Understanding Food Allergies and Sensitivities

Have you noticed that more and more people are avoiding certain foods for health reasons?  It turns out that food allergies and intolerances are more common than we once thought. Identifying and eliminating food allergies can solve a broad range of health problems.  I have had hundreds of patients find that once they learn to eat a diet free of their triggering foods, they can get off prescription medications and enjoy much better health.  It turns out good scientific studies are backing up this treatment method.

The symptoms of food allergies can be obvious, such as when people have anaphylactic reactions to peanuts or shellfish.  These food allergies are usually easy to identify.  Other allergic reactions are much subtler and can be delayed, making it challenging to figure out which foods are causing symptoms.  For instance, acid reflux is commonly aggravated by eating certain foods, but the reaction may come the next day.  I have had many patients who determine that dairy causes their sinus congestion, but it may take two days for their sinus headache to set in.  Therefore, to identify most food allergies, careful testing and dietary experiments are necessary.  Food reactions can range from fatigue, depression, post nasal drip, ear infections, constipation, diarrhea, skin issues, headaches, joint pain and more.  In my twenty years of naturopathic medical practice, I have found that helping people eliminate food allergies has been one of the most successful interventions that we can make to help people feel better with less medication.   I am happy that medical science is confirming my clinical experience in several studies on food allergies.

Children who get ear infections often have food allergies that cause excess mucous in their middle ear, setting them up for infection.  A clinical study showed that 94% of ear infection prone children who avoided their food allergies had fewer ear infections.

Many factors can cause migraine headaches, and food allergies can be one of them.  In a study of chronic migraine sufferers who avoided food allergies, 85% became headache free.  In another study, patients with rheumatoid arthritis who avoided food triggers fared much better than the placebo group who ate normally.  In a follow-up study 10 years later, of the 100 rheumatoid arthritis patients who avoided food allergies, one-third were still well on a food allergy free diet alone, without medication, which is remarkable.

Irritable bowel syndrome is a condition I see frequently and know it to respond well to naturopathic treatments, including food allergy elimination.  In a study published in the Lancet medical journal, 14 out of the 21 patients with IBS who went on a hypoallergenic diet for one week became symptom-free.

Celiac disease is a special type of food intolerance where the immune system not only reacts to gluten, but it can send out anti-bodies that affect healthy tissue, like the intestinal lining, the brain, the thyroid and more.  Screening for this food reaction is available through an MD or an ND through blood testing, and a diagnosis can be confirmed by a biopsy taken by a specialist.  Anyone with digestive issues should be tested, but so should people with autoimmune, neurologic and psychiatric conditions. For people with Celiac disease, avoiding gluten containing food, such as wheat, can be life changing.  While true Celiac disease is uncommon, more people have non-celiac gluten intolerance or a simple wheat intolerance.  These people also fare better off wheat and / or gluten containing foods.

While it may take some careful testing and experimenting to figure out which foods are contributing to a health issue, it is certainly worth the additional effort.  When I coach my patients on how to avoid their food allergies and enjoy healthy alternatives, they are often thrilled that something so simple can make such a difference to their wellbeing.

Dr. Deidre Macdonald is a naturopathic physician whose practice is in downtown Courtenay. Contact 250 897-0235 or www.getwellhere.com.

Healing Concussion and Traumatic Brain Injury

The human brain is a remarkable feat of engineering.  But with the consistency of Jello, it is quite vulnerable to damage from injuries.  Every year about 200,000 Canadians suffer concussions.  Sports injuries and car accidents are two common causes of brain injuries, but for seniors, concussions are more likely to be caused by a fall.  The good news is that the brain can recover from minor concussions within a short time. But for multiple concussions or more traumatic brain injuries, the path to recovery can be long and winding.  Post-concussion syndrome can persist for years without the proper help.  Research is showing that there are many ways to enhance healing of the brain. No matter how long it’s been since the brain injury, it’s never too late to jump-start more repair of those delicate structures of the brain that run our mind and body.

