As Naturopathic doctors, we strive to uncover and treat the reason why a person has a symptom or disorder. It is often not enough to just provide a diagnosis. Working to remove the barriers to a healthy body will lead to less symptoms, less medication and a healthier future. So what are the possible reasons for thyroid conditions and auto-immune diseases such as Hashimoto’s?
First of all, gut health. This is where I start because it is one of the most common places for the immune system to be triggered. A chronic, low grade inflammatory response to certain bacteria, yeast, parasite or lack of good flora can be enough to launch an immune response. An over-simplified way to explain this is the immune system is busy reacting and it makes a “mistake” leading to a response against our own body tissue such as the thyroid. SIBO, candida, dysbiosis, H. pylori, poor beneficial bacteria, Celiac disease, low stomach acid, and low digestive enzymes can be chronic conditions that will trigger. Sometimes there can be a particular food sensitivity but often it is the flora.
We also look at exposures and the ability detoxify. Mold exposures such as living in a water damaged building at any point in life up to now is actually more common that you’d think. Sometimes it is obvious - mold in the shower or on windows, curtains, or walls. Other times, it is simply living in an old home, basement suite or even a new build (think of the rain in Vancouver while building and sealing up!). Mold releases mycotoxins which are tiny particles that get stored in the body. Combine the exposure with difficulties detoxifying and excreting (ie constipation) and this can push the body towards auto-immunity. Other exposures can be heavy metals from dental amalgams, growing up near or around industry, farms, pesticides, old homes with lead paint. Mercury, lead, aluminum and other metals store away and affect cardiovascular health, the hormone system, nervous system and brain health and immune system.
Another avenue to explore is chronic infections such as Lyme disease and Epstein-Barr virus (EBV). Lyme is caused by several different infections carried by the tick vector. Having mononucleosis in your youth may mean you still carry the EBV which causes it. Studies show a correlation to EBV and Hashimoto’s and many people will describe flares of sore throat and fatigue in times of higher stress or depletion. While more difficult to test and diagnose, it is possible to do so through private labs. Treatment can be successful at eradicating these infections once diagnosed, often antibiotics or antivirals are prescribed.
Starting the journey towards root cause is exciting. It takes time and patience to run through this extensive list but with a good history intake by your Naturopathic doctor, we should be able to pick an ideal place to start. Everything can be tested with labs to confirm or rule out a diagnosis . See examples of lab reports here.
Under active thyroid conditions are commonly missed with symptoms of lack of energy. The traditional method of blood testing only one of the six markers of thyroid health is the main reason why so many hypothyroidism cases are overlooked. Conventional medicine evaluates the level of Thyroid Stimulating Hormone (TSH) in a wide range as a measure of thyroid health. While this value is appropriate to rule out extreme cases of over active (hyper) or under active (hypo) thyroid conditions, it does not detect the many cases of subclinical hypothyroidism and auto-immune thyroiditis that are seen in the general population.
A brief explanation of how the thyroid is responsible for metabolism will make it clears to which blood markers to test. The brain, specifically the anterior pituitary gland, secretes a hormone called Thyroid Stimulating Hormone or TSH. This in turn travels to the thyroid gland which is found in the lower third of the neck and activates the production of a type of thyroid hormone called T4. T4 is then released and travels by blood to the cells in the body where it is actively converted into another thyroid hormone, T3. The conversion requires a number of conditions and co-factors to be present such as selenium and zinc. T3 is the most active thyroid hormone and is responsible for metabolism - energy production - in the body. How this translates, for example, is maintaining optimum weight, having energy through out the day, keeping the body at a constant temperature and maintaining a stable mood.
When T4 levels are low, the brain detects this and sends the signal for more TSH to be produced. This results in an increased production in T4 and thus a rise in T3 levels. In a case where hypothyroidism is missed, often only TSH is tested alone, and the value falls within the broad “normal” range. Many people will display a high-normal TSH but have low blood levels of T4 and T3 which are not routinely tested, therefore not treated.
In some instances, T3 is converted into an unusable form of thyroid hormone called reverse T3 (rT3). This occurs often when there is a high level of physical or emotional stress and the stress hormone cortisol is high. rT3 cannot be used for promoting metabolism therefore when it is high, symptoms of hypothyroidism are usually present. Levels of rT3 are not regularly tested in conventional medicine.
