Iron is a crucial part of our daily diet and probably the most common deficiency among menstruating females. Fortunately, there are plenty of iron-rich foods that you can incorporate into your diet to improve your nutritional health, iron intake, and energy levels. This article will cover what foods are high in iron and why getting iron from food is so important. Why Iron Is a Vital Part of Your Diet? Iron plays a critical role in a variety of bodily functions. Most importantly, iron makes up hemoglobin, a transport molecule that red blood cells use to deliver oxygen to the tissue throughout your body. Oxygen is one of the most important cellular respiration and energy production factors. Your body also needs iron, like the active thyroid hormone, to make important hormones. As one might imagine, an iron deficiency can lead to several adverse health ramifications. An iron deficiency may result in several potentially severe symptoms that can negatively affect your daily life. Anemia is the most common condition associated with iron deficiency and is impactful. Here are a few of the symptoms those with anemia may experience: Fatigue Shortness of breath Dizziness Headaches Chest pain The best way to avoid anemia is by getting the right amount of iron with an iron-rich diet. Heme vs Non-Heme Sources You’ll hear a lot about iron ‘bioavailability’, meaning how readily available or absorbable the iron is in the food that you’re consuming. Heme iron comes solely from animal-based sources, such as meat, poultry and seafood. Heme iron tends to be more easily absorbed than non-heme plant-based sources. The National Institutes for Health (NIH) suggested that a solely plant based diet requires double the daily iron intake compared to those eating meat (1). The guidelines from the NIH for daily iron intake are as follows (1): Nonpregnant Women ages 19 to 50 18 milligrams (mg) Pregnant Women 27 mg For women Age 51 and Older, 8 mg For men Age 19 and Older, 8 mg Infants and Children 7 to 16 mg, depending on age Sources of Iron-Rich Foods If you want to enhance your diet with iron, you’ll be happy to know that many iron-rich foods are affordable and delicious. While not high in iron, some foods, like citrus fruits, will help you absorb more iron from your meals since vitamin C aids irons transport across the gut. Here are some foods that can boost your body’s iron levels. Oysters, mussels and Clams If you love to splurge on fresh seafood, you’ll be happy to know that the price tag has great nutritional benefits. According to the USDA, six medium oysters come with a whopping 6.1 mg of elemental iron, a 3rd of a woman’s daily intake. Shrimp and crab are great, too, providing between 2-3 mg per 3 oz serving. Important to note this would not be advisable for pregnant women due to the increased risks of infection from raw foods. Dark Leafy Greens Dark leafy greens are always a go-to plan based sources of iron. 100g of boiled spinach provides 1.6mg of non-heme iron, whereas broccoli provides approximately 1mg per 100g serving. Broccoli is also high in vitamin C, which can help the body to absorb the non-heme iron it contains. Red Meat Red meat, pork chops, and especially organ meats like liver and giblets make for a fantastic source of iron. Red meat serves up around 3-4 mg per 100g depending on the source, whereas organ meats are closer to 6 mg per 100g serving (although not everyones cup of tea). These sources are also high in saturated fat and can raise cholesterol levels, so they should be eaten in rotation and as part of a balanced diet. Dark Chocolate If you need more iron in your diet, dark chocolate is a good source of iron. Dark chocolate has 8 mg per 100 g serving!!! You’re welcome. Eggs Along with fortified cereals and oats, eggs make a great way to kickstart your iron intake in the morning, giving you about 1 mg per serving. Legumes Legumes and other kinds of beans, like black beans and kidney beans, are reliable sources of iron. While they're all non-heme sources, they contain up to 2 mg per 100g serving. Let's not forget about tofu, which lends up to 5.4 mg per 100g! Eating a Balanced, Iron-Rich Diet Fortunately, there are many iron-rich foods that you can easily incorporate into your diet. While taking other nutritional needs into account, the best source of iron for you can be something you love to eat regularly. Nutrition is essential to everybody aspect, so you’ll want to ensure you get what you need. To learn more about testing your iron and determining possible correlations to your symptoms, contact Dr. Courtney Holmberg, Naturopathic Doctor in Toronto, at (647) 351-7282 today to book a consultation.​ ​ References: https://ods.od.nih.gov/factsheets/Iron-Consumer/ https://fdc.nal.usda.gov/index.html

It probably comes as no surprise that a gluten-free diet has become one of the most popular food trends of this decade. Originally deemed inflammatory to the small intestine of celiac patients, gluten intolerance has since been correlated to a number of other medical conditions such as irritable bowel syndrome, anxiety, dermatitis, autoimmune disorders, and so on. Grocery stores now dedicate a whole section to gluten-free products and foods, creating many alternatives that mimic the wheat-based staples of the North American diet. And while these products are helpful for individuals with allergies or intolerances to gluten, a considerable number without these diseases still adopt a gluten-free lifestyle in hopes of reaping some health benefits. ​But there's one major mistake many people are making. Gluten is a grain protein found in wheat, spelt, barley, and rye. Its also added as a filler to many dressings and sauces, such as soya sauce. Individuals with intolerances to gluten may experience a number of symptoms, including but not limited to gas, bloating, diarrhea/constipation, joint pain and/or swelling, fatigue, brain fog, mood issues such as anxiety or depression, headaches, mouth ulcers, and dermatitis herpetiformis (unique to celiac disease). And while gluten intolerances exist, the list of associated symptoms is very broad and non-specific, meaning the same symptoms can also be seen in a number of other medical conditions such as food intolerances, anemias, dysbiosis, hypochlorhydria, and so on. It's always best to talk to your Naturopath or Family Doctor before deciding to sustain a gluten-free diet. The most important fact I want to highlight here is this... A product labelled "gluten-free" does NOT mean it's a healthier alternative. Now let me be clear... following a gluten-free lifestyle lays some important groundwork for a less refined, more whole foods, and overall healthier diet. However, the mistake is made when, instead of limiting refined foods like bread, crackers, and pasta altogether, people reach for their gluten-free alternatives. To shed evidence on the situation, new and interesting research coming out of Harvard University found after reviewing 30 years worth of medical data that individuals limiting or completely avoiding gluten had a 13% increased risk of type 2 diabetes [1]. Now does that mean gluten prevents diabetes? Unlikely. But what it does suggest is that gluten-free foods often contain less fibre and other macronutrients helpful in preventing metabolic disorders. Secondly, the most common ingredients found in gluten-free alternative products are rice and corn. Most of the corn in these kinds of pasta is genetically modified, and because corn flour doesn't stay together as well as wheat, a number of chemical binding agents get added to the mix to create a wheat-like texture. A cup of brown rice pasta has a glycemic index (GI) of 92 and a glycemic load (GL) of 52 !!! (I call it diabetes in a box), vs a cup of whole wheat pasta with a GI of 37 and a GL of 17 [2]. Also, if you didn't know, rice is loaded with arsenic, with brown rice being the highest source of it. Without going into too much detail on this topic, I'll direct you to the Environmental Working Group's website, which has a great resource here highlighting the problems with arsenic, how it's getting into our rice and ways to limit/avoid it [3]. So yes, this Naturopath enjoys the occasional slice of toasted whole grain bread with brunch and the occasional hoppy brewed beverage on a summer patio. I'm fortunate to not experience a gluten intolerance, which means I don't