Concussions are difficult to diagnose with imagine like an MRI or CT scan, and the symptoms of post-concussion syndrome can be easily attributed to other things.  I often ask my patients about concussions and sometimes find that they do indeed have symptoms of post-concussion syndrome such as:  fatigue, memory loss, cognitive issues, headache, depression, anxiety, irritability, sleep issues, sensitivity to light or sound, issues with sight or hearing, nausea, dizziness and more.

The best approach after a brain injury is to minimize the damage and promote brain healing as soon as possible.  To do that, we have to understand how the brain cells actually get damaged with brain injury.  Then we can use treatments that target those processes. Most medical professionals are not versed in strategies to address what’s really going on in concussion and brain injury, and so these processes are left to damage the brain especially in the critical first few days after concussion.  We need to institute neuroprotection strategies that promote healing, and it’s never too late to start.

Neural inflammation is a significant cause of loss of brain cells, and the connections between them, after head injury.  There are a number of natural products that help to regulate neural inflammation such as curcumin, the DHA portion of fish oil, and green tea. Aerobic exercise also has tremendous benefits to the brain.

We also want to decrease oxidative stress on the brain cells by ingesting higher amounts of anti-oxidant rich foods and medicines.  Berries are rich in antioxidants and Vitamins C and E can be helpful too.

The blood brain barrier (BBB) is intended to only allow certain things to enter the brain from the blood, but after brain injury, there can be a breach in this filtering system.  Toxins then can enter the brain and cause more damage.  Alpha lipoic acid is excellent for healing the BBB and is also an antioxidant.

Mitochondria are the furnaces of the cells, producing needed energy.  The brain cells are particularly dependent on mitochondria for energy. Brain injury can damage the mitochondria and especially lead to brain fog and fatigue.  To heal from brain injury, we need to ramp up the mitochondrial function by taking supplements such as coenzyme Q10, B vitamins as well as eating whole foods and exercising.

We want to stimulate that parts of the brain that can regenerate by enhancing neural stem cells. Humble nutrients like Vitamin D and melatonin can help accomplish these goals.

Promote the lymphatic drainage in the brain called glymphatics. Like a Zamboni clearing the effects of ice skating on an ice rink, the glymphatics of the brain clear away the normal waste products that build up in the brain daily.  This is even more important post brain injury. Sleep is the time when these mechanisms ramp up the most, so I help my concussion patients enhance their sleep.

The nerves of the brain are intimately linked to the chemistry of the digestive system.  Chemicals produced by the gut bugs, or intestinal microbiome, travel to the brain and influence mood, thinking and more.  Having a healthy digestive system will help brain function and naturopathic physicians are an excellent resource for tools to enhance gut health.

Other treatments for concussion are also getting much needed attention.

Brain training can help make new connections in the brain.

The ketogenic diet, while somewhat arduous, has been shown to help a number of brain diseases, including post-concussion syndrome.

Neurofeedback is a sort of visual gym for learning to retrain and re-pattern disrupted brain activity (and is available in Comox).

Functional Neurology practitioners can help target the part of the brain that is malfunctioning and provide specific stimulation to heal those parts.

Cold laser therapy to the skull has demonstrated benefits to many patients at a Toronto clinic and human clinical trials are underway.  This painless treatment has been shown in animal studies to enhance brain healing after traumatic brain injury.  I have treated over 1000 people for various health issues with laser therapy as it helps to gently but quickly regenerate damaged tissue throughout the body.

Reducing electromagnetic fields that may not affect people with healthy brains, but may be one more stress on an injured brain. Turning off wireless at night and removing cordless phones from the bedroom are a good way to start.

There is hope.  No matter how far out from a brain injury, there is always reason for hope.  With the right treatment, people can improve significantly even years after a brain injury if they are willing to invest in their brain health.

