by Dr. Talia Marcheggiani, ND | May 16, 2015 | Autoimmune, Beauty, Diet, Digestion, Education, Food, Food Sensitivities, Hair, Health, Hormones, Natural Body Care, Nutrition, Self-care, Women's health
This is likely one of the shallowest posts I’ll ever write—it’s about hair. However, what is so shallow about hair? We all know the importance of having a good hair day. It seems from the moment we wake up, look in the mirror and notice that our top bun has left proper, succulent waves and not weird, irregular angles of frizz, that the rest of the day will be infused with magic. Our hair plays a huge role in who we are and how we see ourselves. When movie characters want to change their identities, the first thing they do is stash themselves in a truck stop bathroom with a box of hair dye and go to town on their manes. Further, and admittedly sticking to the shallow side of things, I’m often suspicious when every photo of a man on Ok Cupid shows himself wearing a hat—what on earth is he hiding? At any rate, concerns about hair health gets people, namely women, into my office. Sometimes seemingly shallow, trivial health concerns act as gateways to lifestyle changes and a journey to health and wellbeing. Since our bodies don’t really require hair for survival, hair health, along with sex drive and energy, is one of the first things to decline when we enter into a state of imbalance. It therefore becomes an important initial warning sign that things have gone array with our health.
Hair holds a significant place in our self-perception and daily routines, often influencing our confidence and identity. When hair health falters, whether due to genetics, hormonal changes, or lifestyle factors, individuals may seek solutions like Hair Restoration Therapy to regain a sense of normalcy and well-being. While the desire for lush locks may seem superficial to some, it often serves as a catalyst for deeper introspection and lifestyle changes, underscoring the interconnectedness of physical appearance and overall health.
Hair loss is often a concern for many women and men. It’s normal to notice a few strands of hair in the shower—the average woman loses about 50 to 100 strands of hair per day. However, when patches of hair seem to be missing, areas of thinning are present or a reduction in overall hair volume (usually indicated by a decrease in thickness of the pony tail), this can point to possible pathological hair loss.
In the quest to address concerns about hair loss, the choice of shampoo becomes a crucial element in maintaining scalp health. Opting for a sulfate free shampoo for oily scalp emerges as a thoughtful strategy to navigate this common challenge. This type of shampoo not only gently cleanses the hair but also ensures that the scalp’s natural oils are preserved, striking a balance that is particularly beneficial for those experiencing issues like thinning or reduced hair volume.
While losing a few strands daily is normal, unusual patterns of hair loss can signal pathological conditions that may require medical attention.
History and Labs:
When coming in to see your naturopathic doctor, he or she may ask you the following questions:
Do you notice any itchiness or flaking of the scalp? These symptoms could indicate a number of skin conditions of the scalp that contribute to hair loss: seborrheic dermatitis, infection by a fungus called Malassezia furfur that causes dandruff, or psoriasis of the scalp, an autoimmune condition. The ND may diagnose via trial-and-error or perform skin-scraping to rule out a fungal infection. A skin biopsy may be indicated to provide a definitive diagnosis, however this test is invasive.
What do you labs look like? Comprehensive lab work is necessary in patients with hair loss. It’s important to see what iron status is, as well as thyroid health. Low iron or under-functioning thyroid can be the root cause of hair loss as can high androgens, the male sex hormones.
Which medications are you taking? Oral contraceptives can cause a deficiency in vitamins and minerals, such as zinc and B vitamins, that can cause hair loss. Other medications that can cause hair loss include, and or not limited to, blood pressure medications, antidepressants, antibiotics, acne medications, chemotherapeutics agents, immunosuppressants and pain medications. An ND can work with your doctor to decrease your list of medications by addressing the root cause of concerns, if possible, or collaborate in switching medications. This, of course, will only be done in collaboration with the prescribing doctor.
What’s bugging you? Stress can contribute significantly to hair loss. The mechanism of action is varied, but a decrease in circulation to the scalp, protein deficiency and depletion of vitamins used by the adrenal glands, can be possible causes of hair loss. Telogen effluvium is a condition where the body pushes the hair follicles into a “resting phase” so that they no longer grow and produce hair. This is done because when under stress, the body enters survival mode and does not dedicate precious resources to non-survival entities such as hair health. Alopecia areata an autoimmune condition in which the immune system of the body attacks the hair’s follicles, causing large patches of hair to fall out. This is said to be cause or aggravated by severe stress. Trichotillomania is a mental health condition in which the individual plucks out hair as a self-soothing mechanism.
What are you other symptoms? Weight gain, irregular periods, acne and hair growth on the face can indicate PCOS, which also can cause loss of scalp hair due to higher-than-normal testosterone levels. Men with high testosterone will also experience more hair loss. Digestive symptoms can indicate malabsorption of important fat-soluble vitamins or iron, which can contribute to hair loss if resulting in deficiency.
What hair products do you use? A sensitivity to sulphates and/or other chemical additives to hair products can contribute to hair loss or a decrease in the lustre and overall health of hair follicles.
Treatment:
The naturopathic treatment for hair loss, involves identifying and treating the root cause of symptoms, not the hair loss itself. A potential treatment plan might consist of the following:
Restoring health by replenishing depleted or deficient vitamins and minerals.
Eliminating infection or scalp fungus if necessary.
Managing stress in healthy, constructive ways.
Balancing hormones and the immune system via herbs, supplements and dietary changes.
Nourishing the hair by adding in vitamins that support hair health, such as fish oil. This also involves changing shampoos and conditioners to more natural, sulphate-free forms.
Castor oil hair mask:
Once a week, when my hair starts looking drier and duller, I do a castor oil hair mask and scalp massage. Castor oil is an anti-fungal and anti-inflammatory oil. It has the added benefit of increasing blood flow to the area it is applied to, in this case the scalp, which can increase hair growth. It is also a wonderful moisturizer and nutrient-rich hair supplement. It can help fuse together and moisturize split ends. Performing a self-scalp massage is a great way to increase body love by performing self care and has a grounding effect on the body, which reduces mental-emotional stress.
Apply a liberal amount of castor oil to palms. Rub oil into palms to warm it. Starting at the scalp, work oil into the hair follicles, applying a firm pressure and moving the fingertips in circles. Massage for 5 minutes, moving the oil through the shaft of the hair to the ends. After performing massage, leave oil in hair for at least an hour or overnight. Finally, shampoo and condition hair as usual to remove oil. Warning: castor oil can stain fabrics so sleep with an old pillowcase and wear an old t-shirt while performing castor oil scalp massages.
