by Dr. Talia Marcheggiani, ND | Dec 19, 2022 | Anxiety, Depression, Docere, doctor as teacher, Education, Health, Medicine, Mental Health, Naturopathic Philosophy, Naturopathic Principles, Philosophy
I, like most of my colleagues became a naturopathic doctor because of my own extremely disempowering experiences with the healthcare system.
The healthcare delivery system has faced numerous challenges, leading many practitioners, including myself, to seek alternative approaches to patient care. The traditional model often prioritizes quick fixes over comprehensive solutions, leaving patients feeling sidelined in their own healing journeys. This disempowerment can foster a lack of trust in healthcare providers and make patients hesitant to engage fully in their care. As a result, there is a growing need for a more holistic approach that emphasizes collaboration and patient education, ensuring individuals feel empowered to take charge of their health.
Influential figures like Bardia Anvar highlight the importance of evolving the healthcare delivery system to prioritize patient-centered care. Dr. Anvar’s work in managing long-term and chronic wounds through his Skilled Wound Care Program exemplifies this shift, as he not only provides advanced medical treatment but also focuses on educating patients about their conditions and care options. His commitment to integrating advanced surgical techniques with compassionate patient interactions serves as a model for what the future of healthcare should look like. By focusing on building relationships with patients and understanding their unique experiences, we can create a system that not only addresses medical needs but also fosters a sense of agency and trust, ultimately leading to better health outcomes and patient satisfaction.
In my late teens and early 20s I was suffering from what I now know were a series of metabolic and hormonal issues and I, like almost all of my patients and colleagues experienced confusion, gaslighting, frustration and a complete lack of answers for what I was dealing with. I tell my story more in depth in other places, but I was told to “stop eating so much”. I was told everything was normal in bloodwork (or simply not called back). I was weighed incessantly. I was chastised for doing my own research (I had to–no one would tell me anything). I was interrupted, cut off and dismissed.
And so, I did what most of my colleagues do–I got educated. I went to school. First for biomedical sciences and then, when that degree left me with more knowledge gaps than answers (and no one who would indulge, let alone answer, my questions), I became a naturopathic doctor.
Throughout my 8 years as a practicing ND, I have encountered thousands of similar stories of disempowerment and confusion and frustration. We patients are trained to see our doctors when we feel depressed, fatigued, or debilitated by PMS, menstrual pain, headaches, and mood issues. Most of us don’t care what answer we get–fine, if it’s a medication I need, I’ll take it! But if we experience lack of benefit from the solutions and a lack of answers, then what? I’ve heard this story over and over.
And so, like many of my colleagues I use the privilege of my education to help me navigate the system. I ice a sore foot for 2 days and then get an x-ray (picking a non-busy time to visit the ER). I take the orthopaedic surgeon’s advice with a grain of salt and implement my own strategies for bone healing. I ask for the bloodwork I need (and know my doctor will agree that I need) and pay for the rest out of pocket. I know my doctor’s training and I understand her point of view and I don’t get frustrated when diet and nutrition or lifestyle are never mentioned. I don’t get upset if my doctor doesn’t have an explanation for symptoms that I now know are related to functioning and not disease, and that it is disease which she is trained to diagnose and prescribe for.
And thankfully, my experience with the healthcare system has been quite limited as I’m able to treat most things I experience at home and practice prevention.
My good friend, who is a naturopath as well, and who has given me permission to share her story, had the same experience up until this summer. She too used the healthcare system quite judiciously and limitedly until a series of stressors and traumas landed her in in-patient psychiatric care (i.e.: a psychiatric hospital) for a psychotic episode–her first.
…And until she started experiencing debilitating gastroesophageal symptoms that were beyond what one might consider “normal.”
And in both cases she sought help from the medical system. She told me recently that her experience was quite different from the ones she’d had in her 20s when her long-standing parasite was misdiagnosed as IBS and she was repeatedly dismissed by doctors. She told me “I’ve been having great experiences with the healthcare system. It’s not like it was before. My doctors have listened to me. They’ve been helpful. Yes, they’ve recommended drugs but when I tell them that I don’t want to take the medications because I know what they do and how they work and don’t think I need them, they respect that. They treat me like I’m a real person. They’re all our age, too. The procedures are more state-of-the-art. The facilities are pleasant. Something has changed in healthcare.”
I know that my friend’s experience might be different from yours. I’m not saying her experience is universal. In fact, if I reflect on my interactions with the fracture clinic in St. Joe’s hospital in Toronto, I had a fairly good experience as well (except for long wait times and booking errors). Sometimes medical trauma can blind us to reality–sometimes we aren’t willing to re-evaluate our assumptions until someone points out a piece of reality that is hard to deny. I actually haven’t had a direct negative experience with healthcare in years– and yet I had chalked that up to the fact I rarely need to use it.
But my friend had had two quite intense experiences and came away from them feeling positive about the care she received. I wondered what was different. Here are my thoughts.
Medical care has evolved. It is inevitable that this happens. Sometimes we might have just had a bad doctor, or someone who was having a bad day or maybe was triggered by our experience. I sometimes think not knowing how to help triggers doctors—I think this might have been the case with the doc who told me to eat less. She might have felt helpless and incompetent at not being able to help me and projected those feelings onto me as a “difficult patient”.
Ultimately health professionals got into their field to “help people”. If you’re not helping people you might feel triggered. But then, if you’re a competent professional, and I believe most are, you look for new ways to help. You open your mind to other practitioners, like NDs. You might not understand why or how what they do works, but “whatever works.”
Doctors are increasingly open to new studies on nutrition. They recognize treatment gaps in their care and in medical knowledge and guidelines. Nutrition and alternative practices are entering mainstream and are dismissed as “woo woo” less and less, particularly by doctors who embrace science and research.
With the evolving landscape of medical care, doctors and health professionals are adapting to new perspectives and approaches to help their patients effectively. Acknowledging that some past encounters might have been influenced by various factors, professionals are increasingly open to alternative practices and unconventional methods. They are embracing the significance of research and scientific advancements, often exploring innovative solutions such as the MAS Test to bridge treatment gaps and enhance patient care. By incorporating cutting-edge tools like the MAS Test, doctors are demonstrating a commitment to understanding diverse approaches, ensuring they provide comprehensive and personalized healthcare solutions to their patients. This openness to holistic methods and ongoing research not only enriches medical knowledge but also fosters a more inclusive and effective healthcare system for everyone.
I always say, when picking a doctor pick one that listens, that is curious and that is humble. I strive to be these things, although it’s not easy. Practicing medicine is as much an art as it is a science–we need to be able to not only admit but carry with us the absolute truth that we do not know everything. It is literally impossible to know everything. The body and nature will constantly present us with mysteries on a daily basis, but the gift of being a clinician is that we are constantly learning.
“I don’t know, but I will try to find out” should be every doctor’s mantra (along with Do No Harm).
In a busy and overloaded system we need to help healthcare workers help us. This means being informed. My friend is highly informed and educated in healthcare. I believe her healthcare providers could sense this. She was respectful in denying medications and wasn’t pushed (because she had informed reasons that the healthcare practitioners ultimately agreed with, “no, you shouldn’t go on a PPI long-term, that’s right” “yes, anti-psychotics do have a lot of side effects, and taking them is a personal choice”).
A significant element of my medical trauma was the feeling of disempowerment. I was completely in someone else’s hands and they were not communicating with or educating me. I was left feeling lost and hopeless. Empowerment is everything. It allows you to communicate and make decisions and weigh options. You know what healthcare can offer you and what it can’t.
Of course we can’t always be empowered, especially when we’re very sick and when we’re suffering. In this case, having advocates in your corner are essential. Perhaps it’s having an ND who can help you navigate the system, think clearly and help you weigh your options.
I also recognize that it is hard to be empowered in emergencies. Fortunately, modern medicine handles emergencies exceptionally well. Still, in this case, having an advocate: friend, practitioner or family member, is an incredible asset.
Physicians are burned out. Patients are burned out. I believe this is because of responsibility. Neither the medical system nor the individual can possibly be solely responsible for your health. I believe that responsibility is better when shared. We need help. We can’t do things alone: we need someone’s 8+ years of education, diagnostic testing, clinical experience and compassion. We also need our own sense of empowerment so that doctor’s don’t succumb to the immense pressure of having to fix everyone and everything.
My sister in law is an ER nurse and once remarked (when asked if the ER was busy and chaotic) “people need to learn self-care”. She didn’t mean self-care as in bubble baths. She meant: learning how to manage a fever at home, when a cut needs stitches or how to determine if a sore ankle is a sprain, strain or break. A lot of people were coming in with colds—self-limiting, non-serious infections that could easily be treated at home. This was burning her out. Of course, she meant, go to the ER if you’re not sure. But, there are many non-grey areas in which we can feel empowered to manage self-limiting, non-serious health conditions as long as we know how to identify them or who to go to for answers.
Education is power. In a past life (before becoming an ND and while studying to become one) I was a teacher. I am still a teacher and in fact the Latin root of the word doctor, docere, means “to teach.” Healthcare is teaching. No doctor should say “just take this and call me in the morning” and no patient should accept this as an answer. We have the right to ask, “what will this pill do? When can I stop taking it? How does it work?” This is called Informed consent: the right to know the risks and benefits of every single treatment you’re taking and the right to respectfully refuse any treatment on any grounds.
You have the right to a second opinion. You have the right to say, “Can I think about this? I’d like to read more about it.” You have every right. You have the right to bring a hard question to your doctor, like “do I really need this statin? A study in Nature found that the optimal cholesterol level for reduced all-cause mortality is around 5.2 mmol/L, which is much higher than mine. Do I really need to be on something that lowers my cholesterol?”
If we can’t speak to our doctors, we turn to Google. Being a good researcher is a skill. This is what I was trained to do at naturopathic medical school and in undergrad. How can you tell if a study is a good study? Does the conclusion match the results? What does this piece of research mean for me and my body? Your doctor should be able to look at you and answer your questions to your satisfaction. This is basic respect.
You deserve to access the results of your blood tests and be walked through the results, even if everything is “normal”. Even a normal test result tells a story. We deserve transparency.
I was once told in a business training for healthcare practitioners (NDs, actually) that “people don’t want all the information. They don’t want to know how something works. They just want you to tell them what to do.”
Now, I sincerely disagree with this. In my experience, patients listen vividly when I walk them through bloodwork, explain what I think is happening to them and try to describe my thought process for the recommendations I’m making. I’m sure a lot of what I say is overwhelming–and then I try to put it differently, and open the conversation up to questions to ensure I’m being understood. Again, doctor as teacher, is a mantra we should all live by. There are few things more interesting than learning how our bodies work. In my experience, patients want to know!
When our bodies occur as a mystery, we are bound to live in fear. We are bound to feel coerced and pressured into taking things that our intuition is telling us to wait on, or seek a second opinion for. When we are scared to ask our doctors questions or take up their time, we end up having to deal with our concerns on our own. When we are dismissed we end up confused and doubting ourselves. We end up disconnected from our bodies. We are anxious. We catastrophise. We give away our power to strangers.
Empowerment is everything. It helps us connect to our bodies. It strengthens our intuition. We know where to go or who to go to for answers (or at least a second or third, opinion). We can move ahead with decisions. (i.e.: “I’m going to take this for 8 weeks and if I don’t like the side effects, I will tell my doctor that I want to wean off or ask for another solution”). We are aware of the effects and side effects of medications. We are aware of our options. We know if something isn’t right for us. We can make food and life style choices in an informed and empowered way. We can feel in our bodies who is trustworthy. We can trust ourselves and our bodies.
When patients are empowered, I believe doctors experience less burnout. The responsibility is shared evenly among patients, friends, family and a circle of care of helpers. No one faces the entirety of the weight of their health alone. No one should.
