How are you? No, but for real. Uncovering anxiety and depression.

How many times have you asked that question yet are not quite ready to hear the full answer? Are you asking to be polite or out of habit or are you truly there to listen. Of course no one is being rude when they ask that question out of habit. Sometimes this question can open up a can of worms and in my opinion, this is where the good comes. This question, "How are you?", if you have more than a second to listen, or more importantly to answer, is a time to get real, to allow those feelings and emotions to come boiling up instead of being suppressed, which can eventually cause physical or mental health issues.

There was a recent study that showed the connection between Alzheimers and stress. This proves, yet again, the connection between the mind and the body. We also hear heart-wrenching stories of those taking their life due to depression, when no one around them knew they were suffering.  I see this mind-body connection every week, both personally and professionally. 

Professionally I ask the question “How are you?", usually hoping for more detail, to figure out if there is an emotional connection to the root of my patients concern. Time and time again there is! Because I understand the mind body connection I ask these questions first before doing any extra testing or giving supplements. I love taking the time to listen. Most people aren’t given that time or space and it can be very therapeutic. 

Personally, building a practice and understanding how to structure it to best suit my needs is hard. I have learned this since I started and still struggle to find the right balance. I can suffer health wise myself because of stress and worry. No job is perfect but being the perfectionist that I am I can’t seem to settle for anything else. I want to help you, I want you to heal, I want to give you that space and be open to truly listening to your answer when I ask how you are. In order to do that I need to find time to answer that question myself, to breath, to meditate, to talk. Practice what I preach. 

Are you feeling overwhelmed, anxious or depressed? Don’t hide it. Find people that can support you. That could be family and friends or it could be someone with an unbiased approach or simply a sounding board; a counsellor, a therapist or me, an ND. We are all happy to listen and to help. It’s time to talk.  

In health & happiness,

Dr. Karen

5-Day Stress & Anxiety Challenge - Get Started!

Vitamin D: Are You Deficient?

Clinic lab test available to you!

This vitamin, or hormone to be exact, is known as the sunshine vitamin. But are you actually getting enough sun exposure to to produce optimal levels of vitamin D?

Vitamin D plays many vital roles in our body. Virtually every cell in the body has a vitamin D receptor, which, when bound to vitamin D, can influence the expression of more than 200 genes. It maintains normal blood levels of calcium and phosphorus, to support proper bone development, it modulates cell growth, support the immune system, reduces inflammation and much more!

Vitamin D Levels:

The optimal level of 25-OH D is 75-100 umol/L (recent research has shown a possible optimal range at 120-150 umol/L), however the current Canadian average of D3 levels is 67.7 nmol/L. This means more than 70% of Canadians are deficient. I have seen patients which much lower numbers than this. Even down to 23 nmol/L! (Higher is not always better though for this fat soluble vitamin. However, most cases of toxicity symptoms are at 25000-60000 IU/day for 1-4 months. This is much higher than the ND recommended dose.)

Where do we get vitamin D?

We synthesize most of our vitamin D from sunlight exposure. It is estimated that 20 minutes, with face and arms exposed, provides 200 IU for people with light coloured skin. A moderate sunburn can produce 10000IU per day. However, sunscreen and sunblocks over SPF 8 prevents formation of D3, and most of us are indoors often throughout the summer and get minimal exposure to sunlight on these darker days of fall and winter. We source some vitamin D from food, with seafood being the most significant source, sardines to be exact! Mushrooms and egg yolk also have small amounts.

This is why it is recommended that most Canadians supplement with vitamin D.

What does Vitamin D effect?

To display the vast effects vitamin D has on the body here is a list of conditions that have been linked to vitamin D levels:

• Fractures and Osteoporosis - Vitamin D along with K2 if needed to increase calcium absorption - D3 supplementation is associated with a 22% decrease in risk of falls

• Depression - D3 deficiency has been linked to increased incidence of depression 

• Autoimmune conditions - D3 deficiencies have shown an increase risk of autoimmune diseases such as MS, psoriasis and rheumatoid arthritis 

• Thyroid health - There is an association between low vitamin D status and autoimmune thyroid diseases such as Hashimoto’s thyroiditis and Graves’ disease

• Poor immune system - Vitamin D helps the immune system adapt and ward off infection, beneficial in cold and flu season

• Metabolic disorders - D3 helps restore beneficial gut bacteria which in these studies has shown to have a key role in diabetes and heart disease 

How much Vitamin D to supplement?

