefly recap what IBD actually is and the symptoms it causes. 

What Is IBD?

Inflammatory bowel disease refers to conditions like ulcerative colitis and Crohn’s disease. These conditions are linked to ongoing inflammation in the gastrointestinal tract. In ulcerative colitis, patients develop inflammation and lesions on the lining of the large intestine and rectum. Crohn’s disease is a type of IBD that involves the lining of the digestive tract. Crohn’s usually involves inflammation in deeper layers of the digestive tract compared to ulcerative colitis.    

What Causes IBD?

IBD is an autoimmune disease believed to be caused by an abnormal immune response to gut microbiota or food in susceptible people. In IBD, the immune system malfunctions and attacks the cells in the gastrointestinal tract. The cells in the intestines are innocent bystanders but the immune system thinks they’re foreign invaders. The primary cause and the triggers of IBD are still unknown.

IBD may have a genetic component, since it occurs in some people who have family members with the disease. However, most IBD patients don’t have a family history of the disease. 

IBD risk factors include:

  • Younger Age Most people with IBD are diagnosed before the age of 30, but some patients don’t develop the condition until they’re in their 50s or 60s. 
  • Family History – People with a close relative who has IBD are at higher risk of the condition. 
  • Cigarette Smoking – This is a risk factor for Crohn’s disease.
  • Nonsteroidal Anti-inflammatory Medications (NSAIDS) – Anti-inflammatory drugs like ibuprofen (Advil, Motrin, etc.) and naproxen sodium (Aleve) as well as others in this class may increase the risk of developing IBD or worsening the condition in people who already have it.

Inflammatory Bowel Disease Symptoms

IBD symptoms are different depending upon how severe your inflammation is and where it’s located. IBD patients usually go back and forth between disease flares and periods of remission. 

Symptoms of ulcerative colitis and/or Crohn’s include:

  • Abdominal pain 
  • Blood in the stool
  • Constipation, especially when inflammation occurs in the rectum. 
  • Diarrhea
  • Fatigue
  • Poor appetite
  • Unintended weight loss

IBD Complications 

Ulcerative colitis and Crohn’s disease share several complications. These include:

  • Increased risk of blood clots
  • Increased risk of colon cancer
  • Increased risk of primary sclerosing cholangitis, a condition that causes scarring within the bile ducts, leading to liver injury.
  • Inflammation of the skin, eyes, and joints

Patients with IBD also take medications that can have side effects. For example, corticosteroid drugs increase the risk of osteoporosis and high blood pressure, as well as other conditions. 

Possible complications of Crohn’s disease:

  • Anal fissure, a small tear in the tissue lining the anus.  
  • Bowel obstruction
  • Fistulas. Inflammation leads to these abnormal connections between different body parts. In Crohn’s, fistulas can develop near the anal area and may become infected. 
  • Malnutrition

Possible complications of ulcerative colitis:

  • Dehydration caused by frequent diarrhea. 
  • Toxic megacolon, a condition where the colon rapidly widens and swells. 
  • Perforated colon, a hole in the colon that often occurs due to toxic megacolon. 

Fight The Flare

The first thing I do for a patient who’s in the middle of an IBD flare is to begin an anti-inflammatory protocol while at the same time ordering important tests. The two goals at first:

  1. Prevent tissue inflammation 
  2. Bring symptoms into remission

One of the best ways to calm the tissue inflammation and get out of flares is the specific carbohydrate diet (SCD). The SCD diet is a whole-foods diet including vegetables, fruit, fish, meat, nuts, beans, and healthy fats and oils. It excludes sugars, processed foods, preservatives, all grains, starchy vegetables, and lactose. In patients with diarrhea, I’ve really seen the SCD make a HUGE difference. The elemental diet is also very useful for seven to 10 days. An elemental diet is a liquid formula providing all of the basic nutritional elements you need for health, in a form that your body can easily absorb. One clinical trial of 23 patients with ulcerative colitis found that 56% went into remission on an elemental diet and nearly half of those remained in remission for 7 to 28 months.  

Even if the patient isn’t gluten sensitive, I urge the patient to go on a gluten-free diet. Gluten promotes leaky gut, a condition that will stop a patient from going into remission. Mostly, I encourage any patient in an IBD flare to go on a paleo-type diet, with no gluten and no carbs.

For patients in flare mode, I also recommend a Chinese herbal formula called Yunnan Paiyao. In addition, I put them on high-dose DHEA to support the adrenals as they withdraw from corticosteroid drugs. 

It’s also important anyone with diarrhea take electrolytes like magnesium and potassium. And Epsom salt baths and butyrate enemas are a part of my anti-flare strategy.

Interpreting Test Results and Treating Accordingly

While making those initial changes to diet and supplements, I order a number of tests in IBD patients. These include stool tests, as well as tests to find out if a patient is nutrient deficient, and tests for markers of oxidative stress, methylation, and neuroinflammation. Figuring out a person’s specific problem areas helps build a protocol precisely for their needs.

Oxidative stress is what you might know as free radical damage. Oxidative stress happens when free radical production goes out of control. Inflammation from IBD can cause oxidative stress in the colon.

Methylation is an important process that affects many bodily functions. People can have genetic defects in methylation. These defects are linked to the development of IBD. Often the genetic defect involves the inability to metabolize the folic acid form of the B vitamin folate. We get around this by giving patients a special form of folate that can bypass the pathway needed to use folic acid. This special form of folate is called 5-MTHF.  

You’re probably wondering what neuroinflammation has to do with IBD. Well, one is inflammation in the brain and the other is inflammation in the gut. I am interested in markers of neuroinflammation in IBD patients because of the gut-brain axis. What’s happening in the brain is linked to the gut and what’s happening in the gut is linked to the brain. 

Stool testing is another important test in patients with IBD. Stool testing detects parasites, an imbalance in the gut microbiome, and fungal infections—all of which can impact your gut health. This type of testing can let me know if specific types of good bacteria are lacking. In this way, I can build up what’s missing in the gut by giving high-dose probiotics, fiber, prebiotics and more to patients who need them. 

 Adrenal Testing

I order adrenal hormone testing for my IBD patients. Adrenal testing is important because the adrenals make the stress-hormone cortisol. Many patients with IBD are vulnerable to mental stress, which can make IBD attacks worse or even knock someone out of remission. 

Patients who are in a flare and on corticosteroid drugs cannot take the adrenal test right away. This type of drug raises cortisol levels and will throw off adrenal test results. In this case, I may have to wait until symptoms are more controlled and the patient can wean off of corticosteroids. I also take them off high-dose DHEA. Only then am I able to test adrenal function. 

Mycotoxins Testing 

In the past, I only ordered mycotoxin tests in IBD patients who were not getting results from the usual treatments. But now, after years of treating IBD patients, I’ve noticed there’s a strong connection between toxins made by mold (mycotoxins) and ulcerative colitis. 

Yes, this is a thing. Even studies published in medical journals confirm it. 

That’s why I no longer wait to test IBD patients for mycotoxins. Instead, my attitude is usually: let’s just get ahead of this and deal with mycotoxins if they are a problem. 

Food Sensitivity Testing

Food sensitivities are an important factor in IBD. They can trigger inflammation in the gut. They can stress the immune system so that it malfunctions. They can promote intestinal permeability, or leaky gut.

In IBD patients, there could be two things going on:

  1.  Actual food sensitivities where you have an immune reaction to certain foods. 
  2.  Foods irritating the gut without causing any immune reaction. In this case, the irritation and inflammation occurs in a biochemical way. These types of foods are still difficult to digest or are feeding the bad bacteria even if you’re not actually having an immune reaction to them.

The type of food sensitivity testing I like to use not only tests for IgE and IgG but also other aspects of food sensitivities, such as complement. This helps me capture food reactions that are immune-mediated and those that are not.

How To Stay in Remission During IBD

Best Diet For IBD

Conventional “wisdom” says you shouldn’t eat salads and fiber when you have IBD.

Wrong. Very wrong.

You eventually want to emphasize roughage and fiber so you’ll have the prebiotics you’ll need to feed the beneficial bugs in your gut. But timing is everything. 

During the remission phase, the goal is to emphasize resistant starch and various types of prebiotics. This type of starch feeds the good bacteria in your colon. I personalize this plan based upon the results of your microbiome testing. The key is to choose prebiotics that only feed the good bacteria, not the harmful ones. 

When in remission, expand your diet a little compared to when you were in a flare. Dairy and gluten probably are only going to make things worse. But you can add other things back into your diet one at a time and watch how you react. 

The key? Choose foods less likely to cause a flare-up. Avoid gluten, dairy, eggs, nuts, and seeds. 

 

Identify Your IBD Triggers

Another helpful strategy during remission? Focus on preventative management of your stress. For example, if you know you get stressed around the holidays, be proactive and plan ways to reduce your stress such as extra self-care during that time of the year. 

The key is to pinpoint your triggers. Do your flares only happen in the winter? Then we need to find out what’s causing them. At that time of year I also want to look at vitamin D levels to make sure yours aren’t too low. 

 

The Best Type of Exercise for IBD

Healthy exercise is also important. By healthy I mean don’t overdo it, especially if you have IBD. Aim for mild cardio three times per week but focus more on weight training, which can help build the microbiome and reduce inflammation. 

On the other hand, too much intense cardio (more than 30 minutes), can increase inflammation and spike cortisol levels. Intense cardio can boost levels of an inflammatory protein known as IL-6. High levels of IL-6 are linked to IBD flares. 

When you do any cardio exercise, aim for shorter walks or hikes in nature. 

