All About Naturopathic Medicine, An Educational Talk

In this video I give an education talk to a group of seniors at the Bernard Betel Centre about naturopathic medicine. I discuss our philosophy, education, what kinds of conditions we treat and answer some questions along the way.

Where There Is Mental Illness, There Is Poor Digestion

Where There Is Mental Illness, There Is Poor Digestion

the-gut-mood-connectionI’m tired of hearing mental health conditions blamed on a “chemical imbalance”. Patients everywhere are being told that their mental health conditions are, literally, “all in their heads”. With this diagnosis—often distributed insensitively, and without much attention to the complex factors in thoughts, beliefs, emotions, the environment, biology, nutritional status, mental and emotional as well as physical stressors, and life circumstances (just to name a few) that can contribute to mental health imbalances—patients are left with the message that they are somehow damaged, broken, or that their condition arose out of an inherent weakness that they somehow possess. Through the numerous conversations I’ve had with those struggling with mental health symptoms, I have come to understand that oftentimes there are phrases that rob power more than the term “brain/chemical imbalance”.

Fortunately, there is still more to emerge in the wonderful world of science. Very little actual evidence supports the chemical imbalance theory of depression and researchers and clinicians alike are forced to admit that symptoms of conditions such as depression and anxiety are often the result of multiple factors that come together. Contrary to the common narrative of mental illness being a sign of weakness, evolutionary biologists are uncovering evidence that symptoms of depression might be the result of a highly adaptive strength based on preserving the body during times of great mental, emotional and physiological stress—showing, in fact, that depression and anxiety might in fact be afflictions of the strong, not the weak.

In my practice, I approach depression and anxiety from a functional medicine standpoint. This means, simply, that I look not at the title of the condition my patients come in with (I care very little if you have depression, or anxiety, or bipolar disorder, etc.—the name is not the thing itself), but how the condition occurs uniquely for them. By paying close attention  to the multitude of symptoms, thoughts, and factors that influence the mood and emotions, I am able to uncover underlying pathways that point to imbalance in the body and dig up the roots from where the symptoms might have arisen in the first place. Through this method, focussing on the functioning of the body rather than it’s pathology, we’re able to bring the body back into a state of balance and reverse symptoms permanently, rather than simply slapping a band-aid over them.

When it comes to mental health, it is important to emphasize that depression and anxiety (as well as other mental health diagnoses) are not diseases at all; they are symptoms. When presented with low mood, feelings of sadness and worthlessness, lack of motivation, lethargy, brain fog, changes in appetite and weight, abysmal self-esteem and so on—all symptoms that many patients with depression face—we need to follow the threads of symptoms back to the point where things began unraveling. It is necessary to backtrack to the biological imbalances where symptoms first began.

There is an overwhelming amount of research coming out in the field of mental health that links the gut and digestive health to mental health symptoms, indicating that depression might not be a brain chemical imbalance at all, but a gut chemical imbalance. Where there is depression and anxiety, there is more often than not, a digestive issue.

We have always known that the digestive track and brain have an intimate bond. From the vagus nerve that enervates the gut and begins in the cranium, to the mood-regulating neurotransmitters that are created in the gut, we all have the experienced the tummy aches linked to grief or the power of anxiety to loosen our bowels. We’ve all noted the phenomenon that great ideas or moments of clarity seem to spontaneously arise from, not the brain, where we always assumed our thoughts were formed, but the gut (hence the term, “gut feeling”, which we use to characterize intuitive insights).

When it comes to issues with the brain—thoughts, moods, emotions, feelings, etc., where else should we look for answers than our brain’s close cousin, friend and confidant, the gut. Mental health symptoms can arise from impaired digestion in a number of ways:

  • A failure of the gut cells (enterocytes) to create neurotransmitters. The majority of serotonin (the “Happy Hormone”) is produced in the gut. Inflamed and unhappy gut cells are often unable to make serotonin.
  • An imbalance in the healthy gut bacteria that influences whole-body health. We have 10x more cells in our gut than in our body in the form of almost 5 lbs of symbiotic gut bacteria. This bacteria ensures our well-being by helping us digest our food, soothing inflammation, educating our immune system, killing off harmful pathogens, creating bulk for our stools and, relevant to the field of mental health, producing neurotransmitters important for regulating mood, such as serotonin and dopamine.
  • Research has gone into the connection between a low-level of inflammation in the brain and its affect on mood. Inflammation is usually a product of our diet, stress and food sensitivities. In naturopathic medicine and functional medicine we treat inflammation with the assumption that nearly all inflammation begins in the gut. A condition called “Leaky Gut” is a failure of the important seal between the intestinal walls and the rest of the body. When this seal is broken, toxins, proteins and other debris are free to enter the bloodstream, wrecking havoc, setting the immune system off course and, eventually, triggering symptoms of inflammation, autoimmunity and mental health issues.
  • Our body requires many building blocks to maintain its complex fortress. Difficulties in the digestive cells’ ability to absorb essential fats, amino acids and vitamins required for brain health, hormone regulation, detoxification and immunity, among the thousands of other chemical reactions in the body, will result in impairment in overall functional. Nutrient deficiencies are more common, even in developed societies, than one might think. Deficiencies arise from: impaired absorption, inadequate diet, increased amounts of stress and the ingestion of foods or medications the deplete the body of nutrients. In any case, optimizing the gut’s ability to digest and absorb the nutrients we’re either eating or supplementing is key for improving health and mood.

When it comes to understanding mental health issues I, as a clinician, realize it is hardly ever just one factor involved. Properly helping someone with anxiety or depression heal involves understanding the constellation of potential causes and how they inter-connect and relate to one another. Through this detective work, we can begin the journey of unraveling the imbalances and restoring the body’s ability to function and heal.

Treatment plans usually involve a combination of replenishing essential nutrients that patients are deficient in (deficiency can be detected through blood work, health history or symptoms), repairing the gut’s ability to absorb, restoring the body’s balance of healthy gut bacteria, removing food sensitivities and healing digestive inflammation, balancing hormones, and managing lifestyle stress and environmental factors that may be contributing to low mood.

My patients make impressive commitments to healing and are willing to examine their bodies and past experiences, in order to do the hard work of healing. Beyond my role as a doctor, I am committed to working as a facilitator, teacher and guide. My job is not to tell people the right path to walk, but to help them understand their body’s complex language, listen to the signals and messages that arise from it, and understand what those signals are asking of them.

For more information, click here. I run a practice with a special focus in mental health, youth mental health and hormonal conditions. I work in Bloor West Village in Toronto, Canada.

 

The Gut-Brain Connection

The gut-brain connection has gotten the attention of researchers and functional medical practitioners. I discuss, briefly, what research has shown us in regards to the complex realm of the microbiome and how depression may be a result of inflammation in the brain, stemming from inflammation in the gut.

My name is Dr. Talia Marcheggiani and I am a naturopathic doctor and mental health expert in Toronto.

Today we’re going to talk about the gut-brain connection and how that can influence your mental health symptoms.

I think we intuitively know that the gut and brain are connected. When you feel mental symptoms of anxiety we immediately notice the effects on our gut.

During times of stress, we know that we have indigestion, we’re more predisposed to things like diarrhea and irritable bowel syndrome.

Even anatomically there’s a nerve, called the Vagus nerve, that directly connects the brain to our digestive system.

This nerve is responsible for putting into that “rest and digest” state.

When this nerve is stimulated, our bodies start to secrete digestive enzymes, saliva starts to be secreted and we’re able to break down our food and absorb the nutrients from the food that we’re eating.

A lot of research has been going on, that you might be aware of, about healthy gut bacteria. And more and more people, especially medical doctors, happily, are prescribing probiotics anytime someone is prescribed antibiotics for a bacterial infection.

Scientists have started to study more about these gut bacteria. We know we have, like, 5 lbs of gut bacteria, sitting in our digestive systems. Over 100 trillion cells, this is more than 10x the amount of cells we have in our physical bodies, and more DNA than we have in our body.

We’re more bacteria than we are human!

And these gut bacteria, we can’t survive without without them, they influence the very physiology we experience and they definitely impact our health.

These bacteria are responsible for helping us digest our food, and for our mental and emotional wellness as well as keeping our immune system in check.

So, a disbalance in bacteria, or an increase in that negative, bad bacteria and not good strains of healthy bacteria, can lead to diseases like autoimmune disease or multiple sclerosis, or things like chronic fatigue syndrome as we’re seeing in research.

Scientists are starting to study more about how the bacterial balance in our gut can influence our mood and mental health.

These gut bacteria can actually produce serotonin. So that’s the happy hormone in the brain. And you may have heard of serotonin, especially if you suffer from depression or anxiety because your doctor might have recommended a kind of medication called SSRIs, or Selective Serotonin Reuptake Inhibitors, or a similar drug, SNRIs, like Venlafaxine, which is a Selective Serotonin and Norepinephrine Reuptake inhibitors.

This is based on on the Monoamine Hypothesis that there is this chemical imbalance in the brain. That your body is either not making enough, or absorbing enough or reacting to serotonin enough.

When we’re given these antidepressants, the idea is that we’re recorrecting this brain imbalance and that’s as much of the story as we’ve got. We don’t know why these brain imbalances are around.

So I think that, if we’re going to stick with this hypothesis, which is still controversial in science, we should look to the gut bacteria because we know that gut bacteria produces a significant amount of serotonin and, if we’re blaming depression and anxiety on serotonin deficiencies, why not look at the gut and find out how we can influence the balance of healthy gut bacteria so that we’re producing enough serotonin. Especially if we’re relying on drugs to correct the imbalance and we don’t have enough serotonin for the drugs to work properly.

