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.
The gut-brain connection has gotten the attention of researchers and functional medical practitioners. I discuss, briefly, what research has shown us in regards to the complex realm of the microbiome and how depression may be a result of inflammation in the brain, stemming from inflammation in the gut.
My name is Dr. Talia Marcheggiani and I am a naturopathic doctor and mental health expert in Toronto.
Today we’re going to talk about the gut-brain connection and how that can influence your mental health symptoms.
I think we intuitively know that the gut and brain are connected. When you feel mental symptoms of anxiety we immediately notice the effects on our gut.
During times of stress, we know that we have indigestion, we’re more predisposed to things like diarrhea and irritable bowel syndrome.
Even anatomically there’s a nerve, called the Vagus nerve, that directly connects the brain to our digestive system.
This nerve is responsible for putting into that “rest and digest” state.
When this nerve is stimulated, our bodies start to secrete digestive enzymes, saliva starts to be secreted and we’re able to break down our food and absorb the nutrients from the food that we’re eating.
A lot of research has been going on, that you might be aware of, about healthy gut bacteria. And more and more people, especially medical doctors, happily, are prescribing probiotics anytime someone is prescribed antibiotics for a bacterial infection.
Scientists have started to study more about these gut bacteria. We know we have, like, 5 lbs of gut bacteria, sitting in our digestive systems. Over 100 trillion cells, this is more than 10x the amount of cells we have in our physical bodies, and more DNA than we have in our body.
We’re more bacteria than we are human!
And these gut bacteria, we can’t survive without without them, they influence the very physiology we experience and they definitely impact our health.
These bacteria are responsible for helping us digest our food, and for our mental and emotional wellness as well as keeping our immune system in check.
So, a disbalance in bacteria, or an increase in that negative, bad bacteria and not good strains of healthy bacteria, can lead to diseases like autoimmune disease or multiple sclerosis, or things like chronic fatigue syndrome as we’re seeing in research.
Scientists are starting to study more about how the bacterial balance in our gut can influence our mood and mental health.
These gut bacteria can actually produce serotonin. So that’s the happy hormone in the brain. And you may have heard of serotonin, especially if you suffer from depression or anxiety because your doctor might have recommended a kind of medication called SSRIs, or Selective Serotonin Reuptake Inhibitors, or a similar drug, SNRIs, like Venlafaxine, which is a Selective Serotonin and Norepinephrine Reuptake inhibitors.
This is based on on the Monoamine Hypothesis that there is this chemical imbalance in the brain. That your body is either not making enough, or absorbing enough or reacting to serotonin enough.
When we’re given these antidepressants, the idea is that we’re recorrecting this brain imbalance and that’s as much of the story as we’ve got. We don’t know why these brain imbalances are around.
So I think that, if we’re going to stick with this hypothesis, which is still controversial in science, we should look to the gut bacteria because we know that gut bacteria produces a significant amount of serotonin and, if we’re blaming depression and anxiety on serotonin deficiencies, why not look at the gut and find out how we can influence the balance of healthy gut bacteria so that we’re producing enough serotonin. Especially if we’re relying on drugs to correct the imbalance and we don’t have enough serotonin for the drugs to work properly.
Gut cells on their own produce 95% of the serotonin in the body so basically every single chemical that we have in our brain is produced or exists in the gut.
So, we need to be able to feed the gut cells so that they’re producing healthy amount of hormone we need to experience a healthy mood and live our lives in ways that are stress-free and energized and happy so that we can effective in our lives.
Mentally and emotionally, you might know this “gut feeling” that we talk about in language and that’s kind of permeated throughout cultures. So, we know that when we have this feeling in the gut that, it’s almost like an intuition. Some people will say, “I just knew it, because I felt it in my gut.” And I think that we’ve always had this intuition. We’ve always had this connection between what our mental state, our thoughts, beliefs and emotions are telling us and what our gut is telling us.
We think that we think with our brains and that all of the mental symptoms we experience are happening at the level of the brain, but because of this tight gut-brain connection, we know that’s not true.
People that have done brain studies actually find that we have thoughts before we have brain activity a lot of the time so, I wonder if we’re actually thinking with our gut, which is a revolutionary and radical thought, but we’re finding more and more evidence for this in science.
You may have heard of the condition called “Leaky Gut” or the more official, scientific term is “Intestinal Permeability”. Our gut is really selective about what it absorbs for good reason. What happens, though, when we’re experiencing chronic stress, or we use a lot of antibiotics or maybe eat things like high-sugar foods, caffeine, or a lot of alcohol, we can cause gut inflammation, which starts to allow bacteria, food toxins, or whole proteins from food into the blood, into the body by breaking down the integrity of the gut.
