Authored by Dr. Aidanne

Supporting Your Immune System
As we step into fall, our immune systems need a little extra help to fend off common seasonal illnesses (ie. Cold, flu, etc.), seasonal allergies, and the stress of a new school year. Below are some essential nutrients and practices to support your immune system.

Vitamin D
Vitamin D is a crucial player in maintaining a robust immune system. During the fall and winter months daylight grows shorter, we transition to spending less time outside, and the sun rests at a lower altitude than during the summer months. Since our bodies are able to synthesize Vitamin D from exposure to UV radiation when at peak altitude, this means our natural vitamin D levels can drop come the fall and winter. Consider incorporating vitamin D-rich foods into your diet, such as fatty fish (like salmon and mackerel), fortified dairy products if tolerated, and egg yolks. If you find it challenging to get enough vitamin D from food alone or have sensitivities to these foods, a supplement is a great option. Again, be sure to consult with your provider to determine which dosing schedule is right for you!

Vitamin C
Vitamin C is a staple in most medicine cabinets, especially this time of year. Vitamin C’s reputation as an immune support stems from its ability to help stimulate the production of white blood cells, which are essential for fighting infections. Citrus fruits (ie. oranges, grapefruits, and lemons), bell peppers, strawberries, and broccoli are excellent sources of vitamin C. 

Zinc
Zinc plays a significant role in immune function and cell division. It’s essential for wound healing and can help reduce the duration and severity of colds. Foods high in zinc include nuts, seeds, legumes, and whole grains. Adding these to your meals can give your immune system the extra support it needs.

Astragalus
Astragalus is an herb traditionally used in Chinese medicine to boost immunity and energy. Recent research supports its role in enhancing immune function. Specifically, studies have shown that Astragalus can promote white blood cell production and activity, which is crucial for fighting off infections. Astragalus polysaccharides have been shown in the literature to stimulate the production and function of white blood cells, which are responsible for a prompt & profound immune response.(1) While Astragalus can be taken as a supplement, it’s also available in teas or tinctures. As always, be sure to speak with your naturopathic provider before starting any new supplement.

Elderberry
Elderberry, derived from the Sambucus tree, is rich in antioxidants and vitamins that support robust immune function. The literature is mixed on the ability of elderberry to prevent colds and flus, but it may help to reduce the duration of common cold symptoms.(2) My favorite way to use elderberry is as a syrup, which you can even make at home if you’re feeling ambitious!

Meals as Medicine
Your diet plays a pivotal role in maintaining overall health and supporting your immune system. Packing a balanced lunch can help your brain perform at its best while you tackle new material in the classroom. Here are some tips and favorite meal ideas to keep you fueled and focused:

• Balanced Meals: Aim for a lunch that includes a good mix of protein, fat, and carbohydrates. Protein helps with muscle repair and growth, fat provides sustained energy, and carbohydrates fuel your brain. Think uncured turkey, tomato & avocado sandwiches, quinoa salads with beans & veggies, etc.
• Easy Grab-and-Go Options: Meal prepping is key to staying on track with healthy eating, even on the busiest of days. Prepare snacks and meals that are easy to grab and go, such as:
  • Single Serve Hummus or Guacamole Packets with Chopped Veggies
  • Fruit & nut bars
  • Homemade trail mix. 
  • Turkey Jerky
  • Hard Boiled Eggs or Mini Egg Muffins with Veggies
  • Overnight Oats or Chia Puddings with Berries or Apple & Cinnamon 
  • Greek Yogurt Cups with Walnuts, Seeds and Fruit
  • Stuffed Peppers 
  • Turkey Roll-Ups with Hummus, Feta & Olives

Rejuvenating Sleep
Sleep is a fundamental aspect of health, especially when you're balancing schoolwork, extracurricular activities, and social events. Ensuring you get quality rest also helps with memory consolidation, cognitive performance, and overall well-being.

Sleep Needs by Age: Based on CDC guidelines, recommended sleep hours for different age groups include the following within a 24-hour period (3):

• Children (5-6 years): 10-12 hours
• Children (7-12 years): 9-12 hours
• Teenagers (13-18 years): 8-10 hours
• Young Adults (18-25 years): 7-9 hours

Sleep Hygiene Tips: Maintain a regular sleep schedule, limit screen time before bed, and create a relaxing pre-sleep routine to help signal to your body that it’s time to wind down. Sleep thrives on routine, so the more structure you can integrate here the better sleep you will achieve!

References:
1.Denzler K, Moore J, Harrington H, et al. Characterization of the Physiological Response following In Vivo Administration of Astragalus membranaceus. Evid Based Complement Alternat Med. 2016;2016:6861078. doi:10.1155/2016/6861078
2. Wieland LS, Piechotta V, Feinberg T, et al. Elderberry for prevention and treatment of viral respiratory illnesses: a systematic review. BMC Complement Med Ther. 2021;21(1):112. Published 2021 Apr 7. doi:10.1186/s12906-021-03283-5
3. https://www.cdc.gov/sleep/about/index.html 

Authored by Dr. Barrett

Authored by Dr. Barrett

Authored by Dr. Aidanne

In this article we will outline how we use sugar, how insulin resistance develops, common signs and symptoms of dysglycemia, and naturopathic approaches to manage blood sugar levels.

How Our Bodies Use Sugar:
Our bodies need three key macronutrients to survive: fat, protein, and carbohydrates. Carbohydrates come from foods such as fruits, vegetables, legumes, nuts, seeds, and grains. When we consume carbohydrates, our body makes enzymes to break it down into glucose. Glucose is a form of sugar that serves as the primary energy source for our cells. As a response to increased sugars entering the blood stream, our pancreas produces a hormone called insulin, the primary role of which is to facilitate entry of glucose into our cells. Once in the cell, glucose can be further broken down through the Krebs Cycle and used for energy. 

As glucose levels rise, so does insulin. Due to factors like genetics, lifestyle, and diet, cells can become less responsive to insulin over time. It's like the locks on the cell are getting a bit rusty, and insulin's key can’t work as well to open the door. Once this happens, the body tries to compensate by producing more insulin to complete the same task. This can become taxing on the pancreas and leaves blood glucose levels remain high, which can eventually lead to the development of type 2 diabetes.

Signs of Dysglycemia:
Common signs and symptoms of dysglycemia include increased thirst, increased hunger, frequent urination, fatigue, mood changes, sleep challenges, and difficulty concentrating. Often, we hear that symptoms of fatigue set in shortly after eating a carbohydrate rich meal. Blood sugar imbalances can also impact our other organ systems and often contributes to acne, PCOS, thyroid imbalances, abdominal discomfort, joint pain, reduced kidney function, erectile dysfunction, poor immune function and delayed wound healing. 

Testing:
Routine blood work is used to determine one’s glucose regulation. This testing could include a comprehensive metabolic panel (CMP), fasting blood glucose, insulin and hemoglobin A1c. 

Fasting blood glucose levels below 100 milligrams per deciliter (mg/dL) are generally considered normal. Levels between 100-125 mg/dL may indicate prediabetes (impaired fasting glucose), while levels of 126 mg/dL or higher on two separate tests typically indicate diabetes. 

Hemoglobin A1c (HbA1c) is a marker that reflects average blood glucose levels over the past 2-3 months. It provides a comprehensive view of long-term glucose control. A normal HbA1c level is typically below 5.7%. Levels between 5.7% and 6.4% suggest an increased risk of diabetes (prediabetes), while levels of 6.5% or higher are indicative of diabetes. 

Naturopathic Approach to Blood Sugar Management:
Naturopathic medicine emphasizes a holistic approach to healing by addressing the root causes of imbalances rather than focusing on treating symptoms. 

Movement:
Engaging in consistent, routine movement is one of the best ways to address dysglycemia, because when we move our bodies our tissues burn sugars for fuel. Regular movement also improves insulin sensitivity over time. The CDC recommends a combination of aerobic exercise and strength training tailored to your fitness level. Ultimately the goal is to achieve 150 minutes weekly of moderate to vigorous exercise, but this could look like many different things! Swimming, biking, walking, pilates, Barré, dancing, yoga, HIIT. You name it! Get creative and get out there.  


Nutrition and Diet:
Using food as medicine is key when it comes to blood sugar regulation! Poor food quality is often where the issue arises in the first place. We encourage our patients to focus on a whole-foods, plant rich diet high in fiber, vitamins, and antioxidants. Pairing carbohydrate rich foods with proteins, fiber, and beneficial fats can help to not only improve satiety but also stabilize post-prandial glucose levels to prevent spikes and dips that can negatively impact insulin signaling. Complex carbohydrates and resistant starches found in whole grains and legumes are often a better option than refined carbohydrates as they provide a steady release of glucose and prevent spikes in blood sugar (But be careful with white rice!). Adding 1⁄2 an avocado to meals has also been shown to help stabilize post-meal glucose levels.

Stress Management:
Chronic stress can contribute to insulin resistance. Encourage stress-reduction techniques such as meditation, yoga, and deep breathing exercises.

Herbs & Nutritional Supplements:
After lifestyle factors have been addressed, herbs and nutrients can be a useful tool to both lower blood sugar levels and support insulin sensitivity. The following are a few of the many evidence-based interventions that may help!

Berberine: 
Numerous studies have demonstrated berberine's ability to improve insulin sensitivity and reduce blood glucose levels. A meta-analysis from 2021 concluded that berberine can significantly lower fasting blood glucose and hemoglobin A1c levels in individuals with type 2 diabetes. Berberine works by of increasing glucose uptake in cells, improving insulin sensitivity, and reducing inflammation.
 
Cinnamon:
Cinnamon has been studied for its potential to enhance insulin sensitivity and lower blood glucose levels. Two systematic reviews, one from 2013 and another from 2023, highlighted several clinical trials suggesting that cinnamon supplementation may contribute to improved glycemic control in people with type 2 diabetes., The active compound in cinnamon, cinnamaldehyde, is believed to have insulin-sensitizing effects, helping cells respond more effectively to insulin.

