Estrogen levels in the brain and body affect our brain’s levels of dopamine and norepinephrine, two neurotransmitters that are implicated in mood disorders like depression, psychosis and anxiety.
Our brain has several built-in recycling processes to keep us level-headed. When neurotransmitters (brain chemicals that have mood-regulating effects) are finished with their tasks, enzymes recycle them, breaking them down into their chemical parts to be reused again at a later date. This process controls the level of chemical nervous system stimulation in our brains and keeps our moods regulated.
You’re at home, late a night, working on an important assignment, driven by the excitement of the topic at hand. Your brain is flooded with dopamine, a brain chemical that is connected to positive mood and motivation, pleasure and reward; dopamine pathways are activated when we’re engaged in a task that is pleasurable and rewarding, when our lives are flooded with meaning and we’re working towards a goal. Dopamine, however can also be connected to psychosis, conditions like schizophrenia and bipolar disorder, and also be linked to impulsive behaviour, aggression and irritability, when over-expressed.
Typing happily, you near the end of your assignment. Suddenly, your computer screen goes dark. Your heart begins to race, your skin prickles and you’re overtaken by anxiety, panic and fear. Your body is releasing norepinephrine, a chemical connected to stress, anxiety and the “Fight or Flight” response, but that also allows us to feel alert and energized. Your heart pounds as your reboot your computer. You are hyperaware of the sounds and smells around you. Your skin prickles and your breathing is loud and rapid.
You exhale with relief as your computer screen lights up again, revealing that your assignment is unharmed. Stress drains out of your body, and your norepinephrine levels fall. You begin to tire; it’s time for bed. You add some finishing touches to your work, hit “save” and turn in for the night. The stress and motivation you felt only hours before dwindle, as the neurotransmitters responsible for these responses are swept out of your synaptic clefts and recycled.
When our brains have had enough stimulation of dopamine (mood, reward, pleasure, but also aggression, irritability, impulsivity and psychosis) and norepinephrine (stress and anxiety, “Fight or Flight”, but also alertness and energy), both get recycled through COMT, which pulls them out of circulation, breaks them down into their chemical parts, and reassembles them for later use.
We all have variability in how fast our COMT enzyme works, based on the expression of the COMT genes in our DNA. Some of us have slower COMT genes, meaning that our brain levels of dopamine and norepinephrine tend to be higher than other people’s, as our ability to clean up and recycle these hormones is slowed. This might result in an individual (depending on other genetic and lifestyle factors) who is at a higher risk of mental health conditions like psychosis or bipolar disorder, or someone who is more irritable, prone to aggression, or stress intolerant.
Others have more COMT gene expression, resulting in a faster enzyme that clears dopamine and norepinephrine more quickly, resulting in lower brain levels of these neurotransmitters. If other factors are present, these individuals may be more at risk for mental health conditions such as depression, low mood, lack of motivation, or susceptible to addictions.
Beyond genetics, there are several environmental and biological factors that may affect the speed of the COMT enzyme. One of these factors is estrogen. Estrogen slows the COMT enzyme down by as much as 30%. This means that when estrogen levels are high (seen in many women around ovulation or premenstrually, or in women with generally high estrogen levels, termed “Estrogen Dominance”, COMT performs more slowly and dopamine and norepinephrine levels remain elevated.
Depending on the extent of the problem, women with high estrogen often experience anxiety and irritability and a low tolerance for stress. On the more severe end of the spectrum, some women experience conditions such as PMDD (Premenstrual Dysphoria Disorder) or PMS-induced psychosis, resulting from abnormally high brain levels of dopamine and norepinephrine due to high estrogen. These conditions probably result from a combination of high estrogen, slowed COMT and other genetic and lifestyle factors. Xenoestrogens from environmental toxins, or birth control pills may also slow COMT and further exacerbate some of the symptoms of estrogen dominance.
Conversely, women with lowered levels of estrogen, such as those with amenorrhea (missed menstrual cycles) from various causes—PCOS is one, so is the birth control pill, especially progestin-only pills, or hormonal IUDs—or women who are peri-menopausal or menopausal, will have a faster COMT enzyme. This means that dopamine and norepinephrine will be cleared from the brain more quickly. Low levels of these neurotransmitters may result in depression: low mood, low energy and lack of motivation. On the extreme end, low levels of dopamine in the brain may result in conditions like Parkinson’s. Currently, research is being done on estrogen-replacement therapy as a treatment for Parkinson’s because of its ability to increase brain dopamine levels through slowing COMT.
When it comes to birth control pills, which are combination of synthetic estrogen and synthetic progesterone (“progestins”), or just straight progestin, either in pill-form or in a hormonal IUD, effects can be unpredictable. There is evidence that oral contraceptive use, especially progestin-only contraception, can exacerbate anxiety and depression, especially in teens. The pill acts by suppressing ovulation and suppressing natural hormone production, which may result in low levels of naturally-occurring progesterone and estrogen, which can slow COMT. However, the synthetic estrogens from the pill may interact with COMT, speeding it up in some women. Therefore the effects of specific forms of birth control on individual women is hard to predict; if functional medicine and genetic research tells us anything, it’s that there is no one-size-fits-all when it comes to striking the right hormonal balance.
Estrogen also has effects on another enzyme, called MAO-A, that recycles serotonin, the “Happy Hormone”, often implicated in depression and anxiety. Like COMT, estrogen slows down MAO, reducing the speed at which the body breaks down serotonin, resulting in higher brain serotonin levels. Drops in estrogen around and before a woman’s period, or low estrogen levels, may result in feelings of depression. Many women report feeling depressed and craving carbs and sugar around their periods. This is often related to a drop in serotonin as estrogen levels fall right before menses. Drops in serotonin levels due to drops in estrogen levels after childbirth may explain postpartum depression, according to some researchers.
The link between estrogen and its effects on COMT and MAO hint at the complexities of the body and brain’s hormonal milieu and its implications for hormonal regulation and mental health. Mental wellness is a complex state involving a variety of factors: hormones, enzymes and neurochemical pathways that are affected by our environment, our genetics and our hormonal predispositions. This is why I believe in taking a functional approach to mental health, seeing our mental health symptoms for what they are: symptoms, and making efforts to uncover underlying causes rooted in lifestyle, genetics and our environment. I believe the way to address symptoms is to trace them back to their source.
For many women, treating depression, anxiety and stress-intolerance may involve balancing estrogen levels and healing the menstrual cycle. For others it may involve supporting genetic susceptibilities with lifestyle changes, finding a birth control method that balances (or coming off entirely), and reducing exposure to xenoestrogens, supporting estrogen detoxification pathways, and addressing women’s health conditions such as irregular menses, and conditions like PMS, fibroids, endometriosis and PCOS.
I talk about contrast showers for boosting immunity, lowering inflammation, mood, pain and weight loss.
Hello everyone, my name is Dr. Talia Marcheggiani, I’m a naturopathic doctor and today I’m going to talk about hot and cold contrast showers. As naturopathic doctors, one of our modalities is hydrotherapy. Hydrotherapy comes from naturopathic medicine’s roots, using hot and cold water to make changes to circulation, hormonal functioning and immune functioning. I’m going to talk about some of the science behind hot and cold contrast showers.
This is something I recommend to my patients to increase their immune activation, decrease autoimmunity, improve mood and hormonal functioning, as well as increase circulation and there’s some evidence that it might help with weight loss as well.
So, firstly, things like exercise and hot and cold therapies induce a little bit of stress. There’s two kinds of stress: distress, which is sort of that chronic, cortisol-fuelled stress that a lot of people come in with, in a state of burnout that’s causing things like inflammation, and mental-emotional illness, and autoimmune issues, and dysbiosis, and then there’s something called eustress, which is more like exercise, cold therapy: short, small bursts of stress that actually up-regulate proteins and genes in our body to combat stress. These genes are involved in DNA repair, increase antioxidant synthesis, and the antioxidants that our body makes are far more powerful than the ones that you’re going to get from food or supplements.
So, by upregulating these genes, we can protect ourselves from cancer, neurodegenerative disease, and other chronic diseases. It’s really powerful stuff, this is called a “Hormetic” response, hormesis, where small stressors mount bigger responses by the body than is needed to deal with those stressors and overall we’re better off; there’s this net beneficial effect. This is one of the proposed mechanisms for some of the antioxidants or flavonoids in green leafy vegetables. It’s not that they provide us with antioxidants, it’s that they encourage our body to make antioxidants due to the small, toxic load that they present to us. And so there’s some evidence that getting short bursts, or longer bursts of cold, very cold, will increase a hormone called norepinephrine. Norepinephrine is involved in depression and mood. Norepinephrine is a catecholamine and it increases the sympathetic nervous system, which is that fight or flight nervous system. When boosted in small amounts, it can actually elevate mood and so a lot of anti-depressant medications also induce, or inhibit the reuptake of norepinephrine. So these are called SNRIs and they include things like Venlafaxine and Cymbalta. So there’s some evidence that norepinephrine increases 2-3 times after only 20 seconds of immersion in cold water. There’s a connection between norepinephrine lowering pain and inflammation and increasing metabolism and there’s some anecdotal evidence and one study, at least, was done to show that cold immersion therapy actually decreased symptoms of depression.
There’s also these things called hot and cold shock proteins, heat shock proteins and cold shock proteins. So, for example, one is called RBM3, which is a cold shock protein, and these proteins can actually help increase longevity and they can actually help decrease incidences of neurodegenerative diseases and neurodegeneration, so something like Alzeimer’s disease or Parkinson’s disease, which can help us with health longevity, so staying healthier into our later years.
We know that inflammation is one of the drivers of the aging process. Probably the primary driver of the aging process, and one of the main factors in chronic, debilitating disease, and, especially in my focus, mental health, there’s more and more researching coming out that inflammation, low levels of inflammation in the brain, is the main cause of mental health conditions, such as depression, and anxiety, bipolar disorder, OCD, ADHD. There’s these low levels of inflammation that contribute to the symptoms of low mood and by increasing norepinephrine, through small bursts of cold and increasing those cold shock proteins, we’re actually able to combat these mental health conditions. Norepinephrine decreases inflammation by decreasing a cytokine called TNF-a that is known to increase inflammation in the body and in the brain. TNF-a can cross the blood brain barrier and it can inhibit serotonin synthesis and it can actually also increase neuro-inflammation, causing symptoms of mental health disorders.
There’s some studies that cryotherapy, for rheumatoid arthritis actually decreased pain significantly. And there’s also some studies that being in cold water, that cold shock, can actually increase the immune system activation. It’s good to increase our immune system activation if our immune cells are behaving properly. If our immune cells are attacking ourselves, then we want to decrease the immune response. But having higher levels of lymphocytes, especially cytotoxic T lympthocytes that are involved in killing cancer cells, is a very positive thing and that’s been shown to increase in people that underwent cryotherapy, or really acute, short exposure to intense cold.
