IBS Symptoms and Treatment – Could You Have SIBO?

Picture of woman holding her stomach with red area of inflammation radiating from underneath her handsCould I have undiagnosed IBS?

Prevalence and Symptoms of IBS

Statistics show that approximately 2 in 10 people in the UK have IBS.  Many more people are thought to have IBS who have either not been diagnosed correctly or haven’t consulted a GP for a diagnosis. Many people think that IBS symptoms such as constipation, loose stools, going to the toilet less than once a day, wind or bloating is normal.

In terms of a healthy bowel movement, the gold standard is 2 to 3 times a day and doesn’t leave any marks on the toilet bowel or even on the toilet paper!  Can you honestly say your stools are like that?

Common Treatments for IBS

IBS is commonly “treated” with medications such as Moviprol to relieve constipation or Immodium to stop diarrhoea. Proton Pump Inhibitors such as Omeprazole and Lansoprazole are prescribed to relieve symptoms of acid reflux and heartburn. All of which have side effects.

So, we are going to take a look at the side effects of using such medications. However, please consult a qualified health professional before making any decisions about medications.

Effects of Moviprol: Picture of multicoloured medications

If you are taking Moviprol, have a look at the sodium content in it.  It is very high and the wrong sort of sodium in the wrong sort of amounts can affect our cell health, blood pressure and heart health.

Effects of Immodium:

When we have loose stools, there is a reason the body is trying to eliminate so rapidly.  We need to find out the reason, whether it is excess toxicity trying to escape or rapid transit time due to stress.

If we just ‘fix’ the symptom, then where will that toxicity go if we are stopping it from coming out?  It goes deeper, where it can store itself in joints such as in arthritis, extra tissue such as endometriosis, or, even worse, in organs.

Effects of Omeprazole / Lanzoprazole and the Question of Stomach Acid Production:

Numerous research studies have indicated the dangers of Proton Pump Inhibitors.  There have been links made in various studies between PPIs and an increase in mortality, stomach cancer and even neurological conditions such as dementia.  Whilst I’m not suggesting you stop taking medication without talking to your GP, it does raise concerns that you might not have been aware of.

Not only do these medications have concerns surrounding their long term effects, but also stop a vital function of the body – they decrease the production of acid in the stomach.  “But I’ve got acid heartburn”, I hear you say, “so why would I not want to decrease the production of stomach acid?”

Diagrammatic illustration of an open lower oesophageal sphincter allowing acid to backflow into the eosophagus, causing GERDStomach acid purposes

Well to answer that question, let’s look at the main purposes of stomach acid production:

  • The production of stomach acid actually triggers the tightening of the lower oesophageal sphincter, which prevents stomach acid from rising up into the oesophagus.  So causes of acid reflux can actually include too little stomach acid. Conversely the treatment often dished out like sweets for acid reflux is the very thing that can cause reflux in the first place!
  • Secondly, it is produced to break down proteins so that we can use them to regenerate our bodies.  So when people don’t produce enough stomach acid, they can have impaired protein digestion and are not able to use the protein they take in to maintain optimum physical function.  Instead it putrifies in the large intestine, causing toxicity.
  • Thirdly, stomach acid has the effect of killing of any unwanted bacteria and prevents it from accumulating in the small intestines, a major cause of 60% plus of IBS cases!

Whilst some people do produce too much stomach acid, the majority of people actually produce too little. This is usually after use of antacids such as Gaviscon or PPIs.

I can hear you saying, well that’s all well and good Bee, but the symptoms of IBS are horrendous so what do I do?  Well don’t worry, there are lots of natural alternatives. Most importantly naturopathic nutrition looks at addressing the root cause. So let’s take a look at some possible root causes of IBS. Our main focus is on the biggest known cause of IBS, SIBO.

Causes of IBS

SIBO

Research suggests that one of the biggest causes of IBS could be something you have never even heard of! Diagram illustrating the anatomy of the lower digestive tractSIBO – small intestinal bacterial overgrowth.  Studies have shown that 60-84% of people with IBS actually have something called SIBO which is causing their IBS symptoms?

But what is it?  And is it curable?  Well, we are supposed to have an abundance of certain bacteria in our large intestine, but not in our small intestine.  SIBO is where bacteria have overgrown backwards into the small intestine.

Causes of SIBO

Poor gut motility

Poor gut motility is when food and bacteria aren’t being swept down through your digestive tract effectively.  Gut motility is controlled by something called the migrating motor complex (MMC for short).

The functioning of the MMC can be impaired by illnesses such as gastroenteritis (gastric flu) or a severe bout of food poisoning (24 hrs or more). I can also be impaired by infections such as Lyme Disease or mould toxicity, and even an impact that has knocked or shaken the head.  This is not as easy to address and may warrant ongoing treatment with natural prokinetics to keep everything moving through.

Poor digestion

Picture of a man with his head in his hands looking stressedAs discussed above, low stomach acid is obviously one cause.  Other causes include impaired production of digestive enzymes, impaired production of bile and low secretory IgA which acts as an immune defence in the gut.

Causes can even be as simple as drinking with or close to meals (which dilutes your digestive juices). Or not chewing your food properly and eating whilst distracted (by our phones or the TV). Eating on the go, or eating under stress or whilst upset or angry can also cause poor digestion.

Stress shuts down our digestive system. With so many people under constant chronic stress, it is affecting their digestion all the time.  Taking time to do some deep breathing or anything that calms you before every meal, helps switch your body into rest and digest mode.

Obstructions and abdominal adhesions

Adhesions are scar tissue that form after surgery, a perforated appendix or a haemorrhage.  Obstructions can be caused by conditions such as endometriosis, diverticulitis and superior mesenteric artery syndrome.

Medications and stimulants

We have already discussed the dangers of anti-diarrhoea medications and PPIs above. Other medications such as opiates, narcotics, antispasmodics and even trycyclic antidepressants such as amitriptyline can all cause poor gut motility, as can cigarette and cannabis use.

For some people SIBO can reoccur throughout their life, depending on the cause, but for others it can be cured by addressing the route cause.

How Do I Know If I have SIBO

Consult a SIBO practitioner like myself who can carry out primarily a 3 hour lactulose breath test, possibly Lab technician assessing lab test resultsfollowed by a glucose test as well if necessary.  It is important that the test is a 3 hour test and that it tests for both methane and hydrogen.

Methane & hydrogen are emitted by bacteria in the small intestine, before you have had chance to absorb your food. Causing the symptoms of wind, bloating, stomach cramps, iron deficiency, B vitamin deficiency, fatigue, etc!  But a word of warning… There is a third gas, called hydrogen sulphide, that doesn’t show up on a standard test.

Hydrogen Sulphide

Leading expert in the field, Dr Mark Pimental, has recently developed a test for Hydrogen Sulphide SIBO. Unfortunately, at the time of writing this article, it is not yet available in the UK.

