A naturopathic doctor offers tips for navigating the often contradictory and confusing world of modern human nutrition.
As soon as we start to feel comfortable with our grasp of human nutrition—which foods are healthy, which ones are unhealthy, and how to eat a balanced diet for optimal health—a new study gets published that shatters our once-felt sense of confidence.
Confusingly contradictory health claims constantly appear in the news, like the American Heart Association’s vilification of coconut oil. The vegan diet-promoting documentary What the Health, currently trending on Netflix, turns convention on it head by assuaging our fears of refined sugar, instead blaming animal protein, eggs and dairy for the worldwide diabetes epidemic. Even I find myself doubting the 15 years I’ve spent studying and working in the field of human health every time paradoxical nutritional data is uncovered.
When I was in high school, I remember patting myself on the back for choosing fat-free options, hoping the leanness of my food would encourage leanness of my flesh. I gave up meat, understanding that I was making a healthier choice; I was told that meat, fat and cholesterol were all culprits of heart disease. I tried giving up eggs and dairy, trying on veganism in order to minimize my impact on the environment. I did an elimination diet while at naturopathic medical school, removing gluten. When my colleagues started reading about the Paleo Diet—grains were the enemy all along, while meat was good for us—I slowly began to embrace a “primal” diet. I started removing myself from the influence of decades’ worth of poorly conducted research and began welcoming saturated fat back into my life. Fat was fine; it was carbs that were the root of all disease. Atkins had gotten it right from the beginning. Eventually I cut out all carbs and sugar and tried a ketogenic diet, eating lots of fat, moderate amounts of meat, and some vegetables.
My journey brings me here, to my Facebook newsfeed, which has been infiltrated with articles condemning coconut oil and saturated fat for raising LDL cholesterol and contributing to cardiovascular disease. “But I thought it was healthy!” Friends, family and patients cry, tearing their hair out in confusion over the news. Some patients have watched Netflix’s What the Health, a documentary from the makers of Cowspiracy, which asserts that sugar’s link to type II diabetes may not bas as strong as previously thought.
The flip-flopping is frustrating for sure, especially for those of us who are committed to living healthy lives for as long as possible. But before we toss our tubs of coconut oil and liquid stevia drops in the garbage and start pulling out the white sugar and margarine again, we should consider how nutritional research is conducted. Let’s entertain different traditional, holistic viewpoints on food and nutrition in order to learn how to feed our bodies optimally.
The Problem with Nutritional Research
There are several problems with how we study nutrition. One of the challenges lies within science itself; scientific studies, by their very nature, attempt to isolate all of life’s complexity down to two variables in order to study them while nutrition, as it’s practised in the day to day lives of human beings, consists of an infinite number of important factors that are often not taken into account.
Most human diet studies are epidemiological. Researchers follow populations of people for years, tracking what they eat and noting how many diseases they get over time. They then synthesize the data to create story. For instance, how much fibre did the people who had heart disease eat? Did those who avoided gluten have a higher risk of diabetes?
In order to assess dietary intake, most epidemiological studies use Food Frequency Questionnaires, or FFQs. Study participants are asked how often they eat certain foods (such as chicken) per week. They are asked to check a box, from “none” to “more than 6 times a week”. As a clinician interested in how my patients’ nutrition may be affecting their health, I assess diet in a few different ways. In the initial appointment, I ask my patients to recall everything they’ve consumed in the past 24 hours to get a rough overview of how they typically eat. Then, between the first and second appointments, I have my patients track their foods in a diet diary over the course of one to two weeks. The accuracy with which my patients report their food intake from the day before depends on their memories, perceptions, and diligence in recording, among other things, and this can compare drastically with their diet diaries that are recorded in real time. Not only do the mundane memories of daily meals evade us, we are often found guilty of deceiving ourselves based on how we feel we should be eating, rather than how we actually are. I find it hard to believe that participants are filling out FFQs accurately.
Also, the stories that epidemiological studies create from the data establish correlation, not causation. With many correlations (like one of my favourites: ice cream consumption and drowning—both occur in summer) there is often no direct relationship. If assessing the connection between fat intake and diabetes, a good study will take into account all meaningful variables, such as how often the participants exercised, or whether they had existing cardiovascular disease. However, considering all the possible factors that might effect the relationship is virtually impossible. For instance, what was the status of the gut flora of the participants? What was their antioxidant or mineral status; were they magnesium deficient? Were they consuming meat that was pasture-raised or corn-fed? How high was their daily toxic exposure? Did they experience chronic stress? How well were they sleeping? What were their levels of inflammation like? And so on.
The trouble with studying nutrition and disease is that, when it comes to health, context matters; context may be all that matters. For instance, while we know that barbecued meat can produce carcinogens that potentially lead to cancer, a study found that when the meats were seasoned with rosemary the carcinogenic load of the meat was neutralized. It’s nearly impossible to form a complete picture when we insist on studying isolated factors, leaving out many important details.
Animal studies, while allowing for tighter control (we don’t ask mice to report their diets, we just feed them), are also flawed. Firstly, mice and humans are completely different species with different nutrient requirements. However, animal study designs can also be problematic. Animals are given lard and white sugar to assess the effects of a high fat, high sugar diet on their health—their diets are exaggerated for the purpose of the study. Human beings, however, eat burgers, cake, and ice cream. We don’t eat single nutrients like fat and sugar, we eat food. If a mouse gets sick on a diet of lard and table sugar is it because of the foods it was eating, something he wasn’t eating, or some other unforeseen factor? There may be a huge difference between eating a high-fat diet with no vitamins and minerals, and eating a high-fat diet that contains complete nutrition.
A third method for studying human nutrition is through randomized control trials, or RCTs. In RCTs humans are randomized into a group that receives an intervention, like a dietary plan, or a control group that is told to follow some other diet or just eat normally. These trials control as many variables as possible, but the timeframe for these studies is often too short to garner meaningful information about health outcomes, which may take years to manifest. It is also difficult to get participants to stick to meal plans. Further, it’s hard to establish consensus for each diet being studied. For example, when assessing the nutritional merits of the Paleo diet, how many servings of vegetables should participants be told to consume? How many grams of fat? What types of fat?
It’s important that we can use studies to seek answers to our questions about the relationship between nutrition and health. However, due to its many limitations, nutritional research can only take us so far. This is why one study may indicate that high sugar diets contribute to diabetes risk, while another study finds no relationship.
A New Food Guide
If we can’t trust research studies to tell us what to eat, who do we trust? Surely we can’t rely on Canada’s Food Guide, with it’s outdated recommendations that simultaneously overemphasize grains and dairy, while continuing to uphold archaic views on fat. Primarily created in the 40’s to help Canadian families ration their food during the war, the Food Guide was not necessarily created to promote the optimal health of those who follow it.
Dr. Ray Cronise, a former NASA scientist, outlines a food pyramid in his paper to help organize food into nutrient content. I often borrow his pyramid to depict nutritional balance to my patients.
Ray’s pyramid is composed of four circles, three that form the base of the pyramid, forming the three main groups of macronutrients: protein, fat, and carbohydrates, and foods that are composed primarily of each. The circle at the top represents the foods that contain a higher number of micronutrients: vitamins and minerals, which are mainly non-starchy vegetables like leafy greens.
Protein-rich foods include meat and animal products, including fish, eggs and dairy. Fat-rich foods include nuts, seeds and oils like coconut oil, avocado and olives. Carbohydrate-rich foods include starchy vegetables like potatoes, grains, legumes and fruit. Ray concedes, however, that none of these foods are composed of a single macronutrient; animal products often contain a significant amount of fat; nuts and seeds also contain protein and carbohydrates; and legumes and grains contain some protein as well.
Ray points out that most diets, particularly the Standard American Diet, is bottom-heavy. North Americans generally over-consume macronutrient-rich foods that are higher in fats, carbs, proteins, and calories in general, and under-consume micronutrient-rich foods like fruits and vegetables. Because of this, North Americans consistently fail to meet the levels of vitamins, minerals and antioxidants essential for optimal bodily function.
It seems that even “healthy” diets tend to focus on the bottom of the pyramid, restricting certain groups of foods while making up the balance by over-emphasizing others. Paleo and low-carb dieters often fixate on the right side of the pyramid, including animal products, nuts and seeds, but avoiding grains and legumes, while vegan and vegetarian diets concentrate on the left side of the pyramid, eschewing all animal products and getting protein from grains, legumes and nuts instead.
One thing all healthy diets seem to emphasize, however, is fruit and vegetable consumption. When studying the merits of a vegan or paleo diet, it is the non-starchy, micronutrient-rich vegetables that may confer most of the health benefits, regardless of the carb, fat and protein content. Therefore, Ray recommends focusing on the top of his food pyramid, eating as many vegetables as possible, while eating a balance of foods from the base.
Since we rarely eat pyramids, I often depict this balance for my patients using a plate. I divide the plate into four quarters. One half of the plate is dedicated to colourful vegetables, with at least a full quarter dedicated to greens. The other two quarters of the plate are divided into starches: grains, legumes, tuberous vegetables, and proteins: meat, dairy, eggs, fish, or legumes. Oils and fats can be used to cook with or added to the meal in the form of avocados, nuts and seeds.
Listening to the Body as Guide
So, while Ray’s advice to eat as many green and colourful vegetable as we can while eating a balance of the foods at the bottom of the pyramid is sound, how can we establish what the right balance is for us? Many of us will have vastly different requirements for the macronutrients: carbs, fat and protein. My body has an energy demand that is different from that of my 6′ friend who lifts weights daily, or my 90-year old hypertensive, mainly sedentary Italian grandmother. As a naturopathic doctor, who believes in an individualized approach to health, I tend to reject top-down dietary recommendations that ignore the variabilities among people.
A friend of mine, having damaged his health through a string of restrictive dieting, argues that all food—even refined sugar and saturated fat—has a place in a healthy diet. He believes our bodies are designed to crave fat, protein and carbohydrates in ratios that promote optimal health. He writes in his book that we can eat whatever we want as long as we eat intuitively and avoid foods laden with “fake” flavours and processed oils, like corn oil, that confuse our internal cues and hunger signals. He also argues, like the filmmakers in the Netflix documentary, What the Health, that there is no evidence that refined sugar causes diabetes, and that diets based on avoidance of certain foods are detrimental for health.
While I’m not convinced that refined sugar deserves to be completely cleared of all charges, I agree that mindful and intuitive eating may be the key to maintaining balance. Healing with Whole Foods by Paul Pitchford places awareness and physical activity at the base of its Integrative Food Pyramid. The idea is that we need to first establish the foundations of movement and mindfulness before we begin to talk about food intake. As my friend says, perhaps the key is tuning in to our own internal physiological and emotional cues through mindfulness, paying attention to hunger and cravings, rather than measuring calories, carbs, protein, or fat grams.