There’s also an ability to lose weight when exposed to cold, over the long term. There’s a man called Ray Cronise who lost over 80 lbs by just habitually exposing himself to mildly cold temperatures. And one of the mechanisms for this weight loss is through non-shivering thermogenesis, in which the cells in the mitochondria uncouple proteins that make energy and they dedicate all the stored energy in fat to making heat. Kind of like cutting your bike chain. So instead of biking, you’re not moving forward, but you’re generating energy and you’re generating heat. And so our body will do this when it’s slightly cold that it can increase heat. Our body is always striving to maintain constant temperature, between 1 or 2 degrees. This process is regulated by norepinephrine, which rises acutely as soon as we’re exposed to just a few seconds of cold. This can be 40-50 degree water. And then I already mentioned that short, cold exposure can increase the production of antioxidants. Our mitochondria are constantly creating reactive oxygen species and reactive nitrogen species. This is just a product of normal cell metabolism. These become toxic, though and damage DNA if our body doesn’t also produce anti-oxidants to clear out those reactive oxygen species and reactive nitrogen species. The cold induces a little bit of a stress that increases our metabolism that increases the reactive oxygen and nitrogen species in our mitochondria and therefore our body is incited to up-regulate the enzymes that create those powerful anti-oxidants that I talked about that are far more powerful than the ones that you can get from food: vegetables, fruits, vitamin C supplement. A couple of these enzymes are glutathione reductase and superoxide dismutase, which are very powerful to our cells.
There’s some evidence that hot and cold therapy can increase muscle mass, can increase muscular strength and aerobic endurance. So this is great for athletes post-workout to lower inflammation and improve muscle regensis. And then, it can also increase something called mitochondrial biogenesis, which is the production, or the replication of more mitochondria in the tissues, especially the muscle tissue. So our body will increase the mitochondria content, the mitochondrial mass, in muscle tissue under certain conditions. These conditions are mainly fasting, exercise, and hot and cold shock.
So, what I’ll recommend to my patients, somebody who’s suffering from low immunity, so they’re getting frequent colds and flus, or maybe autoimmunity, or maybe just general inflammation and pain, brain fog sluggishness adrenal fatigue, that kind of sluggish lethargy from depression. So it’s more the sluggish depression, I’ll recommend hot and cold showers.
So what you do is, in your shower, either during your shower, during your regular cleaning routine, or after your shower is done, and you’ve already washed your hair and everything, you’re going to turn the water on to a reasonably hot temperature, so not so hot that it’s scalding, and you’re going to leave that hot water on for 30 seconds to 1 minute. When that’s done, you’re going to turn the shower to as cold as you can tolerate. So with my patients I often coach them to start with a lukewarm temperature before going whole hog and doing cold. And this is just to coax the body into that stress response that we want, that short, quick stress response that’s going to do all those good things: up-regulate anti-oxidant production, increase norepinephrine, decrease inflammation, increase mitochondria synthesis, burn fat. So you’re going to try and make it as cold as possible, for 20 to 30 seconds, and then you’re going to cycle back and forth at least 5 to 10 times, always end on cold, and then, when you’re done, towel off and keep warm.
There’s some evidence that doing this before bed can actually increase REM sleep and help you sleep more soundly without waking up in the middle of the night. We all know that a good sound sleep is going to set the tone for the next day and your energy for the next day. And then there’s also some evidence that doing this in the morning can increase your energy and alertness throughout the day, so it’s almost like this same practice at different times of day impacts our circadian rhythms differently and can give us more of what we want: either more profound sleep or more daytime energy.
So, that was hot and cold showers, my name is Dr. Talia Marcheggiani and you can check out my website at taliand.com or contact me at connect@taliand.com . A lot of this research came from Dr. Rhonda Patrick at foundmyfitness.com .
I often recommend smoothies as an easy way to manage mental health symptoms, balance blood sugar, reduce inflammation and increase energy. I discuss the types of foods I put into my morning smoothie and their benefits on the body and mind.
Hello, everyone. My name is Dr. Talia Marcheggiani, I’m a naturopathic doctor with a special focus in mental health and emotional wellness and today I’m going to talk to you about how to make one of my favourite breakfasts to recommend patients: the morning smoothie. I always recommend smoothies in the mornings because it’s a great way to take care of a lot of your daily recommended nutrients in terms of protein, vegetable, anti-oxidant-rich berries and a healthy source of fat.
I always recommend somewhere between 20-30 grams of protein in the morning for people with depression and anxiety as well as digestive issues, hormonal imbalances, anything like fatigue or chronic stress because when we wake up in the morning we’ve been fasting for at least 8 hours. Sometimes in healthier cases, it’s actually better to fast for 12 hours and so throughout the night our blood sugar hasn’t been stimulated, we haven’t been increasing our blood sugar throughout the night and so, when we start our morning with something like, in North America, like we usually start, with a piece of toast or some sugar-rich cereal, our blood sugar goes from the lowest point, since we’ve been fasting for so long, and spikes. And then around 10 am, a couple hours after we’ve had our breakfast, our blood sugar will drop again, causing symptoms of hypoglycemia, which can worsen stress, it can trigger cortisol release and cause fatigue, worsening of anxiety and depression. And then throughout the day our blood sugar’s going to go up and down as we start to crave sugar again and it’s more likely to throw us off our balanced state that we want to be in.
So I start by recommending 20-30 g of protein to my patients in the morning and they often ask me what they can eat. And I’ll recommend something like leftovers from the night before, like a chicken breast has about 30 g of protein. Other patients ask “can I eat eggs?” And eggs are wonderful to eat but in order to get 30 g of protein you need to eat about 5 or 6 eggs, which is not typical. We usually eat 1 or 2. Although eggs is a great addition. You can throw eggs into your smoothie as well.
It’s also important to get a nice source of fat in your smoothie. So this is something that we often leave out, we don’t put sources into smoothies and so I recommend something like ground flaxseed or coconut oil, olive oil if you have that lying around, avocado, you can even through your fish oil in, if you’re that kind of person.
And I always throw in a leafy green, which you can’t taste. A cup of something like spinach or kale is a source of leafy greens. It’s full of fat-soluble vitamins as well as things that help us detoxify the estrogens from our body and keep our hormones balanced. This is something I always recommend for women with irregular periods or heavy periods, or things like PCOS, Polycystic ovarian syndrome, endometriosis, infertility. Anything that causes estrogen to go off and if you’ve read some of my articles you know that a lot of us suffer from estrogen-dominance. This is just more estrogen than progesterone in the female body. Even men can suffer from this and that’s because we’re just exposed to so many things, so many toxins in our environment that are activating estrogen receptors. So by eating leafy greens, we allow our bodies to detoxify a lot of those xeno-estrogens, those toxic estrogens in our environment.
So all you need is a blender. I like to throw in some baby spinach, pre-washed. I just eye it and throw in a couple of handfuls. That amount. Just a couple servings of spinach. The nice thing about things like spinach is it blends really well. You don’t taste it and depending on how much other ingredients you throw in, your smoothie might not even be green, so you can also fool your kids by throwing some spinach in their smoothies.
I always throw in some frozen berries. You can put in blueberries or a berry medley. I get it from No Frills for about $11 for a bag. Frozen’s nice because your smoothie gets icey. It might not be the best for winter but the days are still warm our digestive fire is still strong enough to be able to digest things that are cold.
Today the fat I’m going to add is coconut oil. Coconut oil is a saturated fat, but it contains medium-chain triglycerides, which our body doesn’t need to convert into sugar to be used as energy so we can just use them right away as an energy source. It’s great for the skin and it’s great for gut-healing because of its anti-fungal properties. It’s also really good for balancing blood sugar and boosting our metabolism. 2 tablespoons, I put in.
Fats are great medicinal foods. You can throw in a couple tablespoons of olive oil if you have cholesterol issues, blood sugar issues. The right kinds of fats are very anti-inflammatory and we know that inflammation is implicated in things like digestive issues, depression and anxiety, stress and so, by making sure we’re getting the right balance of fats in our diet, you can start in your morning smoothie, by setting your fat balance on the right track, be able to balance inflammation and feel really good throughout the day.
This smoothie will also keep you full really long, well into the afternoon because of the source of fats in it. I like to throw in things like eggs as well, just raw eggs. It’s difficult for me to really recommend it universally to all my patients because there is, of course, the risk of salmonella in raw eggs. So, at your own risk you can try it out, but I find it really makes it taste nice and rich as well as give us a good source of cholesterol. And cholesterol’s a good thing, because we need cholesterol to make hormones. Especially in depression and anxiety. You don’t want to be sacrificing cholesterol or taking—of course this depends on your health history—but there’s a risk of depression in people who are taking statin drugs, cholesterol-lowering drugs that are lowing our cholesterol in the body because how are we making our hormones if we don’t have enough cholesterol.
You can also throw in something like an avocado, it makes it nice and thick and rich or some peanut butter or almond butter, or nut butter. I’m also going to throw in some ground flaxseed.
Flax has two really great medicinal benefits. I use it for hormone-balancing in a lot of my patients with things like period irregularities or amenorrhea, this is not getting your period, infertility. So what flax does is it activates estrogen receptors. But it activates them weakly so if you’ve too much estrogen, the flax competes for the estrogen by binding to receptors preventing those hyper-estrogenic effects and if you don’t have enough estrogen, so in the case of post-menopause or ovarian failure, flax binds to estrogen receptors and causes the estrogen effects that we really want, like libido and energy and the expression of female sex characteristics. It can also clear skin and it’s great for acne, it’s great for regulating periods. It’s great for balancing heavy periods, bringing periods back and making them more regular.
Flax is also great for constipation because it’s a good source of fibre and you need to grind the flax, it needs to be milled. And this is because our body can’t break down whole flaxseeds. So you might have seen breads or crackers where there’s whole flaxseeds and they advertise flax on the package, well it really doesn’t so us any good. It just passes right through the body. It’s not adding those fibres or medicinal fats.
Finally, this is a protein powder that I just got from Bulk Barn. I find that Bulk Barn is the cheapest in terms of protein powders. I use a vegan protein powder. So this is great is you’re vegan or vegetarian. Whey is the best absorbed protein, but personally I have a food sensitivity to whey, caseine and other dairy products, so I go with vegan protein, which is a mix of pea protein, hemp protein and rice protein. But you can also use whey. If you’re sensitive to dairy and not sure if you’re sensitive to whey, always go with a whey isolate, because whey isolate doesn’t contain caseine, which is the protein in milk that most people react to. So it’s just pure whey.
