Anemia: A commonly missed caused of fatigue

Did you know...

That iron deficiency is a commonly overlooked cause of fatigue? 😫

There are many reasons for fatigue including poor sleep, poor diet, stress, sometimes hypothyroidism. However anemia (low ferritin levels) is one that is sometimes missed and can cause similar fatigue symptoms.

Anemia symptoms can include mental fatigue, such as confusion and brain fog, physical fatigue, hair loss and even restless leg syndrome.

Low iron intake in your diet is a common cause but some other causes to consider include celiac disease, SIBO, IBD, and heavy periods.

This is even more important to screen for in pregnancy but not often checked outside this time period.

If you are vegetarian you should be checked for anemia and B12 deficiency as these nutrients are harder to get in your diet.

Ferritin levels range from 5-272ng/ml however optimal levels are 50-150ng/ml. I have seen this number at below 10 and now be flagged!! 🚩

Another important note: If you struggle with constipation while taking your iron supplement you may want to try a different form, eg. iron bisglyincate vs. elemental iron (Feramax) as each has a different absorption rate in your digestion.

Always tired? When is the last time you had your ferritin checked?✔️

Do I have a Food Sensitivity? Is it an issue and how to test.

Since I see a lot of digestive issues in my practice I find that food sensitivities are something worth exploring in many. They are quite common and can lead to a variety of different health concerns from digestive complaints, to skin issues such as eczema or psoriasis, to fatigue and joint pain. They are different from severe food allergies, such as an anaphylactic reaction to peanuts that occurs immediately, as they are a more delayed reaction. Food sensitivity symptoms can take up to 72 hours to appear after eating, so a low-grade food sensitivity can be hard to spot. The more severe a sensitivity the quicker and/or more severe you notice the symptom.

What causes food sensitivities?

When we eat foods we are sensitive to it causes the digestive track lining to become inflamed and small “breaks” in the lining occur allowing partially digested food particles to “leak” into your bloodstream, where your immune system sees them as invaders. Your body then produces antibodies (IgG antibodies) which circulate and attach to the food particle. When your body cannot eliminate the antigen-antibody complexes quickly, your immune system mounts a larger response leading to symptoms of chronic inflammation. The more of this food you eat, a higher level of inflammation can occur. So not only can you suffer from local digestive symptoms, it can then cause systemic inflammation.

Damage to the intestinal lining (aka leaky gut) can be caused by several things other than a main food sensitivity, such as gluten. This could be medications including PPIs, antibiotics which disrupt the normal flora in the intestine, overgrowth of other bacteria such as yeast or Candida, other invading bacteria, and high stress causing lower levels of digestive enzymes and blood circulation to the gut.

How do you test for food sensitivities?

The gold standard for food sensitivity testing is an elimination diet. Meaning, you eliminate all the common foods sensitivities such as gluten, eggs, dairy, sugar etc, for 3-4 weeks then reintroduce these foods back in one at a time to investigate what, if any, reaction you have to that individual food. It may be different for different foods, for example, cramping and diarrhea from dairy and bloating and fatigue from gluten.

Another way to test food sensitivities that I do often in my practice is a blood IgG test, testing 96 common food sensitivities with a simple blood prick test. The test is measuring the amount of IgG antigen-antibody complexes produced when your blood is exposed to that food. The higher the level, the worse the sensitivity. I have seen big improvements in patients health when they identify and eliminate their food sensitivities.

Do you have to eliminate foods forever?

Now my goal is never to limit someones diet even more longterm, so I interpret a test result a couple ways.

There may be 1-5 foods that are high on the list and these are generally the true sensitivities, ie - contribute to the leaky gut picture. These foods would be eliminated either longterm or for several months while we heal the gut and address any other contributing factors.

If many foods sensitivities come up, some in moderate levels, it proves there is a leaky gut and systematic inflammation. I advise to limit these foods for the time being and stress the importance of gut healing using probiotics and soothing and healing herbs for the gut. We also may need to explore stress levels, and other systemic bacterial overgrowth contributing to inflammation.

Once we complete a gut healing protocol it is easier to introduce certain foods back into your diet.

Do you have symptoms of a food sensitivity?

If you are struggling with digestive concerns, skin issues, fatigue, joint pain, depression even, and haven’t explored triggers from your diet, I would suggest reaching out to an ND like myself to explore this possibility. As I mentioned above, there may be more to the story that just a food trigger but it commonly has a component in someone health concerns.