Following our internal cues may be difficult, as the book TheDorito Affect outlines. The author points out how certain foods are engineered to override our hunger and satiation signals and monopolize our cravings, leading us to overeat. Therefore, if we’re going to follow our body’s signalling, mindfulness is a requirement, but so is following the advice of Michael Pollen, author of The Omnivore’s Dilemma, who famously tells us to “Eat food. Not too much. Mostly Plants.”
Pollen urges us to stick to foods that resemble something we might encounter in nature: eat foods our grandmothers would recognize; purchase foods that come from a plant, not foods that are made in one; and to stick to whole foods or packaged foods with five listed ingredients or less. Pollen also encourages us to cook and prepare as much of our own foods as possible. Do you have a craving for potato chips, ice cream, or dark chocolate? Feel free to indulge, as long as you make it yourself using the raw, natural ingredients. The theory is that, when the body is given clean, whole food, it regulates its hunger and satiety signals to communicate to you exactly what it needs.
Heal the Individual
When it comes to whole foods, I believe that there are no “good” or “bad” foods, generally speaking. Observational studies that examine how traditional societies ate suggest to us that saturated fat, animal protein, dietary cholesterol, and carbohydrates all have a place in a balanced diet. However, when it comes to diet, especially therapeutic diets, it’s my job to consider the individual and their health context: there are no good or bad foods, but some foods are better or worse for certain people, and some may even be better or worse for certain people at certain points along their health journeys.
When I am helping my patients calm inflammation, heal their digestive systems, clear their skin, or manage autoimmune disease, I often recommend identifying food sensitivities and eliminating those foods from the diet. Oftentimes these foods need to removed only temporarily, but sometimes foods may need to be removed indefinitely. Patients with insulin resistance, such as in the cases of obesity, PCOS, diabetes or metabolic syndrome, often do well on a low-carbohydrate diet to restore insulin sensitivity. Again, these anti-inflammatory, reduced-carbohydrate diets may only be required until hormonal balance is restored. Older adults concerned with promoting longevity, or patients undergoing cancer treatment, may do better restricting protein to lower their levels of growth factors, while athletes and stressed out adults may require higher amounts of protein to promote muscle building, or to synthesize mood-regulating neuro-chemicals. A woman who is stressed, depressed, exhausted and iron deficient may feel much better increasing her dietary intake of red meat to help regulate her nervous system. Another woman, with a family history of colon cancer, may do better avoiding it.
Endless factors need to be taken into account when we consider which dietary style is right for us. Our health goals, health status, nutrient status, digestive system health, immune system health, liver functioning, insulin sensitivity and hormone balance, levels of stress, toxic load and inflammation are just some of the things that I consider when making lifestyle recommendations for my patients. Lifestyle preferences, tradition, culture, religious backgrounds, cooking abilities, time constraints, and other factors, will also all play a role in our food choices and eating habits.
Our emotional connection to food and our ethics also matter. While veganism is certainly not a diet I recommend, if consuming animal products is out of line with one’s morals, then following a vegan diet may be the healthiest way for them to live in accordance his or her beliefs. Similarly, someone with a history of disordered eating may need to lift all food limitations, even junk food, in order to heal his or her relationship with food and hunger.
Investigations into the eating patterns of traditional societies tell us that human beings thrive on a variety of different diets. Optimizing diet for the individual goes beyond following the latest research or government and industry-funded health recommendations. It involves eating a variety of natural, whole foods, learning to pay attention to the body’s hunger signals, and even working with a health professional who uses diet to help promote health and manage disease on an individual level.
I talk about the supplements I take on a daily basis and their indications.
Hey, Everybody, my name is Dr. Talia Marcheggiani and I’m recording to you guys from my kitchen in Toronto. And this video is about the supplements that I take as a naturopathic doctor and health experimenter. When it comes to making treatment plans for my patients I prefer to focus on the Therapeutic Order, so starting with the foundations of health, which usually means making adjustments to diet and lifestyle and if possible using food prescriptions and functional foods to help heal the body as opposed to relying on supplements. And this is just from clinical experience and from a cost-benefit perspective. So, of course it’s better to get these nutrients from food sources, because, when you eat a pile of kale, like a big plate of leafy greens, you’re getting all of the vitamins that we know about: the magnesium, the fat-soluble vitamins, like A, D, E, and K, some iron, and all of the flavonoids, and anti-oxidants that are present in that big pile of greens, but you’re also getting a lot of nutrients that we haven’t been able to isolate and that we don’t know is present in those foods. Some of those nutrients may act synergistically. And so it’s always better to get things from their whole-food source, I think. That’s the philosophy that I come at when it comes to health and healing. And I’m always looking for the obstacles to cure. Ideally I’m prescribing something like magnesium to replenish a magnesium depletion or to compensate for a diet that may be inadequate for magnesium, or to replenish magnesium deficiency. So I’m not a big fan of prescribing a ton of supplements, and I think my patients appreciate that, because of the cost and the annoyance of taking a lot of things. That being said, there is definitely a benefit to supplementing with vitamins and minerals and other sort of functional supplements to improve optimal health. We’re trying, obviously, to eat a diet that meets the recommended daily nutrition intake for all the vitamins and minerals that the body needs to function optimally, but there’s some evidence that increasing these levels and taking higher doses of these vitamins and minerals may actually help our body perform properly. So, if you take something like vitamin C, if someone is completely deficient in vitamin C that will manifest as a disease called scurvy, where you’ve got loose gums, or you’re experiencing problems in creating collagen. You’re getting sore on the skin, there’s skin issues, there’s gum issues. And then there’s an adequate amount of vitamin C, where you’re not seeing those symptoms, and then there’s having optimal vitamin C, where your body is able to not just meet its daily requirements for all of the chemical reactions that it needs for us to feel our best, and look our best, but now it’s got an abundance of vitamin C and now it’s able to really divert a lot of the vitamin C that it’s getting to increase energy, to boost immunity, to target cancer cells, to exert an anti-oxidant effect, to accommodate all of the free radicals we might be exposed to, living in our modern times.
So, that being said, I do my own self-experimentation with vitamins and minerals, and there’s a few things that I’ll take on the regular, that I’ll take all the time, and then there’s other things that I might play around with, just to see what it’s like to take the medicine. Depending on what it is, I think doctors should taste their own medicine every now and then to know what the effect is on their patients and what their patients’ experience would be, experimenting with these vitamins and minerals.
So, the first thing I take, and this is something that I started taking in school, is a B complex. And a B complex contains all of the B vitamins. Some people get confused, they’ll refer to their B12 supplement as a B complex or they’ll refer to a B complex as B12, or they’ll get confused about all of the different B vitamins. In this product there are all of the B vitamins, from B1 all the way to folate. These B vitamins are cofactors in thousands of chemical reactions in the body. We need vitamin B6, for example, to make serotonin out of tryptophan and 5HTP, those are all the amino acids that are present in the pathway to synthesize serotonin and without B6 we’re not able to make serotonin, no matter how many of those building blocks, tryptophan building blocks, may be present in the body. So, if we’re deficient in these cofactors, our body is just not able to function properly. And we burn through B vitamins a lot more quickly when we’re under stress and some people have higher requirements for them. And some people have an issue metabolizing certain forms of B vitamins. So, for example, there’s some people that have an issue taking folic acid, which is often thrown into a lot of our grains and cereals, that are fortified and lots of multivitamins and taking that folic acid and making it into its active form, about 40%of people have a genetic polymorphism that reduces their ability to methylate and to make active folate and, therefore, they need to supplement with the activated from of folate otherwise the folic acid that’s in all of their foods starts to build up in their tissues and there’s some evidence that that can cause problems.
I showed you which B vitamin I use. I use the AOR brand and one thing to look for in a B vitamin is, what is the form of folate in it? So, you want to look for one that has L-5-MTHF or that’s the methyl-tetrahydrafolate, that’s the active form of folate. And you also want to look at the B12, what’s the form of B12? So there’s 3 different forms of B12: cyanocobalamin, hydroxycobalamin and methylcobalamin. Cyanocobalamin is the synthetic form and, for the same reason that people have a problem activating folate, they may have a problem activating B12 and using it. And it’s the methylated form, methylcobalamin, that crosses the blood brain barrier, and that would have effects on depression and anxiety, and help with cognitive decline, and energy and all of those things. So, it’s important to look for a B vitamin that’s got those activated forms of the B complex. And you also want one that has adequate forms and that will be better absorbed. And so, taking a B complex is not something that you can overdose on readily because it’s water-soluble, so you may notice, as you start to take it, that your body starts to up-regulate the receptors to absorb them, for the initial weeks of taking it, you might have really yellow pee. And that’s normal, that shouldn’t cause any issues, but it’s one side effect that sometimes surprises people when your first morning urination is highlighter neon yellow.
The other thing that’s a staple in my supplement regime is magnesium. So, magnesium is, again a cofactor in tons of chemical reactions, and one of the really important functions that magnesium has is in DNA repair and also in mitochondrial function. So, mitochondria are the furnaces in our cells. Without magnesium, our DNA won’t have that ability to repair itself, which can cause us to allow DNA mutations or issues with DNA replication to go unnoticed and that can cause problems such as cancer down the line. It’s not that you’re deficient in magnesium one day and that manifests as symptoms, it’s something that will manifest over time, over decades of having just insufficient magnesium to achieve optimal health. So, you might be meeting your general needs where you’re not outwardly deficient in magnesium but, you’re not getting those levels to really have your body functioning at its best. Magnesium deficiency can manifest as symptoms, as physical, clinical symptoms in people and a big one is tense and tight muscles. Magnesium is a skeletal muscle relaxant and a smooth muscle stimulant. So what that means is that, if you’re the kind of person that has got really tense shoulders, lots of muscle knots, lots of aches and pains, that are muscular in nature, magnesium can help relax that skeletal muscle. And if you’re the type of person that suffers from menstrual cramps, or constipation, then magnesium is helpful for getting things moving and stimulating motility of the digestive tract and relaxing the uterus as well. Magnesium, there’s been some studies showing that magnesium can be beneficial for headaches, and that is probably due to its muscle-relaxant properties. Magnesium is also a great remedy for fatigue and, like B vitamins we burn through magnesium a lot more quickly when we’re stressed. 40% of people have a diet that it is inadequate to obtain their optimal levels of magnesium. This may be because we’re not eating enough leafy greens, which is a really great source of magnesium. It’s about 2 cups of spinach or chard a day to get the 300 mg of the magnesium, and also from soil depletion. So, when crops are not rotated, and the soil’s not replenished, the next round of crops are grown in a soil that’s depleted and therefore those plants aren’t absorbing the nutrients that were then going to enter our bodies after we eat those plants. And from this soil depletion, it’s hypothesized that that’s why our magnesium levels are so low. Also, a diet that’s high in processed sugar increases our magnesium needs, and a lifestyle that’s high in stress also increases our magnesium needs, as we need it to make stress hormones.
