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.


What Causes Chronic Constipation in Adults and How to Relieve It

You’re all plugged up and can’t poop. You feel more backed up than a rush hour traffic jam.  

Maybe it feels like there’s something in there that refuses to budge.

Your stomach is so bloated it looks like you swallowed a bowling ball.

If you have chronic constipation, we’re sure you’ll agree when we say it’s a real pain in the butt.  

The good news? There are ways to get things moving again. But before we go into constipation relief, we’ll talk about what constipation actually is and what causes it. 

 

What Is Constipation?

From a conventional medicine perspective, constipation is defined as having less than three bowel movements per week. 

Functional medicine providers, on the other hand, usually want patients to have one to three bowel movements per day. That’s because they recognize the importance of bowel movements for removing toxins and other waste products.

Constipation can also refer to unhealthy stool. Doctors use what’s known as the Bristol Stool Chart to determine the health of a patient’s poop. This type of chart describes stool as being one of seven types. Type 1 (separate hard lumps) or type 2 (lumpy and sausage shaped) both indicate constipation.  

 

What Causes Constipation? 

Constipation can have a variety of causes, which is why it’s also a good idea to work with a functional medicine provider to find the root cause. 

In some cases, people can have structural and anatomical issues that cause constipation. Medications like opioid drugs can also lead to constipation. 

When those are not the issue, the most common causes of constipation are:

The Good Bugs vs. the Bad Bugs

The collection of microbes in your gut—both good and bad—are called the gut microbiome. When the microbes that make up the microbiome become imbalanced—either by the bad outnumbering the good or by too much of one type of microbe—it can lead to gastrointestinal problems, including constipation. 

Indeed, research shows that an imbalanced gut microbiome can affect how quickly food moves through your bowels and cause constipation. On the other hand, researchers have shown that a healthy gut microbiome prevents constipation. They accomplished this by performing what’s known as a fecal transplant, a procedure where fecal matter from patients who are healthy is transplanted into someone who has gastrointestinal problems. When scientists performed this procedure on patients with constipation, the patients’ gut microbiota and their constipation symptoms improved.   

Because constipation is linked to an imbalanced gut microbiota, it’s also linked to other health problems you would never think have anything to do with the gut. For example, people with constipation are at an increased risk of having hay fever

 

Candida or Yeast/Fungal Overgrowth

An infection with Candida or any other type of fungus can lead to an imbalance in the gut microbiome. This spells trouble for GI health and stool not moving as smoothly through the intestines. 

 

Sluggish Thyroid

The thyroid gland is important for many processes in our bodies. When it’s underactive—a condition known as hypothyroidism—it causes the body’s processes to slow down. Hypothyroidism slows down the speed at which food moves through the digestive tract. 

 

Dehydration

If you want to know how to relieve constipation in adults, drinking enough water is one of the best solutions. 

The large intestine isn’t supposed to be the Sahara desert. It needs fluids to function. When you haven’t had enough water, the colon will grab it from the food, turning stools hard, dry, and more painful to pass. Being well-hydrated also keeps food moving through the intestines. 

 

Parasite Infection 

Usually, a parasitic infection starts with acute diarrhea soon after the infection started, like right after returning from a trip. But in my clinical practice I regularly see parasite-caused diarrhea turn into either chronic constipation or constipation alternating with diarrhea. 

Patients who have parasite-caused constipation also have bowel movements that feel incomplete.

 

Pregnancy-Related Constipation

Constipation is a common complication of pregnancy. Nearly half of all pregnant women get constipated at some point during their pregnancy.

During pregnancy, constipation is caused by the dramatic increase in the hormone progesterone, which affects the intestinal muscle and causes food to move through the intestines more slowly.   

 

Small Intestinal Bacterial Overgrowth

Small intestinal bacterial overgrowth—SIBO for short—is another common cause of constipation. SIBO is an abnormal increase in the bacterial population of the small intestines, especially with species of bacteria not usually found in this area of the body.   

Diarrhea is a more common symptom of SIBO. When constipation occurs with this condition, it’s usually due to the methane-dominant form of SIBO. In this type of bacterial dysbiosis, there is an overgrowth of bacteria that make methane which can be detected on SIBO breath tests. 

 

 How To Relieve Constipation in Adults 

It’s no fun being all backed up. Your body can’t get rid of waste and digestion is hampered. You may lose your appetite and when the poop finally comes out, it hurts. While you have probably tried the popular recommendations of drinking water and taking fiber, it may not have been enough. Here are my tried-and-true chronic constipation treatments to get my patients regular again.

Stay hydrated – Drink at least eight glasses of filtered water every day. Coffee and juice don’t count. Neither does tea unless it’s herbal tea. Helpful hint: put a pinch of sea salt in the water. This will help you absorb the fluid better. 

Also, sip on warm water with lemon first thing in the morning. Drink this slowly and it will stimulate the gastrocolic reflex, which controls the movement of food through the GI tract after a meal.    

Get a good night’s rest – Our bodies have their own internal clocks which control our circadian rhythms. When we ignore our natural circadian rhythms, it can lead to many problems, including constipation. That’s why between 48% and 81.9% of people working either rotating or night shifts have some form of GI problem including constipation. 

Researchers also have found that morning IBS symptoms were worse after a night of poor sleep. The IBS symptoms improved after the study subjects slept better.

One reason why lack of sleep causes constipation is because it can affect the gut microbiota.  

Get Moving – Walking and yoga are both helpful for constipation relief. Exercise is linked to what scientists call better gut motility—in other words it helps move food faster through your digestive tract. 

Use a Squatty Potty – As the name implies, this allows you to squat when you poop. It’s a better, more natural angle and decreases straining. 

Biofeedback –  Biofeedback is a way to control some of your body’s functions. You can use it to help train your colon muscles to become more coordinated. 

 

Foods to Help Constipation in Adults

I have found that a paleo diet can really get things moving again. This diet mimics a hunter-gatherer diet of meat, fish, eggs, seeds, nuts, fruits, veggies, and healthy fats and oils. In the paleo diet, there is no sugar, refined flour, gluten or dairy. 

A low FODMAP diet or specific carbohydrate diet (SCD) has also worked in many of my patients with constipation. FODMAP stands for fermentable oligo-, di-, and monosaccharides and polyols. These are nondigestible carbohydrates which can trigger gut symptoms in some people. The SCD eliminates most carbohydrates including grains, starches, dairy, and sugars with only specific carbohydrates that require minimal digestion allowed. Fresh fruit, most vegetables, grass fed meat, and wild-caught fish are allowed while starches, grains, and processed or canned foods are prohibited. Usually, these types of diets are used for chronic diarrhea, but I’ve seen them kickstart bowel movements, especially when a patient has a chronic infection or an imbalanced gut microbiome.  

If you find that your constipation gets worse with starches and sugars, stop eating sweets, which is really a good idea for your health anyway. Avoid using flours. Eat only whole food carbs like root veggies and whole grains if tolerated. Examples of root vegetables are daikon radish, beets, carrots, and parsnips. Beets are the best option especially if you notice that insoluble fiber makes your constipation worse.

Increasing healthy fats from olive oil, ghee, coconut, organic butter, and eggs is also helpful. Make sure you’re getting 2 tablespoons or more per meal—6 tablespoons per day. Fats can increase the rate at which foods move through your digestive tract.   

If you tolerate dairy, try making 24-hour yogurt from full-fat cream. Yogurt is a good source of probiotics, which nourish the gut microbiome.

Unless you know or suspect that FODMAP veggies make your constipation worse, get more fiber in your diet by eating seven to 11 servings of vegetables per day.

It’s also a good idea to boost potassium intake. A great way to do this is by making homemade juice with cucumber, tomato, spinach, chard, and melon. Ripe bananas, avocados, and kiwi are also rich sources of potassium.  

Fermented foods like chia soaked in kombucha are another ideal choice. These can promote a diverse and balanced microbiome.  

 

Supplements for Constipation 

The most common method of constipation relief are laxatives and stool softeners. Warning: these are gut irritants and are not a friend to the gut lining. What’s worse, you can become dependent (otherwise known as habituated) on laxatives so that your gut “forgets” how to poop regularly on its own. 

People also often use fiber supplements for constipation, but this can backfire. Fiber supplements can make some people worse. Acacia and partially hydrolyzed guar gum (PHGG) are often the fiber supplements that constipated people can handle the best.

Digestive enzymes and a hydrochloric acid (HCL) supplement are other good choices.  Bile support, especially in people who have trouble digesting fats, can help regulate gut motility and transit time (the amount of time food takes to get through your intestines). MegaGuard is a bile support supplement that works well for my constipated patients.

Magnesium oxide or citrate (500 – 2,000 mg at night) can get things moving. Work up to the higher dose slowly. Some people do better with magnesium hydroxide. Magnesium is osmotic, which is just a fancy way of saying it pulls water into the colon. Remember, the colon needs water and magnesium helps there. Natural Calm is a high-dose magnesium supplement you can try.

Another way to increase magnesium levels is to take an Epsom salt bath before bed. This will also soothe away stress.

Buffered vitamin C (2,000 mg) before breakfast and lunch will get your bowels moving. Colon Rx, which includes both Magnesium Oxide and the Ayurvedic herb triphala, has been used for millennia for bowel regulation. Both of these are non-habituating and very safe ways to reduce constipation.