Dietary Supplements for IBD

Each of my patients with inflammatory bowel disease has a different supplement protocol  customized to their test results and where they are in the course of the disease. Here are some of the supplements I may use in IBD patients:

  • Yunnan Paiyao, a Chinese herbal formula for inflammation.
  • High-dose probiotics
  • Prebiotics
  • Liposomal glutathione, which as an antioxidant reduces oxidative stress. In the early stages of treatment, I prefer this over the glutathione precursor N-acetyl cysteine (NAC) because NAC  can thin the gut lining.
  • Nutrients that show up deficient on testing such as B vitamins.
  • Curcumin or turmeric extract to reduce inflammation.

It’s Critical To Work With a Functional Medicine Provider

As I mentioned earlier, if you try to treat yourself you could really make things worse.

Or you could delay your recovery. 

There’s an order of treatments that need to take place and this order is unique to each patient. 

That’s why I invite you to reach out to me for a free 15-minute troubleshooting call to find out the best course of action for you. If after the call you come on board as a patient, I’ll order the right tests for you and start you on an anti-inflammatory protocol. 

The goal is to get you into a long-lasting IBD remission. My protocol has worked on many patients and it’s very effective, but it may take time. At first, you might take one step forward and two steps back. But with persistence, testing, and modifying your protocol, we can find the winning combination to turn off your IBD. In the end, we can calm your gut’s inflammation and get your digestive tract feeling comfortable and healthy again. 

If you’d like to see an example of how this approach can bring lasting remission, read a real-life case study of one of my patients with UC (coming soon).  


Restless Leg Syndrome

What Causes Restless Leg Syndrome? Natural Remedies for RLS

You’ve just fallen asleep when it hits. That uncontrollable urge to move your legs. 

Your legs also ache and throb. 

It’s known as restless leg syndrome (RLS), and it makes you feel like you need to put a leash on your legs to keep them from trying to run away. Down boys! Down!

Restless leg syndrome is a condition where your legs are fidgety and uncomfortable, usually at night during sleep. But sometimes it can happen during the day when lying down or sitting for a long time, like when you’re in the car or at the movies. 

 

Symptoms of Restless Leg Syndrome

The main symptom is the urge to move the legs. However, people with restless legs describe other symptoms such as:

  • Aching
  • An “electric” feeling 
  • Crawling
  • Creeping
  • Itching
  • Pulling
  • Throbbing

The condition is known for:

  • Happening when lying or sitting for a long time. 
  • Relief with movement. The urge usually goes away when walking or stretching. 
  • Occurring mostly at night.

In some people, the disorder happens together with twitching or kicking of the legs while they’re sleeping. This condition is known as periodic limb movement of sleep.

 

Causes of Restless Legs Syndrome

There are a lot of reasons why you have restless legs. Since I specialize in treating women with gastrointestinal disorders I’m really familiar with one of the most common causes of RLS—small intestinal bacterial overgrowth, or SIBO for short. An imbalance in the gut microbiome—what scientists call dysbiosis—is also often to blame. 

But there are other factors that can cause restless legs. In fact, there might be more than one culprit involved. Let’s dive into all those factors in this blog post and I’ll tell you the natural remedies for restless legs syndrome that have worked for my patients.  

 

SIBO and Restless Legs

In my clinical practice, I see a lot of patients with SIBO who also have restless legs. Studies in medical journals confirm the link between SIBO and restless legs. 

If you want to know more about what is SIBO, I recommend you read this blog post I wrote. Meanwhile, in a nutshell, SIBO is an imbalance in the microbes that live in the small intestine. 

This can mean that there are too many bacteria or the wrong kind of bacteria that don’t belong in the small intestine.   

So what does SIBO have to do with restless legs? A lot. 

SIBO causes inflammation in the gut, which leads to the release of hepcidin, a hormone critical in delivering iron to the body and the brain. 

Iron is necessary for growth and development as well as supplying the body with oxygen through the blood. But more important for our topic here, iron is a cofactor in the production of dopamine, a brain chemical (neurotransmitter) that tells leg muscles to relax at night. Without enough dopamine, muscles can remain hyperactive. The result? Restless legs syndrome. 

When the body releases too much hepcidin, you might not even realize there’s a problem with iron. When you get tested for iron levels or for ferritin, the tests come back normal. And yet your body isn’t able to use the iron that’s available. 

Eating enough protein is also critical for making dopamine. The body needs the amino acids tyrosine and phenylalanine from protein as well as iron to make dopamine. 

I’m not the only one who connected the dots between SIBO and restless legs. In a small study published in the online version of the journal Sleep, SIBO was found in all seven participants with RLS. Compare this to the general population without restless legs; SIBO occurs in less than 15% of people. 

Restless Legs Treatment #1: Work with a functional medicine provider to test for and treat SIBO. Dietary changes, probiotics, fiber, digestive support, and antimicrobials are often used to turn around SIBO. Eat 1-1.2 grams of protein per kilogram of body weight, taken daily in divided doses.  

 

Gut Microbes Gone Bad

Sometimes, treating SIBO isn’t enough and the restless legs continue. There could be many reasons for that, but one of them could involve gut dysbiosis beyond just SIBO. Gut dysbiosis causes inflammation in the gut and the body. In my practice, I don’t just test for SIBO. I use stool testing to look for bacterial overgrowth, fungus, and parasites.

Imbalanced gut bacteria lead to many of the same problems that occur with SIBO, such as the release of hepcidin and the inability of the brain to use iron.   

Restless Legs Treatment #2: Balance the gut microbiota through the use of a good probiotic and avoid factors that lead to an imbalance such as eating too much sugar and processed foods and stress. Your functional medicine provider may use antimicrobials, antiparasitics, and/or digestive support to optimize your gut microbiome. Eat 1-1.2 grams of protein per kilogram of body weight, taken daily in divided doses.  

 

High Histamine 

Another reason why SIBO or dysbiosis causes restless leg syndrome is because they can lead to histamine excess

Histamine is a chemical found in many cells of the body. It causes allergy symptoms like itchy, red eyes, runny nose, and sneezing. When the body makes too much of it, it changes how the nervous system functions. This can be a problem for people with restless legs.

People who make too much histamine or who have histamine intolerance often have problems sleeping, since histamine is a brain stimulant. 

The catch? Because histamine revs up the brain,  people with restless legs who also are making too much histamine can get by on little sleep. They’re not sleepy in the daytime and can function even though they’re exhausted. 

Scientists are now beginning to believe that targeting histamine receptors may reduce restless leg syndrome. Histamine receptors are proteins found on the surface of some cells. These proteins are triggered by histamine.  Think of receptors like locks on a door and histamine as the key that fits into the lock and gets it to open.   

Mast cells are immune cells found in the blood that release histamine as part of an allergic reaction. Now researchers are finding that when mast cells are activated, it may cause restless legs. People who have a condition known as mast cell activation syndrome are more likely to have restless legs compared to healthy controls.  

Restless Legs Treatment #3: You can start by supplementing with DAO, an enzyme that breaks down histamine. Two other ways to support histamine levels are Natural D-Hist from Orthomolecular Medicine and quercetin. A low-histamine diet may also help.  

But keep in mind that histamine excess is complicated. There are different pathways through which people have problems. It’s best to work with a functional medicine provider to find out if histamine excess is part of your problem and if so, why you’re making too much histamine. 

 

B Vitamins for Restless Legs Syndrome

Vitamins B12 and vitamin B1 (thiamine or benfotiamine) can both fend off restless legs. For example, in patients with inflammatory bowel disease, vitamin B12 deficiency is linked to an increased risk of restless legs syndrome. 

Vitamin B1 helps the body make a chemical called acetylcholine, which is involved in motor control. In other words, B1 supports the health of the nerves that control the muscles.  So it makes sense that if you’re low in vitamin B1, your legs and body will fidget. 

The body also needs vitamin B1 to make dopamine. As I mentioned earlier, dopamine is a brain chemical that says to the leg muscles: “Relax! Relax!”

I’ve had patients tell me that even when other restless legs treatments didn’t help, vitamin B1 worked miracles. 

Restless Legs Treatment #4: Start by taking a B complex vitamin or vitamin B1 (up to 100 mg). You may need to go up to 300 mg, which you should only do under the supervision of a functional medicine provider. 

 

Food Sensitivities

Food sensitivities may be to blame for restless legs in some people. A case study of three patients found that food sensitivities caused movement disorders including repeated shrugging of the shoulders. In these patients,  milk, coffee, eggs, aspartame (Nutrasweet), tea, chocolate, citrus, raspberries, strawberries, potatoes, beef, and pork caused the most problems. This matches my experience in clinical practice. 

Restless Legs Treatment #5: Work with a functional medicine provider, who can order food sensitivity tests to find out which foods don’t agree with you. They may also suggest an elimination diet or just removing the foods that bother you from your tests. After a trial period without the foods, your practitioner will instruct you to introduce one at a time while watching for symptoms. That way you can see which food is causing your restless legs.  

 

Other Causes of Restless Legs

Here are other common reasons why my patients develop restless legs:

  • Alcohol, caffeine, nicotine
  • Certain medications 
  • Low vitamin D
  • Pregnancy
  • Stress/anxiety
  • Vigorous exercise

 

Drugs That Cause Restless Legs Syndrome

Sometimes, the cause of restless legs is a certain prescription medication. Here are some of the most common drugs that cause restless legs.:

  • Allergy meds
  • Diphenhydramine
  • Neuroleptics
  • Selective serotonin reuptake inhibitors (SSRIs)
  • Tricyclic antidepressants

 

Getting Rid of Restless Legs

I specialize in treating GI disorders and women’s health. So if you have digestive symptoms and restless legs, I know how to get at the root cause of why your legs are so fidgety. 

The first step? Book a free 15-minute troubleshooting call with me to find out the best course of action. 

If after the call you come on board as a patient, I’ll order certain tests to show whether your restless legs are caused by nutrient deficiencies, gut dysbiosis, or histamine excess. Whatever the cause, I’ll be on it until I find out what’s wrong. Book a call today so you’ll sleep more deeply tomorrow.   