If however you have a flat line across the whole of your 3 hour breath test, it is possible that this is not in fact a negative breath test for SIBO, but in fact a positive indicator that you have hydrogen sulphide SIBO. So if you have previously been tested, as I was, and told that the test is negative because you had a flat line but you are still symptomatic, you may in fact need treating for Hydrogen Sulphide SIBO.  A trained SIBO practitioner should be able to help you interpret the test and give you some indication of how long treatment might take.

I also order a stool test for my clients to see what possible causes of SIBO may exist.  Lab tests I use include GI Effects from Genova Diagnostics and GI Map, depending on someone’s signs and symptoms.

Natural treatments for SIBO

The natural treatment for SIBO that I prescribe to my clients is herbal antimicrobials to kill off the excess bacteria, Picture of medicinal herbsof a particular type and dosage.  These should always be taken under supervision.

I also prescribe a 2 phase diet which can virtually eliminate symptoms within a couple of weeks in some people.  However, this diet is not meant as a long-term strategy.  We need to fix the cause, as opposed to just managing the symptoms with diet.

Phase 2 diet

The diet works by eliminating / reducing a group of fermentable carbohydrates called FODMAPs.  Designed by one of the leading experts in the field, Nirala Jacobi, adapted from Alison Siebecker’s SIBO Specific Diet, the diet is specifically targeted at starving the bacteria to help with their elimination.  It has also been designed to be as varied as possible, because restricting any food groups can cause disruption to the gut microbiome, the community of “normal” bacteria that are supposed to live in our large intestine and modulate our immune system, help us detoxify effectively, produce vitamins and in short keep us healthy.

If someone has Hydrogen Sulphide SIBO I tailor the diet, as hydrogen sulphide producing bacteria will thrive on different foods to hydrogen and methane producers.

Meal spacing

Other strategies I employ include meal spacing, i.e. eating with four to five hour gaps in between. This can help the MMC to sweep excess bacteria out, so regular grazing can also be problematic.

I also, depending on someone’s stool test results, address any digestive issues with specific enzymes, address any leaky gut, inflammation or lowered gut immunity and assess whether someone needs to take hydrochloric acid in the form of Betaine HCl.  I would also prescribe a prokinetic to ensure that motility is working as well as possible and possibly also a biofilm disruptor, as bacteria are known to create a biofilm around themselves to protect themselves.

There are also many natural treatments for symptoms such as bloating, reflux, constipation and diarrhoea.  Take a look at www.siboinfo.com  for more info.

Microbiome restoration

I end my treatment with microbiome restoration, as the antimicrobials, although natural, and the restricted diet, Gut bacteriado to some extent alter the gut microbiome.  This can be done through prebiotic supplements and including prebiotic rich foods in the diet, but has to be done at the end of treatment, as it can otherwise make someone very symptomatic.

Probiotics, fermented foods, yoghurts such as Yakult, etc will not on their own be enough to recolonize our gut bacteria.  Those bacteria need to keep being fed prebiotic foods in order to grow, thrive and survive.

Other Causes of IBS

Other causes of IBS can include;

  • parasitic infections (almost impossible to pick up unless you use PCR testing to test for DNA and standard tests throw up a lot of false negatives)
  • Coeliac disease (which your GP can test you for as long as you are still eating gluten)
  • Non-coeliac gluten sensitivity (don’t think if you are not coeliac that gluten is fine as this could be you!)
  • Disease causing bacteria such as Klebsiella Pneumoniae that produce endotoxins (linked with endometriosis in some cases), any of the individual causes of SIBO on their own
  • Inflammatory Bowel Disease (Crohn’s and Ulcerative Colitis)
  • Removal of gallbladder or part of the bowel
  • Diverticulitis
  • Candida or other fungal overgrowth
  • Food intolerances
  • Salicylate or oxalate sensitivity
  • Histamine intolerance
  • Disrupted gut flora
  • Or simply a poor diet.

I shall be diving deeper into some of these other causes in future articles.

Often removing highly inflammatory foods such as dairy, gluten and sugar can have a huge impact on someone’s digestion.  Again, testing as part of my six step programme instead of guessing, can often get to the route cause of any of these, together with hydration, supplementation, lifestyle changes, clearing up the diet and detoxification.

If you would like help with any digestive issues, contact me for a free 15 minute chat to find out how I can help you.

References

Bharucha, A. E., Seide, B. M., Zinsmeister, A. R., & Melton, L. J. (2007). Insights into normal and disordered bowel habits from bowel diaries. The American journal of gastroenterology103(3), 692-8.
Bures, J., Cyrany, J., Kohoutova, D., Förstl, M., Rejchrt, S., Kvetina, J., Vorisek, V., … Kopacova, M. (2010). Small intestinal bacterial overgrowth syndrome. World journal of gastroenterology16(24), 2978-90.
Ghoshal, U. C., Shukla, R., & Ghoshal, U. (2017). Small Intestinal Bacterial Overgrowth and Irritable Bowel Syndrome: A Bridge between Functional Organic Dichotomy. Gut and liver11(2), 196-208.
Thomson, A. B., Sauve, M. D., Kassam, N., & Kamitakahara, H. (2010). Safety of the long-term use of proton pump inhibitors. World journal of gastroenterology16(19), 2323-30.

Treating IBS Course

We can run a course for you covering IBS, the causes and how to relieve the symptoms.

Contact me to get some more information on the courses/ workshops that I can run for you.

How To Get A Better Sleep Naturally – Improve Your Sleep Quality

Picture of a grey cat sleeping soundly on a white duvet

Are You Getting Enough Sleep and Is It The Right Quality?

Sleep duration

Firstly, what is the right amount of sleep?  Well researchers quote between 7-9 hours sleep a night.  It is down to the individual to you to decide whether you can function well on 7, 8 or 9 hours.  Which amount of sleep leaves you ready to spring out of bed in the morning?  If the answer is “no amount of sleep leaves me springing out of bed” then read on, as I explore how sleep quality is just as important as duration.

Importance of both the Right Amount of Sleep and the Right Quality of Sleep

Researchers have found that skimping on sleep, and also have over 9 hours sleep, can both increase your chances of getting Type II Diabetes.  Lack of sleep or disrupted sleep quality can also increase inflammation, affect your heart health and blood pressure, cause you to go into fight or flight mode (which means your body cannot digest, your brain cannot process as effectively and your body can’t repair), cause weight gain due to disruption to the hormones which signal to your brain that you are full after eating and even increase your chances of colorectal cancer or all-cause mortality!

So what do we mean by quality of sleep?

Well a good night’s sleep should leave you feeling refreshed the nextwoman having a good night's sleep morning.  During the night our body uses sleep to repair and detoxify and we actually carry out the most detoxification between the hours of 10pm and 12pm, so I advise all my clients to have their head on the pillow by 10pm, something for all you night owls to consider.

For those of you with adrenal issues, you may find that you have something called “day night reversal” where you have more energy at night.  This is because your cortisol levels are dysregulated.  Cortisol is the hormone that wakes you up in the morning and should lower throughout the day so that you can sleep at night.  Often people with adrenal dysregulation get a second wind around 11pm so ideally you want to try and get to sleep before then if at all possible.  But, as always, with adrenal dysregulation you do need to look at addressing the root causes, of which there can be many.  There is a great app called Sleep Cycle which you can use to monitor how deeply you are sleeping https://www.sleepcycle.com/how-it-works/

Hints and Tips to Improve Sleep

So how do we go about improving our sleep?