If you have methane-dominant SIBO, Atrantil can treat constipation. It works for many people, but not everyone. It can take up to 21 days to see the full effect.

If you have a severe episode of constipation and nothing else is working, try glycerin suppositories or enemas using water, saline, or coffee. These can make a huge difference to get the gut moving in quick time.

Herbal formulas can work. But be cautious with ingredients like Senna, rhubarb, and aloe. You can become dependent (or habituated) on all of these stimulant laxatives if you use them too often and for too long. If you’ve been taking any of these ingredients, taper slowly while using other support. 

Some herbal formulas I like are:

Smooth Move tea is another herbal option to help with constipation relief. It also contains Senna, so only use it occasionally and work with your functional medicine provider to uncover and address the root causes of your constipation.

 

Probiotics for Constipation 

In choosing a probiotic supplement, avoid formulas that have too high a level of fructo-oligosaccharides (FOS), galacto-oligosaccharides (GOS), inulin, chicory, or arabinogalactan. These ingredients at too high a level can cause a flare in imbalanced gut microbiota. If you have a gut infection, wait until it is cleared to take any supplements with those ingredients.

Some probiotics for constipation that I like: 

Test one species first. Start with about 40 billion and then ramp up as far as 300 billion by doubling your dosage every three days. Stop if your symptoms worsen.

 

Critical Tests If You Have Chronic Constipation

As you read earlier in this article, there are a lot of causes of constipation. Some of them could be damaging more than just your GI tract. That’s why it’s important to test for parasitic and other gut infections, Candida and fungal overgrowth, and an imbalance in the gut microbiota. Depending on the specifics of your case, we might choose to use the GI-MAP, the Parawellness Stool Pathogen panel, or the BiomeFX panel. We might also include Lactulose and Fructose Breath Testing for gasses that can indicate SIBO.

You really don’t want to tackle these types of gut imbalances on your own. Instead, 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, recommend a plan customized for you, and put you on the path to feeling like your regular self again.   


A Functional Medicine Approach to Healing IBS

So, your doctor says you have IBS - Irritable Bowel Syndrome.

This diagnosis can either feel like a relief or a nightmare.

On the one hand, an IBS diagnosis means some of the causes of digestive issues like Crohn’s, Ulcerative Colitis, and Celiac disease have been ruled out - that’s a good thing. 

But on the other hand… IBS is essentially a name for “something’s wrong but we don't know what.”

And in the functional medicine, holistic approach I use - that’s not a good enough answer. In fact, it's not an answer at all!

An IBS diagnosis leaves people to suffer through their symptoms alone - which is bad enough - but even worse, it ignores the root cause of the issue.

And because the gut is so integral to overall health, issues in your gut inevitably lead to more health issues - hormones, mental health, weight concerns, thyroid issues, and more.

So why do we accept this? Why do doctors tell you that you “just” have IBS and send you out the door?

Because treating IBS isn’t easy! There’s no one pill that can fix it, because no two people have the same causes. It requires a multi-step, hands-on treatment approach that usually needs to be tweaked in real time. That’s not the kind of care most standard MDs are able to provide.

Don’t worry - I got you! Today I’m going to share my approach to treating IBS.

But buckle up, because this isn’t a quick 3-step process (sorry!). Today, we’re diving deep into the nitty gritty of treating one of the trickiest conditions out there. 

 

You’re Entitled To More Than One Problem

In Chinese medicine school, I often heard the saying “You’re entitled to more than one problem at the same time.” This was the tongue-in-cheek way of saying it’s the norm, not the exception, for a patient to have multiple contributing factors to any health challenge they faced. 

And this is especially true in the case of IBS because the gut is so intricately connected to every part of the body, but also because one gut issue - like inadequate digestive secretions (due to stress, medications, etc.) - can create the environment for another problem to arise. 

That’s why the treatment plan I use for IBS has a lot of steps. Because you may have low stomach acid, or bacterial overgrowth, or a parasite… but that’s more than likely not going to be the only issue you’re dealing with. Instead of obsessing over discovering the one root cause of your IBS, my approach works systematically through the most common issues, creating a powerful foundation for lasting health.

So let’s peel back the layers, step-by-step, and tackle this together. 

 

Start From The Top and Work Down

Most people don’t think of it this way, but the mouth is actually the start of the gut. The mouth has its own microbiome that directly influences the composition of the large intestine microbiome. In fact, research has shown that simply brushing your teeth 3x daily can measurably lower levels of candida in the stool. 

94% of Americans have some degree of gingivitis and the mouth and sinus are home to fungal strains including Candida species (present in 75% of participants), followed by Cladosporium (65%), Saccharomycetales (50% for both), Aspergillus (35%), Fusarium (30%), and Cryptococcus (20%). In addition, gram negative bacteria such as Enterococcus faecium, E faecalis, Escherichia coli,  Klebsiella pneumoniae, and Proteus mirabilis are also common in the mouth. These are the same bacteria most commonly overgrown in cases of Small Intestine Bacterial Overgrowth (SIBO). 

The best defense is controlling bacteria levels in the mouth with your oral hygiene routine. I recommend Dentalcidin toothpaste and Biocidin Dental Rinse as an important first step for anyone with dysbiosis or candida, SIBO, IBD, IBS, gas that clears the room, or a history of poor dental health. 

 

Optimize Your Gut Terrain

Once you’ve got your new oral hygiene routine in place, the next step is to optimize your gut terrain and environment.

Before we ever run a stool panel, clear a pathogen or take those precious leaky gut supplements, and especially before we start going down side rabbit holes like mold, we need to replace any missing digestive secretions and work on meal hygiene and transit time. This literally sets the stage for a healthy gut.

Digestive secretions include stomach acid (HCL), bile, and pancreatic enzymes. HCL is secreted by parietal cells in the stomach in response to the smell and taste of food, as well as distension in the stomach and small intestine (distention occurs when food enters the stomach). 

HCL is particularly important for the breakdown of protein. Most importantly, however, HCL acts as the first domino for all the other digestive secretions. Without adequate HCL, all other secretions will suffer!

The #1 reason for inadequate HCL? Stress. HCL release is triggered via the vagus nerve which connects the brain and the gut. Vagus nerve activation requires a parasympathetic state of the nervous system. You might know this as the “rest and digest” mode. Eating while stressed, busy, or otherwise unfocused is therefore a major cause of low HCL. Other causes include the use of PPIs and other acid-blocking meds, as well as the presence of certain bacteria in the gut like H. pylori, which can denature HCL. 

Adequate HCL then triggers the release of bile from the gallbladder. Bile is necessary for the digestion of fats, but bile also acts as an antimicrobial in the small intestine, helping to prevent bacterial overgrowth. Bile also collects toxins for the liver to secrete. Bile levels can be impacted by inadequate HCL, dehydration, gallbladder issues or removal, and exposure to high levels of toxins. If bile is inadequate it can lead to dysbiosis of the microbiome and deficiencies in fat soluble vitamins like A, D, E, and K and nutrients. 

Pancreatic enzymes are secreted by the pancreas and play key roles in breaking down carbs like sugar and starches as well as fats. Pancreatic enzymes allow starches to be broken down in the small intestine, rather than fermented, preventing bacterial and fungal overgrowth. Pancreatic enzymes act as a bactericidal against Escherichia coli, Shigella species, Salmonella species, and Klebsiella pneumoniae, and have fungistatic activity against Candida albicans. The release of pancreatic enzymes is dependent on adequate HCL. 

HCL, bile, and enzymes can all be supplemented if needed, but there are other things you can do as well. First up, make sure you’re hydrated. Proper hydration is necessary for the production of digestive secretions - think of water as the key ingredient. Secondly, slow down and really chew your food. Thorough chewing allows time for the brain to signal the gut that food is coming, and the gut to secret HCL and bile in response. 

With my one-on-one clients I utilize gut testing to check enzyme levels, and often supplement HCL, bile, and enzymes as needed.

 

What About Probiotics?

I tell my clients to introduce fermented foods as tolerated - even if that’s only a single strand of sauerkraut to start. 

Beyond that, certain probiotics can be really helpful. Some strains support secretory IgA, which protects the mucosal barrier of the gut. Those include spore based probiotics, S. boulardii, L. plantarum, L. Reuteri, and B. lactis.

Generally well-tolerated probiotics include OrthoSporeIG, or MegasporeBiotic. For those who are highly sensitive, you may want to start with HU58 instead, which is a single spore organism.

Probiotics can also support specific symptoms of IBS. For diarrhea, S. boulardii works well. I like Floramyces. For constipation, Optibac  (1-4 doses per day) or HN019 strain of Bifidobacterium lactis (Xymogen’s Probiomax) are my favorites. BioGaia Protectis drops, which contain Lactobacillus reuteri DSM17938, are my favorite for bloating. And in general, many IBS patients benefit from Ideal Bowel Support which contains L.plantarum 299V. 

 

Address Motility & Transit Time

Addressing motility and transit time goes hand-in-hand with optimizing the terrain of the gut. Bacteria in the gut bloom like a coral reef after meals. If food and bacteria are moving through the gut and into the large intestine, that’s a great thing. But if food isn’t moving as it should, bacteria can bloom in the small intestine, and that’s a problem.

Bacterial overgrowth in the small intestine (SIBO) is a factor in as many as 80% of all IBS cases. (That being said, it’s not the only cause of IBS. I see it more often as a contributing cause - more the “branch” than the “root” of IBS!)

