There is a time and a place for the meds. They're wonderful at what they do. But sometimes this comes at a price. Often, side effects are simply nutrient deficiencies induced by their long-term use. The good news? Prevention of complications is simple, it just involves knowing what to take.
Here's the meds a lot of my patients are on, indications of their depletion, and what to do about it. If you have a suitcase of meds, you might want to ask your ND or MD. Lastly, this entry is dedicated to one particular patient of mine. :)
Metformin: notorious for depleting vitamin B12. Symptoms of B12 deficiency often include fatigue and neuropathies such as numbness and tingling, or slight tremors. The problem here is that neuropathies are also expected with poorly-controlled diabetes so most often people are blamed for not being good with their meds when really it could be the start of a slippery neurological slope. If you're on Metformin, B12 is required, and you may need some folic acid as well.
Acid blockers: also wonderful at depleting B12 which needs stomach acid in order to be absorbed. Same symptoms happen when it gets low. Sublingual (under the tongue) B12 is recommended in this case rather than a pill you swallow, but there will be other issues resulting from chronically low stomach acid such as acne rosacea, gas and bloating, heartburn, and likely a host of other nutrient deficiencies.
Statins: great at reducing cholesterol...and Coenzyme Q10. Most people after a while start feeling muscle aches and pains. Some people have this to such an extreme that they stop the meds. While other options exist for cholesterol control, if you're on a statin such as Crestor or Lipitor, get on CoQ10 as well.
Diuretics (aka "water pills"): deplete magnesium, potassium (though some don't), calcium, and some B-vitamins including folic acid and B1. Most often I see the complications with electrolyte imbalances and particularly magnesium since it's difficult to get a good dose through the diet as-is. Muscle cramps and twitches, heart palpitations, and anxious feelings often happen. Because most of the depletions here are the water-soluble vitamins, I usually recommend a good multi.
Birth control pills: these deplete a number of nutrients in small quantities - even the low-dose pills. I usually recommend a good multi or even a prenatal vitamin while on the pill which may help to ease the transition when you stop it. The hefty dose of B-vitamins in a good prenatal can help with stress and likely PMS symptoms as well!
Reference: Natural Medicines Comprehensive Database: Drug Influences on Nutrient Levels and Depletion.
Obesity has now been declared a disease in the US. The health risks of carrying around a spare tire are nearly endless: diabetes, insulin resistance, heart attack, stroke, blood clotting, fatty liver, etc, etc, ETC. Know all this but can't quite make the huge shift? Start small and simple.
Central obesity specifically refers to the increased amount of fat around the midsection, or the 'spare tire'. The issue here is that it's an indicator that fat isn't only in the skin, it's packing in around your organs. Not to mention the amount of fat you carry influences your hormones. Abdominal fat acts differently than, say, thigh fat (ladies, we'll discuss the saddle bags further on another day) in that it increases inflammatory markers associated with diabetes, cardiovascular events, and also infertility in both men and women by affecting sperm quality, egg quality, and ovarian function. The insulin resistance induced by obesity contributes to hair loss (looking at you men out there...) or hair growth in women in all the wrong places as we see in polycystic ovarian syndrome, or PCOS.
Ditch the spare tire. You will be amazed at the health benefits that follow. They are endless. Your loved ones will also thank you.
Wondering where to start? 9 not-so-fancy starting tips for you:
1. MOVE. You don't have to train for a marathon, just get moving. Walk, bike, hike, play the Wii, park farther away, get off the bus/subway one stop early, get a pedometer... JUST MOVE.
2. Stop the pop.
3. Cut the booze. Limit to one drink per day.
4. Cut the sweet treats in half for 2-3 weeks. Then cut them in half again, but always leave yourself time to indulge. Be gentle yet strict.
5. Make sure half your plate is veggies. Potatoes don't count. And they can't be fried.
6. No fried foods. Grill, sautee, stir-fry, or steam.
7. Night snacker? Try popcorn, veggies & hummus, edamame, frozen fruit sorbet (blend frozen fruit, a dash of vanilla extract, and a wee bit of milk), roasted veggies, or a bowl of soup.
