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: https://www.ncbi.nlm.nih.gov/books/NBK430924 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.

Our digestive tract is a complex system that relies on multiple factors to keep it regular. Its primary role is to break down the foods we eat, absorb the nutrients we require, and rid of the wastes we don't need. For some people, having a daily bowel movement is regular as clockwork, whereas others may go days on end before their next bowel movement. However, a daily bowel movement is not the only sign you should pay attention to when evaluating your gut motility. The consistency of the movement is also important, with denser movements often indicating your gut motility is lagging, while loose movements mean motility is rushed. Having a daily bowel movement is often considered to be a staple indication of overall health, as well as a telltale sign of the state of your gut environment. And while everyone's norm may look different, consistency is critical nonetheless. The most common factors that affect regularity are often diet, exercise, and fluid intake. However, bowel function is fundamentally a nervous system response, meaning it can be manipulated beyond simple lifestyle factors. In order to help you hack gut motility, let’s first break down the actual mechanism of how a bowel movement happens, and the neurotransmitters and nutrients that maintain its function. What Stimulates Bowel Movements? The gut maintains is own unique enteric nervous system, which acts independently of your autonomic system to create muscular contractions known as peristalsis. Peristalsis propels food through the digestive tract and eventually out of the body. In order for this system to function correctly, it requires regular signalling of its muscles to release and contract, which are regulated by the neurotransmitter, acetylcholine. An abundance of acetylcholine binds to cholinergic receptors to encourage contraction, and the ultimate breakdown of acetylcholine encourages relaxation, creating the rhythmic waves of peristalsis we desire. How Can You Increase Gut Motility? The moral of this potentially overly science-y story is proper acetylcholine management = proper gut motility. This neurotransmitter is a combination of two primary molecules: acetyl CoA and choline, formulated via the enzyme choline acetyltransferase (ChAT). ​ First, we need to create acetyl CoA, which is relativity easy to do since in the nerve cell, its primarily accomplished by converting glucose into acetyl CoA during glycolysis (figure 1). Glucose is ingested naturally via carbohydrates, so step one is to ensure you're ingesting a sufficient amount of complex carbohydrates each day (this is one of the reasons why some people who follow a low-carb or SCD, FODMAP, or ketogenic diet may notice more constipation). Step two is to ensure these carbs break down into their desired metabolites, which requires the right amount of thiamine, or vitamin B1. This vitamin upregulates a critical enzyme known as pyruvate dehydrogenase and supports the conversion of glucose into acetyl CoA instead of lactate. ​ Funny enough, the most commonly fortified thiamine foods tend to be processed carbohydrates, which are often the first things we cut out of our diets when we want to make healthier eating choices. The very cause of irregular bowel movements could easily be a lack of thiamine in your diet, which can be remedied by increasing the intake of vitamin B1. Most adults should consume at least 1.2 mg of thiamine daily, and children between the ages of 1 and 18 should get between 0.5 and 1 mg (1). Secondly, we need the micronutrient choline, which is found in the highest amounts of fatty foods such as eggs and salmon, or vegetables like cauliflower and Brussel sprouts. It can also be supplemented in forms such as citicoline, but it's best to speak to your healthcare provider before doing so. Once you are consuming healthy carbs, choline, and vitamin B1, you also need to make sure your body is producing choline acetyltransferase (ChAT) enzymes to turn acetyl CoA and choline into our desired neurotransmitter, acetylcholine. Thankfully, ChAT production occurs naturally within the body. Butyrate is a short-chain fatty acid made by healthy gut flora via the fermentation of fibre. It has been shown to help increase ChAT production (2), as well as support healthy gut barrier function and prevent increased intestinal permeability (more commonly nicknamed “leaky gut syndrome”). Eating more fibrous veg, or consuming butyrate-rich foods, such as butter, may support gut motility. Another option could be fibre supplementation with partially hydrolyzed guar gum (PHGG), which is my fibre of choice. PHGG has been shown to decrease symptoms of irritable bowel syndrome (3,4), and benefit the growth of Bifidobacterium and butyrate-producing bacteria in the human large intestine (5), without causing the majority of side effects seen with psyllium use. Why Coffee and Nicotine Make You Poop! Most people report bowel movement stimulation after a cup of coffee, and 1 in 6 people experience constipation when they quit smoking. You’ve probably guessed by now that it's because these two stimulants have direct impacts on acetylcholine. Coffee (particularly, caffeine) actually functions as an acetylcholinesterase inhibitor, meaning it slows the breakdown of acetylcholine in the postsynaptic cleft, allowing it to provide more nerve stimulation and muscle contraction. Nicotine binds directly to the cholinergic receptors that acetylcholine activates, producing similar effects as this neurotransmitter. The take-home message... If you’re trying to quit coffee or smoking, but are fearful of the effects on your gut, know there are alternative ways to get things going without all the dangerous side effects. There are many factors causing irregular bowel movements, with a lack of acetylcholine being just one of them. If you want further help to determine the cause of irregular bowel movements or wish to discuss ways to support optimal gut health, please feel free to contact Toronto Naturopathic Doctor, Dr. Courtney Holmberg at 647-351-7282 to schedule a consultation today!