In my protein powder, I also mix gelatin. So gelatin is just a crystalized powder. I put in one scoop of protein powder for 30 grams of protein. So gelatin comes from the hooves of animals. It’s rich in collagen and it can actually increase the amount of collagen in the body. It’s an incomplete protein, so it has a lot of an amino acid called glycine, which most of us are deficient in because we don’t get a lot of glycine from the meat of animals. It’s actually located in the collagen. Glycine’s a really calming neurotransmitter. We use it to bind minerals, so if you’re my patient you might have been prescribed magnesium glycinate, which is an easier absorbed form of magnesium, also a source of glycine, to help calm the body. It activates those suppressive neurotransmitters, the GABA pathways in the brain so it’s great for calming anxiety and great for preparing us for sleep. But it doesn’t make you tired for the rest of the day. What’s great about getting a source of collagen is that it can help with gut healing. It can help with the integrity of the gut in leaky gut situations and it’s great for the skin and hair because we know our skin is made of collagen as well as our joints. So, if you have acne, acne scars, if you’re suffering from premature aging or sun damage, a couple tablespoons of gelatin or collagen hydrosylate is a great thing that you can do every morning.
So I’m just going to add in, as your liquid source you can add in something like water, I usually just use water or almond milk. I’m going to use coconut milk today because it’s delicious. I’m going to mix a little bit of coconut milk with water. Just tap water. I’m going to add some tap water. So how much water you add depends on how thick you want your smoothie and the quality of your blender. I filled it up to about 500 ml. I like to eat a lot in the mornings.
Put it into your blender. So this is my smoothie pre. And then you just pour your smoothie in a glass. Mine’s kind of on the watery side. It turns out purple, not green at all, so you can still fool the kids. If you want to make it sweeter, you can add in half a banana, or even some maple syrup. But it tastes pretty good. It tastes like berries.
So this is great because liquid is obviously, it’s pre-chewed, so it’s easier for our body to absorb the nutrients, which is nice in the morning, especially for people who aren’t really into breakfast. It’s also really portable you can put it in a mason jar or a glass container and take it to work. You can drink it half before leaving for work and half while in your in the car or commute or on the subway. A lot of your nutrition for the day is taken care of. So, even if you, have not-an-ideal lunch or dinner you’ve gotten a great source of highly-absorbable protein, you’ve gotten some gut-healing in in the form of gelatin. You’ve gotten some healthy fats and a serving of leafy greens and anti-oxidant-rich berries. So, you’re on your way for a healthy day.
In response to my very popular article about the Mirena IUD and how that can upset hormone balance, or further an existing imbalance, I talk about a condition called “estrogen dominance” can result in hormonal symptoms, such as PMS, infertility, weight gain and anxiety.
Hello everyone, my name is Dr. Talia Marcheggiani. I’m a naturopathic doctor with a special focus in mental health and hormones, especially women’s hormones.
So, today I’m going to talk about an article I wrote about a year and a half ago that gotten a lot of activity online and it’s called “Let’s Talk Mirena: Anxiety and Hormone Imbalance”. I wrote the article because I was seeing a few patients who had the Mirena IUD and a series of similar symptoms. So, anxiety, panic attacks, and just a general sense of hormone imbalance. And when we ran their labs, when I looked at the levels of progesterone in their blood, they had very low progesterone. So I wrote an article about this and about the phenomenon of “estrogen dominance” that we naturopaths talk about a lot. And I got this resounding response online, so even today, sometimes, I’ll get a couple emails a day of people expressing their experiences and their agreement with the article and their confusion and frustration and anxiety around some of the symptoms that they’ve been experiencing since getting the IUD.
So, the reason I wrote the article is not because I don’t agree with the Mirena IUD. I’ve written another article called “Having a Healthy Birth Control Experience” in which I state that as a form of contraception, a hormonal birth control and a hormonal implant such as the IUD can be really great measures against unwanted pregnancy, because their efficacies are very very high—I think the Mirena IUDis about 99%pregnancy avoidance— and you don’t need to think about it, you don’t need to take a pill every day, so for some women this is ideal.
The issue is that a lot of women are being prescribed the Mirena IUD as a solution for Estrogen Dominance. And so what I find in my clinical practice, and I’ll talk more about estrogen dominance in the course of this video, but what I find in my clinical practice is, because it doesn’t address the underlying cause, and because it’s hormonal in and of itself, and it adds more hormones to the body, in a specific location, the uterus, and because it doesn’t address the underlying imbalance, it either worsens or ignores the condition of estrogen dominance, causing symptoms to get worse and women to feel frustrated and lost and then write to me.
Mirena is often prescribed to women with heavy and painful menstrual bleeding. So, this could be a diagnosis of endometriosis, or ovarian cysts, or just symptoms that they’re experiencing. So a lot of them might be experiencing iron deficiency because of the heaviness of the bleeding and a lot of women are out of commission for a couple of days every month because their period is so heavy and uncomfortable and they feel weak and they’re in pain and maybe they deal with really intense PMS. Some of my patients deal with PMS for 2 weeks out of the month, which is crazy and super uncomfortable.
Conventional medical doctors prescribe the Mirena IUD to combat these symptoms because with birth control and the IUD, one of the side effects is really light periods and some people don’t even get their period at all on Mirena and so you can imagine, if you’re period is this time of the month where you can’t go to work and you’re just basically hemorrhaging from the insides, then it would be a massive relief to not have to deal with a period anymore for 5 years, which is how long the hormones last in Mirena.
But one of the issues is that we need to look at the cause of these symptoms. Oftentimes these symptoms are caused by a difference in estrogen and progesterone, so these are two of the main female sex hormones. One of the things that happens in conditions like endometriosis or heavy and painful periods is that the estrogen is high in relation to the progesterone in the body. And so this is really apparent in a condition like endometriosis where there’s often high estrogen and also fibroids. So both of those cause terrible periods, and they need to be ruled out when periods are heavy and uncomfortable. And then there’s ways that we can deal with that as naturopaths.
But even without an underlying health condition, just primary dysmenorrhea, that’s not caused by another diagnosis is often the result of estrogen dominance.
And so the Mirena, because it’s made of only progesterone, can help with the uterine symptoms of estrogen dominance, which would be the heavy and painful periods. However, we have estrogen and progesterone receptors all over our body, not just in our uterus, and so when we’re putting hormones in one part of the body, and they’re not ending up in the rest of the body, we start to worsen that deficiency, or that relative deficiency in progesterone.
So women will mention, and one of the most common symptoms is anxiety and panic attacks, because progesterone this kind of calming effect on the central nervous system, on the brain, so it kind of chills you out and helps you handle stress.
Estrogen is a hormone that causes women to ovulate, so it’s a pro-ovulatory hormone and it also helps build up the uterine lining. So the more estrogen we have, the thicker the lining and therefore when we shed the lining during our period, the more we have to shed. So, more estrogen, the thicker the lining, the heavier and, by proxy, more painful the period.
Progesterone is a hormone that, in terms of reproduction, it helps us maintain the lining (of the uterus). So, if you ovulate and then that egg gets fertilized by sperm, then the egg gets implanted in the uterus and progesterone starts to increase, so pregnancy is a very progesterone dominant condition and one of the signs of a low progesterone state is when women who have been pregnant say that that’s the most balanced they’ve ever felt because progesterone is naturally higher in pregnancy.
Progesterone starts to rise when you become pregnant and that maintains the lining throughout the 9 months and then, after the 9 months, you have your baby. If the egg doesn’t become fertilized then progesterone rises for the last 2 weeks of the cycle and then it falls, along with estrogen, you shed your lining and then you have a period.
And for some women, they sail right into their periods. They have no PMS symptoms, they might feel a little bit bloated a couple of hours before and then they go to the washroom and go, “ok, look, there’s blood I’m having my period.” And for other women, it’s not the case, they get warning signs, like i said, before two weeks, so pretty much from ovulation to when their period happens. So, half of their life: 2 weeks out of every month.
And so, what happens with a lot of women is that there’s higher estrogen in relation to progesterone. So we call this “Estrogen Dominance”. And there can be three possibilities in this state. One is that estrogen is abnormally high and progesterone is normal, or optimal. Another is that estrogen is normal or optimal, progesterone is low, and a third option is that you have both at the same time: so estrogen is high and abnormal and progesterone is low and that’s more common than you think in a lot of women who are dealing with really severe symptoms, that divide between the two hormones is really off. And, as I mentioned before, prescribing birth control pill or Mirena IUD are not solutions because they’re not correcting the underlying imbalance. They’re not looking at the cause of why this imbalance is happening in the first place. Instead, they introduce foreign, fake or synthetic hormones into the system to try and correct the balance, but our body has a delicate balance and a delicate ecology and so when we try and shift that balance artificially sometimes we pay the price and we don’t necessarily feel balanced.
So, why does this occur? Why do people get estrogen dominance and how do you fix it? So, when it comes to the first situation, high estrogen, and normal progesterone, there’s a couple of reasons why estrogen might be high. So the first is exposure to foreign estrogen, or excess estrogens in the environment. And, so many of you may have heard of these “xenoestrogens”, or toxic estrogens, from sources such as BPA, so the lining of tin cans, or those plastic water bottles or baby bottles that everyone was throwing out and replacing with glass and stainless steel, which is a great idea. So, we’re in contact with these in the environment through the cosmetics, cleaning products, and some of the plastics that we hold and interact with on a daily basis. And paper receipts have this as well. So cashiers and people that handle receipts regularly are in contact with BPA. And it’s absorbed through the skin. So just this exposure to these toxic estrogens can activate estrogen receptors and it increases estrogen in the body. And that’s problematic. We know that these can also set the stage for hormonal cancers, like breast cancer, you might have heard of estrogen-receptor positive breast cancer, or ovarian cancer and endometrial cancer and cervical cancer. So these are all kind of these foreign estrogens influence the body’s hormones in a negative way causing growths.
The second reason why estrogen might be high is the reduced ability of the body to detoxify estrogens. So, when we’re done using the estrogen that we need, our liver cleans our blood of estrogen, then we dump the estrogen biproducts into the colon and then we eliminate them by having a bowel movement. And this is a normal process in lowering the toxic estrogen or the estrogen metabolites, the estrogen we don’t need anymore. And so when this process is either over-burdened by too many xenoestrogens, so those plastic estrogens, or limited in some way because our liver is trying to detoxify other things, such as alcohol, or tylenol, or some of these over-the-counter drugs, the liver just can’t handle the burden and so, in terms of treatment we need to bolster the liver’s detoxification abilities. And a lot of the time those two things exist at the same time: you’re getting too many foreign estrogens, we need to clean up the environment and the diet and make sure everything you’re getting is promoting a healthy estrogen metabolism.