Motility is controlled by the migrating motor complex (MMC), an electrical wave that originates in the brain via the vagus nerve. The MMC acts like a broom, sweeping food and bacteria through the small intestine and into the large. Many factors can contribute to a deficient MMC, including bacterial overgrowth itself, which can secrete toxins that disrupt the vagus nerve. 

To improve motility, I use prokinetics (not to be confused with laxatives), which help trigger normal MMC function, as well as other approaches to keep bowels moving regularly. But if motility issues are chronic, it’s a sign of an impaired gut-brain axis. Modalities that can heal the gut-brain axis include:

  • Neuroplasticity
  • Biofeedback
  • Frequency Specific Microcurrent 
  • Vagal nerve stimulation
  • Acupuncture
  • Therapy like EMDR, or somatics for trauma

 

Nutrition Based On Symptoms

Once the gut terrain and motility have been addressed, it’s time to look at your diet. For all my clients dealing with IBS or other gut issues, I have some basic diet recommendations:

  • Paleo or Autoimmune Paleo as a foundation
  • Focus on nutrient dense foods, including gut-healing foods like bone broth, 24-hour yogurt, and sauerkraut (just start small)
  • Gluten, dairy, and added sugar-free
  • Avoid eating the same foods day after day - variety is key
  • Stay well hydrated
  • Practice good meal hygiene (sitting down to eat, avoiding screens while eating, slowing down, chewing thoroughly)
  • Incorporate fermented foods as tolerated (start really small)
  • Incorporate fiber-containing plants as much as tolerated

While many people want to skip these simple diet changes, they matter. It’s a foundation, not an aside. You will not get better if you’re only eating gluten free toasted waffles, even if you tolerate them well! By the same token, if you’ve found you can stay symptom-free by eating a very limited diet, we eventually need to expand your phytonutrients and nutrients in general if you want to actually get better (and enjoy eating again!). 

For those patients with more specific concerns, I do often trial special therapeutic diets like the Specific Carbohydrate diet (SCD), low-FODMAP, or low histamine. Having diarrhea 15 times per day? Try the SCD Diet. (Just make sure you don’t skip the essential Intro phase!) Tons of bloating, belching, and some loose stool or constipation? I’d suggest a low-FODMAP trial. And for those with lots of rashes, headaches/migraines, hives, itching, anxiety, insomnia, brain fog, sudden episodic diarrhea after meals, and allergies with foods, I will try a low histamine diet. (And some may need to take it a step further and follow low nickel - especially if rashes or eczema are present - or have salicylate or oxalate intolerances as well.)

 

And Now We Test

You might be surprised to see that only now am I considering testing  - stool testing, breath tests, or even hormone panels. The truth is that there is so much to work on long before any labs need to be ordered. And for some people, simply improving the health of the oral microbiome, optimizing the gut environment, and making some nutrition changes are all that is needed to completely resolve symptoms! I too often see people on fancy gut protocols, who aren’t getting results, simply because they have addressed the foundation first! Bottom line: don’t skip ahead!

But once we’ve covered the basics, testing can provide invaluable information that leads us forward in the right direction and saves you a ton of wasted time, energy, and money. 

My two essential tests are multiple stool panels and hormone testing. In addition, I often find breath testing for SIBO, organic acids tests, and food sensitivity testing to be valuable tools, as well. 

 

Why You Need Hormone Testing for A Gut Problem

It might seem odd if your symptoms are all in your gut, but hormone testing is a must-have tool for treating IBS. Why? Because your struggle with inflammation in the gut, and your ability to resolve it, is to some extent limited or empowered by how harmonious and optimized your hypothalamic–pituitary–adrenal (HPA) axis is. Cortisol, the primary “stress hormone” whose production and release is controlled by the HPA axis, is like your own endogenous prednisone. If cortisol levels are sky high, or have tanked and are too low, the body can’t repair tissues (like leaky gut) or resolve inflammation. Trophic hormones like DHEA are also essential for tissue repair. Stress and cortisol also inhibit secretory IgA, the most important immunoglobulin for repairing the mucosal barrier of the gut. I think of secretory IgA like the immune system of the gut. 

Most of my clients have some level of hormone dysfunction - but once we know what it is, we can take active steps to mitigate it. I recommended actively addressing stress and trauma with tools like therapy, EMDR, vagal nerve stimulation, and tools like the Gupta Program or the Inaura platform. 

 

Order These 2 Stool Tests

I always use two stool tests to detect pathogens like H. pylori, fungal overgrowth, and parasitic infections. Right now my favorites are GI Map and Parawellness. To get started, I prefer to use tests that focus on identifying pathogens vs. microbiome tests like BiomeFx or the Genova Panel. While general microbiome wellbeing is incredibly important, if pathogens aren’t first tested and cleared, they will usually impede any improvements to the health of the microbiome. (That said, I do love the BiomeFX for really targeted rebuilding of the beneficial microbiome after we’ve “weeded” the garden!) 

That being said, the microbiome is essential in understanding why pathogens are a problem for some people but not others. It’s not just about what pathogens are present, but how your body responds to the pathogen. This is akin to the concept in Chinese medicine of Wei Qi. Wei Qi has its roots in the Kidney Qi (your core energy, or how strong you were when you came in, based on genetics, and how well you’ve nurtured that with nutrition, lifestyle, and exposure). 

Wei Qi is the concept that the hand of cards you were dealt (genetics), under the influence of the exposures you’ve had or lifestyle you’ve chosen or been able to afford = your resilience. You might have also heard of this concept as “epigenetics.” Chinese medicine practitioners have been talking about it for 5,000 years! 

Pathogens can shift or suppress the immune system, increasing susceptibility to SIBO and other opportunistic dysbiosis. Parasites and gut infections degrade the protective lining of the gut, called the mucin lining, to decrease secretory IgA levels. They do this to stay alive: they need to degrade the immune system in the gut to prevent being destroyed.

In addition, many parasites can mimic or directly trigger IBS or Inflammatory bowel disorders including Giardia lamblia, Entamoeba histolytica, Cyclospora, and Cryptosporidium. In one study, blastocystis infection was found in 67% of IBS patients, and other research found that the prevalence of blastocystis, cryptosporidium and giardia is higher in IBS patients than in controls, and likely play a role in the development of IBS. 

If you’re thinking, “There’s no way I have a parasite,” think again! Risk factors include simple things like travel outside the U.S. and swimming in lakes/oceans/rivers. Lots of food intolerances - or food intolerances that change frequently - are also a warning sign for parasites, as parasites are able to “switch” the immune system from innate immune response (the TH1 immune system) to the “food allergy” response (TH2 immune system). Many people report no obvious symptoms. That’s why I test everyone, across the board.

 

Creating Your Custom Treatment Plan

One we have test results in hand, it’s time to create your customized healing strategy. While no two cases of IBS are the same, there are some general rules I follow:

 

#1 Start With H. Pylori (If Present)

Because H. pylori breaks down stomach acid, as well as “partners” with and encourages other pathogens, if it is present, it’s where I start. (H. pylori also promotes histamine synthesis and can contribute to histamine induced symptoms).

 

#2 Clear Other Pathogens

Once H. pylori has been addressed I move down the list of parasites such as Endolimax nana, Giardia, Entamoeba coli, Entamoeba histolytica, etc.

 

#3 Candida & SIBO

Next, I like to tackle candida overgrowth and SIBO. I often clear candida first, especially in the case of methane-dominant SIBO, because there is a strong association between candida and methane SIBO, and the SIBO often won’t respond to treatment unless the candida is cleared first. 

 

#4 Find & Treat Other Factors (If Needed)

If candida is not clearing after appropriate clinical steps, or, if SIBO won’t resolve after appropriate treatment, I look “further down the rabbit hole” for other things that could serve as impediment to those resolving like:

  • Heavy metals burden
  • Mycotoxins (Mold exposure)
  • Other biotoxin issues like Lyme and tick-borne diseases, chronic viral infections

(And if a patient has a known history with these  - like a mouthful of mercury amalgam fillings, or once lived in a moldy apartment, or known tick bites - I skip ahead and test for these issues earlier.)

 

Let’s Talk About SIBO

Like I mentioned earlier, SIBO is an underlying cause of IBS in as much as 80% of cases. But that doesn’t mean SIBO is the only cause of your IBS. SIBO is often just one aspect of a bigger set of issues. In fact, I often see patients who have had four or more rounds of SIBO treatment and still have symptoms. Why?

Often it’s because they have other parasites or pathogens that haven't been treated. Another common reason is that they actually have SIFO - small intestine fungal overgrowth. A 2015 study showed 25% of patients with unexplained GI issues actually had SIFO. SIFO symptoms are the same as SIBO symptoms, but common SIBO treatments like rifaximin and neomycin are just fuel on the SIFO fire. SIFO can be treated, too - it just requires a different treatment. 

 

Exceptions to the Rule

Now you know my basic treatment approach for IBS - but there are some exceptions. If someone is too overburdened, run down, or “weakened”, by what they’ve endured in body burden, often combined with a lifetime or period of high stress, sleep deficit, limited nutrition (because of what they can’t tolerate, or what is available), and poor assimilation, and are running on a deficit - they may need a different approach.

In these cases, a person may be too vulnerable to tolerate pathogen removal, either because it would leave them more vulnerable to another pathogen, or damage the microbiome itself. (Even natural agents can cause damage - looking at you, Oregano oil!)

