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    When we think of hormones, the first images that pop into our minds are often complex biochemical pathways within our endocrine system. However, recent scientific discoveries have shed light on an unexpected player in the intricate symphony of hormone regulation: the gut microbiome. This expanding field of research has unveiled a remarkable connection between the gut microbiota and estrogen levels, introducing us to the world of the "estrobolome." The Gut Microbiome: A Microscopic Ecosystem The gut microbiome is an intricate ecosystem of trillions of microorganisms residing in our gastrointestinal tract. These microorganisms play a crucial role in digestion, immune system regulation, and even the synthesis of certain vitamins. Recent studies have extended their influence even further, uncovering their role in modulating the levels of sex hormones, particularly estrogen. Estrogen is a pivotal hormone that contributes to the development and function of reproductive organs in females, but its effects extend far beyond reproduction. It plays a role in bone health, cardiovascular health, mood regulation, and more. Maintaining the right balance of estrogen is essential for overall well-being. The term "estrobolome" refers to the collective gut microbiota that are involved in metabolizing and influencing estrogen levels. These bacteria encode enzymes that can either promote the breakdown of estrogen into less active forms or lead to the production of more active forms of the hormone. One key player in the estrobolome is an enzyme called β-glucuronidase. This enzyme has the ability to deconjugate estrogen metabolites, allowing them to be reabsorbed into the bloodstream. To simplify, when estrogen is metabolized in the liver, it is often attached to other molecules (conjugated) to make it water-soluble and easier for the body to eliminate. However, when β-glucuronidase is overly active, it can break these conjugates, allowing estrogen metabolites to be reabsorbed back into the bloodstream instead of being excreted. This can lead to higher levels of active estrogen circulating in the body. Balancing Act: Gut Health and Estrogen Levels A higher level of active estrogen can potentially have various effects, both positive and negative. On the positive side, it might contribute to better bone health and cardiovascular function. On the negative side, an excess of active estrogen has been associated with an increased risk of estrogen-related cancers, such as breast and ovarian cancer. The types and amounts of bacteria in the gut can influence the activity of the estrobolome, thereby affecting estrogen metabolism. A healthy gut microbiome seems to promote the excretion of estrogen metabolites in their less active forms, helping to maintain a balanced hormonal environment. On the other hand, an imbalanced gut microbiome, often referred to as dysbiosis, could lead to excessive β-glucuronidase activity and an increased risk of estrogen-related health issues. Several factors can influence the composition and function of the gut microbiome, including diet, antibiotic use, lifestyle choices, and more. Diets rich in fibre and plant-based foods are associated with a healthier gut microbiome, while a diet high in processed foods and low in fibre can negatively impact it. Antibiotics, while sometimes necessary, can disrupt the balance of gut bacteria, potentially affecting estrogen metabolism. Implications for Health and Future Research Understanding the estrobolome and its connection to estrogen metabolism opens new avenues for personalized healthcare and disease prevention. Imbalances in estrogen levels have been linked to conditions such as polycystic ovary syndrome (PCOS), endometriosis, cystic breast disease, and even certain cancers. Manipulating the gut microbiome to influence estrogen metabolism could potentially offer novel therapeutic strategies. As the field of microbiome research advances, scientists are exploring ways to harness the power of probiotics, prebiotics, and dietary interventions to optimize estrogen metabolism. However, it's important to note that this is still a relatively new area of study, and more research is needed to fully comprehend the complexities of the estrobolome and its impact on health. The connection between the gut microbiome and estrogen levels is a remarkable revelation that underscores the intricate interplay between our bodies' systems. The estrobolome's role in influencing estrogen metabolism introduces a fresh perspective on hormone regulation and presents opportunities for innovative approaches to healthcare. As researchers continue to unravel the mysteries of the gut-estrogen connection, we are on the cusp of a new era in personalized medicine, where understanding and supporting the gut microbiome could have far-reaching implications for hormonal health and overall well-being. To learn more or explore how your gut health may be influencing your hormones, contact Dr. Courtney Holmberg, a Naturopathic Doctor in Toronto at (647) 351-7282 or by scheduling an initial consult today.


    Intermittent fasting is unlikely to be news to you by now. It has gained considerable attention in recent years as a promising dietary strategy for improving health, promoting weight loss, and potentially extending lifespan. While it may seem like a trendy diet fad, the concept of intermittent fasting has deep roots in human history and is backed by a growing body of scientific research. From stabilizing blood sugar levels to boosting brain function, intermittent fasting has proven to be a lifestyle change with incredible advantages. However, like any diet change, it must be done correctly, and it may not apply to everyone. Let’s delve into the science behind intermittent fasting, examining its potential benefits and exploring the various methods of implementation. Intermittent Fasting & Blood Sugar Benefits Blood sugar regulation is crucial for maintaining overall health, preventing chronic diseases, and improving life expectancy and longevity. Intermittent fasting has been proven by numerous studies to have significant benefits on glucose control and insulin resistance. At a certain point when we fast, our body goes into a state of ketosis, where it starts to use stored fat as fuel instead of glucose. This shift in energy metabolism helps regulate blood sugar levels by reducing insulin resistance and decreasing fat-based body mass. Additionally, intermittent fasting promotes the release of a special hormone known as adiponectin, which plays a crucial role in regulating blood sugar levels. Higher adiponectin levels have been linked to better insulin sensitivity as well as lower risk of developing diabetes. Intermittent Fasting & Inflammation Benefits Inflammation is among the body's natural responses to protecting against foreign invaders and healing damaged tissues. However, chronic inflammation causes various health issues, such as arthritis, heart disease, autoimmunity, and even cancer. One key benefit of intermittent fasting is its ability to reduce inflammation in the body. When we fast, our body enters a state called autophagy (1), where it starts breaking down old cells and repairing damaged ones. This process helps eliminate toxins, waste products, damaged cells and proteins, which overall help to reduce inflammation. Intermittent Fasting & Memory and Mood Benefits Memory and mood play a crucial role in our overall well-being. Intermittent fasting has been found to be beneficial for both memory and mood. When we fast intermittently, our brain undergoes certain physiological changes that can enhance cognitive function and boost memory. Research has shown that intermittent fasting stimulates the production of a protein called BNDF, or brain-derived neurotrophic factor, that promotes the growth of new neurons and strengthens existing ones (2). However, most (if not nearly all) of these research studies were done in men. A number of studies conducted that included women have reported side