What Supplements Does a Naturopathic Doctor Take?

I talk about the supplements I take on a daily basis and their indications.

Hey, Everybody, my name is Dr. Talia Marcheggiani and I’m recording to you guys from my kitchen in Toronto. And this video is about the supplements that I take as a naturopathic doctor and health experimenter. When it comes to making treatment plans for my patients I prefer to focus on the Therapeutic Order, so starting with the foundations of health, which usually means making adjustments to diet and lifestyle and if possible using food prescriptions and functional foods to help heal the body as opposed to relying on supplements. And this is just from clinical experience and from a cost-benefit perspective. So, of course it’s better to get these nutrients from food sources, because, when you eat a pile of kale, like a big plate of leafy greens, you’re getting all of the vitamins that we know about: the magnesium, the fat-soluble vitamins, like A, D, E, and K, some iron, and all of the flavonoids, and anti-oxidants that are present in that big pile of greens, but you’re also getting a lot of nutrients that we haven’t been able to isolate and that we don’t know is present in those foods. Some of those nutrients may act synergistically. And so it’s always better to get things from their whole-food source, I think. That’s the philosophy that I come at when it comes to health and healing. And I’m always looking for the obstacles to cure. Ideally I’m prescribing something like magnesium to replenish a magnesium depletion or to compensate for a diet that may be inadequate for magnesium, or to replenish magnesium deficiency. So I’m not a big fan of prescribing a ton of supplements, and I think my patients appreciate that, because of the cost and the annoyance of taking a lot of things. That being said, there is definitely a benefit to supplementing with vitamins and minerals and other sort of functional supplements to improve optimal health. We’re trying, obviously, to eat a diet that meets the recommended daily nutrition intake for all the vitamins and minerals that the body needs to function optimally, but there’s some evidence that increasing these levels and taking higher doses of these vitamins and minerals may actually help our body perform properly. So, if you take something like vitamin C, if someone is completely deficient in vitamin C that will manifest as a disease called scurvy, where you’ve got loose gums, or you’re experiencing problems in creating collagen. You’re getting sore on the skin, there’s skin issues, there’s gum issues. And then there’s an adequate amount of vitamin C, where you’re not seeing those symptoms, and then there’s having optimal vitamin C, where your body is able to not just meet its daily requirements for all of the chemical reactions that it needs for us to feel our best, and look our best, but now it’s got an abundance of vitamin C and now it’s able to really divert a lot of the vitamin C that it’s getting to increase energy, to boost immunity, to target cancer cells, to exert an anti-oxidant effect, to accommodate all of the free radicals we might be exposed to, living in our modern times.

So, that being said, I do my own self-experimentation with vitamins and minerals, and there’s a few things that I’ll take on the regular, that I’ll take all the time, and then there’s other things that I might play around with, just to see what it’s like to take the medicine. Depending on what it is, I think doctors should taste their own medicine every now and then to know what the effect is on their patients and what their patients’ experience would be, experimenting with these vitamins and minerals.

So, the first thing I take, and this is something that I started taking in school, is a B complex. And a B complex contains all of the B vitamins. Some people get confused, they’ll refer to their B12 supplement as a B complex or they’ll refer to a B complex as B12, or they’ll get confused about all of the different B vitamins. In this product there are all of the B vitamins, from B1 all the way to folate. These B vitamins are cofactors in thousands of chemical reactions in the body. We need vitamin B6, for example, to make serotonin out of tryptophan and 5HTP, those are all the amino acids that are present in the pathway to synthesize serotonin and without B6 we’re not able to make serotonin, no matter how many of those building blocks, tryptophan building blocks, may be present in the body. So, if we’re deficient in these cofactors, our body is just not able to function properly. And we burn through B vitamins a lot more quickly when we’re under stress and some people have higher requirements for them. And some people have an issue metabolizing certain forms of B vitamins. So, for example, there’s some people that have an issue taking folic acid, which is often thrown into a lot of our grains and cereals, that are fortified and lots of multivitamins and taking that folic acid and making it into its active form, about 40%of people have a genetic polymorphism that reduces their ability to methylate and to make active folate and, therefore, they need to supplement with the activated from of folate otherwise the folic acid that’s in all of their foods starts to build up in their tissues and there’s some evidence that that can cause problems.

I showed you which B vitamin I use. I use the AOR brand and one thing to look for in a B vitamin is, what is the form of folate in it? So, you want to look for one that has L-5-MTHF or that’s the methyl-tetrahydrafolate, that’s the active form of folate. And you also want to look at the B12, what’s the form of B12? So there’s 3 different forms of B12: cyanocobalamin, hydroxycobalamin and methylcobalamin. Cyanocobalamin is the synthetic form and, for the same reason that people have a problem activating folate, they may have a problem activating B12 and using it. And it’s the methylated form, methylcobalamin, that crosses the blood brain barrier, and that would have effects on depression and anxiety, and help with cognitive decline, and energy and all of those things. So, it’s important to look for a B vitamin that’s got those activated forms of the B complex. And you also want one that has adequate forms and that will be better absorbed. And so, taking a B complex is not something that you can overdose on readily because it’s water-soluble, so you may notice, as you start to take it, that your body starts to up-regulate the receptors to absorb them, for the initial weeks of taking it, you might have really yellow pee. And that’s normal, that shouldn’t cause any issues, but it’s one side effect that sometimes surprises people when your first morning urination is highlighter neon yellow.

The other thing that’s a staple in my supplement regime is magnesium. So, magnesium is, again a cofactor in tons of chemical reactions, and one of the really important functions that magnesium has is in DNA repair and also in mitochondrial function. So, mitochondria are the furnaces in our cells. Without magnesium, our DNA won’t have that ability to repair itself, which can cause us to allow DNA mutations or issues with DNA replication to go unnoticed and that can cause problems such as cancer down the line. It’s not that you’re deficient in magnesium one day and that manifests as symptoms, it’s something that will manifest over time, over decades of having just insufficient magnesium to achieve optimal health. So, you might be meeting your general needs where you’re not outwardly deficient in magnesium but, you’re not getting those levels to really have your body functioning at its best. Magnesium deficiency can manifest as symptoms, as physical, clinical symptoms in people and a big one is tense and tight muscles. Magnesium is a skeletal muscle relaxant and a smooth muscle stimulant. So what that means is that, if you’re the kind of person that has got really tense shoulders, lots of muscle knots, lots of aches and pains, that are muscular in nature, magnesium can help relax that skeletal muscle. And if you’re the type of person that suffers from menstrual cramps, or constipation, then magnesium is helpful for getting things moving and stimulating motility of the digestive tract and relaxing the uterus as well. Magnesium, there’s been some studies showing that magnesium can be beneficial for headaches, and that is probably due to its muscle-relaxant properties. Magnesium is also a great remedy for fatigue and, like B vitamins we burn through magnesium a lot more quickly when we’re stressed. 40% of people have a diet that it is inadequate to obtain their optimal levels of magnesium. This may be because we’re not eating enough leafy greens, which is a really great source of magnesium. It’s about 2 cups of spinach or chard a day to get the 300 mg of the magnesium, and also from soil depletion. So, when crops are not rotated, and the soil’s not replenished, the next round of crops are grown in a soil that’s depleted and therefore those plants aren’t absorbing the nutrients that were then going to enter our bodies after we eat those plants. And from this soil depletion, it’s hypothesized that that’s why our magnesium levels are so low. Also, a diet that’s high in processed sugar increases our magnesium needs, and a lifestyle that’s high in stress also increases our magnesium needs, as we need it to make stress hormones.

So, B complex and magnesium.

I often recommend to my patients to take magnesium before bed because of the skeletal muscle-relaxant properties, it helps to calm the body and the mind. There’s different forms of magnesium and the forms are prescribed based on what your therapeutic goals are. So, something like a magnesium citrate will be prescribed for somebody who’s tending more to the constipation, because it can help draw water into the bowels and have a bit of an osmotic laxative effect. So, it doesn’t sort of stimulate the bowels, like a laxative would, like sennakot, but it will draw water into the bowels to kind of flush the system out. That can be problematic over the long-term so do that under the supervision of a doctor or naturopathic doctor. And then, for people that are really sensitive to those laxative effects of magnesium, they may want to go with a magnesium that’s conjugated to an amino acid such as glycine. And so I often recommend magnesium glycinate, because a lot of us are also deficient in glycine. Another good source of glycine is collagen, or gelatin, and glycine has this sort of relaxant and modulating effect on the nervous system, and so it can be great for depression and anxiety, more so for anxiety because of its calming effect on the brain.

So, another supplement that I take is zinc. So, this is not the best form of zinc, I just picked this up because it was cheap and I could find it—I think I got this one at Bulk Barn, this is a zinc citrate. Even better absorbed form is zinc picolinate, so there’s a study that shows that that’s the best-absorbed form of zinc, which is appropriate for somebody that experiences nausea when they take zinc, which goes away in a few minutes, but it kind of sucks to have so, if that’s happening to you, then going with a more absorbable form of zinc, or taking zinc with food. A zinc deficiency manifests as dry skin, and depressed immune system, so you’re getting infections a lot more often than the average person. But inadequate levels of zinc can manifest as hair loss, leaky gut, depression and anxiety. Zinc helps us with neurogenesis, so it actually helps us make BDNF, brain-derived neurotropic factor, which is a chemical that our brain uses to make new neurons, and to promote resilience against stress. It sort of protects the brain against mental and emotional stress. And I also prescribe it for cystic acne and hormonal acne. And zinc is a really good remedy for PMS and heavy menstrual periods and vegetarians are often deficient in zinc.

4th is a fish oil. So a fish oil is combined with two kinds of omega 3 fatty acids: EPA and DHA.The one I use has got a 5:1 ratio for EPA. So, EPA is the anti-inflammatory omega 3, the anti-inflammatory fish oil. DHA is the fish oil that we use to build up our brain tissues. Most of our brain mass is made of fat and it’s mostly this kind of fat, DHA. So there’s some good studies that, because of its anti-inflammatory properties, EPA can help increase symptoms of depression. And this is probably because there’s some evidence that depression, like other mental health conditions, is an inflammatory condition in the brain. We don’t have pain receptors in our brain, so if our brain is experiencing even a small level of inflammation, it can kind of go undetected. It may just manifest as negative thoughts, mental chatter, low mood, lower or impaired neurogenesis. We’re not experiencing that acute, sharp memory that we’re used to, maybe we’ve got some brain fog, maybe we’re having trouble recollecting names and those kind of things. And there’s a little bit of evidence that it can be heart healthy as well. Our diet is really rich in omega 6 fatty acids. These are the more, inflammatory—this is sort of a general statement—they’re little bit more on the inflammatory side. I think our diet is about 10:1 omega 6:omega 3. And that’s mainly because we’re consuming animal products from animals that are not fed their natural diet, so for example cows should be eating grass, but we’re feeding them corn, which tends to make the fat in their meat more composed of the omega 6 fatty acids, and also because we’ve been told to avoid saturated fats and to eat a lot of industrial seed oils, like canola oil and corn oil, and vegetable oil, which is just corn oil, and soy oil. And so, these kind of oils are also rich in omega 6, those kind of pro-inflammatory fats. It’s been shown that our ancestors, our hunter-gatherer ancestors, had a diet that was more 1:1, for omega6:omega3. So, supplementing with omega 3 fish oils or eating fish a few times a week, those fatty fish I mentioned in other videos, decreases that ratio of omega 6 to omega 3. I also take NAC. And the reason I take NAC is I did a genetic test that showed that I have impaired phase II liver enzymes. So my body has a little bit of difficulty making glutathione, which helps detoxify all of the toxins and free radicals that pass through my body, all of the hormone metabolites. So, no matter how clean I live, if I’m using natural cleaning products, natural body care products, I’m still exposed to toxins, as we all are: there’s car exhaust outside, we’re consuming things that are wrapped in plastic, so no matter how perfect you try and be, you’re still going to be exposed to things. And so, to encourage my body to make more glutathione, I give it NAC, which is a precursor to making glutathione, the antioxidant. NAC helps with liver detoxification, so it also helps decrease symptoms of hormone metabolites, that estrogen dominance, that I also talk about in other videos, and it can also help with detoxifying the brain, so neurons. And that’s through its antioxidant effects and it kind of cleans out mitochondria. So you imagine if you’re running your car in your garage, the process of your car metabolizing, so spending its fuel, is creating some chemicals that are coming out of the exhaust pipe. And if your garage door is closed, all of those chemicals are filling the garage. And so, taking NAC is a little bit like opening a window, it’s just helping your body get rid of all of those toxic metabolites from performing its chemical duties. So I’ll take NAC and I’ll recommend NAC for mental health conditions, especially OCD and bipolar disorder. And sort of on that note, I also take something called estro-adapt. And it doesn’t have to be this product, there’s many other products that are similar to this, estroadapt has DIIM and calcium d-glucarate. Both of those are chemicals that help the body metabolize estrogen. So I’ve talked about estrogen dominance and other videos and the estrogen is not just one hormone, it’s a group of hormones and that there’s also these xenoestrogens, so these estrogens that are toxins in our environment that exert estrogenic effects. So, some of these include fragrances, and bisphosphenol A, BPA, that’s found in plastic, that has received a lot of media attention, what DIIM and calcium d-glucarate do is help us with normal estrogen processing. So, estrogen, when don’t need it any more, when it’s already done its thing, or those more toxic forms of estrogen, they’re conjugated in the liver, so the liver makes them inactive and then they’re dumped into the colon, where they’re removed from the body. And what happens if any of those steps are impaired, so if your liver is sort of overburdened processing other things, or you’re not able to process those hormones as well, is you’re going to have a higher level of metabolites in the body, or if you’re constipated, or if you’ve got a dysbiosis situation happening, and some pathogenic gut bacteria that aren’t able to keep estrogen conjugated, so they sort of put it back into it’s active form and the body reabsorbs it, which is not what you want. You want to get rid of those toxic estrogens.

