Heart rate variability - A valuable tool to track well-being

A healthy heart does not beat like a metronome, but actually changes its rhythm with each heart beat. The constant variation between each beat is called your heart rate variability (HRV). This is something I have been speaking about to several of my patients recently, as more people have smart watches and other health tracker apps that can measure this.

What affects HRV?

There are certain situations that result in a higher HRV and other situations resulting in a lower HRV, reflecting your hearts ability to respond to different situations. This ultimately reflects how your nervous system is responding. HRV can react to stress and/or illness before resting heart rate, which makes it one of your body’s most powerful signals—providing useful insights into your stress levels, recovery status, and general well-being.

Generally a lower HRV is associated with your “flight or flight” response, stress or illness. A higher HRV is associated with your “rest and digest” response, general fitness and good recovery. It is amazing how we can track how just a 5 minutes meditation exercise can improve your HRV.

There are some things we cannot control that affect HRV such as age, hormone cycles, illness and amount of stress we have. However, to improve HRV there are things we can control such as sleep routine, alcohol and caffeine intake, how we manage stress and fitness level.

Tracking HRV

A high or low HRV is relative to each person. It is therefore best to track your own HRV over time and generally aim for a higher level, or track what improves it and decrease it, instead of comparing to others. It can range from 20 to above 150 depending on the tracker. Also, sometimes it is ok to see a lower levels for a short period of time, eg. during a strenuous activity where our nervous system is working hard to increase our heart rate. It is then how we recover that matters.

HRV fluctuates often throughout the day so is is helpful to track it in a controlled setting like sleep. However, some trackers, like the smart watch may limit this if you don’t want to wear it at night.

I see a lot of digestive issues, fatigue, insomnia etc in my practice and it almost always has a component that connects back to the nervous system. If we can help manage our stress response and improve HRV, that can help us tremendously over time. Ultimately, you don’t NEED to track HRV to check in with how you are doing overall. However there are some pretty neat tools out there now that can track things like HRV that we can use to our advantage.

Thoughts? Check in with me if you have questions.

Dr. Karen

Adaptogens for Healing Burnout

Do you feel like you are running on empty but you can’t find the time to refuel and replenish? A feeling of overwhelm can eventually turn into burnout and it is an unfortunate epidemic in our society these days. We tend to have too much going on than our bodies can handle and we don’t take the time to recharge our batteries. Women are more likely to feel the impact of overwhelm and burnout on their mental and physical well-being but that doesn’t mean we don’t see it in men. You may be a nurse who does shift work, a police officer needing to pump out adrenaline on the job, a new mom getting little sleep, or a menopausal women taking care of both teenagers and elderly parents. It all leads to the same thing if we can’t take care of ourselves! 

Some mild symptoms you may commonly experience are fatigue, poor sleep, sugar cravings and irritability. It can eventually lead to symptoms you may not acknowledge as burnout such as anxiety or depression, insomnia, poor memory, low libido, muscle soreness, inability to lose that dreaded belly fat, and a poor immune system. What we really need to watch out for is when the body can’t support itself anymore and autoimmune conditions such as Hashimotos thyroiditis or rheumatoid arthritis occur or potentially blood sugar issues or chronic hives. Eekk!

What is burnout?

Burnout is when you have pushed your stress response system pasts its limit of resilience. Your body is putting on the brakes to protect itself as best it can, forcing you to take it easy. Its the little white flag saying “I surrender.” These are the clues for you to take a step back or support your way through it. This is where adaptogens come in! Thank goodness all is not lost! 

What are adaptogens?

Adaptogens are herbs and fungi that have been around for many years. They help us adapt and heal from stress, hence the name, and they definitely come in handy in my practice! There are a few categories of adaptogens - calming, nourishing and stimulating - therefore best to know where you're at in the “burnout phase” to get the most out of them. If you use something too stimulating when you need more nourishing you may be adding fuel to the fire and cause more anxiety. 

Stimulating: These are helpful when you aren’t quite burnt-out but need support to get through an intense time, eg. studying at medical school, meeting a work deadline or working a night shift. Examples - panax ginseng, matcha, rhodiola.

Nourishing: When you need to fill the bucket up again and refuel these come in handy. They acts as building blocks lets say to boost cortisol. Most of the adaptogens fall into this category. Examples - ashwagandha, rhodiola, holy basil, licorice (not advised for high blood pressure), medicinal mushrooms. 