effects, including hunger, mood swings, lack of concentration, reduced energy, and headaches on fasting days (3,4). It may also increase the risk of depression in both men and women (5). Modified methods of intermittent fasting (which we’ll discuss in a moment) should be considered for women. Heart Health and Weight Loss Benefits The cardiovascular system is critical for overall well-being, and intermittent fasting can significantly improve heart health. Fasting has been shown to not only reduce blood pressure levels but also prevent heart attacks due to its benefits of promoting weight loss. Excess weight stresses the cardiovascular system and increases the risk of conditions like coronary artery disease and myocardial infarction. Furthermore, since intermittent fasting has been found to decrease inflammation in the body, it benefits the cardiovascular system by lowering the chronic inflammation that is closely linked to various heart diseases like atherosclerosis and congestive heart failure. A Note on Intermittent Fasting in Women Above and beyond the well-known benefits of intermittent fasting for weight loss, heart health and inflammation, there are some more unique considerations when we consider the totality of research and how it applies to intermittent fasting in women. Overall, the data is lacking. Most studies have been conducted exclusively in men. However, some literature on fasting in women highlights the following: Hormonal Changes: Women experience hormonal fluctuations throughout their menstrual cycle, including changes in estrogen and progesterone levels. Some studies suggest that women's responses to fasting may vary depending on their menstrual phase. For instance, fasting during the luteal phase (the second half of the menstrual cycle) might be more challenging due to increased hunger and cravings. Fertility and Reproductive Health: There are concerns about the impact of intermittent fasting on women's fertility and reproductive health. Extreme forms of intermittent fasting, especially those leading to rapid weight loss or very low-calorie intake, may disrupt the menstrual cycle and, in some cases, lead to amenorrhea (absence of menstruation). This can have implications for fertility and bone health. The best approach to intermittent fasting for women generally considers a modified approach, such as the ‘Crescendo Method’ which involves fasting 12–16 hours for two to three days a week on non-consecutive days, for the ‘16/8 Method’ where fasting is done for 16 hours a day, and all calories are eaten within an eight-hour window. Women are advised to start with 14-hour fasts and eventually build up to 16 hours. Conclusion Intermittent fasting is incredibly powerful in offering numerous health benefits. From regulating blood sugar levels and reducing inflammation to improving memory and mood, the advantages of intermittent fasting are truly impressive. With that being said, it's always best to listen to your body and consult a health expert before commencing any new diet/eating regimen or fasting program. There's more to intermittent fasting benefits than what's covered above. Most importantly, you need an intermittent fasting program crafted to match your body type, health, and special needs/lifestyle without exposing you to risks. To learn more about whether intermittent fasting is right for you (or working for you), contact Dr. Courtney Holmberg, a Naturopathic doctor in Toronto, at 647-351-7282 today. References: Pak M, Bozkurt S, Pınarbaşı A, Öz Arslan D, Aksungar FB. Effects of Prolonged Intermittent Fasting Model on Energy Metabolism and Mitochondrial Functions in Neurons. Ann Neurosci. 2022 Jan;29(1):21-31. doi: 10.1177/09727531211072303. Epub 2022 Feb 2. PMID: 35875426; PMCID: PMC9305913. Seidler K, Barrow M. Intermittent fasting and cognitive performance - Targeting BDNF as potential strategy to optimise brain health. Front Neuroendocrinol. 2022 Apr;65:100971. doi: 10.1016/j.yfrne.2021.100971. Epub 2021 Dec 18. PMID: 34929259. Heilbronn LK, Smith SR, Martin CK, Anton SD, Ravussin E. Alternate-day fasting in nonobese subjects: effects on body weight, body composition, and energy metabolism. Am J Clin Nutr. 2005 Jan;81(1):69-73. doi: 10.1093/ajcn/81.1.69. PMID: 15640462. Harris L, Hamilton S, Azevedo LB, Olajide J, De Brún C, Waller G, Whittaker V, Sharp T, Lean M, Hankey C, Ells L. Intermittent fasting interventions for treatment of overweight and obesity in adults: a systematic review and meta-analysis. JBI Database System Rev Implement Rep. 2018 Feb;16(2):507-547. doi: 10.11124/JBISRIR-2016-003248. PMID: 29419624.


    Berberine, a natural compound found in several plants like Goldenseal and Oregon Grape, has gained recent attention for its potential to aid in weight loss, largely due to the sensationalization of Ozempic and its dramatic impacts seen in many celebrities. Recent scientific studies have revealed promising effects of Berberine on reducing insulin resistance, as well as regulating hormones that play a crucial role in blood sugar regulation, appetite control, and overall metabolic health. While Berberine's effects are not as direct as those of GLP-1 agonists like Ozempic, emerging research suggests that Berberine can influence GLP-1 levels and activity, contributing to its potential benefits in managing insulin resistance and weight loss, but with possibly fewer side effects. How Does Berberine Work? Enhances Insulin Sensitivity: Berberine has been shown to enhance insulin sensitivity, which is crucial for maintaining balanced blood sugar levels. Insulin resistance, a condition where cells become less responsive to insulin, can lead to elevated blood sugar and weight gain. By improving insulin sensitivity, Berberine helps cells effectively take up glucose from the bloodstream, reducing the need for excess insulin production. This not only supports blood sugar control but can also contribute to weight loss by preventing excessive fat storage. GLP-1 Release and Regulation: GLP-1 is a hormone produced in the intestines in response to food intake. It stimulates insulin secretion from the pancreas, suppresses glucagon release (which reduces blood sugar levels), slows down gastric emptying, and promotes feelings of fullness. Berberine's impact on GLP-1 is complex and is thought to involve multiple mechanisms. Some studies suggest that Berberine can indirectly influence GLP-1 release by improving gut health and increasing the number of GLP-1-producing cells in the intestines, and can therefore help with overall blood sugar regulation and appetite control. Regulates Fat Metabolism: Berberine can influence the expression of genes related to fat metabolism. It activates an enzyme called adenosine monophosphate-activated protein kinase (AMPK), which plays a key role in cellular energy regulation. Activation of AMPK promotes fat breakdown (lipolysis) and inhibits the formation of new fat cells (adipogenesis). These effects lead to reduced fat accumulation and support weight loss. Inhibits Gluconeogenesis: Berberine has been found to inhibit gluconeogenesis, the process by which the liver produces glucose. This is significant because excessive glucose production by the liver can contribute to high blood sugar levels and insulin resistance. By reducing gluconeogenesis, Berberine helps to lower overall glucose levels in the bloodstream, resulting in better blood sugar control and increased weight loss. Modulates Gut Microbiota: Emerging research suggests that Berberine may have a positive impact on gut health and the composition of gut microbiota. A balanced gut microbiome is associated with better metabolic health and weight regulation. Berberine is thought to influence the gut environment in ways that promote the growth of beneficial bacteria and suppress harmful ones, which could contribute to improved weight management. Appetite Regulation: Berberine may also impact appetite regulation by influencing hormones that control hunger and satiety. Along with its impacts on GLP-1, some studies suggest that Berberine can influence the