Herbal Bitters

Herbal Bitters

Bitters are a group of plant constituents, which are not like other plant constituents but are rather distinguishable by their taste when consumed (bitter principle).  Many believe that for bitters to induce their physiological effects they must be tasted.  This is important when considering how to use bitters, for example as a tincture or a capsule. 

Bitters have been traditionally used as a digestive stimulant, enjoyed most often as a cocktail before a meal.  Using bitters before a meal helps to stimulate digestion generally, including the flow of digestive secretions, stimulating gallbladder bile flow (cholagogue), acting as a hepatic to aid liver function, and stimulating the vagus nerve to promote intestinal peristalsis. 

Spring is a perfect time to introduce bitters to help aide in sluggish winter digestion, where most of us have been indoors and sedentary far more.  Spring is also a great season to help the liver detoxify.

Taraxacum officinale, or Dandelion leaf and root, is a great example of bitter plant that can be used fresh in salads or in soups, is abundant in spring, and promotes both digestion and liver function.  Of course it can be used as a dried leaf/root or tincture. 

Another commonly recognized bitter used as food (or beverage in this case), is Humulus lupulus, or Hops, which is found in beer.

Many plants have the bitter principle and also have secondary actions apart from the actions that I listed above, so it is important to exercise caution when using any new herb. 

Bitters are great for spring and for putting a little spring in your digestion.  See the references listed for more information.


Contact Dr. Peters for a free “meet the doctor” visit to see if naturopathic medicine is right for you.



Hoffmann, D. (2003). Medical herbalism: The science and practice of herbal medicine. Rochester, VT: Healing Arts Press.

Marciano, M., Dr. (2013, November 05). The Bitter Principle. Retrieved April 23, 2016, from https://thenaturopathicherbalist.com/plant-constituents/the-bitter-principle/

The Scoop on Digestive Enzyme Supplements

There are many digestive enzyme supplements available on the store shelves and it can be confusing to choose the right one for yourself or your customer.  Through my time at working at various health food stores, here are some helpful tips to weed through the confusion.

From what I can see, two main confusing elements exist when selecting a digestive enzyme supplement; one is selecting the right formula and two is comparing different formulas. 

Selecting the Right Formula

In most stores, there are generally two types of enzyme supplements and it is important to select the right type for the right job.  One formula tends to be made to reduce inflammation and one tends to aide digestion of foods.

Generally speaking, if an enzyme formula has as a majority, or is solely made up of, enzymes such as papain, bromelain, pancreatin or “proteolytic” enzymes (which break down proteins), then you are looking at an enzyme formula to reduce inflammation. 

On the other hand, a digestive enzyme formula will generally contain enzymes such as protease, lipase, amylase, cellulase, lactase, etc. to help with the breakdown of various food components (protease for proteins, lipase for fats, amylase for carbohydrates, etc.).  These ingredients are indications that you are looking at a formula to assist with digestion of food.

Comparing Different Formulas

Comparing enzyme supplements with each other is difficult for one primary reason; there is not a general standardized method for listing enzymes on a label.  Companies can list either the amount (weight measurement, such as milligrams (mg)) of each enzyme per capsule or they can list the activity (units of activity) of each enzyme per capsule.  In Canada, manufactures are required to list the mg of each enzyme and they may list the activity of each enzyme.  The confusion stems from the fact that an enzyme’s efficacy is measured by it’s activity, not by it’s weight.  To make a good comparison, we need to know a supplement’s enzyme’s activity.

It makes it difficult to compare different supplements because one, we want to know the activity of the enzyme, and two because some brands don’t list the activity.

Furthermore, when comparing activity of different supplements, different brands use different enzyme activity measurement units (FCC vs USP).  Thus, it is important to be able to convert between the different units in order to compare properly. 

How to Choose

I have been unable, as of yet, to find a complete source for comparison, nor a fully reliable one.  In the meantime, see the link below for a starting point to help you in your decision making. http://rnblog.rockwellnutrition.com/enzymes-standards-of-measurement/

See the references listed below for more information on enzymes, enzyme supplements, and comparing different formulas.


Contact Dr. Peters for a free “meet the doctor” visit to see if naturopathic medicine is right for you.



