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.

M.E./Chronic Fatigue Syndrome & Fibromyalgia

Picture of ME/CFS & Fibromyalgia Awareness Day RibbonMillions Missing

May 12th is ME and Fibromyalgia Awareness Day.  Across the world today a campaign called #millionsmissing will be taking place.  Events have been arranged in cities worldwide where people with ME’s empty pairs of shoes are laid out. The shoes are labelled with a message about how they are missing from their lives due to ME. The aim is to highlight the devastation that this condition causes to 17-20 million people worldwide. As for Fibromyalgia, it affects between 1.2-2.8 million people in the UK and 3-6% internationally.

Unanswered questions

It’s clear Fibromyalgia and ME can cause so much devastation to so many people’s lives. So, why is the medical profession still devoid of answers? And why do people with these conditions struggle to be understood by professionals that are supposed to support them? People with these conditions also deal with in disbelief from their friends and families?

Invisible symptoms

Part of the problem is that in many cases, the symptoms are invisible.  Chronic pain, cognitive difficulties, post-exertional flu like malaise after minimal physical or cognitive activity. At my worst, something as small as holding a conversation for 10 minutes or eating a meal would leave me exhausted! Other symptoms include gastro-intestinal problems, dizziness, coordination difficulties, poor balance, poor body temperature regulation. Suffers also experience increased heart rate on sitting to standing. This means the heart is working much harder to keep the person upright due to a lack of energy being produced.

These are just some of the symptoms of these conditions and are a far cry from the common perception that ME/CFS is about being tired!  Another part of the problem is that they fluctuate. Therefore, people see you doing things that they’d expect you not to be able to do. However, they then don’t witness the exacerbation of all your symptoms afterwards and the debilitating effect that this can have.

Diagnostic tests

I think the biggest problem is the apparent lack of a diagnostic test.  There are lab tests (I run many of these for Picture of lab technician testing samplesmy clients) that can show up biochemical dysregulation. This shows abnormalities with mitochondrial energy production, parasitic infections, gastrointestinal imbalances and cortisol levels. This gives us a lot of information about how to work with the adrenals. We also get full thyroid panels, heavy metal toxicity, mycotoxin exposure etc. that can all result in ME/CFS.

But none of these tests are available through conventional medicine.  So is it that there is no test, or is it that when someone’s blood panel comes back as “normal” they simply aren’t looking for the right markers that would indicate biochemical dysregulation?

Physiology of ME/CFS & Fibromyalgia

So what do we know about what’s going on inside the body in these conditions? Well, we know that there is dysfunction in the mitochondria in the cells that are responsible for producing energy. We also know that there is dysregulation of the HPA axis, and immune dysregulation. Also, that people experience extensive inflammation and the body’s drainage systems are not working effectively. Nearly everyone I have encountered with these conditions has gastro- intestinal issues.

Is it physical or psychological?

Despite all of this evidence from researchers, particularly with ME/CFS, there is still much controversy about whether it is a physical condition. The aim of this blog is not to get into the politics of why this controversy exists and is perpetuated. Suffice to say that, amidst clear research showing physical signs of biochemical dysregulation, it still exists. One can only postulate as to the secondary gain that could be had by the powers that be in continuing to perpetuate this.

SIBO

For me, looking back at my medical records there were actually signs of something physical going on.  I had delayed gut motility (delayed emptying from the stomach into the duodenum). I also had duodenitis (inflammation in my small intestine). This discovered over 20 years ago but never mentioned to me.  We now know that delayed gut motility is a major contributory factor to SIBO, the cause of 60% of IBS!  A recent study showed that 90% of people with Fibromyalgia have SIBO. SIBO is where bacteria have overgrown in the small intestines, producing endotoxins and nutritional deficiencies. I also had numerous blood tests showing raised levels of eosinophils and decreased white blood cell count, indicating some kind of immune dysregulation, again left unaddressed.

Picture of bacteriaIron deficiency

It wasn’t until another practitioner suggested I get a full iron panel rather than the standard iron tests that I found I had iron deficiency. The bacteria overgrowing in SIBO can actually eat your nutrients as they start to eat your food before you can absorb it.

