Vancouver Naturopathic Doctor
Dr. Marni Ross, ND

Naturopathic Articles by Dr. Ross

Taking Control of Menopausal Weight Gain

By the time women reach 40 years old, which is even before the average age of menopause, our metabolisms slow down.  We need to consume 100-200 calories less than we used to, just to maintain the same weight.  For every woman, in order to properly diagnosis and treat each person individually, a practitioner must look at many factors including the adrenal glands, glucose and insulin levels, female hormone imbalances, thyroid levels, digestive health and lifestyle habits.

The first area I would like to address is a topic called estrogen dominance.  This term means an excess of estrogen (“bad estrogen”) to progesterone.  A woman’s level of healthy estrogen declines as she approaches menopause which contributes to the typical menopausal symptoms of hot flashes, dry skin, decreased libido etc.  However, it is the “bad estrogens”, also called xenoestrogens, that contribute to weight gain (specially increase in abdominal fat).  We are exposed to these xenoestrogens through commercially raised meat and poultry, high fat dairy, pesticides, plastics and cosmetics.  Increased bad estrogen can also slow down the metabolism by its effect on decreasing thyroid hormones.

Another factor that contributes to weight gain is insulin resistance, also known as Syndrome X.  Insulin is the hormone whose main function is to process sugar (glucose) in the bloodstream and carry it to the liver, muscle cells and fat.  When your body has too much insulin, relative to glucose, your cells can become resistant or desensitized.  Insulin resistance can be diagnosed through elevated blood work such as fasting blood sugar and insulin, triglycerides, uric acid and increased waist to hip ratio. 

Digestive health also needs to be addressed when looking at a healthy metabolism.  Studies have shown that there are different types of good bacteria in the guts of healthy individuals compared to those that are obese.  Therefore, having enough good bacteria in your diet is extremely important, not only for healthy digestion but for promoting an efficient metabolism as well. 

Cortisol levels have a direct impact on metabolism.  When under high amounts of stress, higher cortisol levels are released and this signals the sympathetic physiological response or the flight or fight response.  The release of these hormones signals a cascade of events to carry out, one being the encouragement of the body to store fat.

Lack of sleep also plays a huge role on weight gain.  There are two hormones involved in appetite and sleep, called Ghrelin and Leptin.  Ghrelin, the hormone that increases appetite, is elevated during times of sleep deprivation while Leptin, the appetite suppressing hormone is decreased during these times.  In other words, when you are sleep deprived, you may be hungrier. 

Treatment involves initially addressing which of the above mentioned factors are contributing to the weight gain.  If the weight gain is simply due to an increase in cravings and calorie consumption, then there are some herbs that may be used in the short term such as Green Tea extract and Garcinia. 

If the underlying issue is due to a hormone imbalance such as estrogen dominance, insulin resistance or cortisol imbalance, then speak to a Naturopathic Doctor about the many treatment options that are available. 



A Naturopathic Approach to Controlling Blood Sugar

World Health Organization recommending a significant decrease in daily sugar consumption, I thought it would be beneficial to provide some information on ways to cut sugar from the diet while offering some helpful tips.
Sugar has become so prevalent in our diets.  We might not even be aware that we are eating sugar as it is often hidden in various terminology on product labels.  Therefore, it’s so important to read labels and be aware of the various terms and forms of sugar. The hidden sugars to watch for include:  sucrose, fructose, maltose, lactose, glycogen, glucose, mannitol, sorbitol, galactose, monosaccharides, and polysaccharides.

Insulin is a hormone produced by the pancreas that your body needs to convert sugar into energy.  There are nutrients and herbs that have been shown to help support insulin production and stabilize glucose metabolism.  Chromium is an essential mineral (it is not made by the body, it must be obtained by the diet) and it enhances the effect of insulin in the body.  Long term supplementation of Vitamin E has a positive effect on blood sugar levels.  Increasing Zinc consumption, either through the diet or as a supplement, can improve glucose levels.

There are natural sugars that can substitute white sugar but should still be eaten in small amounts.  These include honey, date sugar, cocoa, carob and stevia. 

