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Bolster Your Immune System for The Holiday Season

Q&A: How Will My Immune System Survive The Holidays?

 

With winter and family holidays fast approaching, I am constantly asked about what can be done to bolster the immune system and reduce stress. Here are some easy tips to get you through the rest of the year.

 

Q: I’m travelling a lot over the holidays, what can I do to boost my immune system?

 

A: A recent study used elderberry to prevent the onset of influenza during air travel. The study looked at 600-900 mg of elderberry extract containing 90-135mg of anthocyanins. Study participants took 2 capsules per day for 10 days before air travel. Two to four days before departure, the dosage was increased to 3 capsules per day, until 4 days after arrival at their destination (1).

immune system dr. eric viegas

Anthocyanins belong to the flavonoid group of phytochemicals; commonly found in teas, wine, fruits, vegetables, nuts, olive oil, and cocoa. They add vibrant color to these foods, along with a potent antioxidant capacity. Recent research into the human effects of anthocyanins has revealed their ability to strengthen blood vessels, balance the immune system, and combat inflammation (2,3).

 

Of the 312 participants taking the elderberry extract, 29 developed a cold. The group taking the placebo treatment had greater symptom severity and over twice the duration of illness compared to the elderberry group.

 

For more information on how you can best avoid the cold and flu this year, click here

Q: I’ve heard sugar can compromise my immune system. What lifestyle behaviours can help me with my sweet tooth?

 

A: Sugar is a contributing factor when dealing with illness over the holidays. Try structuring your meals with a low carbohydrate content, and increase your consumption of proteins from meat and vegetable sources. Some good vegan sources of protein include pumpkin seeds, lentils, black beans, almonds, and tempeh.

healty immune system dr. eric viegas

Munching on high protein snacks will help to keep your blood sugar stable, increase feelings of fullness, and make it less likely for you to grab extra holiday treats.

 

Q:What about stress and my immune system? My family drives me crazy over the holidays, and I know I’m going to get sick because of the added stress…

 

A: Stress is an inevitable part of everyone’s lives. Unfortunately, you can’t pick your family, but you can build your resilience to the added stress that comes with holiday get togethers.

 

Daily yoga is an excellent way to tone your nervous system and help you keep a cool head when dealing with added stress.

healthy immune system dr. eric viegas

A recent systematic review of 11 studies found that yoga enhanced the production of the body’s own antioxidants vitamin C and glutathione in healthy, diabetic, prediabetic, hypertensive, and renal disease patients. As a result, there was a significant reduction of oxidative stress after a session of yoga (4).

 

The great thing about yoga is that you don’t need to go to a class to reap the health benefits. A quick search of youtube will get thousands of results for many different types of yoga; one for every person’s unique needs.

 

Have a safe and happy holiday!

 

References:

 

  1. Tiralongo E, Wee SS, Lea RA. Elderberry supplementation reduces cold duration and symptoms in air-travelers: a randomized, double-blind placebo-controlled clinical trial. Nutrients. 2016;8(4):182.
  2. Lila, Mary Ann. “Anthocyanins and Human Health: An In Vitro Investigative Approach.” Journal of Biomedicine and Biotechnology 2004.5 (2004): 306–313. PMC. Web. 2 Nov. 2017.
  3. Youdim K, Martin A, Joseph J. Incorporation of the elderberry anthocyanins by endothelial cells increases protection against oxidative stress. Free Radic Biol Med. 2000;29(1):51–60.
  4. Pal, R. & Gupta, N. (2017). Yogic practices on oxidative stress and of antioxidant level: a systematic review of randomized controlled trials. Journal of Complementary and Integrative Medicine, 0(0), pp. -. Retrieved 2 Nov. 2017, from doi:10.1515/jcim-2017-0079.

Eczema FAQs & How Naturopathic Medicine can help

eczema dr eric viegas

Dr. Eric Viegas, ND

 

Why do I have Eczema?

  • Partly due to genetics, immune dysregulation causing allergic inflammation, and environmental factors.
  • If you have a family history of eczema you are more likely to develop it. Environmental factors like bacterial (staphylococcus aureus) colonization of damaged skin, and chronic phthalate exposure (found in textiles, food products, and plastics) contribute to inflammation and immune dysregulation.
  • There is some evidence that the presence of helicobacter pylori, a bacteria commonly known for causing stomach ulcers, can also contribute to immune dysregulation and inflammation of the skin barrier.
  • Food triggers are also an important contributor to eczema. Increased intestinal permeability contributes to allergen sensitization, so chances are good that your digestive system needs some help. A naturopathic doctor can work with you to establish which foods may be contributing to your eczema.
  • If you have endocrine problems like thyroid disease it is best to take your medication and be well managed, as worsening hypothyroidism may also worsen the severity of your eczema.

 

What is the best treatment for Eczema?

  • A combination of dietary management, skin care, and stress management will help to control the chronic symptoms of eczema and address the underlying causes.

 

Can diet affect Eczema?

  • Eggs, wheat, dairy, soy, peanuts, tomatoes, and artificial colours & preservatives have been implicated as triggers in a large percentage of eczema cases. Elimination of these offending foods has been shown to restore normal intestinal function and reduce the progression of new food allergies. Avoidance of these foods may be continued for up to one year to achieve the best results.
  • There is also a growing body of evidence to support histamine intolerance in the development and severity of eczema. In histamine intolerance, ingestion of histamine-rich foods (think red wine, aged cheeses, cured meats) overwhelms your gut’s ability to breakdown this inflammatory molecule. Overtime, more systemic signs of histamine intolerance (rashes, heart palpitations, irritable bowel syndrome, and allergies) develop.
  • Eating more fatty fish (eg. salmon, herring) in pregnancy, lactation, infancy and childhood has shown protective effects against eczema in epidemiologic studies.

 

What lifestyle behaviours can help with my eczema?