Epilogue: If you haven’t noticed, this seemingly shallow subject matter is the perfect segue into talking about a basic naturopathic approach, which involves taking a thorough history, ordering lab work to find the root cause of symptoms and then treating accordingly using non-invasive therapies that aim to treat the cause, not just the symptoms themselves. Notice how this is vastly different from walking into a supplement store and purchasing a product called “Hair Loss Formula” or some other facsimile. While this formula may replenish some deficient vitamins, it is masking the real cause, which may be PCOS or celiac disease, and delay effective treatment for these conditions. Hopefully this highlights the importance of seeking a professional opinion rather than self-diagnosing and self-prescribing!
by Dr. Talia Marcheggiani, ND | May 8, 2015 | Balance, Canadian College of Naturopathic Medicine, Clinic, doctor as teacher, Emotions, Finding yourself, Personal, Reflections
It seems like the only thing I can focus on right now is negative space.
Like the obsession with the space between a model’s waif-like thighs, affectionately termed the “thigh gap”, I have seemingly been attributing way too much time and attention to the lack of things in my life. Life is up in the air right now—a freeze-frame of dust particles that someone has stirred up, and we all wait breathlessly to see where they will settle on the ground.
That’s it: I feel unsettled.
And this unsettled feeling has the tendency to sharpen the focus on the things I don’t have in life. The search doesn’t need to go far. I lack stability in my career, a romantic relationship, my own apartment—the typical signs that life is moving forward. I don’t know what two months will bring, let alone the next few years and, as someone who spent all but two years of their waking adult life in academia, not having a future laid out before them in the form of assignments, tests and other externally imposed milestones leaves me feeling uncontained. There is no one conducting evaluations on my life but myself.
And what an astute evaluator I’ve become:
How am I doing? The best way for the masochist to answer this question is to look at how other people are doing. There are plentiful points of comparison if I want to feel fully inferior. Everyone seems to have more patients than I do, nicer apartments and fulfilling relationships. They seem to be moving somewhere. I just feel stuck, not at a crossroads, but at the edge of a cliff. Am I just supposed to jump? Did everyone else jump? Or did they end up hitching a ride on some lucky parachute that happened to pass by a few minutes before me? Why are they lucky? What are my eyes closed to? When will it be my turn? Or am I simply cursed? The mind stirs up more dust. Sense of personal injustices prevail.
This unsettled feeling can’t last.
So I strive. The answer must lie in working harder. After all, it’s what we’re told to do. Push on. Move forward. Just do it, as Nike says, sweat beading on foreheads. There’s always sweat beading on the foreheads of the mentally unsettled.
I hand out business cards, but no one calls me. I try calling them. I look for other jobs that are poor fits. I take more shifts at the day-job I’m holding on to for secure cash. I go to business networking meetings that I don’t connect with and try to convince myself that I should just force myself to make it work. I search desperately for an apartment, and despair when I don’t get the one I finally love. I hold on to past relationships well past their due dates and complain and obsess and analyze what went wrong to my friends, whose patience can’t possibly last much longer. I notice myself compromising my values and dreams in order to get away from the edge of the cliff.
Still I get nowhere.
So I turned to the only thing I know how to when the mind is desperate and despairing and the spirit is looking to the future for salvation—I turn to the present. The dust in up in the air, so to speak. Everything is unsettled. And yet, how am I? I’m more or less alright. I’m warm. I’m fed. I’m rested. My plight is ridiculous when compared to tiny Vietnamese hands sewing buttons on Banana Republic blouses. Who taught me this sense of entitlement?
I have a place to live and some money coming in (the longer it takes me to find an apartment, consequently, the more I end up saving). I have friends who are genuinely concerned about me and a generous, loving and supportive family. I have hobbies and social events to attend. The blessings in my life are numerous.
Why am I so intent on speeding down the highway of life? What will happen when I arrive at my destination? When I have a beautiful apartment, patients booked months in advance, when I’m in a wonderful, loving and passionate relationship with someone who inspires me, what will I do then? Once the dust is settled, won’t I eventually, decide to stir it up again? If I can’t be content in the present, when will I ever find that elusive contentment that always seems to slip out of our grasp?
Most of all, I ask myself, what is behind my longings? Are the reason I long for these things pure? Or, like a perfume or Coca-Cola ad, do I really want what’s behind what they’re selling me: the beauty, enchantment, lightness, freedom and magic that life often promises us but we seldom encounter in the places we’re told to look.
I wonder if, with eyes closed and mind settled, I’ll be able to breathe clear air again. Perhaps then I’ll find a path down from this cliff, a creative alternative to the already available options: jumping, backing down or sitting and waiting for a magical parachute to come and save me.
Between all the wants, needs, dreams and aspirations, between the striving is space. In that space I might find a little room to breathe. But who can really breathe with dust in their lungs?
by Dr. Talia Marcheggiani, ND | Apr 21, 2015 | Botanical Medicine, cancer, Detoxification, Diet, Endocrinology, Fertility, Food, Health, Mental Health, Nutrition, Skin health, Weight Loss, Women's health
Estrogen is the dominant female hormone. It is actually a group of hormones, called the estrogens, that are responsible for the development of female secondary sex characteristics: the development of breast tissue and the proliferation of the uterine lining. Estrogen helps prepare the body for ovulation. Not all estrogens are created equal, however. Some estrogens are associated with an increased risk of certain female cancers, such as breast cancer.
Excess estrogen, especially in the form of these so-called “bad” estrogens, seems to be a common theme among women in North America. Stress, caffeine intake, synthetic estrogens in birth control pills and hormone replacement therapy and xeno-estrogens from cleaning products, plastics and cosmetics are among some of the causes of excess levels of estrogen in the body. Because of these environmental factors, many women suffer from something called “Estrogen Dominance”.
Symptoms of estrogen dominance include stubborn weight gain, anxiety, premenstrual symptoms of breast tenderness, acne, irritability, fatigue and brain fog. Estrogen dominance can contribute to worsening of health conditions such as infertility, fibrocystic breasts, repeated miscarriages, uterine fibroids and endometriosis as well as increase the risk of developing certain cancers.