8. Breathe. Reducing stress reduces cortisol. Cortisol will help pump up the spare tire.
9. Be accountable. To anyone. Find yourself a team and get them cheering for you.
YOU CAN DO THIS. If I can be of help, or if you need a team member, please ask. :)
Just a few of the many research papers supporting weight loss:
Abdominal fat and inflammatory markers. http://www.ncbi.nlm.nih.gov/pubmed/23712970
Effects of 4 different diets on adipose tissue. http://www.ncbi.nlm.nih.gov/pubmed/22258266
Effects of abdominal fat on insulin resistance. http://www.ncbi.nlm.nih.gov/pubmed/23739143
BMI and sperm quality. http://www.ncbi.nlm.nih.gov/pubmed/22693175
Adipokines and infertility. http://www.ncbi.nlm.nih.gov/pubmed/21510912
Androgenic alopecia and insulin resistance. http://www.ncbi.nlm.nih.gov/pubmed/19094069
One of my all-time favourite recommendations for digestion...and maybe a few other reasons! Let's get to it.
1. Heartburn. Wait, acid for acid? Yep. Sometimes there is too much acid production in the stomach. Sometimes there's not enough. The lower esophageal sphincter, or the top door of the stomach, runs on a negative feedback mechanism. This means when there's enough acid, it shuts, and when there isn't enough, it doesn't get that signal and stays open causing the little acid that's there to splash up. Next time you have heartburn, try a bit of ACV and wait about 5-10 minutes. That's about how long it takes for the signals to get working.
*If this worsens things, an antacid should neutralize everything. Or, try deglycyrrhizinated licorice (DGL) tablets which will coat the esophagus and protect from acid.
2. Gas and bloating. Sometimes we don't digest enough of our food ourselves and smaller particles make it through to the large intestine where bacteria get to feast...and output gas. Making sure your digestive cascade is working starts in the mouth with chewing properly. The next step is the increase in stomach acid in response to food. This signals the release of enzymes from the stomach and pancreas, and triggers bile release from the gallbladder. Ramping up your body's own digestive juices is one key to a healthy belly.
3. Itchy dermatitis. ACV can act as a topical counter-irritant leaving itching to subside. Make sure there's no broken skin first. If it's itchy dandruff, ACV doubles as a wonderful conditioner. And no, you don't smell afterward!
How to take it:
I recommend half a shotglass of ACV and topping up with water. That's your dose. Rinse out your mouth though so that any residual acid doesn't break down enamel, or have straw handy so that the regular dose of vinegar goes straight down the hatch.
[Disclaimer: this is a stock photo. I don't actually know this brand, though I'm sure they're great, but any ACV will do!]
This is an exercise I had one of my intern groups do a while back. Everyone gets a major hormone and gets to figure out it's effect on other hormones. This is the web that results. I know, right! And this is as neat as it usually turns out...
I meet a lot of women with one or more of the following: painful periods, irregular periods, heavy periods, horrible PMS including moods, breast tenderness, and back pain, problematic weight gain, acne, or fatigue. Balancing hormones takes a bit of investigative work to find out what's going on down at the root level. There's always a few common threads: cut out exogenous hormones, effectively clear metabolites, and regulate cortisol. Oh, cortisol.
Exogenous hormones come from non-organic meat and dairy and from endocrine disrupting chemicals from plastics and our personal care products. BPA, phthalates, triclosan, parabens, etc. are all examples of known endocrine disruptors. Check your cabinets and replace with healthier stuff as you go. This is a huge task and takes time, so work over the next year to have a healthier bathroom. Check out www.ewg.org for product comparisons.