Fenugreek: 
Fenugreek is an herb commonly used in traditional medicine and has been studied for its potential antidiabetic effects. A randomized controlled trial from 2014 found that fenugreek supplementation significantly reduced fasting blood glucose and improved insulin sensitivity in patients with type 2 diabetes. The soluble fiber in fenugreek may contribute to its blood sugar-lowering effects, possibly by slowing down the absorption of glucose.

Myoinositol:
Myo-inositol is a naturally occurring sugar alcohol that belongs to the Vitamin B family. Myoinositol has been shown to support insulin sensitivity in those living with PCOS. A recent meta-analysis also suggested that myo-inositol supplementation during pregnancy may help reduce the risk of gestational diabetes due to its insulin sensitizing effects.

Be sure to consult with your naturopathic doctor prior to using these compounds, as dosing can vary per person and regular bloodwork is needed to monitor both their safety & efficacy. 

References:

• National Diabetes Statistics Report 
• ​https://emedicine.medscape.com/article/117853-clinical
• Inzucchi SE, Lupsa B, Nathan DM, Wolfsdorf JI, Rubinow K. Clinical presentation, diagnosis, and initial evaluation of diabetes mellitus in adults. UpToDate. Current through Oct 2023. Updated Nov. 8, 2023. 
• Amanat S, Ghahri S, Dianatinasab A, Fararouei M, Dianatinasab M. Exercise and Type 2 Diabetes. Adv Exp Med Biol. 2020;1228:91-105. doi: 10.1007/978-981-15-1792-1_6. PMID: 32342452.
•  Park E, Edirisinghe I, Burton-Freeman B. Avocado Fruit on Postprandial Markers of Cardio-Metabolic Risk: A Randomized Controlled Dose Response Trial in Overweight and Obese Men and Women. Nutrients. 2018;10(9):1287. Published 2018 Sep 12. doi:10.3390/nu10091287
• Pang B, Zhao LH, Zhou Q, et al. Application of berberine on treating type 2 diabetes mellitus. Int J Endocrinol. 2015;2015:905749. doi:10.1155/2015/905749

• Guo J, Chen H, Zhang X, et al. The Effect of Berberine on Metabolic Profiles in Type 2 Diabetic Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Oxid Med Cell Longev. 2021;2021:2074610. Published 2021 Dec 15. doi:10.1155/2021/2074610


• Robert W. Allen, Emmanuelle Schwartzman, William L. Baker, Craig I. Coleman, Olivia J. Phung
• The Annals of Family Medicine. Sep 2013, 11 (5) 452-459; DOI: 10.1370/afm.1517
•  Zarezadeh, M., Musazadeh, V., Foroumandi, E. et al. The effect of cinnamon supplementation on glycemic control in patients with type 2 diabetes or with polycystic ovary syndrome: an umbrella meta-analysis on interventional meta-analyses. Diabetol Metab Syndr 15, 127 (2023). https://doi.org/10.1186/s13098-023-01057-2
• Rafraf M, Malekiyan M, Asghari-Jafarabadi M, Aliasgarzadeh A. Effect of fenugreek seeds on serum metabolic factors and adiponectin levels in type 2 diabetic patients. International Journal for Vitamin and Nutrition Research. 2014;84(3-4):0196-0205.
• Merviel, P., James, P., Bouée, S. et al. Impact of myo-inositol treatment in women with polycystic ovary syndrome in assisted reproductive technologies. Reprod Health 18, 13 (2021). https://doi.org/10.1186/s12978-021-01073-3
• Greff D, Váncsa S, Váradi A, Szinte J, Park S, Hegyi P, Nyirády P, Ács N, Horváth EM, Várbíró S. Myoinositols Prevent Gestational Diabetes Mellitus and Related Complications: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Nutrients. 2023; 15(19):4224. https://doi.org/10.3390/nu15194224

Authored by Dr. Barrett

1. Hypothyroidism

• Definition: Underactive thyroid; insufficient production of thyroid hormones.
• Common Causes: Autoimmune thyroiditis (Hashimoto's), iodine deficiency, medications.
• Symptoms:
  • Fatigue
  • Weight gain
  • Cold intolerance
  • Hair loss
  • Depression

2. Hyperthyroidism

• Definition: Overactive thyroid; excessive production of thyroid hormones.
• Common Causes: Graves' disease, thyroid nodules, inflammation/recent viral infection.
• Symptoms:
  • Weight loss
  • Rapid heartbeat
  • Anxiety
  • Tremors
  • Heat intolerance

3. Hashimoto's Thyroiditis

• Definition: An autoimmune condition causing hypothyroidism.
• Common Features:
  • Presence of thyroid antibodies
  • Gradual destruction of thyroid tissue
  • Fluctuating thyroid hormone levels

4. Graves' Disease

• Definition: An autoimmune condition causing hyperthyroidism.
• Common Features:
  • Presence of thyroid antibodies
  • Overstimulation of thyroid gland
  • Increased production of thyroid hormones

5. Thyroid Nodules

• Definition: Abnormal growths or lumps in the thyroid gland.
• Common Causes: Iodine deficiency, inflammation, genetic factors.
  
• Symptoms:
  
  • Swelling in the neck
    
  • Difficulty swallowing
    
  • Hoarseness
    
  • Pain or discomfort

Hypothyroidism
Hypothyroidism is a condition characterized by an underactive thyroid, where the thyroid gland fails to produce sufficient thyroid hormones. This condition can manifest due to various factors and affects individuals of all ages, with a higher prevalence in women and older adults.

Common Symptoms of Hypothyroidism:

• Weight gain
• Fatigue
• Cold intolerance
• Constipation
• Hair loss
• Depression
• Dry skin
• Muscle weakness
• Joint pain
• Memory issues

​Causes of Hypothyroidism:
Autoimmune Thyroiditis (Hashimoto's):

• The most common cause of hypothyroidism is Hashimoto's thyroiditis, an autoimmune condition where the immune system attacks and damages the thyroid gland. See more details about Hashimoto’s below. 

Iodine Deficiency:

• In regions with insufficient dietary iodine, the thyroid may struggle to produce thyroid hormones, leading to hypothyroidism.

Thyroid Surgery or Radioactive Iodine Treatment:

• Individuals who have undergone thyroid surgery or received radioactive iodine treatment may experience a reduction in thyroid function.

Medications:

• Certain medications, such as lithium and amiodarone, can interfere with thyroid hormone production.

Congenital Factors:

• Some individuals may have congenital conditions affecting thyroid development or function.

Pituitary Disorders:

• Dysfunction of the pituitary gland, which regulates thyroid function, can result in hypothyroidism.

​
Diagnosis:

• Diagnosis involves blood tests measuring TSH (Thyroid Stimulating Hormone), Free T3, and Free T4 levels.
• Anti-TPO antibodies and Anti-TG antibodies may be tested to determine if the hypothyroidism is autoimmune (Hashimoto's).

Conventional Treatment:

• Standard treatment involves thyroid hormone replacement therapy, typically with synthetic T4 (levothyroxine/synthroid).

Hyperthyroidism
Hyperthyroidism is a condition marked by an overactive thyroid, where the thyroid gland produces an excess of thyroid hormones. This heightened thyroid activity can arise from various factors and typically affects individuals under the age of 40, with a higher prevalence in women.

Common Symptoms of Hyperthyroidism:

• Weight loss
• Rapid heartbeat
• Anxiety
• Tremors
• Heat intolerance
• Sweating
• Insomnia
• Palpitations
• Bulging eyes (Graves' ophthalmopathy)

Causes of Hyperthyroidism:
Graves' Disease:

• The most common cause of hyperthyroidism is Graves' disease, an autoimmune condition where the immune system stimulates the thyroid to produce excessive hormones.

Thyroid Nodules:

• Abnormal growths on the thyroid, known as nodules, can lead to an overproduction of thyroid hormones.

Thyroiditis:

• Inflammation of the thyroid, often caused by infections or autoimmune factors, can cause a temporary release of stored thyroid hormones.

Excessive Iodine Intake:

• Consuming an excessive amount of iodine, whether through diet or supplements, can lead to hyperthyroidism.

Medications:

• Certain medications, such as amiodarone, interferon, and lithium, can disrupt thyroid function.

Pituitary Disorders:

• Dysfunction of the pituitary gland, which regulates thyroid function, can result in excessive thyroid hormone production.

Diagnosis:

• Diagnosis involves blood tests measuring TSH (Thyroid Stimulating Hormone), Free T3, and Free T4 levels.
• Thyroid antibodies, specifically TSI (Thyroid Stimulating Immunoglobulin), are often tested to confirm Graves' disease.
• Imaging studies, such as a thyroid ultrasound or nuclear thyroid scan, may be conducted to assess the size and condition of the thyroid.

Conventional Treatment:

• Conventional treatment includes antithyroid medications (methimazole, propylthiouracil), radioactive iodine therapy, or surgical removal of the thyroid (thyroidectomy).

Hashimoto’s
Hashimoto's thyroiditis, clinically known as chronic autoimmune (lymphocytic) thyroiditis, is an autoimmune condition where the immune system erroneously targets and dismantles the thyroid gland, causing a gradual decline in thyroid function. Hashimoto's is significantly more prevalent in women, occurring seven times more frequently than in men.

Common Symptoms of Hashimoto's:

• Weight gain
• Fatigue
• Cold intolerance
• Constipation
• Hair loss
• Depression
• Heavy periods
• Muscle aches
• Poor concentration
• Dry skin

Some individuals with Hashimoto's experience Hashitoxicosis, characterized by alternating periods of excessive thyroid hormone release and subsequent hypothyroid symptoms, creating a roller-coaster effect.

Contributing Factors to Hashimoto's:
Postpartum:

• Immune system shifts during pregnancy may trigger postpartum Hashimoto's, either transient or permanent.

Iodine:

• Mild iodine deficiency is linked to a lower prevalence of Hashimoto's, while excessive intake is associated with a higher incidence.

Molecular Mimicry:

• Immune response to substances (e.g., gluten, bacteria) can lead to confusion, resulting in an attack on thyroid tissues.

