Current research suggest that gluten can increase systemic inflammation, contributing to a worsening of mental health symptoms, as well as other inflammatory conditions, such as pain and autoimmune disease.
Transcript:
Hello, you guys, my name is Dr. Talia Marcheggiani and I’m recording to you guys from my clinic in Bloor West Village. It’s call Bloor West Wellness Clinic, in Toronto, Ontario, Canada. And today, I’m going to talk to you guys about how a gluten sensitivity might be the underlying cause of your mental health conditions or other inflammatory conditions such as arthritis, migraines and digestive symptoms like IBS.
One of the reasons that I’m recording this video is because gluten is a really hot topic in the health and wellness industry and you’ve probably encountered your own versions of gluten-free food, or articles on the internet about how gluten is this evil toxin and there’s a lot of misconceptions around this and so I’m going to just talk a little bit about what gluten is and my own journey with cutting gluten out of my diet and how I came to that space where I was willing to do the experimentation and cut it out and see what my results were.
So, gluten isn’t a toxic substance per se, I mean there’s opinion around this in certain circles based on what it can do and how it affects the immune system and the results it can have on digestion, if you have sensitivity to it. But, what gluten is, is it’s a protein complex; it’s a bunch of proteins that are found in grains—wheat, rye and barley. And the protein complex consists of different proteins called gliadins. I might use gliadin and gluten interchangeably; it’s the same thing.
And, so, there is a health condition called Celiac Disease that’s a very serious health condition; it’s an autoimmune condition where the body attacks an enzyme called transglutaminase that’s involved in processing gliadin molecules. So this is not a reaction to gluten, per se, it’s an autoimmune reaction that’s caused by, that’s caused any time the body comes into contact with gliadin or gluten.
And celiac disease is a very serious health condition, it affects about 1% of the population, but there’s some room there for debate. So, some people think that you acquire celiac disease as you go on, and there’s evidence for that. And also, some people think that there’s a great underestimation of how many people are affected by celiac disease, that the number is higher than 1%, but that a lot of the cases do undetected.
And so celiac disease is diagnosed by blood tests. We’re looking at transglutaminase and endomysial antibodies, but the gold standard diagnosis is doing an intestinal biopsy. So, that’s how you find out if you have celiac disease, or not. So some people have done a blood test and they’ve tested negative for celiac disease, but are exhibiting some of the symptoms and so an intestinal biopsy will tell you yes or no definitively whether you have it or not.
Now, whether someone with celiac disease should avoid gluten or not isn’t really the debate here, I mean, that’s obvious. So, if you have celiac disease you have to avoid gluten 100%, it can’t be in your diet. You can’t even have a crumb of it. You have to use special toasters, or toaster bags, for your gluten-free toast. You have to make sure that your oatmeal hasn’t been contaminated by gluten. You can’t shop at Bulk Barn because there could be cross-contamination with gluten-containing substances. So, it’s almost like an allergy, you really have to be careful about coming into contact with gluten. And when people avoid gluten, if they have celiac disease, then that disease is managed.
So, whether someone with celiac should avoid gluten or not is not up for debate. What is is in this grey area, which is what you’ll be reading about online and that you’ll hear certain professional say is kind of myth, is this idea of non-celiac gluten sensitivity or gluten sensitivity. These are people who don’t have celiac disease, but for one reason or another notice that, when they take gluten out of their diet, they feel better. And when they reintroduce gluten they feel worse. And the symptoms are complex, just like in celiac disease. So, in celiac, people can get rashes, they can get joint pain, they can experience brain fog, they can experience brain damage, they can get arthritis, they can start getting other conditions such as thyroid conditions and so the symptoms are so wide-spread because of the inflammation that is triggered by eating gluten, and this is also the case with non-celiac gluten sensitivity—people who avoid gluten.
So, my story was that when I was a student at the naturopathic college, one of the things that I was exposed to in first year was this idea about elimination diets and leaky gut, which I’ll explain in a bit more depth, but you might have heard me write or talk about leaky gut. And, this idea that things like gluten or dairy could be contributing to some symptoms that I was experiencing and that a lot of patients were experiencing, and that taking these foods out in a systematic fashion, so doing a really clean diet, or a “hypoallergenic diet”, or a diet that’s basically chicken, rice and maybe some spinach, that that would heal a lot of the complaints that I and many others were experiencing, but that probably gluten was implicated in that.
So I was really resistant to this for at least two years. So, I wasn’t an early adopter at all to this idea, a lot of my classmates got the information, they went out and they started eliminating a lot of these foods from their pantries and they tried eliminations just for fun—well, for fun and also to experiment and to heal themselves and to “walk the talk”, as we say. But, I was living with my Italian grandmother and I would have toast for breakfast, I’d have pasta for probably lunch and dinner. I was getting gluten in my diet a lot and the idea of taking it out and resisting those familial pressures was—I just didn’t want to deal with it.
But, throughout the first couple of years of school I was also getting migraines on an almost weekly basis. And these migraines would take me out for the entire day. So, for the entire day I’d be throwing up, lying in the dark with a cloth on my head, trying to take some Advil, or something to mitigate it, but this was a chronic thing that I was going through.
Best case scenario, I’d get these once a month, but they were things that I was getting often. And I also had this life-long problem with bloating, these kind of IBS symptoms, like gas and bloating and, when I first started the naturopathic college, it was amazing to me that that was something we were talking about, because I’d kind of written that off as just being something, a peculiarity or particularity about my body that I’d just have to live with and it didn’t even occur to me that something that wasn’t considered a “disease”, per se, could be something that warranted attention and that had a treatment that went along with it, and a cause.
So I was kind of intrigued by that idea, like “oh, you mean I don’t need to be bloated?” and that, even though I’m not sick, like I’m healthy, I don’t have a disease, I don’t have high cholesterol or some of autoimmune disease, or type one diabetes, or something like that, but that the idea that an imbalance, or symptoms that were uncomfortable could be treated was totally new and exciting for me.
And so there was this intrigue in being gluten-free, but also this resistance to it.
And then, I think I was at a talk at school where we were given—it was sort of an information session, we were given free samples of a 7-day detox that involved shakes. And so, I did that because I had this free box, probably worth about $80 and I just decided, “ok, well I’m going to do this detox, it will be good for me. It will be sort of my introduction to eliminating a lot of these foods. It’ll be easy.” And it was really difficult. The first two days I had massive headaches as I was withdrawing from a lot of the things I was addicted to, such as caffeine, sugar and, probably, gluten, as well. But that sort of set the stage because I felt a lot better after that process, even after only that week of eliminating the foods. And so, when I started introducing the things I was eating normally back in, such as pasta and bread, I felt a lot worse. So, that discrepancy kind of woke me up to the idea that maybe these foods aren’t that great for me. And then I began a process of elimination and noticed really good results. I mean I don’t get migraines any more. It’s very very rare, and it’ll be a combination of weather and other factors and stress and overwork. But, that once-a-week, or even once-a-month, being in the dark with a cloth on my head, no noise and vomiting all day: that’s in the past. And now when I reintroduce gluten I can maybe tolerate a bit of it, but I definitely notice a difference in my energy levels, in my digestion, and just in my mental functioning and in my mood when I make a habit of having it more often. So, I’m basically grain and gluten-free and have been so for about 4 or 5 years.