release of hormones like ghrelin and leptin, which play a role in appetite control. By helping to reduce appetite and promote feelings of fullness, Berberine can support individuals' struggles with portion control and in making healthier food choices. Comparing Berberine Against Ozempic? Ozempic, on the other hand, works by mimicking the action of GLP-1, a hormone produced in the intestine. It binds to GLP-1 receptors in the pancreas, promoting the release of insulin and inhibiting the release of glucagon. This mechanism helps regulate blood sugar levels and reduce insulin resistance. Additionally, Ozempic slows down the emptying of the stomach, leading to increased feelings of fullness and reduced appetite (aka an appetite suppressant). So is Berberine really "Nature's Ozempic''? Although they share the common goal of managing insulin resistance and promoting weight loss, there are notable differences in their origin, availability, and mechanisms of action. Origin: Berberine is a natural compound derived from plants, while Ozempic is a pharmaceutical drug synthesized for specific therapeutic purposes. Availability: Berberine is available as a dietary supplement and can be purchased over the counter, whereas Ozempic requires a prescription from a healthcare professional. Mechanism of Action: Berberine exerts its effects through AMPK activation, increasing insulin sensitivity, reducing hepatic glucose production, and promoting fat breakdown. Ozempic, on the other hand, mimics GLP-1, enhancing insulin secretion, suppressing glucagon release, slowing down gastric emptying, and reducing appetite. Clinical Evidence: Both Berberine and Ozempic have been studied extensively for their effects on insulin resistance and weight loss. Multiple clinical trials have demonstrated the effectiveness of Berberine in improving insulin sensitivity and reducing body weight. Similarly, Ozempic has shown significant efficacy in reducing HbA1c levels (a measure of long-term blood sugar control) and aiding weight loss in individuals with type 2 diabetes. Duration of use: While Ozempic's impacts can be seen in as little as 4-5 wks, a few studies have shown that taking a berberine supplement over the course of three months results in significant weight loss. Possible Risks and Side Effects Some of the most common issues associated with Berberine are as follows: Gastrointestinal Distress: diarrhea, constipation, flatulence, or stomach upset when taking Berberine. Starting with a lower dose and gradually increasing it may help reduce the likelihood of these symptoms. Low Blood Pressure: Berberine has been shown to have a blood pressure-lowering effect. While this can be beneficial for individuals with hypertension, it could potentially lead to low blood pressure (hypotension) in those with already low blood pressure levels. Interactions with Medications: Berberine has the potential to interact with various medications, including certain antibiotics, anticoagulants, and blood-sugar-lowering drugs. Consultation with a healthcare professional is crucial, especially if you are on any medications, to avoid potential interactions. Microbiome Health: berberine has antimicrobial properties, and can influence the beneficial flora of your digestive tract. This would be a possible risk factor to those with a history of extensive antibiotic use, IBS, and pre-existing gut bacterial imbalances. Allergic Reactions: Some individuals may experience allergic reactions to Berberine or plants containing it. Allergic symptoms could include rash, itching, swelling, or difficulty breathing. Liver & Kidney Function: While Berberine is generally considered safe for the liver, individuals with pre-existing liver conditions should exercise caution and consult a healthcare provider before using it. Berberine's impact on electrolyte levels, particularly potassium, has been noted in some studies. People with conditions that affect electrolyte balance, such as kidney problems, should use Berberine cautiously and under medical supervision. Pregnancy and Breastfeeding: There is limited research on the safety of Berberine during pregnancy and breastfeeding. Pregnant or breastfeeding individuals should avoid using Berberine without consulting their healthcare provider. Long-term Safety: While short-term use of Berberine appears to be well-tolerated, the long-term safety of extended use is not fully understood. Regular medical check-ups and monitoring are advisable if you plan to use Berberine for an extended period. Comparatively, Ozpemic maintains the same side effect profile, but with more notable long-term concerns, such as pancreatitis, gallbladder issues, possible thyroid tumours, and damage to kidney function, not to mention the harmful metabolic impacts from appetite suppression and resultant calorie restriction. Furthermore, individuals experiencing rapid weight loss from drugs in this category will also see a decline in muscle mass, and more concerningly, are at increased risk for bone loss & reduced bone density. So is Berberine really Nature's Ozpemic? As you can see, while Berberine can offer promising benefits for weight loss, it's not a magical solution on its own. It works best when incorporated into a comprehensive approach that includes a balanced diet, regular physical activity, and other healthy lifestyle habits. Before starting any new supplement, including Berberine, it's advisable to consult with a healthcare professional, especially if you have underlying medical conditions or are taking other medications to ensure that any interventions are safe and appropriate for your individual health needs. To further discuss available options to safely expand your toolkit for optimizing your hormones and metabolic health, contact Dr. Courtney Holmberg, Naturopathic Doctor in Toronto at 647 351 7282 today. References: Davies, M., Pieber, T. R., Hartoft-Nielsen, M. L., Hansen, O. K., Jabbour, S., Rosenstock, J., ... & Bode, B. (2017). Effect of oral semaglutide compared with placebo and subcutaneous semaglutide on glycemic control in patients with type 2 diabetes: A randomized clinical trial. The Journal of the American Medical Association, 318(15), 1460-1470. Mosenzon, O., Blicher, T. M., Rosenlund, S., Eriksson, J. W., Heller, S., Hels O., ... & Davies, M. (2020). Efficacy and safety of oral semaglutide in patients with type 2 diabetes and cardiovascular disease (PIONEER 6): A randomised, double-blind, placebo-controlled phase 3a trial. The Lancet, 396(10253), 863-874. Yin, J., Gao, Z., Liu, D., Liu, Z., & Ye, J. (2008). Berberine improves glucose metabolism through induction of glycolysis. American Journal of Physiology-Endocrinology and Metabolism, 294(1), E148-E156. Zhang, Y., Li, X., Zou, D., Liu, W., Yang, J., Zhu, N., ... & Ning, G. (2012). Treatment of type 2 diabetes and dyslipidemia with the natural plant alkaloid berberine. The Journal of Clinical Endocrinology & Metabolism, 93(7), 2559-2565. Lee YS, Kim WS, Kim KH, Yoon MJ, Cho HJ, Shen Y, Ye JM, Lee CH, Oh WK, Kim CT, Hohnen-Behrens C, Gosby A, Kraegen EW, James DE, Kim JB. Berberine, a natural plant product, activates AMP-activated protein kinase with beneficial metabolic effects in diabetic and insulin-resistant states. Diabetes. 2006 Aug;55(8):2256-64. doi: 10.2337/db06-0006. PMID: 16873688. Utami AR, Maksum IP, Deawati Y. Berberine and Its Study as an Antidiabetic Compound. Biology (Basel). 2023 Jul 8;12(7):973. doi: 10.3390/biology12070973. PMID: 37508403; PMCID: PMC10376565. Sun S, Yang Y, Xiong R, Ni Y, Ma X, Hou M, Chen L, Xu Z, Chen L, Ji M. Oral berberine ameliorates high-fat diet-induced obesity by activating TAS2Rs in tuft and endocrine cells in the gut. Life Sci. 2022 Dec 15;311(Pt A):121141. doi: 10.1016/j.lfs.2022.121141. Epub 2022 Oct 29. PMID: 36341914. Zhang Q, Xiao X, Li M, Li W, Yu M, Zhang H, Ping F, Wang Z, Zheng J. Berberine moderates glucose metabolism through the GnRH-GLP-1 and MAPK pathways in the intestine. BMC Complement Altern Med. 2014 Jun 9;14:188. doi: 10.1186/1472-6882-14-188. PMID: 24912407; PMCID: PMC4057525.