So what I’ll recommend is doing a detox twice a year, Spring and Fall is a great time to do a detox and I’ll do another video on detoxification because our body can detoxify pretty effectively. It takes care of all of our detoxification needs, but sometimes it helps to give it a little bit of a boost, and so a product like this, with DIIM and I3C, or indole-3-carbinol, which is not in this product, or calcium d-glucarate, is really helpful for lowering those estrogen toxicity symptoms, which could be heavy menstrual periods, anxiety before your period, PMS, hormonal acne, irregular periods, weight gain, especially around the hips and a predisposition to female cancers, such as breast cancer. Another way you can get this from diet is from green leafy vegetables. So those are all the crucifates, broccoli, cauliflower, cabbage, brusselsprouts, chard, spinach, kale, all of those vegetables are really rich in I3C and DIIM and those help us clean estrogen from our body. Finally, I take an adaptogen. So, adaptogens, this is Withania complex, they’re herbs that literally just help the body adapt to stress. So my two favourites are withania, or ashwaghanda, and rhodiola. And I like taking them together, this complex doesn’t have rhodiola in it, but it does have ginseng, which is a little bit more stimulating. It’s got withania, it’s got ginseng, and it’s got licorice, and it has skullcap, which is a little bit more calming, nervous system calming. And, so what withania does, these just help us against the pro-aging and pro-inflammatory stress effects. So, they help sort of protect our tissues against stress, they protect our brain against stress, they can help calm the body down, they help the adrenal glands function more optimally, and rhodiola in particular, helps increase BDNF, just like zinc, so it increase brain-derived neurotropic factor, NAC also does this as well, and there’s a connection between low levels of BDNF and depression and anxiety and mental health conditions. The low levels of BDNF may be from nutrient deficiencies, or it could be from inflammation in the brain and that inflammation could be just a stress resistance. So, the stress hormone is coursing through our body 24/7 and our brain sort of stops responding to them as well, kind of like a diabetic, a type II diabetic, stops responding as effectively to insulin, an a resistance develops and, since those stress hormones have an anti-inflammatory effect, when you start becoming resistant to them, inflammation ensues. And so what withania and rhodiola do is just help calm down that inflammation. I’m a big fan of herbal medicine because in addition to sort of its active medicinal properties, herbs are also flavonoids, and have really important nutrients, like I talked about that big pile of leafy greens, we’re not exactly sure what is in these nutrients. We just know that, as a whole, they work really well. And so they’re flavonoids, they’re also anti-inflammatory, they’ve got anti-oxidants, as well as their medicinal properties that we can isolate and study. So I like herbs, it sort of brings us closer to nature, it puts a piece of nature into our body and some of that intelligence of nature, rather than just one supplement or one ingredient would do. And, because we’re so stressed out, and not all stress is bad. You think of a new mom, she just had a baby, she’s full of love and joy, but there’s sleep-deprivation, there’s all these kind of thoughts, and new responsibilities that are filling her life, so she’s stressed out, but she’s not full of negativity and negative thoughts. And so that’s still stress, the body still perceives that as stress. Some signs of stress are waking up in the middle of the night wide awake, inability to fall asleep, that tired and wired feeling, feeling like you’re getting an energy crash around 2-4pm, feeling a little bit more tired than usual, feeling a little bit more burnt out, feeling a little bit of ennui, and lack of motivation, so a lot of those signs of depression are actually present in someone who’s chronically stressed out: lots of mental chatter, lots of negative thinking and irritability can also be signs of stress. It manifests differently in every single person and so I’ll go through a full work-up to see how stressed out somebody is feeling and what their state of stress is. And there’s a difference between perceived stress and how stressed out you think you are, and actual, physiological stress and what the body’s under. And being in a state of inflammation, as well as riding the blood sugar roller coaster can also increase our physiological stress.

Finally, I take 5HTP. And I take this before my period, so I don’t take it all the time. I may take a couple hundred mg of it before bed, just to help with sleep. And, so 5HTP is a precursor to make serotonin. A lot of women will experience a dip in serotonin right before their period, sometimes up to a week before, so these women will experience irritability, those mental and emotional PMS symptoms, cravings for sugar, inability to sleep, worsening of depression and anxiety right before their period. And so sometimes they can benefit from 5HTP, which is an amino acid. 5HTP needs magnesium and B6 to work properly, though. So, we need to make sure the body has got adequate amounts of those nutrients, either through supplementation or diet, so that it can take that 5HTP and make it into serotonin. 5HTP crosses the blood brain barrier and so that sort of helps us get it into our brains where it can be made into serotonin. And the good thing about amino acids, like NAC and 5HTP and some of the other ones I mentioned in my amino acid video, is that they work pretty quickly, so sometimes they can exert their effects within hours and sometimes even within a matter of days, whereas something like fish oil can take months to be incorporated into the cell membranes and change the fatty acid profiles of our cells.

Even B vitamins work pretty quickly as well. So, these are what I take. You’re going to need something different, maybe less things, maybe more things. Some of these things are things that I experiment with, and sometimes I’ll do a wash. So, a lot of the time, if my patients are on a ton of things and they come in in that state, I’ll wash them, we’ll have them stop a few things, see if symptoms return, see what their baseline of health is. Because sometimes we just need a boost and to just take these things for a few years or months, and then our body gets back on track, sometimes we need some continual support throughout our lives. And so, everyone is different, everybody has different individual biochemical needs and everyone has different challenges with getting diet into their life and exercise and meeting those foundational health needs. And so someone who is a little bit more challenged in that department, who’s got a really busy and stressful lifestyle may need more nutritional support, someone who’s in a chronic disease state, recovering from more serious health issues may need more support and someone who’s having trouble maintaining their minimal nutritional requirements through diet may need some more support.

Again, I always tell people to pay for a consult with a functional medical doctor or a naturopathic doctor to figure out what your supplement regime would be. I see a lot of people in healthfood stores kind of going it alone and, not to say that you can’t get great information from the internet, but it may result in your taking a lot of things that you don’t really need, spending a lot of money that’s not targeting a specific health concern or meeting your higher levels of nutritional requirements. And also the form of the supplements and the dosing is something that’s individualized, that we need to talk about. So, there was a Marketplace study with CBC that showed that a lot of these vitamins and minerals that aren’t from professional brands and aren’t 3rd party tested don’t actually contain what they say they contain. This is specifically a problem with herbal remedies. So, if you have any questions leave me a comment below my video and you can check out my website at taliand.com .

The Therapeutic Order of Naturopathic Medicine

The Therapeutic Order is a tool that helps guide naturopathic treatment approaches. I explain how naturopathic doctors’ healing philosophy might differ from the conventional medical model.

Hi, guys, I’m Dr. Talia Marcheggiani and I’m recording to you guys from my clinic in Bloor West Village and today I’m going to talk about some myths about naturopathic medicine, especially regarding our relationship with conventional medicine and medications and, in order to talk to you about that, I want to talk to you about something called the Therapeutic Order. So the therapeutic order is from our traditional roots in the formation of the profession of naturopathic medicine. This is one of our philosophical ideas about how to treat somebody that comes in our door and how people should be treated in terms of the medicine that we practice. And this is a 7-step process, or a hierarchy, of what our treatment goals are for seeing somebody. And the reason that I’m relating the Therapeutic Order to medications is because one of the steps in this hierarchy of the Therapeutic Order is pharmaceutical medication. And so I feel that, in naturopathic medicine, most of us, and certainly in our philosophy, in regards to medication, it’s not that we don’t agree with medication or surgery or conventional treatments, it’s our agreement about when they’re implemented and it’s also about our efforts to treat patients before the need for surgery or medications arises. And so, the Therapeutic Order is a system of interventions and we go from lower-force interventions to higher force interventions and the first step in the Therapeutic Order is to remove obstacles to health.

So, anytime someone walks into my office, and is displaying certain symptoms, I’m always looking for, what are the obstacles that their body is facing when it’s trying to achieve its optimal state of health and wellness. Our bodies have evolved over 300 billion years, from whatever our common ancestor was, that first created life, we’re this result of a lineage of survivors, if we’re here on the planet today. And so our bodies have evolved amazing mechanisms to preserve our health and well-being to ensure that our genes are carried on to future generations. So when somebody is coming in in the initial stages of disease, and so this may manifest for you as just this subclinical feeling of “imbalance”, for lack of a better word, there’s often an obstacle in the way. And a big obstacle that often presents itself in my patients’ lives is stress. That’s one that’s huge and that’s the reason that I talk about it so often. Another is toxic burden from our environment. Things like pesticides, plastics, smog pollutants in our air, in our water, in our food, that can also cause an obstacle to health or just give our bodies some extra things it has to deal with that divert it from its job of making us feel and look our best. And another thing, of course, is diet that’s inadequate, that’s not providing us the nutrients that we need or a diet that’s providing us with anti-nutrients, so it’s preventing us from absorbing the vitamins, the minerals and the macronutrients that we need to function optimally.

And some naturopathic doctors will focus on the energetic aspect, the spiritual aspect. So, is the person in front of them pursuing a meaningful life, do they feel satisfied with their work, are they satisfied with their relationships. So, anytime one of these major pillars of our health is lacking that can also present an obstacle to us feeling our best. And oftentimes the obstacle is a mental-emotional one, even if the symptoms that are manifesting are physical.

So, another video that explains this is my wheel of balance video in talking about stress and when I work with mental health, a stage to mental health promotion is emotional wellness, which is why I use that term so often, rather than focusing on eradicating or eliminating or managing symptoms of mental “illness”—and I prefer to say mental health conditions, rather than mental illness—how can we improve our emotional wellness, how can we improve our mental wellness, as opposed to focusing on disease.

Most naturopathic doctors will focus on this level, this will be inherent in our philosophy we’re always going to be looking for what the obstacles are that are in the way of our patients’ achieving symptom-free lives or a life of low or no symptoms, and a life of abundant wellness and energy, and healthy weight management and healthy mood and all of the things that indicate robust health. This will always be inherent in our philosophy.

The second step in the Therapeutic Order is to stimulate the Vis, so this is the “vis medicatrix naturae”, which is Latin for the healing power of nature, which may seem a little bit woo woo to some people, but you can think of the Vis as metabolism or homeostasis, and this is the idea that our body is primed for optimal health, and our body is always striving to maintain balance. And there’s this idea in naturopathic philosophy that sometimes this inherent energetic mechanism that causes life and all living beings, that sometimes it needs to be stimulated and oftentimes the therapies to do this are more in the energetic realm. So things like homeopathy and acupuncture and hydrotherapy as well, so using water and various temperatures to increase metabolism, hormonal balance, homeostatic balance and blood flow, so those are all scientific terms for what I think the Vis attempts to describe.

So, I tend also to use diet in this realm and herbs. I believe that herbs, and there’s some research for this, some evidence that herbs are modulating, that herbs, as opposed to drugs, kind of seek where things are lacking and they balance our hormonal milieu, our hormonal landscape, more than a medication, which is man-made and an example of this is that some people supplementing with straight vitamin A experienced some negative outcomes in large studies that were done. But if you eat foods that are high in vitamin A, those negative symptoms from vitamin A supplementation seem to balance themselves out and that’s because there are some nutrients present in vitamin and nutrient-rich foods that we haven’t discovered yet and that seem to act synergistically with other chemicals, natural chemicals, that are present in those foods. And so, by taking nature into our bodies through forest bathing, so physically being in nature, or through the consumption of plants and natural substances, I believe that we receive some of those messages from nature. And I can get into this in future videos. I find that herbs have intelligence behind them. And that’s not necessarily woo-woo or pseudoscientific, there’s some research for sure that show that herbs modulate through their anti-inflammatory effects, their anti-oxidant effects, and their hormone-balancing effects, in ways that pharmaceuticals don’t do to the same extent.

So, these two stages, when patients are coming in and we’re focusing our treatment, we’re removing obstacles and stimulating the body’s capacity to heal and you can think about this. If you break a bone, we’re definitely going to remove the obstacle, which is whatever broke the bone in the first place, and then we’re going to promote the body’s ability to heal. It’s not conventional medicine that heals the bone, we simply align the bone so that it can fuse together. It’s the body that heals it. So, we’d be promoting the healing of that tissue with some of the nutrients that the body needs. So this can be applied no matter how serious the medical condition, but definitely it will always be implicit in our treatment plans and how we look at the body. And sometimes that’s enough, if somebody is just coming in with a general feeling of imbalance or, you know, someone who’s coming in with a good state of health, without a loss of apparent symptoms that just wants to manage their health in general, then we’ll kind of stop there, but we might teach you some ways to detoxify, to encourage a healthy diet, and the healthy consumption of health-promoting foods and we’ll let you sort of maintain that on your own.

But what often happens is that people are coming in, because we’ve been taught in our culture in North America and Canada, especially, to come in and seek medical care when we’re feeling ill, a lot of the time people will come in with some kind of issue, so some specific symptoms, and oftentimes these symptoms are apparent or located within one organ system. And so the third step in the Therapeutic Order is to strengthen weakened systems. So this might be somebody who’s coming in a liver issue and this may be a diagnosed issue, or based on their symptoms, we’re noticing some impairment in the liver in general. And so we take treatment a step further and we start to focus on actually repairing the tissues that are present in the liver and so we’ll be using some, perhaps, liver detoxification, some more intense diets, so diets that are geared more to therapeutics, and using some herbs and nutrients to clean out the liver.

We can also use some of our energetics, at this stage, acupuncture, homeopathy, hydrotherapy, self-care practices, and we’ll definitely be removing obstacles to cure, so high-sugar diets, or overconsumption of alcohol, or a high toxic burden. We’ll be looking at those things as well, but we’re also taking it a step further and specifically focusing on the liver in this case.

At this stage of treatment, acupuncture therapy becomes a powerful tool to complement the healing process. By targeting specific points in the body, acupuncture helps to balance energy flow, reduce inflammation, and promote the body’s natural healing abilities. This approach is particularly beneficial for those dealing with chronic conditions or weakened systems, as it provides a holistic method to address underlying issues.

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And this is something that I see most of in my practice, is people coming in with hormonal imbalance, with a mental health condition, with digestive issues, skin issues, hair falling out, and so we’re ordering labs, we’re targeting specific organ systems, and we’re, maybe not necessarily putting these symptoms into a diagnostic category, that would be diagnosed by a conventional doctor, so sometimes these are still subclinical, but there’s definitely symptoms present, people are suffering and they’re noticing a change and they’re probably have already sought help with their medical doctor and maybe were told everything was fine, or maybe they received a diagnosis.

The 4th stage in the Therapeutic Order is to correct structural integrity. So, if our posture, if our alignment is off, then our health is not going to work properly, there’s not going to be proper nerve conduction, there won’t be proper circulation, there won’t be proper functioning of our organ systems. If our rib cage is collapsed, we won’t be breathing properly and we won’t be oxygenating our tissues. If our pelvis is out of alignment we won’t experience proper digestion and digestive regulation. And I often refer out for this stage, I might refer to an osteopath or a chiropractor, or a physiotherapist or massage therapist. I might so some acupuncture myself, but typically for structural correction, I’ll refer to another practitioner and I myself see a massage therapist, chiropractor, osteopath and do quite a bit of hydrotherapy and work on aligning my body through yoga and things like that because of its importance and just general health maintenance.

While this is the 4th stage in the Therapeutic Order, I often recommend that it be implemented as some kind of healthcare strategy that focuses on structural integrity be implemented early on or as a maintenance, especially because we’re so sedentary and we spend so much time in front of our computers and often engage in repetitive exercise. Working on structural integrity management is so important.

The 5th stage in the Therapeutic Order is the use of natural substances to restore and regenerate. And so this is a little bit like symptom management, if you can imagine that. The objective of naturopathic medicine is not necessarily to fix a specific disease, which is often confusing, because we have a very disease-focused healthcare system, not necessarily a health-focused one. And so we’re sort of indoctrinated into this view that if you don’t have a diagnosis that you’re healthy, or that health is the absence of symptoms, which is certainly not the philosophy of the world health organization who believes that health is a mixture of our mental and spiritual and emotional and physical wellbeing and not simply the absence of disease, however we do have a sickcare system rather than a healthcare system, and so we’re educated not to go to the emergency room or your family doctor unless you feel like it’s serious enough to warrant a diagnosis and, if it’s not, then you’re often sent home and told everything’s fine. And patients will always come in having told me that their labs are fine. And they are, they’re fine in the framework of not requiring a diagnosis, or pointing to necessary pathology, but they’re certainly not fine in the sense that not things that we can improve on and that are not giving us warning signals of what could come in the future.