Constipation

How To Relieve Constipation in Children

I’m a gut health expert, who has done everything “right”... and my toddler daughter has been struggling with constipation!

Yes, it feels a little vulnerable to tell you this, but above all else I want to always be honest.

So here’s the honest truth: no matter how hard we try to care for ourselves and the ones we love, sometimes health issues still present themselves. When they do, we have two choices. We can either bury our head in the sand and wish it wasn’t so, or meet the challenge head on.

So today let’s dig into constipation in kids: what causes it, and how we can help. Plus, I’ll share my own story of helping my daughter through this health challenge.

 

My Daughter’s Constipation Story

From the time I found out I was pregnant, I did everything I could to set my daughter up for a lifetime of gut health. I used oral and vaginal probiotics leading up to her birth, and pushed for a vaginal delivery (even though I had a lot of pressure for a C-section). When she was born, I gave her probiotics on my nipple, and later in bottles of breastmilk. 

We waited to introduce solids until she was a little over 6 months, and then introduced them according to the book Super Nutrition for Babies, which is based on the work of Dr. Weston A. price and heavily influenced by the paleo diet. Her first foods were all high-fat, breast milk-mimicking foods like puréed liver and broth, egg yolk from a very softly boiled egg, puréed fish and lamb, and avocado. 

And it seemed to really work: by eight months old, she was downing a cup of broccoli at a time. She loved tasting new food - sauerkraut, pickles, curry, and all the veggies. 

But then, after a family vacation to Mexico and a bout of food poisoning, something seemed to change. Suddenly, her belly was protruding more than it had before, and she was skipping multiple days between bowel movements. When she did go, she sometimes cried and complained it hurt. Her diet hadn’t changed - so I couldn’t blame too many crackers and cookies, or low fiber intake. It was something deeper than just diet.

As a functional medicine practitioner, I had some hunches as to what was going on - and I’ll share exactly what I did to get her back to daily poops at the end of this post.

But first, let’s dive into constipation in children: why, what, and how we can help.

 

Signs of Constipation in Kids

Depending on the age of your child, they may not be able to communicate that they’re feeling backed up. That’s why it’s important for parents to keep an eye on things. (And even kids that are verbal may not connect that their tummy hurts because they haven’t been pooping!)

Here are signs of constipation, based on age:

Babies

Constipation is most common in babies during transitions - either from breastmilk to formula, or with the introduction of solids. If a baby is exclusively being fed breastmilk or formula and has constipation, that’s a red flag for a bigger issue, most commonly food sensitivities.

Signs of constipation include going 4+ days without a bowel movement, less frequent bowel movements than normal, crying while passing stools, dry or pebble-like stool, or struggling/straining while pooping. 

Toddlers

Normal is considered anywhere from daily to once every 3 days, but sudden changes are a red flag - like if your usual daily pooper has gone 3 days without going. Older toddlers might tell you their tummy hurts, or that it hurts to poop. You might also notice that their stomach pokes out more than usual, and that it’s hard to the touch. Bowel movements might be difficult to pass or unusually large. The stool may seem to move out and then back in before they can successfully pass it.  

Because pooping is painful when they’re constipated, toddlers might also start to hold their poop and avoid going. This only makes the problem worse, so it’s ideal to jump in right away with some of the solutions I'll outline here, before they start holding their bowel movements in.

 

Foods That Cause Constipation in Children

Not enough fiber is the most common food-related cause of constipation. Your child's age + 5 = the number of grams of fiber they should be consuming each day. The exception are babies under six months of age: they have no need for food besides breastmilk or formula. If you’ve introduced solids before six months and your baby is struggling with constipation, stop feeding them - especially if you started with rice cereal or something similar!

Hand-in-hand with not enough fiber goes too many high-starch foods like crackers, cookies, pasta, bread, etc.

Food intolerances, most commonly to cow dairy and wheat or gluten, are another common food-related cause of constipation. Many kids transition from breastmilk or formula straight to cow’s milk, which for many, is the primary cause of constipation. Wheat is also hard to digest and can be constipating for some children. Separately, they may also have gluten intolerance, where gluten exposure causes inflammation and various GI symptoms.

 

Foods to Help Constipation in Children

In general, kids should be on a Paleo-template diet that emphasizes lots of whole foods, in whole form, the majority of the time. (If your kids are eating this way, you likely don’t need to worry about fiber). There is always room for “excursions” from the diet for special occasions, but those excursions should remain excursions, and not become part of the everyday way of eating. 

If you need to overhaul the way your kids are eating, do it slowly and keep them involved. It’s great to have kids in the kitchen, helping you cook. And don’t forget you can blend veggies into all sorts of things! (I’ve included one of my favorite high-fiber, veggie packed recipes for kids at the bottom of this post!)

Adding in these foods to help constipation in children is especially beneficial:

Sugar free water kefir with chia seeds - provides hydration and beneficial wild probiotic strains, adding chia not only helps moisten the intestine, but makes it more fun for kids to eat

Fermented veggies - more beneficial bacteria and fiber. You might think your kid would never eat them, but you would be surprised how many toddlers and babies love them, especially fermented beets!

High fiber foods - strawberries, apples, pears, prunes, bananas, avocado, beets, blueberries, raspberries, broccoli, chickpeas, lentils, black beans, pumpkin, peas, spinach, and sweet potatoes are some of my favorites. 

What about oats? While oats get a ton of buzz for being high-fiber, I find that many children have a very hard time digesting grains. Grains contain lectins and phytates, two anti-nutrients that can cause leaky gut. I don’t recommend emphasizing grains, and instead focusing on other high-fiber foods. 

Finally, make sure your kids are well hydrated! Babies over 6 months can have 2-3 ounces of water, a few times daily (and will get the majority of their hydration from breastmilk or formula). Toddlers should be drinking 16-32 ounces of liquids daily, with the majority being water, not milk, milk substitutes, or juice. 

If your child refuses to drink enough water, soaking fruit in water in the fridge overnight can add some flavor, as can a splash of something flavorful such as the low-sugar Kefir Water drink mentioned above, or coconut water. 

 

What Else Causes Constipation?

If diet has already been addressed and constipation isn’t improving, it’s time to dig a little deeper. Some of the other causes of constipation I commonly see in children include parasites, H pylori, Candida overgrowth, and Small Intestine Bacterial Overgrowth (SIBO). 

Kids touch… everything! And they constantly put their hands in their mouths, making them prime candidates for parasites and pathogens. Plus, their immune systems aren’t yet fully mature, making them more susceptible to things like foodborne illness or parasites in water. (Water can be contaminated when traveling - but even city and well water can become constmainted. That’s why we use a Berkey water filter.)

Acute GI infections, such as food poisoning, can also lead to a condition called Post-Infectious Irritable Bowel Syndrome, better known as Small Intestine Bacterial Overgrowth (SIBO). Learn more about SIBO here.. 

All of these issues can be diagnosed via stool panels and treated naturally with child-specific herbal protocols. (As a mom, I know how hard it is to get kids to take anything yucky-tasting… so I worked hard to find a treatment plan kids would actually take!) 

If your child is old enough to blow into a tube, we can also run a SIBO breath test, but in kids I find treating dysbiosis more generally based on stool panels alone is typically adequate (and saves you money and time, too!)

 

Constipation Relief Supplements

In addition to diet, specific supplements can make a huge difference in kids’ constipation.

Herbs: I prefer gentle carminative herbs (gas-relieving) over laxatives, because laxatives can be habit-forming (even herbal ones!) That being said, I prefer herbal laxatives over Miralax any day!

Why I Don’t Recommend Miralax

Miralax is often a first line of defense against constipation in kids, but for several reasons, I don’t like it, including that it contains red dye, hasn’t been approved for use in kids or long-term use by the FDA, and is associated with ADHD and other mood/behavior disorders. It can often be habit-forming, and leave kids dependent on it to poop. There are lots of herbal alternatives that work just as well, without these concerns. 

Pre- and Probiotics: Probiotics are the good bacteria that live in the gut, and prebiotics are the food probiotics need to thrive. I recommend MegaSporeBiotic (which i use at ¼-½ the adult dosage of 2 caps per day, depending on the child’s weight) and MegaPre prebiotic (2 caps per day, which is ⅓ adult dosage). If you want to try a prebiotic option, I recommend Begin Health Growing up Prebiotics that use human milk oligosaccharides, which are identical to the most abundant prebiotic naturally found in breastmilk [plus get 20% off first purchase with my code: BRIE20].

Magnesium: This mineral can help bring water to the bowels. I use Mag-Go kids.

 

Try These Tricks to Help Ease Constipation

In addition to diet and supplements, there are a few other tricks to try:

Drink this: For quick relief, I like ¼-⅓ cup aloe vera juice and 1 teaspoon to 1 tablespoon of liquid chlorophyll, 3x daily.

Massage: I use Chinese medicine tuina techniques with oil, followed by raising the knees up to the right and then around clockwise in a circle. Repeat this several times a week for about 10 minutes.  Below is another massage location for constipation in children, on the hand. Start at the base of the thumb and work in a clockwise direction, pressing and releasing along the circle. 

Get into position: Giving kids a place to rest or elevate their feet while pooping puts them into an ideal posture for pooping. This makes a big difference. I like the Squatty Potty for Toddlers or Super Pooper Plus.

Make time to go every day: Kids are busy moving from activity to activity - and sometimes when the urge to go comes on, they’d rather ignore it than stop what they are doing. That’s why I recommend creating a habit of trying to poop at roughly the same time every day. (If you notice they have a time they most often poop, like after lunch, that’s a good time to try!) Just keep it light hearted: go sit on the toilet, read a book or sing a song, and don’t make a big deal out of it. If they don’t poop, NBD. It’s about building a habit. 