  • First, stop scratching. Scratching will break the skin barrier and allow for bacterial colonization.
  • In terms of keeping clean, baths are more beneficial than showers as long as you remember to “soak and smear”; bathe, pat yourself dry, and then apply a very generous amount of moisturizer to the skin. For added benefit, soak oatmeal in a clean cloth bag in your bath to soothe your skin.
  • People suffering from the itchiness of eczema tend to have more anxiety, and feel more stressed out. Finding an outlet for your stress and keeping your anxiety at a manageable level will help to benefit your outlook and the severity of your eczema. A naturopathic doctor has many tools to address high stress and anxiety.

 

What are natural topical remedies for Eczema?

  • Seabuckthorn oil, castor oil, olive oil, coconut oil, calendula oil, chickweed cream, and moisturizers containing beeswax can all help to moisturize the skin and maintain its barrier. It is also important to use a mild pH-neutral soap free of any perfumes or fragrances to avoid any unwanted skin irritation.

 

What Supplements are good for Eczema?

  • Daily fish oil supplementation and use of the probiotic strains lactobacillus acidophilus and bifidobacterium bifidum are two supplements with good evidence for use in eczema.
  • However, you should always consult your doctor before starting any new medication or supplement. A naturopathic doctor will take a thorough health history to determine any other health concerns that should be addressed along with your skin health and come up with a comprehensive treatment plan. It is not uncommon for people with eczema to also experience digestive issues, allergic rhinitis (seasonal allergies), and asthma.

 

References:

 

Kido M., Tanaka J., Aoki N., et al: Helicobacter pylori promotes the production of thymic stromal lymphopoietin by gastric epithelial cells and induces dendritic cell-mediated inflammatory Th2 responses. Infect Immun 2010 Jan; 78: pp. 108-114

 

Elias P.M., and Schmuth M.: Abnormal skin barrier in the etiopathogenesis of atopic dermatitis. Curr Opin Allergy Clin Immunol 2009 Oct; 9: pp. 437-446

 

de Maat-Bleeker F., and Bruijnzeel-Koomen C.: Food allergy in adults with atopic dermatitis. Monogr Allergy 1996; 32: pp. 157-163

 

Agata H., Kondo N., Fukutomi O., et al: Effect of elimination on food-specific IgE antibodies and lymphocyte proliferative responses to food antigens in atopic dermatitis patients exhibiting sensitivity to food allergens. J Allergy Clin Immunol 1993; 91: pp. 668-679

 

Kremmyda L.S., Vlachava M., Noakes P.S., et al: Atopy risk in infants and children in relation to early exposure to fish, oily fish, or long-chain omega-3 fatty acids: a systematic review. Clin Rev Allergy Immunol 2011 Aug; 41: pp. 36-66

 

Barnes B.: Thyroid therapy in dermatology. Cutis 1971; 8: pp. 581-583

 

Maintz, L., et al. “Evidence for a reduced histamine degradation capacity in a subgroup of patients with atopic eczema.” The Journal of Allergy and Clinical Immunology. Vol. 117, No. 5 (2006): 1106–1112.

 

Worm, M., et al. “Exogenous histamine aggravates eczema in a subgroup of patients with atopic dermatitis.” Acta Dermato-Venereologica. Vol. 89, No. 1 (2009): 52–56.

 

Chronic Prostatitis: When antibiotics and pain meds aren’t enough

Chronic Prostatitis Dr. Eric Viegas Naturopathic Medicine Ottawa

Chronic Prostatitis: When antibiotics and pain meds aren’t enough

 

Dr. Eric Viegas, ND

 

Chronic Prostatitis is an inflammation of the prostate gland and commonly affects young males who have had a previous viral or bacterial infection. It is estimated that about half of all males will be diagnosed with some form of prostatitis during their lifetime. About 90% of these men fall into the category of chronic prostatitis (CP). CP can be caused by a history of sexually transmitted infections and E. Coli, but also occurs without the presence of bacteria or viruses. The most commonly reported symptom in CP is continuous or spasmodic pain that is described as “dull” or “aching”. Pain occurs either in the perineum, penis, scrotum, or low back. Urological issues like incomplete emptying of your bladder, obstructed flow, pain on urination & ejaculation, and sexual dysfunction add to what is usually an already high level of psychological stress.

 

Chronic nonbacterial prostatitis (CnbP), CP without the presence of an infection, is a multifactorial condition; psychological stress, lack of physical activity, food sensitivity, allergies, autoimmunity, and neuromuscular dysfunction are theories of possible triggers in the development of CnbP. After a thorough assessment to rule out other possible diseases, doctors will often prescribe antibiotic and pain relief therapy. Unfortunately, non-bacterial prostatitis has a tendency to recur after antibiotic therapy, and pain medications carry risks of gastrointestinal bleeding if used long-term.

 

Interstitial Cystitis (IC) shares symptom overlap with CPPS. People with IC develop pain, irritation, and urinary problems without the presence of an infection. Unfortunately, both IC and CPPS are treated with antibiotics for symptom relief, but antibiotics are not recommended as a primary therapy; nor should they be used if a person has failed to respond to antibiotics in the past. Men diagnosed with CP and CnbP may have IC; in which case, they fall into the category of Chronic Pelvic Pain Syndrome (CPPS).

 

Quercetin, a bioflavonoid I mentioned in my seasonal allergies post, is an excellent anti-inflammatory nutrient and mast cell inhibitor. Mast cells release histamine in your body, and have been found in high concentrations in the bladders of people with IC. A combination of quercetin, nettle root, pygeum, and curcumin may benefit people who suffer from IC and CP. A quality of life increase, and a decrease in symptoms of CP were reported by men with CPPS after a month long trial of Nettle, Pygeum, Curcumin, and Quercetin with antibiotics. Cernilton, a blend of rye pollens, has been used in the past to successfully treat urinary problems in men with benign prostatic hyperplasia (BPH); an enlargement of the prostate. BPH is similar to CP in that there is usually obstructive and inflammatory problems in the prostate and urinary ducts. Cernilton may benefit men who suffer from CPPS and CP by improving urinary symptoms, pain, and quality of life. A healthy inner bladder wall is lined by a protective substance known as glycosaminoglycans. The use of the glycosaminoglycans glucosamine, chondroitin, and sodium hyaluronate may help with symptoms of IC.