limit it completely, but I also don't consume it often. My diet tends to limit refined carbohydrates in general, gluten and gluten-free all the same. Remember, the foods that were always gluten-free (ie popcorn) are now re-branding with gluten-free labels in hopes of catching a few more consumers who are getting in on the action. We must act as educated consumers, or else it becomes very easy to fall victim to the next biggest health trend and miss the mark completely. The moral of the story is if you're going gluten-free, part ways with refined carbohydrates instead of reaching for the chemically altered, less nutritious gluten-free substitutes. And for goodness' sake, eat your veggies. [1] Low gluten diets may be associated with a higher risk of type 2 diabetes. American Heart Association Meeting Report Presentation 11. March 09, 2017. ​http://newsroom.heart.org/news/low-gluten-diets-may-be-associated-with-higher-risk-of-type-2-diabetes?preview=076d [2] The University of Sydney Glycemic Index Database. http://www.glycemicindex.com/www.ewg.org/foodscores/content/arsenic-contamination-in-rice [3] Arsenic is in rice - should you worry? Environmental Working Group Food Database. http://www.ewg.org/foodscores/content/arsenic-contamination-in-rice

Whether or not you're new to the coconut oil craze, or you've been soaking your skin with it for years, there is no doubt you've made the right choice by hopping onboard. Despite the fact that this natural, drupe-based oil received unwarranted flak for a number of years for being a saturated fat, the jury is out... and we were wrong. And although it lacks a few extra double bonds, this oil has many - if not more - health benefits than a number of the other unsaturated vegetable oils that sit in most pantries today. But the best part… theres evidence to prove it. So without further ado, heres why… first things first… a lesson on fatty acids Generally speaking, fatty acids are long molecules found in both vegetable and animal products that are used by the body to create lubrication for our joints, insulation for our nerves, protective cushioning for our organs, and ultimately make up the outer membrane of every single cell in our body. By now, I'm sure you've begun to appreciate their importance. The key to remember about any fat is the types, quantities, and lengths of the fatty acids it contains. To explain, there are both saturated fatty acids (SFA), which lack double bonds (like coconut oil) and are therefore solid at room temperature, and unsaturated fatty acids, which contain double bonds (like our omega oils) and are liquid at room temperature. For a long time, if was believed that saturated fats were bad for our health, but that myth is debunked below. In the food industry, there exists a third form known as hydrogenated fatty acids, which basically means the unsaturated fat has been given a few extra hydrogen atoms to make it more stable at room temperature. However, in doing so, the break down of this product creates trans fats, which are not found in nature and are unrecognizable to our bodies, therefore ending up places they shouldn't - like the walls of our arteries. the myth about saturated fat A meta-analysis done by the American Journal of Clinical Nutrition concluded that we've had it wrong for years - saturated fats are evidently harmless, and there is "no significant evidence that dietary saturated fat is associated with increased risk of Coronary Heart Disease or Cardiovascular Disease". Furthermore, another study from the AJCN showed that replacing SFA with unsaturated fatty acids had no effect on the fluidity or stiffness of arterial walls. Now this doesn't mean that everyone at risk for heart disease should go liberally divulging on animals fats and cheese, as there is an importance to the type of saturated fat consumed, and of course in moderation. That importance is in it's length. Coconut oil is set apart from other fatty acids because it is made up predominantly (~70%) of medium-chain fatty acids, which are absorbed directly into the digestive tract and sent straight to the liver, and unlike animal and dairy products, they do not require bile salts for breakdown. Coconut oil is therefore a direct source of energy - remember this for later. To top it all off, a saturated fat like coconut oil tolerates high temperatures much better than most unsaturated fats like corn, sunflower, or olive oil, and that is due to it's higher smoke point. The smoke point of an oil is the temperature at which the oil begins to break apart, producing byproducts and free radicals that can be dangerous to the body. Most unrefined oils on the shelves (depending on their quality) have a smoke point ranging from 250 - 320°F, whereas coconut oil ranges upwards of 350°F. Therefore, the use of coconut oil decreases the risk of free radical damage from cooking. why we should all ditch the carbs for fat While every cell in the body burns glucose (the breakdown product of all carbohydrates), the heart and skeletal muscle in particular prefer fatty acids, as it is a greater source of energy production, and doesn't require insulin to do so. This point is very important, as so much of the population today experiences insulin resistance (the first step to type II diabetes) due to the overburden of insulin our body experiences from all the sugar we consume. FUN FACT: 4 g of sugar on a food label = 1 tsp of white sugar… think about it next time you read the side of a box. Moreover, the foods we eat and the sources they come from have effects on the way in which our body handles our hormones. Firstly, high amounts of sugar increases insulin, which counters cortisol, leading to more fat storage in the abdomen and less breakdown. Now for the importance of those medium-chain fatty acids I mentioned. One study shows that the thermic effects of medium-chain fatty acids in coconut oil are greater than long-chain fatty acids of equal calorie content, suggesting an important take home message: a calorie is not a calorie. There isfurther evidence to suggest that increasing medium-chain fatty acids in the diet can increase your body's energy expenditure by 5%, which averages an extra 120 calories burnt per day. The ketone bodies that are produced from coconut oil's metabolism is also shown to have appetite reducing effects, meaning less calories consumed throughout the day. So yes, it is too good to be true … sugar = fat storage, and fat = weight loss. other fabulous facts about coconut oil FOR YOUR SKIN and HAIR: it has an SPF of 10 (blocking ~20% of the suns rays), making it not only incredibly hydrating to the skin and hair, but protective. Furthermore, coconut oil is made up of ~ 60% lauric acid, a natural antiviral, antibacterial, and antifungal, making it a great topical treatment for infected wounds or fungal infections like tinea. Don't forget, it works the same way internally, for preventing things like candida. FOR YOUR BRAIN: we all know fatty acids are essential for brain function and development, but medium-chain fatty acids specifically are turned into ketones by the body, which some studies have shown to have therapeutic effects in conditions such as epilepsy and Alzheimer's. Something to consider... FOR YOUR CHOLESTEROL: studies show coconut oil increases levels of HDL (the "good" cholesterol) and lowers oxidative damage of LDL (the type that clogs our arteries when exposed to oxidative damage). FOR YOUR DIGESTION: because it requires no energy for breakdown or transportation across the intestines, people who suffer from IBS or Crohn's may benefit from the ease of coconut oil's absorption. More remarkably, those who suffer from gallstones or bile duct conditions will not be affects by coconut oil, as this fat requires no bile salts for emulsification. Hooray! FOR YOUR HEALTH: fat soluble substances, like vitamin A, D, E, and K, and minerals like calcium are all more readably absorbed when taken with coconut oil. Your mood, your bones, and your immune system will love you for it. REMEMBER: like any oil, coconut oil varies in quality. When choosing a brand, go for UNREFINED and VIRGIN forms (meanly those lovely medium-chain fatty acids haven't been destroyed in the making). My favourite so far - Carrington Farm's cold-pressed, organic coconut oil, found at Costco for a fantastic price (~17$ for a tub that will last you months).