Intestinal Permeability (Leaky Gut):

• Breakdown in the gut barrier allows larger particles into the bloodstream, triggering an immune response.

Genetic Predisposition:

• A family history of thyroid disease is strongly associated with Hashimoto's, although specific contributing genes are not fully understood.

Stress:

• Chronic stress, if not managed, may impact cortisol levels, affecting the immune system and contributing to the development of Hashimoto's.

Radiation Exposure:

• Excessive radiation to the thyroid increases the risk of thyroid disorders.

Diagnosis:

• Blood work and/or a thyroid ultrasound are used for diagnosis.
• Comprehensive blood work includes TSH, FT3, FT4, Anti-TPO antibodies, and Anti-TG antibodies.
• Elevated antibodies suggest Hashimoto's, even in the absence of abnormal TSH, T3, or T4 levels.

Conventional Treatment:

• Conventional treatment often involves synthetic T4 replacement, with little distinction between Hashimoto's and hypothyroidism.

Grave’s Disease
Graves' disease, an autoimmune disorder, is marked by the immune system mistakenly attacking the thyroid gland, resulting in excessive production of thyroid hormones. Unlike Hashimoto's, Graves' disease leads to hyperthyroidism, causing an overactive thyroid. This condition is more prevalent in women and often manifests in individuals under the age of 40.

Common Symptoms of Graves' Disease:

• Weight loss
• Rapid heartbeat
• Anxiety
• Tremors
• Heat intolerance
• Sweating
• Insomnia
• Palpitations

Individuals with Graves' disease may also experience Graves' ophthalmopathy, characterized by eye-related symptoms such as bulging eyes, double vision, and eye irritation.

Contributing Factors to Graves' Disease:
Genetic Predisposition:

• Family history of thyroid disorders increases the likelihood of developing Graves' disease, indicating a genetic component.

Molecular Mimicry:

• Similar to Hashimoto's, molecular mimicry plays a role, with the immune system targeting the thyroid due to confusion with external substances, often involving the TSH receptor.

Stress:

• Chronic stress may contribute to the development of Graves' disease, potentially through its impact on the immune system.

Infections:

• Certain infections, particularly viral infections, have been linked to the onset of Graves' disease.

Pregnancy:

• Pregnancy, like in Hashimoto's, can trigger shifts in the immune system, leading to the development of Graves' disease.

Smoking:

• Cigarette smoking has been associated with an increased risk of Graves' disease and exacerbation of symptoms.

Diagnosis:

• Diagnosis involves blood tests measuring TSH, Free T3, Free T4, and thyroid antibodies (TSI—Thyroid Stimulating Immunoglobulin).
• Imaging studies, such as a thyroid ultrasound, may be conducted to assess the size and condition of the thyroid.

Conventional Treatment:

• Conventional treatment often includes antithyroid medications (methimazole, propylthiouracil), radioactive iodine therapy, or surgical removal of the thyroid (thyroidectomy).

Thyroid Nodules
Thyroid nodules are abnormal growths or lumps in the thyroid gland, a common condition that can vary in size and nature. While most nodules are benign, some may raise concerns about thyroid function or the possibility of thyroid cancer.

Common Features of Thyroid Nodules:

• Presence of a palpable lump or swelling in the neck
• Difficulty swallowing or breathing, particularly for larger nodules
• Hoarseness or voice changes
• Occasionally, pain or discomfort in the neck

​Causes of Thyroid Nodules:
Iodine Deficiency:

• In regions with low dietary iodine, the thyroid may develop nodules as a compensatory response.

Thyroiditis:

• Inflammation of the thyroid, whether due to autoimmune factors or infections, can lead to nodule formation.

Multinodular Goiter:

• An enlargement of the thyroid gland, known as a goiter, can harbor multiple nodules.

Cysts:

• Fluid-filled sacs may develop within the thyroid, forming cystic nodules.

Benign Tumors:

• Non-cancerous tumors, such as adenomas, can contribute to nodular growth.

Thyroid Cancer:

• While most nodules are benign, some may indicate thyroid cancer, necessitating thorough evaluation.

Diagnosis:

• Diagnosis involves imaging studies, such as ultrasound, to assess the size, location, and characteristics of the nodules.
• Fine Needle Aspiration (FNA) biopsy may be performed to extract cells for microscopic examination.
• Blood tests, including thyroid function tests, may aid in assessing thyroid hormone levels.

​Conventional Treatment:

• Treatment depends on the nature of the nodules. Benign nodules may be monitored, while interventions such as surgery or radioactive iodine therapy may be considered for larger or suspicious nodules.

Thyroid Health in General
Dietary Interventions: A cornerstone of our treatment involves advocating for a high-antioxidant diet abundant in vegetables. Nourishing the body with these vital nutrients supports overall health and specifically targets the oxidative stress often associated with thyroid disease.

Health Foundations: We ensure that patients have a solid foundation of health including proper sleep, hydration, physical activity and rest time. 

Nutrient optimization: We test our patients for nutritional status such as vitamin D, ferritin and other synergistic nutrients/hormones that are necessary for proper thyroid function. 

Herbal medicine: We may utilize specific herbs to support thyroid health such as ashwagandha, guggul and bladderwrack. 

Autoimmune Thyroid Diseases

Digestive Health: We work to identify and heal any intestinal permeability and foster a healthy balance of flora in the gastrointestinal tract. This holistic approach acknowledges the interconnectedness of gut health and immune function.

Identify Triggers: We look for factors that may contribute to autoimmune disease such as the Epstein Barr Virus, dysbiosis, food sensitivities such as gluten, and heavy metal exposure. 

Mind-Body Medicine: Recognizing the impact of stress on autoimmune disease, our approach incorporates mind-body medicine. We assess stressors, analyze stress responses, and explore somatic manifestations. Questions about the ability to express one's truth are posed, acknowledging the proximity of the thyroid to the voice box and its potential role in stress-related dysfunction.

Herbal Medicine: We utilize herbs that reduce thyroid function in hyperthyroid states such as Grave’s disease. 

Nutritional Support: We tailor nutritional needs to each patient but some examples include carefully monitoring iodine intake in Hashimoto’s patients to avoid excess, enhancing selenium intake to support a healthy immune response, and ensuring optimal nutrient intake to support phase II liver detoxification (high sulfur foods for example).  

Collaboration with a Naturopathic Doctor: For those navigating Hashimoto's or Grave’s Disease, we recommend collaborating with a naturopathic doctor. Identifying the root causes of autoimmune diseases and tailoring treatment to individual needs are central to our philosophy. Together, we strive to restore balance and enhance overall well-being. With Grave’s disease we also recommend working with an endocrinologist. 

Authored by Dr. Barrett and Dr. Aidanne

Cold and flu season are here, so let’s work to keep your immune system in tip-top shape to lower the risk of falling ill this winter. How the immune system functions is influenced by many internal and environmental factors. Staying active, practicing proper hand hygiene, using humidifiers, making good nutritional choices, managing stress, prioritizing sleep and using herbs or supplements can all help! ​​

​Nutrition to Support Your Immune System:

Proper nutrition is the foundation of a strong immune system. We like to advise our patients to “eat the rainbow” when it comes to vegetables and fruits, as each color band offers a different and nourishing antioxidant. 

Antioxidants help to protect cells from the oxidative stress and toxins your body experiences as you fight an infection. Foods that fall in the yellow to red bands are rich in Vitamin A precursors which also support our gut related immune system and mucus membranes. Bell Peppers & Citrus fruits such as oranges, grapefruits, lemons, and limes are especially rich in Vitamin C, which supports the production of immune cells and has been shown to help reduce the severity and duration of colds. 

Garlic contains allicin, which has potent antimicrobial, antifungal, and anti-inflammatory properties to help the body better clear infections. 

Ginger & turmeric both have strong antioxidant and anti-inflammatory effects to help the immune cells function & clear infections more efficiently. 

Probiotics are found in fermented or aged foods such as sauerkraut, kimchi, kombucha, kefir, miso, tempeh, pickled veggies and yogurt. These beneficial microbes help to keep our gut related immune cells responsive to invaders. 

Mushrooms such as maitake and shiitake contain beta-glucans which can stimulate immune function and tell the body to make more macrophages and natural killer cells. 

Achieving sufficient protein intake is also key, as the amino acids we get from breaking protein down are used to make our antibodies. This can come from nuts, seeds, legumes, lean meats, etc. 

Finally, staying well hydrated is a must! This not only helps improve circulation to transport the nutrition you just gained to your tissues, but also facilitates waste removal and lymph flow. Aim to achieve at least half your body weight (lbs) in ounces of water daily. Also, fighting off infections will induce sweating that can lead to dehydration. Adding some electrolytes can also help offset this and get you feeling better faster.

Lifestyle Factors:

1.) Movement:

Regular exercise confers many benefits to the immune system. When our muscles flex and extend, there is a pumping action that occurs which promotes lymph flow. The lymphatic system produces white blood cells (WBC) or lymphocytes which are crucial for identifying and eliminating pathogens such as viruses. The lymphatic system is also responsible for clearing bacterial and viral waste products back to the bloodstream for elimination. Regular movement also helps to increase circulation of white blood cells (WBC) which allows the immune system to better patrol for threats and act quickly to fend them off. Movement also relieves stress, reduces inflammation, and promotes a restful sleep all of which are needed to prevent an overactive immune response and help our tissues heal. Also, we work up a sweat to cool our internal temperature down. When this temperature rises, it keeps certain bacteria and viruses from settling into the system. 

2.) Sleep:

During sleep, the body produces antibodies, primes T-cells for optimal function, and releases cytokines. Cytokines help to keep the inflammatory process well synchronized to activate the immune system and target viral or bacterial cell death. Both duration and quality of sleep are important. Deep, restorative sleep is more beneficial than disrupted patterns. Aim to achieve 7+ hours nightly and develop your daily sleep hygiene practices (ie. maintaining a consistent sleep-wake schedule, comfortable sleeping environment, limiting screen time before bed, ensuring the bed is only used for sleep or intercourse, etc.) 