Stimulants

Caffeine, which is found in tea, coffee and chocolate, can affect your sleep quality for over 6-8 hours so I always recommend steering clear of anything with caffeine in from at least 2pm in the afternoon. This is true of other stimulants as well, such as tobacco.

Alcohol

Alcohol may seem like it’s getting you off to sleep but the actual quality of sleep after alcohol is poor. Not only is it a diuretic, dehydrating and toxic to the brain, but it also switches off REM sleep, the most restorative type of sleep, so steering clear of alcohol a good few hours before bed if not altogether can help improve sleep quality.

Food

Woman watching TV eating popcorn in her pyjamasStaying away from food for up to 4 hours before sleeping can help us sleep more deeply as our body is not busy trying to digest food, which is a big stress on the body.  The caveat to this is those with blood sugar dysregulation, who would do well to have a little resistant starch before bed to stop their cortisol spiking throughout the night and waking them up.  However, as usual, looking at ways of addressing blood sugar issues is an even more effective strategy, which a naturopathic nutritionist can help you with.

Light after Sunset

You may well have heard about the effects of blue light on melatonin production, the hormone that assists us, amongst other things, to sleep deeply. Blue light emits from electrical devices such as computers, smart phones, digital displays on clocks or radios, etc.  There are a number of apps out there such as F.lux which you can download onto your computer to enable it to dim the blue light emitting from the screen and later smartphones tend to have built in blue light dimmers that you can switch on in their settings.

For those devices where you cannot dim the blue light, the answer is simple – blue light blocking glasses such as Blu Blockers that you wear after the sun goes down.  These are ideal, as it’s not just blue light but also strip lighting, lightbulbs, the light in the fridge, in fact any type of lighting that can upset the body’s melatonin production other than orange or red lighting.  So another helpful tip is to change your lightbulbs to orange or red ones wherever possible.

Electronics

Picture of laptop, smartphone and games controller on a white backgroundElectronics emit frequencies that can interfere with your sleep. Even when you put your smartphone on airplane mode, it is still emitting, so switch everything off (including switching stuff off at the plug) and position your bed away from any electrical cables or plug sockets.

Wi-fi

Wi-fi signals have been shown in research studies to significantly affect the quality of our sleep as well as our overall health. Whilst we may be surrounded by wi-fi from our neighbours, we can ensure that we reduce our exposure by turning our own wi-fi off before sleep or, even better, hard wire our devices and switch the wi-fi in your home off permanently.

Darkness in the Bedroom

How dark is your bedroom? If there is light coming into the room from devices or seeping through the window from street lights, that can all affect your sleep quality.  Practical solutions include black out blinds or eye masks.

Your Body Clock

Getting up and going to bed at the same every day sets your body clock. Lying in at weekends completely disrupts your body clock, so come Monday morning your body is expecting to lie in again, so regular waking up and sleeping times will help immensely.

Exercise

Regular moderate exercise at least 4 hours away from sleep, if not more, will also help improve sleep quality. Beware of overtraining as this can actually spike your cortisol levels and lead to adrenal dysregulation.

Daylight

Picture of an inflatable yellow sun in a field of grass with a blue sky in the background with white fluffy cloudsYou might be surprised to hear that it’s not just the lighting at night but also the light that you take directly through your retinas first thing in the morning that can help to reset our sleep / wake rhythms.  Try getting 20 minutes of either direct sunlight or full spectrum daylight directly into your retinas (without glasses or contact lenses) every morning.

Hydration

Hydration can hugely impact on the quality of your sleep. I was on sleeping pills for years and still only getting 3 hours of sleep a night, but when I started to hydrate I never had a problem with insomnia again and was able to come off the sleeping pills.  We lose water naturally even when sleeping as we lose it through our breath.  So check out my blog on hydration to read more about how to keep hydrated.

Room Temperature

According to the Sleep Council, “hot, cold and draughty rooms can seriously impact on your sleep.” They suggest that the ideal room temperature for a good night sleep should be between 16 to 18°C (60 to 65°F).

Relaxation v. Stimulation

Switching off stimulation 2 hours before bed can help our brain settle down in preparation for sleep. StimulationGinger and white tabby sleeping on a black and whit striped duvet can take the form of work, study or even stimulating TV programmes.  If you can do anything to actually slow your brain waves down, such as alternate nostril breathing or using apps such as Heartmath, that can also be a great help.

Magnesium levels can also impact how well you are able to relax. Naturopathic techniques such as Epsom salt baths and footbaths or taking magnesium citrate can all help, as can techniques that redirect blood flow away from the brain to the feet.

References

Al-Abri, M. A., Jaju, D., Al-Sinani, S., Al-Mamari, A., Albarwani, S., Al-Resadi, K., Bayoumi, R., Hassan, M. Al-Hashmi, K. (2016). Habitual Sleep Deprivation is Associated with Type 2 Diabetes: A Case-Control Study. Oman medical journal, 31(6), 399-403.
Bedrosian, T. A., & Nelson, R. J. (2017). Timing of light exposure affects mood and brain circuits. Translational psychiatry, 7(1), BMJ Open.
Brasure M, MacDonald R, Fuchs E, Olson CM, Carlyle M, Diem S et al. Management of Insomnia Disorder. Rockville (MD): Agency for Healthcare Research and Quality (US); 2015. (AHRQ Comparative Effectiveness Review; Volume 159).
Chaput, J.P., McNeil, J., Despres, J.P., Bouchard, C. and Tremblay, A., (2013). Seven to eight hours of sleep a night is associated with a lower prevalence of the metabolic syndrome and reduced overall cardiometabolic risk in adults. PloS one, 8(9), p.e72832.
Chepesiuk, R. (2009). Missing the dark: health effects of light pollution. Environmental health perspectives, 117(1), A20-7
Dolezal, B. A., Neufeld, E. V., Boland, D. M., Martin, J. L., & Cooper, C. B. (2017). Interrelationship between Sleep and Exercise: A Systematic Review. Advances in preventive medicine, 2017, 1364387.
Drake, C., Roehrs, T., Shambroom, J., & Roth, T. (2013). Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 9(11), 1195-200. doi:10.5664/jcsm.3170
Hatori, M., Gronfier, C., Van Gelder, R. N., Bernstein, P. S., Carreras, J., Panda, S., Marks, F., Sliney, D., Hunt, C. E., Hirota, T., Furukawa, T. Tsubota, K. (2017). Global rise of potential health hazards caused by blue light-induced circadian disruption in modern aging societies. NPJ aging and mechanisms of disease, 3, 9. doi:10.1038/s41514-017-0010-2
Hysing M, Pallesen S, Stormark KM, et a. (2015). Sleep and use of electronic devices in adolescence: results from a large population-based study
Mirghani, H.O., Mohammed, O.S., Almurtadha, Y.M. and Ahmed, M.S., (2015). Good sleep quality is associated with better academic performance among Sudanese medical students. BMC research notes, 8(1), p.706.
Obradovich, N., Migliorini, R., Mednick, S. C., & Fowler, J. H. (2017). Nighttime temperature and human sleep loss in a changing climate. Science advances, 3(5), e1601555. doi:10.1126/sciadv.1601555
Okamoto-Mizuno, K., & Mizuno, K. (2012). Effects of thermal environment on sleep and circadian rhythm. Journal of physiological anthropology, 31(1), 14. doi:10.1186/1880-6805-31-14
Park, S. Y., Oh, M. K., Lee, B. S., Kim, H. G., Lee, W. J., Lee, J. H., Lim, J. T.,Kim, J. Y. (2015). The Effects of Alcohol on Quality of Sleep. Korean journal of family medicine, 36(6), 294-9.
Shan, Z., Ma, H., Xie, M., Yan, P., Guo, Y., Bao, W., Rong, Y., Jackson, C.L., Hu, F.B. and Liu, L., (2015). Sleep duration and risk of type 2 diabetes: a meta-analysis of prospective studies. Diabetes care, 38(3), pp.529-537.