Empowerment and health don’t mean that you’ll be completely free of disease, or that your body will never get sick, or that you will be pain and suffering free. We all get sick. However, empowerment can help you notice something is off. Increased awareness helps you advocate for yourself to get the care you need in a timely fashion. It helps you take necessary steps, even if you’re afraid. You might be less afraid when you have more information. You might have more hope when you know all your options.
Empowerment in healthcare is everything. And here’s the thing: your doctor wants you to be empowered. Empowered patients are fun to work with. They ask good questions. They are respectful. They are open. They give us practitioners an opportunity to learn. My friend experienced this. I’m sure she was a joy of a patient to work with because she was knowledgeable, alert and present. She maintained her own power. She asked questions when she was unsure. She knew what questions to ask. She knew where to go for answers on her own time. She knew which information was relevant for her practitioners to know. She knew how to ask for time and space before making a decision. She knew how to maintain her sense of autonomy. Most of all, empowerment gives us the strength to find a new practitioner if the therapeutic relationship we’re in isn’t respectful or supportive.
I believe we get into the helping professions to help–to heal, to learn and to alleviate suffering. We all swore an oath to “do no harm”.
What do you think? How has health empowerment helped you navigate your own healthcare?
by Dr. Talia Marcheggiani, ND | Nov 28, 2022 | Anxiety, Autoimmune, Depression, Digestion, Gut Microbiome, Health, Hormones, Mental Health, metabolic health, Microbiome, Skin health
Hippocrates once said “all disease begins in the gut” and, even though as a naturopathic doctor I have internalized this to the utmost degree, I still forget from time to time.
So, when I was having an increase in histamine symptoms (itchy eyes, runny nose, inflammation, congestion, itchy skin, immune issues), dental issues (bad breath, swollen tongue, increase in plaque and bleeding gums), gut issues (bloating, constipation, sugar cravings) and mood issues (PMS, low motivation, fatigue, brain fog, lower mood, fatigue) as well as other random symptoms such as decreased stamina, cold intolerance and otherwise just feeling “blah”, it took me an embarrassingly long amount of time to connect all these symptoms to being caused by a gut microbial imbalance.
The dental issues I was experiencing, like bad breath, swollen tongue, and increased plaque buildup, were all signs that something deeper was off. Bleeding gums, which I initially attributed to inconsistent flossing, were actually part of a bigger issue tied to my overall health. It was frustrating to deal with these problems, especially since I didn’t immediately connect them to my gut. But the truth is, oral health and gut health are closely linked. A gut imbalance can lead to inflammation that affects not just the digestive system but also the gums and teeth. When the gut isn’t in harmony, it’s much easier for bacteria to thrive in the mouth, leading to plaque, cavities, and gum disease.
Finding the right support for my oral health became a priority. I realized that alongside addressing my gut, I needed professional dental care to manage these symptoms. That’s when I turned to vibrant dental, where they not only provided excellent cleanings and treatments but also offered holistic advice that took my overall health into account. With their help, I started to see improvements in both my oral and gut health, which ultimately boosted my mood and energy levels. It was a reminder that our health is interconnected, and sometimes, solving one issue requires looking beyond the obvious symptoms.
Our gut bacteria outnumber the cells of our body by 10 to 1. These little guys influence our digestion, mood and immune system. They affect our brain function. A recent study in Frontiers in Psychiatry (Nguyen et al., 2021) even connects the diversity of our microbiome with loneliness and wisdom.
Interestingly, loneliness and wisdom have been found to occur in inverse relationship with one another. In other words, the wiser you are, the less lonely. It’s important to note here that loneliness is not the same thing with isolation or being alone–sometimes alone time is necessary for the type of self-reflection that imbues wisdom.
Wisdom is a complex phenomenon that is made up of traits like compassion towards self and others, self-awareness and reflective thinking and deep knowledge about the world and the meaning of life events. From this description we can imagine how protective wisdom might be against mental illness and how it may lend to mental, emotional and physical wellness.
The wiser you are, the better able you may be to make meaning of and persevere through life’s difficulties and connect with others. Wisdom lends itself to an overarching view of self, life and humanity that may allow us to respond to life’s challenges with resilience.
Perhaps a wise person who is alone may also be aware that they are also part of an interconnected ecosystem that includes self and others. They may be aware of their place within the fabric of existence. In this way, they are never really alone.
Further, the meaning they may derive from states of aloneness may protect them against the feelings of social isolation that are characterized by loneliness. Imagine a wise figure. Perhaps they are alone, but would you say they are lonely?
Our gut is sometimes called “the second brain” and forms part of the microbiota-gut-brain axis in which our gut bugs influence the health of our intestines and thus influence our nervous system, immune system and brain (Cryan & Dinan, 2012). Our gut microbiome can even influence personality traits such as agreeableness, openness and even neuroticisim (Kim et al,m 2018). Interestingly, unhealthy gut bacteria like proteobacteria (associated with SIBO) were associated with low conscientiousness and high neuroticisim (Kim et al., 2018).
Does this mean that diet can influence our tendency to hand things in on time and keep our rooms clean? hmm…
It’s interesting to think that we all have a sense of our personalities and who we are as people. We imagine ourselves to be introverted or extraverted, artistic, creative, liberal or conversative. We might consider ourselves kind or trustworthy, blunt or afraid of conflict. We may identify as people who make healthy eating choices and enjoy exercising or who have sweet tooths (teeth?).
Amidst this self-discovery, the exploration of mbti personalities seamlessly weaves into the fabric of our understanding, adding another layer to the rich and diverse mosaic of human characteristics. Delving into the realm of MBTI personalities opens a door to a nuanced comprehension of ourselves and those around us. The Myers-Briggs Type Indicator, with its sixteen distinctive personality types, provides a structured framework to decipher the intricacies of our individuality. This insightful exploration not only enhances self-awareness but also fosters a greater appreciation for the diverse ways in which personalities interlace and contribute to the vibrant mosaic of the human experience.
But what if we are less in control of our behaviour and even personality than we think? The truth is the bacteria in our gut produce chemicals that influence our behaviour: what we crave and eat and even how we act and think. In turn, this influences the composition of our gut.
Prosocial behaviour is associated with more gut biodiversity, and people who are more social tend to have microbiomes that are more diverse (Johnson, 2020). This makes sense if you think about it. If you’re exposed to a variety of people and environments, you’re likely exposed to a variety of bacteria and viruses as well. These microbes are ingested and incorporate themselves into our bodies.
When we visit different environments we consume foods in those environments. When we socialize with various people, we often share food. This increase in food diversity will also influence gut microbial diversity.
As I write this, I wonder about the effects of social isolation of the past 2-3 years. During Covid, our social circles decreased. Currently we are seeing a rise in infections: colds, flus and other illnesses (RSV, hand food and mouth disease, pink eye and so on), particularly in children. I wonder if this lack of socialization has affected our microbiomes and thus our individual and collective immunity. A hypothesis worth exploring, perhaps…
Further, the hypersanitization may also have contributed to shifting the health of our microbiome. It still remains to be seen.
We know that a lack of gut diversity can affect our immune system and is associated with obesity, inflammatory bowel disease and major depressive disorder (Jiang et al., 2015). In mice, the health of the microbiome is essential for their social development (Desbonnet et al., 2014)!
So, what does this mean practically and clinically?
Throughout my studies and years practicing as a naturopathic doctor, a clear-cut path towards improving microbiobial health of the gut is still unclear to me. We know that increasing the amounts of plants and fibre in the diet can support gut diversity. But we also know that fibre can cause constipation and bloating in some individuals and aggravate their digestion and that there are many indiviudals who at least anecdotally seem to thrive on diets that reduce fibre, such as the Carnivore Diet or an Animal-Based Diet (which, by the way, I’m not necessarily recommending here).
For me, gut health has largely been about paying attention and noticing when things have gone astray and then (and this part is harder than it sounds) correctly attributing what has gone astray to a shift in the health of my microbiome.
This has been years in the making. Our gut produces pain in response to stretch (i.e.: from gases in the intestines). We don’t necessarily feel pain in our gut if we’re experiencing intestinal permeabilty (leaky gut) or dysbiosis. This means that there is not a lot of feedback from our body that tells us about the state of our gut. Our gut doesn’t always hurt if it’s inflamed or imbalanced in the way your shoulder might. We need to look for other signs and symptoms that alert us to the state of health of our guts.
For me symptoms of gut imbalance often correlate with symptoms of candida overgrowth (something I, like many, am prone to). Candida, a species of yeast, tends to flourish in my body if my overall gut ecosystem is failing to keep it in check. Sometimes this can occur due to stress, and increase of sugar in my diet and other factors.
Symptoms I notice are:
– A change in oral health: more plaque on my teeth, bad breath, tongue coating, bleeding gums, and so on.
– A change in mood and mental functioning: symptoms of depression or dysthymia such as apathy, low motivation and lethargy. Brain fog, difficulty concentration, poorer executive function (particularly initiating tasks or increased procrastination).
– A change in digestion: persistent bloating, more constipation (involving not just frequency but stool quality. They might be stickier or harder to pass).
– A change in immune function: more mucus production and congestion. Allergy symptoms. Trouble breathing,.
– A change in energy and metabolism: reduced stamina despite exercising. Weight gain. Water retention. Fatigue. Feeling cold.
– A change in cravings: wanting more sugar, binge-eating and overeating. Obsessing about food. Cravings for sugar after meals. Feeling “hangry” more often. Difficulty feeling full. Mental hunger (hunger despite feeling the presence of food in the stomach).
– A change in hormonal health: changes to libido, vaginal flora. heavier periods, irregular periods. Increased PMS.
And so on. If this seems like virtually every system in the body is affected, I remind us all that Hippocrates said it first (or at least most famously): “all disease begins in the gut”.
What is the solution? Like recognizing the cause, the solution is often subtle. For me it was focusing attention to gut health and slowly steering the ship back to healthier habits.
The problem with dysbiosis is it often maintains itself. Low energy leads to less socialization and less motivation to cook healthy meals. More cravings lends to poorer food choices. These are just some examples of what you can imagine to be a variety of maintenance processes that are caused by and serve to perpetuate dysbiosis.
Therefore for me, the solution is not to make drastic changes but to identify and shift these patterns in support my microbiome.
1) I took sugar out of my diet. For me this involved shifting away from my 3 fruits a day to starchy vegetables (like squashes, etc.) I thrive on a Paleo-like diet (a whole foods diet that emphasizes fruit, vegetables and animal protein) and subtly shifted back to one.
I didn’t completely eliminate fruit sugar as I don’t believe there is a need. However, I recognized that I was likely overconsuming sweet foods as a response to dysbiosis and this wasn’t serving me.
2) I got on a comprehensive and broad-spectrum probiotic. I often tell my patients that probiotic prescribing is more of an art than a science and involves some trial-and-error. I typically look for one that has 8+ strains and a high CFU (colony forming unit) count. I took Colon Care 90 Billion by New Roots. This is certainly not the only good one and it might not be the right one for you, but it’s one I selected for myself based on a variety of factors I was looking for that supported my individualized assessment of my gut health.
For me probiotics can be highly effective, but they take time to work. They often can aggravate symptoms initially. The first symptoms I notice that indicate improvement are an improvement in oral health.
3) I supported my digestion in general. This involves for me supporting the liver and gallbladder, which influence gut motility, bile flow (which helps keep the small bowel free of bacteria) and fat digestion (which prevents growth of more pathogenic microbes and stabilizes blood sugar).
4) I consumed anti-candida, antimicrobial foods that work for me (again, this is after much trial and error). Raw garlic, coconut oil, apple cider vinegar and oregano oil. I also started on a candida herbal supplement that incorporates cloves, black walnut and other anti-microbial herbs that selectively kill pathogenic microbes while typically preserving healthy ones.