A few weeks of support for healing gastritis, esophagitis, or leaky gut prior to digging in to increasing enzymes or HCL levels or endeavoring to clear a pathogen can make all the difference. They may also need several weeks of gentle detox support. I might use Chinese herbs, immunoglobulins and/or probiotics for  secretory iGA support, or treatments aimed at supporting HPA Axis normalization.  I think of this as strengthening Spleen (digestive) Qi and Wei Qi. 

 

Retest, Rebuild, Revitalize

We’ve already covered a lot, but we’re not done yet. In fact, these three final steps might be the most important. Please don’t skip them!

#1 Retest

Once we’ve completed our first round of treatment, it’s time to retest. Failure to retest is the most common reason people relapse after treatment. Yes, it really is worth the time and money! Retesting gives us insight into how you responded to treatment, if further treatment is needed, or if problems have been resolved. The only exception to this is SIBO testing: if your SIBO symptoms are 90% or more resolved, we often don’t need to retest, because SIBO doesn’t always look perfect on paper.

#2 Repair & Rebuild

We have already started the process of improving the gut terrain and environment. Now is the time to kick it into high gear and increase both probiotic and prebiotic foods. These help “bulletproof” the microbiome, preventing future infections and problems. Now is also the time to add supplements for anti-inflammation and leaky gut repair (butyrates, glutamines, curcumins, immunoglobulins, prebiotics, probiotics, nutrients like vitamins A, D etc). 

This is also the right time to utilize advanced microbiome testing like BiomeFX. We can use that information to focus on further diversifying the microbiome, because diversity is strength.

#3 Revitalize

Finally, I focus on detox support, nutrient replacement, and optimization of other systems that may have been impacted as innocent bystanders of the gut issues. Using an organic acids panel like ION, I take a look at liver detox, antioxidant status, amino acid status, neurotransmitter status, leaky brain, skin, and lungs, mitochondria and metabolism, and inflammation throughout the body. 

Even if you do every other step in the process, missing this one is like missing the icing on the cupcake. (I know, bad analogy for someone practicing nutritional medicine, even if it’s a gluten free, sugar free cupcake!). 

This step is WHY we bother doing the rest. You set out to clear your IBS because you don’t want to run to the bathroom 10 times per day. You don’t want to struggle to get to sleep, stay asleep, think clearly, or deal with rashes or autoimmunity.  You don’t want an overburdened detox system and excess oxidative stress to cause you to age prematurely. But clearing the gut and supporting the microbiome will only get you part way to relief (very far, but not entirely). 

For long term resilience and vitality, here’s what else I’m looking at:

  • Replacing missing nutrients
  • Supporting detox pathways
  • Glutathione status
  • Ability to optimally metabolize (aka use for energy) carbs, fats, and proteins, 
  • Omega fatty acid balance
  • Mitigating inflammation
  • Supporting mitochondrial function
  • Lowering oxidative stress
  • Optimizing brain function

Healing IBS Is A Journey

In case you haven’t picked up on it yet… healing IBS isn’t a “quick and easy” process. But most things that are really worth it in life take time and effort. You likely are not going to see impressive results by just taking a few supplements or cutting gluten from your diet.

But that’s not a reason to get discouraged. Trained practitioners like myself have years of experience, working with thousands of clients.There’s nothing more gratifying than helping a patient  - especially if that patient feels they have tried “everything” - peel back the layers of their IBS one by one and finally find relief!

If you need support healing IBS, I want to invite you to book a complimentary, no-obligation chat with my team. We’ll hear your story and let you know how we think we can help. 

>>> Schedule your free consultation here

Living with IBS is hard. You don’t just have to accept this as your normal. We would love to help. 


PMS and PMDD symptoms

Natural Treatment of PMS and PMDD

Raise your hand if you struggle with menstrual cramps, painful periods, irritability, mood swings, depression, and more the days and weeks leading up to your period. 

If you raised your hand, you are not alone! 

Nearly 90% of all menstruating women in the United States experience premenstrual syndrome (PMS) in their lifetime. And approximately 3% of those women experience such severe symptoms that they can be categorized as having premenstrual dysphoric disorder (PMDD).

Contrary to what some people may think, PMS and PMDD are real conditions. They can cause significant physical discomfort, impact your mental and emotional health, and disrupt your daily life.

Below, we’ll review the symptoms, causes of PMS and PMDD and how to naturally treat them. 

 

What are PMS and PMDD?

PMS is a group of symptoms that many women experience during the luteal phase of their menstrual cycle. Typically starting around ovulation and ending the first day of their period. 

PMDD, on the other hand, is a type of PMS but the symptoms are much more severe. Women who suffer from PMDD experience a decreased response to the body’s inhibitory molecule, GABA, which helps to limit activity associated with stress and anxiety. Causing women to experience five or more common PMS symptoms for seven or more days.

 

PMS and PMDD Symptoms

PMS can begin a few days or up to two weeks before the start of a woman’s period with mild to moderate symptoms. These symptoms only occur within those two weeks and are not present during the rest of the month. 

PMS can present with a variety of physical, emotional, and cognitive symptoms including:

  • Bloating
  • Headache
  • Fatigue
  • Acne flare-ups
  • Breast tenderness
  • Mood swings
  • Depression or anxiety
  • Changes in appetite
  • Insomnia
  • Constipation or diarrhea

PMDD shares many of the same symptoms as PMS, but these symptoms are much more severe. These symptoms can be so severe that they disrupt tasks of daily living. And, many women experience very little relief from common over-the-counter medications.

 

What Causes PMS and PMDD?

Scientific research hasn’t conclusively identified the cause of PMS or PMDD. Nor has it determined why some women experience it more severely than others. But, research has suggested several different theories as to what causes PMS and PMDD.

 

Hormonal changes that occur during the menstrual cycle:

Many believe that PMS occurs in response to the changing levels of the hormones estrogen and progesterone. Also referred to as the sex hormones. 

These hormonal fluctuations are thought to increase anxiety, irritability, and other mood changes experienced before your period.

 

Interaction between sex hormones and neurotransmitters:

The fluctuating levels of the sex hormones can impact the brain chemicals serotonin, dopamine, and GABA. Estrogen is required to synthesize serotonin and increases the number of serotonin receptors in the brain. Whereas progesterone helps stimulate dopamine release and increase GABA function.

Because both estrogen and progesterone levels drop before your period, the production and the effect of these “feel-good” chemicals are impacted. Leading to increased anxiety, changes in mood, and insomnia.

In women who struggle with PMDD, progesterone alters the shape of their GABA receptors making it harder for GABA to bind to them and improve mood, depression, or anxiety.

 

Other contributing factors:

There are other contributing factors that could lead to both PMS and PMDD including:

  • Genetics – There are hundreds of genes that help eliminate toxins from our bodies. One example is the COMT gene which helps to eliminate estrogen from your body. Those with the slow COMT gene mutation struggle to eliminate excess estrogen and can experience endometriosis, strong PMS, and fibroids to name a few.
  • Weight – No matter the cause for being overweight, an increase in fatty tissue equals an increase in hormones. Increased production of estrogen can cause inflammatory responses in the body and promote many PMS symptoms.
  • Estrogen Dominance – If the gut is not processing estrogen or the liver is unable to detox estrogen, the body will have an increased level of estrogen relative to progesterone. 
  • Detox Issues – If the liver is unable to detox excess estrogen it may be too stressed and require you to decrease your toxin load in other ways.
  • Gut Health – Our intestines are filled with trillions of bacterial cells (known as the microbiome) that work together to regulate the production, metabolism, and detoxification of hormones. When the microbiome is disturbed and the bacteria is damaged, dysbiosis can occur. Learn more about the importance of gut health and hormones here.
  • Histamine Intolerance – How your body reacts to the foods you eat can be driven by hormone fluctuations. Estrogen dominance can increase histamine and adequate progesterone can help balance it out.

Diagnosing PMS and PMDD

There is no definitive test to diagnose PMS or PMDD. However, there are several screening tools I used when diagnosing PMS and PMDD. 

  • Estrogen and Progesterone – DUTCH test or a serum blood test done seven days post ovulation to evaluate your estrogen and progesterone levels. 
  • Adrenal Testing – DUTCH test to evaluate your adrenal health and confirm you are not experiencing an HPA axis dysregulation
  • Thyroid – You need adequate amounts of thyroid hormones for your ovaries to make progesterone. Progesterone also helps the thyroid function well. Research has reported that a high percentage of women with PMS also have hypothyroidism.
  • Blood Glucose and Insulin Sensitivity – High blood sugar levels lead to high insulin levels which decreases the sex hormone-binding globulin (SHBG). If your insulin is always high there won’t be much SHBG causing estrogen and testosterone to rise relative to progesterone. 

Natural Treatment of PMS and PMDD

If you have PMS or PMDD, there are several natural treatments that I use to relieve symptoms. These can include strategies such as diet modifications, exercise, and supplements. All focused on improving your overall well-being, stress relief, and symptom management.

Here are some of my more commonly used natural treatments for PMS and PMDD.

