Food Friday: Old-Fashioned Oatmeal Coconut Cookies

Don't get me wrong I love chocolate in my cookies but these are a great alternative for a "healthy" treat at tea time. Ok, not so healthy with 1 cup of sugar in them, but the oats are a great source of fibre for gut health from their beta-glucans. Beta-glucans are prebiotics that are fermented by the good bugs in our gut. In that fermentation process, the bugs produce short chain fatty acids, such as butyrate, which provides energy for the intestinal cells. Beta-glucans also increase the viscosity of our food moving through the intestines, allowing more time for nutrient digestion and absorption.

On to the recipe!

Ingredients:

• 1 cup butter (or vegan butter in my case)

• 1/2 cup coconut sugar (or whatever you have at this point!)

• 1/2 cup lightly packed brown sugar

• 1 egg

• 1 tsp vanilla

• 1 cup shredded unsweetened coconut

• 1 1/2 cups gluten free flour (or spelt flour - both are delicious)

• 1 1/2 cups oats (large flake or quick)

• 1 tsp baking powder

• 1 tsp baking soda

• 1/4 tsp salt

Directions:

1. Preheat the oven to 375F and line a baking sheet with parchment paper.

2. Beat the butter, sugar & brown sugar until light and fluffy, around 1-2 minutes (By hand like me or with electric mixer). Add the egg & vanilla and mix/beat again to combine. Add the remaining ingredients & mix until well combined and the mixture sticks together, around 1 minute.

3. Scoop about 2 tbsp of dough into a ball, rolling with your hands (or use an ice cream scoop), and place them evenly spaced on the prepared baking sheet (work in batches). Press down lightly with your hands to slightly flatten the cookies. Bake until lightly golden brown around the edges, 8-10 minutes. Remove from the oven, transfer the cookies to a cooling rack, and repeat with the remaining dough.

4. Enjoy!

In health & happiness,

Dr. Karen

(Recipe adapted from fraicheliving.com)

Constipation - What moves your bowels?

Regular bowels are an important sign of good health. Our bowels are a primary function of elimination and detox. When this is backed up, we start to use secondary organs of elimination such as your skin, or lungs...which is not ideal. ⠀

Do you suffer from constipation? Check out the bristol stool chart if you haven't seen it before. Constipation could mean daily hard to pass stool, or not going for several days. ⠀

Why are you constipated?

1. There could be an imbalance of bacteria in your gut, aka SIBO, or yeast overgrowth.

2. You could have stagnation of bile from the liver/gallbladder, which is very important to stimulate bowels. ⠀

3. You could have a low fibre diet (but this gets quite complicated for those who have experienced constipation for awhile - due to point #1 typically). ⠀

4. You are not stimulating movement of bowels by moving your whole body. Exercise and twists are key here. ⠀

5. You are STRESSED! If our body is stressed our muscles tighten, including our digestive tract.

What moves our bowels?

1. Get into a routine - We detox during the night for the most part, since our body is at rest, so the morning is when the cycle should be completed, aka a bowel movement. If you wake at the same time each morning, after a good night sleep, your body should start getting into a rhythm and you shouldn’t need extra support. Try it!

2. Try extra support - Try a mug of warm water with lemon. It helps to stimulate liver detox and the warm water gets your intestines warmed up (like a warm up before a big run). Your morning coffee may do the trick as well since it is bitter. Bitters stimulate stomach acid, enzymes and bile secretion, all essential for proper digestion and bowels.

3. Exercise and twist - The simple twist I’m doing above is one way to stimulate the bowels. It’s like wringing out a towel and moves things through. Exercise gets lymph moving, helpful for detox.

4. Hydration - The bowels absorb water to bulk up the stool. This then creates a signal to stimulate a bowel movement. Hydrate with lots of water throughout the day (ideally not ice water, and not just during meals!)

5. Get rid of bad bacteria - Methanobacteria are among those typically high with constipation. Bifido bacteria tend to be low with constipation. These are only 2 patterns I see in practice as it depends on the individual. We ultimately need to eliminate an overgrowth with antimicrobial herbs and a specific diet, then increase the beneficial bugs with supplements or food.

6. Stimulate bile flow - Bile is crucial for proper bowel stimulation. If it is trickling out too often and irritating bowels it can cause diarrhea, and if it is stagnant in the gallbladder (or liver if you don’t have a gallbladder) constipation tends to happen. Simple diet hacks, fibre, cholagogue herbs, and nutrients such as lecithin, and phosphatidylcholine all help to stimulate bile. Cholagogue herbs include milk thistle, burdock, dandelion or artichoke.

7. Relax - I know this is easier said that done but this is key! Deep belly breathing goes a long way to stimulate the vagus nerve ultimately stimulating your bowels.

Questions about constipation? Let me know!

In health & happiness,

Dr. Karen

Estrobolome - The Gut-Hormone Connection

Improving your digestion goes beyond keeping your gut happy. It is connected to a number of different “systems” in our body, one being your hormones, estrogen in particular. When this isn’t in balance it can affect mood, weight, cycle, libido, acne and even bone health. 

What is the Estrobolome?

The gut microbiome is the collection of bacteria, both good and bad, in the digestive system. Ideally there should be no imbalance in the bacteria, called a dysbiosis, but due to diet, antibiotics, stress, or environmental exposure it is common for an imbalance to occur. 