Herbs that have been researched for their anti-diabetic properties include Cinnamon, Gymnema and Bilbery.  It is important to speak with a licensed healthcare practitioner before taking these supplements to determine if they are suitable for you. 


Gluten Intolerance Testing:  What Options are Available?

 
The rise in gluten intolerances is becoming quite evident.  Most grocery stores have gluten-free alternatives these days and many restaurants are providing gluten-free substitutes.  So what is causing the shift to eliminate gluten from our diets?  Is it because people cut it out for a certain period of time and they note marked improvements in their health?  Or are people having testing done to see if they are in fact gluten intolerant?

When it comes to my practice, most of my patients have tried avoiding gluten before coming to see me if they felt they could have problems with gluten.  Sometimes, an elimination diet is enough and they are confident to say that they are gluten intolerant.  However, more often than not, an elimination diet is not conclusive.  Compliance with this diet can be difficult for many people and the symptoms are not consistent.  This is when gluten intolerance testing can be quite valuable.

At my clinic, I offer a variety testing options:

  • IgG/IgE Blood Serum Blood draw (as part of a food panel)  - If you are looking to do overall food allergy testing, in addition to gluten, this is the way to go.  This tests for both immediate (IgE) and delayed (IgG) reactions to 95 different foods.
  • IgG Fingerstick (as part of a food panel) – This is another general food allergy test, that only tests for the delayed (IgG) reactions to foods.  It does not involve a blood draw, rather a simple prick from the tip of the finger.
  • Saliva Testing as part of an adrenal hormone panel – This is a useful test if you feel you have a cortisol imbalance (cortisol is your “stress” hormone).  There is a link between ingestion of gluten, gut inflammation and increased cortisol levels.  If you choose to test for a gluten intolerance through saliva, without doing the entire adrenal panel, this is an option as well.
  • Gluten Sensitivity Stool Testing - This type of testing has become popular due to the large amount of immune cells that line the intestinal tract assigned to protect the body from foreign invaders.  In this case, a specific antibody that your body produces against gluten called fecal anti-gliadin IgA is assessed. 
  • Gluten Sensitivity Gene Test (cheek swab) – This tests for your risk of having or developing a gluten intolerance based on your genetic predisposition. 

Removing gluten from your diet, if you are allergic or intolerant, can change every aspect of your health and well-being.  Talk to your Naturopathic Physician to see what options are best for you.


Monitoring Internal pH Helps Evaluate Overall Health


Measuring your pH can give you a good indication of your body’s systems and it can tell you if your organs are overburdened.  An abnormal pH does not indicate disease but it does however help evaluate health or disease potential.  Using pH paper (with a urine or saliva sample) will indicate if your body chemistry is too acidic or too alkaline.  However, if is very rare to find individuals in North America who are too alkaline.  A normal saliva pH is around 6.5 and a normal morning urine pH is around 6.6.

If your pH is too low, then you might be told that you are “acidic”.  Basically your body chemistry balance is acidic due to the effects of the food you are consuming.  So what can you do?  To start with, make some changes in your diet.  Switch to alkaline-forming foods (such as green leafy vegetables, berries, almonds, etc.)  and decrease the amount of acidifying foods (corn, wheat, cheese, peanut butter, etc.) you are eating.  Drink at least 6-8 glasses of water everyday in order to improve kidney function.  Try supplementing your diet with some grass juices such as barley, alfalfa and wheat grass juices.  Have about 2 tablespoons of apple cider vinegar everyday.  It’s acidic for the gastrointestinal tract but alkalizing for the blood.  It’s important to monitor your urinary or saliva pH everyday.  If you’ve made changes to your diet and your pH is still the same, you can try having some alkalinizing salts. 


Should You Vaccinate Your Children?

I do not usually tell my patients whether to vaccinate or not.  I prefer to educate them on the benefits and side effects of vaccinations and help them to make an informed decision. 