    When we think about body recomposition (aka drop fat and build muscle), most of us assume that diet and exercise are the most critical pieces. And while that may be true, it's equally as important to consider the role of hormones in this equation, including maintaining close control of insulin levels. To understand how to optimize insulin levels for muscle growth and function, we must first take a moment to understand what insulin is, and what role it plays in our physiology. What Is Insulin? Insulin has become a very popular hormone in mainstream media and social channels recently, primarily because of some fad drugs many celebrities use for weight loss. Insulin is an anabolic (aka storage) hormone released by the beta islet cells of the pancreas in response to rises in glucose levels. This growth hormone helps the body process carbohydrates by signalling cells in the muscles, heart and liver to uptake glucose from the bloodstream to either process it as energy or store it for later use. Interestingly, it also regulates the breakdown of muscle proteins. What is Insulin Resistance? Insulin resistance is a metabolic condition characterized by the body's reduced sensitivity or responsiveness to the effects of insulin. It occurs when cells become less able to efficiently take up and utilize glucose in response to insulin signalling. Several factors contribute to the development of insulin resistance: Obesity: Excess body fat, particularly visceral fat (fat around the abdominal organs) is strongly associated with insulin resistance. Adipose tissue releases inflammatory substances called adipokines, which interfere with insulin signalling and disrupt glucose uptake. Sedentary lifestyle: Lack of physical activity and a sedentary lifestyle contribute to the development of insulin resistance. Regular exercise improves insulin sensitivity, allowing cells to respond better to insulin and utilize glucose. Genetics: Family history and certain genetic factors can predispose individuals to insulin resistance. Specific gene variants are associated with impaired insulin signalling and glucose metabolism. However, it's important to remember that genetics alone do not determine the development of insulin resistance - environment and lifestyle factors almost always play a role. Processed diet: A diet high in refined carbohydrates, sugary foods, and saturated fats can contribute to insulin resistance. Consuming excessive amounts of these foods can lead to chronically elevated blood sugar levels and subsequent insulin overproduction, leading to insulin resistance over time. Chronic inflammation: Inflammation, often associated with conditions like obesity and metabolic syndrome, can interfere with insulin signalling pathways and promote insulin resistance. Over time, insulin resistance can lead to the development of type 2 diabetes, as the pancreas compensates by producing more insulin to overcome the reduced effectiveness of insulin. As such, prolonged insulin resistance can overwhelm the pancreas and cause it to fail, leading to insulin deficiency and high blood sugar levels. How Does Insulin Affect Muscles? Insulin plays a crucial role in muscle development by regulating various metabolic processes. When insulin is released by the pancreas in response to increased blood sugar levels, it facilitates the uptake of glucose into muscle cells. This glucose serves as an energy source for muscle contraction and replenishes glycogen stores for future use. Furthermore, insulin promotes protein synthesis in muscle tissue. It stimulates the transportation of amino acids into muscle cells, which are the building blocks for protein synthesis. Increased insulin levels also inhibit protein breakdown, creating a more favourable environment for muscle growth and repair. Insulin also aids in nutrient delivery to muscles by enhancing blood flow. It promotes vasodilation, leading to increased blood circulation and nutrient supply to muscle tissue. This ensures a sufficient oxygen and nutrient supply for optimal muscle function and growth. However, it's important to note that while insulin supports muscle development, excessive insulin levels resulting from conditions like insulin resistance or diabetes can have negative effects. High insulin levels can contribute to fat storage and actually hinder muscle growth. Therefore, maintaining a balanced insulin response through a healthy diet, regular exercise, and proper insulin management is crucial for maximizing muscle development. What This Means for You It's important to note that finding optimal insulin balance is a complex task influenced by various factors. Maintaining a healthy weight, engaging in regular physical activity, following a balanced diet, and managing other metabolic risk factors are always key. However, there are a few strategies almost anyone can try to optimize muscle mass growth. To improve insulin levels for muscle mass growth, here are some strategies that can be beneficial: Balanced Diet: This one seems obvious, but still needs to be said. Focus on consuming a well-balanced diet (instead of cutting major foods like carbs or fats) that includes a variety of nutrient-dense foods. Include lean proteins, whole grains, fruits, vegetables, and healthy fats. Avoid excessive intake of refined sugars, alcohol, and processed foods, as they can negatively affect insulin sensitivity. Macronutrient Distribution: Distribute macronutrients appropriately in your diet. Ensure an adequate intake of protein to support muscle growth and repair, as well as sufficient carbohydrates to provide energy for workouts and replenish glycogen stores. While the optimal protein intake for individuals can vary greatly, a good rule of thumb to calculate the necessary intake is between 0.8 - 1.2 g of protein per kg body weight. However, intense training may require an intake of up to 2.0 g/kg body weight, so always consult your clinician on this. Timing of Carbohydrate Consumption: Time your carbohydrate intake around your workouts. Consuming carbohydrates before and after exercise can help optimize glycogen replenishment and enhance insulin sensitivity. Saving carbohydrates until later if the day if your insulin is high can help prevent elevated baseline levels all day, and result in better long-term insulin responses. Regular Exercise: Also a given, but here's your reminder to engage in regular resistance training exercises that target major muscle groups. Resistance training has been shown to improve insulin sensitivity and promote muscle growth. Incorporating cardiovascular exercise into your routine can also have positive effects on insulin sensitivity. Optimal types and quantities of exercise vary based on the individual, but a general guideline for adults is to engage in at least 150 minutes of moderate-intensity aerobic exercise (walking, biking, swimming, dancing) per week, or 75 minutes of vigorous-intensity exercise (running, high paced cycling, HIIT) spread across the week. Sleep and Stress Management: This is where I see most people struggle. Prioritizing sufficient sleep and effective stress management is a must. Lack of sleep and chronic stress can negatively impact insulin sensitivity by driving more cortisol and gluconeogenesis (increasing blood sugar from storage). Aim for 7 to 8 hours of quality sleep and adopt stress-reduction techniques such as meditation or engaging in activities you enjoy. Regular Medical Check-ups: Regularly monitor your blood sugar and insulin levels by consulting with a healthcare professional. They can provide guidance on managing insulin levels and assess any underlying health conditions that may affect insulin sensitivity. It's important to note that individual requirements may vary, and consulting with a healthcare professional who can provide personalized guidance and support in optimizing insulin levels for muscle mass growth is recommended. Finding the best approach to overall fitness can be challenging with so much information (and misinformation) everywhere, so speaking with a professional can help you find the right combination of diet and exercise to reach your fitness and overall health goals. To schedule an appointment with Dr. Courtney Holmberg, Naturopathic Doctor in Toronto, call us at (647) 351-7282 for more information.


    In today's fast-paced world, anxiety has become prevalent, affecting people of all ages and backgrounds. While medical interventions can be crucial for severe cases, many individuals with mild to moderate anxiety might benefit from exploring natural methods to manage their symptoms. As a medical professional, I recognize the importance of a holistic approach to health that combines traditional medicine with lifestyle changes and natural remedies. In this blog, we'll delve into the most researched and effective strategies to manage anxiety naturally. 8 Natural Strategies to Manage Anxiety Prioritize Sleep Quality One of the most underestimated contributors to anxiety is inadequate sleep. Sleep deprivation can increase stress hormones, exacerbating anxiety and decreasing your ability to cope with daily challenges. Establish a regular sleep schedule, create a calming bedtime routine, and ensure your sleep environment is conducive to relaxation. Avoid electronic devices before bed, as the blue light emitted can disrupt your sleep cycle. Stay Physically Active Regular exercise is a potent natural remedy for anxiety. Physical activity releases endorphins, which are known as "feel-good" hormones. Engaging in activities like jogging, swimming, yoga, or even a leisurely walk can positively impact your mood. Aim for at least 150 minutes of moderate exercise per week. Mindfulness and Meditation Mindfulness practices and meditation have gained significant recognition for their ability to reduce anxiety. These techniques encourage you to focus on the present moment, helping to break the cycle of worry about the future. Deep breathing exercises, progressive muscle relaxation, and guided imagery can all be valuable tools in managing anxiety naturally. A 2013 study published in the journal "JAMA Internal Medicine" compared mindfulness-based stress reduction (MBSR) with an SSRI (sertraline) and a placebo in adults with generalized anxiety disorder. The study found that both MBSR and sertraline significantly reduced anxiety symptoms, with MBSR showing efficacy similar to the medication. Additionally, the study found that MBSR had a more durable effect over time after treatment discontinuation. Another study published in the journal "Depression and Anxiety" in 2016 examined the effects of mindfulness meditation versus an SSRI (escitalopram) in individuals with generalized anxiety disorder. The study found that both interventions effectively reduced anxiety symptoms, and mindfulness meditation showed comparable efficacy to the SSRI but without the side effects. Balanced Diet and Hydration The food you consume can impact your mood and anxiety levels. Focus on a well-balanced diet rich in whole grains, lean proteins, fruits, and vegetables. Omega-3 fatty acids found in fish, flaxseeds, and walnuts have been linked to reduced anxiety. Avoid excessive caffeine and sugar, as they can exacerbate feelings of restlessness and nervousness. Staying hydrated is equally important, as dehydration can amplify stress. Herbal Remedies Several herbal remedies have shown promise in managing anxiety. Valerian root, passionflower, ashwagandha, and chamomile are often used in herbal teas or supplements to promote relaxation. However, it's essential to consult with a healthcare professional before incorporating these supplements into your routine, especially if you're already taking medication or have underlying health conditions. Adequate Nutritional Supplements Certain nutrients play a role in maintaining optimal brain function and mood regulation. Magnesium, for instance, has been linked to reduced anxiety symptoms. B vitamins, particularly B6, B12, and folate, are essential for healthy brain function. Consult with a healthcare provider about getting proper blood work to assess for deficiencies and before taking any supplements to ensure they're appropriate for your needs. Limit Stimulants and Alcohol While it might be tempting to turn to stimulants like caffeine or alcohol for temporary relief, these substances can actually exacerbate anxiety in the long run. Caffeine can increase heart rate and nervousness, while alcohol's depressant effects can disrupt sleep patterns and exacerbate anxiety. Limit Screen Time Excessive screen time, particularly on social media or news platforms, can contribute to anxiety by exposing you to constant information and potential stressors. A study published in the journal "JAMA Pediatrics" in 2019 found that high levels of screen time were associated with a higher likelihood of experiencing symptoms of depression and anxiety in adolescents. The study suggested that screen time, particularly on social media platforms, might contribute to feelings of inadequacy and social comparison, which could increase anxiety. Furthermore, research published in "Computers in Human Behavior" in 2020 explored the relationship between screen time and psychological well-being in young adults, and to no surprise, the study found that higher levels of screen time were associated with higher levels of anxiety and depressive symptoms. Consider setting boundaries on your screen time and designating tech-free periods throughout your day. Anxiety management is a personalized journey; what works for one person may not work for another. Natural approaches can be valuable tools in managing anxiety, but it's crucial to remember that seeking professional guidance is essential, especially if your anxiety is severe or persistent. A medical professional can provide personalized recommendations based on your individual health status and needs. Combining these natural methods with expert advice allows you to take meaningful steps towards a calmer, more balanced life. To see how a Naturopathic Doctor can approach your anxiety holistically, contact Dr. Courtney Holmberg, Naturopathic Doctor in Toronto, ON, at 647 351 7282 or by booking online here. Anxiety can be challenging to manage, but you do not need to do it alone.