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.

If the herb known as Ashwagandha is foreign to you, you've come to the right place. This herb has actually been used for centuries in Ayurvedic medicine and is well-documented for its traditional uses and beneficial effects on sleep, energy, stress and cognition. The botanical name given to the herb is Withania Somnifera and it belongs to the Solanaceae family. Some know it by its common name of 'Indian Ginseng' since it originates in India. In India, Ashwagandha has been used for centuries. There are specific properties of the herb that are now being researched as a natural treatment for a variety of medical conditions. So far, research studies have discovered the herb contains properties that can help: Alleviate Arthritis Induce Sleep Reduce Inflammation Reduce Stress and Anxiety The herb is classified as an adaptogenic herb. This simply means it has the ability to help stabilize various physiological conditions and help the body establish better homeostasis. In addition, it helps normalize the “flight or fight” response we experience during extremely stressful situations. The many holistic effects of ashwagandha demonstrate the power of herbal medicine, which has been largely integrated into naturopathic treatments for decades. Let's explore the many wonderful benefits of ashwagandha. How Is Ashwagandha Used in Naturopathic Medicine? Ashwagandha is composed of many medicinal compounds such as amino acids, fatty acids, choline, alkaloids, and steroidal lactones. Given these properties, along with the ability to use the entire plant for therapeutic purposes, some of the benefits one could experience include: Brain Cell Degeneration Reduction: Research studies have suggested that improved memory and learning benefits could possibly be used to help people suffering from Alzheimer’s.An 8-week study in 50 adults showed 300 mg of Ashwagandha root extract twice daily significantly improved general memory, task performance and attention [1], making it a promising option for dementia and cognitive decline. However, Ashwagandha has cognitive benefits extending beyond preventing brain cell degeneration. Alongside this powerful effect, the root of the herb has been shown to increase focus, attention span, and short-term memory, suggesting this root could also be used to help you perform better at work or in school. Attention deficit disorder patients could consider supplementing medications with ashwagandha extract or transitioning to natural medicine altogether. Reduces Depression without Feeling Drowsy: When taken daily, Ashwagandha has been shown to lower cortisol levels by 28% [2], reduce stress by 44% [3], minimize anxiety by 69%, and improve depressive symptoms by 68%, which makes it better than some first-line anti-anxiety and antidepressant drugs at stabilizing mood and insomnia. The best part – it's generally without any side effects or withdrawal symptoms. Improved Thyroid Function and Weight Management: Studies have also been conducted on Ashwagandha and its effects on the thyroid gland. Using the herb on a regular basis has been shown to help support the conversion of thyroid hormones into their active form, helping certain people who have had either under-active or over-active thyroid glands [4]. Strengthens the Immune System: People that have cancer and are seeking treatment have used Ashwagandha to help boost their immune system response, which is usually lowered from chemotherapy. The herb has also been shown to help reduce fatigue and discomfort, while simultaneously helping protect against some of the negative side effects associated with radiation. and chemotherapy. Always consult your medical doctor and naturopath before using Ashwagandha if you are undergoing any of these treatments. Enhances Sexual Stimulation for Men and Women: For both men and women, who are experiencing a reduced sex drive, the herb has been used to increase sexual response. In addition, it has helped men with low sperm counts increase levels to help with conception. Furthermore, research has noticed some men have better testosterone production, which can be beneficial for those that have low testosterone levels. Helps Stabilize Blood Sugar Levels: Test tube studies have shown the herb to increase insulin secretion and improve insulin sensitivity in muscle cells [5]. Also, several human trials show improved blood sugar regulation in patients with diabetes [6,7]. One trial showed hypoglycemia benefits at 30 days of use equivalent to some medications without adverse effects [8]. Benefits Heart Health We already know that ashwagandha has powerful effects on reducing stress and anxiety. But its impact on health proves far greater than just making you feel more peaceful. Studies have proven that the evergreen root from the nightshade family can lower blood pressure and significantly improve outcomes for patients with hypertension. Supplementing your medications with this root may help maximize positive outcomes. The herb has also shown promising results on lipid profiles. For instance, using the herb has been shown to reduce “bad” (LDL – low-density lipoprotein) cholesterol levels [8]. Furthermore, healthy people without a personal history of heart disease can benefit from it too. The root helps prevent heart disease and improves general cardiac function, making it a great option for those with no current signs of heart disease but a high-risk family history. With its ability to lower blood pressure, bad cholesterol, and sugar levels, ashwagandha can positively affect heart health. For those struggling with heart disease, ashwagandha should be a top therapy to consider. Increase Energy Levels Fitness fanatics are always looking for supplements to aid their workouts. Even for more sedentary people, ashwagandha naturally boosts energy levels and helps with chronic fatigue syndrome. Try substituting pre-workout supplementals with