Unless you've been living under a rock, I'm sure you've come across the ingredient every product is labelling free of and every consumer is trying to avoid gluten. One of the most common questions I'm asked with regard to dietary changes in practice is "should I be gluten-free too?" Stats say roughly 29% of households now have a family member who eats gluten-free, and the "Gluten Free" label has become the top 5th label claim since 2011. But when asked, less than a third of respondents (including those who claimed to be gluten-free) actually knew what gluten was and where it was found. So... what is it? Why is it bad for us? And what's with all the hype anyways? There are a number of articles circling the web on either side of the gluten fence. I'm not here to persuade you but to inform you, so listen closely. First off... what is gluten? Gluten, by definition, is a family of proteins, made up of gliadin and glutenin that give bread its elasticity, or ability to rise. The family that seems to be problematic in today's diet is found in wheat, barley and rye. Dr. Tom O'Bryan, a certified gluten practitioner in the US, discusses the reason for its "toxicity". He states that although not everyone may show symptoms of sickness from eating gluten, the human body does not produce intestinal enzymes to break down the gliadin component of the protein [1]. For someone with celiac disease, this is a serious problem. Their immune system produces an anaphylactic response when exposed to the gluten protein (even in minute amounts)... much like someone would with a bee allergy, but in their gut. These people often carry a gene that predisposes them to this condition, and a gluten-free diet is absolutely essential for them. The interesting fact is that there has been a 4 fold (or 400x) increase in the incidence of celiac disease over the past 50 years [1]. That leaves us with the question... Why is gluten suddenly a problem? Although wheat hasn't changed, and has been cultivated now for roughly 10000 years, its been only in the last 500 years that the actual content of gluten in wheat-based foods has gone up [2]. This is because gluten helps breads rise and holds food together, making for better texture, and is therefore actually added to foods already containing gluten. It can also be found in cosmetics, hair products, and household cleaners. It's important to note that although only 3% of those with the celiac gene actually develop celiac disease, roughly 30% of the population carries the gene. So why isn't everyone developing celiac? Tom O'Bryan states this is due to the concept of loss of oral tolerance - meaning overexposure and weakened gut health due to environmental factors may be the key to the expression of this gene [3] Can we test for it? The short response would be yes. Without boring you with the details, blood samples can test for antibodies to the gluten components to see if your body is mounting an immune response to them, but the gold-standard testing for diagnosing celiac disease is an intestinal biopsy, looking for destruction of the brush border, or "microvilli" of the gut lining. HOWEVER... it's very important to understand that lab testing is not the gavel of medicine. Clinical symptoms are just as, if not more important, than lab values. Now, science says these tests are very accurate at determining celiac disease - but only in those with full-blown villous atrophy, or complete destruction of the brush border. If the lab tests included all stages of symptoms, the stats drop to roughly 27-32% efficacy [4.5]. This means that, in this case in particular, the testing is really only conclusive for those with COMPLETE microvilli destruction, not partial or moderate states. Therefore, although people are symptomatic, they're experiencing false negatives with testing, and are deemed "non-celiac". This leads us to the topic causing the most controversy... Non-Celiac Gluten Insensitivity Have I lost you yet? So you've tested negative for celiac disease. Or in some cases, your blood tests are positive, but the biopsy is negative (for further info on this, check out this article). But you're experiencing symptoms. How can this be explained? A condition called "NON-CELIAC GLUTEN SENSITIVITY", or NCGS - is a condition that the medical community is slowly including as a clinical diagnosis. Basically, your biopsy does meet the criteria for celiac disease, but you're still mounting an immune response to gluten. While it's still largely misunderstood, there's research that attributes this phenomenon to "leaky gut syndrome", which is basically inflammation in the gut that develops from the environmental exposures that allow substances to pass between the cells instead of through. So now your immune system is reacting to the gluten you're intaking in a systemic inflammatory way, much like you're body would react to a bacteria or virus coming through the gut. This inflammation is not localized to the gut, as these antibodies cycle through your body, causing a number of indirect symptoms. such as bloating and gas, joint pain, skin conditions, mental fog/depression, fatigue, etc. This is where we see cross-linking between other immune conditions, such as Hashimoto's Thyroiditis (hypothyroidism), Inflammatory bowel disease, Systemic Lupus, Inflammatory skin conditions, etc. Some of the symptoms: the Journal of Attention Disorder (2004) published a study showing people with ADHD also reported the following list of symptoms, all of which improved with a gluten-free diet: 87% bloating 83% abdominal pain 31% sores in the mouth 68% lack of wellbeing 64% fatigue 54% headache 39% anxiety 31% joint or mm pain So is a gluten-free diet healthier? Again, the short response would be maybe. IF DONE PROPERLY. Since gluten-free has become so widely recognized as a healthier way of eating, many food companies have followed the trend of creating gluten-free alternatives. Now, just because something is labelled "gluten-free" does not mean this alternative is healthier for you - most cereals, bread, and snack foods are loaded with high fructose corn syrup to make up for the loss of gluten, which comes with a whole new bag of problems. What can I do? 1. eat NATURALLY gluten-free items If you've chosen to avoid gluten, also choose to avoid the alternatives. Corn and rice-based products are gluten-free but skip on the bread, cereal, and snack alternatives. Choose whole foods, increase produce and protein (grass-fed as opposed to grain), and up your omega 3s (flax, walnuts, fish, etc) to offset the more inflammatory omega 6s that come from grains. Choose items such as quinoa, rice, millet, or buckwheat for your grains. Cook with almond or coconut flour. Search the web for gluten-free blogs (they're everywhere). If you've got to have your bread fixed, find a great local gluten-free bakery you can trust. 2. do some further reading There is so much on this topic that I haven't even touched on. There's research on the theory that gluten sensitivity is correlated to Alzheimer's and Dementia, as well as a number of other neurological conditions. Although quite opinionated, these books are user-friendly resources to find out more: - The Grain Brain, David Perlmutter, MD - The Wheat Belly, Dr. William Davis, MD 3. address your gut Leaky gut syndrome is a consequence of lifestyle and environment. Many things cause inflammation in our enterocytes, leading to food allergies and systemic symptoms. Your naturopath can run a food allergy test, or IgG test to find out if you're having an immune-mediated response to any of the foods you're consuming - not just gluten. Learn more about FOOD ALLERGY TESTING HERE >> Furthermore, if any of these symptoms sound like something you're experiencing, see if naturopathy can help by booking your naturopathic consult HERE >> References: Celiac Disease on the Rise. Mayo Clinic: http://www.mayo.edu/research/discoverys-edge/celiac-disease-rise US perspective on gluten related disease. Clinical and Experimental Gastroenterology. http://cdn.thedr.com/wp-content/uploads/2014/11/US-perspective-on-gluten-related-diseases-Leonard-2014.pdf Meresse B., , Ripoche J., Heyman M., Cerf-Bensussan N., Celiac disease: from oral tolerance to intestinal inflammation, autoimmunity and lymphomagenesis, Nature Vol 2 No 1, JANUARY 2009 Abrams JA, Diamond B, Rotterdam H, Green PH. Seronegative celiac disease: increased prevalence with lesser degrees of villous atrophy, Dig Dis Sci. 2004 Apr;49(4):546-50 Tursi A., Seronegative Coeliac Disease: a Clinical Challenge. BMJ 26 April, 2005.