    Let’s be honest - hair is often a defining feature of our appearance and an extension of our identity. For many women, our hair is also a means of self-expression. That's why hair loss can be very distressing and impact self-esteem. There are various reasons why women experience hair loss, ranging from genetics to lifestyle factors. In this blog, we will explore the most common causes of women's hair loss and shed light on potential solutions. Androgenetic Alopecia (Female Pattern Hair Loss) Androgenetic alopecia, also known as female pattern hair loss, is one of women's most prevalent causes of hair loss. Androgens are a group of hormones, including testosterone, which are predominant in men but are also produced in smaller amounts in women. Hair follicles in the scalp have androgen receptors, which means they can be influenced by these hormones. In some cases, when the balance between androgens and other hormones shifts, hair follicles can become more sensitive to the androgens. This increased sensitivity can lead to a process called "miniaturization," where hair follicles shrink over time and produce thinner, shorter, and less pigmented hair strands. Genetics plays a significant role in determining susceptibility to this condition. Conventional treatment options range from topical minoxidil solutions to prescription medications like spironolactone and finasteride, but often only help while in use and may not resolve the issues long term. Nutritional Deficiencies Vitamins and minerals are essential for hair growth and maintenance. Deficiencies in nutrients like iron, biotin, zinc, and vitamin D can lead to hair loss. Iron is often the most common cause seen in practice, with research suggesting approx 60% of individuals experiencing hair loss present with iron deficiencies. A balanced diet rich in lean proteins, nuts and seeds, vegetables, and dark leafy greens can help combat hair loss due to nutritional deficiencies. Hormonal Changes Hormonal fluctuations can also play a substantial role in women's hair loss. Hormones naturally fluctuate in women due to various life stages such as puberty, pregnancy, postpartum, and menopause. These fluctuations can impact the hair growth cycle. During pregnancy, for example, higher estrogen levels prolong the growth phase (anagen) of the hair cycle, resulting in fuller hair. However, estrogen levels drop rapidly after childbirth, and many hairs enter the resting (telogen) phase simultaneously, leading to postpartum hair shedding. Hormonal changes during menopause can also lead to hair thinning due to decreased estrogen levels and potential androgen dominance. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders (hypothyroidism and hyperthyroidism), and chronic stress can also lead to hair thinning. Treating the underlying hormonal imbalance often results in improved hair health. Telogen Effluvium Telogen effluvium is a reversible condition that occurs when there is an abrupt shift in the hair growth cycle. This shift leads to increased hair follicles entering the resting (telogen) phase, followed by shedding. Common triggers include significant physical or emotional stress, major surgeries, rapid weight loss, childbirth, and certain medications. The hair loss is diffuse and occurs all over the scalp. While not much can be done to immediately reverse the shedding, managing the underlying cause and ensuring a balanced diet rich in vitamins and minerals can aid hair regrowth. Traction Alopecia Traction alopecia is a form of hair loss caused by repeated pulling or tension on the hair follicles. Tight hairstyles like braids, weaves, and ponytails can lead to hair loss, particularly around the hairline and temples. Avoiding tight hairstyles and giving hair regular breaks can prevent further damage. Medical Conditions and Medications Certain medical conditions such as alopecia areata (an autoimmune disorder), lupus, and scalp fungal infections can lead to hair loss. Additionally, some medications used to treat cancer, depression, arthritis, and high blood pressure can have hair loss as a side effect. Stress Chronic stress can disrupt the normal hair growth cycle. Elevated cortisol (aka our ‘stress’ hormone) disrupts the normal hair growth cycle by pushing more hair follicles into the resting phase, resulting in hair shedding. Practicing stress management techniques such as meditation, yoga, and deep breathing can help mitigate its effects on hair health. Hair loss in women can result from a combination of genetic, hormonal, nutritional, and lifestyle factors. Understanding the root causes of hair loss is the first step toward finding effective solutions. If you're experiencing significant hair loss, it's advisable to consult your healthcare professional to identify the underlying cause, as it may often not be one factor in isolation causing the hair loss, and more importantly, hair regrowth may not occur under the root cause has been accurately addressed. If you aren’t sure what to do about hair loss, call (647) 351-7282 for a consultation with Dr. Courtney Holmberg, a Naturopathic Doctor in Toronto. Dr. Holmberg will assist in getting answers as to why your hair is falling out and solutions to address the issue and improve your overall health. Make an appointment today to learn more about testing and a natural approach to health. References: Treister-Goltzman Y, Yarza S, Peleg R. Iron Deficiency and Nonscarring Alopecia in Women: Systematic Review and Meta-Analysis. Skin Appendage Disord. 2022 Mar;8(2):83-92. doi: 10.1159/000519952. Epub 2021 Nov 19. PMID: 35415182; PMCID: PMC8928181. Ho CH, Sood T, Zito PM. Androgenetic Alopecia. [Updated 2022 Oct 16]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: Birch MP, Lalla SC, Messenger AG. Female pattern hair loss. Clin Exp Dermatol. 2002 Jul;27(5):383-88. doi: 10.1046/j.1365-2230.2002.01085.x. PMID: 12190638. Sinclair R, Patel M, Dawson TL Jr, Yazdabadi A, Yip L, Perez A, Rufaut NW. Hair loss in women: medical and cosmetic approaches to increase scalp hair fullness. Br J Dermatol. 2011 Dec;165 Suppl 3:12-8. doi: 10.1111/j.1365-2133.2011.10630.x. PMID: 22171680.