Diet

Eating healthy is critical to managing PMS and PMDD. Some foods can increase the likelihood of some symptoms like bloating, blood sugar fluctuations, fatigue, and mood swings. I recommend:

  • Omit refined sugar, carbs, caffeine, and alcohol.
  • Choose grass-fed, wild, and organic foods when possible. 
  • Boost your veggie intake! Load up on cruciferous veggies and fruits high in antioxidants like broccoli, cauliflower, brussels, kale, and arugula.
  • Increase your fiber during the luteal phase of your cycle. 
  • Add 2 TBSP of ground flaxseed to your diet daily

Exercise

Move your body daily! Several research studies have shown that moderate cardio exercise everyday can help improve PMS and PMDD symptoms in four to eight weeks! 

Aim for 30 to 40 minutes per day of cardio exercise or yoga. 

Supplements

Getting the required dietary supplements each day has been shown to improve PMS and PMDD symptoms. Depending upon your symptoms and dietary requirements I recommend the following supplements:

  • Magnesium: Migraine headaches, anxiety, adrenal concerns, blood pressure issues…your magnesium is likely lacking. Think of it as a calming agent that you can use just about anytime. 
  • Vitamin B6: Helps to produce progesterone and promote GABA synthesis which can ease fatigue, irritability, and insomnia. I recommend beginning with 50 mg. 
  • Vitamin E and good fats. Vitamin E supplements and essential fatty acids help combat the effects of PMS by reducing the effects of the hormone prolactin. I suggest starting with 800 iu Vitamin E Tocotrienols, 2 caps of omegaMonoPure 1300 [email office for more information on this product], or 2 caps of EPO (bonus: EPO is great for glowing skin!).  
  • Calcium: Adding additional calcium support has shown to be a simple and effective treatment for the luteal phase symptoms of PMS. I recommend adding 1200 mg of calcium per day.
  • Saffron: In women with mild to moderate depression, saffron has shown to have an antidepressant-like effect. And, it can be used throughout the luteal phase of your cycle. I used the product MoodStasis beginning with 15 mg twice a day.
  • Progesterone Drops. Augmenting your progesterone with natural progesterone drops based on your labs can help mimic your body’s progesterone production. This cyclic taper allows us to taper up or down based on your personal need. (email our office for help with this product)
  • Hormone-balancing herbal blends. A hormone-balancing herbal blend can help promote progesterone production and estrogen clearance. I often use Vitex, DIM, or CDG to promote progesterone production. I use Calcium d-Glutarate to help prevent estrogen metabolites from recirculating back into the bloodstream from the gut and to help eliminate excessive estrogen. And there are many classical Chinese herbal formulas specific to women’s health and hormones that I will often incorporate based on your constitution and symptom presentation. 

Liver Detox

If the liver has to work hard to filter out harmful toxins from the body, its capacity to cleanse the blood from estrogen can be compromised. In addition to decreasing your overall toxic load, eliminating alcohol can help improve your liver’s ability to detox excess estrogen. Alcohol increases allopregnanolone (a neurosteroid made from progesterone) which can reduce the effectiveness of GABA. Ultimately increasing symptoms of PMS and PMDD.

Say Goodbye to PMS and PMDD Naturally 

The bottom line is…if your PMS symptoms occur month after month and affect your quality of life, it’s time to get some help! You don’t need to live with physical discomfort, mood swings, anxiety, or depression. 

Based on your symptoms and lab results, we will develop a personalized treatment plan to help you say goodbye to PMS and PMDD! 

Are you ready to say goodbye to PMS? Begin by scheduling a free 15-minute troubleshooting call


Anxiety Disorder

Anxiety Disorder Symptoms, Hormonal Imbalance, and Histamine Intolerance: The Surprising Connection

Your brain is foggy. Making even small decisions feels overwhelming. 

You’re worried about everything and it’s hard to sleep at night. 

The fatigue that nearly overpowers you makes you want to go back to bed and pull the covers over your head and hide from everyone and everything.

You’re cranky, restless, and on edge. Panic attacks cause your heart to race and your palms to get sweaty. 

Even if you only have only a couple of these problems, you may have generalized anxiety disorder.  That’s the bad news. 

The good news? You can feel at peace, happy, and calm again. The answer lies in balancing your hormones. But that’s not all. You’ll also need to get rid of problems like blood sugar imbalance that cause your hormones to get out of whack. Then there’s histamine intolerance, which is strongly linked to hormonal imbalances and anxiety.

 

Hormone Imbalance: The Victim Not the Villain 

Imbalanced hormones are not the villains responsible for your anxiety disorder. They’re more like the victims of other problems happening in your body. That’s why as a functional medicine provider specializing in irritable bowel syndrome, inflammatory bowel disease, and women’s fertility issues I see a lot of patients who also suffer from anxiety and panic attacks.  

In fact, 75% of my patients present to my clinic with anxiety along with other issues like acid reflux, irritable bowel syndrome (IBS), inflammatory bowel disease (IBD), digestive issues, endometriosis and many more. 

Hormones are actually responders, the language the body uses to talk to itself. Hormones express what they’re seeing in the different tissues around your body and tell your body how best to respond. 

In other words, when hormones break, it’s not typically the root cause of your problems. Rather, the hormones shift in response to the root cause or causes of your health problems. 

That said, working to adjust and balance hormones  can help you feel better. When your hormones are balanced, you will have more energy and bandwidth to work on the real root cause underlying your health problems.

In this article, I’m going to dive into one common factor that breaks hormonal balance. Then I’ll hone in on one of the most important hormones for people suffering from anxiety disorder and its link to histamine intolerance. 

I’ll also shed light on some of the other reasons for anxiety and panic attacks and let you know what you can do to feel less anxious and more at peace. 

First, though, let’s talk about what generalized anxiety disorder actually is and its symptoms.

 

What Is Generalized Anxiety Disorder?

Everyone gets anxious from time to time. Work deadlines, tests at school, dealing with relationship problems or other stressors can all lead to occasional anxiety. 

People with generalized anxiety disorder, on the other hand, experience ongoing worry or fear much of the time. 

Often, people with anxiety disorder feel anxious or get panic attacks even while trying to make simple decisions. Generalized anxiety disorder can cause problems at work, in school, and in your relationships.     

Symptoms of generalized anxiety disorder include :

  • Difficulty concentrating or brain fog
  • Fatigue
  • Insomnia (difficulty falling or staying asleep)
  • Irritability
  • Restlessness
  • Worry

Generalized anxiety disorder and panic disorder are some of the most common mental disorders in the United States. These are different types of anxiety disorders. Technically, conventional medicine considers panic attacks to be a separate disorder. However, in my experience as a functional medicine provider, most people aren’t going to have panic attacks without already having generalized anxiety disorder. 

Symptoms of panic attacks include:

  • Feeling out of control
  • Feelings of impending doom
  • Pounding heartbeat or rapid heart rate
  • Shortness of breath, smothering, or choking
  • Sweating
  • Trembling

Past trauma can trigger panic attacks. But they can also happen in people who have never experienced any trauma. 

 

Blood Sugar Imbalances Wreak Havoc on Hormones

One of the most common reasons why hormones break is because your blood sugar isn’t balanced. I have seen many patients get 90% better just by balancing their blood sugar.

Low blood sugar mimics anxiety. When your blood sugar crashes, the body attempts to push up blood glucose levels. It does this by making epinephrine, otherwise known as adrenaline, which triggers glucose production in the liver. 

Increased adrenaline leads to a “fight-or-flight” stress response in the body. This same biochemical process is also linked to anxiety. 

If you tumble into a chronic, on-going low blood sugar state, your body may boost its production of the stress hormone cortisol. This helps tissues in the body be less reactive to insulin, which boosts glucose circulation in the bloodstream. But high levels of cortisol can cause problems, too.

Guess what higher cortisol levels are also linked to? Anxiety. 

What’s more, in my work with thousands of patients, blood sugar swings have been the biggest driver of fatigue, anxiety, and mood swings!

A functional medicine provider can order the right tests for blood glucose and insulin sensitivity. These include LDH (lactate dehydrogenase), HbA1c (hemoglobin A1c), SHBG (sex hormone binding globulin), fasting glucose, fasting insulin, and sometimes glucose response testing.

To resolve low blood sugar problems that show up on the tests, eat more healthy fats, which are easier to assimilate and digest. 

High quality protein is also important. Back before I knew I had polycystic ovary syndrome – a condition linked to insulin resistance – I was eating vegan and vegetarian and chowing down on carbs. This was the wrong approach because anytime you have a problem with blood sugar or insulin, carbs are the bad guys.

 

The Soothing Effects of Progesterone 

Your brain has receptors for sex hormones like progesterone. So it’s not surprising that progesterone can influence brain function and mood. 

If you have anxiety, progesterone is one of your best friends.

Women with low progesterone levels are prone to anxiety. That’s why in conditions of low progesterone such as during PMS, post-childbirth, perimenopause, and menopause there’s an increase in anxiety and frequency of panic attacks.  

Progesterone and its metabolite allopregnanolone act as a natural antidepressant, enhance mood, and relieve anxiety. Progesterone has a calming effect on the brain. It increases the actions of a feel-good, calming neurotransmitter known as GABA (gamma-aminobutyric acid).

By giving GABA a helping hand, progesterone acts like a hormonal lullaby, helping you fall asleep easier and stay asleep longer. 

 

What’s Histamine Intolerance Got to Do With It?

Histamine is a chemical released by some cells of the body. If you’ve ever had an allergic reaction or seasonal allergies, you’re likely familiar with its effects such as runny rose, sneezing, or hives. 