Among many roles, the gut microbiome plays a crucial role in regulating circulating estrogen levels. Specific microbes in the microbiome, called the estrobolome, specifically do this. The microbes in the estrobolome produce an enzyme called beta-glucuronidase, which deconjugates estrogens into their active forms. This increases estrogens that are reabsorbs and capable of binding to estrogen receptors in the body and influencing those hormonal physiological processes. This process is known as phase 3 estrogen detox and when there is the right amount of beta-glucuronidase, estrogen homeostasis is maintained. When dysbiosis occurs, the estrobolome up-regulates or down-regulates beta-glucuronidase leading to a deficiency or excess of estrogen in the body. I most commonly see an estrogen excess. 

Common signs of excess estrogen which can be influenced by estrobolome are:

• bloating, especially before your period

• irritability 

• acne

• breast tenderness

• heavy periods

• headaches or migraines 

• PCOS picture 

Issues with deficient estrogens post-menopausal influenced by the estrobolome are:

• increased risk of osteoporosis

• increased risk of cardiovascular disease 

• increase risk of obesity 

What affects the estrobolome?

Anything that disrupt the gut microbiome typically affects the estrobolome as well. 

• Poor diet and lifestyle are the most common triggers for dysbiosis. Certain bacteria feed on certain food we eat (sugar and gluten as common examples), grow and in tern tell the brain to eat more of that food, causing an overgrowth. Studies have shown that a shift in the diet can induce microbial shifts within 24 hours. Focus on organic food when you can, cruciferous vegetables such as broccoli and brussels sprouts and fibre. 

• Antibiotics and birth control pills both have been found to alter the microbiome and estrogen levels, leading us to believe it is affecting the estrobolome. 

• A broad spectrum probiotic can influence the microbiome to shift positively. Antimicrobial herbs may be effective at eliminate an overgrowth. Talk to an ND like me to discuss if these are advised for you. 

• Calcium-D-Glucurate is a supplement that is a beta-glucuronidase inhibitor. This allows estrogen to remain conjugated, in its inactive form, to be safely eliminated from the body. This is very handy for someone with known estrogen excess. 

This gut-hormone connection proves to me that gut health is again at the root of many health concerns. We don’t want to forget proper liver support or hormone support with certain herbs, but it is important to not skip the gut! 

In health & happiness,

Dr. Karen

SIBO - Test Don't Guess

Small intestinal bacteria overgrowth (SIBO) may be more prevalent than we think. Research shows that 50-84% of IBS patients test positive for SIBO. This is with old testing methods that would show many false positives, therefore my assumption is that it is even more prevalent than we think. All it may take for someone to develop SIBO is a bout of food poisoning! That’s it! For some it is more complicated than that.

I have discussed the main reasons someone may have SIBO in a previous post, but let’s jump right into how you accurately diagnose SIBO. In my practice I ask a lot of questions in the first visit. This is because we can gain a lot of clinical information about what may be going on by just getting all the information. A physical exam, specifically an abdominal exam in these cases, is my next step in gathering information. SIBO has a handful of specific symptoms I am looking for which guide my treatment plan. But SIBO also a handful of symptoms that are unique to the individual and can be systemic, for example joint pain, rosacea, hypothyroidism.

Test Don’t Guess

If your symptoms indicate to me that you may have SIBO, before jumping into treatment, it is very helpful to test for it. Not only will this confirm, or deny, a positive result, but it will also guide what type of antimicrobials I’ll use and for how long depending on what the results show. The higher the results, the more rounds of antimicrobials we typically have to do.

The SIBO breath test is the most accurate non-invasive way to diagnose SIBO right now. Research continues to be done to advance our testing methods. The best option is a breath test that is a 3-hour lactulose breath test looking at both Hydrogen (H2) and methane (CH4) levels. This is the type and amount of gas that is produced if you have SIBO. Hydrogen SIBO typically presents as diarrhea (among other symptoms), and methane SIBO typically presents as constipation. The 3 hour test ensures you are testing the entire length of the small intestine, where only a small amount of bacteria should be, not an overgrowth. Stool testing, which we may do for other GI complaints, is only relevant to the large intestine. There is no accurate test yet for a 3rd type of SIBO, hydrogen sulphide. However, there are patterns on the results and patterns in symptoms that may indicate this type. This is not testing for Candida, however it is common for these to present together.

Ultimately if you test positive for SIBO, I treat it. However, 2/3 of patients have shown to relapse post-treatment. There are number of reasons for this but this is why it is always important to treat the patients and not the condition. I aim to treat the root cause along with the SIBO - if we can. Sometimes this isn’t possible depending on the case, so we do are best. It can also take time, and even different circumstances, for example a less stressful job perhaps, to treat the root. 1/3 of cases are luckily non-recurring and the patients feels better quickly and for good. Phew!

All in all, testing is very helpful to me as a clinician if I suspect a bad case of SIBO. It takes the guesswork out of the treatment and ensures a more accurate and quicker treatment result. Treating SIBO is a team effort but the more information we have the better it can be!

Are you interested in getting tested for SIBO? Let me know!

In health & happiness,

Dr. Karen