The type of SIBO I had wasn’t even showing up on private lab tests as I had something called hydrogen sulphide SIBO. This has no definitive test at the moment, just signs from existing lab tests.  And that particular type of bacteria can…. guess what?  Damage the mitochondria in your cells that are crucial for energy production!

SIBO can also cause visceral hypersensitivity. This could explain why, if 90% of people with Fibromyalgia in one study were shown to have SIBO, they also had increased hypersensitivity to pain.  Even after I trained and qualified as a naturopath, it took me a lot of continuing training to work out all of these pieces of the jigsaw.

Naturopathy with chronic illness

So how can naturopathy help ME/CFS and Fibromyalgia?  Well, firstly, naturopathy, looks at disease quite differently to conventional medicine. Disease is a process which establishes itself over a period of time. When I first had my case history taken by a naturopath, I was surprised to see that I hadn’t suddenly been struck down by the virus that appeared to have started my ME/CFS. In reality, there had been signs of dysregulation, albeit minor, from an early age.

Naturopathy also looks at the body as a whole entity, not separating the body and the mind. ME/CFS has been cited to have numerous causes. A virus was the straw that broke the camel’s back for me. For other people, it might be a traumatic event, an injury, an infection, childhood trauma, or ongoing stress. This has led to much debate within the ME community as to whether someone is correctly diagnosed with ME if their ME does not start with a virus.

But to me this is missing the point. Heart attacks can be caused by several different causes – stress, physical blockages, the food we eat, lifestyle, etc.  But despite the fact that there can be numerous causes of heart attacks, nobody disputes that they are a physical condition. Nor that the end result is the same or that any stress or lifestyle factors that led to its onset need addressing. The job of a naturopath is to work out the case history to assess how the body got to that position in the first place and start to unravel it. Then you can start giving the body what it needs to kickstart its own innate healing ability.

My story

I developed M.E. back in 1996, followed by Fibromyalgia a few years later.  In my case, adverse childhood events ledWoman holding head in hands to an overproduction of stress hormones on an ongoing basis. Continual production of cortisol led to my immune system and my digestive system shutting down.

Dry skin

The first signs of something wrong were extreme dry skin. Unbeknown to me, this was a sign that my body was dehydrated. I had no clue until I became ill that I even needed to drink 4 pints of water a day to keep myself hydrated and that drinking tea and coffee was not the same thing.

My Diet

My diet was poor, which would certainly have been affecting my microbiome. We now know that this complex community of microbes that lives inside us are so important for the health of our bodies and minds. Couple this with a digestive system that was not working effectively and I began to develop numerous food allergies and intolerances. Which, you cannot have without gut permeability where the lining of the gut becomes permeable, allowing partially undigested food into the blood stream that shouldn’t be in there! So, I wasn’t absorbing the nutrients from my food. At the same time my body was launching an attack on what I was eating, giving rise to inflammation.

Stress

This contributed to further internal physical stress, which elevated my cortisol levels further. This gave rise to an overproduction of histamine.  This resulted in histamine intolerance, which meant that I could no longer eat foods containing high levels of histamine without reacting. It was only after my training as a naturopath and further continuing professional development that I worked out that I had histamine intolerance.

Digestion

I was put on antacids due to gastrointestinal issues, which I later found out gave rise to further problems.  Acid reflux is often caused by not enough stomach acid being produced. This causes the lower oesophageal sphincter to become weak and when this happens the acid can rise up into the oesophagus from the stomach.

SIBO

We need a certain amount of acid in our stomach to break down proteins and to kill any unbeneficial microbes that we might take in through what we eat and drink.  So the antacids contributed to the onset of my SIBO, together with more nutritional deficiencies.

At the time of the onset of my ME/CFS I was working long hours, partying hard and not getting much sleep.  A virus came along and tipped everything over.  For others overtraining can be a contributory factor.  The point is that we all have different reasons as to why we become ill, regardless of the illness and regardless of the causes.

picture of Sherlock Holmes with a magnifying glass searching for cluesRecovery

The job of a good naturopath is to find the clues. Help the client to rehydrate effectively, improve digestion, repair the gut lining, nerve damage. I also use food and supplements to repair any damage to the cells or mitochondria. Finally, it is important to deal with any parasitic infections, bacterial or fungal overgrowth.