So, B complex and magnesium.
I often recommend to my patients to take magnesium before bed because of the skeletal muscle-relaxant properties, it helps to calm the body and the mind. There’s different forms of magnesium and the forms are prescribed based on what your therapeutic goals are. So, something like a magnesium citrate will be prescribed for somebody who’s tending more to the constipation, because it can help draw water into the bowels and have a bit of an osmotic laxative effect. So, it doesn’t sort of stimulate the bowels, like a laxative would, like sennakot, but it will draw water into the bowels to kind of flush the system out. That can be problematic over the long-term so do that under the supervision of a doctor or naturopathic doctor. And then, for people that are really sensitive to those laxative effects of magnesium, they may want to go with a magnesium that’s conjugated to an amino acid such as glycine. And so I often recommend magnesium glycinate, because a lot of us are also deficient in glycine. Another good source of glycine is collagen, or gelatin, and glycine has this sort of relaxant and modulating effect on the nervous system, and so it can be great for depression and anxiety, more so for anxiety because of its calming effect on the brain.
So, another supplement that I take is zinc. So, this is not the best form of zinc, I just picked this up because it was cheap and I could find it—I think I got this one at Bulk Barn, this is a zinc citrate. Even better absorbed form is zinc picolinate, so there’s a study that shows that that’s the best-absorbed form of zinc, which is appropriate for somebody that experiences nausea when they take zinc, which goes away in a few minutes, but it kind of sucks to have so, if that’s happening to you, then going with a more absorbable form of zinc, or taking zinc with food. A zinc deficiency manifests as dry skin, and depressed immune system, so you’re getting infections a lot more often than the average person. But inadequate levels of zinc can manifest as hair loss, leaky gut, depression and anxiety. Zinc helps us with neurogenesis, so it actually helps us make BDNF, brain-derived neurotropic factor, which is a chemical that our brain uses to make new neurons, and to promote resilience against stress. It sort of protects the brain against mental and emotional stress. And I also prescribe it for cystic acne and hormonal acne. And zinc is a really good remedy for PMS and heavy menstrual periods and vegetarians are often deficient in zinc.
4th is a fish oil. So a fish oil is combined with two kinds of omega 3 fatty acids: EPA and DHA.The one I use has got a 5:1 ratio for EPA. So, EPA is the anti-inflammatory omega 3, the anti-inflammatory fish oil. DHA is the fish oil that we use to build up our brain tissues. Most of our brain mass is made of fat and it’s mostly this kind of fat, DHA. So there’s some good studies that, because of its anti-inflammatory properties, EPA can help increase symptoms of depression. And this is probably because there’s some evidence that depression, like other mental health conditions, is an inflammatory condition in the brain. We don’t have pain receptors in our brain, so if our brain is experiencing even a small level of inflammation, it can kind of go undetected. It may just manifest as negative thoughts, mental chatter, low mood, lower or impaired neurogenesis. We’re not experiencing that acute, sharp memory that we’re used to, maybe we’ve got some brain fog, maybe we’re having trouble recollecting names and those kind of things. And there’s a little bit of evidence that it can be heart healthy as well. Our diet is really rich in omega 6 fatty acids. These are the more, inflammatory—this is sort of a general statement—they’re little bit more on the inflammatory side. I think our diet is about 10:1 omega 6:omega 3. And that’s mainly because we’re consuming animal products from animals that are not fed their natural diet, so for example cows should be eating grass, but we’re feeding them corn, which tends to make the fat in their meat more composed of the omega 6 fatty acids, and also because we’ve been told to avoid saturated fats and to eat a lot of industrial seed oils, like canola oil and corn oil, and vegetable oil, which is just corn oil, and soy oil. And so, these kind of oils are also rich in omega 6, those kind of pro-inflammatory fats. It’s been shown that our ancestors, our hunter-gatherer ancestors, had a diet that was more 1:1, for omega6:omega3. So, supplementing with omega 3 fish oils or eating fish a few times a week, those fatty fish I mentioned in other videos, decreases that ratio of omega 6 to omega 3. I also take NAC. And the reason I take NAC is I did a genetic test that showed that I have impaired phase II liver enzymes. So my body has a little bit of difficulty making glutathione, which helps detoxify all of the toxins and free radicals that pass through my body, all of the hormone metabolites. So, no matter how clean I live, if I’m using natural cleaning products, natural body care products, I’m still exposed to toxins, as we all are: there’s car exhaust outside, we’re consuming things that are wrapped in plastic, so no matter how perfect you try and be, you’re still going to be exposed to things. And so, to encourage my body to make more glutathione, I give it NAC, which is a precursor to making glutathione, the antioxidant. NAC helps with liver detoxification, so it also helps decrease symptoms of hormone metabolites, that estrogen dominance, that I also talk about in other videos, and it can also help with detoxifying the brain, so neurons. And that’s through its antioxidant effects and it kind of cleans out mitochondria. So you imagine if you’re running your car in your garage, the process of your car metabolizing, so spending its fuel, is creating some chemicals that are coming out of the exhaust pipe. And if your garage door is closed, all of those chemicals are filling the garage. And so, taking NAC is a little bit like opening a window, it’s just helping your body get rid of all of those toxic metabolites from performing its chemical duties. So I’ll take NAC and I’ll recommend NAC for mental health conditions, especially OCD and bipolar disorder. And sort of on that note, I also take something called estro-adapt. And it doesn’t have to be this product, there’s many other products that are similar to this, estroadapt has DIIM and calcium d-glucarate. Both of those are chemicals that help the body metabolize estrogen. So I’ve talked about estrogen dominance and other videos and the estrogen is not just one hormone, it’s a group of hormones and that there’s also these xenoestrogens, so these estrogens that are toxins in our environment that exert estrogenic effects. So, some of these include fragrances, and bisphosphenol A, BPA, that’s found in plastic, that has received a lot of media attention, what DIIM and calcium d-glucarate do is help us with normal estrogen processing. So, estrogen, when don’t need it any more, when it’s already done its thing, or those more toxic forms of estrogen, they’re conjugated in the liver, so the liver makes them inactive and then they’re dumped into the colon, where they’re removed from the body. And what happens if any of those steps are impaired, so if your liver is sort of overburdened processing other things, or you’re not able to process those hormones as well, is you’re going to have a higher level of metabolites in the body, or if you’re constipated, or if you’ve got a dysbiosis situation happening, and some pathogenic gut bacteria that aren’t able to keep estrogen conjugated, so they sort of put it back into it’s active form and the body reabsorbs it, which is not what you want. You want to get rid of those toxic estrogens.
So what I’ll recommend is doing a detox twice a year, Spring and Fall is a great time to do a detox and I’ll do another video on detoxification because our body can detoxify pretty effectively. It takes care of all of our detoxification needs, but sometimes it helps to give it a little bit of a boost, and so a product like this, with DIIM and I3C, or indole-3-carbinol, which is not in this product, or calcium d-glucarate, is really helpful for lowering those estrogen toxicity symptoms, which could be heavy menstrual periods, anxiety before your period, PMS, hormonal acne, irregular periods, weight gain, especially around the hips and a predisposition to female cancers, such as breast cancer. Another way you can get this from diet is from green leafy vegetables. So those are all the crucifates, broccoli, cauliflower, cabbage, brusselsprouts, chard, spinach, kale, all of those vegetables are really rich in I3C and DIIM and those help us clean estrogen from our body. Finally, I take an adaptogen. So, adaptogens, this is Withania complex, they’re herbs that literally just help the body adapt to stress. So my two favourites are withania, or ashwaghanda, and rhodiola. And I like taking them together, this complex doesn’t have rhodiola in it, but it does have ginseng, which is a little bit more stimulating. It’s got withania, it’s got ginseng, and it’s got licorice, and it has skullcap, which is a little bit more calming, nervous system calming. And, so what withania does, these just help us against the pro-aging and pro-inflammatory stress effects. So, they help sort of protect our tissues against stress, they protect our brain against stress, they can help calm the body down, they help the adrenal glands function more optimally, and rhodiola in particular, helps increase BDNF, just like zinc, so it increase brain-derived neurotropic factor, NAC also does this as well, and there’s a connection between low levels of BDNF and depression and anxiety and mental health conditions. The low levels of BDNF may be from nutrient deficiencies, or it could be from inflammation in the brain and that inflammation could be just a stress resistance. So, the stress hormone is coursing through our body 24/7 and our brain sort of stops responding to them as well, kind of like a diabetic, a type II diabetic, stops responding as effectively to insulin, an a resistance develops and, since those stress hormones have an anti-inflammatory effect, when you start becoming resistant to them, inflammation ensues. And so what withania and rhodiola do is just help calm down that inflammation. I’m a big fan of herbal medicine because in addition to sort of its active medicinal properties, herbs are also flavonoids, and have really important nutrients, like I talked about that big pile of leafy greens, we’re not exactly sure what is in these nutrients. We just know that, as a whole, they work really well. And so they’re flavonoids, they’re also anti-inflammatory, they’ve got anti-oxidants, as well as their medicinal properties that we can isolate and study. So I like herbs, it sort of brings us closer to nature, it puts a piece of nature into our body and some of that intelligence of nature, rather than just one supplement or one ingredient would do. And, because we’re so stressed out, and not all stress is bad. You think of a new mom, she just had a baby, she’s full of love and joy, but there’s sleep-deprivation, there’s all these kind of thoughts, and new responsibilities that are filling her life, so she’s stressed out, but she’s not full of negativity and negative thoughts. And so that’s still stress, the body still perceives that as stress. Some signs of stress are waking up in the middle of the night wide awake, inability to fall asleep, that tired and wired feeling, feeling like you’re getting an energy crash around 2-4pm, feeling a little bit more tired than usual, feeling a little bit more burnt out, feeling a little bit of ennui, and lack of motivation, so a lot of those signs of depression are actually present in someone who’s chronically stressed out: lots of mental chatter, lots of negative thinking and irritability can also be signs of stress. It manifests differently in every single person and so I’ll go through a full work-up to see how stressed out somebody is feeling and what their state of stress is. And there’s a difference between perceived stress and how stressed out you think you are, and actual, physiological stress and what the body’s under. And being in a state of inflammation, as well as riding the blood sugar roller coaster can also increase our physiological stress.