To learn more about how this type of multifaceted approach might be able to help you, contact naturopathic physician Dr. Deidre Macdonald, ND at 250 897-0235 or via getwellhere.com

Bladder Infections in the Age of Antibiotic Resistance

Remember the days when you would go to the doctor and get an antibiotic for every sniffle and cough? Those days are over because overuse and overreliance on antibiotics have created bacteria which can no longer be killed by ordinary antibiotics.  Doctors are now rightly conflicted because the antibiotics they prescribe may kill most of the bacteria but leave the few that are resistant and allow those strains to proliferate.  Multiple antibiotic resistant strains of bacteria cause infections in one in 16 people admitted to hospitals in Canada and cost $250 million per year. The Public Health Agency of Canada estimates that by 2050, there will be 10 million deaths annually worldwide caused by antibiotic-resistant bacteria, overtaking diabetes and cancer combined.

In my 22 years practicing as a naturopathic physician, I have seen an increasing rate of these tough infections in my patients.  In particular, I have seen many women, particularly older women, who’ve had multiple bladder infections in a year, and some even need to use very strong intravenous antibiotics to treat them. The naturopathic approach to treating recurrent UTIs goes beyond just killing the superficial bacteria.  It endeavors to change the environment that is allowing the bacteria to persist.  It is a multi-faceted approach that is an example of how naturopathic medicine can play a role in reducing antibiotic resistance by stopping these types of tough bugs in their tracks.

UTIs are generally created by bacteria from the feces migrating up the urethra and taking hold in the bladder.  In tough recurrent cases, biofilms can form that harbor infection.  Biofilms are a slimy goop that protects the bacterial community from antibiotics and the body’s natural defenses. For my patients with recurrent UTIs, the first step is to make sure they understand how to practice good hygiene.  Then I teach them how to check their own urine at home with a dip stick that can show signs of infection.  I use herbs that help to reduce the adherence of the bacteria to the bladder wall.  These herbs essentially flush out the bacteria, unlike antibiotics which are trying to kill them. Thus, the bacteria don’t mutate to avoid the herbs the same way.  I also use antibacterial herbs to reduce the population.  Plus we look at ways to break down the biofilm to allow greater access to the bacteria.  Scientific studies have shown that there are herbs that can do just that.  For my older patients, we look at strengthening the tissues of the urethral opening by introducing a bit of estrogen locally.  Repeated antibiotic use in the past has usually disturbed the natural defences provided by the good bacteria in the body.  Studies show that oral use of certain probiotics bolsters the genital good bacteria colonies, which can then act as the first line of defense against migrating nasty bacteria and reduce the incidence of UTIs as effectively as daily use of an antibiotic. I also look at ways to enhance the immune system with lifestyle and natural medicines, so the body’s natural defences are in fighting shape.  This type of whole-body approach can be very successful at stopping the cycle of infection and thus reduces the use of antibiotics.  We all need to do our part to turn the tide on antibiotic resistance.

Dr. Deidre Macdonald is a naturopathic physician practicing in downtown Courtenay.  250 897-0235 ww.getwellhere.com

Preventing Illness while Travelling

Even though we live in one of the most beautiful parts of the world, many people from the Comox Valley travel abroad for business or pleasure.  Part of preventative medicine is planning ahead for a safe trip and making good choices while overseas.  How far you need to go to ensure a healthy travels depends a lot on where you are going of course.  For travel in North America and Western Europe, some common sense is all you need. Pack a first aid kit, make sure you have adequate travel medical insurance, and practice good street smarts.  Taking a self defense course is a wise move for travelers, as criminals often lurk in highly touristy areas and count on tourists having their guard down.

If you are travelling further abroad to developing countries, the Centre for Disease Control and Prevention has a website where you can learn which immunizations are recommended or required for the areas you’ll be visiting.  Travel medical clinics are also a great source of information.  Updating your basic immunizations may not be a bad idea especially if you are travelling to areas where the population may be under-vaccinated.

Preventing food and water borne disease is important if you don’t want to spend your holiday on the toilet or worse.  People on stomach acid blocking medication for acid reflux or other stomach issues are especially prone to these types of infections because stomach acid is the first line of defense against ingested bugs.  Working with a naturopathic physician to find alternatives to acid blocking medications may be a wise choice if you want to stay healthy while travelling.  Taking probiotics prior to a vacation can also bolter your body’s defenses against food and water borne illness.   I encourage my patients to pick up some electrolyte powder and I write them a prescription for antibiotics ahead of time to tuck into their suitcase just in case they get a nasty case of traveler’s diarrhea.

