Woman with chronic pain

You Can Take Control of Chronic Pain

Chronic pain is a common and complex problem affecting 20–30% of the population of Western countries. The pharmaceutical industry has garnered billions of dollars in painkiller and anti-inflammatory sales, yet this hasn’t come without potential health risks to consumers from a well-documented crisis level of opioid addiction to frequent gastrointestinal complications and an increased risk of developing cardiovascular disease. We witness these side effects with an understanding that pharmaceuticals may provide partial, and not always full relief from chronic pain.

It’s no wonder we’re hearing from a lot of patients who are looking for a more natural approach to managing their chronic pain.

 

What is Chronic Pain?

We all feel physical pain from time to time. Injury, inactivity, sickness and disease can cause many different types of aches and pain. When this occurs, our bodies work hard to heal so that we can return to our normal lives. But what happens if the pain doesn’t go away, or doesn’t fully go away, or even worse… begins to hurt more? This is when pain becomes chronic. Chronic pain is defined as pain that lasts more than three months.

What Does Chronic Pain Feel Like?

Chronic pain comes in many forms. It can be dull, sharp, heavy, tingling, throbbing, burning, squeezing, shooting, achy, or sore. I can be a mix of any of these forms, or be only one. It can come and go or be consistent over the course of a day or many days, but it is always recurring. It can also be dull, or acute, or a mix of both and anywhere in between. It can happen during the day or night, or both.

The Emotional and Social Cost of Ongoing Pain

Chronic pain takes its toll on your lifestyle, your relationships and your mental health. It can create brain fog during the day and sleep disturbances and/or sleepless nights. Chronic pain sufferers also regularly report feelings of fatigue, sadness, nervousness, overwhelm, irritability, frustration and anger. There are high incidences of anxiety and depression among chronic pain sufferers.

Additionally, long-term depression increases the probability of a person reporting high levels of chronic pain. All of this combined can create a terrible cycle of inactivity and suffering.

 

Anti-Inflammatory Diet Graphic

Natural Options for Chronic Pain Are Available

In addition to the conventional approach, there are a number of natural modalities that can work alongside medication and potentially lessen the need for pharmaceutical support. Here are some of our favourites.

Movement

Regular, gentle physical movement, particularly activities involving the mind-body connection or meditative movement therapies (MMT) help minimize chronic pain. These activities strengthen the body and help develop mindfulness, leading to stress reduction, at the same time. Pilates, Tai Chi, Qi Gong, and Yoga are fantastic examples of mind-body therapies.

Flexibility training, core training, balance training, and light strength training are other forms of movement that help manage chronic pain by lubricating the joints, improving your overall stability and increasing your range of motion.

Acupuncture

Acupuncture has been used in traditional Eastern medicine for thousands of years. It involves inserting small needles into the skin at specific acupoints, typically leaving them in place for up to 30 minutes while you rest. The body reacts to the process by releasing endorphins into your bloodstream. These endorphins act as natural painkillers and also affect the part of the brain that governs serotonin, one of the brain chemicals that positively affect mood.

An Anti-Inflammatory Diet

Keeping inflammation under control is critical when it comes to managing chronic pain. Adopting an anti-inflammatory diet can help reduce your diet’s impact on inflammation and is something you can start today. The main tenets of a diet designed to lessen inflammation include:

Eliminate sugar

Too much added sugar is one of the primary contributors to chronic, low-grade inflammation.

Eat Your Greens

Eat a diet rich in an assortment of vegetables. Choose a variety of colours and vegetable types to ensure you are getting a wide variety of vitamins, minerals, enzymes and antioxidants. Cruciferous vegetables, such as cabbage and broccoli are particularly rich in phytonutrients that help lower inflammation.

Limit Nightshades

Some people benefit from limiting or completely removing vegetables in the nightshade family. These include tomatoes, bell peppers, white potatoes, and eggplant.

Check for Food Sensitivities

Knowing whether your body is reacting to certain foods known to commonly trigger sensitivities, such as wheat and dairy, can help you choose your ingredients appropriately and lessen any inflammatory reactions.

Eat Whole Foods

A whole food diet means avoiding processed or refined foods, instead opting for foods in their original form, chock full of vitamins, minerals and fiber. This includes whole grains like oats, quinoa, brown rice, buckwheat, and spelt, as well as fresh vegetables, whole, unprocessed proteins and beans.

Choose Cooking Oils Wisely

Refined oils such as soybean, cottonseed and canola oils are highly unsaturated and oxidize easily when they come into contact with heat in the refinement process, leading to harmful trans fats. Less refined oils with a higher smoke point make healthier options that your body will know what to do with. Extra virgin olive oil and coconut oil have a smoke point of around 400F, making them good choices for healthy cooking.

Eat Less Red Meat

When it comes to reducing pain and inflammation, red meat is under scrutiny not so much for the saturated fat it contains, but rather because red meat is high in arachidonic acid. This essential fatty acid is pro-inflammatory and plays a role in promoting pain messaging in the body. If you already have symptoms of inflammation and chronic pain, reducing how much red meat you eat can help tone down those pain-promoting chemical messages.

Eat More Fish and Nuts

Oily fish such as salmon, sardines and mackerel contain anti-inflammatory essential fatty acids, as do seeds such as hemp, flax and pumpkin seeds, and nuts such as walnuts, almonds and hazelnuts. These fats help your body to build healthy cells and hormones, and reduce inflammation throughout the body.

Drink plenty of filtered water

Adequate water intake helps flush inflammatory toxins and irritants out of your cells. Water helps your body to eliminate waste effectively, lubricates your joints and muscles, and is the vehicle many nutrients need to be properly absorbed into your body. Water is an absolute must if you are working to reduce inflammation and pain.

 

Chronic Pain graphic

Supplements & Herbs to Consider

Several supplements and herbs have been researched for their role in helping reduce pain and inflammation in the body. Our favourites include the following:

Supplements

  • Oils rich in Omega-3 Fatty Acids, including fish oil and flax oil
  • Oils rich in linolenic acid, including borage seed oil, evening primrose oil, and blackcurrant seed oil
  • Vitamin D
  • Chondroitin sulphate
  • Glucosamine
  • S-adenosylmethionine (SAMe)
  • Pycnogenol
  • Resveratrol
  • Alpha-Lipoic Acid

Herbs

  • Turmeric/Curcumin
  • Ginger
  • Spirulina
  • Cat’s Claw
  • Devil’s Claw
  • White willow bark
  • Green tea
  • Boswellia
  • Triphala

Everyone’s journey with chronic pain is unique. The modalities that may work wonders for one person, may not work as well for another for a variety of reasons. The best results can be achieved with a tailored, holistic treatment plan that is adapted to the individual and managed through the different stages of healing and/or pain management.

 

Resources

Achilefu, A., Joshi, K., Meier, M., & McCarthy, L. H. (2017). Yoga and other meditative movement therapies to reduce chronic pain. The Journal of the Oklahoma State Medical Association, 110(1), 14–16.

Berman B. M. (2003). Integrative approaches to pain management: how to get the best of both worlds. BMJ (Clinical research ed.), 326(7402), 1320–1321. https://doi.org/10.1136/bmj.326.7402.1320-a

Crofford L. J. (2015). Chronic Pain: Where the Body Meets the Brain. Transactions of the American Clinical and Climatological Association, 126, 167–183.

Dansie, E. J., & Turk, D. C. (2013). Assessment of patients with chronic pain. British journal of anaesthesia, 111(1), 19–25. https://doi.org/10.1093/bja/aet124

de Heer, E. W., Gerrits, M. M., Beekman, A. T., Dekker, J., van Marwijk, H. W., de Waal, M. W., Spinhoven, P., Penninx, B. W., & van der Feltz-Cornelis, C. M. (2014). The association of depression and anxiety with pain: a study from NESDA. PloS one, 9(10), e106907. https://doi.org/10.1371/journal.pone.0106907

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Using medication: Painkillers: How common are severe side effects of NSAIDs? 2016 Apr 6 [Updated 2017 Aug 10].

Maroon, J. C., Bost, J. W., & Maroon, A. (2010). Natural anti-inflammatory agents for pain relief. Surgical neurology international, 1, 80. https://doi.org/10.4103/2152-7806.73804

Şahin, N., Karahan, A. Y., & Albayrak, İ. (2017). Effectiveness of physical therapy and exercise on pain and functional status in patients with chronic low back pain: a randomized-controlled trial. Turkish journal of physical medicine and rehabilitation, 64(1), 52–58.

Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis. Arch Intern Med. 2012;172(19):1444–1453. doi:10.1001/archinternmed.2012.3654


stress and hormones

Happy Hormones, Happy Mind.

Fluctuating moods are normal. Feeling lethargic after a long day, the ever-growing pressures of keeping up with work, family, relationships, health, irritability close to menstruation, and prolonged sadness after a personal loss or trauma are all natural (although perhaps less desirable) shifts in mood.  There are thousands of reasons our moods can fluctuate, but what happens when you can’t figure out why you’re feeling down? What happens when your lethargy feels chronic, your irritability continuous and your moods shift from one to the next as though they have a life of their own?

Then it’s time to look a little deeper into the possible root causes. Hormonal imbalance in all genders, a condition that comes up often in clinical practice, counts malaise and mood swings as common symptoms. Such imbalances often go undetected in conventional medical care, yet feature high on our list of suspects in functional care.

In this article, we’ll discuss some effective actions you can take to help balance your hormones and get your life back on track.

Common Reasons Hormones Fall Out of Balance

Maintaining the delicate balance of hormones is key to optimal health and longevity, and even a slight imbalance can cause undesirable side effects. Modern life is rife with hormone disruptors that can contribute to hormonal imbalances that in turn often lead to mood fluctuations.  Here are some of the most common factors that can affect hormonal balance:

  • Stress: The hormone cortisol is released into our system when we experience stress. If that stress continues over the long term without significant times of rest it can exacerbate health issues, particularly anxiety and depression, and cause an imbalance in hormone production in the body.
  • Nutrition: Nutrient deficiencies due to digestive issues or a diet that is high in processed foods and/or low in nutrients can disrupt the body’s ability to build hormones and maintain balance.
  • Weight Gain: Stubborn weight gain is one of the more common signs of a hormonal imbalance, potentially being eventually attributed to thyroid imbalance, PCOS or perimenopause. However, excess weight in itself can contribute to an imbalance as visceral fat reduces the body’s sensitivity to insulin and may also contribute to high estrogen levels.
  • Menopause & Perimenopause: A decrease in estrogen levels as women get older can disrupt testosterone and progesterone levels, affecting the entire body. Hot flashes, sleepless nights, mood swings and anxiety are some of the most common symptoms of a hormonal imbalance experienced during menopause.
  • Pharmaceuticals: It is well known that steroids and opioids have the potential to disrupt hormones, causing such symptoms as testicle shrinkage in men and male pattern baldness in women. The birth control pill, HRT and fertility meds are also candidates, as synthetic hormones have been known to bind to the wrong receptors, bringing on an imbalance.