 

Putting The Plan Into Action

Let’s go back to my daughter’s story, and I’ll explain how and what I did to get her pooping regularly again.

Although she was already eating a diverse diet of lots of plant foods, I doubled down on getting her plenty of fiber, made sure she was well-hydrated, and added a magnesium supplement. Despite these changes, we still had an issue.

My next step was adding some simple herbs that are safe for kids, like Easy Going and Bioray Pooper

When that still wasn’t enough, I ordered a stool test for her. The test showed overall general dysbiosis and low secretory IgA, a sign of immune function. I created a custom protocol of herbs and probiotics to address the dysbiosis and clear the bacteria. We also added chiropractic and acupuncture - (both of which she loved! She asks me to give her acupuncture now, regularly!)

acupuncture

After a few weeks of treatment, we re-tested: the dysbiosis was improved, but her secretory IgA was still low, and now the stool panels had revealed candida and H pylori. (Note: it’s not completely uncommon to treat a finding, retest, and uncover another layer of pathogenic organisms. This often relates to disruption of biofilms). We started a new treatment and added massage and cat/cow stretching - and that did the trick! Now she’s back to regular pooping, her tummy isn’t hard or distended, and she doesn’t have pain when she goes.

As a mom and a health practitioner, there’s nothing like seeing a successful treatment! But as you may have noticed - it wasn’t a simple one-step process, or just a matter of adding in one supplement. The human body is complex, and often the treatments that are most effective are a little more complex, too. 

But don’t worry - you don't have to figure this out yourself! If you’ve already tried the suggestions in this blog post, and your little one is still struggling, book a free 15-minute consult with my team here

Brie

PS - Here’s one of my favorite recipes for muffins - kids love it, and it packs a great dose of fiber and veggies. 


muffin

Fiber and Veggie Muffins

Here’s one of my favorite recipes for muffins - kids love it, and it packs a great dose of fiber and veggies.

Ingredients

  • 1 and 1/2 cups Paleo Flour or Gluten Free Baking Flour (which happens to be high fiber!)-- Bob's Mills.
  • 1/2 cup flax seed
  • 1 generous tbsp baking soda
  • 3/4 tsp salt
  • 1 generous tsp pumpkin pie spice can use combination of cinnamon and nutmeg
  • 3 tsp of chia seeds soaked in 3 tsp of water for 10-15 minutes
  • 1 cup milk (we use Milkadamia or almond milk in our house)
  • 1 and 1/2 tsp of vanilla
  • 1/3 cup of olive oil
  • 1 tsp apple cider vinegar [optional 1/2 cup maple syrup or honey]
  • 1/2 cup of ripe banana
  • 1/2 cup of unsweetened organic canned pumpkin.
  • 1/2 cup of mashed cooked (or organic canned) sweet potato

Instructions

  1. Preheat oven to 420 degrees.
  2. Mix all of your dry ingredients together.
  3. Mix all of the wet ingredients together well.
  4. Combine the wet and dry ingredients by folding them together. Do not over mix.
  5. Pour into a muffin tin with liners.
  6. Bake at 420 degrees for 20 minutes. Then turn down to 400 degrees for 20 minutes. Additional cooking time depends on your oven and ranges from 10-35 minutes. Check occasionally with a toothpick. It should come out clean.

Important! Cool for 30 minutes before removing from tin. The longer they rest, the more solid the muffins will become.


Thyroid

How Diet and Nutrition Can Help Thyroid Issues

Fatigue that no amount of caffeine can shake, uncomfortable constipation, and wait… is that a bald spot???

These are just some of the key symptoms of Hashimoto’s Disease, the most common cause of underactive thyroid (hypothyroid) in the United States.

But sadly, despite being so common, Hashimoto’s is poorly understood by many doctors and likely under-diagnosed. And that’s a huge bummer, because there is SO much we can do to manage and control Hashimoto’s - you don’t just have to accept it!

So today, let’s dig into what Hashimoto’s is, how it affects the body, and most importantly, what we can do to treat it holistically, including how diet and nutrition can help thyroid issues. 

 

What is Hashimoto’s Disease?

Hashimoto’s is an autoimmune disease where the immune system attacks the thyroid gland, causing tissue damage and preventing it from producing adequate thyroid hormones. Low thyroid hormones cause the symptoms of Hashimoto’s including:

  • Fatigue 
  • Depression 
  • Constipation
  • Hair loss
  • Pale and dry skin
  • Loss of fertility
  • Intolerance to cold
  • Heavy or irregular periods

While Hashimoto’s can occur in both men and women, it (and all autoimmune disease) is more common in women. 

 

How Do I Get Tested for Hashimoto’s?

Hashimoto’s is diagnosed via blood test for thyroid stimulating hormone (TSH) and thyroid peroxidase (TPO) antibodies. High TSH levels and the presence of antibodies are both indicative of Hashimoto’s. However, even if TSH levels are normal (or even low!)high TPO levels are still indicative of Hashimoto’s. High TSH levels occur when available active thyroid hormone (T3/T4) levels are low, or receptivity to these hormones is low, tricking the body to think they aren't around. All this is to say that it’s important to test both TSH and TPO for an accurate diagnosis. 

There are three stages of Hashimoto’s:

Silent Autoimmune - This occurs when antibodies are elevated, but there are no symptoms of hypothyroid or tissue destruction. If not addressed, this will progress to the next stage. 

Autoimmune Reactivity - Elevated TPO antibodies, with symptoms of hypothyroidism (fatigue, thinning hair, etc.), but no clinically noticeable loss of thyroid tissue.

Autoimmune Disease - Occurs when antibodies are elevated, hypothyroidism symptoms are present, and there is measurable tissue destruction. 

Ideally, we would catch Hashimoto’s at the silent autoimmune phase, but the reality is that most people are not tested until symptoms are present, and are therefore in the reactivity or disease stage when they begin treatment. This is one reason why I advocate for routine thyroid screening, ideally annually. At the very least thyroid levels should be screened at the time of the first period (menses), postpartum, and during menopause, because these are the three periods of life when women are most likely to express and autoimmune condition. 

Hashimoto’s and thyroid disease are not always synonymous. If TSH levels are high, but no antibodies are detected, it could be hypothyroidism from another cause. 

 

Can Hashimoto’s Disease Be Cured?

Getting a Hashimoto’s diagnosis is scary, and it’s only normal to wonder “Can I fix this?”

The answer isn’t black and white. Technically, Hashimoto's is considered incurable (as are most autoimmune diseases). However, that does not mean you’re doomed. In functional medicine, the goal is to get autoimmune disease into remission. 

I promise, you absolutely can be healthy and have an autoimmune disease in remission! My job is to help you do just that. 

So how do we do that? As a functional medicine practitioner, I treat disease by addressing the root cause. That means understanding why you got sick is incredibly important. The “why” will inform how to best treat your disease. Before we get into treatment, let’s talk about why disease occurs. 

 

What Causes Hashimoto’s?

Like all autoimmune diseases, hashimoto’s doesn’t have one cause. Instead, it develops due to a complex interplay of predisposing factors and a triggering event. Predisposing factors “set the stage” so that when a trigger occurs, disease develops. If you’re not sure what risk factors or triggers could be present for you, we can work together to test and establish your root cause. 

Here are some established risk factors for Hashimoto’s:

  • Genetic (having a family member who also has Hashimoto’s)
  • Other autoimmune disorders (vitiligo, Grave’s disease, type 1 diabetes, lupus, Rheumatoid arthritis, etc.)
  • Polycystic ovarian syndrome (PCOS)
  • History of Traumatic Brain Injury
  • Maternal autoimmune disease, especially if inflammation was present during gestation
  • Chronic infections (bacterial, viral)
  • Multiple adverse reactions to foods, chemicals, etc. (loss of tolerance)

Let’s go over some of the more common triggers I see with my own patients:

1. Toxin Exposure

For some people toxin exposure is not a serious issue, but for others, toxin exposure can trigger autoimmunity. (The difference is likely due to differences in detox capabilities, including the ability to biotransform heavy metals). In those who do struggle with toxin exposure, common chemicals like BPA have been shown to trigger autoimmunity. The issue can be with both total toxin exposure, as well as chemical immune reactivity. In chemical immune reactivity, even very small exposures can create an immune reaction. 

It’s very important that people with autoimmune disease aggressively detox toxins, but it's essential to do it in the right order! If detox is begun before the autoimmunity is under control, the detox can actually flare autoimmune symptoms and make them worse.

 

2. Viruses 

Viruses are known to trigger autoimmune disease. Hepatitis C, human Parvo b12, Coxsackie, and herpes viruses, in particular Epstein Barr Virus (EBV - the virus that causes mononucleosis), are all known to trigger Hashimoto’s.

 

3. Bacteria

Bacteria and the biofilms they create can both trigger autoimmune disease. Bacteria can closely resemble human tissues well as decorate the extracellular matrix (ECM) of their biofilms with molecules that resemble human tissues. These molecules are recognized by the immune system, causing activation of autoimmune pathways.

These bacteria have all been implicated in the development of Hashimoto's: H. Pylori (which can actually be protective in IBD, but, can be a trigger for other autoimmune conditions like psoriasis, vitiligo, and RA), Borrelia Burgdorferi (Lyme), Yersinia Enterocolitica, Staph, and Strep. 

 

4. Gluten

Gluten induces leaky gut, even if a person doesn’t have Celiac disease. It is immunogenic, cytotoxic, and proinflammatory. In those with autoimmune disease, gluten can flare symptoms and prevent remission. It can have a negative effect on the microbiome and boost oxidative stress. 

However, gluten isn’t the only problem food! In many people, other common trigger foods include grains, eggs, dairy, soy, chocolate, coffee, and legumes. 