Estrogen detoxification can be done effectively through a healthy diet that aims at improving estrogen clearance in the liver and regulation of the action of estrogen at cell receptors. By following this diet, patients can experience an improvement in hormonal health conditions, clearer skin and weight loss.
This diet is adapted from Dr. Joseph Collins RN, ND at yourhormones.com.
Cruciferous vegetables: Vegetables from the cabbage family, such as cabbage itself, cauliflower, broccoli, brussel sprouts, kale, bok choy, spinach, collard greens and other leafy greens are rich in a nutrient called indole-3-carbinol, or I3C. I3C gets converted to diindolymethane (DIM) in the body, which is responsible for clearance of excess estrogens in the liver. Consume a minimum of 3-4 servings of these vegetables per week.
Rosemary: Rosemary, when added to meats as a seasoning enhances the formation of good estrogens (the ones less likely to cause cancer or health concerns). Rosemary has the added benefit of antioxidant activity. It also enhances memory and mood and helps with thyroid function, improving weight loss, metabolism and energy levels.
Flaxseed: 2-4 tablespoons per day of ground flaxseed promotes healthy estrogen metabolism. The seed contains lignans, which help clear excess estrogens from the body. Flax also contains phytoestrogens, which control how much estrogen can bind to estrogen receptors. This means it can decrease excess estrogen activity or increase deficient estrogen activity, making it an effective remedy for a variety of female health complaints. Flax is rich in healthy omega-3 fats and contains fibre, making it an important remedy for treating inflammation and constipation. Flaxseed is digested and absorbed when ground, and best stored in the fridge as the oils in the seed quickly go rancid at room temperature.
Salmon and other fatty fish: Salmon and other fatty fish contain EPA, an omega-3 fatty acid, is an important anti-inflammatory oil. It has been shown to be effective in treating inflammatory conditions, cardiovascular disease and mental health conditions, such as depression, anxiety and ADHD. It helps increase the formation of “good” estrogens in the body. Enjoy 2-3 servings of fatty fish per week, or supplement with a quality fish oil.
Isoflavones: Isoflavones, such as those found in soy, are antioxidants effective at increasing good estrogens in the body. Since soy is often heavily processed, using herbs such as Trifolium pratense, Pueraria montana and Pueraria lobata either in teas, capsules or tinctures, will help provide an adequate dose of isoflavones.
Activated folic acid: Folic acid is responsible for converting estrogen into a very healthy, methylated form that can decrease the risk of certain cancers. Many people are unable to convert folate into the active 5-methyltetrahydrofolate, which is essential for hormone metabolism, DNA synthesis, homocysteine metabolism and nervous system function (good mental health, memory and energy). Other B vitamins to supplement with are B6 and B12 as they help folic acid metabolism estrogen into their anti-cancer form. Folic acid is found in dark leafy greens, which also contain your daily doses of indole-3-carbinol.
If you are experiencing symptoms of estrogen dominance in the form of a female health complaint, book an appointment to learn what else you can do to experience healthy, happy, pain-free periods and look and feel your best. Contact me.
by Dr. Talia Marcheggiani, ND | Mar 31, 2015 | Alignment, Balance, Beauty, Chronic pain, Exercise, Fitness, Health, Mind Body Medicine, Physical Medicine, Yoga
When you go through an upsetting breakup with your boyfriend, the thing to do, apparently, is attend an Ecstatic Dancing workshop. The friend who invited me didn’t say much about it, except that it was, “a place to dance without being hit on.” Apparently the practice would cleanse my aura and allow me to vibrate with the rhythms of the universe. So, I thought, why the heck not.
The Facebook invite hilariously clarified the tone of the event with their tag: “No alcohol, no drugs, no talking. We dance barefoot.” I took a sip of my wine and clicked “Going”. I was sold.
I showed up wearing yoga clothes and a tunic I got from India so I would fit in. My friends and I were greeted by girls wearing headbands whose faces were frozen in an expression of ethereal ecstasy, as if they’d just heard white angels whisper in their ears. They cleansed our chakras with a sage smudging and offered us “elixirs” of green tea kombucha. I was in over my hippie head—it was exactly the kind of weird I needed.
We entered a church gym full of people wearing flowing clothing who were gaily unleashing their spirits to music. I became acutely aware of not knowing what to do with my hands. A girl there with wild, frizzy hair and a long sheer robe was twisting and turning like a branch in the wind. It was like she had no bones. She looked like a goddess. I remember thinking that, if I could dance like her, I would consider myself well on my way to spiritual integration.
Instead, my body seemed to be at the mercy of 29 years of awkward repression and self-resistance, most of which I carried in the form of muscle tension. However, I tried to overcome the trauma of grade 6 dances and let myself succumb to the barefoot madness. I let my body pulse to the music as best I could. I felt free.
There were a group of girls who obviously frequented these kinds of events, wearing what looked like thick elastic bands that wrapped around their torsos and legs. One of the girls in the group was built like a princess warrior. Her body was pure sinew and bones. She was doing something that looked like graceful backward cartwheels, her face a picture of calm focus. I wanted to be like her when my spirit grew up.
When the no talking rule was lifted, I approached her to find out her secret. I imagined it had something to do with the elastic bands she was wearing. Maybe they bore the secret of why she was so present in her physical body. (I’m sure it had nothing to do with the years of yoga practice she’d committed to). “It’s called the Body Braid,” She told me, when I asked what she was wearing. “It helps you maintain proper alignment. I wear it for an hour everyday and since getting it, it’s helped transform my body.”
While I wasn’t sure what her pre-braided body must have looked like, I wanted a piece of this alignment and freedom for myself. I wanted my body to transform! She looked like she was wrapped in a cushy elastic hug. Her shoulders were back and not curving inwards like mine tend to. I instinctively raised a hand to my left shoulder to massage out a constant knot I’d lugged around since my first week of medical school.
Alignment matters. Having a toned, healthy body requires our bones and muscles to be in the right place. If they’re not, which happens due to improper posture, repetitive movements, incorrect footwear and, of course, excessive sitting, we experience tightness, pain and an overall poor-looking physique. You’ve seen it before: slouched shoulders, a bend at the hips, neck craning forward—not very sexy. Alignment helps with lymphatic drainage and proper circulation. It helps with muscle toning. This braided yogi I was talking to was perfectly aligned. She looked like she was ready to pick up a spear and tear after a zebra through the savannah. I imagined her climbing trees, dancing freely under the stars and doing backflips on a whim. Standing next to her I felt doughy and slouchy in comparison. I didn’t like the feeling.
