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.
Certain amino acids, when taken therapeutically, can affect our body’s ability to produce neurotransmitters that can greatly impact our mental and emotional health. These therapies can help treat depression, food addictions, alcoholism, psychosis and anxiety, among other things.
Transcript:
Hello, everybody, my name is Dr. Talia Marcheggiani. I am a naturopathic doctor and I work in Toronto and I focus on mental health and hormones, especially women’s hormones.
Today I want to talk to you guys about amino acid therapy and amino acid supplementation in preventing cravings, particularly for substance addictions or sugar addiction, but also for improving our mood and mental health and for treating specific psychiatric conditions.
Amino acids are the building blocks of protein. If you think of a string of beads, amino acids are the individual beads that get connected in a string and then folded up into the proteins that make up our body. Our body is basically just a hunk of protein and water. And these proteins set the stage for all of the chemical reactions, as well as the structure of our body.
When it comes to addictions and mental health conditions, there’s a lot of debate around what sets the stage for someone to experience addiction, or struggle with addictions throughout their life. And one of the things that gets a lot of blame, that also fits the pharmaceutical model, especially when it comes to depression and the prescription of serotonin re-uptake inhibitors, is this idea that mental health and addiction is something innate, that we’re born with and that needs to be corrected chemically with something like a drug like an SSRI. And we know that there’s obviously a genetic component to addictions and mental health and it’s certainly not the fault or moral failing in the person that’s suffering from these kind of things, but we also know that our genes don’t write the entire story of our experience and that, for many people, there’s lifestyle changes that can really influence genetic predispositions.
So a study that was done in rats who had a built-in genetic predisposition to addiction, to cocaine addiction, particularly, because they had a deficiency in a hormone called “dopamine”, or issues with their dopamine synthesis, and cocaine is a really potent stimulator of dopamine, which is kind of like a pleasure and reward hormone, or neurotransmitter, in our brains. These kinds of rats that were treated with amino acids, they didn’t display addictive behaviours, so they were essentially cured and their genetics were no longer relevant in terms of how they were acting out, or their behaviour, which is really promising because it was just amino acid therapy.
So neurotransmitters are hormones that work in our brain; they’re produced and act in the brain. Well, we know now with more research, I mean that’s the traditional definition of neurotransmitter, but from more research we’ve found that there’s evidence for the gut producing certain neurotransmitters like serotonin. So you can watch another video where I talk about the gut and how important it is to have a healthy gut when it comes to managing mental health, especially in depression and anxiety.
There’s a few neurotransmitters that are really, that really influence our behaviour and our mental health status and so the first one I already mentioned is dopamine, which gives us that sense of reward and gives us a sense of pleasure. So, dopamine is active when you’re doing something that is really internally motivating. You’re engrossed in a task. In terms of addictions, it’s that seeking behaviour. So a lot of people will experience pleasure in seeking out their substance of choice or thinking about indulging in sugar when they get home from work. So, that’s dopamine, that’s sort of our—the pleasure that we get from acting in the world and it definitely runs part of the show when it comes to addictions.
To quote another study in rats, so dopamine is really prevalent in our hypothalamus and so, with rats, you can give them a lever where they can direct cocaine directly into that area, and so it gives them a giant hit of dopamine. And rats that are given that option, will choose that option over food and so they’ll just stimulate their brain until they die. They’ll drink some water here and there but most of the time all they do is stimulate their dopamine. So that’s how pleasurable it is. It’s pretty much the influence of how we behave in the world and what goals we set for ourselves in the world as well. It’s how we get our delayed gratification, it’s how we work towards pleasurable tasks and how we engage in things like study or work goals or things like that.
Another neurotransmitter, serotonin, which I’ve talked about before, and that’s what the SSRIs, so selective serotonin re-uptake inhibitors are working on. And those are the most widely prescribed psychiatric medications. And that’s the hypothesis that people with depression and anxiety have a deficiency in serotonin: just this kind of innate serotonin deficiency where they either don’t make enough or they’re metabolizing it more quickly than other people. So serotonin is kind of our happy hormone, that’s what gives us a sense of well-being and pleasure. And, there’s no evidence for this hypothesis, however know that through stimulating serotonin pathways, to an extent, we can get some favourable outcomes. We also know that SSRI medications deplete serotonin, and that there’s a connection between serotonin and sugar addictions, because eating sugar will increase serotonin. So a lot of women with sugar cravings during PMS. So a couple of weeks, sometimes up to two weeks before their periods, some women will get really intense cravings for sugar and carbs, and that’s indication of a fall in serotonin before their period, which is causing them to seek out these things to boost their serotonin levels. And that can be treated with amino acids.
And then a third is acetylcholine. So acetylcholine is involved in memory and cognition and sort of that feeling of being engrossed in a task. Not so much involved in pleasure, but in our ability to stay focussed and to concentrate.
A fourth neurotransmitter is called GABA. GABA suppresses our nervous system. So, this is relevant in people with anxiety and this is what the drug class benzodiazepines work on, is GABA receptors. So, in our limbic system, GABA kind of calms down that fight or flight, or that fear state in our body. And oftentimes people who have a heightened nervous system or stress response could use some GABA to calm them down.
So there’s a few amino acids that work on these neurotransmitters. So these neurotransmitters are built with an amino acid backbone. By giving these amino acids, we’re kind of like—if you think of all these neurotransmitters assembled on a factory line, the amino acid is the starting point. So if you’re giving a lot of the supplies, then you’re more likely to cause in increase in production of the thing that you’re increasing the supply for.
We also know that there can be deficiencies in amino acids and therefore, if there’s a shortage of supplies for the key ingredients for the things you’re producing in a factory, you’re not going to get the end result because there’s just not enough of the raw materials to make what you’re trying to make.
So, we can have things like serotonin deficiency not so much because there’s a genetic predisposition, or an issue with the brain’s ability to metabolize it or make it, but maybe that there’s a deficiency in the amino acids, or the vitamins and minerals that are needed to create serotonin.
When it comes to naturopathic medicine and functional medicine, we kind of look at this. We try and see how we can influence the body’s biochemical pathways to get more of what we’re noticing is lacking. And so one of the ways that we can find out which neurotransmitters are lacking is by running some functional tests. That’s not really a big part of my practice because of the cost involved in that, but we can tell a lot through symptoms. So we can tell a lot by asking, are people getting sugar cravings, what’s their drug of choice, are they heading towards cocaine or are they calming their nervous system down and stimulating their GABA pathways with alcohol. Are they trying to get that pleasure sensation with something like heroin? Are they going for stimulants or central nervous system depressants? So, based on what someone is addicted to, or looking at and really breaking down their addictive behaviours, we can find out more about which neurotransmitters might be off. And in a lot of cases there’s a deficiency in many of them.
One of the first things to recommend, just generally, is to increase more protein in the diet, because we know that these amino acids are contained in proteins. And, strangely enough, we don’t get a lot of high-quality protein in our diet in the Standard American Diet, so you think of a bacon and eggs breakfast and McDonald’s lunch and you’re like, ‘well, there’s protein in those foods…’ But, in something like eggs, we’re only getting about 6 grams of protein an egg, whereas I recommend more like 20 to 30 grams of protein in the morning for breakfast. And the reason for this is, of course, to just increase the amount of amino acids that your body can then use to make neurotransmitters, but also to keep blood sugar stable, because drops in blood sugar are going to cause stress hormones to be released and potentially for these neurotransmitters to be altered, worsening addictions, especially addictions to sugar and alcohol, which boost our blood sugar.
So the first thing, dopamine, that amino acid that creates dopamine is tyrosine. So, for some people, and tyrosine is a very stimulating amino acid, so people that kind of have that 2 pm slump, sometimes benefit with some tyrosine, or tyrosine in the morning when they’re feeling really low. And so these people kind of suffer from boredom, they really like stimulants, so they’ll do the caffeine, or they’ll use cocaine on the weekends, or they’re really involved in pleasure-seeking behaviour like, maybe they had a diagnosis of ADHD as a kid, or adult-onset ADHD, which is more involved in traumatic experiences and mental health and neurotransmitter imbalance than it is some genetic predisposition.
Sometimes with these people, supplementing with tyrosine can help, just give them that dopamine boost and keep their nervous system more stimulated so that they don’t need to stimulate it with substances.
For serotonin, the building block is l-tryptophan, which is then made into something called 5-HTP. So some naturopaths will prescribe l-tryptophan as a supplement, I tend to go more with 5-HTP because it passes a step so that your body has to do less work. 5-HTP is really great to help with sleep. It’s good to help with boosting mood, to a certain level, and it’s also really great for PMS sugar cravings, and alcohol cravings. I find myself, personally, so this Christmas I’m going sugar and alcohol free. I’ve been sugar and alcohol free for a few months, but I’m going to carry that on through the holidays, so I’ve had to turn to 5-HTP before my period because I realized how many sugar cravings I get before then. And, miraculously, just with a few hundred milligrams of 5-HTP, I’ve noticed a giant change in the foods that I was craving and in my ability to hold off on having sugar and alcohol. So, pretty powerful.