Gut cells on their own produce 95% of the serotonin in the body so basically every single chemical that we have in our brain is produced or exists in the gut.

So, we need to be able to feed the gut cells so that they’re producing healthy amount of hormone we need to experience a healthy mood and live our lives in ways that are stress-free and energized and happy so that we can effective in our lives.

Mentally and emotionally, you might know this “gut feeling” that we talk about in language and that’s kind of permeated throughout cultures. So, we know that when we have this feeling in the gut that, it’s almost like an intuition. Some people will say, “I just knew it, because I felt it in my gut.” And I think that we’ve always had this intuition. We’ve always had this connection between what our mental state, our thoughts, beliefs and emotions are telling us and what our gut is telling us.

We think that we think with our brains and that all of the mental symptoms we experience are happening at the level of the brain, but because of this tight gut-brain connection, we know that’s not true.

People that have done brain studies actually find that we have thoughts before we have brain activity a lot of the time so, I wonder if we’re actually thinking with our gut, which is a revolutionary and radical thought, but we’re finding more and more evidence for this in science.

You may have heard of the condition called “Leaky Gut” or the more official, scientific term is “Intestinal Permeability”. Our gut is really selective about what it absorbs for good reason. What happens, though, when we’re experiencing chronic stress, or we use a lot of antibiotics or maybe eat things like high-sugar foods, caffeine, or a lot of alcohol, we can cause gut inflammation, which starts to allow bacteria, food toxins, or whole proteins from food into the blood, into the body by breaking down the integrity of the gut.

So, when it comes to health, for most health conditions, especially when there’s a few symptoms that seem disconnected and it’s hard to find the relationship between them, naturopathic medicine and, now, functional medicine and, hopefully soon, conventional medicine, begins to look at gut health.

So if I’m sitting across from a patient who has a long list of health symptoms that seems like they’re not connected and has digestive symptoms—and 40-60% of the population, in general has some kind of digestive symptom, whether it be bloating after eating, feeling fatigued after eating, just feeling like your food is sitting in your stomach and not really moving through, GERD, so acid reflux, heartburn, diarrhea and constipation, or those IBS symptoms, gas and bloating—when I sit across from a patient with any of those symptoms, the first place we go, in terms of treatment, is to look at the gut.

So how do you keep your gut healthy? There’s a few things. The first is to eliminate anything that’s causing gut inflammation, so this could be excessive caffeine and alcohol, excessive refined sugars, antibiotics without doing a probiotic immediately after or during an antibiotic treatment, chronic mental and emotional stress, or physical stress, and food sensitivities: something we’re eating that’s causing our immune system to react and our gut to become inflamed.

Ensuring a proper bacterial balance by either supplementing with a probiotic or eating a variety of fermented foods such as kefir, yogurt, kombucha or saurkraut, and making sure that we’re eating a variety of whole foods: whole grains, fruits and vegetables, and healthy fibres that are going to feed that healthy gut bacteria.

So, when it comes to mental health, such as depression and anxiety, chronic mental stress, even things like bipolar, OCD, conventional medicine tends to just look at the brain and blame the brain on the host of symptoms that patients might experience.

Naturopathic medicine looks at the entire body. And since we know that the gut and brain are connected, and our patients are simultaneously experiencing mental health symptoms and digestive symptoms, we definitely have to treat the gut.

For more information, you can visit my website at taliand.com, or send me an email at connect@taliand.com.

I work at Bloor West Wellness Clinic in Bloor West Village, in Toronto.

Should I Go On Anti-Depressant Medication?

Should I Go On Anti-Depressant Medication?

IMG_0013_CC“I was born with an imbalance in my brain,” my patient explains to me, “The medication corrects it—Since I started taking Cipralex, I wake up feeling like a normal person again.”

It is estimated that about 10% of adults in North America are taking a medication to help them cope with anxiety and depression. Many people swear by these substances, others claim that they worsen depression, cause uncomfortable side effects and fail to treat the root cause of symptoms, numbing us to the experience and cause of our emotional pain and physical symptoms. The reality is, however, that prescriptions for these medications is increasing.

What are anti-depressants?

Most anti-depressant medication falls into the pharmaceutical category of SSRI, or Selective-Serotonin Re-uptake Inhibitors, like Prozac or Cipralex. These medications prevent the body from mopping up the “happy hormone”, serotonin, in the brain, making its feel-good effects last longer. The result is thought to be more serotonin in the brain and, therefore, increased feelings of happiness and euphoria. Other drugs work on preventing the re-uptake of other neurotransmitters, brain chemicals dopamine and norepinephrine, which also cause feelings of happiness, pleasure and reward, and give us energy.

The Monoamine Theory of Depression:

The leading theory of depression for decades, the Monoamine Theory, states that in people who suffer from depression, there is an imbalance in serotonin production and signalling in the brain—a “serotonin deficiency”—which SSRI medication corrects. Because this is how anti-depressant medication works, this has taken over as the prevailing theory of depression. However, there has never been a published study that proves that people who suffer from depression or anxiety have issues with brain serotonin production or metabolism. It almost seems that pharmaceutical companies have “reasoned backwards” creating a theory in order to support anti-depressant use.

As patients, we want to believe that the medicine our doctors give us is just that, medicine—something that treats the root cause of disease and makes us healthier, rather than covering up our symptoms while the underlying problem continues to worsen. However, most medications don’t work that way. While Advil may alleviate a headache, we intuitively know that our headache was not caused by an Advil deficiency. Likewise, alcohol may calm down those plagued by social anxiety, but we know that alcohol isn’t a cure for social anxiety; it is a drug that can temporarily help symptoms and relying on it will only cause further health problems down the line. We know that for most health conditions, while a drug may help temporarily, something else is going on inside our bodies that warrants attention.

While the percentage of people who are medicated for depression has increased in recent years, the rate of disability from mental health conditions is steadily on the rise. This is perplexing, especially if these drugs are doing what they’re “supposed to”, which is curing a brain chemical imbalance. Shouldn’t medicating patients with depression result in a cure, or at least a declining rate of disability for mental health concerns? Clearly, something else is going on.

Harnessing the Placebo Effect:

Many patients report the fact that anti-depressant medications saved their lives, radically turning around serious and debilitating symptoms. I’ve heard quite a few stories from individuals who couldn’t get out of bed until they found the right SSRI for their body.

The data shows that SSRI medication has the ability to reduce depressive symptoms by 30% in individuals, a modest reduction at best, but still significant. But, do these medications work as well as the studies claim? A glance at the entire body of research casts doubt on the efficacy of anti-depressant medication:

Firstly, there is a large body of unpublished negative studies. This means that studies that show there is no difference in anti-depressant medication and placebo is left out of the body of literature, favouring a bias for positive publications, publications that find anti-depressants work. Medical research draws conclusions by producing studies over and over again. When the results of several studies are combined, doctors and researchers are able to draw conclusions about whether a medication works or not. When only positive research is published, without negative research to balance it out, it casts medications in a favourable light that they may not necessarily deserve. This is an unfortunate phenomenon in medical science as a whole, and often skews the evidence in favour of drugs that may not be as effective as we hope.

Secondly, the gold standard for evidence, the Randomized Control Trial (RCT) may have design flaws due to the nature of the medications being tested. In RCTs, patients are randomized into two groups. One group is given placebo and the other the active drug that is being tested. The subjects and the people evaluating them are both blinded—neither knows which group is given the drug and which is given the placebo. This reduces the possibility of bias in reporting and observing the effects of the medication. The idea is because an inert pill, or “placebo” may be able to exert the effects of a drug, providing about 30% benefit, according to some sources. However, when patients who are in the active group experience side effects of the medication: gastric symptoms, nausea, headaches, altered sleep and appetite, they quickly become alert to the that fact that they are in the medication group, leaving room for the placebo effect to occur. This is termed the “Active Placebo Effect”. When SSRIs are compared with active placebos—placebos that don’t act as medicine but produce the same side effects—we found their effects rapidly diminished, perhaps because the placebo effect was not taking effect anymore.

What about the people who SSRIs help?

To cast doubt on the efficacy of anti-depressants does not in any way invalidate those who have felt the medications helped them. Every body is different and I believe that it is not for us to say how someone should or shouldn’t be reacting to a medication or therapy. The mysteries of our bodies are vast and there is only so much that we’re aware of in the world of medicine and health. Furthermore, the placebo effect, while often being used to dismiss therapies (“oh, it’s probably just a placebo effect”) should really be viewed as an amazing miracle of medicine and evidence of how powerful our bodies and minds are. The placebo effect shows us that, according to our beliefs, we have the power to heal ourselves. We believe that we’re getting treatment, we believe the treatment will help us, and the very nature of those beliefs heals our physical bodies. 

This does not mean that the people who were suffering before taking the medication were “faking it” or should have been able to just snap out of it—that’s not how the placebo effect works. The placebo effect is based on changing our beliefs, which, as you may know, is not something we can simply will ourselves to do. However, the fact that our beliefs hold this kind of healing power, I find, frankly, is amazing. The placebo effect shows us evidence of an almost magical ability of the mind-body connection to heal ourselves, without side effects, and I believe it is something that we should harness and celebrate.

What’s the problem, then?

While anti-depressants may be harnessing the placebo effect to help individuals heal, there are downsides to them as well.