Finally, I take 5HTP. And I take this before my period, so I don’t take it all the time. I may take a couple hundred mg of it before bed, just to help with sleep. And, so 5HTP is a precursor to make serotonin. A lot of women will experience a dip in serotonin right before their period, sometimes up to a week before, so these women will experience irritability, those mental and emotional PMS symptoms, cravings for sugar, inability to sleep, worsening of depression and anxiety right before their period. And so sometimes they can benefit from 5HTP, which is an amino acid. 5HTP needs magnesium and B6 to work properly, though. So, we need to make sure the body has got adequate amounts of those nutrients, either through supplementation or diet, so that it can take that 5HTP and make it into serotonin. 5HTP crosses the blood brain barrier and so that sort of helps us get it into our brains where it can be made into serotonin. And the good thing about amino acids, like NAC and 5HTP and some of the other ones I mentioned in my amino acid video, is that they work pretty quickly, so sometimes they can exert their effects within hours and sometimes even within a matter of days, whereas something like fish oil can take months to be incorporated into the cell membranes and change the fatty acid profiles of our cells.
Even B vitamins work pretty quickly as well. So, these are what I take. You’re going to need something different, maybe less things, maybe more things. Some of these things are things that I experiment with, and sometimes I’ll do a wash. So, a lot of the time, if my patients are on a ton of things and they come in in that state, I’ll wash them, we’ll have them stop a few things, see if symptoms return, see what their baseline of health is. Because sometimes we just need a boost and to just take these things for a few years or months, and then our body gets back on track, sometimes we need some continual support throughout our lives. And so, everyone is different, everybody has different individual biochemical needs and everyone has different challenges with getting diet into their life and exercise and meeting those foundational health needs. And so someone who is a little bit more challenged in that department, who’s got a really busy and stressful lifestyle may need more nutritional support, someone who’s in a chronic disease state, recovering from more serious health issues may need more support and someone who’s having trouble maintaining their minimal nutritional requirements through diet may need some more support.
Again, I always tell people to pay for a consult with a functional medical doctor or a naturopathic doctor to figure out what your supplement regime would be. I see a lot of people in healthfood stores kind of going it alone and, not to say that you can’t get great information from the internet, but it may result in your taking a lot of things that you don’t really need, spending a lot of money that’s not targeting a specific health concern or meeting your higher levels of nutritional requirements. And also the form of the supplements and the dosing is something that’s individualized, that we need to talk about. So, there was a Marketplace study with CBC that showed that a lot of these vitamins and minerals that aren’t from professional brands and aren’t 3rd party tested don’t actually contain what they say they contain. This is specifically a problem with herbal remedies. So, if you have any questions leave me a comment below my video and you can check out my website at taliand.com .
I talk about 8 functional foods that can help calm inflammation, boost neurotransmitter synthesis and restore common nutrient deficiencies that might contribute to low mood and mental health conditions.
My name is Dr. Talia Marcheggiani. I’m a naturopathic doctor with a focus in mental health and emotional wellness as well as hormonal health and hormone balancing, and today I’m going to deliver a short video about some foods that you can add to your diet to help your mental health.
These are all medicinal foods that act like prescriptions, like anti-depressants, that you can just add to your diet. So, a lot of these foods are recommended based on the idea that depression is an inflammatory condition in the brain. There’s more and more research that shows that there’s low levels of inflammation in people who have depression and anxiety and other mental health conditions like bipolar disorder, schizophrenia, ADD, ADHD and even sub-diagnostic symptoms, such as brain fog and cognitive disruptions. So all of these are a result of some kind of inflammation in the brain. And so a lot of these foods are working to heal depression and anxiety with their ant-inflammatory properties.
And so the first thing that’s recommended to eat are lots of anti-inflammatory fats. These are omega 3 fatty acids such as fish oil. So you can either increase the amount of fish oil by having fatty fish three times a week. You can remember what a fatty fish is by the acronym SMASH. And SMASH stands for sardines, mackerel, anchovy, salmon and herring, and also trout, so SMASHT. And these kinds of fish are rich in the omega 3’s EPA and DHA. Our body can make EPA, but some of us have impaired ability to make it. And so supplementing is necessary for a lot of these people. If you’re looking for a fish oil, make sure you look for one that has a higher amount of EPA compared to DHA. This is very important, because studies on depression are very favourable for fish oil supplementation, but the ratio of EPA to DHA has to be at least 3:1 or higher, and the higher the ratio, the higher the amount of EPA relative to DHA, the better the anti-depressant effects, and the mood-regulating effects. So, fish oil actually showed positive outcomes treating bipolar disorder and schizophrenia, so there’s a mood-stabilizing effect as well. And we think because our brain is made up largely of DHA and EPA, but also the anti-inflammatory effects are very helpful for mood and emotional balancing and mood balancing.
Coconut oil is also another great oil you can add to your diet. Coconut oil is a saturated fat, but it’s rich in something called Medium Chain Triglycerides. So these are saturated fats that the body uses readily for energy. So they don’t go through the normal process of digestion that other fats have to go through. They’re absorbed in our lymphatic system. So we get those fats, the energy from those fats, right away.
Coconut oil is very anti-bacterial and anti-fungal, so it can help regulate bacterial balance in our gut and it can give you a boost of energy. There’s also some evidence that being in ketosis, so this means relying on fats for energy, as opposed to carbohydrates, and, to an extent, proteins. Being in ketosis, so burning fat for fuel: body fat or dietary fat, has a mood-stabilizing effect. And so you might read about intermittent fasting, Ketogenic diet. I wouldn’t recommend doing that without working with a functional medicine practitioner, nutritionist or a naturopath, because there are some negative downsides to doing those kinds of diets prolonged, without supervision, but there is some growing evidence for that. But one thing you can do is add coconut oil to a morning smoothie, or eat a couple of tablespoons in the morning, even looking at some Bulletproof coffee recipes, that can also help with keeping your mood steady or your energy high in the morning.
Staying on the topic of fats and nuts, something that is really great for mental health are Brazil nuts. And Brazil nuts are high in a nutrient called selenium, which our body needs to create an anti-oxidant, the main anti-oxidant in our body, glutathione. You may have heard me talk about n-acetyl cysteine, NAC, which is an amino acid that I often recommend for people with bipolar disorder, for schizophrenia and, to an extent, depression and anxiety, and especially personality disorders, like borderline personality. There can be a very strong mood-stabilizing effect with NAC. And that’s probably because—we’re not exactly sure why that is—but it’s probably because NAC is the precursor to what our body uses to make glutathione, but we can’t make glutathione without selenium. So two brazil nuts a day, and they’re really delicious and fun to eat, they’re big nuts—two brazil nuts a day gives you the 200 mcg of selenium that’s the therapeutic dose. It’s also helpful for thyroid health.
Another thing I tend to recommend and am recommending a lot more in my practice is collagen, specifically gelatin, but for the more health-food minded people, going with a collagen hydrosylate supplement from grass-fed meat is something that I often recommend. But, for most people and myself, I just throw some gelatin that you can buy at Bulk Barn, into a shake or into a seed bowl, or into something that I’m eating like oatmeal, or I’ll make jello out of it.
So, gelatin is really rich in collagen, so it’s made from the hooves of animals, and collagen has a gut-stabilizing effect, so it can help heal the gut. A lot of us suffer from something called “leaky gut” in which inflammation in the gut makes its way to the rest of our body and can affect our brain. Leaky gut can often result in “leaky brain”, resulting in inflammation in the brain and then mental health symptoms. So, collagen helps to repair the gut barrier and the blood-brain barrier. It’s also very anti-inflammatory because it’s high in an amino acid called glycine, which is a calming neurotransmitter as well as an amino acid. It can also help balance the immune system. So anyone that has a low level of autoimmunity, or maybe your immune system is on the sluggish side and you’re getting colds and flus and infections more readily than others, collagen is a great supplement for that. Because our main sources of protein: meat, legumes, whole grains, nuts and seeds, don’t contain a lot of glycine. We’re pretty glycine deficient in our society because we’re not eating that much gelatin, we’re not getting as much bone broth. And so you can get collagen from from making bone broth, from stewing bones and accessing that bone marrow, or you can get it from something like gelatin, which is from hooves, from the collagen-rich membranes, the cartilages, of animals. There’s also fish collagen for more pescatarian-oriented people.
Collagen is also really great for anti-aging, for treating hair loss, for skin and for cellulite. So, all aesthetic things that might bring someone in to my practice, but also really great for mood balancing. A good source of protein as well.
You can either just throw it into a shake, mix it into some water or make your own jello. And I make jello by boiling some fruit, about a cup of blueberries in water. I boil it until the blueberry juice is extracted, then I add a couple tablespoons of gelatin and then I put it in the fridge until it’s hard. And you have a natural jello you can serve to your kids. It’s pretty good.
Another great food to help balance your mood and mental health is turmeric. Turmeric, or curcumin, as it’s scientifically called, is a spice that is used mostly in India. It’s a yellow spice, it stains things yellow: your clothes, your counter, your intestines. It has very very strong anti-inflammatory benefits. It also helps the liver detoxify, it’s been shown to have anti-cancer properties, it’s a really powerful, nutrient-rich plant, root. So studies have shown that two grams per day of turmeric actually outperformed Prozac for treating depression and probably this is due to its anti-inflammatory properties in really lowering inflammation in the brain, which we know is really one of the underlying roots of depression. The way that we get to that inflammation is different in every person with depression, but there is this kind of common thread of inflammation that’s going on in every case of mental health condition, mental illness. So, adding turmeric to foods, or supplementing with turmeric, is a great way to combat that inflammation and keep moods balanced.
Some other foods you might want to add to your diet are foods that are rich in zinc. So, these are mainly things like pumpkin seeds. You’ve got to get around two cups, though, of pumpkin seeds, to get a decent therapeutic dose of zinc, or oysters. Or you can supplement with zinc. Zinc, again, is anti-inflammatory, it can help heal the gut. We need it to make neurotransmitters and enzymes that our brain needs to rebalance mood. And there’re also some studies that zinc increases something called BDNF. BDNF is a chemical in the brain that help with neurogenesis, this is the creation of new neurons in an area of the brain called the hippocampus. So you may have heard “you can’t teach and old dog new tricks” or that our neurons never regenerate once we reach a certain age, and this is not true because new research has shown that we do have neurogenesis, something called neurogenesis, that increases and changes and grows new neurons even as we age. And so anyone suffering from brain fog or really high amounts of cognitive stress, or mental illness, maybe benefit from zinc as that increases the neurogenic abilities of the brain. It’s also very anti-inflammatory and it can help with leaky gut and leaky brain situations. Vegetarians, unfortunately, are often deficient in zinc just because we get most of it from animal products and animal sources, but really upping your pumpkin seed intake might get you to a therapeutic level of zinc or you can supplement as well.