Our skin provides us with a wonderful reflection of what’s occurring below its surface. Contrary to popular belief, acne is not a result of improper facial hygiene. It typically presents itself as the unfortunate indicator that there's an internal problem. And while most reach for the latest and greatest topical products that promise results, many forget to ask the important question of "why is this happening in the first place?" The root of acne formation is centred on the oil gland, known as the sebaceous gland. Hormonal changes, inflammatory foods, disrupted skin pH, etc. can lead to changes in the quality and amount of sebum produced, creating low-level inflammation. This inflammation can plug the follicle, creating little papule-like lesions called closed comedones. Bacteria see these comedones as honeymoon destinations, and the more overgrown with bacteria these blocked follicles become, the larger and more cystic the resulting "pimple". If the cyst ruptures below the dermis, the lesions last a lot longer and are more likely to trigger scarring. So how do we manage it? Since lesions are most commonly the result of oxidative damage and hormonal imbalances, the trick is to work from the inside out. HORMONES First and foremost, we must investigate hormones. Higher levels of dihydrotestosterone are attributed to increased sebaceous gland activity and acne formation. This is common in conditions like PCOS and congenital adrenal hyperplasia, with associated symptoms of irregular or infrequent menses, the middle-age onset of acne, male-patterned hair growth around the chin/nipples/stomach/hands, and insulin resistance. However, not all of these symptoms have to be present for hormones to be disrupted, making it difficult to uncover the underlying problem. Hormone testing can be a useful tool in these cases Speak to your ND about completing a thorough hormonal assessment Furthermore, evaluate your birth control pill. Certain birth control pills have higher androgen activity than others, resulting in a higher likelihood to worsen acne. While birth control is never my suggested treatment of choice for acne, if you choose to use it, ensure it's an appropriate combination. THE LIVER While balancing hormones in the body is important, the elimination of these hormones is just as critical. Your liver acts as a filter, eliminating degraded hormones and preventing hormonal congestion that results in acne. Alcohol, birth control, environmental toxins, etc all burden our liver on a daily basis, leading to sluggish detoxification and toxins being shifted to our major detox organ, the skin. Try: lemon water in the morning, dandelion root tea, 2-3 L of water daily (depending on body weight), alcohol-free for 6 wks DIET A high intake of refined carbohydrates, sugars, and preservatives results in blood sugar spiking, and subsequent boosts in insulin levels. High levels of insulin in the bloodstream trigger sebum production and an increase in pore-clogging cells. Dairy also tends to be a problematic food, as it's rich in IGF-1, which also promotes insulin release. An imbalanced, high-carb diet may be attributed to you producing all the wrong hormones as an older adolescent or adult. Try: a low GI diet, removing dairy for 6-8 wks, having your insulin resistance measured DIGESTION Just as the liver detoxifies hormones, the colon actually excretes them. If bowel movements are not regular, degraded hormones sit in the gut waiting to be reactivated and resorbed by "bad" bacteria. Furthermore, consuming foods you may be sensitive to (ie food intolerances) results in higher levels of overall inflammation in the diet every time you eat them. Try: lactobacillus acidophilus probiotics, increasing intake of naturally fermented foods like kombucha or sauerkraut Consider: Food Sensitivity Testing ​ NUTRIENTS Certain minerals and vitamins have been shown to be effective treatments for acne-prone skin. Zinc-containing foods, like pumpkin seeds, lamb, chicken, kefir etc, are encouraged for those with acne, as a recent study published in BioMed Research International identified a correlation between low zinc levels and the severity of acne. Furthermore, B6, B5 and Vitamin A all have balancing effects on skin pH and sebum production. Always remember, vitamins and nutrients at the therapeutic dosages required to treat certain conditions can have severe risks and side effects. Never self-prescribe; always speak to a licensed professional. TOPICALS Last but not least, what you put on your skin is important. If you’ve been using strong washes or cream moisturizers, STOP now. Harsh chemicals in washes that come over the counter or prescription grade strip the natural pH of the skin, leading to higher amounts of oil production to recent the balance. Furthermore, creams are glycerin based, which the skin does not properly absorb. Instead, it sits on the surface of the skin, trapping debris and oil within the pores, and preventing the skin from breathing. That sounds like a recipe for acne to me. Try gentle foaming cleansers without sulphates and benzoyls, and serum moisturizers that are glycerin-free (light carrier oils are important). As always, feel free to contact me should you have any questions regarding testing and/or treatments. References: 1. Leyden JJ. Therapy for acne vulgaris. N Engl J Med 1997; 336(16):1156-62. 2. Pantothenic Acid, Vitamin B5 for Acne by Jeffrey Dach MD. http://www.drdach.com/Acne_B5.html 3. Rostami Mogaddam M, Safavi Ardabili N, Maleki N, Soflaee M. Correlation between the severity and type of acne lesions with serum zinc levels in patients with acne vulgaris. Biomed Res Int. 2014;2014:474108

Magnesium is the 4th most abundant mineral in the human body. It is found in every cell in the body and is an essential component in regulating over 600 different biochemical reactions and bodily functions. It helps convert food into energy, build new proteins, repair DNA/RNA, regulate muscle relaxation, and balance neurotransmitters in the brain, nervous system, and gut. It has direct impacts on heart health, blood pressure, immune response, metabolic rates, and more. ​ Unfortunately, magnesium deficiency is on the rise, with an estimated 50% of the population in the US and Europe getting less than their daily requirement of magnesium (1). Historically, magnesium was abundant in the foods we ate and the water we drank. However, today, most soil-grown produce has been shown to be more magnesium depleted than ever, and even the grass and grains livestock eats lacks magnesium content. For those of us that live in the city, our water is treated with chlorine and fluoride to remove bacteria and minerals, like magnesium. Furthermore, the consumption of caffeine, sugar, alcohol, and medications like birth control pills, antihypertensives, insulin, and certain antibiotics all deplete magnesium further. One particularly important mechanism magnesium regulates is our balance and utilization of calcium. Every cell has a regulatory switch that controls the balance between calcium and magnesium, and when there is a deficiency in magnesium, the switch will allow excess calcium into the cells. This can ultimately lead to cellular calcification, amongst a number of other concerns, including: Muscle Cramps and Spasms – Calcium is essential for muscle contraction, whereas magnesium allows muscular fibres to unbind, and ultimately relax. As a result, low levels of magnesium may lead to muscle stiffness, cramping, and spasms. Calcification of the Arteries – Magnesium deficiencies increase the risks of calcification in the arteries as a result of unopposed calcium in the bloodstream. Atherosclerosis and arteriosclerosis are primary warning signs. Hypertension (High Blood Pressure) – Calcification can cause blood pressure rates to become higher. A Harvard study showed that those with the highest magnesium intake had the healthiest blood pressure levels. Fatigue/Lack of Energy – All of our cells contain adenosine triphosphate (ATP), a chemical that must bind with magnesium in order to convert itself into energy. With low magnesium levels, our energy molecules remain unusable, and as a result, our energy level often declines. Problems Sleeping – Magnesium promotes active muscle relaxation, and is essential for the proper function of our GABA receptors. When activated, GABA promotes restful relaxation, improving not only our ability to fall asleep but maintain sleep. Furthermore, Hormone Imbalances – There is a direct correlation between estrogen/progesterone and magnesium levels in women. The higher the hormones – the lower the magnesium. Additionally, increased hormone levels during pregnancy can quickly deplete magnesium levels. Low magnesium levels can make menstrual cycle cramping more severe. Pregnancy Health Complaints – Pregnant women tend to have more cramping, pregnancy-related high blood pressure, and other such problems, all signs of low magnesium levels. Depression and Anxiety – Chemical imbalances in the brain brought on by stress and anxiety could be contributed to magnesium