So, why is gluten bad? Why gluten? Why is that an issue? The obvious answer is that it’s so present in our society. So, in North America, gluten is one of the main staples in our diets. So, pasta for lunch, bread or a sandwich for dinner, and toast for breakfast, or cereal. We’re getting gluten as a main source in our diet, in wheat, very often. And so, when we’re exposed to certain foods continually, we become more susceptible to an immune response against those foods.
But also, gluten has, we see in the mechanism of celiac disease, there are these, this genetic predisposition to react to gluten. And so on immune cells, and we know that our digestive system is the gateway between our bodies and the external environment. And so, how our immune system kind of “educates” itself is by sampling things from the environment and deciding what’s us—and we shouldn’t attack ourselves, because that creates an autoimmune issue—what’s us, what’s ourselves and what’s food, what’s useful to the body, what’s supposed to be incorporated into the body as fuel—and what is not helpful for the body, what is toxic, what is foreign, and what we need to defend against, like bacteria and viruses.
So, our digestive system is kind of involved in sampling from the environment, deciding and showing those pieces of the environment to the immune system, and letting the immune system decide what it’s going to do about these things.
So, when we’re eating foods we’re kind of presenting them to the immune system. And our immune cells have different receptors, so they’re called receptors, but they’re sort of like, you can describe them as like locks for keys or little sort of antennae that feel out the environment. And so people with the receptors, HLA-DQ2 and HLA-DQ8 receptors, on their immune cells, those people tend to react and to connect those receptors with gliadin molecules, so gluten molecules, and that signals an immune response from the body. And when the body thinks it’s come into contact with something that it needs to trigger an immune response against, so that means something foreign, something threatening to us and to our health, then a whole inflammatory pathway starts to take place.
So, think about when you get a cold. You come into contact with the virus and the reason that that virus doesn’t kill us is because our immune system reacts to it. When you get a cold, depending on what virus you’re in contact with, you might get the swollen throat, and the pain, and maybe a fever, and maybe some mucus production, some runny nose. You might feel tired because it takes a lot of energy to mount an immune response like that.
So, when we’re experiencing inflammation, it’s really useful for us, because we’re killing off the things that could kill us, basically we’re at war with something from our environment, but it also doesn’t feel great to be in that state. And so we get into trouble when we’re in an inflammatory state and it’s not for the right reasons, like that we’re trying to attack something (acutely) and get rid of it.
So, a lot of people have these receptors. So even though only 1% of people react to gluten in the sense of celiac disease, about 30% of people express these HLA-DQ2/8 receptors on their immune cells. And so, coming into contact with gluten on a regular basis could be problematic for these people and it could trigger some inflammation.
Another thing that gluten does is create a leaky gut situation. So, I’ve talked about leaky gut before. Our intestinal cells, so our intestine is this long tube from our mouth to our anus, and it winds around and it goes from mouth to esophagus, to stomach, to small intestine, large intestine, and then rectum and anus, and different things happen along that process. And in our small intestine, we have these really long, they’re kind of like cylindrical cells. And, on one end, on the end that’s in contact with what we eat, there’s these little fingers, these villi that reach out into the environment and that maximizes our ability to absorb the things that good for us—the foods that we eat. And, in between—so, the villi kind of control, ok we’re going to break down the carbs, and we’re going to break down the amino acids, from proteins and we’re going to break down the fatty acids, and we’re going to absorb all of the ions and the minerals and the vitamins and we’re going to control how we take them in. We’re also going to control how we take in foreign substances, because we’re going to, remember, show them to the immune system and say “take a look, this is what’s in our environment. This is what you guys might need to prepare yourselves to defend against if this becomes a problem for us.”
And so, we really control, tightly, what we’re taking in through our intestine. So our intestine doesn’t just want to open up the gates and let whatever is outside in, it’s got these really specialized mechanisms for letting certain things into the body. And, so, between these intestinal cells. You imagine these cylindrical cells, almost like a hand, with little fingers, and they’re lined up all along your intestine. And between them are something called tight junctions. And so those, they might become more or less permeable depending on the state of the gut, and that’s controlled by something called zonulin.
Zonulin will open up that permeability and let things in between the cells. And lower amounts of zonulin will maintain a more closed environment. And so one thing that gluten has been shown to do, or gliadin, is increase levels of zonulin, which opens up our intestine to the external environment. And think about the things we eat. Think about the things that swallow, by accident or intentionally, the things in our environment that are toxic, or giant pieces of protein from foods. So, protein in and of itself can cause an immune reaction. We have children that are deathly allergic to peanuts and other nuts.
So, it becomes problematic when we have all this stuff just entering our body. And so gluten opens up the gut to allow all these things to enter the body. And so we end up mounting an immune response to things that would otherwise be harmless to us, like dairy, or eggs, those kind of things that are actually nutritious and helpful for our bodies. So, we start to enter this state. When we’re in a leaky gut state we start to enter a state of inflammation. And inflammation has widespread effects. In my case it was migraines and bloating and digestive symptoms, a foggier mind, foggier brain and lower mood as well. And in some people it can be bipolar disorder. It could be worsening of symptoms on the autism spectrum. It could be depression and it could be anxiety. And when we’re in that inflammatory state we have higher amounts of something called, they’re like excitotoxins, or endotoxins. And so these are toxins like lipopolysaccharides, or LPS, as it’s most often referred to, that trigger anxiety, they activate the limbic system, they activate the amygdala; these are fear centres in our brain.
We also have something called the Blood Brain Barrier (BBB). And that’s really similar to the intestinal barrier with the tight junctions, and that prevents things from getting into our brain that are in our bloodstream. So, it’s like we have this second wall of defence because our brain is so important to our survival and fluctuations in our brain chemistry have really disastrous effects. So we have this extra sort of layer called the BBB that prevents things from getting into our brain. And when we’re in a high inflammatory state, like when we’re exposed to gluten, we get these cross-reactions where what keeps our blood brain barrier intact starts to separate, so we get this leaky brain picture. So we’ve got a leaky gut and also a leaky brain happening. And so we’re getting these toxins, and we’re getting inflammatory mediators entering the brain.
And more research into depression and other mental health conditions has shown that inflammation might play a giant role in low mood. There was one study done with patient who were hospitalized for bipolar disorder. So, these were people who were in a psychiatric facility. And they measure their blood for antibodies against gliadin. And they found that there were elevated antibodies in these people. So, there wasn’t a control group, they weren’t testing against non-bipolar, or people that didn’t have a bipolar diagnosis, but they found that every single patient, who was diagnosed with bipolar disorder and was hospitalized, so their symptoms were severe enough to require hospitalization, had elevated levels of antibodies to gliadin. Then they retested them some time later and found that having high levels of gliadin, or even further rises in gliadin antibodies, predicted whether they were rehospitalized. So, we can infer from that that their symptoms worsened. And so we know that there is this connection between mental health conditions, you know, depression and anxiety and bipolar and even psychosis (and gluten sensitivity). Another study showed that there were high levels of antibodies in people who had psychosis and psychotic symptoms.