So, in order to make serotonin, 5-HTP also needs some B vitamins and magnesium. So, people that are deficient in things like B6 and B12 and folate, so I’m looking at vegetarians who often have B12 deficiencies, or vegans. And, actually I see a lot of B12 deficiency or suboptimal B12 in people that eat meat as well, so this isn’t necessarily something is only applicable to vegetarians.
But it’s important for a lot of people to supplement then with these other cofactors that help make serotonin, especially if they’re on an SSRI already. And I don’t advise just doing this on your own, it’s better to do this with a professional who can figure out what’s the underlying cause of a neurotransmitter imbalance and then help prescribe a comprehensive treatment plan that will get you to better neurotransmitter synthesis and treat your symptoms, or the underlying condition.
Something else that I find really helpful, and this is one of my favourite nutrients in psychiatry and in women’s health and something I take is something called N-acetyl cysteine, or NAC, “NAC”. And NAC is from the amino acid cysteine and it produces something called glutathione. So glutathione is the primary antioxidant in the body. This is what our body uses to neutralize all of the free radicals, that is kind of a buzzword—people will tell you to drink green tea, eat blueberries, to get antioxidants, well, the main antioxidant our body uses is something called glutathione, and NAC helps produce glutathione.
It helps our liver detoxify and, in hospitals medical professionals will give people intravenous NAC to treat Tylenol overdose, which we know is liver toxic, so it’s widely recognized that NAC can treat toxicity of the liver. It’s also a powerful antioxidant for the lungs so I prescribe it to patients who are smokers or recovering from smoking or aren’t really ready to quit smoking yet but are experiencing some of the bronchitis, the emphysema, or the increased phlegm or lung issues that go along with a chronic habit of smoking. So, it’s a powerful antioxidant and it has an affinity for the lungs and for excess mucus production. It also helps balance estrogen because of the liver detoxification, so it helps us detoxify estrogen through the liver, and is really helpful for a condition called polycystic ovarian syndrome, which is when the ovaries are producing testosterone and not responding to other hormones properly, so this is really helpful. It also helps with blood sugar balance. NAC’s the best. And so, there’s lots of research for NAC in things like bipolar disorder and schizophrenia and psychosis and OCD. So these more serious psychiatric conditions, NAC can really help balance. And we’re not sure exactly why but one of the hypothesis is that, because it creates glutathione, it helps lower inflammation, and we know that inflammation is implicated in mental health conditions and so that’s why NAC might be so useful. It doesn’t interact with psychiatric medications and so it’s a really big part of my practice.
New research has shown that NAC can help with addictions and cravings for things like nicotine, cannabis, food, so binge eating, cocaine and gambling, interestingly enough. And then there’s a new study that NAC can help treat porn addiction. So, it’s involved in helping lower that desire for, not necessarily substances, or food, but behavioural addictions as well, which is useful. And there’s studies in trichotillomania, so that’s like, compulsive hair plucking—so people will pluck their eyelashes or pluck their hair—or skin picking, and NAC can work pretty rapidly in bringing down those desires and stopping those behaviours.
GABA is something you also might have heard of. So, GABA was a neurotransmitter that I cited before, that calms the nervous system down. GABA, there’s debate about whether it crosses the blood brain barrier. So, our brain has this really tight wall that it prevents certain substances from crossing. That’s to protect our brain tissue from toxins and foreign objects, or foreign substances. So we’re not sure, necessarily, if GABA’s acting on the brain unless there’s a leaky brain situation happening, so kind of like leaky gut, we can also have that with our blood brain barrier. But there’s herbal combinations that help stimulate GABA, that I implement in my practice sometimes to help people that are experiencing panic attacks or anxiety, to get them to a level where they can then make the changes that are going to sustain them. So, things like valerian and hops, and passionflower and something that I prescribe a lot, kava, another herb called lemon balm. So, sometimes combinations of these, or just one of these things can help, especially before bed. And so, one of the indications for GABA deficiency is a craving for wine, especially at the end of the day, and particularly white wine. I guess it has more GABA-stimulating properties. I have a lot of patients, many of them female patients, that just really crave a glass of wine at the end of the day. And a few other patients that will have an after-work beer. So, just doing some GABA, or some GABA herbs, on the way home from work might be enough to decrease that need to reward and balance that nervous system, because the alcohol does have a GABA-stimulating effect and calms people down. It’s us looking for a way to self-medicate and trying to balance our neurotransmitters through the actions that we’re familiar with that don’t necessarily set us up for powerful health because they perpetuate further addictions, like turning to alcohol to calm ourselves back down, or as a reward and stress relief.
And the last neurotransmitter I’m going to talk about is something called l-glutamine. So, glutamine is a fuel for brain cells and for gut cells, as well as kidney cells. It’s another amino acid, it’s involved in creating the neurotransmitter glutamate, which is excitatory. So, this is something that increases our nervous system tone.
So, glutamine we prescribe as naturopaths a lot for leaky gut because it helps feed our enterocytes, or our gut cells, it can help repair them. So, somebody with celiac disease who’s experienced a lot of intestinal damage and has now taken out gluten, might need some glutamine, some l-glutamine to repair the gut cells that were damaged or increase that cell turnover so that they’re no longer experiencing symptoms.
L-glutamine has kind of got a sugary taste, but it doesn’t stimulate us like sugar does, and so one thing that people do when they’re experiencing sugar and alcohol cravings is to take some glutamine powder or open up a capsule of l-glutamine and let it dissolve under their tongue. And they experience a remarkable decrease in their sugar and alcohol cravings, those physiological cravings—the emotional cravings are another piece, obviously—but the physical cravings where our body is really asking for these foods, the l-glutamine can really help calm that down powerfully. So this is something that I’m going to experiment with myself and with some patients that I know could really benefit from this.
So I wanted to give this talk, just to give you guys some easy things to try over the holidays, especially when you’re experiencing some of those sugar or alcohol cravings or getting into a situation where your vices are playing out in excess. I know that this is going to be helpful for me, because of my commitment to no sugar or alcohol this holiday season, which is actually easier than it sounds. And one thing to note too, is that with amino acids, because we’re pushing pathways, they don’t work necessarily like drugs that can take, like an SSRI can take 4 to 6 weeks before it’s effect comes on. These work within days. So, when I was experiencing sugar cravings before my period last month, and I started to take 5-HTP, which remember stimulates serotonin, or helps us produce serotonin, and can help with sugar cravings, and carb cravings. When I started to take 5-HTP, I noticed this sense of well-being and uplifted mood within a few days and it was a noticeable effect, as well as deepened sleep. My sugar cravings immediately dissipated when I started taking it. So it took a few doses to eliminate my sugar cravings and then a few days to increase my mood, which I didn’t even realize was kind of falling, based on that serotonin deficiency before my period. So, these are really powerful therapies that you can try. I don’t advise doing it on your own, but seeking the help of a professional, but these are things that can really help balance brain chemistry during the holiday season and set you up for better mental health.
So, next talk I’m going to talk about leaky gut and leaky brain and how avoiding gluten can help with mental health conditions. So, have a great holiday, everyone and I’ll see you next time. My name is Dr. Talia Marcheggiani, and I’m a naturopathic doctor who practices in Toronto. If you have any questions give me a shout on my email at connect@taliand.com. Happy Holidays.
My mother tells a story about my childhood where she is standing in the kitchen, preparing dinner. I stand below her, tugging at her shirt, and begging for food.
“I’m hungry”, I say, according to her recollection of that moment and many others like it; she says that as a child I was always preoccupied with food. My constant yearning for something munch got to the point where every time she tried to cook dinner, I’d follow her to the kitchen, like a hungry dog, and persistently beg for food. I was insatiable, she claims. But, as an adult looking back I wonder, insatiable for what?
I remember that moment, but from the third person perspective. So I wonder if it’s as past events sometimes go, where the telling of a memory from an outsider’s perspective serves to reshape it in the imagination. I can feel the emotions, however, watching my 4-year old form tugging on my mother’s clothing, her body towering over me, her face far away. She stands at the stove. I remember feeling full of… what was that yearning? Was it for food? Was it hunger for physical sustenance or nutrition from some other source? I wonder if the constant, nagging hunger was an articulation, in 4-year old vocabulary, of the need for something else: attention, affection or reprieve from boredom. I remember being told at one point that my favourite show was on and felt some of the anxiety of missing what I was lacking dissipate: a clue.
As a child, adults occupy the gateway to food. As adults, the gateways take on another form. Perhaps it is anxiety about body shape or the guilt of knowing that eating too much of a certain kind of thing isn’t nutritious. Perhaps the barrier to sustenance is financial. However, when I stand now in the kitchen, bent over the fridge, arm slung over the open door, contemplating a snack, I know that I am making a choice. And, for myself, as for many others, it’s not always clear whether the call to eat is hunger and physiologically based.
In the west, we have an abundance problem. More and more adults are reaching obese proportions. Metabolic diseases of excess like diabetes and cardiovascular disease are increasing and more and more women are experiencing the hormonal dysregulation that can come from carrying more body fat.