The last important component to comprehensive thyroid testing is looking at the production of antibodies against the thyroid. It is estimated that about half of all hypothyroid cases are caused by an auto-immune attack on the thyroid gland. In cases where this causes mostly hypothyroid symptoms, it is called Hashimoto’s thyroiditis and is diagnosed by the presence of anti-thyroid peroxidase antibodies (anti-TPO). Many people with Hashimoto’s will have high levels of a second type of antibody that targets the protein thyroglobulin (anti-TG). When providing a complete evaluation of thyroid function and health, testing for thyroid antibodies is recommended. Grave’s disease is another example of an auto-immune thyroid condition, however it results in hyperthyroidism.
In order to get the most comprehensive evaluation of thyroid function, a minimum of four blood markers should be tested. TSH, T4, T3 and anti-TPO make up a standard thyroid panel. Sometimes the addition of rT3 and anti-TG are included and can add valuable information. Blood should be drawn in the morning but does not require fasting overnight. Thyroid levels fluctuate throughout the day but are most stable before noon in the average person. If medication is currently being taken for hypothyroidism, consultation with the doctor is advised to determine if medication should be taken before or after the blood draw.
Those individuals on thyroid medication can also benefit from testing more thoroughly. Many cases of Hashimoto’s thyroiditis are missed upon initial diagnosis because antibodies were not checked. Other common findings when testing hypothyroid patients are that T3 levels are not optimal and the addition of other thyroid medications or herbs will greatly benefit thyroid health and metabolism.
For additional information or questions, please use the contact form HERE.
Yours in Health,
Dr. Jennifer Luis BSc, BEd, ND
One of the most common digestive conditions that I see in practice is candida. Also called yeast overgrowth and sometimes dysbiosis, candida is a condition that originates in the digestive tract but can and often does have effects throughout the body.
Biology 101 quick lesson: we all have trillions of microorganisms in the gut that have many functions including absorption of nutrients (such as B12), modulating of the immune system, and digestion. In fact, there are so many bacteria in the intestines that bowel movements consist of up to 75% bacteria and yeast! It is only when the proportions of good bacteria, bad bacteria and yeast are altered from the healthy range that there is a problem. Symptoms of imbalance can be digestive in nature such as excess gas and bloating, loose stools or constipation, abdominal pain, indigestion, reflux and heartburn. However, depending on the severity of yeast overgrowth, it is not uncommon to see urinary tract infections, yeast infections, skin rashes, hives, fatigue, brain fog, weight gain, dizziness, anxiety, insomnia, neurological symptoms, nutrient deficiencies (anemia for example) and more.
How can you get candida? It is not contagious rather it stems out of the gut environment favouring yeast growth and creating poor conditions for good bacteria growth. This can occur due to antibiotic use, food sensitivities, a weakened immune system, low stomach acid and other health scenarios. For some, candida takes a long time to form whereas others notice it right away after eating a sugary treat. It affects both sexes and all ages, from infants through to the elderly.
Candida can be tested for quite easily and treated with diet and supplementation. Symptoms of candida are the first clue and often end up being the best way to monitor treatment. At Downtown Wellness Centre and Vitalia, we can test for the presence of candida antibodies by blood and determine the strains and sensitivity (ie which herbs and anti-fungals are specific to killing the strains present in an individual) by stool collection. The information that is gathered through the stool test is very valuable when creating an individualized treatment protocol as no two digestive tract environments are alike. Often it is important to determine food sensitivities and eliminate those foods from the diet while treating the yeast as we want to ensure the healthiest environment possible for the good bacteria to grow.
Dietary changes are necessary and can be thought of as a cleanse in order to starve out the sugar-loving yeast. A customized diet is also prescribed with anti-fungal supplements and multi-strain, high dose probiotics. For more information please click here.
Yours In Health,
Dr. Jennifer Luis ND
Everyday I find myself recommending the use of apple cider vinegar to promote good digestive health. A patient of mine recently told me about how common and plantar warts were easily removed by apple cider vinegar within 1 week of applying daily. I was very impressed and decided to test this out on a stubborn wart on one of my children. This wart had been a true survivor after months of different applications and remedies but it had no chance against apple cider vinegar. Nightly a cotton ball was soaked in vinegar then squeezed and fastened to the wart with some tape over night. A huge change took place over night and the battle was won by the 6th application. This inspired me to research some of the other uses of apple cider vinegar.
Commonly I prescribe 1-2 teaspoons of apple cider vinegar to be consumed right before a meal for digestive health. This has a few functions. The acidity acts as a stimulant to the brain and stomach to get the digestive process started and therefore improves secretion of digestive enzymes and the break down of food. Apple cider vinegar also promotes the stomach lining to release more stomach acid which is very important to the digestive process and of noteworthy mention - B12 and protein absorption in the small intestine. In turn, symptoms that are usually thought to be associated with high stomach acid levels (actually due to low acid levels) will begin to resolve within a week of consistent use. As an added benefit, along with a balanced diet and exercise, apple cider vinegar could potentially help with weight loss as it promotes satiety, or the sensation of being full due to the acetic acid content.