So, we know that there is this connection with mental health and with inflammation and that this inflammation can be worsened by a gluten sensitivity or gluten reactivity and that maybe 30% or more of people are susceptible to reacting to gluten in some kind of way. And that gluten just in and of itself might cause this leaky brain situation or leaky gut situation. So, one thing I do is that I don’t do this with every single patient that I see who comes in with depression or anxiety or stress. I mean I don’t jump right into prying gluten from their hands, because my own experience was that it took me literally two years to think about removing it and I had to come to it on my own. But, I might plant the seed, or we might do something like a trial run. Especially someone who’s got mental health symptoms, or is coming to me for mental wellness, and they also have digestive symptoms. I mean, those two things together are a clue that doing some elimination diet, or some leaky gut healing or removing foods like gluten could be a good idea.
But I might present the option to them. We find that most treatment does really need to have 100% compliance rate. So, some patients will come back and say, “you know, I kind of took gluten out, maybe 70-80%” and that’s really great, because I think that it sort of sets the stage for creating a gluten-free lifestyle and doing a gluten-free trial, but really what the research is showing is that we need to 100% take it out to allow the gut healing and the brain healing to occur and to lower those inflammatory mediators.
But, the good news is that it usually takes about 2 to 4 weeks to get symptoms to really come down. So, it’s not like you’re on this trial for life and you can go back to your pasta—if you don’t notice any change after 2 to 4 weeks, at all, then you can go back to your pasta with the peace of mind that this isn’t an issue for you. But, if you do notice some improvement after removing it, then it is something that we can investigate either down the line, when you’re ready, or something that you might want to consider. It’s sort of like planting that seed. But, I don’t pry out of my patients’ kicking and screaming hands. It will be something that we might work on down the road, and something that is always kind of on the table or on the back burner for future attempts and experimentation.
And so, the gold standard, when it comes to treating gluten sensitivity, is just to do an elimination, so take gluten out of your diet for about a month, 100% out, as best you can. There are blood tests that you can do and those can show an elevated antibody response to gluten or gliadin or wheat as well as other foods. The one I do on my patients looks at about 120 different foods. And this is great because having a piece of paper that shows you what your immune system is dealing with in the moment that you got the blood work done is useful. And people tend to, when it’s a blood test, it tends to hold more authority than simply the subjectivity of symptoms. But, really, the best way to see how gluten affects you or how certain foods are affecting you in your immune system is to do an elimination diet, remove it 100% from your diet, give your body some time to heal and then reintroduce it and see what it does to you once you’ve healed from the state that it’s put you in.
Doing that removal is important because the antibodies are only one part of the immune system and so when I’ve done a food sensitivity test on myself, I felt crappy because you have to eat the food for a while. So I was reintroducing gluten into my diet and I didn’t have a high gluten antibody. I had antibodies to other foods, but not gluten. So I kind of psychologically was like, “well, I guess I’m ok to eat it, then.” And went back to eating it a bit more regularly and then experienced really terrible symptoms and my mental health took a decline and then I had to take it out again.
So, the labs don’t necessarily tell the whole story. What does tell the whole story are your symptoms. So, taking gluten out for 2 or 4 weeks is what I recommend most people do. And, so how do you take it out? So, really what the goal is, because, and I’m saying this piece now because there were some articles that were floating around, it was a few months ago, but I’m sure they’re still around, that said, “going gluten-free is unhealthy. It’s dangerous.” And I was really confused by that because I was like, it’s not like wheat is this really important food in our diet that’s giving us all kind of nutrients. We fortify grains with things like folic acid and other B vitamins, like riboflavin. But, they’re not super nutritionally dense, and it’s not like we have a calorie deficiency where we need to get more carbs and calories. I’m not telling people to avoid spinach, or something that is really giving them a lot of nutritional currency, so why would it be harmful to take gluten out?
And then I realized how it’s often being taken out. So, you go to the grocery store and you find that there’s a whole gluten-free section. They basically have gluten-free breads or gluten-free Oreo cookies. And those gluten-free Oreo cookies are for, like, celiac children that want to join in with the rest of the group. They’re not like, “oh, I’m eating these gluten-free Oreo cookies. These are a healthy choice that I’m making.” It’s a substitute for a junky food. You’re substituting one junky food for another junky food, but the only thing is that you’re still maintaining your gluten-free status while on the substitution.
And when it comes to gluten-free breads vs. whole grain breads or whole wheat breads. Probably whole wheat breads have more nutritional bang for their buck; they’re higher in fibre, they have more nutrients. And gluten is a protein, which is what causes the immune system reactivity that it does, but if you don’t react to proteins, they’re healthy for us and we need them, because they contain the amino acids and they fill us up, and they do all the other things that proteins from other foods do. So, usually gluten-free bread doesn’t have very many proteins in it.
So, yeah, if you’re choosing between nutritional value of a gluten-free bread versus a whole wheat bread, then the whole wheat bread is better for you. So, we see this in people that do gluten eliminations and they’re kind of like, ok I’m going to take my wheat pasta and I’m going to have rice pasta instead. I’m going to take my gluten-free toast in the morning, or my gluten toast, my wheat toast in the morning and have gluten-free toast instead. So, that’s not the healthiest way to go about it. It might be a good way to transition when you’re trying to do an elimination. It gives you peace of mind, it allows you to still have your Oreos. It’s not creating a giant change, then that could be helpful. But really what we’re aiming to do is not just substitute wheat products, or gluten-containing products, for non-gluten-containing products and leave it at that, we’re trying to shift into a more traditional diet, like a Mediterranean diet or a Paleo diet, that’s higher in the fruits and the vegetables, and that’s higher in the healthy fats and that’s more protein-rich, and that the proteins are from better, cleaner sources. So, that’s the end goal. So, it’s not that we’re happy with patients eating rice flour and tapioca bread. It’s about switching to a cleaner and more sustainable diet that our bodies evolved to thrive on.
However, the immuno-reactivity of gluten is really what we’re trying to deal with when we’re going on a gluten-free diet, especially the 2 to 4 week trial run. And so what you’re doing on that 2 to 4 week period that’s allowing you to stay on gluten, if that involves gluten-free rice bread, then that’s another story and I think, as a naturopathic doctor working with people who are struggling to get rid of gluten and see if that’s an issue for them, I think that’s ok for the short term.
So, it’s not that going off gluten is bad for you, it’s how we do it. Are we changing our habits for better ones or are we kind of sustaining some of the same Standard North American Diet habits and just cutting the gluten out and thinking that that’s healthy for us, or that that’s going to cause weight loss, or whatever.
No, this is a different thing that I’m talking about. I’m talking about gluten as a root cause of inflammation that then leads to psychiatric disorders, such as bipolar, depression, and anxiety.