We often focus on disease prevention and healing the body rather than focusing on the symptoms or the pathology. We’re looking for the underlying cause. However, sometimes we get far enough along that we do need to manage symptoms, otherwise people aren’t going to notice benefit. And, so, further along the disease process, further along the naturopathic order we need to reach. To manage the diseases. These are a little bit higher-force interventions, rather than sort of encouraging tissue repair, like we were doing in the 3rd stage of the Therapeutic Order, now we’re focusing more on managing symptoms, managing inflammation through herbs that are going to calm it down quickly, and detoxify quickly, and we’re going to manage headaches with herbs, that are just generally anti-inflammatory. So we’re going to be looking at symptom-management. And so a lot of the time we’ll do that in conjunction with the other 4 stages of the Therapeutic Order, but this time there is a heavy focus on keeping symptoms under control for better quality of life and to move the needle further.

And the 6th step of the Therapeutic Order is similar to the 5th, except we’re using pharmacological devices and so it’s not that we’re against pharmacology and medications in naturopathic medicine, at all, we simply want to encourage patients to come and see us before things get to the point where you require medications and I certainly believe and I think even many conventional practitioners agree with me on this, that medications are probably too widely prescribed or over-prescribed. And this may be that there are no other solutions and, as a clinician, you want to help the person sitting in front of you and aren’t really sure how to go about that. So somebody comes in to your office who has depression and you’re going to reach for the selective-serotonin reuptake inhibitor, the SSRI, the Prozac or Cipralex, you’re not going to tend to risk using herbs or focusing on diet or digestion or those kind of things, you’re going to use this “proven method” and you’re going to implement that right away, whereas my philosophy would be to, depending on how serious the case is, to implement other interventions and make sure that our terrain is being treated, that we’ve removed some obstacles to cure, we’ve encouraged spiritual and life-meaning pursuits and we’re stimulating the body’s own healing mechanisms and anti-inflammatory mechanisms, and that maybe we’re directly targeting the brain with some nutrients and some vitamins and that we’re making sure structural integrity is there, and that we’re even using some herbs to manage depression because we know that St. John’s Wort works very similarly to an anti-depressant in terms of its efficacy. And then, if those things are not working or not having enough of an impact, then we might talk about an SSRI, depending on how severe the case is.

And I say this not to create a stigma around medication use at all. Every single body is different and everybody’s going to need a different treatment concoction and it’s never going to be just one treatment or very rarely will it just be one panacea, no matter how much we wish that there were, it’s going to be a few things that we need to implement to help manage our own health, so that’s when we’ll reach for the pharmaceuticals, when the natural treatments are not having enough of an impact, or the disease process has progressed far enough.

And then the last is the use of high-force interventions, so surgery, radiation and chemotherapy. When you’re diagnosed with cancer, then it’s definitely appropriate to do radiation and chemo or to excise the tumour, or if there’s joint degeneration to the extent that it can’t further be repaired, and you can’t sort of prevent it any longer, because you’ve reached the point where the cartilage in your joint is damaged, then a joint replacement is appropriate. It’s not that we’re against these things either, it’s that we believe in trying as hard as we can to prevent them from being necessary. But when appropriate, they’re definitely a gift that we have in our culture and the time that we live in that we can use these kinds of things to improve our quality of life and to get us back on track in terms of our health. And so very rarely will I see somebody who requires this stage of intervention, even naturopaths that work with cancer, their focus is not to treat cancer with natural therapies but to support the whole patient and to improve the outcomes of the high-force interventions, often an obstacle to healing from cancer is that patients aren’t able to finish their course of chemo due to the side effects, and so a lot of the natural therapies can help boost the efficacy of the medication and reduce the side effects and make patients feel better, so that they’re able to complete their treatment and then have better outcomes. So, at these two, the last two stages, where we’re using medications and high-force interventions, natural medicine is working to support the terrain and to support the body, through the therapies, through the side effects and to also encourage the therapies to work better.

And just to recap, the stages of the Therapeutic Order are first, number one, remove the obstacles to health, number two, stimulate the Vis Medicatrix Naturae, or stimulate homeostasis, improve our body’s self-healing mechanisms through applying nutrients, or looking at energetics, or using herbs to balance our systems and promote proper hormone balance. And the third is to strengthen weakened organ systems, focusing on one organ that may be the culprit in causing symptoms in particular, and really using nutrients that target that organ and the tissues that that organ has. Number four is to correct structural integrity, creating proper alignment and healing the musculoskeletal system through things like chiropractic medicine, osteopathy, massage therapy, even hydrotherapy and acupuncture, doing exercise like yoga as well fits under there. And number five is to use natural substances to restore and regenerate, so this is using natural substances to work directly with symptoms, to promote healing, but in patients that are further along the road to pathology and maybe already have a diagnosis of some health condition. And number six is to use pharmaco-substances to halt progressive pathology, so these are palliating, they’re stopping disease, they’re treating somebody who is either not responding enough or whose disease has progressed far enough that natural therapies are no longer strong enough. And then the seventh stage of the Therapeutic Order is to use high-force invasive modalities, such as surgery, radiation and chemotherapy and, again, these are removing the disease. Often that stage is usually life or death situations, we’re working to remove what’s causing a danger to our body and to our ability to survive. And so naturopathic medicine cover this whole spectrum. We have therapies that cover the whole spectrum of these stages and we’re working to treat the whole person not focusing on the disease or the symptoms, but looking at the person in front of us, and taking into account their lifestyle their preferences, their unique individuality and genetic expression and individual expression. My name is Dr. Talia Marcheggiani, I’m a naturopathic doctor and I work at Bloor West Wellness in Bloor West Village in Toronto. Take care.

8 Foods for Mental Health

I talk about 8 functional foods that can help calm inflammation, boost neurotransmitter synthesis and restore common nutrient deficiencies that might contribute to low mood and mental health conditions.

My name is Dr. Talia Marcheggiani. I’m a naturopathic doctor with a focus in mental health and emotional wellness as well as hormonal health and hormone balancing, and today I’m going to deliver a short video about some foods that you can add to your diet to help your mental health.

These are all medicinal foods that act like prescriptions, like anti-depressants, that you can just add to your diet. So, a lot of these foods are recommended based on the idea that depression is an inflammatory condition in the brain. There’s more and more research that shows that there’s low levels of inflammation in people who have depression and anxiety and other mental health conditions like bipolar disorder, schizophrenia, ADD, ADHD and even sub-diagnostic symptoms, such as brain fog and cognitive disruptions. So all of these are a result of some kind of inflammation in the brain. And so a lot of these foods are working to heal depression and anxiety with their ant-inflammatory properties.

And so the first thing that’s recommended to eat are lots of anti-inflammatory fats. These are omega 3 fatty acids such as fish oil. So you can either increase the amount of fish oil by having fatty fish three times a week. You can remember what a fatty fish is by the acronym SMASH. And SMASH stands for sardines, mackerel, anchovy, salmon and herring, and also trout, so SMASHT. And these kinds of fish are rich in the omega 3’s EPA and DHA. Our body can make EPA, but some of us have impaired ability to make it. And so supplementing is necessary for a lot of these people. If you’re looking for a fish oil, make sure you look for one that has a higher amount of EPA compared to DHA. This is very important, because studies on depression are very favourable for fish oil supplementation, but the ratio of EPA to DHA has to be at least 3:1 or higher, and the higher the ratio, the higher the amount of EPA relative to DHA, the better the anti-depressant effects, and the mood-regulating effects. So, fish oil actually showed positive outcomes treating bipolar disorder and schizophrenia, so there’s a mood-stabilizing effect as well. And we think because our brain is made up largely of DHA and EPA, but also the anti-inflammatory effects are very helpful for mood and emotional balancing and mood balancing.

Coconut oil is also another great oil you can add to your diet. Coconut oil is a saturated fat, but it’s rich in something called Medium Chain Triglycerides. So these are saturated fats that the body uses readily for energy. So they don’t go through the normal process of digestion that other fats have to go through. They’re absorbed in our lymphatic system. So we get those fats, the energy from those fats, right away.

Coconut oil is very anti-bacterial and anti-fungal, so it can help regulate bacterial balance in our gut and it can give you a boost of energy. There’s also some evidence that being in ketosis, so this means relying on fats for energy, as opposed to carbohydrates, and, to an extent, proteins. Being in ketosis, so burning fat for fuel: body fat or dietary fat, has a mood-stabilizing effect. And so you might read about intermittent fasting, Ketogenic diet. I wouldn’t recommend doing that without working with a functional medicine practitioner, nutritionist or a naturopath, because there are some negative downsides to doing those kinds of diets prolonged, without supervision, but there is some growing evidence for that. But one thing you can do is add coconut oil to a morning smoothie, or eat a couple of tablespoons in the morning, even looking at some Bulletproof coffee recipes, that can also help with keeping your mood steady or your energy high in the morning.

Staying on the topic of fats and nuts, something that is really great for mental health are Brazil nuts. And Brazil nuts are high in a nutrient called selenium, which our body needs to create an anti-oxidant, the main anti-oxidant in our body, glutathione. You may have heard me talk about n-acetyl cysteine, NAC, which is an amino acid that I often recommend for people with bipolar disorder, for schizophrenia and, to an extent, depression and anxiety, and especially personality disorders, like borderline personality. There can be a very strong mood-stabilizing effect with NAC. And that’s probably because—we’re not exactly sure why that is—but it’s probably because NAC is the precursor to what our body uses to make glutathione, but we can’t make glutathione without selenium. So two brazil nuts a day, and they’re really delicious and fun to eat, they’re big nuts—two brazil nuts a day gives you the 200 mcg of selenium that’s the therapeutic dose. It’s also helpful for thyroid health.

Another thing I tend to recommend and am recommending a lot more in my practice is collagen, specifically gelatin, but for the more health-food minded people, going with a collagen hydrosylate supplement from grass-fed meat is something that I often recommend. But, for most people and myself, I just throw some gelatin that you can buy at Bulk Barn, into a shake or into a seed bowl, or into something that I’m eating like oatmeal, or I’ll make jello out of it.

So, gelatin is really rich in collagen, so it’s made from the hooves of animals, and collagen has a gut-stabilizing effect, so it can help heal the gut. A lot of us suffer from something called “leaky gut” in which inflammation in the gut makes its way to the rest of our body and can affect our brain. Leaky gut can often result in “leaky brain”, resulting in inflammation in the brain and then mental health symptoms. So, collagen helps to repair the gut barrier and the blood-brain barrier. It’s also very anti-inflammatory because it’s high in an amino acid called glycine, which is a calming neurotransmitter as well as an amino acid. It can also help balance the immune system. So anyone that has a low level of autoimmunity, or maybe your immune system is on the sluggish side and you’re getting colds and flus and infections more readily than others, collagen is a great supplement for that. Because our main sources of protein: meat, legumes, whole grains, nuts and seeds, don’t contain a lot of glycine. We’re pretty glycine deficient in our society because we’re not eating that much gelatin, we’re not getting as much bone broth. And so you can get collagen from from making bone broth, from stewing bones and accessing that bone marrow, or you can get it from something like gelatin, which is from hooves, from the collagen-rich membranes, the cartilages, of animals. There’s also fish collagen for more pescatarian-oriented people.

Collagen is also really great for anti-aging, for treating hair loss, for skin and for cellulite. So, all aesthetic things that might bring someone in to my practice, but also really great for mood balancing. A good source of protein as well.

You can either just throw it into a shake, mix it into some water or make your own jello. And I make jello by boiling some fruit, about a cup of blueberries in water. I boil it until the blueberry juice is extracted, then I add a couple tablespoons of gelatin and then I put it in the fridge until it’s hard. And you have a natural jello you can serve to your kids. It’s pretty good.

Another great food to help balance your mood and mental health is turmeric. Turmeric, or curcumin, as it’s scientifically called, is a spice that is used mostly in India. It’s a yellow spice, it stains things yellow: your clothes, your counter, your intestines. It has very very strong anti-inflammatory benefits. It also helps the liver detoxify, it’s been shown to have anti-cancer properties, it’s a really powerful, nutrient-rich plant, root. So studies have shown that two grams per day of turmeric actually outperformed Prozac for treating depression and probably this is due to its anti-inflammatory properties in really lowering inflammation in the brain, which we know is really one of the underlying roots of depression. The way that we get to that inflammation is different in every person with depression, but there is this kind of common thread of inflammation that’s going on in every case of mental health condition, mental illness. So, adding turmeric to foods, or supplementing with turmeric, is a great way to combat that inflammation and keep moods balanced.

Some other foods you might want to add to your diet are foods that are rich in zinc. So, these are mainly things like pumpkin seeds. You’ve got to get around two cups, though, of pumpkin seeds, to get a decent therapeutic dose of zinc, or oysters. Or you can supplement with zinc. Zinc, again, is anti-inflammatory, it can help heal the gut. We need it to make neurotransmitters and enzymes that our brain needs to rebalance mood. And there’re also some studies that zinc increases something called BDNF. BDNF is a chemical in the brain that help with neurogenesis, this is the creation of new neurons in an area of the brain called the hippocampus. So you may have heard “you can’t teach and old dog new tricks” or that our neurons never regenerate once we reach a certain age, and this is not true because new research has shown that we do have neurogenesis, something called neurogenesis, that increases and changes and grows new neurons even as we age. And so anyone suffering from brain fog or really high amounts of cognitive stress, or mental illness, maybe benefit from zinc as that increases the neurogenic abilities of the brain. It’s also very anti-inflammatory and it can help with leaky gut and leaky brain situations. Vegetarians, unfortunately, are often deficient in zinc just because we get most of it from animal products and animal sources, but really upping your pumpkin seed intake might get you to a therapeutic level of zinc or you can supplement as well.

Another really great addition to your diet to help balance mood and to improve your mental and cognitive health are fermented foods. So, these include things like kefir, kombucha, kim chee, saurkraut, and yogurt, if you do dairy. These things, they contain probiotics, and studies show that it may be better to supplement or to add fermented foods to your diet rather than supplementing with a probiotic, and this is obviously an individualized recommendation that would have to be made by a doctor, but adding fermented foods to your diet, especially if you make them at home and ferment them at home, like you make your own kombucha or your own kefir, that can actually boost the probiotic capacity of your gut. Probiotics actually make neurotransmitters, they make things like serotonin, and the calming neurotransmitter GABA and they can help us digest our food, like gluten, as well as combat inflammation and regulate our entire immune system. It’s also important to feed those probiotics with something called resistant starch that you can find in carbohydrates that have been cooled to room temperature after they’ve been cooked, so, for example brown rice that’s after it’s been cooked as been cooled to room temperature, potato starch, green bananas, black beans, and jerusalem artichokes. These are all starches that bacteria feed on and that keeps them populated in the gut. Coconut oil tends to kill more pathogenic bacteria and therefore can promote a healthy bacterial balance.