Firstly, SSRI medications have a long list of side effects, from weight gain and fatigue to sexual dysfunction and vitamin deficiencies, being on these medications over the long-term can be unpleasant for some and seriously affect quality of life for others.

Secondly, anti-depressant medications are notoriously difficult to get off of. I have assisted many patients in getting off their medication, with the help of their medical team, but it’s never easy and must always be done slowly and responsibly. Getting off medication involves a slow wean over months with support of natural therapies, psychotherapy and lifestyle changes. Because these drugs force the brain to adapt, causing a very real chemical imbalance, oftentimes the withdrawal effects are so intolerable that patients are not able to come off.

Most patients who decide to try anti-depressant medications are not aware how difficult it will be to stop taking the medication, if they should eventually choose to do so. This is unfortunate, as I believe that full informed consent should be applied to patients so that they may make appropriate decisions about their health—patients should be made aware that they are expected to stay on the medication for life and that weaning will be very difficult and, in some cases, not possible.

Finally, there is a growing body of evidence showing that patients who do not receive medication, but other forms of help such as diet and lifestyle changes, psychotherapy and stress management, do better, have higher rates of remission and less relapse than those who are medicated. As we see with the studies that show that more medication is correlated with more disability from mental health concerns, it is possible that medicating depression is only worsening the problem for most people.

So, what causes anxiety and depression? 

Scientists and clinicians are not sure what the cause of depression is. However, the Cytokine Theory of Depression and the Gut-Brain Connection are two areas that are gaining increasing interest from researchers. These theories state that depression may be a cause of inflammation in the body that affects the brain, and that imbalances in gut health, especially with gut bacteria may offset mental health, respectively. Naturopathic doctors also notice a clinical correlation between burnout or “adrenal fatigue” and mental health symptoms.

Healing the mind and body, however, starts with creating a therapeutic relationship with a professional that you trust. After that, I find that healing the gut, correcting inflammation and nutrient deficiencies while addressing harmful core beliefs and stress can have wonderful results for healing depression and anxiety.

Depression is a symptom:

Psychiatry would have us believe that depression and anxiety are conditions that we are born with. Conventional medicine states that perhaps we have a familiar tendency to develop these conditions, perhaps we’ve had them since childhood, but, and in this case it is clear, depression and anxiety are not things that you heal from; they are things you simply manage.

I disagree. I don’t believe that depression and anxiety stand on their own as diseases, but symptoms of a deeper imbalance. Like any symptom, I believe mental health concerns are trying to tell us something. Our bodies have no other way of communicating with us other than through the symptoms they produce: lack of motivation, sore muscles, bloating and diarrhea, headache, joint pain, brain fog, fatigue and so on. As naturopathic doctors, we are trained to listen, not just to our patients, but the messages their bodies are signalling to us through symptoms.

This means that, when I start seeing a patient with depression, whether they are on medication or not, we develop a full work-up, asking in-depth questions about sleep, diet, exercise, digestion, mental status, mood, energy, reproductive health and so on. I connect these symptoms together to find out what is going on beyond what may be immediately visible.

Depression and anxiety often have a root cause. The cause may be stress, childhood trauma, leaky gut, adrenal fatigue, inflammation or even medication and drug use itself. Through uncovering the root of the issue, we are able to treat it, helping the body restore itself to balance and health.

My philosophy of healing is that, sometimes, illness can be a gift, especially if it encourages us to delve deep into our lives and values and make the necessary changes for healing ourselves. Sometimes depression and mental health challenges can be the beginning of a grand and fulfilling journey where we learn to connect more deeply to our bodies, discover our life purpose and a greater sense of happiness and life satisfaction.

 

Tired, Fat, Cold and Depressed: Treating Hypothyroidism Naturally

Tired, Fat, Cold and Depressed: Treating Hypothyroidism Naturally

New Doc 67_2I have some amazing news—my patient is better. Whereas only a few short months ago, he was plagued by inexplicable weight gain, debilitating fatigue, depressed mood—convincing him he must be suffering from clinical depression—a sore throat and an inability to regulate his temperature, now he feels normal. A few months ago, his lab results indicated a serious and spiralling case of autoimmune thyroid disease. Now the lab results shows markers that are completely within the normal limits. My patient got to where he is now naturally—he did not take a single medication. His body was unleashing an aggressive attack against his thyroid gland under a year ago. Now, his thyroid is healthy, happy and working normally. My patient is back to work, exercising, traveling, feeling happy, fulfilled and creative. He is no longer suffering.

The Thyroid Gland

The thyroid gland is an important organ. Shaped like a butterfly and located right below the Adam’s Apple on the front of the neck, it has a variety of essential, life-sustaining tasks. The thyroid is responsible for maintaining our body’s metabolic function. It keeps our cells busy, and allows us to convert our food and fat energy into important metabolic functions. It regulates our hormones, cardiovascular system, skin and hair health, contributes to mood, regulates body temperature, balances estrogen and progesterone in females, thereby contributing to healthy fertility, and helps with the functioning of the immune system.

However, as important as the thyroid gland is, it’s also the body’s “canary in the coal mine”, susceptible to the smallest changes in our health status. Physical, mental and emotional stress can contribute to declines in healthy thyroid functioning, as can exposure to environmental toxins, inflammation and deficiencies in important nutrients such as iron, zinc, selenium and iodine. Because of the thyroid’s senstivities, however, we can use impending thyroid symptoms as signs of overall body imbalance. Therefore, treating thyroid symptoms at their root is important for restoring our bodies to mental, emotional and physical health.

Hypothyroidism Symptoms

Most commonly, when the health of the thyroid gland is affected, it’s functions decline, causing hypothyroidism, or under-active thyroid. Hypothyroidism of any cause is the most common thyroid condition and is very common in the general population, affecting about 4-8% of North Americans. The symptoms range from mildly upsetting to debilitating and can show up in a variety of the body’s organ systems. They include feelings of puffiness, especially of the face, caused by water retention; fatigue; dry skin and hair; hair loss; constipation and slow digestion; mental depression and low mood; acne; mental sluggishness, brain fog and poor memory and concentration; menstrual irregularities, heavy or scanty menstrual flow; infertility; cold hands and feet; orange-tinted skin; and, of course, weight gain that is unexplained by changes to diet and activity levels.

Bloating, yeast overgrowth and dysbiosis can occur from hypothyroidism when the core body temperature drops below 37 degrees Celsius. A cooler body temperature due to under-active thyroid can upset the intestinal flora and cause an overgrowth in harmful bacteria and yeast, causing further fatigue, weight gain, depression and digestive symptoms.

Diagnosis and Lab Testing

In the standard medical model, thyroid conditions are screened by testing a hormone called TSH, or Thyroid Stimulating Hormone. TSH is not a thyroid hormone, but a hormone produced by the brain that signals the thyroid to work. Through measuring TSH, doctors can tell indirectly how hard the thyroid is working. Is TSH is high, it can indicate a sluggish thyroid, since it is requiring more stimulation from the brain. Lower TSH levels may indicate that the thyroid is working fine. So, the higher the TSH levels, the more sluggish the thyroid. However, the reference ranges for TSH are from 0.3 to 5 U/ml, which indicates a wide range of possible thyroid states. A TSH under 5 will not be flagged by a medical doctor as being hypothyroid, even though symptoms may be present!

More progressive clinicians start to become concerned about thyroid function when symptoms are present and TSH is above 2.5 U/ml. Therefore, many patients with under-active thyroid and upsetting thyroid symptoms may be told by their doctors that everything is fine, delaying treatment and invalidating their decision to seek help.

When TSH is off, doctors then test the thyroid hormones T4 and T3. (There is also T1, T2 and calcitonin). The thyroid makes the hormones T3 (20%) and T4 (80%) but the active hormone that allows the thyroid to exert it’s effects on the body is T3. T4 must be converted to T3 by the body. Problems of conversion of T4 to T3 can be caused by stress and inflammation. It may be helpful for your doctor to test for reverse T3, a hormone that is created from T4 if the body is in a state of imbalance.

To detect if hypothyroidism is caused by autoimmune disease, also known as Hashimoto’s Thyroiditis, doctors will test for antibodies that attack the thyroid, anti-TPO and anti-thyroglobulin. An imbalance in the immune system and inflammation in the body, often caused by stress, can cause the body’s own immune system to attack the thyroid gland, preventing it from working properly.

Treat the Patient, Not the Disease

Naturopathic and functional medicine aims to use lab testing to detect patterns that are playing out below the surface of the body. We connect signs and symptoms and labs, not to diagnose a disease but to look at patterns of imbalance that are playing out in our patients’ bodies before disease sets in. This allows us to intervene before things are too late and healing becomes more difficult.

The Cause of Hypothyroidism

Gluten: There are numerous studies that link thyroid issues to celiac disease or non-celiac gluten sensitivity. In one study of 100 patients, hypothyroid symptoms were reversed after following a completely gluten-free diet for 6 months. 

Goitrogens: Soy, raw cruciferous vegetables (kale, broccoli, cauliflower, spinach, etc.), nightshades (tomatoes, potatoes eggplant, etc.) and coffee can act as “goitrogens”, suppressing the thyroid. Lightly cooking leafy greens, avoiding soy, especially processed, GMO soy, coffee and nightshades is helpful for avoiding the thyroid-suppressive effects of these foods.

Leaky gut: Food sensitivities, bacterial imbalance, antibiotic use, stress, excess alcohol and caffeine and intestinal infections can disrupt the barrier between the intestine and the rest of the body. Termed “intestinal permeability” or “leaky gut” this condition is getting increasing attention for being the root cause of inflammatory and autoimmune conditions. Identifying food sensitivities through an IgG blood test or trial-and-error and then healing the gut for 3-6 months is essential for getting thyroid health on track.