And, so one thing I’m going to say as well is that sometimes it’s not enough just to take out gluten and so what I do—or other foods that are suspect, right, so dairy could be another culprit in this or things like eggs, or soy. There’s many things that we could react to. But we often start with gluten. So, often taking the food out isn’t enough and we need to do some gut healing with things like l-glutamine, which I mention in my amino acid talk and also restoring the probiotic balance and doing some things that are just helping repair the gut, getting digestion back on track, getting your digestive motility moving through things like digestive enzymes and bitter herbs and things that like. And so, I’m just going to mention three probiotics that have been shown—they’re called “psychobiotics”. They’re nicknamed that because of the beneficial effects on mental health and in another lecture I was also talking about how the probiotics in our gut are also responsible for producing serotonin that our body has available to it, which we know is the “happy hormone”, that’s what the selective serotonin re-uptake inhibitors work on. So, getting the right balance of bugs in your gut could be just as effective, potentially, as taking an antidepressant medication. So, that’s really cool. But the three bugs that a lot of research has been done on are the Lactobacillus casei, Bifidobacteria longum and Lactobacillus helveticus, which has been shown in studies to actually decrease anxiety and to lower levels of cortisol, which we know is also implicated in depression and anxiety and probably other more serious psychiatric disorders.
So, I hope that was enlightening. We talked about how gluten can contribute to inflammation, leaky gut and thereby exacerbate or create mental health issues. How going gluten-free is not the same as going “whole foods” and how going gluten-free might be the answer or at least a part of your self-care process in healing from mental health conditions.
Thanks a lot, guys. I hope you’re having a good New Year, a good 2017, and I’ll see you soon.
My website is taliand.com and you can contact me at connect@taliand.com. I’m a naturopathic doctor and I focus on mental health and I work in Toronto, Ontario, at Bloorwest Wellness Clinic.
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.
The gut-brain connection has gotten the attention of researchers and functional medical practitioners. I discuss, briefly, what research has shown us in regards to the complex realm of the microbiome and how depression may be a result of inflammation in the brain, stemming from inflammation in the gut.
My name is Dr. Talia Marcheggiani and I am a naturopathic doctor and mental health expert in Toronto.
Today we’re going to talk about the gut-brain connection and how that can influence your mental health symptoms.
I think we intuitively know that the gut and brain are connected. When you feel mental symptoms of anxiety we immediately notice the effects on our gut.
During times of stress, we know that we have indigestion, we’re more predisposed to things like diarrhea and irritable bowel syndrome.
Even anatomically there’s a nerve, called the Vagus nerve, that directly connects the brain to our digestive system.
This nerve is responsible for putting into that “rest and digest” state.
When this nerve is stimulated, our bodies start to secrete digestive enzymes, saliva starts to be secreted and we’re able to break down our food and absorb the nutrients from the food that we’re eating.
A lot of research has been going on, that you might be aware of, about healthy gut bacteria. And more and more people, especially medical doctors, happily, are prescribing probiotics anytime someone is prescribed antibiotics for a bacterial infection.
Scientists have started to study more about these gut bacteria. We know we have, like, 5 lbs of gut bacteria, sitting in our digestive systems. Over 100 trillion cells, this is more than 10x the amount of cells we have in our physical bodies, and more DNA than we have in our body.
We’re more bacteria than we are human!
And these gut bacteria, we can’t survive without without them, they influence the very physiology we experience and they definitely impact our health.
These bacteria are responsible for helping us digest our food, and for our mental and emotional wellness as well as keeping our immune system in check.
So, a disbalance in bacteria, or an increase in that negative, bad bacteria and not good strains of healthy bacteria, can lead to diseases like autoimmune disease or multiple sclerosis, or things like chronic fatigue syndrome as we’re seeing in research.
Scientists are starting to study more about how the bacterial balance in our gut can influence our mood and mental health.
These gut bacteria can actually produce serotonin. So that’s the happy hormone in the brain. And you may have heard of serotonin, especially if you suffer from depression or anxiety because your doctor might have recommended a kind of medication called SSRIs, or Selective Serotonin Reuptake Inhibitors, or a similar drug, SNRIs, like Venlafaxine, which is a Selective Serotonin and Norepinephrine Reuptake inhibitors.
This is based on on the Monoamine Hypothesis that there is this chemical imbalance in the brain. That your body is either not making enough, or absorbing enough or reacting to serotonin enough.
When we’re given these antidepressants, the idea is that we’re recorrecting this brain imbalance and that’s as much of the story as we’ve got. We don’t know why these brain imbalances are around.
So I think that, if we’re going to stick with this hypothesis, which is still controversial in science, we should look to the gut bacteria because we know that gut bacteria produces a significant amount of serotonin and, if we’re blaming depression and anxiety on serotonin deficiencies, why not look at the gut and find out how we can influence the balance of healthy gut bacteria so that we’re producing enough serotonin. Especially if we’re relying on drugs to correct the imbalance and we don’t have enough serotonin for the drugs to work properly.
Gut cells on their own produce 95% of the serotonin in the body so basically every single chemical that we have in our brain is produced or exists in the gut.
So, we need to be able to feed the gut cells so that they’re producing healthy amount of hormone we need to experience a healthy mood and live our lives in ways that are stress-free and energized and happy so that we can effective in our lives.
Mentally and emotionally, you might know this “gut feeling” that we talk about in language and that’s kind of permeated throughout cultures. So, we know that when we have this feeling in the gut that, it’s almost like an intuition. Some people will say, “I just knew it, because I felt it in my gut.” And I think that we’ve always had this intuition. We’ve always had this connection between what our mental state, our thoughts, beliefs and emotions are telling us and what our gut is telling us.
We think that we think with our brains and that all of the mental symptoms we experience are happening at the level of the brain, but because of this tight gut-brain connection, we know that’s not true.
People that have done brain studies actually find that we have thoughts before we have brain activity a lot of the time so, I wonder if we’re actually thinking with our gut, which is a revolutionary and radical thought, but we’re finding more and more evidence for this in science.
You may have heard of the condition called “Leaky Gut” or the more official, scientific term is “Intestinal Permeability”. Our gut is really selective about what it absorbs for good reason. What happens, though, when we’re experiencing chronic stress, or we use a lot of antibiotics or maybe eat things like high-sugar foods, caffeine, or a lot of alcohol, we can cause gut inflammation, which starts to allow bacteria, food toxins, or whole proteins from food into the blood, into the body by breaking down the integrity of the gut.
So, when it comes to health, for most health conditions, especially when there’s a few symptoms that seem disconnected and it’s hard to find the relationship between them, naturopathic medicine and, now, functional medicine and, hopefully soon, conventional medicine, begins to look at gut health.
So if I’m sitting across from a patient who has a long list of health symptoms that seems like they’re not connected and has digestive symptoms—and 40-60% of the population, in general has some kind of digestive symptom, whether it be bloating after eating, feeling fatigued after eating, just feeling like your food is sitting in your stomach and not really moving through, GERD, so acid reflux, heartburn, diarrhea and constipation, or those IBS symptoms, gas and bloating—when I sit across from a patient with any of those symptoms, the first place we go, in terms of treatment, is to look at the gut.
So how do you keep your gut healthy? There’s a few things. The first is to eliminate anything that’s causing gut inflammation, so this could be excessive caffeine and alcohol, excessive refined sugars, antibiotics without doing a probiotic immediately after or during an antibiotic treatment, chronic mental and emotional stress, or physical stress, and food sensitivities: something we’re eating that’s causing our immune system to react and our gut to become inflamed.