How To Stop Getting Migraines – Preventing Migraine Headaches

Causes of Migraines

Hydration

Migraines can be caused by a number of factors, but ultimately migraines indicate a state of dehydration and toxicity at head level.

So in order to start treating migraines, you must be hydrating adequately on a daily basis.  Check out my blog on hydration for a starting point.

Diet

Food Intolerances

Food intolerances can also play a part and certain foods are highly inflammatory, such as gluten, dairy and sugar. So,Picture of grain of wheat in a black circle with black line through it eliminating common culprits for 4-6 weeks under supervision can help you identify whether foods are triggering your migraines.  Other common culprits might include grains, eggs, nightshades, etc. so it is always better to do this under supervision so that you are not cutting out valuable nutrients blindly.

Amines

Of particular note are a group of substances called “amines”.  Foods high in amines include caffeine, cheese, citrus fruits, chocolate, wine, fermented foods and even foods such as spinach, tomatoes and avocados.  Some people may have too much histamine in their system so that any additional amines cause the bucket to overflow, if you like.

Other people may not have the enzymes to break down histamine. This could be due to pathogenic bacteria or parasites. It could also be due to an overgrowth of bacteria in the small intestine impairing the production of enzymes or as a result of certain genetic variations.  All of this can be analysed through lab testing, but ultimately the approach is the same.  Hydrate, eliminate toxins as much as possible and open up the body’s detoxification pathways through naturopathic techniques.  Some people may benefit from taking supplementary diamine oxidase but it is quite hard to get hold of in the UK and is not a cure all for everyone, giving that histamine intolerance can have a variety of different causes.

Useful Supplements

Picture of various supplements in someone's handCertain supplements can help immensely, such as magnesium, butterbur, feverfew, Coenzyme Q10, Vitamin B2 and the vitamins involved with methylation (B12, folate and B6).  Again, this also depends on the cause.  If someone cannot detoxify effectively (has problems with methylation), then that’s where the methylation supplements come into use.

Magnesium is always implicated in migraines and I would suggest taking a well-absorbed form such as magnesium citrate.  However, a caveat with magnesium is that it can start to push waste and toxins from the cell, so if the body’s pathways of elimination (bowel, liver, blood, lymph, etc) are not working as effectively as they could be, going in with large doses of magnesium can be counter-productive, so again a holistic programme working on opening up the routes of elimination, hydrating, removing inflammatory foods, etc is recommended, as opposed to just blindly taking supplements without understanding what’s going on in your own individual body.

References

Bunner, A. E., Agarwal, U., Gonzales, J. F., Valente, F., & Barnard, N. D. (2014). Nutrition intervention for migraine: a randomized crossover trial. The journal of headache and pain, 15(1), 69.

Gaul, C., Diener, H. C., Danesch, U., Migravent® Study Group (2015). Improvement of migraine symptoms with a proprietary supplement containing riboflavin, magnesium and Q10: a randomized, placebo-controlled, double-blind, multicenter trial. The journal of headache and pain, 16, 516.

Hoffmann, J., & Recober, A. (2013). Migraine and triggers: post hoc ergo propter hoc?. Current pain and headache reports, 17(10), 370.

Lipton RB, Göbel H, Einhäupl KM, Wilks K, Mauskop A.(2004).Petasites hybridus root(butterbur) is an effective preventive treatment for migraine. Neurology.

Mauskop A, Varughese J. (2012). Why all migraine patients should be treated with magnesium.

Pareek, A., Suthar, M., Rathore, G. S., & Bansal, V. (2011). Feverfew (Tanacetum parthenium L.): A systematic review. Pharmacognosy reviews, 5(9), 103-10.

Riebl, S. K., & Davy, B. M. (2013). The Hydration Equation: Update on Water Balance and Cognitive Performance. ACSM’s health & fitness journal, 17(6), 21-28.

 

The Causes of Hayfever and How To Stop Symptoms Naturally

Can You Alleviate Hayfever Naturally?

Picture of woman in a field of grass blowing her nose

So along with the glorious weather, up goes the pollen count.  For the approximately 20 million hayfever sufferers in the UK, that hardly feels fair does it?  But do you have to dose yourself up with steroid sprays, drops and antihistamines or is there a more natural solution that doesn’t leave you with side effects?

Pharmaceutical vs Natural Treatments for Hayfever Symptoms

“I don’t have any side effects and the antihistamines work just fine”, I hear you say.  Well all pharmaceuticals have substances in them that are not found in nature and therefore the body can respond in unpleasant ways such as getting drowsiness and headaches.

Side effects of steroid sprays and drops can include fatigue and even mood swings.  Steroid treatments for hayfever can also play havoc with the natural production of cortisol, which helps us wake up alert in the morning, deal with stressors throughout the day and lowers to help us sleep at night.

There are natural alternatives that work in the same way as pharmaceutical products, as I’ll discuss below, which can help alleviate the symptoms of allergies.  But as I will go on to explain, you still need to treat the cause when it comes to allergies, as histamine is an important and useful chemical in the body that regulates where the blood flows to, so ideally we only want to use these substances to deal with the symptoms whilst we treat the cause.

Natural Anti-Histamines

  • Notably the bioflavonoid quercetin has been found in a number of studies to have a natural anti-histamine effect. This natural substance is found in foods such as buckwheat (particularly buckwheat tea), onions, green Picture of onions and garlictea, apples and berries but is even more beneficial in supplement form.
  • Vitamin C containing bioflavonoids can have a powerful effect in treating hayfever symptoms, as the bioflavonoids increase the absorption and therefore the antioxidant and anti-histamine action of the vitamin C.
  • Methionine helps break histamine down and binds it to get it out of the body, as some people can’t break down histamine in the body effectively due to certain variations in their genes.
  • Substance such as Beta Glucans and Lactobacillus L92 help to modulate immune function.
  • Substances such as Boswellia, Luteolin and Curcumin are all natural anti-inflammatories.