Dysbiosis: There is a close correlation between thyroid health and the health of the gut bacteria. Every human has 4-5 lbs of essential, life-giving bacteria living in their intestinal track. These bacteria help us break down food, help train our immune system and product hormones like thyroid hormone and serotonin, the happy hormone. It is estimated that 20% of thyroid hormones are produced by gut bacteria. Therefore a disruption in gut bacteria can wipe out the body’s ability to regulate the thyroid and metabolism effectively.

Environmental toxins: Toxic estrogens, heavy metals and other environmental toxins can suppress thyroid function. The thyroid gland is a sponge that is susceptible to whatever toxic burden the body is under and therefore, thyroid issues may be the first sign that the body is under toxic stress. 2-3 yearly detoxes are recommended to improve liver health, decrease the toxic burden and support a healthy thyroid. Detoxes are best done by eating a clean, grain-free diet and detoxifying the home by reducing exposure to pesticides, radiation, tobacco smoke, excessive alcohol, mercury from fish and silver fillings, bromide, fluoride and chloride (from swimming pools), which can decrease the body’s ability to absorb iodide.

Stress: Stress can suppress thyroid function by preventing the conversion of T4 to T3, the active form of thyroid hormone. During stress, T4 becomes something called “reverse T3”. Both cortisol and thyroid hormones require the amino acid tyrosine for their production. Therefore, during times of the stress, when the demands on the body for making cortisol are higher, not as many resources may be used to produce thyroid hormones and hypothyroid symptoms may result. Ensuring proper cortisol function and decreasing stress is important for recovering from thyroid symptoms.

Nutrient deficiency: Thyroid hormones are made of tyrosine and iodine. A deficiency in protein and iodine may result in an inability of the body to make thyroid hormone. Selenium is also important for converting T4 to T3. Zinc and iron are also important for proper thyroid functions and, in modern day society, these deficiencies are very common.

Inflammation: Using high omega-3 fatty acids EPA and DHA from fish, rhemannia and turmeric can help bring down systemic inflammation and decrease autoimmunity, thereby working to treat autoimmune Hashimoto’s thyroiditis and restoring thyroid function.

A Word On Medication

Synthroid is a synthetic version of the thyroid hormone T4. When prescribed, it can replace the need for the thyroid to act and help the body get back into balance. However, since T4 must be converted to T3 in order to become active, simply adding Synthroid may not be enough to eradicate thyroid symptoms if there is a problem converting T4 to T3, such as selenium deficiency, dysbiosis, inflammation or stress. Furthermore, when the cause of hypothyroidism is autoimmune, this means that there are antibodies attacking the thyroid, not that there is something wrong with the thyroid itself. Without addressing the underlying autoimmunity and inflammation, patients will only need to eventually continue to increase their Synthroid dosage as the ability of the thyroid to function gradually decreases.

For more information on how to address thyroid symptoms naturally, contact me for a free 15-minute consultation.

“Fat” is not a Feeling

I’m tucking away at the cake again because the people who’ve invited me for dinner have dessert. Dessert: the gluten-y, sugar-y, dough-y sweetness of relief from deprivation, the dopamine and serotonin rush when the food smashes against my lips, teeth and tongue and gets swallowed, in massive globs, into my stomach. The desire for more smashes maddeningly around my skull. Getting the next fix is all I can think about. I reach for another slice when no one is looking. I guess some people call this binging, a complete loss of control around “forbidden” foods. All I care about is devouring another bite, and feeling the euphoric blood sugar rush that flushes me with giddiness and good feelings before the shame sets in.

One I’ve begun to indulge, however, the voice demanding more exits stage left and is replaced with a little gremlin who fills my head with sneering and loathsome disparagement. It doesn’t speak in whole sentences, but rather in snippets, sentence fragments and hateful keywords. Sugarrr…. it hisses, gluten, bloating… FAT! Ugly, worthless…No control, no willpower, useless… failure…FAT! Not that the cake contains fat, but fat is what I will become when I allow the cake to become a part of me, the little evil voice suggests. Sometimes I can temporarily drown out his voice by eating more cake, which only makes him louder once all the cake is gone or my stomach groans with fullness.

I’ve come to realize that this cycle can be set off with feelings of boredom, anxiety and, most of all, hunger. A low-calorie diet, detox or a period of controlled eating leaves me susceptible to these binge lapses. It’s taken me the better part of 30 years to figure that out. However, stress can also send me to the pantry, digging out whatever sugary treats I can find. And so the cycle of loss of control followed by self-loathing begins.

The next day, or even within the next few hours, I feel fat.

Fat feels a certain way to me. It feels physical: puffy, bloated and sick. Most of all, it feels like I’ve done something wrong, that I am wrong. It brings with it feelings of lethargy and heaviness, not the light, perkiness I associate with health and femininity. I feel gross, unworthy of good things: attention, love, affection. I feel like I’ve failed. I feel like I’ve lost control of myself. For, if I can’t even control when I shove in my mouth, how can I have power over anything else in life?

However, a person can’t really feel fat. I mean, especially not after only a day of overeating.

And besides, fat is not a feeling.

Perhaps fat was a stand-in feeling for other difficult emotions my childhood brain couldn’t fully comprehend. Like the time I wrote in my diary, at the age of 8 years old, That’s it, I’m fat, I’m going on a diet. From now on, I’m only eating sandwiches. Funny and touching, but also sad, I wonder what 8-year-old me was really feeling when she claimed to feel “fat”. Perhaps she felt helpless, out of control, different from the herd and hopeless about fitting in.

If I pause to peer below the surface of “fat”, I find other words or cognitive connections that underlie it. When I feel “fat” I also feel out of control, worthless, lonely, like a failure. I sometimes feel sad and anxious. Sometimes I simply feel full, like I’ve fed myself, and as I’ve often heard repeated, “It’s important to leave a meal feeling a little bit hungry”, the feeling of being fed can induce feelings of guilt.

Everywhere we look, the media equates “healthy” with thin, glistening bodies. Fitness models with amenorrheic abs, bounce back and forth on splayed legs in front of a full make-up, costume, lighting and camera team to simulate the image of running through a field. “Losing weight” equals “getting fit” equals “being healthy”. As a society we’ve failed to ask ourselves what “health” might mean and instead deliver the whole concept over to impossible standards of beauty, making “health” as unachievable as the stringy bodies that represent it. While I intellectually know that this isn’t the case, that health comes in all sizes—and may actually hover around “plus” sizes, in actual fact—restriction has been imprinted in my brain as a sign of healthy self-control.

But, maybe the definition of health needs to come from digging within and asking the question What does health mean to you? Perhaps the body knows more than the marketing media does about what it needs for health. Maybe, just sometimes, it needs cake to be healthy. Maybe even the act of overindulgence is healthy sometimes.

Perhaps if I give my body enough of the healthy food and fuel it needs, it won’t go crazy the next time it sees cake. When we try to murder ourselves by holding our breath to stop our breathing, we pass out. The body deems us too irresponsible to control the precious task of breathing and so it turns the lights out on conscious breath control. Our very own physiology doesn’t trust our conscious thought if we abuse it. So, when I force my body to survive and thrive on restrictions, self-hate and negative talk, perhaps it induces a binge. Maybe I binge to survive. Or maybe my body loves cake as much as I do.

Instead of feeling like a failure, because I didn’t win the fight against my body, perhaps I should respectfully hand it back the reins and tell it, with my conscious mind, “I trust you, I respect you, I’ll listen to you more carefully from now on.”

And, like Marie Antoinette once granted her people, I can grant my body permission, and let it eat cake.

A Naturopathic Approach to Depression and Mood

A Naturopathic Approach to Depression and Mood

mental healthAccording to Statistics Canada, 1 in 4 people suffer from a mental health condition in Canada. Most of these individuals will fall between the cracks of a medical system that is not equipped to deal with the rise of stress and mood disorders, such as depression.

Naturopathic doctors understand that the mind and body are connected. Science has long established the relationship between the digestive system and mood, often termed the “Gut-Brain Connection” and the connection between the mind, mental health and the immune system, even establishing an entire field termed “psychoneuroimmunology”, linking depression to inflammation in the brain and body. However when it comes to our conventional healthcare model, mental health conditions are treated as separate from the rest of the body. In mainstream medicine, depression is largely treated as a brain chemical imbalance. It is thought that deficiency in the “happy” chemicals in the brain, like serotonin and dopamine, influence mood and must be “corrected” with anti-depressants. Despite emerging science about the brain, emotions, and mood, mental health conditions are commonly viewed as something that has “gone wrong” in the brain.

This reductionist approach to mental health often overlooks the intricate interplay between various physiological systems and their collective impact on mental well-being. For instance, conditions like ADHD are frequently discussed in terms of specific symptoms and brain function, yet they also involve broader aspects of cognitive and emotional regulation. One notable challenge associated with ADHD is time blindness, where individuals struggle to perceive and manage time effectively. This symptom highlights the complexity of ADHD and underscores the need for a more holistic view of mental health, recognizing that these conditions cannot be fully understood by focusing solely on brain chemistry.

Integrating a more comprehensive approach to mental health, such as the one advocated by Healing Psychiatry of Florida, can offer significant benefits. By addressing ADHD time blindness alongside traditional treatments, this approach acknowledges the multifaceted nature of mental health issues and emphasizes the importance of considering how various factors—both physiological and psychological—interact. This broader perspective not only enhances treatment effectiveness but also supports individuals in managing their conditions in a more integrated and compassionate manner.