Ensuring a proper bacterial balance by either supplementing with a probiotic or eating a variety of fermented foods such as kefir, yogurt, kombucha or saurkraut, and making sure that we’re eating a variety of whole foods: whole grains, fruits and vegetables, and healthy fibres that are going to feed that healthy gut bacteria.
So, when it comes to mental health, such as depression and anxiety, chronic mental stress, even things like bipolar, OCD, conventional medicine tends to just look at the brain and blame the brain on the host of symptoms that patients might experience.
Naturopathic medicine looks at the entire body. And since we know that the gut and brain are connected, and our patients are simultaneously experiencing mental health symptoms and digestive symptoms, we definitely have to treat the gut.
For more information, you can visit my website at taliand.com, or send me an email at connect@taliand.com.
I work at Bloor West Wellness Clinic in Bloor West Village, in Toronto.
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.
According to Statistics Canada, 1 in 4 people suffer from a mental health condition in Canada. Most of these individuals will fall between the cracks of a medical system that is not equipped to deal with the rise of stress and mood disorders, such as depression.
Naturopathic doctors understand that the mind and body are connected. Science has long established the relationship between the digestive system and mood, often termed the “Gut-Brain Connection” and the connection between the mind, mental health and the immune system, even establishing an entire field termed “psychoneuroimmunology”, linking depression to inflammation in the brain and body. However when it comes to our conventional healthcare model, mental health conditions are treated as separate from the rest of the body. In mainstream medicine, depression is largely treated as a brain chemical imbalance. It is thought that deficiency in the “happy” chemicals in the brain, like serotonin and dopamine, influence mood and must be “corrected” with anti-depressants. Despite emerging science about the brain, emotions, and mood, mental health conditions are commonly viewed as something that has “gone wrong” in the brain.
This reductionist approach to mental health often overlooks the intricate interplay between various physiological systems and their collective impact on mental well-being. For instance, conditions like ADHD are frequently discussed in terms of specific symptoms and brain function, yet they also involve broader aspects of cognitive and emotional regulation. One notable challenge associated with ADHD is time blindness, where individuals struggle to perceive and manage time effectively. This symptom highlights the complexity of ADHD and underscores the need for a more holistic view of mental health, recognizing that these conditions cannot be fully understood by focusing solely on brain chemistry.
Most treatments for depression and anxiety are based on the low-serotonin theory of depression, which roughly states that depression is due to decreased production of certain neurotransmitters, such as serotonin, in the brain. Following this model, drugs are prescribed to artificially change neurotransmitter levels. While we understand that anti-depressant medications such as selective serotonin and selective serotonin and norepinephrine re-uptake inhibitors (SSRIs and SNRIs) work better than placebo (in about 40-60% of cases), scientists don’t know for certain why they have an affect. When starting SSRI and SNRI drugs, patients experience an immediate increase in neurotransmitter levels in the brain, however, it takes 2-4 weeks before there are noticeable changes to mood. This points to the fact that the proposed mechanism (increasing neurotransmitter levels) may not in fact be how these drugs work. However, it is in the interest of the pharmaceutical companies manufacturing such drugs to perpetuate the idea that anti-depressant medications are “restoring” the natural chemical balance in the brain, despite lack of evidence that this is the case.
This is furthered by a paper published by the Neuroscience and Behavioural Reviews last year that challenges the low-serotonin theory of depression, stating that improvement on SSRI medication might be the body overcoming the effects of the drug, rather than the drug assisting patients in feeling better (1). This may explain why patients feel worse in the first few weeks of starting anti-depressant medication. The authors venture to say that anti-depressant medication may in fact be creating an obstacle to cure in patients with depression, making it harder for patients to recover in the short-term. The authors of the study argue that most forms of depression provide an evolutionary advantage by providing the body with natural and beneficial adaptations to stress (1).
Since we understand that our digestive system and immune system are linked to our mood and overall functioning, it becomes imperative that we learn how to fuel our brains, improve digestion, balance inflammation and take proactive measures against our increasing levels of stress.
Getting help for a mental health disorder first involves removing the stigma and discrimination around mental health—depression, anxiety and other mood disorders are not signs of weakness, they are common conditions that a large portion of the population is dealing with daily. Next, it is important to seek help from a trusted practitioner who will take the time to listen to your case, treat your body as a whole entity, not just a collection of organs, and connect with you as a person, not just your symptoms or diagnosis. The following are some proposed and effective methods of working with depression and mental health conditions.
1. Healing the gut.
Science has largely started referring to the digestive system as the “second brain”, due to its possession of something called the Enteric Nervous System, a collection of millions of nerve cells that control digestive function and communicate directly with the brain. Because of this intricate connection, research has shown that irritation to the digestive system, through bacterial overgrowth, gut inflammation and a variety of other mechanisms, can trigger significant changes to mood (2,3). Since 30-40% of the population suffers from digestive symptoms such as bloating, flatulence, GERD, IBS, constipation, diarrhea and IBD, this connection is important. Additionally, emerging research is showing the link between beneficial gut bacteria and mood, establishing the fact that certain probiotics are capable of producing neurotransmitters and thereby contributing to mood and mental functioning (2,3).
Naturopathic medicine has long established a connection between the gut and brain when it comes to health, recognizing that conditions such as IBS are aggravated by stress, depression and anxiety and treating the digestive concerns with patients with depression by prescribing quality probiotics and identifying and removing food sensitivities among other things. In addition, not only is gut function important for regulation of the nervous system and, in turn mood, a healthy digestive system is required for proper absorption of the amino acids and micronutrients necessary for synthesizing neurotransmitters.
2. Essential nutrients and adequate nutrition.
If the body doesn’t possess the building blocks for building hormones and neurotransmitters, it won’t make them. While SSRI medication keeps brain serotonin levels elevated, it also depletes the vitamins and minerals responsible for producing serotonin. Supplementing with quality brands and correct doses of vitamins B6, folate and B12, as well as magnesium and zinc and ensuring adequate protein intake, is essential to treating mental health conditions and mood. Some sources state that 70-80% of the population is deficient in magnesium. Since magnesium is needed for production of a variety of hormones and neurotransmitters, a deficiency can cause an array of symptoms from low mood and muscle pain, to insomnia and fatigue. Getting put on high-quality, professional grade vitamins and minerals at therapeutic doses should be done under the care of a licensed professional, such as a naturopathic doctor.
3. Fish oil.
A meta-analysis in 2014 concluded that fish oils are effective at treating low mood and even patients diagnosed with major depressive disorder (4). Since the brain requires the fatty acids EPA and DHA found in fish to function, ensuring adequate intake of fatty fish or using a high-EPA supplement at an effective dose is a cornerstone of natural treatment for depression. The ratio of EPA:DHA is important, however, so ensure you’re receiving a prescription from a licensed naturopathic doctor (not all brands on the market are created equally and some products may even negatively impact mood). Another proposed mechanism of action for fish oil benefitting mood is in its anti-inflammatory properties. Emerging research has suggested that depression may be correlated with low-levels of brain inflammation.
