Naturopathic Medicine
Gluten – what you need to know!
May 6, 2012 | 
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I’m sure that most of you have heard about gluten, or know someone who is gluten intolerant. But, what does ‘intolerant’ actually mean? Let’s start with the basics.
What is gluten?
Gluten is a protein found in grains and cereals such as wheat, barley, triticale, rye, etc. 
It provides elasticity to dough, allowing it to rise and take on its characteristic chewy, soft texture. It is also added as a thickener to many prepared foods such as imitation meats, sauces and gravies. Once you start looking for gluten – it’s everywhere!
Types gluten intolerance
1. Celiac Disease
- Celiac disease is an autoimmune condition, not an allergy or intolerance. The presence of gluten triggers the production of antibodies resulting in damage to the mucosa of the small intestine. This can result in loose stool (but not always), weight loss, fatigue and various nutrient deficiencies such as B12 and iron defeciency. Screening for celiac disease can be done through bloodwork, but can only be diagnosed with a biopsy of the small intestine.
- A new in-office/home test is now available, allowing for more convenient screening. The Biocard test can be purchased online, or at our office. During the month of May we will be offering the Biocard test at a reduced rate – $45.
- Gluten avoidance is mandatory for those with celiac disease, otherwise damage will continue to occur. Individuals with celiac disease must avoid all gluten-containing grains such as wheat, barley, rye, spelt and kamut.
2. Wheat allergy
- Wheat allergy is an IgE bound histamine reaction of the immune system.
- Unlike celiac disease, the reaction is usually only to wheat, so other grains (such as rye and barley) may be ok. Spelt and Kamut should also be avoided though as they are wheat relatives.
- Also unlike celiac diease, allergies are sometimes outgrown, so an allergic child may not become an allergic adult.
3. Wheat/Gluten Intolerance
- Symptoms of a wheat and/or gluten intolerance can vary quite a bit. Some people may experience digestive symptoms such as diarrhea, gas or constipation, but others may experience headaches, fatigue, anxiety or depression.
- Unlike celiac and wheat allergy, there is no reliable testing available to detect intolerance. The gold standard “test” is an elimination diet. By eliminating all wheat and/or gluten for a minimum of 3 weeks, intolerance can be ruled in or out based on the return of symptoms with a subsequent challenge. Often times, other foods are eliminated as well and the patient is put on a strict hypoallergenic diet. While not difficult per se, this diet does require a bit of planning and guidance, which an ND is qualified to provide.
More Information:
- Canadian Celiac Association
- http://www.celiac.com/
- About.Com – Info page on Celiac Disease/Wheat allergy
Posted in Celiac, Gluten, Gluten-Free, Naturopathic Medicine, Nutrition, Uncategorized, allergies | 
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Naturopathic Approach to Irritable Bowel Syndrome (IBS)
Irritable Bowel Syndrome (IBS) is a functional disorder of the gastrointestinal tract leading to symptoms such as gas, bloating, constipation, and diarrhea. Symptoms can range from mild to debilitating. There is no lab test or exam that can be used to diagnose IBS because there are no changes in the tissues- IBS is a result of dysfunction in the digestive tract. While there are many things that can contribute to digestive dysfunction including stress, most patients that I treat with IBS have a combination of food sensitivities or intolerances and dysbiosis which is an imbalance of the healthy gut flora and the potentially harmful gut flora. Oftentimes, flooding the system with healthy bacteria or probiotics is enough to rebalance the flora but sometimes it is necessary to actively kill off the harmful bugs. If you have IBS, try keeping a food diary for 2-3 weeks to see if your symptoms get worse with a specific food. If they do, remove the food from your diet for at least 2 weeks and take a probiotic (kefir is a great food source) to see if you notice any improvement. Determining food sensitivities can often be tricky; your naturopathic doctor can help you figure out if you are reacting to any foods and can advise you on the best way to rebalance your gut flora.
Posted in Irritable Bowel Syndrome, Naturopathic Medicine, Nutrition, probiotics | 
Tags: Food Sensitivities | Comments Closed
Need a sugar fix? Thoughts on overcoming sugar addiction.