While I don’t recommend aspiring to the emaciated standard that we see plastered on magazines, Pinterest ads or runways, I do think that, for many people, balancing energy intake with energy output could be beneficial for optimal health and hormonal signalling. Body fat is metabolically active. It also stores toxins and alters that way our body metabolizes and responds to hormones, insulin being just one example, estrogen being another. Therefore, conditions like PCOS, infertility, diabetes, PMS and dysmenorrhea, or certain inflammatory conditions might benefit from a certain amount of weight loss.
An addition here: this post is not about body-shame or even necessarily about weight loss per se. It’s about overcoming emotional eating patterns that might even derive from the same disordered patterns that manifest in anorexia or bulimia. The goal of this post is to bring more awareness to how we operate within the complex relationships many of have with food and with our own bodies.
There are many reasons why we eat and physiological hunger is only one of them. Tangled up in the cognitive understanding of “hunger” is a desire for pleasure, a desire to experiment, to taste, to experience a food, to share with family and friends, to enjoy life. There are also deeply emotional reasons for wanting food: to nurture oneself, as reward, to combat boredom and to smother one’s emotions like anxiety, depression, ennui, yearning for something else— we often eat to avoid feeling.
Health issues aside, I believe that Emotional Eating (as it’s so-called) is problematic because it dampens our experience of living. By stuffing down our emotions by stuffing our faces we prevent ourselves from feeling emotions that it might be beneficial for us to feel in order to move through live in ways that are more self-aware, mature, self-developed and meaningful. While some emotional reasons to eat might be legitimate (acknowledging your beloved grandmother’s hard work by having a few bites of her handmade gnocchi, for instance), many of the reasons we eat linger below the surface of our conscious mind, resulting in us suffering from the consequences of psychological mechanisms that we are unaware of. I believe in making choices from a place of conscious awareness, rather than a place of subconscious suffering.
In heading directly into the reasons I am tempted to emotionally eat, I’ve learned quite a lot about myself. I’ve ended up eating less, as I’ve become more aware of the non-hunger-related reasons that I reach for a snack, but that doesn’t have to be the end goal for everyone. I believe that just understanding ourselves through uncovering and analyzing the emotions that influence our everyday behaviours can have life-changing effects; it allows us to know ourselves better.
As I work through the process of understanding why I overeat, I’ve realized there are a few steps to address. I believe that there are layers to the reasons we enact unconscious behaviours and first, it is important to untangle the physiological from the emotional reasons for eating, understand what real hunger feels like, address the “logical” reasons for overeating and then, when ready, head straight into the emotions that might cause overeating to occur
Distinguishing between physiological hunger and emotional hunger:
The first step, of course, is to distinguish between physiological/physical hunger—the body’s cry for food, calories and nourishment—and emotional hunger. Typically, physiological hunger comes on slowly. It starts with a slow burn of the stomach, growling, a feeling of slight gnawing. It grows as the hours pass. For some it might feel like a drop in blood sugar (more on this later): feeling lower energy, dizzy and perhaps irritable. Physiological hunger occurs hours after the last meal, provided the last meal was sufficient. Usually, if one drinks water at this time, the physiological hunger subsides and then returns. Essentially, eating a meal or snack will result in the hunger vanishing and returning again still hours later.
Emotional hunger, however, is different. It starts with an upper body desire to eat. It might be triggered by commercials, social situations, or certain strong emotions. There might be cognitive reasons to eat (“I might be hungry later” or, “Oh! We’re passing by that taco place I like!”) that are not directly guided by the physical desire for sustenance. Emotional eating is often felt in the mouth, rather than the stomach. It might be brought on by the desire to taste or experience the food, rather than to fill oneself. The cravings might be specific, or for a certain food-source, such as cookies (this is not a hard and fast rule, however). Emotional hunger does not vanish from drinking water. Emotional hunger comes on suddenly, and is often not relieved by eating the prescribed amount of food (having a full meal); oftentimes we finish lunch only to find ourselves unable to get the cookies at the downstairs coffee shop out of our heads.
2. Settling hormonal reasons for overeating: serotonin, insulin, cortisol:
Not all physiological hunger, however, is experienced as the slow, gnawing, slightly burning, grumbling stomach sensation described above. Sometimes we experience the need to eat because our blood sugar has crashed, or our neurological needs for serotonin have gone up. We might eat because stress hormones have caused blood sugar to spike and then crash. We might also experience certain cravings for food because our physiological needs for macronutrients; like carbs, fat or protein; or micronutrients, like sodium or magnesium, have not been met.
Therefore, it becomes essential to address the hormonal imbalances and nutritional deficiencies that might be causing us to overeat. Oftentimes, getting off the blood sugar rollercoaster is the first step. This often involves a combination of substituting sugar and refined flours for whole grains, increasing fats and protein, and, of course, avoiding eating carbohydrate or sugar-rich foods on their own. It often involves having a protein-rich breakfast. I tend to address this step first whenever my patients come in and express feeling “hangry”: irritable and angry between mealtimes.
Often drops in brain-levels of serotonin cause us to crave carbohydrate-rich foods. This is very common for women experiencing PMS. In this case, balancing hormones, and perhaps supplementing with amino acids like l-glutamine, tryptophan and 5-HTP, can go a long way.
One of the questions I ask my patients who crave a snack at 2-3 pm (a mere 2-3 hours after their lunchtime meal), assuming their lunch contained adequate nutrients, is “Do you crave, sugar, caffeine, salt or a combination of the above?” Cravings for sugar or salt at this time might indicate a drop in cortisol and give us a clue, combined with the presence of other symptoms, that this person is in a state of chronic stress, burnout or adrenal fatigue. In this case, it is essential to support the adrenal glands with herbs, nutrients, rest, and consuming adequate protein during the afternoon crash.
Finally, when it comes to cravings for foods like chocolate, meat or nuts, or even specific vegetables (when living in South America I would experience over-whelming cravings for broccoli, funnily enough), I find it important to identify any nutrient deficiencies. It is common to experience a deficiency in something like magnesium, iron, selenium, zinc, and the fat-soluble vitamins A, D, E and K; and our bodies will do their best to beg us for the specific foods they’ve come to learn contain these nutrients. Either consciously eating more of these foods (like brazil nuts in order to obtain more selenium), preferably in their healthiest form (such as dark chocolate, as opposed to milk chocolate, to obtain magnesium), or directly supplementing (in the case of severe deficiency), often results in the cravings diminishing.
3. The Hunger Scale and food diaries:
One of the first things I have patients do is understand the Hunger Scale. There are a variety of these scales on the internet that help us cognitively understand the stages the body goes through on its quest to ask for food and it’s attempt to communicate fullness. Being able to point to certain levels of hunger and fullness and pinpoint those physiological feelings on the Hunger Scale allows us to further flush out the subtleties between a physical or emotional desire for food.
Food diaries, I find, can help bring more awareness to one’s daily habits. Oftentimes, keeping a food diary for a few weeks is enough for some patients to drop their unwanted eating behaviours altogether. Other times, it can help us detect food sensitivities and unhealthier eating patterns or food choices. It also helps me, as a practitioner, work off of a map that illustrates a patient’s diet and lifestyle routines in order to avoid imposing my own ideas in way that may not be sustainable or workable for that particular individual.
A word about diet diaries, however: when recording food for the purpose of uncovering emotional eating behaviours, I often stress that it is important to record every single food. Sometimes people will avoid writing in their diary after a binge, or outlining each food eating when they feel that they’ve lost control, writing instead “junk food”. Guilt can keep us from fully confronting certain behaviours we’d rather not have acted out. However, I want to emphasize that the diary is not a confession. It’s not, nor should it be, an account of perfect eating or evidence that we have healed. Keeping a diet diary is simply a tool to slow down our actions and examine them. It’s a means of finding out how things are, not immediately changing them into what we’d like them to be. This is an important reminder. The best place to start any investigation into being is from a place of curiosity. Remember that the point of this exercise is to observe and record, not necessarily to change, not yet; it is very difficult or even, I would argue, impossible to completely eradicate a behaviour if the reasons for engaging in that behaviour escape our conscious awareness.
Therefore, recording food allows us to begin to poke at the fortress that contains the subconscious mind. We start to slow down and uncouple the thoughts and emotions from the actions that they precede and, in doing so, develop some insights into how we work. It can also help to start jotting down other relevant points that might intersect with what was eaten. These pieces of information might include time of day, where you were, what thoughts were popping into your head, and how you felt before and after eating the food. As we observe, more information begins to enter our conscious experience, allowing us to better understand ourselves.
4. Pealing back the layers: Understanding the “practical” and logical reasons for overeating:
One of the things that I have noticed, through my own work with addressing emotional eating, is that there are often layers to the “reasons” one might overeat. Some of the first layers I encountered were cognitive, or seemingly “logical” reasons. For example, I noticed that before eating without hunger I might justify it by thinking “I need to finish the rest of these, I don’t want them to go to waste”, or “I’ll finish these in order to clean out the container”, or “I should eat something now so I won’t be hungry later”, or “I didn’t eat enough (insert type of food) today so I’ll just eat something now, for my health”, or “If I don’t have some (blank) at so and so’s house, she’ll be offended”.
