The Many Faces of Food Intolerances

We all know that eating healthy food is essential to maintaining our health. But sometimes, what is healthy food for one person, can be a cause of physical distress for another. Deciphering which foods are causing problems can be a frustrating task. But in my 24 years of practicing naturopathic medicine, I’ve found that helping my patients to identify and eliminate food intolerances can often be a powerful key to unlocking better health. 

 The trouble is that often, people’s food intolerances don’t fit the usual stereotype of a person who has an immediate and dramatic reaction to certain foods like peanuts or shellfish.  Those immediate hypersensitivity reactions are usually easy to identify and can be tested. But there are about 15 different ways that people can react to foods, and only a few of them can be tested through conventional lab tests. 

 The most common food reaction I see is delayed hypersensitivity reactions. I have helped countless people overcome eczema by identifying food reactions. Sinus or mucous-related conditions are often aggravated by food reactions, as are many digestive issues. Chronic fatigue and “brain fog” are red flags that food sensitivities may be at play. There are tests available through naturopathic physicians that can begin the process of elimination and reintroduction needed to pin down the culprits. 

 Celiac disease is actually an autoimmune disease in which gluten triggers a variety of symptoms that are digestive, neurological, psychiatric and autoimmune. A blood test or upper intestinal biopsy can diagnose this often overlooked condition. 

 In some people, the issue isn’t so much allergies as it is an inability to digest certain foods properly. For instance, people with a (fixable) microbiome imbalance in the small intestine can have excessive fermentation of certain starches which then creates gas, bloating, diarrhea, constipation and more. The foods most likely to ferment have been categorized under the acronym FODMAP foods, which include lactose-containing dairy products, onions and garlic, beans, cabbage family vegetables and more. 

For my patients with chronic hives, flushing, digestive issues, headaches, anxiety and more, we also look at the possibility of a histamine intolerance. There are certain foods that contain histamine, which is normally broken down by the body. Foods that are aged or fermented like deli meats, yogurt, beer, wine and others can be especially triggering. 





Oxalates are naturally high in spinach, strawberries, rhubarb and more.  For people with chronic bladder pain, Irritable Bowel Syndrome, and kidney stones oxalates can be a trigger. The intestinal microbiome is supposed to metabolize the oxalates in our foods, but an imbalance in the microbiome can prevent that process, causing a building up of oxalates in the blood and urine. 

Food additives can cause an incredible range of symptoms from temper tantrums, hives, swelling, migraines and more.  Key culprits to consider are MSG (there are many ways food manufacturers hide MSG on food labels), sulphites (used as a preservative in dried fruit, wine, vinegar, commercial baking) and nitrates (found in deli meats, bacon, ham, and food dyes. Artificial sweeteners like aspartame can create issues for some, as can the sweeteners called sugar alcohols like sorbitol and maltitol. I especially see the latter causing gas and diarrhea.  





 Acidic foods can trigger irritation of already sensitive tissues. For instance, excessive orange juice intake can trigger bladder issues, and acid reflux can be triggered by caffeine, alcohol, tomatoes and more.  

 Salicylates are naturally occurring chemicals in fruits, vegetables, spices and some medicines. But for some people, they can trigger asthma and allergies as well as digestive distress and headaches. 

 So if you have a dead-end diagnosis like Irritable Bowel Syndrome, chronic headaches, asthma or Chronic Fatigue syndrome or you just don’t feel your best, consider investigating the array of food intolerances as a possible way to unlock some of your health and vitality. 

Naturopathic physicians have extensive training in nutrition and regularly use custom nutrition plans as medicine.  We make sure that you know what you CAN eat as well as help you pin down specific foods to avoid.

5 Things to Know about Infertility

More and more couples are starting families later in life and thus the number of people experiencing infertility has gone up significantly over the last two decades. People can have trouble having their first child, but equally heartbreaking is the inability to conceive or carry a second or third child. Naturopathic physicians are in a unique position to help couples uncover the cause of their infertility and enhance their health to increase the chances of becoming and staying pregnant. Depending on the cause, treatment strategies can incorporate healthy options like lifestyle changes and natural medicines to enhance male and female fertility. There are five things you should consider if you are trying to conceive. 