Think sugar isn’t addictive? Think again. A study conducted at Princeton University found that rats could indeed become addicted to sugar, and would display symptoms of withdrawal after a period of time without their “sugar fix”. And more concerning is that the researchers found that sugar acted as a gateway drug for the rats. What does this mean for our kids, who have more sugar in their diet than any other generation? Sugar stimulates the release of dopamine in the brain, just like other well known addictive substances such as cocaine and heroine. It really IS an addiction for some people.
But, isn’t sugar naturally found in foods? How can it be so bad for us?
Fruit contains naturally occurring fructose, which is very different than sucrose (table sugar) or even fructose added to foods during manufacturing. And, fructose from fruit (sometimes called levulose) is balanced out by the vitamins, minerals, fiber and enzymes naturally present in the fruit. When sucrose or fructose is added to foods, it’s often paired with refined white flours, colourings and flavourings. Not such a great combo. So, the two can’t really be compared.
If sugar is so bad, can I use sugar substitutes?
Artificial sweeteners are definitely out, as they still raise the threshold for sweetness which can trigger sugar cravings. And, they’re chemicals. Natural sweeteners like honey, coconut sugar and maple syrup are better, but still contain sugar. And agave nectar, which many people believe to be healthier, isn’t – it’s actually high in fructose and is heavily processed. So, while natural sweeteners are better than white table sugar, they still have the potential to cause harm. In other words, moderation is key.
Ok, I’m an addict – what do I do?
1. Start the day with a low-glycemic, protein rich breakfast. Resist the urge to have toast in the morning as high carbohydrate meals can trigger mid-morning slumps in blood sugar, resulting in the need for a “quick fix”
2. Avoid anything “white” – no white bread, rice, potatoes or crackers.
3. Protein at every meal. Protein, along with fat and fiber help to reduce the glycemic load of a meal, resulting in a more stable rise and fall of blood sugar levels.
While the above measures can help some people stave off their sugar cravings (or at least help get them under control), many others need to go cold turkey. In that case, a visit to an ND can help you formulate a plan. There are also a few key nutrients involved in blood sugar metabolism that can help. And, since dopamine receptors are involved in sugar addiction, some people need a lot of support, which an ND can provide.
Personal Care Products: Are they making us sick?
There has been a flurry of news attention recently on the potential dangers of toxic ingredients in personal care products. Certain ingredients have been linked to respiratory conditions, endocrine disruption, and even cancer. Avoiding potentially harmful additives can be challenging as products often contain long lists of chemicals that can be hard to decipher. I often encourage my patients to start by avoiding phthalates. Phthalates help lotions to penetrate skin and help synthetic fragrances to last longer. Unfortunately, they also disrupt hormones and have been linked to PMS, infertility, and breast cancer. Phthalates are not usually listed in the ingredients but whenever you see fragrance, perfume, or parfum you can assume they are present. That means choosing non-scented products and those scented with essential oils.
Avoiding phthalates is a great start. Other ingredients to watch out for include parabens, triclosan, and sodium lauryl sulfate. Environmental Defence Canada has put together a pocket shopping guide of Toxic Ten Ingredients as part of their Just Beautiful campaign that you can download from justbeautiful.ca. You can also visit lesstoxicguide.ca for lists of non-toxic products that you can find in Nova Scotia.
Posted in Environmental Medicine, Infertility, Naturopathic Medicine, PMS, fertility, hormone health, womens health | Comments Closed
Treating inflammation – the root of heart disease
As we learn more about how heart disease develops, we see that the usual suspects – cholesterol, diabetes and hypertension – aren’t the only factors at play. And, some research is suggesting that our attack on cholesterol may be especially unfounded, given the relative ineffectiveness of statins in most healthy adults (ie no history of heart attacks) and the myriad of side effects they come with. Inflammation is emerging as the root cause of heart disease.
How does inflammation cause heart disease?
For many years heart disease was seen as a kind of plumbing problem—that is, as merely a matter of plaque building up in the walls of blood vessels and clogging them. But it is more complicated than that. Blood vessels are nothing like pipes—they are active tissue that absorbs cholesterol from the blood, and this may result in damage to the vessel walls. In trying to heal this damage, inflammatory cells come into the vessel walls. They then release many chemicals that may cause further damage. Smoking, high blood pressure, poor diet, etc. may hasten this process. Inflammation may also contribute to the rupturing of plaque, which in turn triggers a blood clot, resulting in a heart attack or stroke.