deficiency, as well as certain types of depression. Furthermore, as mentioned above, magnesium’s relationship to GABA receptors means that lower levels result in a less relaxed state of mind. Deficiencies in Other Minerals – Without the right level of magnesium in the cells, other minerals, such as calcium, potassium, vitamin K and vitamin D, are not utilized correctly. Bone Density Concerns – In order for Vitamin D to be able to help absorb calcium into the bones, where it belongs, it needs the right amount of magnesium. Magnesium also works with a hormone called calcitonin that draws calcium out of the muscles, circulatory system, and soft tissues so it can be absorbed by the bones. With the proper magnesium levels in the body, risks for heart disease, heart attack, kidney stones, calcification in the arteries, and osteoporosis are reduced. To ensure proper magnesium levels, expose yourself to these magnesium-rich foods: Spinach and Chard: ~ 157 mg/cup Pumpkin Seeds: ~ 92 mg/1/8 cup Almonds: ~ 80 mg/1 cup Black Beans: ~ 60 mg/ ½ cup Avocado: ~ 60 mg/1 medium Dark Chocolate: ~ 95 mg/1 square (did you know specific chocolate cravings are suspected to be a sign of a Mg deficiency!) Bananas: ~ 30 mg/1 medium If you have experienced any of the signs discussed, and want to find out more about the benefits of magnesium, please feel free to contact Toronto Naturopathic Doctor, Dr. Courtney Holmberg at 647-351-7282 to schedule a consultation today! Rosanoff A1, Weaver CM, Rude RK. Nutr Rev. Suboptimal magnesium status in the United States: are the health consequences underestimated? 2012 Mar; 70(3):153-64. Elin RJ, Rude RK. Oral magnesium and wellness. The Magnesium Report: Clinical, Research and Laboratory News for Cardiologists. 2000. Fox C, Ramsoomair D, Carter C. Magnesium: its proven and potential clinical significance. Southern Medical Journal. 2003;94(12):1195-201. Kimura M. Overview of Magnesium Nutrition. In: International Magnesium Symposium. New Perspectives in Magnesium Research. London: Springer-Verlag; 2007:239-260. Pumpkin Seed Nutritional Profile: superfoodprofiles.com/raw-pumpkin-seeds-nutrition

The Ketogenic diet is an extremely popular diet amongst the weight loss community. Originally brought to light for its promising research in epilepsy management, it quickly became a hopeful solution for those looking to quickly shed pounds without massive caloric restrictions. But like any trend, we must weigh all the pros and cons, while simultaneously accounting for the long-term impacts on our health. First off, let's break down what the ketogenic diet actually involves. The premise of the diet focuses on reducing carbohydrates to force the body into an anabolic (breakdown) state, known as ketogenesis. Ketogenesis is a metabolic process our bodies enter into when sources of glucose (both dietary and stored) cannot keep us with metabolic needs, forcing the body to produce ketone bodies from adipose tissue (aka fat) to use for energy in place of sugar. As you can imagine, this is favourable for weight loss for several reasons. In addition to fat now being used as fuel, the blood sugar staying so low sharply drops insulin secretion, which further reduces the stimulus for fat and sugar storage. As long as the body remains deprived of carbohydrates, ketosis is sustained and weight loss continues. There’s also the concept of something called ‘super fuel’, meaning ketone bodies produce more usable ATP molecules (aka energy) to the heart, muscles, and brain than glucose, resulting in the additional energy and mental focus many people report while in ketosis.1 ​ Studies are showing very promising results for epilepsy, and have been well documented and proven to be effective for rapid weight loss, with initial weight loss of up to 10 lbs in 2 weeks or less.1 However, literature exceeding 2 years of use is lacking, and some studies raise show some red flags are raised within 3 months into ketosis that may have more concerning health implications long-term. Let’s dive further into what those risks are. #1: Vitamin and mineral deficiencies. While the ketogenic diet does help to eliminate certain unhealthy foods, like refined sugars and carbohydrates, it also eliminates fruits and other vegetables that contain carbs. It’s no surprise that fruits and vegetables provide a primary source of the vitamins and minerals the body needs for optimal health, in addition to being high in antioxidants. Now, there are also two ways to approach ketosis – one that maintains a high low-carb vegetable intake and a balanced amount of saturated fats, and one that involves eating bacon and hamburger patties at every meal. All that aside, Harvard health highlights the most common nutrients depleted on a ketogenic diet are electrolytes like sodium and potassium, magnesium, calcium and b vitamins.2 Supplementation is an option, but no concrete evidence shows supplementing vitamins and minerals provides the same health outcomes as getting them from nutritious food, so I always suggest food first. #2: Ketosis, digestive health, and the microbiome. Beyond constipation that comes from a lack of grains & fibre that result from a keto diet, the impacts of a long-term high fat/low carb diet on the microbiome are of my greatest concern. Without dietary fibre, people on the Keto diet can experience either diarrhea or constipation, as well as bloating. Sometimes these are transient side effects, and other times not. However, dietary fibre is the key ingredient to a microbiota-accessible carbohydrate (or MAC) diet. Fibre is what feeds our flora, which they then convert it short-chain fatty acids like butyrate that provide us with the endless health benefits we hear about surrounding probiotics. Without fibre, our flora suffers, which is demonstrated in the literature looking at all fibre-deficient diets, including FODMAP and gluten-free diets.3 Even short-term ketosis reveals a “statistically significant increase in Desulfovibrio spp, a bacterial group supposed to be involved in the exacerbation of the inflammatory condition of the gut mucosa-associated to the consumption of fats of animal origin”.4 To vastly oversimplify the research, it seems the benefits of the ketogenic diet on the microbiota as a whole are unclear. Some studies show a favourable increase in beneficial flora, while others show the opposite. In summary, the take-home seems to be that an overall decrease in microbial diversity is seen in those following a ketogenic diet.3 #3: The Keto diet can worsen athletic performance, and maybe even long-term weight loss Losing fat sounds great when you want to get fit. However, recent research found that in a ketogenic state, study participants performed worse on running and high-intensity cycling tasks after being on the Keto diet for four days, compared to participants that spent the same four days following a high-carb diet.5 The conclusion of the study suggests “short-term low-carbohydrate, ketogenic diets reduce exercise performance in activities that are heavily dependent on anaerobic energy systems. These findings have clear performance implications for athletes, especially for high-intensity, short-duration activities and sports”.5 Therefore, you may wish to again if you’re considering using the ketogenic diet to fuel your HIIT workouts every morning. Recent studies have also highlighted that “ketogenic diets impair glucose and lipid metabolism in mice” 6, suggesting that long-term use may actually alter metabolic activity. There may also be concerns around the “yo-yo” effects of the Keto diet (where people lose fat, only to gain it back, and oftentimes more) on long-term metabolism. #4: Following the Keto diet long-term can increase the risks of chronic diseases. Since fat consumption is essential to fueling ketogenesis, participants need to consume foods with high-fat content to maintain a ketogenic state. As a result, a rise in cardiovascular risk factors is often seen. Some literature shows an increase in blood pressure and cholesterol levels in ketogenic states, which is something I also see demonstrated in blood work for my current patients on a ketogenic diet. A study from the American College of Cardiology found that people following the Keto diet long-term had a higher risk of developing atrial fibrillation, a common heart rhythm disorder that also increases risks of heart disease and strokes.7 Other literature also highlights adverse effects including hepatic steatosis, hypoproteinemia, and kidney stones.1 In conclusion, it’s safe to say the use of a ketogenic diet needs to be evaluated on a case-by-case basis, and there calls for a collection of better long-term safety research before the diet can be considered as an ongoing intervention. With your microbiome always at the forefront of my mind, short-term ketosis may result in some favourable shifts in weight and metabolism, but offsetting the long-term impacts should be discussed with your ND. To find out more about the right dietary adjustments for your gut and metabolism, please feel free to contact Toronto naturopathic doctor, Dr. Courtney Homberg at 647-351-7282 to schedule your appointment today. Sources: Masood W, Annamaraju P, Uppaluri KR. Ketogenic Diet. [Updated 2020 Dec 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. https://www.health.harvard.edu/staying-healthy/should-you-try-the-keto-diet#:~:text=Other%20potential%20keto%20risks%20include,and%20C%2C%22%20McManus%20says. Reddel S, Putignani L, Del Chierico F. The Impact of Low-FODMAPs, Gluten-Free, and Ketogenic Diets on Gut Microbiota Modulation in Pathological Conditions. Nutrients. 