And then, why progesterone might be low, which is the other arm or possibility of this estrogen dominance condition that I’m speaking of is stress, mainly. So, when we’re stressed out, and we’re dealing with a lot our body produces a hormone called cortisol and that’s the “stress hormone” that helps us deal with high amounts of pressure and stress. And a lot of the time stress is not perceived so, just this feeling of being tired and wired, disrupted sleep, sugar cravings around 3-4pm, having a difficult time getting up in the morning, feeling a little bit stretched thin, maybe feeling a drop in motivation, are all signs of chronic stress. So what happens is our adrenal glands, these pyramid-shaped endocrine glands that sit on top of the kidneys, they make cortisol. And when our body has more cortisol than it needs, or when it needs to make progesterone, it takes the cortisol and it makes progesterone with it. So it’s kind of like leftover cortisol that it’s not using gets made into progesterone. After ovulation, the ovaries also produce progesterone, but part of the progesterone production in the body come from the adrenal glands.
So you can imagine: if you’re stressed out and you’re spending all of your adrenal function on making cortisol you’re not going to have enough time or resources to make progesterone. So a lot of bringing up progesterone balance is by either lowering environmental stress or increasing adrenal function. We also look a nutrient deficiencies and we can also look at bringing pituitary balance by using an herb called vitex, which can help balance hormones and kind of right that estrogen-progesterone imbalance that might be going on.
So what happens when you give the Mirena, or you give an oral contraceptive to deal with this? Well, what happens is, there’s an imbalance and you induce another imbalance kind of over top. So, the body is still not making enough progesterone, there’s still too much estrogen, toxic estrogen, and what you’re doing is giving synthetic progesterone, which doesn’t have the same effects, progestins, synthetic progesterone, it doesn’t have the same effects as regular progesterone and often doesn’t work on the brain, so it doesn’t have that low anxiety effect, that calming effect, and it doesn’t prevent the estrogen-dominant cancers, it doesn’t help with ovarian cysts, it doesn’t manage endometriosis, other than stopping your periods, perhaps, if you’re reacting to it. And then you’re also, if you’re doing a combined oral contraceptive pill, you’re introducing more xenoestrogens to the body that your liver then has to clear out and that are going to cause more of those estrogen-dominant symptoms. And, in the colon we know that oral contraceptives can cause a bacterial imbalance, so a dysbiosis in the gut and potentially constipation and so that throws off our whole system. I’ve talked about how important that gut bacteria is for mental health and mood and just digestion and everything. So, more cells are in our gut than in the rest of our body. So our gut microbiome is super important to our health and well-being.
So, how does a naturopathic doctor address estrogen dominance? This is a big part of my practice especially because I see a lot of women with month-long PMS, acne, polycystic ovarian syndrome, so irregular periods, or missed periods, or they have a family history of hormone-dominant cancers and they’re trying to prevent these things from happening down the line, or they’re just having terrible periods. They’re having weight gain, or bloating, or anxiety that’s related to the period or really bad PMS, so mood swings, depression around their period or a condition called PMDD, which is really really severe depression right before the period.
So the first thing I do is order labs. And so your medical doctor might have done labs, gotten your estrogen and progesterone measured in your blood and your doctor might have said, “oh, it’s fine, it’s normal”, and this is true to the extent that when your medical doctor is evaluating your labs, they’re looking at massive reference ranges. So our reference ranges are a bit more narrow because we’re trying to look at the optimal levels for fertility and for feeling like your optimal, amazing self. We’re looking at, “is your estrogen within an optimal range, is your estrogen on the high side, and therefore, could be brought down? And does that match your symptom picture? Do you have estrogen dominance symptoms and a relatively high estrogen level? Is your progesterone lower than optimal to maintain a uterine lining in pregnancy, to not have a miscarriage in the first trimesters, etc. etc.” So we look at labs, and then we, using our natural therapies, we prescribe diet, supplements, and some lifestyle changes to help re-establish that hormonal balance.
So, if you have any more questions, just send me an email, at connect@taliand.com or check out some of the articles that I mentioned in this video.
Want to balance your hormones, energy and mood naturally? Check out my 6-week foundational membership program Good Mood Foundations. taliand.com/good-mood-learn
I’m tired of hearing mental health conditions blamed on a “chemical imbalance”. Patients everywhere are being told that their mental health conditions are, literally, “all in their heads”. With this diagnosis—often distributed insensitively, and without much attention to the complex factors in thoughts, beliefs, emotions, the environment, biology, nutritional status, mental and emotional as well as physical stressors, and life circumstances (just to name a few) that can contribute to mental health imbalances—patients are left with the message that they are somehow damaged, broken, or that their condition arose out of an inherent weakness that they somehow possess. Through the numerous conversations I’ve had with those struggling with mental health symptoms, I have come to understand that oftentimes there are phrases that rob power more than the term “brain/chemical imbalance”.
Fortunately, there is still more to emerge in the wonderful world of science. Very little actual evidence supports the chemical imbalance theory of depression and researchers and clinicians alike are forced to admit that symptoms of conditions such as depression and anxiety are often the result of multiple factors that come together. Contrary to the common narrative of mental illness being a sign of weakness, evolutionary biologists are uncovering evidence that symptoms of depression might be the result of a highly adaptive strength based on preserving the body during times of great mental, emotional and physiological stress—showing, in fact, that depression and anxiety might in fact be afflictions of the strong, not the weak.
In my practice, I approach depression and anxiety from a functional medicine standpoint. This means, simply, that I look not at the title of the condition my patients come in with (I care very little if you have depression, or anxiety, or bipolar disorder, etc.—the name is not the thing itself), but how the condition occurs uniquely for them. By paying close attention to the multitude of symptoms, thoughts, and factors that influence the mood and emotions, I am able to uncover underlying pathways that point to imbalance in the body and dig up the roots from where the symptoms might have arisen in the first place. Through this method, focussing on the functioning of the body rather than it’s pathology, we’re able to bring the body back into a state of balance and reverse symptoms permanently, rather than simply slapping a band-aid over them.
When it comes to mental health, it is important to emphasize that depression and anxiety (as well as other mental health diagnoses) are not diseases at all; they are symptoms. When presented with low mood, feelings of sadness and worthlessness, lack of motivation, lethargy, brain fog, changes in appetite and weight, abysmal self-esteem and so on—all symptoms that many patients with depression face—we need to follow the threads of symptoms back to the point where things began unraveling. It is necessary to backtrack to the biological imbalances where symptoms first began.
There is an overwhelming amount of research coming out in the field of mental health that links the gut and digestive health to mental health symptoms, indicating that depression might not be a brain chemical imbalance at all, but a gut chemical imbalance. Where there is depression and anxiety, there is more often than not, a digestive issue.
We have always known that the digestive track and brain have an intimate bond. From the vagus nerve that enervates the gut and begins in the cranium, to the mood-regulating neurotransmitters that are created in the gut, we all have the experienced the tummy aches linked to grief or the power of anxiety to loosen our bowels. We’ve all noted the phenomenon that great ideas or moments of clarity seem to spontaneously arise from, not the brain, where we always assumed our thoughts were formed, but the gut (hence the term, “gut feeling”, which we use to characterize intuitive insights).
When it comes to issues with the brain—thoughts, moods, emotions, feelings, etc., where else should we look for answers than our brain’s close cousin, friend and confidant, the gut. Mental health symptoms can arise from impaired digestion in a number of ways:
A failure of the gut cells (enterocytes) to create neurotransmitters. The majority of serotonin (the “Happy Hormone”) is produced in the gut. Inflamed and unhappy gut cells are often unable to make serotonin.
An imbalance in the healthy gut bacteria that influences whole-body health. We have 10x more cells in our gut than in our body in the form of almost 5 lbs of symbiotic gut bacteria. This bacteria ensures our well-being by helping us digest our food, soothing inflammation, educating our immune system, killing off harmful pathogens, creating bulk for our stools and, relevant to the field of mental health, producing neurotransmitters important for regulating mood, such as serotonin and dopamine.
Research has gone into the connection between a low-level of inflammation in the brain and its affect on mood. Inflammation is usually a product of our diet, stress and food sensitivities. In naturopathic medicine and functional medicine we treat inflammation with the assumption that nearly all inflammation begins in the gut. A condition called “Leaky Gut” is a failure of the important seal between the intestinal walls and the rest of the body. When this seal is broken, toxins, proteins and other debris are free to enter the bloodstream, wrecking havoc, setting the immune system off course and, eventually, triggering symptoms of inflammation, autoimmunity and mental health issues.
Our body requires many building blocks to maintain its complex fortress. Difficulties in the digestive cells’ ability to absorb essential fats, amino acids and vitamins required for brain health, hormone regulation, detoxification and immunity, among the thousands of other chemical reactions in the body, will result in impairment in overall functional. Nutrient deficiencies are more common, even in developed societies, than one might think. Deficiencies arise from: impaired absorption, inadequate diet, increased amounts of stress and the ingestion of foods or medications the deplete the body of nutrients. In any case, optimizing the gut’s ability to digest and absorb the nutrients we’re either eating or supplementing is key for improving health and mood.
When it comes to understanding mental health issues I, as a clinician, realize it is hardly ever just one factor involved. Properly helping someone with anxiety or depression heal involves understanding the constellation of potential causes and how they inter-connect and relate to one another. Through this detective work, we can begin the journey of unraveling the imbalances and restoring the body’s ability to function and heal.
Treatment plans usually involve a combination of replenishing essential nutrients that patients are deficient in (deficiency can be detected through blood work, health history or symptoms), repairing the gut’s ability to absorb, restoring the body’s balance of healthy gut bacteria, removing food sensitivities and healing digestive inflammation, balancing hormones, and managing lifestyle stress and environmental factors that may be contributing to low mood.
My patients make impressive commitments to healing and are willing to examine their bodies and past experiences, in order to do the hard work of healing. Beyond my role as a doctor, I am committed to working as a facilitator, teacher and guide. My job is not to tell people the right path to walk, but to help them understand their body’s complex language, listen to the signals and messages that arise from it, and understand what those signals are asking of them.
For more information, click here. I run a practice with a special focus in mental health, youth mental health and hormonal conditions. I work in Bloor West Village in Toronto, Canada.
I have some amazing news—my patient is better. Whereas only a few short months ago, he was plagued by inexplicable weight gain, debilitating fatigue, depressed mood—convincing him he must be suffering from clinical depression—a sore throat and an inability to regulate his temperature, now he feels normal. A few months ago, his lab results indicated a serious and spiralling case of autoimmune thyroid disease. Now the lab results shows markers that are completely within the normal limits. My patient got to where he is now naturally—he did not take a single medication. His body was unleashing an aggressive attack against his thyroid gland under a year ago. Now, his thyroid is healthy, happy and working normally. My patient is back to work, exercising, traveling, feeling happy, fulfilled and creative. He is no longer suffering.