How is inflammation measured?
There is an easy way to test for inflammation, since it can prompt the liver to produce a protein in the blood known as C-reactive protein (CRP). Elevated levels of CRP often accompany or signal an increased risk of heart attack and stroke. This may help explain why many people who get heart attacks have normal blood cholesterol levels and no other identifiable risk factors.
The link between elevated CRP levels and heart disease has been found in several studies, and there is some evidence that CRP may be a more important indicator of heart disease risk than high LDL (“bad”) cholesterol. In an eight-year study involving 27,939 women more than half of the women who eventually developed heart disease had high CRP levels even though their LDL levels were not considered high. This is such a key finding, as so much of our treatments which focus on “prevention” single out cholesterol, when in fact cholesterol may not even be a major player!
How to treat inflammation
As always, naturopathic medicine focuses on the whole person, and not just the symptoms. If inflammation is occurring in one area of the body (joints, heart, etc) it’s likely to be affecting other areas as well. Some believe that inflammation may be the root of many chronic diseases, including cancer, Alzheimer’s, etc.
1. Get plenty of good fats. I’m always talking about the benefits of omega-3-fatty acids, namely DHA and EPA. If there’s one supplement that most people can benefit from, it’s a good quality fish oil. Omega-3 fats can be found in cold water fatty fish such as salmon, mackerel, herring, sardines and tuna. Many people struggle to get the recommended 3+ servings a week though, and opt to take a supplement. If you do supplement, please make sure you take an omega-3 supplement, and not a 3-6-9 version. Most people get plenty of omega 6 and 9, and too much of these essential fats can lead to a pro-inflammatory response as the following diagram suggests.
When looking for a fish oil supplement, look for one that is molecularely distilled to remove impurities. Quality matters when it comes to fish oil – you get what you pay for. And, make sure you are getting enough – aim for a minimum of 1.5 grams of EPA/DHA per day. If you take medications such as aspirin and warfarin, you should consult with your health care practitioner first as high doses of fish oil can cause further thinning of the blood.
2. Get lots of greens! Make sure you are getting a minimum of 2.5 cups of green veggies/day – kale, spinach, boy choy, swiss chard, etc. Don’t skimp when it comes to these veggies! Also, have a look at Dr. Weil’s “Anti-Inflammatory” pyramid” – it’s a good place to start!
3. Choose grass-fed meat over grain fed meat. Grass fed meats contain higher amounts of omega-6 fatty acids, which can be pro-inflammatory. Grass fed beef is actually a good source of omega-3 fats! Local and free-range farmers are easily found at farmer’s markets in the area.
4. Avoid exposures to chemicals whenever possible. The link between chemical exposure and inflammation is based on the theory that these chemicals require a high antioxidant load to neutralize them. Don’t waste your antioxidants on chemicals!
5. See a Naturopathic Doctor. Treating inflammation is not quick fix. It requires an in-depth assessment into diet, lifestyle and risk factors.
Tasty Gluten-Free Snacks
Tasty Gluten Free Snacks
One of my personal struggles is to fully commit to a gluten free diet. I have been pretty close for the last few years but it keeps sneaking in. I find snacks especially challenging- I can only handle so many almonds! One of my goals over the holidays was to find a few gluten free snacks that would suit my lifestyle and also be appealing to my 5 year old stepson- for me that means quick and easy to prepare, tasty, loaded with protein, and easy to eat on the playground. My New Year resolution is to commit to a gluten free diet- if that is something you are working on or if you are simply looking for some new snack ideas, I hope you enjoy these recipes.