As awareness grows regarding the interconnectedness of mental and physical well-being, there’s an increasing demand for holistic approaches to health and wellness. Online certification programs in holistic health and wellness, such as those offered by https://it.scholistico.com, play a pivotal role in equipping individuals with the knowledge and skills to address the multifaceted nature of human health. These courses delve into various modalities and disciplines, including naturopathy, nutrition, mindfulness, and integrative medicine, providing a comprehensive understanding of how different aspects of life impact overall wellness.

By embracing a holistic perspective, these certification programs empower students to adopt a more holistic approach to health care, recognizing the intricate interplay between physical, emotional, and spiritual well-being. With a curriculum grounded in evidence-based practices and emerging research, students gain insights into alternative therapies and lifestyle interventions that complement conventional medical treatments. As society increasingly acknowledges the limitations of the traditional medical model in addressing mental health concerns, the availability of online certification courses in holistic health and wellness serves as a beacon of hope, fostering a new generation of practitioners committed to holistic healing and compassionate care.

Most treatments for depression and anxiety are based on the low-serotonin theory of depression, which roughly states that depression is due to decreased production of certain neurotransmitters, such as serotonin, in the brain. Following this model, drugs are prescribed to artificially change neurotransmitter levels. While we understand that anti-depressant medications such as selective serotonin and selective serotonin and norepinephrine re-uptake inhibitors (SSRIs and SNRIs) work better than placebo (in about 40-60% of cases), scientists don’t know for certain why they have an affect. When starting SSRI and SNRI drugs, patients experience an immediate increase in neurotransmitter levels in the brain, however, it takes 2-4 weeks before there are noticeable changes to mood. This points to the fact that the proposed mechanism (increasing neurotransmitter levels) may not in fact be how these drugs work. However, it is in the interest of the pharmaceutical companies manufacturing such drugs to perpetuate the idea that anti-depressant medications are “restoring” the natural chemical balance in the brain, despite lack of evidence that this is the case.

This is furthered by a paper published by the Neuroscience and Behavioural Reviews last year that challenges the low-serotonin theory of depression, stating that improvement on SSRI medication might be the body overcoming the effects of the drug, rather than the drug assisting patients in feeling better (1). This may explain why patients feel worse in the first few weeks of starting anti-depressant medication. The authors venture to say that anti-depressant medication may in fact be creating an obstacle to cure in patients with depression, making it harder for patients to recover in the short-term. The authors of the study argue that most forms of depression provide an evolutionary advantage by providing the body with natural and beneficial adaptations to stress (1).

Since we understand that our digestive system and immune system are linked to our mood and overall functioning, it becomes imperative that we learn how to fuel our brains, improve digestion, balance inflammation and take proactive measures against our increasing levels of stress.

Getting help for a mental health disorder first involves removing the stigma and discrimination around mental health—depression, anxiety and other mood disorders are not signs of weakness, they are common conditions that a large portion of the population is dealing with daily. Next, it is important to seek help from a trusted practitioner who will take the time to listen to your case, treat your body as a whole entity, not just a collection of organs, and connect with you as a person, not just your symptoms or diagnosis. The following are some proposed and effective methods of working with depression and mental health conditions.

1. Healing the gut.

Science has largely started referring to the digestive system as the “second brain”, due to its possession of something called the Enteric Nervous System, a collection of millions of nerve cells that control digestive function and communicate directly with the brain. Because of this intricate connection, research has shown that irritation to the digestive system, through bacterial overgrowth, gut inflammation and a variety of other mechanisms, can trigger significant changes to mood (2,3). Since 30-40% of the population suffers from digestive symptoms such as bloating, flatulence, GERD, IBS, constipation, diarrhea and IBD, this connection is important. Additionally, emerging research is showing the link between beneficial gut bacteria and mood, establishing the fact that certain probiotics are capable of producing neurotransmitters and thereby contributing to mood and mental functioning (2,3).

Naturopathic medicine has long established a connection between the gut and brain when it comes to health, recognizing that conditions such as IBS are aggravated by stress, depression and anxiety and treating the digestive concerns with patients with depression by prescribing quality probiotics and identifying and removing food sensitivities among other things. In addition, not only is gut function important for regulation of the nervous system and, in turn mood, a healthy digestive system is required for proper absorption of the amino acids and micronutrients necessary for synthesizing neurotransmitters.

2. Essential nutrients and adequate nutrition.

If the body doesn’t possess the building blocks for building hormones and neurotransmitters, it won’t make them. While SSRI medication keeps brain serotonin levels elevated, it also depletes the vitamins and minerals responsible for producing serotonin. Supplementing with quality brands and correct doses of vitamins B6, folate and B12, as well as magnesium and zinc and ensuring adequate protein intake, is essential to treating mental health conditions and mood. Some sources state that 70-80% of the population is deficient in magnesium. Since magnesium is needed for production of a variety of hormones and neurotransmitters, a deficiency can cause an array of symptoms from low mood and muscle pain, to insomnia and fatigue. Getting put on high-quality, professional grade vitamins and minerals at therapeutic doses should be done under the care of a licensed professional, such as a naturopathic doctor.

3. Fish oil.

A meta-analysis in 2014 concluded that fish oils are effective at treating low mood and even patients diagnosed with major depressive disorder (4). Since the brain requires the fatty acids EPA and DHA found in fish to function, ensuring adequate intake of fatty fish or using a high-EPA supplement at an effective dose is a cornerstone of natural treatment for depression. The ratio of EPA:DHA is important, however, so ensure you’re receiving a prescription from a licensed naturopathic doctor (not all brands on the market are created equally and some products may even negatively impact mood). Another proposed mechanism of action for fish oil benefitting mood is in its anti-inflammatory properties. Emerging research has suggested that depression may be correlated with low-levels of brain inflammation.

4. Healing the adrenals.

According to evolutionary biology, depression may be a necessary adaptation to stress that promoted our survival and ability to pass on our genes. Since about 70% of the population identifies as being significantly stressed, it is no wonder that the number of mental health conditions is also rising. Naturopathic medicine and other alternative health fields recognize a collection of symptoms caused by prolonged, chronic stress that they term “adrenal fatigue”. Adrenal fatigue is characterized by high levels of prolonged mental, emotional and physical stress, low energy, insomnia, food cravings, and depressive symptoms such as low mood, apathy and lack of enjoyment in previously enjoyed activities, changes to sleep, weight, appetite and energy levels. Whether symptoms of chronic stress are misdiagnosed as mild to moderate depression in people, or whether lifestyle stress is the cause of physiological depression, there is often a significant stressor that complicates symptoms of low mood in most people. Using herbs, nutrition and stress-reduction techniques is important for improving resilience, as is taking steps to decrease the amount of stress present in one’s life. Researching and experimenting with various self-care practices is also important for managing low mood and promoting mental health.

5. Mind-body medicine.

Mind body medicine involves working with the body’s energetic healing forces to remove obstacles to cure and ensure the smooth flow of energy throughout the body. The main modalities that naturopathic medicine uses for these purposes are acupuncture, homeopathy and working with meditation and visualizations. While some reject these streams of healing as being pseudoscientific, there is a growing body of research to back them up. A study by the Journal of Alternative and Complementary medicine showed that acupuncture was as effective as medication at reducing depression after six weeks (5). Mind-body medicine works by integrating our thoughts, emotions and physical sensations to give us more awareness about the body as well as provides us with powerful tools for managing stress.

6. Counselling.

We know that counselling is a preferred first-line treatment for depression and other mood disorders and that counselling and medication in combination is far better than medication alone. While there are a variety of psychotherapeutic models and styles, research suggests that the therapeutic relationship is one of the most powerful determinants of positive health outcomes (6). Therefore working with a clinician that you trust, connect and resonate with is the first step to finding effective therapy. Cognitive Behavioural Therapy (CBT), a style of therapy based on changing ingrained and habitual thoughts, beliefs and behaviours that may be contributing to low mood, is one of the main therapeutic modalities for depression and is supported by a number of studies. Motivational Interviewing is another counselling model that helps patients work through and change addictive behaviours and has substantial evidence behind it.

In addition to established therapeutic approaches like Cognitive Behavioral Therapy (CBT) and Motivational Interviewing, there’s growing recognition of the importance of specialized interventions tailored to specific mental health challenges. For individuals grappling with complex issues such as trauma or relationship difficulties, psychosexual therapy can offer a targeted and effective means of support. This form of therapy delves into the intricate interplay between psychological and sexual health, addressing concerns that may have profound impacts on overall well-being. Moreover, it’s crucial to acknowledge the role of holistic approaches in promoting mental wellness. In essence, the landscape of mental health treatment is diverse and evolving, offering a spectrum of options to meet the unique needs and preferences of each individual on their path to healing and growth.

When seeking therapy, it’s essential to consider not only the specific therapeutic model but also the fit between the therapist and the individual seeking help. For instance, someone in New York City might specifically search for cbt therapy nyc to find therapists trained in this evidence-based approach within their local area. However, beyond geographical considerations, finding a therapist with whom one feels a genuine connection and trust is crucial for therapy to be effective. This connection forms the foundation of a therapeutic relationship that can support individuals in navigating their mental health challenges and achieving meaningful change.