 

5. Mold

Mold is a silent epidemic that can trigger and exacerbate autoimmune conditions. Both the individual and the home need to be tested and treated for mold. In individuals, mold can be tested using urinary mycotoxins, CIRS markers, and VCS testing. An IEP (indoor environment professional) should assess the home for mold with an ERMI test. In general, humidity over 50% in any room is a problem. Test this with a hydrometer.

 

How to Treat Hashimoto’s Naturally

Now that we’ve covered some of the more common causes I see in Hashimoto’s, we can get into the good stuff: what you can do to put the disease in remission!

 

1. Test to Find the Root Cause

There’s a lot to cover here, but the first thing I do with any new patient is testing to help determine what their root cause is. Some key things I’m looking for are gut pathogens, bacteria, fungii, viruses, and chemical compounds that can trigger the immune system. 

With that information in hand, I move down the line of treatments, starting at the mouth!

 

2. Optimize the Microbiome & Gut Health

The microbiome begins in the mouth, so that’s where I start treatment as well. We need to optimize the oral flora and change out any products that could be damaging the mouth’s microbiome for healthier picks. Next up, I’ll start a protocol to heal leaky gut. Healing leaky gut is essential, but it’s not the only step, so don’t stop here!

We’ll also optimize digestive secretions and microbiome resilience in this step to help prevent any future gut infections. A lack of adequate stomach acid prevents proteins from being fully broken down. Those larger, more intact proteins then enter the bloodstream and are more likely to trigger immune activity. For anyone with autoimmune issues, or who is having immune reactions to specific foods, supplemental HCL to boost stomach acid levels is a must.

 

3. Balance Your Blood Sugar

No matter what dietary changes you do or don’t make (more on that below), the most important is eating in a way that supports balanced blood sugar. When blood sugar is high, the pancreas produces a surge of insulin. That insulin surge has an inflammatory effect on the body, causing autoimmune conditions to flare. This connection is so strong, I have seen clients put their autoimmune condition into remission just by balancing their blood sugar. It’s really that important. If diet changes alone aren’t enough, we can use key supplements to help bring blood sugar back into balance.

 

4. Optimize HPA-Axis Hormones

The hypothalamic-adrenal-pituitary (HPA) axis hormones include cortisol, the “stress” hormone. Optimizing this system often requires active stress management - more on that below.

 

5. Measure & Adjust Key Nutrient Levels

Key nutrients for Hashimoto’s health include omega fatty acids, selenium, zinc, and vitamins A,C, and D. Before supplementing, I always test. 

 

6. Detox Safely

If testing has revealed the presence of compounds like heavy metals, it’s very important that detox is done safely. Aggressive detox strategies can backfire for people with autoimmune disease, as the detox process can flare the autoimmune condition if the person has an immune reaction to the chemicals being detoxed. I recommend testing for what chemicals a person has reactivity to, then working to calm the reactivity, and finally detoxing with herbs and supplements like glutathione, as well as exercise and sweating.

 

7. Helminth Therapy

OK, this does sound crazy at first, but the research backs it up. Helminths are a specific type of worm, and the larval form (not the whole worm) is a common infection in much of the world. In countries with the highest infection rate of helminths, autoimmune disease rates are lowest. Helminths release tuftsin-phosphorylcholine (TPC), which turns on T- and B-regulatory cells. A prescription version of TPC has been shown to cure autoimmune conditions in animals, and clinical trials are underway. In the meantime, helminth therapy can be life-changing. I’ve been studying helminth therapy for years - read my blog post about it here.

 

How Diet and Nutrition Can Help Thyroid Issues

There’s no one perfect diet for Hashimoto’s (sorry!). Instead, I start with the Autoimmune Paleo (AIP) diet and customize based on the individual. No one should blindly follow a highly restrictive diet like AIP long term. Diversity is the key to a strong and healthy microbiome, so don’t eat the same thing day in and day out.

That being said, restricting certain foods can be helpful. At a minimum, I recommend avoiding gluten and dairy. For many people with Hashimoto’s, removing nightshades can also be beneficial. And if testing shows the presence of antinuclear antibodies (ANA) or rheumatoid factor (RF), I suggest cutting lectins as well. Also consider reducing sodium intake (or supplementing with potassium at salty meals) since high sodium activates the pro-inflammatory immune pathway TH-17, which pours gas on the Hashimoto’s fire. 

In some cases, intermittent fasting, a lower calorie or starch diet, and exercise (but not all 3 at once!) can be used to increase autophagy (clearance of proteins). Poor autophagy can increase immune reactivity. But please note, this is not me telling you to starve yourself. These are advanced techniques that should only be used in certain people under the care of a highly trained practitioner. 

 

Lifestyle Changes for Hashimoto’s Remission

While they aren’t “sexy,” lifestyle changes to better manage stress, get adequate sleep, and exercise are probably the most important part of any plan to treat Hashimoto’s. 

 

1. Why Sleep Matters

We know that sleep disorders (in those without sleep apnea) increase the risk of developing autoimmune conditions. The body primes and develops immune cells while we are sleeping, and a lack of sleep also induces an inflammatory response. Lack of sleep also leads to dysfunctional natural killer (NK) cells, a key part of the immune system, especially important for fighting viruses. 

If you take away one thing from this blog post, let it be this: unless you’re getting proper sleep, you have very little chance of autoimmune recovery. It’s that important! In fact, I consider sleep and blood sugar (see above) to be the two “cornerstones” of healing autoimmunity. The easiest way to get started on a better sleep pattern is to develop a routine pattern of sleep, rising and going to bed at roughly the same time every day - and bonus points if your bedtime can be before 10 PM. 

 

2. Managing Stress

Stress activates interleukin-17, creating a cascade that affects the immune system. But, it’s important to differentiate between good stress, which does not affect IL-17, and negative stress, which does. Positive stressors include things like exercise you enjoy, while negative stress might be an unsupportive partner or an unfulfilling job. I suggest active practices to reduce stress like GUPTA, Inaura, EMDR, therapy with a trained professional (especially Somatic therapy), Synctuition, Hypnotherapy, Ziva meditation, and MBSR training. 

 

3. Exercise

Sedentary behaviors can heighten inflammatory responses in the body. Any increase in movement is a good thing and better than none - so simple changes liking parking further away or taking the stairs instead of the elevator really can help. That being said, more intense workouts do have more anti-inflammatory actions, and are a great tool for those who are able to do them. However, going too hard is a real risk. A good rule of thumb is that you should be able to recover from the workout within one day. If you’re laid out on the couch for days after a workout, it was too hard. 

 

Will I Need Medication, Too?

I believe in mixing the best of both Western and alternative medicine… which means sometimes, yes, medication is a tool we need to use. Using medication isn't “failing” and it doesn’t mean taking other steps to heal your Hashimoto's - like the ones I’ve described in this article - aren’t worth the effort. 

No matter where you’re starting or what your goals are, we can work together to find an effective, sustainable path toward remission.

 

Need Help With Hashimoto’s?

Helping women overcome health challenges like Hashimoto’s is my (gluten free) bread and butter. There’s nothing I love more than meeting a new client, hearing their story, and helping them create a customized plan to achieve their health goals.

If you have Hashimoto’s and you want support finding the root cause, creating a customized treatment plan, and recovering your health, I would be honored to support you. The first step is to book a free, no-obligation consultation with my team. 

Let’s tackle your health goals together!

>>> Book a free consult today


How To Detox Your Body The Right Way

So you’ve decided to go on a detox cleanse.

Maybe you’re starting a seven-day cleanse.

Or you’re going on a juice fast.

NEWSFLASH! Neither of these methods are true detoxification, the kind that can remove harmful toxins from your body. 

Don’t get me wrong. Both seven-day cleanses and juice fasts can have real benefits. Seven-day cleanses are great for people who are generally healthy and who want to reset their bodies. Juice fasts give your gut a break, and you’re boosting your antioxidant intake.   

But if you’ve been exposed to toxins and really need to detox your body, those strategies aren’t going to work. 

In this blog post, I’ll go into what detoxification is and what it isn’t. But before we go there, let’s review the red flags that suggest you need to detoxify in the first place.

 

Common Symptoms of Broken Detox

The only way to know for sure if you need to be on a detoxification program is to work with your functional medicine provider to order the right tests (more on this later).

But there are some symptoms of toxin exposure that can clue you in that you need detox. For example:

  • Autoimmune problems
  • All over joint and connective tissue pain
  • Brain fog
  • Flare ups of latent viral infections (loss of immune tolerance). For example, your herpes infection comes out of hiding after 10 years and causes you to suddenly get cold sores. 
  • General malaise
  • Random headaches
  • Rapid skin aging
  • Resistant weight loss
  • Skin breakouts like eczema, acne, rashes
  • You just don’t feel as well
  • You react to everything around you: food, chemicals, environmental exposures like pollen, the fact that it’s Wednesday. ☺

But you don’t have to be a complete mess to have a detox problem. In many cases, the full ramifications of having toxins build up in your body doesn’t show up until years later. 

A lot of people are overburdened with toxins and don’t know it because symptoms haven’t showed up yet. 

 

Sources of Toxin Exposure

Toxins are all around us in the food, air, and water supply. Here are some of the more common ones we’re exposed to daily:

 

Toxins show up in places you’d never think about—like the disposable plastic lid on that almond milk latte you just grabbed to go. Some common places that you’ll encounter toxins include:

  • Seafood (mercury)
  • Non-organic fruits and vegetables (glyphosate, pesticides)
  • Water-damaged buildings (mycotoxins). Half of all buildings in the United States are water damaged, so mycotoxins are a common problem.
  • Items not labeled BPA-free: Linings of cans, cash register receipts, toothbrushes, cloudy plastic containers. However, even items labeled BPA-free can contain BPS. This is another type of chemical that is just as toxic or more so than BPA.
  • Personal care products like shampoo, conditioner, moisturizers (phthalates)
  • Pesticides and herbicides sprayed on your yard or around your office (glyphosate and others)

You can’t get away from these environmental toxins, so your best bet is to get tested to make certain your detoxification is working like it’s supposed to do. With those results, a detox program can be tailored to your needs. How do you do that? By working with functional medicine providers like me to order the right tests and design customized protocols.