Gluten Free Breakfast Bars
Ingredients:
- 1 ¼ cup almond flour
- ¼ tsp salt
- ¼ tsp baking soda (gluten free)
- ¼ cup olive oil
- ¼ cup maple syrup or honey
- 1 tsp vanilla extract
- ½ cup shredded coconut
- ½ cup pumpkin seeds, raw and unsalted
- ½ cup sunflower seeds, raw and unsalted
- ¼ cup almonds, whole or slivered
- ¼ cup raisins (optional)
Directions:
In a small bowl, combine almond flour, salt and baking soda. In a large bowl, combine olive oil, sweetener and vanilla. Stir dry ingredients into wet and mix in coconut, pumpkin seeds, sunflower seeds, almonds, and raisins. Grease an 8×8 baking dish with olive oil and press the dough into the baking dish. Bake at 350° for 20 minutes.
Dried Fruit and Nut Bites
Ingredients:
- 2 cups dried fruit of choice (I love the combination of apricots, cranberries and some coconut; if you prefer something sweeter, include 2-3 dates)
- 2 cups raw nuts and seeds of choice
- dash cinnamon
- pinch salt
- ~3 cups raw sesame seeds
Directions:
Pulse 2 cups of dried fruit in food processor and transfer to a bowl.
Pulse 2 cups of nuts and seeds until finely chopped.
Add nuts and seeds to dried fruit with a dash of cinnamon and pinch of salt.
Knead together and form 1 inch balls.
Roll each ball in raw sesame seeds.
Resolve to be healthy in 2012!
I love the holidays, but hate the expectations that come with the New Year. But, as my friend and colleague Dr. Jillian Murphy, ND points out, if we don’t take time to think about resolutions would we ever think about change and how to make ourselves better?
So, I thought I’d make things a bit easier for those of you who are hoping to make a resolution (or two) and need some help sticking with it! Here’s a quick list of small things that can make a big impact on your overall quality of life and health.
1. Take a multivitamin. This basic step is such a great insurance policy. A good quality supplement will be free of fillers, come in capsule form and ideally be taken in divided doses (ie. 2-3x/day). One-a-day vitamins are convenient, but you won’t absorb as much as you will from a multi-dose vitamin. And, if you have any concerns about the risks and benefits of a daily multi-vitamin, have a look through this report from the Harvard School of Public Health. It does a great job of explaining why you’re better off taking one!
2. Eat a reliable source of probiotics. Good bacteria like those found in fermented foods such as yogurt, kefir and saurkraut are proving to be more and more important to overall health than ever before. Not only are they involved in maintaining a healthy gut, they also play am important role in maintaining a healthy immune system. For example, a Cochrane Review found that those who took probiotics were less like to suffer with upper respiratory infections. These “good bacteria” are also important for those with autoimmune conditions, allergies and eczema. Diet should be sufficient to maintain a healthy population of gut bacteria, but you may need to supplement if you’ve taken antibiotics, recently travelled, take certain medications or have a GI illness. In these cases, we’re happy to help.
3. Eat your Greens! Yes, I know you’ve heard this before, but do you know why? Leafy green vegetables such as spinach, kale, swiss chard and the like are loaded with phytonutrients. Dark leafy greens are a rich source of vitamin C, K, E, and B, as well as iron, calcium (must be cooked), and fiber, which are essential for good health. Recent studies have shown that Vitamin K plays an important role in preventing osteoporosis, arthritis, diabetes, and atherosclerosis. Vitamin E has been shown to prevent skin cancer. Greens also contain beta carotene (converts to vitamin A), lutein, and zeaxanthin which are powerful antioxidants.
4. Get rid of “white food”. Most people know that white bread isn’t the best choice, but other white foods like white potato and white rice should also be limited. Choose sweet potato, brown rice, quinoa or millet more often! Insulin resistance is on the rise, and “white foods” should be a “less often” choice.
5. Have your Vitamin D status assessed. There’s a growing body of evidence about the role of vitamin D in maintaining health, and it’s very far reaching (read www.vitamindcouncil.org for more info. In Nova Scotia, the minimum level required to maintain bone health is 75 nmol/L, and I can’t tell you the number of patients I see with numbers well below that. If you haven’t had this simple blood test, ask your doctor to check it for you at your next appointment. And, if you are found to be deficient, touch base with us on how best to optimize your levels.
Hope 2012 is full of peace, health and wellness for you and your family!