Promotion of apple cider vinegar for the use of dandruff caused by yeasts or fungi is common. Mixing apple cider vinegar with water into a spray bottle appears to kill the micro-organisms and improve scalp dandruff. Along the lines of yeast and candida, the natural enzymes found in apple cider vinegar can help with internal yeast overgrowth as well.
Consider adding apple cider vinegar into your daily routine. Choose a high quality source such as Bragg’s Organic Apple Cider Vinegar and consider one of the options mentioned HERE to help you get started.
Did you know that anxiety can be caused or amplified by poor digestion? This is a relatively common relationship that I have seen in clinic multiple times over the years. Last year, a 28 year-old female came to the clinic for help with anxiety. She had always been a “worrier” but noticed that the anxiety had turned into something more than just worrying. After 2 panic attacks that occurred without a trigger or identifiable cause, she came looking for support. Not wanting to take traditional anti-anxiety medications suggested by her MD, her friend had suggested coming to see a naturopath.
Reviewing her full health history which included excess gas and bloating that couldn’t be related to any particular food along with a skin rash and sugar cravings, I suggested that she do the stool microbiology test. Yeast was discovered and treatment started along with dietary changes. After an initial increase in anxiety for a few days, a very noticeable drop in symptoms occurred by the second week. This continued to improve until she no longer felt anxious without reason. What is the connection between yeast and anxiety?
The neuroendocrine system is a complex network of nervous tissue surrounding the intestines and is often referred to as our second brain. 70-90% of the hormone serotonin is produced and secreted here and is then transported to the brain via blood. Serotonin, aka the “feel good” hormone has very important functions, such that many pharmaceutical drugs act to mimic or enhance serotonin levels (eg - prozac, citalopram, cipralex). When serotonin levels are low, symptoms of depression, anxiety, insomnia, addictions and weight gain can be observed. If digestive health is not optimum as in the example when there is yeast overgrowth, it is difficult to produce appropriate levels of serotonin leading to anxiety and other symptoms. By treating the gut health and restoring balance, the neuroendocrine system is more efficient and able to increase serotonin levels thus alleviate symptoms. It was the link for this patient having anxiety and yeast-overgrowth/candida. Here is an example of the Doctor's Data Microbiology Stool Test that was used.
I just had to share this new delicious recipe that I have fallen in love with this past month. On my quest to eat less grains and more vegetables, I have been eating a lot more cauliflower. This newest favourite makes my whole family happy, especially my daughter who loves Indian foods and spices. The trick to this dish is to roast the cauliflower first in a bit of olive oil to really bring out the toasty flavour. The spices are all ones that I have on hand and my inspiration for the blend came from my favourite cookbook "The Whole Life Nutrition Cookbook" by Alissa Sergersten and Tom Malterre.
Indian Fried Cauliflower "Rice"
1 large head of cauliflower, cut into florets and tossed in olive oil
2 tablespoons coconut oil
1/4 - 1/2 cup of cashews, slivered almonds or nut of your choice
1/4 teaspoon sea salt
1 teaspoon ground cumin
1 teaspoon black mustard seeds
1 1/2 teaspoons ground coriander
3-4 green onions, sliced
1/4 cup chopped fresh cilantro
Toss cauliflower florets in about 1 tablespoon of olive oil or melted coconut oil and bake at 350F for 30-45 minutes. Turn florets while baking and remove from oven when edges are browned. Use a food processor to blend the cauliflower into a rice-like consistency.
In a large skillet or wok, heat the coconut oil until hot and melted. Add the nuts and spices and let cook while stirring for 1-2 minutes until the nuts start to brown slightly. Add in the chopped green onion and stir. Place the cauliflower rice into the wok and stir for 30 seconds. Remove from heat and add cilantro, mix and enjoy! Left-overs (if any - not often in my house) can be enjoyed for several days if refrigerated.
We all know that sleep is important for our bodies to rest, heal and rebuild. For example when melatonin is released from the brain into the blood stream, the body naturally starts to cool down in temperature and slowing down overall. However this release during sleep triggers the release of another important hormone - growth hormone. Growth hormone will initiate the repair of damaged cells, re-build muscles and bone and indirectly contribute to fat loss. Therefore it is vital to maintain a solid sleep to promote recovery from illness or inflammation, weight loss and physical well-being.