When looking more closely into these justifications, I found them to be flawed. However, they were logical enough for me to eat for reasons other than to satisfy a legitimate, physiological yearning for nutrients. It’s interesting to see how the mind often tries to trick us into certain behaviours and how we comply with its logic without argument.
5. Addressing the practical reasons: Planning:
In order to address the first layer of rationale for eating when not hungry, I decided to do the following: I would plan my next meal and either have it ready in the fridge, or pack it with me to go, and then I would wait all day until I was hungry enough to eat it. I would repeatedly ask myself, every time I thought of reaching for my portions, “Am I hungry now?” And would answer that question with, “Is there a rumbling in my stomach? No? Then it’s not time to eat.”
I found it would often be a several hours later before my body would genuinely ask for the food. I also found that eating satisfied the physical hunger often much sooner than it took me to finish the food. I realized how I often eat much more food and much more often, than I genuinely need.
However, holding off eating until physical hunger arises takes a conscious effort that is often unsustainable. Few of us can move through our busy lives constantly asking ourselves how hungry we are and when, and then have food at the ready to satisfy that hunger with appropriate, healthy choices. Therefore, I used this practice as a mere stepping stone to move through the deeper layers of emotional eating. By addressing the rational and logical reasons for overeating, I was able to get in touch with the deeper, emotional (and, arguably, real) reasons for which I was eating without hunger.
6. Pealing back the layers: Understanding the deeper, emotional reasons for overeating:
For a while I would wake up, make myself a coffee, and then wait until I felt hungry. Sometimes the feeling would arise in a few minutes, sometimes it would take hours. Depending on what I’d eaten the previous day and what my activity levels were, I would often not get hungry until well into the afternoon. However, the thoughts of eating something would frequently persist. And when the thoughts came up, whereas before they would be satisfied by me having something to eat, I now resisted them. When I resisted the thoughts, their associated emotions would strengthen. I then decided to journal before reaching for food, especially when I wasn’t sure if I was actually hungry or not.
Journalling can help us pull up, process and make sense of some of our emotions. I would write about what I might be feeling—what I might be asking for that wasn’t food. Through doing this, emotional reasons for hunger began to surface. The more I held off eating, the stronger and more clear the emotions became. It was a deeply uncomfortable process. This is why we emotionally eat—removing the emotions is often far more pleasant than dealing with them.
Emotions that surfaced were anxiety, ennui, boredom, loneliness and sometimes even anger. However, boredom and a listless, almost nihilistic, sense of ennui were among the two most common emotions I realized that eating medicated for me. For me, eating was entertainment. It broke up the monotony of the day and gave my senses something to experience. It gave my body something to do: chewing, tasting and digestion. Not eating made that sense of boredom grow stronger.
7. Addressing the emotional reasons: Nurturing and preventing:
Knowing more about the root emotional causes for overeating allowed me to work more closely with the source of my behaviour. I find that the closer we get to the source, to the roots, the more effective we are at removing the weeds, or behaviours, from our lives. I knew now that if I didn’t want to overeat, I would have to prevent myself from getting bored. I would have to have checklists of things to do. I would stay active and engaged in life: in my work, my friendships, and the other non-food-related things that brought meaning to my life.
During this time, I did more yoga and meditated. I journaled and wrote. I also meditated on boredom. I traced it back to where I might have felt it in my life before and noticed themes of boredom in my childhood. I realized that the child tugging on her mother’s shirt and asking when dinner was ready was probably a child who needed something to do, a child who was bored.
8. Pealing back the layers further: Working directly with core emotions:
Going even further, we can begin to peal back the layers of the emotional reasons for overeating in order to avoid replacing one “addiction” with another—such as replacing overeating with over-busying oneself, distraction or overworking. I began to find other emotions that ran deeper than mere boredom. I also realized that whenever I had felt boredom in the past, there was a threshold, often filled with discomfort, that I would eventually surpass. Once surpassing this threshold, a well of creativity, or a plethora of interesting insights, would spring forth. I remember as a child I would create stories, or lie on my bed and stare that the ceiling of my bedroom, contemplating the nature of the universe. These beautiful moments had been made possible by boredom and my courage to not distract myself from it.
Working with a therapist, or doing some deep inner work, we can access the core beliefs and emotions that might cause these emotional reasons for overeating to exist. Oftentimes we encounter core beliefs whose effects spill out into other areas of our lives, preventing us from living fully and consciously. Working through these beliefs can be deeply satisfying and help us experience transformational self-growth.
9. Setbacks: Understanding Change Theory:
Finally, engaging in this process of self-discovery doesn’t follow the same pattern in every person. Some people may find that their reasons for overeating are dissolved as soon as they start recording the foods they eat (this is surprisingly common). Others might find that years of working with a therapist have resulted in a mere dent in their ability to eat in response to hunger and to stop unwanted eating behaviours. In most everyone progress is not linear.
Change Theory and the Stages of Change schema depicts the alteration of behaviours as cyclical, rather than linear. As we move through the stages, we enter a cycle of pre-contemplation, contemplation, planning, action and maintenance. Sometimes we fall out of the cycle and relapse. Many people working with behavioural changes and addictions prefer to rename relapse “prolapse”, claiming that prolapse is a necessary stage for continuing the cycle of change and that much is to be learned from failing at something. It is through observing how the world produces unexpected results, and then attempting to understand the unexpected while trying again, where learning takes place. We don’t really learn if we don’t fail.
Sometimes addictive behaviours, emotional eating included, worsen at a time when someone is on the verge of making a massive breakthrough. Sometimes poking at a new layer of the source of unwanted behaviour accompanies an exacerbation in the practice of that behaviour. Having curiosity and self-compassion throughout the process is essential. Savouring the increased self-awareness that comes with any effort to effect change in one’s life is part of the enjoyment of the experience.
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.
Healing the digestive system requires patience, curiosity, and a willingness to engage deeply with the body’s needs. The digestive tract is intricately connected to every other system in the body, including the immune system, the nervous system, and even emotional well-being. A skilled gastroenterologist can be a crucial ally in unraveling the complex interplay between these systems, identifying imbalances, and guiding patients toward solutions that honor their unique experiences. Together, we can pinpoint the underlying causes of digestive distress, whether it’s nutrient malabsorption, bacterial overgrowth, or a deeper reaction to life’s stresses, and begin the work of true healing.
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.
With 18% of the population suffering, anxiety is the most common mental health condition in North America. Through clinical practice, I’ve quickly come to learn that “anxiety” is a term that means many different things to different people. Its symptoms can range from a mild sense of unease to full-blown panic attacks and the burdensome weight of impending doom. Anxiety disorders are quite diverse. They include, according to the DSM-IV, specific phobias, generalized anxiety disorder (GAD), post-traumatic stress disorder (PTSD), social anxiety, obsessive compulsive disorder (OCD) and even mixed anxiety and depression. Oftentimes the symptoms become crippling; they prevent the patients I see from living their optimal, authentic lives, instead living in a state of fear and self-loathing.
Symptoms
The symptoms of anxiety are holistic. They range from mental symptoms: excessive worry, insomnia, nervousness and anticipation, to name a few, to genitourinary symptoms like frequent urination, and gastrointestinal symptoms. There is a strong connection between anxiety and mental stress and irritable bowel syndrome (IBS), an elusive condition of the gut that results in unpredictable symptoms like bloating, diarrhea, constipation and stomach pain, which is often debilitating for those who suffer from it and very difficult to effectively treat. Other symptoms of anxiety include excessive sweating, muscle tension, rapid heart rate, changes in vision, hot and cold flushes and can be associated with suicidal ideation, self-harm and substance abuse disorders, when anxiety becomes severe.
Conventional Treatment
Unfortunately the conventional treatment for anxiety is limited. The first-line treatment is pharmaceutical and involves using a medication like citalopram, a selective-serotonin re-uptake inhibitor (SSRI), the same medication used to treat mild-moderate depression. This medication is prescribed based on the theory that anxiety is a extraverted version of depression, and that both involve disturbances in the production and signalling of serotonin, the “happy hormone”, in the brain. Benzodiazepines are another line of drugs used to treat anxiety symptoms, as they increase brain GABA levels, a calming brain chemical. However, “benzos” are best prescribed only in the short term (2-4 weeks) to manage serious symptoms. They are addictive in the long-term and can have serious side effects, such as being overly sedating, and depressing breathing, especially when mixed with other sedatives, such as alcohol.
Naturopathic Approach
When I first meet a patient who is suffering with anxiety, I begin by taking a complete case. I have never met two patients who have had identical anxiety symptoms—no two cases of anxiety are alike and therefore, no two cases should be approached in the same way. Therefore, it is important for me to get a complete case history, with details of how anxiety manifests in my patients’ lives: how it affects them, where it might have come from and what specific symptoms are faced on a daily basis. I also inquire about hormonal systems, digestive symptoms, sleep, diet and past medical history. It is important for me to treat the person, not the condition. This means that my patients and I spend time developing a relationship. I make an effort to get to know them during the first few visits, thereby getting to know how their condition uniquely occurs for them.