5) I supported my microbiome by integrated back into nature: getting outside more, reducing chemical exposure (soaps, fragrances, plastics, pesticides, etc.) and getting more sunlight. Camping outside in the cold, sleeping on the ground and brushing my teeth in a natural brook in Nova Scotia also likely contributed to shifting the diversity of my microbiome through encouraging the exchange of my microbes with those of the earth.
6) I supported the body’s stress response by getting more sleep. When I’m awake I try to get as much sun exposure as possible. Our microbiome and our Circadian Rhythms are intricately connected. Supporting one can support the health of the other (Bishehsari et al., 2020). Regarding this, I wonder if Daylight Savings Time made some of us more susceptible for microbial imbalances in our guts? Hm…
Getting off track is a holistic multi-facted process. We all know our own vices and susceptibilities if we look deep enough.
Therefore, getting on track is an equally holisitic and comprehensive process. It involves wisdom (which, conveniently, increases as your microbial health increases). I can help you figure things out if you’re new to this process.
After implementing these strategies and paying a bit more attention for a few weeks I slowly and surely notice myself feeling more like myself. Getting back on track: more energy, better mood, better cold tolerance (this is a big one!) and better gut health. My appetite has regulated incredibly. I feel like a different person. But the shifts have been slow and sometimes subtle (as is often the case with shifting an entire ecosystem) and paying attention to them is a very important part of the process.
Wisdom.
It’s not just diet. It’s not just supplements. It involves looking at the relevant factors and gently moving back in the right direction with patience and persistence. Maybe your main point of focus needs to be eating regular meals and meal planning. Maybe you need more strength-training. Maybe you need to start socializing more, getting out in public (knitting circle, anyone? I’ve been hearing so much about knitting circles these days, haha–a sign from the universe?).
Maybe it’s time to look at emotional eating with a pair of fresh eyes (perhaps through the lens of your microbiota). Maybe you need to take a walk outside today. Everyday. Breathe fresh air. Take a probiotic.
Contact me if you need support! I’m here for you.
What else do you do for your gut microbiome?
References:
Bishehsari, F., Voigt, R. M., & Keshavarzian, A. (2020). Circadian rhythms and the gut microbiota: From the metabolic syndrome to cancer. Nature Reviews Endocrinology, 16(12), 731–739. https://doi.org/10.1038/s41574-020-00427-4
Cryan, J. F., & Dinan, T. G. (2012). Mind-altering microorganisms: the impact of the gut microbiota on brain and behaviour. Nature reviews. Neuroscience, 13(10), 701–712. https://doi.org/10.1038/nrn3346
Desbonnet, L., Clarke, G., Shanahan, F., Dinan, T. G., & Cryan, J. F. (2014). Microbiota is essential for social development in the mouse. Molecular psychiatry, 19(2), 146–148. https://doi.org/10.1038/mp.2013.65
Jiang, H., Ling, Z., Zhang, Y., Mao, H., Ma, Z., Yin, Y., Wang, W., Tang, W., Tan, Z., Shi, J., Li, L., & Ruan, B. (2015). Altered fecal microbiota composition in patients with major depressive disorder. Brain, behavior, and immunity, 48, 186–194. https://doi.org/10.1016/j.bbi.2015.03.016
Johnson, K. V. A. (2020). Gut microbiome composition and diversity are related to human personality traits. Human Microbiome Journal, 15, 100069.
Kim, H. N., Yun, Y., Ryu, S., Chang, Y., Kwon, M. J., Cho, J., Shin, H., & Kim, H. L. (2018). Correlation between gut microbiota and personality in adults: A cross-sectional study. Brain, behavior, and immunity, 69, 374–385. https://doi.org/10.1016/j.bbi.2017.12.012
Nguyen, T. T., Zhang, X., Wu, T.-C., Liu, J., Le, C., Tu, X. M., Knight, R., & Jeste, D. V. (2021). Association of loneliness and wisdom with gut microbial diversity and composition: An exploratory study. Frontiers in Psychiatry, 12. https://doi.org/10.3389/fpsyt.2021.648475
by Dr. Talia Marcheggiani, ND | Nov 27, 2022 | Anxiety, Autoimmune, Food, Health, Nutrition, Supplements, Vitamins
Did you know it can take modern medical research 17 to 20 years before it reaches mainstream medical practice?
Sometimes it takes us time to be sure and this means repeating study results over and over again with various populations. Sometimes, however it can take time to instill new consciousness into our habits and routines. We humans are creatures of habit and prone to bias. It can he hard to change our minds and change our ways, which can lead to even the most well-meaning and intelligent doctors making outdated recommendations or relying on old science.
For instance, have you ever been told (or know someone who’s been told) to avoid eggs for your cholesterol (facepalm). What about low-fat diets? Ridiculous as it may seem, this is still being said to my patients.
You get my point, right?
This brings me to the topic of supplementation for two nutrients that we North Americans are prone to deficiency in: Vitamin D and Iron.
Let’s start with iron.
Iron:
Is needed to make hemoglobin in red blood cells. It shuttles oxygen around the body. We use that oxygen for cellular respiration (to make energy) in our mitochondria.
Low iron can lead to anemia (lack of red blood cells, hemoglobin and hematocrit).
Low iron can cause symptoms such as: low energy, low mood (dopamine), low thyroid function, feelings of cold, racing heart, anxiety, dizziness, weakness, hair loss, dry and pale skin, low stamina and exercise tolerance as the body is not able to move oxygen around the body to make energy.
So, what do you do when your iron is low? Supplement, right? Normally, I would have said yes.
That’s where things have changed for me.
So, I noticed that even if I recommended gentle iron supplements (iron bisglycinate or heme iron), patients wouldn’t take them. Even if they didn’t cause constipation (which the conventionally prescribed ferrous fumarate is infamous for) or other gastrointestinal symptoms, patients had a certain aversion to iron supplements that was hard to explain.
Further, sometimes they would raise blood iron levels and sometimes they wouldn’t. Sometimes they would raise levels and then levels would fall back down again.
It’s interesting to note that iron is the most abundant element on the planet, making up 35% of the Earth. It is fortified in commonly eating foods like bread and cereals. The problem is not iron intake, it is iron metabolism, or the way that iron is moved throughout the body.
We can have 10 times the amount of iron lodged in our tissues than is present and measured in our blood. And this isn’t good. Iron interacts with oxygen and causes oxidation (or “rusting”). This can cause inflammation of our tissues, like gut tissue. It can negatively impact our livers. We want iron safely stored in hemoglobin.
In order to get iron out of our tissues we need an enzyme call ceruloplasmin, which depends on the element copper. Copper is needed to get iron out of the tissues and into the blood in the form of hemoglobin so that it can be used to move oxygen to our mitochondria to give us energy.
Now, we also need preformed vitamin A (retinol, only found in animal foods) to load copper into ceruloplasmin.. (to get iron into hemoglobin so that oxygen can get to our cells, it’s like that song “The Farmer takes a wife”, haha). You get the picture.
Put simply:
Energy– > oxygen in mitochondria –> hemoglobin (with iron) –> requires ceruloplasmin (vitamin A and copper).
So, the key to supporting iron levels and energy production is not more iron! It’s the nutrients that help iron work properly in the body. Copper and Vitamin a, which are found (along with highly absorbable heme iron) in Beef Liver!
Interestingly enough Whipple, Minot and Murphy were awarded the Nobel prize in physiology and medicine in 1934 when they discovered that beef liver cured anemia and pernicious anemia (B12 deficiency).
Beef liver is rich in choline (supports the liver, especially fatty liver, cell membranes, brain health, digestion, gallbladder function, mood and memory), zinc, B vitamins and hyaluronic acid.
Very often we find that we are implementing too many interventions and the key is to go back to our roots: to nature and ancestral practices to solve our problems. Sometimes we don’t need more technology, but more nature. An ancestral food that few of us consume anymore (at least not regularly). Good old beef liver. I will tell patients to consume lightly cooked grass-fed liver or take it in a supplement form (which is what I do).
For more on this topic, check out my podcast episode on it!
This brings us to Vitamin D.
Vitamin D is actually a hormone. It regulates 900 genes in the body that are involved in bone health, immune function (supporting low immune function and autoimmunity) and mood.
We humans get vitamin D from the sun. Sun hits cholesterol in our skin and our skin makes vitamin D. This is the best way to get vitamin D. Therefore in sunny climates, get sun! Clothing and sunscreen blocks vitamin D, fyi. About 20 minutes a day of direct sun on 20% of your skin (t-shirt and shorts), can generally give you your daily vitamin D.
However, in the winter, our skin does not have access to sun exposure and we don’t make vitamin D. So what do we do? Well, up until recently I would have told you to take a vitamin D supplement, in the form of drops (as D is fat-soluble) to make sure that your blood levels of 25-hydroxyvitamin D (25-OH D) is >125 nmol/L.
However: vitamin D requires magnesium to be activated in the body (and most modern humans are notoriously deficient in magnesium). Sometimes low blood levels of D are actually an indication of low magnesium.
Further, high levels of supplemental vitamin D also deplete levels of vitamin A (or retinol). Vitamin A and vitamin D must be taken together as they are biological partners. In fact, one of the things that sunlight does is activate preformed vitamin A in the skin as well as activate vitamin D synthesis. Vitamin A helps activate Vitamin D receptors (and remember that vitamin A is responsible for iron metabolism as well).
The good news is that both vitamin D and vitamin A are found together in nature in Cod Liver oil (along with the antiinflammatory omega 3 fish oils EPA and DHA). So, I am more frequently recommending Cod liver oil as a vitamin D source along with magnesium to help support vitamin D metabolism in the body. We need to get vitamin D from a supplemental source in the winter if we’re not getting enough sun, however the precautionary principle will tell us that historic supplementation (what our Northern ancestors might have practiced) contains lots of wisdom.
Nutrients don’t work in isolation. They work in networks (just like our hormones and immune cells). We need copper and Vitamin A to regulate iron. We need magnesium and vitamin A to regulate vitamin D.
Isolating and supplementing with single vitamins and minerals may be indicated for some patients (going deep and narrow, particularly for people with pronounced and specific deficiencies), however in general I’m moving to a more holistic and ancestral prescribing practice with most patients when appropriate–this is where I see the current evidence pointing: to a more holistic vs. reductionist approach.
That being said, everyone is different and so all prescriptions are highly individualized. There are some people who these supplements are not indicated for or appropriate for and so alternatives are prescribed.
The reason my practice is built around 1:1 visits is because this is where the magic lies. In individualist prescribing. You are not the same as your neighbour. You have specific needs and considerations for your health.
I hope that makes sense. The world of nuritition is a fascinating subject. In order to stay on top of the current best practices it is my responsible to be on top of the research (sifting through the vast arrays of information) and flexible enough to pivot my approach when necessary.
I don’t practice the same way I did when I graduated. Or even the exact same way I did last year. It is important to keep things fresh and current and not let ego stand in the way of changing things for the better.
What do you think? Do you take beef liver and cod liver oil? How’s that been going for you?
by Dr. Talia Marcheggiani, ND | Jan 15, 2022 | Allergies, Anxiety, Autoimmune, Depression, Detoxification, Digestion, Elimination Diet, Food, Food Sensitivities, Gut Microbiome, Leaky Gut, Nature, Nutrition, Preventive Medicine, Science
G.K. Chesterton described a scenario like this:
“There exists in such a case a certain institution or law; let us say, for the sake of simplicity, a fence or gate erected across a road. The more modern type of reformer goes gaily up to it and says, “I don’t see the use of this; let us clear it away.” To which the more intelligent type of reformer will do well to answer: “If you don’t see the use of it, I certainly won’t let you clear it away. Go away and think. Then, when you can come back and tell me that you do see the use of it, I may allow you to destroy it.”