Mosquitoes can be much more than just an annoyance as they can transmit disease.  There are at least 17 known mosquito borne infections including Lyme disease, Zika, Malaria, and Dengue Fever. It is a good idea to pay attention to whether or not mosquitoes are known to live in the areas where you’ll be travelling. Try to cover up and use insect repellents.  DEET is well known, but Picardin has some advantages.  You can even invest in special clothing that has insect repellent infused in the fabric.  Local work wear stores may carry these clothes.  Choosing air conditioned accommodation can help too.  Where malaria is a risk, there are medications that can be taken to prevent the disease from taking hold.

Sometimes people forget to pack their common sense when travelling abroad.  Remember to practice hand washing, safe sex, and street smarts.  The number one cause of death while travelling is motor vehicle accidents.  Mopeds are especially dangerous and some travel health insurance won’t cover injuries related to mopeds.  With a little prevention and travel savvy, you can enjoy your amazing adventures abroad and come home with great stories instead of ill health.

Healing Concussion and Traumatic Brain Injury

Every year about 200,000 Canadians suffer concussions.  Sports injuries and car accidents are two common causes of brain injuries, but for seniors, falls are a common cause.  The good news is that the brain can usually recover from minor concussions within a short time. But for multiple concussions or more traumatic brain injuries, the path to recovery can be long and winding.  Post-concussion syndrome can persist for years without the proper help.  Research is showing that there are many ways to enhance healing of the brain. No matter how long it’s been since a brain injury, it’s never too late to jump-start more repair of those delicate structures of the brain that run our mind and body.

The symptoms of post-concussion syndrome can include fatigue, memory loss, cognitive issues, headache, depression, anxiety, irritability, sleep issues, sensitivity to light or sound, issues with sight or hearing, nausea, dizziness and more.

The best approach after a brain injury is to minimize the damage and promote brain healing as soon as possible.  To do that, we have to understand how the brain cells actually get damaged with brain injury.   Then we can use treatments that target those processes. We need to institute neuroprotection strategies that promote healing, and it’s never too late to start.

There are about seven known mechanisms we can target to help heal a damaged brain.  Neural inflammation is a significant cause of loss of brain cells after head injury.  Oxidative stress on the brain cells damages delicate structures. The blood brain barrier (BBB) is intended to only allow certain things to enter the brain from the blood, but after brain injury, there can be a breach in this filtering system.  Toxins then can enter the brain and cause more damage.  Mitochondria are the furnaces of the nerve cells, producing needed energy.  After brain injury, the mitochondria can’t supply as much energy to the neurons. The brain’s natural healing may be compromised, so we want to stimulate the parts of the brain that can regenerate by enhancing neural stem cells. We need to promote the lymphatic drainage to clear away the normal waste products that build up in the brain daily.  The brain is intimately linked to the digestive system.  Having a healthy digestive system will help brain function.  Naturopathic physicians are trained in methods to address each of these seven mechanisms to enhance brain healing after concussion.

Other treatments for concussion are also getting much needed attention.  Brain training can help make new connections in the brain.  Neurofeedback is a sort of visual gym for learning to retrain and re-pattern disrupted brain activity (and is available in Comox). Functional Neurology practitioners can help target the part of the brain that is malfunctioning and provide specific stimulation to heal those parts.  Cold laser therapy to the skull has demonstrated benefits to many patients at a Toronto research clinic and human clinical trials are underway.  This painless treatment has been shown in animal studies to enhance brain healing after traumatic brain injury.

No matter how far out from a brain injury, there is always reason for hope.  With the right treatment, people can improve significantly even years after a brain injury if they are willing to invest in their brain health.

How to be an EMPOWERED Patient

Medical science now shows that when patients are empowered to play an active role in their health care, they are more invested in the process, which results in greater health. Medical education is redefining the doctor-patient relationship as one that respects the patient as an intelligent participant in health care decisions. The old doctor-patient relationship put the doctor in an authoritative role, as in “doctor knows best” and patients were in a passive role, as in “follow the doctor’s orders.” Now physicians are taught the principles of “shared informed decision making”; doctors and patients share information and collaborate in treatment decision. Patients are empowered with information and take ownership in creating their health. Here are four tips for becoming a more engaged and empowered patient.