A large portion of the naturopathic diagnostic process is identifying the cause of anxiety. While conventional medicine points to dysfunctions in the brain, naturopathic medicine approaches anxiety holistically. We understand that because anxiety can affect nearly every body system, it can also manifest as a result of imbalances in a number of organ systems. In the first few visits, we spend time analyzing the web of our patients’ symptoms in order to untangle the clues that might lead us to the root cause.
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The Root Causes of Anxiety
A holistic approach to anxiety aims to uncover the root cause of symptoms by investigating imbalances in a variety of body systems. In the body there is a balance between the sympathetic nervous system (fight or flight) and the parasympathetic nervous system (rest and digest). When one system is turned on, the other is turned off. A healthy body can oscillate between the two states easily, activating the fight and flight response during times of stress and activating the rest and digest response the rest of the time. Anxiety is present in the fight or flight, sympathetic nervous system state.
Cause: Stress
More than half of North American adults are experiencing some sort of mental, emotional or physical stress. Chronic stress relies on production of the hormone cortisol, which on its own can disrupt brain levels of happy hormones, like serotonin and dopamine. Chronic stress can also lead to burnout, or adrenal fatigue, which results in an inability of the body to respond to stress in a healthy manner. Instead of producing cortisol, the adrenal glands rely on epinephrine and norepinephrine (adrenaline and noradrenaline) to confront stressful situations. These hormones result in symptoms of anxiety like racing heart-rate, rapid respiration, muscle tension, mental worry, dry mouth and sweating palms. Being stuck in the fight or flight state, can cause anxiety or worsen existing symptoms.
2. Cause: Malnutrition and Hypoglycaemia
Protein, vitamins and minerals are the building blocks our bodies need to perform its millions of chemical reactions. Trying to heal anxiety without the proper ingredients for health is like trying to build a house without bricks, cement or nails. Neurotransmitters like serotonin and dopamine, and hormones like cortisol require the amino acids (protein) tryptophan and tyrosine for their synthesis, respectively. They also require cofactors, or “builders”, to make neurotransmitters, which include zinc, b-vitamins, magnesium and iron. Stress, because of it’s demands on cortisol production, can deplete these precious ingredients, increasing our dietary requirements. Decreasing vitamin and mineral content in food due to poor quality food production also means we’re not getting enough of these key nutrients and supplementation might be necessary to ensure our body is running optimally.
In addition, rising and falling blood sugar levels from a high-carb diet can cause hypoglycaemia. Hypoglycaemic symptoms can mimic anxiety symptoms, such as dizziness, racing heart, irritability, sweating and fatigue.
Iron deficiency is also a common finding in North Americans, especially menstruating women or vegetarians. Since iron is responsible for carrying oxygen in the blood, a decrease in oxygen carrying capacity results in rapid heart-rate and increased breathing rate, which can also be confused for symptoms of anxiety or panic attacks.
3. Cause: Digestive Issues
Although serotonin, the happy hormone, is primarily active in the brain, studies show that up to 90% of it is made in the intestinal tract. Therefore, a disruption in the health of digestive cells or the bacteria that coats the gut, can result in a disruption in mood as well as digestive symptoms like IBS. 40-60% of people have some sort of digestive issue in North America and there is a close connection between digestive issues and mood, termed the “gut-brain connection”.
Food sensitivities and issues with the health and integrity of intestinal cells can lead to wide-spread inflammation in the body, affecting the nervous system. Scientists have found that low levels of inflammation in the brain and an overactive immune system can contribute to depression and other mental health conditions as well as the breakdown of brain function, contributing to memory loss, headaches and difficulty concentrating and retaining information.
Furthermore, an inability to break down and absorb protein and micronutrients results in an inability for the body to make neurotransmitters like serotonin, which require protein and various vitamins and minerals for its production.
4. Cause: Hormonal Imbalance
Because of the high exposure to xeno-estrogens, or toxic estrogens, many women in North America suffer from a phenomenon called “estrogen dominance”, where there is either too much estrogen in the body or not enough progesterone to provide hormonal balance. Symptoms of estrogen dominance include, weight, gain, painful and heavy periods, irregular periods, fibroids, acne, PMS, infertility and an increased incidence of female cancers, such as breast and ovarian cancer. Estrogen and progesterone, in addition to being female hormones that control secondary sex characteristics like breast and hip development and fertility, also exert effects on the brain. Estrogen can cause irritability and anxiety symptoms, while progesterone has a stress-relieving and calming effect. Estrogen dominance, when not controlled, can worsen existing anxiety or be the cause.
5. Cause: Core Beliefs and Mental Schemas
Our brains are wired to retain the lessons we learn, especially if these lessons have been experienced alongside strong emotions, such as trauma. These emotional memories are often implicit and non-verbal, located in lower brain centres, below the level of our conscious thoughts. Once the memories are laid down, they can last a lifetime, influencing our thoughts, emotions and behavioural reactions to present day triggers. Anxiety and other mental health conditions can often be symptoms of these emotional memories, also called “core beliefs” or “mental schemas”. These beliefs dictate to us implicitly how the world works and, if left unexamined, can limit what is possible for us in our lives. When these beliefs get triggered, anxiety symptoms can result. Getting to the core of the symptoms and making the implicit memories verbal is the key to unlocking hidden psychological causes of mood disorders.
Holistic Solutions for Anxiety
Healing anxiety first involves identifying the specific symptoms that my patients present with and looking for potential causes among the common causes outlined above. In addition to a thorough history, I may order blood work to check the B12 and iron status of my patients. I may order a food sensitivity test or check for hormone levels like progesterone, estrogen and cortisol in the saliva and blood, depending on the symptoms a patient presents with.
When I work with patients, we often work together to develop a comprehensive strategy for coping with stress. Oftentimes this involves looking for ways to decrease stress in their lives, such as cutting back on work hours and setting healthy boundaries. Other times it involves looking for activities to incorporate into their lifestyles to manage stress, such as going for long walks (walking slowly for 1 hour can lower cortisol levels and help manage stress), engaging in meditation, yoga, nature exposure, journalling and other activities that have been proven to lower stress hormones.
Creating a nutritional plan is also important for managing anxiety. I work with the place my patients are at, rather than pushing a full dietary overhaul. Making minor adjustments to diet, such as adding more protein, especially in the morning, more fruits and vegetables and less refined carbs and sugars, can do wonders for decreasing anxiety symptoms. Reducing caffeine and alcohol consumption can also greatly benefit symptoms.
Depending on the specific symptoms and lifestyle of my patients, I might recommend nutritional supplementation to improve neurotransmitter synthesis. I also prescribe supplements to help my patients’ bodies through times of stress, depending on their stress levels and other symptoms they present with. Keeping supplements to a few key nutrients that treat the root cause of symptoms is preferable to taking handfuls of pills every day.
Improving gut health is important. This means supplementing with a good quality probiotic, identifying and removing food sensitivities, and eating a diet that is low in inflammatory fats and high in health-promoting omega 3 fatty acids. A digestive aid such as digestive enzymes or herbal bitters can also help with the body’s ability to absorb valuable nutrients from a healthy diet.
Balancing hormones by supporting liver function, adjusting birth control brand and dosage, and minimizing exposure to hormonal toxins such as BPA, fragrances or phthalates can help treat symptoms of estrogen dominance, if present.
Finally, counselling to identify core beliefs can also be beneficial for eradicating emotional memories that are no longer beneficial to patients and that can be contributing negatively to symptoms of anxiety and mood, is important. CBT, narrative therapy, mindfulness training and Coherence therapy are all processes through which patients can begin to identify and challenge the core beliefs that may be contributing to or causing their anxious symptoms.
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Just as nutritional and hormonal adjustments can support physiological well-being, tailored therapy provides the emotional tools necessary to navigate stress, heal from past traumas, and build a more balanced, fulfilling life.
For more information on a naturopathic approach to your anxiety, visit my contact page.
Today, I’m 30, working on my career as a self-employed health professional and a small business owner and living on my own. I’ve moved through a lot of states, emotions and life experiences this year, which has been appropriate for closing the chapter on my 20’s and moving into a new decade of life. I’ve experienced huge changes in the past year and significant personal growth thanks to the work I’ve been blessed to do and the people who have impacted me throughout the last 30 years. Here are 30 things this past year has taught me.
Take care of your gut and it will take care of you. It will also eliminate the need for painkillers, antidepressants, skincare products, creams, many cosmetic surgeries, shampoo and a myriad of supplements and products.
Trying too hard might not be the recipe for success. In Taoism, the art of wu wei, or separating action from effort might be key in moving forward with your goals and enjoying life; You’re not falling behind in life. Additionally, Facebook, the scale and your wallet are horrible measures to gauge how you’re doing in life. Find other measures.
If you have a chance to, start your own business. Building a business forces you to build independence, autonomy, self-confidence, healthy boundaries, a stronger ego, humility and character, presence, guts and strength, among other things. It asks you to define yourself, write your own life story, rewrite your own success story and create a thorough and authentic understanding of what “success” means to you. Creating your own career allows you to create your own schedule, philosophy for living and, essentially, your own life.