Detoxification

Detoxification is a huge part of the process. Using naturopathic techniques to open up the body’s routes of elimination, starting with ensuring the bowels are working correctly. Then the liver, working backwards to the lymph and then the cell.  I know people who have had lymph drainage or massages and said it has made them worse.  Why?  Because if you release lymph before you improve drainage and detoxification pathways, the toxins released from lymph cannot exit the body effectively.

So it’s about doing the right things at the right time in the right order.  Before I started seeing a naturopath I thought I had tried everything – homeopathy, reflexology, numerous nutritionists, osteopathy, the list was endless.  But this opening up of the detoxification pathways in the right order was a big part of the jigsaw.

Stress

For me, changing my stress response which has been hardwired since a child has been another big factor. Together with structural work through a chiropractor as my ribs were not expanding and allowing me to breathe in enough oxygen.  So, whilst I am not saying that naturopathy is the whole answer, it was and continues to be a major part of it.

There’s no magic pill for recovery

So, for all of you reading this who have ME/CFS or Fibromyalgia, I completely understand what you are going through. I have been virtually bedridden for 8 years with both conditions, with a battle over 2 decades to find the answers. Culminating in my own training as a naturopath lead me to a place where I could get back to work.  So please don’t give up hope. Please don’t wait for the magic pill to come along that will cure everything.  I know what it’s like to feel like you have tried everything.

Taking responsibility for my own healing instead of waiting for the magic answer was so empowering. Had I not done so, and learnt everything I have shared with you in this blog, I would still be bedridden with these conditions today.  I am not saying that implementing the naturopathic approach was easy or that it can produce miraculous results over night.

Point to remember

It took me many years to get as ill as I did, so expecting a miracle cure just wasn’t realistic.  And, there was a lot of trying things out to see what worked and what didn’t. But, the main premise with naturopathy is to first do no harm.  And the nutritional changes, supplements, hydration and detoxification techniques I tried did enable my body to kickstart its own innate healing ability.

I am now at a point where I am working as a naturopath, with 2 other part-time jobs as well! This is a world away from where I was. Being too ill to have a conversation for more than 10 minutes, losing the ability to read or having to crawl on my hands and knees to get from my bed to the toilet!

If you want to find out more about how naturopathy can help ME/CFS or Fibromyalgia, please contact me to book a free 15 minute chat.

 

 

Stress – What is it and How to Manage it?

Picture of a man with his head in his hands looking stressedThe month of April has been Stress Awareness month. Today’s article will be looking at different types of stress, their effects on our physical body and how we can reduce our stress through simple dietary and lifestyle changes.

Our bodies are designed to deal with stress. We have an in-built response controlled by the sympathetic nervous system called “fight or flight” that enables us to deal with short-lived stress.  This could be anything from getting out of the way of an oncoming car quickly to having a row with a loved one.

Types of stress

What many people don’t realise is that stress can be physical as well as mental, such as an ongoing infection, gut dysbiosis or a physical accident putting stress on the body systems. Whether physical or psychological, this built-in response gives rise to a whole cascade of physiological effects:

Adrenaline

Is produced to kick start your reactions and then cortisol is secreted to keep you alert.

Sweat

We sweat more to cool down our muscles, which causes water loss.

Blood flow

The blood flow is directed to our extremities and away from the frontal cortex, the part of our brain that allows us to analyse. If you think about primitive man, he needed to be able to react quickly without analysing when approached, for example, by a tiger. Directing blood flow to the extremities allowed him to either run away or fight.  They do so by increasing heart rate, restricting blood vessels and increasing blood pressure.

Waste elimination

The urge to urinate and defecate increases so that the body can lose weight in order to be able to fight more efficiently.

Breathing

Shallow and rapid breathing enables oxygen to be diverted to the muscles to get them ready to run or fight. This will also cause further water loss.