Inability to clear metabolites refers to the organs of elimination, specifically the liver and the colon. Sex hormones are fat-soluble which means they are excreted in the bile and hopefully out of the colon, unless constipation is an issue. Getting lots of fibre and moving the bowels will prevent any of the hormone metabolites (specifically estrogen) from being reabsorbed for round 2. And round 2 isn't pretty. Fresh ground flaxseed is a wonderful and safe method for both helping move the bowels and for binding up the estrogen metabolites.
Regulate cortisol. If you look closely at the picture, you'll see a bunch of red (inhibitory) lines that come from one source... that source is cortisol. Stress reduction, exercise, proper sleep, rest, vacations, and mindfulness all keep cortisol in check. If you're doing the best you can but still are trying to cope with the day-to-day stress of the big city, talk to your ND about adrenal support. It can work wonders and can lift that big inhibitory burden off of your endocrine system.
For many, this is a serious concern and if hormones are too crazy, it can be a sign that something else is going on. Always ask your doctor or ND and get some hormone testing and investigatory work done.
It's that wonderful time of the year when I get to figure out what to plant in the garden. I have a fully potted garden but manage to grow just about everything I can think of... or at least try to! Given that many will be out at the nurseries over the next couple of weeks, I thought I'd share some of my favourite medicinal garden plants that make wonderful teas.
1. German Chamomile (Matricaria recutita specifically). Pick off the flowers and use for digestive upset or to relax. It's an antispasmodic and nervine (meaning it works on the nervous system) so it's particularly effective for abdominal cramping such as with IBS. Add a slice of fresh ginger if there's nausea involved.
2. Peppermint. Not just for mojitos! Pick the leaves for a stomach-calming tea. Helps with most aspects of digestion but be careful if you're prone to heartburn as it may worsen it. Wonderful with chamomile after over-doing it at that BBQ!
3. Catnip. You may have to share this one if you have a furry friend. Catnip is a nervine which means it helps to calm down anxiety. This is great to blend with chamomile for your own sleepytime tea.
4. Lemon balm. Another one to add to your nighttime tea as this is also a nervine. If you have thyroid issues, skip this one or consult with your ND before using it.
5. Thyme and oregano. Excellent antimicrobials for if you're fighting a cold or flu. When the season changes and the sniffles start, make a nice tea with some lemon or add into soups.
6. Rosemary. The active constituent here helps to increase blood flow to the brain and can help with memory and cognitive function. These effects are also delivered via olfactory glands, so even smelling the essential oil from the plant can help.
Easy, healthy, raw, awesome. Gluten-free, dairy-free, processed-free, fake-free. What more could you ask from a tasty, chocolatey morsel?
12 medjool dates (pitted)
1/4 cup cocoa powder
1 cup walnuts
1/2 cup almonds
1/4 cup each of sunflower, pumpkin, and flax seeds
1 tbsp cinnamon
1 tbsp coconut oil
1 tbsp water
1/2 tsp vanilla extract
pinch of sea salt
Throw all of the nuts and seeds into the food processor first and blend until the nuts are a coarse flour. Add all of the other ingredients and blend for another minute or two until a thick dough forms. Roll into balls and refrigerate. The whole process will take you less than 10 minutes. Awesome, indeed.
*If you use honey dates, make sure you soak them overnight and you'll need a bit more because they're smaller. Medjool dates are much softer so they'll blend up easier.
If you're popping by Evolve today, you'll find a sampler of these goodies. They're crispy, crunchy, high in protein, high in good fats, dairy-free, gluten-free, and really easy to make. Your fridge will do most of the work.
You can use any combination of nuts/seeds that you want and mix it up with different dried fruits. I used dates but was really hoping for goji berries. Next time...