And lastly, I’m going to talk about leafy greens. So, adding a cup of spinach, or two cups of spinach or chard to your diet will give you the amount of magnesium you need. Magnesium has a calming effect on the body. We need it to make the neurotransmitters like serotonin, dopamine and melatonin, to help with sleep. Magnesium also can help balance mood and help us with stress. A lot of us suffer from stress. It can also make our brain more resilient to stress, as stress is one of the major causes of neuro-inflammation in people with mental illness and this can be stress from a significant trauma, it can be psychosocial stress, interpersonal stress, the stress of being out of work, even long-term chronic stress or burnout from school and work and things like that. So, two cups of spinach gives you your daily magnesium serving. You can also get it from chocolate but you need to eat quite a bit of chocolate.

So, in boosting your mental health, or in promoting mental and emotional wellness, you can add all of these foods to your diet and balance your inflammation, feel good and nourish yourself.

5 Tools for Emotional Wellness and Mental Health

I talk about 5 essential tools for caring for your mental and emotional health. These are powerful self-care practices that can help balance your mind and emotions.

Hello, everybody, my name is Dr. Talia Marcheggiani. I am a naturopathic doctor with a focus in mental health and hormonal health.

Despite the increasing amount of research into mental health conditions and psychiatric conditions, and the increase in interventions and early recognition and pharmaceutical therapies that come with mental health diagnoses, we’re actually seeing more debility in mental health outcomes: more debility, more morbidity. So we’re seeing worsening of outcomes even though we’re applying more interventions.

So, how could this be? You expect that the better the drugs that we’re developing, the less disease we should encounter, if those drugs are actually working to counteract the disease process. We’re not seeing that in the realm of mental health, especially when it comes to the common conditions such as depression and anxiety.

And when it comes to disease in the west, we’re not really winning the war against disease. So, things like cardiovascular disease, cancer, hormone imbalances such as diabetes, hypothyroidism, mental health conditions such as depression and anxiety, ADD and ADHD, infertility, neurological disease such as MS and Parkinson’s, autoimmune disease, such as, again, MS and things like Hashimoto’s Thryoiditis and myasthenia gravis, and immunodeficiencies such as HIV. All of these diseases are on the rise, all of these chronic, lifelong diseases. And so, despite these advances in research and drug development, we’re not seeing an improvement in our ability to manage these diseases or prevent them.

And there is obviously not one simple solution to this problem, but one thing I want to point our attention to is this increase in stress and this connection to stress and the diseases that I mentioned. Obviously it’s not just one cause, that would simplify the entire system to an almost ludicrous degree, but there is an estimation that 75-90% of hospital visits are either directly or indirectly related to stress.

And some of the symptoms of stress, so chronic stress or even acute stress, are an increased heart rate, elevated blood pressure, elevated blood sugar, decreased memory and cognition, disrupted levels of serotonin, leading to depression and anxiety, disrupted levels of the other hormones such as dopamine and norepinephrine, and addiction to stress, so a chance in the opioid receptors and the brain structure, altered hormone synthesis, increased inflammation, altered gut flora, etc., etc., and a change in the immune system. So, basically, every system of the body is affected by stress. And being in a prolonged, acute state of stress is lethal to the body.

So, we can look at the rise of cardiovascular disease and diabetes and the fact that stress increases our heart rate and increases our blood pressure and increases our blood sugar. And we can make some of those connections between the symptoms of stress and the diseases that are increasing in our society.

When it comes to mental health, we see how our neurotransmitters and our brain structure and our gut and our immune systems are affected by chronic stress and we can infer that some mental health conditions are either caused by or aggravated by this chronic stress situation. And, so, by not addressing stress and by not looking into stress and finding healthy ways to manage it, we’re doing ourselves a disservice in the management of these diseases and the prevention of them,

So, there’s a few theories that connect—there’s that Monoamine Hypothesis when it comes to mental health, that people with depression and anxiety have this inherent brain imbalance. So they don’t make enough serotonin, or their brains for some reason aren’t responding to serotonin. Again, it’s a very reductionistic model because it reduces all of the experience of depression and anxiety and conditions such as ADD and ADHD and bipolar down to one single neurotransmitter and it oversimplifies the entire system and the entire constellation of symptoms that people can experience and the life situations surrounding these conditions and the fact that they’re comorbid with things like stress and poverty and childhood trauma and those kinds of things.

But there’s some other theories that we can look at, and some other kind of pieces of the puzzle that we can add to create a more inclusive narrative. So there’s a theory called the Mind-Body Theory and this kind of arises as a counteraction, or a counter-philosophy to what Descartes discovered or decided that he discovered, which was that the mind and body are separate entities—this dualistic hypothesis. We know absolutely that that’s not true but our mind and body are completely connected and that our mind probably doesn’t reside only in our brain because our nervous system extends throughout the entire body and our minds are also inter-relational, so they’re a product our environments and our relationships with other people as well.

We know that the gut is the second brain, for the amount of neurons that it inhabits and the neurotransmitters that influence its function. Our gut health affects our mood depending on how healthy it is. And we call this connection, another word for it, a more scientific word, is “Psychoneuroimmunology”. This is the connection between the immune system, the nervous system, and our psychology, our mood: our thoughts and emotions. So, we know that everything in the body is interconnected and you can’t prescribe an antibiotic and not expect that there’ll be sequelae or consequences, or side effects that affect a different body system. And we see that all the time now, but we have to understand how tugging on one thread in this interconnected web is going to affect another piece of it further down the line.

There’s also this Energetic Model of mental health, and that’s that the emotions have their own energy. There’s this theory that the emotions can manifest as physical symptoms and we see this in the work of Gabor Mate, who writes extensively about stress and addictions and mental health, in his book “The Body Says No”. He talks about how the health of our thoughts and emotions impact our physical stress. And so it’s not just that our thoughts and emotions can impact our mental health, but also our physical health and might set the stage for us to get conditions like cancer, or autoimmune disease, and all of the other diseases that I mentioned.

So, when it comes to stress and our mental health and emotional wellbeing, we need to take a proactive approach. Just like we do with getting vaccinations, and preventing colds and flus, and getting proper nutrition, and exercise and all of that, we need to be strategic about how we manage our stress.

The World Health Organization defines mental health as “A state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.” So, notice that this definition isn’t simply the absence of disease and it’s not necessarily a normalizing—being “happy” or not having a diagnosis. This definition is about realizing one’s potential and experiencing emotional “wellness”, for lack of a better word. So, an ability to cope with life’s stressors and to live a life of meaning and purpose.

So I want to talk about 5 tools that are really important for establishing a self-care and emotional wellness routine, for improving mental health. These strategies may not be sufficient enough for more serious psychiatric conditions, but I believe that they form the foundation of proper lifestyle strategies to help with increasing our emotional wellness and our ability to cope with life’s stressors.

So the first one I want to talk about is something called “Self-Care”, which is becoming kind of a buzzword in high-stress communities such as universities, and even some offices and corporations. So, one of the first things I want to talk about is the power of saying “No”. Sometimes saying No, especially for more agreeable individuals, and a lot of the time for women, saying no is a difficult thing for us to do.

When I give this presentation to a group I always ask them, “Why is it hard for you to say no? What would happen if you didn’t say no? Let’s say a friend invites you out and you’re just not feeling it, or you’re invited to a baby shower and it’s just more than you can handle and you wish you could say no, but you don’t.” And, one thing that everybody says is that they’d feel guilty, if they said no. This is sort of universal. And so I ask them, “What would happen if you didn’t say no? What would happen if you went along with it, even if you just didn’t have the energy to devote to this commitment?” And people say that they’d feel resentment. And so when it comes to deciding what things to take on and what things to discriminate against in terms of the tasks that we take on, the commitments that we make, we’re kind of stuck between this dichotomy between feeling guilt and resentment spectrum. One of my mentors, Gabor Mate, in his book “The Body Says No”, talks about when faced with this choice between guilt and resentment, especially when we’re more prone to guilt-avoidance by saying yes more often than maybe we should, he said “choose guilty every time”, because the feeling of guilt, and obviously this isn’t a hard or fast rule, but the feeling of guilt is more indicative that you’re taking care of yourself.

His theory as well is that resentment tends to build up in the body and contributes to the cause of more disease such as cancer and this cancer personality that he writes about is the woman that will say yes to things and is scared to say no out of guilt. So, resentment is far more damaging for the body and therefore, when trying to avoid guilt, maybe move towards guilt, especially when you know that you might be taking on more than you should. And also pay attention to the idea that when we say yes to things we’re saying no to other things. So, we’re always saying “no” and “yes”. We only have 24 hours in the day and so, by saying yes to that baby shower that you’d rather not go to, what are you saying no to? Are you saying no to doing a yoga class for you, or getting extra sleep, or saving your money for a family vacation? So, paying attention to those commitments that we make. There’s a great article online called “The Law of F- Yes! Or No.” And this law is, if you’re faced with a decision and you’re not feeling like this, “F- Yes!”, then say no and save that time and save those commitments for something else that you’re more enthusiastic about.

When it comes to self-care, there’s another great article that talks about the BACE method, so that’s BACE. And this stands for these 4 pillars of self-care. And the first one of body-care. So that’s making sure you have a healthy diet, that you’re supporting yourself nutritionally, that you’re getting movement in, that you’re sleeping enough. A is acceptance, just allowing the emotions, and that self-care, that self-love to come through. C is connection, so establishing those interpersonal relationships and prioritizing them, especially relationships that feel nurturing, where you can be your authentic self. And E is enjoyment, finding activities that are fun and cause a sense of enthusiasm and enjoyment in your life. And this is something that’s often a problem for a lot of adults with lots of responsibilities that, when I ask them to rate on a scale of 1 to 10 how much fun they have, or how satisfied they are with the amount of fun in their life, they often rate it pretty low.

A lecture that I attended, there was a woman who was talking about self-love and improving self-worth and recommends asking oneself this: “what would someone who loves themselves do? Or say?” and that can be pretty powerful for just examining how our internal dialogue is manifesting and how we’re talking to ourselves and treating ourselves. Would someone who loves themselves eat that? Or say that? Or do that activity or say yes to that commitment? And, you know, just sitting with that question can be really helpful for changing some behaviours, or adding perspective to our daily lives.

There’s also this, lastly in the realm of self-care, there’s this idea of Wu Wei, which is a Taoist idea, which is translated roughly into the art of “effortless action”. In our society we’re kind of educated to pair action with effort. So, we don’t feel like we deserve success unless our success was the result of a massive amount of effort that we’ve put in, and stress. And, according to wu wei, this idea that action is objective, we can measure it, but effort is subjective. So, you can see if you’re performing an action, but the perception of effort behind it is this kind of subjective and thought-based experience. So, we can do the laundry or DO the laundry. We can do laundry from a place of self-love and self-care, like “I want to care for my clothes, and to have nice clothes to wear tomorrow and I’m going to do this for myself and I’m going to be mindful as I do it”. And I’m going to do this out of necessity, but also out of a natural drive that’s coming from this place within. Or I can have laundry on my to-do list that’s causing me stress. So, sometimes even wu wei is about doing less and not feeling guilty for that.

The second tool for emotional wellness is journalling and writing. This is one of my favourites. So, journalling allows us to keep a record, to get creative, and to engage in self-expression. And when we write we engage both sides of our brains: the motor centres, the language centres, the centres that are involved in language perception and in language generation, also our visual centres. So, a lot of the brain is lit up in the act of writing and that can help integrate some of our deeper thought processes.

Writing down things leads to clarity and focus. We’re forced to deepen our thought processes and remove ourselves from some of the cognitive loops we might be engaged in. We can complete our thoughts and reach their inevitable, often ridiculous conclusions and this kind of comes from some core beliefs, or, we call them “automatic thoughts.” Like, “I’m a failure” or “I’m worthless”. Those kind of things that our brain generates based on past experiences that may not be relevant anymore to who we are now. Through writing we’re forced to look inside of ourselves, to causes and explanations for how we feel. We’re also able to express ourselves and rid the body of pent up emotions, such as anger and aggression and sadness, shame.

I often recommend that people write a letter. Especially if there’s someone in the past that’s done damage to them, or hurt them. Someone that they miss, sometimes remembering somebody through a letter: sometimes people wish that they could communicate with someone who’s passed away or is no longer in their life anymore and, through this letter-writing, you’re able to.

I also have people write letters to themselves from the perspective of their personality at age 80, and this can sometimes provide perspective for patients who are depressed and young, because it gives them an idea; it increases the perspective of their lives. And sometimes I have people personify and anthropomorphize their problems or addictions and write letters to that or write letters from that and through that process can learn a lot about the relationship between themselves and alcoholism, for example.

There’s another great activity I like called the “God Jar”, for people that have constant worries or wake themselves up at night and process things or who are anxious about the future—The God Jar or the Wish Jar. And so, you get a mason jar and little pieces of paper and you write things that you’re worried about or things that you’re anxious about or thinking about and you scrunch them up and throw them into this jar and, in essence, symbolically, you’re giving those problems to “God”, or to the universe or you’re just simply filing them away for later use. And this is sort of a subconscious, or conscious, dumping of your problems, especially if you don’t have immediate control over them. I mean, in the middle of the night you’re not going to be able to finish your taxes when you’re supposed to be sleeping, or solve a problem at work. And that can often worsen our problems, when we’re not getting enough sleep. Then I sometimes have people open up that jar 6 months later and take a look at some of the things they’ve written and that can also generate feelings of accomplishment and achievement and perspective when you find out that those things that you were so worried about 6 months ago are no longer even relevant and you barely remember them. So, it’s pretty powerful.

Another great exercise is something called a Gratitude Journal. And there’s a Ted Talk about this that, for 21 days, and I like to tell people to do this for a full month, 28 days. If you write 3 things that you’re grateful for at the end of the day for 21 days, it actually changes your brain structure and helps you see things in a more positive light and focus on the blessings, rather than the things that you lack. Our brains have a negative bias. So, they’re wired to pay attention to the things that we’re missing out on and that we’re lacking and when we focus on and acknowledge the things that are going right for us, it can sort of change our perspective. And, throughout the day, as you’re doing this exercise, you’re going to be paying attention to things that you’re going to have to write down later, so you’re paying attention to the things that went well, that you want to include in your gratitude journal. And this can have profound effects.

There’s some studies about journalling. And there was a study that showed that patients with HIV or AIDS, who wrote about their life for 30 minutes had an increased CD4 T cell count—and that’s the cells in the body that are affected by the HIV virus. So, by simply writing about their lives, something profound, it wasn’t just a grocery list. But writing something profound about their lives, such as sharing their life story, actually increased their immune system’s ability to function in the face of the HIV virus.

And then, similarly, there was another study in patient with rheumatoid arthritis—this is an autoimmune condition—they had these patients write for 20 minutes a day, for 3 days, and they found that their symptoms went down and their immunoreactivity went down. So we’re seeing these two studies, and we’re not exactly sure of the causal effect, these studies are a little bit correlative and very difficult to control for, because patients who are in the study, subjects know if they’re writing in their journal or not. But these studies were controlled against people who were just kind of mindlessly writing about grocery lists. So, it was writing about more profound concepts and sort of outlining a significant life event, or life story, or significant events that were happening in the day that had an emotional charge to them.

So, we find that engaging in journalling, even 20 or 30 minutes a day, can actually modulate the immune system. So, if you have a immunodeficiency issue, like HIV, it can increase immunoreactivity, and if you have an autoimmune disease like rheumatoid arthritis, or asthma, if can lower that immunoreactivity and inflammation. So there’s this evidence that journalling and our thoughts and emotions are directly impacting our immune system and our immune system’s ability to function and balance itself.