4. Healing the adrenals.
According to evolutionary biology, depression may be a necessary adaptation to stress that promoted our survival and ability to pass on our genes. Since about 70% of the population identifies as being significantly stressed, it is no wonder that the number of mental health conditions is also rising. Naturopathic medicine and other alternative health fields recognize a collection of symptoms caused by prolonged, chronic stress that they term “adrenal fatigue”. Adrenal fatigue is characterized by high levels of prolonged mental, emotional and physical stress, low energy, insomnia, food cravings, and depressive symptoms such as low mood, apathy and lack of enjoyment in previously enjoyed activities, changes to sleep, weight, appetite and energy levels. Whether symptoms of chronic stress are misdiagnosed as mild to moderate depression in people, or whether lifestyle stress is the cause of physiological depression, there is often a significant stressor that complicates symptoms of low mood in most people. Using herbs, nutrition and stress-reduction techniques is important for improving resilience, as is taking steps to decrease the amount of stress present in one’s life. Researching and experimenting with various self-care practices is also important for managing low mood and promoting mental health.
5. Mind-body medicine.
Mind body medicine involves working with the body’s energetic healing forces to remove obstacles to cure and ensure the smooth flow of energy throughout the body. The main modalities that naturopathic medicine uses for these purposes are acupuncture, homeopathy and working with meditation and visualizations. While some reject these streams of healing as being pseudoscientific, there is a growing body of research to back them up. A study by the Journal of Alternative and Complementary medicine showed that acupuncture was as effective as medication at reducing depression after six weeks (5). Mind-body medicine works by integrating our thoughts, emotions and physical sensations to give us more awareness about the body as well as provides us with powerful tools for managing stress.
6. Counselling.
We know that counselling is a preferred first-line treatment for depression and other mood disorders and that counselling and medication in combination is far better than medication alone. While there are a variety of psychotherapeutic models and styles, research suggests that the therapeutic relationship is one of the most powerful determinants of positive health outcomes (6). Therefore working with a clinician that you trust, connect and resonate with is the first step to finding effective therapy. Cognitive Behavioural Therapy (CBT), a style of therapy based on changing ingrained and habitual thoughts, beliefs and behaviours that may be contributing to low mood, is one of the main therapeutic modalities for depression and is supported by a number of studies. Motivational Interviewing is another counselling model that helps patients work through and change addictive behaviours and has substantial evidence behind it.
7. Mindfulness.
More and more research is coming out about the Buddhist practice of mindfulness meditation for preventing depression, managing stress, working with mood disorders and preventing relapse in major depressive disorder. Recent evidence published in JAMA has shown that Mindfulness-Based Cognitive Therapy (MBCT), a form of secular mindfulness meditation was just as effective as medication for treating mild to moderate depression (7). Mindfulness involves looking inward, without judgment at the thoughts, feelings and physical sensations produced by the body. Practicing it cultivates the skills of awareness, attention and presence. According to Jon Kabat-Zinn, one of the founders of MBCT, “Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgementally. It’s about knowing what is on your mind.” Mindfulness improves mood by allowing participants to better understand their own emotional states without getting caught up in identifying with negative emotions and belief systems.
If you or a friend or family member is suffering from a mental health condition, it is important to be educated about options. Naturopathic medicine is a great first-line option for those who have been newly diagnosed with a mood disorder, as well as a preventive measure for those simply dealing with stress, and a great complement to those who have been living with a mental health condition for some time and are already on medication. I work with children, adolescents, adults, pregnant patients, postpartum women and patients dealing with addictions. I have additional training in motivational interviewing, mindfulness-based stress reduction, narrative therapy and CBT and structure my visits to allow for more time for counselling. Contact me for more information on how to work with me.
References:
Andrews, PW, Bharwani, A, Lee, K.R., Fox, M, Thomsom, JA. Is serotonin an upper or a downer? The evolution of the serotonergic system and its role in depression and the antidepressant response. Neuroscience & Biobehavioral Reviews, 2015; 51: 164
Dinan, T, Cryan, J. Regulation of the stress response by the gut microbiota: Implications for psychoneuroimmunology. Psychoneuroimmunology (2012) 37, 1369-1378
Wang, Y. Kasper, LH. The role of micro biome in central nervous system disorders. Brain Behav. Immun. (2014).
Grosso G, Pajak A, Marventano S, et al. Role of Omega-3 Fatty Acids in the Treatment of Depressive Disorders: A Comprehensive Meta-Analysis of Randomized Clinical Trials. Malaga G, ed. PLoS ONE. 2014;9(5):e96905. doi:10.1371/journal.pone.0096905.
Sun, H, Zhao, H, Ma, C, Bao, F, Zhang, J, Wang, D, Zhang, Y. and He, W. Effects of Electroacupuncture on Depression and the Production of Glial Cell Line–Derived Neurotrophic Factor Compared with Fluoxetine: A Randomized Controlled Pilot Study. The Journal of Alternative and Complementary Medicine. September 2013, 19(9): 733-739.
Siegel, D. The Mindful Therapist. Mind You Brain, Inc. New York: 2010.
Goyal, M, Singh, S, Sibinga, ES, et al. Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis. JAMA Intern Med.2014;174(3):357-368. doi:10.1001/jamainternmed.2013.13018.
A singular narrative is told and retold regarding medicine in the west. The story goes roughly like this: the brightest students are accepted into medical schools where they learn—mainly through memorization—anatomy, physiology, pathology, diagnostics, microbiology, and the other “ologies” to do with the human physique. They then become doctors. These doctors then choose a specialty, often associated with a specific organ system (dermatology) or group of people (pediatrics), who they will concentrate their knowledge on. The majority of the study that these doctors undergo concerns itself with establishing a diagnosis, i.e.: producing a label, for the patient’s condition. Once a diagnosis has been established, selecting a treatment becomes standardized, outlined often in a cookbook-like approach through guidelines that have been established by fellow doctors and pharmaceutical research.
The treatment that conventional doctors prescribe has its own single story line involving substances, “drugs”, that powerfully over-ride the natural physiology of the body. These substances alter the body’s processes to make them “behave” in acceptable ways: is the body sending pain signals? Shut them down. Acid from the stomach creeping into the esophagus? Turn off the acid. The effectiveness of such drugs are tested against identified variables, such as placebo, to establish a cause and effect relationship between the drug and the result it produces in people. Oftentimes the drug doesn’t work and then a new one must be tried. Sometimes several drugs are tried at once. Some people get better. Some do not. When the list is exhausted, or a diagnosis cannot be established, people are chucked from the system. This is often where the story ends. Oftentimes the ending is not a happy one.
On July 1st, naturopathic doctors moved under the Regulated Health Professionals Act in the province of Ontario. We received the right to put “doctor” on our websites and to order labs without a physician signing off on them. However, we lost the right to inject, prescribe vitamin D over 1000 IU and other mainstay therapies we’d been trained in and been practicing safely for years, without submitting to a prescribing exam by the Canadian Pharmacists Association. Naturopathic doctors could not sit at the table with the other regulated health professions in the province until we proved we could reproduce the dominant story of western medicine—this test would ensure we had.