2019;11(2):373. Published 2019 Feb 12. doi:10.3390/nu11020373 Tagliabue A, Ferraris C, Uggeri F, Trentani C, Bertoli S, de Giorgis V, Veggiotti P, Elli M. Short-term impact of a classical ketogenic diet on gut microbiota in GLUT1 Deficiency Syndrome: A 3-month prospective observational study. Clin Nutr ESPEN. 2017 Feb;17:33-37. doi: 10.1016/j.clnesp.2016.11.003. Epub 2016 Dec 18. PMID: 28361745. Wroble KA, Trott MN, Schweitzer GG, Rahman RS, Kelly PV, Weiss EP. Low-carbohydrate, ketogenic diet impairs anaerobic exercise performance in exercise-trained women and men: a randomized-sequence crossover trial. J Sports Med Phys Fitness 2019;59:600-7. DOI: 10.23736/S0022-4707.18.08318-4 Li Y, Yang X, Zhang J, Jiang T, Zhang Z, Wang Z, Gong M, Zhao L, Zhang C. Ketogenic Diets Induced Glucose Intolerance and Lipid Accumulation in Mice with Alterations in Gut Microbiota and Metabolites. mBio. 2021 Mar 30;12(2):e03601-20. doi: 10.1128/mBio.03601-20. PMID: 33785628; PMCID: PMC8092315. https://www.acc.org/about-acc/press-releases/2019/03/06/10/29/low-carb-diet-tied-to-common-heart-rhythm-disorder

PCOS (Polycystic Ovary Syndrome) is a hormonal disorder common in reproductive-age women. The exact cause of PCOs is not fully understood. Women with this condition may experience higher levels of androgen (male hormones), prolonged or infrequent menstrual periods, and problems in the ovaries. ​ When PCOS can be diagnosed earlier, and treatment can begin, risks of long-term complications could be reduced. PCOS can develop during the first menstrual period or later in life from a change in health, like becoming obese. Common Symptoms Associated with PCOS Some of the more common symptoms that could indicate a woman has developed PCOS include: Excessive levels of androgen. Having elevated levels of androgen can cause baldness, excess bodily and facial hair, and severe acne. Irregular menstrual cycles. If periods are irregular, prolonged, or infrequent, it could indicate PCOS. For instance, menstrual periods are abnormally heavy, occur more than 30-40 days apart, or occur less than nine times a year. Fluid buildup in the ovaries. If fluid retention is occurring in the ovaries, they can become enlarged and not release eggs regularly. Furthermore, ovaries can fail to function correctly. Becoming obese. Excessive weight gain can aggravate the symptoms associated with PCOS. ​ Side Effects of PCOS There are several side effects a woman may experience when she has PCOS, such as: Premature Births Miscarriages Infertility Type 2 Diabetes Metabolic Syndrome Sleep Apnea Eating Disorders Anxiety Depression Endometrial Cancer Abnormal Bleeding of the Uterine Nonalcoholic Steatohepatitis Gestational Diabetes High Blood Pressure during Pregnancy How Is PCOS Diagnosed? There are several different methods used to diagnose PCOS. Typically, your healthcare provider will inquire about your medical history, menstrual cycles, weight changes, and so on. Additionally, they may perform a pelvic exam, blood tests, and an ultrasound. A pelvic exam helps identify abnormalities in the ovaries. Blood tests can check insulin levels and levels of androgen. An ultrasound helps provide information about the appearance of the ovaries and reproductive system. How Is PCOS Treated? There are different treatment options for PCOS. Specific treatments will vary depending on the individual and the extent of their symptoms. However, lifestyle changes are very common. For example, if you are obese, your healthcare provider will prescribe treatment to lose excess weight, exercise more frequently, and eat a healthy diet while limiting carbohydrates. There are also medications to help regulate menstrual periods and increased levels of androgen. Ideally, treatment should focus on decreasing the effects of PCOS. It is important to remember that treatments can be ongoing to manage the condition. In some cases, you may be referred to a specialist to address specific issues and concerns, like infertility. If you suspect you might have PCOS, it is imperative to schedule an appointment with a healthcare provider as soon as possible. If you have further questions about PCOS, suspect you might have it, or want to know how to manage PCOS using holistic treatment methods, please feel free to contact Toronto naturopathic doctor, Dr. Courtney Homberg at 647-351-7282 to schedule your appointment today.

The use of hormonal birth control is one of the most common and effective ways to prevent pregnancy, as well as manage unwanted symptoms of reproductive health. Hormonal birth control, whether a pill, an implant, or a patch, all function in a fairly similar way. They introduce synthetic hormones into the body to prevent ovulation and increase cervical mucus – a tandem effect that helps prevent pregnancy. Birth control pills are also prescribed to help alleviate symptoms of certain gynecological conditions, like endometriosis, and regulate menstruation. However, if you have been diagnosed with a chronic gut dysfunction disorder and are struggling to treat it, your birth control may be an attributing factor. ​ Sex Hormones and Your Microbiota Women account for more annual diagnoses of chronic gut dysfunction than men.[1] A growing body of evidence has demonstrated that the fluctuation of the female reproductive hormones estrogen and progesterone have been demonstrated to be contributing factors in the onset of digestive dysfunction.[2] The relationship between hormones and the gut is symbiotic; one affects the other. Evidence shows that women with IBS report a higher incidence of PMS and dysmenorrhea (painful periods)3, suggesting gut dysfunction seems to have a negative impact, at minimum, on the regulation of hormones and perception of pain. Conversely, there is mounting evidence demonstrating the impacts of sex steroid hormones on the gut microbiota. To date, studies demonstrate clear evidence that specific phyla, family and genere variances to the microbiome of rodents result from gonadectomy and hormone replacement4. In adult rats who undergo ovariectomy, shifts in the relative abundances of two major phyla, Bacteroidetes and Firmicutes were demonstrated. Furthermore, we see this demonstrated in humans during pregnancy, and between sexes. Men have higher concentrations Bacteroidetes and Prevotella than women,5,6 suggesting a role for sex chromosomal gene expression or differences in gonadal hormone levels in the modulation of the gut microbiota. Koren et al7 also found a large shift in the gut microbiota from the first to the third trimester of pregnancy women, with an increase in overall diversity and a proliferation of Proteobacteria and Actinobacteria (and resultant changes in metabolism). Lastly, we see exacerbations of pre-existing inflammatory bowel disease in women on oral contraceptives8. This poses an important question – do synthetic hormones, like the ones in birth control, further upend the balance and fluctuations of our microbiome? ​ So what does this mean for someone on a birth control pill? Well, we know that hormones influence the gut microbiota, and an improperly functioning microbiome can lead to several comorbidities, such as: Increased Intestinal Permeability (what the internet likes to refer to as “Leaky Gut” – undigested proteins, micronutrients, and potentially toxins that pass through the lining of your intestines inappropriately, often triggering an immune response. Gut Dysbiosis – a general state of imbalance of gut flora that can cause bloating, gas, acne, mental fog, constipation, indigestion, diarrhea, etc. Small Intestinal Bacterial Overgrowth – the overgrowth of bacteria in the small intestine which can cause cramping, bloating, diarrhea, constipation, indigestion, and gas. Gallstones – when gallstones develop they can impede the secretion of bile, leading to chronic pain, bloating, and gas. Allopathic medicine often resorts to gallbladder removal surgery to mitigate symptoms. Rebalancing the Imbalance To improve or eliminate the symptoms of chronic gut issues, switching to non-hormonal birth control may be an option for you. However, if you are using birth control to treat another underlying gynecological condition it may not be in your best interest to simply stop taking it. Always speak to your Doctor and Naturopath before discontinuing any medication to ensure this option is right for you. If non-hormonal interventions are not an option, it is important to focus on rebuilding and supporting a healthy gut microbiome. One of the best