Posted in Naturopathic Medicine, Nutrition, Uncategorized, Vitamin D, Wellness, probiotics | 1 Comment »
Practical Tips for Surviving the Holidays
Here we are, just 2 weeks away from Christmas Day. You are in good company if you find yourself surrounded by friends, food and fun. But, you may also find yourself run ragged, tired, stressed out and feeling out of control. Sound familiar? As we approach “the happiest time of the year”, it can be easy to get off track and fall away from the 80/20 rule, in food and in life! So, to keep yourself balanced here are some practical tips:
- Set boundaries. If you have to attend several functions (social or otherwise), plan to eat well before you go so that you don’t arrive hungry. And, decide which occasions are worth the treat, and which should be avoided.
- Remember that calories from alcohol can add up quickly, and that people tend to make poorer food choices after having a drink or two.
- Stick to the “real foods”. You’ll fare better by sticking to fruit and cheese, and staying away from other hors d’oeuvres that may be fried of cooked with a lot of fat, etc.
- If you’ve been invited to a party or gathering, offer to bring a healthy dish. At least you’ll be sure of one healthy option!
- To manage stress levels, avoid the temptation to load up on caffeine and sugar. The quick rise in blood sugar, and subsequent crash, can make things worse. Many people experience anxiety during the crash, which won’t help you feel more in control.
- Get 8 hours of sleep. Don’t skimp on sleep at this time of year. If you aren’t sleeping well, talk to us about options such as melatonin, inositol, or other herbs.
- B vitamins are especially important at this time of year, as they are used up quickly under stressful conditions. A B-Complex, along with a good multivitamin may be a good idea.
- Herbs such as licorice, eleuthrococcus and ashwaganda are known as adaptogenic herbs. Adaptogens are useful in times of stress, and may be helpful if you are having symptoms such as excessive fatigue, disordered sleep patterns, weight changes and/or difficulty coping with day-to-day stressors. Talk to us if you feel you may need adaptogenic support.
And, finally, remember that the holidays are meant to be a time of celebration and gathering. We wish you you and family peace and joy, and the best of health in 2012.
Osteoporosis and Diet – Beyond Calcium.
Just a few short years ago, the bulk of dietary recommendations for osteoporosis revolved around calcium. But, over the past number of years, new players have come onto the field and calcium is now taking somewhat of a backseat when it comes to importance.
Vitamin D
Vitamin D is the “sunshine vitamin”. While exposure to sunlight provides vitamin D, Canadians are at risk of seasonal vitamin D deficiency because winter sunlight in northern latitudes above 35º does not contain enough ultraviolet B for vitamin D production. Osteoporosis Canada’s new guidelines (July 2010) recommend daily supplements of 400 to 1000 IU for adults under age 50 without osteoporosis or conditions affecting vitamin D absorption. For adults over 50, supplements of between 800 and 2000 IU are recommended. I feel that everyone (especially those with osteoporosis) should have their vitamin D levels check (ask for 25-hydroxyvitamin D). This allows for individualized supplementation.
In my experience, most people in Nova Scotia need more than the recommended amounts to maintain optimal levels of vitamin D.
Magnesium
Magnesium is a very important mineral, and vitamin D’s most important cofactor. In fact, it has been shown that low levels of magnesium inhibit formation of the active form of Vitamin D.
Food sources of magnesium include:
- Halibut
- Spinach
- Squash
- Seeds, especially pumpkin and toasted sesame
- Beans, especially pinto and black
- Plantain, raw
- Nuts, especially Brazil nuts, almonds, peanuts
Magnesium oxide is the most common form of magnesium sold, but only about 4% is absorbed, making it ineffective at providing the body’s magnesium needs. Magnesium taurate, glycinate, citrate, and gluconate have demonstrated higher absorption and bioavailability. Magnesium malate and glycinate are considered by many to be even more effective supplemental forms.
Vitamin K
This vitamin, once only known for it’s role in blood clotting is thought to be as important as Vitamin D and Calcium in maintaining bone health. Unlike other fat-soluble nutrients, vitamin K is not stored in the body and must be received daily through diet or supplementation. In fact, research indicates one can become deficient in vitamin K in as little as 7 days. While there are 3 types of vitamin K, K2 is an important cofactor for Vitamin D.