Physiology

Our digestive, reproductive and immune systems shut down to conserve energy in order to fight or run from the impending threat.

Cortisol

Increased cortisol production elevates blood sugar, to give us more energy. It also modulates inflammation within the body. This is all great for short-lived acute stressors as after the stressor has gone our nervous system switches back toInfographic showing the effects of stress on the body, mind, emotions and behaviour parasympathetic, also known as rest and digest.  This is the system responsible for digestion and healing.

Never ending stress

In today’s modern world, stress is often ongoing and chronic. It can be caused by financial problems, problems at work or ongoing family situations. In these situations, our sympathetic nervous system is continually on.  We cannot be in “fight or flight” and “rest and digest” at the same time, so our immune system starts to struggle. Our digestion becomes affected, we lose the ability to think clearly, our memory gets worse, our sleep is affected, and so on.  Sound familiar?

Symptoms of stress

Clearly this cascade of physiological reactions is not desirable on an ongoing basis and can lead to a whole host of physical symptoms and conditions. This can include excessive weight gain from storage of excess cortisol produced under stress, heart attacks, strokes, M.E./CFS and diabetes, to name just a few.  But this isn’t something to get even more stressed out about!  Why? Because, as always, there are things we can do.

Whilst we may not be able to do anything about these external stressors, we can reduce the amount of internal stress. We can do this by making simple lifestyle and dietary changes to reduce the existing load on our bodies and switch back into our parasympathetic nervous system (“rest and digest”).

So how can we begin to make these changes?

Hydration

Well the first thing we need to address is our hydration.  As we’ve seen, Picture of waterthe stress response causes us to lose water and as a result of this it’s really important that we replace that water in the right way daily (see my blog about water).

The other thing we can do is start to cut out those things that we ingest that cause us to lose more water, such as stimulants like sugar, caffeine and cigarettes.  Alcohol and stimulants are often the first thing we reach for when we feel bad. However, we need to give our body the right ingredients to make our own feel good hormones, which we do through food and supplementation.

Nutrition

Even certain foods such as gluten and dairy can cause us to lose water.  Because gluten and dairy are so difficult to digest, the body creates a lot of mucous to try and break them down, and guess what mucous is made from?  That’s right, water!

We can soak any dried foods such as nuts, seeds, legumes and grains for a good 8 hours before cooking or eating them and this well help to increase their ability to hold water.  Just throw away the soak water, give them a good rinse and they are good to go.

Congees, also known as Chinese rice porridge, are an excellent water rich way of using food to hydrate the body.  Moving away from processed foods to a whole food, organic diet full of water rich vegetables is also a good choice.

A healthy plate should be well over half full of water rich organic veggies, (both raw and cooked) and sea vegetables (although anyone with IBS or histamine intolerance may require much more tailored dietary advice, as certain vegetables and seaweeds can trigger a negative response in certain people).

B vitamins and magnesium

Whilst there are many nutrients that we need to ensure we are getting on a daily basis to help our bodies deal with the effects of stress. Two nutrients of particular mention are B vitamins and magnesium.  Any tension anywhere in the body can indicate inadequate levels of magnesium, as magnesium enables us to physiologically relax.  Symptoms such as migraines, cramps, even heartburn, can be caused by insufficient amounts of magnesium.

However, supplementing with magnesium should be done at the right time and at the right dosage as magnesium can cause cells to release toxicity.  If our detoxification pathways are not open enough, this can cause more issues.  This is why another important thing we need to address is improving our elimination of toxins, which will take further stress off our systems.  This can be done through a variety of naturopathic techniques, as well as using diet and fluids to cleanse.  As for B vitamins, they are literally gobbled up under stress, so we can often see a higher need for a good quality B complex in ongoing stress.

Herbs

Herbs are also very useful in helping us normalise the stress response.  They are called adaptogenic as they can allow the body to achieve equilibrium.  However, a word of caution, as some herbs are more stimulating and some more Picture of a variety of medicinal herbscalming.  I like to run a saliva cortisol panel, as cortisol levels vary throughout the course of the day. They start high in the morning to get us out of bed, and reducing at night to allow us to get restful sleep.