Taking the example of weight loss and the contribution of good quality sleep, Dr. Natasha Turner (author of “The Supercharged Hormone Diet” pg 54-55) has come up with a list of the top 10 tips to decrease interference of fat loss (from release of growth hormone) while you sleep. Some highlights are as follows:
These are simple tips to get you started on a more balanced sleep/wake cycle which will have positive impacts on mood, energy, dietary cravings, body composition and more. Sometimes even though all of the effort is made, sleep can still be challenging to maintain or initiate. It is in those cases that a closer look at individual hormone levels and balances is required. For example the stress hormone cortisol can often be blamed for waking during the night when in high levels. Melatonin production declines with age as does growth hormone. These hormones can be supported through natural therapies such as supplementation, acupuncture, yoga and more. For more information please feel free to send questions or call the clinic.
Spring is here and we have already witnessed trees budding and spring flowers making their ascent. Or, you may have already noticed itchy ears and nose accompanied by sneezing. Our seasonal allergies on the West Coast start as early as February, with Alder trees being the first to release pollen. Late winter and spring allergies are usually related to trees and shrubs while late spring and summer are often grass pollen allergies. Environment Canada has pollen counts and charts available on their website for more information.
Preparing your body beginning 2 months before symptoms start can help to reduce your body’s response to pollen. Allergens such as pollen cause histamine to be released from pockets in white blood cells that sit in the skin and along mucus membrane surfaces such as the nose, mouth and throat. Histamine is responsible for itchy eyes, nose, skin, inner ears and palate and runny noses. Potent natural anti- histamines that can reduce the release of histamine are Vitamin C and quercetin. Quercetin has also been studied for its antiviral, anti- inflammatory and anti-cancer properties. Food sources that have higher amounts of quercetin include citrus fruits, broccoli, red onions, green tea and red grapes. Finding the right dose of supplemental quercetin will lead to a drastic decrease in allergy symptoms.
Intra-venous (IV) therapy using Vitamin C in moderate doses will prepare the body for seasonal allergies and reduce the potency of symptoms. I personally noticed a reduction in symptoms of about 90% when coupled with quercetin.
IV Vitamin C is offered at Downtown Wellness Centre and Vitalia Health Care and should be considered starting in March, April and May for tree and grass allergies.
Naturopathic medicine is based on six principles that govern the naturopathic approach. When patients come for their first visit, it is usually explained that Naturopaths are very similar to medical doctors in their education and core curriculum. Where Naturopaths differ is their approach to treatment. One of the main areas in the body where diseases and ailments originate is the digestive system. For example, if a patient comes into the office with a primary concern of headaches or migraines often the best place to investigate the cause is by looking at the intestinal health. This is not the most obvious connection when going through conventional medicine but to a trained Naturopath, we know that many ailments can be linked back to inflammation in the gut.
To outline what a Naturopathic Physician is, a look into the six principles is explored below.
#1 - First, Do No Harm. When determining the best treatment protocol to use with a patient, Naturopaths will choose the least invasive and safest options. For example, if a minor infection results from a small wound such as a scrape, herbs such as tea tree oil or calendula may be recommended for topical application. These herbs are safe and effective and do not involve antibiotics, surgery or ointments that require liver function tests before applying. On the other hand, if a more serious infection is present, a Naturopath will recognize when an antibiotic may be necessary to prevent a decline of health. Naturopathic physicians in BC can prescribe a wide range of medications that are dispensed by pharmacists including antibiotics, hormone therapies, anti-hypertensives, diabetic medications and more. Often these options are second-line to more natural therapies such as diet and exercise, herbs, acupuncture, supplements and homeopathy.
#2 - The Healing Power of Nature. The premise that the body has the tools to heal itself is the foundation upon Naturopathic medicine. When a patient presents with a cold, immune support is given so that the body will be supported in it’s fight to regain good health. Our immune systems are very complex and involve hundreds of enzymatic reactions to keep us strong in the face of disease processes. Why do Naturopaths recommend Vitamin C when a patient is feeling under the weather? It is because Vitamin C has a role in the functioning of white blood cells - or the “soldiers”of the immune system. Give the soldiers the right nutrition and they can continue to fight against invasion.