 

How To Test for Toxins in Your Body

Before starting a detox cleanse, it’s critical to get tested to see if you have a detox problem and how severe it is. 

Patients who have had an obvious exposure should definitely get tested. For example, if a person grew up in an agricultural area, or near a coal plant, or worked in a hair salon, it’s a safe assumption that a detox treatment is needed. 

Sometimes, however, it’s not so obvious. Exposure can come from working in the garden, eating food that’s not organic, drinking tap water for years, living or working in a building with water damage, and the list goes on and on. 

We often see patients who are loaded with really nasty toxins. 

Testing not only helps us understand how well your detoxification is working—it also helps us establish a baseline, so we can get a snapshot of whether detox treatments are working by retesting again after treatment.

The tests I use to tell how well your detox pathways are working are reviewed in the next section. But popular detox cleanses and juice fasts miss all of this. They don’t address how well your body’s detoxification- your unique biochemistry- is actually working.

 

Common Detox Tests

Your body cleanses itself of toxins using glutathione, sulfation, methylation, and a few other pathways. So, I always run tests to tell me how well these detoxification pathways are working in your body. 

We want to know whether you have a glutathione deficiency as indicated by urine pyroglutamate and sulfate tests. Low sulfate levels show the body is using up glutathione faster than it can make it due to the high burden of toxins. 

When you run out of glutathione, it leads to a high level of oxidative stress, which is an imbalance between damaging free radicals and beneficial antioxidants. The body needs some oxidative stress, but when there’s too much of it, cells become damaged. Tissues can be harmed. Disease processes can be triggered and aging speeds up.

My favorite antioxidant test? Urine 8-hydroxy-2-deoxyguanosine, or 8-OHdG for short, is a marker of DNA damage due to free radicals. If that marker is 3.5 or higher it means your detoxification is shot. Your rate of all-cause mortality just went up significantly, you have a greater chance of getting cancer, and you’re aging faster. But there’s good news. We can balance your DNA damage by boosting levels of glutathione and antioxidants.    

Detox tests often measure levels of the following markers: 

  • Pyroglutamate – High levels mean that your body is detoxing vigorously and needs glutathione support. 
  • Sulfate – Low levels indicate your body is running out of what it needs for detoxification, especially sulfation and glutathione.
  • 8-OHdG – High levels indicate your detoxification is weak and antioxidants are out of balance.
  • P-hydroxyphenyllactate – High levels of this marker show that your antioxidant levels are getting too low. You may need vitamin C.
  • Hydroxymethylglutarate – High levels show you’re not getting enough of the antioxidant and energy producer, coenzyme Q10.
  • Methylmalonate – High levels show you’re having trouble with your methylation detoxification pathway. You need vitamin B12. 

 

What a Detox Program Is Not

First, going on a juice fast is not detoxing because it’s low in protein. All the detox pathways need amino acids. And where do we get amino acids from? You guessed it: protein. 

The best way to ruin your body’s natural detox abilities is to go on a protein-deficient diet. That’s why we see a lot of vegans or vegetarians who can’t carry out detoxification. Many of these patients haven’t developed a comprehensive nutrition plan to make sure they get enough protein, because creating this type of plan is labor intensive. And carrying through with it is even more difficult!

Going on a vegan or vegetarian diet often comes from a place of compassion and doing what seems best for your health. But there are some risks.  

It is very hard to get all of the nutrients you need on a meat-free diet. Vegans and vegetarians who aren’t getting the nutrition they really need and who have protein malnutrition can be highly toxic. Sure, they eat a lot of antioxidant-rich plant foods. But due to the lack of protein and impaired detox, they can ironically have a lot of oxidative stress. Remember, oxidative stress results when detox mechanisms aren’t working and it damages tissues and cells and speeds up aging.

We find that vegans and vegetarians can also have problems with an important process known as methylation. Healthy methylation is involved in so many processes in our bodies, including detox. Vitamin B12 is a critical nutrient for methylation, but vegans and vegetarians are often deficient in this vitamin.  

Having said all that, a plant-forward diet is something everyone should be on for good health regardless of what other diet criteria you choose. 

 

A Real Detox Cleanse Takes Time

A real detox program is stretched out over time. It’s not the same as a seven-day detox cleanse. If your glutathione levels are depleted and you notice your aging is accelerated it’s going to take three to six months, or more in some cases, to get your detox tests in the normal ranges. It might take a year to get your glutathione levels up to where they need to be. 

 

How To Detox Your Body

The first step is to work with a functional medicine provider to help you personalize an effective protocol. When a patient needs to undergo a detox program, I always start with what’s going on in the gut. Often, the gut is the main source of toxins and oxidative stress. That’s why in most cases, I clean up the gut first.

In regards to dietary supplements, it’s really important that you address both Phase I and Phase II liver detoxification pathways. 

In Phase I, the liver breaks down toxins and makes them less harmful and water-soluble. This process creates a large amount of free radicals, which leads to excessive oxidative stress. 

In Phase II detoxification, another molecule is linked to the toxin to make the toxin less harmful. This is known as conjugation.     

Herbal combos that include dandelion, milk thistle, and artichoke leaf really just emphasize Phase I liver detox. If you’re taking supplements that address only Phase I and not Phase II,  you can go into what’s called pathological detox. This means your efforts to detoxify are actually backfiring. You’re not effectively getting rid of toxins. You’re making yourself more toxic.

When a patient feels bad during detox it’s often because the patient is doing pathological detoxifying by only supporting the Phase I pathway.  Or, in some cases, the patient doesn’t have enough bile flow to move the toxins out.  

Here are the detox supplements I often use in my patients to make sure I’m supporting both a patient’s Phase I and Phase II detoxification:

Coffee enemas can also promote bile flow.

 

Don’t Go It Alone

Your body’s detox can break in so many ways. That’s why a detox cleanse is going to be more effective if I customize a detox protocol designed especially for your needs. I do this based on testing to find out how well your body is—or isn’t—getting rid of toxins.  Book a free 15-minute troubleshooting call with me to find out the best course of action. 

If after the call you come on board as a patient, I’ll order the right tests for you. I’ll also support your gut health and your body’s unique biochemistry to address the root causes of your detox problems. If the tests warrant, I’ll put you on a cleansing detox program that supports both Phase I and Phase II in order to eliminate uncomfortable detox symptoms. The goal? Make your body as clean and pure as possible so you’ll feel your best once again.


Diarrhea

What Causes Diarrhea in Adults and How to Stop It

Diarrhea can take control of your life. I’m not talking about the average tummy bug kind of diarrhea. I’m talking about the type of diarrhea that lasts for days, weeks, months, or even years…chronic diarrhea. 

Diarrhea can disrupt the rhythm of your daily life, and take a real toll on your body. But, the good news is that you do not have to live with chronic diarrhea! Diarrhea is a treatable medical condition. Together, we can uncover what’s causing your diarrhea, help to treat your symptoms, and get you back on the road to good health. 

 

Diarrhea Symptoms

Passing loose, watery stools three or more times per day is the primary symptom of diarrhea. Other symptoms can accompany diarrhea including:

  • Belly bloating
  • Cramping
  • An urgent need to use the bathroom
  • Nausea
  • Abdominal pain 

Some people can experience more severe symptoms including:

  • Blood or mucus in your stools
  • Fever or chills
  • Vomiting
  • Light-headedness or dizziness 

 

What Causes Diarrhea?

There are a variety of factors that can cause diarrhea. Temporary diarrhea, lasting one to two days, can result from a viral infection, the food you ate or traveling. 

On the other hand, chronic diarrhea can indicate a more serious problem. The most common causes of chronic diarrhea include inflammatory bowel disease (Crohn’s disease and ulcerative colitis), chronic infections, and malabsorption syndromes (cystic fibrosis, Celiac disease, lactose intolerance, etc.)  in which food is not digested and absorbed. 

Chronic diarrhea is a common complaint amongst our patients. Below are seven of the most common causes of chronic diarrhea that we treat including gallbladder removal, IBD, gut dysbiosis or pathogen imbalance, histamine intolerance, gluten intolerance or Celiac, dairy intolerance, and SIBO. 

 

1. Gallstone or surgical removal of the gallbladder

Frequent loose, watery stools after having gallstones or having your gallbladder removed (cholecystectomy) is common. The gallbladder collects bile to release when you eat aiding in the digestion of fats. Removing the gallbladder takes away the main storage site for your bile acid. Instead, the bile acid is stored in the gut causing it to be less concentrated and drain into the intestines. Once in the intestines, it can have a laxative effect making stools looser. 

GI transit times can also be altered after gallbladder surgery causing transit times to decrease in the small intestine and accelerate in the colon. This impairs the body’s ability to absorb water from your stool leading to looser, watery stools. 

2. IBD

Inflammatory bowel diseases (IBD), including Crohn’s, Ulcerative Colitis, and other types of colitis (microscopic or lymphocytic colitis), are diseases of chronic inflammation. IBD causes tissue destruction and inflammation of the bowel walls limiting the body’s ability to absorb fluids. This results in loose, watery, or even completely liquid stools. 

Patients with IBD may experience frequent and urgent bowel movements because fluid moves more rapidly through the intestine. You may also see blood in or on the stool and experience extreme weight loss, anemia, fever, and loss of appetite.

3. Gut Dysbiosis or Pathogen Imbalance 

Gut dysbiosis is a generic term for an imbalance in gut flora. Our digestive tract contains a delicate balance of different kinds of bacteria. When one species becomes overgrown or gets wiped out, the balance is thrown off leading to diarrhea along with many other symptoms. 