Natural Alternatives to Steroid Sprays and Drops

  • Netti potting can have a similar effect as steroid sprays and eye drops without the side effects and urine therapy can increase its effectiveness even further.
  • Haymax is a natural and non-toxic preparation which can be put in the nostrils and under the eyelashes to catch any pollen and reduce aggravation to the eyes and nasal passage.

Immunotherapy

Picture of bee collecting pollenImmunotherapy is about introducing a tiny bit of the substance you are allergic to into the body with the aim of getting the immune system to become effective at dealing with it.  However, most forms of immunotherapy are through injection.

Injections go straight through the first line of defence of the immune system into the blood stream – as you’ll see below, that’s how we get allergies in the first place, by compromising that first line of defence, which is extremely stressful and dehydrating to the body, further worsening the conditions under which the allergy manifested in the first place.

Bee pollen can be a useful oral form of immunotherapy, starting with 1 grain under the tongue and increasing by a grain a day as long as no reaction is felt.

Causes of Hayfever

Leaky Membranes

So as I’ve stressed above, treating the symptoms can provide initial relief but we must also treat the cause.  So how do allergies exist in the first place.  Pollen is not a dangerous substance is it?  We have an external skin, but did you know that we also have an internal skin, our mucous membranes, where our skin turns inwards in our urinary tract, respiratory tract, gastrointestinal tract and also the reproductive tract for us females.  This internal skin is meant to keep things that we breathe in or ingest out of the blood stream.  We cannot have an allergy unless something has somehow got through that internal skin.  So how can that happen?

The membranes of our internal skin can become “leaky” for a number of reasons.  The main reason is when we suppress an appropriate inflammatory response.  We can have inflammation as the result of an external injury, such as a cut or a bite or an injury to tissue, but also as the result of excessive toxicity within the body.

Toxicity can build up not just through what we ingest, breathe in, or think, but also through what we suppress.  So the body might have the need to release toxins through diarrhoea, vomiting, increased perspiration or even, for us ladies, heavier menstruation.  However, we often thwart the body’s attempt to release the build up of toxins by using medications and products such as anti-perspirants, which stop symptoms but lead the body to throw an inflammatory response to try and deal with the toxins.

Detoxification

In addition, if the bodies routes of elimination (bowel, liver, lymph, etc) are not working effectively then this can alsoThe word detoxification typed on a typewriter prevent the toxins from getting out.  So then what happens (which also happens in injury) is that the white blood cells will move towards and stick to the side of the blood vessels, histamine is released into the area and the blood vessel becomes more permeable, so that the white blood cells which are part of our immune system can start cleaning up that area for us.

Pain, swelling, redness and loss of function occur as a result of our body trying to rid itself of the toxicity.  It is an intelligent response.  If this is allowed to run its course, the white blood cells can get through into the tissue, clean up the situation, and then the blood vessels will cease to be permeable.  However, if this response is suppressed by medications, for example anti-inflammatories, then the process cannot take place, the toxicity goes deeper and the blood vessels remain permeable, or “leaky” as the body recognises that there is still toxicity that needs to get out and keeps that membrane permeable.

Repairing Leaky Membranes

Where the membranes in the gut, or indeed anywhere else, are leaky, allowing the allergen into the blood, there are a number of useful supplements.  These include:

  • L-glutamine
  • Colostrum (for those who are not allergic to dairy)
  • Collagen
  • Zinc
  • Vitamins A and D (which should be taken together as they compete for cell receptor sites)

Again, advice should be sought as to what to use when and for how long, depending on the particular issues presenting.  This is why I never give dosages for supplements in my blogs, as without guidance people can continue taking inappropriate supplements for inappropriate lengths of time and throw off their vitamin and mineral balance.

Lowered Immunity

Even if a substance permeates our internal skin and gets into the blood, our immune cells should still be able to deal with it, as long as our routes of elimination are working well.  But when the amount of toxicity coming into our body is greater than the immune cells can deal with or our routes of elimination aren’t operating well enough to get the toxins out effectively, of which dehydration is a huge part (read my blog about water to find out more), then the immune system’s next intelligent reaction will be to batten down the hatches to try and keep the allergen out.

So our immune system hasn’t “gone wrong” – it’s actually trying to protect us.  The symptoms of hayfever, created by the release of histamine, which is a natural substance that is part of our immune system, are there to keep things out of our blood stream by sneezing out the pollen, creating mucous or creating itching which makes our eyes and nose water.

How to Decrease Our Toxic Load to Improve Immunity

It is good to take out both inflammatory foods and foods that we react to.  But we also need to look at the amount of Picture of someone using wi-fi on their mobile phonetoxins we breathe in or absorb through our skin in our cleaning products and put on our skin in terms of our personal care products.

Is the water we are drinking clean?  Is the air that we are breathing in in our homes clean?  What about electromagnetic frequencies in our homes such as our wi-fi, bluetooth, smartphones, wireless devices?  Do we switch them off at night?  Can we hardwire our computers and switch the wi-fi off altogether?  Is our food organic or covered in pesticides (or, in the case of meat, antibiotics)?  Are we eating processed food that the body cannot recognise or are we eating whole unprocessed foods? Do we smoke, or take recreational drugs, or prescription drugs?  Toxicity can come from a whole host of places, but the aim of a good naturopathic healing programme is to look at ways to reduce exposure as much as possible.

How to Increase our Ability to Eliminate Toxins

Sleep

Sleeping between 10:00pm-12:00am actually gives us the most restorative sleep of the whole night.  Our body uses sleep to repair itself, so ensuring we turn off our electrical devices at least an hour before bed can help us get into deeper sleep when we do hit the pillow.  Studies show increased imbalances in those people who sleep less than 7 hours a night and 7-9 hours is what we should all be aiming for.

Diet

picture of some vegetables

We can use diet not only to nourish, but also to cleanse.  But we need to make sure before we start doing things like green smoothies, juicing, fasting, superfoods, etc that our routes of elimination are open and working well, as when we start releasing toxicity from our cells by using food in this way, we need to ensure the body can see it out and allow it to exit efficiently.

Improving Bowel Function

Psyllium husk, prokinetics such as Iberogast, enemas or soaked flaxseeds (the latter is contraindicated in those with diverticulitis) are all excellent ways to ensure the bowels are open.  And we cannot have our bowels working effectively unless we are hydrating with 4 pints of clean plain water a day (see my blog on water).

Improving Liver Function

We can open up liver with castor oil packing, coffee enemas (contraindicated in those with adrenal stress).  Milk thistle, glutathione, n-acetyl cysteine and alpha lipoic acid can all help the liver to detoxify more effectively.

Improving lymph flow

Exercise, massage and lymph brushing can all help to move lymph, but we want to ensure bowels and liver are working well before we start to move lymph otherwise the toxins that we release will have no exit route.