Here's how to make them:
3/4 cup honey
1/2 cup almond-cashew butter (though you can use any nut butter)
1/2 cup sesame seeds
1/2 cup pumpkin seeds
1/2 cup cashews
1/2 cup dates
1/2 cup grated coconut
1/4 cup almonds
3 cups crispy rice cereal (gluten-free)
In a pot over low heat, combine honey and nut butter. Let it warm up and become runny for about a minute. While this is heating up, whiz together the bigger nuts in a food processor or blender until they're coarse. Do the same for the dates (which are surprisingly loud). Mix the nuts, seeds, dates, and cereal in a bowl and toss. Pour the honey/nutter butter mixture on top and stir until well combined. Press onto a greased or parchment paper
1. What are your thoughts on multivitamins? There's a time and a place for these and quality matters. Big time. I prefer if my patients get their nutrients through food but recognize that most of us are on the go, up early, out entertaining clients, or just plain too tired to cook. Even in those scenarios, it can be possible to get what you need through the right choices in food.
Where a multivitamin is necessary or if my patients really want one, I focus on quality. Often the bioavailability (how well your body absorbs and uses each nutrient) or formulation of the multi is poor meaning that the balance of what's in the multi or the forms of each nutrient can leave almost the whole content coming out your other end.
Another issue: the binders and fillers often in lower-quality multivitamins are very difficult for our bodies to break apart and digest. The longer it takes, the less likely you are to absorb anything that comes out of it. If your multivitamin is a tablet, try leaving one in vinegar for about 30 minutes, rinse it off, then in a bit of water with a pinch of baking soda for another hour. This will give you a (very) rough idea of what that pill will go through in the stomach and small intestine. Most of them will barely reduce by half. This doesn't tell us anything about what you're absorbing though, only how sticky the binders are.
2. You do acupuncture? Yes.
3. Should I cut out gluten? If you can link your symptoms to a food sensitivity, then sure. If you go gluten-free for, say, a month and you feel much better, try re-introducing it. If your symptoms return, that's a valuable piece of information. I definitely don't recommend it as a catch-all though but if you feel it's worth testing out, give it a shot.
I often hear of people who are going gluten-free as a weight-loss strategy which is definitely a bad idea. Just because a product is gluten-free, doesn't mean it's healthy for you. Often they're packed with sugar and can actually lead to weight gain.
4. I'm feeling crappy but I'm taking all of my vitamins and supplements - should I take more? There are at least 20 supplements that we all could be taking just because they're healthy, but that does not mean they're therapeutic. I'm not a fan of long-term supplementation. I believe that supplements do just that: they supplement the diet.
Many people benefit from a "supplement holiday". When taking high-dose nutrients in pill form, the body can only absorb so much at once and knows what to do with food more than a pill. There are also additional enzymes in food which helps to absorb these nutrients. When a suitcase of supplements comes in, I go through each one, figure out what's therapeutic (meaning which will help your symptoms), and go from there.
5. Should I take anything for my cold? My view is that you can take something that will get rid of your cold in 3-5 days, or you can go home, rest, make some tea, watch a whole season of your favourite show and get rid of your cold in 3-5 days.
There's nothing wrong with letting your immune system stretch its legs every so often. In fact, it's good for you. Don't panic if a little fever sets in. This is the healthy response to getting rid of bugs. If you get sick often or have trouble kicking it (i.e. if your colds last weeks or you're getting one after another), then it would be time to call in some reinforcements, but more importantly, let's figure out why you're getting sick so often!
Any other questions, I'm more than happy to answer! email@example.com.
It's a lean, green, inflammation-fighting machine! I recently bought a huge box of organic baby spinach and then, true to Toronto form, the weather dropped 20 degrees to bone-numbing cold the next day. My desire for fresh salads came to a grinding halt.
It was shortly before that when a patient of mine told me about adding spinach to smoothies. I was a bit surprised as it was something I had never tried before. I expected stringy and leafy bits to be left behind which I think is why I never gave it a whirl (ha ha... blender...whirl...!). Until this past week when I've been enjoying one of my favourite leaves a la Popeye! Almost.
Spinach is amazingly rich in nutrients, specifically folate, vitamins K and A, and a whole range of trace minerals. It's high in fibre and low in calories. It's anti-inflammatory, filling, nutritive, and keeps you regular. It's great fresh in a salad, mixed with rice and beans, or wilted down in a curry.