    Menopause can be a challenging transition, impacting not only a women’s quality of life, but her relationships, health goals, and career. Not to mention the day-to-day symptoms of hot flashes, night sweats, insomnia, and anxiety can be debilitating, with few options for relief. Herbal therapies and nutraceuticals can certainly help lessen the severity of these symptoms. Still, for many women, they’re also taking into consideration the long-term impacts of the loss of estrogen on their cardiovascular health, bone health, and, most importantly, brain health. Many women and clinicians alike are familiar with the option of hormone replacement therapy (HRT) - in more updated terminology, 'menopause hormone therapy' (MHT) - through and after menopause, but many don’t take advantage of their use due to decades-old research from the Women’s Health Initiative in 2002 stopping their study due to researchers finding that the combination of estrogen and progestin had an increased risk of breast cancer, heart attacks, stroke, and blood clots (1). Data shows the use of HRT following this study dropped by approximately 80% (2). However, since then, numerous meta-analyses and long-term observational data have helped paint a more well-rounded realm of research to inform clinical care guidelines surrounding HRT. Now, we just have to work to raise educated awareness and break the stigmas. A Summary of the Latest Hormone Replacement Therapy Data: The 2002 WHI study flaws/misinterpretations were that primarily older women were at high risk from the use of hormones. The benefits of hormone therapy generally outweigh the risks for healthy women who are under 60 years old and were initiated within ten years from the onset of menopause. In an 18-year follow-up study among ~28,000 post-menopausal women, all-cause mortality (aka death in general) and cause-specific mortality (aka death from cardiovascular disease, cancer, and other significant causes) was seen to be no different between the intervention group and the placebo group when HRT was used for a median of 5.6-7.2 years (3). In the same study, the authors conclude that when HRT use is introduced early in menopause, women generally live longer than those who didn't take hormones. Furthermore, according to pooled stats of over 30 RCTs, women who started HRT before age 60 had a 39% lower risk of death than those who didn't take hormones. Although total cancer mortality did not differ significantly between intervention and placebo groups, significant increases in breast cancer were seen in the treatment group using oral estrogen plus progestins (3,4). Findings for breast cancer point to an adverse effect from progestin (artificial progesterone) on the breast epithelium (3), but are linked to favourable effects on decreasing endometrial cancer with long-term use. Important things to consider: these studies only evaluate one dosage, one formulation of a hormone, and one route of administration (aka not transdermal estrogen and bioidentical progesterone); thus, results are not necessarily generalizable to all patients and hormone preparations. The loss of estrogen through menopause has been linked to an increased risk of dementia and Alzheimer’s, explaining why women are at higher risk than men of developing it later in life (5). Brain imaging studies show a lower metabolic state in the brain has been observed through the menopause transition in women, likely relating to increased brain amyloid-beta deposition as compared to premenopausal women and age-matched men (6). Estrogen replacement therapy for young women transitioning through menopause (under 60 and within 5 years of menopause) is a promising option for preventing this hypometabolic brain state and reducing the risk of Alzheimer's (especially in those genetically predisposed). However, for women older than 60 or 5+ years after menopause, or for those presenting with signs of dementia already, HRT may actually increase the risks. Each cause should be looked at individually. This leads to our next question… What about Bioidentical Hormones Increased breast cancer risks were seen in groups using oral hormones, with synthetic progestins. Since these studies, newer formations of hormones that were not widely used at the time of these studies, such as transdermal estrogen and micronized progesterone. Transdermal estrogen shows superior benefits since it is applied across the skin and therefore surpasses the liver, minimizing negative impacts on liver function and the risk of blood clots and strokes. Furthermore, the most available literature so shows that when transdermal estrogen is used in combination with oral micronized progesterone, no increased risk of breast cancer has been observed thus far. Where else is HRT beneficial? Outside of menopause (loss of menses > 1 year) and perimenopause (a loss of or delay in menses > 7 days after age 45), premature ovarian insufficiency (POI) occurs when the loss of ovarian function and associated hormones declines prior to age 40. These women experienced extended periods of their lifespan without the protective impacts of estrogen and progesterone, and as such, are at significantly greater risk of bone loss & osteoporosis, cognitive disorders, and premature mortality (largely associated with cardiovascular disease). This group of women is often offered an oral contraceptive as a management tool; however, synthetic hormones do not equate to the same health benefits as physiological replacement of deficient hormones and as such, do not provide the same protection as HRT. If you've been given 'the pill' to manage your premature ovarian insufficiency, I highly encourage you to revisit your options. Contraindications to consider While numerous health benefits may be seen for those interested in using MRT/HRT to manage menopause, personal medical history must always be considered. The risks will likely outweigh the benefits in groups of women who have a personal history of breast, endometrial, as well as any hormone-receptive-positive cancer, including those with known BRCA or HER genetic family history. This is why all use of hormone replacement must be considered on a case-by-case basis, with informed consent, so you know your risks. In conclusion, women are more likely to suffer from hormone-related challenges through menopause (with many reporting negative impacts on their sleep, work performance, and relationships, and each case must be looked at individually) than be given the option of considering hormone replacement to manage their symptoms or lower their risks. If you suspect you may be showing early signs of perimenopause, if you’re in the midst of menopause symptoms, or if you wish to discuss the use of BHRT, schedule your initial consult with Dr. Courtney Holmberg, ND, at 647 351 7282 today. References: Manson JE et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women's Health Initiative randomized trials. JAMA. 2013 Oct 2;310(13):1353-68. Manson JE, Kaunitz AM. Menopause Management--Getting Clinical Care Back on Track. N Engl J Med. 2016 Mar 3;374(9):803-6. Manson JE, Aragaki AK, Rossouw JE, et al. Menopausal Hormone Therapy and Long-term All-Cause and Cause-Specific Mortality: The Women’s Health Initiative Randomized Trials. JAMA. 2017;318(10):927–938. Manson JE, Chlebowski RT, Stefanick ML, et al. Menopausal hormone therapy and health outcomes during the intervention and extended poststopping phases of the Women’s Health Initiative randomized trials. JAMA. 2013;310(13):1353-1368.'s%20protective%20effects,of%20the%20amyloid%2D%CE%B2%20protein. Scheyer O, Rahman A, Hristov H, Berkowitz C, Isaacson RS, Diaz Brinton R, Mosconi L. Female Sex and Alzheimer's Risk: The Menopause Connection. J Prev Alzheimers Dis. 2018;5(4):225-230. doi: 10.14283/jpad.2018.34.


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


    Let's face it, our face is our resume, and glowing skin is something we're all after. ​​ Breakouts, congestion and a dull complexion can be common, and at times frustrating, especially when we're doing 'all the right things'. ​ While there is no cookie-cutter solution to healthy skin, there are certainly a few simple lifestyle changes and adjustments to your daily routine you can make to reduce the appearance of blackheads, whiteheads, and other types of acne. Follow these tips to help jumpstart your journey to clear skin. Cleanse Once A Day Cleansing is an essential part of any skincare routine. It helps remove dirt, oil, makeup, dead skin cells, and other impurities that clog your pores and hair follicles. However, overwashing can also compromise your skin's microbiome & barrier, resulting in dehydration and an overcompensation of oil production that causes acne. Start your day with lukewarm water to rinse (but not ‘wash’ your face), and finish the day with a gentle cleanser. For acne-prone skin, use non-foaming options, and choose products that are in line with your skin's natural pH of ~ 6. Make sure you don't scrub too hard or over-wash, as this can make acne worse and leave your skin more prone to irritation. Moisturize Your Skin One of the most important steps to glowing skin is moisturizing. Dry skin often leads to increased oil production and acne breakouts, so it's crucial to keep your skin hydrated. When choosing a moisturizer, my general motto is ‘less is more’. Choose limited-ingredient products that contain high-hydration ingredients, like hyaluronic acid. If your skin is acne prone, avoid pore-clogging ingredients like oils and parabens. If you have oily skin, this doesn't mean you should skip moisturizing. Choose an oil-free formula to control excess sebum production while providing much-needed hydration. Drink Water! It sounds so straightforward, but most people's dry skin, wrinkles and under-eye bags are being emphasized by dehydration. No amount of $$ fancy creams can replace internal hydration, so drink up. You should aim for approximately your kg. body weight in oz. of water per day (ie 60 kg = 60 oz water minimum). Choose Non-Comedogenic Products Comedogenicity means how likely a product is to clog your pores. Non-comedogenic skincare products are designed to keep pores clear. This is especially important for people with acne-prone skin, as blocked pores can lead to irritation. Look for products with the "non-comedogenic" label when shopping for skincare and makeup items, such as aloe vera, vitamin C, hyaluronic acid and glycerin. This will ensure that you don't use anything that could potentially cause or worsen your breakouts. If your skin is particularly dry, higher glycerin content help hold hydration to the top layer of your skin, known as your epidermis, and reduces flaking without breaking you out. Limit Sun Exposure Sun exposure can cause skin inflammation and worsen existing acne breakouts. To prevent this, make sure to wear sunscreen when outdoors, even on cloudy days. Choose an SPF 30 or higher with broad-spectrum protection that blocks UVA and UVB rays. Also, avoid spending too much time in the sun during peak hours (between 10 am and 4 pm). Try Topical Active Ingredients Do you have severe acne? If so, consider trying topical products with salicylic acids or retinol. These ingredients can help: Reduce inflammation Unclog pores Fight bacteria Look for creams or gels that contain these active ingredients and apply them directly to the affected areas of your skin. Make sure to start with a lower concentration and work your way up, as these ingredients can be drying. Always talk to a professional to see if retinol is safe for regular use (avoid direct sun and do not use it when pregnant). Talk to a Professional and Learn How to Deal with Acne Today ​ If you have constant breakouts and want to learn how to reduce acne, it may be time to consult a professional. A naturopathic doctor can help diagnose the root cause of your clogged pores and acne-prone skin and create a customized treatment plan. ​ At Platinum Health & Wellness, Dr. Courtney Holmberg, ND, specializes in creating personalized solutions using evidence-based treatments to help people learn how to prevent acne and pimples and take control of their skin health. Call 647-351-7282 to book your appointment and start on the path to clear skin!