 

Men with CPPS do not have to suffer in silence. There are alternatives to commonly prescribed medications that can significantly improve urinary symptoms and quality of life. For more information on which nutrients and therapies are right for you, speak to your naturopathic doctor.

 

References:

  1. McGowan C., Krieger J. Prostatitis, Epididymitis, and Orchitis. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Diseases 2015; Updated Edition 112: 1381-1387.
  2. Matsui, Hirofumi et al. “The Pathophysiology of Non-Steroidal Anti-Inflammatory Drug (NSAID)-Induced Mucosal Injuries in Stomach and Small Intestine.” Journal of Clinical Biochemistry and Nutrition 48.2 (2011): 107–111.
  3. Forrest JB, Schmidt S. Interstitial cystitis, chronic nonbacterial prostatitis and chronic pelvic pain syndrome in men: a common and frequently identical clinical entity. J Urol. 2004;172(6, pt 2):2561-2562.
  4. Katske F., Shoskes DA., Sender M., et al. Treatment of interstitial cystitis with a quercetin supplement. Tech Urol 2001; 7: 44-46.
  5. Cai T, Mazzoli S, Bechi A, Addonisio P, Mondaini N, Pagliai RC, Bartoletti R. Serenoa repens associated with Urtica dioica (ProstaMEV) and curcumin and quercitin (FlogMEV) extracts are able to improve the efficacy of prulifloxacin in bacterial prostatitis patients: results from a prospective randomised study. Int J Antimicrob Agents 2009; 33(6):549-53.
  6. MacDonald R1, Ishani A, Rutks I, Wilt TJ. A systematic review of Cernilton for the treatment of benign prostatic hyperplasia. BJU Int. 2000; 85(7):836-41.
  7. Wagenlehner FM1, Schneider H, Ludwig M, Schnitker J, Brähler E, Weidner W. A pollen extract (Cernilton) in patients with inflammatory chronic prostatitis-chronic pelvic pain syndrome: a multicentre, randomised, prospective, double-blind, placebo-controlled phase 3 study. Eur Urol. 2009 Sep; 56(3): 544-551.
  8. Theoharides TC. Treatment approaches for painful bladder syndrome/interstitial cystitis. Drugs 2007; 67: 215-235.

Interstitial Cystitis: Some Ways to Relieve Urinary Pain and Anxiety

Interstitial Cystitis Dr. Eric Viegas Naturopathic Medicine Ottawa

Interstitial Cystitis: Some Ways to Relieve Urinary Pain and Anxiety

 

Dr. Eric Viegas, ND

 

Interstitial Cystitis (IC) is an inflammatory condition of the urological system, particularly the bladder wall, and is thought to affect more women than men. Age of onset can be anywhere from childhood to middle-age, and a majority of people with IC are caucasian. As mentioned in my chronic prostatitis blogpost, men are often overlooked when it comes to IC, since most doctors assume it is a primarily female condition. Your doctor should perform a thorough work up to determine if your urinary condition is the result of prostate issues, IC, or other factors. Strangely, the urinary frequency, urgency, and pelvic pain common in IC often occur in the absence of any traceable infections or blood in the urine.

 

Pain flare ups of IC occur at the beginning of a woman’s period, and/or after sexual intercourse. People with IC may experience pain in the bladder, pelvis, vagina, tip of the penis, low back, and lower abdomen. IC can significantly compromise quality of life; people worry about getting to the bathroom on time and a normal everyday commute to work can be extremely panic-inducing. Psychological distress is a key factor in the worsening of anxiety and depression in people with IC.

 

There are two types of IC: classic or ulcerative IC, and non-ulcerative IC. In classic IC, the bladder develops patches of inflammation leading to ulcers and scarring. Overtime, classic IC causes reduction in bladder capacity. In non-ulcerative IC, there are no obvious physical changes to suggest pathology of the bladder wall. Unfortunately, little is currently known about how people develop non-ulcerative IC, and some people are mistakenly treated for chronic urinary tract infection (UTI) with antibiotics.

 

Some conditions associated with IC include irritable bowel syndrome, endometriosis, allergies, fibromyalgia and mood disorders.

 

Strenuous exercise, prolonged sitting, allergies, and certain foods can aggravate IC. Acidic foods like beer, tomatoes, chocolate, and coffee can aggravate symptoms of IC, so the first step in improving IC is to identify and eliminate these foods.

 

Some other foods that have been linked to a worsening of IC symptoms:

  • Lima beans, Lentils
  • Avocados
  • Peaches
  • Spicy Foods
  • Plums
  • Gluten
  • Grapefruit, Oranges, Lemons etc
  • Dairy
  • Pineapple
  • Raisins, Prunes

 

Demulcents are substances that can repair and soothe inflamed or irritated internal tissues. In IC, an irritated and inflamed bladder wall is the main culprit behind urinary frequency, urgency and pain. Your naturopathic doctor (ND) has access to a variety of botanical demulcents that can be combined in a daily drink to combat urological inflammation. Your ND can also add botanical medicines or nutritional supplements to combat anxiety and depression, to make your stress response more manageable, and improve your quality of life.

 

Quercetin–a bioflavonoid discussed at length in both my posts on allergies, and prostatitis—is a nutritional supplement that can stop the activation of mast cells in an allergic response and protect the bladder wall by reducing inflammation. The use of Vitamin A has been shown to inhibit mast cell activation, and protect mucosal surfaces from irritation and inflammation. Glucosamine, a member of the glycosaminoglycan family, can repair the bladder wall and allow for a more comfortable passing of urine.  

 

Naturopathic medicine offers a comprehensive treatment plan for IC. With dietary and lifestyle factors taken care of, NDs can use a variety of botanical medicines and nutritional supplements to decrease the severity of symptoms and improve quality of life for people with IC. There are many ways to find relief. Speak to your ND today!

 

References:

 

Espinosa G, Murray MT. Cystitis and interstitial cystitis/painful bladder syndrome. Textbook of Natural Medicine; 159: 1308-1317.

 

Ching C. Interstitial cystitis. First Consult 2012.