Never mind that this dominant story wasn’t a story about our lives or the medicine we practice—nowhere in the pages of the texts we were to read was the word “heal” mentioned. Nowhere in those pages was there an acknowledgement about the philosophy of our own medicine, a respect towards the body’s own self-healing mechanisms and the role nature has to play in facilitating that healing process. It was irrelevant that the vast majority of this story left out our years of clinical experience. The fact that we already knew a large part of the dominant story, as do the majority of the public, was set aside as well. We were to take a prescribing course and learn how primary care doctors (general practitioners, family doctors and pediatricians), prescribe drugs. We were to read accounts of the “ineffectiveness” of our own therapies in the pages of this narrative. This would heavy-handedly dismiss the experience of the millions of people around the world who turn to alternative medicine every year and experience success.
We were assured that there were no direct biases or conflict of interests (no one was directly being paid by the companies who manufacture these drugs). However, we forget that to have one story is to be inherently and dangerously biased. Whatever the dominant story is, it strongly implies that there is one “truth” that it is known and that it is possessed by the people who tell and retell it. Other stories are silenced. (Author Chimamanda Ngozi Adichie describes this phenomenon in her compelling TED Talk, “The Danger of a Single Story”).
Despite the time and money it cost me, taking the prescribing course afforded me an opportunity to step outside of the discouraging, dominant story of the standard medical model and thicken the subordinate stories that permeate the natural and alternative healing modalities. These stories began thousands of years ago, in India and in China, at the very root of medicine itself. They have formed native ancestral traditions and kept entire populations and societies alive and thriving for millennia. Because our stories are not being told as often, or told in the context of “second options” or “last resorts”, when the dominant narratives seem to fail us, the people who tell them run the risk of being marginalized or labeled “pseudoscientific.” These dismissals, however, tell us less about The Truth and more about the rigid simplicity of the singular story of the medical model.
It is frightening to fathom that our body, a product of nature itself, encompasses mysteries that are possibly beyond the realm of our capacity for understanding. It’s horrifying to stand in a place of acknowledgement of our own lack of power against nature, at the inevitability of our own mortality. However, if we refuse to acknowledge these truths, we close ourselves off to entire systems that can teach us to truly heal ourselves, to work with the body’s wisdom and to embrace the forces of nature that surround us. The stories that follow are not capital T truths, however, they can enrich the singular story that we in the west have perpetuated for so long surrounding healing.
The body cannot be separated into systems. Rather than separating depression and diarrhea into psychiatry and gastroenterology, respectively, natural medicine acknowledges the interconnectivity between the body’s systems, none of which exist in a vacuum. When one system is artificially manipulated, others are affected. Likewise, an illness in one system may result in symptoms in another. There have been years of documentation about the gut-brain connection, which the medical model has largely ignored when it comes to treatment. The body’s processes are intricately woven together; tug on one loose thread and the rest either tightens or unravels.
We, as products of nature, may never achieve dominion over it. Pharmaceutical drugs powerfully alter the body’s natural physiology, often overriding it. Since these drugs are largely manmade, isolated from whole plants or synthesized in a lab, they are not compounds found naturally. Despite massive advances in science, there are oceans of what we don’t know. Many of these things fit into the realm of “we don’t know what we don’t know”—we lack the knowledge sufficient to even ask the right questions. Perhaps we are too complex to ever truly understand how we are made. Ian Stewart once wrote, “If our brains were simple enough for us to understand them, then we’d be so simple that we couldn’t.” And yet, accepting this fact, we synthesize chemicals that alter single neurotransmitters, disrupting our brain chemistry, based on our assumption that some people are born in need of “correcting” and we have knowledge of how to go about this corrective process. Such is the arrogance of the medical model.
There are always more than two variables in stories of disease and yet the best studies, the studies that dictate our knowledge, are done with two variables: the drug and its measured outcome. Does acetaminophen decrease pain in patients with arthritis when compared to placebo? A criticism of studies involving natural medicine is that there are too many variables—more than one substance is prescribed, the therapeutic relationship and lifestyle changes exert other effects, a population of patients who value their health are different than those who do not, the clinical experience is more attentive, and so on. With so many things going on, how can we ever know what is producing the effect? However, medicine is limited in effect if we restrict ourselves to the prescription of just one thing. This true in herbalism, where synergy in whole plants offers a greater effect than the sum of their isolated parts. By isolating a single compound from a plant, science shows us that we may miss out on powerful healing effects. Like us, plants have evolved to survive and thrive in nature; their DNA contains wisdom of its own. Stripping the plant down to one chemical is like diluting all of humanity down to a kidney. There is a complexity to nature that we may never understand with our single-minded blinders on.
Studies are conducted over the periods of weeks and, rarely, months, but very rarely are studies done over years or lifetimes. Therefore, we often look for fast results more than signs of healing. This is unfortunate because, just as it takes time to get sick, it takes time to heal. I repeat the previous sentence like a mantra so patients who have been indoctrinated into a medical system that produces rapid results can reset expectations about how soon they will see changes. Sometimes a Band-Aid is an acceptable therapy; few of us can take long, hard looks at our lives and begin an often painful journey in uncovering what hidden thought process or lifestyle choices may be contributing to the symptoms we’re experiencing. However, the option of real healing should be offered to those who are ready and willing.
When we study large masses of people, we forget about individuality. When we start at the grassroots level working with patients on the individual level, we familiarize ourselves with their stories, what healing means to them. In science, large studies are favoured over small ones. However, in studies of thousands of people, singular voices and experiences are drowned out. We lose the eccentric individualities of each person, their genetic variability, their personalities, their preferences and their past experiences. We realize that not everyone fits into a diagnostic category and yet still suffers. We realize that not everyone gets better with the standard treatments and the standard dosages. Starting at the level of the individual enables a clinician to search for methods and treatments and protocols that benefit each patient, rather than fitting individuals into a top-down approach that leaves many people left out of the system to suffer in silence.
It is important to ask the question, “why is this happening?” The root cause of disease, which naturopathic medicine claims to treat is not always evident and sometimes not always treatable. However, the willingness to ask the question and manipulate the circumstances that led to illness in the first place is the first step to true and lasting healing; everything else is merely a band-aid solution, potentially weakening the body’s vitality over time. No drug or medical intervention is a worthy substitute for clean air, fresh abundant water, nutritious food, fulfilling work and social relationships, a connection to a higher purpose, power or philosophy and, of course, good old regular movement. The framework for good health must be established before anything else can hope to have an effect.
The system of naturopathic medicine parallels in many ways the system of conventional pharmaceutical-based medicine. We both value science, we both strive to understand what we can about the body and we value knowledge unpolluted by confusing variables or half-truths. However, there are stark differences in the healing philosophies that can’t be compared. These differences strengthen us and provide patients with choice, rather than threatening the establishment. The time spent with patients, the principles of aiming for healing the root cause and working with individuals, rather than large groups, offer a complement to a system that often leaves people out.
There are as many stories of healing and medicine as there are patients. Anyone who has ever consulted a healthcare practitioner, taken a medicine or soothed a cold with lemon and honey, has experienced some kind of healing and has begun to form a narrative about their experience. Anyone with a body has an experience of illness, healing or having been healed. Those of us who practice medicine have our own experience about what works, what heals and what science and tradition can offer us in the practice of our work. Medicine contains in its vessel millions of stories: stories of doubt, hopelessness, healing, practitioner burnout, cruises paid for my pharmaceutical companies, scientific studies, bias, miracle cures, promise, hope and, most of all, a desire to enrich knowledge and uncover truth. Through collecting these stories and honouring each one of them as little truth droplets in the greater ocean of understanding, we will be able to deepen our appreciation for the mystery of the bodies we inhabit, learn how to thrive within them and understand how to help those who suffer inside of them, preferably not in silence.
