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Breakthroughs in Irritable Bowel Syndrome
Irritable 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
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 physician who works at the Macdonald Centre for Natural Medicine.
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
Hope for Parkinson’s Disease
Muhammad Ali and Michael J. Fox are famous people who have Parkinson’s disease, and one in 500 people in Canada will join their ranks. Parkinson’s disease (PD) is a degenerative neurological disease that slowly affects the ability to control movement. Symptoms can include tremors, difficulty walking and speaking. Early symptoms can include decreased thirst, loss of smell, constipation, anxiety and decreased arm swinging while walking. This condition was thought to be chronic and progressive and could only be managed with medications. Now, with a deeper understanding of the factors that contribute to nerve cell damage, there are targeted strategies that can slow or even reverse the disease to some degree. Many of these principles are just smart preventative lifestyle strategies for all of us who want to protect our brains from degeneration.
Dr. Laurie Mischley is a naturopathic doctor who works with people with Parkinson’s disease in Seattle. The average Parkinson’s patient has a symptom score of 500 at the time of diagnosis in a standardized test for Parkinson’s, and their score goes up by 38 points per year on average. In contrast, Dr. Mischley’s patients have an average 200-300 point decrease in their score over one year of treatment. Those numbers got my attention when she spoke at a recent brain health conference I attended.
Dr. Mischley is emphatic that Parkinson’s does not have to be a progressive, irreversible disease. Progression can be slowed and sometimes reversed to a degree if we seek to understand what is stressing the neurons and remove those stresses while supporting optimal brain health with targeted lifestyle strategies and natural medicines. Dr. Mischley says that by the time PD is diagnosed, the processes that created it have been in the works for twenty years or more. Science has shown us that risk factors include drinking well water with high manganese or pesticide runoff, head trauma, heavy metal exposure (welders), dairy consumption, pesticide exposure, certain viral or fungal infections, intestinal microbiome imbalances, autoimmune processes, high iron, low B12, smoking, drinking and more. If we can identify and target these neurological stress factors, we can improve brain health.
Lab tests can help us identify the stress factors associated with Parkinson’s disease. These include inflammatory markers (CRP), blood sugar work up, iron, vitamin B12, food allergies, heavy metal testing, intestinal testing, brain auto-antibody testing, vitamin D, oxidative stress tests, (low) cholesterol, homocysteine, DHEA-S, thyroid function and more. Naturopathic physicians can order these types of lab tests and provide thorough analysis.
Dietary interventions include eating more plant-based foods, such as fruit, vegetables, nuts and seeds and healthy oils. Fish and organic chicken are encouraged, while dairy, red meat, flour and sugar are discouraged. Exercise can play an important role in Parkinson’s treatment, and our local recreation centres are providing classes specifically for this condition. Natural medicines are also vital for creating an environment in the brain where the nerves can thrive. Coenzyme Q10 and fish oil are associated with better outcomes in PD. Glutathione precursors provide protection against oxidative stress in the brain, which is critical for PD. Targeting heavy metal elimination, autoimmune balancing, gut microbiome restoration, mitochondrial repair, and homocysteine-lowering are the types of individualized treatments on which naturopathic physicians can coach their patients. Medications that promote dopamine are an important aspect of the management of PD, but knowing that you can also address the causative factors and take charge of the progression of this condition is empowering.
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.
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.
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 or Dr. Peters by emailing us or calling (250) 897-0235
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The Macdonald Centre for Natural Medicine
448 10th Street Courtenay, B.C.