Manage Stress to Help Balance Your Hormones & Your Mood

Managing your stress levels is one of the most important things you can do to support your mood as well as your  hormonal balance and break the cycle. The following key factors have been shown to make a difference in our ability to be more emotionally balanced and to adapt better to the stressors in our lives:

Sleep Hygiene

Just like the health of your teeth is dependent on good oral hygiene, the quality of your sleep is dependent on good sleep hygiene. Sleep hygiene, at its core, is the sum of behavioural and environmental factors that promote regular, good sleep where you wake up feeling refreshed every morning. Here are our suggestions for sleep hygiene:

  • Create a nightly routine and stick to it
  • Go to bed at the same time every night
  • Keep your bedroom quiet, dark and cool
  • No screen time for at least one hour before bed
  • Go to sleep on an empty stomach
  • Don’t consume caffeine after 12:00 pm

Adopt an Anti-Inflammatory Diet

An anti-inflammatory diet that is nutrient dense, low in sugar, and high in probiotic foods can go far to help manage your stress levels.  The links between stress, anxiety, inflammation and the microbiome of your gut are well known. The following suggestions can help keep inflammation and your gut microbiome balanced:

  • Eat a diet rich in vegetables, especially dark, leafy greens and low starch carbohydrates like sweet potatoes.
  • Enjoy fermented foods such as Kombucha, kimchi, sauerkraut, kefir,  and yogurt.
  • Reduce consumption of food containing refined sugars and enjoy foods sweetened with maple syrup, honey, blackstrap molasses, monk fruit, or stevia.
  • Avoid processed foods.
  • Increase your fibre intake, with a focus on whole grains and legumes
  • Regularly eat fish or supplement your diet with an omega 3 essential fatty acid supplement.

Exercise

Regular physical activity helps reduce stress. It stimulates your feel-good endorphins and helps you sleep better at night. It is generally recommended to do 30 minutes of daily, moderate exercise to keep your stress levels in check. This can include anything from a walk in your neighbourhood, to yoga, to playing soccer. What’s most important is that you keep moving and, ideally, you do something that brings joy.

Setting Boundaries

Determining and enforcing clear and consistent boundaries in both our personal and professional lives is particularly important during times of high stress.  Setting boundaries around your physical space, your feelings, needs, and responsibilities helps to maintain emotionally safe personal and professional lives, and plan how to respond when your boundaries are encroached upon or broken. Boundaries act as a stress buffer, keeping us from falling into negative-rumination, mood swings, and patterns of abuse.

Mindfulness & Self-Compassion

A regular practice of mindfulness helps build an inner strength that makes us more resilient to stress.  A regular practice of self-compassion helps us to not suffer when we don’t meet our own expectations of managing stress. Try journaling about what went well and what was positive at the end of each day. Together, mindfulness and self-compassion are powerful tools that can drastically increase our resilience, reduce our stress levels, and balance our moods.

Get a Hormone Check-Up

If lifestyle changes are proving difficult or are not making the difference you had hoped, working with a natural health practitioner is a good next step towards rebalancing your hormones and your mood.  Your functional doctor can perform a number of tests to check your levels of estrogen, progesterone, testosterone, cortisol and your thyroid to determine if there is any kind of imbalance. Your practitioner can then guide you through a tailored lifestyle, nutrition and supplement support plan based on your specific results.

 

References

Ali SA, Begum T, Reza F. Hormonal Influences on Cognitive Function. Malays J Med Sci. 2018;25(4):31-41. doi:10.21315/mjms2018.25.4.3

Childs E, de Wit H. Regular exercise is associated with emotional resilience to acute stress in healthy adults. Front Physiol. 2014;5:161. Published 2014 May 1. doi:10.3389/fphys.2014.00161

Firth J, Gangwisch JE, Borisini A, Wootton RE, Mayer EA. Food and mood: how do diet and nutrition affect mental wellbeing? [published correction appears in BMJ. 2020 Nov 9;371:m4269]. BMJ. 2020;369:m2382. Published 2020 Jun 29. doi:10.1136/bmj.m2382

Hiller-Sturmhöfel S, Bartke A. The endocrine system: an overview. Alcohol Health Res World. 1998;22(3):153-164.

Moyer AM, Matey ET, Miller VM. Individualized medicine: Sex, hormones, genetics, and adverse drug reactions. Pharmacol Res Perspect. 2019;7(6):e00541. Published 2019 Dec 6. doi:10.1002/prp2.541

Ndefo UA, Eaton A, Green MR. Polycystic ovary syndrome: a review of treatment options with a focus on pharmacological approaches. P T. 2013;38(6):336-355.

Ranabir S, Reetu K. Stress and hormones. Indian J Endocrinol Metab. 2011;15(1):18-22. doi:10.4103/2230-8210.77573

Ray JA, Kushnir MM, Meikle AW, Sindt JE, Strathmann FG. An exploratory study Evaluating the impact of opioid and non-opioid pain medications on serum/plasma free testosterone and free estradiol concentrations. Drug Test Anal. 2017 Oct;9(10):1555-1560. doi: 10.1002/dta.2174. Epub 2017 Mar 31. PMID: 28182836.

University of Illinois at Urbana-Champaign, News Bureau. (2020, June 25). Control over work-life boundaries creates crucial buffer to manage after-hours work stress. ScienceDaily. Retrieved June 7, 2021 from www.sciencedaily.com/releases/2020/06/200625122734.htm

Yazdi Z, Loukzadeh Z, Moghaddam P, Jalilolghadr S. Sleep Hygiene Practices and Their Relation to Sleep Quality in Medical Students of Qazvin University of Medical Sciences. J Caring Sci. 2016;5(2):153-160. Published 2016 Jun 1. doi:10.15171/jcs.2016.016


healthy aging

Top Tips for Healthy Aging

We have more aging adults alive today than at any other time in history. This is no small feat. With advances in medicine, better access to resources, and improvement in our general quality of life, living well into our 80s and beyond is a realistic expectation to hold.

That being said, there is a general understanding that getting older means developing health complications. Osteoporosis, arthritis, heart disease, diabetes, cognitive decline, hearing loss and decreased stamina are often associated with aging. The question that remains is, is this physical decline inevitable? The answer is not necessarily. When it comes to healthy aging, lifestyle plays a role and although we may not be able to change genetics or random chance, a preventive lifestyle can make a big difference.

1 - Lower Your Stress

High levels of stress over prolonged periods of time is dangerous at any age, but can be more difficult to recover from as we get older. When we experience stress, the hormone cortisol is released into our system. For instances of short-term stress, this is a good thing, cortisol acts as an internal alarm system and is crucial for keeping us safe. Once the stressful situation has passed, our cortisol level should drop in accordance with our heart rate.

How Stress Makes You Feel Older

Long-term stress often keeps our internal alarm system activated. This wreaks havoc on the body affecting our sleep and recovery time, our energy levels, our mental and emotional acuity. Prolonged stress can lead to:

  • weight gain
  • insomnia
  • migraines
  • short-term memory problems
  • brain fog
  • digestive problems
  • inflammation
  • high blood pressure
  • high cholesterol
  • heart disease

Over time, stress can become naturalized in our body. We get used to it. We know we’re stressed out but we lose track of the degree, and how long we’ve been experiencing it. Dealing with the consequences of long-term stress just becomes normal.

Lifestyle Changes That Help

The preventative measures listed below can help minimize your cortisol levels and regain your health:

  • an anti-inflammatory diet
  • acupuncture
  • time in nature / being outdoors
  • regular moderate exercise
  • nutrient balancing and supplement support for your adrenals
  • weighted blanket

2 - Manage Your Insulin

Insulin may not be something you discuss with your family doctor if you don’t have a diabetes diagnosis, but research tells us that maintaining stable insulin levels is a key to longevity. Meanwhile, insulin resistance due to chronically high insulin has been shown to predict and accelerate the development of age-related diseases including hypertension, coronary heart disease, dementia, stroke, cancer, and type 2 diabetes.

Ditch Refined Carbohydrates

When we eat a steady diet of refined carbohydrates and quickly absorbed sugars, our cells slowly become more insulin resistant, requiring more insulin to maintain healthy blood sugar levels. The higher our insulin levels stay, the more resistant our cells become, eventually leading to what is often called metabolic syndrome: A collection of symptoms including fatigue, excess fat around the midsection, increased blood pressure, elevated fasting blood sugar and increased inflammation throughout the body.

Insulin Testing

Insulin levels go up long before they develop into issues such as hypoglycemia and prediabetes, and early detection can help change the course of what happens next. Often, we are unaware that our insulin levels have increased and are nearing dangerous levels. Lab testing to determine your levels is important in understanding where you stand now as well as having a measurement to assess your progress.

Lifestyle Changes

The actions needed to prevent and reduce insulin resistance in the early stages are fairly simple: reduce your consumption of refined carbohydrates, eat protein at every meal, and stay active. An Integrative/functional/naturopathic practitioner can help you keep track of your insulin levels and recommend the right supplements for your specific needs.

3 – Keep Your Hormones Balanced

Hormones are messengers that affect everything in our bodies, from our growth and development to reproduction, tissue repair, metabolism, immunity, and inflammation. Keeping our hormones functioning optimally is imperative to staying healthy. As we age however, our hormone secretion becomes less efficient, which leads to imbalances and changes in the effectiveness of our internal systems.

Hormones and Aging

This imbalance can lead to a wide variety of health issues such as:

  • unexpected weight gain or loss
  • dry skin and hair
  • weak nails
  • fatigue
  • muscle weakness, aches, tenderness, and/or stiffness
  • joint pain, stiffness and/or swelling
  • anxiety
  • depression
  • Brain fog, memory and more!

Hormone Testing

If you are concerned about your hormone levels, your doctor/we/I can run tests to check your levels of testosterone, progesterone, estrogen, cortisol and thyroid hormones and determine your current hormonal status as well as a plan to get your hormones balanced.

A Hormone-Friendly Lifestyle

Balancing your hormones through diet and lifestyle habits can make a big difference in your overall health and the aging process. Our suggestions include:

  • Eat nutrient dense foods and healthy fats
  • Plenty of sleep every night
  • Stress reduction
  • Regular moderate exercise
  • Supplementation to help support your overall health
  • If needed, bioidentical hormone replacement therapy (BHRT) may help with symptoms.