    Depression is a mental health condition that can make eating regularly or preparing nutritious meals to feel impossible. Unfortunately, besides medication, our system has little support to help patients diagnosed with depression, so you might feel overwhelmed with how to approach it or discouraged even to start. Many doctors use talk therapy and medications to treat depression, but did you know that nutritional deficiencies and mental health are strongly linked? While supporting depression takes much more than eating your fruits and vegetables, arming yourself with the knowledge about how your diet can affect your mood, you can start to take more control over your mental health. Let's dive into how what you eat affects your brain and mood. How Does Nutrition Affect Depression? Proper nutrition is essential to your mind and body's well-being, and it can help reduce the severity of some depressive symptoms. ​ Nutritional deficiencies, especially vitamin D, B12, and iron, increase your risk of depression. A nutrient deficiency may also lead to a hormone imbalance, which is common among those with significant depression. First, if you’ve recently been diagnosed, start by asking your medical doctor or naturopath to check in on common nutrient deficiencies like iron, b12, and vitamin D since one in three depression cases is linked to defects. Did you know that depression, anxiety and insomnia, among other neurological disorders, all correlate to neuroinflammation? That's right; depression is inflammatory. The processed foods common in North American diets do nothing to help this, including: Highly processed, low-fibre foods Trans fats (margarine, hydrogenated oils) Canola, corn, soybean oils High glycemic foods that spike your blood sugar levels Artificial sweeteners like Splenda and high-fructose corn syrup Meat and dairy-raised or grain-fed diets GMO crops, like soy and corn ​ What Nutrients Foster Healthy Brain Function? A few primary nutrients play a significant role in fostering a healthy brain. By choosing foods naturally rich in these nutrients and supplementing your diet with vitamins where necessary, you can make a big impact on your mental health. Protein Protein is for much more than simply building muscle mass — it also promotes neurological health. The amino acids in protein provide the critical building blocks for both your hormones and your neurotransmitters. If you aren’t eating enough protein, you may lack the amino acids key to producing your ‘happy hormones’ like serotonin and dopamine. The higher availability of these two hormones is essential in counteracting depression. Vitamin D For people who spend a lot of time indoors or live in climates with less sun, vitamin D deficiency is a common problem (it's suggested that ⅔ Canadians are deficient). Low vitamin D levels are often linked to depression due to the high accumulation of vitamin D receptors in the same brain area that depression affects. Vitamin D is also a hormone modulator, assisting in generating some of the essential hormones that keep us feeling content. Spending some time every day in sunlight is an excellent way to get more vitamin D. Eggs, mushrooms, and fatty fish are also reliable sources of vitamin D; however, its rarely enough to keep you from deficiency. Talk to your naturopath about testing your levels and how much is ideal for supplementation. Omega-3 Fatty Acids Interestingly, depression incidents are reported to be less common in groups that consume more fatty fish, which sparked an investigation into Omega 3’s and their role in reducing depression. And to no surprise, according to studies, Omega-3 fatty acids support brain health. While the mechanism between depression and Omega-3 isn’t yet conclusive, its proposed benefits come from omega-3’s ability to travel through the blood-brain barrier easily, interact with mood-related molecules in the brain, and provide inflammatory modulating effects. Adding fatty fish, nuts, and seeds like walnuts and chia seeds to your diet can increase your body’s omega-3 saturation and improve mood. You can also supplement Omega 3’s. However, the ratio and concentration do seem to matter. The most effective Fish Oil preparations appear to have at least 60% EPA relative to DHA, with benefits typically best seen with over 1000 mg of EPA per day. Get Your Mental Health Back on Track with Nutrition Whether you need more vitamin D or other nutrients in your diet, a healthy diet can be the first step toward a happier lifestyle. However, it is essential to acknowledge that making changes or finding the motivation to do so when in a depressed state can feel daunting. However, support is available. To learn more about where to start in taking control of your diet and ruling out nutritional deficiencies which may be impacting your mental health, contact Dr. Courtney Holmberg, ND, at (647) 351-7282 today to book a consultation.​


    The term 'hormonal imbalance' gets thrown around a lot these days. If you've scrolled through social media or listened to any health related podcasts recently, you're sure to have come across this buzz word. But what are we actually referring to when we say hormonal imbalance? Are they talking about sex hormones, metabolic hormones, or adrenal hormones? Is this a symptomatic imbalance or a clinical one? It's important to know what we're referencing when we talk about hormones since the term itself is an umbrella for numerous communication molecules that float through the body. Let's spend a moment and actually break down the most important hormonal systems in your body, and identify where imbalances may exist. Sex steroid​ hormones Your sex steroid hormones, often referenced as your reproductive hormones, kick in at puberty and control - you guessed it - our reproductive systems. Imbalances in these systems can lead to acne, hair loss, PMS symptoms, low lidibo, and in more significant cases, irregular or missed periods, infertility issues and extreme fatigue/mood issues. The most common issue facing young women in my practice is hyperandrogenism, or excessive production of testosterone, leading to acne, hair loss and darkened hair growth. It’s often caused by conditions like PCOS or excessive stress, but in some cases it can also be genetic. Correcting ovulation patterns and dealing with the mental and physical stressors placed on the body are the most common alternative to oral birth controls and androgen suppression medications in these situations. PMS is also a common symptom of hormonal imbalance, although its important to differentiate if the symptoms is being caused by hormones, or just made worse by a change in hormones. Its common for women to have lower progesterone levels compared to their estrogen, resulting in PMS symptoms presenting the last 7-10 days of their cycle. This again is correcting by supporting ovulation and managing aggravating factors like stress, lack of sleep and exercise. Metabolic Hormones There are numerous hormones that control your metabolism, but the most impactful ones are insulin and thyroid hormones. Insulin is a reactive hormone, meaning in only released in the presence of glucose in the blood stream, and the most those levels go up and down, the more the cells start to gradually ignore insulin signals. This means cells cannot update glucose as energy, resulting in weight gain and fatigue as the primary symptom. Weight gain and fatigue can also be as a result of low thyroid hormones. Your thyroid products hormones that control the rate in which your body burns fuel, amongst other things, so a lack of it slows things down. If you’re experiencing any of these symptoms, these would be important hormones to look into getting tested. Adrenal Hormones Cortisol, epinephrine and norepinephrine are a few of the corticosteroid hormones are made in the small organ that sites above your kidneys, known as your adrenals. Overstimulation of this organ from both physical and mental stressors can lead to an overproduction of these hormones, presenting as anxiety, panic, lack of appetite, insomnia, and so on. Simultaneously, a lack of these hormones can cause extreme