The third tool for mental and emotional wellness is interpersonal support. And, being a naturopathic doctor who does a lot of counselling in my practice, I tend to favour psychotherapy and counselling as a form of social support for people that don’t feel that they can be authentic or have that deep connection with people in their lives.

There’s evidence that loneliness is the new epidemic, especially in our society and, as social animals, connecting with others is part of our biology, part of who we are. Through therapy, what I really like about it, is it can help us reframe the past and our personal identity. We can start to identify some automatic thoughts and core beliefs, which are deep-seated beliefs that may not serve us anymore in the present and may actually be contributing to feelings of low mood or behaviours that are unwanted. It can also allow us to rewrite our life story, so, looking back on the past and reframing certain events, from the perspective of someone maybe with more resources and power. For example, someone with a history of trauma may have an idea of powerlessness and being victimized and, in every single story of trauma that I’ve encountered, people have always responded in some way. Either psychologically, mentally, emotionally, if not in action, and sometimes just recognizing these responses changes our whole perception of the event and our identities in the present, our ability to act in the present. So, there is evidence that stress is related to our perception of things that happen, not actually what happened. So, for example, imagine somebody that’s just broken up with their girlfriend and they were very in love. And you can image what their mental and emotional state would be like. Maybe the next day they don’t feel like getting out of bed, there’s clothes all over the floor, they haven’t brushed their teeth, they’re feeling extremely sad, and crying. And nothing has changed biologically in this person, but the situation surrounding their life has changed. Then imagine that this person wakes up the next day and they’re in this state of low mood and depression. And they get a phone call. And it’s their girlfriend saying, “you know, I’d like to get back together, I made a mistake, I’m in love with you and I don’t want to be broken up anymore.” So you can imagine that this person’s mood is going to change rapidly as the situation changes. And so, there is a change in their circumstances, but not in their physical biology.

And sometimes, in past events, there’s the story that our minds create around what happened, and then there’s the actual events that happened. So you might call your partner and they don’t pick up the phone, and we start to create a story about why that is. Maybe it’s because they don’t love us anymore, they want to break up with us, that we’re worthless, that no one’s ever loved us, that we’ll never find love, that we’ll always be alone. But, in actuality, we don’t know those things and the only thing that’s happening is they’re just not picking up the phone and there’s thousands of explanations for that.

We perceive situations based on our personal histories, our physical conditions, our state of minds, etc., and things that we’ve learned in the past and also our core beliefs. So, we filter our experiences through our perceptions and our identities and personalities and so, by understanding more about these things, we can understand why we pick out certain events and draw conclusions from the connection between those events rather than others. There’s some people that, when they fail a test, they just think, “Oh, it was a hard test, or maybe I didn’t study hard enough.” And there’s others that think “I’m a failure, I’ll never pass anything, there’s no point in trying, I’m dropping out of school.” And so it’s not just the event but our perception of the event that change our thoughts, mood and behaviours.

Another great thing that therapy and social support can do, is help us identify our passions and purpose in life. So there’s a psychological that I really like to listen to called Jordan Peterson that talks about how the purpose of life is not necessarily well-being and happiness, because happiness is a state that can be derived chemically, through doing things like cocaine, or substance abuse, and happiness might just be a disposition that certain people embody better than others and that life is suffering. And this is present in Buddhist philosophy that no matter how we live, we’re going to encounter events that are devastating for us, and that are hard for us to deal with. And so, in those situations, we’re not going to feel happy, so what’s going to drive us? What’s going to push us forward? What’s going to keep us going in those times and so his theory or idea is that we should look for what makes it worth it: what adds meaning to our life. What is our potential in life? What is our purpose? What gives us that sense of meaning such that, when we encounter these situations of suffering and hopelessness that we’re able to continue on. So, having a direction for our lives, and having a sense of identity and purpose that gets us up in the morning and makes us move forward, even when we’re not particularly feeling happy that day.

Therapy and social support are also great for just self-acceptance. So, having other people mirror back to us who we are and how we’re being in the world.

The 4th tool for emotional wellness is mindfulness and meditation, so very very powerful tools. It’s arguably very difficult to be healthy in this day and age without some form of mindfulness meditation, or meditation practice to combat the increase in stress that we encounter in our society. So, mindfulness is—there’s many different techniques, but the main tenant is just taking the perspective of the compassionate, detached observer to our thoughts, emotions and physical sensations. So, when we split our mind or watch our thoughts, we can get a better sense of awareness of how emotions and thoughts arise in our body, pass through our bodies, and how we’re not them—that there’s this observer role that we can also take, that we can watch ourselves from.

Mindfulness allows us to stay in the present and reframe certain situations and just slow time down so that we’re not victims to the whims of our biology, that we’re able to understand it a little bit more. And there’s a great resource on the internet called “Mindfulness-Based Stress Reduction” that’s a secular kind of meditation by a man in Massachusetts called Jon Kabat Zinn and you can download body scan meditations or take a course in MBSR in your town. I highly recommend them; they’re really great for developing mindfulness practice.

There’s also yoga, and qi gong and tai qi, and these kind of integrated, mindfulness-based and physical exercises that can help slow us down, bring us into the present and help us observe our minds and emotions a little bit better. And there’re amazing for managing stress. There’s good evidence building about them helping us deal with stress and manage our mental health conditions.

And the 5th tool for mental and emotional wellness is to look at that mind-body connection that I mentioned before. The mind-body theory sees our thoughts and emotions as energy that can impact our cellular biology, from that idea of psychoneuroimmunology. And there’s increasing evidence about this and how calming our thoughts down, doing some mindfulness meditation, can affect our heart-rate and can affect our blood pressure, and journalling can affect how our immune system responds.

There’s this idea that if our thoughts and emotions aren’t processed properly they can become trapped and stagnated in the body and contribute to disease. So, Gabor Mate mentioned that resentment can build up and lead to things like cancer. It’s one of his theories that he’s observed through working with patients.

We know that there’s this connection between physical manifestations of symptoms and physical conditions and certain emotional causes. In medicine we know this because every time a study is done, a randomized control trial, two groups need to be divided amongst the subjects. One is given a placebo, an inert pill. And this idea that someone who believes they’re taking medicine will notice a positive effect, is something that we just take for granted, but we build into every single study that we do, if it’s a good study. So, this idea that you can take a pill, believe it’s helping you, and actually physically notice a change in your body is really remarkable. And this just proves that there’s this connection between the mind and body, that we can further explore and exploit.

So, there’s things like herbal remedies that help our body increase our cells’ resilience to stress and help manage the stress hormone cortisol. And these are some herbs called adaptogens. So, they literally help us adapt to stress. And these are things like withania or ashwaghanda, rhodiola, ginseng, even nervine herbs like St. John’s Wort and skullcap can help balance our neurotransmitters and our stress hormones and lower inflammation in the body.

Doing self-care things like getting a massage, or getting acupuncture can help. And there’s a study that compares acupuncture to Prozac, so getting one acupuncture session a week for 6 weeks was actually comparable to Prozac for decreasing symptoms of depression and anxiety.

In my practice I always address diet and gut health and just make sure people are absorbing their nutrients, that they’re guts are producing the proper amounts of neurotransmitters, that there’s the proper bacterial balance, that there’s no inflammation being caused by a gut dysregulation. And we also want to remove those external stressors that can be contributing to an impaired digestive system. So, there is this saying that “we are what we eat,” but more accurately, we are what we absorb, because you can eat a lot of stuff, but, depending on how you’re digestion is functioning, we might not be absorbing all of it and incorporating it into our body, into our cells.

So, inflammation in the gut, caused by a bacterial imbalance, or food sensitivities can impact our health and we have some evidence that depression and anxiety can be caused by some latent levels of inflammation in the brain. And we know that there is an impact on gut health and increasing levels of inflammation and also stress. And really lowering that stress response, healing the gut, can have huge impacts on our mood. Establishing routine, and sleep are major pillars. So, I don’t think I’ve ever encountered a patient who felt mentally healthy when they had disrupted sleep. A lot of the time having a ritual around sleep and getting into a routine and waking up at the same time every day, really working on getting deep sleep—so avoiding electronic use before bedtime, trying to get as many hours before 12 am of sleep as possible, so preferably having a 10pm bedtime or winding down around 10 pm. Doing things like teas, or hot baths, or reading a book before bed or doing some yoga or stretches or meditation before bed to teach the body that it’s time to start relaxing is really important and has huge impacts on health, on our mood, on our emotional wellness, our ability to cope with stress, our ability to heal from stress, and our ability to balance inflammation and the immune system.

There’s evidence that exercise—I mean exercise is arguably the first-line therapy for someone with depression, especially someone under the age of 24. Instead of reaching for pharmaceutical interventions, such as selective-serotonin reuptake inhibitors, more psychiatrists are recommending exercise to young patients, which is wonderful. I’m so happy about that! And, so 30 minutes of a moderate to intense form of exercise such as weight training, or running or moving your body, can help release some of those trapped emotions, as well as boost those neurotransmitters and help our body increase its resilience against stress.

And then, finally, I just want to point out that making sure that we’re supporting our neurotransmitter synthesis through diet is really important. So, making sure that we’re getting enough magnesium, zinc and B vitamins, and proteins and amino acids, which are all helping us create the neurotransmitters like serotonin and dopamine that are going to impact our mood and mental health. So, we can journal, but we are physical beings, and we are a product of our biology. So, by supporting that biology through proper nutrition, we’re able to incorporate those nutrients and create the proper components of our body for proper mental and emotional wellness.

So, I also like to ask people this miracle question. So, this is the final thing that I’m just going to conclude on. The Miracle Question is from a modality called “Solution-Focused Therapy”. And this question is, “if you woke up tomorrow and all of your issues were completely gone, you woke up in an amazing 10 out of 10 state of energy and physical well-being and mental and emotional well-being, what would be possible for you? What would your day look like?” If you can stand in that place and sort of write down what you’re aiming at, what you’re aiming towards, it helps set the stage for taking the proper actions that preserve your mental and emotional wellness. And it also helps you stand in a new territory, one that’s not of disease or illness, but one of possibility.

And, finally, I was at this free meditation circle as we were talking about self-love, and we were talking about how difficult it can be to love oneself. Because, oftentimes we have these core beliefs that drive our psyches and oftentimes these core beliefs are negative. And so what was said was that it’s often hard to stand in a place of self-love when you’re intent on changing things and you’re not happy with where you are now. And so, he said, the person running the meditation said, “self-love is like a garden. So, you can nourish the soil and water the seeds, but you can’t actively force the garden to grow.” So what you can do is, you can take care of the things you love in yourself, all the things that you have in your right now, rather than trying to be somewhere that you’re not currently at. And this is kind of like when you have, for parents out there, if you have a child, you love your 4-year old child, and you don’t put expectations on them that you would a 25-year old. So, you’re loving your 4-year old at where they’re at, but also recognizing that this is somebody who is developing and so you’re loving their potential to develop, just as you’re loving their 4-year old incarnation, their 4-year old manifestation of their personalities. So you’re loving their potential to grow, just as you love the seeds that you’ve planted in your garden, but you’re also loving things where they’re at. And through that act of self-love and tending to the garden, or tending to your child, you’re encouraging that growth and development in the directions that you want.

My name is Dr. Talia Marcheggiani. I’m a naturopathic doctor and I work in Bloor West Village, in Toronto.

A Naturopathic Approach to Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome, or PCOS, is the most common hormonal imbalance in women of reproductive age and can result in weight gain, infertility, acne, irregular cycles and unwanted hair growth. I talk about a naturopathic and functional approach to managing symptoms of PCOS and restoring hormone balance.

Hello, everybody. My name is Dr. Talia Marcheggiani. I’m recording to you guys from my clinic in Bloor West Village. It’s called Bloor West Wellness Clinic. And today I want to talk to you guys about one of my favourite conditions to treat when it comes to naturopathic medicine. And this condition is called Polycystic Ovarian Syndrome. And this is an endocrine, or hormonal condition, and it affects about 10% of women. It’s the most common cause of hormonal imbalance in women of menstruating age. And it’s a syndrome, so it’s not a disease. There’s a different constellation of symptoms that arise with it and this could be one of the causes of infertility in a lot of women. And because the symptom pictures are so diverse, it’s really hard for a lot of women to be suspected for a diagnosis of PCOS, or polycystic ovarian syndrome.

So, PCOS, the hallmark, the diagnostic criteria, based on the Rotterdam Criteria, is having either two of these three symptoms: anovulation or oligomenorrhea, which means having periods that are irregular. So, either having more than one period per month or missed cycles and long cycles of 6 weeks or more. The average female menstrual cycle is about 26-34 days, so having periods outside of that “normal” range could indicate one of the symptoms of PCOS. The other one is something called “hirsutism”, which is caused by high androgens, or male sex hormones, like testosterone or DHEA. And some of the symptoms of that are acne, so hormonal acne, those pustular, cystic acne that happens around the chin and jaw-line, or the chest and back. And “hirsutism”, which is the male-pattern hair growth, which is great, if you’re a woman, to have, which is the hair on the mustache and chin. So, you kind of sport a Frida Kahlo mustache and probably have to deal with that on the regular. Similarly, having hair loss on the scalp, is another sign. So, when you think of men, men will typically experience male-pattern hair loss, and hair-growth in the facial area.

And the third symptoms is the presence of cysts on the ovaries, which is diagnosed or sighted with a transvaginal ultrasound. There’s a scope placed through the vagina and an ultrasound is done to see if there are cysts on the ovaries.

It can also be diagnosed with lab work, so that’s not using the Rotterdam criteria, but there are two hormones that the brain makes that control the ovaries and these are called FSH, or follicle-stimulating hormone, and LH, lutenizing hormone. The brain makes the hormones and they tell the ovaries when to ovulate and the ovaries also make LH, lutenizing hormone after they’ve ovulated, or after the corpus luteum forms, after ovulation should happen, so whether the egg is fertilized or not, the corpus luteum will form.

And so PCOS is probable when you order labs and find that, so the FSH and LH should be almost the same, they should be at a 1:1 ratio and PCOS suspect when the LH to FSH ratio is 2:1 or higher. So you have either 2 or more times the LH than you have FSH. And this is because in PCOS, the ovaries will secrete a lot more LH and that is one of the reasons why they hypothesize that there are high androgens, because the LH can stimulate more androgen release.

So, there’s a “skinny PCOS”, so these are women with those symptoms that don’t experience obesity or metabolic syndrome, and then there’s the metabolic syndrome type of PCOS and in these patients there’s an insulin-resistance present, or a glucose-intolerance. And so these women will frequently experience hypoglycaemic crashes. They’ll also probably be on the obese side and really struggle to keep weight off and they’ll experience the low energy, the cravings for carbs. They’ll experience the hunger that comes two hours after a meal, despite having eaten an adequate amount of fat and protein, and this is really problematic for them because they’re set up for diabetes and for cardiovascular disease down the line. And then they’re also experiencing symptoms of obesity and they’re not super happy with how they look.