The Thyroid Gland
The thyroid gland is an important organ. Shaped like a butterfly and located right below the Adam’s Apple on the front of the neck, it has a variety of essential, life-sustaining tasks. The thyroid is responsible for maintaining our body’s metabolic function. It keeps our cells busy, and allows us to convert our food and fat energy into important metabolic functions. It regulates our hormones, cardiovascular system, skin and hair health, contributes to mood, regulates body temperature, balances estrogen and progesterone in females, thereby contributing to healthy fertility, and helps with the functioning of the immune system.
However, as important as the thyroid gland is, it’s also the body’s “canary in the coal mine”, susceptible to the smallest changes in our health status. Physical, mental and emotional stress can contribute to declines in healthy thyroid functioning, as can exposure to environmental toxins, inflammation and deficiencies in important nutrients such as iron, zinc, selenium and iodine. Because of the thyroid’s senstivities, however, we can use impending thyroid symptoms as signs of overall body imbalance. Therefore, treating thyroid symptoms at their root is important for restoring our bodies to mental, emotional and physical health.
Hypothyroidism Symptoms
Most commonly, when the health of the thyroid gland is affected, it’s functions decline, causing hypothyroidism, or under-active thyroid. Hypothyroidism of any cause is the most common thyroid condition and is very common in the general population, affecting about 4-8% of North Americans. The symptoms range from mildly upsetting to debilitating and can show up in a variety of the body’s organ systems. They include feelings of puffiness, especially of the face, caused by water retention; fatigue; dry skin and hair; hair loss; constipation and slow digestion; mental depression and low mood; acne; mental sluggishness, brain fog and poor memory and concentration; menstrual irregularities, heavy or scanty menstrual flow; infertility; cold hands and feet; orange-tinted skin; and, of course, weight gain that is unexplained by changes to diet and activity levels.
Bloating, yeast overgrowth and dysbiosis can occur from hypothyroidism when the core body temperature drops below 37 degrees Celsius. A cooler body temperature due to under-active thyroid can upset the intestinal flora and cause an overgrowth in harmful bacteria and yeast, causing further fatigue, weight gain, depression and digestive symptoms.
Diagnosis and Lab Testing
In the standard medical model, thyroid conditions are screened by testing a hormone called TSH, or Thyroid Stimulating Hormone. TSH is not a thyroid hormone, but a hormone produced by the brain that signals the thyroid to work. Through measuring TSH, doctors can tell indirectly how hard the thyroid is working. Is TSH is high, it can indicate a sluggish thyroid, since it is requiring more stimulation from the brain. Lower TSH levels may indicate that the thyroid is working fine. So, the higher the TSH levels, the more sluggish the thyroid. However, the reference ranges for TSH are from 0.3 to 5 U/ml, which indicates a wide range of possible thyroid states. A TSH under 5 will not be flagged by a medical doctor as being hypothyroid, even though symptoms may be present!
More progressive clinicians start to become concerned about thyroid function when symptoms are present and TSH is above 2.5 U/ml. Therefore, many patients with under-active thyroid and upsetting thyroid symptoms may be told by their doctors that everything is fine, delaying treatment and invalidating their decision to seek help.
When TSH is off, doctors then test the thyroid hormones T4 and T3. (There is also T1, T2 and calcitonin). The thyroid makes the hormones T3 (20%) and T4 (80%) but the active hormone that allows the thyroid to exert it’s effects on the body is T3. T4 must be converted to T3 by the body. Problems of conversion of T4 to T3 can be caused by stress and inflammation. It may be helpful for your doctor to test for reverse T3, a hormone that is created from T4 if the body is in a state of imbalance.
To detect if hypothyroidism is caused by autoimmune disease, also known as Hashimoto’s Thyroiditis, doctors will test for antibodies that attack the thyroid, anti-TPO and anti-thyroglobulin. An imbalance in the immune system and inflammation in the body, often caused by stress, can cause the body’s own immune system to attack the thyroid gland, preventing it from working properly.
Treat the Patient, Not the Disease
Naturopathic and functional medicine aims to use lab testing to detect patterns that are playing out below the surface of the body. We connect signs and symptoms and labs, not to diagnose a disease but to look at patterns of imbalance that are playing out in our patients’ bodies before disease sets in. This allows us to intervene before things are too late and healing becomes more difficult.
The Cause of Hypothyroidism
Gluten: There are numerous studies that link thyroid issues to celiac disease or non-celiac gluten sensitivity. In one study of 100 patients, hypothyroid symptoms were reversed after following a completely gluten-free diet for 6 months.
Goitrogens: Soy, raw cruciferous vegetables (kale, broccoli, cauliflower, spinach, etc.), nightshades (tomatoes, potatoes eggplant, etc.) and coffee can act as “goitrogens”, suppressing the thyroid. Lightly cooking leafy greens, avoiding soy, especially processed, GMO soy, coffee and nightshades is helpful for avoiding the thyroid-suppressive effects of these foods.
Leaky gut: Food sensitivities, bacterial imbalance, antibiotic use, stress, excess alcohol and caffeine and intestinal infections can disrupt the barrier between the intestine and the rest of the body. Termed “intestinal permeability” or “leaky gut” this condition is getting increasing attention for being the root cause of inflammatory and autoimmune conditions. Identifying food sensitivities through an IgG blood test or trial-and-error and then healing the gut for 3-6 months is essential for getting thyroid health on track.
Dysbiosis: There is a close correlation between thyroid health and the health of the gut bacteria. Every human has 4-5 lbs of essential, life-giving bacteria living in their intestinal track. These bacteria help us break down food, help train our immune system and product hormones like thyroid hormone and serotonin, the happy hormone. It is estimated that 20% of thyroid hormones are produced by gut bacteria. Therefore a disruption in gut bacteria can wipe out the body’s ability to regulate the thyroid and metabolism effectively.
Environmental toxins: Toxic estrogens, heavy metals and other environmental toxins can suppress thyroid function. The thyroid gland is a sponge that is susceptible to whatever toxic burden the body is under and therefore, thyroid issues may be the first sign that the body is under toxic stress. 2-3 yearly detoxes are recommended to improve liver health, decrease the toxic burden and support a healthy thyroid. Detoxes are best done by eating a clean, grain-free diet and detoxifying the home by reducing exposure to pesticides, radiation, tobacco smoke, excessive alcohol, mercury from fish and silver fillings, bromide, fluoride and chloride (from swimming pools), which can decrease the body’s ability to absorb iodide.
Stress: Stress can suppress thyroid function by preventing the conversion of T4 to T3, the active form of thyroid hormone. During stress, T4 becomes something called “reverse T3”. Both cortisol and thyroid hormones require the amino acid tyrosine for their production. Therefore, during times of the stress, when the demands on the body for making cortisol are higher, not as many resources may be used to produce thyroid hormones and hypothyroid symptoms may result. Ensuring proper cortisol function and decreasing stress is important for recovering from thyroid symptoms.
Nutrient deficiency: Thyroid hormones are made of tyrosine and iodine. A deficiency in protein and iodine may result in an inability of the body to make thyroid hormone. Selenium is also important for converting T4 to T3. Zinc and iron are also important for proper thyroid functions and, in modern day society, these deficiencies are very common.
Inflammation: Using high omega-3 fatty acids EPA and DHA from fish, rhemannia and turmeric can help bring down systemic inflammation and decrease autoimmunity, thereby working to treat autoimmune Hashimoto’s thyroiditis and restoring thyroid function.
A Word On Medication
Synthroid is a synthetic version of the thyroid hormone T4. When prescribed, it can replace the need for the thyroid to act and help the body get back into balance. However, since T4 must be converted to T3 in order to become active, simply adding Synthroid may not be enough to eradicate thyroid symptoms if there is a problem converting T4 to T3, such as selenium deficiency, dysbiosis, inflammation or stress. Furthermore, when the cause of hypothyroidism is autoimmune, this means that there are antibodies attacking the thyroid, not that there is something wrong with the thyroid itself. Without addressing the underlying autoimmunity and inflammation, patients will only need to eventually continue to increase their Synthroid dosage as the ability of the thyroid to function gradually decreases.
For more information on how to address thyroid symptoms naturally, contact me for a free 15-minute consultation.
People seek out naturopathic doctors for expert advice. This immediately positions us as experts in the context of the therapeutic relationship, establishing a power imbalance right from the first encounter. If left unchecked, this power imbalance will result in the knowledge and experience of the practitioner being preferred to the knowledge, experience, skills and values of the people who seek naturopathic care.
The implicit expectation of the therapeutic relationship is that it’s up to the doctor to figure out what is “wrong” with the body patients inhabit and make expert recommendations to correct this wrong-ness. After that, it’s up to the patients to follow the recommendations in order to heal. If there is a failure to follow recommendations, it is the patient who has failed to “comply” with treatment. This “failure” results in breakdown of communication, loss of personal agency on the part of the patient, and frustration for both parties.
When speaking of previous experience with naturopathic medicine, patients often express frustration at unrealistic, expensive and time-consuming treatment plans that don’t honour their values and lifestyles. Oftentimes patients express fear at prescriptions that they had no part in creating, blaming them for adverse reactions, or negative turns in health outcomes. It’s common that, rather than address these issues with the practitioner, patients take for granted that the treatment plan offered is the only one available and, for a variety of reasons, choose to discontinue care.
One of the elements of Narrative Therapy—a style of psychotherapy founded by Australian Michael White—I most resonate with is the idea of the “therapeutic posture”. In narrative therapy, the therapist or practitioner assumes a de-centred, but influential posture in the visit. This can be roughly translated as reducing practitioner expertise to that of a guide or facilitator, while keeping the agency, decision-making, expertise and wisdom of the patient as the dominant source for informing clinical decisions. The de-centred clinician guides the patient through questioning, helping to reframe his or her identity by flushing out his or her ideas and values through open-ended questions. However, the interests of the doctor are set aside in the visit.
From the place of de-centred facilitation, no part of the history is assumed without first asking questions, and outcomes are not pursued without requesting patient input. De-centring eschews advice-giving, praise, judgement and applying a normalizing or pathologizing gaze to the patient’s concerns. De-centring the naturopathic practitioner puts the patient’s experiences above professional training, knowledge or expertise. We are often told in naturopathic medical school that patients are the experts on their own bodies. A de-centred therapeutic gaze acknowledges this and uses it to optimize the clinical encounter.