 

  1. Don’t wait to get help.  Medical workup for infertility usually begins after a year of unsuccessfully “trying.” But for women who are over 35 it is recommended to start investigations after 6 months, or sooner if they are approaching 40. Anyone with very irregular cycles shouldn’t wait at all. With my patients, I usually start with a thorough history and physical exam to look for clues. Then I recommend comprehensive lab work to look for the cause. Gynecologists can do imaging to help find anatomical issues. 


  1. Don’t forget the guy. Almost half the time, infertility is due to the “male factor”. Semen analysis can identify issues. For male infertility, once we rule out anatomical problems, there are science-backed lifestyle factors and natural medicines to improve sperm quality and quantity. For instance, the herb Ashwagandha was shown in a placebo-controlled study to increase sperm count by 167% and to increase sperm motility by 57% in three months.

  2. If a woman isn’t cycling regularly, she may not be ovulating, or may not be able to support a pregnancy. Hormone imbalance can be caused by many issues, including excess stress, weight loss, over-exercising, toxin exposure and more. In addition, PCOS is a pituitary disorder that causes excess androgens (“male” hormones). Menstruation can be less frequent or non-existent and ovulation is sporadic. Naturopathic medicine has excellent strategies to address these types of hormone issues safely and effectively. For instance, Chaste tree helps balance the pituitary gland while N-acetyl cysteine can safely enhance ovulation. Most conventional medicines for PCOS and irregular menstruation are contraindicated in pregnancy, so they are not helpful for women trying to conceive. 



  1. Heavy or painful periods can be a clue. Endometriosis can cause very painful periods and can affect fertility. Fibroid tumours are a common cause of heavy periods and can affect conception or increase miscarriages. Naturopathic physicians seek to address the underlying causes of these issues in safe ways (see my blog article and video about endometriosis). 


  1. Remember to check for autoimmune conditions.  Low thyroid can affect other hormones, anti-sperm antibodies can prevent conception, and autoimmune blood clotting disorders like anti-phospholipid syndrome can be a cause of recurrent miscarriages. 

For couples who want to take an active role in enhancing their fertility, there are ways to narrow down any issues and use safe naturopathic strategies to get on track. There’s nothing more satisfying as a doctor than helping a couple to get pregnant, and providing them adjunctive naturopathic medical care during pregnancy and beyond.

 

Bioidentical Hormones – Research Update

The pros and cons of hormone replacement therapy (HRT) for perimenopausal and menopausal women have been hotly debated for many years. As a naturopathic physician, I’ve helped women navigate the choppy waters of menopause for over two decades. I believe that hormone management should be very individualized and I  generally recommend lifestyle first, natural medicines second, and pharmaceuticals third, if possible. I recently completed a course that analyzed the research on HRT over the last 20 years. When you look carefully at the research, there is a role for hormone replacement therapy to help manage symptoms of perimenopause and menopause safely and effectively and to serve as a preventative medicine. 

First, some history. HRT was used for 70 years before the Women’s Health Initiative (WHI) did the first large placebo-controlled study in 2002. This groundbreaking study sounded alarms regarding increased breast cancer risk in women who took Premarin (estrogen) and Provera (synthetic progesterone).  In addition, they found a higher rate of blood clots, potentially leading to strokes and more, so many women were unprescribed HRT as a result. 

Subsequent analysis determined that the study had major flaws. The average age of the women starting estrogen therapy was 65. We now understand there is a critical window for starting hormone therapy to maximize the benefits and reduce the risks, which is within ten years of one’s menopause, or under 60. 

Second, the estrogen used in the experiment was extracted from pregnant mares’ urine and contained non-human estrogens. Now, most prescriptions written use a bioidentical estrogen called estradiol or E2. It is processed much differently in the body and has fewer risks. The progesterone used was a synthetic cousin of our progesterone called progestin, which comes with many more side effects. Third, the route of administration of estrogen matters. Yes, taking oral pills of estrogen does increase blood clotting, especially in women over 60. However, using a patch or cream on the skin does not do so in any significant way. We’ve come a long way from 2002 to understand how to use these hormones safely. 