In other words, beware of tearing down structures until you fully understand their benefit.
Chesterton’s Fence can also be thought of as the Precautionary Principle. Not following this principle led to scientific practices like frontal lobotomies or removing the entire large intestine because doctors didn’t understand the benefits of these structures or the consequences of removing them.
A narrow range of focus, i.e., this organ is causing a problem, or we don’t know why it’s here, led to drastic action that resulted in unforeseen, disastrous consequences.
I believe that such is the case with our stomach acid.
The stomach is essentially a lined bag filled with acid. Stomach pH is from 1.5 to 3.5, acidic enough to burn a hole in your shoe. However, the mucus layer of the stomach protects it from being destroyed by the acid. The acid in the stomach helps dissolve and digest the food chewed up by the teeth and swallowed.
Stomach pH is needed for breaking down proteins. Stomach acid also plays a role in absorbing minerals such as calcium, zinc, manganese, magnesium, copper, phosphorus and iron. It activates intrinsic factor, which is needed for B12 absorption in the small intestine.
Stomach acid regulates the rate of gastric emptying, preventing acid reflux.
Fast-forward to a condition called gastric esophageal reflux disease, or GERD. GERD affects about 20% of Western countries, characterized by high esophageal pH and reflux of the stomach acid and stomach contents into the esophagus. While the stomach is designed to handle a shallow pH environment, the esophagus is not. A doorway called the lower esophageal sphincter, or LES, keeps stomach contents where they should be–in the stomach.
In GERD, the tone of the LES is weak, resulting in a backflow of stomach contents. This can damage the esophagus, causing heartburn, pain, bad breath, coughing and even problems like ear pain, sore throat, and mucus in the throat. Silent reflux occurs when these symptoms occur without burning.
The symptoms occur from the stomach’s acidic contents irritating the more delicate tissues of the esophagus. So, rather than treat the root problem, i.e., the reflux, drugs like proton pump inhibitors (PPIs), H2 blockers, and buffers like Tums are recommended to reduce the stomach’s acidity.
Essentially, with GERD, we are tearing down Chesterton’s Fence to pave a road without taking even a moment to consider why the fence might be there in the first place.
About 12% of people are prescribed PPIs. They are given for GERD, gastritis, and IBS symptoms like bloating and stomach pain. Most of my patients are prescribed them for virtually any stomach complaint. PPIs, it seems, are the hammers wielded by many GPs, and so every digestive concern must look like a nail. Most people are put on them inevitably, without a plan to end the use and address the root cause of symptoms, which in most GERD cases are low LES tone.
PPIs raise stomach pH, disrupting stomach function. This causes issues with mineral absorption and protein digestion. Their use results in B12, vitamin C, calcium, iron, and magnesium deficiencies. Many of these deficiencies, like magnesium deficiency, can’t be tested and therefore might show up sub-clinically in tight muscles, headaches, painful periods, disrupted sleep and anxiety, and constipation. Therefore they fly under the radar of most primary care doctors.
No one connects someone’s heartburn medication with their recent onset of muscle tightness and anxiety.
Many of my patients report difficulties digesting meat and feeling bloated and tired after eating, particularly when consuming a protein-rich meal. They conclude that the meat isn’t good for them. The problem, however, is not meat but that stomach acid that is too diluted to break down the protein in their meal, leading to gas and bloating as the larger protein fragments enter the small intestine.
Many digestive problems result from this malabsorption and deficiency in stomach acid, not too much. Zinc is required for stomach acid production, and one of the best sources of zinc is red meat (zinc is notoriously lacking from plant foods). I have recently been prescribing lots of digestive enzymes and zinc to work my patients’ digestive gears.
Therefore, beware of tearing down a fence without understanding why it’s there. Stomach acid is essential for digesting our food, and regulating blood sugar and building muscle mass through protein digestion.
It is necessary for mineral absorption and B12 digestion. Our stomachs were designed to contain an extremely low pH. They evolved over millennia to do this. Stomach acid is low for a reason. It’s highly unlikely that our bodies made a mistake when it comes to stomach acid.
Therefore, beware of messing with it.
Consider that our bodies know what they’re doing. Consider the importance of finding and treating the actual root cause, not one factor that, if mitigated, can suppress symptoms while causing a host of other problems.
Don’t block your stomach acid.
As Hippocrates said, “All disease begins in the gut.”
It is the boundary between us and the outside world, the border where our body carefully navigates what can come in and nourish us and what should stay outside of us: our fence. Beware of tearing it down.
References:
Antunes C, Aleem A, Curtis SA. Gastroesophageal Reflux Disease. [Updated 2021 Jul 18]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK441938/
Daniels B, Pearson SA, Buckley NA, Bruno C, Zoega H. Long-term use of proton-pump inhibitors: whole-of-population patterns in Australia 2013-2016. Therap Adv Gastroenterol. 2020;13:1756284820913743. Published 2020 Mar 19. doi:10.1177/1756284820913743
Heidelbaugh JJ. Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications. Ther Adv Drug Saf. 2013;4(3):125-133. doi:10.1177/2042098613482484
by Dr. Talia Marcheggiani, ND | Dec 8, 2021 | Addiction, Anxiety, Cold and Flu Remedies, Depression, Detoxification, Exercise, Fitness, Happiness, Health, Inflammation, Mental Health, metabolic health, Motivation, Nature, Nature Cure, Stress
In the winter of 2019 I took a surfing lesson in Costa Rica. I fell in love–the sun and salt water on my skin, the beautiful view of the beach, the spray off the back of the waves, the loud crashing of translucent turquoise, and the feeling of power, ease, flow and grace as I stood on a board, using the energy of the earth to fly across water.
The problem was, however, I would be going home in a week to a landlocked part of the world that spends a lot of its months covered in ice.
It was depressing.
Then I met a girl from Toronto, a psychotherapist who worked at a clinic just down the street from my old one.
“You can surf in Toronto, you know”, she informed me.
Where? I thought, astounded.
“On the lakes!” She exclaimed.
I was flabbergasted–perhaps I could be a surfer after all. The beach bum lifestyle, the rock hard abs, the zinc oxide cheek bones, the chronically wet hair, watching the winds and tides and slipping out for a sun-soaked hour during a work break. Could this be true–could you surf the Great Lakes?
“The thing is,” she continued, “the surf season is from October to March”.
Oh.
Winter surfing.
It was still interested, though.
Back in Toronto, I waited for the next strong February East wind and headed to a surf spot I’d heard about on Lake Ontario. I was met with a crowd of black neoprene-clad surfers, soaked by water, wind and sleet. The elements were harsh. The stoke, however, was infectious.
Ok, I could do this, I thought.
My next stop was the surf shop. I purchased gear and the rest is history.
Not a lot of us are built to slip into near-freezing water during the frigid winter months to catch a few waves. Lake waves are harder to catch, the currents are strong, ice chunks are a thing to watch out for, and… it’s friggin’ cold! But, surfing is surfing. The lakes provide beautiful landscapes, just like the ocean, and the feeling of catching a wave and riding it is the same.
There’s also the benefit of body hardening.
We modern humans are very different from our hunter-gatherer ancestors. Our genes may be the same, but our lifestyles couldn’t be further apart. Down-filled jackets and central heating protect us from the discomfort of the elements. In a sense, our lives are temperature controlled.
However, our incidence of chronic degenerative disease has never been higher.
Body hardening practices involves exposure against natural stimuli, such as intense cold, that results in increased resilience–resistance to disease and improved health.
A 1998 study in QJM: an international journal of medicine looked at antioxidant production in German winter swimmers.
Winter swimming, just like winter surfing, is a thing. As of the 90s, there were 3000 Germans who participated in winter swimming clubs. They were known to experience a 40% reduction in respiratory diseases compared to the rest of the population, debunking the notion that if you exposure yourself to cold you’ll “catch a cold”.
The study looked at 23 male and 13 female who had been members of a Berlin winter swimming club for more than two years. On average they swam for 5 to 10 minutes on a weekly basis in water between 1 and 5 degrees celsius. Their blood levels of glutathione were compared with that of 28 healthy men and 12 healthy women who had never participated in cold-exposure body hardening therapies such as winter swimming.
Glutathione is our body’s main antioxidant. It protects us from free radicals (reactive oxygen and reactive nitrogen species, ROS and RNS, respectively) that are harmful to our cells. It is produced from three amino acids: glycine, cysteine, and glutamine.
Glutathione reduces oxidative stress produced by these free radicals that occur in cells as a result of their energy production, as well as toxins, pollutants and other stressors. A deficiency of glutathione is associated with an increased risk of cancer, accelerated aging, and other diseases, such as metabolic disease like diabetes and cognitive diseases like Parkinson’s. It decreases as a result of aging, chronic disease, toxin exposure, and chronic stress.
Elevating glutathione status has been shown to improve conditions like insulin resistance, autoimmune diseases, cognitive and mental health conditions, fatty liver and cirrhosis, autism, and respiratory diseases.
It was found that after cold water exposure, blood levels of antioxidants like glutathione decreases, indicating that cold water exposure induces oxidative stress on the body. However, after a period of time, glutathione levels rose higher than that of baseline.
Baseline blood levels of glutathione were higher in cold water swimmers, indicating that their bodies were more efficient at producing glutathione in response to the temporary oxidative stress imposed on them by the cold exposure.
In essence, “what doesn’t kill you makes you stronger”.
This is called hormesis: when temporary stress is imposed on our bodies, we respond with adaptive measures, such as increased glutathione production to combat that stress. However, our bodies are smart. They figure that if we’re exposed to some cold stress, there might be more coming. Therefore, it might be a good idea to invest energy into hardening, preparing for more of that same stress in the future and, in essence, becoming more resilient. And so, when exposed to a stressor, we often produce more antioxidant than is needed to simply overcome that stressor, and this results in an overall net benefit to our health and well-being.
Just like lifting weights makes us stronger for the next time we lift weights, we become stronger and more resilient at our baseline as we prepare for the next hit of cold, heat, exercise, or stress.
The 1998 study also revealed that cold water swimmers had more enzymes that combat free radicals such as superoxide dismutase, glutathione peroxidase, and catalase, meaning that their cells were better prepared to ramp up antioxidant production quickly and neutralize free radicals at a moment’s notice, if needed.
Cold water swimmers also produced four times more norepinephrine after their cold exposure. Norepinephrine is part of our fight or flight response, but is also associated with increased energy, mood, motivation and well-being. Imagine a hit of caffeine–that’s a bit what cold burst can do to you via norepinephrine. Heart race increases, and we’re filled with an excited euphoria.
Norepinephrine is part of the reason why cold therapy has been touted as a remedy for depression. Cold exposure provides a much-needed burst of mobilizing chemicals to kickstart feelings of well-being and motivation for people who are struggling with low mood and arousal.
Cold therapy also increases dopamine by 250%, according to a 2000 study in the European Journal of Applied Physiology. Dopamine gives us the sense of motivation and meaning in pursuing a goal. It fills us with purpose and drive. So many of us are starved of dopamine and therefore so much of our culture involves trying to increase dopamine: scrolling social media, consuming sugar, playing video games, and so on.
The problem with many of these attempts to boost dopamine is that they come with a cost. We get a hit of pleasure from consuming sugar, for example, followed by a dip in our baseline levels of dopamine. Overall, we’re left feeling empty, foggy, purposeless, and addicted. We experience cravings that need to be filled.
Even supplements like Macuna pruriens and l-tyrosine, designed to boost dopamine levels, result in crashes 30 to 45 minutes after they peak.
Cold exposure, however, gives us a hit of dopamine that remains elevated for hours without a resulting crash. This provides an intense boost to mood, motivation, cognitive function, concentration, focus, purpose and drive. Like norepinephrine this can also contribute to cold therapy’s anti-depressive effect.