There is such as thing as being ready. You can push people to do what you want, but if they’re not ready, it’s best to send them on their way, wherever their “way” may be. Respecting readiness and lack thereof in others has helped me overcome a lot of psychological hurdles and avoid taking rejection personally. It’s helped me accept the fact that we’re all on our own paths and recognize my limitations as a healer and friend.
Letting go is one of the most important life skills for happiness. So is learning to say no.
The law of F$%3 Yes or No is a great rule to follow, especially if you’re ambivalent about an impending choice. Not a F— Yes? Then, no. Saying no might make you feel guilty, but when the choice is between feeling guilty and feeling resentment, choose guilt every time. Feeling guilty is the first sign that you’re taking care of yourself.
Patience is necessary. Be patient for your patients.
Things may come and things may go, including various stressors and health challenges, but I will probably always need to take B-vitamins, magnesium and fish oil daily.
Quick fixes work temporarily, but whatever was originally broken tends to break again. This goes for diets, exercise regimes, intense meditation practices, etc. Slow and steady may be less glamorous and dramatic, but it’s the only real way to change and the only way to heal.
When in doubt, read. The best teachers and some of the best friends are books. Through books we can access the deepest insights humanity has ever seen.
If the benefits don’t outweigh the sacrifice, you’ll never give up dairy, coffee, wine, sugar and bread for the long term. That’s probably perfectly ok. Let it go.
Patients trust you and then they heal themselves. You learn to trust yourself, and then your patients heal. Developing self-trust is the best continuing education endeavour you can do as a doctor.
Self-care is not selfish. In fact, it is the single most powerful tool you have for transforming the world.
Why would anyone want to anything other than a healer or an artist?
Getting rid of excess things can be far more healing than retail therapy. Tidying up can in fact be magical and life-changing.
It is probably impossible to be truly healthy without some form of mindfulness or meditation in this day and age.
As Virginia Woolf once wrote, every woman needs a Room of Own’s Own. Spending time alone, with yourself, in nature is when true happiness can manifest. Living alone is a wonderful skill most women should have—we tend to outlive the men in our lives, for one thing. And then we’re left with ourselves in the end anyways.
The inner self is like a garden. We can plant the seeds and nurture the soil, but we can’t force the garden to grow any faster. Nurture your garden of self-love, knowledge, intuition, business success, and have faith that you’ll have a beautiful, full garden come spring.
Be cheap when it comes to spending money on everything, except when it comes to food, travel and education. Splurge on those things, if you can.
Your body is amazing. Every day it spends thousands of units of energy on keeping you alive, active and healthy. Treat it well and, please, only say the nicest things to it. It can hear you.
If you’re in a job or life where you’re happy “making time go by quickly”, maybe you should think of making a change. There is only one February 23rd, 2016. Be grateful for time creeping by slowly. When you can, savour the seconds.
Do no harm is a complicated doctrine to truly follow. It helps to start with yourself.
Drink water. Tired? Sore? Poor digestion? Weight gain? Hungry? Feeling empty? Generally feeling off? Start with drinking water.
Do what you love and you’ll never have to work a day in your life. As long as what you love requires no board exams, marketing, emailing, faxing, charting, and paying exorbitant fees. But, since most careers have at least some of those things, it’s still probably still preferable to be doing something you love.
Not sure what to do? Pause, count to 7, breathe. As a good friend and colleague recently wrote to me, “I was doing some deep breathing yesterday and I felt so good.” Amen to that.
As it turns out, joining a group of women to paint, eat chocolate and drink wine every Wednesday for two months can be an effective form of “marketing”. Who knew?
“Everyone you meet is a teacher”, is a great way to look at online dating, friendships and patient experiences. Our relationships are the sharpest mirrors through which we can look at ourselves. Let’s use them and look closely.
Being in a state of curiosity is one of the most healing states to be in. When we look with curiosity, we are unable to feel judgment, anxiety, or obsess about control. Curiosity is the gateway to empathy and connection.
Aiming to be liked by everyone prevents us from feeling truly connected to the people around us. The more we show up as our flawed, messy, sometimes obnoxious selves, the fewer people might like us. However, the ones who stick around happen to love the hot, obnoxious mess they see. As your social circle tightens, it will also strengthen.
If everyone is faking it until they make it, then is everyone who’s “made” it really faking it? These are the things I wonder while I lie awake at night.
Happy Birthday to me and happy February 23rd, 2016 to all of you!
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.
Integrating a more comprehensive approach to mental health, such as the one advocated by Healing Psychiatry of Florida, can offer significant benefits. By addressing ADHD time blindness alongside traditional treatments, this approach acknowledges the multifaceted nature of mental health issues and emphasizes the importance of considering how various factors—both physiological and psychological—interact. This broader perspective not only enhances treatment effectiveness but also supports individuals in managing their conditions in a more integrated and compassionate manner.
As awareness grows regarding the interconnectedness of mental and physical well-being, there’s an increasing demand for holistic approaches to health and wellness. Online certification programs in holistic health and wellness, such as those offered by https://it.scholistico.com, play a pivotal role in equipping individuals with the knowledge and skills to address the multifaceted nature of human health. These courses delve into various modalities and disciplines, including naturopathy, nutrition, mindfulness, and integrative medicine, providing a comprehensive understanding of how different aspects of life impact overall wellness.
By embracing a holistic perspective, these certification programs empower students to adopt a more holistic approach to health care, recognizing the intricate interplay between physical, emotional, and spiritual well-being. With a curriculum grounded in evidence-based practices and emerging research, students gain insights into alternative therapies and lifestyle interventions that complement conventional medical treatments. As society increasingly acknowledges the limitations of the traditional medical model in addressing mental health concerns, the availability of online certification courses in holistic health and wellness serves as a beacon of hope, fostering a new generation of practitioners committed to holistic healing and compassionate care.
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.
In addition to established therapeutic approaches like Cognitive Behavioral Therapy (CBT) and Motivational Interviewing, there’s growing recognition of the importance of specialized interventions tailored to specific mental health challenges. For individuals grappling with complex issues such as trauma or relationship difficulties, psychosexual therapy can offer a targeted and effective means of support. This form of therapy delves into the intricate interplay between psychological and sexual health, addressing concerns that may have profound impacts on overall well-being. Moreover, it’s crucial to acknowledge the role of holistic approaches in promoting mental wellness. In essence, the landscape of mental health treatment is diverse and evolving, offering a spectrum of options to meet the unique needs and preferences of each individual on their path to healing and growth.
When seeking therapy, it’s essential to consider not only the specific therapeutic model but also the fit between the therapist and the individual seeking help. For instance, someone in New York City might specifically search for cbt therapy nyc to find therapists trained in this evidence-based approach within their local area. However, beyond geographical considerations, finding a therapist with whom one feels a genuine connection and trust is crucial for therapy to be effective. This connection forms the foundation of a therapeutic relationship that can support individuals in navigating their mental health challenges and achieving meaningful change.
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.
This is a common story that can describe any number of patients I see in my private practice: My patient has been doing well–she’s been exercising regularly; she’s been cutting out sugar and processed foods and watching what she eats. She’s been having salads for lunch. She’s even gotten her husband on board! He’s started to have salads for lunch with his cheeseburger (instead of fries) and given up having a row of cookies in the evening. All things considered, she’s been doing great. However, despite her best efforts, after one month of tiresome slog, restriction and dedication, she’s only managed to lose a few pounds. Her husband? He’s lost 10.
“He has more to lose,” I suggest to her. “Those few pounds you’ve lost are gone for life—slow and steady stays off forever.” I am her cheerleader, but the truth is: hormones, especially when it comes to women.
Hormones are the body’s telegrams. They are produced in glands in tissue like the gut, ovaries, adrenals and brain and act on distant cells in the body, telling them how to behave. When it comes to weight loss, hormones can be the culprit if diet and exercise have failed to produce results. Hormones control appetite, mood, food cravings, metabolic rate, fat gain and distribution and hunger, among other things. Any hormonal imbalance will sabotage weight loss efforts and it’s often the first place I look when a patient has weight loss goals that they aren’t achieving with diet and exercise alone.
The Players:
There are numerous hormones in the body that are responsible for the above actions, however the main ones that we can affect through diet and lifestyle are insulin, cortisol, estrogen and the thyroid hormones. These are just some key players in a team, however just by working on these four, we can start to see results.
Interconnectedness:
Hormones are complex entities, not only for the wide array of effects, but for their tendency to effect the action of each other. For example, high cortisol can effect levels of estrogen, insulin and the thyroid hormones. High insulin can affect cortisol and estrogen. And so on. Working on hormones is like attacking a giant knot and often requires starting from the basics: diet and lifestyle.
Insulin Imbalance:
Insulin is an important hormone in the body—we can’t live without it. Released by the pancreas after a carbohydrate-rich meal in response to rising levels of sugar in the blood, insulin gets sugar into cells where it can be used as fuel. It also brings down blood sugar, making it a main culprit in hypoglycemic crashes and sugar cravings. The problem with insulin, however, is when we overeat carbohydrates and sugar, we overuse the insulin response. The result is abdominal fat, weight gain (insulin tells the body to store fat), a blood sugar roller coaster, mood swings (that “hangry” feeling) and intense sugar cravings and energy crashes.