However, in the case of long-term stress, the cortisol pattern can take a variety of unhelpful forms, including day night reversal. This is where someone’s cortisol levels are low in the morning, making it difficult to get out of bed, and high at night, making it difficult to get to sleep.  In fatigue conditions such as Myalgic Encephalomyelitis / Chronic Fatigue Syndrome, often people can produce very little cortisol at all.  So, which herbs are used when depends on each individual’s pattern of cortisol and adrenaline production and the use of glandulars may even be required to rebuild the adrenal glands in some cases.

Exercise

We all know that exercise is good for us, but too much exercise, such as heavy training and running, can elicit the same stress response.  Of course, our bodies are designed to be able to deal with some stress, but when exercise becomes excessive, this too can affect us physically.  In cases of adrenal fatigue, such as with M.E./CFS and fibromyalgia, the wrong type of movement can actually have a detrimental effect on the body as the body is unable to regenerate cellular energy efficiently (more on this in my forthcoming blog on M.E./CFS and Fibromyalgia).

Behaviours

We can also change our behaviours.  For example, I always tried to fit so much into my routine that I would be continually late and find myself driving about stressed if I hit traffic.  Now, I try and leave extra time for traffic delays and I can drive about without putting additional stress on myself.  It seems obvious, doesn’t it, but I’m sure we all have habits or behaviours that don’t serve us well, but over which we we have some control.

Emotions

Did you know that unprocessed emotions can actually be stored as physical toxicity at cellular level?  How many of us bottle up our emotions, and stoically bury how we feel and “get on with things”.  There are so many techniques available nowadays to help us safely uncover and clear these emotions. There is EFT (emotional freedom techniques) and EMDR (eye movement desensitisation and reprocessing), hypnotherapy and counselling, to name just a few.

For those of us who have had past trauma, particularly childhood trauma, our system actually becomes hard-wired to sympathetic dominance, i.e. “fight or flight”.  The trauma doesn’t even have to be an obvious trauma like abuse. It could be something like the divorce of parents, a difficult relationship with a parent as a child or bullying at school.  The ACE (Adverse Childhood Experiences) study found a clear correlation between adverse childhood events and chronic health conditions suffered in later life.  This makes total sense when we consider the physiological effects of ongoing stress that we’ve looked at above.

Picture of a woman writing in a journalPositive affirmations

Our thoughts have also been shown to alter how we respond to stress.  In Rhonda Byrne’s book, “The Magic”, we are encouraged to take up a month-long challenge of gratitude journaling.  Having tried this, it definitely changed the way I felt.  I practice Nichiren Buddhism (see here) which has a profound effect on a daily basis on whether I sink into negativity with my thoughts or have a positive outlook.

This was especially important for me when I was bedridden for several years with adrenal fatigue. Focusing on how bad I felt or on every single symptom would only increase guess what?  How bad I felt.  Anyone familiar with Louise Hay’s work will know how positive affirmations can change how we feel.  However, we still need to remember to feel and process our emotions!

Other things that can help us to manage stress include yoga, deep breathing exercises and how regularly we eat. Finally, a great way to release stress is to laugh, and could you think of a better way?!