3.) Stress Management:

Have you ever gotten sick after a particularly stressful period of time? This is common! Prolonged or chronic stress weakens the immune system. When we are put into a stressful situation, our body produces cortisol to sound the “fight or flight” alarm. High levels of cortisol over time can suppress the production and function of our lymphocytes. These include T-cells which kill infected cells and B-cells which produce antibodies aimed to fight off future invaders. Chronic stress also promotes low grade inflammation, which can not only damage our tissues but interfere with immune signaling. When our vitamin and nutrient resources are going toward offsetting the damage of this stress response, it will take longer for our tissues to heal. Our first line of protection such as the skin and mucous membranes will suffer. Stress also reduces variety in our microbiome which results in a weakened gut related immune system. Be sure to schedule time for yourself during the week and, if you need more support, please talk to your mental health specialist and naturopathic doctor about ways to manage your stress!


4.) Environment: 

Maintaining a clean will keep the immune system from being bogged down by dust mites or other irritants. Also, as the weather cools the air dries and can become irritating to the bronchi and lungs. Using a humidifier to keep your home between 30-50% humidity may help reduce this irritation. 

Proper hand hygiene is a simple and great way to prevent the spread of infectious organisms. Please be sure minimize face touching, touching communal surfaces, and regularly scrub and soap your hands for at least 20 seconds before rinsing. Ideally, hand sanitizers would be 60% alcohol or greater is soap is not available. 

Hydrotherapy: 

1.) Alternating or Cold Showers
It is tempting to turn the shower temperature up as the weather grows colder. Try alternating this heat with a burst of cold water. When exposed to both extremes, the blood vessels constrict and dilate. This alternation induces a pumping action in the vasculature that not only improves circulation but also keeps the lymphatics moving smoothly. Even 15-20 seconds of cold can help for every 2-3 minutes of heat. Always be sure to end your shower with cold water!

2.) Nasal Lavage
The hairs and mucus membranes of our nose are a first line of defense against airborne pathogens. Irrigating the sinuses and nasal passages with a saline solution and warm water can help to flush out irritants, dust, allergens and bacteria. It can also moisturize the nasal cavity and thin mucus to alleviate sinus pressure and resulting headaches. Doing this before bed can also improve sleep which we know is important to ensure a robust immune response!

Supplements:

Vitamin D
The cells of our skin are able to produce this key vitamin when we spend time in the sunshine. During the winter months, our exposure to sunlight dwindles because we not only spend more time inside but hours of daylight are shortened. Vitamin D supplementation is key during the winter months to keep the immune system running smoothly. Vitamin D signals to our genes to make and activate T-cells, and ensure the immune response is appropriate for the given pathogen. 

Vitamin C
Our body’s demand for vitamin C goes up during times of stress, such as travel, psychological stress or infection. Vitamin C is involved in the production of antibodies by B-cells, helps damaged tissues heal after illness, modulates the inflammatory response, and signals to the cells to make more white blood cells to keep the immune system strong. Vitamin C can be supplemented but is easily accessible through consuming a variety of fruits and vegetables. 

Zinc
Zinc has been shown to reduce the duration and intensity of cold symptoms. It also helps maintain a healthy barrier to keep our mucus membranes responsive to invaders. Zinc also protects immune cells by acting as an antioxidant. 

Elderberry
Elderberry also known as Sambucus nigra is a common ingredient in over the counter cough drops or medicines, as it has a long standing traditional use of supporting the upper respiratory tract and immune system. A recent meta analysis supports the use of elderberry to reduce upper respiratory symptoms associated with the common cold and influenza.(1) 

Licorice
Licorice or Glycyrrhiza glabra is a root that has a very distinct, sweet flavor profile. It not only serves to soothe an irritated throat and dry cough, but has been shown in in vitro or cell studies to have antiviral capacity against HepB, EBV, RSV, herpes and influenza.(2,3) Be sure to avoid this if you have high blood pressure as it can cause your pressure to go up further. 

Echinacea 
If you enjoy pollinator gardens, you’ve likely passed this purple coneflower. Echinacea is most effective when used preventatively to reduce the risk of getting a cold. (4) Echinacea has a stimulating effect on the immune system by increasing the activity of our first responders such as macrophages and neutrophils, as well as T-lymphocytes and natural killer cells which destroy infected cells. (5)

References:
1. Hawkins J, Baker C, Cherry L, Dunne E. Black elderberry (Sambucus nigra) supplementation effectively treats upper respiratory symptoms: A meta-analysis of randomized, controlled clinical trials. Complement Ther Med. 2019;42:361-365.
2. Fiore C, Eisenhut M, Krausse R, et al. Antiviral effects of Glycyrrhiza species. Phytother Res. 2008;22(2):141-148.
3. Zuo J, Meng T, Wang Y, Tang W. A review of the antiviral activities of glycyrrhizic acid, glycyrrhetinic acid and glycyrrhetinic acid monoglucuronide. Pharmaceuticals (Basel). 2023;16(5):641.
4. Jawad M, Schoop R, Suter A, Klein P, Eccles R. Safety and efficacy profile of echinacea purpurea to prevent common cold episodes: a randomized, double-blind, placebo-controlled trial. Evid Based Complement Alternat Med. 2012;2012:841315.
5. Park SJ, Lee M, Kim D, et al. Echinacea purpurea extract enhances natural killer cell activity in vivo by upregulating mhc ii and th1-type cd4+ t cell responses. J Med Food. 2021;24(10):1039-1049.

Authored by Dr. Barrett

Start planning now

• As our days are getting shorter and the cool air is starting to blow in it is all too common that we stop our summer time exercise routines. 
• Think about what exercise routines have worked for you in the past and start planning now. 

Embrace Outdoor Activities

• Dress appropriately: Invest in cold-weather workout gear, including moisture-wicking layers, insulated jackets, gloves, and thermal leggings.
• Start slowly and gradually increase the intensity as your get used to the cold weather.
• Winter sports: Try activities like ice skating, cross-country skiing, fat tire biking, snowshoeing, or even sledding for a fun and active winter experience.

Find Indoor Classes

• If the cold just isn’t for you then sign up for a gym or get a home gym set up. 
• Maybe you pause your gym membership in the summertime to take advantage of the warm weather. Now it’s time to get back to the gym!
• If you find group exercise classes keep you motivated seek out some in your area. 

Set Goals and Create a Routine

• Set specific fitness goals for the fall and winter months to keep you motivated and accountable. 
• Establish a workout routine and schedule it into your day to make exercise a consistent habit.

Make it Social

• Exercising with a friend or partner can make it easier to keep up the habit. 
• Join a local sports league or recreational group to stay active while socializing.

Stay Safe

• Wear reflective gear when it’s darker out.
• Use tracks on your shoes to prevent slipping on the ice. There are so many types you can use. I find I can continue running well into winter and early in the Spring with the proper tracks on my sneakers. 
• Avoid outdoor exercise during extreme cold or icy conditions to prevent accidents and injuries.

Remember that staying active during the fall and winter is not only beneficial for your physical health but also for managing stress and improving mood, which can be particularly important during the darker and often busier holiday seasons. 

Authored by Dr. Aidanne

IBS is considered a “diagnosis of exclusion” which means that it is typically given once the more serious conditions that affect the structure or function of the GI tract are ruled out (ie. IBD, celiac, endometriosis, or hypothyroidism).

What is normal?

In order to understand potential IBS triggers, knowledge of normal digestive function is key. 

Even before we eat, our body is setting our system up for success by making digestive enzymes and acid in response to the smells and sights we experience while cooking. When we finally take a bite, chewing both manually grinds foods and stimulates saliva production that contains enzymes to break carbohydrates down. Swallowing then sends our food down the esophagus and into the stomach where acid and digestive enzymes await to to break it down further. From there, the small intestine is responsible for absorbing micronutrients. The large intestine sucks out all the water to form our stool and is home to our gut microbiome.

So what can lead to IBS?

Although there may be more at play and the exact causes of IBS are uncertain, I commonly encounter these four triggers in my practice:

1.) Gut Motility Issues & Mental Health

Our autonomic nervous system has two main branches, the parasympathetic (aka “rest and digest”) and sympathetic (aka “Fight or flight”). You may recall that during a period of intense stress, your bowel movements were not normal. Maybe you experienced a loose stool due to overactive nerves or were unable to pass one for multiple days. This is due to the significant impact that stress has on our vagus nerve. The vagus nerve is responsible for stimulating digestive juices and driving muscle contractions (aka peristalsis) that keep our bowels moving smoothly. When we eat on the run or do not allow our body time to calm before eating we impair our digestive function. 

How we eat and when we eat can also play a role. IBS can often occur if meals are skipped, too large, or if we’re eating sporadically. Also, the plants we eat throughout the day provide us with fiber needed to regulate our bowel motility. The gut loves consistency! 

Also, there is a well established bidirectional set of signals that pass between the brain and our gut tissue. Ninety percent of our serotonin is produced in the gut, so when these levels are low it can not only impact our mood but also impede peristalsis and increase sensitivity of the nerves of the gut. Addressing both mental health concerns, neurotransmitter imbalances and gut motility is an effective IBS management strategy. 

2.) Microbiome Imbalances

Balance and diversity are essential when it comes to the community of bacteria, viruses, and fungi that live in our large intestine. Either insufficient or overgrown levels of these microbes can cause disruptions to bowel transit time and symptoms such as gas and bloating. Insufficiency is more common in cases of looser stools and the yeast Candida is a common culprit for those living with constipation, bloating and flatulence. Fiber is important here as well, as it not only helps to bulk up the stool but can nourish our gut bacteria. 

A stool sample is the best way to gain insight into possible imbalances in the large intestine. 

3.) Foods Sensitivities

When we eat foods our bodies do not tolerate well, the undigested food fragments that make their way through our GI tract activate our gut related immune system. This can cause a lot of local irritation and inflammation which serve to make the gut tissue more sensitive. 

Common food sensitivities that contribute to IBS symptoms include gluten, dairy, eggs, soy, nuts, alcohol, and foods rich in FODMAPs. 