And we’re not exactly sure what causes PCOS in women. There’s evidence for it being heritable, so genetically passed on. There’s evidence for it being caused by insulin-dysregulation, and perhaps the ovaries are not responding properly to insulin. What insulin does, is it helps us take in fuel or glucose into our cells and, just like all the cells in our body, the ovaries require insulin to absorb glucose so that they can function properly. And so one of the theories of PCOS is that the ovaries are resisting insulin and the insulin is signalling them to grow, but they’re growing in the absence of proper fuel, or proper glucose as fuel and so they’re creating these follicles, or cysts.

And so, absence of periods, or irregular periods; male-pattern hair growth; obesity; infertility and then the presence of those cysts on the ovaries are all symptoms of PCOS. So, when we’re trying to get a diagnosis, we’ll send patients in for a transvaginal ultrasound. We’ll also look at their fasting blood glucose and fasting insulin. We’ll look at their progesterone and estrogen, because oftentimes these women are suffering from estrogen-dominance: there’s low progesterone and high estrogen in relation to the levels of progesterone. We’ll look at their FSH and their LH, and I’ll also check out their thyroid because oftentimes the symptoms of hypothyroidism and PCOS are overlapping and so I want to find out if there’s a thyroid pathology happening in the background.

So, one of the main reasons that women will come in with PCOS is because they’re trying to get pregnant, or they want to preserve their fertility in the future. They might come in for acne issues or the hair growth, or just to sort out their periods, but the main reason that they come in is fertility. And 40% of women with PCOS do experience infertility or fertility challenges. So this is a big issue for them.

And the reason I love treating PCOS in my practice is I find that, and this is sort of perhaps not technical or scientific, but I find that the personality of women with PCOS tends to be more phlegmatic, so they’re usually more agreeable, and happier and patients that really want to do good work and so it’s really enjoyable to work with them. But also, the reason I love treating patients with PCOS is because there are so many effective strategies that naturopathic medicine offers and I don’t see an equal amount of strategies in the conventional system.

And I’ll talk a little bit about some of the conventional therapies of PCOS. So, what happens is, in conventional therapy, is they kind of look at the symptoms in the syndrome spectrum and they kind of try to deal with each symptom individually. So they look at irregular periods and they’ll prescribe a birth control pill. So, like, “ok, we’ll just over-ride your own hormonal production and we’ll control your periods and get you cycling regularly”, which obviously doesn’t treat the underlying hormonal imbalance, because you’re just placing exogenous, fake hormones on top of the picture.

Or they’ll say, “ok, there’s blood-sugar dysregulation, so I’m going to prescribe a diabetic medication called ‘metformin’, which will help resensitize your cells to insulin”, which again is not the best strategy, although there’s some evidence to support that this helps. But, we’re not again treating the underlying issue of insulin resistance and metformin is pretty toxic to oocytes, or ovarian cells, so when you’re treating infertility you’re not setting the body up for healthy ovulation and producing a healthy baby. So, ehh, metformin.

And then we have, they’ll treat the high androgen symptoms, the hirsutism symptoms, the hyperandrogenism, by prescribing spironolactone, or Yas or Yasmin birth control pills, that block androgens. And, again, not the best strategy because it’s not treating the underlying cause, and there’s some evidence that Yas and Yasmin are one of the oral contraceptive pills that set you up for a higher risk of blood clots compared to other pills. So, women who are taking these are slightly higher than normal, compared to other birth control pills, risk of pulmonary embolism, deep vein thromboses, and those kind of blood clotting issues, which could be fatal. So, that’s an issue, right? And, again, not treating the underlying cause.

So there’s not that many great therapies and they’re not holistic. They’re not looking at the whole picture, they’re kind of reactionary and they’re just treating the symptoms. And then in terms of fertility, so women will undergo IVF treatments or they’ll be prescribed ovulation drugs like Clomid, which increase estrogen and get your body ovulating, kind of forcing ovulation to happen and again can be an issue because these women with PCOS are having sometimes an estrogen dominance picture, so their estrogen is high in relation to their low progesterone and so adding more estrogen-promoting drugs like clomid could just make life a mental and emotional disaster for these women while they still have the drug in their bodies. That could happen to a lot of women, but, again, not the best. It could achieve the end goal of getting pregnant, by increasing your chances, but we’re not looking at what’s going on.

And so, what happens, if when I first see a patient with PCOS, we’ll run the labs, or I’ll get the labs that their family doctor has run, if that was done recently, and we’ll take a look at their symptoms, so I’ll ask them how their periods are, and if they get PMS symptoms, and how often their periods come. And I’ll get them to track their periods, so I can see are they happening regularly, and they’re just very far apart? Or are they all over the place? We’ll look at their FSH and their LH, to see if they have that classic high LH to FSH ratio, and we’ll look at their insulin and fasting blood glucose and their testosterone. And I’ll ask them about symptoms, like acne and hair growth and we’ll talk about weight loss and if they’re getting those hypoglycaemic or insulin resistance symptoms. And we’ll talk about mood and emotions and digestion as well, which I talk about with all my patients, and energy and things like that, because we want to get a holistic picture and we want to —the reason is when I’m treating people I’m treating from the premise that it’s possible to be healthy and we can influence our health and the more I examine healthcare, and the healthcare model that is conventional, the more I doubt that that’s the premise that they’re standing on. Right? They’re kind of looking at making symptoms manageable, or maybe achieving outcomes or end goals, or preventing death and things like that, but they’re not coming at health conditions from a place of: “this person can influence the situation that they’re in through targeting and trying to understand the root cause of what’s going on, and then treating that.” So that’s where I’m coming at it. I’m looking at the whole picture, and I’m trying to understand this person’s unique hormonal imbalance and what the symptoms are that manifest from that.

Then it comes to choosing a treatment plan, so there’s lot of treatment that have a robust amount of evidence surrounding them and so you frequently hear people say that naturopathic medicine, or functional medicine, of these natural forms of medicine have no evidence and they’re pseudoscientific, well there’s tons of evidence for increasing fertility and improving PCOS using natural remedies, like nutriceutical remedies and herbal remedies.

So, first of all we have something called inositol. Inositol acts like a sugar in the body and what it does is it re-sensitizes the ovaries to insulin and serves as a fuel for the ovaries. And inositol doesn’t have much of a taste, it doesn’t have any side effects. It actually has some positive effects in helping with bipolar disorder and psychosis and those kind of mental health disorders, so if those are comorbid, then it’s great. If you have PCOS and you have bipolar, then inositol is a great choice. And with inositol, there’s some studies that show that in 3 months of supplementing with inositol periods have become regular, hyperandrogenism symptoms have gone down, so the acne and hair growth, and women had a 1 in 2 chance of getting pregnant. And then another 3 months of that, and their chances went up. So, inositol on its own is pretty powerful.

Another nutriceutical is N-acetyl cysteine, so NAC, which helps the liver clear out hormones and rebalance hormones and another great remedy for PCOS. We’re not exactly sure how it works, but there’s some theories about it rebalancing hormones, and perhaps through it’s antioxidant activity, because NAC creates an antioxidant, the main antioxidant in the body called “glutathione”. So, probably through its antioxidant activity, it’s helping the mitochondria, those fuel-houses for the cell, work better.

Another thing, when it comes to PCOS are some herbal remedies. So there’s an herb called vitex that helps establish a healthy hormonal estrogen and progesterone balance and that could be appropriate for some women. And there’s some studies using white peony and licorice that can help lower those hyperandrogenism symptoms. And then there are some herbs like saw palmetto that can help balance those high androgens as well, as they bind up testosterone and DHEA in the blood, so they increase something called sex hormone binding globulin (SHBG) and that can help clear out excess testosterone.

So those are just a few of these herbal and nutriceutical remedies that can be helpful in PCOS and I might prescribe some B-complex or some magnesium depending on how the adrenal glands are functioning and how hormones are cycling. And another thing we really like to do is tackle PCOS with diet and improve that blood-sugar balance if some of those insulin resistant symptoms or metabolic syndrome symptoms are there. And there’s a great study that shows that front-loading, so really increasing the calories that women are eating in the morning, having moderate calories at lunch and then having a lower or lighter dinner, kind of a snack for dinner, is really helpful in promoting fertility, lowering those androgens, resensitizing the ovaries and the other cells in their bodies to insulin and thereby resetting the hormonal stage. Really cool that this study just by changing your diet, although not the easiest change, is helpful for balancing hormones and you’re not doing something toxic, like the birth control pill or metformin, or something like that.

Also, a paleolithic diet, so changing the glycemic index of your diet by choosing fruits and vegetables that are lower on the glycemic index, so those leafy greens and adding fat and protein to every meal. It’s difficult as a vegetarian to shift hormones for the better and so I often recommend a more paleolithic diet to women, however, vegetarians, it is possible to increase your protein, it just takes a little bit more of conscious effort. And the reason that paleo diet is helpful is because it is lower glycemic index and has those higher fruits and vegetables with their antioxidant properties, but it also promotes the healthy fats and having an adequate intake of lean protein, such as your chicken, fish, lean beef, or eggs and even some dairy products depending on how someone tolerates that. And the last thing I’m going to talk about—this is just sort of a PCOS overview—the last thing I’m going to talk about is, with my patients I always work on self-care and stress relief because we know that the stress hormone cortisol can really mess up the other hormones in our body. It can contribute to insulin or worsen insulin resistance. It can worse that estrogen-dominance picture, it can prevent us from making enough progesterone because the progesterone and the cortisol pathway follows the same pathway and so that could be problematic if we need more progesterone but we’re using all of the resources to make it on making cortisol to deal with our stressful lifestyle. And a big part of managing PCOS, I find, is just getting cortisol under control and that might include increasing self-care, getting into things like yoga or meditation or doing some shin-rin yoku, like in the other video where I talk about Japanese Forest Bathing, so spending time in nature. That could be walking in the woods, or gardening, even watering a plant or hanging out with a pet or animal. Doing these things that feel nurturing and feel supportive to the mind and the emotions and help us face the daily stressors that we face with more resilience are all great strategies for managing hormonal health.

So, if you have any questions, just send me an email at connect@taliand.com or you can check out my website at taliand.com and my blog for other articles on hormonal balance, such as estrogen dominance, choosing an oral contraceptive pill, if you need one, and another article that I wrote about PCOS.

Have a great day, and I’ll see you guys soon.

 

A Morning Smoothie Recipe for Mental Health

I often recommend smoothies as an easy way to manage mental health symptoms, balance blood sugar, reduce inflammation and increase energy. I discuss the types of foods I put into my morning smoothie and their benefits on the body and mind.

Hello, everyone. My name is Dr. Talia Marcheggiani, I’m a naturopathic doctor with a special focus in mental health and emotional wellness and today I’m going to talk to you about how to make one of my favourite breakfasts to recommend patients: the morning smoothie. I always recommend smoothies in the mornings because it’s a great way to take care of a lot of your daily recommended nutrients in terms of protein, vegetable, anti-oxidant-rich berries and a healthy source of fat.

I always recommend somewhere between 20-30 grams of protein in the morning for people with depression and anxiety as well as digestive issues, hormonal imbalances, anything like fatigue or chronic stress because when we wake up in the morning we’ve been fasting for at least 8 hours. Sometimes in healthier cases, it’s actually better to fast for 12 hours and so throughout the night our blood sugar hasn’t been stimulated, we haven’t been increasing our blood sugar throughout the night and so, when we start our morning with something like, in North America, like we usually start, with a piece of toast or some sugar-rich cereal, our blood sugar goes from the lowest point, since we’ve been fasting for so long, and spikes. And then around 10 am, a couple hours after we’ve had our breakfast, our blood sugar will drop again, causing symptoms of hypoglycemia, which can worsen stress, it can trigger cortisol release and cause fatigue, worsening of anxiety and depression. And then throughout the day our blood sugar’s going to go up and down as we start to crave sugar again and it’s more likely to throw us off our balanced state that we want to be in.

So I start by recommending 20-30 g of protein to my patients in the morning and they often ask me what they can eat. And I’ll recommend something like leftovers from the night before, like a chicken breast has about 30 g of protein. Other patients ask “can I eat eggs?” And eggs are wonderful to eat but in order to get 30 g of protein you need to eat about 5 or 6 eggs, which is not typical. We usually eat 1 or 2. Although eggs is a great addition. You can throw eggs into your smoothie as well.

It’s also important to get a nice source of fat in your smoothie. So this is something that we often leave out, we don’t put sources into smoothies and so I recommend something like ground flaxseed or coconut oil, olive oil if you have that lying around, avocado, you can even through your fish oil in, if you’re that kind of person.

And I always throw in a leafy green, which you can’t taste. A cup of something like spinach or kale is a source of leafy greens. It’s full of fat-soluble vitamins as well as things that help us detoxify the estrogens from our body and keep our hormones balanced. This is something I always recommend for women with irregular periods or heavy periods, or things like PCOS, Polycystic ovarian syndrome, endometriosis, infertility. Anything that causes estrogen to go off and if you’ve read some of my articles you know that a lot of us suffer from estrogen-dominance. This is just more estrogen than progesterone in the female body. Even men can suffer from this and that’s because we’re just exposed to so many things, so many toxins in our environment that are activating estrogen receptors. So by eating leafy greens, we allow our bodies to detoxify a lot of those xeno-estrogens, those toxic estrogens in our environment.

So all you need is a blender. I like to throw in some baby spinach, pre-washed. I just eye it and throw in a couple of handfuls. That amount. Just a couple servings of spinach. The nice thing about things like spinach is it blends really well. You don’t taste it and depending on how much other ingredients you throw in, your smoothie might not even be green, so you can also fool your kids by throwing some spinach in their smoothies.

I always throw in some frozen berries. You can put in blueberries or a berry medley. I get it from No Frills for about $11 for a bag. Frozen’s nice because your smoothie gets icey. It might not be the best for winter but the days are still warm our digestive fire is still strong enough to be able to digest things that are cold.

Today the fat I’m going to add is coconut oil. Coconut oil is a saturated fat, but it contains medium-chain triglycerides, which our body doesn’t need to convert into sugar to be used as energy so we can just use them right away as an energy source. It’s great for the skin and it’s great for gut-healing because of its anti-fungal properties. It’s also really good for balancing blood sugar and boosting our metabolism. 2 tablespoons, I put in.

Fats are great medicinal foods. You can throw in a couple tablespoons of olive oil if you have cholesterol issues, blood sugar issues. The right kinds of fats are very anti-inflammatory and we know that inflammation is implicated in things like digestive issues, depression and anxiety, stress and so, by making sure we’re getting the right balance of fats in our diet, you can start in your morning smoothie, by setting your fat balance on the right track, be able to balance inflammation and feel really good throughout the day.

This smoothie will also keep you full really long, well into the afternoon because of the source of fats in it. I like to throw in things like eggs as well, just raw eggs. It’s difficult for me to really recommend it universally to all my patients because there is, of course, the risk of salmonella in raw eggs. So, at your own risk you can try it out, but I find it really makes it taste nice and rich as well as give us a good source of cholesterol. And cholesterol’s a good thing, because we need cholesterol to make hormones. Especially in depression and anxiety. You don’t want to be sacrificing cholesterol or taking—of course this depends on your health history—but there’s a risk of depression in people who are taking statin drugs, cholesterol-lowering drugs that are lowing our cholesterol in the body because how are we making our hormones if we don’t have enough cholesterol.