There are several pathogens known to cause gut dysbiosis including bacterial, yeast, parasites, and viral pathogens.

  • Acute Bacterial Pathogens: The most common bacterial organisms to cause diarrhea include: e coli, shigella, Campylobacter Jejuni, Citrobacter, yersinia enterocolitica, salmonella, and Staphylococcus aureus. Chronic bacterial toxins like those secreted by C Difficile can also lead to diarrhea. Older adults in healthcare facilities, like hospitals or nursing homes, or who have recently been on antibiotics, are more at risk for contracting C Difficile.
  • Yeast and Fungal Overgrowth: Rapid growth of Candida (a yeast) and cryptococcus (a yeast-like fungus) in the GI tract can lead to diarrhea, especially after antibiotic use.
  • Parasites: Intestinal parasites including giardia, entamoeba histolytica, Cryptosporidium Parvum, and Protozoan parasites like blastocystis hominis, Cyclospora, Dientamoeba Fragilis, Entamoeba coli, and endolimax nana can cause diarrhea. Parasitic infections are often, but not always, marked by stomach cramps, bloating, nausea, and watery diarrhea. 

4. Histamine Intolerance

Histamine is a chemical that notifies the brain when to release stomach acid for digestion. And, it is part of our response to injury or an allergic reaction. Histamine intolerance occurs when the body is unable to break down enough of it in the intestines, causing histamine levels in the blood to rise. 

Histamine intolerance can result from a multitude of factors including a combination of genetics, and a leaky gut. This leads to decreased secretion of DAO enzyme (used to break down histamine), liver detox overburden, and dysbiosis. 

5. Gluten Intolerance or Celiac 

Gluten, a protein found in wheat, can cause inflammation in the gut and can change the structure of the gut wall. For people with gluten intolerance or Celiac disease, gluten can cause chronic diarrhea along with other GI symptoms. 

6. Dairy

Dairy products contain three components that can cause diarrhea: lactose, whey, and casein. 

Lactose intolerance is an inability to digest lactase, a sugar found in milk products. Lactose intolerance occurs when the small intestine does not make enough of the digestive enzyme lactase. This condition is common in adults with a genetic predisposition or after an injury, disease, or infection of the small intestine. Lactose intolerance causes diarrhea by increasing the volume of water in the colon, which in turn increases the volume and liquid content of the stool.

Casein and whey, the two proteins in milk products, can cause an allergic reaction when the body thinks the protein is harmful. Most people with an allergy to casein or whey have symptoms that appear as infants and outgrow them with age. However, patients with gut wall damage can experience dairy protein intolerance with diarrhea and other GI symptoms. 

7. SIBO

SIBO is an overgrowth of bacteria in the small intestine. Normally, the small intestine contains fewer bacteria than the large intestine and is focused on food absorption. For many who have SIBO, diarrhea is a common symptom.  

How is Chronic Diarrhea Diagnosed

The key to diagnosing chronic diarrhea is to uncover the underlying root causes so that we can address them and prevent future relapses. Common tests for patients with chronic diarrhea may include:

  • Comprehensive Stool Microbiome Testing – A stool sample can be used to evaluate the root cause of digestive tract issues. Functional medicine stool tests provide information about absorption, digestion, yeast overgrowth, bacterial imbalance, parasite infection, inflammation, metabolic activity, and immune function.
  • SIBO Breath Testing with both lactulose and fructose for best accuracy 
  • Blood Test – Specific blood tests can help identify celiac disease antibodies and yeast antibodies. 
  • Imaging – Imaging can include endoscopy, colonoscopy, or sigmoidoscopy and is generally used to diagnose or rule out Inflammatory Bowel Disease or structural issues as a driver for symptoms.  

 

Natural Remedies and Treatments for Diarrhea

The challenging part of treating diarrhea is that there is not a one size fits all treatment plan. Many mild cases of diarrhea will resolve on their own. But, for more severe, chronic cases of diarrhea there are a variety of natural remedies and treatments available.

Diet

Specific Carbohydrate Diet (SCD):

The SCD diet is incredibly effective at stopping urgent, frequent bowel movements. This is for you if you run to the bathroom 10 to 20 times per day. The SCD diet focuses on removing carbohydrates that are not fully digested and remain in the gut leading to an overgrowth of harmful bacteria.  It is particularly helpful for my patients who have Crohn’s disease, celiac, ulcerative colitis, and chronic diarrhea.

Download a free guide to properly starting the SCD diet from the team at Healthy Gut.

Starch and Meat Diet:

A starch and meat diet is an alternative to the SCD diet that works for some people. This whole-food diet is focused on eating foods like white rice, white potatoes, meat, fish, and poultry. Like the SCD diet, this diet limits all processed and canned foods. 

Diet Considerations During Flare-Ups:

Curing the cause of chronic diarrhea can take time. And, flare-ups happen. During diarrhea flare-ups keep these diet considerations in mind.

  • Be cautious with fruit, except for bananas
  • Raw vegetables can be hard to digest and cause GI upset
  • High amounts of fats and oils can be difficult for a sensitive digestive system. Limit high-fat foods like egg yolks, cream, oils, and bacon.

Many other diets (low FODMAP, Low Histamine, Low Salicylate, Low Oxalate, or Autoimmune Paleo) can be useful for the treatment of diarrhea depending on the underlying causes.

 

Stress Reduction

Have you ever had to run to the bathroom before a presentation or a big event? That’s your gut responding to stress! Increased levels of stress can cause changes to your gut motility, which means that your body can slow down or speed up food processing based on your levels of stress. 

Active stress relief activities are a critical component of naturally treating diarrhea. Try watching a funny movie, taking an Epsom salt bath, meditating, or practicing moderate exercise daily.  

 

Sleep

Many of your body’s metabolic processes occur during the night, including digestion. And, sleep provides your body the much-needed energy for digestion to happen.

A few nights of poor sleep might not have a major impact on your GI health. But, chronic insomnia or poor sleep can impact your GI and contribute to your chronic diarrhea.

 

Supplements

Depending on the cause of your diarrhea, a variety of supplements may be beneficial to you. I often incorporate the following supplements into my patient’s treatment plans. 

Digestive Enzymes:

After eating, enzymes break down the food so that we can absorb the carbohydrates, fats, and proteins. Without enzymes, larger food pieces remain in our gut and begin to ferment, feeding the bacteria. This can either slow down digestion or speed it way up. 

There has been significant research indicating the successful use of digestive enzymes to support patients with chronic diarrhea. The key to digestive enzymes is taking enough with the right balance of acidity for them to work. It may take some time, but my patients who use digestive enzymes report amazing results!

I recommend Holozyme by Healthy Gut.

High Dose Probiotics:

High-dose probiotics have been shown to balance the gut microbiome and improve intestinal permeability promoting intestinal barrier functions and alleviating many inflammatory responses.

Depending on the cause of your diarrhea, I recommend a variety of probiotics usually containing 250 (or more) organisms daily to help control diarrhea. Below are a few of my go-to probiotics:

  • S. Boulardii, a probiotic yeast strain, is my number 1 go-to for helping alleviate diarrhea, especially if it was a result of antibiotic use. But, in my clinical experience, patients with IBD should proceed with caution with introducing S. boulardii because Anti-Saccharomyces cerevisiae antibodies (ASCA) have been associated with Crohn’s disease. Saccharomyces Cerevisiae (Brewer’s/Bakers yeast) is similar enough to S Boulardii that the immune systems of sensitive individuals can cross-react, potentially triggering a symptom flare.
  • Bacillus Claussi, a spore-forming probiotic, is an effective probiotic for treating diarrhea, preventing antibiotic associated diarrhea, and may be viable as the only treatment in some cases of SIBO where tolerated.
  • Bacillus Subtilis is a multifunctional probiotic ideal for preventing the growth of bacteria and enhancing nutrient digestion. HU58, a strain of bacillus subtilis, is used for the management of antibiotic-associated diarrhea in adults.
  • Lactobacillus Rhamnosus GG (LGG) is one of the most widely used probiotic strains and it is ideal for patients with histamine driving their diarrhea. In addition, there are many well-documented studies showing that LGG is indicated for the prevention and treatment of gastro-intestinal infections and diarrhea.
  • UltraFlora Intensive contains Lactobacillus plantarum 299v, a probiotic strain of lactic acid bacteria that is naturally occurring in the human gut. This probiotic is excellent at decreasing anti-inflammatory symptoms making it ideal for reducing diarrhea in patients with IBS, C. diff, spontaneous colitis, and high E coli levels. 
  • High-dose lactobacillus, found in TheraLac, promotes healthy, rapid growth of all beneficial bacteria that can boost immune health and promote regularity. 

Immunoglobulins or Colostrum:

Immunoglobulins and colostrum help strengthen the body’s natural immune system. While also fighting bacteria and viruses that cause diarrhea. I recommend utilizing a bovine-derived serum that is lactose-free to repair and support healthy gut barrier functions.

Chinese Herbal Formulas:

This is far from an exhaustive list of Chinese herbal formulas for diarrhea, but these are three of my favorites to use with my patients. 

  • Shen Ling Bai Zhu San – Usee for poor nutrient absorption, bloating, and/or loose stools.
  • Raise Qi – Helpful for poor digestion, bloating and gas pain, chronic diarrhea, and loose stools.
  • Huo Xiang Zheng Qi San – Ideal for treatment of acute diarrhea or travelers' diarrhea.   

 

Short-Term Support in a Pinch

When you're in a pinch, it’s always helpful to keep a few diarrhea treatments in your arsenal. I recommend keeping these on hand: 

  • Bismuth Subsalicylate: Also known as Pepto-Bismol, increases the amount of fluid your intestines can absorb while reducing inflammation and overactivity of your intestines. Note that both liquid and chewable Pepto-Bismol may contain fermentable sweeteners. Follow the label for dosage.
  • Imodium: Imodium works to slow motility for sudden diarrhea. Follow the label for dosage.