I wanted the Body Braid.
I found it on the internet for under $100. It was made in Canada and developed by a medical doctor. I immediately ordered one and a few weeks later it arrived. I figured it was cheaper than a series of massages.
The body braid is made of two intersecting elastic bands in black or white that are about 5 cm wide. The straps can be adjusted and are sized according to your height. An instructional video on their website shows you how to wrap the braid around your body with 4 wraps on each side, one under each arm, one around the hips, behind the knee and around the shin. The end of each wrap is secured under the feet like a stirrup.
Once I was finished wrapping myself in, I felt my shoulder press back, my thighs straighten and the arches of my feet lift.
I liked the buoyant, uplifting feeling. It was teaching my body how to be—I was hooked.
I had a date that night and seriously considered either cancelling or wearing the thing out to the bar. Both those options seemed far superior to separating myself from this magical feeling of elasticity and buoyancy. (I eventually did remove it to go on the date, but probably shouldn’t have bothered. Next time I know: always prioritize posture.)
Since buying it, I’ve worn it for yoga classes, exercise, going out for walks and sitting at the computer.
My postural goals are to align my shoulders and take some strain off of my lower back. I want to feel integrated and connected to my body. In the cerebral world we live in, our bodies are often simply viewed as tools to carry our skulls around. The Body Braid is helping to connect all the parts of me: physical, mental and emotional.
For more information: bodybraid.com
*Body Braid did not endorse me to write this blog. However, I really wish they had.
by Dr. Talia Marcheggiani, ND | Mar 24, 2015 | Balance, Diet, Digestion, Docere, Education, Fitness, Food, Health, Naturopathic Philosophy, Naturopathic Principles, Nutrition, Preventive Medicine
Many health complaints are common, but not normal.
“I take migraine medicine everyday,” boasted L. She then went on to describe her plenitful medicine cabinet that, at the age of 23, she’d stocked quite well. “I get headaches when the weather’s bad, when I forget my glasses, when I’m hungry-” she went on. I repressed my immediate impulse to give her a list of supplements she could take and dietary changes she could make to never have another headache again, and simply said, “Well, L, you know I have a practice in the West end. If you want any more support…You can call—”
“—No, I’m good”, she responded, hurriedly. “I just need to find out how to get more of my medication.” The medication she referred to was high dose acetominophen, or Tylenol. She was taking 1 g pills and her doctor had told her that she could dose up to 4 g per day. Since 4 g will cause immediate liver failure, I was happy to learn she hadn’t needed to get that high… yet. What’s more, she wasn’t treating the cause of her condition. She was just addressing the symptoms, and consequently negatively affecting her health.
To use the car dashboard analogy, when your fuel light comes on and makes a noise while you’re driving on the highway, what do you do? Most people, without giving it another thought, will pull over to address the root cause of the chaos by adding more gas to the car. Very few of us will take out a hammer and smash the dashboard in. In fact, most of us cringe at how ridiculous the thought is. Imagine the entire naturopathic community cringing when they hear about someone swallowing several grams of Tylenol to smash out their migraine.
Pulling the car over to refuel and smashing the dashboard both serve to stop the annoying blinking and beeping of the fuel light. One of them is addressing the root cause and actually paying attention to what your car needs. The other is, well… I’ll let you come up with an appropriate adjective.
So this begs the question: why do we insist on smashing our symptoms away? The fuel light may be annoying, but drivers value its presence as a tool to let us know that we need to refuel lest we end up stranded on the highway without gas. The blinking light lets us know what is going on inside our car.
Why don’t we view our body’s symptoms in the same way?
I have patients who think that their depression is a part of them, or that the painful distention under their belly buttons after eating is “normal”. Sometimes we identify with our physical ailments to the point where they define us, as if it’s our lot in life to have acne or poor digestion or to be overweight—it’s not.
Dandruff, painful menses, seasonal allergies, aches and pains are not “normal.” Sure, they’re common. No, they don’t necessarily mean you have some life-threatening disease, and therefore your family doctor probably doesn’t have a reasonable solution for them, besides smashing at them with the hammers in their toolbox from time-to-time.
When I saw my first ND, I was excited at the idea that, even though my doctor assured me that the random, annoying symptoms I was suffering from were “normal”, they were in fact not normal and something could be done about them. From the ND’s standpoint, the symptoms were an indication of budding imbalances and treating them was preventing more serious conditions down the line. Feeling cold all the time and excessively full after meals weren’t just annoying symptoms, they were important messages from my body that things weren’t all right and that something needed to be done.
Is there an annoying symptom you’ve been experiencing that you’ve come to accept as something you just have to live with?
Contact me to find out what we can do about it!
by Dr. Talia Marcheggiani, ND | Mar 19, 2015 | Creativity, Diet, Endocrinology, Exercise, Fertility, Health, Lifestyle, Medicine, Mind Body Medicine, Nutrition, Paleo, Sex, Sexual Health, Skin health, Weight Loss, Women's health
PCOS, or Polycystic Ovarian Syndrome, a condition which affects an estimated 10% of women in North America and is the most common endocrinological dysfunction in women.
Its symptoms and the people it affects are as diverse as there are people affected; it’s one of my favourite conditions to treat.
Signs and Symptoms:
PCOS is characterized by hormone dis-regulation. Oftentimes it presents with cysts on the ovaries, but not always. In PCOS there is often elevated blood glucose and other markers of insulin resistance. There are often issues with menstruation: the absence of periods (amenorrhea), or heavy and irregular bleeding (dysmenorrhea). Weight gain is common—although some women with PCOS can be thin—as is hormonal acne and hirsutism, a nice word for male-pattern hair growth: excess hair growth around the chin and upper lip, the chest or navel region. Pelvic pain around ovulation may occur when cysts rupture. Infertility is common in women with this condition.