Green leafy vegetables are the best source of vitamin K – another good reason to eat them!
Boron
Boron is a trace mineral, recently found to be important in bone health. It is found in many foods, but concentrated in:
- fresh fruits and vegetables
- nuts
- seeds
- honey
- dried prunes
So what about Calcium? Do I still need to take it?
Calcium is still a very important mineral in preventing and treating osteoporosis. However, most of the recent research seems to indicate that you can get too much of a good thing, and that less is more when it comes to calcium. A recent study, which analyzed data from the WHI (Women’s Health Initiative) found that women who started taking calcium and vitamin D had increased risk for heart attack and stroke. But, dietary sources of calcium aren’t a problem – so be sure to include good sources of calcium every day. And, discuss the need for calcium supplements with your ND or MD.
M. J. Bolland, A. Grey, A. Avenell, G. D. Gamble, I. R. Reid. Calcium supplements with or without vitamin D and risk of cardiovascular events: reanalysis of the Women’s Health Initiative limited access dataset and meta-analysis. BMJ, 2011; 342 (apr19 1): d2040 DOI: 10.1136/bmj.d2040
Posted in Naturopathic Medicine, Nutrition, Osteoporosis, Uncategorized, womens health | Comments Closed
Seasonal Affective Disorder – aka ‘Winter Blues’
As we get ready to move the clocks back next weekend, people who suffer from Seasonal Affective Disorder (SAD) begin to dread the coming months. Those who suffer from SAD begin to experience:
- fatigue
- depression
- crying spells
- irritability
- trouble concentrating
- body aches
- change in sleep patterns
- decreased activity level
- overeating, especially of carbohydrates.
What causes SAD?
- Your biological clock (circadian rhythm): The reduced level of sunlight in fall and winter may disrupt your body’s internal clock, which lets you know when you should sleep or be awake. This disruption of your circadian rhythm may lead to feelings of depression.
- Serotonin levels: A drop in serotonin, a brain chemical (neurotransmitter) that affects mood, might play a role in seasonal affective disorder. Reduced sunlight can cause a drop in serotonin that may trigger depression.
- Melatonin levels: The change in season can disrupt the balance of the natural hormone melatonin, which plays a role in sleep patterns and mood.
- Vitamin D Defeciency: Because vitamin D is produced when our skin is exposed to sunlight, declining levels of Vitamin D may play a role in SAD.
- Living far from the equator. Seasonal affective disorder appears to be more common among people who live far north or south of the equator. This may be due to decreased sunlight during the winter, and longer days during the summer months.
Treating SAD
Light therapy
In high-intensity, full-spectrum light therapy, also called phototherapy, you sit a few feet from a specialized light therapy box so that you’re exposed to bright light. Light therapy mimics outdoor light and appears to cause a change in brain chemicals linked to mood.
Light therapy is a good place to start for seasonal affective disorder. It generally starts working in two to four days and causes few side effects.
Enjoy the sunshine!
Make sure you take advantage of sunny days, and try to get some early morning sunlight exposure. A brisk walk around the block, or walking to work is a great idea.
Exercise
As with any type of depression, exercise helps to relieve symptoms and has many other benefits.
Supplements
Work with your ND or MD to ensure that you have adequate stores of Vitamin D. This vitamin is measured using either a blood or saliva test. Some people need to take much more than the recommended 1000 IU/day to meet their needs.
Melatonin is another interesting supplmement, which many people find helpful during the winter months, especially when sleep disruptions are present. Most people can safely start taking melatonin, beginning with 1-3 mg before bed. As always, consult with your ND or MD before taking mealtonin if you are taking any prescription medications.
The Naturopathic Approach
As with any symptom or condition, we work with you to get to the root cause of illness. We asses diet, lifestyle and environment to help you achieve health and wellness. SAD is a condition which responds very well to naturopathic medicine, and has helped many people get through the winter with a little bit more sunshine.
If you have any questions, please don’t hesitate to contact us.
Posted in Naturopathic Medicine, Seasonal Affective Disorder, Vitamin D, depression | Comments Closed