Firstly, knowledge is power. You need to understand your body and any issues that you have. Ask your doctor to write down any words that are new to you, such as the name of a diagnosis, a test or treatment. Ask them to explain anything that you don’t fully understand, or work with a naturopathic physician to deepen your understanding of your health conditions. The internet can be a wonderful source of information, but, without the context a physician can provide, it can be overwhelming.

Secondly, keep a health journal. A health journal is a place where you can keep a record of your health issues, tests, procedures and medication. Keeping track of your health history helps you to be an informed, knowledgeable patient. Knowledge allows you to take more control of your healthcare. The best health journals have separate tabs for pharmaceutical and natural medicine history, hospitalizations, surgeries, blood work, imaging and other tests, specialist reports, allergies, and family medical history. I encourage my patients to get copies of all their lab work. Sixteen percent of abnormal lab results are not reported to the patient in Canada. In my 22 years of practice, I have found many missed diagnoses by going over lab work that the patient hadn’t seen. You can get copies of blood work easily by having your blood taken at Life Labs and setting up an online account to view your labs, or if you have blood taken at your doctor’s office or one of the hospital’s outpatient labs you can call 1 866 370-8355 and ask them to mail you your lab work. Your doctor can also print a copy of your lab work. I encourage my patients to ask their family doctor for copies of their specialist reports as well as imaging reports (x-rays, CT scans and MRIs).

Thirdly, an empowered patient needs to ask why. Any good problem solver needs to investigate the cause of the problem in order to create a lasting solution. Yet, in health care, we are often satisfied with treatments that mask symptoms but don’t address the underlying causative factors. You can take medications to lower blood pressure, but pills are not able to address the reasons why your blood pressure went up in the first place. When I prescribe pharmaceuticals, it is often because we need to control symptoms quickly, and buy the patient some time while we implement a plan to address the underlying causes and seek a long term solution that will optimize their health.

Fourthly, you can create a health care team to support your health goals. It may serve you to consult more than one health professional to create the optimal plan for your health. Your family doctor is an essential player in helping you access the conventional medical system when you need it. Family doctors are incredibly knowledgeable and hardworking, but they don’t have the time or training to provide for all the complex needs of their patients. Naturopathic physicians are medically trained physicians who focus on optimizing health with lifestyle, natural medicines, and pharmaceuticals when needed. Counsellors, physiotherapists, and other practitioners can all add their expertise to your health care team. An empowered patient lets their family doctor know who is on their team and encourages communication between practitioners.

Alzheimer’s Prevention and Treatment

Our brains are made up of an intricately interconnected web of neurons, run by electrical impulses that jump from cell to cell across gaps called synapses.  Chemical messengers help transmit those impulses, and this symphony of cells, chemicals and electricity results in all the thoughts, feelings and bodily functions that make us who we are. Age related memory loss and Alzheimer’s disease are examples of neurodegenerative conditions, and affect as many as 30% of the population over 70.  Drugs for Alzheimer’s disease have limited benefit, at best slowing progression.  The cause of Alzheimer’s is too complex for us to ever find a solution in a pill bottle. The brain is intimately connected to the rest of the body. Dysfunction in the body can damage the delicate components of the brain.  Cognitive decline is the result of a long trajectory of multiple stresses on the brain, many of which can be reduced by lifestyle change and natural medicine.