4 - Keep Inflammation at Bay

Inflammation is the body’s way of protecting itself. Physical injuries trigger the release of proteins, antibodies and increased blood flow to the area to repair the damage.

What many people are not aware of is that long-term exposure to irritants and toxins, food sensitivities, autoimmune disorders and even stress can cause an inflammatory response too. When this response continues for more than a few days, it’s considered chronic.

How Chronic Inflammation Ages You

Chronic inflammation is a major component of accelerated aging and a risk factor for developing atherosclerosis, hypertension, diabetes, strokes, heart attacks, fibromyalgia, arthritis, sinus infections, autoimmune conditions and cancer.

Testing for Inflammation

Your doctor can run a number of tests to check for inflammatory signals in your blood including the ESR blood test (erythrocyte sedimentation rate) or a CRP blood test (C-reactive protein). Food sensitivity testing can sometimes help get to the root of the problem.

Living an Anti-Inflammatory Lifestyle

Preventive measures for chronic systemic inflammation include:

  • Adopting an anti-inflammatory diet
  • Reducing stress levels
  • Regular exercise
  • Ensuring your vitamin D levels are good
  • Including anti-inflammatory superfoods into your diet: omega-3 fatty acids (fish oil), linolenic acid (flax and hemp seed oils), green tea, turmeric, ginger, spirulina.

5 - Keep Moving

And finally, regular physical activity is crucial to aging well. As we get older we start to lose bone density and muscle mass which impacts not only our physical strength, but more importantly our stability, bone strength and immune system. Keeping active and flexible throughout all stages of life allows us to stay healthy and remain independent in our later years.

Choose Activities that Suit You

Regular activity doesn’t have to mean team sports (although there is no harm in that.) Find a form of exercise that suits your lifestyle and level of fitness, and stick to it: Taking a walk, a Yoga or Pilates practice, swimming or cycling are all great lifelong habits. Make sure to include an element of weight resistance which helps strengthen your bones and joints as well as improving heart health.

Getting Your Body Some Help

Physiotherapists, chiropractors and osteopaths are all professionals who can help you understand your current physical condition. They can assess your flexibility, strength, and range of motion and develop a tailored plan to help you strengthen any weaknesses and correct imbalances. Knowing and addressing physical imbalances now can help to prevent chronic pain and injury as you get older.

Although aging isn’t a choice, aging well is. There is a lot you can do to optimise your version of the aging process by identifying problem areas and adopting a preventive lifestyle. It’s never too late to make a difference.

Working with a functional practitioner is a great place to start. Together we can run labs to identify and target your specific imbalances and begin your path to better long term health.

 

References:

Akintola AA, van Heemst D. Insulin, aging, and the brain: mechanisms and implications. Front Endocrinol (Lausanne). 2015;6:13. Published 2015 Feb 6. doi:10.3389/fendo.2015.00013

Chung HY, Kim DH, Lee EK, et al. Redefining Chronic Inflammation in Aging and Age-Related Diseases: Proposal of the Senoinflammation Concept. Aging Dis. 2019;10(2):367-382. Published 2019 Apr 1. doi:10.14336/AD.2018.0324

Ferrucci L, Fabbri E. Inflammageing: chronic inflammation in ageing, cardiovascular disease, and frailty. Nat Rev Cardiol. 2018;15(9):505-522. doi:10.1038/s41569-018-0064-2

Graham JE, Christian LM, Kiecolt-Glaser JK. Stress, age, and immune function: toward a lifespan approach. J Behav Med. 2006;29(4):389-400. doi:10.1007/s10865-006-9057-4

Hiller-Sturmhöfel S, Bartke A. The endocrine system: an overview. Alcohol Health Res World. 1998;22(3):153-164.

Lakhan SE, Vieira KF. Nutritional and herbal supplements for anxiety and anxiety-related disorders: systematic review. Nutr J. 2010;9:42. Published 2010 Oct 7. doi:10.1186/1475-2891-9-42

McMurdo ME. A healthy old age: realistic or futile goal?. BMJ. 2000;321(7269):1149-1151. doi:10.1136/bmj.321.7269.1149

Ranabir S, Reetu K. Stress and hormones. Indian J Endocrinol Metab. 2011;15(1):18-22. doi:10.4103/2230-8210.77573

Schwarz NA, Rigby BR, La Bounty P, Shelmadine B, Bowden RG. A review of weight control strategies and their effects on the regulation of hormonal balance. J Nutr Metab. 2011;2011:237932. doi:10.1155/2011/237932

Swarup S, Goyal A, Grigorova Y, et al. Metabolic Syndrome. [Updated 2020 Nov 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK459248/

Thau L, Gandhi J, Sharma S. Physiology, Cortisol. [Updated 2021 Feb 9]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan.

Yaribeygi H, Panahi Y, Sahraei H, Johnston TP, Sahebkar A. The impact of stress on body function: A review. EXCLI J. 2017;16:1057-1072. Published 2017 Jul 21. doi:10.17179/excli2017-480


improve digestion

Digestive Issues? Here’s What You Can Do to Tame Them

“After your meal, sit a while, then walk a mile.” - Dr. Bernard Jensen

 

Good digestion. When it’s all working smoothly, we tend to take it for granted, but when things get out of balance it can quickly become all we think about. Heartburn, bloating, nausea, diarrhea - we may make jokes about them, but these symptoms of poor digestion can make us feel downright miserable, not to mention antisocial.

Digestive disorders have risen dramatically in recent years, likely because our fast-paced lifestyles contain many elements that contribute to problems, such as high stress levels, too much time spent sitting, not enough movement and definitely not enough quality sleep. If you experience pain in your digestive system, it is of course important to see your family doctor so that they can help you rule out any medical issues. The good news is that if a medical issue is not the reason, it’s often possible to get your digestion back on track by implementing a handful of simple, lifelong habits.

Let’s look at some ways you can figure out that funny tummy, reclaim your social life and feel confident that what you eat is truly nourishing your body.

8 Proven Habits to Support Your Digestion Every Day:

Eat a Whole Food Diet

A “whole food” diet means opting for the most natural, least-processed version whenever possible, no matter what form your diet takes (balanced, low carb, vegetarian, etc). A whole baked apple instead of apple pie, for example, a handful of nuts over a protein bar, or whole grain over refined white flour. This is the best way to make sure your food contains all of its essential nutrients and enzymes so that it is nourishing and easier to digest. Not to mention that the additives and excess sugar found in many processed foods can feed the bad bacteria in your gut, contributing to gut irritation, bloating and cramps.

Drink Plenty of Water

One of the most common culprits for constipation is dehydration. Water serves 4 main functions in digestion. First, it is necessary for your body to produce the various digestive enzymes and juices that help break down your food. Next, it is the vehicle nutrients ride in so that your body can absorb them easily. It also helps to keep things well-lubricated so that the fiber you eat turns into a soothing, puffy gel and your digested food moves easily through your intestines. And finally, water is a fundamental ingredient in muscle movement - and your gut is essentially a long tube made up of muscles that need to contract in a specialized wave-like motion called “peristalsis”. Well hydrated muscles are able to contract as needed to push the digested food through the gut and out of the body so that it doesn’t sit around for too long and start to cause irritation.

Unfortunately digestion isn’t always the body’s top priority. Survival takes precedence, so if your body senses that you need more water elsewhere in the body such as your brain or legs (fight & flight), it will redirect water from your gut to serve the immediate survival need, making your stools harder to pass.

Choose High Fiber Foods

As healthy fiber from whole grains, beans, lentils, nuts and seeds, fruits and (most importantly) vegetables passes through your body, it absorbs water and other fluids to form a gel-like substance that feeds the good bacteria and soothes the gut wall. It helps provide bulk to stools, which helps them move along the digestive tract more easily, contributing to regularity and that sometimes elusive feeling of complete elimination.

However, it is important to remember that if you currently eat a low-fiber diet, you must be careful not to ramp up your intake too quickly, as that can lead to gas, discomfort and, ironically, constipation. Make sure you increase your fiber intake slowly over a few days or weeks - especially if you are adding an extra fiber supplement such as freshly ground flax seeds - while also drinking more water as the fiber itself can absorb a lot.

Eat Consciously

As mentioned above, stress has a way of messing with digestion. So keeping stress low is particularly important during mealtimes. You can achieve this by simply slowing down, avoiding eating on the go, and making a conscious effort to sit down at a table to eat your meal.

Turn off the TV, take slow, deep breaths and pay attention to the pleasure of good food. Use your senses throughout the meal - taste, smell, textures - food should be enjoyed after all. Savour every bite instead of absent-mindedly snacking while thinking of something else and you’ll improve digestion by putting your body into “rest and digest'' mode and giving it all the right signals to trigger the necessary digestive enzymes. Not to mention, conscious eating helps to reduce the chance of overeating to the point of feeling too full.

Chew Your Food Properly

What’s the rush? When you chew your food, you’re starting the digestive process. The mechanical action of your teeth breaks food into smaller pieces to increase its surface area, so that digestive enzymes can get to work. Chewing also triggers the production of saliva, the first enzyme in a cascade of different enzymes, each triggering the next to achieve complete digestion and absorption of nutrients from your food.

Aim to chew your food 20 - 30 times before you swallow for best results. That’s right, just like Grandma told you.

Support Your Digestive Enzymes

If chewing your food doesn’t go far enough towards easing an overly-full feeling after meals, try supporting your digestive enzymes more directly. This can simply mean taking a shot of apple cider vinegar before meals to provide enough acid to trigger stomach digestion. Alternatively, chewable digestive enzymes made from papaya and pineapple actively break down protein in your food, and more comprehensive and targeted digestive enzyme supplements are available too.

Feed Your Good Bacteria

Your digestive tract contains trillions of good bacteria that support gut health by breaking down specific carbohydrates, soothing the gut wall and producing hormones such as serotonin, the “feel-good hormone”. Maintaining that microbiome is essential for avoiding digestive problems like gas, bloating, constipation, and diarrhea - and for mental health.

Make sure to eat a wide variety of healthy whole foods to help sustain them, and fermented foods to help replenish them. These include unsweetened probiotic yogurt, kimchi, kefir, miso, and sauerkraut.

Probiotic supplements can help replenish and balance your gut bacteria if food alone isn’t enough at first. Research suggests they’re an effective supplement to reduce the symptoms of existing digestive problems.

Move Your Body

This brings us back to the quote from digestive health pioneer Dr. Bernard Jensen: “After your meal, sit a while, then walk a mile.” The reason for this suggestion is simple: When you move, your digestive system moves. Scientists have found that exercise can improve the rate at which you digest food. Gravity and movement stimulate peristalsis by helping to trigger various “fullness” receptors in your colon. This results in more muscle movements pushing your digested food through the digestive tract at a regular pace.