Did you know that children receive 33 doses of 10 vaccines by the age of five?  As parents, it is important to know the truth about vaccines.  This includes: 

  • Accurate incidences of side effects for all vaccines
  • Which vaccines can be delayed or eliminated
  • Whether combination vaccines like MMR (measles, mumps, rubella) can be given individually

Many parents are unaware that they can get exemption from vaccinating their children for medical, philosophical or religious reasons.

Since the late 1950’s, when mandatory mass vaccinations started, there has been an increase in ADD, asthma, autism, childhood diabetes, learning disabilities and other chronic health problems.  On the other hand, we are fortunate to have stopped the epidemics of smallpox, polio, diptheria and measles.  Vaccines have become a necessary part of our lives, however, each act of administering small bits of disease can have possible debilitating consequences.  Every possible attempt should be made to ensure that today’s vaccines and those in the future are as safe as possible.

If you decide not to vaccinate, then there are homeopathic protocols that can be administered to children at any age to help protect against various diseases.  If you do go ahead with vaccinations, then there are excellent treatments that can be recommended that can support the kidneys and liver during the process while also preventing the binding of toxic material to the cells.  This ensures the benefits of the vaccines are received while removing potential toxins such as preservatives and other additives.

The most important thing is to know your options and consult your health practitioner to make an informed decision for both you and your children.


How to Nourish Healthy Skin


Most people are not aware that our skin is considered to be one of our main detoxification organs along with the liver, kidneys and colon.  So the expression “we are what we eat” is especially true when we talk about our skin.  It is unusual for people to be 100% truly happy with their skin.  Common complaints include skin that is too dry, too oily, too wrinkled, too many blemishes, too blotchy or too pale.  Genetics plays a huge role in the appearance of our skin as well as environmental exposures, however, one of the biggest factors that we have control over is what we choose to put into our bodies.

Here are the top 10 super foods that have been shown to nourish our skin and prevent the aging process:

  • Green tea
  • Olive oil
  • Avocado
  • Green vegetables
  • Berries
  • Garlic
  • Nuts (walnuts and brazil nuts)
  • Fish
  • Whole grains – rye, barley, brown rice, oats
  • Melons, especially watermelons (including the seeds)
  • Beans

When it comes to the skin, aging is not the only concern that arises for some people.  Common skin conditions that Naturopathic Doctors see include acne, rosacea, eczema, psoriasis and fungal infections.  The diagnosis and treatment of skin problems can be very frustrating to some patients because the underlying cause is often unknown.  Some possible causes include food allergies, Candidiasis (yeast overgrowth), essential fatty acid deficiencies, systemic (whole body) inflammation and excess histamine release, nutrient deficiencies, environmental factors and poor elimination function. 

If you have a skin condition of any kind, consider lab testing to find the underlying cause.  For example, there is a simple blood test that can be done to uncover food allergies and a stool analysis to diagnose Candida or the presence of yeast.  There are other blood tests that can be done to determine nutrient deficiencies and elevation of inflammatory markers. 

Once the underlying cause is determined, naturopathic treatments can be used to replenish a nutrient deficiency or reduce inflammation in the body through dietary modifications, nutritional and herbal supplements.  Ensuring proper elimination functions is often a key component to treatment as well.  Book in with your naturopath to see which treatment protocol is best for you. 


Premenstrual Syndrome

Premenstrual syndrome (or PMS) is a set of symptoms, both physical and emotional, that as many as 80% of women suffer from every month.  Most women are able to manage their symptoms and carry on with daily routines, however, a small percentage of women (2-5%) feel it has a significantly negative impact on their lives where relationships and work are affected.  Women who seek treatment are often prescribed either the birth control pill (to balance their hormones) and/or anti-depressant medication (to control their mood).  Naturopathic medicine can provide a wide range of alternatives to these options with fewer side affects.

Symptoms of PMS vary but the most common ones include irritability, mood swings, anxiousness, sadness and fatigue. Physical changes might be bloating, breast tenderness, headaches and food cravings. Symptoms usually start a few days before menses but for some women they could even start right after ovulation, 2 weeks before menses.  That’s half a month of feeling unwell!

