Dr. Laura: Drugs that affect the microbiome

Drugs are one of the major factors that affect the microbiome. The impacts vary depending on the drug and duration of treatment.

The environmentfoodstress and drugs  all contribute to changes in the microbiome. This is why it is important to recognize and address any contributors that cause troubles.

Clinical intake and tests flushes out root causes and provide clarity. 

Why should I care?

Unique patterns in the microbiome link to different diseases. An unhealthy microbiome links to depression, anxiety, autistic disordersvitamin and mineral status (nutrient absorption)hormone production,  eczemadiabetes, obesity, arthritis and inflammatory bowel psoriasis and other autoimmune, conditions, heart healthcholesterolnon-alcoholic fatty liver disease (NAFLD), diseases.  Research continues to expand this list.  

What is the microbiome?

The human microbiome exists in the gastrointestinal/urogenital tract and the skin. The trillions of cells that make up our microbiome actually out number the human cells that we have in our body by tenfold. Are we microbes having a human experience?

Healthy microbiome?

A healthy regular stool is not always indicative of a healthy microbiome. History of autoimmune conditions, food sensitivity, sugar cravings, gas, pain, bloating, bad breath, candidiasis, brain fog, mood changes, weight issues, skin issues, joint pain, trauma, stress, headaches, use of birth control or other hormones, frequent use of antibiotics and certain drugs can all be factors or indicators of microbiome disruption. 

What drugs affect the microbiome?

Your microbiome may be out of balance if you are currently, or have history of taking, any of the following drugs:

  • Antibiotics
  • Cancer Therapies
  • Antihistamines
  • Antidiabetic drugs
  • Anti-inflammatory drugs
  • GI disorder drugs
  • Non-steroidal Anti-inflammatory drugs
  • Anti-psychotic drugs
  • Anti-coagulants
  • Hormones: estrogen, birth control, thyroid hormone

Find out more…tests available

One helpful test to look at the key players of the microbiome is the comprehensive stool and parasitic analysis. Knowledge of the landscape certainly helps streamline the treatment. 

Food sensitivities often rise when the microbiome is off balance. It is important to recognize the foods that are bothersome. Then remove them for a while and do the work to remove unwanted microbes and replace with healthy ones while repairing the gastrointestinal tract lining. Protocols are patient specific based on the microbiome the lining of gastrointestinal tract and the overall health of the patient. 

Dr. Laura M. Brown ND is a Naturopathic Doctor with a functional medicine approach. She is a Certified Gluten Practitioner, a HeartMath Certified Practitioner and is a graduate of Adapt Level 1 at Kresser Institute of Functional Medicine. Essentially, Dr. Brown helps people better digest their food and the word around them. More at www.naturalaura.ca and  www.forwardhealth.ca

Dr. Laura: Boost your energy

The energy powerhouses of cells are called mitochondria. These tiny organelles are derived solely from our mother’s DNA and are reposible for generating the energy our bodies need to run.

Mity Mitochondria

  • Make up about 10% of our body weight
  • 200-2000 per body cell
  • relies on the fats, carbohydrates and proteins we eat
  • loves to run on ketones
  • Needs nutrients like calcium, B vitamins, CoQ10, N-Acetyl-Cysteine, Magnesium, Alpha lipoid acid, lysine

Energy Drains

Fatigue comes from drains on the mitochondrial function. This can happen with any type of toxic burden:

  • long term nutrient deficiency
  • poor sleep habits
  • hormonal disruption
  • eating too much in general
  • eating too much sugar
  • excessive exercise
  • heavy metals
  • viruses and spirochetes (Lymes)
  • pesticides
  • plastics, PCB’s
  • drugs
  • mold

Signs of Mitochondrial Dysfunction

Unexplained fatigue, the need for more than 8 hours of sleep on an ongoing basis, poor exercise recovery, impaired sense of smell or taste, headaches, poor motivation, depression, anxiety, brain fog, forgetfulness, extra sensitive to light and noise – are all indicators of poor mitochondrial dysfunction. While other things may be at play like poor thyroid function, hypothalamus, pituitary or adrenal function, it is important to also consider the mitochondria.

Boost Your Energy

Support the mitochondria and reclaim your energy. An initial naturopathic appointment will start the process to understand the source of your energy drain. Together a same day plan could initiate the changes required to boost energy.

Dr. Laura M. Brown, ND

Dr. Phil Shares: Menopause Belly: Why Fat Accumulates & How to Tackle It?

 

Many women notice after age 45 that fat seems to accumulate readily at the waist. There are even terms for it, like menopause belly, muffin top, or “meno-pot.” What does the science tell us about menopausal belly fat and how to get rid of it? What are the hormonal drivers and are they amenable to change with personalized lifestyle medicine? Certainly belly fat, specifically subcutaneous and visceral abdominal fat, increases during menopause,1-3 when the changing hormonal environment can bring with it a remodeling of fat storage patterns. Abdominal fat, especially visceral fat, is biochemically different and more metabolically active than fat stored in other areas, secreting more pro-inflammatory cytokines and adipokines.4 That means preventing or reversing belly fat is not just a vanity project, it’s a meaningful step in managing a woman’s overall health, as abdominal fat has been consistently linked with insulin resistance, impaired glucose control, and overall higher cardiometabolic and breast cancer risk. Practitioners are often asked ‘How can I get rid of menopausal belly fat?’, and it is important to remember that effective management is multifaceted – encompassing an understanding how changes in sex steroids interact with other endocrine systems and also with lifestyle choices, and recognizing the best time to implement a lifestyle medicine approach is in the years before a woman’s final menstrual period.