So with all that information you may be wondering how much to actually supplement. This really depends on your individual levels of 25-OH D. As stated early, I’ve seen a patient with levels in the 20s (nmol/L), so they would need a much higher dose of D3 to reach optimal levels, compared to someone that is slightly deficient, let’s say in the 60-70nmol/L range. If you suffer from any of the above health conditions, I advise to get your vitamin D levels tested. The quicker you raise D3 levels if you are deficient, the sooner symptoms will improve. The common recommended dose of 1000-2000IU may not be enough for you! That said, if we were to give higher levels of D3, a dose of 5000-8000IU, it is important to know D3 levels and assess the necessity of vitamin K2 and vitamin A supplementation - all these soluble vitamins play a role with each other to prevent toxicity. Sufficient levels of potassium and magnesium have also been suggested to protect against vitamin D toxicity.

So ask your doctor to test your vitamin D levels, 25-OH D levels to be exact. There is a simple blood test I do in practice to assess your levels. Book in for a blood test visit to get yours tested today!

In health & happiness,

Dr. Karen

The Winter Blues: 5 Ways to Beat Seasonal Affective Disorder and Depression

It always surprises me after the time change in November how dark it can get in the evenings. Every year around this time I have to check in with myself and how I am feeling and every year I realize, after a gentle reminder from those around me, that the darker days do affect my mood. Living in Vancouver for 4 years, where it is raining most of the winter, I would forgot how much happier people were with the sun out, until the skies opened and you get a glimpse again of sunny summer days. The same goes for most of Canada however. When a patient comes to me concerned about their mood, I always ask whether they notice a more depressed mood in the winter...most say yes! 

An important point is that there could be a easy explanation as to why you are feeling depressed and ruling these out first is key. There are a few common reasons I see in my practice, for why people feel depressed. They are vitamin D deficiency, adrenal fatigue, hormone imbalances, hypothyroidism and food allergies/sensitivities. Simple blood work, a health history and/or elimination diet can help decipher if your mood is affected by one of these issues.  However these simple tips can make a drastic change in your mood.

1. Light Exposure:

As the day shorten our circadian rhythm adapts and melatonin production increases. This in turn decreases serotonin production. Unfortunately this combination doesn’t improve sleep. Getting some light exposure in the morning, helps to keep our circadian rhythms in check. Suggestions for this are going for a 20 minute walk in the morning when it is brighter out, in nature is an added bonus, or investing in a sunlamp. I recently learned that the Public Libraries around HRM have these on loan!

2. Vitamin D3:

One of the first vitamins I think about when it comes to mood is vitamin D. It plays an important role in many things, including bone, skin and immune health, but it also contributes to improving mood. There are several studies that show an association with low vitamin D status and mood disorders, including seasonal affective disorder. 30 minutes of full-exposure to sunlight, without sunscreen, can provide between 10,000 to 20,000IU of vitamin D. In the winter, or if we work in an office all year, it is difficult to get enough D3, therefore we need to supplement. I suggest 2000-5000IU/day for mood disorders, however it is recommended to have your vitamin D levels checked to avoid toxicity. 

3. Increase Endorphins:

On these cold darker days we tend to sink into the couch. Exercise, even moderate amounts, have been proven to increase endorphins and serotonin production, ultimately improving your mood. Start by walking 20 minutes in the morning or at lunch if you are just getting back into it, or increase the intensity with HIIT workouts. Massage also has been studied to increase endorphins, or any physical touch for that matter! Our testosterone levels have been shown to increase in the winter so take advantage of the increased sex drive. 

4. B Vitamins:

These vitamins are also important to regulate mood. B vitamins are necessary for every energy reaction in your body, including the production of hormones and neurotransmitters mentioned above. Women on oral contraception become deficient in B6 (and magnesium), therefore it is even more important to supplement in these women. I recommend a multi-B vitamin, with higher amounts of certain Bs depending on the person. 

5. Decrease Sugar Intake:

When our blood sugar spikes then crashes it stimulates a stress response in our body. An increased cortisol level in turns affects other hormones and neurotransmitters and ultimately affects mood. If you are having energy crashes or bouts of fatigue or depression take inventory at how much sugar you are eating in a day. The recommendation is no more than 6g/day! Good quality protein, fat and fibre in the morning will set your day off right so you won’t be craving that 2pm sugary snack. 

As you can see there are many tools to consider to help with SAD and depression. There are other nutrients and botanicals that I would consider in my practice, depending on the person and if they are on medication or not. For a more individualized approach consider booking an appointment with me or your local ND.

In health & happiness,

Dr. Karen

p.s Check out these posts if interested - PMS: Recognizing the Signs, Anxiety: Tried & Tested Tools, Adrenal Fatigue