So, when it comes to health, for most health conditions, especially when there’s a few symptoms that seem disconnected and it’s hard to find the relationship between them, naturopathic medicine and, now, functional medicine and, hopefully soon, conventional medicine, begins to look at gut health.
So if I’m sitting across from a patient who has a long list of health symptoms that seems like they’re not connected and has digestive symptoms—and 40-60% of the population, in general has some kind of digestive symptom, whether it be bloating after eating, feeling fatigued after eating, just feeling like your food is sitting in your stomach and not really moving through, GERD, so acid reflux, heartburn, diarrhea and constipation, or those IBS symptoms, gas and bloating—when I sit across from a patient with any of those symptoms, the first place we go, in terms of treatment, is to look at the gut.
So how do you keep your gut healthy? There’s a few things. The first is to eliminate anything that’s causing gut inflammation, so this could be excessive caffeine and alcohol, excessive refined sugars, antibiotics without doing a probiotic immediately after or during an antibiotic treatment, chronic mental and emotional stress, or physical stress, and food sensitivities: something we’re eating that’s causing our immune system to react and our gut to become inflamed.
Ensuring a proper bacterial balance by either supplementing with a probiotic or eating a variety of fermented foods such as kefir, yogurt, kombucha or saurkraut, and making sure that we’re eating a variety of whole foods: whole grains, fruits and vegetables, and healthy fibres that are going to feed that healthy gut bacteria.
So, when it comes to mental health, such as depression and anxiety, chronic mental stress, even things like bipolar, OCD, conventional medicine tends to just look at the brain and blame the brain on the host of symptoms that patients might experience.
Naturopathic medicine looks at the entire body. And since we know that the gut and brain are connected, and our patients are simultaneously experiencing mental health symptoms and digestive symptoms, we definitely have to treat the gut.
For more information, you can visit my website at taliand.com, or send me an email at connect@taliand.com.
I work at Bloor West Wellness Clinic in Bloor West Village, in Toronto.
I have some amazing news—my patient is better. Whereas only a few short months ago, he was plagued by inexplicable weight gain, debilitating fatigue, depressed mood—convincing him he must be suffering from clinical depression—a sore throat and an inability to regulate his temperature, now he feels normal. A few months ago, his lab results indicated a serious and spiralling case of autoimmune thyroid disease. Now the lab results shows markers that are completely within the normal limits. My patient got to where he is now naturally—he did not take a single medication. His body was unleashing an aggressive attack against his thyroid gland under a year ago. Now, his thyroid is healthy, happy and working normally. My patient is back to work, exercising, traveling, feeling happy, fulfilled and creative. He is no longer suffering.
The Thyroid Gland
The thyroid gland is an important organ. Shaped like a butterfly and located right below the Adam’s Apple on the front of the neck, it has a variety of essential, life-sustaining tasks. The thyroid is responsible for maintaining our body’s metabolic function. It keeps our cells busy, and allows us to convert our food and fat energy into important metabolic functions. It regulates our hormones, cardiovascular system, skin and hair health, contributes to mood, regulates body temperature, balances estrogen and progesterone in females, thereby contributing to healthy fertility, and helps with the functioning of the immune system.
However, as important as the thyroid gland is, it’s also the body’s “canary in the coal mine”, susceptible to the smallest changes in our health status. Physical, mental and emotional stress can contribute to declines in healthy thyroid functioning, as can exposure to environmental toxins, inflammation and deficiencies in important nutrients such as iron, zinc, selenium and iodine. Because of the thyroid’s senstivities, however, we can use impending thyroid symptoms as signs of overall body imbalance. Therefore, treating thyroid symptoms at their root is important for restoring our bodies to mental, emotional and physical health.
Hypothyroidism Symptoms
Most commonly, when the health of the thyroid gland is affected, it’s functions decline, causing hypothyroidism, or under-active thyroid. Hypothyroidism of any cause is the most common thyroid condition and is very common in the general population, affecting about 4-8% of North Americans. The symptoms range from mildly upsetting to debilitating and can show up in a variety of the body’s organ systems. They include feelings of puffiness, especially of the face, caused by water retention; fatigue; dry skin and hair; hair loss; constipation and slow digestion; mental depression and low mood; acne; mental sluggishness, brain fog and poor memory and concentration; menstrual irregularities, heavy or scanty menstrual flow; infertility; cold hands and feet; orange-tinted skin; and, of course, weight gain that is unexplained by changes to diet and activity levels.