The changing hormonal environment

A robust understanding of the hormonal changes associated with perimenopause and menopause can guide women toward effective intervention. Here are the top five hormonal changes associated with the menopausal transition.

  • Changes in estrogen and estrogen dominance: Menopause is often framed simply as the loss of estrogen, but the road from pre- to post-menopausal estrogen levels is not necessarily smooth. Although loss of estrogen itself is linked with increasing abdominal fat,2,3 paradoxically the estrogen dominance that occurs in perimenopause and that may continue into menopause is seen clinically as a culprit in expanding abdominal fat mass.5 Between age 35 and 45, most women are beginning to run low on ripe eggs and experience hormonal changes linked with advancing reproductive age.6 During this time reduced progesterone coupled with high and erratic estrogen occurs.6,7 Estrogen declines but is in relative excess to progesterone. This is the definition of estrogen dominance: having a progesterone level that’s less than 100X the level of estrogen, creating an imbalance in the estrogen-progesterone partnership and essentially an inadequate level of progesterone to keep estrogen in check. Local estrogen production in adipose tissue can also contribute to estrogen dominance during this time. For example, aromatase enzymes, responsible for converting androgens to estrogens, are more active in visceral adipose tissue of post-menopausal women in response to cortisol.8

 

  • Cortisol: Dysregulation of the HPA axis and cortisol excess can manifest as increased central and visceral fat mass and metabolic disturbances such as insulin resistance.9,10 Increased production of cortisol,11 and conversion of cortisone (inactive) to cortisol (active) has been described in post-menopausal women,12 indicating that increased cortisol synthesis and conversion could contribute to metabolic dysfunction in these women. Cortisol is regulated in part by sex steroids, and estrogen down-regulates the expression and activity 11β-HSD1, the enzyme involved in converting inactive cortisone to active cortisol13 – so higher estrogen, lower 11β-HSD1 and less active cortisol formed. Declining estrogen levels during menopause can have a knock-on effect on cortisol formation, and 11β-HSD1 has been shown to be upregulated particularly in visceral fat in post-menopausal compared with pre-menopausal women. 1,11,12 As well as contributing directly metabolic dysfunction, higher cortisol can feed back to hormonal environment and contribute to estrogen dominance occurring at this time through cortisol-induced aromatase activity.8,14

 

  • Insulin: Fat cells accumulating in the abdomen is linked with insulin resistance. The pro-inflammatory cytokines produced by abdominal fat interferes with insulin signaling.15 This results in insulin resistance where cell response to insulin is lost, which creates a cycle where greater production of insulin is required to manage blood glucose levels. Insulin is a gatekeeper of metabolism, and rising insulin levels can set off a chain reaction that ultimately leads to a cycle of weight and abdominal fat gain. Insulin can lower production of sex hormone binding globulin (SHBG) in the liver.16,17 Lower SHBG results in greater free androgens and estrogens in circulation, and is linked with visceral fat and insulin resistance in menopausal women.18,19 In addition, insulin resistance can have a knock-on effect on leptin, insulin’s cousin.

 

  • Leptin: Leptin is the put-down-your-fork hormone, the one that tells you when you are full.20 Elevated insulin levels eventually lead to elevated leptin, which despite what you may think, does not mean you are more likely to put down your fork and stop eating. Instead, consistently elevated leptin levels lead to a dysfunction of leptin receptors and they stop sending signals to the brain to tell you to stop eating – this is called leptin resistance.21 The mechanisms driving leptin-resistance are complex, but high intakes of refined carbohydrates have linked with its development.22

 

  • Thyroid hormones: Thyroid hormones, which regulate how quickly we burn calories and maintains our metabolism, can becomes unbalanced with age, a trend that has been labeled ‘thyropause’. If the thyroid becomes underactive, this can lead to symptoms including weakness, fatigue, and weight gain.23

What can be done?

One of the biggest myths in women’s health is that once hormones change with menopause, abdominal adiposity is immovable – however addressing modifiable hormones such as cortisol and insulin in the following ways can have an impact.