It seems that if we engage in something hard and uncomfortable, something that requires effort–like cold exposure–our body rewards us with an increase in mood, motivation and drive through the enhancement of dopamine production in our brains.
Winter surfing has been an immense gift to my health and well-being. It’s given me purpose, community, exposure to nature, and a wonderful outlet for body hardening. If I go more than a week without a surf session I start to feel a bit of withdrawal. There is nothing more therapeutic than hours spent checking the forecast, and driving to chase waves in order to end up floating in the middle of a beautiful lake, surrounded by nature and friends.
With regular winter surfing I feel invigorated, energized and fit–the mood-lifting effects of the cold exposure is comparable to nothing else.
This winter my message to everyone is: get outside. Exposure yourself to cold. Expose yourself to nature. Use the elements and the changing seasons as tools to enhance your health.
There are incredible mood-elevating, immune system-boosting and anti-aging benefits to becoming more resilient. While it may be uncomfortable, cold adaptation is a sign of your improved vitality and disease resistance.
Nature’s harshness evolved us. Temperature extremes helped to shape our DNA. Our genes contain codes for amazing mental, emotional, and physical resilience. They are waiting to be turned on at a moment’s notice, if only they’re given a reason.
Cold exposure flips the on-switch to your body’s incredible superpowers. Let’s explore the potential of this beautiful vessel in which we all live.
References:
Šrámek, P., Šimečková, M., Janský, L. et al. Human physiological responses to immersion into water of different temperatures. Eur J Appl Physiol 81, 436–442 (2000). https://doi.org/10.1007/s004210050065
W.G. Siems, R. Brenke, O. Sommerburg, T. Grune, Improved antioxidative protection in winter swimmers, QJM: An International Journal of Medicine, Volume 92, Issue 4, April 1999, Pages 193–198, https://doi.org/10.1093/qjmed/92.4.193
Image: Dean Weare at www.dweare.com
by Dr. Talia Marcheggiani, ND | Oct 24, 2021 | Anxiety, Beauty, Depression, Health, Medicine, Meditation, Mental Health, Mindfulness, mood, Nature, Nature Cure, Outdoors, Philosophy, Psychology, Self-care
“There’s a sunrise and a sunset every day and you can choose to be there or not.
“You can put yourself in the way of beauty.”
– Cheryl Strayed, Wild
Yellow and orange hues stimulate melatonin production, aiding sleep.
Melatonin is not just our sleep hormone, it’s an antioxidant and has been studied for its positive mood, hormonal, immune, anti-cancer, and digestive system effects.
Our bodies have adjusted to respond to the light from 3 billion sunsets.
While we can take melatonin in supplement form, use blue light blocking glasses, or use red hued light filters and, while tech can certainly help us live more healthfully, it’s important to remember that the best bio-hack is simply to remember your heritage and put yourself back in nature’s way.
The best tech of all is in the natural rhythms of the planet and encoded in your beautiful DNA.
Optimal health is about re-wilding. Optimal health is about remembering who you are and coming back to your true nature.
You have the code within in you to live your best, healthiest life. I believe healing is about tapping into that code, supporting our nature, and allowing the light of our optimal health template to shine through.
The proximity to water can improve focus, creativity, health and professional success according to marine biologist and surfer Wallace J. Nichols in his book, Blue Mind.
A “blue mind” describes a neurological state of of calm centredness.
Being around water heightens involuntary attention, where external stimuli capture our attention, generating a mind that is open, and expansive, and neurochemicals like dopamine and serotonin are released.
He says, “This is flow state, where we lose track of time, nothing else seems to matter, and we truly seem alive and at our best”.
Contrast a blue mind to a red mind, where neurons release stress chemicals like norepinephrine, cortisol in response to stress, anxiety and fear.
From the book Mindfulness and Surfing:
“Surfing is not just about riding a wave, but immersion in nature: the aching silence of a calm sea is punctuated by a cluster of blue lines. The point is to spend a little more time looking and listening than doing.
“Maybe this is not just about being but about what the philosopher Heidegger called “becoming”–a being in time, an unfolding sense of what he further called ‘dwelling’.
“When we dwell, we inhabit.”
Jungian Psychoanalyst, Frances Weller posed the question, “What calls you so fully into the world other than beauty?”
In other words, “Without beauty what is it that attracts us into life?”
Our human affinity for beauty is perhaps the greatest pull of all into aliveness. And yet so many of us feel purposeless, or that life is meaningless. In our world we are suffering from a “Meaning Crisis”, which perhaps partially explains the epidemic of mental health issues that plague us.
We spend so much time bogged down in the business of being alive: bills, chores, work–“dotting Ts and crossing Is” as I like say 😂
This is part of the reason why 1/6th of my 6-week Mental Health Foundations program (Good Mood Foundations) involves getting into nature. For there is nothing more beautiful than the gorgeous imperfection of the natural world.
We are called by it. There are myriad scientific studies on the power of “Forest Bathing” for de-stressing, for mental health, for supporting our mood, hormonal health, immune systems, social relationships, and so on.
And yet so often when we say words like “beauty” we call on images of “perfection”: symmetrical youthful faces, bodies with zero fat on them, etc.
We are focused on the missing parts instead of how the effect of nature’s imperfect beauty has on us–and thus we rob ourselves of the pleasure of being in the presence of beauty.
For what is pleasure but beauty personified? And what is depression other than a lack of deep, embodied soulful pleasure?
I find being in nature brings me closer, not so much to beauty as a concept of commercial idealism, but a sense of pleasure. It pulls me into my body.
I feel my feet on the ground, my breath timing my steps, the birdsong and wind in my ears, and I feel calmed, and centred, called into the experience of being fully alive.
If you’re struggling to find meaning, practice showing up to your sunsets for a few evenings in a row.
Put yourself in the way of beauty.
When the sunsets show up everyday, will you show up too?
by Dr. Talia Marcheggiani, ND | Oct 10, 2021 | Alcohol, Anxiety, Balance, Book Review, Depression, Emotional Wellness, Emotions, Happiness, Healing Stories, Health, Meditation, Mental Health, Mind Body Medicine, Mindfulness, Psychedelics, Psychology, Self-care
It was a crappy week and I was chatting with a friend online. He said something that triggered me… it just hit some sort of nerve. I backed away from my computer, feeling heavy. I went to the kitchen to pour myself a glass of water and collapsed, elbows on the counter, head in my hands, my body shaking and wracking with deep, guttural sobs.
A few seconds later, I’m not sure how long exactly, I stood up. Tears and snot streaming down my face, I wiped them off with a tissue. I felt lighter, clearer. I was still heavy and sad, but there was a part of me that had opened. I went back to my computer and relayed some of this to my friend, “what you said triggered me, but it’s ok, it just hit a personal nerve. I’m ok now though, I know you didn’t mean any harm”. I typed to him.
Joan Rosenberg, PhD in her book 90 Seconds to a Life You Love, would have said that, in that moment, I had been open to feeling the moment-to-moment experience of my emotions and bodily sensations. I felt the waves of emotions run through my body, and let them flow for a total of up to 90 seconds. And, in so welcoming that experience and allowing it to happen rather than blocking it, fighting it, projecting it (onto my friend or others), I was able to release it and let it go.
For many of us, avoidance is our number one strategy when it comes to our emotions. We don’t like to feel uncomfortable. We don’t like unpleasant sensations, thoughts and feelings and, most of all, we don’t like feeling out of control. Emotions can be painful. In order to avoid these unpleasant experiences, we distract ourselves. We try to numb our bodies and minds to prevent these waves of emotion and bodily sensation from welling up inside of us. We cut ourselves off.
The problem, however is that we can’t just cut off one half of our emotional experience. When we cut off from the negative emotions, we dampen the positive ones as well.
This can result in something that Dr. Rosenberg titles, “soulful depression”, the result of being disconnected from your own personal experience, which includes your thoughts, emotions and body sensations.
Soulful depression is characterized by an internal numbness, or a feeling of emptiness. Over time it can transform into isolation, alienation and hopelessness–perhaps true depression.
Anxiety in many ways is a result of cutting ourselves off from emotional experience as well. It is a coping mechanism: a way that we distract ourselves from the unpleasant emotions we try to disconnect from.
When we worry or feel anxious our experience is often very mental. We might articulate that we are worried about a specific outcome. However, it’s not so much the outcome we are worried about but a fear and desire to avoid the unpleasant emotions that might result from the undesired outcome–the thing we are worrying about. In a sense, anxiety is a way that we distract from the experience of our emotions, and transmute them into more superficial thoughts or worries.
When you are feeling anxious, what are you really feeling?
Dr. Rosenberg writes that there are eight unpleasant feelings:
- sadness
- shame
- helplessness
- anger
- embarrassment
- disappointment
- frustration
- vulnerability
Often when we are feeling anxious we are actually feeling vulnerable, which is an awareness that we can get hurt (and often requires a willingness to put ourselves out there, despite this very real possibility).
When we are able to stay open to, identify and allow these emotions to come through us, Dr. Rosenberg assures us that we will be able to develop confidence, resilience, and a feeling of emotional strength. We will be more likely to speak to our truth, combat procrastination, and bypass negative self-talk.
She writes, “Your sense of feeling capable in the world is directly tied to your ability to experience and move through the eight difficult feelings”.
Like surfing a big wave, when we ride the waves of the eight difficult emotions we realize that we can handle anything, as the rivers of life are more able to flow through us and we feel more present to our experience: both negative and positive.
One of the important skills involved in “riding the waves” of difficult feelings is to learn to tolerate the body sensations that they produce. For many people, these sensations will feel very intense–especially if you haven’t practice turning towards them, but the important thing to remember is that they will eventually subside, in the majority of cases in under 90 seconds.
Therefore, the key is to stay open to the flow of the energy from these emotions and body sensations, breathe through them and watch them crescendo and dissipate.
This idea reminds me of the poem by Rumi, The Guest House:
This being human is a guest house.
Every morning a new arrival.
A joy, a depression, a meanness,
some momentary awareness comes
as an unexpected visitor.
Welcome and entertain them all!
Even if they’re a crowd of sorrows,
who violently sweep your house
empty of its furniture,
still, treat each guest honorably.
He may be clearing you out
for some new delight.
The dark thought, the shame, the malice,
meet them at the door laughing,
and invite them in.
Be grateful for whoever comes,
because each has been sent
as a guide from beyond.
One of the reasons I was so drawn to Dr. Rosenberg’s book is this idea of the emotional waves lasting no more than 90 seconds. We are so daunted by these waves because they require our surrender. It is very difficult however, if you suffer from anxiety to let go of control. To gives these emotional waves a timeframe can help us stick it out. 90 seconds is the length of a short song! We can tolerate almost anything for 90 seconds. I found this knowledge provided me with a sense of freedom.
The 90 seconds thing comes from Dr. Jill Bolt Taylor who wrote the famous book My Stroke of Insight (watch her amazing Ted Talk by the same name). When an emotion is triggered, she states, chemicals from the brain are released into the bloodstream and surge through the body, causing body sensations.
Much like a wave washing through us, the initial sensation is a rush of the chemicals that flood our tissues, followed by a flush as they leave. The rush can occur as blushing, heat, heaviness, tingling, is over within 90 seconds after which the chemicals have completely been flushed out of the bloodstream.
Dr. Rosenberg created a method she calls the “Rosenberg Reset”, which involves three steps:
- Stay aware of your moment-to-moment experience. Fully feel your feelings, thoughts, bodily sensations. Choose to be aware of and not avoid your experience.
- Experience and move through the eight difficult feelings when they occur. These are: sadness, shame, helplessness, anger, embarrassment, disappointment, frustration, vulnerability.
- Ride one or more 90 second waves of bodily sensations that these emotions produce.