Histamine isn’t always the bad guy. We need some histamine to release stomach acid and to help move food through the gut. The important thing is for histamine to complete its life cycle by being broken down and cleared from the body. 

When that doesn’t happen histamine intolerance occurs. This is when the body makes too much histamine and too little of the diamine oxidase (DAO) enzyme needed to break it down.

Anxiety is a symptom of histamine intolerance. Other symptoms include headaches, fatigue, nausea, irregular menstrual cycles, sinus issues, digestive problems, tissue swelling, and dizziness. 

In my experience, people most likely to suffer from histamine intolerance are people who are perfectionists. These are often the same people who suffer from anxiety and panic attacks. They want things to be a certain way and hold high expectations. 

Characteristics of people most likely to develop histamine intolerance include:

  • Academic overachievers 
  • Highly motivated 
  • Inner anxiety with a calm exterior
  • Being competitive – with themselves and/or others
  • Having obsessive/compulsive or ritualistic behaviors, or a need for structure and strong routine, feeling of order and control over things.

The above characteristics can actually be positive and work in your favor. If you have those characteristics you’re highly intelligent, super productive, and probably are successful in work and life. When your hormones are in balance these traits can work for you. 

However, if your histamine is too high and your hormones are out of balance then you might develop poor stress tolerance, feelings of anxiety, and insomnia.  

 

Progesterone Guards Against Histamine Intolerance

Progesterone enhances DAO,  the enzyme that breaks down histamine. So progesterone helps histamine meet its maker and clear it from the body. 

Estrogen dominance, on the other hand, boosts the body’s production of histamine. Women whose histamine production is estrogen driven will see flares of their problems either right before ovulation or more likely right before their period, because that’s when they’re naturally estrogen dominant. 

Does anything else cause histamine intolerance besides estrogen dominance? You bet. Genetics can play a role. My own histamine intolerance was partly caused by genetics. But the gut plays a huge role, too. For me, my high histamine and hormonal imbalance came down to the “bad” organisms in my digestive tract (Helicobacter pylori, Giardia, and Candida albicans

Leaky gut leads to lower levels of DAO and in turn high histamine. This is because the place where your body makes DAO is mostly mucosal barriers like the intestines. 

If your liver isn’t working its best, that will cause problems, too. The liver detoxifies histamine. If its detox abilities are weakened, histamine will build up in the body. It’s just one more thing to fill your bucket up to the point of overflowing.  

 

Other Hormones to Watch in Anxiety and Panic

In my patients with anxiety, I always keep an eye on other hormones besides progesterone. These include:

  • Thyroid – If thyroid hormone levels are up and down like in Hashimoto’s it can mimic bipolar disorder. Low thyroid hormones are also linked to low progesterone.
  • DHEA (Dehydroepiandrosterone) – DHEA is the most abundant circulating hormone. Balancing levels of DHEA can lead to better mood and less anxiety. 
  • Serotonin/Estrogen – Serotonin makes you feel content, happy, calm, and ready for sleep. It reduces anxiety and the tendency to think about sad or dark thoughts over and over (cyclical thinking or ruminating). You need estrogen to convert amino acids into serotonin.   
  • Cortisol – Cortisol is primarily produced by the adrenal glands. Adrenal fatigue can make you less likely to cope with stress. If you have a poor stress response, cortisol can be too high or too low. If cortisol goes up due to stress, your progesterone levels can take a tumble. 

 

Strategies to Reduce Anxiety and Panic Attacks

Here are some simple changes you can make to feel calmer and less anxious:

  • Reset your inner clock. First thing in the morning, immerse yourself in bright outdoor sunlight without wearing sunglasses. After sundown, expose yourself to dim light. If you’re not doing these things, neither dietary supplements nor hormone replacement therapy will work.  
  • Let go of toxic people, habits, and behaviors
  • Seek professional therapy
  • Practice stress management techniques like transcendental meditation, hypnotherapy, somatic therapy, nature immersion, the Gupta Program, and psychedelic journeying

 

Natural Hormone Replacement and Dietary Supplements for Stress 

Natural Progesterone - Please email office to discuss

A functional medicine provider can prescribe personalized, low-dose bioidentical progesterone.  This can relieve symptoms of histamine intolerance and estrogen dominance.  

Vitamin B6

Vitamin B6 supplements can help with histamine balance including PMS related to histamine. Vitamin B6 can:

  • Help produce progesterone.
  • Promote GABA synthesis.
  • Convert L-tyrosine and 5-hydroxytryptophan (5-HTP) to dopamine and serotonin, respectively.
  • Enhance DAO production and lower histamine.

Start with 50 mg of vitamin B6 in the form of P5P. You can take more under the guidance of a functional medicine provider. 

Magnesium

Magnesium is a natural stress reliever. I prefer the chelated form of glycinate and the product Neuro-Mag.

L-Theanine, Passionflower

L-theanine, a substance found naturally in green tea, produces calming brain waves. Passionflower (Passiflora incarnata) also has soothing effects.  

Taurine

Taurine is an amino acid that promotes formation and release of GABA, which quiets down  excitatory signals in the brain. A typical dose is 250 mg – 1,000 mg/day. 

Glycine

Best for acute panic attacks rather than chronic anxiety, glycine is an amino acid that interferes with the release of the neurotransmitter norepinephrine. At the first sign of a panic attack, place two grams of glycine powder under the tongue and let it slowly dissolve. This process can be repeated every few minutes if necessary and, in most cases, the problem will resolve within 10 to 15 minutes. 

Cannabidiol (CBD)

This phytocannabinoid has calming, soothing effects. In human studies, CBD reduced anxiety caused by a public speaking test in subjects with social anxiety disorder.  

Lavela

This lavender-derived substance (also known as Silexan™) promotes relaxation and calms nervousness. 

 

I Can Help Balance Hormones and Relieve Anxiety 

To find out whether the root cause of your anxiety disorder and panic attacks is blood sugar issues, low progesterone, or problems with other hormones, you’re going to need an experienced functional medicine practitioner. The first step is to book a free 15-minute troubleshooting call with me. 

If after the call you come on board as a patient, I’ll order the best tests for you and develop a treatment plan based on your unique biochemistry. You will find out the steps you need to take to feel calmer and happier. I know anxiety isn’t easy but together we’ll find a solution to make your life easier.


SIBO

How to Prevent SIBO (Small Intestinal Bacterial Overgrowth) Relapse

You have SIBO (Small Intestinal Bacterial Overgrowth) and you completed all the necessary steps in the “kill phase” of treatment. You run a follow-up breath test and your gas levels have normalized! Or, you didn’t retest, but your symptoms are 90% better! This is great progress and it feels like you are finally moving forward!

But, if you’re just killing the bacteria – you’re only halfway there!!

Many SIBO patients get their initial SIBO treatments and feel good for a while. But then, all the bloating, gas, cramping, constipation, or diarrhea begin to make a very unwelcome comeback. For various reasons, too much bacteria will once again start colonizing the wrong part of the GI tract leading to SIBO relapse. 

Unfortunately, it’s common to have SIBO relapse. But, don’t get discouraged. You’re not wading through the murky waters of SIBO treatment alone.   

Let’s break down if your symptoms are IBS or SIBO, why SIBO relapse might happen, what you can do, and how to help prevent a relapse in the first place.

 

Are my symptoms IBS or SIBO?

When it comes to gut issues, it can be difficult to identify and understand your symptoms. In general, there are two common conditions of the intestines that can present very similarly: Irritable Bowel Syndrome (IBS) and SIBO.

IBS is a functional gastrointestinal disorder. It affects the two-way communication between your digestive system and your brain. When this communication system malfunctions it can throw off your entire digestive tract. Leading to symptoms like abdominal pain, bloating, and altered bowel habits such as constipation or diarrhea. Sounds a lot like SIBO, doesn’t it?

A single underlying cause of IBS has not been identified. But honestly, there are many factors that could lead to IBS including food sensitivities, severe infections, stress, or intestinal muscle issues. What’s interesting is that up to 78% of patients diagnosed with IBS have SIBO.

IBS and SIBO are complex conditions. But, since these conditions can present so similarly it’s important to rule out SIBO with a breath test so that we can customize your treatment plan.

 

What causes SIBO relapse?

I know what you’re asking…if I’ve done the work to identify the cause of SIBO and the SIBO treatment…why on earth is my SIBO coming back?! 

Unfortunately, approximately 45 percent of all SIBO patients will experience a SIBO relapse. There are three primary reasons that my patients experience SIBO relapse: diet, underlying gut conditions, and medications.

Diet

Let’s call it like it is, diet changes are never a quick fix, they are a lifestyle change. A diet that is high in sugar, refined carbohydrates, FODMAP vegetables, or alcohol can make SIBO symptoms like gas, bloating, constipation or diarrhea worsen or relapse. It’s important to introduce foods like starchy veggies in the long run because it feeds the good gut flora. But introducing too much too soon is when you run into issues. 

Underlying Gut Conditions

A physical obstruction in the gut can be both a cause of SIBO and subsequently the cause of SIBO relapse. Crohn’s disease, celiac, diabetes, and leaky gut are the four most common gut conditions that can cause SIBO. 

Medications

Some medications may help with certain issues while wreaking havoc on others. Medications like antibiotics, antihistamines, NSAIDs, acid-blocking drugs (PPIs), and steroids all disrupt your normal gut flora. Some kill healthy bacteria and others increase the permeability of your gut. But, they all increase your chance of SIBO relapse.