  • Make foundational changes to dietary intake. When evaluating diet, consider factors that influence insulin levels, such as high carbohydrate intakes or intake of refined carbohydrates which require greater insulin response to manage spikes in plasma glucose. Remove inflammatory or trigger foods, as inflammation can contribute to insulin resistance.31 Add in foods rich in antioxidants which promote detoxification. Eliminate alcohol which robs you of deep sleep and lowers metabolism by more than 70% for 24 hours. Choosing when to eat during the day can also make a positive impact to insulin levels and insulin sensitivity. Time-restricted feeding (TRF) protocols, a type of intermittent fasting, where food is consumed during a limited number of hours per day (often 6 or 8) has been shown to reduce body weight and abdominal fat32 and improve insulin sensitivity even without weight loss.33

 

  • Add more movement to the day. Sitting is like the new smoking. Approximately 35 chronic diseases and conditions are associated with sedentariness, and sedentary behavior makes people more prone to gain body fat.24 High intensity interval training (HIIT) is effective at reducing abdominal and visceral adiposity, as well as improving insulin sensitivity and building muscle.25,26 Studies in post-menopausal women show that HIIT training results in greater abdominal and visceral fat mass loss compared to continuous exercise programs (where heart rate was maintained at a constant level)27,28 showing that HIIT is a time-efficient strategy for improving central obesity in this population. In addition to HIIT programs, practicing yoga can be recommended for menopausal women, showing significant reductions in menopausal symptoms.29 In broader populations, interventions that included yoga asanas were associated with reduced evening and waking cortisol levels, as well as improved metabolic symptoms.30

 

  • Support reparative sleep. A primary step to losing belly fat is to get enough sleep and to make it quality sleep. Epidemiological studies have repeatedly shown links between sleep duration and the risk of obesity and central adiposity.34 People sleeping 7-8 hours/night night have been shown to accumulate less visceral fat mass than those sleeping for ≤6 hours/night.35 Sleep debt leads to changes in leptin and other hormones related to satiety, greater feelings of hunger, dietary indiscretion and poor food choices, as well as reduced physical activity and insulin resistance.34 In other words, getting that solid sleep needs to be a priority. As well as sleep quantity, sleep quality has to be considered, as poorer sleep quality is associated with higher visceral fat mass.36 Subjective poor sleep quality is linked with altered cortisol response37 and insulin resistance in postmenopausal women.38