According to the esteemed North American Menopause Society, estrogen has strong evidence showing it helps with hot flashes and night sweats. They say it can be used for women of any age in low doses locally for genital and urinary symptoms and to improve sexual function. Systemic estrogen also helps to prevent bone loss and fracture associated with osteoporosis. The research shows this benefit is most relevant if estrogen is started within five years of menopause and the benefit is lost after ceasing the estrogen therapy. Topical estrogen therapy can slightly reduce cardiovascular disease risk but only if started early.  

The most interesting evidence regarding estrogen replacement therapy is around reducing cognitive decline. One in three people develop a significant cognitive decline in their lifetime, and ⅔ of the people with Alzheimer’s are women. Estrogen has many protective effects on the brain, including increasing neuronal growth and repair, increasing neuroplasticity, decreasing the build-up of tau proteins and amyloid plaques (associated with Alzheimer’s), and much more. Estrogen therapy seems to help slow cognitive decline, not reverse it. One study showed that women who started estrogen at 75 years old had a worse rate of decline. So, yes, there is a critical window for starting estrogen. Women who have their ovaries removed or have very early menopause may especially benefit from starting estrogen therapy right away. 

Evidence shows that estrogen may help somewhat with joint pain, muscle weakness, sleep issues, depression, skin aging, dry eyes, hearing loss, and diabetes. But what about breast cancer? Well, after years of analysis of the WHI study, it has been shown that when they started giving horse estrogens and synthetic progestin to women far older than the critical age window in oral vs. transdermal doses, after three years, an increase of less than one case of breast cancer over the placebo rate per 1,000 women per year could be attributed to the hormones. That risk is less than the increased risk of breast cancer associated with drinking two glasses of wine a day, and the same as the risk of being obese or inactive. In women who took only estrogen (women who’d had a hysterectomy), there was a slight decrease in breast cancer rate vs. placebo. Three French studies showed that when bioidentical estrogen is used with women in a better age window and coupled with bioidentical progesterone, there was no increase in breast cancer rates.  

HRT isn’t for everyone, so discuss it with a conventional or naturopathic doctor up to date on the latest research analysis to see if you would be a suitable candidate and what to expect. For people without extended health insurance, compounding pharmacies can make up HRT prescriptions for about ⅓ to ½ the cost of pharmaceutical suppliers—tell your naturopathic or conventional doctor your preference.  Another advantage of compounded bioidentical hormones is various delivery methods can be used depending on the desired effects and preference of the patient. Transdermal absorption of hormones has been well established in scientific research. So the bottom line is that bioidentical estrogen with bioidentical progesterone can have a role to play not only in the management of symptoms of menopause but also in the enhancement of the ageing process.


Breakthroughs in Irritable Bowel Syndrome

IBS pictureIrritable Bowel Syndrome or IBS as it’s commonly called, may not be the most exciting topic to read about. But for the 5 million Canadians who suffer from it, learning about breakthroughs in treatment is definitely news worth reading. Medical research has made the connection now between IBS and the microbiome, the immune system and the nervous system. While stress and food intake may confound an IBS problem, breakthroughs in our understanding of the microbes in our intestines are helping to solve the deeper issues that can drive this health condition.

IBS symptoms can include bloating, excess gas and burping, some degree of constipation, diarrhea or both, and often an element of abdominal pain or discomfort. As a naturopathic physician, I regularly treat patients who have been told they have IBS, and that there’s not much they can do about it. The fact is, there are potential solutions to these issues. My first step is to explain that IBS is a diagnosis of exclusion, meaning we must rule out overt infection, cancer, inflammatory bowel disease, reproductive issues and more. Once we’ve done that, we can take steps to find out what is causing that person’s IBS.