Bloating, yeast overgrowth and dysbiosis can occur from hypothyroidism when the core body temperature drops below 37 degrees Celsius. A cooler body temperature due to under-active thyroid can upset the intestinal flora and cause an overgrowth in harmful bacteria and yeast, causing further fatigue, weight gain, depression and digestive symptoms.
Diagnosis and Lab Testing
In the standard medical model, thyroid conditions are screened by testing a hormone called TSH, or Thyroid Stimulating Hormone. TSH is not a thyroid hormone, but a hormone produced by the brain that signals the thyroid to work. Through measuring TSH, doctors can tell indirectly how hard the thyroid is working. Is TSH is high, it can indicate a sluggish thyroid, since it is requiring more stimulation from the brain. Lower TSH levels may indicate that the thyroid is working fine. So, the higher the TSH levels, the more sluggish the thyroid. However, the reference ranges for TSH are from 0.3 to 5 U/ml, which indicates a wide range of possible thyroid states. A TSH under 5 will not be flagged by a medical doctor as being hypothyroid, even though symptoms may be present!
More progressive clinicians start to become concerned about thyroid function when symptoms are present and TSH is above 2.5 U/ml. Therefore, many patients with under-active thyroid and upsetting thyroid symptoms may be told by their doctors that everything is fine, delaying treatment and invalidating their decision to seek help.
When TSH is off, doctors then test the thyroid hormones T4 and T3. (There is also T1, T2 and calcitonin). The thyroid makes the hormones T3 (20%) and T4 (80%) but the active hormone that allows the thyroid to exert it’s effects on the body is T3. T4 must be converted to T3 by the body. Problems of conversion of T4 to T3 can be caused by stress and inflammation. It may be helpful for your doctor to test for reverse T3, a hormone that is created from T4 if the body is in a state of imbalance.
To detect if hypothyroidism is caused by autoimmune disease, also known as Hashimoto’s Thyroiditis, doctors will test for antibodies that attack the thyroid, anti-TPO and anti-thyroglobulin. An imbalance in the immune system and inflammation in the body, often caused by stress, can cause the body’s own immune system to attack the thyroid gland, preventing it from working properly.
Treat the Patient, Not the Disease
Naturopathic and functional medicine aims to use lab testing to detect patterns that are playing out below the surface of the body. We connect signs and symptoms and labs, not to diagnose a disease but to look at patterns of imbalance that are playing out in our patients’ bodies before disease sets in. This allows us to intervene before things are too late and healing becomes more difficult.
The Cause of Hypothyroidism
Gluten: There are numerous studies that link thyroid issues to celiac disease or non-celiac gluten sensitivity. In one study of 100 patients, hypothyroid symptoms were reversed after following a completely gluten-free diet for 6 months.
Goitrogens: Soy, raw cruciferous vegetables (kale, broccoli, cauliflower, spinach, etc.), nightshades (tomatoes, potatoes eggplant, etc.) and coffee can act as “goitrogens”, suppressing the thyroid. Lightly cooking leafy greens, avoiding soy, especially processed, GMO soy, coffee and nightshades is helpful for avoiding the thyroid-suppressive effects of these foods.
Leaky gut: Food sensitivities, bacterial imbalance, antibiotic use, stress, excess alcohol and caffeine and intestinal infections can disrupt the barrier between the intestine and the rest of the body. Termed “intestinal permeability” or “leaky gut” this condition is getting increasing attention for being the root cause of inflammatory and autoimmune conditions. Identifying food sensitivities through an IgG blood test or trial-and-error and then healing the gut for 3-6 months is essential for getting thyroid health on track.
Dysbiosis: There is a close correlation between thyroid health and the health of the gut bacteria. Every human has 4-5 lbs of essential, life-giving bacteria living in their intestinal track. These bacteria help us break down food, help train our immune system and product hormones like thyroid hormone and serotonin, the happy hormone. It is estimated that 20% of thyroid hormones are produced by gut bacteria. Therefore a disruption in gut bacteria can wipe out the body’s ability to regulate the thyroid and metabolism effectively.