By the way, exercise also reduces stress, boosts energy, improves mood and supports good heart health.

Digestive symptoms like bloating, diarrhea and indigestion shouldn’t be holding you back from enjoying life. If you’d like to talk about further strategies, lab tests to check the status of your microbiome, or you simply want help creating a plan to implement these tips, contact us today.

References:

Dr. Bernard Jensen. Dr. Jensen's Guide to Better Bowel Care: A Complete Program for Tissue Cleansing through Bowel Management. Avery; 1190th ed. edition (Sept. 1 1998)

Anderson JW, Baird P, Davis RH Jr, Ferreri S, Knudtson M, Koraym A, Waters V, Williams CL. Health benefits of dietary fiber. Nutr Rev. 2009 Apr;67(4):188-205. doi: 10.1111/j.1753-4887.2009.00189.x. PMID: 19335713.

Everhart JE, editor. The burden of digestive diseases in the United States. US Department of Health and Human Services, Public Health Service, National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases. Washington, DC: US Government Printing Office, 2008; NIH Publication No. 09-6443.

Boekema PJ, Samsom M, van Berge Henegouwen GP, Smout AJ. Coffee and gastrointestinal function: facts and fiction. A review. Scand J Gastroenterol Suppl. 1999;230:35-9. doi: 10.1080/003655299750025525. PMID: 10499460.

Oettlé GJ. Effect of moderate exercise on bowel habit. Gut. 1991 Aug;32(8):941-4. doi: 10.1136/gut.32.8.941. PMID: 1885077; PMCID: PMC1378967.

McFarland LV. Use of probiotics to correct dysbiosis of normal microbiota following disease or disruptive events: a systematic review. BMJ Open. 2014 Aug 25;4(8):e005047. doi: 10.1136/bmjopen-2014-005047. PMID: 25157183; PMCID: PMC4156804.


natural relief chronic pain

Lifestyle Factors to Reduce Pain and Inflammation

Chronic pain is a common and complex problem affecting 20–30% of the population of Western countries. The pharmaceutical industry has garnered billions of dollars in painkiller and anti-inflammatory sales, yet this hasn’t come without potential health risks to consumers from a well-documented crisis level of opioid addiction to frequent gastrointestinal complications and an increased risk of developing cardiovascular disease. We witness these side effects with an understanding that pharmaceuticals may provide partial, and not always full relief from chronic pain.

It’s no wonder we’re hearing from a lot of patients who are looking for a more natural approach to managing their chronic pain.

What is Chronic Pain?

We all feel physical pain from time to time. Injury, inactivity, sickness and disease can cause many different types of aches and pain. When this occurs, our bodies work hard to heal so that we can return to our normal lives. But what happens if the pain doesn’t go away, or doesn’t fully go away, or even worse… begins to hurt more? This is when pain becomes chronic. Chronic pain is defined as pain that lasts more than three months.

What Does Chronic Pain Feel Like?

Chronic pain comes in many forms. It can be dull, sharp, heavy, tingling, throbbing, burning, squeezing, shooting, achy, or sore. I can be a mix of any of these forms, or be only one. It can come and go or be consistent over the course of a day or many days, but it is always recurring. It can also be dull, or acute, or a mix of both and anywhere in between. It can happen during the day or night, or both.

The Emotional and Social Cost of Ongoing Pain

Chronic pain takes its toll on your lifestyle, your relationships and your mental health. It can create brain fog during the day and sleep disturbances and/or sleepless nights. Chronic pain sufferers also regularly report feelings of fatigue, sadness, nervousness, overwhelm, irritability, frustration and anger. There are high incidences of anxiety and depression among chronic pain sufferers.

Additionally, long-term depression increases the probability of a person reporting high levels of chronic pain. All of this combined can create a terrible cycle of inactivity and suffering.

Natural Options for Chronic Pain Are Available

In addition to the conventional approach, there are a number of natural modalities that can work alongside medication and potentially lessen the need for pharmaceutical support. Here are some of our favourites.

Movement

Regular, gentle physical movement, particularly activities involving the mind-body connection or meditative movement therapies (MMT) help minimize chronic pain. These activities strengthen the body and help develop mindfulness, leading to stress reduction, at the same time. Pilates, Tai Chi, Qi Gong, and Yoga are fantastic examples of mind-body therapies.

Flexibility training, core training, balance training, and light strength training are other forms of movement that help manage chronic pain by lubricating the joints, improving your overall stability and increasing your range of motion.

Acupuncture

Acupuncture has been used in traditional Eastern medicine for thousands of years. It involves inserting small needles into the skin at specific acupoints, typically leaving them in place for up to 30 minutes while you rest. The body reacts to the process by releasing endorphins into your bloodstream. These endorphins act as natural painkillers and also affect the part of the brain that governs serotonin, one of the brain chemicals that positively affect mood.

An Anti-Inflammatory Diet

Keeping inflammation under control is critical when it comes to managing chronic pain. Adopting an anti-inflammatory diet can help reduce your diet’s impact on inflammation and is something you can start today. The main tenets of a diet designed to lessen inflammation include:

  • Eliminate sugar: Too much added sugar is one of the primary contributors to chronic, low-grade inflammation.
  • Eat Your Greens: Eat a diet rich in an assortment of vegetables. Choose a variety of colours and vegetable types to ensure you are getting a wide variety of vitamins, minerals, enzymes and antioxidants. Cruciferous vegetables, such as cabbage and broccoli are particularly rich in phytonutrients that help lower inflammation.
  • Limit Nightshades: Some people benefit from limiting or completely removing vegetables in the nightshade family. These include tomatoes, bell peppers, white potatoes, and eggplant.
  • Check for Food Sensitivities: Knowing whether your body is reacting to certain foods known to commonly trigger sensitivities, such as wheat and dairy, can help you choose your ingredients appropriately and lessen any inflammatory reactions.
  • Eat Whole Foods: A whole food diet means avoiding processed or refined foods, instead opting for foods in their original form, chock full of vitamins, minerals and fiber. This includes whole grains like oats, quinoa, brown rice, buckwheat, and spelt, as well as fresh vegetables, whole, unprocessed proteins and beans.
  • Choose Cooking Oils Wisely: Refined oils such as soybean, cottonseed and canola oils are highly unsaturated and oxidize easily when they come into contact with heat in the refinement process, leading to harmful trans fats. Less refined oils with a higher smoke point make healthier options that your body will know what to do with. Extra virgin olive oil and coconut oil have a smoke point of around 400F, making them good choices for healthy cooking.
  • Eat Less Red Meat: When it comes to reducing pain and inflammation, red meat is under scrutiny not so much for the saturated fat it contains, but rather because red meat is high in arachidonic acid. This essential fatty acid is pro-inflammatory and plays a role in promoting pain messaging in the body. If you already have symptoms of inflammation and chronic pain, reducing how much red meat you eat can help tone down those pain-promoting chemical messages.
  • Eat More Fish and Nuts: Oily fish such as salmon, sardines and mackerel contain anti-inflammatory essential fatty acids, as do seeds such as hemp, flax and pumpkin seeds, and nuts such as walnuts, almonds and hazelnuts. These fats help your body to build healthy cells and hormones, and reduce inflammation throughout the body.
  • Drink plenty of filtered water: Adequate water intake helps flush inflammatory toxins and irritants out of your cells. Water helps your body to eliminate waste effectively, lubricates your joints and muscles, and is the vehicle many nutrients need to be properly absorbed into your body. Water is an absolute must if you are working to reduce inflammation and pain.
  • Supplements & Herbs to Consider: Several supplements and herbs have been researched for their role in helping reduce pain and inflammation in the body. Our favourites include the following:

Supplements

Herbs

Oils rich in Omega-3 Fatty Acids, including fish oil and flax oil

Turmeric/Curcumin

Oils rich in linolenic acid, including borage seed oil, evening primrose oil, and blackcurrant seed oil

Ginger

Vitamin D

Spirulina

Chondroitin sulphate

Cat’s Claw

Glucosamine

Devil’s Claw

S-adenosylmethionine (SAMe)

White willow bark

Pycnogenol

Green tea

Resveratrol

Boswellia

Alpha-Lipoic Acid

Triphala

Everyone’s journey with chronic pain is unique. The modalities that may work wonders for one person, may not work as well for another for a variety of reasons. The best results can be achieved with a tailored, holistic treatment plan that is adapted to the individual and managed through the different stages of healing and/or pain management. As a functional/naturopathic/integrative healthcare practitioner, I/we have the lab tests and resources to support you.

 

Resources

Achilefu, A., Joshi, K., Meier, M., & McCarthy, L. H. (2017). Yoga and other meditative movement therapies to reduce chronic pain. The Journal of the Oklahoma State Medical Association, 110(1), 14–16.

Berman B. M. (2003). Integrative approaches to pain management: how to get the best of both worlds. BMJ (Clinical research ed.), 326(7402), 1320–1321. https://doi.org/10.1136/bmj.326.7402.1320-a

Crofford L. J. (2015). Chronic Pain: Where the Body Meets the Brain. Transactions of the American Clinical and Climatological Association, 126, 167–183.

Dansie, E. J., & Turk, D. C. (2013). Assessment of patients with chronic pain. British journal of anaesthesia, 111(1), 19–25. https://doi.org/10.1093/bja/aet124

de Heer, E. W., Gerrits, M. M., Beekman, A. T., Dekker, J., van Marwijk, H. W., de Waal, M. W., Spinhoven, P., Penninx, B. W., & van der Feltz-Cornelis, C. M. (2014). The association of depression and anxiety with pain: a study from NESDA. PloS one, 9(10), e106907. https://doi.org/10.1371/journal.pone.0106907

InformedHealth.org [Internet]. Cologne, Germany: Institute for Quality and Efficiency in Health Care (IQWiG); 2006-. Using medication: Painkillers: How common are severe side effects of NSAIDs? 2016 Apr 6 [Updated 2017 Aug 10].

Maroon, J. C., Bost, J. W., & Maroon, A. (2010). Natural anti-inflammatory agents for pain relief. Surgical neurology international, 1, 80. https://doi.org/10.4103/2152-7806.73804

Şahin, N., Karahan, A. Y., & Albayrak, İ. (2017). Effectiveness of physical therapy and exercise on pain and functional status in patients with chronic low back pain: a randomized-controlled trial. Turkish journal of physical medicine and rehabilitation, 64(1), 52–58.