I personally find that in psychotherapy, the applicability of de-centring posture seems feasible—patients expect that the therapist will simply act as a mirror rather than doling out advice. However, in clinical practice, privileging the skills, knowledge and expertise of the patient over those of the doctor seems trickier—after all, people come for answers. At the end of naturopathic clinical encounters, I always find myself reaching for a prescription pad and quickly laying out out my recommendations.
There is an expected power imbalance in doctor-patient relationships that is taught and enforced by medical training. The physician or medical student, under the direction of his or her supervisor, asks questions and compiles a document of notes—the clinical chart. The patient often has little idea of what is being recorded, whether these notes are in their own words, or even if they are an accurate interpretation of what the patient has intended to convey—The Seinfeld episode where Elaine is deemed a “difficult patient” comes to mind when I think of the impact of medical records on people’s lives. After that we make an assessment and prescription by a process that, in many ways, remains invisible to the patient.
De-centred practice involves acknowledging the power differential between practitioner and patient and bringing it to the forefront of the therapeutic interaction.
The ways that this are done must be applied creatively and conscientiously, wherever a power imbalance can be detected. For me this starts with acknowledging payment—I really appreciate it when my patients openly tell me that they struggle to afford me. There may not be something I can do about this, but if I don’t know the reason for my patient falling off the radar or frequently cancelling when their appointment time draws near, there is certainly nothing I can do to address the issue of cost and finances. Rather than being a problem separate from our relationship, it becomes internal the the naturopathic consultation, which means that solutions can be reached by acts of collaboration, drawing on the strengths, knowledge and experience of both of us.
In a similar vein, addressing the intersection of personal finance and real estate within the therapeutic relationship requires a delicate balance of empathy and practicality. Patients may be navigating the complexities of homeownership or rental expenses, which can significantly impact their overall well-being. Encouraging open communication about these financial stressors fosters an environment where solutions can be explored collaboratively. It’s essential to recognize that financial challenges are not isolated issues but are intricately woven into the fabric of a person’s life, influencing mental and emotional well-being.
For instance, a patient might express concerns about the financial strain associated with homeownership, prompting a discussion about alternative housing options or budgeting strategies. In this context, exploring unconventional opportunities, such as innovative approaches to real estate like eXp Realty, could naturally arise. Integrating discussions about progressive real estate models within the therapeutic dialogue allows for a holistic exploration of solutions, leveraging the expertise and experiences of both the practitioner and the patient. This approach not only addresses immediate concerns but also lays the foundation for a collaborative and conscientious partnership in navigating the multifaceted aspects of personal finance and real estate.
De-centred practice involves practicing non-judgement and removing assumptions about the impact of certain conditions. A patient may smoke, self-harm or engage in addictive behaviours that appear counterproductive to healing. It’s always useful to ask them how they feel about these practices—these behaviours may be hidden life-lines keeping patients afloat, or gateways to stories of very “healthy” behaviours. They may be clues to hidden strengths. By applying a judgemental, correctional gaze to behaviours, we can drive a wedge in the trust and rapport between doctor and patient, and the potential to uncover and draw on these strengths for healing will be lost.
De-centred practice involves avoiding labelling our patients. A patient may not present with “Generalized Anxiety Disorder”, but “nervousness” or “uneasiness”, “a pinball machine in my chest” or, one of my favourites, a “black smog feeling”. It’s important to be mindful about adding a new or different labels and the impact this can have on power and identity. We often describe physiological phenomena in ways that many people haven’t heard before: estrogen dominance, adrenal fatigue, leaky gut syndrome, chronic inflammation. In our professional experience, these labels can provide relief for people who have suffered for years without knowing what’s off. Learning that something pathological is indeed happening in the body, that this thing has a name, isn’t merely a figment of the imagination and, better still, has a treatment (by way of having a name), can provide immense relief. However, others may feel that they are being trapped in a diagnosis. We’re praised for landing a “correct” diagnosis in medical school, as if finding the right word to slap our patients with validates our professional aptitude. However, being aware of the extent to which labels help or hinder our patients capacities for healing is important for establishing trust.
To be safe, it can help to simply ask, “So, you’ve been told you have ‘Social Anxiety’. What do you think of this label? Has it helped to add meaning to your experience? Is there anything else you’d like to call this thing that’s been going on with you?”
Avoiding labelling also includes holding back from using the other labels we may be tempted to apply such as “non-compliant”, “resistant”, “difficult”, or to group patients with the same condition into categories of behaviour and identity.
It is important to attempt to bring transparency to all parts of the therapeutic encounter, such as history-taking, physical exams, labs, charting, assessment and prescribing, whenever possible. I’ve heard of practitioners reading back to people what they have written in the chart, to make sure their recordings are accurate, and letting patients read their charts over to proofread them before they are signed. The significance of a file existing in the world about someone that they have never seen or had input into the creation of can be quite impactful, especially for those who have a rich medical history. One practitioner asks “What’s it like to carry this chart around all your life?” to new patients who present with phonebook-sized medical charts. She may also ask, “Of all the things written in here about you, what would you most like me to know?” This de-emphasizes the importance of expert communication and puts the patient’s history back under their own control.
Enrolling patients in their own treatment plan is essential for compliance and positive clinical outcomes. I believe that the extent to which a treatment plan can match a patient’s values, abilities, lifestyle and personal preferences dictates the success of that plan. Most people have some ideas about healthy living and natural health that they have acquired through self-study, consuming media, trial-and-error on their own bodies or consulting other healthcare professionals. Many people who seek a naturopathic doctor are not doing so for the first time and, in the majority of cases, the naturopathic doctor is not the first professional the patient may have consulted. This is also certainly not the first time that the person has taken steps toward healing—learning about those first few, or many, steps is a great way to begin an empowering and informed conversation about the patients’ healing journey before they met you. If visiting a naturopathic doctor is viewed as one more step of furthering self-care and self-healing, then the possibilities for collaboration become clearer. Many people who see me have been trying their own self-prescriptions for years and now finally “need some support” to help guide further action. Why not mobilize the patient’s past experiences, steps and actions that they’ve already taken to heal themselves? Patients are a wealth of skills, knowledge, values, experiences and beliefs that contribute to their ability to heal. The vast majority have had to call on these skills in the past and have rich histories of using these skills in self-healing that can be drawn upon for treatment success.
De-centring ourselves, at least by a few degrees, from the position of expertise, knowledge and power in the therapeutic relationship, if essential for allowing our patients to heal. A mentor once wrote to me, “Trust is everything. People trust you and then they use that trust to heal themselves.”
By lowering our status as experts, we increase the possibility to build this trust—not just our patients’ trust in our abilities as practitioners, but patients’ trust in their own skills, knowledge and abilities as self-healing entities. I believe that de-centring practitioner power can lead to increased “compliance”, more engagement in the therapeutic treatment, more opportunities for collaboration, communication and transparency. It can decrease the amount of people that discontinue care. I also believe that this takes off the burden of control and power off of ourselves—we aren’t solely responsible for having the answers—decreasing physician burnout. Through de-centring, patients and doctors work together to come up with a solution that suits both, becoming willing partners in creating treatment plans, engaging each other in healing and thereby increasing the trust patients have in their own bodies and those bodies’ abilities to heal.
This is a common story that can describe any number of patients I see in my private practice: My patient has been doing well–she’s been exercising regularly; she’s been cutting out sugar and processed foods and watching what she eats. She’s been having salads for lunch. She’s even gotten her husband on board! He’s started to have salads for lunch with his cheeseburger (instead of fries) and given up having a row of cookies in the evening. All things considered, she’s been doing great. However, despite her best efforts, after one month of tiresome slog, restriction and dedication, she’s only managed to lose a few pounds. Her husband? He’s lost 10.
“He has more to lose,” I suggest to her. “Those few pounds you’ve lost are gone for life—slow and steady stays off forever.” I am her cheerleader, but the truth is: hormones, especially when it comes to women.
Hormones are the body’s telegrams. They are produced in glands in tissue like the gut, ovaries, adrenals and brain and act on distant cells in the body, telling them how to behave. When it comes to weight loss, hormones can be the culprit if diet and exercise have failed to produce results. Hormones control appetite, mood, food cravings, metabolic rate, fat gain and distribution and hunger, among other things. Any hormonal imbalance will sabotage weight loss efforts and it’s often the first place I look when a patient has weight loss goals that they aren’t achieving with diet and exercise alone.
The Players:
There are numerous hormones in the body that are responsible for the above actions, however the main ones that we can affect through diet and lifestyle are insulin, cortisol, estrogen and the thyroid hormones. These are just some key players in a team, however just by working on these four, we can start to see results.
Interconnectedness:
Hormones are complex entities, not only for the wide array of effects, but for their tendency to effect the action of each other. For example, high cortisol can effect levels of estrogen, insulin and the thyroid hormones. High insulin can affect cortisol and estrogen. And so on. Working on hormones is like attacking a giant knot and often requires starting from the basics: diet and lifestyle.
Insulin Imbalance:
Insulin is an important hormone in the body—we can’t live without it. Released by the pancreas after a carbohydrate-rich meal in response to rising levels of sugar in the blood, insulin gets sugar into cells where it can be used as fuel. It also brings down blood sugar, making it a main culprit in hypoglycemic crashes and sugar cravings. The problem with insulin, however, is when we overeat carbohydrates and sugar, we overuse the insulin response. The result is abdominal fat, weight gain (insulin tells the body to store fat), a blood sugar roller coaster, mood swings (that “hangry” feeling) and intense sugar cravings and energy crashes.
Balancing Insulin:
Insulin is best balanced by diet, particularly managing carbohydrate intake and emphasizing healthy fats and protein in the diet. Fat and protein slow sugar absorption. This prevents a rise in blood sugar and decreases the need for insulin. The result is feeling satiated for longer, having stable energy and decreasing food cravings.
Morning protein:
The first step in balancing insulin release is to increase morning protein. I recommend aiming for 30 g of good quality, lean protein for breakfast like a chicken breast, or scoop of whey isolate protein powder in a whole foods smoothie. I was once accused jokingly of “not knowing that breakfast is”, when recommending chicken breasts for breakfast. However, perhaps it’s North America that has a skewed sense of what makes a decent morning meal. If the aim of breakfast is to break the fast that you’ve had throughout the night, then starting it off with a high-carb, high-sugar, nutrient-sparse piece of toast or bowl of breakfast cereal seems crazy to me. In Colombia and India, two places I’ve spent some time, we started off the day with a protein-rich stew or meat soup.
To balance insulin make sure that every meal, even snacks, contain some form of protein or a fat. Avoid eating carbohydrates by themselves and keep servings of carbs to a minimum and in their unprocessed, whole form (like large flake oats, quinoa and brown rice as opposed to flours or cereals).