fatigue and burnout. Your adrenal hormones have a large influence on the rest of your endocrine system, which is often why stress makes all hormonal issues much worse. Testing for hormonal issues You many have been told by your MD that blood work for your hormones will not provide answers, and in many cases, that's correct. ​ Unfortunately, unless is there something pathologically wrong (like PCOS or an adrenal crisis), its hard to test for these issues via standard blood work, since most hormones are to limited in the blood stream to identify more functional imbalances. ​ This is where more sensitive testing like saliva and urine may be of value, and I emphasize the may. Not all issues can be ruled in or out via hormone assessments, and that's why its important to talk an experienced Naturopathic Doctor about options for testing and if its right for you. How to regulate hormones naturally ​ I always advise starting with these simple steps to address hormone imbalanced before you involve supplementation. Protein helps you feel fuller for longer and is critical when trying to balance your metabolic hormones. Eat around 20 to 30 grams with every meal, or for certain people, your body weight in lbs. Eat fresh vegetables (especially greens), and fermented foods to support the beneficial bacteria in your gut. This combats insulin resistance and boosts your immunity. Cut out sugar as far as possible to protect your gut and stabilize your metabolic hormones Improve the amount of fibre you eat to improve insulin sensitivity, manage your hunger, and feed your gut Use your body as feedback for exercise. If you’re constantly injuring yourself or shorting yourself on sleep just to get a workout in, consider the impacts that has on adrenals. If you’re feeling tired a lethargic, considering adding in low intensity movement to pick up your energy. Find ways to relax and combat stress to reduce cortisol levels. This may also help you lose weight as excess cortisol interferes with insulin production. Get the recommended 7 to 8 hours of sleep at night to reduce hunger, improve insulin sensitivity, and regulate endocrine production. ​Speak to Dr. Courtney Holmberg About More Natural Ways to Balance the Endocrine System ​ Learning how to properly balance hormones can make significant changes to your life, but also be mindful to be objective when considering whether or not your hormones may play a role in your symptoms. To learn more about hormones and their role in your health, as well as discuss proper hormone testing if necessary, contact Toronto Naturopath, Dr. Courtney Holmberg at 647-351-7282 or schedule your appointment online today.


    Irritable bowel syndrome (IBS) is a common GI disorder impacting roughly 1 in 5 Canadians, with our incidence rate being one of the highest in the world (18% vs 11% globally). However, despite its high prevalence, health care costs and impacts on people's quality of life, our understanding of the true ‘root cause’ of IBS is limited. It often occurs in association with gut infections (often referred to as post-infectious IBS), bacterial overgrowths (also known as SIBO), or heightened stress (people exposed to stressful events, especially in childhood, tend to have more symptoms of IBS). Fortunately, outside of impacts on quality of life, the good news is IBS doesn't cause changes in bowel tissue or increase the risks of colorectal cancer. Irritable bowel syndrome can cause the following symptoms, which may differ in each person. Cramping Abdominal pain Bloating and gas Changes in how often you have a bowel movement Diarrhea Constipation Generally speaking, the muscles of the colon of people with IBS tend to contract more than in people without this condition, causing cramps and pain. These problems cause the digestive tract to become very sensitive, and this is where diet and lifestyle changes come into play Diagnosing IBS The diagnosis is considered a ‘diagnosis of exclusion’, meaning all other causes of symptoms must be ruled out to rule in IBS. It’s important to work with your clinician to complete the proper testing to rule out other factors, such as infection, bacterial overgrowth, celiac disease, IBD and other overlapping pathologies. However, the most up-to-date studies suggest the microbiota in our gut plays a key role in the pathophysiology of IBS and poses the question if probiotics can truly help. Which probiotics could help IBS Research has suggested that an important factor in the management of IBS is to support a balance of the gut-brain axis, and probiotics in the correct doses + correct strains can assist with this [2]. The two most well-researched species of probiotics are “Lactobacillus” and “Bifidobacterium,” which have not only been shown to aid the digestive system but also assist the immune system, provide anti-inflammatory benefits to the gut, strengthen the intestinal barrier and many more influences, including improvements in mood and metabolism. However, strain specificity matters and not all probiotics may work. Lactobacillus plantarum 299v The literature demonstrates some really promising results with this probiotic strain. L. plantarum 299v has been shown to lower inflammatory markers associated with cancer risk, prevent c. difficile diarrhea in antibiotic recipients, and improve IBS symptoms including gas, bloating, abdominal pain and irregular stools. A recent review of the research also concluded that the intake of L plantarum 299V at only 5-10 billion CFU per day was shown to significantly relieve abdominal pain and flatulence, and normalize stool in IBS sufferers, providing significant improvements to their quality of life with only 4 weeks of use [3]. Bifidobacterium Infantis (also referred to as bifidobacterium longum) A meta-analysis of the probiotic strain b. infantis (a strain commonly found in many IBS targeted probiotic combinations) also concluded that when used in combination with other composite probiotics, b. infantis significantly reduced abdominal pain, bloating and distension in IBS sufferers. Not only were symptoms improved, but there is also data suggesting that this strain of flora assists in increasing plasma concentrations of tryptophan, the precursor of serotonin [4]. While studies don’t show significant benefits with the use of antidepressant therapies (aka SSRIs) in the management of IBS, serotonin delivered locally by bacteria may be more effective. Studies also prove that probiotics can help, even in their inactive state. One study looked at the use of an inactive probiotic in women with IBS, and 30% of the women reported an improvement in pain and less discomfort within a three-week or more period compared to those taking the placebo. When treating IBS, of course, we cannot exclude diet and stress management as a part of a well-rounded treatment plan (read more about the FODMAPs diet for IBS here), but it's evident that the right probiotics have a largely positive effect. To learn more about IBS, proper diagnostic assessments, and treatment options for irritable bowel syndrome, please contact Toronto Naturopathic Doctor, Dr. Courtney Holmberg at 647-351-7282 to schedule your appointment today. Other References: Lovell RM and Ford AC. Global prevalence of and risk factors for irritable bowel syndrome: A meta-analysis. Clin Gastroenterol Hepatol. 2012 Jul;10(7):712-21.e4. Pimentel M, Lembo A. Microbiome and Its Role in Irritable Bowel Syndrome. Dig Dis Sci. 2020 Mar;65(3):829-839. doi: 10.1007/s10620-020-06109-5. PMID: 32026278. Kaźmierczak-Siedlecka K, Daca A, Folwarski M, Witkowski JM, Bryl E, Makarewicz W. The role of Lactobacillus plantarum 299v in supporting treatment of selected diseases. Cent Eur J Immunol. 2020;45(4):488-493. doi: 10.5114/ceji.2020.101515. Epub 2021 Jan 25. PMID: 33613097; PMCID: PMC7882405. Andrew P. Allen, Gerard Clarke, John F. Cryan, Eamonn M. M. Quigley & Timothy G. Dinan (2017) Bifidobacterium infantis 35624 and other probiotics in the management of irritable bowel syndrome. Strain specificity, symptoms, and mechanisms, Current Medical Research and Opinion, 33:7, 1349-135.

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