by Sara Gottfried, MD and Annalouise O’Connor, PhD

Shared by Dr. Phil McAllister @ Forward Health Guelph

Citations

  1. Yamatani H et al. Association of estrogen with glucocorticoid levels in visceral fat in postmenopausal women. Menopause. 2013;20(4):437-442.
  2. Shen W et al. Sexual dimorphism of adipose tissue distribution across the lifespan: a cross-sectional whole-body magnetic resonance imaging study. Nutr Metab (Lond). 2009;6:17.
  3. Lovejoy JC et al. Increased visceral fat and decreased energy expenditure during the menopausal transition. Int J Obes (Lond). 2008;32(6):949-958.
  4. de Heredia FP et al. Obesity, inflammation and the immune system. Proc Nutr Soc. 2012;71(2):332-338.
  5. Prior JC. Progesterone for symptomatic perimenopause treatment – progesterone politics, physiology and potential for perimenopause. Facts Views Vis Obgyn. 2011;3(2):109-120.
  6. Hale GE et al. Hormonal changes and biomarkers in late reproductive age, menopausal transition and menopause. Best Pract Res Clin Obstet Gynaecol. 2009;23(1):7-23.
  7. Hale GE et al. Endocrine features of menstrual cycles in middle and late reproductive age and the menopausal transition classified according to the Staging of Reproductive Aging Workshop (STRAW) staging system. J Clin Endocrinol Metab. 2007;92(8):3060-3067.
  8. McTernan PG et al. Glucocorticoid regulation of p450 aromatase acitivty in human adipose tissue: gender and site differences. J Clin Endocrinol Metab. 2002;87(3):1327-1336.
  9. Paredes S et al. Cortisol: the villain in metabolic syndrome? Rev Assoc Med Bras (1992). 2014;60(1):84-92.
  10. Incollingo Rodriguez AC et al. Hypothalamic-pituitary-adrenal axis dysregulation and cortisol activity in obesity: a systematic review. Psychoneuroendocrinology. 2015;62:301-318.
  11. Li S et al. Effects of menopause on hepatic 11β-hydroxysteroid dehydrogenase type 1 actvity and adrenal sensitivity to adrenocorticotropin in healthy non-obese women. Gynecol Endocrinol. 2011;27(10):794-799.
  12. Andersson T et al. Tissue-specific increases in 11β-hydroxysteroid dehydrogenase type 1 in normal weight postmenopausal women. PLoS One. 2009;4(12):e8475.
  13. Andersson T et al. Estrogen reduces 11β-hydroxysteroid dehydrogenase type 1 in liver and visceral, but not subcutaneous, adipose tissue in rats. Obesity (Silver Spring). 2010;18(3):470-475.
  14. McTernan PG et al. Gender differences in the regulation of P450 aromatase expression and activity in human adipose tissue. Int J Obes Relat Metab Disord. 2000;24(7):875-881.
  15. Castro AV et al. Obesity, insulin resistance and comorbidities? Mechanisms of association. Arq Bras Endocrinol Metabol. 2014;58(6):600-609.
  16. Plymate SR et al. Inhibition of sex hormone-binding globulin production in the human hepatoma (Hep G2) cell line by insulin and prolactin. J Clin Endocrinol Metab. 1988;67(3):460-464.
  17. Loukovaara M et al. Regulation of production and secretion of sex hormone-binding globulin in HepG2 cell cultures by hormones and growth factors. J Clin Endocrinol Metab. 1995;80(1):160-164.
  18. Davis SR et al. The contribution of SHBG to the variation in HOMA-IR is not dependent on endogenous oestrogen or androgen levels in postmenopausal women. Clin Endocrinol (Oxf). 2012;77(4):541-547.
  19. Janssen I et al. Testosterone and visceral fat in midlife women: the Study of Women’s Health Across the Nation (SWAN) fat patterning study. Obesity (Silver Spring). 2010;18(3):604-610.
  20. Klok MD et al. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obes Rev. 2007;8(1):21-34.
  21. Engin A. Diet-induced obesity and the mechanism of leptin resistance. Adv Exp Med Biol. 2017;960:381-397.
  22. Harris RBS. Development of leptin resistance in sucrose drinking rats is assocated with consuming carbohydrate-containing solutions and not calorie-free sweet solution. Appetite. 2018;132:114-121.
  23. Diamanti-Kandarakis E et al. Mechanisms in endocrinology: aging and anti-aging: a combo-endocrinology overview Eur J Endocrinol. 2017;176(6):R283-R308.
  24. Levine JA. Sick of sitting. Diabetologia. 2015;58(8):1751-1758.
  25. Boutcher SH. High-intensity intermittent exercise and fat loss. J Obes. 2011;2011:868305.
  26. Maillard F et al. Effect of high-intensity interval training on total, abdominal and visceral fat mass: a meta-analysis. Sports Med. 2018;48(2):269-288.
  27. Maillard F et al. High-intensity interval training reduces abdominal fat mass in postmenopausal women with type 2 diabetes. Diabetes Metab. 2016;42(6):433-441.
  28. Nunes PRP et al. Effect of high-intensity interval training on body composition and inflammatory markers in obese postmenopausal women: a randomized controlled trial. Menopause. 2018;Oct 1.
  29. Cramer H et al. Yoga for menopausal symptoms-a systematic review and meta-analysis. Maturitas. 2018;109:13-25.
  30. Pascoe MC et al. Yoga, mindfulness-based stress reduction and stress-related physiological measures: a meta-analysis. Psychoneuroendocrinology. 2017;86:152-168.
  31. Caputo T et al. From chronic overnutrition to metainflammation and insulin resistance: adipose tissue and liver contributions. FEBS Lett. 2017;591(19):3061-3088.
  32. Gabel K et al. Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: a pilot study. Nutr Healthy Aging. 2018;4(4):345-353.
  33. Sutton EF et al. Early time-restricted feeding improves insulin sensitivity, blood pressure, and oxidative stress even without weight loss in men with prediabetes. Cell Metab. 2018;27(6):1212-1221.e3.
  34. Koren D et al. Role of sleep quality in the metabolic syndrome. Diabetes Metab Syndr Obes. 2016;9:281-310.
  35. Chaput JP et al. Change in sleep duration and visceral fat accumulation over 6 years in adults. Obesity (Silver Spring). 2014;22(5):E9-12.
  36. Sweatt SK et al. Sleep quality is differentially related to adiposity in adults. Psychoneuroendocrinology. 2018;98:46-51.
  37. Huang T et al. Habitual sleep quality and diurnal rhythms of salivary cortisol and dehydroepiandrosterone in postmenopausal women. Psychoneuroendocrinology. 2017;84:172-180.
  38. Kline CE et al. Poor sleep quality is associated with insulin resistance in postmenopausal women with and without metabolic syndrome. Metab Syndr Relat Disord. 2018;16(4):183-189.

 

Sara Gottfried, MD

Sara Gottfried, MD is a board-certified gynecologist and physician scientist. She graduated from Harvard Medical School and the Massachusetts Institute of Technology and completed residency at the University of California at San Francisco. Over the past two decades, Dr. Gottfried has seen more than 25,000 patients and specializes in identifying the underlying cause of her patients’ conditions to achieve true and lasting health transformations, not just symptom management.

Dr. Gottfried is the President of Metagenics Institute, which is dedicated to transforming healthcare by educating, inspiring, and mobilizing practitioners and patients to learn about and adopt personalized lifestyle medicine. Dr. Gottfried is a global keynote speaker who practices evidence-based integrative, precision, and Functional Medicine. She has written three New York Times bestselling books: The Hormone Cure, The Hormone Reset Diet, and her latest, Younger: A Breakthrough Program to Reset Your Genes, Reverse Aging, and Turn Back the Clock 10 Years.

Annalouise O’Connor, PhD, RD

Dr. Annalouise O’Connor is the R&D Manager for Therapeutic Platforms and Lead for Cardiometabolic and Obesity platforms at Metagenics. Her role involves research coordination, as well as developing formulas for targeted nutrition solutions and programs to assist practitioners in the optimal management of their patients’ health. Annalouise trained as an RD and worked in clinical and public health settings. Dr. O’Connor completed her PhD in the Nutrigenomics Research Group at University College Dublin (Ireland) and postdoctoral work at the UNC Chapel Hill Nutrition Research Institute.