Cortisol Imbalance:
One of the main hormone imbalances I notice when it comes to stubborn weight gain is cortisol imbalance. Cortisol is the stress hormone. It’s released by the adrenal glands, two pyramid-shaped endocrine glands that sit on top of the kidneys, in response to stress. Animals have two modes of operation: fight or flight or rest and digest. Cortisol increases blood sugar and alertness and tells the body to divert attention to gearing us up for combat or escape, and moves us away from investing energy in digestion, immunity and concentration. Cortisol is a wonderful hormone; it keeps us awake, and makes us feel alert and well, priming us to be effective in our busy, stressful lives. However, our bodies weren’t made for long-term stress response and we spend most of our time in fight or flight mode.
Cortisol and blood sugar:
Cortisol raises blood sugar, causing insulin to be released. This starts us on a blood sugar roller coaster trip, leading to sugar cravings, energy crashes and storing fat.
Cortisol and fat distribution:
Cortisol doesn’t directly tell the body to store fat (it happens through other mechanisms that happen in response to high cortisol), but it does encourage fat redistribution. Cortisol tells the body to move fat from the hips and thighs and deposit in the abdomen, face and shoulders, leading to the sexy “Buffalo Hump”. We know that abdominal fat carries more health risks than fat in other areas of the body so this detail can be troublesome when it comes to long-term effects.
Cortisol and the thyroid:
Cortisol impacts the thyroid by preventing the conversion of T4 to the more active T3. T3 and T4 are important thyroid hormones that set the body’s metabolic rate, among other things.
Cortisol and the sex hormones:
Cortisol can lead to estrogen dominance by diverting resources away from estrogen and progesterone production. In menopause, this is particularly troublesome, as the body relies on the adrenal glands, rather than the ovaries, to produce the sex hormones. High cortisol can result in progesterone deficiency and estrogen dominance symptoms, which can negatively affect weight loss. Cortisol also causing accelerated aging and who wants that?
Cortisol Balancing:
The main thing when it comes to cortisol balancing is to Calm Down—or as I like to poignantly put it, Calm the F#$% Down. The way this is done is highly individualized. Some recommendations I have are: meditation, yoga, exploring acupuncture (a wonderful way to balance cortisol, among other things), journaling, taking a day off, re-evaluating priorities at work and at home, etc. Mainly, getting 7-9 hours of sleep a night is essential for managing the stress response.
Taking it easy:
When it comes to weight loss, I often notice that certain efforts hinder our progress. It’s important to keep caloric intake adequate—eating too few calories can stress the body out, causing cortisol release. It’s also important to manage exercise. While exercise can teach the body how to manage stress, it does produce cortisol in the short-term. Therefore it’s important to keep exercise short and intense. Weight-training, short bursts of cardio (no more than 20 minutes) and varying intensities with High Intensity Interval Training, Tabata or Crossfit, are the best choices for weight loss. Training for a marathon or long-distance bike race may be fun and fulfilling, but they are not the best choices for weight loss, as they prolong the stress response and can work against you, rather than in your favour.
When I have a patient who is intensely tracking what they eat and over-exercising my advice is often (and it’s not that well-received, as you can imagine) “Take it easy”. Easing up on exercise and relaxing calorie-counting may be hidden pieces in the weight loss game.
Herbs and supplements:
There are a variety of nutrients to take to support adrenal function. The main things to consider, with the advice and counsel of a trained naturopathic doctor are B-vitamins, magnesium and adaptogenic herbs (the help the body adapt to stress).
Estrogen Dominance:
Estrogen, actually a group of hormones, are female sex hormones. Their main job is to promote the expression of female sex characteristics, the growth of breast tissue and to control ovulation. Estrogen also causes body to fat to be distributed to the thighs, buttocks and lower abdomen. The problem with modern society is an imbalance in the two female sex hormones, estrogen and progesterone. Due to stress and toxic environmental estrogens, or xenoestrogens, among other things, modern women have more estrogen relative to progesterone in their bodies. The effects of this are numerous and include, stubborn weight gain in the thighs (the famed “saddlebags), cellulite, acne, PMS, painful menstrual periods, fibroids, hormonal conditions such as PCOS, and the occurrence of certain female cancers, especially breast cancer. Estrogen can also contribute significantly to anxiety symptoms.
Estrogen balancing:
Correcting estrogen dominance primarily involves supporting estrogen detox pathways in the liver. Chemicals such as I3C, DIIM and calcium-d-glucarate help increase the liver’s ability to clear foreign estrogens from the body. Supporting digestive health also allows us to remove estrogens—they are neutralized in the liver and eliminated through the colon. Leafy greens contain a high amount of these chemicals, so ensuring you get adequate amounts in your diet is important for estrogen metabolism. Ground flaxseed, rosemary and fish oil are also important nutrients for clearing excess estrogen from the body.
Reducing exposure:
Try to reduce exposure to foreign estrogens by avoiding the use of plastic bottles and plastic-lined cans, using natural skincare and body products and natural cleaning aids whenever possible. It’s also important to see a naturopathic doctor 2-4 times a year for a medically-assisted natural detoxification to clear the body of toxic estrogens.
Hypothyroidism:
The thyroid gland sits on the neck, just below the Adam’s Apple. It releases two hormones T4, and the more active T3. These hormones are responsible for setting the body’s metabolic rate—converting fat into heat and energy. Thyroid deficiency, or hypothyroidism is more common in our society than we think (naturopathic doctors have stricter criteria for laboratory reference ranges than conventional medicine—we look for signs of health, not disease). Conventional medicine deems hypothyroidism as having a TSH (thyroid stimulating hormone) level above 5—for this hormone, all you need to know is lower is better—however ND’s will start to treat the thyroid when symptoms are present and TSH is above 2.5. Symptoms of hypothyroidism are stubborn weight gain, constipation, feeling cold, fatigue, especially brain fog, weak memory, hair loss, dry skin and thinning of the eyebrows.
Supporting the thyroid:
The thyroid gland is a fragile organ, sensitive to inflammation and stress. When there is inflammation in the body, often caused by stress, diet or insulin resistance, the thyroid is the first gland to suffer. Most cases of hypothyroidism are autoimmune in nature. Therefore, naturopathic doctors aim to correct inflammation by prescribing an anti-inflammatory diet and looking for food sensitivities. When we identify food sensitivities (through specialized IgG antibody testing or an elimination diet) and remove them from the diet, we can focus on gut healing which treats inflammation and helps repair the thyroid.
Managing stress:
Low calorie diets have the effect of suppressing thyroid function, which leads to the yo-yo dieting effect. Avoid extremely low calorie diets, or opt for intermittent fasting or calorie-cycling instead. Aim for slow and steady weight loss so as not to harm metabolic rate, which makes weight loss more difficult in the long run.
I previously mentioned that cortisol can harm the thyroid and that hormones are interlinked. Cortisol prevents the conversion of T4 to the more active T3, which can slow metabolism.
Nutrients:
A deficiency in iodine, zinc, iron and selenium, among other nutrients, can negatively impact the thyroid. Talk your naturopathic doctor about testing and supplementation.
Summary:
What would a visit to a naturopathic doctor look like? When it comes to hormones, treatment is often complex as it targets the root cause of symptoms and involves detangling the complicated web of hormones that are at play. This can require some diagnostic detective work. A naturopathic doctor will take your complete health history, order labs and perform physical exams if necessary. A common treatment plan might look like this:
Sleep: 7-9 hours per night
Take stress seriously: sign up for a round of acupuncture, start meditation, do yoga, journal, etc.
Measure hormones via saliva: cortisol, testosterone, DHEA, estrogen, progesterone
Identify food sensitivities via an elimination diet or an IgG Food Panel that tests for antibodies to certain foods in the blood.
Correct nutritient deficiencies through diet and supplementation
Herbs for hormonal support: estrogen detoxification, thyroid support, gut healing, adrenal support, glucose control and blood sugar balancing.
Exercise: short, intense bursts that target muscle-building
Diet: high protein, especially in the morning, healthy fats, low carbs and eliminate sugar, processed foods and food sensitivities.
To learn more about how naturopathic medicine can help you lose weight, balance hormones and fight disease, contact my clinic Bloor West Wellness at 416 588 0400 to set up an initial appointment. Let’s get started today!
Want to balance your hormones, energy and mood naturally? Check out my 6-week foundational membership program Good Mood Foundations. taliand.com/good-mood-learn
As a student of naturopathic medicine, I didn’t quite get herbs. They were natural, sure, but why would I prescribe them in lieu of homeopathy, dietary changes or nutritional supplements? I didn’t get it.
I liked herbs; I understood the idea of synergy—the fact that the effect of the entire plant is greater than the sum of its parts. Also, I knew that plants often have superior effects to some drugs in that they often contain active ingredients that balance the side effects otherwise caused by most pharmaceutical medications. For example, anti-inflammatory herbs like turmeric and licorice root also support and strengthen the immune system, rather than suppress it, as most anti-inflammatory drugs tend to do. For most drugs that lower inflammation, a common side effect is severe immune deficiency. This is not the case for herbs that lower inflammation, which actually benefit the immune system. So, I knew herbs were cool.
I also liked the idea that each tincture was individually created for the totality of symptoms a patient presented with. Creating a specific medicine for each individual seemed to fit with the idea of singularity in medicine, which I resonated with. However, for a long time I didn’t get herbs. And I’ve often been reluctant to prescribe herbs in my practice.
First of all, I don’t have my own dispensary so sending patients off to buy tinctures created a kind of disconnection from the source of my prescriptions. Secondly, as many of you who have tried it can contest, tinctures (or herbs extracted in alcohol) taste terrible and make compliance hard, even for myself. Thirdly, tinctures are quite expensive. Each 50 ml of tincture can cost upwards of $5 making a month’s supply of herbs quite costly. This is funny because many of the herbs that are so costly to buy grow like weeds in southern Ontario (dandelion, for example, is often considered a weed) and tinctures aren’t that difficult to make. Fourthly, I didn’t like to prescribe tinctures because, as I understood it, people would only feel better while actively taking the herb. In my mind, the herb worked like a drug in that once you stopped taking it, the positive effects would diminish. This differed from my understanding of homeopathy, which stimulates the body to heal itself, correcting nutritional deficiencies or looking for and treating the root cause of symptoms. I doubted whether the way we were taught to prescribe herbs did in fact treat the root cause. This is important because the guiding principles of naturopathic medicine dictate that we aim to do this whenever possible.
I had no doubt, however, that herbs were effective. Taking a tincture seemed to be far more effective for me and the patients I treat than taking supplements. Herbs are nutritional—they are a food and a medicine and therefore contain a myriad of health benefits beyond treating what they are prescribed to treat.