Another really great addition to your diet to help balance mood and to improve your mental and cognitive health are fermented foods. So, these include things like kefir, kombucha, kim chee, saurkraut, and yogurt, if you do dairy. These things, they contain probiotics, and studies show that it may be better to supplement or to add fermented foods to your diet rather than supplementing with a probiotic, and this is obviously an individualized recommendation that would have to be made by a doctor, but adding fermented foods to your diet, especially if you make them at home and ferment them at home, like you make your own kombucha or your own kefir, that can actually boost the probiotic capacity of your gut. Probiotics actually make neurotransmitters, they make things like serotonin, and the calming neurotransmitter GABA and they can help us digest our food, like gluten, as well as combat inflammation and regulate our entire immune system. It’s also important to feed those probiotics with something called resistant starch that you can find in carbohydrates that have been cooled to room temperature after they’ve been cooked, so, for example brown rice that’s after it’s been cooked as been cooled to room temperature, potato starch, green bananas, black beans, and jerusalem artichokes. These are all starches that bacteria feed on and that keeps them populated in the gut. Coconut oil tends to kill more pathogenic bacteria and therefore can promote a healthy bacterial balance.
And lastly, I’m going to talk about leafy greens. So, adding a cup of spinach, or two cups of spinach or chard to your diet will give you the amount of magnesium you need. Magnesium has a calming effect on the body. We need it to make the neurotransmitters like serotonin, dopamine and melatonin, to help with sleep. Magnesium also can help balance mood and help us with stress. A lot of us suffer from stress. It can also make our brain more resilient to stress, as stress is one of the major causes of neuro-inflammation in people with mental illness and this can be stress from a significant trauma, it can be psychosocial stress, interpersonal stress, the stress of being out of work, even long-term chronic stress or burnout from school and work and things like that. So, two cups of spinach gives you your daily magnesium serving. You can also get it from chocolate but you need to eat quite a bit of chocolate.
So, in boosting your mental health, or in promoting mental and emotional wellness, you can add all of these foods to your diet and balance your inflammation, feel good and nourish yourself.
I often recommend smoothies as an easy way to manage mental health symptoms, balance blood sugar, reduce inflammation and increase energy. I discuss the types of foods I put into my morning smoothie and their benefits on the body and mind.
Hello, everyone. My name is Dr. Talia Marcheggiani, I’m a naturopathic doctor with a special focus in mental health and emotional wellness and today I’m going to talk to you about how to make one of my favourite breakfasts to recommend patients: the morning smoothie. I always recommend smoothies in the mornings because it’s a great way to take care of a lot of your daily recommended nutrients in terms of protein, vegetable, anti-oxidant-rich berries and a healthy source of fat.
I always recommend somewhere between 20-30 grams of protein in the morning for people with depression and anxiety as well as digestive issues, hormonal imbalances, anything like fatigue or chronic stress because when we wake up in the morning we’ve been fasting for at least 8 hours. Sometimes in healthier cases, it’s actually better to fast for 12 hours and so throughout the night our blood sugar hasn’t been stimulated, we haven’t been increasing our blood sugar throughout the night and so, when we start our morning with something like, in North America, like we usually start, with a piece of toast or some sugar-rich cereal, our blood sugar goes from the lowest point, since we’ve been fasting for so long, and spikes. And then around 10 am, a couple hours after we’ve had our breakfast, our blood sugar will drop again, causing symptoms of hypoglycemia, which can worsen stress, it can trigger cortisol release and cause fatigue, worsening of anxiety and depression. And then throughout the day our blood sugar’s going to go up and down as we start to crave sugar again and it’s more likely to throw us off our balanced state that we want to be in.
So I start by recommending 20-30 g of protein to my patients in the morning and they often ask me what they can eat. And I’ll recommend something like leftovers from the night before, like a chicken breast has about 30 g of protein. Other patients ask “can I eat eggs?” And eggs are wonderful to eat but in order to get 30 g of protein you need to eat about 5 or 6 eggs, which is not typical. We usually eat 1 or 2. Although eggs is a great addition. You can throw eggs into your smoothie as well.
It’s also important to get a nice source of fat in your smoothie. So this is something that we often leave out, we don’t put sources into smoothies and so I recommend something like ground flaxseed or coconut oil, olive oil if you have that lying around, avocado, you can even through your fish oil in, if you’re that kind of person.
And I always throw in a leafy green, which you can’t taste. A cup of something like spinach or kale is a source of leafy greens. It’s full of fat-soluble vitamins as well as things that help us detoxify the estrogens from our body and keep our hormones balanced. This is something I always recommend for women with irregular periods or heavy periods, or things like PCOS, Polycystic ovarian syndrome, endometriosis, infertility. Anything that causes estrogen to go off and if you’ve read some of my articles you know that a lot of us suffer from estrogen-dominance. This is just more estrogen than progesterone in the female body. Even men can suffer from this and that’s because we’re just exposed to so many things, so many toxins in our environment that are activating estrogen receptors. So by eating leafy greens, we allow our bodies to detoxify a lot of those xeno-estrogens, those toxic estrogens in our environment.
So all you need is a blender. I like to throw in some baby spinach, pre-washed. I just eye it and throw in a couple of handfuls. That amount. Just a couple servings of spinach. The nice thing about things like spinach is it blends really well. You don’t taste it and depending on how much other ingredients you throw in, your smoothie might not even be green, so you can also fool your kids by throwing some spinach in their smoothies.
I always throw in some frozen berries. You can put in blueberries or a berry medley. I get it from No Frills for about $11 for a bag. Frozen’s nice because your smoothie gets icey. It might not be the best for winter but the days are still warm our digestive fire is still strong enough to be able to digest things that are cold.
Today the fat I’m going to add is coconut oil. Coconut oil is a saturated fat, but it contains medium-chain triglycerides, which our body doesn’t need to convert into sugar to be used as energy so we can just use them right away as an energy source. It’s great for the skin and it’s great for gut-healing because of its anti-fungal properties. It’s also really good for balancing blood sugar and boosting our metabolism. 2 tablespoons, I put in.
Fats are great medicinal foods. You can throw in a couple tablespoons of olive oil if you have cholesterol issues, blood sugar issues. The right kinds of fats are very anti-inflammatory and we know that inflammation is implicated in things like digestive issues, depression and anxiety, stress and so, by making sure we’re getting the right balance of fats in our diet, you can start in your morning smoothie, by setting your fat balance on the right track, be able to balance inflammation and feel really good throughout the day.
This smoothie will also keep you full really long, well into the afternoon because of the source of fats in it. I like to throw in things like eggs as well, just raw eggs. It’s difficult for me to really recommend it universally to all my patients because there is, of course, the risk of salmonella in raw eggs. So, at your own risk you can try it out, but I find it really makes it taste nice and rich as well as give us a good source of cholesterol. And cholesterol’s a good thing, because we need cholesterol to make hormones. Especially in depression and anxiety. You don’t want to be sacrificing cholesterol or taking—of course this depends on your health history—but there’s a risk of depression in people who are taking statin drugs, cholesterol-lowering drugs that are lowing our cholesterol in the body because how are we making our hormones if we don’t have enough cholesterol.
You can also throw in something like an avocado, it makes it nice and thick and rich or some peanut butter or almond butter, or nut butter. I’m also going to throw in some ground flaxseed.
Flax has two really great medicinal benefits. I use it for hormone-balancing in a lot of my patients with things like period irregularities or amenorrhea, this is not getting your period, infertility. So what flax does is it activates estrogen receptors. But it activates them weakly so if you’ve too much estrogen, the flax competes for the estrogen by binding to receptors preventing those hyper-estrogenic effects and if you don’t have enough estrogen, so in the case of post-menopause or ovarian failure, flax binds to estrogen receptors and causes the estrogen effects that we really want, like libido and energy and the expression of female sex characteristics. It can also clear skin and it’s great for acne, it’s great for regulating periods. It’s great for balancing heavy periods, bringing periods back and making them more regular.
Flax is also great for constipation because it’s a good source of fibre and you need to grind the flax, it needs to be milled. And this is because our body can’t break down whole flaxseeds. So you might have seen breads or crackers where there’s whole flaxseeds and they advertise flax on the package, well it really doesn’t so us any good. It just passes right through the body. It’s not adding those fibres or medicinal fats.
Finally, this is a protein powder that I just got from Bulk Barn. I find that Bulk Barn is the cheapest in terms of protein powders. I use a vegan protein powder. So this is great is you’re vegan or vegetarian. Whey is the best absorbed protein, but personally I have a food sensitivity to whey, caseine and other dairy products, so I go with vegan protein, which is a mix of pea protein, hemp protein and rice protein. But you can also use whey. If you’re sensitive to dairy and not sure if you’re sensitive to whey, always go with a whey isolate, because whey isolate doesn’t contain caseine, which is the protein in milk that most people react to. So it’s just pure whey.
In my protein powder, I also mix gelatin. So gelatin is just a crystalized powder. I put in one scoop of protein powder for 30 grams of protein. So gelatin comes from the hooves of animals. It’s rich in collagen and it can actually increase the amount of collagen in the body. It’s an incomplete protein, so it has a lot of an amino acid called glycine, which most of us are deficient in because we don’t get a lot of glycine from the meat of animals. It’s actually located in the collagen. Glycine’s a really calming neurotransmitter. We use it to bind minerals, so if you’re my patient you might have been prescribed magnesium glycinate, which is an easier absorbed form of magnesium, also a source of glycine, to help calm the body. It activates those suppressive neurotransmitters, the GABA pathways in the brain so it’s great for calming anxiety and great for preparing us for sleep. But it doesn’t make you tired for the rest of the day. What’s great about getting a source of collagen is that it can help with gut healing. It can help with the integrity of the gut in leaky gut situations and it’s great for the skin and hair because we know our skin is made of collagen as well as our joints. So, if you have acne, acne scars, if you’re suffering from premature aging or sun damage, a couple tablespoons of gelatin or collagen hydrosylate is a great thing that you can do every morning.
So I’m just going to add in, as your liquid source you can add in something like water, I usually just use water or almond milk. I’m going to use coconut milk today because it’s delicious. I’m going to mix a little bit of coconut milk with water. Just tap water. I’m going to add some tap water. So how much water you add depends on how thick you want your smoothie and the quality of your blender. I filled it up to about 500 ml. I like to eat a lot in the mornings.
Put it into your blender. So this is my smoothie pre. And then you just pour your smoothie in a glass. Mine’s kind of on the watery side. It turns out purple, not green at all, so you can still fool the kids. If you want to make it sweeter, you can add in half a banana, or even some maple syrup. But it tastes pretty good. It tastes like berries.