Vickers AJ, Cronin AM, Maschino AC, et al. Acupuncture for Chronic Pain: Individual Patient Data Meta-analysis. Arch Intern Med. 2012;172(19):1444–1453. doi:10.1001/archinternmed.2012.3654


collagen

Step Into the Fall Season with Collagen

By Dr. David M. Brady and Danielle Moyer, MS, CNS

 

The fall season - what’s not to love? Warm drinks, pumpkin patches, and holidays with loved ones. Oh, and dry skin and achy joints.

There may be a way to enjoy all the good parts of fall without the bad parts. Studies show that supplementing with collagen peptides may help.

Up to 30% of the protein in our body is naturally produced collagen [1]. The word collagen is derived from the Greek word “kolla”, which means glue. Collagen can be interpreted as the “glue” that holds our body together and constitutes, along with the bones, most of the body’s structural support [2].

Unfortunately, our bodies start to lose collagen around 18 to 29 years of age. At the age of 40, the body can lose around 1% of its total collagen per year. At age 80, collagen production can be 75% lower compared to young adults. Collagen loss is a byproduct of natural aging, but can be accelerated by free radicals from unhealthy diets, sunlight, environmental pollution, smoking, alcoholism, and disease [3-4].

Studies have shown that supplementing with bioactive collagen peptides can reverse this age-dependent collagen loss and can be incredibly beneficial for the body [4]. Collagen helps to strengthen our bone, tendons, and cartilage, and can improve the health and appearance of our hair, skin, and nails.

Benefits of high-quality collagen peptides [1]:

  • Increase bone density, mass, and quality
  • Reduce osteoarthritis symptoms (pain and stiffness)
  • Reduce risk of fractures
  • Improve skin elasticity, thickness, and hydration
  • Improve nail health and reduce brittleness
  • Reduce wrinkle formation
  • Reduce cellulite appearance
  • Improve joint, cartilage, tendons, and ligament health
  • Reduce post exercise joint pain in young athletes and improve ankle stability  
  • Improve blood pressure
  • Improve muscle strength and gastrointestinal tract health
  • Improve hair quantity and quality

It is possible to get collagen from whole-food, protein sources. However, many individuals, especially the elderly, do not consume enough adequate protein. Even those who do consume adequate protein do not digest it optimally and often do not eat those foods with the highest concentrations of collagen – animal skins, bone broth, and tendons [1].

Research suggests that supplementing between 2.5 to 15 grams of collagen peptides per day can lead to the health benefits listed above [5]. Those who need higher amounts in that range include athletes, aging individuals, those recovering from injury, and menopausal women not on hormone-replacement therapy [1]. 

In powder form, collagen peptides are convenient and easy to incorporate into a diet. It can be sprinkled into smoothies, shakes, coffee, tea, lemonade, yogurts, dips, salad dressings, soups, sauces, mashed potatoes/cauliflower, casseroles, and desserts [1].  

It is no surprise that collagen peptide powders are becoming more popular. With the glut of products on the market, it is essential to choose high quality, well-researched collagen peptide blends. Specific brands, like Whole Body Collagen by Designs for Health, contains a research-proven specific molecular weight collagen peptide formula produced to optimize their beneficial properties [1].

It is important to note that collagen peptide supplements must be complemented by other supportive bone nutrients in the diet and/or supplementation to support healthy bones: Calcium, magnesium, silicon, and vitamin D, K1 and K2 [1].

So, this fall season, let’s do something different.

Let us lower our need to apply skin care products for dry skin and over-the-counter remedies to relieve our body aches. Instead, let us improve and maintain proper collagen levels in our body to directly support our body’s bones, joints, skin, hair, and nails at the source. Consider stepping into fall with some collagen peptides this year. 

References: 

  1. Paul C, Berger A. Whole Body Collagen. Designs for Health Website. Published August 2018. 
  2. Deshmukh SN, Dive AM, Moharil R, Munde P. Enigmatic insight into collagen. J Oral Maxillofac Pathol. 2016;20(2):276-283. doi:10.4103/0973-029X.185932
  3. León-López A, Morales-Peñaloza A, Martínez-Juárez VM, Vargas-Torres A, Zeugolis DI, Aguirre-Álvarez G. Hydrolyzed Collagen—Sources and Applications. Molecules. 2019;24(22):4031. doi:10.3390/molecules24224031
  4. Bolke L, Schlippe G, Gerß J, Voss W. A Collagen Supplement Improves Skin Hydration, Elasticity, Roughness, and Density: Results of a Randomized, Placebo-Controlled, Blind Study. Nutrients. 2019;11(10):2494. doi:10.3390/nu11102494
  5. Paul C, Leser S, Oesser S. Significant Amounts of Functional Collagen Peptides Can Be Incorporated in the Diet While Maintaining Indispensable Amino Acid Balance. Nutrients. 2019;11(5):1079. doi:10.3390/nu11051079

vitamin k

What is Vitamin K and Why is it Important?

By Dr. David M. Brady and Danielle Moyer, MS, CNS

 

Vitamin A = Eyes.

Calcium = Bones.

What about vitamin K?

Vitamin K doesn’t get as much press as other vitamins, but that does not mean it is less important.

The “K” in vitamin K originates from the Danish word “koagulation”, which translates to “coagulation”. One of the main roles of vitamin K is assisting in blood coagulation. Meaning, if you are bleeding from a cut, vitamin K is a main player in helping the blood clot (or stop) naturally! Through time, we have learned that vitamin K’s importance goes well beyond just blood clotting.

Roles & functions of vitamin K

  1. Help with blood clotting
  2. Lowers inflammation in the body, helping with any inflammatory/autoimmune disease
  3. Gene expression (Properly expressing you genetic code)
  4. Supports optimal bone health, increasing collagen and calcium content of bones  
  5. Supports teeth/oral health  
  6. Supports cardiovascular health
  7. Anticancer effects
  8. Reduces risk of kidney stones
  9. Prevention or reversal of osteoporosis, which may reduce bone fracture risk  
  10. For men, increased testosterone

Research has found that vitamin K, vitamin D, and vitamin A all work in concert together. For vitamin K to fully display all of its potential benefits, vitamin D and vitamin A must be optimized as well [1].

Effects of low vitamin K levels and/or deficiency:

  1. Easy bruising and bleeding (nosebleeds, bleeding gums, blood in urine/stool, heavy menstrual bleeding) [2]
  2. Improper bone mineralization
  3. Reduced health of joint cartilage, tendons, ligaments
  4. Suboptimal skin health, elasticity, and overall appearance
  5. Impaired insulin secretion and increased insulin resistance
  6. Increased risk of kidney stone formation
  7. Suboptimal energy production
  8. Inadequate antioxidant protection in the brain
  9. Increased severity of cystic fibrosis
  10. Reduced testosterone production [1]

Supplementation with high doses of standard vitamin E (d-alpha-tocopherol), ranging from 800-1200 IU, has been shown to impair and interfere with vitamin K’s blood clotting ability, whereas excess vitamin A supplementation can interfere with vitamin K absorption [1-2]. Both should be avoided unless specifically advised by your doctor and/or nutritionist.

Vitamin K has many forms

Vitamin K has different forms that can be grouped into three classifications: vitamin K1, vitamin K2, and vitamin K3. We will focus on vitamin K1 and K2, as they are the forms found in supplements and produce the benefits listed above.

Vitamin K1, or phylloquinone:

Vitamin K1 is the most common form of vitamin K in the diet and occurs naturally in certain vegetables, vegetable oils, seeds, and algae [1].

Foods with high vitamin K1 content:

  • Kale
  • Swiss chard
  • Parsley
  • Broccoli
  • Spinach
  • Watercress
  • Leaf lettuce (green)
  • Soybean oil
  • Canola oil
  • Olive oil
  • Cottonseed oil [2]

The best way to absorb vitamin K1 through the vegetables above is to eat them cooked, blended, or juiced (as opposed to raw), as well as eating them with a source of dietary fat.

Elements that destroy vitamin K in food are exposure to light and hydrogenation (as in hydrogenated oils). Hydrogenated oils are created during industrial cooking, frying, or baking, and will be listed  “partially hydrogenated” or “hydrogenated” on the ingredients list of processed foods.

A large portion of the population get their main sources of vitamin K1 from vegetable oils rather than vegetables. When the oils are hydrogenated from fast foods or processed foods, this can lead to low levels of vitamin K in the individual [1].

Vitamin K2, or menaquinones:

Vitamin K2 represents 90% of the total vitamin K stored in our body because a large portion of vitamin K1 gets converted into vitamin K2 for storage.

Vitamin K2 has 14 different forms. They are labeled MK-1 through MK-14. “MK” stands for menaquinone. The most discussed and researched forms are vitamin MK-4 and vitamin MK-7 [1].

Vitamin K2 is technically not a “vitamin” because our bodies can actually produce it themselves. Synthesis can occur through the bacteria in our intestines in a healthy gut environment. It is important to note that if a person uses an antibiotic, this can kill over 70% of the beneficial gut bacteria that normally produces vitamin K2 and extra supplementation may be necessary [4].

Since other animals and fermentation processes can synthesize vitamin K2, we can also find it in foods like:

  • Grass fed-meat and liver, fish, and egg yolk
  • Yogurt, cheese, sour cream, buttermilk
  • Sauerkraut, kimchi, and natto

Certain individuals who have difficulty converting vitamin K1 into vitamin K2 because of age-related changes, certain diseases, genetics, or chronic antibiotic use may particularly benefit from supplementation of vitamin K2. The diseases of concern include osteopenia, osteoporosis, osteoarthritis, and arterial calcification [1].

One will often find both MK-4 and MK-7 in supplements, in addition to vitamin K1. Vitamin MK-7 displays some, but not all of the beneficial effects of MK-4, and has not been proven to be more effective than vitamin K1 or vitamin MK-4. There is also a unique element called geranylgeraniol (GG) which can facilitate more natural production of vitamin K in the body. Some supplements now contain K1 and K2-MK-4 along with GG to ensure that they all work together to promote optimal delivery of vitamin K2 (as MK-4) to tissues supporting normal blood clotting, bone mineralization, and arterial elasticity. [3]. This is good news, as MK-7 is 10 times more expensive than MK-4 per milligram basis [1]. Expensive does not always mean better, and when the hard science is looked at regarding vitamin K metabolism it may be that the marketing on some vitamin K2 sub-types is more hype than reality!

brady vitamin k

The best approach to optimize vitamin K

Overt vitamin K deficiencies are rare in the United States, but lower than optimal levels are more common [4].

The adequate intake (AI) of vitamin K1 is 90 mcg for women and 120 mcg for men. It has been found that 60-70% of the US does not meet this standard, which some argue is already below what may be necessary for optimal health.

The best recommendation for any age or gender is to get as much vitamin K1 from eating an abundance of leafy greens (or their juices) or healthy oils (such as olive oil) every day.