FODMAPs are fermentable sugars that some individuals do not break down well. When undigested, FODMAPs draw water into the intestines resulting in looser bowel movements and increased peristalsis. FODMAPs often cause bloating from our gut microbes feasting on them and producing gas as a byproduct. Although a low FODMAP diet is not meant to be implemented long term, it can provide relief while other factors are being ruled out. 

4.) Genetics & Enzyme Deficiencies

Enzyme deficiencies can be inherited. The classic example is an inability to produce lactase which is needed to break down lactose. This then leads to lactose intolerance which can trigger diarrhea, bloating, gas and abdominal pain if someone eats dairy. Sucrase, isomaltase and alpha-galactosidase can all impact ones ability to break down sugars. Supplementing with digestive enzymes or herbs to support enzyme production can be helpful in these cases. 

5.) Medications

Common medications that can worsen or trigger IBS symptoms include NSAIDs, antibiotics, antidepressants, PPIs, opioids, hormonal medications, etc.

​
References:

• Patel N, Shackelford K. Irritable Bowel Syndrome. [Updated 2022 Oct 30]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534810/
  
• Wald A. Clinical Manifestations and Diagnosis of Irritable Bowel Syndrome in Adults. UpToDate. Updated July 20, 2022. Current through July 2023. 

Authored by Dr. Aidanne

Authored by Dr. Barrett

Abdominal bloating and distention are two of the most commonly reported gastrointestinal concerns. Bloating is a feeling of tightness, pressure or fullness in your abdomen. You may even notice a visibly distended abdomen and clothing can feel tight. While it is not usually a serious medical concern, chronic or severe bloating can significantly impact one's quality of life. In this article, we will explore the various causes of abdominal bloating.





Causes of bloating:

Gas Production:

• Gas production occurs naturally as a part of digestion. Bacteria live in our intestines and fermented leftover carbohydrates. If there is too much fermentation happening excessive gas can be produced. This gas is eventually passed as flatulence. 
• SIBO (small intestine bacterial overgrowth) is just what it sounds like, an overgrowth of bacterial in the small intestines. This causes excessive bloating and discomfort with most meals. This gas can become trapped for long periods of time before being passed. 

Swallowing Air:

• Swallowing air unintentionally is a common cause of abdominal bloating. This can happen when talking while eating, chewing gum, drinking through a straw, or consuming carbonated beverages. Individuals who are anxious or nervous may also swallow air more frequently, exacerbating bloating symptoms.
  

Stress:

• Stress can impact the movement and contractions of your gastrointestinal tract. It can either speed up or slow down the movement of food through your intestines, leading to changes in bowel habits and potential bloating.
  
• Stress can lead to the redirection of blood flow away from the digestive system to support other parts of the body preparing for the sympathetic or "fight or flight" response. This reduced blood flow can hinder the optimal functioning of the GI tract and cause bloating.
  

Food Sensitivities/Intolerances:

• Food intolerances and sensitivities occur when the body has difficulty digesting certain substances, such as lactose, fructose, or gluten. In these cases, the undigested components can ferment in the intestines, leading to gas production and bloating. Common culprits include dairy products, wheat-based products, beans, and certain fruits.
  

Menstruation:

• Bloating and water retention can occur during the menstrual cycles due to hormonal fluctuations. This monthly occurrence can lead to abdominal discomfort and swelling.
  

Bowel Obstruction or Serious Conditions:

• In rare cases, abdominal bloating can be a symptom of more serious conditions, such as bowel obstruction, ovarian cysts, uterine fibroids, or even certain cancers. If bloating is accompanied by severe pain, sudden weight loss, or persistent changes in bowel habits, medical attention should be sought immediately.
  

Therapeutic options:

Dietary Modifications:

• Identify and avoid trigger foods that can cause bloating, such as carbonated drinks and certain artificial sweeteners.
  
• Avoid food intolerances. These are often identified by using an elimination diet. 
  
• Consider trying a low-FODMAP diet, which restricts fermentable carbohydrates that may cause gas and bloating in some individuals. Note: this diet is for temporary relief and should not be followed longer than 6 weeks. 
  

Chew Slowly and Avoid Swallowing Air:

• Eat meals at a slower pace to reduce the amount of air swallowed during eating.
  
• Avoid using straws and chewing gum, as they can lead to swallowing excess air.
  

Microbiome Support:

• Consuming probiotic-rich foods or taking probiotic supplements can promote a healthy balance of gut bacteria and improve digestion, potentially reducing bloating.
  
• Eating prebiotic fibers can help support a healthy microbiome. Foods high in prebiotic fibers include garlic, onions, bananas, apples, and oats. 
  

Deep Belly Breathing:

• Deep breathing activates the parasympathetic nervous system, which is responsible for promoting a "rest and digest" response in the body. This helps relax the muscles in the gastrointestinal tract, facilitating better digestion and reducing bloating.
  
• Deep breathing can aid in the release of trapped gas from the digestive system. When you take slow, deep breaths, you stimulate movement in the intestines, which may help relieve gas and bloating.
  

Herbal teas:

• Certain herbal teas such as peppermint, ginger, fennel and chamomile can aid in digestion and help to reduce bloating. 
  

Apple Cider Vinegar (ACV) and Bitter Herbs:

• ACV contains acetic acid, which is thought to stimulate the production of digestive enzymes, potentially aiding in the breakdown of food and improving digestion.
  
• Bitter herbs such as dandelion, gentian, chamomile, and artichoke can help stimulate the production of digestive enzymes and the release of bile to improve digestion. These herbs may also have carminative properties, meaning they help reduce gas and gloating in the digestive system. 
  
  • These herbs can be consumed as a tea or tincture or incorporated into dishes.
    

Regular physical activity:

•  Regular exercise can help improve bowel motility and prevent constipation, both of which can reduce bloating.
  

Manage Stress:

• Stress and anxiety can worsen bloating symptoms. Practicing relaxation techniques, such as deep breathing, meditation, yoga, or mindfulness, can help reduce stress and its effects on digestion.
  

Resources:

• Lacy BE, Cangemi D, Vazquez-Roque M. Management of Chronic Abdominal Distension and Bloating. Clin Gastroenterol Hepatol. 2021 Feb;19(2):219-231.e1. doi: 10.1016/j.cgh.2020.03.056. Epub 2020 Apr 1. PMID: 32246999.
  

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Authored by Dr. Aidanne

Did you know that:

• Men on average live 5.9 years less than women (1)
• Nearly 51% of men over the age of 20 have hypertension (2) 
• The top 6-leading causes of death in males of all origins include heart disease, cancer, unintentional injuries, chronic respiratory conditions, stroke and diabetes (3)
• 40% of men over the age of 20 are obese (2)

It’s important that men feel supported when it comes to their health and here is where disease prevention is key! 

Naturopathic medicine is aptly suited to help manage chronic conditions including, but not limited to:

• Male Factor infertility
• Cardiovascular Disease & Associated Risk Factors (ie. Hypertension, High cholesterol, Diabetes, Stroke, Atherosclerosis, etc.)
• Benign Prostatic Hyperplasia (BPH)
• Erectile Dysfunction (ED)
• Prostate Cancer

Male Factor Infertility:
Women often feel the full weight of responsibility when it comes to failure to conceive, but of course it takes two to tango! The shape, quality, and motility of sperm are all important in successful conception. Various factors such as hormone imbalances, excess alcohol consumption, unmanaged stress, environmental pollutant exposure, poor diet with a high glycemic index, smoking, etc. can all negatively affect a man’s sperm leading to entirely male-based infertility in 20-30% of cases. (4) 

Cardiovascular Disease, BPH & ED:
I plan to discuss these concerns together not because they are medically similar, rather because they are intricately related. 

BPH is characterized by growth of the prostate tissue which can put pressure on the bladder leading to lower urinary tract symptoms of frequent urination, waking at night to urinate (aka. Nocturia), intermittent stream, straining, incontinence and increased urgency. Although the mechanism is not known with certainty, it is hypothesized that the intermittent wakings at night to urinate may negatively affect blood pressure possibly contributing to hypertension. (5) Also, it is well established that both obesity and Type 2 Diabetes are risk factors for BPH in part because they contribute to a state of inflammation and increased oxidative stress. See below for how to combat this! 

The integrity of our blood vessels, blood pressure, and heart rate also play a key role in the process of arousal that is negatively impacted in ED. (6) It is also common for those living with Type 2 diabetes to experience ED as a side effect of neuropathy in the peripheral tissues. (7)

Prostate Cancer:
Prostate cancer (PC) was the leading form of new cancers diagnosed in Minnesota in 2020 and fortunately the relative 5-year survival rate is 97.1% when caught early. (8,9) PC is more prevalent in African American men, and the most significant risk factors include age and family history. That said, diet plays an integral role in supporting favorable PC outcomes and maintaining remission.  

A Naturopathic Approach:
The fundamental pillars of health that keep us well are the diet and lifestyle. All of the conditions above would benefit from quality sleep, smoking cessation, regular movement and a diet with reduced red meat, dairy, sugar, and alcohol. (10) 

Any form of movement is beneficial to a man’s health. With regard to fertility, moderate interval training has been shown to support sperm count and semen volume, where cycling can have a detrimental effect. (11) Aerobic training positively challenges our cardiovascular system and strength training can help regulate hormone production and metabolism. Greater than one hour a week may reduce severe nocturia by 34% compared to staying sedentary. (12) Ideally we would be aiming for a mix of activities and intensities, but consistency is the most important factor!

High dietary sugars increase oxidation and stress on the body that can increase inflammation of the prostate and also slow sperm motility. The latter contributes to male factor infertility. 

A generally anti-inflammatory diet includes increased amounts of vegetables, deeply pigmented fruit (ie. Berries, pomegranate, cherries, etc.), tomato, omega-3 rich fish & plants, and green tea. All of these foods are high in dietary anti-oxidants which help to offset oxidative stress and its resulting inflammation.  Lycopene is a nutrient that comes from red-colored fruits and veggies, and is particularly supportive to the prostate. (13)

Nutrients and herbs also have a supportive role to play! To improve fertility outcomes, targeted antioxidants such as CoQ10, Vitamin C, Vitamin D, and Zinc can enhance sperm counts and prevent fragmentation of the sperm itself. In cases of cardiovascular disease, BPH, ED and PC I often recommend herbs and nutrients to balance testosterone, increase circulation, balance blood sugars and ease the stress response. Some of my favorites include Saw palmetto, Nettle, Berberine, Pygeum, Reishi, Ginkgo, L-arginine, and Vitamin C. 