So this is great because liquid is obviously, it’s pre-chewed, so it’s easier for our body to absorb the nutrients, which is nice in the morning, especially for people who aren’t really into breakfast. It’s also really portable you can put it in a mason jar or a glass container and take it to work. You can drink it half before leaving for work and half while in your in the car or commute or on the subway. A lot of your nutrition for the day is taken care of. So, even if you, have not-an-ideal lunch or dinner you’ve gotten a great source of highly-absorbable protein, you’ve gotten some gut-healing in in the form of gelatin. You’ve gotten some healthy fats and a serving of leafy greens and anti-oxidant-rich berries. So, you’re on your way for a healthy day.
The key to having healthy, delicious meals on the go is organization. I explain how I overcome a busy schedule by doing a focused grocery-shop, heating up the oven and batch-cooking seven or more whole-food, healthy meals in under three hours.
You know the feeling: you’re finishing up a long day of work, your blood sugar levels are dropping, and you’re wondering what you’re going to eat once you get home. When you assess the situation, you realize that you’re coming home to a fridge that’s empty, and your Julia Childsesque inspiration levels are at an all-time low. You decide on frozen pizza (freezer burnt and sad), and a half-eaten jar of pickles.
My patients sometimes tell me that they don’t have time to cook and so they end up microwaving a Lean Cuisine or throwing limp fish sticks into the oven once they’ve dragged themselves through the front door. I find this interesting because I know that I can stick some chicken breast, squash and broccoli in the oven and have it ready quicker than you can say “leaky gut”. I believe, though, that the secret to success is preparation, mindset, a little bit of organization and nutritional know-how.
I frequently get caught in the “what-am-I-going-to-eat” spiral but, with a fridge stocked with foods that are already cooked and can last for days, I usually end up eating something that’s pretty good for me. Here’s what I do on a weekend, or weeknight when I have a little more wiggle-room in terms of time: batch-cook. With the right prep you can throw together an endless combination of meals with minimal waste that requires very little prep and assembly the day of. What’s more, all of these meals are grain-free and nutrient-rich to keep hormones stable, energy sustained and mood high.
Step 1:Grocery shopping. On the way home from my clinic, I whip out my portable grocery bag and make a quick stop at the grocery store, or meat store and fruit and vegetable markets. When grocery-shopping I’m in and out in record time, and this is because I forgo straining to read complicated labels, or getting lost in heavily-processed middle aisles, and just stick to the peripheries: fruits and vegetables, deli, meat, fish, freezer. 95% of grocery-shopping should be about stocking up on perishables like proteins, veggies and fruits. I buy:
2-3 bags of pre-cut coleslaw, chopped kale, baby spinach and boxes of baby arugula from the pre-washed salad section
fennel, zucchini, broccoli, eggplant, tomatoes from the vegetable section
a bag of apples and avocado from the fruit section
goat cheese and natural sliced turkey breast from the deli section
chicken breast or chicken thighs, ground beef, steak and/or fish from the meat and fish section
eggs from the dairy fridge
frozen blueberries from the freezer
At home, in my cupboards, I know I already have things like: coconut milk, curry spices, salt, pepper, tomato salsa, tomato paste, frozen shrimp (in the freezer), chicken broth, and things like gelatin, flaxseed, pumpkin seeds, vinegar, oils, etc. I also have onions, garlic and lemon in the fridge. If I didn’t have those, I would have picked them up too.
Step 2: Get cooking. When I get home I toss the heavy bag on the counter, wash my hands, grab the chopping board and knives out of the drawer and get to work. I throw on a favourite podcast (try Invisibilia, The Jordan Peterson Podcast, The Mental Illness Happy Hour, Shrink Rap Radio, Chris Kresser, or Found My Fitness—I welcome your suggestions for future batch-cooking sessions) and begin the batch-cooking.
I chop up the broccoli, eggplant and tomatoes. Setting the oven to 400 degrees, I drizzle coconut oil over the broccoli with some salt and pepper and get it browning in the oven. Next I line a baking sheet with tomatoes and eggplants and some sliced zucchini, add a bit of olive oil, salt, pepper and spices and bake those (when they’re cooked, I’ll add some flaxseeds to give them a breaded-kind of taste with none of the refined carbs and all the hormone-regulating fibre and healthy fats).
I drizzle the chicken breast with lemon and spread tomato salsa on top. Done. When the vegetables are finished I’ll cook it at 350 degrees for about 20-30 minutes, until chicken is cooked through. Then I’ll slice the chicken up to throw on salads or to warm up and have with vegetables.
I start browning the beef with onions, garlic and grass-fed butter. Once beef is browned, I add the shredded cabbage from the bags of coleslaw I bought, and possibly some of the shredded kale. I add coconut milk and curry spices and a little bit of chicken broth, salt and pepper. Thai-style paleo stir-fry done!
I get out a big container and chop up fennel. I mix that up with arugula and store it in the fridge. I’ll add some chicken breast, chopped apple, pumpkin seeds and goat cheese to this tomorrow for a delicious, protein-rich salad lunch. I make dressing out of lemon, tahini, garlic, olive oil, salt and pepper and store that in a little jar in the fridge, so that I can throw it on the salad in the morning. I can also add cut-up sliced turkey breast to this if I run out of chicken.
I pre-spiralize some left-over zucchini with my vegetable spiralizer and store the noodles in the fridge. I make pasta sauce by adding Italian spices and olive oil to diced tomatoes or tomato paste. All I need to do for a low-carb pasta is add the sauce and some shrimp to the noodles and lightly cook until the noodles are soft. Voila: zucchini-noodle shrimp pasta. Also, a major delight of mine are Miracle Noodles, zero-calorie noodles made of glucomannan prebiotic fibre. All you have to do is rinse them. They’re super filling and taste just like rice noodles.
I cook kale, goat cheese and tomatoes together. I add the mixture to muffin tins and add eggs (I add all 12 eggs to make 12 frittatas). When the oven’s free, I cooked everything at 350 degrees until the eggs are cooked through (about 20 minutes). Sometimes I cut up the sliced turkey breast to add or I use it to “line” the muffin cups, for added protein. I let the frittatas cool and then store them in an air-tight container in the fridge.
When the time comes, right before I’m ready to eat, I’ll cook the steak or fish on the stove. Steak takes me about 3-4 minutes to cook it, tops. I just brown eat side for 2-3 minutes and add salt and pepper. Salmon takes no time at all; I might bake it for 15 minutes or sauté it after pre-marinating it with some lemon, butter and dill, or Sriracha hot sauce, garlic, tamari sauce and dash of maple syrup.
I mash up the avocados with cocoa powder, some coconut oil, gelatin, protein powder and a bit of liquid stevia to make avocado pudding. I also save some avocados to eat with meals, add to salads, and mix into smoothies, or sprinkle with salt for a healthy-fat snack.
That’s it! I pack everything up in containers and store in the fridge. All I need to do when I get hungry is spoon out portions, warm and eat. I can also opt for freezing some things if I don’t think I’ll get to them in the next few days.
The verdict: 7+ meals prepared in the time it took me to listen to 1-2 podcast episodes. Here’s what I eat for the next few days:
Breakfasts:
Mini frittatas with kale, goat cheese and tomatoes. I grab 2-3 on my way out the door.
Smoothies: with baby spinach, frozen blueberries, coconut oil, protein powder (already had some), gelatin, water. I throw these in a blender and enjoy.
Avocado pudding
Lunch/Dinner:
Arugula salad with cut up chicken breast, pumpkin seeds, goat cheese, fennel, apple and lemon tahini dressing
Chicken breast and roasted vegetables and/or roasted broccoli
Salmon or steak with broccoli, roasted vegetables, or salad
Cooked eggs with avocado and some arugula salad
Cabbage and ground beef coconut curry (I can add zucchini noodles or Miracle Noodles to this)
Zucchini noodle shrimp pasta with tomato. I can also forgo the shrimp and serve with steak, salmon or chicken breast.
Snacks:
I’ll eat a handful of pumpkin seeds, apples and peanut butter, mini frittatas, turkey breast slices or avocado pudding. I’m usually not much of a snacker, though.
As a naturopathic doctor, one of the first things I recommend to my patients is a breakfast overhaul. Adding healthy fats, protein and vegetables to the first morning meal can change your hormonal signalling and improve your energy and mood.
When it comes to writing my patients prescriptions for pills, even natural ones, I tend to be a minimalist. This means I try to limit my supplement recommendations. Depending on my patients’ concerns, I prefer to work with their diets and lifestyles, making useful tweaks and suggestions to their daily routines. I find my patients appreciate this and often stick to these mini changes in the long-term, which means that a) these changes are easy and sustainable and b) they work! When I begin to work with a new patient for the first time, some of the first recommendations I make is that they begin to rethink the way they do breakfast.
The Standard America Diet may be SAD in many ways, but the main meal that brings a tear to my eye is our affectionately termed “most important meal of the day”—breakfast, when we break our nightly fasts and engage in the consumption of low-nutrient, high-carb atrocities like breakfast cereals, muffins (aka mini cakes) and instant oatmeals packed full of sugar.
If the meals we eat in a day could be viewed as a series of performances, then breakfast would be the opening act. It sets the stage for our blood sugar and hormone-regulation for the rest of the day. When we begin our days with simple carbohydrates (the composition of the above-mentioned breakfast foods), we strap ourselves in for a blood-sugar roller coaster ride that throws off the signalling of all the other hormones in the body, taxing our adrenal glands, our sex hormones, our mood and mental health and even setting the stage for weight gain and chronic inflammation.
I tend to believe that some people do genuinely do well without breakfast. There is some research that suggests that fasting for a portion of the day (at least 12 hours a day) can regulate blood sugar and insulin levels and help us manage our weight and day-time energy levels. It can even help us sleep more deeply. However, for those of us who are hungry in the morning (or a few hours after), there is evidence that getting a complete meal into our bodies within the first hour of waking can start the circadian clocks present in our livers and digestive organs, priming us for a day of abundant energy, good digestion, and an efficient metabolism. In fact, the research on intermittent fasting seems to indicate that skipping dinner, rather than breakfast, might be more beneficial, as our bodies are more insulin-sensitive in the morning and therefore more able to use food for fuel, rather than storing it as fat, at that time of the day.
When we first wake up, our cortisol levels should be at their highest. Cortisol is a stress hormone, yes, but also responsible for giving us feelings of wakefulness and alertness. Eating, especially on a consistent schedule, can help boost cortisol levels, thereby boosting early-morning energy levels. Additionally, like the brain, the liver possess its own circadian rhythms. It punches in its time clock for work once we eat our first bite of food or take our first sip of a non-water beverage, allowing us to digest, detoxify, and process certain hormones in the body.