Stress

Stress can also play a part in the onset of allergies as when we are under stress we produce the stress hormone Woman holding head in handscortisol which has the effect of directing energy away from the immune system. We cannot be in a state of “fight, flight or freeze” at the same time as “rest and repair”.

Stress reduction techniques

  • Journaling
  • EFT
  • Mindfulness
  • Chanting
  • Meditation
  • Laughter
  • Gratitude journaling
  • Doing something every day that you enjoy
  • Taking a daily walk in nature for 20 minutes
  • Linseed tea – see my recipe for linseed tea
  • Adrenal packs – foundations of health blog
  • B vitamins, particularly B5, are gobbled up under stress so supplementing with a well balanced vitamin B formula, high in B5, can be useful.

Gut Issues

The other major factor that can play a part in lowered immunity is the disruption of our microbiome, the community of microbes that live in and on us, in our guts, our mouths, our skin, etc, through antibiotics, poor diet and “hygiene” – i.e. the use of antibacterial handwashes, etc.  Healing any gut issues is paramount when dealing with allergies, given that 80% of our immune system is in the gut.

Healing the Gut

How we do this depends on what is going on with the gut, which lab testing can show us.  For example, we can have pathogenic organisms living in the gut that can impair our digestion and make our gut “leaky” so that we develop food intolerances and testing will show us what is residing there.

Picture of digestive systemProbiotics

We can also increase the beneficial bacteria such as Lactobacillus GG.  Sacharomyces Boulardii can also be very useful in helping to maintain a healthy balance of bowel flora.

But throwing probiotics at the situation will not repopulate our bowel flora.  In order to really get the balance back we need to provide our bowel flora with the foods they need to thrive. This includes prebiotic foods and fermented foods are key.  However, depending on an individual’s particular gut issues, probiotics and prebiotics may not be something we initially jump into. This is because in some issues, such as histamine intolerance or SIBO, it can make symptoms worse.  This is why testing is so useful.

Digestive enzymes

Digestive support in the form of digestive enzymes and Betaine HCl can also be useful in helping to restore the gut. However, a caveat is that some people should not take Betaine HCl. Also, there are people that do produce too much stomach acid (although many others do not produce enough, despite having symptoms such as acid reflux). Therefore, a skilled practitioner can help decide whether Betaine HCl is appropriate for you.

Another important factor in healing the gut can be to remove inflammatory foods. This includes dairy, gluten and sugar and anything else that a person may be reacting to, which can be deduced via an elimination diet.

An inability to make our own anti-inflammatory messengers

Tissue hormones called prostaglandins modulate inflammation in the body.  If we have not got the raw ingredients to make our prostaglandins, this may affect our ability to naturally switch off an inflammatory response.

How to make our prostaglandins

To make sure we are able to make our own anti-inflammatory messengers, we need to give our body what it needs toPicture of various supplements in someone's hand make them, namely a good quality multivitamin and mineral containing zinc, selenium, vitamin C, vitamin E, magnesium, omega-3 and omega-6, vitamin B3 and vitamin B6.  We need to make sure the liver is able to deal with omega-3s before we introduce them. Therefore, it’s a good idea to prepare the body by taking 2 teaspoons of good quality lecithin a day.  Sources of omega-3 include flaxseed oil, with which you need to take lecithin to emulsify it, and krill oil, which contains its own emulsifier.

References

Akramienė, et al. (2007). Effects of b-glucans on the immune system

Ashraf R and Shah NP (2014). Immune system stimulation by probiotic microorganisms. Crit

Aziz et al. (2018). Anti-inflammatory effects of luteolin: A review of in vitro, in vivo, and in silico studies.

Hewlings, S. J., & Kalman, D. S. (2017). Curcumin: A Review of Its’ Effects on Human Health. Foods (Basel, Switzerland)6(10), 92. doi:10.3390/foods6100092

Mlcek J, Jurikova T, Skrovankova S, Sochor J. (2016). Quercetin and Its Anti-Allergic Immune Response.

Siddiqui, M. (2011). Boswellia serrata, a potential antiinflammatory agent: an overview. Indian journal of pharmaceutical sciences73(3), 255-61.

Younes, A. K., & Younes, N. K. (2017). Recovery of steroid induced adrenal insufficiency. Translational pediatrics6(4), 269-273.

How To Make A Ginger Kidney Pack For Kidneys, Adrenals and Cystitis

What are Kidney Packs Useful for?

  • Cystitis
    Picture of some root ginger on a wicker tray
  • Kidney stones
  • Adrenal glands

How do Ginger Kidney Packs Work?

  • Ginger kidney packs assist kidney and adrenal function by strongly increasing blood circulation and movement of body fluids and getting rid of stagnation in these areas.
  • The strong continuous heat from the ginger and hot water penetrates deep into the body by dilating blood vessels to move stagnant fluid, helping to break up accumulated mucous, fatty and mineral deposits. Ginger also penetrates easily into the body.

When Shouldn’t you use a Ginger Kidney Pack?

  • Babies or very old people
  • Pregnancy
  • Appendicitis
  • Pneumonia
  • High fever
  • If the bowels aren’t moving at least once a day, in which case you should look at natural techniques such as psyllium husk (making sure you have good hydration in place first) and enemas to get them moving.

 How do I Make a Ginger Kidney Pack?

  • Finely chop in a blender or grate about 4-5 ozs of fresh root ginger (or a good tbsp. of ginger powder)
    Picture of a nut milk bag
  • Place the grated / chopped up ginger into an old white cotton sock tied at the top (no die on it). If you don’t have one you can just sieve the ginger off at the end or use a nut mylk bag.
  • Put the ginger (still in the sock / nut mylk bag) into a pan with 1 litre of clean water. Bring it almost to the boil but don’t allow it to reach boiling point as this will decrease the properties of the ginger.  Then turn it down to a simmer for 15 minutes on the lowest heat.
  • Drain the hot ginger liquid into a pan and soak some castor oil packing cloth in the water.
  • Apply it as hot as you can bear to the kidney area without burning yourself.
  • Wrap yourself in a folded towel and pin it round you to keep the kidney pack in place and maintain its heat.
  • Refresh the pack in the hot ginger water approx. every 5 minutes until the flesh slows a lasting deep red colour (usually takes 20-30 minutes).
  • Use freshly prepared ginger water each time you do a kidney pack.

How Often Should I Use A Ginger Kidney Pack?

  • The simple answer is, whenever you feel like!  Any time the body or mind is under stress, or you have a kidney related issue such as cystitis or kidney stones, ginger packs can be very helpful, as long as the bowels are working well.
  • If you want a bit more of a structure, you could use it 3-5 times a week for a month or you could do a course for a week every day.

References

Hamed, M. A., Ali, S. A., & El-Rigal, N. S. (2012). Therapeutic potential of ginger against renal injury induced by carbon tetrachloride in rats. TheScientificWorldJournal2012, 840421.

Mashhadi, N. S., Ghiasvand, R., Askari, G., Hariri, M., Darvishi, L., & Mofid, M. R. (2013). Anti-oxidative and anti-inflammatory effects of ginger in health and physical activity: review of current evidence. International journal of preventive medicine4(Suppl 1), S36-42.