Balancing Insulin:
Insulin is best balanced by diet, particularly managing carbohydrate intake and emphasizing healthy fats and protein in the diet. Fat and protein slow sugar absorption. This prevents a rise in blood sugar and decreases the need for insulin. The result is feeling satiated for longer, having stable energy and decreasing food cravings.
Morning protein:
The first step in balancing insulin release is to increase morning protein. I recommend aiming for 30 g of good quality, lean protein for breakfast like a chicken breast, or scoop of whey isolate protein powder in a whole foods smoothie. I was once accused jokingly of “not knowing that breakfast is”, when recommending chicken breasts for breakfast. However, perhaps it’s North America that has a skewed sense of what makes a decent morning meal. If the aim of breakfast is to break the fast that you’ve had throughout the night, then starting it off with a high-carb, high-sugar, nutrient-sparse piece of toast or bowl of breakfast cereal seems crazy to me. In Colombia and India, two places I’ve spent some time, we started off the day with a protein-rich stew or meat soup.
To balance insulin make sure that every meal, even snacks, contain some form of protein or a fat. Avoid eating carbohydrates by themselves and keep servings of carbs to a minimum and in their unprocessed, whole form (like large flake oats, quinoa and brown rice as opposed to flours or cereals).
Cortisol Imbalance:
One of the main hormone imbalances I notice when it comes to stubborn weight gain is cortisol imbalance. Cortisol is the stress hormone. It’s released by the adrenal glands, two pyramid-shaped endocrine glands that sit on top of the kidneys, in response to stress. Animals have two modes of operation: fight or flight or rest and digest. Cortisol increases blood sugar and alertness and tells the body to divert attention to gearing us up for combat or escape, and moves us away from investing energy in digestion, immunity and concentration. Cortisol is a wonderful hormone; it keeps us awake, and makes us feel alert and well, priming us to be effective in our busy, stressful lives. However, our bodies weren’t made for long-term stress response and we spend most of our time in fight or flight mode.
Cortisol and blood sugar:
Cortisol raises blood sugar, causing insulin to be released. This starts us on a blood sugar roller coaster trip, leading to sugar cravings, energy crashes and storing fat.
Cortisol and fat distribution:
Cortisol doesn’t directly tell the body to store fat (it happens through other mechanisms that happen in response to high cortisol), but it does encourage fat redistribution. Cortisol tells the body to move fat from the hips and thighs and deposit in the abdomen, face and shoulders, leading to the sexy “Buffalo Hump”. We know that abdominal fat carries more health risks than fat in other areas of the body so this detail can be troublesome when it comes to long-term effects.
Cortisol and the thyroid:
Cortisol impacts the thyroid by preventing the conversion of T4 to the more active T3. T3 and T4 are important thyroid hormones that set the body’s metabolic rate, among other things.
Cortisol and the sex hormones:
Cortisol can lead to estrogen dominance by diverting resources away from estrogen and progesterone production. In menopause, this is particularly troublesome, as the body relies on the adrenal glands, rather than the ovaries, to produce the sex hormones. High cortisol can result in progesterone deficiency and estrogen dominance symptoms, which can negatively affect weight loss. Cortisol also causing accelerated aging and who wants that?
Cortisol Balancing:
The main thing when it comes to cortisol balancing is to Calm Down—or as I like to poignantly put it, Calm the F#$% Down. The way this is done is highly individualized. Some recommendations I have are: meditation, yoga, exploring acupuncture (a wonderful way to balance cortisol, among other things), journaling, taking a day off, re-evaluating priorities at work and at home, etc. Mainly, getting 7-9 hours of sleep a night is essential for managing the stress response.
Taking it easy:
When it comes to weight loss, I often notice that certain efforts hinder our progress. It’s important to keep caloric intake adequate—eating too few calories can stress the body out, causing cortisol release. It’s also important to manage exercise. While exercise can teach the body how to manage stress, it does produce cortisol in the short-term. Therefore it’s important to keep exercise short and intense. Weight-training, short bursts of cardio (no more than 20 minutes) and varying intensities with High Intensity Interval Training, Tabata or Crossfit, are the best choices for weight loss. Training for a marathon or long-distance bike race may be fun and fulfilling, but they are not the best choices for weight loss, as they prolong the stress response and can work against you, rather than in your favour.
When I have a patient who is intensely tracking what they eat and over-exercising my advice is often (and it’s not that well-received, as you can imagine) “Take it easy”. Easing up on exercise and relaxing calorie-counting may be hidden pieces in the weight loss game.
Herbs and supplements:
There are a variety of nutrients to take to support adrenal function. The main things to consider, with the advice and counsel of a trained naturopathic doctor are B-vitamins, magnesium and adaptogenic herbs (the help the body adapt to stress).
Estrogen Dominance:
Estrogen, actually a group of hormones, are female sex hormones. Their main job is to promote the expression of female sex characteristics, the growth of breast tissue and to control ovulation. Estrogen also causes body to fat to be distributed to the thighs, buttocks and lower abdomen. The problem with modern society is an imbalance in the two female sex hormones, estrogen and progesterone. Due to stress and toxic environmental estrogens, or xenoestrogens, among other things, modern women have more estrogen relative to progesterone in their bodies. The effects of this are numerous and include, stubborn weight gain in the thighs (the famed “saddlebags), cellulite, acne, PMS, painful menstrual periods, fibroids, hormonal conditions such as PCOS, and the occurrence of certain female cancers, especially breast cancer. Estrogen can also contribute significantly to anxiety symptoms.
Estrogen balancing:
Correcting estrogen dominance primarily involves supporting estrogen detox pathways in the liver. Chemicals such as I3C, DIIM and calcium-d-glucarate help increase the liver’s ability to clear foreign estrogens from the body. Supporting digestive health also allows us to remove estrogens—they are neutralized in the liver and eliminated through the colon. Leafy greens contain a high amount of these chemicals, so ensuring you get adequate amounts in your diet is important for estrogen metabolism. Ground flaxseed, rosemary and fish oil are also important nutrients for clearing excess estrogen from the body.
Reducing exposure:
Try to reduce exposure to foreign estrogens by avoiding the use of plastic bottles and plastic-lined cans, using natural skincare and body products and natural cleaning aids whenever possible. It’s also important to see a naturopathic doctor 2-4 times a year for a medically-assisted natural detoxification to clear the body of toxic estrogens.
Hypothyroidism:
The thyroid gland sits on the neck, just below the Adam’s Apple. It releases two hormones T4, and the more active T3. These hormones are responsible for setting the body’s metabolic rate—converting fat into heat and energy. Thyroid deficiency, or hypothyroidism is more common in our society than we think (naturopathic doctors have stricter criteria for laboratory reference ranges than conventional medicine—we look for signs of health, not disease). Conventional medicine deems hypothyroidism as having a TSH (thyroid stimulating hormone) level above 5—for this hormone, all you need to know is lower is better—however ND’s will start to treat the thyroid when symptoms are present and TSH is above 2.5. Symptoms of hypothyroidism are stubborn weight gain, constipation, feeling cold, fatigue, especially brain fog, weak memory, hair loss, dry skin and thinning of the eyebrows.
Supporting the thyroid:
The thyroid gland is a fragile organ, sensitive to inflammation and stress. When there is inflammation in the body, often caused by stress, diet or insulin resistance, the thyroid is the first gland to suffer. Most cases of hypothyroidism are autoimmune in nature. Therefore, naturopathic doctors aim to correct inflammation by prescribing an anti-inflammatory diet and looking for food sensitivities. When we identify food sensitivities (through specialized IgG antibody testing or an elimination diet) and remove them from the diet, we can focus on gut healing which treats inflammation and helps repair the thyroid.
Managing stress:
Low calorie diets have the effect of suppressing thyroid function, which leads to the yo-yo dieting effect. Avoid extremely low calorie diets, or opt for intermittent fasting or calorie-cycling instead. Aim for slow and steady weight loss so as not to harm metabolic rate, which makes weight loss more difficult in the long run.
I previously mentioned that cortisol can harm the thyroid and that hormones are interlinked. Cortisol prevents the conversion of T4 to the more active T3, which can slow metabolism.
Nutrients:
A deficiency in iodine, zinc, iron and selenium, among other nutrients, can negatively impact the thyroid. Talk your naturopathic doctor about testing and supplementation.
Summary:
What would a visit to a naturopathic doctor look like? When it comes to hormones, treatment is often complex as it targets the root cause of symptoms and involves detangling the complicated web of hormones that are at play. This can require some diagnostic detective work. A naturopathic doctor will take your complete health history, order labs and perform physical exams if necessary. A common treatment plan might look like this:
Sleep: 7-9 hours per night
Take stress seriously: sign up for a round of acupuncture, start meditation, do yoga, journal, etc.
Measure hormones via saliva: cortisol, testosterone, DHEA, estrogen, progesterone
Identify food sensitivities via an elimination diet or an IgG Food Panel that tests for antibodies to certain foods in the blood.