PCOS is a syndrome, rather than a disease, which means it presents as a collection of symptoms that can be varied in their presentation and severity. Lab work may read that estrogen, testosterone and LH (a hormone produced by the pituitary gland and ovaries) are high and progesterone and FSH (a hormone released by the pituitary gland) are relatively low. However, what brings a woman with PCOS or PCOS-like symptoms into my office is varied and usually consists of any combination of visible symptoms: hair growth, weight gain, acne, menstrual irregularities or infertility.
Etiology:
We are uncertain how the collection of symptoms that is PCOS arises. One prominent theory is that issues with blood sugar and insulin regulation create ovarian cysts or disruptions in the secretion of sex hormones. This causes the ovaries to release more LH, which has the power to raise testosterone. High insulin, testosterone and estrogen can cause weight gain, hair-growth, acne, absence of ovulation (anovulation) and the inability to maintain the uterine lining and therefore carry a pregnancy to term.
Diagnosis:
PCOS is diagnosed by symptoms. It involves a combination of symptoms: amenorrhea (or absence of menstrual periods), infertility, hair growth on the face, acne and insulin resistance. The presence of ovarian cysts, as detected on an ultrasound were once diagnostic, but many patients present with symptoms and are cyst-free. An increase in LH and testosterone, with lab values indicating insulin resistance and metabolic syndrome, can also lead doctors to suspect PCOS, when appearing in conjunction with other symptoms.
Because it is a syndrome, patients often come into my practice with a variety of complaints. Some come in to deal with their skin health, others want help with fertility or menstrual cycle regulation and many others come in with weight loss goals.
Conventional Treatment:
Treatment in conventional medicine is simple: oral contraceptives. If your testosterone is high and estrogen and progesterone are out of whack, the conventional medical system tells us to simply override natural hormone production, or lack thereof, with synthetic versions of the same thing. For my professional opinion on regulating hormones with oral contraception, see my post on the birth control pill (which I no longer take). These birth control pills often contain chemicals that prevent the secretion of male hormones. This helps clear up acne and hair growth.
Medication for type II diabetes, Metformin, is used to help regulate insulin. Patients experience weight loss on Metformin, as it helps control insulin resistance, however it also depletes vitamin B12, which means that regular injections of B12 are necessary to avoid deficiency symptoms. Further, Metformin doesn’t address the root cause of insulin resistance, which is most likely lifestyle and hormonal imbalance. This means that patients will be medicated (and therefore receiving B12 injections) for life.
I do not mean to negate the fact that oral contraception and Metformin have helped countless women. I respectfully acknowledge the fact that the lens I look through is one of a different, more natural and whole-bodied approach to medicine that aims to treat the individual by addressing the root cause of disease.
In short: I prefer to try it the naturopathic way first.
Naturopathic Treatment:
Lifestyle. Naturopathic remedies are very effective, but often quite involved. They begin with lifestyle modifications—a low glycemic index diet like the Mediterranean or the Paleo diets, that emphasize whole foods, like fruits, vegetables, healthy fats and lean protein and eliminate sugar, white flours and white carbohydrates. Exercise is important in treating PCOS. One of my professors advocates intense cardio, such as high-intensity interval training, or weight-lifting 5-6 days a week. This must be done for several months before effects are seen and blood sugar and other hormones are regulated.
Supplementation and botanicals. Myo-inositol, a B vitamin, is a first-line treatment for PCOS in the natural health world. The amount of research steadily growing behind its use should probably make this gentle and effective treatment first-line for treating PCOS in all healthcare fields. Studies show that, when dosed properly, inositol can regulate blood sugar, assist with weight loss and regulate menses, even promote fertility.
Herbs like Vitex agnus-castus, or chaste tree, can help regulate the balance between estrogen and progesterone. Spearmint and Serenoa repens, or saw palmetto, can help decrease male hormones in the body. Gymnema and berberine are other therapies useful for regulating blood sugar and helping with weight loss.
Ensure that you are receiving counsel from a licensed naturopathic doctor before supplementing. The dose and quality of supplements and herbs is essential to feeling better—don’t hack it in the health food store alone!
Acupuncture. Acupuncture has been shown to be effective for promoting fertility. I have had some good success in promoting pregnancy and fertility with acupuncture in my practice. Fertility clinics in Canada now use acupuncture before and after IVF treatments to ensure treatment success. It also helps to relieve stress and lower cortisol, which helps with insulin-lowering and blood sugar management.
In Traditional Chinese Medicine, PCOS can manifest as dampness, Qi or yang deficiency or issues with the Spleen or Kidneys. Acupuncture can help tonify and balance these patterns.
Homeopathy. I have had success using homeopathy in conjunction with lifestyle and supplementation in treating PCOS. Homeopathy acts deeply on the energetic level of disease, working on the level of emotions and sensations and working to address the energetic cause of disease. It involves a thorough interview and an individualized prescription from a licensed naturopathic doctor or homeopath.
Mind-Body Medicine. The ovaries are located at the level of the second chakra, which is an energetic centre in the body associated with sexuality and creativity. Christine Northrup, MD, asserts that the presence of ovarian cysts represents an energetic blockage in our creative power and unmet emotional needs. Louise Hay, author of “You Can Heal Your Life” tells us that ovarian cysts represent some sort of past hurt that we can’t let go of. Crying, journalling and identifying repressed emotions can help to remove these energetic blockages. In many women with PCOS, there is an imbalance in the identification with their femininity, or what it means to be a woman.
Sometimes our bodies alert us of imbalances in our emotional lives through the presence of physical symptoms. As a naturopathic doctor, it is essential I address all levels of the person—mentally, emotionally and spiritually, not simply physically.
PCOS is a diverse and challenging condition to treat that can cause a lot of hardship for the women who suffer from it. However, a diagnosis of PCOS can be an opportunity for growth and transformative healing through naturopathic medicine. For this reason, I find it can be one of the most interesting and rewarding conditions to treat. Contact me to find out more.
by Dr. Talia Marcheggiani, ND | Mar 2, 2015 | Clinic, Community, Creativity, Finding yourself, Gratitude, Health, Patients, Private Practice
I wrote this post a few months ago while beginning my private practice. When I first wrote this post, the next week an incredibly good-fit-of-a-patient walked in my door! A month later, another booked in! I have been blessed from the start with a roster of wonderful people who have found their way into my practice. I’m posting this blog post to celebrate that and keep morale high.