Humans are adapted to intake up to 1,000 mcg of vitamin K1 daily with no adverse effects [1]. Since it seems improbable that all individuals will achieve this goal via their diet, supplementation of vitamin K1 and/or K2 may be warranted for a large portion of the population.

Vitamin K may be particularly crucial for adolescents going through peak bone development and those of reproductive age. It is also important for older individuals, especially women in peri- and established menopause and men with lower than optimal testosterone levels. Lastly, it is also crucial for those on chronic antibiotic therapy as well as those with severe gastrointestinal malabsorptive disorders (Crohn’s disease, ulcerative colitis, celiac disease, cystic fibrosis, chronic pancreatitis) [1,4].

Anticoagulant drugs, such as warfarin or Coumarin, directly interfere with vitamin K utilization in the body, and large doses of vitamin K may undermine the medication. It is advised for a patient on these drugs to not avoid vitamin K intake, but rather, keep their vitamin K levels consistent at the dietary intake of 90 to 120 mcg/day, avoiding any large fluctuations. Vitamin K intake from food and supplements should be closely monitored with a doctor if you are undergoing anticoagulant therapy [2].

Labs to get your vitamin K levels assessed  

If you are curious about your vitamin K levels, there are two scientifically validated functional markers: Uncarboxylated osteocalcin and uncarboxylated Matrix GLA protein [3]. One can also look at whole blood clotting and prothrombin time [4]. Plasma or blood levels are not valid indicators of vitamin K status [3]. Talk to your doctor to see which test may be appropriate and best for you.

The takeaway

Some argue that vitamin K will soon become the “new vitamin D”, where it becomes a household topic and everyone wants to optimize their levels. Many researchers performing reviews on vitamin K call for more research to further clarify its roles in clinical applications [1]. In the meantime, the least we can do is eat our green leafy vegetables! We have vitamin K to thank for that advice.  However, a more proactive approach involves the use of a well designed and balances vitamin K supplement, such as Tri-K. Discussing vitamin K supplementation with you functional medicine physician and clinical nutritionist is also suggested.  

 

References

  1. Paul CI. Vitamin K. In: Pizzorno, JE, Murray MT, ed. Textbook of Natural Medicine. 5th ed. St. Louis, MO: Elsevier; 2021: 919-947. 
  2. Gropper SS, Smith JL, Carr TP. Advanced Nutrition and Human Metabolism. 7th ed. Boston, MA: Cengage Learning; 2018: 408-415.
  3. Brady DM, Paul C. Tri-KTM: Three Pathways to Vitamin K. Designs for Health. Published April 2021. 
  4. Hidgon, J. Vitamin K. Linus Pauling Institute: Micronutrient Information Center website. https://lpi.oregonstate.edu/mic/vitamins/vitamin-K. Published 2000. Reviewed August 2014. Accessed July 29, 2021. 

mast-cell-activation-syndrome

Mast Cell Activation Syndrome (MCAS)

By Dr. David M. Brady and Danielle Moyer, MS

 

Mast Cell Activation Syndrome (MCAS) is a condition with newfound fame. MCAS first emerged in the 1980s, but has gained recognition and started to appear in the medical literature at a growing rate in the last decade [1]. It falls under the umbrella of mast cell activation diseases (along with systemic mastocytosis and mast cell leukemia) [2]. Such a new condition currently brings up more questions than answers, and more research is needed on diagnostic criteria, valid disease biomarkers, and treatment methods.

As a result, patients are searching for answers themselves about their chronic symptoms and suspected self-diagnosed MCAS. This has caused a rise of patient self-help groups on social media and lay literature surrounding MCAS. The size and discussion of these social media groups are “outpacing the science, which has led to controversy with regards to diagnostic criteria and treatment” [3]. Issues arise when individuals of these groups determine MCAS to be the cause of their complex systems, when they may be due to other conditions or diseases with similar symptomatology. Therefore, they may not be receiving or seeking the appropriate care and it is important to know the differences. 

What is Mast Cell Activation syndrome?

To explain MCAS, we have to begin by answering: “what are mast cells?” Mast cells are involved in our body’s natural inflammatory response, protecting our body from injury, infection, bacteria, and allergic reactions. MCAS occurs when these mast cells are overproduced and/or when their activation is higher than what is necessary for the body [4]. The altered mast cell production causes complex, multisystem symptoms involving the gastrointestinal, skin, respiratory, neurologic, and cardiovascular system [3]. It may even cause certain individuals to go into anaphylactic shock for no apparent reason (a condition called idiopathic anaphylaxis) [4].

According to research, here are some of the classic symptoms of MCAS [3-6]:

  • Gastrointestinal
    • Abdominal pain and cramping
    • Diarrhea
    • Nausea
    • Vomiting
    • Abdominal bloating
    • Gastroesophageal acid reflux
  • Skin
    • Flushing
    • Hives
    • Itching
  • Respiratory
    • Throat tightening sensation
    • Stuffy nose and sinus irritation
    • Difficulty breathing and wheezing
  • Neurological
    • Headache
    • Brain fog
  • Cardiovascular
    • Feeling faint (without actually fainting)
    • Heart palpitations  
    • Low blood pressure (hypotension)

These symptoms are worsened by predictable triggers, like certain foods, strong scents, temperature changes, stress, alcohol, or certain medications. Patients suffering from MCAS may need assistance in identifying their triggers and education on proper avoidance [3].

How do you get diagnosed with Mast Cell Activation Syndrome?

There are three criteria used when diagnosing a patient with MCAS in order to avoid misdiagnosis, as well as overgeneralization of clinical symptoms that a patient may exhibit [7].

The first criterion is display of the previously listed symptoms involving two or more organ systems at the same time. The symptoms must be recurring and/or chronic, independent of other conditions or disorders, and must require treatment or therapy [2,7].

The second criterion is the elevation of certain blood markers called serum tryptase or mast cell-derived metabolites while actively suffering from MCAS symptoms. Diagnostic markers in the blood vary, as increased MCAS symptoms may last for varied times (from hours to days to weeks). Patients who do not meet the laboratory criteria for MCAS may be considered to have “suspected MCAS”. These patients will receive trials of different therapies, but with ongoing testing for other conditions [2,7].

The third criterion relates to how MCAS is treated. If a patient responds positively to drugs that inhibit mast cell mediators or block mast cell release, this can fulfil the third co-criterion of a MCAS diagnosis [2,7].

How is Mast Cell Activation Syndrome treated?

There is no cure for MCAS, so an individual’s treatment plan is tailored to target their specific symptoms. As stated above, effective treatment for MCAS is considered to be a criterion for the diagnosis of MCAS [2,7]. If the patient's symptoms are decreased in frequency, severity, or goes away with the avoidance of known triggers, or with medications including H1 and H2 histamine receptor antagonists (blockers), anti-leukotrienes, or mast cell stabilizers, this can further support the diagnosis of MCAS [3]. 

What other conditions or diseases can Mast Cell Activation Syndrome be confused with?

MCAS is an incredibly complicated disorder that results in both common and unusual symptoms across many different body systems. That being said, it is easy to confuse symptoms caused by MCAS with those from other conditions or diseases, including:

  • Systemic mastocytosis
    • Systemic mastocytosis falls under the same umbrella as MCAS - “mast cell activation diseases.” Systemic mastocytosis results from genetic mutations and leads to an abnormal accumulation of mast cells in one or more organ systems, including the bone marrow, skin, and gastrointestinal tract. MCAS differs from systemic mastocytosis, although they do have similar presentations and symptoms [3].
  • Irritable Bowel Syndrome (IBS)
    • Patients with IBS have been shown to have increased mast cell activation in their intestines compared to healthy subjects. The difference between IBS and MCAS is that IBS symptoms are congregated and isolated in the gastrointestinal tract, whereas MCAS symptoms are in more than one organ system [3].
  • Histamine Intolerance
    • Histamine Intolerance is an imbalance of histamine (an amino acid compound in the body involved in local immune responses and inflammation) in the body and a reduced ability to process them. Symptoms of histamine intolerance mirror those of MCAS including headache, hypotension, facial flushing, diarrhea, nausea, vomiting, abdominal pain, congestion, and asthma. However, these symptoms only occur when eating histamine-rich foods in contrast to MCAS symptoms which can have various triggers [3]. Symptoms of histamine intolerance may also be reduced, or eliminated, by taking the histamine degrading enzyme diamine oxidase (DAO) with meals. 
  • Those with prominent gastrointestinal symptoms with suspected MCAS may also consider ruling out other inflammatory conditions like [3]:
    • Celiac disease
    • Eosinophilic Esophagitis (EoE)
    • GI tract malignancies, or anatomic defects
    • Small intestinal bacterial overgrowth (SIBO)
    • Intestinal dysbiosis (an imbalance in gut microbes)
    • Bile salt diarrhea, especially in those who have had abdominal surgeries, especially gallbladder removal (cholecystectomy).
  • There are several chronic symptom disorders that may be confused with MCAS [3]:
    • Chronic pain syndromes
    • Chronic fatigue syndromes (CFS)
    • Fibromyalgia (FMS/FM)
    • Multiple chemical sensitivity syndrome (MCS)
    • Chronic syndromes from infections or other exposures, such as chronic Lyme disease syndrome and/or other tick borne co-infections.
    • Various auto-immune diseases
    • Endocrinopathies
    • Psychiatric conditions

Recent evidence suggests that there is a common familial occurrence of systemic mast cell activation diseases, meaning there may be a genetic component. If a family member has one of these diseases, your risk may be increased as well [8].

The Takeaway

Mast cell activation syndrome (MCAS) is an incredibly complex condition. Some research theorizes that the incidence and prevalence of MCAS may increase in relation to the increase of other allergic or hypersensitivity conditions [3]. However, more research is needed for improved recognition, diagnosis, treatment, and patient counseling of MCAS beyond the current social media “experts” and patient blogs. Although many patients out there have a large assortment of chronic, multisystem symptoms for seemingly unknown reasons, it is incredibly important to distinguish MCAS versus other diseases or conditions for proper treatment as more research is discovered.