References

Block, J. P., He, Y., Zaslavsky, A. M., Ding, L., & Ayanian, J. Z. (2009). ‘Psychosocial stress and change in weight among US adults.’ American journal of epidemiology, 170(2), 181-92.
Church, D., Stern, S., Boath, E., Stewart, A., Feinstein, D., & Clond, M. (2017). ‘Emotional Freedom Techniques to Treat Posttraumatic Stress Disorder in Veterans: Review of the Evidence, Survey of Practitioners, and Proposed Clinical Guidelines.’ The Permanente journal, 21, 16-100.
Dimsdale, J. (2008). ‘Psychological stress and cardiovascular disease.’ Journal of the American College of Cardiology, 51(13), 1237-46.
Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, Koss MP, et al. (1998). ‘The relationship of adult health status to childhood abuse and household dysfunction.’ American Journal of Preventive Medicine. 14:245-258
Goldstein, D. (2010). Adrenal responses to stress. Cellular and molecular neurobiology, 30(8), 1433-40.
Kennedy, D. O., Veasey, R., Watson, A., Dodd, F., Jones, E., Maggini, S., & Haskell, C. F. (2010). ‘Effects of high-dose B vitamin complex with vitamin C and minerals on subjective mood and performance in healthy males.’ Psychopharmacology, 211(1), 55-68.
Pakan, J (2015). ‘Counseling to Reduce Stress and Anxiety: A Mixed Methods Study’.
Panossian, A., & Wikman, G. (2010). ‘Effects of Adaptogens on the Central Nervous System and the Molecular Mechanisms Associated with Their Stress-Protective Activity.’ Pharmaceuticals (Basel, Switzerland), 3(1), 188-224.
Popkin, B. M., D’Anci, K. E., & Rosenberg, I. H. (2010). ‘Water, hydration, and health. Nutrition reviews.’ 68(8), 439-58.
Rowe, P. C., Underhill, R. A., Friedman, K. J., Gurwitt, A., Medow, M. S., Schwartz, M. S.,
Speight, N., Stewart, J. M., Vallings, R. Rowe, K. S. (2017). ‘Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Diagnosis and Management in Young People: A Primer.’ Frontiers in pediatrics.
Yaribeygi, H., Panahi, Y., Sahraei, H., Johnston, T. P., & Sahebkar, A. (2017). ‘The impact of stress on body function: A review.’ EXCLI journal, 16, 1057-1072. doi:10.17179/excli2017-480

Infertility – The Causes

Male and female reproductive symbolsThis week is National Infertility Awareness Week.  The universally accepted definition of infertility is being unable to conceive after one year of unprotected sex with no birth control, regardless of cause. In the last 50 years sperm production has dropped by 50%.  Recent research has showed an increase from 1 in 6 to 1 in 8 women who meet this definition and 1 in 10 men.  So what has contributed to this increase in infertility and drop in sperm production?

Causes of infertility

From a naturopathic viewpoint, infertility is caused by a combination of toxicity and dehydration at cellular level. This leads to stagnation and hormonal imbalances.  A study led by researchers at the Harvard School of Public Health showed that making five or more lifestyle changes, can reduce the chances of infertility due to ovulation disorders by up to 80%!

So, let’s take a look at some of the factors that can contribute to this increased toxicity, dehydration and stagnation at the cellular level and how we can overcome them.

Our toxic environment

In today’s world we are bombarded with hormones and chemicals on a daily basis.  They appear in our picture of 2 glasses of milkdairy produce, in our farmed meat and fish and in our water supply. Phytoestrogens such as unfermented and non-organic soy can mimic oestrogen.  There is a whole host of research now showing that plastic packaging leaches oestrogen mimicking chemicals into our foods and drinks.  Stimulants such as caffeine, cigarettes and sugar can also affect the balance of our hormones.  So these statistics come as no surprise.

Add in the pollution in the air that we breathe in every day. And then add in the toxicity from heavy metals, moulds and the use of chemical products we use. We can start to see how toxicity can build up in the body and dehydrate us.  It’s the liver’s job to break down both toxins and hormones and eliminate them. However, the world in which we live now is so far removed from nature that our poor livers are overworked!

Hydration

So first we need to tackle hydration through clean water, staying away from those oestrogen mimicking plastic bottles! (See my blog post on water).  We can add to this with fluids like linseed tea and soaked foods (such as nuts, seeds and grains).  It is key is to remove anything in our control that may cause us to lose water, such as diuretics like tea and coffee, alcohol, fizzy drinks, gluten and dairy.

Stress

Stress also causes us to lose water so this is where learning some good stress reduction techniques can help. Techniques include yoga, breathing, mindfulness or a spiritual practice such as chanting.

picture of some vegetablesNutrition

If what we eat and drink makes us, our hormones, our blood, sperm, eggs, and so on. Then, obviously nutrition plays a crucial factor in our reproductive ability. Therefore, nutrition of course must be addressed first.  We live in a world of fast food and processed foods which have little nutritional value and will not help us in our quest to conquer infertility.