Correct nutritient deficiencies through diet and supplementation
Herbs for hormonal support: estrogen detoxification, thyroid support, gut healing, adrenal support, glucose control and blood sugar balancing.
Exercise: short, intense bursts that target muscle-building
Diet: high protein, especially in the morning, healthy fats, low carbs and eliminate sugar, processed foods and food sensitivities.
To learn more about how naturopathic medicine can help you lose weight, balance hormones and fight disease, contact my clinic Bloor West Wellness at 416 588 0400 to set up an initial appointment. Let’s get started today!
Want to balance your hormones, energy and mood naturally? Check out my 6-week foundational membership program Good Mood Foundations. taliand.com/good-mood-learn
As a student of naturopathic medicine, I didn’t quite get herbs. They were natural, sure, but why would I prescribe them in lieu of homeopathy, dietary changes or nutritional supplements? I didn’t get it.
I liked herbs; I understood the idea of synergy—the fact that the effect of the entire plant is greater than the sum of its parts. Also, I knew that plants often have superior effects to some drugs in that they often contain active ingredients that balance the side effects otherwise caused by most pharmaceutical medications. For example, anti-inflammatory herbs like turmeric and licorice root also support and strengthen the immune system, rather than suppress it, as most anti-inflammatory drugs tend to do. For most drugs that lower inflammation, a common side effect is severe immune deficiency. This is not the case for herbs that lower inflammation, which actually benefit the immune system. So, I knew herbs were cool.
I also liked the idea that each tincture was individually created for the totality of symptoms a patient presented with. Creating a specific medicine for each individual seemed to fit with the idea of singularity in medicine, which I resonated with. However, for a long time I didn’t get herbs. And I’ve often been reluctant to prescribe herbs in my practice.
First of all, I don’t have my own dispensary so sending patients off to buy tinctures created a kind of disconnection from the source of my prescriptions. Secondly, as many of you who have tried it can contest, tinctures (or herbs extracted in alcohol) taste terrible and make compliance hard, even for myself. Thirdly, tinctures are quite expensive. Each 50 ml of tincture can cost upwards of $5 making a month’s supply of herbs quite costly. This is funny because many of the herbs that are so costly to buy grow like weeds in southern Ontario (dandelion, for example, is often considered a weed) and tinctures aren’t that difficult to make. Fourthly, I didn’t like to prescribe tinctures because, as I understood it, people would only feel better while actively taking the herb. In my mind, the herb worked like a drug in that once you stopped taking it, the positive effects would diminish. This differed from my understanding of homeopathy, which stimulates the body to heal itself, correcting nutritional deficiencies or looking for and treating the root cause of symptoms. I doubted whether the way we were taught to prescribe herbs did in fact treat the root cause. This is important because the guiding principles of naturopathic medicine dictate that we aim to do this whenever possible.
I had no doubt, however, that herbs were effective. Taking a tincture seemed to be far more effective for me and the patients I treat than taking supplements. Herbs are nutritional—they are a food and a medicine and therefore contain a myriad of health benefits beyond treating what they are prescribed to treat.
It wasn’t until I read author and herbalist Matthew Wood’s works on herbalism that I began to internalize the idea that herbs do in fact stimulate the body to heal itself. Plants contain an inherent wisdom, according to Wood and his studies in western and Native American herbalism. Plants eradicate disease by stimulating the healing powers of the body and strengthening the body’s capacity to heal itself from disease. The body is constantly trying to heal itself from ailments and, when these processes become blocked for one reason or another, disease symptoms begin to manifest. Herbs can strengthen the body’s healing processes, when prescribed in a certain way, and large doses for long courses of time are not necessary. Further, once the disease is eradicated, the herbs can be stopped. When prescribed as a healing catalyst, disease doesn’t return once the herbal prescriptions have done their work.
Wood writes, “It should be understood that herbs can be used either way: to stimulate the self-healing powers of the organism to return to health, or to artificially manipulate the organism to fit an artificial goal.” He uses the examples of goldenseal, which at high doses can kill bacteria or viruses that have invaded the body and in smaller doses can increase the mucosa and digestive systems of the body to rid itself of the invaders and, in turn, strengthen the body against future invasions.
In regards to the cost of herbal tinctures, there are relatively simple ways to get the effects of herbs by making your own tinctures.
Read on to support liver detox, hormonal health and cardiovascular health by creating your own rosemary tincture using dried rosemary, one of my favourite herbs of the moment, and a bottle of white wine:
Rosmarinus officinalis, is the latin name for rosemary, a member of the mint family. While better known for its ability to perfectly complement roast chicken, it has a number of health benefits. Rosemary’s energetic actions are stimulating and warming, according to Matthew Wood. It clears up phlegm and dampness, stagnation and sluggishness in the tissues.
Rosemary has the ability to boost metabolism and increase the absorption of sugars and fats, which make it an appropriate nutritional supplement for people with diabetes. It can help drive glucose into the cells, diminishing the need for the body to release large amounts of insulin, re-sensitizing cells to insulin and lowering blood sugar. It can help nourish the entire body and has a special affinity for the heart, lungs, spleen, liver and kidneys.
Rosemary is currently often used to detoxify toxic, exogenous estrogens from the body while promoting the conversion of health-promoting estrogens in the liver. It is a powerful stimulator of liver detoxification. It therefore serves as a cheap and useful remedy for seasonal, full-body detoxes or coming off oral contraceptive or synthetic hormones, such as the fertility drugs given before IVF treatments. It is also useful for promoting circulation and lymphatic drainage, moving sluggishness and excess weight and creating warmth and vitality in the body’s circulatory systems.
Herbalists use rosemary tincture or oil applied topically to the head and neck to treat migraines from tense shoulder and neck muscles. Its scent is aromatic and stimulating and can improve memory and cognition. It is an effective remedy for mental-emotional depression when taken internally, especially where patients feel damp, sluggish, lack motivation and experience feelings of mental dullness.
As a digestive aid, rosemary can help relieve abdominal bloating and flatulence. It also helps stimulates appetite. It helps burn up phlegm in the stomach and can aid in weight loss.
In addition, rosemary contains antimicrobial properties, meaning it can be used to kill bacterial and viral infections, especially when taken at the beginning of a cold.
It is a powerful heart tonic, especially where there is edema and circulatory stagnation, such as early signs of congestive heart failure. It also can help with arthritic pains and joint stiffness when applied topically to joints or taken internally as an anti-inflammatory.
In Matthew Wood’s book, The Practice of Traditional Western Herbalism, he recommends creating a rosemary infusion (infuse fresh leaves and flowers in a pot of boiled water and keep covered) or a tincture using white wine as the alcohol base.
A few days into taking this tincture (mixed with a little water to dilute the strong taste), I’ve noticed my skin clear, my digestion improve, my stomach flatten (I no longer have any bloating and I’ve been experimenting with eating wheat again for the first time in years), and my energy increase. My symptoms of PMS this month subsided before my period even came. I had a canker sore in my mouth that immediately went away once I started taking rosemary wine. I’ll certainly be adding this cheap and effective DIY remedy to my self-care and general health-promoting regime.
Wine has long been celebrated not just for its flavors but also for its versatility in enhancing daily life. Whether you’re crafting a special recipe or simply enjoying a glass with friends, wine adds a touch of elegance and enjoyment. Thanks to the convenience of online shopping, finding the perfect bottle has never been easier. A reliable wine store can offer a wide selection, from classic reds and whites to sparkling varieties and unique blends. With detailed descriptions and recommendations available, you can explore new options tailored to your tastes, all from the comfort of home.
Beyond the joy of sipping, wine has a way of elevating any occasion, from quiet evenings to lively celebrations. Ordering from an online not only gives you access to premium labels but also allows you to discover exclusive offerings that might not be available locally. The convenience of doorstep delivery means you’re always prepared to host guests, experiment with food pairings, or simply treat yourself to a moment of relaxation.
Here’s how to make your own.
Rosemary Wine:
Ingredients:
1 handful (approximately 250 ml) of rosemary leaves, dried, cut up as small as possible (you can use a packet of rosemary spice from the grocery store). Extra points for organic.
1 bottle (750 ml) of white wine (Wood recommends a good quality wine, I used a cheap homemade one I was given as a gift).
1 empty glass bottle/jar
Directions:
Put rosemary in the empty glass jar. Pour entire 750 ml bottle of white wine over rosemary and let stand in a cool, dry place for 2-3 days. Then strain out the herbs and store the liquid tincture in a cool, dry, dark place, like a cupboard.
Talk to your naturopathic doctor about appropriate dosing, though most botanical prescriptions involve 1 tsp of tincture 2-3 times a day away from food. This will vary according to your health challenges and health goals, among many other factors.*
Reference:
Wood, Matthew. 2004. The Practice of Traditional Western Herbalism: Basic doctrine, energetics and classification. Berkeley, California: North Atlantic Books.
*This article is not to be confused with medical advice from a licensed naturopathic doctor. If you suffer from one of the above-mentioned conditions and believe rosemary might help, please book an appointment to receive an appropriate assessment.