You can also throw in something like an avocado, it makes it nice and thick and rich or some peanut butter or almond butter, or nut butter. I’m also going to throw in some ground flaxseed.

Flax has two really great medicinal benefits. I use it for hormone-balancing in a lot of my patients with things like period irregularities or amenorrhea, this is not getting your period, infertility. So what flax does is it activates estrogen receptors. But it activates them weakly so if you’ve too much estrogen, the flax competes for the estrogen by binding to receptors preventing those hyper-estrogenic effects and if you don’t have enough estrogen, so in the case of post-menopause or ovarian failure, flax binds to estrogen receptors and causes the estrogen effects that we really want, like libido and energy and the expression of female sex characteristics. It can also clear skin and it’s great for acne, it’s great for regulating periods. It’s great for balancing heavy periods, bringing periods back and making them more regular.

Flax is also great for constipation because it’s a good source of fibre and you need to grind the flax, it needs to be milled. And this is because our body can’t break down whole flaxseeds. So you might have seen breads or crackers where there’s whole flaxseeds and they advertise flax on the package, well it really doesn’t so us any good. It just passes right through the body. It’s not adding those fibres or medicinal fats.

Finally, this is a protein powder that I just got from Bulk Barn. I find that Bulk Barn is the cheapest in terms of protein powders. I use a vegan protein powder. So this is great is you’re vegan or vegetarian. Whey is the best absorbed protein, but personally I have a food sensitivity to whey, caseine and other dairy products, so I go with vegan protein, which is a mix of pea protein, hemp protein and rice protein. But you can also use whey. If you’re sensitive to dairy and not sure if you’re sensitive to whey, always go with a whey isolate, because whey isolate doesn’t contain caseine, which is the protein in milk that most people react to. So it’s just pure whey.

In my protein powder, I also mix gelatin. So gelatin is just a crystalized powder. I put in one scoop of protein powder for 30 grams of protein. So gelatin comes from the hooves of animals. It’s rich in collagen and it can actually increase the amount of collagen in the body. It’s an incomplete protein, so it has a lot of an amino acid called glycine, which most of us are deficient in because we don’t get a lot of glycine from the meat of animals. It’s actually located in the collagen. Glycine’s a really calming neurotransmitter. We use it to bind minerals, so if you’re my patient you might have been prescribed magnesium glycinate, which is an easier absorbed form of magnesium, also a source of glycine, to help calm the body. It activates those suppressive neurotransmitters, the GABA pathways in the brain so it’s great for calming anxiety and great for preparing us for sleep. But it doesn’t make you tired for the rest of the day. What’s great about getting a source of collagen is that it can help with gut healing. It can help with the integrity of the gut in leaky gut situations and it’s great for the skin and hair because we know our skin is made of collagen as well as our joints. So, if you have acne, acne scars, if you’re suffering from premature aging or sun damage, a couple tablespoons of gelatin or collagen hydrosylate is a great thing that you can do every morning.

So I’m just going to add in, as your liquid source you can add in something like water, I usually just use water or almond milk. I’m going to use coconut milk today because it’s delicious. I’m going to mix a little bit of coconut milk with water. Just tap water. I’m going to add some tap water. So how much water you add depends on how thick you want your smoothie and the quality of your blender. I filled it up to about 500 ml. I like to eat a lot in the mornings.

Put it into your blender. So this is my smoothie pre. And then you just pour your smoothie in a glass. Mine’s kind of on the watery side. It turns out purple, not green at all, so you can still fool the kids. If you want to make it sweeter, you can add in half a banana, or even some maple syrup. But it tastes pretty good. It tastes like berries.

So this is great because liquid is obviously, it’s pre-chewed, so it’s easier for our body to absorb the nutrients, which is nice in the morning, especially for people who aren’t really into breakfast. It’s also really portable you can put it in a mason jar or a glass container and take it to work. You can drink it half before leaving for work and half while in your in the car or commute or on the subway. A lot of your nutrition for the day is taken care of. So, even if you, have not-an-ideal lunch or dinner you’ve gotten a great source of highly-absorbable protein, you’ve gotten some gut-healing in in the form of gelatin. You’ve gotten some healthy fats and a serving of leafy greens and anti-oxidant-rich berries. So, you’re on your way for a healthy day.

The 6-2-6 Breath for Stress and Overwhelm

The 6-2-6 breath is a yogic breathing technique that can help calm the mind, benefitting feelings of anxiety and overwhelm.

Hello. My name is Dr. Talia Marcheggiani. I’m a naturopathic doctor and mental health professional. I focus my practice on mental health and emotional wellness. I’m just at home right now with my dog, Coco, and we’d like to show you a very quick meditation that you can do.

This is a great thing to do. It’s something I teach my patients to do when they’re feeling overwhelmed or stressed out at work. It’s a great way to combat anxiety and depression as well as a really great way to dive into a meditation practice if you don’t already have your own practice.

Encouraging patients to engage in mindful activities like meditation is indeed a valuable strategy for mitigating stress and promoting mental well-being. As individuals navigate the challenges of modern life, finding effective coping mechanisms becomes increasingly crucial in combating anxiety and depression. Moreover, incorporating meditation into daily routines not only offers a reprieve from stress but also serves as a gateway to cultivating a deeper sense of mindfulness and self-awareness.

For those seeking additional support in managing stress, exploring natural remedies such as CBD  presents a promising avenue for relaxation and stress relief. Whether used in conjunction with meditation or as a standalone remedy, CBD flower represents a natural alternative that aligns with the ethos of mindfulness and self-care. By embracing complementary strategies that prioritize mental well-being, individuals can embark on a journey towards greater resilience and balance in the face of life’s stressors.

I also find just spending 3 to 5 minutes a day to sit and focus on the breath, especially deepening the breath, is a great way to dive into meditation and establish your own meditation practice.

So all you have to do is start by either sitting in a chair with your back straight and your feet flat on the floor or in a cross-legged position. You can put your hands on your knees, but what I like to do is tell people to start with their hands on their lower abdomen. That way we can practice moving the breath into the lower abdomen, feel the abdomen rise and fall with the breath, and thereby ensure that we’re sending our breaths down into the belly as we breathe.

It’s called the 6-2-6 Breath. It’s very simple, so all you do is breathe in for a count of 6, hold the breath for a count of 2 and breathe out for the count of 6. By lengthening our inhales and exhales we’re able to stimulate the vagus nerve, which activates the parasympathetic nervous system. This is the “rest and digest” arm of the autonomic—think “automatic”—nervous system in the body. When we’re in a state of stress, overwhelm or depression, we’re usually in a sympathetic of “fight or flight” state and by calming and deepening the breath we’re also able to calm the body, establish a sense of safety within the body, and calm the mind and emotions.

So I want everyone to just close your eyes and breathe in. Start by deepening your breaths. You should feel your hands rise and fall as you breathe.

So when you’re ready let’s begin our inhale for the count of 6. So, inhale, 3, 4, 5, 6, and pause for 2, exhale 3, 4, 5, 6. Pause, 2. And inhale 3, 4, 5, 6. Pause, 2, and exhale, 3, 4, 5, 6. Pause, 2, inhale, 3, 4, 5, 6. Pause, 2, exhale, 3, 4, 5, 6. Pause, 2, inhale, 3, 4, 5, 6, pause, 2, exhale, 3, 4, 5, 6.

So you can continue doing this breath. I recommend spending 3 minutes just settling into the breath and body. You can do this while at work. You can do it at home, you can do it before bed to calm the body down, to help with a more restful sleep. I like how it helps us move out of the space of overwhelm, stress and anxiety, centre into our body and establish more possibilities for clarity and for ways to move forward in overwhelming situations.

Let me know what you think, try it yourself and leave your comments or questions below. You can also follow my blog at taliand.com.

Alternate Nostril Breathing

Alternate nostril breathing is a yogic breathing practice that can help boost mental clarity and calm the mind.

Hello, everyone. My name is Dr. Talia Marcheggiani and I’m a naturopathic doctor with a special focus in mental health and emotional wellness and today I’d like to show you a special kind of breathing technique for balancing both the right and left hemispheres of the brain.

This breathing technique can help, if we’re feeling overwhelmed and if we’re feeling anxious, to calm the body down, and bring us out of that fight-or-flight stress response. And likewise, if we’re feeling really depleted and tired it can bring up our energy levels and give us a boost of clarity and concentration.

In Ayurvedic medicine—this is the ancient Indian medicine—it’s believed that each nostril supplies oxygen for each side of the brain: the right and left hemispheres. And we know from neuroscience that the right hemisphere of the brain is more involved in creativity and relationships and intuition, whereas the left hemisphere is more analytical and language-based and reason-based. The right side of the body is more masculine and Yang in nature and the left side is more Yin in nature. It’s believed in Ayurvedic medicine that each nostril controls oxygen to each side of the brain.

So this only takes about 3-5 minutes and I encourage you to try it just as a meditation technique if you’re beginning a meditation practice, or to calm the body or something to do before sleep where you can balance the brain and relax the body before drifting off into a sounder and better night’s sleep.

So if you take a seat on the floor or on a surface like your bed, you can sit in a cross-legged position. Or if you’re sitting in a chair have your feet flat on the floor and your back straight. So just have your shoulders back and down and keep your back in a straight, upright position. It shouldn’t feel too stiff. You should have a natural curve at the back of your spine.

Have your left arm either palm facing down or palm facing up on your left knee.

Take your right hand. You’re going to take the index fingers, the peace sign, and you’re going to place them right between your eyebrows. This is the “Third Eye”. You’re going to have your ring finger and your thumb free.

Just take a moment. You can close your eyes or you can watch what I’m doing here, but I’ll talk you through it. Now I just want you to feel your breath deepen. So send your breath to the lower abdomen. If you want you can place your hand on the lower abdomen and just feel the breath move the abdomen in and out as you breathe.

Deeper breaths have a calming and more calming effect on the body. They also stimulate the vagus nerve, which is the nerve that runs from our brain to our digestive system and is involved in calming the body down and bringing it into that rest and digest state.

When you’re ready take one deep, cleansing breath in and exhale and then block off the right nostril with your thumb. Breathe in through the left nostril. Using the ring finger close both nostrils and then release your thumb and the right nostril and exhale.

Breathe in through the right nostril… block it off…hold… and release and breathe out through the left. Now try it again. So, breathe in through the left, block it off, and exhale through the right. Inhale through the right. Block it off. Exhale through the left. Inhale again through the left. Block it off. And exhale through the right. So, if you want you can stop here and just continue on your own, but let’s continue together for another two minutes. I’ll just guide you through it. Inhale through the right nostril. Block. Exhale through the left. Inhale. Block. Exhale through the right. Inhale. Block it off. Exhale through the left. Inhale through the left. Block. And exhale through the right. Inhale. Block. And exhale.

One more cycle. Inhale. Block. Exhale. Inhale. Block. And exhale. Now place both hands on your knees, facing up or down. Keep your eyes closed and take a couple more inhales, breathing into the belly. Notice how you’re feeling; if you’re feeling a sense of calm, or an increased sense of clarity. You probably noticed that one of your nostrils was more blocked than the other one and that through doing this practice you managed to either switch which nostril was activated or clear both for better breathing.

If you want you can take a few moments here and just pay attention to your breath, or begin your meditation practice. Or, continue on your day. Thanks!

A Naturopathic Doctor Prepares 7+ Meals in Three Hours or Less

A Naturopathic Doctor Prepares 7+ Meals in Three Hours or Less

The key to having healthy, delicious meals on the go is organization. I explain how I overcome a busy schedule by doing a focused grocery-shop, heating up the oven and batch-cooking seven or more whole-food, healthy meals in under three hours.

You know the feeling: you’re finishing up a long day of work, your blood sugar levels are dropping, and you’re wondering what you’re going to eat once you get home. When you assess the situation, you realize that you’re coming home to a fridge that’s empty, and your Julia Childsesque inspiration levels are at an all-time low. You decide on frozen pizza (freezer burnt and sad), and a half-eaten jar of pickles.

My patients sometimes tell me that they don’t have time to cook and so they end up microwaving a Lean Cuisine or throwing limp fish sticks into the oven once they’ve dragged themselves through the front door. I find this interesting because I know that I can stick some chicken breast, squash and broccoli in the oven and have it ready quicker than you can say “leaky gut”. I believe, though, that the secret to success is preparation, mindset, a little bit of organization and nutritional know-how.

I frequently get caught in the “what-am-I-going-to-eat” spiral but, with a fridge stocked with foods that are already cooked and can last for days, I usually end up eating something that’s pretty good for me. Here’s what I do on a weekend, or weeknight when I have a little more wiggle-room in terms of time: batch-cook. With the right prep you can throw together an endless combination of meals with minimal waste that requires very little prep and assembly the day of. What’s more, all of these meals are grain-free and nutrient-rich to keep hormones stable, energy sustained and mood high.

Step 1: Grocery shopping. On the way home from my clinic, I whip out my portable grocery bag and make a quick stop at the grocery store, or meat store and fruit and vegetable markets. When grocery-shopping I’m in and out in record time, and this is because I forgo straining to read complicated labels, or getting lost in heavily-processed middle aisles, and just stick to the peripheries: fruits and vegetables, deli, meat, fish, freezer. 95% of grocery-shopping should be about stocking up on perishables like proteins, veggies and fruits. I buy:

  • 2-3 bags of pre-cut coleslaw, chopped kale, baby spinach and boxes of baby arugula from the pre-washed salad section
  • fennel, zucchini, broccoli, eggplant, tomatoes from the vegetable section
  • a bag of apples and avocado from the fruit section
  • goat cheese and natural sliced turkey breast from the deli section
  • chicken breast or chicken thighs, ground beef, steak and/or fish from the meat and fish section
  • eggs from the dairy fridge
  • frozen blueberries from the freezer

At home, in my cupboards, I know I already have things like: coconut milk, curry spices, salt, pepper, tomato salsa, tomato paste, frozen shrimp (in the freezer), chicken broth, and things like gelatin, flaxseed, pumpkin seeds, vinegar, oils, etc. I also have onions, garlic and lemon in the fridge. If I didn’t have those, I would have picked them up too.

Step 2: Get cooking. When I get home I toss the heavy bag on the counter, wash my hands, grab the chopping board and knives out of the drawer and get to work. I throw on a favourite podcast (try Invisibilia, The Jordan Peterson Podcast, The Mental Illness Happy Hour, Shrink Rap Radio, Chris Kresser, or Found My Fitness—I welcome your suggestions for future batch-cooking sessions) and begin the batch-cooking.