Some of my patients respond well to avoiding certain foods, so we usually work to identify food triggers. Some MDs are sharing the research out of Monash University about the FODMAP diet which are foods known to cause IBS symptoms in some people. These foods can provide the fuel to our intestinal bacteria to make gas. But people with a healthy gut can handle those foods just fine, and many FODMAP foods are healthy foods, like broccoli, apples and garlic. If someone feels better on a FODMAP elimination diet, I see that not as a solution, but as a clue that their intestinal microbiome needs work.

By far the most common cause of IBS in my experience is an imbalance in the bacterial lining of the intestines called the microbiome. The large intestine is supposed to have a lot of bacteria and it is normal to ferment the leftover foods there. But the 12 feet of the small intestine are supposed to be relatively bacteria-free. Even if bacteria that is normal to have in the large intestine ends up growing in the small intestine, these bacteria will ferment the normal healthy foods we eat and create gas, intestinal irritation and nutritional issues.

What can cause bacterial overgrowth in the small intestine? There are many factors, but the most common one is a history of gastrointestinal infection. Even a case of traveller’s diarrhea, food poisoning, or viral gastroenteritis that resolves nicely can trigger an autoimmune reaction in about 20% of people. That autoimmune reaction can attack the nerves that stimulate the muscles that cause the sweeping motion inside the small intestine that moves food along between meals. Without this motion, food pools in the small intestine, bacteria can migrate upward from the large intestine, a ‘compost’ is formed, and excess bacteria blooms. Studies of military personal showed that prior gastrointestinal infection was a much stronger predictor of who would get IBS than stress level. Other studies have shown that GI infections can lead to motility disorders in the esophagus and intestines.

Brain injuries are also a potential cause of Small Intestine Bacterial Overgrowth (SIBO). The brain orchestrates the motility of the small intestine, so a brain injury can hamper its ability to coordinate the flushing of the small intestine, allowing a bacterial overgrowth to ensue. Autoimmune disease can also be connected, as well as abdominal surgeries, long term diabetes and more.

Fortunately, there is a specialized test for SIBO that can be ordered through naturopathic physicians. The gold standard test is a series of breath tests that looks for hydrogen and methane gases that have formed in the gut, been absorbed into the blood and are then breathed out. If a test comes back positive, I coach my patients on a four-step program. The first step is to prepare the intestine by opening up the biofilm that the bacteria hide out in. Then we use prescription or herbal antibacterial agents that exclusively target the bacteria in the small intestine. When that phase is complete, patients’ IBS symptoms are significantly better and we work on addressing the underlying cause, which is the motility disorder in the small intestine. There are prescription and herbal “pro-kinetic” agents that rehabilitate the muscles of the inner small intestine so the problem will stay away for good. In addition, we work to heal the intestinal lining to make it more resilient using natural medicines and SIBO specific probiotics.

People who live with IBS deserve to understand why they have these symptoms and what they can do about it. The goal is to repair the gut once and for all, not just manage symptoms. When we understand and treat the underlying issues, lasting resolution is possible.

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

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6 Ways to Reduce Stress and Improve Health

Life is full of transitions and challenges.  Keeping our minds and bodies strong can help us navigate life with grace.  Here are the six strategies that my most resilient patients use in their lives.  See if there are some gems in here for you. 

Keep things in perspective
We can deal with a lot more than we think, but only “in the moment”. Some planning for the future is prudent, but too much forward-thinking these days can get you down. Trust that whatever comes down the pike in the future, you have the inner strength to deal with it, if and when it happens. Then let it go and focus on the preset.

If worries about the future are getting you down, try switching mental channels. Regularly take stock of what you have to be grateful for; appreciating the big and small things can make you feel better. After her husband suddenly died, Sheryl Sandberg, the Chief Operating Officer at Facebook, would ask herself each day, “what are three things I did well today”. Even little things can count. It’s about being kind to yourself (but not easy on yourself) – that’s my mantra!

Get active outdoors
Staying active, especially outdoors, boosts brain chemistry and helps your immune system.
Getting natural light these days is essential for our brain and mood. Getting the blood pumping is like an anti-depressant without side effects (as anyone who exercises regularly will enthusiastically tell you!)