 

Dr. Laura: Can Fasting Heal Auto Immune Disease?

Fasting is known to initiate cellular clean-up, reduce inflammation, heal leaky gut and reset the immune system. What better formula could we ask for when it comes to autoimmune disease?

Can Fasting Really Help AutoImmune Suffering?

After a recent talk at Goodness Me! I did on the safety of fasting, I was left with more questions on how fasting could help those suffering with autoimmune conditions like multiple sclerosis, Sjogren’s, celiac, diabetes type I, Hashimoto’s thyroiditis, ulcerative colitis, psoriasis and rheumatoid arthritis.

In the interim I have played with intermittent fasting over the past couple of months and my body says “thank you!” My digestion has not been this good for years and the persistent scalp psoriasis has all but disappeared. Even when I eat tomatoes, a common trigger for me. It seems anacdotal, however fellow colleagues in the the functional medicine industry like Mark Hyman, Amy Myers, and Courtney Sperlazza all agree.

What Kind of Fasting?

There are many kinds of fasting. We fast when we exclude a single food or types of foods from our diet. So the 30-day reset with no grains, sugar or dairy is a type of fast. This is a good start. The Ketogenic diet is a type of fast too. A Keto diet for a while may be helpful because it switches the body from a carb burning engine to a fat burning engine. But here I am talking about intermittent and more extended fasts to give complete
digestive rest
. When the body is not busy digesting and sorting out where to use or store the blood sugar, it can focus on cellular clean up and repair. Of course when you do eat, nutrient dense foods are a must because you are eating less overall and will need to pack the nutrients you need into less meals. If you are sensitive to foods, like tomatoes, dairy, wheat and sugar for me, that doesn’t mean I go back to eating them all the time. If at all. My excuse was I was in beautiful Italy and learning to make a succulent Bolognese sauce.

Can Anyone Fast?

No. Fasting isn’t for everyone. Not for children or pregnant mothers, those who are malnourished or those with anorexia or bulimia – that’s just playing with fire. Fasting also has to be monitored if you are on medications or have certain medical conditions. Medical complications include gout, cardiac arrhythmia, and postural hypotension.

How Long to Fast?

There is nothing written in stone about the perfect length of fast. And if you ever feel nauseous, dizzy or unwell you should eat. This isn’t about starvation. It’s about digestive rest. It’s about resetting insulin sensitivity and the immune system. Also, we know where the food is and have access to it if we need it. So it’s not starvation.

What Foods are Allowed?

As I mentioned above there are no real rules and there are many different  types and lengths of fasts. If you are on the thinner side and can’t stand to loose some weight, then you better consider bone broth fasts, where there are some nutrients and fat going in. If you have a little loving around that waist line, you likely can feed off that for a while and have coffee, tea and of course LOTS OF WATER.

For more information on whether fasting is right for you, and how to do it, book an appointment with Dr. Laura M. Brown ND. 519.826.7973.

 

Dr. Laura: How does your thyroid function?

Feeling tired, loosing hair, bring fog, brittle nails, constipated,  periods heavy and cholesterol rising? Perhaps your thyroid is to blame.

What does thyroid hormone do?

Thyroid hormone keeps:

  • our metabolism humming
  • hair and skin smooth and silky
  • muscles and tendons well lubricated
  • mood bright
  • digestion moving along
  • brain firing on al cylinders
  • LDL cholesterol at healthy levels

How do you measure thyroid function?

General practitioners assess Thyroid Stimulating Hormone (TSH), and if it is out of range, T4 and T3 is measured. Sometimes an ultrasound is done to visualize the size and health of the gland, to assess nodules or help diagnose thyroid cancer.  Naturopathic doctors, functional medicine doctors and endocrinologists will be more likely the ones to run a full thyroid panel (freeT4, freeT3, TSH, TPO, Anti-Thyroglobulin and reverse T3).

How does the body naturally balance thyroid hormone?

T3 is the active hormone in the body and is made from T4. Although the T4 is made in the thyroid, conversion to T3 happens mostly in the liver and the gastrointestinal tract.   A normal functioning thyroid gland works with the hypothalamus in the brain using a negative feedback system to indicate when there is enough active thyroid hormone in the system.

How does the medical doctor balance thyroid?

Traditionally synthroid or levothyroxine is prescribed to treat inadequate levels of thyroid hormone and treatment is geared to reach a desired TSH level. Direct T3 therapy (Cytomel) is rarely prescribed due to lack of research and clinical experience. Typically the family doctor will  treat to normalize the TSH, but recent research, and numerous patient complaints may indicate that this is not enough.

More research is required to support T4 and T3 combination therapy, whether it is levothyroxine plus cytomel or natural desiccated thyroid, alone or in combination.

Research finds TSH monitoring is not enough to determine adequate thyroid functioning and some medical doctors agree a 4:1 ratio of T4:T3 predicts patient satisfaction and better health.

What does the naturopathic doctor do to balance the thyroid?