Environmental toxins: Toxic estrogens, heavy metals and other environmental toxins can suppress thyroid function. The thyroid gland is a sponge that is susceptible to whatever toxic burden the body is under and therefore, thyroid issues may be the first sign that the body is under toxic stress. 2-3 yearly detoxes are recommended to improve liver health, decrease the toxic burden and support a healthy thyroid. Detoxes are best done by eating a clean, grain-free diet and detoxifying the home by reducing exposure to pesticides, radiation, tobacco smoke, excessive alcohol, mercury from fish and silver fillings, bromide, fluoride and chloride (from swimming pools), which can decrease the body’s ability to absorb iodide.
Stress: Stress can suppress thyroid function by preventing the conversion of T4 to T3, the active form of thyroid hormone. During stress, T4 becomes something called “reverse T3”. Both cortisol and thyroid hormones require the amino acid tyrosine for their production. Therefore, during times of the stress, when the demands on the body for making cortisol are higher, not as many resources may be used to produce thyroid hormones and hypothyroid symptoms may result. Ensuring proper cortisol function and decreasing stress is important for recovering from thyroid symptoms.
Nutrient deficiency: Thyroid hormones are made of tyrosine and iodine. A deficiency in protein and iodine may result in an inability of the body to make thyroid hormone. Selenium is also important for converting T4 to T3. Zinc and iron are also important for proper thyroid functions and, in modern day society, these deficiencies are very common.
Inflammation: Using high omega-3 fatty acids EPA and DHA from fish, rhemannia and turmeric can help bring down systemic inflammation and decrease autoimmunity, thereby working to treat autoimmune Hashimoto’s thyroiditis and restoring thyroid function.
A Word On Medication
Synthroid is a synthetic version of the thyroid hormone T4. When prescribed, it can replace the need for the thyroid to act and help the body get back into balance. However, since T4 must be converted to T3 in order to become active, simply adding Synthroid may not be enough to eradicate thyroid symptoms if there is a problem converting T4 to T3, such as selenium deficiency, dysbiosis, inflammation or stress. Furthermore, when the cause of hypothyroidism is autoimmune, this means that there are antibodies attacking the thyroid, not that there is something wrong with the thyroid itself. Without addressing the underlying autoimmunity and inflammation, patients will only need to eventually continue to increase their Synthroid dosage as the ability of the thyroid to function gradually decreases.
For more information on how to address thyroid symptoms naturally, contact me for a free 15-minute consultation.
I’m tucking away at the cake again because the people who’ve invited me for dinner have dessert. Dessert: the gluten-y, sugar-y, dough-y sweetness of relief from deprivation, the dopamine and serotonin rush when the food smashes against my lips, teeth and tongue and gets swallowed, in massive globs, into my stomach. The desire for more smashes maddeningly around my skull. Getting the next fix is all I can think about. I reach for another slice when no one is looking. I guess some people call this binging, a complete loss of control around “forbidden” foods. All I care about is devouring another bite, and feeling the euphoric blood sugar rush that flushes me with giddiness and good feelings before the shame sets in.
One I’ve begun to indulge, however, the voice demanding more exits stage left and is replaced with a little gremlin who fills my head with sneering and loathsome disparagement. It doesn’t speak in whole sentences, but rather in snippets, sentence fragments and hateful keywords. Sugarrr…. it hisses, gluten, bloating… FAT! Ugly, worthless…No control, no willpower, useless… failure…FAT! Not that the cake contains fat, but fat is what I will become when I allow the cake to become a part of me, the little evil voice suggests. Sometimes I can temporarily drown out his voice by eating more cake, which only makes him louder once all the cake is gone or my stomach groans with fullness.
I’ve come to realize that this cycle can be set off with feelings of boredom, anxiety and, most of all, hunger. A low-calorie diet, detox or a period of controlled eating leaves me susceptible to these binge lapses. It’s taken me the better part of 30 years to figure that out. However, stress can also send me to the pantry, digging out whatever sugary treats I can find. And so the cycle of loss of control followed by self-loathing begins.
The next day, or even within the next few hours, I feel fat.
Fat feels a certain way to me. It feels physical: puffy, bloated and sick. Most of all, it feels like I’ve done something wrong, that I am wrong. It brings with it feelings of lethargy and heaviness, not the light, perkiness I associate with health and femininity. I feel gross, unworthy of good things: attention, love, affection. I feel like I’ve failed. I feel like I’ve lost control of myself. For, if I can’t even control when I shove in my mouth, how can I have power over anything else in life?
However, a person can’t really feel fat. I mean, especially not after only a day of overeating.
And besides, fat is not a feeling.