 

I Can Help Identify the Cause of Your Diarrhea and Get You Back on the Path to Good Health

Are you ready to troubleshoot your chronic diarrhea? Get a better understanding of your digestive health and the natural approach to resolving diarrhea once and for all, by booking a free 15-minute call with me. 

If after the call you come on board as a patient, your clinician will order the best tests for your specific situation, and develop a unique treatment plan so that you can get back on the road to good health.

 

References:

 "Symptoms & Causes of Diarrhea | NIDDK." https://www.niddk.nih.gov/health-information/digestive-diseases/diarrhea/symptoms-causes. Accessed 31 Mar. 2022.

 "GI-MAP® Interpretive Guide - Diagnostic Solutions Laboratory." https://www.diagnosticsolutionslab.com/sites/default/files/u16/GI-MAP-Interpretive-Guide.pdf. Accessed 6 Apr. 2022.

"Histamine: The Stuff Allergies are Made of - MedlinePlus." 1 Apr. 2019, https://medlineplus.gov/medlineplus-videos/histamine-the-stuff-allergies-are-made-of/. Accessed 6 Apr. 2022.

"Enzyme therapy for functional bowel disease-like post-prandial ...." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6910206/. Accessed 12 Apr. 2022.

"Probiotics for infectious diarrhea - PMC - NCBI." https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1773578/. Accessed 19 Apr. 2022.

"Bacillus clausii - The Probiotic of Choice in the Treatment of Diarrhoea." https://www.longdom.org/open-access/bacillus-clausii--the-probiotic-of-choice-in-the-treatment-of-diarrhoea-2157-7595-1000211.pdf. Accessed 12 Apr. 2022.

 "Bacillus subtilis HU58 and Bacillus coagulans SC208 Probiotics ...." 11 Jul. 2020, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7409217/. Accessed 12 Apr. 2022.

"Towards a better understanding of Lactobacillus rhamnosus GG - PMC." 29 Aug. 2014, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155824/. Accessed 12 Apr. 2022.

The role of Lactobacillus plantarum 299v in supporting treatment of ...." 25 Jan. 2021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7882405/. Accessed 12 Apr. 2022.

 


candida

It Takes Two To Tango: Testing Your Household for Candida Overgrowth and Common Bugs

You’ve done a full lab work-up with a functional medicine provider and found out you’ve got an overgrowth of some bugs. Maybe Helicobacter pylori (H. pylori), Candida albicans, and protozoan gut parasites like Giardia.   

You follow your doctor’s treatment program to get rid of these infections. The only problem? The infections stubbornly refuse to go away and your health problems continue.

So why, oh why, won’t your tests and health conditions clear up?

The problem could be someone else living in your household. Maybe it’s your lover. Maybe it’s your child. Maybe it’s another relative who shares utensils and dishes with you. 

The point is, they could be infected, too. And even if you follow your doctor’s recommendations to the letter, if the people living with you are infected but doing nothing about it, you could get re-infected over and over.

The key to getting rid of the unwanted organisms in your body and feeling better is to have everyone in your household tested. 

In this blog post I’ll share the story of one patient I’ll call Carla and her boyfriend, Neal.  I insisted Neal get tested to see if he had the same organisms that infected Carla. When he was tested, the results were interesting, to say the least.  

 

Carla’s Story: Resolving Pain and Other Problems

Carla’s symptoms began more than 10 years ago, although her health problems became extreme a year ago. She complained of excruciating neck and back pain that became worse a week before and during her period.  

She had extreme fatigue and a history of vaginal and urinary tract infections and now felt a frequent urge to urinate. She also struggled with diarrhea and bloating.  Autoimmune disease ran in her family, specifically her mother. 

To find out what was happening to Carla, I ordered tests. These showed she had a mild H. pylori infection. She had low levels of beneficial bacteria like Clostridia and Faecalibacterium prausnitzii. This indicated she had gut dysbiosis, a condition where the good bacteria in the intestines are outnumbered by the bad bacteria.  

She also had mildly elevated levels of the protozoan parasite Giardia intestinalis, as well as some yeast.  

 

The Big Breakthrough in Pain Relief

One of the big breakthroughs in Carla’s case came when we tested her amino acid levels. Her levels of the amino acid homocysteine were very low. Normally, doctors get concerned about high homocysteine levels, since homocysteine is a red flag pointing toward cardiovascular disease risk and inflammation. 

In Carla’s case, since she wasn’t making enough homocysteine that meant she didn’t have enough of the amino acid methionine, which is recycled from homocysteine.

Methionine is essential for a process known as methylation, which regulates many processes in the body. Methylation is involved in the way your body processes estrogen and histamine. It regulates brain chemicals known as neurotransmitters. And you need healthy methylation to detoxify those pesticides, herbicides, or pollution you’re exposed to while eating, drinking, or breathing.    

When your methionine levels are low, you don’t make enough of another important substance known as S-adenosylmethionine (SAMe).  

I gave Carla SAMe and guess what happened? Her pain almost completely resolved! The pain now only showed up right before her periods. She was in tears while she was on the phone with me, saying she had “got her life back.”

That was major progress. But we still had to get the pain to go away completely and to improve gut health, because there was likely an autoimmune component to her problems. That’s when I suggested that we order the same tests for her boyfriend. 

 

Fungi and Parasites and Bacteria, Oh My!

So why did I insist Neal get tested? It’s because not everybody who has an infection with a pathogenic microbe actually has symptoms. It’s a concept called, “asymptomatic carrier.” People can have H. pylori or Candida and because they have no symptoms, they would never know they had it- until they get tested. 

Whether or not a person has symptoms from a pathogenic bug is determined by a few factors. It has to do with how robust and resilient our immune systems are and how a bug interacts  with our genetics and our health history. Someone who has leaky gut or autoimmune issues from other causes is going to have a much higher tendency to be symptomatic.

Likewise, someone who has any microbiome destruction is less resilient. It’s like an equation. It depends on how resilient we are versus how pathogenic is the bad microbe.

If you’re sick and your sexual partner isn’t, that can still mean that they have  Candida or H. pylori. Candida can be a reservoir for H. pylori, which is why H. pylori is known to be sexually transmitted. H. pylori can live vaginally inside the Candida.

So, if you have oral sex (blush! blush!), guess what?  Your partner has Candida in their mouth and now they  give it to you after you’ve finally gotten rid of your vaginal yeast problem. Or you could give your partner H. pylori. Not the kind of gifts you want to give each other!

H.pylori infects at least 50% of people, but that doesn’t mean it’s normal. Although it can be asymptomatic, it causes so many problems in so many people that when possible, especially when treating kids, I make sure we do our best to get rid of the infection.

Carla’s boyfriend Neal didn’t have any specific H. pylori or Candida symptoms but he did have some health problems that served as red flags.

He had colon issues including diverticulitis. In this condition, pouches in the colon known as diverticula become inflamed and sometimes infected. This leads to abdominal pain, nausea, fever, and changes in bowel habits.  

He’d also had his gallbladder removed. The gallbladder produces bile, which kills bacteria and fungus.

So it wasn’t surprising that his tests revealed some problems.

 

Testing Carla’s Partner for Intestinal Pathogens

It turns out Neal and Carla had a lot in common. Neal’s test results were similar to Carla’s. He had Giardia. He also had a moderate amount of yeast. In addition, he had a protozoan parasite known as Endolimax nana

Like Carla, he also had H. pylori. And like Carla he had low levels of beneficial bacteria in his GI tract. At the same time, he had high levels of opportunistic bacteria that can lead to an imbalance between the good guys in the gut and the bad—in other words intestinal dysbiosis. We see this a lot in people who have had their gallbladder removed because they lose the protective effect of bile against infections.

 

Treating for H. Pylori and Parasites

Based on their test results, I treated Carla and Neal in much the same way. Their H. pylori wasn’t particularly pathogenic, meaning they had less harmful strains. Their symptoms also didn’t match what I might see in someone who has a bad H. pylori infection. 

So instead of treating it like an H. pylori overgrowth, I took a more proactive stance. I had them take PyloGuard probiotic to stop H. pylori from going out of control and causing more problems. When H. pylori is left unchecked it can cause gastrointestinal inflammation and symptoms like reflux, gastritis, ulcers, and more. 

PyloGuard is a specific probiotic called  Lactobacillus reuteri DSM 17648 known to inhibit H. pylori. It’s an easy-to-take H. pylori treatment—just open one capsule per day in water and sip it. This approach will help you reduce  H. pylori naturally.   

I also treated both of them for parasites, giardia, and yeast. 

 

Looking to the Future

We’re not done with treatment yet, but we’re seeing a lot of improvement. Carla says her energy is much better and her brain fog has decreased. She had more improvements in her pain after she started taking progesterone. She is a different person.

Prior to beginning the parasite program, Neal complained that his respiratory tract seemed congested. He noticed less congestion after beginning the program.

When Carla first arrived in my office, she was a mess and was at the end of her rope. Now, she’s feeling so much better, which gives her hope and motivates her to take further steps. When you feel even a little bit better you want to keep going. 

As treatment progresses with Carla and Neal, stay tuned for more updates on their progress. 

 

We’ll Help You and Your Loved Ones

If you’re feeling sick and not getting any better, it’s a good idea to have your household members and sexual partner tested and treated, too. You don’t want to keep getting re-infected.  Book a free 15-minute troubleshooting call with me to find out the best course of action. 

If after the call you come on board as a patient, I’ll order the right tests for you and your loved ones, check for common parasites, Candida, and H. pylori if warranted, and get rid of the root cause of your health problems. That way, we’ll restore your energy and make you feel like yourself again. Your loved ones will also reap the rewards of this approach.