Naturopathic doctors seek to support the thyroid in making T4 and the body’s ability to convert the T4 to the active form of thyroid known as T3.   A naturopathic doctor offers support to people on pharmaceuticals like synthroid or levothyroxine, and is also able to additionally or solely prescribe advice for nutraceutical  support and natural desiccated thyroid.

A naturopathic doctor will:

  • look at the full thyroid panel
  • adrenal health
  • cholesterol panel
  • sex hormone health
  • the function of the liver
  • health of gastrointestinal tract,
  • nutrient balance of things like selenium, zinc, iron and iodine

How is cholesterol linked to thyroid function?

T3 levels are also inversely linked to LDL Cholesterol. When thyroid levels are low, LDL cellular reception is reduced, leaving more LDL in the blood stream.  Emerging research finds treatment with T4 alone (synthroid, levothyroxine) does not always correct the high levels of cholesterol induced by poor thyroid function. Rising levels of LDL cholesterol in peri-menopausal women with symptoms of fatigue should trigger an investigation into the balance of T4 and T3, not just TSH.

What drives T3 levels down?

  • Body shuttles T3 to reverse T3 in times of starvation and stress
  • Poor feedback function in the hypothalamus
  • Thyroiditis
  • High levels of natural and environmental estrogens
  • Epstein Barr Virus

T3 levels are increasingly challenged as xenoestrogens (environmental contaminants) rise in developed countries.  Peri-menopausal women also experience challenges. This is because estrogen (unopposed by progesterone as ovulation slows down), or estrogen mimickers like xenoestrogens (from plastics, pesticides and insecticides) have the ability to bind up Thyroid Binding Globulin and somehow affect the T4 to T3 conversion ratio. Some research points to Epstein Barr Virus impacting the genome and ultimately the function of the thyroid.

For more help optimizing your thyroid function, book an appointment with Dr. Laura M. Brown, ND.

 

Dr. Laura: 21 Reasons You Might be Constipated

Bowels that move slow or are difficult to pass are not only uncomfortable, they are unhealthy. It is important we eliminate from our bowels at least once, and up to three times per day. Constipation is an issue affecting up to 20% of the population(1).

When the stool stays in the colon for extending lengths of time, toxins and hormones that have been packaged and processed for elimination are at risk for re-absorption back into the body. Not passing stool frequently enough will lead to a feeling of toxic overload.

What is constipation?

  1. Irregular bowel movements
    1. Pass less than 3-5 stools per week.
  2. Difficulty passing stool.
    1. Hard stool, requires straining,
    2. Insufficient, unsatisfactory, incomplete stool

21 Reasons You Might be Constipated

  1. Diet lacks fibre and vegetables
  2. Diet too high in proteins and carbs, especially in sugar & starch
  3. Dairy or wheat sensitivity
  4. Too much dairy (cheese)
  5. Other food sensitivities
  6. Insufficient microflora
  7. Dysbiosis (overgrowth of the wrong kinds of bacteria in the intestines)
  8. Small Intestinal Bacterial Overgrowth (SIBO) (root cause may be hypothyroid and migrating motor complex)
  9. Hypothyroid affecting the migrating motor complex
  10. Lack of regular daily exercise
  11. Insufficient water intake
  12. Supplements such as iron, calcium
  13. Overuse of laxatives
  14. Side effects of prescription drugs- painkillers (opioids), anti-depressants
  15. Irritable bowel syndrome or diseases
  16. Colon cancer
  17. Stress
  18. Pregnancy
  19. Diabetes mellitus
  20. Hemorrhoids
  21. Nervous system disruption as in spinal cord lesions, MS & Parkinson’s.

Best ways to “get moving” –> relieve your constipation

Laxatives are okay occasionally. Too much use will lead to dependence, which is not how nature intended and don’t fix what’s really happening. Have a look at some of the possibilities of what may cause constipation and see what you can correct. Dr. Laura M. Brown, ND can help you access and interpret many different types of testing.

References:

  1. Portalatin M, Winstead N. Medical Management of Constipation. Clinics in Colon and Rectal Surgery. 2012;25(1):12-19. doi:10.1055/s-0032-1301754.

Dr. Laura: 5 Major Factors in Menopausal Weight Gain

Menopausal weight gain is troublesome and annoying.

Menopausal weight gain can increase risks for cardiac events and insulin dysregulation.

5 Major factors in menopausal weight gain:

  • Genetics
  • Sex hormone changes
  • Sleep
  • Depression
  • Stress
  • Diet

Figure out what’s going on in your body!  Learn how hormone levels, including the thyroid estrogen and progesterone, sleep hygiene, physical activity, diet and stress play a role in menopausal weight gain.

Sex hormone changes trigger menopausal weight gain

  • When the years leading to menopause set in, ovulation slows down before it stops. Ovulation is required before progesterone can be released. If you don’t ovulate, it creates irregular balances of estrogen and progesterone in the body.
  • Chemicals like BPA (plastics), cadmium, phthalates (soaps, detergents), and pesticides contribute to estrogen dominance.
  • Low progesterone against pre-declining estrogen makes for relative estrogen excess compared to progesterone. This means estrogen dominance for a time.
  • Estrogen dominance leads to poor thyroid hormone availability, reducing metabolism
  • If thyroid function is sluggish, this leads to poor estrogen clearance, more estrogen builds up in the body
  • Poor thyroid function can lead to weight gain and increase in LDL cholesterol. Elevated LDL cholesterol is linked to increase risk in cardiovascular disease.
  • As menopause progresses, estrogen declines. Estrogen decline leads to deposition of fat around the mid section.