 

Abascal K, Yarnell E. Alternative and Complementary Therapies. April 2008, 14(2): 69-77. doi:10.1089/act.2008.14203.

 

Yarnell E. Alternative and Complementary Therapies. February 2009, 3(4): 269-275. doi:10.1089/act.1997.3.269.

 

Hudson T. Alternative and Complementary Therapies. July 2004, 7(2): 88-90. doi:10.1089/10762800151125074.

 

Hudson T. “Interstitial Cystitis: A New Approach.” Townsend Letter for Doctors and Patients, Feb. 2001, p. 172. Academic OneFile, Accessed 19 May 2017.

 

Dunlap C, et al. An integrative approach to interstitial cystitis. Explore: The Journal of Science and Healing 2013; (9)1: 48 – 52.

 

Insomnia: When Counting Sheep Won’t Help Ewe

Insomnia Dr. Eric Viegas Naturopathic Medicine Ottawa

Insomnia: When Counting Sheep Won’t Help Ewe

Dr. Eric Viegas, ND

 

If you have chronic trouble sleeping then chances are you are one of the estimated 3.3 million Canadians struggling with insomnia. ‘Insomnia’ refers to the disruption of: time taken to fall asleep, amount of time asleep (versus time in bed) through the night, waking up too early, and feeling unrefreshed on waking.1 Insomnia is extremely frustrating, and can be a fearful prospect knowing that it can lead to impaired memory and concentration.1 As a result, insomnia can predispose you to be more accident prone at home, on the road, and in the workplace.1 Insomnia exists as its own disorder, but it is also associated with a large number of physical and mental illnesses. For example, mood disorders like depression and anxiety are both associated with insomnia.1

 

So what can be done to help you get a better night’s sleep? First, it is important to identify the underlying cause of your insomnia. If you are sensitive to light and noise, make sure your bedroom is as dark as possible and remove any electronics that might be distracting you from falling asleep. The ‘blue light’ emitted from our TVs, laptops, and mobile phones all effect the release of melatonin from our brains.2 A small amount of melatonin, one of the most well known natural sleep aids, is secreted by your pineal during the day. At night, melatonin secretion spikes to help us get to sleep. Exposure to ‘blue light’ before bed suppresses melatonin secretion and tricks our bodies into thinking we should be awake.2 If you are not willing to give up your bedtime electronics, you can reduce ‘blue light’ exposure by turning down the brightness of the device, and/or downloading an app (eg. Twilight). The long term use of benzodiazepine medication for anxiety and panic disorders can deplete the brain’s supply of melatonin.3 Overtime, a disruption in circadian rhythm reduces normal sleeping habits. Melatonin supplementation can help with normalizing circadian rhythm, and alleviating withdrawal symptoms from anti-anxiety meds.3 Insomnia, fatigue, ADHD, IBS, and breast cancer risk, are all associated with melatonin deficiency.3 Symptoms of fibromyalgia, bulimia, neuralgia, certain forms of depression, and certain postmenopausal problems improve with melatonin supplementation.3 Other common underlying causes of insomnia include mood disorders, hormone imbalance, sleep apnea, chronic pain, and exercising too close to bedtime.

 

The need to be busy has has left us overworked and overtired. When our bodies are in a constant state of stress, our systems shift from ‘rest and digest’ to ‘fight or flight?’. As a consequence, our adrenal glands secrete more cortisol; a hormone responsible for increasing blood sugar, and the breakdown of fat & muscle, for the energy to get us away from danger. Cortisol spikes in the morning to get us out of bed, and is very low at night to help us fall asleep. In a chronically stressed state, high cortisol will worsen insomnia and–if left untreated–will eventually lead to adrenal fatigue. Speak to your naturopathic doctor about your health concerns to help determine the underlying cause(s) and help tailor a treatment plan specific to your individual needs. Acupuncture, nutritional changes through diet and supplements, counselling, and sleep hygiene advice are all parts of naturopathic treatment that can help get you back to sleep and leave you feeling well rested.

 

References:

 

  1. Tjepkema M. “Insomnia”. Statistics Canada Health Reports. 2005 17(1): 9-25.
  2. 2. Schmerler, Jessica. “Q&A Why is Blue Light Before Bed Bad For Sleep?” Scientific American. Nature America, September 2015.
  3. Rohr UD, Herold J. “Melatonin deficiencies in women.” Maturitas. 2002 Apr 15(41): 85-10.

10 Ways to Kick Fatigue

Fatigue Dr. Eric Viegas Naturopathic Medicine Ottawa

10 Ways to Kick Fatigue

Dr. Eric Viegas, ND

 