Eat mindfully
I’m always working on my relationship with food to make it more about physical nourishment than fulfilling my cravings or stuffing emotions. The more I eat whole, unprocessed foods, the less I am drawn to processed foods. Menu planning gets me excited about what I can eat, and less focused on what I can’t eat. Taking a moment to breathe before I eat and feeling gratitude for the beautiful, colourful, natural food I’m eating elevates the process (and helps digestion.)

Take a few supplements
Even with the best lifestyle, natural medicines can help you be your best now and in the future. Some of my favourites are Vitamin D, fish oil, probiotics, resveratrol, and curcumin (turmeric extract). They all have abundant research showing benefits for health. For patients experiencing stress and burnout, I recommend a formula called Adrenal 2. If depression and anxiety are an issue, our ND’s can recommend scientifically proven natural approaches for treatment. For people concerned about their immune resilience, our herbal formula of Elderberry and Astragalus is generally safe for long-term use.

Reach out to others
Is there someone in your expanded circle who might need a call? Hearing a human voice these days can mean the world to someone else, and it always feels good to help others. While awkward at first, using video calls can create a sense of connection almost as good as the real thing. Or maybe let the people in your circle know that you could use some support? Have some time that could be used for volunteer work? Search online for COVID friendly opportunities.

Seek professional support
Seeing a naturopathic physician might be just what you need to focus on a plan for optimal physical and mental health. We take the time to listen, help you understand your health issues, and make a plan for better health in the safest, most natural way possible. We all need to up our game these days and having a trained professional on your team makes good sense. It’s a sign of strength to ask for help. Don’t just put up with so-so mental or physical health; with some focused strategies, you can feel better.

Want to see Dr. Macdonald or her
wonderful new associate ND Dr. Shawn Peters?

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Acupuncture for Men's Health

Men may experience a number of changes throughout their lives.  Some of these changes may be in the realm of sexual health (such as erectile dysfunction, premature ejaculation, and prostatitis) but many men also experience other health challenges, such as low back pain, depression, and insomnia.  Acupuncture is a safe and effective treatment for all of these conditions.  Through the use of fine needles at specific points along areas of the body, acupuncture works to stimulate the body’s own healing responses by addressing the root causes of disease, as does naturopathic medicine.  This makes these two health systems a wonderful fit.

 

As a naturopathic doctor certified in acupuncture the unique opportunity I have when using acupuncture is that I can utilize many other treatments at the same time.  Low back pain, depression, insomnia, and sexual dysfunction are all well treated with a combination of therapies…acupuncture plus nutrition, herbal medicine, supplementation, spinal adjustments, and/or pharmaceutical prescriptions.  Being certified in prescriptive authority, I have access to all of these treatments to best help my patients improve their health.  Naturopathic doctors can also order lab tests, perform physical exams, and customize treatment options to round out the best program for you.

 

Many men experience low back pain and know how impactful pain can be on their life and work.  Finding effective treatments is important.  Both traditional acupuncture and ear acupuncture can help improve low back pain and decrease the sensation of pain. This can lead to improved function and get you moving well again. Acupuncture used alongside other therapies such as spinal alignment and soft tissue massage may further increase the chance of success.

 

Depression, anxiety, stress, and insomnia are experienced by many people and still, it is difficult for many men to talk about it and seek help.  Acupuncture has been shown to reduce symptoms in some experiencing depression.  Ear acupuncture can be effective at reducing anxiety.  Stress is closely tied to mental health and has impacts on both sleep quality and mental wellbeing.  Both traditional and ear acupuncture work to reduce stress by improving parasympathetic tone (our “rest and digest” state), which may address the root cause for some with insomnia.  In conjunction with other strategies to promote mental wellbeing, like diet, exercise, herbal medicine, and supplementation, a combined protocol takes into account the unique situation affecting you.

 

Male sexual health concerns can also be addressed using acupuncture.  Studies have shown positive results in reducing urination difficulties in those with prostatitis (inflamed prostate).  It can also be effective at improving premature ejaculation and some types of erectile dysfunction.