So, a good pre-conceptual plan should look at moving someone away from processed and phytoestrogens towards a whole food diet. From there, you can gradually building up the amount of raw foods that someone can tolerate. Raw foods have a great cleansing ability for those who do not have digestive issues.  (For anyone with digestive issues, fixing the gut first is key, so that we can obtain maximum nutrition for us and baby.)  We can then start to use what we are eating, together with supplementation, to obtain the vital nutrients that are needed to be able to conceive.  Once someone has transitioned over to a whole foods diet, we can then start to use certain foods and fluids to allow the cells to release toxicity.

In the pre-conception phase key nutrients include:

Vitamin E

Which increases fertility in men and women by helping stabilise hormonal balance.  It is also an antioxidant, helping prevent against free radical damage which can affect sperm, egg and also foetus.  Other important antioxidants include vitamins A, E and C and selenium.

EPA and DHA

These are types of essential Fatty Acids critical for sperm production, hormonal balance and cell growth and repair. It should be noted that on a vegan diet EPA and DHA cannot be obtained from food.  Also, some people have difficulty converting the essential fatty acid ALA found in plant based sources to EPA and DHA. So, any factors that inhibit the conversion such as trans fats, alcohol consumption, sugar intake and stress should be avoided.  (See my blog about vegan sources of essential fatty acids.)

Zinc

Zinc is essential for building healthy sperm and eggs, cell division necessary for reproduction and for allowing the egg to implant in the womb.

Folic acid

No doubt everyone has heard of folic acid in pregnancy.  Folate is the natural, more bioavailable form and adequate levels of folate. It is important for the reduction of homocysteine, which has been shown to be high in women who have miscarried.  Sources include spinach, broccoli and liver.  A good supplemental dose would be 800mcg a day.

Magnesium

This is critical for healthy contractions and will help develop the foetus and can be started during the preconception phase, so as not to suddenly produce a cleansing effect on the cells during pregnancy.  It can be found in leafy greens and nuts and seeds such as cashews, brazil nuts and pumpkin seeds.  A good supplemental dose would be 2 x 100mg magnesium citrate capsules before bed.

B vitamins

These are vital for the production of healthy sex hormones and sprouting is an excellent way to introduce them into the diet naturally as sprouting exponentially increases the B vitamin content of what you are sprouting.  For example, soaking and then sprouting mung beans increases their B vitamin content by up to 285%!  Sprouts also provide us with live enzymes and that raw cleansing aspect.

Calcium and iron

Iron and calcium are also critical for the mother’s blood supply to the baby, so it’s a good idea to increase these naturally through foods.  Calcium in particular is better delivered through vegan sources such as sesame seeds, tahini, almonds, hazelnut, kale, hemp seeds, buckwheat and sea vegetables and when we eat a good balanced diet high in these types of food there is no need for supplementation of calcium.  Iron can be found in salmon, meat, seaweeds, soaked nuts and seeds, soaked whole grains, leafy green vegetables and avocados.  (See my vegan blog for more information about getting optimum calcium and iron levels on a vegan diet).

Selenium, arginine and acetyl l-carnitine

These also help in the quantity, quality and function of sperm.

So a good idea, along with increasing these nutrients in our diet, would be to take a good quality multivitamin and mineral (see “Purposeful Supplementation”), a good omega 3 formula such as krill oil, 200mg magnesium citrate before bed, an antioxidant combination and 30mg zinc.  However, everyone is individual, so it is best to work with a practitioner to decide exact requires for supplementation.  Also, the rate at which supplements are introduced will depend upon how well someone’s liver is cleansing, which is established through a full case history, as throwing supplements at a situation can put further work on a sometimes already overworked liver.

Lifestyle factors

Factors such as how much sleep we get per night is also crucial.  For us to maintain optimum health andPicture of a Tablet, mobile phone and laptop wellbeing we need to be getting rid of the toxicity we take in on a daily basis.  Our bodies are designed to cleanse when we sleep and we do the most cleansing between 10pm and 3am, which is all the more reason for us to get an early night!  Factors such as shift-working or the introduction of blue light into our retinas from TV screens, strip lighting, computers, ipads or phones, for example, can affect our ability to produce melatonin, our sleep hormone.  This too can disrupt our ability to cleanse.  Other lifestyle factors that can affect our ability to cleanse at night include how much natural daylight we get straight into our retinas (we need at least 20 minutes a day), exercise and fresh air.