  1. See your doctor: Fatigue has many root causes, and your naturopathic doctor can perform relevant assessments to determine what the best course of treatment should be.  
  2. Learn to say No: It’s easy to be inundated with favours, errands, and requests from your family and friends. Sometimes the best option when you are struggling with fatigue is to simply say, “No”. Establishing and maintaining boundaries in your personal and professional life help in your recovery from fatigue. It may seem selfish, but if you don’t have enough energy for yourself, how can you help other people?
  3. Get a good night’s sleep: This one is kind of a “no-brainer” when it comes to fatigue. Practicing good sleep hygiene will enable you to have a more restful sleep. Keep your room as dark as possible, and use a night mask if your bedroom still seems too bright. Avoid using your cell phone, computer, and TV before bed as the blue light these devices emit will affect your brain’s ability to give you a deep sleep. Keep the bedroom for sleep and sex only, this will help establish healthy sleep habits. If urinating at night is an issue, avoid drinking liquids within 2 hours of bedtime.
  4. Invest in gentle exercise: In our society, there is a focus on being busy. It’s assumed that if you aren’t always on the go, then you must be lazy. The same rhetoric seems to be true for the fitness industry. Most people feel that they need to exhaust themselves at the gym in order for workouts to be beneficial. However, if you’re struggling with fatigue, the best workout is a gentle one. Your body needs time to recover. 5×5 workouts (5 reps, 5 sets) with moderate to heavy weight will work out your muscles, get your heart rate up, and won’t deplete your energy reserves as much as high volume workouts.
  5. Practice Mindful Eating: This is a tricky one, because it’s easy to mindlessly eat in front of your phone, computer, or TV. Taking your time when eating can help to relax your nervous system and jumpstart your digestion. Share a meal with your friends. When your digestive system functions better, so will your immune system, and you’ll be able to recover from fatigue faster.
  6. Drink Plenty of Water: Water between meals will help move sluggish bowels and help you deal with the indoor dry heat this winter.
  7. Avoid Stimulants: Although it may seem like a good idea in the short term, coffee and other drinks that contain caffeine should not be consumed in excess. Overtime, caffeine addiction can worsen stress and anxiety, and affect sleep patterns. Instead, opt for herbal teas like peppermint, ginger, and lemongrass. These herbal teas can help ease nervous tension, and won’t cause an energy crash during your busy day.
  8. Practice Self-care: Do some yoga, get a massage, go for a walk in the snow, hang out with friends, paint, laugh, sing….Spending time doing the things you love will reduce stress and improve your mood. In Chinese Medicine, frustration, irritability, anger, and insomnia can sometimes be tied to a stagnation of energy flow. The best way to maintain a healthy flow of energy is to express your creative side.
  9. Eat to maintain stable blood sugar: Low blood sugar, known as hypoglycemia, is a common cause of fatigue. Avoiding processed and packaged foods that contain high amounts of simple sugars is an easy way to keep blood sugar stable. Instead of sugary cereal for breakfast, opt for oats. Add sources of good fat and protein like eggs, avocado, nuts, and lean meats. Fiber from fruits and vegetables will also aid in healthy blood sugar levels.  
  10. OM Yourself: Meditation can help increase energy and focus. You’ve probably heard this many times, but think that either you don’t have enough time in your day, or that you simply can’t sit still for that long. It’s okay. Start small, no one became a yogi overnight. Even if it’s a 1 minute meditation, that amount of downtime is still good for your body and mind.

 

Magnesium, Migraines, and Mitochondria

Migraines Magnesium Mitochondria Dr. Eric Viegas Naturopathic Medicine Ottawa

Magnesium, Migraines, and Mitochondria

 

Dr. Eric Viegas, ND

 

An estimated 2.7 million Canadians, more women than men, suffer from migraine headaches. A migraine is often a throbbing, one-sided headache with nausea, vomiting, sensitivity to bright lights, or aura. An aura can be a quick disturbance of visual or neurological function, and usually precedes a migraine attack.

 

There are a few different causes of migraines, and one or more could be at play in individual cases. One theory is that blood vessels increase pressure by constricting, and then reactively dilating. This sudden alteration in blood flow can lead to a migraine headache. Another theory suggests that issues with mitochondria–the powerhouses of the cell–affect energy production, and causes a migraine. Tobacco use, caffeine consumption, and birth control pills can increase the frequency of migraines in certain people (1,3). Too large of an ingestion of salt can lead to a migraine 6-12 hours later (2). It is also worthwhile to check if the side effects of any medications you are taking may be worsening your headaches.

 

A possible underlying cause of migraine headaches is an intolerance to wheat, citrus, eggs, tea, coffee, chocolate, milk, beef, corn, cane sugar, yeast, mushrooms, and/or peas. Elimination of these offending foods for 8 weeks helped 60 migraine patients reduce their frequency of headaches from 402 to just 6 per month (3). Interestingly, magnesium is typically deficient in migraine patients (4). Supplementation of magnesium can improve mitochondrial energy output, and reduce the frequency and/or severity of migraine headaches (5). Riboflavin (vitamin B2), and Niacinamide (vitamin B3) can be effective for migraine relief as they play important roles in mitochondrial energy production. Coenzyme Q10 also benefits mitochondria and, as a result, migraine headaches (6).

 

Estrogen has been linked to menstrual migraine headaches, and postmenopausal women may experience a reduction in migraines and tension-type headaches due to a decline in sex hormones. Serotonin agonists like 5-HTP may acutely relieve and prevent menstrual headaches (8). If you suffer from migraines and also have a history of fibromyalgia or myofascial pain syndrome, you may benefit from mitochondrial support, magnesium, and 5-HTP (9, 10). An underlying cause of anxiety and insomnia may perpetuate migraine and tension-type headaches amongst postmenopausal women and the general population (7). There are many migraine treatment alternatives; this was just a small summary of strategies for a big headache.

 

References:

  1. Werner A. Treatment of migraine. N Engl J Med 2002; 347: 764.
  2. Brainhard JB. Salt load as a trigger for migraine. Minn Med 1976; 59: 232-233.
  3. Grant ECG. Food Allergies and Migraine. Lancet 1979; 1: 966-969.
  4. Barbiroli B, Lodi R, Cortelli P, et al. Low brain free magnesium in migraine and cluster headache: an interictal study by in vivo phosphorus magnetic resonance spectroscopy on 86 patients. Cephalgia 1997; 17: 254.
  5. Weaver K. Magnesium and migraine. Headache 1990; 30: 168.
  6. Okada H, Araga S, Takeshima T, Nakashima K. Plasma lactic acid and pyruvic acid levels in migraine and tension-type headache. Headache 1998; 38: 39-42.
  7. Neri I, Granella F, Nappi R, Manzoni GC, Facchinetti F, Genazzani AR. Characteristics of headache at menopause: a clinico-epidemiologic study. Maturitas 1993; 17(1): 31-37.
  8. Brandes JL. The influence of estrogen on migraine: a systematic review. JAMA 2006; 295(15): 1824-1830.
  9. Caruso I, Sarzi Puttini P, Cazzola M, Azzolini V. Double-blind study of 5-hydroxytryptophan versus placebo in the treatment of primary fibromyalgia syndrome. Journal of International Medical Research 1990; 18(3): 201-209.
  10. Birdsall TC. 5-hydroxytryptophan: a clinically-effective serotonin precursor. Alt Med Rev 1998; 3(4): 271-280.

 

Anxiety Disorders: What Are Your Options?

