Leaky Gut - Yes there could be "holes" in your gut!

As a Naturopathic Doctor who sees a lot of gut issues, I get questioned often by people who have heard the term leaky gut, wondering what it is and if it could be the cause of their health issues. This is something I do see often in practice and I find very important to fix in order to treat a number of different issues, such as IBS, eczema, depression and most autoimmune disorders.

What is leaky gut?

Your gut is actually quite fragile as the lining of your intestines is made up of only 1 layer of cells, called enterocytes, lying between your gut lumen and the blood vessels. A border of microvilli on top increases the surface area to aid in absorption of nutrients, water and electrolytes. The intestinal lining also regulates the trafficking of environmental antigens (1) . These enterocytes are held together by tight junctions, like water-way locks, preventing the cells to come apart when inappropriate. Remember the childhood game red-rover? This is the game your gut is always playing. However, damage to the gut lining from inflammation and stress, releases a protein called zonulin which weakens these tight junctions making the lining more permeable (2) and ultimately creating small gaps between the enterocytes that cannot close up. Food particles, or antigens get absorbed between the cells now instead of through the cells, activating an inflammatory and/or immune response in the gut and blood stream.

What health issues can this cause:

• Local inflammation - IBS symptoms such as bloating, cramping, diarrhea, constipation

• Autoimmune conditions (1) - Hashimotos thyroiditis, Rheumatoid arthritis, Lupus and IBD, MS

• Systemic conditions - eczema, psoriasis, acne, joint pain, headaches, seasonal allergies

• Mental/emotional issues - depression and anxiety, chronic fatigue

What causes leaky gut:

• Gluten - this was the first thing found to increase zonulin levels

• Bacteria and infections - or bacterial endotoxins also found to increase zonulin levels

• Stress - this decreases stomach acid and digestive enzymes leaving larger particles of food to descend into the intestines which irritate the gut lining

• Medications such as proton pump inhibitors, antibiotics and NSAIDs

• Simple sugars and food additives

How to fix leaky gut:

If you haven’t read my blog post about the 4Rs in gut health, I’d lead you there to shed a little more light on my whole gut healing protocol. Ultimately we need to reestablish the zonulin-dependent intestinal barrier function to close up those gaps between the cells. There are a few favourites of mine that been shown to be very effective at REPAIRING the gut, but don’t forget to REMOVE, REPLACE and REINOCULATE as well.

• L-glutamine - this is my go-to for any gut issues, from mild to major. Always given in powder form to ensure a high enough dose.

• Collagen - helps to support and strengthen the gut lining like glutamine. I love the brand Sproos that I carry in my practice.

• Zinc carnosine - studied to heal the gut, including the stomach lining after H.pylori or an ulcer or after NSAID use

• Mucilaginous herbs - marshmallow, aloe vera, DGL, slippery elm

If you struggle with any of the conditions listed above do not hesitate to reach out to discuss the best treatment options for you! Heal your gut to heal your body and start feeling yourself again.

In health & happiness,

Dr. Karen

References:

1 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384703/

2 - https://www.ncbi.nlm.nih.gov/pubmed/21248165

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

September is RESET Time!

Every year around this time is it a common theme that we need to reset after a summer of less routine. September 1st, or when the kids go back to school, is usually a set point to do so for many. So if you have fallen off any of your health goals this summer, remember there are many just like you and it IS possible to get back on track! 

With that said, I want to remind you of simple things you can do to optimize your routine, and ultimately your energy, sleep, weight and mood. 

1. Set a wake time and bed time:

There is much research on the benefits of getting up at the same time every morning and going to sleep at the same time every night. Our body LOVES routine so it thrives when this happens. You may notice that after waking at the same time for a couple weeks with an alarm, your body will then naturally wake on its own at that time. Try using the bedtime app on your iPhone, but then put it on the dresser across your bed (not beside your head!) so you have to actually get up to turn it off. Wear earplugs, or a face mask, if need be while you adjust to this schedule.

2. Lemon Water in the Morning:

There are two reasons I love this for my patients. One, the warm water and lemon are wonderful for gut health. It acts as a gentle detoxifier in the morning and stimulates digestive juices. This can initiate a bowel movement or simply prime the digestive system for food. Second, it forces you to sit and relax in the morning (yes, please set out time to do this and not while running to get the kids packed up, or during a workout). Taking a few minutes in the morning for calm sets the tone for the day. We want to carry that feeling throughout the day. Meditation could be this time of calm for you as well if that suits you. 

3. Exercise in the Am:

The best time in chinese medicine to exercise is between 9-11 in the morning. It is the time of the Spleen, which in chinese medicine controls the muscles. I understand this is unreasonable for most but the point to take here is the earlier the better for exercise, especially if you have trouble sleeping. We want to wind down and calm the nervous system in the evening so a gentle yoga class is fine but a vigorous one may not be helpful. I love getting up and working up a sweat in the morning and then be ready to take on the rest of the day without worrying about exercise. 

4. Greens, Greens, Greens:

I always like to challenge my patients to try and get at least one serving of greens in a day (getting two?...even better!). Add spinach to a smoothie, make a breakfast hash with kale, eat a big salad at lunch or roast broccoli for dinner. Just something green, once a day 🙂 

5. Roll Back on Sweets:

Ice cream galore, cold ciders or coolers a plenty…summer staples for some. Let’s roll back on the sweets this September to balance blood sugar and energy as the darker days approach. If you know me, I have a sweet tooth, but I try to limit myself to a healthier treat such as a couple pieces of dark chocolate, a energy ball with dates or a few chocolate chips in the evening or during that 3pm slump. Out of sight, out of mind right! 

6. Blood Work to check:

If you have been feeling sluggish or anxious even during these summer months, I suggest getting some blood work done to assess a couple things. Vitamin D is key to have in a healthy range as we move into fall, as well as thyroid levels (TSH). Both affect your mood and energy and your thyroid controls your metabolism. Hypothyroidism is often missed and TSH is often something I find can be out of an ideal range yet not actual out of range for your MD to catch it yet. 

There you have it, a few basic things to check in with for yourself as we RESET this month! Any questions, I am always here to help. 

In health & happiness, 

Dr. Karen