 

The number of health concerns that acupuncture can be utilized for, either alone or in conjunction with other therapies, along with being safe and with few side effects, makes it an excellent treatment choice for many men’s health concerns.  To find out if acupuncture and naturopathic medicine is right for you, contact Dr. Peters for a free “meet and greet”.

 

Dr. Shawn Peters, ND is a naturopathic doctor practicing in downtown Courtenay.

Dr. Shawn Peters, ND is a naturopathic physician who works at the Macdonald Centre for Natural Medicine.

Call now to book an appointment or a “meet and greet” visit

As always, this is purely general health-related information and is not meant to substitute for a visit with a regulated healthcare practitioner.  Always consult your licensed naturopathic doctor or medical doctor should you have any questions or concerns

Hormone Testing: What it Really Reveals

In my naturopathic medical practice, I commonly have patients come in who want to have their hormones tested. They feel something isn’t right. They don’t feel their best, and they suspect that hormones are to blame, so they want to be tested. But hormone testing isn’t as simple as it seems. We have to find the right type of test for the individual. The good news is that there are more options than ever for investigating hormone imbalances in men and women. With the right information, we can target our therapies to directly address the core of the issue and get better results faster.



When premenopausal women have something clearly abnormal going on with their hormones, it’s a good idea to do blood hormone testing. For instance, if a woman rarely or never menstruates, we need to rule out conditions like pituitary tumors, autoimmune diseases of the ovaries, and Polycystic Ovarian Syndrome (a.k.a. Anovulatory Androgen Excess). I generally run an extensive panel of pituitary and ovarian hormone levels in those cases.



If a woman is menstruating normally but still feels her hormones are off, the utility of blood testing is questionable. Testing must be timed with the cycle to make any sense of the numbers. But the reference ranges of what is considered normal are so large that most times women will be told they fall somewhere within what’s considered the “normal” range. That’s not helpful for someone who is infertile, or who suffers from serious PMS, low libido or chronic fatigue.



In cases where we need more information to get to the root of the hormone imbalance, urinary hormone panels are proving to provide a lot of nuanced information. The advantage of a comprehensive urinary hormone metabolite analysis is that it not only gives information about the typical hormones like estrogens, progesterone, androgens, cortisol and melatonin, but it also looks at their precursors or parent hormone. So if any levels are off, we can look upstream to see where the problem started. Urinary hormone testing also shows how the hormones are being metabolized or broken down. Sometimes it’s the breakdown products of the hormones that are the problem.



We also know that all the hormones are deeply connected. The thyroid, pituitary, ovarian/testicular, and adrenal hormones all affect each other. Urinary hormone testing can give insights as to the interplay of these four systems. Then we can target our efforts to get the greatest ripple effect on the whole hormone system.



Salivary hormone testing is another option for hormone testing, but it just isn’t the best way to test for hormones like estrogen and testosterone. I reserve this method for testing the adrenal hormones cortisol and DHEA. For people with insomnia, chronic fatigue, or anxiety, getting insight on the hypothalamus/pituitary/adrenal axis can shed light on these chronic issues. Since cortisol levels change throughout the day, it’s great to be able to collect a simple salivary sample four times a day. That said, urinary hormone metabolite panels also can be done four times a day, and they provide all that information and much more.



To monitor hormone levels in women who need to take prescription hormone replacement therapy in perimenopause and menopause, blood testing or even urinary testing can be utilized. Naturopathic physicians can order these lab tests for their patients, and extended health insurance often helps cover the costs. Our local Lifelabs offers both blood testing and urinary hormone testing.
So if you have been told your hormones are “normal” but you suspect that something is not quite right, there may be other ways to get answers.

Boosting Testosterone Naturally by Dr. Shawn Peters, ND

Testosterone is a sex hormone, often thought of as the “male” hormone (though males simply have more of it, as females have more estrogen).  Testosterone often provides the spark that can be fundamental to the experience of many men, like robust energy, libido, and strength.  Decreased levels of testosterone can result in low energy, reduced libido, a loss of muscle mass and increase in abdominal fat, as well as changes in mood and cognition.