When scientists study the brains of people with Alzheimer’s they find amyloid plaques and neurofibrillary tangles from excess Tau protein. It is normal for these proteins to form, and the body has process to flush them out.  When excess amyloid and tau are formed, or not cleaned out, nerve signalling is impaired and shrinkage of key centres of the brain speeds up. Dementia was once thought to be progressive and irreversible.  We know now that buildup of amyloid plaques and neurofibrillary tangles are the result of years of stress on the brain such as neuroinflammation, oxidative stress, mitochondrial dysfunction (energy production in cells), high blood sugar / insulin, microbiome (intestinal bacteria) imbalances and more.  New research shows that these processes can be prevented and reversed which can preserve or improve cognitive function.  There are strategies that can also increase a healthy chemical in the brain called brain derived growth factor, promote neurogenesis (expansion of nerve cells), enhance the clearing of amyloid and Tau proteins (autophagy), and build new pathways in the brain (promote neuroplasticity).

I help my patients accomplish these goals by coaching them on how to create a lifestyle conducive to a healthy brain.  Food is your best brain medicine, so that’s where I start with my patients. Lack of sleep or use of pharmaceutical sleep aids are both associated with memory loss as it is during sleep that the brain clear amyloid.  Exercise increases brain-derived-growth-factor. Sustained aerobic exercise is particularly beneficial for preventing shrinkage of the brain’s memory centres. The gut-brain connection is important for brain health too, so improving digestion is key, as is stress reduction, and brain exercises.

I also educate my patients on the use of a few key natural medicines that have been researched to improve brain health.  For instance, a study of people taking the DHA component of fish oil showed an improvement in memory after six months. Resveratrol is a grape skin extract that helps to inhibit the creation of and promote the clearance of amyloid and tau, delaying the onset and progression of cognitive impairment. Curcumin, a turmeric extract, supports neuron regeneration, reduces neuroinflammation and helps clear amyloid plaques. Coenzyme Q10, Vitamin D and many other natural medicines also have shown benefits for dementia.  A ground-breaking study was conducted on 11 people diagnosed with early Alzheimer’s disease or cognitive impairment, most of whom had the Alzheimer’s gene.  They were given a multifactorial naturopathic protocol of lifestyle changes and natural medicines.  All but the one most advanced case had reduction in symptoms sufficient to reverse the diagnosis of Alzheimer’s and some showed increased brain volume on scans.  It is this multi-faceted approach to brain health that is necessary to keep our brains healthy and functioning well so we can live long and full lives.

Help for Anxiety – Naturally

Anxiety is certainly part of the human condition. We are, after all, animals with very few physical defences, so we need an alarm system to keep us safe.  The physical responses to fear make us ready to run from predators, fight back, or in some cases freeze and “play dead”.  When that normal fear response becomes a regular pattern of anxiety, it can be overwhelming.  In my practice, I regularly talk with patients who are experiencing a level of anxiety that is distressing to them.  Once people experience anxiety, they often become afraid of experiencing it again, and go to great lengths to avoid trigger situations. The good news is that there are very effective tools for breaking free of the cycle of anxiety without having to limit your life.

As a physician, my first inclination is to rule out physical causes of anxiety, such as certain medications or health conditions.  The most obvious physical trigger is caffeine intake.  People who are prone to anxiety are wise to avoid caffeine as its effect on the body magnifies nervous tension.  Another very common trigger, especially in young people, is low blood sugar or hypoglycemia.  Skipping meals or eating refined flour and sugars can cause a sudden drop in blood sugar.  When that happens, the brain tells the adrenal glands to release adrenaline, which causes rapid heart rate, sweating, and anxiety.  Thyroid conditions, both hyper and hypo, can contribute to anxiety.  Patients love that I am able to run up to six blood tests to rule out thyroid conditions as opposed to the one test that is generally covered by MSP.  Blood tests can also help to identify anemia, B vitamin or vitamin D deficiencies, all of which can affect brain chemistry profoundly. I often hear from patients that the hormone balancing work we do helps their mood and anxiety levels.

Relaxation techniques are an important part of learning to deal with anxiety.  Meditation is simply learning to observe your mind and make choices about where it is focusing.  Mindfullness Based Stress Reduction is a program that has been rigorously studied to show superior benefits to anxiety over medication. Adding an element of self- compassion into your daily self-talk practice takes the process deeper and is very effective.  Dr. Kirsten Neff’s Ted Talk is a good place to start to explore the practice of self-compassion.

