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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
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
The Diet Wars – Vegan vs Low Carb
You have no doubt noticed that there are two trends in nutrition these days that are at odds with one another. If you walk down the book aisle at Costco, you’ll see ten books on low carbohydrate diets – Low GI, Paleo, Atkins etc. These diets recommend one eat lots of meat and fat, and little flour and sugar. You’ll also see ten books on the Vegan diet – lots of veggies and grains, and no meat or dairy. Each convincingly states its case that it is the superior diet for preventing disease yet they are vastly different diets. So what is the truth?
This conflict was played out at a recent naturopathic medical conference. The focus of the conference was cardiology and we had two keynote speakers who were well known cardiologists. They both started their talks the same way by saying, “After years of practicing interventional cardiology, I got tired of performing an angioplasty on a patient one year, then seeing them back a few years later for bypass surgery. I realized that I wasn’t part of the real solution which is to prevent and reverse this disease. I went on a mission to find lasting solutions for cardiovascular disease.”
The first speaker was Dr. Mimi Guarneri, Director of Scripps Centre for Integrative Medicine. She said, “I realized the culprit was animal fat.” She became a proponent of the new Ornish program and recommends a Vegan diet. The second speaker was Dr. William Davis, who wrote the book Wheat Belly. His conclusion was that the reason for the rise in cardiovascular disease is the sugar, pasta, muffins and bread that North Americans have eaten more of since the low fat craze in the 80’s. He says that high carb diets are causing obesity, insulin resistance, and inflammation, which all cause cardiovascular disease and more. He recommends that we stop eating bread, sugar, and other carbs and eat all the meat we want. In fact, when I asked him if is possible to be a healthy vegan, he basically said “no”.
I went on a quest to find the answer to this dilemma and to negotiate some peace in the diet wars. But first we have to understand the players. The vegan diet and the low carb diets each have their strengths and weaknesses. And is there a third path that might take the best of both worlds and leave the rest?
A vegan diet is certainly intended to be high in nutrient dense whole foods like vegetables, fruits, grains, nuts, seeds and beans. Science tells us that low animal fat diets are associated with lower rates of cardiovascular disease and reducing red meat reduces colon cancer risk. The high fiber content of a good vegan diet is great for blood sugar and cancer. In addition, there is no doubt that a vegan diet is kinder to animals and the environment. I respect people who chose a vegan diet because they care about animals and our planet. I do think you can be healthy on a vegan diet with dedication and education.
However the real world challenge of a vegan diet is that often I see people filling up on refined carbs like bread, pasta, and sweets and not eating enough protein. Those are the folks who gain weight on a vegan diet and impair their blood sugar. Potatoe chips, fries, pop and candy are all technically vegan. Also, there are many nutrients that are challenging to get on a vegan diet, including fish oils, which lower heart disease. Calcium, vitamin D, vitamin B12, iron, zinc and iodine can become deficient on a vegan diet.
The low carb diets, such as the Paleolithic diet and Atkins are very low on carbs and focus on vegetables, meat and fats. A survey showed that 55% of U.S. adults said they were avoiding or eating less sugars and carbohydrates. That’s good news for blood sugar and diabetes prevention for sure. The low carb diets work as well or better than traditional diabetic diets. Research comparing different diets for weight loss have shown that the low carb diets do have a slight advantage in helping people lose weight. People on a low carb diet feel more satisfied with less calories. There may also be a metabolic advantage that promotes fat burning. That’s great, because being overweight and having diabetes both increase the risk of cancer. But what about heart disease?
The research shows that a low carb diet is no better than the standard American diet (S.A.D.) in terms of preventing cardiovascular disease. The high levels of animal fat in this diet are pro-inflammatory and we know that damages arteries. These diets tend to be low in fiber, which can cause constipation. If fruit is eliminated, a valuable source of phytonutrients is lost. Also, some carbohydrates are needed to make serotonin. Studies show that if people are prone to depression, restricting carbs can make it worse.
So which diet wins the diet war? Any extreme diet has nutritional issues and can be hard to maintain in the real world. Why don’t we combine the best of the vegan diet (high plant based foods, low animal fat, low red meat) and the best of the low carb diets (low in refined sugar and flour). The DASH diet does just that. The Dietary Approach to Stop Hypertension diet is based on extensive research and is a healthy balanced diet that is high in vegetables, fruits, nuts, seeds, low saturated fat meat like turkey and chicken breasts, fish and low fat dairy. It is low in sugar and refined flour. Grains are ideally whole, as in brown rice and quinoa. Salt is limited, which basically means cooking at home since restaurant food is loaded with salt. A beautiful, whole food diet, rich in flavour and nutrition can be attained with this way of eating. It is a way of life that can be sustained and therefore will produce the results we all want – long lasting vibrant health.