But in a blender? Really? If I haven't lost you yet, here's the recipe for what I've been eating daily for the past 2 weeks. It's basically a super nutritious chocolate milkshake:
1 cup of baby spinach
1/2 cup vanilla almond milk
1/2 cup water
1 scoop unflavoured protein powder (I use a mixed vegetarian source)
1 tbsp organic cocoa powder (purely to beef up the antioxidants...)
1 tbsp raw honey
2 tbsp ground flaxseed
Calories: 290 Protein: 30g Fat: 10g (almost all unsaturated good stuff) Carb: 27g
You might already know that my favourite kitchen gadget is my Cuisinart SmartStick (no, I do not work for them!) so that's all I use to blend this up which works fantastically, as always.
Spinach for breakfast...who knew!?
It's around now that I start to hear about falling off wagons. I see the most injuries and concerns regarding weight loss (no one has ever, literally, fallen off a wagon as of yet...phew). For many, it really is a fresh start at a new lifestyle. For others, more of a social pressure and short-lived burst of steam. Here's the top resolution traps I see (all aimed at quick-fixes, you'll notice):
1. Too much, too fast. This usually ends in very demotivating injuries. Like any fitness activity, think of your new goal as "starting training". You will get fit, but you need to give your body some time to figure out the new demands placed on it and to adapt to them. The human body does this incredibly fast but needs a gradual increase rather than sudden. If you feel anything start to hurt or "not feel right", take it down a notch. Breathe. It might be a good idea to see an ND or chiropractor to evaluate your form so you can hit the ground running...properly! Set yourself up for a long-term goal. Start slow and get stronger.
2. Switching to "diet ___". There's actually little evidence to support artificial sweeteners helping with weight loss, and even some linking them to weight gain. We do know that the body's physiological mechanisms don't respond well as simply as had hoped (big surprise!) so it's best to just cut down on the sugar. Again, this can be a gradual transition. Drop by one sugar in your coffee, switch to water with a lemon (or cucumber, sprig of mint, etc) instead of pop, or switch to dark chocolate.
3. Eating more brown bread and pasta. Yes, there's a bit more fibre. No, it will not help with weight loss. Flour-based carbohydrates are simple carbohydrates, even if there's a few seeds sprinkled in for good measure. This might help to understand the difference between a simple carb and a complex carb: If you put it in water and come back in an hour what does it look like? Mushy, gooey, soup-like grossness? Then it's a simple carbohydrate (think bread, pasta, cookies, muffins, etc). Does it look the same as when you put it in the water? Then it's a complex carbohydrate (think rice, beans, sweet potatoes, veggies, fruits). What happens in the water is what happens in your body. More energy and enzymes are needed to break apart complex carbs, meaning they don't spike blood sugar or insulin the way that simple carbs do. Don't get me wrong, whole grain options are definitely better options than their simple white alternatives, but you may be disappointed of you're using them for weight loss.
4. Skipping breakfast. Even if you're still putting your pants on as you head out the door, there's fast options for how to ramp up your metabolism first thing. Starting your day with a healthy dose of protein will get your metabolism going and keep you feeling fuller for longer. This helps with carb cravings later on in the day. Smoothies can be assembled the night before (or thrown together in the morning), eggs can be boiled ahead of time, and steel-cut oats can be made in large batches.
5. Eating less. Less calories in means weight loss, right? In its extreme, yes. When you're not providing the body with the basic caloric needs, metabolism slows, cortisol increases, and physiology favours storage of energy. The body thinks there's a shortage of energy coming in, so it slows everything down a bit to accomodate. Also, when people don't eat regularly they tend to overeat later in the day or at night. Try snacking throughout the day, eating every 2-3 hours, and keep your protein up. Begin tracking your nutritional intake on fitday or myfitnesspal and see how you're doing. Compare how you feel on days you eat more to days when you're not.
Approach it not as a new year's resolution but as a get healthier lifestyle. If you need some specific guidance or want to know what you can do differently, ask your ND or nutritionist. We love food plans!