When it comes to the first meal of the day, there are two basic Breakfast Laws I live by:
The first is to get adequate protein. For most people this means eating at LEAST 20, but preferably 30, grams of protein (about the amount in one decent-sized portion of chicken or beef) in the morning. Protein is the building block of the body: it constructs our neurotransmitters, enzymes and the structure of our cells. When we get adequate amounts at meal-times, it keeps blood sugar stable, which balances mood and energy. Those of us who experience the energy tank around 3pm and crave sweets or require caffeine to get through the rest of the day, often notice that our energy remains stable throughout the day when we eat a high-protein breakfast. However, getting 30 grams of protein in the morning means rethinking what a traditional breakfast looks like: one egg only contains about 5 to 7 grams of protein, depending on size. One cup of oatmeal has only 6. Therefore, I suggest my patients concentrate on adding animal products, such as meats, yogurt and eggs, or vegetarian protein sources like tofu, legumes, peanut butter, and protein powder, to their first meal, or to mix different protein sources (such as turkey and eggs) to get their protein levels up to that 20 to 30-gram range.
The second Breakfast Law is to include healthy fats. Breakfast is a meal, arguably the day’s most important, as that’s when our digestive system is working optimally, our insulin receptors are at their most sensitive, and our metabolism is the most revved. Since a balanced meal contains all of the macronutrients, it’s important not to skip fat in the morning. Fat satiates us and keeps blood sugar stable. It nourishes our brain, cell membranes and forms the backbone of our hormones. Ensuring that we include healthy fats like avocado, olive oil, fish oil, nuts, seeds, grass-fed butter, and coconut, keeps us feeling full and energized well into the afternoon, while giving us a boost to our metabolic rate and improving our fat-burning potential. I tend to recommend coconut oil at this time of day, as the medium-chain triglycerides in coconut oil bypass the digestive system and are used as immediate energy, giving us a much-needed morning boost.
Since the patients I work with are often busy individuals with demanding lives who struggle with chronic stress, hormonal imbalances, mental health concerns and digestive issues, I often suggest beginning the day with a ketogenic breakfast. This means having a breakfast that is high in healthy fats, has a decent amount of protein and micronutrients, from leafy greens or other vegetables, and is low in carbohydrates. By avoiding high levels of carbohydrates early in the morning we harness our body’s fast-burning capacity and regulate our blood sugar and insulin levels. This, in turn, balances our other hormones, such as neurotransmitters, stress hormones and sex hormones. It also keeps inflammation levels low. Eating a high-fat, low-carb breakfast encourages the body to make ketone bodies for energy, which have been shown to promote mental alertness and to balance mood. Patients who take on a ketogenic breakfast for a month often report life-changing effects: more energy throughout the day (avoiding that 3pm crash), brighter mood and mental clarity, less sugar cravings, and greater feelings of satiety that bridge them all the way to lunch-time.
Finally, I often recommend getting a serving of micronutrient-dense leafy greens into the morning meal. We North Americans tend to skimp on our vegetables, especially the majorly health-promoting green leafy ones. Getting one or two servings of vegetables out of the way early on in the day is a great way to boost our vegetable intake.
Here are some healthy and easy-to-throw-together alternatives to that greasy breakfast sandwich lying under a warming lamp in your company’s cafeteria. I swear you’ll never look back:
1. Any variation on the home-made omelette/scrambled eggs/breakfast sandwiches. Grab a bunch of your favourite vegetables, leafy greens preferred, and cook them down in a pan. Add scrambled eggs, a few slices of natural turkey breast, leftover steak, salmon, natural sausages, or tofu (if you’re a vegetarian). Play around with different ingredients like olives, sun-dried tomatoes, roasted zucchini and squash, goat cheese, avocado, arugula, etc. If you need some carbs, serve on gluten-free or sourdough bread, or roll up ingredients into the egg.
2. Mini frittatas. Similar to the omelette idea above, mini frittatas are a pre-prepared version for those of us who have limited time in the morning. You can make these out of virtually anything: ground turkey, kale and goat cheese; sun-dried tomatoes, basil, oregano, olives and arugula; avocado, ham, cheddar and broccoli; thai curry paste, coconut milk and cauliflower; even zucchini, spinach, flaxseed and cocoa powder. Cook up your ingredients sans eggs, then throw everything into a blender (add enough so that you can get your 20 to 30 protein grams from one to three frittatas), ground flaxseed and gelatin (for gut-healing and added protein). Pour into muffin cups and bake at 350 for 20-30 minutes or until eggs are cooked through. Freeze them or store them in the fridge, then grab some on your way out the door to warm up at the office.
3. Smoothies. Smoothies are one of my favourite ways to do breakfast, simply because blending everything together gives you the opportunity to pack a bunch of nutrient-rich foods into one easily digestible, portable place. They tend to taste great too, depending on how you do them.
My three general rules of thumb for creating smoothies is to add: 1) Leafy greens: kale, spinach, chard, etc. 2) Protein: usually in the form of protein powder. I like Vega and Sun Warrior, as vegan sources, but whey isolate also works, if you’re ok with dairy. Pick a protein powder that has no added sugar and at least 20 g of protein per scoop. 3) Fat: half an avocado, or a couple of tablespoons of coconut oil, ground flax or nut butters, etc. After following the three rules, feel free to doctor the smoothie up for variety: add berries, banana or honey to make it sweet and palatable; gelatin/collagen, guar gum or chicory root for gut-healing; cocoa powder to make it chocolate-y (who doesn’t want that); or lemon, spirulina or cilantro to boost your body’s detoxifying prowess in the morning. The possibilities are endless.
My go-to smoothie consists of spinach, frozen blueberries, flaxseed, avocado, coconut oil, water and protein powder. I blend those ingredients up and drink them on the go, or I add nuts and granola on top of a thicker blend and eat it with a spoon as a smoothie bowl. I’m usually full until 1-2 pm.
When my patients protest that their morning routine doesn’t allott them sufficient smoothie-prep time, I suggest they add the unblended ingredients to their blender the night before, storing everything in the fridge. In the morning, all they have to do is hobble over to the “blend” button, throw a lid on everything and fling the entire concoction into their lunch bags. Easy peasy.
4. Yogurt bowls. For those who “do dairy”, one cup of greek yogurt has about 25 grams of protein. I tell my patients to get the highest-fat kind they can find (grocery stores mainly carry up to 2%, whereas natural food stores carry higher fat-content brands). This is because 0% fat yogurt is just bad news; skim milk was used to fatten up pigs in the early 20th century by making them hungrier—it was a well-known trick amongst pig farmers that, for whatever reason, never seemed to become common knowledge for humans. I also encourage my patients to opt for unflavoured, unsweetened yogurt to avoid unnecessary sugar and chemicals. Kefir, or fermented milk, contains multiple strains of gut-loving bacteria and is an effective probiotic, so I often recommend that to patients whose guts needs some love.
To the yogurt, add a combination of chia, flaxseeds, nuts, gelatin, coconut oil, cinnamon and berries. You can store everything in a jar in the fridge overnight (or make a big batch) and grab and go on your way to work. For those who are dairy sensitive or lactose intolerant, coconut yogurt is a delicious alternative. It is protein-sparse, however, so getting protein from other sources, or adding a scoop of protein powder or a few tablespoons of gelatin, is needed to round out the macronutrients.
5. Fat bowls: When I’m in the mood for tons of fats, I make a fatty Paleo “granola” out of various nut and seed butters: tahini, peanut butter (the natural kind where the oil rises to the top) and/or almond butter. I add coconut oil, coconut flakes, ground up nuts (walnuts, almonds, brazil nuts, cashews) and flaxseeds. Then I add cocoa powder and a few drops of liquid stevia and a pinch of sea salt. The whole thing is delicious; like a kind of crunchy, healthier Nutella. You can add one to a half scoop of protein powder or gelatin to boost the protein content. Another fat bowl idea is avocado pudding: add one whole avocado, chocolate protein powder, cocoa powder and some liquid stevia together, and mash everything up by hand or blend in a blender.
6. Ketogenic, low-carb pancakes. Blend 3 eggs, 2 tbs of almond butter, 2 tbs of flaxseed, gelatin, a dash of vanilla extract and sea salt to make the batter, then cook like regular pancakes. You can also make these thin by adding a bit more liquid (water, nut milks, coconut milk), and use them as breakfast wraps, wrapping up things like avocado, goat cheese and arugula with them.
7. Leftovers. Most of the time I have non-breakfast food for breakfast. As I’m personally really into the efficiency of batch-cooking, I always have a few servings of protein (chicken, beef or fish) and ready-cooked vegetables in my fridge. I might also have a pot of curry, a stir-fry, paleo chilli or soup in the fridge as well. Many cultures enjoy savoury and spicy foods for breakfast and there’s no reason that leftover curried vegetables and chicken breast don’t make an awesome first meal of the day.
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.
In response to my very popular article about the Mirena IUD and how that can upset hormone balance, or further an existing imbalance, I talk about a condition called “estrogen dominance” can result in hormonal symptoms, such as PMS, infertility, weight gain and anxiety.
Hello everyone, my name is Dr. Talia Marcheggiani. I’m a naturopathic doctor with a special focus in mental health and hormones, especially women’s hormones.
So, today I’m going to talk about an article I wrote about a year and a half ago that gotten a lot of activity online and it’s called “Let’s Talk Mirena: Anxiety and Hormone Imbalance”. I wrote the article because I was seeing a few patients who had the Mirena IUD and a series of similar symptoms. So, anxiety, panic attacks, and just a general sense of hormone imbalance. And when we ran their labs, when I looked at the levels of progesterone in their blood, they had very low progesterone. So I wrote an article about this and about the phenomenon of “estrogen dominance” that we naturopaths talk about a lot. And I got this resounding response online, so even today, sometimes, I’ll get a couple emails a day of people expressing their experiences and their agreement with the article and their confusion and frustration and anxiety around some of the symptoms that they’ve been experiencing since getting the IUD.
So, the reason I wrote the article is not because I don’t agree with the Mirena IUD. I’ve written another article called “Having a Healthy Birth Control Experience” in which I state that as a form of contraception, a hormonal birth control and a hormonal implant such as the IUD can be really great measures against unwanted pregnancy, because their efficacies are very very high—I think the Mirena IUDis about 99%pregnancy avoidance— and you don’t need to think about it, you don’t need to take a pill every day, so for some women this is ideal.
The issue is that a lot of women are being prescribed the Mirena IUD as a solution for Estrogen Dominance. And so what I find in my clinical practice, and I’ll talk more about estrogen dominance in the course of this video, but what I find in my clinical practice is, because it doesn’t address the underlying cause, and because it’s hormonal in and of itself, and it adds more hormones to the body, in a specific location, the uterus, and because it doesn’t address the underlying imbalance, it either worsens or ignores the condition of estrogen dominance, causing symptoms to get worse and women to feel frustrated and lost and then write to me.