I also often recommend routine bloodwork to ensure that blood sugars are well regulated, markers of cardiovascular inflammation are within normal, and hormone levels are optimal.

Ready to take your health into your own hands? It would be a pleasure to work with you!

Disclaimer: This information is meant for educational purposes only and should not be used as a replacement for professional medical advice.

References:
1. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2022/20220831.htm  
2. https://www.cdc.gov/nchs/fastats/mens-health.htm   
3. https://www.cdc.gov/minorityhealth/lcod/men/2016/all-races-origins/index.htm
4. https://www.ncbi.nlm.nih.gov/books/NBK562258/ 
5. https://pubmed.ncbi.nlm.nih.gov/19359054/ 
6. Sexual Activity in Patients with Cardiovascular Disease. UpToDate. Updated June 7, 2022. 
7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9286480/
8. https://gis.cdc.gov/Cancer/USCS/#/AtAGlance/ 
9. https://seer.cancer.gov/statfacts/html/prost.html 
10. Risk Factors for Prostate Cancer. UpToDate. Updated October 10, 2022.
11. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5675222/ 
12. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4342314/ 
13. https://www.cancer.gov/about-cancer/treatment/cam/hp/prostate-supplements-pdq#_16 

Authored by Dr. Barrett

These microbes do many things for us. So much in fact that without them it would be difficult for us to survive. They digest certain fibers turning them into short chain fatty acids that we need for our digestive health. They communicate with our immune cells and control how we respond to infections. New research indicates that there is a strong connection between our brain health and our microbiome. The microbiome is also considered to be an endocrine organ because it exerts influence on distant organs and pathways (1).

Oral contraceptive pills (OCPs) also known as birth control, impacts the health of our microbiome. The hormones that are naturally produced in our bodies and the hormones that we take orally both impact the composition of our microbiome (2). It makes sense that taking hormones orally would alter the microbiome. For millions of years we were only exposed to hormones that we produce naturally. It’s only been in the last 70 years that we started taking hormones by mouth. 

Folks who take oral birth control (hopefully) know that when they take antibiotics the birth control pill can become much less effective. One hypothesis for this effect is that antibiotics dramatically alter the microbiome where a significant amount of estrogen metabolism takes place (3).

Unfortunately the birth control pill can also increase your risk of inflammatory bowel disease. In two large studies it was found that women who use oral contraceptives for over 5 years had a significantly increased risk for developing inflammatory bowel disease, particularly Crohn’s (4).

It’s not just the gut microbiome that’s impacted by birth control pills. The vaginal microbiome is also altered and the risk of vaginal yeast infections is increased in people taking birth control pills (5).

We need more research into the microbiome but we know enough now to know that taking oral hormones impacts the health of our microbiome. 

In general here are some ways to support a healthy microbiome:

• Consuming fiber daily from a variety of sources. Aim for 30-35g daily. 
• Limit processed foods and high sugar foods in your diet.
• Consume fermented foods.
• Limit your use of antibiotics.

References:

1. Qi X, Yun C, Pang Y, Qiao J. The impact of the gut microbiota on the reproductive and metabolic endocrine system. Gut Microbes. 2021 Jan-Dec;13(1):1-21. doi: 10.1080/19490976.2021.1894070. PMID: 33722164; PMCID: PMC7971312.
2. Hua X, Cao Y, Morgan DM, Miller K, Chin SM, Bellavance D, Khalili H. Longitudinal analysis of the impact of oral contraceptive use on the gut microbiome. J Med Microbiol. 2022 Apr;71(4). doi: 10.1099/jmm.0.001512. PMID: 35452382.
3. Adlercreutz H, Pulkkinen MO, Hämäläinen EK, Korpela JT. Studies on the role of intestinal bacteria in metabolism of synthetic and natural steroid hormones. J Steroid Biochem. 1984 Jan;20(1):217-29. doi: 10.1016/0022-4731(84)90208-5. PMID: 6231418.
4. Khalili H, Higuchi LM, Ananthakrishnan AN, Richter JM, Feskanich D, Fuchs CS, Chan AT. Oral contraceptives, reproductive factors and risk of inflammatory bowel disease. Gut. 2013 Aug;62(8):1153-9. doi: 10.1136/gutjnl-2012-302362. Epub 2012 May 22. PMID: 22619368; PMCID: PMC3465475.
5. Spinillo A, Capuzzo E, Nicola S, Baltaro F, Ferrari A, Monaco A. The impact of oral contraception on vulvovaginal candidiasis. Contraception. 1995 May;51(5):293-7. doi: 10.1016/0010-7824(95)00079-p. PMID: 7628203.

 ​

Authored by Dr. Aidanne

What is Acne?
Acne refers to the inflammation and irritation of the hair follicle that results in trapped oils (also known as “sebum”), skin cells, and various bacteria known as C. acnes that populate the skin surface. When trapped, this mix of materials can produce what we know as pimples that are characteristic of acne. Pimples can come in many forms and show as either white heads, black heads, raised bumps or cysts deep under the skin surface. They are commonly located on the face, arms, chest and back. Whether it is showing as a single pimple or more widespread, the pressure of a clogged follicle can become very painful and lead to scarring.

What Causes Acne?
I hear this question frequently in clinic, and there is no one catch all answer for everyone. Some people may have a single key root cause while others may have a combination of triggers. This is where blood work and functional lab testing are useful to guide proper management of acne.

As with most conditions, acne has both modifiable and unmodifiable risk factors. Modifiable factors are those that are within our control to change. Unmodifiable are those that are out of our control.

Here are some of the most common modifiable triggers for acne:

• Hormonal Changes (ie. estrogen, testosterone, DHT, DHEA, etc.)
• Diet & Food Sensitivities
• Blood Sugar Regulation (ie. Glucose, insulin)
• Stress (ie. Cortisol)
• Nutrient deficiencies

Here are some of the most common unmodifiable triggers for acne:

• Age
• Genetics / Family History

Hormones:
Androgens and androgen precursors are hormones that can lead to acne when elevated. These include testosterone, DHEA, and DHT. The latter has nearly four times the potency of testosterone. These hormones increase the amount of sebum that is produced, which can clog the pores more frequently leading to increased acne. Also, fluctuations in estrogen and progesterone throughout the menstrual cycle can also worsen acne.

Diet & Blood Sugar Regulation:
You may have experienced a pimple or two after eating a lot of baked goods or sugary foods. When we eat foods that are high on the glycemic index, our blood sugar levels go up. Given insulin’s main job is to remove sugars from the blood stream and send them to the tissues to be burned for fuel, a high blood sugar level causes insulin to rise. Elevated insulin levels can drive the production of androgens, thus leading to increased sebum production.

Whey is a protein found in dairy that can trigger acne for a couple of reasons. When consumed regularly, food sensitivities can result in GI related inflammation that weakens the skin barrier. Many people do not tolerate dairy well, and this is often due to either its lactose or whey content. Secondly, consuming whey leads the body to make a chemical called Insulin Like Growth Factor (IGF-1) which triggers cells to grow. What is one of the main hormones that causes tissue growth? Yet again, the answer is testosterone!

Stress:
When stressed, the body makes various hormones to drive the “fight or flight” response. The adrenal glands are the primary source of two key hormones in this process, DHEA and Cortisol. DHEA can be converted into testosterone in the body, and cortisol spikes increase circulating blood sugars so that the body has quick fuel if it needs to act quickly.

Adaptogens are a group of botanical medicines that help the body “adapt” to the stress response and improve stress resiliency. I often include an adaptogen as part of an acne protocol.

Nutrient Deficiencies:
Those living with acne have been found in the literature to be more likely to have low Vitamin A, Vitamin D, Vitamin E and zinc status compared to their counterparts. Where it’s hard to say whether these deficiencies are a main cause acne, their supplementation has been shown to improve the intensity of acne, reduce inflammation, and help skin cells heal.

Authored by Dr. Barrett

Authored by Dr. Aidanne

Up to 7% of women do not experience any symptoms but most women will present with cyclical or chronic pelvic pain, painful intercourse, intense menstrual cramps, fatigue, back pain, bloating, nausea, and infertility (nearly 50%). This pain can severely impact one’s quality of life, mood and sense of self. 

The inner lining of the uterus is meant to respond to estrogen with changes in the menstrual cycle. When found outside of the uterus, this endometrial tissue can wreak havoc on organs and systems due to both its physical presence as well as the inflammatory response it exerts on the local nerves when exposed to estrogen. Up to 7% of people do not experience any symptoms but most people will present with cyclical or chronic pelvic pain, painful intercourse, intense menstrual cramps, fatigue, back pain, bloating, nausea, and infertility (nearly 50%). This pain can severely impact one’s quality of life, mood and sense of self. 

The risk of endometriosis goes up if you have a family history, early onset of menstruation, late menopause, heavy and short menstrual cycles, or have never had a pregnancy. 

The goal of supporting a person with endometriosis is to support clearance of estrogens to lower their effect on the system, alleviate pain, and reduce inflammation. Often women are told that they simply have heavy periods, and they’ll have to either live with it or go on birth control. Although birth control can provide relief, there are other options available. Let’s dive in!

Diet:
​
As elevated sugar in the diet can increase our estrogen levels, minimizing excess carbohydrates and sugar is key in reducing pain symptoms of endometriosis. 

Since we eliminate hormone metabolites through our stool, ensuring that bowel movements are well-formed and easy to pass is important to avoid reabsorbing estrogen. Fibers such as those that come from ground flax seed can help with this and can also reduce estrogen in the blood stream by increasing the level of sex hormone binding globulin (SHBG). 