#3 - Identify and Treat the Causes. This is usually the most common reason why someone decides to seek treatment form a Naturopathic doctor. This principle is what we continuously work towards doing - determining the underlying reason for “dis-ease”, removing the cause and healing from the bottom up. Going back to the example of headaches, it is of course important to rule out any red flag ailments that can be the cause of a headache. Once those have been investigated, often patients find that there is no real explanation for their headaches. As Naturopaths, we will work to determine the source of these headaches - be it certain foods, hormones, muscle tension and so on. Pain relief for headaches is often available in the forms of herbs, acupuncture, injections or homeopathy but that is not only goal. Identifying and treating the cause is the main goal.
#4 - Doctor as Teacher In order to promote good health and well-being, Naturopaths take the time to explain why diet, lifestyle and treatments are necessary to optimize health. Empowering and supporting patents to make informed decisions will ultimately lead to long-term wellness and prevention of illness.
#5 - Treat the Whole Person It is well known and researched that the mind and body have both positive and negative effects on each other. When an individual is under high amounts of mental stress, sometimes physical symptoms such as perspiration occurs, or palpitations, numbness and even changes in digestion. Alternatively, if pain is constantly occurring due to a motor vehicle accident, it is not uncommon for irritability, depression and fatigue to result. Naturopaths use a variety of treatment methods to soothe and heal all aspects of health. The most notable mind-body treatments include acupuncture, homeopathy and diet or lifestyle changes.
#6 - Prevention Why wait until a diagnosis of a chronic disease is made? Prevention is the key to health maintenance. This is an area of focus that Naturopaths explore in detail during 30 - 60 minute appointments by inquiring about personal and family medical history, diet, social history and physical examination. Guidance on nutritious foods to consume or unhealthy food choices to avoid can have huge impacts on health in the present and future. For example, if an individual has heart disease in the family but has not had any concerning blood work or findings on exams, prevention with diet will be an area of focus. Decreasing sugar and increasing healthy fats such as avocado, coconut and olive oil, nuts and seeds help maintain strong cardiovascular health.
As can be seen by the governing principles of Naturopathic medicine, Naturopathic Physicians provide primary health care to patients of all ages and in all stages of health. For more information, please use the contact form HERE.
Not many people can say that they do not like chocolate, especially kids. The health benefits of cocoa beans have been researched and shown to reduce heart disease and cancer incidences in populations which have a higher intake of natural cocoa (Kuna Indians living on Panama’s islands). Processing of cocoa into the types of chocolate common in the USA and Canada removes some of the naturally occurring flavonoids which are protective of the cardiovascular system. The addition of refined sugar and dairy reduces the positive effects of the anti-oxidants and can lead to more negative effects associated with blood sugar dysregulation over time. So what does all this mean? Go back to the basics and consume cocoa in the most natural, unprocessed forms that are readily available in health food stores.
Cocoa nibs are usually found in resealable containers and are either organic or conventional. On their own, the nibs are quite bitter and have a strong taste that kids may not enjoy. Some people will add these nibs into homemade energy balls or smoothies (see recipes following). Cocoa powders are also readily available, look for organic options which usually ensures reduced processing and no additives.
I have decided to share below my top 3 recipes for incorporating cocoa into snacks for the whole family. Please feel free to comment or add substitutions or changes that you have made and enjoyed. The original sources are included for your reference.
Cocoa Energy Balls
(source “Whole Life Nutrition Cookbook” Alison Sergersten)
This is a great protein-rich, healthy fat-rich, anti-oxidant-rich recipe that tastes fantastic!
2 cups raw walnuts
1 cup Medjool dates (pitted)
5 tablespoons organic cocoa powder
shredded coconut to coat
Healthy Nutella spread
(source chocolatecoveredkatie.com )
My kids love this recipe, I overheard my son bragging to his friends that I made this healthy Nutella that is dairy-free and tastes “amazing”. I get a hug from him each time I make it!
2 cups raw hazelnuts (filberts)
1 1/2 tbsp pure vanilla extract
1/4 cup cocoa powder
1/4 plus 2 tbsp maple syrup or agave
1/4 tsp sea salt
2 tsp coconut oil (optional but helps with creamy texture)
1/2 cup milk of choice (I prefer unsweetened chocolate almond milk)
Cocoa Power Smoothie
This is a huge hit in our home. Often this will be an after school snack before the kids head out to their sporting practices or as part of breakfast. The trick is finding a protein powder that tastes good and doesn’t contain sugar.
1 scoop protein powder (Sugar-free chocolate New Zealand Whey with stevia is what we are currently using)
1 tsp cocoa nibs
1 tbsp almond or peanut butter
1/2 or more frozen banana
3-4 ice cubes
1/2 - 1 cup milk (I use unsweetened chocolate almond milk but any of the nut milks would work very well). For a thicker smoothie, use less milk