7. Mindfulness.

More and more research is coming out about the Buddhist practice of mindfulness meditation for preventing depression, managing stress, working with mood disorders and preventing relapse in major depressive disorder. Recent evidence published in JAMA has shown that Mindfulness-Based Cognitive Therapy (MBCT), a form of secular mindfulness meditation was just as effective as medication for treating mild to moderate depression (7). Mindfulness involves looking inward, without judgment at the thoughts, feelings and physical sensations produced by the body. Practicing it cultivates the skills of awareness, attention and presence. According to Jon Kabat-Zinn, one of the founders of MBCT, “Mindfulness is awareness that arises through paying attention, on purpose, in the present moment, non-judgementally. It’s about knowing what is on your mind.” Mindfulness improves mood by allowing participants to better understand their own emotional states without getting caught up in identifying with negative emotions and belief systems.

If you or a friend or family member is suffering from a mental health condition, it is important to be educated about options. Naturopathic medicine is a great first-line option for those who have been newly diagnosed with a mood disorder, as well as a preventive measure for those simply dealing with stress, and a great complement to those who have been living with a mental health condition for some time and are already on medication. I work with children, adolescents, adults, pregnant patients, postpartum women and patients dealing with addictions. I have additional training in motivational interviewing, mindfulness-based stress reduction, narrative therapy and CBT and structure my visits to allow for more time for counselling. Contact me for more information on how to work with me.

References:

  1. Andrews, PW, Bharwani, A, Lee, K.R., Fox, M, Thomsom, JA. Is serotonin an upper or a downer? The evolution of the serotonergic system and its role in depression and the antidepressant response. Neuroscience & Biobehavioral Reviews, 2015; 51: 164
  2. Dinan, T, Cryan, J. Regulation of the stress response by the gut microbiota: Implications for psychoneuroimmunology. Psychoneuroimmunology (2012) 37, 1369-1378
  3. Wang, Y. Kasper, LH. The role of micro biome in central nervous system disorders. Brain Behav. Immun. (2014).
  4. Grosso G, Pajak A, Marventano S, et al. Role of Omega-3 Fatty Acids in the Treatment of Depressive Disorders: A Comprehensive Meta-Analysis of Randomized Clinical Trials. Malaga G, ed. PLoS ONE. 2014;9(5):e96905. doi:10.1371/journal.pone.0096905.
  5. Sun, H, Zhao, H, Ma, C, Bao, F, Zhang, J, Wang, D, Zhang, Y. and He, W. Effects of Electroacupuncture on Depression and the Production of Glial Cell Line–Derived Neurotrophic Factor Compared with Fluoxetine: A Randomized Controlled Pilot Study. The Journal of Alternative and Complementary Medicine. September 2013, 19(9): 733-739.
  6. Siegel, D. The Mindful Therapist. Mind You Brain, Inc. New York: 2010.
  7. Goyal, M, Singh, S, Sibinga, ES, et al. Meditation Programs for Psychological Stress and Well-being: A Systematic Review and Meta-analysis. JAMA Intern Med.2014;174(3):357-368. doi:10.1001/jamainternmed.2013.13018.
Balancing Hormones for Healthy Weight Loss

Balancing Hormones for Healthy Weight Loss

New Doc 8_5This is a common story that can describe any number of patients I see in my private practice: My patient has been doing well–she’s been exercising regularly; she’s been cutting out sugar and processed foods and watching what she eats. She’s been having salads for lunch. She’s even gotten her husband on board! He’s started to have salads for lunch with his cheeseburger (instead of fries) and given up having a row of cookies in the evening. All things considered, she’s been doing great. However, despite her best efforts, after one month of tiresome slog, restriction and dedication, she’s only managed to lose a few pounds. Her husband? He’s lost 10.

“He has more to lose,” I suggest to her. “Those few pounds you’ve lost are gone for life—slow and steady stays off forever.” I am her cheerleader, but the truth is: hormones, especially when it comes to women.

Hormones are the body’s telegrams. They are produced in glands in tissue like the gut, ovaries, adrenals and brain and act on distant cells in the body, telling them how to behave. When it comes to weight loss, hormones can be the culprit if diet and exercise have failed to produce results. Hormones control appetite, mood, food cravings, metabolic rate, fat gain and distribution and hunger, among other things. Any hormonal imbalance will sabotage weight loss efforts and it’s often the first place I look when a patient has weight loss goals that they aren’t achieving with diet and exercise alone.

The Players:

There are numerous hormones in the body that are responsible for the above actions, however the main ones that we can affect through diet and lifestyle are insulin, cortisol, estrogen and the thyroid hormones. These are just some key players in a team, however just by working on these four, we can start to see results.

Interconnectedness:

Hormones are complex entities, not only for the wide array of effects, but for their tendency to effect the action of each other. For example, high cortisol can effect levels of estrogen, insulin and the thyroid hormones. High insulin can affect cortisol and estrogen. And so on. Working on hormones is like attacking a giant knot and often requires starting from the basics: diet and lifestyle.

Insulin Imbalance:

Insulin is an important hormone in the body—we can’t live without it. Released by the pancreas after a carbohydrate-rich meal in response to rising levels of sugar in the blood, insulin gets sugar into cells where it can be used as fuel. It also brings down blood sugar, making it a main culprit in hypoglycemic crashes and sugar cravings. The problem with insulin, however, is when we overeat carbohydrates and sugar, we overuse the insulin response. The result is abdominal fat, weight gain (insulin tells the body to store fat), a blood sugar roller coaster, mood swings (that “hangry” feeling) and intense sugar cravings and energy crashes.

Balancing Insulin:

Insulin is best balanced by diet, particularly managing carbohydrate intake and emphasizing healthy fats and protein in the diet. Fat and protein slow sugar absorption. This prevents a rise in blood sugar and decreases the need for insulin. The result is feeling satiated for longer, having stable energy and decreasing food cravings.

Morning protein:

The first step in balancing insulin release is to increase morning protein. I recommend aiming for 30 g of good quality, lean protein for breakfast like a chicken breast, or scoop of whey isolate protein powder in a whole foods smoothie. I was once accused jokingly of “not knowing that breakfast is”, when recommending chicken breasts for breakfast. However, perhaps it’s North America that has a skewed sense of what makes a decent morning meal. If the aim of breakfast is to break the fast that you’ve had throughout the night, then starting it off with a high-carb, high-sugar, nutrient-sparse piece of toast or bowl of breakfast cereal seems crazy to me. In Colombia and India, two places I’ve spent some time, we started off the day with a protein-rich stew or meat soup.

To balance insulin make sure that every meal, even snacks, contain some form of protein or a fat. Avoid eating carbohydrates by themselves and keep servings of carbs to a minimum and in their unprocessed, whole form (like large flake oats, quinoa and brown rice as opposed to flours or cereals).

Cortisol Imbalance:

One of the main hormone imbalances I notice when it comes to stubborn weight gain is cortisol imbalance. Cortisol is the stress hormone. It’s released by the adrenal glands, two pyramid-shaped endocrine glands that sit on top of the kidneys, in response to stress. Animals have two modes of operation: fight or flight or rest and digest. Cortisol increases blood sugar and alertness and tells the body to divert attention to gearing us up for combat or escape, and moves us away from investing energy in digestion, immunity and concentration. Cortisol is a wonderful hormone; it keeps us awake, and makes us feel alert and well, priming us to be effective in our busy, stressful lives. However, our bodies weren’t made for long-term stress response and we spend most of our time in fight or flight mode.

Cortisol and blood sugar:

Cortisol raises blood sugar, causing insulin to be released. This starts us on a blood sugar roller coaster trip, leading to sugar cravings, energy crashes and storing fat.

Cortisol and fat distribution:

Cortisol doesn’t directly tell the body to store fat (it happens through other mechanisms that happen in response to high cortisol), but it does encourage fat redistribution. Cortisol tells the body to move fat from the hips and thighs and deposit in the abdomen, face and shoulders, leading to the sexy “Buffalo Hump”. We know that abdominal fat carries more health risks than fat in other areas of the body so this detail can be troublesome when it comes to long-term effects.

Cortisol and the thyroid:

Cortisol impacts the thyroid by preventing the conversion of T4 to the more active T3. T3 and T4 are important thyroid hormones that set the body’s metabolic rate, among other things.

Cortisol and the sex hormones:

Cortisol can lead to estrogen dominance by diverting resources away from estrogen and progesterone production. In menopause, this is particularly troublesome, as the body relies on the adrenal glands, rather than the ovaries, to produce the sex hormones. High cortisol can result in progesterone deficiency and estrogen dominance symptoms, which can negatively affect weight loss. Cortisol also causing accelerated aging and who wants that?

Cortisol Balancing:

The main thing when it comes to cortisol balancing is to Calm Down—or as I like to poignantly put it, Calm the F#$% Down. The way this is done is highly individualized. Some recommendations I have are: meditation, yoga, exploring acupuncture (a wonderful way to balance cortisol, among other things), journaling, taking a day off, re-evaluating priorities at work and at home, etc. Mainly, getting 7-9 hours of sleep a night is essential for managing the stress response.

Taking it easy:

When it comes to weight loss, I often notice that certain efforts hinder our progress. It’s important to keep caloric intake adequate—eating too few calories can stress the body out, causing cortisol release. It’s also important to manage exercise. While exercise can teach the body how to manage stress, it does produce cortisol in the short-term. Therefore it’s important to keep exercise short and intense. Weight-training, short bursts of cardio (no more than 20 minutes) and varying intensities with High Intensity Interval Training, Tabata or Crossfit, are the best choices for weight loss. Training for a marathon or long-distance bike race may be fun and fulfilling, but they are not the best choices for weight loss, as they prolong the stress response and can work against you, rather than in your favour.