Antioxidants are needed to offset the oxidative stress that occurs with inflammation. Foods that had a mother and are colorful are typically antioxidant rich, such as green leafy veggies, berries, red onion, carrots, etc. 

Finally, the cruciferous family of veggies (ie. broccoli, cauliflower, Brussels sprouts, etc.) contain compounds in them called indol-3-carbinol (I3C) and diindolylmethane (DIM) which help metabolize estrogens to the lower potency, 2-hydroxyestrone form. 

Food is medicine!

Lifestyle:

The best lifestyle factors to improve symptoms of endometriosis include movement, reducing exposure to environmental estrogens also known as xenoextrogens, and using castor oil packs. 

Movement can have a positive impact on all body systems. In this case, it encourages the muscles to utilize the sugars within our blood stream. When blood glucose levels are reduced, so is the hormone needed to take them out of the blood stream known as insulin. High levels of insulin dampen our liver’s ability to produce SHBG which allows estrogen to roam more freely in the blood stream and exert its effect on bodily tissues. 

Xenoestrogens can come from various sources such as plastics (BPA, BPS), polychlorinated biphenyl (PCB), phthalates in cosmetic products, pesticides, cigarette smoke, exhaust, chemical pollutants, etc. These synthetic estrogen mimicking components can be reduced by:

• Switching to a stainless-steel water bottle
• Buying organic where possible
• Dusting & vacuuming regularly 
• Incorporating EWG approved unscented & phthalate free cosmetic products
• Cooking with cast iron
• Using glass storage containers vs. plastic and avoiding heating plastics

Although the mechanism is not fully clear, castor oil is known to have anti-inflammatory and analgesic effects when used topically. It can be applied to the abdomen or pelvis to alleviate pain symptoms. Talk to your naturopathic doctor to learn more! 

Botanicals & Nutritional Supplementation:

Botanical & nutritional medicines can be used to support the liver in clearing estrogens, bring blood sugars into balance, and alleviate pain by reducing inflammation. 

Common recommendations would include:

• Hormone Regulators – Chaste tree verry, 
• Antioxidants – Melatonin, Resveratrol, EGCg, Pycnogenol
• Anti-inflammatories – Turmeric, Cat’s Claw, Ginger, Garlic
• Liver Supporting – Milk thistle, NAC, Burdock

A placebo-controlled study from 2013 in Brazil showed that melatonin at a dose of 10mg nightly was able to reduce daily pain scores by nearly 40% when taken for 8-weeks. This affect was attributed to melatonin’s ability to decrease both reduce pain on its own and lower levels of a protein called brain-derived neurotrophic factor (BDNF) which makes the nerves more sensitive to pain. 

A 2021 randomized control trial conducted in Iran showed that 400mg of garlic extract taken daily for 1-3 months could improve pelvic pain, low back pain, heavy menstrual bleeding, and painful intercourse. This effect was attributed to garlic’s ability to support estrogen clearance in the liver and its anti-inflammatory Allicin content. 

Interested in learning more? Let’s chat!

References:

1. Schenken, RS. Endometriosis: Pathogenesis, epidemiology, and clinical impact. UpToDate. Updated: Feb 13, 2023. Accessed: Apr 6, 2023.
2. Endometriosis. World Health Organization. Accessed from this link. 
3. Prousky, J. Textbook of Integrative Clinical Nutrition. CCNM Press. 2013.
4. Daka B, Rosen T, Jansson PA, Råstam L, Larsson CA, Lindblad U. Inverse association between serum insulin and sex hormone-binding globulin in a population survey in Sweden. Endocr Connect. 2012;2(1):18-22.
5. Ilhan M, Dereli FTG, Akkol EK. Novel drug targets with traditional herbal medicines for overcoming endometriosis. Curr Drug Deliv. 2019;16(5):386-399.
6. Schwertner A, Conceição dos Santos CC, Costa GD, et al. Efficacy of melatonin in the treatment of endometriosis: A phase II, randomized, double-blind, placebo-controlled trial. Pain. 2013;154(6):874-881.
7. Amirsalari S, Behboodi Moghadam Z, Taghizadeh Z, Jafar Abadi MN, Sabaghzadeh Irani P, Goodarzi S, Ranjbar H. The Effect of Garlic Tablets on the Endometriosis-Related Pains: A Randomized Placebo-Controlled Clinical Trial. Evid Based Complement Alternat Med. 2021 Jul 20;2021:5547058. doi: 10.1155/2021/5547058. PMID: 34335819; PMCID: PMC8315864.

Authored by Dr. Barrett

Authored by Dr. Aidanne

Since the onset of the COVID19 pandemic, researchers and medical professionals have found that the SARs-CoV2 virus can both worsen outcomes for those living with pre-existing cardiovascular disease (CVD) risk factors and increase risk in of CVD outcomes in otherwise healthy individuals.

Those living with hypertension, arrhythmias, poor circulation, diabetes, and dyslipidemia are significantly more susceptible to blood clots, stroke, and inflammation of the heart (aka pericarditis) after infection with COVID19.

But how does the SARs-CoV2 virus exert this effect?

To thrive in a host environment, a virus must first find a molecule on the cell surface to hijack in order to gain entry to the cell. In the case of SARs-CoV2, it hijacks the ACE2 transporter which can be found in cells of our heart, lung, kidneys, nose, mouth, and intestines causing ACE2 enzyme levels to go down. Some major roles of the ACE2 enzyme include keeping our blood pressure tightly regulated and heart beating strongly. Low ACE2 levels can therefore contribute to weakened heart contractions, poor circulation to the heart’s ventricles, and worsened diastolic hypertension.

Once entry into the cell is achieved, the virus causes a cascade of inflammation which drives the production of reactive oxygen species (ROS). ROS can be damaging to the cells, and this is especially true for the cells that line our blood vessels. Injury to the blood vessel causes the vessel walls to constrict, leading blood pressure to go up. Clotting factors also become activated in an attempt to heal the injured tissue, and platelets are made in greater numbers to help fight off the infection. Both clotting factors and platelets thicken the blood and slow circulation with goal of forming a clot. On the skin surface this process would look like the formation of a scab. To coat and reinforce the damaged blood vessel itself, cholesterol and immune cells also come together to lay a fatty steak foundation that sets off the process of atherosclerosis and plaque formation. Together, these processes increase the risk of stroke and heart attack.

Finally, the heart cells themselves can become injured after infection which can be seen from testing markers of cardiac inflammation such as D-dimer, fibrinogen, prothrombin time, and troponin T levels.

Although most people recover once the infection is cleared, some have a hard time overcoming the inflammatory response. In the short term, inflammation plays a protective role to help us fight the virus and activate the immune system. But inflammation in the long term can become detrimental and shows in the cardiovascular system as hardening of the heart muscle, atherosclerosis, altered coordination of nerve signals that regulate the heart’s rhythm, or postural orthostatic tachycardia syndrome (PoTS). There is a lot we still need to learn about what leads one person to respond so differently than another to a SARs-CoV2 infection, so hopefully future research will be able to speak to these knowledge gaps.

In the meantime, naturopathic medicine has a major role to play in supporting and preventing cardiovascular risk factors by means of dietary counseling (especially around antioxidants!), lifestyle changes, use of botanical medicines, and targeted nutritional supplementation.

Interested in learning more? Let’s chat!

References:

1. Danilczyk U, Penninger JM. Angiotensin-converting enzyme ii in the heart and the kidney. Circulation Research. 2006;98(4):463-471.
2. ​Raisi-Estabragh Z, Cooper J, Salih A, et al. Cardiovascular disease and mortality sequelae of COVID-19 in the UK Biobank. Heart. 2023;109(2):119-126.
3. Cenko E, Badimon L, Bugiardini R, et al. Cardiovascular disease and covid-19: a consensus paper from the esc working group on coronary pathophysiology & microcirculation, esc working group on thrombosis and the association for acute cardiovascular care (Acvc), in collaboration with the european heart rhythm association(Ehra). Cardiovascular Research. 2021;117(14):2705-2729. – Picture

Authored by Dr. Barrett

The figure above highlights a few hypothesized mechanisms for developing long-COVID. Today we are going to talk about the relationship between autoimmunity and COVID-19.

Autoimmune disease develops when the immune system starts attacking your own tissues. In addition to genetic factors, environmental triggers including viruses, bacteria and other infectious agents play a major role in the development of autoimmune diseases. There are several mechanisms behind these triggers that include but are not limited to molecular mimicry, bystander activation and epitope spreading. In an oversimplified nutshell there can be cases of mistaken identity (molecular mimicry), our immune system getting overexcited (bystander activation), and chronic inflammation (epitope spreading). One major hypothesis regarding COVID-19  and autoimmune disease is that SARS-CoV-2 aggravates the immune system via molecular mimicry and bystander activation. 

There are several ways that autoimmune disease and COVID-19 are interrelated. COVID-19 may trigger new onset of autoimmune disease. Conversely, people with existing autoimmune disease may be at risk for complications from a COVID-19 infection. People who experience ‘long COVID’ have higher incidence of blood markers for autoimmune disease. 

COVID-19 may trigger the development of autoimmune diseases. One study looked at patients hospitalized with COVID-19 and measured their levels of autoantibodies. Autoantibodies are antibodies that attack our own tissues. They found that approximately 50% of patients hospitalized with COVID-19 generated autoantibodies compared to just 15% of non infected individuals. This indicates that SARS-CoV-2 causes development of new autoantibodies which correlates with an autoimmune response. (1)

Patients with autoimmune diseases specifically rheumatic, IBD, and multiple sclerosis appear to be more vulnerable to severe outcomes from COVID-19 infections. One important note is that all of these conditions increase the risk of cardiovascular disease. In many of the studies, once cardiovascular disease is taken into account, the association between autoimmune disease and severe outcomes from COVID-19 isn’t as statistically significant. In a nutshell, it could be not so much the autoimmune piece that increased the risk but the cardiovascular health of the patient (2). We need more research to understand why patients with autoimmune disease may be at a higher risk for complications and severe outcomes from COVID-19.