Whilst exercise is of course essential to health and wellbeing, excessive exercise can be detrimental due to the fact that it can produce excessive endorphins which can interfere with the reproductive hormones.  Jogging during a pre-conceptual plan can be detrimental for this reason, as can cycling in tight fitting man-made fibres which creates excess heat in the gynae area leading to increased stagnation there.  Moderate to vigorous walking for half an hour 4 or 5 times a week is a great solution to exercise.

picture of a microwave with the door openElectromagnetic frequencies

There is growing research on the toxic effects of electromagnetic frequencies on our bodies, yet wi-fi, Bluetooth and other wireless technologies that emit these strong fields surrounds us every day.  People place their laptops or ipads on their laps and we keep our mobile phones next to our bodies, often near our reproductive area.  Even x-rays and body scanners such as those in airports can have an effect on our systems.  Microwaves are common place but the frequencies they emit denature the foods and fluids we place in them and render them toxic to the body, as opposed to nutrient giving.

Add in factors such as ongoing stress which disrupts our ability to absorb nutrients from our food, dehydrates us and inhibits the production of sex hormones and we have a perfect storm which then makes this increase in infertility unsurprising.

The pre-conception plan

So it is clear why building a great pre-conceptual plan is key and preparing the body to rehydrate and cleanse.  Where time is of the essence due to age, a pre-conception programme should last for a minimum of around 3-6 months.  However, the optimal time for this is two years.  It is absolutely key during this time that the potential mum-to-be does not try to get pregnant, as cleansing is not advised during pregnancy due to the danger of toxicity releasing into the foetus and endangering its survival.  It’s a good idea to keep things stable throughout pregnancy, so introducing cleansing foods and supplements should be done ahead of conception, not during.

So a good plan should look at reducing exposure to toxic substances and foods, improving our liver’s ability to detoxify by introducing naturopathic techniques such as liver packing and hydrotherapy techniques such as sitz baths to remove congestion in the reproductive system, improving lifestyle factors such as sleep, stress, fresh air, daylight and exercise and limiting exposure to electromagnetic frequencies as much as possible.  And it should focus on the potential dad to be, as well as mum, as the ability to reproduce will hinge on both of their nutrient profiles, levels of dehydration and toxicity.

References

Coletta, J. M., Bell, S. J., & Roman, A. S. (2010). Omega-3 Fatty acids and pregnancy. Reviews in obstetrics & gynecology3(4), 163-71.
Jeong, S. H., Kang, D., Lim, M. W., Kang, C. S., & Sung, H. J. (2010). Risk assessment of growth hormones and antimicrobial residues in meat. Toxicological research26(4), 301-13.
Jorge E. Chavarro, Janet W. Rich-Edwards, Bernard A. Rosner, and Walter C. Willett. (2007). “Diet and Lifestyle in the Prevention of Ovulatory Disorder Infertility.” J. Obstetrics & Gynecology. Vol. 110, No. 5.
Malekinejad, H., & Rezabakhsh, A. (2015). Hormones in Dairy Foods and Their Impact on Public Health – A Narrative Review Article. Iranian journal of public health44(6), 742-58.
McKenna, E., Hure, A., Perkins, A., & Gresham, E. (2017). Dietary Supplement Use during Preconception: The Australian Longitudinal Study on Women’s Health. Nutrients9(10), 1119. doi:10.3390/nu9101119
Mohd Mutalip, S. S., Ab-Rahim, S., & Rajikin, M. H. (2018). Vitamin E as an Antioxidant in Female Reproductive Health. Antioxidants (Basel, Switzerland)7(2), 22. doi:10.3390/antiox7020022
Patisaul, H. B., & Jefferson, W. (2010). The pros and cons of phytoestrogens. Frontiers in neuroendocrinology31(4), 400-19.