A brief overview of digestive enzyme facts [Pamphlet]. (2000). Thornhill, ON: NaturPharm.

Cichoke, A. J. (1999). The complete book of enzyme therapy. Garden City Park, NY: Avery Pub.

Haas, E. M., & Levin, B. (2006). Staying healthy with nutrition: The complete guide to diet and nutritional medicine. Berkeley: Celestial Arts.

(2011, January 27). Rockwell Nutrition Blog. Retrieved March 12, 2016, from http://rnblog.rockwellnutrition.com/enzymes-standards-of-measurement/

Digestive Enzymes – Why are they Important?

The Scoop on Digestive Enzymes

Generally speaking, there are 3 classes of enzymes: metabolic enzymes, food enzymes, and digestive enzymes.  Metabolic enzymes are those that facilitate in performing a number of biochemical reactions in the body.  Unless one has a condition that affects how a metabolic enzyme functions in the body most people will never pay attention to these enzymes.  Food enzymes and digestive enzymes, on the other hand, are a different story.  Many people would do well to consider these categories of enzymes and the impact they have on our health.

Food enzymes are those that are found in foods and are present to assist in digesting of that food.  An important consideration of enzymes is that they are made up of amino acids, which are the building blocks of proteins, therefore enzymes are proteins.  The function of proteins is affected by a number of factors, one of which is heat.  Heat denatures proteins which in turn affects their function.  That is to say, heat affects how well an enzyme will function.  As such, incorporating raw foods in one’s diet is a great way to support the digestion of that food.  Consuming a diet of solely cooked foods (not to mention processed and refined), as many people do, may add an extra burden on the body to produce all of the enzymes required to properly digest the foods eaten and/or actually hinder the body’s ability to produce digestive enzymes effectively.

Digestive enzymes are those that are produced by the body to assist in digesting food consumed.  The majority of enzymes required for digestion are produced and secreted by the pancreas, and many elements can impact how well this happens.  Suffice it to say, many people are aided by the use of supplemental digestive enzymes. 

Digestive enzyme supplements tend to be sourced from either animals or plants.  Animal enzymes tend to be sourced from pancreatin, which is tissue from the pancreas of an animal.  This tissue, much like it does within us, is useful at providing digestive enzymes such as protease, amylase, and lipase.  Plant enzymes, while called “plant” enzymes are typically from fungal sources; most digestive enzyme formulas are fungal-based.  Other actual plant digestive enzymes include papain (from papaya) and bromelain (from pineapple). 

Digestive enzymes are useful for a number of conditions, particularly for anything related to impaired digestion.  Basic symptoms of impaired digestion include belching, bloating, flatulence and excessive full feeling after eating.  Digestion is central to all body systems and proper digestive health is core for general good health.


Contact Dr. Peters for a free “meet the doctor” visit to see if naturopathic medicine is right for you.



Bateson-Koch, C. (1994). Allergies, disease in disguise: How to heal your condition permanently and naturally. Burnaby, B.C.: Alive Books.

A brief overview of digestive enzyme facts [Pamphlet]. (2000). Thornhill, ON: NaturPharm.

Cichoke, A. J. (1999). The complete book of enzyme therapy. Garden City Park, NY: Avery Pub.

Haas, E. M., & Levin, B. (2006). Staying healthy with nutrition: The complete guide to diet and nutritional medicine. Berkeley: Celestial Arts.

Help for Diverticulitis

Last year a 73 year old man we’ll call David came to my clinic with acute abdominal pain. Doctors know that the cause of acute abdominal pain can be as benign as gas pains or as serious as cancer. I set out to diagnose his pain by asking questions and examining him. His lower abdomen was tender, his stool had changed and he felt ill. Blood work hinted at an infection, so I sent him to emergency where my diagnosis of diverticulitis was confirmed. Diverticulitis occurs when pouches form in the colon and then get inflamed and infected. It is very common to have diverticulosis, which is the presence of multiple tiny pouches in the colon. In fact, at 60 years old, 30% of the population have diverticuli, increasing to 50-80% by the age of 80. The vast majority of divertuli never cause any problems. Only about 5% of those pouches will ever get infected and be called diverticulitis, but when they do get infected it is considered a medical emergency and is generally treated with antibiotics.