  1. I chop up the broccoli, eggplant and tomatoes. Setting the oven to 400 degrees, I drizzle coconut oil over the broccoli with some salt and pepper and get it browning in the oven. Next I line a baking sheet with tomatoes and eggplants and some sliced zucchini, add a bit of olive oil, salt, pepper and spices and bake those (when they’re cooked, I’ll add some flaxseeds to give them a breaded-kind of taste with none of the refined carbs and all the hormone-regulating fibre and healthy fats).
  2. I drizzle the chicken breast with lemon and spread tomato salsa on top. Done. When the vegetables are finished I’ll cook it at 350 degrees for about 20-30 minutes, until chicken is cooked through. Then I’ll slice the chicken up to throw on salads or to warm up and have with vegetables.
  3. I start browning the beef with onions, garlic and grass-fed butter. Once beef is browned, I add the shredded cabbage from the bags of coleslaw I bought, and possibly some of the shredded kale. I add coconut milk and curry spices and a little bit of chicken broth, salt and pepper. Thai-style paleo stir-fry done!
  4. I get out a big container and chop up fennel. I mix that up with arugula and store it in the fridge. I’ll add some chicken breast, chopped apple, pumpkin seeds and goat cheese to this tomorrow for a delicious, protein-rich salad lunch. I make dressing out of lemon, tahini, garlic, olive oil, salt and pepper and store that in a little jar in the fridge, so that I can throw it on the salad in the morning. I can also add cut-up sliced turkey breast to this if I run out of chicken.
  5. I pre-spiralize some left-over zucchini with my vegetable spiralizer and store the noodles in the fridge. I make pasta sauce by adding Italian spices and olive oil to diced tomatoes or tomato paste. All I need to do for a low-carb pasta is add the sauce and some shrimp to the noodles and lightly cook until the noodles are soft. Voila: zucchini-noodle shrimp pasta. Also, a major delight of mine are Miracle Noodles, zero-calorie noodles made of glucomannan prebiotic fibre. All you have to do is rinse them. They’re super filling and taste just like rice noodles.
  6. I cook kale, goat cheese and tomatoes together. I add the mixture to muffin tins and add eggs (I add all 12 eggs to make 12 frittatas). When the oven’s free, I cooked everything at 350 degrees until the eggs are cooked through (about 20 minutes). Sometimes I cut up the sliced turkey breast to add or I use it to “line” the muffin cups, for added protein. I let the frittatas cool and then store them in an air-tight container in the fridge.
  7. When the time comes, right before I’m ready to eat, I’ll cook the steak or fish on the stove. Steak takes me about 3-4 minutes to cook it, tops. I just brown eat side for 2-3 minutes and add salt and pepper. Salmon takes no time at all; I might bake it for 15 minutes or sauté it after pre-marinating it with some lemon, butter and dill, or Sriracha hot sauce, garlic, tamari sauce and dash of maple syrup.
  8. I mash up the avocados with cocoa powder, some coconut oil, gelatin, protein powder and a bit of liquid stevia to make avocado pudding. I also save some avocados to eat with meals, add to salads, and mix into smoothies, or sprinkle with salt for a healthy-fat snack.

That’s it! I pack everything up in containers and store in the fridge. All I need to do when I get hungry is spoon out portions, warm and eat. I can also opt for freezing some things if I don’t think I’ll get to them in the next few days.

The verdict: 7+ meals prepared in the time it took me to listen to 1-2 podcast episodes. Here’s what I eat for the next few days:

Breakfasts: 

  • Mini frittatas with kale, goat cheese and tomatoes. I grab 2-3 on my way out the door.
  • Smoothies: with baby spinach, frozen blueberries, coconut oil, protein powder (already had some), gelatin, water. I throw these in a blender and enjoy.
  • Avocado pudding

Lunch/Dinner:

  • Arugula salad with cut up chicken breast, pumpkin seeds, goat cheese, fennel, apple and lemon tahini dressing
  • Chicken breast and roasted vegetables and/or roasted broccoli
  • Salmon or steak with broccoli, roasted vegetables, or salad
  • Cooked eggs with avocado and some arugula salad
  • Cabbage and ground beef coconut curry (I can add zucchini noodles or Miracle Noodles to this)
  • Zucchini noodle shrimp pasta with tomato. I can also forgo the shrimp and serve with steak, salmon or chicken breast.

Snacks:

I’ll eat a handful of pumpkin seeds, apples and peanut butter, mini frittatas, turkey breast slices or avocado pudding. I’m usually not much of a snacker, though.

Try it yourself! How do you like to batch-cook?

 

7 Ways a Naturopathic Doctor Can Help You Rethink Breakfast

7 Ways a Naturopathic Doctor Can Help You Rethink Breakfast

As a naturopathic doctor, one of the first things I recommend to my patients is a breakfast overhaul. Adding healthy fats, protein and vegetables to the first morning meal can change your hormonal signalling and improve your energy and mood.

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When it comes to writing my patients prescriptions for pills, even natural ones, I tend to be a minimalist. This means I try to limit my supplement recommendations. Depending on my patients’ concerns, I prefer to work with their diets and lifestyles, making useful tweaks and suggestions to their daily routines. I find my patients appreciate this and often stick to these mini changes in the long-term, which means that a) these changes are easy and sustainable and b) they work! When I begin to work with a new patient for the first time, some of the first recommendations I make is that they begin to rethink the way they do breakfast.

The Standard America Diet may be SAD in many ways, but the main meal that brings a tear to my eye is our affectionately termed “most important meal of the day”—breakfast, when we break our nightly fasts and engage in the consumption of low-nutrient, high-carb atrocities like breakfast cereals, muffins (aka mini cakes) and instant oatmeals packed full of sugar.

If the meals we eat in a day could be viewed as a series of performances, then breakfast would be the opening act. It sets the stage for our blood sugar and hormone-regulation for the rest of the day. When we begin our days with simple carbohydrates (the composition of the above-mentioned breakfast foods), we strap ourselves in for a blood-sugar roller coaster ride that throws off the signalling of all the other hormones in the body, taxing our adrenal glands, our sex hormones, our mood and mental health and even setting the stage for weight gain and chronic inflammation.

I tend to believe that some people do genuinely do well without breakfast. There is some research that suggests that fasting for a portion of the day (at least 12 hours a day) can regulate blood sugar and insulin levels and help us manage our weight and day-time energy levels. It can even help us sleep more deeply. However, for those of us who are hungry in the morning (or a few hours after), there is evidence that getting a complete meal into our bodies within the first hour of waking can start the circadian clocks present in our livers and digestive organs, priming us for a day of abundant energy, good digestion, and an efficient metabolism. In fact, the research on intermittent fasting seems to indicate that skipping dinner, rather than breakfast, might be more beneficial, as our bodies are more insulin-sensitive in the morning and therefore more able to use food for fuel, rather than storing it as fat, at that time of the day.

When we first wake up, our cortisol levels should be at their highest. Cortisol is a stress hormone, yes, but also responsible for giving us feelings of wakefulness and alertness. Eating, especially on a consistent schedule, can help boost cortisol levels, thereby boosting early-morning energy levels. Additionally, like the brain, the liver possess its own circadian rhythms. It punches in its time clock for work once we eat our first bite of food or take our first sip of a non-water beverage, allowing us to digest, detoxify, and process certain hormones in the body.

When it comes to the first meal of the day, there are two basic Breakfast Laws I live by:

The first is to get adequate protein. For most people this means eating at LEAST 20, but preferably 30, grams of protein (about the amount in one decent-sized portion of chicken or beef) in the morning. Protein is the building block of the body: it constructs our neurotransmitters, enzymes and the structure of our cells. When we get adequate amounts at meal-times, it keeps blood sugar stable, which balances mood and energy. Those of us who experience the energy tank around 3pm and crave sweets or require caffeine to get through the rest of the day, often notice that our energy remains stable throughout the day when we eat a high-protein breakfast. However, getting 30 grams of protein in the morning means rethinking what a traditional breakfast looks like: one egg only contains about 5 to 7 grams of protein, depending on size. One cup of oatmeal has only 6. Therefore, I suggest my patients concentrate on adding animal products, such as meats, yogurt and eggs, or vegetarian protein sources like tofu, legumes, peanut butter, and protein powder, to their first meal, or to mix different protein sources (such as turkey and eggs) to get their protein levels up to that 20 to 30-gram range.

The second Breakfast Law is to include healthy fats. Breakfast is a meal, arguably the day’s most important, as that’s when our digestive system is working optimally, our insulin receptors are at their most sensitive, and our metabolism is the most revved. Since a balanced meal contains all of the macronutrients, it’s important not to skip fat in the morning. Fat satiates us and keeps blood sugar stable. It nourishes our brain, cell membranes and forms the backbone of our hormones. Ensuring that we include healthy fats like avocado, olive oil, fish oil, nuts, seeds, grass-fed butter, and coconut, keeps us feeling full and energized well into the afternoon, while giving us a boost to our metabolic rate and improving our fat-burning potential. I tend to recommend coconut oil at this time of day, as the medium-chain triglycerides in coconut oil bypass the digestive system and are used as immediate energy, giving us a much-needed morning boost.

Since the patients I work with are often busy individuals with demanding lives who struggle with chronic stress, hormonal imbalances, mental health concerns and digestive issues, I often suggest beginning the day with a ketogenic breakfast. This means having a breakfast that is high in healthy fats, has a decent amount of protein and micronutrients, from leafy greens or other vegetables, and is low in carbohydrates. By avoiding high levels of carbohydrates early in the morning we harness our body’s fast-burning capacity and regulate our blood sugar and insulin levels. This, in turn, balances our other hormones, such as neurotransmitters, stress hormones and sex hormones. It also keeps inflammation levels low. Eating a high-fat, low-carb breakfast encourages the body to make ketone bodies for energy, which have been shown to promote mental alertness and to balance mood. Patients who take on a ketogenic breakfast for a month often report life-changing effects: more energy throughout the day (avoiding that 3pm crash), brighter mood and mental clarity, less sugar cravings, and greater feelings of satiety that bridge them all the way to lunch-time.

Finally, I often recommend getting a serving of micronutrient-dense leafy greens into the morning meal. We North Americans tend to skimp on our vegetables, especially the majorly health-promoting green leafy ones. Getting one or two servings of vegetables out of the way early on in the day is a great way to boost our vegetable intake.

Here are some healthy and easy-to-throw-together alternatives to that greasy breakfast sandwich lying under a warming lamp in your company’s cafeteria. I swear you’ll never look back:

1. Any variation on the home-made omelette/scrambled eggs/breakfast sandwiches. Grab a bunch of your favourite vegetables, leafy greens preferred, and cook them down in a pan. Add scrambled eggs, a few slices of natural turkey breast, leftover steak, salmon, natural sausages, or tofu (if you’re a vegetarian). Play around with different ingredients like olives, sun-dried tomatoes, roasted zucchini and squash, goat cheese, avocado, arugula, etc. If you need some carbs, serve on gluten-free or sourdough bread, or roll up ingredients into the egg.

2. Mini frittatas. Similar to the omelette idea above, mini frittatas are a pre-prepared version for those of us who have limited time in the morning. You can make these out of virtually anything: ground turkey, kale and goat cheese; sun-dried tomatoes, basil, oregano, olives and arugula; avocado, ham, cheddar and broccoli; thai curry paste, coconut milk and cauliflower; even zucchini, spinach, flaxseed and cocoa powder. Cook up your ingredients sans eggs, then throw everything into a blender (add enough so that you can get your 20 to 30 protein grams from one to three frittatas), ground flaxseed and gelatin (for gut-healing and added protein). Pour into muffin cups and bake at 350 for 20-30 minutes or until eggs are cooked through. Freeze them or store them in the fridge, then grab some on your way out the door to warm up at the office.

3. Smoothies. Smoothies are one of my favourite ways to do breakfast, simply because blending everything together gives you the opportunity to pack a bunch of nutrient-rich foods into one easily digestible, portable place. They tend to taste great too, depending on how you do them.

My three general rules of thumb for creating smoothies is to add: 1) Leafy greens: kale, spinach, chard, etc. 2) Protein: usually in the form of protein powder. I like Vega and Sun Warrior, as vegan sources, but whey isolate also works, if you’re ok with dairy. Pick a protein powder that has no added sugar and at least 20 g of protein per scoop. 3) Fat: half an avocado, or a couple of tablespoons of coconut oil, ground flax or nut butters, etc. After following the three rules, feel free to doctor the smoothie up for variety: add berries, banana or honey to make it sweet and palatable; gelatin/collagen, guar gum or chicory root for gut-healing; cocoa powder to make it chocolate-y (who doesn’t want that); or lemon, spirulina or cilantro to boost your body’s detoxifying prowess in the morning. The possibilities are endless.

My go-to smoothie consists of spinach, frozen blueberries, flaxseed, avocado, coconut oil, water and protein powder. I blend those ingredients up and drink them on the go, or I add nuts and granola on top of a thicker blend and eat it with a spoon as a smoothie bowl. I’m usually full until 1-2 pm.

When my patients protest that their morning routine doesn’t allott them sufficient smoothie-prep time, I suggest they add the unblended ingredients to their blender the night before, storing everything in the fridge. In the morning, all they have to do is hobble over to the “blend” button, throw a lid on everything and fling the entire concoction into their lunch bags. Easy peasy.

4. Yogurt bowls. For those who “do dairy”, one cup of greek yogurt has about 25 grams of protein. I tell my patients to get the highest-fat kind they can find (grocery stores mainly carry up to 2%, whereas natural food stores carry higher fat-content brands). This is because 0% fat yogurt is just bad news; skim milk was used to fatten up pigs in the early 20th century by making them hungrier—it was a well-known trick amongst pig farmers that, for whatever reason, never seemed to become common knowledge for humans. I also encourage my patients to opt for unflavoured, unsweetened yogurt to avoid unnecessary sugar and chemicals. Kefir, or fermented milk, contains multiple strains of gut-loving bacteria and is an effective probiotic, so I often recommend that to patients whose guts needs some love.

To the yogurt, add a combination of chia, flaxseeds, nuts, gelatin, coconut oil, cinnamon and berries. You can store everything in a jar in the fridge overnight (or make a big batch) and grab and go on your way to work. For those who are dairy sensitive or lactose intolerant, coconut yogurt is a delicious alternative. It is protein-sparse, however, so getting protein from other sources, or adding a scoop of protein powder or a few tablespoons of gelatin, is needed to round out the macronutrients.

5. Fat bowls: When I’m in the mood for tons of fats, I make a fatty Paleo “granola” out of various nut and seed butters: tahini, peanut butter (the natural kind where the oil rises to the top) and/or almond butter. I add coconut oil, coconut flakes, ground up nuts (walnuts, almonds, brazil nuts, cashews) and flaxseeds. Then I add cocoa powder and a few drops of liquid stevia and a pinch of sea salt. The whole thing is delicious; like a kind of crunchy, healthier Nutella. You can add one to a half scoop of protein powder or gelatin to boost the protein content. Another fat bowl idea is avocado pudding: add one whole avocado, chocolate protein powder, cocoa powder and some liquid stevia together, and mash everything up by hand or blend in a blender.

6. Ketogenic, low-carb pancakes. Blend 3 eggs, 2 tbs of almond butter, 2 tbs of flaxseed, gelatin, a dash of vanilla extract and sea salt to make the batter, then cook like regular pancakes. You can also make these thin by adding a bit more liquid (water, nut milks, coconut milk), and use them as breakfast wraps, wrapping up things like avocado, goat cheese and arugula with them.

7. Leftovers. Most of the time I have non-breakfast food for breakfast. As I’m personally really into the efficiency of batch-cooking, I always have a few servings of protein (chicken, beef or fish) and ready-cooked vegetables in my fridge. I might also have a pot of curry, a stir-fry, paleo chilli or soup in the fridge as well. Many cultures enjoy savoury and spicy foods for breakfast and there’s no reason that leftover curried vegetables and chicken breast don’t make an awesome first meal of the day.

 

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