Anxiety Dr. Eric Viegas Naturopathic Medicine Ottawa

Anxiety Disorders: What Are Your Options?

 

Dr. Eric Viegas, ND

 

Anxiety disorders affect 1 in 4 Canadians at some point in their lives, making anxiety the most common mental illness in Canada. Psychotherapy and benzodiazepine medication are the conventional treatment options for anxiety. However, benzodiazepine drugs carry a high rate of addiction potential, can make people feel sedated, and carry a long list of side effects. So what can be done about anxiety if you want to pursue other treatment options?

 

First and foremost, it’s important to identify the source(s) and trigger(s) of your anxiety. What makes it better or worse? Is it a social setting that triggers a panic attack? A big test that you’re studying for that’s causing general anxiety? The importance of understanding your anxiety, rather than avoiding it, carries with it a significant mental and physical benefit. Our brains have the ability to tell the difference between suppressing our emotions versus addressing and labelling them. It is okay to feel anxious. Learning from our anxieties offers the opportunity for better self-understanding. When we understand why we react with anxiety, we learn from our thoughts, behaviours, and actions. Identify and label how you are feeling and you’ll find that your mood won’t have as much of an impact on your daily function. Proper sleep, a healthy diet, good social support, and a lifestyle that includes plenty of physical activity all factor into your wellbeing when dealing with anxiety.

 

A diet deficient in certain amino acids, vitamins, and/or minerals can have a negative impact on your mental-emotional wellbeing. Certain amino acids, vitamins, and minerals can help to calm an overactive mind through calming your nervous system, and correcting vitamin and mineral deficiencies that might worsen anxiety. In fact, even low iron can contribute to anxiety. An adequate intake of protein from both animal and vegetable sources can help with amino acid intake, and improved blood sugar control. Stable blood sugar levels can be achieved through the consumption of healthy fats like olive oil, coconut oil, avocados, nuts, and seeds. Fibre from fruits and vegetables can stabilize blood sugar, and add vitamins and minerals to your diet. It is important to avoid packaged foods that contain high amounts of simple sugars when trying to control your blood sugar.

 

Lavender is an excellent anti-anxiety herb, acting on your nervous system to calm your body and mind. In trials involving adults with anxiety, lavender was found to be as beneficial as benzodiazepine medication in alleviating feelings of restlessness, and improving sleep. You can even stuff lavender buds in your pillowcases to help with restlessness during the night. Green tea also helps with feelings of anxiety thanks to theanine. It’s an amino acid that can help reduce feelings of stress, promote relaxation, and help with attention. Green tea and lavender are just a couple of the many alternative treatments for anxiety.

 

Other factors that can contribute to anxiety include (but are not limited to): thyroid disease, heart disease, liver disease, kidney disease, digestive diseases, substance abuse, allergies, depression, and other mental illnesses. It’s important to speak with your doctor to determine the underlying factors influencing your individual anxiety, and discuss what treatment alternatives are right for you.

ADHD: Drugs, Diet, and Naturopathic Medicine

ADHD ADD Dr. Eric Viegas Naturopathic Medicine Ottawa

ADHD: Drugs, Diet, and Naturopathic Medicine

 

Dr. Eric Viegas, ND

 

I recently watched a standup comedy special starring Norm MacDonald. He was commenting on his childhood, and how all he wanted to do while sitting in a classroom was to go outside and play with a big tree branch. He then wondered about hyperactive kids today and their feelings about being stuck in a classroom with the addition of authority figures yelling, “Now we’re going to drug you.” While this commentary is an oversimplification of the plight of modern kids, it does raise the question of whether or not medications are the only option when dealing with attention deficit hyperactivity disorder (ADHD).

 

It is estimated that 5% of all Canadian children ages 3 to 9 fit the criteria for a diagnosis of ADHD (1). Boys are more commonly affected. Inattention, hyperactivity and impulsivity, in both the classroom and at home, are the main symptoms of ADHD. The recent changes to the DSM-V now include details to help doctors identify ADHD in adults, and changes the previous age cutoff in children from 7 to 12 years old (2). It is important to not jump to a hasty diagnosis of ADHD, as there are many other disorders that mimic it.

 

Children who are on the autism spectrum often suffer from ADHD. Oppositional Defiant Disorder (ODD) is often mistaken for ADHD. In ODD, children display angry and irritable mood, argumentative or defiant behaviour, or vindictiveness for at least 6 months. Children and adults with ODD will direct their anger towards at least one person who is not a sibling, and will have significant problems at work, in the classroom, or at home (3). While children with ODD are more likely to also have a learning disability, the important issue here is to receive a thorough workup and diagnosis from a trained psychologist. An accurate diagnosis will ensure that appropriate treatment is provided for you or your child.

 

The American Academy of Pediatrics recommends that preschool children with ADHD receive behavioural therapy as a first line treatment. In school children with ADHD, stimulant medications like methylphenidate (aka Ritalin) and atomoxetine are considered first line treatment (4). Common side effects of these medications include reduced appetite and weight loss, problems sleeping, and stunted growth. Long-term use of methylphenidate can also lead to depletion of zinc in children with ADHD (5). When supplemented with zinc + methylphenidate, children with ADHD in a 2004 study improved in teacher and parent rating scales compared to children taking placebo + methylphenidate (6).

 

In a 2016 retrospective study of around 4200 children in the Netherlands, researchers found that children with ADHD were more likely to be medicated for asthma, seasonal allergies, and eczema. Furthermore, ADHD was deemed to be more common in children whose parents were taking medications for asthma and seasonal allergies (7). In 2015, a systematic review of hypoallergenic diets for children with ADHD found a small but significant improvement in symptom severity (8). Another 2015 study showed that supplementing fish oil into children’s diets for 16 weeks brought down both inflammatory markers and ADHD symptom severity (9).

 

The reality of ADHD is that some people require medication to control their symptoms. A variety of naturopathic interventions can target the side effects of commonly prescribed ADHD medications, ADHD symptoms, and comorbid conditions like allergies and digestive concerns. Speak with your Naturopathic Doctor to find out which interventions are best suited for you or your child.