Many therapeutic techniques such as mindfulness, Dialectical Behaviour Therapy, somatic therapy, and so on utilize these principles. When we expand our window of tolerance and remain open to our physical and emotional experience we allow energy to move through us more gracefully. We move through our stuckness.
Oftentimes though, we can get stuck underwater, or hung up on the crest of a wave. Rumination and high levels of cortisol, our stress hormone can prolong the waves of unpleasant emotion. We may be more susceptible to this if we have a narrow window of tolerance due to trauma.
However, many of us can get stuck in the mind, and when we ruminate on an emotionally triggering memory over and over again, perhaps in an effort to solve it or to make sense of it, we continue to activate the chemicals in our body that produce the emotional sensation.
Therefore, it’s the mind that can keep us stuck, not the emotions themselves. Harsh self-criticism can also cause feelings to linger.
I have found that stories and memories, grief, terror and rage can become stuck in our bodies. Books like The Body Keeps the Score speak to this–when we block the waves, or when the waves are too big we can build up walls around them. We compartmentalize them, we shut them away and these little 90 second waves start to build up, creating energetic and emotional blockages.
In Vipassana they were referred to as sankharas, heaps of clinging from mental activity and formations that eventually solidify and get lodged in the physical body, but can be transformed and healed.
Perhaps this is why a lot of trauma work involves large emotional purges. Breathwork, plant medicines such as Ayahuasca, and other energetic healing modalities often encourage a type of purging to clear this “sludge” that tends to accumulate in our bodies.
My friend was commenting on the idea that her daughter, about two years old, rarely gets sick. “She’ll have random vomiting spells,” my friend remarked, “and then, when she’s finished, she recovers and plays again”.
“It reminds me of a mini Ayahuasca ceremony”, I remarked, jokingly, “maybe babies are always in some sort of Ayahuasca ceremony.”
This ability to cry, to purge, to excrete from the body is likely key to emotional healing. I was listening to a guest on the Aubrey Marcus podcast, Blu, describe this: when a story gets stuck in a person it often requires love and a permission to move it, so that it may be purged and released.
Fevers, food poisoning, deep fitful spells of sobbing may all be important for clearing up the backlog of old emotional baggage and sludge so that we can free up our bodies to ride these 90 second emotional waves in our moment-to-moment experience.
Grief is one of these primary sources of sludge in my opinion. Perhaps because we live in a culture that doesn’t quite know how to handle grief–that time-stamps it, limits it, compartmentalizes it, commercializes it, and medicates it–many of us suffer from an accumulation of suppressed grief sankharas that has become lodged in our bodies.
Frances Weller puts it this way,
“Depression isn’t depression, it’s oppression–the accumulated weight of decades of untouched losses that have turned into sediment, an oppressive weight on the soul. Processing loss is how the majority of therapies work, by touching sorrow upon sorry that was never honoured or given it’s rightful attention.”
Like a suppressed bowel movement, feelings can be covered up, distracted from. However, when we start to turn our attention to them we might find ourselves running to the nearest restroom. Perhaps in these moments it’s important to get in touch with someone to work with, a shaman of sorts, or a spiritual doula, someone who can help you process these large surges of energy that your body is asking you to purge.
However, it is possible to set our dial to physiological neutral to, with courage turn towards our experience, our emotions and body sensations. And to know that we can surf them, and even if we wipe out from time to time, we might end up coming out the other side, kicking out, as Rumi says, “laughing”.
The only way out is through.
As Jon Kabat Zinn says, “you can’t stop the waves, but you can learn to surf”.
by Dr. Talia Marcheggiani, ND | Sep 23, 2021 | Alcohol, Alignment, Anxiety, Autoimmune, Balance, Chronic pain, Community, Depression, Detoxification, Diet, Digestion, Education, Elimination Diet, Emotional Wellness, Emotions, Food, Food Sensitivities, Gluten Free, Health, Inflammation, Medicine, Meditation, Mental Health, metabolic health, Microbiome, Mind Body Medicine, Mindfulness, mood, Nature, Nature Cure, Nutrition, Uncategorized
It’s day one of my period and I’ve been healing a broken foot for 6 weeks. The weather is overcast, thick, humid and rainy.
My body feels thick and heavy. Clothing leaves an imprint on my skin–socks leave deep indentations in my ankles. My face and foot is swollen. My tongue feels heavy. My mind feels dull, achey, and foggy. It’s hard to put coherent words together.
I feel cloudy and sleepy. Small frustrations magnify. It’s hard to maintain perspective.
My muscles ache. My joints throb slightly. They feel stiffer and creakier.
This feeling is transient. The first few days of the menstrual cycle are characterized by an increase in prostaglandins that stimulate menstrual flow and so many women experience an aggravation of inflammatory symptoms like depression, arthritis, or autoimmune conditions around this time. You might get. a cold sore outbreak, or a migraine headache around this time of month. The phenomenon can be exaggerated with heavy, humid weather, and chronic inflammation–such as the prolonged healing process of mending a broken bone.
Inflammation.
It’s our body’s beautiful healing response, bringing water, nutrients, and immune cells to an area of injury or attack. The area involved swells, heats up, becomes red, and might radiate pain. And then, within a matter of days, weeks, or months, the pathogen is neutralized, the wound heals and the inflammatory process turns off, like a switch.
However, inflammation can be low-grade and chronic. Many chronic health conditions such as diabetes, arthritis, PMS or PMDD, depression, anxiety, migraines, even bowel and digestive issues, have an inflammatory component.
In the quest to manage chronic inflammation, people often explore various avenues, including dietary supplements. One such natural option gaining attention is OrganicCBDNugs. Derived from the hemp plant, CBD, or cannabidiol, is believed to possess anti-inflammatory properties, potentially offering relief to those struggling with conditions like arthritis, anxiety, or migraines.
This organic supplement, with its purported ability to interact with the body’s endocannabinoid system, might provide a holistic approach to tackling inflammation-related issues. As we navigate the complexities of our bodies and the ebb and flow of inflammation, exploring natural remedies like Organic CBD could be a step toward finding equilibrium and promoting overall well-being.
As I telly my patients. Inflammation is “everything that makes you feel bad”. Therefore anti-inflammatory practices make you feel good.
Many of us don’t realize how good we can feel because low-grade inflammation is our norm.
We just know that things could be better: we could feel more energy, more lightness of being and body, more uplifted, optimistic mood, clearer thinking and cognitive functioning, better focus, less stiffness and less swelling.
Obesity and weight gain are likely inflammatory processes. Insulin resistance and metabolic syndrome are inflammatory in nature. It’s hard to distinguish between chronic swelling and water retention due to underlying low-grade chronic inflammation and actual fat gain, and the two can be closely intertwined.
It’s unfortunate then, that weight loss is often prescribed as a treatment plan for things like hormonal imbalances, or other conditions caused by metabolic imbalance. Not only has the individual probably already made several attempts to lose weight, the unwanted weight gain is most likely a symptom, rather than a cause, of their chronic health complaint. (Learn how to get to the root of this with my course You Weigh Less on the Moon).
Both the main complaint (the migraines, the PMS, the endometriosis, the depression, the arthritis, etc.) and the weight gain, are likely due to an inflammatory process occurring in the body.
To simply try to cut calories, or eat less, or exercise more (which can be helpful for inflammation or aggravate it, depending on the level of stress someone is under), can only exacerbate the process by creating more stress and inflammation and do nothing to relieve the root cause of the issues at hand.
Even anti-inflammatory over the counter medications like Advil, prescription ones like naproxen, or natural supplements like turmeric (curcumin) have limiting effects. They work wonderfully if the inflammation is self-limiting: a day or two of terrible period cramps, or a migraine headache. However, they do little to resolve chronic low-grade inflammation. If anything they only succeed at temporarily suppressing it only to have it come back with a vengeance.
The issue then, is to uncover the root of the inflammation, and if the specific root can’t be found (like the piece of glass in your foot causing foot pain), then applying a general anti-inflammatory lifestyle is key.
The first place to start is with the gut and nutrition.
Nutrition is at once a complex, confusing, contradictory science and a very simple endeavour. Nutrition was the simplest thing for hundreds of thousands of years: we simply ate what tasted good. We ate meat, fish and all the parts of animals. We ate ripe fruit and vegetables and other plant matter that could be broken down with minimal processing.
That’s it.
We didn’t eat red dye #3, and artificial sweeteners, and heavily modified grains sprayed with glyphosate, and heavily processed flours, and seed oils that require several steps of solvent extraction. We didn’t eat modified corn products, or high fructose corn syrup, or carbonated drinks that are artificially coloured and taste like chemicals.
We knew our food—we knew it intimately because it was grown, raised, or hunted by us or someone we knew—and we knew where it came from.
Now we have no clue. And this onslaught of random food stuffs can wreck havoc on our systems over time. Our bodies are resilient and you probably know someone who apparently thrives on a diet full of random edible food-like products, who’s never touched a vegetable and eats waffles for lunch.
However, our capacity to heal and live without optimal nutrition, regular meals that nourish us and heal us rather than impose another adversity to overcome, can diminish when we start adding in environmental chemicals and toxins, mental and emotional stress, a lack of sleep, and invasion of blue light at all hours of the day, bodies that are prevented from experiencing their full range of motion, and so on.
And so to reduce inflammation, we have to start living more naturally. We need to reduce the inflammation in our environments. We need to put ourselves against a natural backdrop–go for a soothing walk in nature at least once a week.
We need to eat natural foods. Eat meats, natural sustainably raised and regeneratively farmed animal products, fruits and vegetables. Cook your own grains and legumes (i.e.: process your food yourself). Avoid random ingredients (take a look at your oat and almond milk–what’s in the ingredients list? Can you pronounce all the ingredients in those foods? Can you guess what plant or animal each of those ingredients came from? Have you ever seen a carageenan tree?).
Moving to a more natural diet can be hard. Sometimes results are felt immediately. Sometimes our partners notice a change in us before we notice in ourselves (“Hon, every time you have gluten and sugar, don’t you notice you’re snappier the next day, or are more likely to have a meltdown?”).
It often takes making a plan–grocery shopping, making a list of foods you’re going to eat and maybe foods you’re not going to eat, coming up with some recipes, developing a few systems for rushed nights and take-out and snacks–and patience.
Often we don’t feel better right away–it takes inflammation a while to resolve and it takes the gut time to heal. I notice that a lot of my patients are addicted to certain chemicals or ingredients in processed foods and, particularly if they’re suffering from the pain of gut inflammation, it can tempting to go back to the chemicals before that helped numb the pain and delivered the dopamine hit of pleasure that comes from dealing with an addiction. It might help to remember your why. Stick it on the fridge beside your smoothie recipe.
We need to sleep, and experience darkness. If you can’t get your bedroom 100%-can’t see you hand in front of your face-dark, then use an eye mask when sleeping. Give your body enough time for sleep. Less than 7 hours isn’t enough.
We need to move in all sorts of ways. Dance. Walk. Swim. Move in 3D. Do yoga to experience the full range of motion of your joints. Practice a sport that requires your body and mind, that challenges your skills and coordination. Learn balance both in your body and in your mind.
We need to manage our emotional life. Feeling our emotions, paying attention to the body sensations that arise in our bodies—what does hunger feel like? What does the need for a bowel movement feel like? How does thirst arise in your body? Can you recognize those feelings? What about your emotions? What sensations does anger produce? Can you feel anxiety building? What do you do with these emotions once they arise? Are you afraid of them? Do you try to push them back down? Do you let them arise and “meet them at the door laughing” as Rumi says in his poem The Guest House?
Journalling, meditation, mindfulness, hypnosis, breath-work, art, therapy, etc. can all be helpful tools for understanding the emotional life and understanding the role chronic stress (and how it arises, builds, and falls in the body) and toxic thoughts play in perpetuating inflammation.