Mirena is often prescribed to women with heavy and painful menstrual bleeding. So, this could be a diagnosis of endometriosis, or ovarian cysts, or just symptoms that they’re experiencing. So a lot of them might be experiencing iron deficiency because of the heaviness of the bleeding and a lot of women are out of commission for a couple of days every month because their period is so heavy and uncomfortable and they feel weak and they’re in pain and maybe they deal with really intense PMS. Some of my patients deal with PMS for 2 weeks out of the month, which is crazy and super uncomfortable.
Conventional medical doctors prescribe the Mirena IUD to combat these symptoms because with birth control and the IUD, one of the side effects is really light periods and some people don’t even get their period at all on Mirena and so you can imagine, if you’re period is this time of the month where you can’t go to work and you’re just basically hemorrhaging from the insides, then it would be a massive relief to not have to deal with a period anymore for 5 years, which is how long the hormones last in Mirena.
But one of the issues is that we need to look at the cause of these symptoms. Oftentimes these symptoms are caused by a difference in estrogen and progesterone, so these are two of the main female sex hormones. One of the things that happens in conditions like endometriosis or heavy and painful periods is that the estrogen is high in relation to the progesterone in the body. And so this is really apparent in a condition like endometriosis where there’s often high estrogen and also fibroids. So both of those cause terrible periods, and they need to be ruled out when periods are heavy and uncomfortable. And then there’s ways that we can deal with that as naturopaths.
But even without an underlying health condition, just primary dysmenorrhea, that’s not caused by another diagnosis is often the result of estrogen dominance.
And so the Mirena, because it’s made of only progesterone, can help with the uterine symptoms of estrogen dominance, which would be the heavy and painful periods. However, we have estrogen and progesterone receptors all over our body, not just in our uterus, and so when we’re putting hormones in one part of the body, and they’re not ending up in the rest of the body, we start to worsen that deficiency, or that relative deficiency in progesterone.
So women will mention, and one of the most common symptoms is anxiety and panic attacks, because progesterone this kind of calming effect on the central nervous system, on the brain, so it kind of chills you out and helps you handle stress.
Estrogen is a hormone that causes women to ovulate, so it’s a pro-ovulatory hormone and it also helps build up the uterine lining. So the more estrogen we have, the thicker the lining and therefore when we shed the lining during our period, the more we have to shed. So, more estrogen, the thicker the lining, the heavier and, by proxy, more painful the period.
Progesterone is a hormone that, in terms of reproduction, it helps us maintain the lining (of the uterus). So, if you ovulate and then that egg gets fertilized by sperm, then the egg gets implanted in the uterus and progesterone starts to increase, so pregnancy is a very progesterone dominant condition and one of the signs of a low progesterone state is when women who have been pregnant say that that’s the most balanced they’ve ever felt because progesterone is naturally higher in pregnancy.
Progesterone starts to rise when you become pregnant and that maintains the lining throughout the 9 months and then, after the 9 months, you have your baby. If the egg doesn’t become fertilized then progesterone rises for the last 2 weeks of the cycle and then it falls, along with estrogen, you shed your lining and then you have a period.
And for some women, they sail right into their periods. They have no PMS symptoms, they might feel a little bit bloated a couple of hours before and then they go to the washroom and go, “ok, look, there’s blood I’m having my period.” And for other women, it’s not the case, they get warning signs, like i said, before two weeks, so pretty much from ovulation to when their period happens. So, half of their life: 2 weeks out of every month.
And so, what happens with a lot of women is that there’s higher estrogen in relation to progesterone. So we call this “Estrogen Dominance”. And there can be three possibilities in this state. One is that estrogen is abnormally high and progesterone is normal, or optimal. Another is that estrogen is normal or optimal, progesterone is low, and a third option is that you have both at the same time: so estrogen is high and abnormal and progesterone is low and that’s more common than you think in a lot of women who are dealing with really severe symptoms, that divide between the two hormones is really off. And, as I mentioned before, prescribing birth control pill or Mirena IUD are not solutions because they’re not correcting the underlying imbalance. They’re not looking at the cause of why this imbalance is happening in the first place. Instead, they introduce foreign, fake or synthetic hormones into the system to try and correct the balance, but our body has a delicate balance and a delicate ecology and so when we try and shift that balance artificially sometimes we pay the price and we don’t necessarily feel balanced.
So, why does this occur? Why do people get estrogen dominance and how do you fix it? So, when it comes to the first situation, high estrogen, and normal progesterone, there’s a couple of reasons why estrogen might be high. So the first is exposure to foreign estrogen, or excess estrogens in the environment. And, so many of you may have heard of these “xenoestrogens”, or toxic estrogens, from sources such as BPA, so the lining of tin cans, or those plastic water bottles or baby bottles that everyone was throwing out and replacing with glass and stainless steel, which is a great idea. So, we’re in contact with these in the environment through the cosmetics, cleaning products, and some of the plastics that we hold and interact with on a daily basis. And paper receipts have this as well. So cashiers and people that handle receipts regularly are in contact with BPA. And it’s absorbed through the skin. So just this exposure to these toxic estrogens can activate estrogen receptors and it increases estrogen in the body. And that’s problematic. We know that these can also set the stage for hormonal cancers, like breast cancer, you might have heard of estrogen-receptor positive breast cancer, or ovarian cancer and endometrial cancer and cervical cancer. So these are all kind of these foreign estrogens influence the body’s hormones in a negative way causing growths.
The second reason why estrogen might be high is the reduced ability of the body to detoxify estrogens. So, when we’re done using the estrogen that we need, our liver cleans our blood of estrogen, then we dump the estrogen biproducts into the colon and then we eliminate them by having a bowel movement. And this is a normal process in lowering the toxic estrogen or the estrogen metabolites, the estrogen we don’t need anymore. And so when this process is either over-burdened by too many xenoestrogens, so those plastic estrogens, or limited in some way because our liver is trying to detoxify other things, such as alcohol, or tylenol, or some of these over-the-counter drugs, the liver just can’t handle the burden and so, in terms of treatment we need to bolster the liver’s detoxification abilities. And a lot of the time those two things exist at the same time: you’re getting too many foreign estrogens, we need to clean up the environment and the diet and make sure everything you’re getting is promoting a healthy estrogen metabolism.
And then, why progesterone might be low, which is the other arm or possibility of this estrogen dominance condition that I’m speaking of is stress, mainly. So, when we’re stressed out, and we’re dealing with a lot our body produces a hormone called cortisol and that’s the “stress hormone” that helps us deal with high amounts of pressure and stress. And a lot of the time stress is not perceived so, just this feeling of being tired and wired, disrupted sleep, sugar cravings around 3-4pm, having a difficult time getting up in the morning, feeling a little bit stretched thin, maybe feeling a drop in motivation, are all signs of chronic stress. So what happens is our adrenal glands, these pyramid-shaped endocrine glands that sit on top of the kidneys, they make cortisol. And when our body has more cortisol than it needs, or when it needs to make progesterone, it takes the cortisol and it makes progesterone with it. So it’s kind of like leftover cortisol that it’s not using gets made into progesterone. After ovulation, the ovaries also produce progesterone, but part of the progesterone production in the body come from the adrenal glands.
So you can imagine: if you’re stressed out and you’re spending all of your adrenal function on making cortisol you’re not going to have enough time or resources to make progesterone. So a lot of bringing up progesterone balance is by either lowering environmental stress or increasing adrenal function. We also look a nutrient deficiencies and we can also look at bringing pituitary balance by using an herb called vitex, which can help balance hormones and kind of right that estrogen-progesterone imbalance that might be going on.
So what happens when you give the Mirena, or you give an oral contraceptive to deal with this? Well, what happens is, there’s an imbalance and you induce another imbalance kind of over top. So, the body is still not making enough progesterone, there’s still too much estrogen, toxic estrogen, and what you’re doing is giving synthetic progesterone, which doesn’t have the same effects, progestins, synthetic progesterone, it doesn’t have the same effects as regular progesterone and often doesn’t work on the brain, so it doesn’t have that low anxiety effect, that calming effect, and it doesn’t prevent the estrogen-dominant cancers, it doesn’t help with ovarian cysts, it doesn’t manage endometriosis, other than stopping your periods, perhaps, if you’re reacting to it. And then you’re also, if you’re doing a combined oral contraceptive pill, you’re introducing more xenoestrogens to the body that your liver then has to clear out and that are going to cause more of those estrogen-dominant symptoms. And, in the colon we know that oral contraceptives can cause a bacterial imbalance, so a dysbiosis in the gut and potentially constipation and so that throws off our whole system. I’ve talked about how important that gut bacteria is for mental health and mood and just digestion and everything. So, more cells are in our gut than in the rest of our body. So our gut microbiome is super important to our health and well-being.
So, how does a naturopathic doctor address estrogen dominance? This is a big part of my practice especially because I see a lot of women with month-long PMS, acne, polycystic ovarian syndrome, so irregular periods, or missed periods, or they have a family history of hormone-dominant cancers and they’re trying to prevent these things from happening down the line, or they’re just having terrible periods. They’re having weight gain, or bloating, or anxiety that’s related to the period or really bad PMS, so mood swings, depression around their period or a condition called PMDD, which is really really severe depression right before the period.
So the first thing I do is order labs. And so your medical doctor might have done labs, gotten your estrogen and progesterone measured in your blood and your doctor might have said, “oh, it’s fine, it’s normal”, and this is true to the extent that when your medical doctor is evaluating your labs, they’re looking at massive reference ranges. So our reference ranges are a bit more narrow because we’re trying to look at the optimal levels for fertility and for feeling like your optimal, amazing self. We’re looking at, “is your estrogen within an optimal range, is your estrogen on the high side, and therefore, could be brought down? And does that match your symptom picture? Do you have estrogen dominance symptoms and a relatively high estrogen level? Is your progesterone lower than optimal to maintain a uterine lining in pregnancy, to not have a miscarriage in the first trimesters, etc. etc.” So we look at labs, and then we, using our natural therapies, we prescribe diet, supplements, and some lifestyle changes to help re-establish that hormonal balance.
So, if you have any more questions, just send me an email, at connect@taliand.com or check out some of the articles that I mentioned in this video.
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Dr. Ray Cronise, a former NASA scientist, outlines a food pyramid in his paper to help organize food into nutrient content. I often borrow his pyramid to depict nutritional balance to my patients.
Since we rarely eat pyramids, I often depict this balance for my patients using a plate. I divide the plate into four quarters. One half of the plate is dedicated to colourful vegetables, with at least a full quarter dedicated to greens. The other two quarters of the plate are divided into starches: grains, legumes, tuberous vegetables, and proteins: meat, dairy, eggs, fish, or legumes. Oils and fats can be used to cook with or added to the meal in the form of avocados, nuts and seeds.