When I have a patient who is intensely tracking what they eat and over-exercising my advice is often (and it’s not that well-received, as you can imagine) “Take it easy”. Easing up on exercise and relaxing calorie-counting may be hidden pieces in the weight loss game.

Herbs and supplements:

There are a variety of nutrients to take to support adrenal function. The main things to consider, with the advice and counsel of a trained naturopathic doctor are B-vitamins, magnesium and adaptogenic herbs (the help the body adapt to stress).

Estrogen Dominance:

Estrogen, actually a group of hormones, are female sex hormones. Their main job is to promote the expression of female sex characteristics, the growth of breast tissue and to control ovulation. Estrogen also causes body to fat to be distributed to the thighs, buttocks and lower abdomen. The problem with modern society is an imbalance in the two female sex hormones, estrogen and progesterone. Due to stress and toxic environmental estrogens, or xenoestrogens, among other things, modern women have more estrogen relative to progesterone in their bodies. The effects of this are numerous and include, stubborn weight gain in the thighs (the famed “saddlebags), cellulite, acne, PMS, painful menstrual periods, fibroids, hormonal conditions such as PCOS, and the occurrence of certain female cancers, especially breast cancer. Estrogen can also contribute significantly to anxiety symptoms.

Estrogen balancing:

Correcting estrogen dominance primarily involves supporting estrogen detox pathways in the liver. Chemicals such as I3C, DIIM and calcium-d-glucarate help increase the liver’s ability to clear foreign estrogens from the body. Supporting digestive health also allows us to remove estrogens—they are neutralized in the liver and eliminated through the colon. Leafy greens contain a high amount of these chemicals, so ensuring you get adequate amounts in your diet is important for estrogen metabolism. Ground flaxseed, rosemary and fish oil are also important nutrients for clearing excess estrogen from the body.

Reducing exposure:

Try to reduce exposure to foreign estrogens by avoiding the use of plastic bottles and plastic-lined cans, using natural skincare and body products and natural cleaning aids whenever possible. It’s also important to see a naturopathic doctor 2-4 times a year for a medically-assisted natural detoxification to clear the body of toxic estrogens.

Hypothyroidism:

The thyroid gland sits on the neck, just below the Adam’s Apple. It releases two hormones T4, and the more active T3. These hormones are responsible for setting the body’s metabolic rate—converting fat into heat and energy. Thyroid deficiency, or hypothyroidism is more common in our society than we think (naturopathic doctors have stricter criteria for laboratory reference ranges than conventional medicine—we look for signs of health, not disease). Conventional medicine deems hypothyroidism as having a TSH (thyroid stimulating hormone) level above 5—for this hormone, all you need to know is lower is better—however ND’s will start to treat the thyroid when symptoms are present and TSH is above 2.5. Symptoms of hypothyroidism are stubborn weight gain, constipation, feeling cold, fatigue, especially brain fog, weak memory, hair loss, dry skin and thinning of the eyebrows.

Supporting the thyroid:

The thyroid gland is a fragile organ, sensitive to inflammation and stress. When there is inflammation in the body, often caused by stress, diet or insulin resistance, the thyroid is the first gland to suffer. Most cases of hypothyroidism are autoimmune in nature. Therefore, naturopathic doctors aim to correct inflammation by prescribing an anti-inflammatory diet and looking for food sensitivities. When we identify food sensitivities (through specialized IgG antibody testing or an elimination diet) and remove them from the diet, we can focus on gut healing which treats inflammation and helps repair the thyroid.

Managing stress:

Low calorie diets have the effect of suppressing thyroid function, which leads to the yo-yo dieting effect. Avoid extremely low calorie diets, or opt for intermittent fasting or calorie-cycling instead. Aim for slow and steady weight loss so as not to harm metabolic rate, which makes weight loss more difficult in the long run.

I previously mentioned that cortisol can harm the thyroid and that hormones are interlinked. Cortisol prevents the conversion of T4 to the more active T3, which can slow metabolism.

Nutrients:

A deficiency in iodine, zinc, iron and selenium, among other nutrients, can negatively impact the thyroid. Talk your naturopathic doctor about testing and supplementation.

Summary:

What would a visit to a naturopathic doctor look like? When it comes to hormones, treatment is often complex as it targets the root cause of symptoms and involves detangling the complicated web of hormones that are at play. This can require some diagnostic detective work. A naturopathic doctor will take your complete health history, order labs and perform physical exams if necessary. A common treatment plan might look like this:

  1. Sleep: 7-9 hours per night
  2. Take stress seriously: sign up for a round of acupuncture, start meditation, do yoga, journal, etc.
  3. Measure hormones via saliva: cortisol, testosterone, DHEA, estrogen, progesterone
  4. Identify food sensitivities via an elimination diet or an IgG Food Panel that tests for antibodies to certain foods in the blood.
  5. Correct nutritient deficiencies through diet and supplementation
  6. Herbs for hormonal support: estrogen detoxification, thyroid support, gut healing, adrenal support, glucose control and blood sugar balancing.
  7. Exercise: short, intense bursts that target muscle-building
  8. Diet: high protein, especially in the morning, healthy fats, low carbs and eliminate sugar, processed foods and food sensitivities.

To learn more about how naturopathic medicine can help you lose weight, balance hormones and fight disease, contact my clinic Bloor West Wellness at 416 588 0400 to set up an initial appointment. Let’s get started today!

Want to balance your hormones, energy and mood naturally? Check out my 6-week foundational membership program Good Mood Foundations. taliand.com/good-mood-learn

A Naturopathic Approach to Healthy Hair

A Naturopathic Approach to Healthy Hair

IMG_5360This is likely one of the shallowest posts I’ll ever write—it’s about hair. However, what is so shallow about hair? We all know the importance of having a good hair day. It seems from the moment we wake up, look in the mirror and notice that our top bun has left proper, succulent waves and not weird, irregular angles of frizz, that the rest of the day will be infused with magic. Our hair plays a huge role in who we are and how we see ourselves. When movie characters want to change their identities, the first thing they do is stash themselves in a truck stop bathroom with a box of hair dye and go to town on their manes. Further, and admittedly sticking to the shallow side of things, I’m often suspicious when every photo of a man on Ok Cupid shows himself wearing a hat—what on earth is he hiding? At any rate, concerns about hair health gets people, namely women, into my office. Sometimes seemingly shallow, trivial health concerns act as gateways to lifestyle changes and a journey to health and wellbeing. Since our bodies don’t really require hair for survival, hair health, along with sex drive and energy, is one of the first things to decline when we enter into a state of imbalance. It therefore becomes an important initial warning sign that things have gone array with our health.

If you’re someone who sees hair not just as a superficial aspect but as a reflection of your identity and well-being, then delving into the world of dreadlock classes could offer a transformative experience. Consider exploring the comprehensive resources available at https://dreadlockcentral.com/courses/. These courses provide a deep dive into the art of dreadlock maintenance and styling, empowering individuals to cultivate a strong sense of self-expression and confidence through their hair.

Just as concerns about hair health can serve as a gateway to overall well-being, mastering the art of dreadlocks through these classes can become a catalyst for positive lifestyle changes and self-discovery. Whether you’re looking to embrace your natural texture or make a bold statement with your locks, the knowledge and techniques gained from these courses can help you achieve your hair goals while also fostering a deeper connection to yourself and your personal journey of health and wellness. So, if you’re ready to explore the transformative power of dreadlocks and embark on a journey of self-discovery, consider enrolling in dreadlock classes today.

When it comes to expressing individuality and embracing a holistic approach to personal style, integrating human bulk braiding hair into your dreadlock journey can elevate your hair aesthetics to new heights. This premium hair product not only enhances the volume and texture of dreadlocks but also offers a natural look and feel that complements diverse hair types and styles. Whether you’re aiming for thicker, more defined locks or experimenting with intricate styles like braids and twists, bulk human hair provides the versatility and quality necessary to achieve stunning results that align with your unique vision. By using high-quality human hair, you ensure durability and manageability while promoting the longevity and vibrancy of your dreadlocks.

This approach not only enhances the aesthetic appeal of your hairstyle but also contributes to your overall sense of well-being and confidence in your appearance. Embracing these advanced techniques and materials not only expands your creative possibilities but also reinforces a deep connection to your identity and self-expression through the transformative power of hairstyling.

Hair holds a significant place in our self-perception and daily routines, often influencing our confidence and identity. When hair health falters, whether due to genetics, hormonal changes, or lifestyle factors, individuals may seek solutions like Hair Restoration Therapy to regain a sense of normalcy and well-being. This therapy, offered by a specialized plastic surgeon, aims to address hair loss and promote regrowth through various techniques such as laser therapy, PRP (Platelet-Rich Plasma) injections, or surgical procedures like hair transplantation. While the desire for lush locks may seem superficial to some, it often serves as a catalyst for deeper introspection and lifestyle changes, underscoring the interconnectedness of physical appearance and overall health.

Hair loss is often a concern for many women and men. It’s normal to notice a few strands of hair in the shower—the average woman loses about 50 to 100 strands of hair per day. However, when patches of hair seem to be missing, areas of thinning are present or a reduction in overall hair volume (usually indicated by a decrease in thickness of the pony tail), this can point to possible pathological hair loss.

In the quest to address concerns about hair loss, the choice of shampoo becomes a crucial element in maintaining scalp health. Opting for a sulfate free shampoo for oily scalp emerges as a thoughtful strategy to navigate this common challenge. This type of shampoo not only gently cleanses the hair but also ensures that the scalp’s natural oils are preserved, striking a balance that is particularly beneficial for those experiencing issues like thinning or reduced hair volume.