Learning strategies for dealing with life stresses such as relationship issues, future uncertainties, past trauma, addiction and more can help to reduce anxiety.  Counselling and personal development work isn’t just for people with mental illness, it’s for anyone who wants to live life more fully and be the best they can be.  Cognitive Behavioural Therapy is a set of incredibly practical life skills for anyone wanting to be more clear and calm in their lives. The website anxietybc.com is one of the best on the subject.

As a naturopathic physician, I also offer my patients natural medicines that help to heal the nervous system, balance brain chemistry, and normalize the adrenal stress response. These herbs, vitamins and amino acids can be the leg up that people need to get a handle on stress.

Often a person with anxiety can feel overwhelmed by how their mind and body reacts to stress, and with help, they can develop confidence in their ability to be resilient in the face of life challenges.

Dr. Deidre Macdonald is a naturopathic physician who has practiced in downtown Courtenay for 20 years.  www.getwellhere.com 250 897-0235.

 

 

Stop the Pain of Endometriosis Naturally

Menstrual cramps are part of life for many women, but extreme, debilitating pain during the menstrual cycle and beyond can be a sign of an underlying condition called endometriosis. This condition has mystified doctors and deeply affected the lives of millions of women. There have been breakthroughs in the understanding of the mechanisms that drive this painful condition. Treatment options designed to target the underlying cause of this condition are helping women to reduce pain and improve fertility.

Endometriosis is a condition where uterine tissue flows in the wrong direction, up the fallopian tubes, and ends up in the abdominal cavity. That wayward tissue should be detected and destroyed by the immune system, and in fact, that process regularly occurs for many women. But for women with endometriosis, the immune system turns a blind eye to the uterine tissue that has gone astray. These small bits of uterine tissue can adhere to the bowel, the ovary, and other organs. They are sensitive to the same hormones as the regular uterine tissue, so they fill with fluid and blood, which is released during menstruation. The lesions can cause pain throughout the cycle, but when the fluid is released into the abdominal cavity, the pain can be debilitating.

The real question isn’t how come the uterine tissue flows backward, as that seems to be common. The question is, why doesn’t the immune system recognize and destroy the lesions; why are they left to grow unchecked? There is a complex interaction between the hormones and the immune system that is to blame for this problem. It turns out that for people with endometriosis, the immune cells that usually prevent us from attacking our own tissues are working overtime. These T-regulator cells tell the immune system to back off, causing the endometrial lesions to evade surveillance and destruction. But T-regulator cells are just taking instruction from certain immune-suppressing chemicals called cytokines. And those cytokines are influenced by a common hormone imbalance where there is too much estrogen and not enough progesterone. This “estrogen dominance” at the heart of endometriosis can be influenced by a number of genetic, lifestyle and environmental factors.

The other mechanism that drives the growth of endometrial lesions is the presence of naturally occurring chemicals that encourage growth of this specific type of tissue. People with endometriosis have more Vascular Endothelial Growth Factors (VEGT) in their abdominal cavity. VEGT stimulates the uterine cells to proliferate, helps the tissue to grow more blood vessels and ultimately makes the endometriosis lesions grow. People with endometriosis are also found to have more oxidative stress markers in their abdominal cavity as well as increased inflammation. These three factors create a favorable growth environment for the painful lesions.

Treatment is designed to reduce pain but also to try to reduce the size of the lesions or eliminate them. Some treatments provide immediate pain control while others try to address the underlying cause by balancing the hormones and promoting a proper immune response to the lesions. Surgery can be done through a minimally invasive procedure that basically zaps the lesions. While this treatment can provide some relief, I’ve seen patients who just keep developing more lesions. Hormone therapy should be aimed at correcting the estrogen dominance. Oral contraceptives contain estrogen, and while they can help to some degree, progesterone only pills and uterine implants are preferable. The later can help reduce the amount of blood build up in the lesions and reduce pain. However, they prevent ovulation and therefore pregnancy, which may not be suitable for a patient trying to have a family.