 

References:

 

  1. Brault MC, Lacourse E. Prevalence of prescribed ADHD medications and diagnosis among Canadian preschoolers and school-aged children: 1994-2007. Cdn J Psychiatry 2012; 57:93-101.
  2. http://www.icd10data.com/ICD10CM/Codes/F01-F99/F90-F98/F90-/F90.9. Accessed June 17, 2017.
  3. http://www.icd10data.com/ICD10CM/Codes/F01-F99/F90-F98/F91-/F91.3. Accessed June 17, 2017.
  4. ADHD: Clinical practice guideline for the diagnosis, evaluation and treatment of ADHD in children and adolescents. American Academy of Pediatrics 2011.
  5. Viktorinova A, et al. Changed plasma levels of zinc and copper to zinc ratio and their possible associations with parent-and-teacher-rated symptoms in children with ADHD. Biol Trace Elem Res. 2016; 169(1):1-7.
  6. Akhonzadeh S., et al. Zinc sulfate as an adjunct to methylphenidate for the treatment of attention deficit hyperactivity disorder in children: a double blind and randomized trial. BMC Psychiatry 2004; 4: 1-6.
  7. Van der Schans J, et al. Association between medication prescription for atopic diseases and attention-deficit/hyperactivity disorder. Ann Allergy Asthma Immunol 2016.
  8. Heilskov Rytter MJ et al. Diet in the treatment of ADHD in children: a systematic review of the literature. Nord J Psychiatry 2015;69(1): 1-18.
  9. Bos DJ, et al. Reduced symptoms of inattention after dietary omega-3 fatty acid supplementation in boys with and without ADHD. Neuropsychopharm 2015; 40(10): 2298-2306.

 

SIBO: Build Back Your Digestive Defenses

SIBO Dr. Eric Viegas Naturopathic Medicine Ottawa

SIBO: Build Back Your Digestive Defenses

 

Dr. Eric Viegas, ND

 

Our microbiome is the collection of microbes, in and on our bodies, that offer a mutual benefit. The health of our microbiome dictates our overall health status. Human cells that compose us are dwarfed by the number and variety of microbes those cells house. Our microbiota, the friendly microbes in our gut, help to digest food, strengthen our immune system, defend our intestines from unfriendly bacteria, and heal our gut (Gerritsen et al., 2011). The balance of our individual microbiota lies in a complex relationship between our genetics, diet, environment, and even our social circles. Our microbiota is one of the numerous defense systems our bodies use to keep out unwanted organisms from the small intestine. When one or more of these systems fail, an overgrowth of unfriendly microbes is possible.

 

We secrete stomach acid and pancreatic enzymes to better digest our food, but our bodies also use it as a safeguard against unwanted microorganisms. When poor stomach acid secretion fails to defend against colonies of foreign microbes, an overgrowth of these bacteria in the small intestine leads to an imbalanced microbiota. In addition, digestive tract abnormalities, abdominal surgery complications, and impaired gallbladder & pancreatic function can allow overgrowth of foreign microbes that disturb the balance of our microbiota.

 

Impaired migrating motor complexes (MMC) also set the stage for foreign bacteria to colonize the small intestine (Miyano et al., 2013). MMC initiates peristalsis, the muscular contraction of our intestines that moves food through the gut into the colon. MMC also occurs in a fasting state and acts to sweep unfriendly bacteria into the colon, limiting SIBO (Deloose et al., 2012). The vagus nerve controls MMC during parasympathetic nervous system activity (our rest and digest functions). The strength and conditioning of the vagus nerve (‘vagal tone’) also dictates our heart rate and breathing rate. Variation of our heart rate and breathing rate, known as respiratory sinus arrhythmia (RSA), can improve the efficiency of the cardiovascular and digestive systems. RSA is more significant in children and athletes than the elderly. Also, RSA is associated with better mental health and positive social interactions. Vagal tone is enhanced through RSA by practicing yoga (Streeter et al., 2010). Interestingly, deep laughter also stimulates the vagus nerve, causing RSA (Miller et al., 2009). Like to sing in the shower? Singing and making music also enhances RSA and vagal tone (Vickhoff et al., 2013).

 

What about SIBO and its relation to IBS?

 

IBS patients that do not improve with conventional IBS treatments are often diagnosed with SIBO. Long-standing MMC problems result in impaired peristalsis and dysbiosis. IBS patients with SIBO require digestive support coupled with eradication of bacterial overgrowth (Ghoshal et al., 2016). SIBO symptoms overlap with the gas, bloating, diarrhea, constipation, and abdominal pain that is common in IBS. It is estimated that more than half of all IBS patients have SIBO, and about half of all celiac cases also have SIBO (O’Leary, 2003). In celiac disease and SIBO, intestinal inflammation and permeability cause problems with nutrient absorption in the small intestine. As a result, patients are typically deficient in iron and vitamin B12; nutrients that are absorbed in a healthy small intestine. A lack of MMC also affects the secretion of bile for the digestion and absorption of fats and fat soluble vitamins (A,D,E,K) in the small intestine (Simren et al. 2006). In SIBO, some bacteria also digest bile before we can use it, further contributing to fat and fat soluble vitamins ending up in stool (Miyano et al., 2013). Weight loss due to malnutrition is a common symptom in long standing celiac disease and SIBO.

 

...IBD (Crohn’s Disease and Ulcerative Colitis) and SIBO?

 

Complicated cases of crohn’s disease require surgery to remove the ileocecum, a junction point in your digestive system between the small and large intestine. The ileocecal valve sits between the ileum of the small intestine, and the cecum of the large intestine. Though not a true ‘valve’, a healthy ileocecal valve successfully separates the colonies of microbes native to the large intestine from microbes of the small intestine. Once the ileocecum is surgically removed, so is the defense system that prevents colonic bacteria from entering the small intestine, and SIBO occurs. Other abdominal surgeries can also impair MMC.