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
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.
This is likely one of the shallowest posts I’ll ever write—it’s about hair. However, what is so shallow about hair? We all know the importance of having a good hair day. It seems from the moment we wake up, look in the mirror and notice that our top bun has left proper, succulent waves and not weird, irregular angles of frizz, that the rest of the day will be infused with magic. Our hair plays a huge role in who we are and how we see ourselves. When movie characters want to change their identities, the first thing they do is stash themselves in a truck stop bathroom with a box of hair dye and go to town on their manes. Further, and admittedly sticking to the shallow side of things, I’m often suspicious when every photo of a man on Ok Cupid shows himself wearing a hat—what on earth is he hiding? At any rate, concerns about hair health gets people, namely women, into my office. Sometimes seemingly shallow, trivial health concerns act as gateways to lifestyle changes and a journey to health and wellbeing. Since our bodies don’t really require hair for survival, hair health, along with sex drive and energy, is one of the first things to decline when we enter into a state of imbalance. It therefore becomes an important initial warning sign that things have gone array with our health.
Hair holds a significant place in our self-perception and daily routines, often influencing our confidence and identity. When hair health falters, whether due to genetics, hormonal changes, or lifestyle factors, individuals may seek solutions like Hair Restoration Therapy to regain a sense of normalcy and well-being. While the desire for lush locks may seem superficial to some, it often serves as a catalyst for deeper introspection and lifestyle changes, underscoring the interconnectedness of physical appearance and overall health.
Hair loss is often a concern for many women and men. It’s normal to notice a few strands of hair in the shower—the average woman loses about 50 to 100 strands of hair per day. However, when patches of hair seem to be missing, areas of thinning are present or a reduction in overall hair volume (usually indicated by a decrease in thickness of the pony tail), this can point to possible pathological hair loss.
In the quest to address concerns about hair loss, the choice of shampoo becomes a crucial element in maintaining scalp health. Opting for a sulfate free shampoo for oily scalp emerges as a thoughtful strategy to navigate this common challenge. This type of shampoo not only gently cleanses the hair but also ensures that the scalp’s natural oils are preserved, striking a balance that is particularly beneficial for those experiencing issues like thinning or reduced hair volume.
While losing a few strands daily is normal, unusual patterns of hair loss can signal pathological conditions that may require medical attention.
History and Labs:
When coming in to see your naturopathic doctor, he or she may ask you the following questions:
Do you notice any itchiness or flaking of the scalp? These symptoms could indicate a number of skin conditions of the scalp that contribute to hair loss: seborrheic dermatitis, infection by a fungus called Malassezia furfur that causes dandruff, or psoriasis of the scalp, an autoimmune condition. The ND may diagnose via trial-and-error or perform skin-scraping to rule out a fungal infection. A skin biopsy may be indicated to provide a definitive diagnosis, however this test is invasive.
What do you labs look like? Comprehensive lab work is necessary in patients with hair loss. It’s important to see what iron status is, as well as thyroid health. Low iron or under-functioning thyroid can be the root cause of hair loss as can high androgens, the male sex hormones.
Which medications are you taking? Oral contraceptives can cause a deficiency in vitamins and minerals, such as zinc and B vitamins, that can cause hair loss. Other medications that can cause hair loss include, and or not limited to, blood pressure medications, antidepressants, antibiotics, acne medications, chemotherapeutics agents, immunosuppressants and pain medications. An ND can work with your doctor to decrease your list of medications by addressing the root cause of concerns, if possible, or collaborate in switching medications. This, of course, will only be done in collaboration with the prescribing doctor.
What’s bugging you? Stress can contribute significantly to hair loss. The mechanism of action is varied, but a decrease in circulation to the scalp, protein deficiency and depletion of vitamins used by the adrenal glands, can be possible causes of hair loss. Telogen effluvium is a condition where the body pushes the hair follicles into a “resting phase” so that they no longer grow and produce hair. This is done because when under stress, the body enters survival mode and does not dedicate precious resources to non-survival entities such as hair health. Alopecia areata an autoimmune condition in which the immune system of the body attacks the hair’s follicles, causing large patches of hair to fall out. This is said to be cause or aggravated by severe stress. Trichotillomania is a mental health condition in which the individual plucks out hair as a self-soothing mechanism.
What are you other symptoms? Weight gain, irregular periods, acne and hair growth on the face can indicate PCOS, which also can cause loss of scalp hair due to higher-than-normal testosterone levels. Men with high testosterone will also experience more hair loss. Digestive symptoms can indicate malabsorption of important fat-soluble vitamins or iron, which can contribute to hair loss if resulting in deficiency.
What hair products do you use? A sensitivity to sulphates and/or other chemical additives to hair products can contribute to hair loss or a decrease in the lustre and overall health of hair follicles.
Treatment:
The naturopathic treatment for hair loss, involves identifying and treating the root cause of symptoms, not the hair loss itself. A potential treatment plan might consist of the following:
Restoring health by replenishing depleted or deficient vitamins and minerals.
Eliminating infection or scalp fungus if necessary.
Managing stress in healthy, constructive ways.
Balancing hormones and the immune system via herbs, supplements and dietary changes.
Nourishing the hair by adding in vitamins that support hair health, such as fish oil. This also involves changing shampoos and conditioners to more natural, sulphate-free forms.
Castor oil hair mask:
Once a week, when my hair starts looking drier and duller, I do a castor oil hair mask and scalp massage. Castor oil is an anti-fungal and anti-inflammatory oil. It has the added benefit of increasing blood flow to the area it is applied to, in this case the scalp, which can increase hair growth. It is also a wonderful moisturizer and nutrient-rich hair supplement. It can help fuse together and moisturize split ends. Performing a self-scalp massage is a great way to increase body love by performing self care and has a grounding effect on the body, which reduces mental-emotional stress.
Apply a liberal amount of castor oil to palms. Rub oil into palms to warm it. Starting at the scalp, work oil into the hair follicles, applying a firm pressure and moving the fingertips in circles. Massage for 5 minutes, moving the oil through the shaft of the hair to the ends. After performing massage, leave oil in hair for at least an hour or overnight. Finally, shampoo and condition hair as usual to remove oil. Warning: castor oil can stain fabrics so sleep with an old pillowcase and wear an old t-shirt while performing castor oil scalp massages.
Epilogue: If you haven’t noticed, this seemingly shallow subject matter is the perfect segue into talking about a basic naturopathic approach, which involves taking a thorough history, ordering lab work to find the root cause of symptoms and then treating accordingly using non-invasive therapies that aim to treat the cause, not just the symptoms themselves. Notice how this is vastly different from walking into a supplement store and purchasing a product called “Hair Loss Formula” or some other facsimile. While this formula may replenish some deficient vitamins, it is masking the real cause, which may be PCOS or celiac disease, and delay effective treatment for these conditions. Hopefully this highlights the importance of seeking a professional opinion rather than self-diagnosing and self-prescribing!