Naturopathic doctors, through lab testing, physical exam, and thorough history taking, can work to diagnose the cause of decreased testosterone levels, so the correct treatment can be given.  A common cause is called Andropause, a term that refers to the changes in hormone levels with age (akin to changes during menopause in women).  Declining testosterone levels as we age are at least partly responsible for the changes many men experience in their 30’s, 40’s, and beyond.  Not only do levels of testosterone decrease as we age, but the amount of estrogen in relation to testosterone may increase.



A thorough investigation is important to determine the root cause.  In an initial appointment I determine which of the main factors may be playing a role for you…diet and exercise patterns, stress and sleep factors, as well as any underlying health conditions.  Decreased testosterone levels may be associated with certain conditions, like obesity, diabetes, and cardiovascular disease.  Removing any obstacles to you feeling great helps provide a solid foundation for your body to optimally regulate testosterone levels.



There are many tools to help men who are experiencing changes during this time.  Working to optimize diet & nutrients, exercise, and weight management (especially abdominal weight) are all key aspects of a successful plan.



At the same time, many herbal medicines are excellent at improving energy levels and sexual function while reducing irritability and mental fatigue associated with changes in testosterone.  Herbs used successfully may include Eleuthro, Rhodiola, Pine pollen, and many more.  Hops, while being a useful herbal medicine in certain situations, are abundant in beer and too much may worsen the situation.  Herbal licorice root too should be avoided in andropause.



Acupuncture is also shown to be beneficial for male sexual health and hormone balancing, as well as boosting energy.
As a licensed naturopathic doctor, I use any and all of these tools to help every person as an individual look and feel their best.  I strive to listen and educate, assessing your needs and goals so we can work together to keep you vital and healthy in the future.  We may not be able to stop testosterone levels from declining with age, but you and I can work together so you can feel strong and vital with good energy and libido, no matter your age.



As always, this is purely general health-related information and is not meant to substitute for a visit with a regulated healthcare practitioner.  Always consult your licensed naturopathic doctor or medical doctor should you have any questions or concerns.
Dr. Shawn Peters is a naturopathic physician.  He works at the MCNM in downtown Courtenay.

Gastrointestinal Testing: Take the Guesswork out of Gut Troubles

Many people have digestive systems that give them grief. Whether it’s indigestion, ulcers, acid reflux, bloating, gas, constipation, diarrhea, liver problems, IBS, colitis, Crohn’s, diverticulitis or colon cancer, digestive upset is one of the most common reasons that patients come to see me in my naturopathic medical clinic. Naturopathic physicians have many tools for helping people address digestive issues, such as nutritional advice, natural medicines and occasionally prescription medications. Prescription medications are limited in this arena, often just managing symptoms without dealing with the cause, and creating more problems the longer they are used.

In this article I’d like to explain how naturopathic doctors use testing to to help take the guesswork out of treating digestive issues.



Lactose intolerance testing: This breath test helps us determine if it is an inability to digest lactose, the sugar in milk products, that is causing gas, bloating, and/or cramps and diarrhea after eating some dairy products.

Helicobacter pylori testing: This breath test detects the presence of the H. pylori bacteria, which can create ulcers.

Celiac screening: This blood test looks for an antibody called Anti-Tissue Transglutaminase, which is a marker of Celiac disease, an autoimmune reaction to gluten containing grains. Symptoms can include digestive distress, or can manifest as headaches, fatigue, anemia, autoimmune, and psychiatric or neurological conditions.

Bacterial and parasitic infections: Infections such as food poisoning or traveller’s diarrhea can be detected with a stool test.
Colon cancer screening: The FIT test can detect blood in the stool. Everyone should have this test done at least once every two years. Blood tests for anemia can also pick up blood loss, which may trigger an investigation of colon cancer.

Fecal calprotectin: I really like this test as it helps me get an idea of how much inflammation is in my patient’s colon. It helps differentiate Inflammatory Bowel Disease (IBD) from Irritable Bowel Syndrome

All of the above tests can be run by an MD as well as an ND. Naturopathic physicians dig deep into the cause of digestive problems and sometimes need other, more subtle tests.