 

In fact, there are a whole host of conditions that can lead to, or are caused by, SIBO. Any disease state that alters immune function, creates dysbiosis, and/or affects the MMC sets the stage for bacterial overgrowth. Since bacteria can squander bile acids needed for digestion and absorption of fats, the initial breath test for SIBO was the bile acid breath test. Bile acid breath testing fell out of favour, and now hydrogen and methane breath tests are used in the diagnosis of SIBO (Ghoshal, 2016). Patients are instructed to fast, then consume a lactulose or glucose drink. If SIBO is present, bacteria in the small intestine will begin to digest the sugars into hydrogen and methane before the expected colonic bacteria do the same. The reliability of breath testing for SIBO has been questioned due to the variability in normal and abnormal results (Simren et al., 2006). Though, if a positive breath test is present with diarrhea, weight loss, and malnutrition, doctors will treat presumptively. Depending on which gas scored higher on the breath test, doctors will prescribe antimicrobials specific to hydrogen or methane producing bacteria (or a combination).

 

So what can you eat to cut down on methane and hydrogen producing bacteria?

 

In terms of dietary recommendations for SIBO, there is no one size fits all approach. The FODMAPs diet, Specific Carbohydrate Diet (SCD), or Gut and Psychology Syndrome diet (GAPS) may work for some patients, but not others. It is important to identify your own individual food triggers. Sometimes a combination of the previously mentioned diets is what works for patients. An interesting treatment principle when dealing with SIBO is that well fed bacteria are easier to eradicate. So, eating food triggers that cause bacteria to ferment carbohydrates will lead to more efficient eradication using antibiotics and antimicrobials (Chedid et al., 2014). Once bacteria levels and SIBO symptoms are reduced, patients enter a recovery phase to rest and replenish the gut. Certain strains of probiotics can alleviate SIBO after short term therapy, and it is important to speak with your doctor about which strains are most appropriate for you (Kwak et al. 2014).

 

What are some ways to help manage SIBO in my day to day?

 

Successful treatment of SIBO, as with any chronic disease, relies on a holistic focus. Equal emphasis should be placed on eradicating bacteria, repopulating with probiotics, restoring vagal tone/MMC, avoiding food triggers, and healing the gut. Also, Exercise can improve digestive functions by enhancing MMC. Above all, patients should know that the road to recovery will never be linear, relapses often happen (Grover et al., 2008). Understanding mental-emotional health as an overarching goal will help give a big-picture context to patients, and build defenses against stress. Awareness of the connection between our mind and body is what will lead to building back digestive defenses. It’s no wonder that a relaxed state and laughter improves digestion. Finding enjoyment in exercise will also lead to improvements in MMC (Soffer et al., 1991). Finding something that brings you joy, something that leads you to more self-expression, is what will lead to a truly meaningful change. Rest and Digest!

 

For more information on SIBO: sibocenter.com

 

References:

 

Gerritsen J., Smidt H., Rijkers GT., de Vos WM. Intestinal microbiota in human health and disease: the impact of probiotics. Genes Nutr 6; (2011): 209-240. Print.

 

Miyano Y, et al. “The role of the vagus nerve in the migrating motor complex and ghrelin-and motilin-induced gastric contraction in suncus.” PloS one 8.5 (2013). Web.

 

Deloose, Eveline, Pieter Janssen, Inge Depoortere, and Jan Tack. “The Migrating Motor Complex: Control Mechanisms and Its Role in Health and Disease.”Nature Reviews Gastroenterology & Hepatology 9.5 (2012): 271-85. Web

 

Streeter, Chris C., Theodore H. Whitfield, Liz Owen, Tasha Rein, Surya K. Karri, Aleksandra Yakhkind, Ruth Perlmutter, Andrew Prescot, Perry F. Renshaw, Domenic A. Ciraulo, and J. Eric Jensen. “Effects of Yoga Versus Walking on Mood, Anxiety, and Brain GABA Levels: A Randomized Controlled MRS Study.” The Journal of Alternative and Complementary Medicine 16.11 (2010): 1145-152. Web.

 

Miller, Michael, and William F. Fry. “The Effect of Mirthful Laughter on the Human Cardiovascular System.” Medical Hypotheses 73.5 (2009): 636-39. Web.

 

Vickhoff B, Malmgren H, Astrom R, Nyberg G, Ekstrom S-R, Engwall M, et al. “Music structure determines heart rate variability of singers.” Frontiers in Psychology Auditory Cognitive Neuroscience 334.4 (2013): 1-16. Web.

 

Ghoshal, Uday C., et al. “A proof-of-concept study showing antibiotics to be more effective in irritable bowel syndrome with than without small-intestinal bacterial overgrowth: a randomized, double-blind, placebo-controlled trial.” European journal of gastroenterology & hepatology (2016).

 

O’leary, C. “Small Bowel Bacterial Overgrowth, Celiac Disease, and IBS: What Are the Real Associations?” The American Journal of Gastroenterology 98.4 (2003): 720-22. Web.

 

Simren M, Stotzer P-O. “Use and abuse of hydrogen breath tests.” Gut 55.3 (2006): 297-303. Web.

 

Ghoshal, Uday C. “Overview of Hydrogen Breath Tests in Gastroenterology Practice.” Evaluation of Gastrointestinal Motility and Its Disorders (2016): 87-94. Web.

 

Chedid, Victor, et al. “Herbal therapy is equivalent to rifaximin for the treatment of small intestinal bacterial overgrowth.” Global Advances in Health and Medicine 3.3 (2014): 16-24.

 

Kwak DS, Jun DW, Seo JG, Chung WS, Park SE, Lee KN, et al. “Short-term probiotic therapy alleviates small intestinal bacterial overgrowth, but does not improve intestinal permeability in chronic liver disease.” Eur J Gastroenterol Hepatol 26.12 (2014): 1353-1359. Web.

 

Grover, Madhusudan, et al. “Small intestinal bacterial overgrowth in irritable bowel syndrome: association with colon motility, bowel symptoms, and psychological distress.” Neurogastroenterology & Motility 20.9 (2008): 998-1008.

 

Soffer EE, Sumers RW, Gisolfi C. “Effect of exercise on intestinal motility and transit in trained athletes.” Am J Physio 5.1 (1991): 698-702. Web.