When David returned to my office 10 days later, our goal was to heal the intestine and prevent future infections. Since he had taken intravenous antibiotics, I gave him high doses of quality probiotics to replace the good bacteria in the intestines. These probiotics serve as a natural slow release antibiotic, preventing future infections. They also help to prevent a serious side effect of antibiotics, called c. difficile diarrhea. This debilitating and sometimes life threatening bowel infection can occur when strong antibiotics wipe out the protective bacteria in the intestine and allow an opportunistic overgrowth of a common strain of bacteria.

I also counselled him on a nutritious but gentle diet once he was ready to introduce food. We used herbs that sooth and heal the intestinal lining and assist in digestion. Two weeks later he was feeling much stronger and his stools had returned to normal. The goal at this point was to prevent future flare ups of diverticulitis. He will always have pouches, but we can prevent them from getting infected. In the past, doctors advised patient like him to avoid nuts and seeds that could become lodged in the pockets. While this advice makes intuitive sense, it hasn’t held up in clinical research. Eating a high fiber diet and avoiding constipation does reduce relapses, but avoiding nuts and seeds does not.

Reducing inflammation in the intestine is also important for preventing diverticulitis. Ironically, some drugs that reduce inflammation in the joints can increase inflammation in the intestines. The common anti-inflammatory drugs, like ibuprofen, diclofenac and naproxen, all can increase the risk of diverticulitis. Also, eating foods one is allergic to, high fat foods, and sugar are all pro-inflammatory to the bowel. There are herbs that reduce inflammation in the bowel and help to maintain the integrity of the intestinal lining.

After the pain that David had experienced with his acute flare up, he was very motivated to change his diet and take natural medicines designed to prevent reoccurrences. However, he was reticent to stop taking daily ibuprofen because he suffered from arthritis in his knee and hated to miss his morning dog-walks on the beach. We treated his arthritic knee with a safe and effective treatment for arthritis called cold laser therapy, which allowed him to subsequently get off ibuprofen. A year later he returned to treat a shoulder injury (caused by the dog) and reported that his knee was still pain free and he’d had no bowel problems since getting on the naturopathic protocol. This case shows that sometimes the best solution is a blend of conventional and naturopathic medicine.

Gas is No Laughing Matter

While twelve-year-old boys may revel in the sound of their own gas, those plagued by excess gas will find that it is nothing to laugh about.  Excessive burping, bloating and flatulence bring distress and discomfort to more people than would like to admit it.  Despite the significant problem gas can cause, patients are often told something to the effect of, “Well, you have Irritable Bowel Syndrome, and you’re just going to have to live with it.”  I prefer to find and treat the underlying issues which cause gastrointestinal unrest.

Digestive dysfunction on a number of levels can contribute to excess gas.  Some people lack adequate stomach acid, or take acid-blocking medication for acid reflux.  Indigestion and gas problems can occur due to improper break down of food.  Further down, inadequate flow of digestive enzymes or bile can cause food to sit and ferment into gasses.  Constipation, diabetes, parasites, helicobactor pylori, multiple sclerosis and other medical conditions can cause excess gas.

Gas results from the production of gas by intestinal bacteria when they digest sugars and other carbohydrates.  Imbalances in the bacterial lining of the intestines, called the microbiome, can be a significant source of gas and bloating, as well as Irritable Bowel Syndrome.  Immune issues, poor diet, c-sections, antibiotics and acid-blocking drugs can alter the microbiome .  In Small Intestine Bacterial Overgrowth, also known as SIBO, excess gas is a key symptom. Also, a common yeast called Candida albicans can proliferate  to a level that can cause excess fermentation, leading to gas and other symptoms.

Some people’s gas is attributable to food allergies which can be determined with the help of a naturopathic physician.  Celiac disease, or intolerance to lactose, fructose or artificial sweeteners can each result in gas and bloating.  It also probably comes as no surprise that beer and other carbonated beverages have the same affect. Lastly, as any vegetarian knows, beans can cause gas, along with the cabbage family vegetables.

In short, don’t let gas get you down.  It is often a symptom of an underlying disorder which can often respond well to proper treatment.  Anyone who says otherwise, quite frankly, is full of hot air. 

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.