The naturopathic treatment strategy can be used alone or in combination with conventional medical approaches. It endeavors to address the mechanisms that drive endometriosis. Firstly, we target the immune dysfunction that allows the lesions to evade detection. Herbal medicine and antioxidant nutrients can target the hormonal imbalance, oxidative stress, immune imbalance and pro-inflammatory state that typifies this condition. Secondly, hormones and immune system are affected by the intestinal microbiome; the trillions of bacteria that live primarily in the intestine. Our diet influences the microbiome so naturopathic physicians encourage a diet that is low in sugar and refined flour and may give probiotics and other treatments to bolster the microbiome. Thirdly, healthy fats, like omega 3’s have been shown to help prevent and treat endometriosis lesions and reduce pain.
Finally, hormone balance plays a critical role in the naturopathic treatment of endometriosis. To balance the estrogen dominance typical of this condition, there are nutrients that help the body to eliminate old estrogen and herbs that assist the body produce more progesterone. It is also important to support the liver during this process, as it plays a major role in the elimination of old estrogen. The role of environmental toxins in endometriosis is an area of significant concern. Many environmental toxins, like pesticides and plastics, can actually act like super-estrogens once inside the body and have long term effects. Hormones in red meat and dairy may also tip the delicate balance of hormones for women. Reducing exposure to these external sources of estrogen is critical to the prevention and treatment of endometriosis.

With proper guidance, many women with endometriosis can have less pain, better quality of life and preserve their fertility.

Why am I so tired? Thyroid Issue May be the Cause

thyroid

Every week people arrive at my clinic wondering if their thyroid is okay. They’ve often had their conventional doctor check their thyroid, and are told that everything is fine. However, they aren’t convinced. They feel tired, cold, achy, and gain weight easily. They have headaches, depression or constipation, all symptoms that may reflect low thyroid function. Experience has taught me that evaluating the thyroid is complex. Low thyroid function can be caused by the immune system itself and by the dysfunction of other hormone glands in the body. It can be also affected by stress, toxins, and nutritional deficiencies. Evaluation of the thyroid is so much more than just running one test.

The thyroid gland is a small gland in the front of the neck that produces the hormone that sets the metabolic rate of every cell in the body. These hormones tell your body how fast to burn calories, influence stomach acid production, determines moisture levels in the skin and so much more. The thyroid gland is also the most common site of autoimmune disease in the body. The immune system can sometimes attacks the thyroid gland and interferes with its ability to provide the hormones needed for normal tissue function and repair. I had a patient who had gained 47 pounds in one year, despite good diet and regular exercise. Her doctor insisted that her thyroid was functioning properly, according to the one test, the TSH level, that he can run. We ran further tests which showed that she did indeed have antibodies to her own thyroid that were blocking her thyroid from making the hormones she needed to burn calories normally. Once that deficiency was corrected, she had to work hard to lose weight, but it was possible for her to do so.

Another patient came to the clinic already taking thyroid replacement medication but reported feeling as tired and achy as she had when she was first diagnosed as hypothyroid years ago. Again, her TSH test was normal. We dug a little deeper and ran a reverse T3 test. This test determines if her thyroid hormone was being converted to active T3 or a dud version called reverse T3. Elevations of reverse T3 are important if you are sick and need to conserve energy and rest. However, there are other conditions that can trigger this downstream activation of reverse T3. High stress levels, low iron levels, and chronic inflammatory states can all drive up reverse T3 and make you feel unnecessarily tired. In this case, the patient had experienced chronic stress and had an elevated reverse T3. We changed her thyroid medication slightly and gave her additional natural medicines to balance all her thyroid hormones, thus giving her back the vitality she was missing.

Naturopathic physicians prefer a full panel of thyroid hormones to accurately diagnose thyroid problems. This panel includes the relatively stable pituitary hormone TSH, free T4 (inactive thyroid hormone), free T3 (active thyroid hormone), reverse T3 and a thyroid antibody called TPO. Often we are able to unveil issues in the complex dance of the thyroid hormones, which can then be treated in a variety of ways, both holistic and pharmaceutical.

Dr. Deidre Macdonald is a naturopathic physician practicing in downtown Courtenay. 250 897-0235 or www.getwellhere.com