The Ketogenic Diet – What is it and How Does it Work?

The Ketogenic Diet – Not Just About Weight Loss

Picture of good fats and meatYou may have heard about the ketogenic diet and the success that many people have had using it to safely lose weight.

But what is it and does it have other benefits other than weight loss?

Let’s explore….

History

The ketogenic diet has actually been around since the 1920s. It was originally used in treating epileptic seizures, very effectively in fact.  It is known for improving mitochondrial function and cognitive function.

How it Works

The aim of the ketogenic diet is to get the cells of the body to start burning fat for fuel in the form of ketones instead of glucose.  The diet is based on keeping carbohydrate intake at 10% or under of your diet, which amounts to 30 grams max of carbs a day.  And, contrary to popular belief, protein is not a huge part of the diet, at only 20% of your daily food intake.

Things to Note

Good Fats

It is fat, and when I say fat I mean “good” fat, that makes up the majority of the diet, at around 70% of your daily Picture of avocado, nuts, oils and olivesintake of food.  Healthy fats include coconut oil, cold pressed organic oils (in dark glass bottles as the light can turn them rancid), nuts, seeds, coconut, olives, avocado, organic butter and ghee, to name just a few options.

There are a number of things to watch out for, however.  Firstly, if someone’s liver is struggling to process the amount of toxins they are ingesting on a daily basis or if there is stored toxicity in the body, as is the case with many health conditions, then a good detoxification programme to open up the bowels and liver and see that waste out is essential and would include things such as castor oil packing, psyllium husks, lecithin, soaked seeds or even enemas to ensure that the liver is able to break down the fat that is being consumed.

Hydration

Another important factor is that the person needs to ensure they are getting adequate hydration on a daily basis A picture of flowing water(read my article on water for further info) and also that they are taking in electrolytes (which can be helped by taking a pinch of Celtic sea salt or Himalayan salt before each glass of water).  Coconut water and energy drinks are not a great way to take in electrolytes as the sugar in them will almost certainly take you out of ketosis.

Another thing to be aware of is that long-term ketosis can affect your hormones so it is wise, especially for women in the run up to menstruation, to employ “carb cycling”, which involves increasing the amount of carbs around a period and then taking them back down again for the rest of your cycle.

Fasting

Intermittent fasting is also an important part of the ketogenic diet, which can mean fasting for 12 hours at first.  However, if someone is struggling with adrenal fatigue or low energy then this should be done more incrementally. Preferably this would be done with some guidance and a programme tailored at supporting mitochondrial function at the same time. Mitochondrial function is essential for those with conditions such as M.E. (aka Chronic Fatigue Syndrome) and Fibromyalgia.

Exogenous ketones can help someone get into ketosis more easily and avoid what is known as the “keto flu” when used in conjunction with the other advice above, the keto flu being flu-like symptoms that can occur as part of the adaptation process of switching from using glucose to burning fat for energy.

A diet as low in carbohydrates as the ketogenic diet is not advised for pregnant or breastfeeding women, nor children. This is because they need a higher intake of carbohydrates.

Other Health Benefits

Nutritional ketosis is very different to keto acidosis, which is a dangerous condition, and so should not be confused. Picture of a brain encased in a lightbulbNutritional ketosis is highly anti-inflammatory and there is research out there to show that it improves cognitive ability which gives it the potential to help neurological conditions such as Parkinsons or Alzheimers, helps balance blood sugar in both type I (with guidance) and type II diabetes and can even protect against cancers.  So it is so much more than just a weight loss diet.

If you want to know more about the ketogenic diet and whether you can use it to improve physical or mental performance, reduce inflammation, lose weight or you want to find out how it can help your particular health condition, please contact me to arrange a free and informal 15 minute chat.

References

Barañano, K. W., & Hartman, A. L. (2008). The ketogenic diet: uses in epilepsy and other neurologic illnesses. Current treatment options in neurology10(6), 410-9.

Hallböök, T., Ji, S., Maudsley, S., & Martin, B. (2011). The effects of the ketogenic diet on behavior and cognition. Epilepsy research100(3), 304-9.

Miller et al. (2018). Nutritional Ketosis and Mitohormesis: Potential Implications for Mitochondrial Function and Human Health.

Rogovik, A. L., & Goldman, R. D. (2010). Ketogenic diet for treatment of epilepsy. Canadian family physician Medecin de famille canadien56(6), 540-2.

strawberries and cream

Cashew Nut Cream

Are you dairy free or vegan and missing your strawberries and cream this summer?  Well you don’t have to miss out!  Check out my recipe for cashew nut cream.

Linseed Tea – How To Make It & Health Benefits

Picture of linseeds and linseed tea on a saucerIn last month’s “Foundations of Health” blog series, I wrote about the importance of water for hydration.  This month, I’m taking a look at linseed tea.  Linseeds (also known as flaxseeds) are an excellent source of omega 3 fatty acids.  They are also rich in fibre.  But, most importantly, they have an amazing mucilaginous quality that, when made into linseed tea, allows the body to hold onto water.  In fact, linseed tea is one of the most hydrating drinks you can have, coming a close second to water itself!

Importance of hydration

Your body is made up of approximately 75 trillion cells, which need the best possible internal environment to live in to maintain optimal health.  Two things crucial to cell health are oil and water.  We need them both to run our body systems, just like a car!  So linseed tea is an excellent way to re-introduce oil and water to our cells.

Once our cells know that they are getting enough good quality hydration, they can start to release toxins, as long as our routes of elimination are working properly (lovely fluid lymph drainage, fluid blood flow, good liver detoxification processes, good bile production and good elimination via our bowels twice a day).

This is incredibly important for reducing inflammation, which is implicated in pretty much every health condition, including chronic pain, fibromyalgia, chronic fatigue syndrome, cysts, fibroids, endometriosis, neurological conditions such as Alzheimer’s and Parkinson’s, etc.

How to drink linseeds

picture of a string mopYou can also drink the seeds whole, which will introduce fibre to bulk out your stools so that you can eliminate more waste as the linseeds gently cleanse the intestinal wall like a mop!  They will pass through whole, so don’t be alarmed if you see them reappear in the toilet!

Because they are so good at hydrating, they really offer a soothing message to our cells, to such an extent that drinking 1 litre of linseed tea a day can actually have a profound effect on anxiety and panic attacks!  I call it liquid Valium because of its calming, soothing effects.

How to make linseed tea

So that’s the benefits, but how do you make it?  Well there are two ways, the traditional way and the cheat method.  The traditional way is even more effective at soothing and calming as it creates a more mucilaginous consistency, but the cheat method is good for those who would find the traditional method another stress – remember, stress = dehydration!

You can increase the amount of linseeds to make a thicker tea (I find the thicker tea more soothing) or reduce them to make a thinner liquid which some people find more palatable.  If making it the traditional way, you can make a batch and store it in glass bottles / jars for up to 3 days in the fridge.