Contributing factors to thyroid dysfunction:

  • Sagging adrenals (chronic stress)
  • Estrogen dominance
  • Low iron, selenium, iodine or zinc
  • Poor liver function
  • Poor intestinal flora.

Factors in sleep disturbance that contribute to menopausal weight gain

Poor sleep leads to disruption in balance of hormones and time for healing in the body. Lack of sleep itself can contribute to weight gain. The years of menopause are riddled with hurdles to a good night sleep:

  • decline in estrogen can disrupt sleep due to hot flushes
  • Hormone rhythm imbalance from changes in LH, FSH, estrogen and progesterone are thought to contribute to disrupted sleep patterns.
  • From a Chinese Medicine point of view, the Liver Yang rises in menopause, which explains why the sleep is typically disrupted between the hours of 1-3 am. This is why, naturopathically, we look to calm the liver, cool the body and build Yin. Acupuncture and specially blended plant medicines can be very helpful.
  • sleep apnea (in you or your partner) more prevalent in those who are overweight
  • too much technology before bed, or worse yet, in the bedroom inhibits natural melatonin let down. Relative excess of cortisol as it is unopposed by melatonin disrupts sleep and contributes to midsection weight gain

Factors in depression that contribute to menopausal weight gain

Low mood and lethargy generally lend to poor motivation for exercise and healthy habits, which leads often to weight gain.

Here are some common factors in depression and menopause:

  • declining estrogen
  • sluggish thyroid
  • poor nutrient intake
  • imbalance in the intestinal bacteria
  • inflammation in the brain (usually as a result of imbalance in the intestinal bacteria)

How  Stress Relates to Menopausal Weight Gain

In menopause, the ovaries retire and  hand over their hormone duties to the adrenal gland. This is why it is important to support the adrenals at this time. How healthy the adrenals are will dictate how well our bodies will manage the stress and the change in hormone levels. Areas we may not think about in stress that could contribute to adrenal fatigue:

  • sleep disruption
  • inflammation from infections, intestinal dysbiosis, autoimmune conditions
  • too much or too little exercise
  • poor eating habits
  • conditioned stress response (post traumic stress disorder)
  • relationships with others
  • alcohol intake
  • medications and drugs
  • overwork
  • not enough fun & play time

How diet affects menopausal weight gain

  • Generally with age, metabolism slows down and less caloric intake is required. If activity slows or stays the same and intake is not adjusted, subsequent weight gain is likely.
  • Our intestinal tract flora changes as we age, and this changes how estrogen is metabolized.

It is evident that menopausal weight can happen for a lot of reasons. Some of it is a bit of a chickened an egg, like the estrogen dominance and poor thyroid function. It doesn’t matter what comes first, but if not corrected, they build on one another.  A naturopathic doctor’s role is to look at the individual as a whole, remove obstacles, rebuild the body and stimulate natural mechanisms of healing. Women who maintain a healthy habits, hormones and weight will help stave off risks for osteoporosis, cardiovascular disease and cancer.

Solutions to menopausal weight gain include healthy diet, exercise, sleep hygiene, hormone balancing with acupuncture and plant medicines, nutritional and hormonal supplementation.

Dr. Laura M. Brown, ND

References:

Jung SY, Vitolins MZ, Fenton J, Frazier-Wood AC, Hursting SD, Chang S. Risk Profiles for Weight Gain among Postmenopausal Women: A Classification and Regression Tree Analysis Approach. Hsu Y-H, ed. PLoS ONE. 2015;10(3):e0121430. doi:10.1371/journal.pone.0121430.

Franklin RM, Ploutz-Snyder L, Kanaley JA. Longitudinal changes in abdominal fat distribution with menopause. Metabolism. 2009 Mar; 58(3):311-5.

Gietka-Czernel M. The thyroid gland in postmenopausal women: physiology and diseases. Przegla̜d Menopauzalny = Menopause Review. 2017;16(2):33-37. doi:10.5114/pm.2017.68588.

Van Pelt RE, Gavin KM, Kohrt WM. REGULATION OF BODY COMPOSITION AND BIOENERGETICS BY ESTROGENS. Endocrinology and metabolism clinics of North America. 2015;44(3):663-676. doi:10.1016/j.ecl.2015.05.011.

Williams LT, Hollis JL, Collins CE, Morgan PJ. The 40-Something randomized controlled trial to prevent weight gain in mid-age women. BMC Public Health. 2013;13:1007. doi:10.1186/1471-2458-13-1007.

Zheng Y, Manson JE, Yuan C, et al. Associations of Weight Gain From Early to Middle Adulthood With Major Health Outcomes Later in Life. JAMA. 2017;318(3):255-272. doi:10.1001/jama.2017.7092.