While losing a few strands daily is normal, unusual patterns of hair loss can signal pathological conditions that may require medical attention. For those seeking effective solutions, advancements in the field of hair restoration, such as hair transplant procedures, have become increasingly popular. In Seattle, individuals concerned about hair loss often explore options like hair transplants, which can provide a natural and lasting solution to restore hair density. It’s essential to consider factors such as seattle hair transplant cost along with the expertise of professionals to make an informed decision about addressing hair loss concerns. Seeking appropriate medical advice and exploring suitable treatments can help individuals regain not only their hair but also their confidence and overall sense of well-being.

History and Labs:

When coming in to see your naturopathic doctor, he or she may ask you the following questions:

Do you notice any itchiness or flaking of the scalp? These symptoms could indicate a number of skin conditions of the scalp that contribute to hair loss: seborrheic dermatitis, infection by a fungus called Malassezia furfur that causes dandruff, or psoriasis of the scalp, an autoimmune condition. The ND may diagnose via trial-and-error or perform skin-scraping to rule out a fungal infection. A skin biopsy may be indicated to provide a definitive diagnosis, however this test is invasive.

What do you labs look like? Comprehensive lab work is necessary in patients with hair loss. It’s important to see what iron status is, as well as thyroid health. Low iron or under-functioning thyroid can be the root cause of hair loss as can high androgens, the male sex hormones.

Which medications are you taking? Oral contraceptives can cause a deficiency in vitamins and minerals, such as zinc and B vitamins, that can cause hair loss. Other medications that can cause hair loss include, and or not limited to, blood pressure medications, antidepressants, antibiotics, acne medications, chemotherapeutics agents, immunosuppressants and pain medications. An ND can work with your doctor to decrease your list of medications by addressing the root cause of concerns, if possible, or collaborate in switching medications. This, of course, will only be done in collaboration with the prescribing doctor.

What’s bugging you? Stress can contribute significantly to hair loss. The mechanism of action is varied, but a decrease in circulation to the scalp, protein deficiency and depletion of vitamins used by the adrenal glands, can be possible causes of hair loss. Telogen effluvium is a condition where the body pushes the hair follicles into a “resting phase” so that they no longer grow and produce hair. This is done because when under stress, the body enters survival mode and does not dedicate precious resources to non-survival entities such as hair health. Alopecia areata an autoimmune condition in which the immune system of the body attacks the hair’s follicles, causing large patches of hair to fall out. This is said to be cause or aggravated by severe stress. Trichotillomania is a mental health condition in which the individual plucks out hair as a self-soothing mechanism.

What are you other symptoms? Weight gain, irregular periods, acne and hair growth on the face can indicate PCOS, which also can cause loss of scalp hair due to higher-than-normal testosterone levels. Men with high testosterone will also experience more hair loss. Digestive symptoms can indicate malabsorption of important fat-soluble vitamins or iron, which can contribute to hair loss if resulting in deficiency.

What hair products do you use? A sensitivity to sulphates and/or other chemical additives to hair products can contribute to hair loss or a decrease in the lustre and overall health of hair follicles.

Treatment:

The naturopathic treatment for hair loss, involves identifying and treating the root cause of symptoms, not the hair loss itself. A potential treatment plan might consist of the following:

Restoring health by replenishing depleted or deficient vitamins and minerals.

Eliminating infection or scalp fungus if necessary.

Managing stress in healthy, constructive ways.

Balancing hormones and the immune system via herbs, supplements and dietary changes.

Nourishing the hair by adding in vitamins that support hair health, such as fish oil. This also involves changing shampoos and conditioners to more natural, sulphate-free forms.

Castor oil hair mask:

Once a week, when my hair starts looking drier and duller, I do a castor oil hair mask and scalp massage. Castor oil is an anti-fungal and anti-inflammatory oil. It has the added benefit of increasing blood flow to the area it is applied to, in this case the scalp, which can increase hair growth. It is also a wonderful moisturizer and nutrient-rich hair supplement. It can help fuse together and moisturize split ends. Performing a self-scalp massage is a great way to increase body love by performing self care and has a grounding effect on the body, which reduces mental-emotional stress.

Apply a liberal amount of castor oil to palms. Rub oil into palms to warm it. Starting at the scalp, work oil into the hair follicles, applying a firm pressure and moving the fingertips in circles. Massage for 5 minutes, moving the oil through the shaft of the hair to the ends. After performing massage, leave oil in hair for at least an hour or overnight. Finally, shampoo and condition hair as usual to remove oil. Warning: castor oil can stain fabrics so sleep with an old pillowcase and wear an old t-shirt while performing castor oil scalp massages.

Epilogue: If you haven’t noticed, this seemingly shallow subject matter is the perfect segue into talking about a basic naturopathic approach, which involves taking a thorough history, ordering lab work to find the root cause of symptoms and then treating accordingly using non-invasive therapies that aim to treat the cause, not just the symptoms themselves. Notice how this is vastly different from walking into a supplement store and purchasing a product called “Hair Loss Formula” or some other facsimile. While this formula may replenish some deficient vitamins, it is masking the real cause, which may be PCOS or celiac disease, and delay effective treatment for these conditions. Hopefully this highlights the importance of seeking a professional opinion rather than self-diagnosing and self-prescribing!

The Estrogen Metabolism Diet

The Estrogen Metabolism Diet

New Doc 8_8Estrogen is the dominant female hormone. It is actually a group of hormones, called the estrogens, that are responsible for the development of female secondary sex characteristics: the development of breast tissue and the proliferation of the uterine lining. Estrogen helps prepare the body for ovulation. Not all estrogens are created equal, however. Some estrogens are associated with an increased risk of certain female cancers, such as breast cancer.

Excess estrogen, especially in the form of these so-called “bad” estrogens, seems to be a common theme among women in North America. Stress, caffeine intake, synthetic estrogens in birth control pills and hormone replacement therapy and xeno-estrogens from cleaning products, plastics and cosmetics are among some of the causes of excess levels of estrogen in the body. Because of these environmental factors, many women suffer from something called “Estrogen Dominance”.

Symptoms of estrogen dominance include stubborn weight gain, anxiety, premenstrual symptoms of breast tenderness, acne, irritability, fatigue and brain fog. Estrogen dominance can contribute to worsening of health conditions such as infertility, fibrocystic breasts, repeated miscarriages, uterine fibroids and endometriosis as well as increase the risk of developing certain cancers.

Estrogen detoxification can be done effectively through a healthy diet that aims at improving estrogen clearance in the liver and regulation of the action of estrogen at cell receptors. By following this diet, patients can experience an improvement in hormonal health conditions, clearer skin and weight loss.

This diet is adapted from Dr. Joseph Collins RN, ND at yourhormones.com.

Cruciferous vegetables: Vegetables from the cabbage family, such as cabbage itself, cauliflower, broccoli, brussel sprouts, kale, bok choy, spinach, collard greens and other leafy greens are rich in a nutrient called indole-3-carbinol, or I3C. I3C gets converted to diindolymethane (DIM) in the body, which is responsible for clearance of excess estrogens in the liver. Consume a minimum of 3-4 servings of these vegetables per week.

Rosemary: Rosemary, when added to meats as a seasoning enhances the formation of good estrogens (the ones less likely to cause cancer or health concerns). Rosemary has the added benefit of antioxidant activity. It also enhances memory and mood and helps with thyroid function, improving weight loss, metabolism and energy levels.

Flaxseed: 2-4 tablespoons per day of ground flaxseed promotes healthy estrogen metabolism. The seed contains lignans, which help clear excess estrogens from the body. Flax also contains phytoestrogens, which control how much estrogen can bind to estrogen receptors. This means it can decrease excess estrogen activity or increase deficient estrogen activity, making it an effective remedy for a variety of female health complaints. Flax is rich in healthy omega-3 fats and contains fibre, making it an important remedy for treating inflammation and constipation. Flaxseed is digested and absorbed when ground, and best stored in the fridge as the oils in the seed quickly go rancid at room temperature.

Salmon and other fatty fish: Salmon and other fatty fish contain EPA, an omega-3 fatty acid, is an important anti-inflammatory oil. It has been shown to be effective in treating inflammatory conditions, cardiovascular disease and mental health conditions, such as depression, anxiety and ADHD. It helps increase the formation of “good” estrogens in the body. Enjoy 2-3 servings of fatty fish per week, or supplement with a quality fish oil.

Isoflavones: Isoflavones, such as those found in soy, are antioxidants effective at increasing good estrogens in the body. Since soy is often heavily processed, using herbs such as Trifolium pratense, Pueraria montana and Pueraria lobata either in teas, capsules or tinctures, will help provide an adequate dose of isoflavones.

Activated folic acid: Folic acid is responsible for converting estrogen into a very healthy, methylated form that can decrease the risk of certain cancers. Many people are unable to convert folate into the active 5-methyltetrahydrofolate, which is essential for hormone metabolism, DNA synthesis, homocysteine metabolism and nervous system function (good mental health, memory and energy). Other B vitamins to supplement with are B6 and B12 as they help folic acid metabolism estrogen into their anti-cancer form. Folic acid is found in dark leafy greens, which also contain your daily doses of indole-3-carbinol.

If you are experiencing symptoms of estrogen dominance in the form of a female health complaint, book an appointment to learn what else you can do to experience healthy, happy, pain-free periods and look and feel your best. Contact me. 

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