No, I don’t have her yet (edit: there are a few potentials, though!). Instead, I began practice with a few individuals who reflected back my insecurities, made payment awkward (likely more about me than about them) or who threaten to complain about me to the regulatory board (long story) and keep forgetting to follow their treatment plans.
Naturopathic doctors have the second largest scope of practice in Ontario besides medical doctors. We are primary care providers. We are highly trained. If I wanted to get filthy rich I’d have done something else, anything else. I am 29 and I wear sweaters from the Salvation Army and live with my parents—I just want to help people.
I digress. My perfect patient does not yet exist, but in a marketing workshop I took in November, they told us to imagine our ideal patient—where does he or she live, work, drink his or her coffee? I decided to create a blog out of it, killing a few birds (free range turkeys) with a single (humane) stone. That being said, if you read to the bottom of this post and find out that you are, in fact, the perfect patient, or know one that is, then please message me and I will get back to you as soon as I can.
The Perfect Patient
The perfect patient has extended health benefits. However, she understands that health is worth paying for and is willing to go beyond her benefits in order to feel better.
She has faith in naturopathic medicine and in my doctoring skills. She understands the work and education it took to get to where I am. She respects that and recognizes that my opinion is far more informed than that of a health show host, blog poster or supplement store employee.
The perfect patient knows me. She’s heard of me, or read my professional blog, or been to a talk. She jives with my spirit as a doctor and therefore is already sold on me and naturopathic medicine before she comes into the office.
She is compliant. She understands what education and training is behind the treatment recommendations that are prescribed to her. She follows them, determined to make positive changes to her health. And, because she does this, she gets better. She takes an active role in her own health and doesn’t hesitate to help me understand what treatments are feasible and appropriate for her.
She tells all her friends and family about me and how I’ve helped her. She refers them all to me. Like 10-20 people are direct referrals from her.
These referrals begin to refer as well. It’s a great practice because they all connect with my philosophy and follow my recommendations and are willing to pay for my services and don’t cancel their appointments without giving 24 hours’ notice.
They are all respectful of my time. They don’t overstay their visits or bombard me with emails, unless they are genuinely confused about something or they have a legitimate concern and they understand that, if it requires more than 15 minutes of my time then we need to book a follow-up in person or a phone consultation and they know that requires payment. After all, I am a professional.
They all follow my blog and recommend it to friends. One of their friends is a big-deal editor and signs me on for a book deal. I sell a lot of books and this generates even more patients who are in line with my beliefs and the medicine I practice.
Everything flows, naturally and easily. I learn a lot. These patients are introspective and interested in growing. They know that health is the foundation of a good life. They want to make the most out of life, to challenge themselves in interesting ways and embrace love and creativity and spirituality. We have great conversations that allow us to benefit and look at life a little differently. My clinic becomes a place of healing and spiritual growth.
“I feel better just by spending time in the waiting room.” Say the new patients these days.
I start a Alternative Healing Collective with my current clinic owner, an MD/Homeopath. We employ different healthcare providers and pay them salaries. The patients pay a yearly rate and then are charged a smaller fee for a visit. Practitioners and patients form boards and vote on changes and practices of the clinic. It becomes a place of progressive private healthcare.
Students come from around the world to learn from our methods and copy our model of providing accessible, effective healthcare.
We dedicate our time to helping those who can’t pay for the services but are in line with our principles and would benefit from our care. We travel to countries and set up clinics there. We give talks, workshops and classes. We do community acupuncture.
Our clinic becomes a community centre for healing, where patients can drop by, have a tea, listen to a talk or take a class, see a practitioner, meditate, take out books on health or just sit and converse with like-minded individuals. We are closely connected with the arts, especially the visual arts and have non-toxic art studios for health-conscious people who believe in expression and beauty.
Our clinic becomes a model throughout Canada, then throughout the world. We revolutionize the healing professions.
When I retire I become a mentor, an elder. I still see patients and teach classes and write books. Sometimes I write fiction. Sometimes I paint. I feel like a part of the community. I feel I have given back, traveled and grown and lived and loved.
Then I die peacefully, surrounded by family, friends and community and love.
And it all started with the Perfect Patient.
Here’s hoping.
by Dr. Talia Marcheggiani, ND | Feb 16, 2015 | Culture, Emotions, Empathy, Gratitude, Love, Meditation, Mental Health, Mind Body Medicine, Mindfulness, Philosophy, Relationships, Self-care
I was in an emotional crisis. My partner and I were fighting. It was my fault and the anxiety I endured from the confrontation was compounded by a deep sense of guilt and shame. I felt powerless as I waited for him to reach out to me so we could fix the problem while at the same time dreading the future confrontation we’d have. I felt isolated. My nerves were shot.
I texted the problem to my friend, A, the psychotherapist, while sitting on the couch in my pyjamas. At the time I remember wanting to include others in my misery, so that people would ask me about it and tell me everything would be alright, that it happens to all of us—it wasn’t that bad—and that I’d get through this thing.
A tells me, “There is nothing you can do now but wait. Waiting takes courage. So, while you’re waiting, don’t forget to self care.”
Self-care: the illusive term we’d often hear tossed around in naturopathic medical school. The hyphenated compound noun referred to anything from applying castor oil packs to getting enough sleep. In my mind, it brings up images of spa-like indulgences: bubble baths, candles, a junky novel—guilty pleasures. True self-care, however, is far from simple self-indulgences. Audre Lorde owns the most powerful definition of self-care I’ve heard, which is this:
“Caring for myself is not self-indulgence, it is self-preservation. And that is an act of political warfare.”
Rather than being a commercial phenomenon—involving trips to the spa, chocolate binge-eating and shopping sprees—self-care is political. Self-care challenges the inequality and oppression of race, gender, class and sexual orientation in society, by providing us with a means to improve our strength and ensure our survival.
When I read Lorde’s quote, I think of my Italian grandmother Nonna. Barely sitting down to enjoy the dinner she had prepared, she dedicated herself to the service of her family’s well-being. Like many other women, especially Italian Catholic women from her generation, she had been taught that any care for herself was selfishness—a symbol of the highest level of vanity and self-obsession. Nonna, like other women of various colours, religions and socioeconomic statuses, was taught to live a life of self-sacrifice. Any attention paid to her own well-being was regarded as an indulgent after-thought. Women are denied a societal sense of self-worth, which is then paradoxically medicated by advertisers telling us to “treat ourselves” to expensive perks because we’ve “earned it”. We are taught not to love ourselves and then instructed how to remedy this lack of self-love with expensive gifts.