Numerous natural alternative therapies are available including lifestyle changes, vitamin and mineral supplementation, herbal medicines and natural hormones.  When it comes to treatment, what works for one person is different than what works for another.  We are all individuals with our own unique physiological and psychological makeup affected by different stressors. Treatments offered for my patients vary depending on their own individual situations but I would like to outline a few general recommendations.

One of the first steps in treating PMS is addressing liver function. The liver is responsible for metabolizing estrogen so if its function is compromised, then this could lead to excess estrogen levels and an estrogen-dominant state (one possible underlying cause for PMS).  If the liver is determined to be “sluggish”, then various nutrients and herbal remedies might be recommended.  

Some important dietary suggestions include minimizing sugar, refined carbohydrates, caffeine, saturated fats and dairy products. Increase consumption of good fats (fish, nuts, seeds), legumes, fruits and vegetables.  

Studies have shown that specific nutrients are vital in preventing PMS. These include Vitamin B6, Vitamin E, Magnesium, Calcium (carbonate) and Gamma Linolenic Acid (found mostly in Evening Primrose Oil).  It’s always best to get these nutrients from food but if this is not possible then supplementation is recommended.

Herbal medicines that can be beneficial include Chaste Tree, St. John’s Wort, Dandelion Leaf, Lemon Balm and Ginkgo. These herbs can be extremely helpful but it’s important to speak to a knowledgeable healthcare practitioner before taking them to ensure the correct dose and avoid any drug interactions.

PMS is a common condition, with varying degrees of symptoms but as I’ve outlined here, there are many treatment options available. PMS can be well addressed by lifestyle changes and safe and effective nutritional and herbal supplementation.  



Irritable Bowel Syndrome:  A Naturopathic
Approach

Irritable bowel syndrome (IBS) is a chronic gastrointestinal condition that can significantly affect a person’s quality of life.  The disease can be very frustrating to patients because it often takes a long time and many laboratory tests to come up the diagnosis, a diagnosis of exclusion.  What that means is that all laboratory tests come back normal but the symptoms are there, so all other gastrointestinal disorders are ruled out and this is the diagnosis that is given as a result.  The purpose of this article is to outline the signs and symptoms of irritable bowel syndrome, and to discuss the complementary and alternative treatment options available.  

IBS is defined as “abdominal pain or discomfort that occurs in association with altered bowel habits over a period of at least three months.”  Symptoms include constipation and/or diarrhea, flatulence/gas, abdominal pain/bloating, nausea, anxiety and low appetite. Women are about 1.5-2 times more likely to develop IBS than men. Although it is present in all age groups, prevalence of IBS seems to decline with advanced age.  IBS affects daily functioning, work, mood and lifestyle and interrupts sleep, which leads to increased fatigue.

IBS symptoms are often compared to inflammatory bowel disease (Crohn’s disease or ulcerative colitis) or celiac disease but IBS does not present with any abnormal laboratory values.  Although the pathogenesis of IBS is not known, a multi-factorial involvement of diet, gene mutations, psychosocial factors, and immune mediated processes is hypothesized.

IBS can be classified as diarrhea predominant (IBS-D), constipation predominant (IBS-C), or a mixed form (IBS-M).   Since the symptoms vary so greatly between patients, the pharmaceuticals available are mainly targeted at symptom reduction.

Complimentary or alternative treatments have been reported to be used in 50% of people suffering from IBS.   A primary goal of all IBS interventions is to provide the patient with relief of symptoms and improve the quality of life. Although the data from clinical trials may in some cases not provide strong evidence for benefits of dietary modification, it remains the primary non-pharmacological clinical intervention for IBS patients; many healthcare practitioners successfully use exclusion diets.

IBS studies indicate a positive relationship between fat intake and increased stool number and diarrhea.  Intake of carbohydrates can also aggravate IBS symptoms.  Offending carbohydrates include fructose and fructose-containing products such as soft drinks, cereals, and packaged/baked goods. Sorbitol and other sugar-alcohols found in most sugar-free or reduced-sugar products are poorly absorbed in the gastrointestinal tract and may cause increased flatulence, abdominal discomfort, and diarrhea, thus exacerbating IBS symptoms. Other types of sugar-alcohols proposed to aggravate IBS symptoms include mannitol, xylitol, erythritol, lactitol, maltitol, and isomalt.