Cheat spelt out with scrabble lettersCheat method

So, for the cheat method, when you wake up get yourself a litre stainless steel flask (not plastic due to its toxicity), pop 2 tbsp linseeds in, fill the flask to the top with boiling filtered water, pop the lid on and leave for 6-8 hours.  When you’ve let it “brew” for a few hours, sip throughout the day, drinking the seeds whole for their cleansing effect.

Traditional Method

The traditional method involves a large stainless steel pan, filled with about 2 or 3 litres of cold filtered water.  I use 6 tbsp linseeds for a thick tea, you might want to start off with 3 or 4 and see how you like the consistency.  Better to start low and build up as many people find the thinner it is, the more palatable.  Bring the seeds and water almost to the boil but as soon as you see it starting to boil, switch the hob off as it can overflow very quickly, leaving a gloopy mess all over your cooker!  Leave it to sit for 6-8 hours later (or overnight).  Then simmer it on a low heat for an hour.  After an hour, it’s ready to drain the seeds away and drink.  It’s easier to drain the seeds once it is still hot as it gets more mucilaginous when it cools.  Once cooled, it can be stored in glass containers in the fridge for up to 3 days.

Happy hydrating!

References

Goyal, A., Sharma, V., Upadhyay, N., Gill, S., & Sihag, M. (2014). Flax and flaxseed oil: an ancient medicine & modern functional food. Journal of food science and technology51(9), 1633-53.

Kajla, P., Sharma, A., & Sood, D. R. (2014). Flaxseed-a potential functional food source. Journal of food science and technology52(4), 1857-71.

Su, K. P., Matsuoka, Y., & Pae, C. U. (2015). Omega-3 Polyunsaturated Fatty Acids in Prevention of Mood and Anxiety Disorders. Clinical psychopharmacology and neuroscience : the official scientific journal of the Korean College of Neuropsychopharmacology13(2), 129-37.

Vitamin B12 – Why You Need It & Sources

Between 1-6% of people in the UK are deficient in B12. According to NHS GP Dr Ayan Panja, who explains that Vitamin B12 deficiency can occur even when someone’s blood results come back in “normal” range. The problem is that the tests do not look at the functioning level of B12 in the cells, only in the blood serum.  Also, what may be “normal” for one person may be low for another.  There are other tests that can indicate someone’s levels of B12, such as the Organic Acids Test that I use for my clients. Or, by measuring homocysteine levels which are inextricably linked, high levels of homocysteine raising concerns around both B12 and folate.  But why is B12 so important?

picture of man asleep on desk at his computerWhat do we need B12 for?

B12 is an important nutrient for making our DNA, regulating the building blocks that make us and is crucial for the functioning of the cells of the central nervous system.  Deficiency can lead to significantly reduced energy levels, difficulty with detoxification and neurological symptoms.

Source of B12

So where does B12 come from?  Well, B12 is made via bacterial fermentation.  The bacteria that B12 is produced from exist in abundance in the gastrointestinal tracts of animals, which originates from the soil they ingest.  This is why animal sources of B12 are the most bioavailable form, particularly meat, poultry, eggs and fish.  But even animals nowadays are supplemented with B12.  Dairy produce is much lower in B12.

picture of sauerkraut in a mason jarVegan and vegetarian diets

So, where can vegetarians and vegans get reliable sources of B12 from?  Well, fermented foods such as sauerkraut, kimchi, vegan kefir, miso and tempeh are also good sources. Also, sea vegetables (from a clean source) are a great source.  But essentially, in order to ensure you are taking in enough B12 as a vegan or vegetarian, you should be supplementing.  B12 can be stored in the body for long periods, so deficiency symptoms may not become apparent for at least 3 years after someone becomes vegetarian or vegan.

For those of you who aren’t vegan or vegetarian, particularly if you are suffering from fatigue, cognitive problems, diabetic neuropathy, viral hepatitis, anaemia or a neurological disorder, B12 is a must to get tested for. Because, whilst you may be getting sufficient amounts in your diet, you might not be able to absorb it. Particularly if you have low stomach acid (one sign of which can actually be heartburn) or pancreatic insufficiency (signs of which may be difficulty digesting fats).  In fact, so many people nowadays are placed on Proton Pump Inhibitors such as Omeprazole (almost all of my clients who come to see me with health conditions are on Omeprazole!) that this is certainly a consideration, as these drugs reduce the amount of stomach acid.

Picture of digestive systemMedication and B12

Those on metformin or potassium supplements are also a risk group and those of us over 60 are at even greater risk.  Anyone with a history of alcohol abuse, gastric or bowel surgery or Coeliac disease should also ensure they get their levels checked.  Also, doses of 500mg or more of Vitamin C taken with meals can limit our uptake of Vitamin B12, so if you are on high dose Vitamin C supplements, take them at least 2 hours away from your B12 supplement.

B12 supplementation

But how reliable is supplementation?  Well most problems with B12 arise from an impaired ability to absorb nutrients from food, such as with pancreatic insufficiency, low stomach acid or conditions such as Coeliac and Crohns Disease.  So supplementation is not always very effective.  But taking a sublingual form (ie it is absorbed under the tongue) can be much more efficient, and a good daily supplemental dose would be 1000µg.  It certainly isn’t sufficient to rely on the amounts in multivitamins, so I suggest all my vegan and vegetarian clients take a supplemental dose as multivitamin tablets do not provide B12 in sufficient amounts.

The most readily utilised forms of B12 are methylcobalamin and hydroxycobalamin and sublingual supplements that contain both are a good choice.  However, some people may be more suited to methylcobalamin and others more to hydroxycobalamin. It depends on their own individual biochemistry. So, it’s always worth working with a practitioner who can look at the whole picture. This is where lab testing and genetic testing can be particularly useful to tailor someone’s health and wellbeing programme.

References

Ahmed, M. A., Muntingh, G., & Rheeder, P. (2016). Vitamin B12 deficiency in metformin-treated type-2 diabetes patients, prevalence and association with peripheral neuropathy. BMC pharmacology & toxicology, 17(1), 44.
Gilfix, B. (2005). Vitamin B12 and homocysteine. CMAJ : Canadian Medical Association journal. 173(11), 1360.
Heidelbaugh (2013). Proton pump inhibitors and risk of vitamin and mineral deficiency: evidence and clinical implications. Therapeutic advances in drug safety, 4(3), 125-33.
Linder et al. (2017). Drug-Induced Vitamin B12 Deficiency: A Focus on Proton Pump Inhibitors and Histamine-2 Antagonists.
McMullin et al. (2003). Homocysteine and methylmalonic acid as indicators of folate and vitamin B12 deficiency in pregnancy.
O’Leary, F., & Samman, S. (2010). Vitamin B12 in health and disease. Nutrients, 2(3), 299-316.
Panja, A. The prevalence of Vitamin B12 deficiency – An interview with Dr Ayan Panja. https://blog.cytoplan.co.uk/prevalence-vitamin-b12-deficiency-interview-dr-ayan-panja/
Schilling, R. (1955). The Absorption and Utilization of Vitamin B12. The American Journal of Clinical Nutrition