 

How To Prevent SIBO Relapse

Preventing SIBO relapse starts during the “kill” phase of your SIBO treatment. There’s a lot you can be doing during and after SIBO treatment to prevent SIBO relapse. Here are a few things I like to include in SIBO treatment plans:  

  1. Address Low Stomach Acid and Pancreatic Digestive Enzymes – These antimicrobial enzymes help enhance nutrient absorption and assimilation.
  2. Support your Oral Microbiome – 94 percent of Americans have some levels of gingivitis or bacteria in their oral cavities that can impact gut health. I recommend Blocidin toothpaste and dental rinse. Plus, don’t forget about flossing. Sorry, no water picks.
  3. Liver Support – The toxins from SIBO have inundated your liver. The endotoxins (the toxic substances bound to bacterial cell walls) from having SIBO saturate the bile and add to your total liver toxic burden. These systems need their own love to get back up to speed. Resolving the excess gram-negative bacteria is the first step. My favorite for bile support is MegaGuard by Microbiome Labs.  Learn more about bile support and gut health.
  4. Repair Leaky Gut/Mucosal Inflammation and Damage – SIBO has likely led to an inflamed gut and has damaged the cellular walls and lining. Not only do you need to kill off harmful bacteria and rebuild healthy gut flora, but you also need to repair any structural damage. I recommend Super Curcumin by Apex, with either MegaMucosa by Microbiome Labs, or GI Balance by Xymogen.

 

What To Do After You’ve Cleared the Bacteria Causing SIBO

The first phase of SIBO treatment is tough and you’ve survived it. Congratulations! But now what? 

Great question! There is a lot you can do after SIBO treatment to prevent relapse and stay healthy. 

  1. Stay on a modified low FODMAP or SIBO Biphasic. To allow your microbiome to heal, I recommend following one of these diets for two to three months, followed by gradual reintroduction of foods that you have omitted.
  2. Add a Prokinetic to address gastroparesis and support the Migrating Motor Complex (MMC). Gastroparesis slows your stomach’s motility preventing it from emptying properly. MMC sweeps residual bacteria and leftover carbohydrates and protein particles out of the small intestine. Waiting 4 hours between meals allows MMC to work because it is only triggered during a fasted state. So, if we snack all the time or chug large amounts of liquid, we’re inhibiting the MMC housekeeping wave. Limit snacks and sip, don’t chug, your fluids. So remember, eat, stop, eat.
  3. Restore your vagal tone and your MMC by retraining your nervous system signaling.  All of the approaches to restoring vagal tone for improved digestion focus on promoting your parasympathetic nervous system activity, over your sympathetic activity. The parasympathetic nervous system helps restore the body to a calm and composed state and prevents it from overworking. Sympathetic activity, on the other hand, prepares the body for a stress-related activity. Depending on what may be causing your sympathetic activity several techniques can be personalized based on your symptoms. This includes vagal nerve stimulation, gut-focused hypnotherapy, Frequency Specific Microcurrent, acupuncture, or the Gupta Program. And, if there has been a big stress or trauma other treatments like EMDR can be considered. Check out inaura.com to identify additional personalized therapy options.
  4. Add single-strain probiotics and prebiotics to your daily routine. Probiotics and prebiotics, added slowly to your diet, can help to rebuild and maintain your healthy gut flora. Because multi-strain probiotic blends are not generally tolerated by SIBO patients I recommend several single strain options based upon your specific symptoms and tendencies (i.e. bloating, constipation, diarrhea, histamine intolerance, etc.). I personalize your routine with some of my favorites including HU 58 (Microbiome Labs), BioGaia Protectis, probiomax by Xymogen, and Ideal Bowel Support (L Planetarium 299V). I start all my patients on a partial dose and work up to help bulk the stool without triggering SIBO. Once you are tolerating partial doses, we can reintroduce most FODMAP foods along with other strains of probiotics for continued gut repair. The key is going slow and steady. Adding any probiotics too soon or too quickly can flare SIBO.

To get you started, let’s focus on diet, probiotics, and prebiotics.

 

SIBO Treatment: Low FODMAP Diet and SIBO Biphasic Diet

Many of my SIBO patients hit the internet and find a lot of information on the “SIBO diet”. The SIBO diet is also known as a low FODMAP diet. 

I recommend following a low FODMAP diet during SIBO treatment and for a short time after. But, in the long haul, a low FODMAP diet can be too restrictive. It does not offer you the necessary food diversity required for a robust and diverse microbiome. But, after the initial treatment, you can slowly reintroduce foods that will support your gut health and regularity.

Some patients also have a lot of success with a SIBO biphasic diet. This diet plan is as restrictive as the low FODMAP diet to start. But, it slowly reintroduces the most tolerated and least fermentable foods back in overtime. The foods eliminated don't change on the biphasic diet. Instead, it provides more guidance on what foods to reintroduce and when.

In reality, diet does not cause SIBO. Period. Diet can cause many other things like candida and poor microbiome health, but SIBO isn’t caused by diet. Instead, a highly-processed, low-quality diet tends to lead to increased symptoms and SIBO relapse. Diet is simply a way to manage your SIBO symptoms during the kill phase and long-term. And, it’s unique to each patient. Whether you follow a low FODMAP or biphasic diet, your SIBO treatment should include a full evaluation of your diet to help manage and control your symptoms. 

 

Benefits of Probiotics and Prebiotics

I know it sounds strange, but utilizing probiotic and prebiotic supplements in the treatment of SIBO can be beneficial. It seems counter-intuitive. If excess bacteria in the small intestine cause SIBO, why would you want to add more?

Probiotics help to reduce bacterial overgrowth and hydrogen concentrations. And, probiotic supplements can help improve symptoms and restore a healthy gut microbiome. Which in turn increases your resilience against SIBO or general dysbiosis by promoting healthy expression of gut immunity and maintaining a strong and resilient mucosal membrane. 

Prebiotic supplements, on the other hand, essentially provide the nutrients needed for healthy bacteria to flourish in your gut. 

Ongoing research shows that probiotic and prebiotic supplements can be very effective in the treatment of SIBO. They can help improve symptoms, improve lab values, and support long-term gut restoration. Yet, not all probiotics and prebiotics are equal. It’s important to introduce the right supplements to focus on helping resolve your specific issues slowly and only as tolerated. Too much, or the wrong things can lead to SIBO relapse if the body isn’t ready. Generally, I start with PHGG (Partially Hydrolyzed Guar Gum) and Acacia.

 

Get Help With SIBO Relapse

SIBO is an incredibly complex condition that requires a great deal of time and energy to resolve. 

Every case of SIBO requires personalized treatment. And as your health guide, we're here to put the pieces of your puzzle together and get you back on track. You deserve to live your life freely and feel well every day!

So, if you find yourself feeling defeated in your journey to better gut health, we are here to help!

Start by scheduling a no-cost, no-obligation 15-minute consultation call to regain control of your health.

 

References

"Probiotics for Preventing and Treating Small Intestinal Bacterial ...." https://pubmed.ncbi.nlm.nih.gov/28267052/. Accessed 10 Feb. 2022.


Toxic Mold Illness

Is Toxic Mold Illness to Blame for Your Digestive Problems?

It’s frustrating. You’ve got digestive problems but you’ve hit a roadblock in the healing process. 

Maybe you have irritable bowel syndrome (IBS). 

Or maybe you have small intestinal bacterial overgrowth (SIBO).

But you’re not getting any better.

Newsflash: there’s one thing you probably haven’t tried to get rid of your digestive problems. I’m talking about toxic mold exposure. 

 

The Fungus Among Us

Mold is a type of fungi and it’s everywhere around us. It’s in water-damaged homes, on the tiles of our showers, in the soil of potted plants—even in some of the foods we eat.

Really gross, isn’t it?

Well, yes and no. Molds certainly won’t win any beauty contests. Yet, they serve their purpose on this planet. They’re essential to the breakdown of organic matter like fallen leaves or dead trees.  

There are thousands of species of molds. Many of them are harmless to your health. But some molds produce health-harming mycotoxins.

I have made great strides with my IBS and SIBO patients once I realized many of them have symptoms of mold sickness. This isn’t the root cause for all of my patients, but in the people who have mold exposure, resolving the problem can lead to major breakthroughs in their health. 

In this article, I’ll dive deeper into the issue of mycotoxin exposure and how it can wreak havoc on your digestive health. I’ll also give you some suggestions on what you can do about it. 

 

What Are Mycotoxins?

Mycotoxins are substances produced by some molds, usually when the mold feels as if it’s in danger. Kind of like the way a spider or snake shoots out venom when threatened. 

While mycotoxins are good for the fungus, they’re not so good for our health. Mycotoxins are to blame for mold symptoms and are real troublemakers for digestive health.

Some mycotoxins are found in foods and beverages

  • Mycophenolic acid, found in Bleu cheese
  • Ochratoxin, found in cereals, cocoa, coffee, wine, beer, spices, dried fruit, and grape juice.
  • Aflatoxin, found in cereal crops like corn, wheat, and rice, peanuts, eggs, meat, and milk from animals fed contaminated grains.

One of the most common sources of exposure is from coffee mold, which produces mycotoxins in coffee.  Ochratoxin A and aflatoxin B1 are the main mycotoxins that might be found in your daily cup of Joe.  