Calming: When someone is feeling anxious and their body needs to hit the reset button, these calming adaptogens are very helpful. They slow down the output of cortisol. Examples - schizandra (calms the mind), avena sativa, holy basil, motherwort. 

A reminder that adaptogens should not replace nourishing lifestyle habits that support a calm and relaxed state, such as meditation, sleep, nourishing food, time in nature and time with loved ones. Adaptogens are also not suitable during pregnancy. 

If you are feeling burnt-out and need a reset come chat! I’d love to help pick the right adaptogen for you. 

In health & happiness,

Dr. Karen 

Adrenal Fatigue - And The 4 Main Stressors On Our Body

Do you ever wonder what actually happens to our body and adrenal glands with chronic stress? Are you experiencing more than one main stressor leading to "adrenal fatigue" aka HPA dysfunction? More studies are showing negative long term side effects from chronic stress so lets get to the bottom of it and heal the body.

Ever heard the term "adrenal fatigue"? The adrenal glands sit on top of your kidneys and one of their main functions is to produce and secrete a hormone called cortisol. It is stimulated by the hypothalamus and pituitary signals, hence HPA axis. There are many receptors throughout our body that respond to cortisol to stimulate a "fight or flight" response - aka helping us run from that dangerous tiger. However due to four main reasons, our bodies may constantly be running from the tiger when it isn't even there! This of course takes a toll on us. 

Common symptoms of HPA dysfunction:

• fatigue
• insomnia
• brain fog
• anxiety, depression
• chronic colds and flus
• weight gain
• shakiness 
• PMS
• fibromyalgia
• diabetes 
• hypothyroidism
• eczema 

How is your body responding to the stress?

The more I practice, the more I realize the importance of discovering the underlying cause and response of these symptoms for each individual and treating it accordingly. For example, if one patient has more anxiety due to an inability to clear free cortisol effectively due to poor liver or thyroid function, I would treat this much differently than with a patient who is fatigued and depressed due to a down-regulated response in the HPA axis leading to low metabolized cortisol. 

Metabolized vs free cortisol what?? A DUTCH lab test, that I do in my practice and find very valuable, can actually differentiate these hormones and how they are broken down and metabolized. For example free cortisol is how much active cortisol is on our body, representing only 3-5% of our body's cortisol, and metabolized cortisol is what our adrenal glands actually produce, representing around 80%. Blood and salivary tests only test free cortisol, which is not the full representation of what is going on! 

(The DUTCH test actually test test SO MUCH MORE than cortisol, including sex hormones and their metabolites, melatonin and liver detoxification function...all so helpful to see!)

So what is actually causing this HPA axis dysfunction? It typically is not only the day to day stress we experience at our job or due to our daily schedule. If we can decrease these triggers the normal feedback systems within our bodies will recover and symptoms will improve.

Four triggers of HPA dysfunction:

1. Perceived Stress - This is the main trigger of cortisol dysfunction. Whether it be our go-go-go lifestyle preventing us from resting and recovering, or financial, job or relationship stress. Everyone perceives stress differently and some people may be less resilient than others. That trendy word mindfulness comes in here as well as simply taking time for yourself to recovery. 
2. Inflammation - This means ANY type of inflammation, including any autoimmune condition, an inflammatory diet full of sugar and inflammatory foods, gut issues, obesity, or chronic sickness. Inflammation of any kind up-regulates the HPA feedback system to put out the fire. 
3. Blood Sugar Dysregulation - High or low blood sugar affects insulin levels, which ultimately disrupts the HPA axis. This is why is it important to eat a low sugar diet with adequate protein, fat and fibre to slow down absorption of sugar and keep you full for longer. Look for foods with less than 7g of sugar, with full fat and good quality protein. Are you experiencing an energy crash in the afternoon? This means your blood sugar is not regulated! The first thing I suggest is changing your breakfast to include a protein and fat. 
4. Circadian Rhythm Disruption - I say it time and time again that our body LOVES routine. Too much exposure to light in the evenings, aka staring at a screen all evening, and not enough sun exposure during the day, aka too much time in an office and no sunshine, can affect the hormone cycles. Your cortisol can therefore be spiking at the wrong time. 