Increased fiber intake can help to decrease the bloating in some patients, especially psyllium fiber in patients with IBS-C.   Wheat bran fiber on the other hand has been shown to actually worsen the symptoms of IBS patients.  This could be due to a wheat intolerance, which is one of the most common triggers for food sensitivity in people with IBS.

Several studies have been done on the effectiveness of probiotics on IBS and the primary endpoints of many studies are reductions in bloating, abdominal pain and flatulence.  

Single herbs that have been studied include peppermint oil, turmeric extract, and artichoke leaf.  Steam distillation oil extracts from the peppermint plant (Mentha piperita, Lamiaceae) are among the oldest remedies for treatment of GI problems. These extracts are believed to improve IBS symptoms by exerting a spasmolytic effect on the smooth muscles in the digestive tract.   It is suggested to give 0.1-0.2 mL three times daily for no longer than two weeks under the guidance of a health care practitioner.

Exercise can help maintain GI function and reduce stress, which can help relieve some IBS symptoms. Studies of IBS indicate positive relationships between physical activity and symptom relief.  Physical activity, such as pedaling a bicycle and yoga, protect against GI symptom aggravation and alleviates gas in several studies.  

In conclusion, complementary therapies have been proven to reduce symptoms in patients suffering from IBS.  The treatments recommended will vary from patient to patient but a combination of dietary modifications, herbal and nutritional supplementation and lifestyle changes can greatly improve a patient’s quality of life.  

Sources:

1  American College of Gastroenterology Task Force on Irritable Bowel Syndrome, Brandt LJ, Chey WD, et al. An evidence-based position statement on the management of irritable
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2  Rey E, Talley NJ. Irritable bowel syndrome: novel views on the epidemiology and potential risk factors. Dig Liver Dis 2009;41:772-780.
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clinical trials. Eur J Gastroenterol Hepatol 2005;17:411-420.
4  Mathew P, Bhatia SJ. Pathogenesis and management of irritable bowel syndrome. Trop Gastroenterol 2009;30:19-25.
5  Cash BD, Chey WD. Diagnosis of irritable bowel syndrome. Gastroenterol Clin North Am 2005;34:205-220.
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Gastroenterol 2005;39:138-141.
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8  Ford AC, Talley NJ, Spiegel BMR, et al. Effect of fibre, antispasmodics, and peppermint oil in the treatment ofirritable bowel syndrome: systematic review and meta-analysis. BMJ
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Benefits of Fish Oils

Fish oils, sometimes known as Omega 3 fatty acids, are one of those supplements that truly can benefit so many people and help to treat a variety of health conditions.  Fish oils contain two essential fatty acids – EPA (eicosapentaenoic acid) and DHA (docosahexaenoic acid).  These essential fatty acids can be found in vegetarian sources as well, such as flax oil, however only a very small amount can be converted into EPA.  

So what exactly are these essential fatty acids and how can they help you?  DHA is required for optimal brain health.  The cells that surround the brain need these fats.  Therefore DHA specifically helps with memory retention, concentration and focus.  In addition, it is required for the brain of a developing baby, so all pregnant women out there, consider adding fish oils to your list of supplements.  EPA has an anti-inflammatory affect on the body, so any type of inflammatory condition such as arthritis, eczema, allergies, inflammatory bowel disease, asthma and headaches can improve when these fats are taken.  EPA also has a huge impact on cardiovascular health.  Specifically, it can the lower the “bad” cholesterol and can help with arteriosclerosis.

Eating different types of fish such as mackerel, salmon, herring, sardines, black cod, anchovies, albacore tuna, and wild game is a sure way to get your Omega 3 fatty acids.  However, when treating the conditions mentioned above, sometimes eating fish is not enough.  In these situations a good quality fish oil supplement is often beneficial.