Some mycotoxins are found in buildings, especially those produced by black mold:

  • Trichothecenes made from the mold called Stachybotrys (black mold)
  • Ochratoxin, which may hide out in wallpaper, furniture, and fiberglass insulation.

Research suggests that up to 50% of buildings in North America and Europe have water damage that can lead to mold infestations. This has to do with how we build buildings. We wrap them in plastic and use materials that are susceptible to water damage and mold growth.   

What’s more, the mold could be lurking in your home without you even knowing it’s there. Creepy, yes? It’s sometimes good at hiding because not all mold causes that yucky musty smell.

Black mold is the one many people think about when they hear about toxic indoor mold. That’s because it’s one of the most common toxin-producing molds. Black mold symptoms include those mold toxicity symptoms I mention later in this article.

Black mold may be one of the most common — and grossest – molds many people are exposed to, but it’s not the only one that causes issues in people with digestive problems. 

Here are some other mycotoxin-producing molds that can cause mold toxicity symptoms:

  • Aspergillus
  • Chaetomium
  • Cladosporium
  • Fusarium
  • Mucor 
  • Penicillium 
  • Rhizopus 
  • Wallemia

When inhaled or ingested by humans, mold-made toxins can do a real number on the health of susceptible people.

 

When Mold Meets Your Immune System

When exposed to mold, your body can react in one of two ways:

  • Mold allergy – This is a reaction by the immune system to the mold itself. Think runny nose, red eyes, itchy skin.
  • Mold illness – Unlike mold allergies, mold illness causes problems throughout your body. Mold illness can cause widespread inflammation called chronic inflammatory response syndrome (CIRS), otherwise known as biotoxin illness. CIRS can be caused by other factors, but when it occurs together with a known history of mold exposure, odds are mycotoxin exposure is playing a role in this inflammatory illness.  

CIRS is also linked to food sensitivities and intolerances. There’s also a connection between CIRS and hypersensitivity to chemicals and other substances that never bothered you before you were exposed to mold.

 

Symptoms of Toxic Mold Exposure

After exposure to toxic mold, your body may react by developing certain symptoms. In some people, these can be crippling. I’ve treated people exposed to mold who almost couldn’t function. Often, they couldn’t think straight to the point it was very hard for them to even follow my protocol for healing. Many of them had severe pain, nervous system, and/or immune system problems. 

Other mold-exposed people have vague symptoms that are milder or come and go. 

Here are some of the common symptoms of mold exposure:

  • ADD/ADHD
  • Anorexia
  • Asthma
  • Body aches and pains
  • Chronic fatigue syndrome
  • Depression
  • Digestive problems
  • Headaches, especially migraines
  • Histamine-related symptoms
  • Hives
  • Hormone imbalances
  • Hypersensitivity to foods, chemicals, and other items that didn't previously bother you
  • Insomnia
  • Immune system dysfunction
  • Memory/learning problems
  • Mood disorders
  • Poor word recall
  • Pulmonary diseases
  • Rashes
  • Sinus symptoms
  • Unwanted weight loss
  • Weight gain

 

Are You Susceptible to Toxic Mold Syndrome?

Just because you’re exposed to mold doesn’t mean you’ll develop any symptoms of mold poisoning.

Some people can live in a super moldy home, where the mold is actually visible, and yet not experience a single symptom. 

So you’re wondering why you’re not one of those lucky people. Maybe you’re extremely sensitive to mold exposure. You live in the same building with others who are perfectly healthy, yet you’re sick. This can be because:

  • You’re exposed to more mold (you have a higher body burden or toxic load).
  • You’ve been exposed for longer.
  • Your genetic makeup. Some genes boost the susceptibility to mold toxicity by 24%.
  • Your immune system doesn’t identify and clear mold toxins as easily as someone else’s does. In this case even smaller overall exposure levels can harm your health. 

Other reasons why some people are more susceptible to mold sickness than others:

  • Type of mycotoxin you’re exposed to
  • Age
  • Gender
  • Health status
  • Nutritional status

 

Mold and IBS

Digestive problems don’t always come to mind when thinking about mold toxicity. Yet, mold exposure can cause major problems in your digestive tract. 

Mycotoxins can declare all-out war against the good bacteria in your intestines. This causes the bad bacteria to take over.

The result? Constipation, diarrhea, and abdominal pain. Leaky gut also often develops when mycotoxins damage the gut barrier. In leaky gut, undigested food particles or toxins from the outside world leak through your gut lining into your circulation, causing problems not only in your gut, but also throughout the body. 

The opposite of this is also true. If your gut microbiome – the population of good and bad microorganisms that live in your intestines – is well balanced with just the right amount of good little guys, it will make you less susceptible to mold-related digestive problems. They can also protect you from mycotoxins.

 

Mold Makes Life Easy for SIBO

Mold can open the door to infections of the gut by reducing immunity. Toxins from black mold are linked to a drop in levels of a substance called IL-8 in the intestine that helps remove pathogens. This leads to infections in the gut.

SIBO happens when there is an abnormal rise in the overall bacterial numbers of the small intestine – especially types of bacteria not usually found in that part of the body. 

In fact, many cases of SIBO are really post-infectious IBS that occur after a person has experienced food poisoning. If mycotoxins are present, your small intestine is even more vulnerable to this type of infection. 

That means mycotoxins can make you more likely to develop SIBO. And they get in the way of healing this disorder.

Your functional medicine provider can order the right tests to diagnose whether you have SIBO.

 

Testing for Mold Exposure

If a patient with digestive problems has symptoms of mold exposure or has a known exposure to mold, we will order the Great Plains Laboratory or RealTime Labs Mycotoxin Panel. 

There’s also visual contrast sensitivity testing (VCS), which was originally created by the department of defense to find out if soldiers had been exposed to biotoxins. You can take a VCS test online. It costs only $15. 

If the mycotoxin panel indicates you have mold exposure, we’ll order blood work to measure how much inflammation the mycotoxins are causing in your body. We’ll order the same blood work to monitor and measure your progress with treatment. 

 

Treatments for Mold Exposure

Here is what we do to treat IBS and SIBO patients who have mold toxicity. With this protocol, we’ve had excellent results clearing roadblocks to healing. 

  • We urge patients to leave the mold-contaminated environment for several weeks, or until the area can be decontaminated or remediated….lots of outside time is helpful! 
  • Remediate your home or office. Use a professional IEP (independent environmental professional) and make sure they check the HVAC system for mold.
  • Have your home/car/work spaces assessed by trained professionals and also use an ERMI test to make sure your spaces have low enough mycotoxin levels to allow you to start treatment. 
  • Treat and clear GI parasitic pathogens first and improve the health of the microbiota through the use of probiotics. These beneficial bacteria are your gut’s best friend. Many strains of probiotics can reduce the level of mycotoxins by binding to the toxins and boosting the immune system.
  • Usually wait to treat SIBO or Candida-type fungal dysbiosis until after mycotoxin treatment is underway.
  • Eat a low-mold diet, including a mold-free diet brand of coffee such as Bulletproof
  • Take binder supplements that help bind and remove mycotoxins. We can help you choose the right ones for the mycotoxins that are present. We commonly use activated charcoal, chitosan, silica, and BioAloe. 
  • Agents such as liposomal glutathione to coax mycotoxins out from the intracellular space and help remove them.
  • Sauna and sweating [check out HigherDose] helps detoxify mycotoxins—especially ochratoxin - but all mycotoxins to some extent.
  • Neuroplasticity techniques can be extremely effective in helping to minimize symptoms and regulate hypersensitivity in people with mycotoxin issues. My go-to is the Gupta Program.

 

Say Goodbye to the Root Cause of Your Digestive Problems

Is your IBS, SIBO, or other stubborn digestive problems caused by mold toxicity? The first step to finding out is to book a free 15-minute troubleshooting call

If after the call you come on board as a patient, I’ll dig down deep to discover the main reason why you have digestive problems – whether it’s mold sickness or some other cause. Then I’ll recommend the right tests and treatments to start you on your healing journey. We’ll remove the roadblocks that hold you back from optimum gut health and get you feeling your best again.


Veggie Smoothie Recipe

Veggie Smoothie Recipe

Smoothies make for an easy way to start the day but if you throw in a few cups of tropical fruit and some juice….and that super healthy smoothie can actually start to have a lot in common with a can of soda when it comes to sugar content!

I love this veggie forward smoothie for the fiber, water content, minerals, and healthy fats it contains. I’m not a purist— you can certainly throw in some berries or other low glycemic fruit and make it your own creation. But you can feel good knowing that this will feed those commensal microbiome bacteria, provide you with antioxidants, and support stable blood sugar as you get your day going!

Veggie Smoothie Recipe

Ingredients:

  • 3-4 Cups filtered water 
  • 1 Avocado 
  • 4 Lacinto Kale Leaves 
  • 3 Celery Stalks
  • 1 inch Ginger Chunk, peeled, or 1 tsp ginger puree
  • ½ cucumber or 1 zucchini
  • 1/2 Bunch Parsley 
  • Juice of 2 Lemons
  • 1 teaspoon Sea Salt or Himalayan salt 

Optional add in’s: 

  • pinch of cayenne
  • 2 tsp Dulse Flakes
  • substitute cilantro instead of parsley
  • add collagen powder for protein
  • add frozen riced cauliflower
  • add 1 TBS extra virgin olive oil for additional healthy fats.