Food allergy/sensitivity testing: Food allergies can create a lot of grief in the gut. From inflammation to gas, bloating and diarrhea, I’ve seen hundreds of patient respond beautifully to a program of food elimination. There is no perfect test, but there are tests that can give us a starting point for an elimination / challenge process.

Intestinal permeability tests: If the intestines are too permeable, that “leaky gut” can allow toxins and large proteins into the blood and brain. Many inflammatory and immune conditions have been linked in scientific research to “leaky gut”.

GI Effects Comprehensive Stool Profile: This stool test gives us a lot of information about the ability of the digestive system to break down different types of food, the status of the microbiome (bacterial lining), and inflammation or infection in the bowel.

Small intestine bacterial overgrowth test: This breath helps us see if excess gas, bloating, bowel issues and more are due to the wrong bacteria being in the small intestine. Treatments can be targeted to regain balance and restore proper function.

With the right tests, combined with a thorough discussion of the symptoms and history, plus a good abdominal exam, we can often get to the root of the problem and start to design a plan for getting relief.

Call now to book an in-person or video appointment

250 897-0235 drdmac2@gmail.com

Hormone Tests: What They Really Reveal

In my naturopathic medical practice, I commonly have patients come in who want to have their hormones tested. They feel something isn’t right. They don’t feel their best, and they suspect that hormones are to blame, so they want to be tested. But hormone testing isn’t as simple as it seems. We have to find the right type of test for the individual. The good news is that there are more options than ever for investigating hormone imbalances in men and women. With the right information, we can target our therapies to directly address the core of the issue and get better results faster.

When premenopausal women have something clearly abnormal going on with their hormones, it’s a good idea to do blood hormone testing. For instance, if a woman rarely or never menstruates, we need to rule out conditions like pituitary tumors, autoimmune diseases of the ovaries, and Polycystic Ovarian Syndrome (a.k.a. Anovulatory Androgen Excess). I generally run an extensive panel of pituitary and ovarian hormone levels in those cases.

If a woman is menstruating normally but still feels her hormones are off, the utility of blood testing is questionable. Testing must be timed with the cycle to make any sense of the numbers. But the reference ranges of what is considered normal are so large that most times women will be told they fall somewhere within what’s considered the “normal” range. That’s not helpful for someone who is infertile, or who suffers from serious PMS, low libido or chronic fatigue.

In cases where we need more information to get to the root of the hormone imbalance, urinary hormone panels are proving to provide a lot of nuanced information. The advantage of a comprehensive urinary hormone metabolite analysis is that it not only gives information about the typical hormones like estrogens, progesterone, androgens, cortisol and melatonin, but it also looks at their precursors or parent hormone. So if any levels are off, we can look upstream to see where the problem started. Urinary hormone testing also shows how the hormones are being metabolized or broken down. Sometimes it’s the breakdown products of the hormones that are the problem.



We also know that all the hormones are deeply connected. The thyroid, pituitary, ovarian/testicular, and adrenal hormones all affect each other. Urinary hormone testing can give insights as to the interplay of these four systems. Then we can target our efforts to get the greatest ripple effect on the whole hormone system.

Salivary hormone testing is another option for hormone testing, but it just isn’t the best way to test for hormones like estrogen and testosterone. I reserve this method for testing the adrenal hormones cortisol and DHEA. For people with insomnia, chronic fatigue, or anxiety, getting insight on the hypothalamus/pituitary/adrenal axis can shed light on these chronic issues. Since cortisol levels change throughout the day, it’s great to be able to collect a simple salivary sample four times a day. That said, urinary hormone metabolite panels also can be done four times a day, and they provide all that information and much more.

To monitor hormone levels in women who need to take prescription hormone replacement therapy in perimenopause and menopause, blood testing or even urinary testing can be utilized. Naturopathic physicians can order these lab tests for their patients, and extended health insurance often helps cover the costs.

So if you have been told your hormones are “normal” but you suspect that something is not quite right, there may be other ways to get answers.

Dr. Deidre Macdonald is a naturopathic physician who practices in downtown Courtenay. For telephone / video or in-person visits, contact (250) 897-0235