 

References

 

  1. Afrin LB, Ackerley MB, Bluestein LS, et al. Diagnosis of mast cell activation syndrome: a global “consensus-2.” Diagnosis. 2021;8(2):137-152. doi:10.1515/dx-2020-0005
  2. Frieri M. Mast Cell Activation Syndrome. Clinic Rev Allerg Immunol. 2018;54(3):353-365. doi:10.1007/s12016-015-8487-6
  3. Hamilton MJ, Scarlata K. Mast Cell Activation Syndrome – What it Is and Isn’t. PRACTICAL GASTROENTEROLOGY. Published online 2020:7.
  4. Akin C. Mast cell activation syndromes. Journal of Allergy and Clinical Immunology. 2017;140(2):349-355. doi:10.1016/j.jaci.2017.06.007
  5. Valent P. Mast cell activation syndromes: definition and classification. Allergy. 2013;68(4):417-424. doi:10.1111/all.12126
  6. Mast Cell Activation Syndrome (MCAS). American Academy of Allergy, Asthma & Immunology website. https://www.aaaai.org/conditions-treatments/related-conditions/mcas. Accessed July 2, 2021. 
  7. Overview & Diagnosis. The Mast Cell Disease Society, Inc. website. https://tmsforacure.org/overview/. Accessed July 2, 2021. 
  8. Molderings GJ, Haenisch B, Bogdanow M, Fimmers R, Nöthen MM. Familial Occurrence of Systemic Mast Cell Activation Disease. PLOS ONE. 2013;8(9):e76241. doi:10.1371/journal.pone.0076241

Sun Exposure: The Bright and Dark Sides

By Dr. David M. Brady and Danielle Moyer, MS

 

Summer is here and the sun is out!

Being cooped up in our homes for the last year has made many of us seek every opportunity to step outside and experience the fresh air.

If you ask yourself, “Do I have to wear sunscreen?” before stepping outside – you are not alone!

There are both health benefits and risks, and it is challenging to know what actions to take to protect yourself.

 

The “bright” sides to sun exposure:

1. Vitamin D

The best-known benefit of sunlight is vitamin D. When ultraviolet (UV) rays hit our skin, it allows our liver and kidneys to create the active form of vitamin D. Vitamin D improves bone health, reduces inflammation, enhances the immune and nervous systems, and may even regulate blood sugar. It is difficult to get enough vitamin D from food sources alone (fatty fish, mushrooms, tofu, eggs, and fortified milks and cereals), making the sun a much more reliable source [1].

2. Serotonin & mental health

Getting enough vitamin D from the sun has been shown to enhance serotonin production in the brain! Serotonin ,the “happy hormone”, helps stabilize mood and helps with sleeping, eating, and digestion [2].

This helps to explain seasonal affective disorder (SAD). SAD is a specific type of depression and a chronic disease that happens during darker, colder months. Researchers have said that SAD is the most intense during January and February, and affects around 1.5 to 9% of the US population [3]. Studies have shown that a root cause of this disease is the reduction of sun exposure, vitamin D, and serotonin, all of which can be reversed during the sunnier months [4-5]. 

3. Skin, bone, and other health benefits 

Doctors have used UV radiation exposure to treat or help multiple skin diseases, including psoriasis, eczema, dermatitis, or vitiligo, as well as improve bone health by lowering the risk of bone fractures [6]. Sun exposure has also helped treat rheumatoid arthritis, lupus erythematosus, thyroiditis, and inflammatory bowel disease [7]. These benefits can largely be due to vitamin D’s role in inflammation and the immune system.

4. Cancer protection

Research from recent decades shows that the three main forms of skin cancer (melanoma, basal cell carcinoma, and squamous cell carcinoma) can be attributed to excess sun exposure. In fact, skin cancer is one of the most common forms of cancer worldwide.  However, there are some cancers that can result from too little sun. Higher latitude countries with little sunshine tend to have higher rates of Hodgkin lymphoma as well as breast, ovarian, colon, and pancreatic cancers compared to sunnier countries [8-10].

 

The dark sides to sun exposure:

Unfortunately, UV radiation can also be a carcinogen, meaning an agent that causes cancer in humans. UV radiation is linked with skin cancer. More than one million people in the United States are diagnosed with skin cancer each year. An estimated 90% of non-melanoma skin cancer and 65% of melanoma skin cancers are associated with the exposure to UV radiation from the sun [11]. UV radiation also contributes to premature aging of the skin, eye damage, and skin color changes [12].

A person’s skin type affects the degree to which people burn. Those with fair skin tend to burn more rapidly and more severely, whereas those with darker skin do not burn as easily. Furthermore, those with a large number of freckles or moles tend to have higher risks of developing skin cancer. However, regardless of race or ethnicity, everyone is subject to the potential adverse effects of overexposure to the sun. Other factors that increase a person’s risk can be their disease and medication status. Certain diseases, such as lupus, can make a person more sensitive to sun exposure, as well as medications such as antibiotics and antihistamines [13].

 

How do you find the balance?

Many of the health benefits of the sun come from vitamin D. Therefore, the key is to get it safely.

It is best to avoid direct sunlight without protection when the sun’s rays are strongest, usually between 10 AM to 4 PM. If you are outdoors during those hours without sunscreen, the World Health Organization states that 5 to 15 minutes of casual sun exposure to hands, face, and arms two to three times a week during the summer months is sufficient to keep vitamin D levels in the normal range [12]. However, this does not imply that this will allow your vitamin D levels to reach more optimal ranges, prompting many to recommend longer duration (15-30 minutes) of casual sun exposure prior to application of sunscreen. If you live closer to the equator where UV levels are higher, shorter periods of time may suffice. On the other hand, if you have a darker skin tone, you may need more time in the sun (20-30 minutes, two to three times a week) to obtain sufficient vitamin D levels [13]. It is best to check the UV index of your area to help you plan your outdoor activities in a way to prevent sun overexposure.

The best way to assess your vitamin D levels is through a blood test called 25-Hydroxy Vitamin D. Most experts define vitamin D deficiency as a level of less than 20 ng/mL. Whereas the “optimal range” of vitamin D levels has been debated, but many agree upon the range of 40-60 ng/mL [14]. There are also advocates in the integrative medical community of vitamin D levels being maintained in the 60-100 ng/mL range, but evidence for these levels is somewhat scant. 

A lot of individuals are starting to take supplements to ensure proper vitamin D levels. Though you should speak with your doctor or nutritionist about what dosage is right for you, the Recommended Dietary Allowance for adults 19+ years old is 600 IU, and for adults 70+ years old is 800 IU daily. The maximum daily intake for most individuals is 5,000 IU [1], although higher dosages are sometimes used for specific medical reasons under supervision. Supplements are commonly taken in doses varying from 1,000-2,000 IU/day safely (in addition to sunlight) During the winter months, this dosage can be increased. Note that vitamin D is a fat-soluble vitamin, so it must be taken with food for proper absorption. Always consult with your doctor and/or nutritionist before taking any supplements.

 

How do you choose the right sunscreen?

“Sunburns significantly increase the lifetime risk of developing skin cancer, especially for children,” says the US Environmental Protection Agency [13]. In addition to shade and protective clothing and accessories , sunscreen is essential for protection. Sunscreen contains chemicals that absorb or reflect both types of UV radiation (UVA and UVB) to protect you from the sun’s rays.

In 2019, the FDA released a goal of updating sunscreen regulations for the first time since 2011, but had to withdraw their plans. In the FDA’s proposed statement, they recognized only two ingredients as safe and effective in sunscreen: Zinc oxide and titanium dioxide. These two ingredients are classified as “Mineral Product” sunscreens [15-16]. 

Other common sunscreen ingredients (oxybenzone, avobenzone, homosalate, octinoxate, octisalate, octocrylene) used in about 60% of the sunscreens have more questions regarding their safety and efficacy. Though they are not flagged as “unsafe”, the FDA requested additional safety information from the sunscreen industry to consider in their upcoming policy. 

The FDA has flagged one particularly concerning sunscreen ingredient called oxybenzone. The FDA is concerned that oxybenzone could interfere with normal functioning of a number of hormones, including estrogen. Because of this and other potential health concerns, the American Academy of Pediatrics (AAP) advises parents to avoid using sunscreens with oxybenzone on children [15-16]. If you don’t want it on your children, you probably don't want it on you either. 

SPF (sun protection factor) rates how well the sunscreen can block the UV rays. While no sunscreen’s SPF protects you fully from the sun, an SPF of 15 or below must carry a label that it only protects against sunburn, not skin cancer or skin aging. Therefore, it is recommended by the American Cancer Society to use an SPF of 30 or higher. SPF ratings mainly apply to UVB rays, so sunscreen manufacturers that contain SPF that protect against UVB and UVA are labeled “Broad Spectrum” and are highly recommended [17]. 

Sunscreen must be reapplied at least every 2 hours, and maybe more frequently depending on how much you are swimming, sweating, and whether the sunscreen is “water resistant”. Read the label of each sunscreen to know how long it lasts specifically [17]. 

The Environmental Working Group (EWG) is a third-party group that provides a great guide to sunscreen, where you can even “search” your sunscreen brand and see how they rate the ingredients.

 

The takeaway

Balance is key! Both the benefits and risks of sun exposure encourage everyone to find a reasonable “middle-ground”. You can keep yourself safe by wearing appropriate sun-protecting clothes and accessories, applying safe sunscreen, sitting in shade, checking your city’s UV ray index, and timing your sun exposure. Additionally, checking your vitamin D levels at least once a year (ideally once during the winter and once during the summer) can determine what actions are needed to achieve an optimal vitamin D status. 

Safe sun exposure is possible! So, get out there, enjoy the outdoors, and protect your skin. 