It wasn’t until I read author and herbalist Matthew Wood’s works on herbalism that I began to internalize the idea that herbs do in fact stimulate the body to heal itself. Plants contain an inherent wisdom, according to Wood and his studies in western and Native American herbalism. Plants eradicate disease by stimulating the healing powers of the body and strengthening the body’s capacity to heal itself from disease. The body is constantly trying to heal itself from ailments and, when these processes become blocked for one reason or another, disease symptoms begin to manifest. Herbs can strengthen the body’s healing processes, when prescribed in a certain way, and large doses for long courses of time are not necessary. Further, once the disease is eradicated, the herbs can be stopped. When prescribed as a healing catalyst, disease doesn’t return once the herbal prescriptions have done their work.
Wood writes, “It should be understood that herbs can be used either way: to stimulate the self-healing powers of the organism to return to health, or to artificially manipulate the organism to fit an artificial goal.” He uses the examples of goldenseal, which at high doses can kill bacteria or viruses that have invaded the body and in smaller doses can increase the mucosa and digestive systems of the body to rid itself of the invaders and, in turn, strengthen the body against future invasions.
In regards to the cost of herbal tinctures, there are relatively simple ways to get the effects of herbs by making your own tinctures.
Read on to support liver detox, hormonal health and cardiovascular health by creating your own rosemary tincture using dried rosemary, one of my favourite herbs of the moment, and a bottle of white wine:
Rosmarinus officinalis, is the latin name for rosemary, a member of the mint family. While better known for its ability to perfectly complement roast chicken, it has a number of health benefits. Rosemary’s energetic actions are stimulating and warming, according to Matthew Wood. It clears up phlegm and dampness, stagnation and sluggishness in the tissues.
Rosemary has the ability to boost metabolism and increase the absorption of sugars and fats, which make it an appropriate nutritional supplement for people with diabetes. It can help drive glucose into the cells, diminishing the need for the body to release large amounts of insulin, re-sensitizing cells to insulin and lowering blood sugar. It can help nourish the entire body and has a special affinity for the heart, lungs, spleen, liver and kidneys.
Rosemary is currently often used to detoxify toxic, exogenous estrogens from the body while promoting the conversion of health-promoting estrogens in the liver. It is a powerful stimulator of liver detoxification. It therefore serves as a cheap and useful remedy for seasonal, full-body detoxes or coming off oral contraceptive or synthetic hormones, such as the fertility drugs given before IVF treatments. It is also useful for promoting circulation and lymphatic drainage, moving sluggishness and excess weight and creating warmth and vitality in the body’s circulatory systems.
Herbalists use rosemary tincture or oil applied topically to the head and neck to treat migraines from tense shoulder and neck muscles. Its scent is aromatic and stimulating and can improve memory and cognition. It is an effective remedy for mental-emotional depression when taken internally, especially where patients feel damp, sluggish, lack motivation and experience feelings of mental dullness.
As a digestive aid, rosemary can help relieve abdominal bloating and flatulence. It also helps stimulates appetite. It helps burn up phlegm in the stomach and can aid in weight loss.
In addition, rosemary contains antimicrobial properties, meaning it can be used to kill bacterial and viral infections, especially when taken at the beginning of a cold.
It is a powerful heart tonic, especially where there is edema and circulatory stagnation, such as early signs of congestive heart failure. It also can help with arthritic pains and joint stiffness when applied topically to joints or taken internally as an anti-inflammatory.
In Matthew Wood’s book, The Practice of Traditional Western Herbalism, he recommends creating a rosemary infusion (infuse fresh leaves and flowers in a pot of boiled water and keep covered) or a tincture using white wine as the alcohol base.
A few days into taking this tincture (mixed with a little water to dilute the strong taste), I’ve noticed my skin clear, my digestion improve, my stomach flatten (I no longer have any bloating and I’ve been experimenting with eating wheat again for the first time in years), and my energy increase. My symptoms of PMS this month subsided before my period even came. I had a canker sore in my mouth that immediately went away once I started taking rosemary wine. I’ll certainly be adding this cheap and effective DIY remedy to my self-care and general health-promoting regime.
Here’s how to make your own.
Rosemary Wine:
Ingredients:
1 handful (approximately 250 ml) of rosemary leaves, dried, cut up as small as possible (you can use a packet of rosemary spice from the grocery store). Extra points for organic.
1 bottle (750 ml) of white wine (Wood recommends a good quality wine, I used a cheap homemade one I was given as a gift).
1 empty glass bottle/jar
Directions:
Put rosemary in the empty glass jar. Pour entire 750 ml bottle of white wine over rosemary and let stand in a cool, dry place for 2-3 days. Then strain out the herbs and store the liquid tincture in a cool, dry, dark place, like a cupboard.
Talk to your naturopathic doctor about appropriate dosing, though most botanical prescriptions involve 1 tsp of tincture 2-3 times a day away from food. This will vary according to your health challenges and health goals, among many other factors.*
Reference:
Wood, Matthew. 2004. The Practice of Traditional Western Herbalism: Basic doctrine, energetics and classification. Berkeley, California: North Atlantic Books.
*This article is not to be confused with medical advice from a licensed naturopathic doctor. If you suffer from one of the above-mentioned conditions and believe rosemary might help, please book an appointment to receive an appropriate assessment.
I feel sorry for the digestive tracts of this nation, I really do. The owners of these digestive tracts have my sympathy as well—there really is nothing so bad as pooping too much or not pooping enough. Sometimes it’s hard to know which one is worse. Having regular and healthy bowel movements (1-3 times a day) is an essential foundation of good health—regular elimination helps us remove toxins and waste from the body, keeping us energized and well.
A series of patients often come through my office with chronic constipation that is unrelieved by supplements and diet. Most people are getting enough fruits and vegetables or have added more of these foods to their diets and still have a hard time keeping things moving in the lower abdominal quadrants. Since promoting healthy motility is often about daily self-care practices, I’ve complied my list of constipation home-care protocols here, for easy reference. While there are herbs and supplements that can improve motility, add fibre and draw water into the colon and promote healthy elimination, there are also foundational daily practices that must be incorporated as well.
Water:
A no-brainer: we all know that if stools are dry and hard to pass, we need to increase the lubrication of the digestive tract. Gradually increasing your fluid intake by one glass (250 ml) of water per day per week will help your body adjust so that you’re not sent running to the washroom every ten minutes.
Most importantly, however, I like to tell my patients to start the day with a large glass (500 ml) of room temperature water, consumed at once, first thing in the morning. This stimulates the gastrocolic reflex, by filling the stomach with water. In a healthy digestive tract, the contents of the intestine should move through the gut and enter the colon over night where they await the morning meal. Stimulating digestion by ingesting a modest amount of water first thing in the morning can stimulate the contraction of the colon and encourage a bowel movement. Keeping water warm or at room temperature, rather than cold, prevents the water from seizing up the body’s sphincters and allows things to keep moving. This practice also guarantees half a litre of water consumption a day, which we know is essential for proper colon health.
Listening to the body:
Slow motility is often a response to lifestyle. Our bodies send gentle cues to our conscious brains that it’s time to have a bowel movement and oftentimes these cues are ignored. Perhaps we’re in traffic, or rushing out the door, or in a meeting. Perhaps we’re afraid to use the washroom at work, where the acoustics are less-than-ideal. However, when we ignore the calls of nature, we often miss our chance to have a bowel movement for that day. If this has become a reality for you, some bowel retraining might be in order. Bowel retraining involves picking a time of day when it would be most convenient to have a bowel movement—right after breakfast is often a good time—and sitting on the toilet for 10 to 20 minutes. This daily practice will help teach your bowels when a good time to go is, as well as make you conscious of making daily elimination a priority. Think of it as “potty training” for adults.
Fibre:
We all know that regular bowel movements require an adequate amount of dietary fibre. Fibre creates bulk in the intestines, feeds healthy gut bacteria and increases stool weight. A healthy diet contains at least 25 grams of fibre a day from whole food sources. However, when it comes to constipation, not all fibres are created equally. While soluble fibre, from things like chia seeds, oats and legumes has been shown to decrease cholesterol absorption in the gut, it can actually serve to bung us up more. Insoluble fibre, like the kind found in apple skins, flax and wheat bran, can help bulk up the stools and keep things moving smoothly along the digestive tract.
To increase insoluble fibre in the diet, I recommend 2 tbs of ground flaxseed (you can add it to smoothies, morning cereal or the morning 500 ml glass of water) a day. This not only helps promote bowel movements, it also provides healthy omega 3 fats and estrogen-balancing properties for healthy hormones.
As fibre needs to absorb water in order to promote healthy excretion, it is important to prioritize fluid intake. A study involving 63 participants showed that the more fibre they consumed, the more constipated they became. The researchers likened this phenomenon to a traffic jam—add more cars and you simply worsen the traffic jam. Therefore, it’s important to keep the gut sufficiently lubricated to encourage proper motility.
Castor oil packs and self-massage:
Castor oil can help promote smooth muscle motility when applied topically to the abdomen. I instruct patients to massage a liberal amount of oil over the entire abdomen (bra-line to underwear line) and either place a hot water bottle over the area for one hour or leave the oil on overnight. Self-massage paired with castor oil are effective at helping things move more regularly throughout the night. A word of caution, however: castor oil should not be used in pregnancy and before an expected menstrual period as it can stimulate the contraction of the uterus. Castor oil also has the potential to stain clothes and bedsheets, so take extra care.
Pelvic tilt:
A few years ago, the Squatty Potty was all the rage. This new, rather expensive tool, claimed to change the angle that the legs make with the torso, encouraging pelvic floor muscle relaxation and relaxation of the muscles around the anal sphincter. The principles makes sense—we humans have evolved to evacuate our bowels in a squatting position. This increases abdominal pressure and causes puborectalis muscle relaxation, allowing us to have a strain-free experience. The modern toilet, however, does not encourage this angle, which the makers of Squatty Potty claim is the reason that constipation issues are so rampant in Western society. I encourage purchasing a 1-ft high washroom stool to place under the feet while going to the washroom to promote proper posture and sphincter opening.
Exercise:
Daily exercise promotes bowel movements by increasing metabolism, increasing intra-abdominal pressure and strengthening abdominal muscles. Getting 30 minutes of moderate exercise (walking, swimming, cycling, etc.) and performing squats are excellent ways of promoting healthy elimination.
Talk to your naturopathic doctor:
Supplements such as magnesium, vitamin C, probiotics and certain herbs such as burdock, peppermint, chamomile and chicory can also help with constipation. Talk to your naturopathic doctor about what doses, brands and supplements are right for you. Acupuncture and hydrotherapy are also useful treatments. Try to avoid methods that only offer temporary relief from constipation, such as laxative use. These can help in the short term, but like most short-term treatments, can worsen symptoms in the long term and further exacerbate your efforts to promote healthy bowel movements over time.