Patients with long-COVID syndrome exhibit immune characteristics that include higher predisposition to autoimmunity. ANA is a blood marker used to diagnose autoimmune diseases. One study looked at patients who had long-COVID for one year and found a positive ANA in a significant number of patients compared to controls (3). Interestingly these patients also had a poorer antibody response to SARS-CoV-2 and more chronic inflammation. 

It's important to note that while there is evidence suggesting a connection between COVID-19 and autoimmune disease, more research is needed to fully understand the mechanisms behind this association. 

In naturopathic medicine we work to reduce triggers to the immune system, lower systemic inflammation and bring more balance to an overactive immune system. We use a variety of tools including but not limited to nutrition, botanical medicine, microbiome support, mind body medicine, hormone balancing, lifestyle medicine and targeted supplementation. 


References: 

1. Chang SE, Feng A, Meng W, Apostolidis SA, Mack E, Artandi M, Barman L, Bennett K, Chakraborty S, Chang I, Cheung P, Chinthrajah S, Dhingra S, Do E, Finck A, Gaano A, Geßner R, Giannini HM, Gonzalez J, Greib S, Gündisch M, Hsu AR, Kuo A, Manohar M, Mao R, Neeli I, Neubauer A, Oniyide O, Powell AE, Puri R, Renz H, Schapiro J, Weidenbacher PA, Wittman R, Ahuja N, Chung HR, Jagannathan P, James JA, Kim PS, Meyer NJ, Nadeau KC, Radic M, Robinson WH, Singh U, Wang TT, Wherry EJ, Skevaki C, Luning Prak ET, Utz PJ. New-onset IgG autoantibodies in hospitalized patients with COVID-19. Nat Commun. 2021 Sep 14;12(1):5417. doi: 10.1038/s41467-021-25509-3. PMID: 34521836; PMCID: PMC8440763.
2. Winchester N, Calabrese C, Calabrese LH. The Intersection of COVID-19 and Autoimmunity: What is Our Current Understanding? Pathog Immun. 2021 Mar 8;6(1):31-54. doi: 10.20411/pai.v6i1.417. PMID: 33969248; PMCID: PMC8097827.
3. García-Abellán J, Fernández M, Padilla S, García JA, Agulló V, Lozano V, Ena N, García-Sánchez L, Gutiérrez F, Masiá M. Immunologic phenotype of patients with long-COVID syndrome of 1-year duration. Front Immunol. 2022 Aug 24;13:920627. doi: 10.3389/fimmu.2022.920627. PMID: 36090973; PMCID: PMC9451924.
4. Liu Y, Sawalha AH, Lu Q. COVID-19 and autoimmune diseases. Curr Opin Rheumatol. 2021 Mar 1;33(2):155-162. doi: 10.1097/BOR.0000000000000776. PMID: 33332890; PMCID: PMC7880581.
5. Castanares-Zapatero D, Chalon P, Kohn L, Dauvrin M, Detollenaere J, Maertens de Noordhout C, Primus-de Jong C, Cleemput I, Van den Heede K. Pathophysiology and mechanism of long COVID: a comprehensive review. Ann Med. 2022 Dec;54(1):1473-1487. doi: 10.1080/07853890.2022.2076901. PMID: 35594336; PMCID: PMC9132392.

Authored by Dr. Aidanne

Recovering from a COVID19 infection can be challenging enough, let alone living with long COVID symptoms after the infection clears. Digestive upset (ie. nausea, abdominal pain, vomiting) and bowel movement changes are among the more common long COVID symptoms. If you previously lived with a happy gut, this could significantly impact your new day to day life.


And why does it happen? How does the SARS-CoV2 virus affect gut and the microbiome.


To grasp this connection, we must first understand our biology. For those who may be new to this topic, the gut microbiome refers to the community of “flora” including bacteria, yeast, and viruses that colonize our intestines. They are meant to be there in a delicate balance and serve many beneficial purposes. They help us digest our foods, absorb nutrients, keep the intestinal lining healthy, fend off other invaders that may enter the system through our environment, lower inflammation, and make neurotransmitters such as serotonin that communicate with our brain.


This community keeps our bodies running smoothly but their balance is susceptible to damage from exposures in our environment such as infectious disease-causing organisms. We want a variety of beneficial species in the intestines with no one strain becoming dominant.


Various studies have shown that the stool samples of those who have contracted COVID-19 not only have a lower variety of beneficial microbes in their samples compared to a healthy counterpart but they also have a lower quantity of beneficial flora. If you think of the GI tract as a tube that only has so much space for microbes to fill, space that is left empty by the absence of beneficial flora will be filled with more problematic or opportunistic species (ie. Candida, Clostridium, Enterobacter, etc.).


Once these species seize the opportunity to establish themselves in the system, they wreak havoc by first inducing inflammation in the intestinal tissue. This inflammation then signals to the immune cells resting in the brush border of the intestine that we have something to fight off. To kill off these invaders, these local immune cells sound the alarm to their neighbors to make what are called cytokines. These are compounds that help guide the immune response but can further the inflammatory cycle if not kept in check.


Ultimately, the inflammation from this process wears down the protective mucus barrier to the brush border. It can also weaken the bonds called tight junctions that keep the cells of the GI tract close together, and weakened tight junctions contribute to intestinal hyperpermeability or “leaky gut”. If you think of a bucket with holes in it, you can expect that a lot of water will fall through. In a similar vein, if the intestinal lining is leaky we will not be able to digest our foods or absorb our nutrients well which can further contribute to imbalances in the local flora that are not prepared to pick up the leg work in feeding on undigested foods.


To cut this cycle and help the intestinal lining heal, naturopathic medicine offers a diverse set of tools including botanical medicines, probiotics, dietary counseling, and targeted nutritional supplementation.


Are you ready to start your journey? Let’s chat!

​
References:

1. Wang B, Zhang L, Wang Y, et al. Alterations in microbiota of patients with COVID-19: potential mechanisms and therapeutic interventions. Sig Transduct Target Ther. 2022;7(1):1-15.
2. Bernard-Raichon L, Venzon M, Klein J, et al. Gut microbiome dysbiosis in antibiotic-treated COVID-19 patients is associated with microbial translocation and bacteremia. Nat Commun. 2022;13(1):5926.

Authored by Dr. Aidanne

What does testing look like?
An advanced assessment includes testing lipid levels, lipoproteins (proteins that transport lipids in the blood stream), inflammatory markers and hormones.

1) Lipids:
Lipids are fats that our body uses to make hormones, keep our skin vibrant, absorb nutrients, etc. A basic lipid panel is often run as part of routine bloodwork to screen for elevated cholesterol. This includes total cholesterol, HDL, LDL, and triglycerides. Where this is an incredibly important screening measure, it is not comprehensive for assessing overall cardiovascular disease risk.

An NMR Lipo Profile is one example of an extended lipid profile that includes the number and size of each lipid molecule. This is important because smaller lipid molecules are more likely to penetrate an inflamed blood vessel and contribute to plaque.

This test also includes measures of very low-density lipoprotein (VLDL), Apolipoprotein-A and Apolipoprotein-B. VLDL and Apo-B are known to have a high plaque producing potential, where Apo-A is cardio-protective. (2)

2) Inflammatory Markers:
Inflammation plays a leading role in the development of atherosclerosis. (3) Once the inner muscular layer of a blood vessel is irritated and becomes inflamed, it is easier for immune cells and fats to accumulate and produce plaque.

C-reactive protein (CRP) is a protein our body produces in response to inflammation in general. Where it is not specific to the cardiovascular system, it can be a useful marker to track your progress with a treatment plan. (4)

Homocysteine (Hcy) is an inflammatory marker that is more specific to the cardiovascular system. It is the byproduct of protein breakdown that is cleared out of the system with the help of folic acid and other B-vitamins. When elevated, this can be a sign that either:

1. We are not eating enough green leafy vegetables rich in folic acid, OR
2. There is a gene mutation that does not allow the body to make the MTHFR enzyme needed to convert the folic acid we gain from our diet into the methylenetetrahydrofolate (MTHF) form needed for clearing homocysteine.

3) Hormones:
Our bodies make hormones to send signals and ensure the system is operating smoothly. This process can affect how they use fats and sugars. When elevated, thyroid stimulating hormone (TSH), cortisol (the main stress hormones responsible for signaling a fight or flight response in our bodies) and testosterone can cause total cholesterol and LDL levels to rise. (6,7) A similar effect can be seen in response to depleted estrogen levels as a woman experiences menopause.(8)
Insulin is the hormone responsible for drawing sugars out of the blood stream to be burned for fuel in the tissues. When insulin is elevated, this can be a sign that blood sugar levels have been high for a prolonged period which is a potential source of inflammation in the blood vessels.

Do you have a family history of cardiovascular diseases?

Why wait to screen for your cardiovascular status?

We offer comprehensive functional lab testing. To read more about this service click here. 

References:

1. CDC. Heart Disease Facts | cdc.gov. Centers for Disease Control and Prevention.
2. Emeasoba EU, Ibeson E, Nwosu I, Montemarano N, Shani J, Shetty VS. Clinical relevance of nuclear magnetic resonance lipoprofile. Front Nucl Med. 2022;2.
3. Malekmohammad K, Bezsonov EE, Rafieian-Kopaei M. Role of lipid accumulation and inflammation in atherosclerosis: focus on molecular and cellular mechanisms. Front Cardiovasc Med. 2021;8.
4. Nehring SM, Goyal A, Patel BC. C reactive protein. In: StatPearls. StatPearls Publishing; 2022.
5.  Maduka IC, Neboh EE, Ufelle SA. The relationship between serum cortisol, adrenaline, blood glucose and lipid profile of undergraduate students under examination stress. Afr Health Sci. 2015;15(1):131-136.
6. Kaur H, Werstuck GH. The effect of testosterone on cardiovascular disease and cardiovascular risk factors in men: a review of clinical and preclinical data. CJC Open. 2021;3(10):1238-1248.
7. Guetta V, Cannon RO. Cardiovascular effects of estrogen and lipid-lowering therapies in postmenopausal women. Circulation. 1996;93(10):1928-1937.