 

References

  1. Vitamin D. National Institute of Health website. https://ods.od.nih.gov/factsheets/VitaminD-HealthProfessional/. Updated March 26, 2021. Accessed June 15, 2021. 
  2. Bancos I. What is Serotonin? Hormone Health Network website. https://www.hormone.org/your-health-and-hormones/glands-and-hormones-a-to-z/hormones/serotonin. Updated December 2018. Accessed June 15, 2021. 
  3. Nussbaumer-Streit B, Forneris CA, Morgan LC, et al. Light therapy for preventing seasonal affective disorder. Cochrane Common Mental Disorders Group, ed. Cochrane Database of Systematic Reviews. Published online March 18, 2019. doi:10.1002/14651858.CD011269.pub3
  4. Penckofer S, Kouba J, Byrn M, Ferrans CE. Vitamin D and Depression: Where is all the Sunshine? Issues Ment Health Nurs. 2010;31(6):385-393. doi:10.3109/01612840903437657
  5. Patrick RP, Ames BN. Vitamin D hormone regulates serotonin synthesis. Part 1: relevance for autism. FASEB J. 2014;28(6):2398-2413. doi:10.1096/fj.13-246546
  6. Rathod DG, Muneer H, Masood S. Phototherapy. In: StatPearls. StatPearls Publishing; 2021. Accessed June 15, 2021. http://www.ncbi.nlm.nih.gov/books/NBK563140/
  7. Schwalfenberg GK. Solar Radiation and Vitamin D: Mitigating Environmental Factors in Autoimmune Disease. Journal of Environmental and Public Health. 2012;2012:e619381. doi:10.1155/2012/619381
  8. Holick MF. Vitamin D and Sunlight: Strategies for Cancer Prevention and Other Health Benefits. CJASN. 2008;3(5):1548-1554. doi:10.2215/CJN.01350308
  9. Baggerly CA, Cuomo RE, French CB, et al. Sunlight and Vitamin D: Necessary for Public Health. Journal of the American College of Nutrition. 2015;34(4):359-365. doi:10.1080/07315724.2015.1039866
  10. Hoel DG, Berwick M, de Gruijl FR, Holick MF. The risks and benefits of sun exposure 2016. Dermatoendocrinol. 2016;8(1). doi:10.1080/19381980.2016.1248325
  11. Kim I, He Y-Y. Ultraviolet radiation-induced non-melanoma skin cancer: Regulation of DNA damage repair and inflammation. Genes Dis. 2014;1(2):188-198. doi:10.1016/j.gendis.2014.08.005
  12. Radiation: The known health effects of ultraviolet radiation. World Health Organization website. https://www.who.int/news-room/q-a-detail/radiation-the-known-health-effects-of-ultraviolet-radiation. Published October 16, 2017. Accessed June 15, 2021. 
  13. The Burning Facts. United States Environmental Protection Agency website. https://www.epa.gov/sites/production/files/documents/sunscreen.pdf. Published September 2006. Accessed June 15, 2021. 
  14. Mead MN. Benefits of Sunlight: A Bright Spot for Human Health. Environ Health Perspect. 2008;116(4):A160-A167.
  15. EWG’s Sunscreen Guide. Environmental Working Group website. https://www.ewg.org/sunscreen/report/executive-summary/. Accessed June 15, 2021. 
  16. Wadyka S. What You Need to Know About Sunscreen Ingredients. Consumer Reports website. https://www.consumerreports.org/sunscreens/what-you-need-to-know-about-sunscreen-ingredients/. Updated May 22, 2019. Accessed June 15, 2021. 
  17. Choose the Right Sunscreen. American Cancer Society website. https://www.cancer.org/latest-news/choose-the-right-sunscreen.html. Accessed June 15, 2021. 

beating-brain-fog

Beating Brain Fog

By Dr. David M. Brady and Danielle Moyer, MS

 

We have all experienced the feeling at least once: you don’t get enough sleep and the next day you feel sluggish and can’t concentrate. That is the feeling of “brain fog”. Brain fog is not a medical condition, but rather a feeling of confusion, disorganization, and difficulty concentrating or focusing. But what happens when this becomes a chronic sensation? What is causing it and what can you do?

There are numerous explanations for chronic brain fog. It can result from poor sleep, stress, hormonal changes, poor diet, infections, heavy metal exposure, side effects of certain medications, or due to a medical condition, such as anemia, chronic fatigue syndrome, or fibromyalgia [1]. One study revealed through MRI scans that even non-celiac gluten sensitivity can induce brain fog in those who do not have celiac disease or a wheat allergy, but report gastrointestinal upset from gluten [2]. Additionally, long-haul COVID syndrome has been shown to impact a person’s cognitive dysfunction and fatigue for months after contracting COVID.

The good news is one of the strongest influences we have on our brain is through our gut.

Imagine there is a two-way street from your gut to your brain, where cars are continually driving up and down. Now instead of cars, imagine hormones. That two-way street is what we call the “Gut-Brain Axis”. “Listen to your gut” is advice that is actually backed up by science. Here are some hormones that drive up and down, influencing your emotions, mental function, and memory:

  • Leptin: This hormone signals to your brain that you are full after eating, thereby reducing your appetite. It has been shown to impact synaptic plasticity in your brain, influencing spatial learning and long-term depression.
  • Ghrelin: This hormone is secreted on an empty stomach, signaling to your brain to increase your appetite. It has also been shown to enhance spatial learning and memory function. 
  • Glucagon-Like Peptide 1 (GLP1): This hormone regulates energy metabolism by stimulating insulin secretion and energy uptake in muscle cells. It has also been shown to influence spatial memory, cognition, and emotion.
  • Insulin: This hormone is secreted while you are eating to allow your body to convert the newly ingested food into immediately usable energy. Insulin has been shown to alter cognitive processing and synaptic activity [3].

Another important modulator on our brain’s functioning is our immune system, which fights off foreign pathogens and toxins. Chronic infections can lead to chronic inflammation, thereby causing detrimental effects on cognitive function and brain fog [1]. The gut’s role in our immune system is underscored as 70% of our entire immune system is located in our gut [4]!

Making sure there are no roadblocks, traffic jams, or slow pokes on the streets of our gut-brain-axis is crucial for beating brain fog.

Here are some important things to do to clear the way…

 

Eat as many whole foods as possible.

Whole foods consist of fruits, vegetables, legumes, beans, meat, fish, seafood, nuts, seeds, and whole grains that are immunologically tolerated well by you. They are not processed or refined and have minimal added ingredients to them. Plus, they are rich in antioxidants, fiber, and macro and micronutrients. Whole foods influence cognition and emotions through our gut-brain-axis by providing a warehouse of essential nutrients that support hormonal regulation and proper digestion.

For example, omega-3 fatty acids found in flax seeds, chia seeds, walnuts, and fatty fish have been shown to ameliorate cognitive decline in the elderly. They have become a treatment method for mood disorders and improved learning and memory [3].

Poor diets filled with processed foods or “junk” foods can lead to multiple vitamin and mineral deficiencies and also introduce pro-inflammatory foods that can contribute to brain fog, such as trans fats or excess sugar. It is best to limit these foods as much as possible.

 

Eat prebiotics and probiotics.

We have a thing called the “gut microbiome” in our gastrointestinal tract. This is where billions of bacteria live to help us break down food, modulate our immune system, balance hormones, and more. There are both beneficial and harmful bacteria that can live in our GI tract, and it is key to support the beneficial kinds. When we have a plentiful array of healthy bacteria, they produce hundreds of chemicals that influence mental processes such as learning, memory, and mood. In fact, "good" gut bacteria produce about 95% of our body’s supply of serotonin, which is a hormone that impacts both our mood and GI function [5-6].

“Prebiotics” can be thought of as food for our good bacteria. Prebiotic foods have compounds that serve as “fuel” for the beneficial gut bacteria, allowing them to proliferate and positively impact cognition and emotions. Good sources of prebiotics are garlic, onions, leeks, tomatoes, carrots, apples, and asparagus. 

Probiotics are a way to introduce good bacteria into your gut via foods or supplements. This can re-balance your gut bacteria environment when there are too many harmful bacteria - a condition dubbed “dysbiosis”. Probiotic food sources include yogurt, kimchi, sauerkraut, kefir, miso, and pickled veggies.

 

Avoid/Lower Stress.

So, we know that the gut can influence the brain, but how does the brain influence the gut on this bidirectional street? Stress can cause changes to the microbiome, disrupting healthy gut microflora and, in turn, affecting the brain and behavior. Furthermore, chronically elevated stress can cause high levels of cortisol in the body. Cortisol has been shown to have adverse effects on the brain’s functioning by affecting memory, reducing cognitive function, and increasing brain fog [6].

 

Get Moving!  

Regular exercise has been shown to improve memory and thinking skills, and reduce brain fog. Exercise can help to regulate specific hormones, such as insulin, reduce inflammation, and benefit the gut microbiome [7]. A recent study found that 6 weeks of endurance-based exercise training of moderate to vigorous intensity (3 days a week for 30-60 minutes) significantly improved a person’s gut bacteria, which reduced inflammation and enhanced metabolism [7]. Thinking purely of the brain, exercise can affect the health of brain cells, the growth of new blood vessels in the brain, and the abundance and survival of new brain cells. Exercise also benefits mood and sleep and reduces stress and anxiety, which all contribute to reducing brain fog [8]. If you are one of those people who say they “don’t have time to work out”, you may want to read How to Get the Best Bang from Exercise for the Investment in Time.

 

Get a Good Night’s Sleep.

If the brain is foggy and tired, it may be time to look at how well you are sleeping. We have discussed the importance of sleep before in the Sleep Position May Influence Brain Health, The Sleep-Deficit and Chronic Disease Epidemic – Is There a Connection?, Better Sleep for Those with Fibromyalgia, and more. It is important to optimize both the quantity (number of hours) and quality of your sleep, as they are both necessary to reduce brain fog.

 

Although all these suggestions are far from revolutionary, they are all incredibly important. Brain fog can have numerous causes, varying from simply a lack of sleep or a chronic medical condition. Accordingly, brain fog can last from a couple hours to even years. There are supplements that help to alleviate brain fog, such as Brain Vitale, for short term use. However, if you are experiencing chronic brain fog, it is best to identify the underlying cause and work with a doctor and/or nutritionist to find a solution that is personalized to you. 

 

References: 

  1. Torres C. Brain Fog – What is Brain Fog? University of Medicine and Health Sciences website. https://www.umhs-sk.org/blog/brain-fog. Published October 21, 2020. Accessed May 18, 2021. 
  2. Croall ID, Hoggard N, Aziz I, Hadjivassiliou M, Sanders DS. Brain fog and non-coeliac gluten sensitivity: Proof of concept brain MRI pilot study. PLoS One. 2020;15(8). doi:10.1371/journal.pone.0238283
  3. Brain foods: the effects of nutrients on brain function. Accessed May 17, 2021. https://www-ncbi-nlm-nih-gov.libproxy.bridgeport.edu/pmc/articles/PMC2805706/
  4. Vighi G, Marcucci F, Sensi L, Di Cara G, Frati F. Allergy and the gastrointestinal system. Clin Exp Immunol. 2008;153(Suppl 1):3-6. doi:10.1111/j.1365-2249.2008.03713.x
  5. Carpenter S. That Gut Feeling. American Psychological Association website. https://www.apa.org/monitor/2012/09/gut-feeling. Published September 2021. Accessed May 18, 2021. 
  6. Carabotti M, Scirocco A, Maselli MA, Severi C. The gut-brain axis: interactions between enteric microbiota, central and enteric nervous systems. Ann Gastroenterol. 2015;28(2):203-209.
  7. Brady DM. Favorably Altering the GI Microbiome with Exercise. https://davidd139.sg-host.com/wp-content/uploads/2021/03/gut-exercise.pdf. Published July 2018. Accessed May 18, 2021. 
  8. Godman H. Regular exercise changes the brain to improve memory, thinking skills. Harvard Health Publishing website. https://www.health.harvard.edu/blog/regular-exercise-changes-brain-improve-memory-thinking-skills-201404097110. Published April 9, 2014. Accessed May 18, 2021.