Help with Cravings and Stubborn Weight
We all have trillions of bacteria, yeasts and fungi in our bodies, particularly in our intestines. The mix of these microbes makes up our microbiome. New research shows that this microbiome may have more to do with your weight than what you eat. Farmers around the world have long known that feeding antibiotics to chicken and cows fattens them up. Human trials have shown the same thing and scientists now have the research to find out why. Antibiotics, as well as certain dietary choices, change the bacterial lining of the intestines. Those changes allow more calories to be extracted from food. They also increase cravings and appetite by changing hormones. This research gives hope to those who wish to bolster their ability to lose weight. You can change your intestinal microbiome and therefore help your body lose weight.
We now know that our intestinal microbiome affects many important processes, such as digestion, destruction of parasites, mood and brain function, immune system regulation, and prevention of autoimmune diseases. Naturopathic physicians have been working for decades to educate patients about the importance of the microbiome and now scientists around the world are using new technology to understand the microbiome and learn how to foster and protect it.
Why is it that some people seem to put on weight while others lose weight easily? The answer may be that those who lack good bacteria in the intestines seem to extract more calories from food. Recent research shows that thin mice who receive a microbiome transfer from obese mice, gain weight, despite being on a calorie controlled diet. It appears that the microbiome of the obese mice has an increased capacity to harvest energy from the diet.
Another factor in weight gain is the appetite stimulating hormone ghrelin. A healthy microbiome regulates appetite by reducing this hormone. But using antibiotics that alter the microbiome increases ghrelin and is associated with weight gain.
So how do we encourage the growth of an abundant and diverse microbiome? We need to begin at birth. Babies in the womb are “sterile”. The birth canal provides the baby’s first inoculation with the bacteria he or she will need to digest breast milk. Babies born by c-section, who miss out on that bacteria, may be more prone to weight problems as they age. C-sections are a welcome lifesaver at times but I recommend all my c-section babies be given appropriate probiotic supplements (intestinal microbiome powder) as soon as possible after birth.
Humans given antibiotics are more prone to weight gain, just like chickens. Of course antibiotics are another modern medical necessity in some cases. The benefit of antibiotics is generally perceived to be much greater than it actually is for common infections. There are natural medicines that can strengthen the immune system and fight infection without damaging the microbiome. So try to avoid antibiotics and take probiotics if you can’t avoid them.
The foods we eat also cause our microbiome to adapt and change. High refined sugar diets promote the growth of bacteria that influence ghrelin, the appetite-stimulating hormone. Healthier diets help the healthier bacterial to grow. Cats fed higher carbohydrate diets had kittens which ate more and became fatter. (Since we are finding now that mothers can pass on their microbiome to their children, women are well advised to work on enhancing their microbiome even prior to conception.) A whole food diet that is low in both refined carbohydrates and animal fat promotes the healthiest microbiome thus helping to regulate appetite.
I have found that many patients who had difficulty losing weight have an altered microbiome. They often have related symptoms such as digestive issues, allergies, or depression. There are simple tests that can help determine the state of the microbiome. If needed, I coach patients on how to use low carb nutrition and helpful supplements to re-establish the healthy microbiome. When the microbiome comes into balance, cravings are lessened and weight loss is much more easily attained.
My doctor says my thyroid is normal but…
Every week people arrive at the 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, gain weight easily, have headaches, depression and more symptoms that seem to reflect low thyroid function.
As a naturopathic physician, I offer these patients a full thyroid panel. When we test further, we often find that the thyroid really isn’t working optimally. Why the different in approaches?
Our MSP system only allow conventional doctors to run one test to screen for thyroid problems. Naturopathic physicians prefer a full panel to test for TSH, T4 (inactive thyroid hormone), T3 (active thyroid hormone) 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.
Our philosophy is to try to determine if your thyroid is working optimally, not just wait until it is diseased.
Curious about your thyroid? You can book an appointment by emailing back or calling Terry at (250) 897-0235.
If this sounds like the care that you’re seeking, we’d love to hear from you.
You can book a complimentary 15-minute “meet-the-doctor” visit anytime by calling the clinic. You’ll be able to ask questions, find out how we can help, and see if there’s a comfortable fit with your naturopath.
Book an appointment with Dr Macdonald by emailing us or calling (250) 897-0235
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The Macdonald Centre for Natural Medicine
448 10th Street Courtenay, B.C.