Perhaps fat was a stand-in feeling for other difficult emotions my childhood brain couldn’t fully comprehend. Like the time I wrote in my diary, at the age of 8 years old, That’s it, I’m fat, I’m going on a diet. From now on, I’m only eating sandwiches. Funny and touching, but also sad, I wonder what 8-year-old me was really feeling when she claimed to feel “fat”. Perhaps she felt helpless, out of control, different from the herd and hopeless about fitting in.
If I pause to peer below the surface of “fat”, I find other words or cognitive connections that underlie it. When I feel “fat” I also feel out of control, worthless, lonely, like a failure. I sometimes feel sad and anxious. Sometimes I simply feel full, like I’ve fed myself, and as I’ve often heard repeated, “It’s important to leave a meal feeling a little bit hungry”, the feeling of being fed can induce feelings of guilt.
Everywhere we look, the media equates “healthy” with thin, glistening bodies. Fitness models with amenorrheic abs, bounce back and forth on splayed legs in front of a full make-up, costume, lighting and camera team to simulate the image of running through a field. “Losing weight” equals “getting fit” equals “being healthy”. As a society we’ve failed to ask ourselves what “health” might mean and instead deliver the whole concept over to impossible standards of beauty, making “health” as unachievable as the stringy bodies that represent it. While I intellectually know that this isn’t the case, that health comes in all sizes—and may actually hover around “plus” sizes, in actual fact—restriction has been imprinted in my brain as a sign of healthy self-control.
But, maybe the definition of health needs to come from digging within and asking the question What does health mean to you? Perhaps the body knows more than the marketing media does about what it needs for health. Maybe, just sometimes, it needs cake to be healthy. Maybe even the act of overindulgence is healthy sometimes.
Perhaps if I give my body enough of the healthy food and fuel it needs, it won’t go crazy the next time it sees cake. When we try to murder ourselves by holding our breath to stop our breathing, we pass out. The body deems us too irresponsible to control the precious task of breathing and so it turns the lights out on conscious breath control. Our very own physiology doesn’t trust our conscious thought if we abuse it. So, when I force my body to survive and thrive on restrictions, self-hate and negative talk, perhaps it induces a binge. Maybe I binge to survive. Or maybe my body loves cake as much as I do.
Instead of feeling like a failure, because I didn’t win the fight against my body, perhaps I should respectfully hand it back the reins and tell it, with my conscious mind, “I trust you, I respect you, I’ll listen to you more carefully from now on.”
And, like Marie Antoinette once granted her people, I can grant my body permission, and let it eat cake.
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
It’s hard to please everyone nowadays. Some people won’t eat grains, others want to protect the animals. Still other people prefer to cut down on their sugar or avoid foods cooked over certain temperatures to preserve nutrients. How do you satisfy this diverse group of foodies with one one-size-fits-all dessert? The search ends here. These chocolate mint squares are raw, vegan, Paleo, low sugar – the only thing they aren’t is hard to make. They take a few minutes to prepare and all you need are the ingredients and a decent food processor or blender.
They somewhat resemble their tooth-achingly sweet cousin, the Nanaimo Bar, with their pretty layers and chocolate finish, but with a health-promoting twist. While these still count as a dessert, they contain healthy fats (avocado, coconut oil and walnuts), fibre and, well, chocolate. We all love chocolate. They’re also decadent with their bright green middles.
Ingredients:
1 cup large dates, pits removed
1/4 cup cocoa powder
1/2 cup walnuts
3 small avocados
coconut oil
1/4 maple syrup or honey
bakers dark chocolate, or dark chocolate baking wafers (available at Bulk Barn)
2 tsp of peppermint extract
Directions:
Base layer:
Lay some parchment paper on a small baking pan. In a food processor blend together the dates (add a little water to the mixture), cocoa powder and walnuts. Spread the blended ingredients over the parchment paper and place everything in the freezer so that it hardens.
Middle layer:
Blend together the avocados, 2 tbs of coconut oil, the maple syrup and 1 capful of peppermint extract. I like to squeeze in a little lemon to keep the avocados looking nice and green. When the base layer is hard, pour the middle layer on top, then return to the freezer for minimum one hour.
Top layer:
In the microwave or small sauce pan, melt a handful of chocolate, 1 tbs coconut oil and 1/2 capful of peppermint extract. Mix together until everything is liquid and uniform. Pour a thin coating of the chocolate layer on top of the frozen avocado layer then return everything to the freezer.