Once we establish your main triggers and how your body is actually responding to those triggers, several Naturopathic treatment options can help along the road to recovery. I love adaptogenic or nervine herbs to calm or support the HPA axis (more to come on the difference). IV therapy can help to support the immune system and adrenals (still discounted for the month of August!). Addressing the pillars of health of diet and lifestyle are always important as well. 

Questions about what was mentioned here or curious where your hormones lie? Come in for a visit!  I am always here to help. 

In health & happiness, 

Dr. Karen

Anxiety: Tried and Tested Tools

As the concept of mindfulness becomes more recognized, anxiety and high stress seem to be more prevalent. Perhaps we are finally taking note of how our body feels and recognizing that there needs to be a shift, or perhaps we just keep piling on responsibilities.

There is an optimal level of stress, we would not get anything done if we had nothing to drive us (see graph below). However, it is easy to teeter over the edge! 

Finding ways to manage your anxiety so we are not always "on alert", is vital to our health. I have mentioned before that this is something I have struggled with over the years. I have never suffered from lack of sleep due to stress, unless it is the night before a big event, but my stomach and skin suffers and I notice it quickly. Everyone will have their own way anxiety and stress represents itself in their body and recognizing these signs is helpful. It is well documented that anxiety and high stress have many negative implications on our health.

• Does your mind race at night, preventing you from getting to sleep?
• Do you find it hard to concentrate at work?
• Do you find you are overly emotional before your period, or in general?
• Do you get palpitations or a racing heart?
• Do you feel bloated often?
• Is your skin breaking out in hives often?
• …just to name a few.

Tried and Tested Tools:

Over the years, there have been several natural “go-to’s” to manage my stress and anxiety and I wanted to share a few more with you:

1. Yoga: What I love about yoga is that it is for all levels and all body types. There are days I want to push myself and work up a sweat or try a new pose, and days I could sit in child’s pose or legs up the wall the whole time. Both are very nourishing at the right time. The movement is in tune with your breath, connecting mind to body. If you are beginner or would like something slower and nourishing check out www.yogawithadriene.com. If you are in Halifax, check out Shanti Hot Yoga, Rio or Breathing Space - to name a few. If you want a little more fire at home check out www.oneoeight.tv. 
2. Meditation: Start with playing your favourite song, like this one, sit comfortably on the floor and breath deeply, into your chest and belly, until it is over. It can be that simple! Or take 20 minutes a day to try Deepak Chopra’s 21 day mediation challenge - starting Monday. 
3. Rescue remedy: I love having this in my purse at all times for those acute stressors. Bach flowers are an amazing gentle form of medicine and this is a blend of a few. You can find it in any health food store, or the health food section of the grocery store. 
4. Time with friends and family: My friends and family are very important to me. Not only do they make me feel good in the moment, I will live longer because of them! There is a great study showing that social support is a better predictor of lifespan that BMI, pollution and even smoking. My weekends are typically filled with time with my loved ones, decreasing my cortisol levels and increasing oxytocin. 
5. Avoiding stimulants: Unless I am on a very relaxing vacation, I cannot drink coffee or any caffeine. I am a slow metabolizer of coffee, therefore a small amount makes me jittery and spikes my anxiety. I suggest taking a caffeine break for at least 2 weeks, to understand how your body reacts to it. Other options are chamomile or peppermint tea, or just plain water. 
6. Mind mapping: I have started about 3 journals, all with 1-3 entries in it. It is not my thing. However, when I am feeling overwhelmed, making a mind-map or vision board of my ideas helps to organize my thoughts and create a plan. 
7. To do lists: Lists are key to a stress free week. I was introduce to Toodledo by a friend and colleague and it has made life so much easier. I can make due dates, organize by importance, and I don’t have to re-write things over and over. Do you have a favourite To Do app?
8. Acupuncture: Is the tip of your tongue red? Do you have red dots over your tongue? These are clues that your body is “on alert.” Acupuncture addresses this pattern with powerful points like Yin tang or Ht 7. Consistency is key with acupuncture. 

I do take, and suggest, supplements when needed, and that is where a Naturopathic Doctor can help. Sometimes a little extra support is necessary, especially during times of acute anxiety. I also have mentioned before that anxiety could be due to a hidden cause and an ND can help decipher what that might be. 

What are your favourite anxiety busters? Let me know in the comments below 😃

In health & happiness, 

Dr. Karen