ways to support our microbiota is to eliminate foods from the diet that can lead to further imbalance. Cut back or eliminate: High-fructose corn syrup Artificial sweeteners like aspartame, sucralose, and saccharin, along with sugar alcohols (xylitol, sorbitol, mannitol, etc) Processed refined sugar Foods that are artificially coloured Pre-packaged or ready-made foods Fried foods. It is also important to eat a diverse diet rich in whole foods to feed our microbiota and increase the production of a very important short-chain fatty acid, known as butyrate. Butyrate helps to not only improve digestion, but to decrease inflammation, and is increased by the following foods: Prebiotic foods -- artichokes, asparagus, and garlic (not FODMAP friendly) Legumes -- green beans or black beans Fruits – strawberries, mangoes, and melons Fermented foods – sauerkraut, yogurt, kefir, or kombucha Prebiotic fibres, like acacia gum and guar gum For more guidance and help support your gut health, hormones, and achieving a healthy balance, please feel free to schedule an appointment online with Dr. Courtney Homberg, Naturopathic Doctor in Toronto, or by calling the clinic at 647-351-7282 today! [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3569485/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3322543/ 3 https://www.ncbi.nlm.nih.gov/pubmed/16552294 4 https://www.ncbi.nlm.nih.gov/pubmed/27700135 5 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1392899/ 6 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4398427/ 7 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505857/ 8 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4928680/

We all know that getting enough sleep is important. But how important? Sleep impacts our mental health, emotional health, and physical health. But with our busy lives and hectic schedules, it’s often easy to put a good night’s rest on the back burner. Sometimes, even when we get into bed at a reasonable hour, we may not be able to fall asleep or stay asleep. However, recent research confirms continuous sleep deprivation can have more far-ranging consequences on health than we may have once realized, with negative impacts demonstrated on our intestinal microbiomes, immune system, insulin resistance and weight management, amongst a myriad of other health issues. Sleep and Your Microbiome: A Two-Way Street It may be tempting to think that a couple of late nights won’t hurt in the long run, but not getting enough sleep affects your gut health much sooner than you would expect. A 2016 Swedish study showed that after just two nights of less than six hours of sleep, the number of certain beneficial gut bacteria strains was reduced by almost half, while less desirable strains increased in numbers. To make matters worse, the study participants were almost 20% less sensitive to insulin (1), which will result in higher blood sugar levels and increased risks for diabetes. Our second brain — the digestive tract — also has a huge impact on how much sleep and the quality of sleep we get, too. Our microbiome plays a role in our moods, hormones, neurotransmitters, and stress levels — all of which can affect our sleep. Interestingly, about 60-90% of patients with IBS symptoms report mood conditions, such as depression, anxiety and insomnia. Stress hormones, particularly cortisol, adrenaline, and norepinephrine, are all demonstrated to increase significantly under states of sleep deprivation. Mice models have now confirmed that mice exposed to stress have 68% reduction in the diversity of their microbiome, and 72% increase in GI-related disorders when compared to controls (2). What’s even more interesting is that the use of a specific probiotic, L. rhamnosus JB-1, increases GABA reception in the hippocampus through the vagus nerve, and reduced stress-induced corticosterone and anxiety/depression-related behaviours (3). To optimize the health of your microbiome, ensure to: Eat a whole foods, plant-rich diet. Eat probiotic foods, like yogurt, kefir, sauerkraut and kombucha (if they’re tolerated, and if you don’t have SIBO) Add prebiotic foods, like artichokes, asparagus, and apples, to your diet (if they’re tolerated, and if you don’t have SIBO). Avoid refined sugars, simple carbohydrates, and processed foods. Get regular exercise – this lowers your cortisol and improves your sleep quality. Consider testing your microbiome Improve Your Sleep Habits to Improve Your Gut Health Stay away from electronics — especially before bedtime. While many cell phones and other electronics now come with a nighttime setting, the stimulation from screen time can still disrupt melatonin production. Turn off your devices about two hours before bedtime to ensure your brain is relaxed and ready for sleep. Keep your room dark and cool. Ambient light can disrupt circadian cycles and melatonin production. Consider purchasing blackout curtains to reduce exposure to ambient light from outside, cover the LCD screens of clocks and electronics, and make sure to turn off the television. Turning down the thermostat is also conducive to a good night’s rest. Stick to a regular bedtime — even on the weekends. It’s tempting to stay up on the weekends in order to fully maximize our downtime. However, our bodies are designed to stick to a routine and a disruption to that routine will impact circadian rhythms. Limit your caffeine intake. Make sure to check your favourite teas for caffeine and skip the coffee after lunch. If you need a midday boost, consider taking a B-complex vitamin or some adrenal-supportive herbs for a natural pick-me-up that won’t impact your ability to fall asleep. For more information about your digestive health, or to discuss your sleep concerns, please feel free to contact your local Toronto Naturopath, Dr. Courtney Holmberg, ND. Book an appointment online or call 647-351-7282 today! Sources: Benedict, C., Vogel, H., Jonas, W., Woting, A., Blaut, M., Schürmann, A., &Cedernaes, J. (2016). Gut microbiota and glucometabolic alterations in response to recurrent partial sleep deprivation in normal-weight young individuals. Molecular Metabolism, 5(12), 1175-1186. doi:10.1016/j.molmet.2016.10.003 Rea K, Dinan TG, Cryan JF. The microbiome: A key regulator of stress and neuroinflammation. Neurobiol Stress. 2016 Mar 4;4:23-33. eCollection 2016 Oct. Javier A. Bravo, Paul Forsythe, Marianne V. Chew, Emily Escaravage, Hélène M. Savignac, Timothy G. Dinan, John Bienenstock, and John F. Cryan. Ingestion of Lactobacillus strain regulates emotional behavior and central GABA receptor expression in a mouse via the vagus nerve. PNAS September 20, 2011 108 (38) 16050- 16055; https://doi.org/10.1073/pnas.1102999108

Millions of people around the world live with autoimmune disorders, which is why it’s so important that our understanding of these disorders continues to grow rapidly. A growing body of research suggests that chronic illness responds best to a multifaceted methodology of diet and lifestyle changes that include a focus on anti-inflammatory nutrition, moderate exercise, adequate and plentiful sleep, and reasonably reducing stress. This approach to managing autoimmune disease has been termed ‘the Autoimmune Protocol’ (AIP) and may be the key to successfully managing autoimmune disorder symptoms. What you eat matters. What we put into our bodies has a significant impact on our health – even for those of us considered generally healthy. Processed foods, refined sugars, and saturated fats can contribute to the onset of autoimmune symptoms. But even some ‘good-for-you’ foods may affect gut flora and result in the recurrence of autoimmune symptoms. To allow the body to heal from the effects of autoimmune symptoms, it is important to stick to nutritionally dense foods, but more importantly, avoid ingredients that promote inflammation and hence immune activation. Such items include: Processed vegetable oils: corn, canola (rapeseed), palm kernel, peanut, safflower, sunflower and soybean oil Processed food chemicals: artificial colours and flavours, emulsifiers (carrageenan, cellulose gum, guar gum, xanthan gum, lecithin), monosodium glutamate (aka MSG), nitrates/nitrites (naturally occurring are ok), phosphoric acid, propylene glycol, textured vegetable protein (aka TVP), trans fats (hydrogenated and partially hydrogenated vegetable oils, such as margarine), yeast extract, and any chemical on a label you don't recognize or can’t pronounce. Problematic sugars and sweeteners: agave/agave nectar, barley malt, brown rice syrup, cane sugar, caramel, corn sweetener, high fructose corn syrup (really, any corn syrup), crystalline fructose, dextrin, dextrose, evaporated cane juice, fruit juice concentrate, galactose, glucose, inulin, lactose, monk fruit, maltose, maltodextrin, rice syrups, sorghum syrups, sucrose/sucralose, and of course, refined sugar Instead, replace for: Olive oil (at room temperature) or avocado oil when cooking (due to high smoke point and low trans/saturated fats Vegetables such as beets, asparagus, sweet potatoes, and kale Fruits as a sweet treat, such