Note - If you are noticing digestive concerns triggered by higher fibre foods or the lowFODMAP diet has been suggested and is helpful to you, that may be a different issue all together that we can definitely explore as well.

In health & happiness,

Dr. Karen

Food Friday: Tahini Date Energy Balls

It’s no secret I love a good snack and energy balls are so handy and so versatile. My snacks are always geared towards a healthy option with a little sweetness depending on the day and these date filled energy balls are perfect for that. You’ll need a food processor for this one. A mini one will work great.

Dates are a good source of fibre, and contain potassium and magnesium. Tahini (aka ground sesame seeds) is a good source of iron, calcium and a few other minerals and is a great alternative to peanut or almond butter if you need a nut free option. Finally cashews a good source of unsaturated fat. So all in all, although these are a little higher in sugar and calories due the dates and cashews, the bite size is a perfect balance.

Ingredients:

• 3/4 cup dates (soaked in hot water if too dry)

• 1/2 cup oats

• 1 cup cashews

• 1/8-1/4 tsp cardamon

• 1/8 tsp salt

• 1/2 tsp vanilla

• 2 tbsp tahini

• 1 tbsp maple syrup

• shredded coconut

Directions:

• Add cashews and oats to your food processor and pulse for a few seconds to break into smaller pieces but not a flour.

• Add dates and pulse until well processed and combined.

• Add cardamom, salt, vanilla, tahini and maple syrup and pulse until well combined and starts forming a ball. It should stick together well in your fingers.

• Form into 1-2 tbsp balls (just smaller than a golf ball) and roll in coconut.

• Store in freezer. They will last a while there, if they don’t get eaten quickly!

Enjoy!

In health & happiness,

Dr. Karen

Food Friday: Carrot Apple Muffins

Working from home this week I wanted something healthy but hearty to grab as a snack. These muffins were the perfect choice and very easy to make. They are gluten free, dairy free and egg free (if you are looking for any of that!), made in one bowl and found on one of my favourite food blogs - minimalistbaker.com. The hubby likes them as well which is a win.

January is usually used as a reset month for many. I like to look at it as time to refuel and a time to examine how balanced my food choices are, not a time to limit or starve myself. These muffins are a great balanced snack.

Ingredients:

• 1.5 tbsp ground flax seed + 4 tbsp warm water

• 1/4 cup olive oil

• 1/3 cup mashed ripe banana (about 1 banana)

• 1/4 cup maple syrup

• 1/2 cup unsweetened applesauce (or finely grated apple)

• 1/2 cup brown sugar

• 1/2 tsp sea salt

• 1 1/2 tsp baking soda

• 1/2 tsp ground cinnamon

• 1/2 cup unsweetened non-dairy milk (I used soy)

• 1 heaping cup (packed) grated carrot (finely grated)

• 2/3 cup gluten-free rolled oats

• 1/2 cup almond flour/almond meal

• 1 heaping cup gluten free flour (don’t forget the xanthum gum if required)

• 1/4 cup raw walnuts (chopped)

• 1/4 cup raisins (optional)

Directions:

1. Mix ground flax seed and water together in a small cup and let sit to create “flax eggs” - a slightly goopy texture.

2. Preheat oven to 375F and prepare muffin tin with liners (or lightly grease them).

3. Add flax egg mixture, mashed banana, maple syrup and olive oil to a large mixing bowl and whisk to combine.

4. Next add applesauce, brown sugar, baking soda, salt, cinnamon, and whisk to combine.

5. Add almond milk and stir.

6. Add grated carrot and stir.

7. Add oats, almond flour/meal, and gluten-free flour blend and stir. Add raisins here if using and stir.

8. Divide evenly among 12 muffin tins, filling them all the way up to the top, and top with crushed walnuts (optional).

9. Bake for 32-36 minutes, or until deep golden brown and a toothpick inserted into the center comes out clean. When you press on the top it shouldn’t feel too spongey. Better to over-bake than under-bake to make sure the centre is cooked through.

10. Remove from oven and let them set in the pan for 15 minutes. Then flip on their sides still in the pan to let cool completely. (If you try to unwrap them too quickly, they have a tendency to stick to the wrappers.)

11. Once cooled, store in a container or bag at room temp to keep fresh. Freeze after that to keep fresh.

Enjoy!

In health & happiness,

Dr. Karen