Karvonen-Gutierrez C, Kim C. Association of Mid-Life Changes in Body Size, Body Composition and Obesity Status with the Menopausal Transition. Parthasarathy S, ed. Healthcare. 2016;4(3):42. doi:10.3390/healthcare4030042.

Dr. Laura: Root Cause Medicine

Root Cause Medicine

 

How do you get to the root cause of your health problems?

Welcome a medical professional who:

  • Goes over the underlying patterns identified in your recent blood work, imaging and lab reports.
  • Considers laboratory values within ranges and patterns to achieve optimal health, not necessarily waiting until there is frank disease.
  • Collects a detailed health history.
  • Reviews medication side effects
  • Performs an in-clinic physical health screen to look for patterns of cellular health deficits and nutritional decline.
  • Appreciates a medical consideration of how your body, emotional, cognitive and spiritual systems orchestrate and integrate.
  • Knows how to guide you to use food and plants as medicine.

 

Doctor as Teacher

You, at any time, can ask questions. Learn about your condition so you can make an informed decision about your health. You are living in your body 24/7 – so it’s your temple abode. You help your practitioner understand your experience and your practitioner helps you understand why you might feel the way you do.

It is not a one or the other mentality.  You may choose to see your family doctor, your specialist and your naturopathic doctor.

The fist appointment with a naturopathic doctor is about an hour. Based on what is discovered in the first appointment, a treatment plan is created. Things like sleep hygiene, understanding how stress affects the body, diet tips and detoxifying naturally are a part of the general plan, made are made specific to the individual needs.

Recommendations for further testing may be made. Further testing may include things like comprehensive hormone panels, stool analysis, organ system testing, organic acid testing, genomic, nutritional or cardiac profiles, food sensitivity analysis or environmental toxicity.

You may choose to engage in a specific program which helps stimulate your body’s natural mechanisms of healing. These programs may be executed in follow-up sessions that last about 30 minutes and may take place once a week for 4-6 weeks, or may be spaced out more or less, depending on the needs of the individual.

Upcoming Free Educational Seminars

Location: Goodness Me! Guelph

Wednesday April 25, 6:30-8:00pm Simplifying Stress

Wednesday May 16,  Beautiful Botanicals

Wednesday June 13, GUT Circadian Rhythm

Dr. Laura M. Brown ND is a Naturopathic Doctor with a Functional Medicine approach. She is a Certified Gluten Practitioner, a HeartMath Certified Practitioner and is a graduate of Adapt Level 1 at Kresser Institute of Functional Medicine. Essentially, Dr. Brown helps people better digest their food and the world around them. www.forwardhealth.ca

 

Dr. Laura: Is your thyroid to blame?

One in eight women will develop thyroid disease in her lifetime and 15 Million women have a dysfunction, but don’t even know it. Men can have issues too, although at a less rate than women.

Environmental toxins are largely to blame for the rising rates of thyroid disease. Years ago, it was mostly iodine deficiency and this is why iodine was added to salt. Now we point the finger more often at the rising rates of hormone mimickers in our environment like BPA’s and their alternatives in plastics, cadmium, circadian light disrupters, pesticides, herbicides and more.

Untreated thyroid dysfunction can lead to feelings of:

  • Fatigue and exhaustion
  • Brain fog, difficulty focusing thoughts
  • Unexpected weight gain, and with it increased risk of obesity, diabetes, and heart disease
  • High LDL cholesterol – the thyroid plays an important role in fat metabolism
  • Depression – as many as 15% of women on antidepressants have an undetected thyroid problem as the root cause of their depression –but their problem hasn’t been fully investigated. When I check thyroid I check more than the TSH (thyroid stimulating hormone).  I look sub functioning gland by checkin TSH, T3, T4, thyroid antibodies and look for how well cortisol is clearing on the DUTCH hormone test.
  • Anxiety – often because cortisol is not clearing
  • Increased risk of cardiac arrhythmias and congestive heart failure due to the regulatory control of this hormone has on heart rate and rhythm.

Troubles in the digestive track and liver can lead to poor activation of the T4 to T3 hormones. When I work with patients I am always looking for clues in the skin, stress, and sleep and how well the micro biome functions. A good clue to micro biome function is the Comprehensive Stool Analysis by Doctors Data.

If you suspect you may have a thyroid issue, get it tested!  I’ll look at results from a functional medicine perspective, which mean optimal performance, not disease levels of lab markers.

From the heart and research of Dr. Laura M. Brown, ND.

Dr. Laura: Micro biome linked to fatigue, insomnia and hormone regulation

Did you know? You can fix your fatigue, insomnia, and hormones by focussing on your flora. Find out how and why your gut affects your biorhythms in the next complimentary seminar with Dr. Laura M. Brown.

The GUT-Circadian Rhythm Connection

Dr. Laura M. Brown, ND, is a licensed naturopathic doctor, Certified HeartMath Practitioner, Ceritified Gluten Practitioner and has a Functional Medicine approach in her practice. What she really does is help people better digest their food and the world around them.

Wednesday, July 12th 6:30-8:00pm @ Goodness Me

Register Now!