When everything is set in place, carefully cut the recipe into small squares. They will be hard to cut if the top chocolate layer is too thick, as it cracks when hardened. It helps to heat the knife with hot water and slowly cut the squares. Store everything in the freezer and serve cold.
Finding the time and energy to cook during the winter can be tough. However, one of the best things you can do for your health (and wallet) is cook meals at home. Knowing a few slow cooker recipes is essential for getting through a cold, dry winter. Soups, stews and curries are warming and easy to digest; these healthy comfort foods help us feel energized and keep our immune systems strong. Slow cooking is a great way to prepare healthy, hearty meals while you watch the Mindy Project or spend the day working or hiking in the forest. This recipe makes a good amount of eggplant masala, which is perfect for leftovers and lunches. The meal is gluten free (if served with rice) and dairy free as well as vegan. It is high in healthy fibres, healthy fats (if cooked in coconut oil or avocado oil) and protein. The recipe is an adaptation from one I learned at a cooking class I took while traveling in Northern India.
Eggplant Masala (from North India)
Ingredients:
4 medium-sized eggplants
4 large tomatoes (or a can of diced tomatoes)
3 white onions
10 cloves of garlic
1 can of chickpeas or lentils
5 tbs mustard oil, coconut oil or another heat-stable oil (I had avocado oil on hand)
4 tsp ground coriander
3 tsp ground turmeric
2 tsp red chilli peppers
1 tsp salt
1 tsp garam masala
1 tsp mustard seeds
1 tsp cumin seeds
1 tsp fenugreek seed (I couldn’t find fenugreek when I was in the grocery store, and my dog was waiting, tied outside, so I didn’t include it in this recipe. The recipe still tasted lush without it).
a blender, stove and slow-cooker (optional)
Directions:
Heat oil on medium heat, add in the spices to release the flavours.
Blend together tomatoes, onions and garlic. Chop eggplants into 1 inch squares.
Add all the ingredients – eggplants, oil + spices, and vegetable blend, including the lentils/chickpeas – to a slow-cooker and cook on low for 6 hours or on high for 4. Take a walk with your family, meet your friend for coffee, ride your bike, have a bubble bath or leave for work. Another option is cooking the ingredients on a covered pan over medium-high heat for 40 minutes to 1 hour, or until eggplants are soft.
When ready, serve over rice or with chapati or naan.
Perfect for fall, this simple, easily-adapted recipe nourishes a tired digestive system. When the weather gets cold and dry, it serves us well to compensate with foods that are warm in both temperature and constitution. Eating naturally sweetened foods and healthy fats also helps nourish us through what is looking to be a long winter.
SPICED APPLES
Ingredients:
2 apples of your choice
a small handful of nuts: walnuts or pecans
1 tsp cinnamon
1 pinch each of nutmeg, cloves and ginger
1 tbs of oil: olive oil or coconut
Directions:
Chop apples into slices. Put pan on medium heat, add in apples, oil, nuts and spices. Mix ingredients together, adding small amounts of water to reactivate the oil and coat the apples and nuts with spice. Heat until the apples have the desired softness. Allow to cool and enjoy.
This recipe can be consumed as a healthy snack, a dessert or a healthy breakfast (if paired with a protein source such as eggs or steal-cut oats).
I have been gluten-free since the Spring of 2012 when I moved out of my Italian grandmother (Nonna)’s house and stopped being confronted by a daily arsenal of pasta and bread.
Being gluten-free is not hard; it’s only when you combine it with a dairy-free existence (often mistaken for lactose intolerance) that it then becomes problematic. When you start avoiding two or more separate things, you become one of THOSE people in cafes inquiring about the ingredients in everything. You start to hear yourself saying things like “so, are those raw vegan nut ‘cookies’ made with wheat flour? Oh, no? Well then – Ah… spelt. Hm. I’ll just have a $2 apple, then. Thanks.”
The class of 2014 has graduated! I’ve received an email showing that I’ve officially completed my clinic numbers for the term. What has followed in the past few weeks has been a whirlwind of emotions: euphoria, exhaustion, excitement, sadness, grief, accomplishment, pride and anticipation for the future.
For the time being, I’ve returned to my part-time job as an English language teacher in down-town Toronto, entering the grey zone of being a post-graduate, pre-licensed ND on the one hand, and an ESL teacher on the other. Being a part of the real-world and outside of the naturopathic medical student bubble has proven to be interesting. It provides real insight into how other people see naturopathic doctors, or what things they associate with that term.