Detox. No, I don’t mean go on some weird cleanse or drinks teas that keep you on the toilet all day. What I mean is: remove the gunk and clutter from your physical, mental, spiritual, and emotional plumbing. This might look like taking a tech break. Or going off into the woods for a weekend. Eating animals and plants for a couple of months, cutting out alcohol, or coffee or processed foods for a time.
It might involve cleaning your house with vinegar and detergents that are mostly natural ingredients, dumping the fragrances from your cosmetics and cleaning products, storing food in steel and glass, rather than plastic. It might mean a beach clean-up. Or a purging of your closet–sometimes cleaning up the chaos in our living environments is the needed thing for reducing inflammation. It’s likely why Marie Kondo-ing and the Minimalist Movement gained so much popularity–our stuff can add extra gunk to our mental, emotional, and spiritual lives.
Detoxing isn’t just a trendy buzzword; it’s about fostering clarity and wellness in every aspect of our lives, including our living spaces. A clean, organized home can significantly contribute to a healthier mindset and emotional balance. That’s where Clean 4 You comes in, offering a fresh perspective on home cleaning that goes beyond mere tidiness.
They understand that clutter and grime can weigh heavily on our mental and emotional states, which is why they provide services tailored to create an environment that supports your detox journey. By enlisting the help of professionals, you can focus on nurturing yourself while they take care of transforming your space into a sanctuary.
If you’re seeking assistance specifically designed for individuals with unique needs, the NDIS Cleaner Perth service from Clean 4 You is here to help. This dedicated team is trained to cater to the requirements of those on the National Disability Insurance Scheme, ensuring that every client receives the support they need for a clean and safe living environment.
With a commitment to using eco-friendly products and methods, Clean 4 You allows you to detox your home in a way that aligns with your values, providing peace of mind as you embrace a healthier lifestyle. With their expertise, you can achieve a pristine space that not only looks good but feels good, allowing you to focus on your personal wellness journey.
Finally, connect with your community. Loneliness is inflammatory. And this past year and a half have been very difficult, particularly for those of you who live alone, who are in transition, who aren’t in the place you’d like to be, or with the person or people you’d like to be–your soul family.
It takes work to find a soul family. I think the first steps are to connect and attune to oneself, to truly understand who you are and move toward that and in that way people can slowly trickle in.
We often need to take care of ourselves first, thereby establishing the boundaries and self-awareness needed to call in the people who will respect and inspire us the most. It’s about self-worth. How do you treat yourself as someone worthy of love and belonging?
Perhaps it first comes with removing the sources of inflammation from our lives, so we can address the deeper layers of our feelings and body sensations and relieve the foggy heaviness and depression and toxic thoughts that might keep us feeling stuck.
Once we clear up our minds and bodies, and cool the fires of inflammation, we start to see better—the fog lifts. We start to think more clearly. We know who we are. Our cravings subside. We can begin to process our shame, anger and sadness.
We start to crave nourishing things: the walk in nature, the quiet afternoon writing poetry, the phone call with a friend, the stewed apples with cinnamon (real sweetness). We free up our dopamine receptors for wholesome endeavours. We start to move in the direction of our own authenticity. I think this process naturally attracts people to us. And naturally attracts us to the people who have the capacity to love and accept us the way we deserve.
Once we start to build community, especially an anti-inflammatory community—you know, a non-toxic, nourishing, wholesome group of people who make your soul sing, the path becomes easier.
You see, when you are surrounded by people who live life the way you do–with a respect for nature, of which our bodies are apart–who prioritize sleep, natural nutrition, mental health, movement, emotional expression, and self-exploration, it becomes more natural to do these things. It no longer becomes a program or a plan, or a process you’re in. It becomes a way of life–why would anyone do it any other way?
The best way to overcome the toxicity of a sick society is to create a parallel one.
When you’re surrounded by people who share your values. You no longer need to spend as much energy fighting cravings, going against the grain, or succumbing to self-sabotage, feeling isolated if your stray from the herb and eat vegetables and go to sleep early.
You are part of a culture now. A culture in which caring for yourself and living according to your nature is, well… normal and natural.
There’s nothing to push against or detox from. You can simply rest in healing, because healing is the most natural thing there is.
by Dr. Talia Marcheggiani, ND | Sep 11, 2021 | Anxiety, Art, Depression, Emotional Wellness, Emotions, Exercise, Fitness, Happiness, Health, Inflammation, Letting Go, Medicine, Meditation, Mental Health, Mind Body Medicine, Mindfulness, Naturopathic Philosophy, Psychology, Self-care
About a month ago I fractured my right 5th metatarsal (an avulsion fracture, aka “The Dancer’s Fracture” or a “Pseudo-Jones Fracture”).
As soon as I laid eyes on the x-ray and the ER doctor declared, “Ms. Marcheggiani,” (actually, it’s doctor, but ok) “you broke your foot!” things changed.
I have never broken anything before, but if you have you know what it’s like. In a matter of seconds I couldn’t drive. I could barely put weight on it. I was given an Aircast boot to hobble around in, and told to ice and use anti-inflammatories sparingly. My activities: surfing, skateboarding, yoga, even my daily walks, came to a startling halt.
I spent the first few days on the couch, my foot alternating between being elevated in the boot and immersed in an ice bath. I took a tincture with herbs like Solomon’s Seal, mullein, comfrey, and boneset to help heal the bone faster. I was adding about 6 tbs of collagen to oats in the morning. I was taking a bone supplement with microcrystalline hydroxyapatite, pellets of homeopathic symphytum, zinc, and vitamin D.
We call this “treatment stacking”: throwing everything but the kitchen sink at something to give the body as many resources as possible that it may use to heal.
My brother’s wedding came and went. I was the emcee, and the best man. I bedazzled my boot and hobbled around during set-up, photos, presentations, and even tried shaking and shimmying, one-legged on the dance floor. The next few days I sat on the couch with my leg up.
I watched the Olympics and skateboarding videos. I read The Master and the Margarita and Infinite Jest. I got back into painting and created some pen drawings, trying to keep my mind busy.
I slept long hours–an amount that I would have previously assumed to be incapable. The sleep felt necessary and healing. I was taking melatonin to deepen it further.
I closed down social media apps on my phone to deal with the immense FOMO and stop mindlessly scrolling. I journaled instead, turning my focus from the outside world to my inner one.
It was a painful process, and not necessarily physically.
I was confined to my immediate surroundings–not able to walk far or drive. I was at the mercy of friends and family to help me grocery shop. The last year and a half has made many of us grow accustomed to social isolation and a lot of my social routines from years prior had fallen by the wayside.
My world, like the worlds of many, had gotten smaller over the last 18 months. With a broken foot, my world shrunk even further.
The loneliness was excruciating.
It would come in waves.
One moment I would relish the time spent idle and unproductive. The next I would be left stranded by my dopamine receptors, aimless, sobbing, grieving something… anything… from my previous life. And perhaps not just the life I had enjoyed pre-broken foot, but maybe a life before society had “broken”, or even before my heart had.
I thought I would be more mentally productive and buckle down on work projects but it became painfully obvious that my mental health and general productivity are tightly linked to my activity levels. And so I spent a lot of the weeks letting my bone heal in a state of waiting energy.
My best friend left me a voicemail that said, “Yes… you’re in that waiting energy. But, you know, something will come out of it. Don’t be hard on yourself. Try to enjoy things… watch George Carlin…”
During the moments where I feel completely useless and unproductive, waiting for life to begin, I was reminded of this quote by Cheryl Strayed. This quote speaks to me through the blurry, grey haze of boredom and the existential urgency of wasting time.
It says,
“The useless days will add up to something. The shitty waitressing jobs. The hours writing in your journal. The long meandering walks. The hours reading poetry and story collections and novels and dead people’s diaries and wondering about sex and God and whether you should shave under your arms or not. These things are your becoming.”
These things are your becoming.
Something will come out of it.
When I did a 10-Day Vipassana (silent meditation) retreat in the summer of 2018, I learned about pain.
It was Day 3 or 4 and we had been instructed to sit for an entire hour without moving. The pain was excruciating. The resistance was intense. I was at war with myself and then, when the gong went off and there was nothing to push against, I noticed a complete relief of tension. I was fine.
The next time I sat to meditate (another hour after a 10 minute break), I observed the resistance and released it. It’s hard to describe exactly what I did. It was something like, letting the sensations of pain flow through me like leaves on a river, rather than trying to cup my hands around them, or understand or making meaning out of them.
The sensations ebbed and flowed. Some might have been called “unpleasant” but I wasn’t in a space to judge them while I was just a casual observer, watching them flow by. They just were.
And when I have intense feelings of loneliness, boredom or heart-break I try to remember the experience I had with pain and discomfort on my meditation cushion. I try to allow them.
“This too shall pass”.
When I have a craving to jump off my couch and surf, or an intense restlessness in the rest of my body, the parts that aren’t broken, I try to let those sensations move through me.
I notice how my foot feels. How while apparently still, beneath my external flesh my body is busy: it’s in a process. It’s becoming something different than it was before. It’s becoming more than a foot that is unbroken. It’s becoming callused and perhaps stronger.
Maybe my spirit is in such a process as well.
The antidote to boredom and loneliness very often is a process of letting them move through, of observing the sensations and stepped back, out of the river to watch them flow by. A patience. Letting go.
I can’t surf today. But, it is the nature of waves that there will always be more.
Pima Chodron in her book When Things Fall Apart also references physical pain and restless in meditation while speaking of loneliness.
She writes,
“Usually we regard loneliness as the enemy. Heartache is not something we choose to invite in. It’s restless and pregnant and hot with desire to escape and find something or someone to keep us company. When we can rest in the middle, we begin to have a nonthreatening relationship with loneliness, a relaxing and cooling loneliness that completely turns our usual fearful patterns upside down.”
She continues,
“When you wake up in the morning and out of nowhere comes the heartache of alienation and loneliness, could you use that as a golden opportunity? Rather than persecuting yourself or feeling that something terribly wrong is happening, right there in the moment of sadness and longing, could you relax and touch the limitless space of the human heart?
“The next time you get a chance, experiment with this.”
In other words, something will come of this.
by Dr. Talia Marcheggiani, ND | Aug 25, 2021 | Anxiety, Depression, Diet, Hormones, Mental Health, metabolic health, mood, Nutrition, Paleo
Quentin Crisp says, “Repeat yourself loudly and often” and so I’m repeating myself on blood sugar regulation.
I guess if I had to leave a legacy in the world of natural health and lifestyle medicine, if I could sum everyone’s problems down to one key major concept and one key take-home action plan it would be: blood sugar regulation and: eat protein.
Last week was pretty busy in my little homegrown virtual naturopathic practice and I found myself repeating myself loudly (well, in a normal volume voice) and definitely often, the importance of eating protein at every meal and the connection between their symptoms and blood sugar with virtually every patient I saw.
All of my patients last week seemed to be suffering from some combination of the following symptoms:
Fatigue, anxiety, overwhelm, disrupted, restless, and non-restorative sleep, sugar cravings, emotional eating, binge-eating/stress-eating, nausea and bloating, PMS, migraines, low focus and concentration, low libido, low motivation, poor exercise recovery, and weight gain/puffiness/body image issues.
Of course, many of these symptoms were presented as being unrelated to the other. Perhaps stress and stress-eating were related, but sugar cravings and low motivation weren’t necessarily related in my patients’ minds. Neither were their sugar cravings, overwhelm and low libido.
And yet, the common thread that connects all of these symptoms is, you guessed it: blood sugar.
I explained to one patient: even if I gave you a magic wand, that you could wave to make all of your life’s problems disappear, you would probably still be feeling that deep, disconcerting, restless, anxious, “all-is-not-well” feeling in your gut. The reason for this? Blood sugar dys-regulation.