Self-care is about finding ways to cultivate and feel deserving of self-love.
True self-care is essential for moving us forward. Because it prioritizes the health and well-being of a person, it affirms self-worth. This has the power to challenge the oppressive forces of racism, misogyny, classism, homophobia and other prejudices. Self-care helps with trauma recovery. It helps heal.
Self-care builds resilience.
We commonly fall into the thought-trap of regarding self-care inaccessible to certain populations; we assume it requires time, money and energy that not all of us have. Katherine from “I Am Begging My Mother Not to Read This Blog” accurately expresses the sentiment with an ironic twist:
“Make time for yourself. After you’ve run that 5K, started a load of laundry, harvested your organic vegetable garden, run to the bank, paid the bills, dazzled everyone with recipes that are cost-effective, healthy, and delicious, thought of something witty and clever to share with your social networking site, caught up on current events and politics, and cleaned all of the house, that special hour set aside just for you is so critical to your well-being.”
While she certainly has a point, something essential is missed in the definition of self-care. Self-care isn’t about shutting out the sound of your screaming children while you pour yourself a martini and fill the tub with hot water. Self-care is about intention, balance, mindfulness, self-awareness and, above all self-love. It is about taking responsibility for one’s own health and well-being. It is about recognizing your physical, mental and emotional needs and ensuring that those needs are met. Self-care is about reducing stress levels. If a pile of dirty laundry is stressing you out, then mindfully washing those clothes while watching the stress leave your body is self-care.
Self-care is an attitude. You can wash your dirty laundry with the frenzy of a thousand cortisol molecules and your mind on the massive list of other things yet to get done, or you can savour the positive feelings of achievement that comes from checking an item off the to-do list. You can breathe the scent of fabric softener, feel the warmth of the clothes that are coming out of the dryer and acknowledge that you are caring for yourself by ensuring you have clean clothes to wear the next day. It’s perspective and intention that creates self-care. That being said, laundry doesn’t necessarily have to be your thing either.
I have a patient who works 6-day weeks. When I asked her what she does for self-care, she looked at me, puzzled. “You know, self-care—how do you take care of yourself?” I tried to clarify. There was still no dawning of realization on her face. I silently chided myself for asking such an insensitive question.
And yet, my patient was taking care of herself. She was drinking more water, eating more vegetables and exercising. She was coming to see a naturopathic doctor and investing in her health. She was doing plenty of self-care; she just didn’t know it.
The SCaR Foundation outlines the BACE method of self-care, which helps us draw awareness to the simple acts we can engage in to care for ourselves.
Body Care involves exercising regularly, eating healthy food, taking medications and herbal supplements as prescribed. It also encompasses getting up to stretch while sitting at a desk, drinking water, getting enough sleep.
Achievement consists of finishing the daily tasks you have on your to-do list, laundry among them. It also includes working towards goals, like studying for a test or doing your work.
Connecting with Others includes spending time with friends, family, or a pet. Social connection is one of the reasons why we’re alive. Being able to reach out to others for help is one of the strongest manifestations of courage and resilience.
Enjoyment encompasses hobbies, favourite pass-times and indulgences. What activities bring joy and happiness to your life?
Self-care should not be pre-determined. When it becomes someone else’s prescription, it is no longer self-care.
Self-care is not always pleasurable. Sometimes it can be quite uncomfortable, such as making the decision to change careers, end a relationship or get in shape. It can be transformative, such as standing up for yourself. Self-love is a revolutionary act and revolutions aren’t always won peacefully. However, learning to listen to the body allows us to determine which decisions are coming from a place of self-love and not anger, hatred or fear.
My particular self-care story ended well. The very act of reaching out to a friend had already begun the process of self-caring (connection). After talking to A, I got up, changed out of my bathrobe, exercised, showered, and put on a homemade face mask of yogurt, honey and avocado (body care). I read fiction on the couch with a hot mug of cinnamon tea (enjoyment). I did yoga, meditated (body care) and went to a friend’s house for lunch, then another friend’s for dinner (connection). I took a course on a subject I love and met other healthcare practitioners while developing a new counselling skill (achievement). A part of me craved isolation, but I intuited that wouldn’t be a restorative act for me at that time and so I forced myself to move on with my activities, knowing that they would improve my positivity and resilience. In the end, because I took care of myself, I was able to face the situation from a place of strength and compassion for both me and my partner. Self-care helped me move past the shame and connect to the most powerful and loving version of myself.
That was my approach to self-care, because it was what I needed. At that time, I needed to feel healthy, strong and social. I needed to be reminded of who I was. Others in similar situations may decide that they need to grieve alone while watching When Harry Met Sally and devouring wine and popcorn, their faces stained with tears. Self-care is about knowing yourself and recognizing and honouring your needs.
Contrary to what we’ve been told, self-care isn’t selfish. It is the highest expression of connectedness. We can’t take care of others if we are not healthy. And we can’t be healthy without taking care of ourselves.
Self-Care Resources:
Methods-of-Self-Care : Free Ebook
Caring About Self-care : Article
Also, check out this Self-Care Journal, by Rachelle Abellar. It has sections for personal affirmations and action plans for when you’re feeling low. You can buy a copy at lulu.com.
by Dr. Talia Marcheggiani, ND | Feb 6, 2015 | Beauty, DIY, Home Remedies, Natural Body Care, Recipes, Skin health

This winter has been particularly harsh for chapped lips and itchy dry skin. I’ve been tempted more than a few times to buy red clover salve, a skin treatment made with Trifolium pratense, a skin-soothing plant full of antioxidants. Red clover is excellent for treating skin conditions such as eczema, psoriasis, acne, rashes, dryness and other skin disorders. It softens and nurtures skin while also providing anti-inflammatory effects, reducing pain, redness and itchiness.
Health food store salves are expensive, however. Some of them contain unwanted ingredients, even if they are natural—sometimes I prefer not to apply essential oils to my skin when it’s red and raw, as they can cause an aggravation. The tubes are also tiny and inadequate for covering large patches of affected skin. Fortunately it’s easy and cost-effective to make your own salve. I often encourage cash-strapped patients to make their own botanical skin treatments at home.