as apples, figs, grapes, and melons Sweeteners such as stevia or erythritol (if you have no gastrointestinal issues) When you eat matters. Just as important as what we put into our bodies when we put nutrition into our bodies also matters. According to recent studies [1], disruptions to our eating and fasting cycles can contribute to an imbalance in gut microbiota and an increase in inflammatory responses. Try to avoid forcing eating when feeling stressed. Avoid eating late at night, before bed, or during the night. Stick to regular mealtimes instead of grazing throughout the day. Exercise to improve your gut biome. Many autoimmune disorders are stress-triggered. Regular aerobic exercise has been recommended for decades as a natural and healthy way to reduce stress and cortisol levels while increasing feel-good endorphins. Exercise can help to manage the symptoms of chronic illness. But beyond merely symptom management or de-stressing, exercise can improve your gut biome (which we know to be a key factor in the development of autoimmunity). In a recent study [2], scientists studied participants just beginning an exercise regimen. For several weeks during active exercise, the researchers discovered the increased presence of microbes that produce short-chain fatty acids – the acids that help repair damage from inflammation, fight insulin resistance, and help boost metabolism. The presence of these microbes was significantly diminished after participants stopped exercising regularly. Manage your lifestyle. Our constantly-connected sleep-deprived lifestyles are doing more harm than good – especially to our microbiota – and may be contributing factors, along with diet, to the development of autoimmune disorder symptoms. To mitigate these symptoms, it is important to get plenty of sleep and eliminate as much unnecessary stress from daily life. Mindfulness meditation – meditation has been shown to reduce stress, give us a deeper sense of well-being, and help regulate circadian rhythms. It’s also been shown to change our microbiome. Digital detox – being constantly connected not only exposes us to excessive amounts of light but keeps our stress levels up. At least an hour before bedtime, turn off all electronic devices and turn down the lights. Get outside – fresh air and natural light can help restore natural circadian cycles and help reduce stress. Connecting barefoot with the grass, also known as grounding, “reduces pain and alters the numbers of circulating neutrophils and lymphocytes, and also affects various circulating chemical factors related to inflammation” [3]. For more help with supporting your gut health, achieving a balanced lifestyle/diet, or general health guidance in autoimmunity, please feel free to schedule an appointment online with Dr. Courtney Homberg, Naturopathic Doctor in Toronto, or by calling the clinic at 647-351-7282 today! ​ References: [1] https://www.gutmicrobiotaforhealth.com/the-gut-microbiota-clock-the-close-connection-between-gut-microbiota-dietary-patterns-and-the-circadian-rhythm/ [2] https://pubmed.ncbi.nlm.nih.gov/29166320/ [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378297/

Odds are, you know at least one woman around you who has PCOS. It is a common condition affecting women of reproductive age, with prevalence rates approximated to be around 1.4 million in Canada alone. Upon diagnosis, most women’s first question is ‘how will this impact my fertility’? Unfortunately, there is no short answer, but the general conscience is that while PCOS is unlikely to cause infertility, and can certainly make it harder to conceive, and increases the risks of secondary complications. However, the good news is there are numerous ways to improve PCOS to ultimately assist in a woman’s chances of conception and lead to a healthy pregnancy if she has PCOS. Let’s learn more about PCOS and how to improve your chances of getting pregnant with it. What Is PCOS? PCOS or polycystic ovary syndrome is a hormonal condition where the ovaries produce an elevated amount of androgen hormone or male sex hormone. Androgens are naturally present in females in small amounts. However, increased levels can lead to failed or delayed ovulation, irregular periods, and other symptoms such as darkened hair growth and acne. PCOS can result in delayed ovulation, thus causing irregular or no periods for weeks to months. Ovulation is part of the menstrual cycle where follicles in the ovaries release a mature egg, and its timing is arguably one of the most important variables to successfully conceive since the released egg is only viable to be fertilized for approximately 24 hours. In many patients with PCOS, the egg releases at erratic points in the cycle, or sometimes does not release at all, therefore remaining inside the ovaries in the form of a cyst (thus polycystic ovary syndrome). Irregular timing, failed ovulation, or poor quality ovulation all present challenges when trying to fertilize, thus making it more challenging for patients with PCOS to conceive. Symptoms of PCOS Women of any age after puberty, from 15 to 44 years, can develop PCOS. Let us look at the symptoms of it: Irregular, absent periods Weight gain Acne Excessive hair fall Hair thinning Prolonged bleeding during periods Causes Of PCOS The true causes behind PCOS are not yet discovered. However, the literature suggests some factors that are linked to PCOS as follows: 1 - Genetics If someone in your family, such as your mother or relative, has PCOS, you are more likely to develop it correlates to genetics. 2 - Excessive Androgen The female body produces androgens or ‘male patterned hormones’ in certain amounts. However, the higher the androgenic hormones the higher the risk of PCOS. 3 - Overweight Or Obesity Women with obesity and poor BMI are at greater risk of having PCOS due to the impacts of insulin. The vice-versa is also true; women with PCOS tend to gain weight easier. An optimal diet and exercise routine can assist in regulating ovulation if are planning a baby. 4 - Higher Levels Of Insulin As previously mentioned, women with PCOS face trouble with increased insulin levels due to failed insulin uptake. Insulin is known to regulate ovarian function, so irregular levels cause unpunctual ovulation. How To Get Pregnant With PCOS? PCOS can affect fertility and conception in women, however, it often does not mean you cannot get pregnant. Assist the regulation and quality of your ovulation by keeping the following things in check: 1 - Do your best to maintain a healthy weight I list this with a grain of salt, as I see firsthand in practice how hard some PCOS patients struggle to maintain or lose weight despite doing all the right things. This is where further investigation into metabolic function and other exocrine organs is necessary. However, for those with PCOS who do not maintain and balanced diet and exercise routine, doing so can largely improve your chances of pregnancy, and secondary complications during pregnancy such as gestational diabetes, miscarriage, pre-eclampsia, etc. 2 - Track Your Ovulation To stay aware of your fertile days, track your periods and ovulation with the help of tracking apps, or more accurately, using Luteinizing hormone (LH) strips. Remember, the accuracy of these apps isn’t 100% (it's based on statistical averages) and was far from ‘average’, so using LH strips, temperature monitoring, and cervical mucous monitoring can produce significantly more accurate results. 3 - Blood Sugar Levels Make sure to get your blood sugar levels checked by a doctor. Maintaining healthy blood sugar levels is crucial for pregnancy, both prior to conception and during. 4 - Nutraceuticals Speak to your naturopathic Doctor in Toronto about supplements that can help with fertility and regulating your cycle. There are endless studies that now show many nutraceutical products such as inositol, NAC, CoQ10, folic acid, and vitamin D, amongst many others can help improve insulin sensitivity, regulate ovulation, and improve the health of the uterine lining, which is great for all women with PCOS, despite whether or not they’re trying to conceive. There are also numerous supplements that are NOT safe during pregnancy, so ensure to speak to your Naturopath before taking any of the following to confirm the safety of use and proper clinical dosages. ​ Unfortunately, there is no cure for PCOS to date, and it is often not self-limiting (goes away on its own). But you can manage the symptoms with a number of the methods we just mentioned. Eat a balanced diet that is low in refined carbs but high in complex carbs. Keep your weight healthy and consult a practitioner for prescribed medications and professional advice. Lastly, While PCOS is a common condition, and many women will move in and out of symptomatic states throughout their life, it isn’t one that you have to continue to suffer from. For more information about PCOS, or if you need to advise on improving your fertility, please feel free to contact Dr. Courtney Holmberg, ND at 647-351-7282 to arrange a consultation today.