Our body has certain physiological mechanisms that it likes to keep tightly regulated. Among them are blood levels of our sugar (which controls the amount of fuel our brain has for its minute-to-minute functioning), carbon dioxide, salt, and water. When these levels drop in the body we start to feel off. Our stress response is triggered.
Imagine the feeling of holding your breath, as carbon dioxide starts to build up in your blood, you’d pay someone a million dollars to be able to take a breath. Similarly, if you’re seriously thirsty it’s likely all you can think about.
When our blood sugar drops, we feel terrible. The symptoms are anxiety, shakiness, fatigue, low mental energy, burnout, decision fatigue, waking up in the middle of the night, irritability, dizziness and weakness, and an unsettled, doom and gloom feeling. Most of all, however, we crave sugar.
Despite all of the symptoms my patients were expressing last week, one of the main issues they were contending with were sugar cravings. “I just don’t have the motivation to cook a meal”, one patient expressed, “and so I end up eating a bag of chips for dinner, even though I’m not really hungry.”
“You are hungry,” I explained, “the hunger is just not manifesting in the way that you’re used to.
Let me repeat this loudly, ala Quentin Crisp: if you ever find yourself at the end of a bag of chips, or a plate of cookies, or a pile of donuts–you were hungry.
Eating disorder expert Tabitha Ferrar highlights a phenomenon in people recovering from anorexia as “mental hunger”. Physical hunger, the grumbling, gurgling, empty feeling in your stomach is the result of ghrelin and gastric motility, which builds up when leptin levels fall and our stomach is physically empty and creates what many of us assume are the sensations of “true hunger”.
For more on leptin and hunger and how to regulate your metabolism check out my course You Weigh Less on the Moon https://learn.goodmoodproject.ca/courses/you-weigh-less-on-the-moon
However, these symptoms require energy form our body to produce. This is the reason why people with hypothryoidism are constipated–gastric motility takes metabolic energy.
If your body is malnourished, such as the case of anorexia, or even chronic stress and under-eating throughout the day, we often don’t get these signals of “true” hunger.
Our bodies simply don’t have the battery power to create these symptoms. And yet, we need nourishment, particularly we need to elevate our blood sugar to supply our brains with energy.
And so our body sends our signals of “mental hunger”, that feeling of “I can’t stop thinking about the chips in the cupboard”, that often leads to mindless binging as our body tries to replenish its reserves.
If you’re craving sugar, emotionally eating, devouring chips in the afternoons or evenings, or feeling decision fatigue/ or “lack of willpower”, you might need to start focussing on your blood sugar.
Blood sugar dysregulation is also tightly connected to our moods. Think of our body’s homeostatic mechanism as a tightly regulated machine, a fuel gauge on our body’s resources, which are needed in times of stress. When our blood salt, sugar or water levels dip, and our blood CO2 levels rise, we start to feel uncomfortable. This can be remedied by drinking water, sighing, deep breathing, or eating something. When these levels fluctuate and we fail to notice, our body releases stress hormone.
Cortisol is our stress hormone, but it’s also the hormone that plays a role in blood sugar regulation. When blood sugar dips beyond homeostatic levels, cortisol steps in to save the day. Low blood sugar is a stressor on the body. This might look like morning anxiety, feeling tired and wired, waking in the middle of the night unable to fall back asleep.
Again, you might not feel hungry during these moments–just overwhelmed, anxious, irritable, unsettled, weak, dizzy, and fatigued.
You’re in a fight with your partner. You’ve been cleaning out the garage and it’s hot out. You’re annoyed at the way he breathes, at the slow methodical way he goes through your stuff. The mess feels overwhelming, the heat feels stifling. You leave in a huff, ready to set fire to the entire operation.
Grumbling and fuming, you go inside. You take a breather, you eat something, you exhale deeply, you drink some water.
Gradually, as your body starts to shift into physiological neutral, your perception starts to change. The garage feels slightly more tolerable. It’s really just above moving one box at a time, going through it and then starting on the next one. You can do it.
Before you know it, you’re done.
When blood sugar is low our prefrontal cortex, the “ego”, “decision-maker”, executive functioning, planning and cognitive part of the brain, becomes depleted. We might call this “decision fatigue”, “willpower fatigue” or “ego depletion”.
A New York Times article states,
“Administering glucose completely reversed the brain changes wrought by depletion…
“When glucose is low, [your brain] stops doing some things and starts doing others. It responds more strongly to immediate rewards and pays less attention to long-term prospects.”
In essence, you stop being able to make calm and effective decisions.
Brain sugar levels (the brain uses up 60% of available blood sugar) directly contribute to the feeling of being “solid”–able to make rational decisions, to respond to fears and anxieties, to emotionally regulate, to make competent and calm decisions.
When our blood sugar levels dip we start to spiral: we might think erratically, gloomily, catastrophically, and irrationally.
I had a patient who crashed at 3pm everday after school, when his major depression would “come back”. I asked him what he had for lunch, to which he replied he often worked through lunch. Breakfast was a croissant or piece of toast.
His first real (and only) meal was at dinner. The rest of the day was a sea of grazing on ultra-processed foods, sugar and white flour. No real food in sight.
Scarfing down an emergency granola bar every time blood sugar drops is one solution, however whenever we eat carbohydrates on their own, particularly the quick-release carbs like white sugar, or refined grains, our blood sugar spikes. Soon after, insulin is released, causing it to drop again.
Many of us start the day without food, or with a measly breakfast of toast or cereal, or some other carb-only meal. As I tell patients, though, a serving of carbohydrates is not a real meal.
You know what I mean: a bagel for breakfast, a sandwich and pb for lunch, a plate of pasta for dinner. Carbs, while an important part of a complete meal, are completely inadequate at keeping you fuelled for the hours of mental, emotional and physical labour you engage in between meals.
Does this mean you should eat low-carb? No, not necessarily.
What it means is that a meal contains fats, carbs, and protein. Therefore all meals, especially breakfast, and even snacks, should combine those three macronutrients to assure proper fuelling and blood sugar regulation.
When you eat a proper meal in the morning, your blood sugar rises slowly. It requires less insulin to get the fuel into your cells. Your blood sugar is metered out slowly throughout the next few hours instead of being rapidly absorbed.
This means no more spikes and crashes–in blood sugar, energy, mood or cravings. A proper meal provides hours of calm focus, more willpower, and more ability to concentrate and emotionally regulate.
Instead of just toast in the morning, add about 20g of protein to your meal: a scoop of protein powder, 3-4 eggs, a piece of chicken, 3 tbs of collagen powder– in essence, have a proper meal.
Then, for lunch do it again–have a chicken breast on your salad, or a piece of salmon or beef.
Make yourself a smoothie with protein powder. Have a cold soak oats with collagen powder. Make yourself an omelette. Have a bean soup with 1 cup of beans.
Substitute your wheat or rice pasta (which is just carbohydrate) for a legume pasta made of mung bean or lentils, or black beans, which contain fibre and protein and are easier to make into a fast, complete meal.
When patients start having complete meals, starting with breakfast, their change in mood is often dramatic. They feel more mentally and emotionally stable. They have more energy.
Often we feel we get our second wind in the evening: (“I’m more of a night owl”). But so many of us work through our morning meals and only sit down to a complete meal at dinnertime. Maybe your “second wind” is actually just your first wind, purchased from the proper meal you had when you finally sat down and nourished your body.
What about intermittent fasting? Whenever I speak about breakfast there’s at least one DM or question, or “but I thought that…” and the topic of intermittent fasting almost always comes up.
Giving the body a break from eating is a good idea. For about 12 hours, if possible, stop eating.
This usually means stopping eating 3 hours before bedtime and creating an eating window from something like 7am to 7pm.
12:12 (12 hours of fasting and 12 hours of eating) can be great for resting the digestive system and supporting sleep. However, many of my patients use more extreme version of “intermittent fasting”, such as the 16:8 (16 hours fasting and 8 hours feeding) as a go-ahead to skip breakfast.
They wake up and get through the morning on coffee (with cream and sugar, which isn’t actually a real “fast”), and then eventually binge on sugar and chips after dinner, when they finally give their bodies permission to eat. It’s rare that they see the connection.
Most of us attribute the feelings of lack of control around food an issue with emotional eating and willpower. I find that in 99% of cases, “emotional eating” us usually just a result of blood sugar dys-regulation, protein deficiency and under-nourishing earlier on in the day.
A morning without food is a stressor on the body. Female bodies in particular respond to stress by becoming more insulin resistant, which further affects blood sugar dys-regulation and affects metabolic health–this is not what you want.
If you’d like to restrict your eating window, research shows that removing any after-dinner snacking (when our bodies are naturally more insulin resistant) is the way to go.
It’s also important to take a Protein Inventory. Sometimes I just have patients track their protein intake on a website or app like cronometer.com
The exercise is often enlightening, as patients are able to see how the protein density of their diet connects to their mood and energy.
I often get them to track their food for a few days to a week and then ask them: How do you feel on a higher protein day, where you meet your nutritional needs vs. a low protein day? What is your energy like? Your sugar cravings? Your mood? Your mental focus and clarity?
Conditions like OCD, ADHD, depression, anxiety, PMS, PMDD, cognitive issues, dementia, diabetes, pre-diabetes, weight gain, and bipolar all have roots in blood sugar regulation.
Blood sugar dys-regulation, over time can start to result in insulin resistance (often detected far before any changes to lab blood glucose start to show up).
Insulin resistance is the process in which the cells stop responding to insulin, requiring more insulin to be released. This causes inflammation and weight gain and, over time, elevated blood sugar. Insulin resistance can contribute to mood and hormonal issues, cognitive issues, like dementia, and metabolic conditions over time. This is definitely something you don’t want.
If you think you might have insulin resistance (characterized by sugar cravings, fatigue, abdominal weight gain, difficulty losing weight, hormonal issues, mood issues, low energy, and cognitive issues) consider getting your fasting insulin and fasting glucose tested. These two numbers can give you a HOMA-IR score, used to gauge insulin resistance, so you can work to reverse it before it progresses to pre-diabetes and type II diabetes.
Often insulin resistance, inflammation and stress are a never-ending cycle and all need to be addressed, with blood sugar regulation as a key strategy to getting your body’s insulin signal working again.
Signs that your metabolic health is healing are more energy, less cravings, better mood, better sleep, and some weight loss (which usually starts occurring about 6 weeks into a lifestyle change program).
Low calorie diets can also be a significant stressor on the body affecting blood sugar. Making sure that your fat and protein intake are sufficient (aiming for about 1 g of protein per lb of body weight for an active person) is essential to regulating blood sugar, cravings, mood and energy.
For more information on how low-calorie and restrictive diets can actually work against your weight loss, mood and energy goals, check out my course You Weigh Less on the Moon. https://learn.goodmoodproject.ca/courses/you-weigh-less-on-the-moon
So, how do you take control of your sugar cravings today?
Here are some places to start:
- Start your day with a complete breakfast that includes fat, carbs and 20 g of protein
- Eat full meals regularly throughout the day
- “front-load” your calories, eating 60% or more of your food before 1pm
- Aim for 1 g of protein per lb of body weight, or 90g of protein as a minimum
- Track your protein intake along with your mood, energy levels and cravings so that you can have more agency over your food choices, dietary patterns and symptoms.
- Have ready-to-grab protein sources like pumpkin seeds, eggs, protein powder, legume pasta, precooked chicken breasts, canned salmon, and so on.
- If you’re going to try Intermittent Fasting start slowly, begin by avoiding late-night snacking or snacking before dinner.
Finally, book an appointment if you feel ready to support your metabolic health and get your nutrition right to support your hormones and mood!
For more on how to regulate your blood sugar (as well as nutrient levels and inflammation levels) to eat for your mood, check out my course Feed Your Head:
https://learn.goodmoodproject.ca/courses/feed-your-head