Within minutes of applying this balm to my skin, my chapped lips and itchy legs were soothed and redness was calmed. My skin felt smoother, moisturized and less flaky. I’ve even distributed some to small pots to use as a lip balm throughout the day.
DIY Red Clover Salve
You need:
Trifolium pratense (red clover) 100 g dried herb
Liquid oil of choice—I used olive and avocado—enough to cover herbs
1 small mason jar
1 cheese cloth or absorbent paper towel
Pot, stove, slow cooker
Beeswax
Instructions:
Step 1: Oil Infusion
There are two steps to making a salve. The first is to create an oil infusion from the dried herbs. This process extracts the medicinal properties from the plant using oil. The proper, herbalist way to do this is to cover the herbs in the oil of your choice and leave them in the sun for a week or two. However, since I’m pressed for time, I make oil infusions in the slow cooker.
Put the herbs in the small mason jar and cover completely with oil. Fill the slow cooker with water, so that the water level meets the level of oil in the mason jar. Place the mason jar inside the water in the slow cooker. Cook on low overnight.

Step 2: Salve
After the oil has been infused with the active plant constituents, strain out the dried herbs using a cheese cloth. Make sure to squeeze out all the good, nutritious oil from the herbs so that none is wasted.
Create a double boiler by setting a pot filled with water (I reuse the same water from the slow cooker) on the stove and turning the temperature to high.
Sit the mason jar containing just the oil infusion (no herbs) in the water. Once the water is boiling, slowing add in beeswax. A 1:5 beeswax:oil ratio creates a pliable, creamy salve. You can start with less keeping in mind that you can always add more later by reheating the salve in the double boiler. You don’t want to go overboard and add too much beeswax, creating a salve that is too hard. Allow the beeswax to melt into the liquid oil while stirring.
Remove the jar from the stove and allow it to cool to room temperature.
Once cooled, apply to affected skin areas and enjoy the smoothness.

by Dr. Talia Marcheggiani, ND | Feb 2, 2015 | Love, Mental Health, Naturopathic Philosophy, Relationships
My classmate, A, has a treatment plan for me. He wants me to exercise—not the light walks I’ve been doing, but intense cardio intervals and weight-lifting. He wants me to get more sleep and drink more water. When he gives me the instructions, I feel slightly disappointed; I could have prescribed this plan to myself. In fact, even in telling him the story about my fatigue, I had already predicted what he’d recommend. I could hear myself admitting to not getting enough sleep and to often forgetting to drink water. I just hadn’t thought consciously about those facts for a while. Life and self-deception had kind of gotten in the way.
In one way, because I had the answer in front of me, and in another way to please A, who I’d have to report back to the following week, I started to exercise. When I got home, I stopped telling myself that a short, light walk would be enough—I had to start sweating. I stopped kidding myself that five hours of sleep a night was enough and that watching TV on my laptop while lying in bed was a substitute for rest. I made the changes and I began to feel better.
I might have had the internal fortitude to do all of this on my own, but it was talking to someone I trusted that gave me the push I needed. I saw my issues and current lifestyle reflected in A’s eyes. The mirror he held up to me gave me the jolt required for me to start taking care of myself.
The healing relationship is something that is not often credited in mainstream medicine. I am taking a course in Motivational Interviewing (MI) in which we learn to tailor our patient interactions to inspire patients towards making healthy changes in their lives. MI helps people move past places of ambivalence because it acknowledges that, while patients have the power and authority to make changes, they also need the therapeutic relationship to start the first steps of change. We’re often told to share our goals with a friend. One reason for this is that we are held accountable. Another reason is that saying the words out loud helps solidify the need to make a change. Telling another person mirrors our needs, wants and ambitions back to us. Through the act of sharing we gain mutual support and are more likely to move forward with our goals.
When I ended a 5-year relationship and entered the dating scene in late winter of last year, I often joked to my friends that dating was “free therapy.” I had to push myself to leave my bubble of comfort and sit across from a stranger. I had to risk being evaluated by someone else. Dating showed me the need to take chances with my heart and express my feelings and vulnerability. I was confronted by my insecurities—feelings of unworthiness, worry that I wasn’t attractive enough and a deep-rooted fear of rejection and abandonment. I was forced to stare these fears down, acknowledge their existence and work to move past them. This experience helped me become a better person and a better doctor, improving the relationships I have with my patients and coworkers.
Relationships expose our wounds. After all, the human experience is formed in relationship. Even withdrawn introverts rely on others for their daily experiences. Hermits living in the woods are reliant on relationships, or lack thereof. Their identity, forged by their need to escape from others through the conscious rejection of relationships, still reflects their intersubjectivity. Our earliest relationships establish our deeply held beliefs about ourselves and the world. Everything we learn about ourselves is through relationships with other people.
I read this wonderful quote in an article recently,
“Our wounds were formed in-relationship and can only be healed in-relationship. No amount of meditation on a mountain can solve your mommy issues.”
Healing, whether physical, mental, emotional or spiritual, must be done through interpersonal connection. Relationships help expose our wounds while showing us what we can do to address them. While we ultimately heal ourselves, we intuit that the healing process needs the hands of another. Through my last relationship I’ve seen my insecurities held up in front of my face. The need for developing my sense of self-worth, self-love and self-acceptance began to cry out loudly, when reflected through the prism of the relationship I was in. When we’re alone it is easy to ignore these callings—there is no one beside us, challenging us to evolve, and it becomes easier to settle into our ways.
Self-work cannot be done alone.
Healing requires reflection, mirroring, empathy, storying, support and, sometimes, accountability. It requires more than just expertise, self-will and determination. When working on ourselves interpersonally, we are forced to see ourselves through the eyes of another human being and develop the darkest, hidden parts of ourselves, becoming whole.
Therefore, true healing cannot be done outside of relationship. We need someone to share and rewrite our stories with. In some cases, it can be a partner, family member or friend. In others, the ears, eyes and hands of a trusted professional can help you move to the next level of conscious healing and self-evolution.
In short, Googling your symptoms can’t heal you.
I love this quote from Julie Delpy’s character in the movie Before Sunrise:
“If there’s any kind of magic in this world it must be in the attempt of understanding someone sharing something. It’s almost impossible to succeed, really, but who cares? The answer must be in the attempt.”
Healing is in the attempt.