ashwagandha extract, or use it to prepare you for work. Everyone can benefit from feeling more energized and active. Reduces Inflammation and Eases Pain Many people suffer from pain from arthritis and other chronic joint conditions. These frustrating ailments usually have few solutions and become a daily struggle for many. However, naturopathic medicines can address some of these symptoms. Ashwagandha can reduce inflammation and ease joint pain. Use it to ease the impacts of your arthritis or to aid soreness and muscle pain from the gym. Detoxifies the Body Everyone wants to find the next detox craze to put their body in a cleaning state. Instead of drinking lemon juice for days, try adding ashwagandha supplements to your body. Studies show that ashwagandha increases detoxifying enzymes that help clean out organs and reset functionality. This benefit can become particularly powerful for recovering alcoholics with liver damage. Furthermore, the root can protect against heavy metal toxicity, a widespread threat from processed foods and other products. Regulates Menstrual Cycles Irregular menstrual cycles, cramps, and heavy flows can cause discomfort at work, school, or daily life. Thus, many women want to keep their menstrual cycles under control. While birth control offers many positive benefits for women, ashwagandha is a natural approach that can positively impact menstrual regulation. The root can reduce menstrual cramps' pain, duration, and discomfort. Furthermore, it can help prevent uterine cancer. Aids Cancer Patients Studies show that ashwagandha might help combat cancer cells' growth and multiplication. In one study, the natural supplement inhibited cancer cell growth in breast cancer patients. The goal of cancer therapy is to reduce cancer cell growth while simultaneously eliminating existing cancer cells. With its corollary effects of improving chemotherapy and radiation treatment experiences, cancer patients may benefit significantly from this natural substance. Improves Memory The impacts of ashwagandha on working memory continually reveal themselves study after study. In one study that used the KSM-66 variety of the root, participants experienced significant memory and cognitive improvements on the Wechsl memory scale. Whether you’re a forgetful person or at risk for dementia or Alzheimer’s, adding ashwagandha to your daily supplements may offer significant benefits. Increase Testosterone Levels for Men Ashwagandha increases testosterone levels for men of many ages. Health experts link increased testosterone to improvements in muscle growth, bone density, heart health, and sexual vitality. Especially for elderly patients with decreasing testosterone levels, adding ashwagandha could have extremely positive impacts. Improves Sleep Quality and Relaxation Sleep remains one of the most important things for our health. However, many people struggle to get to sleep or stay asleep. These people usually deal with more daytime fatigue, concentration issues, and other problems. Ashwagandha can help improve the onset and efficacy of sleep. Significant improvements to this part of your health can have comprehensive benefits. Eases Symptoms of Perimenopause The onset of menopause impacts every woman differently. However, across the board, it usually causes emotional and energy changes that distress many females entering this phase. Ashwagandha can help reduce the irritation and tension of the perimenopause phase. With its comprehensive benefits for mood, sleep, relaxation, and inflammation, women taking this supplement might have an easier experience during menopause. Maximizes Your 'Healthspan' We often talk about lifespan in terms of how long people live, but I would argue what is more relevant is the quality of life and level of health you're able to maintain throughout that lifespan. You'll often hear this term referred to as your 'healthspan'. With its many positive impacts, taking ashwagandha may contribute to a maximized healthspan. People who integrate this supplement into their diet receive positive holistic benefits and can live to their fullest potential. Older people struggle with declining health from various hormonal shifts and other issues. Taking a supplement to combat these changes can significantly improve one’s later years. Ashwagandha provides excellent aid for elderly health outcomes. DISCLAIMER: Prior to using Ashwagandha, it is highly recommended to consult with a naturopathic doctor first. If you have diabetes, are pregnant, intend to become pregnant, are nursing, have low or high blood pressure, stomach ulcers, autoimmune diseases, or recently had or are getting ready to have surgery, only take Ashwagandha under the supervision of a naturopath or healthcare doctor. Allergies to Ashwagandha may develop for those with nightshade vegetable allergies. For additional information about Ashwagandha and other naturopathic medicinal treatments and services, please feel free to contact Dr. Courtney Holmberg, ND at 647-351-7282 to schedule an appointment today!

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. https://www.alzheimers.org.uk/about-dementia/risk-factors-and-prevention/hormones-and-dementia#:~:text=Oestrogen'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.

Histamine intolerance affects millions of people every year, and many are unaware of its symptoms or that they may be presented with it. The connective tissues in your body produce histamine to help organs, muscles, and nerves receive and deliver messages to your brain and immune system. For example, histamine signalling will trigger your brain tissues to release pent-up stomach acids to process the foods you eat. It also helps the immune system response by drawing attention to damaged tissue that requires repair. Histamine intolerance comes from an overproduction of the histamine molecule from mast cells and basophils. Most patients with histamine intolerance symptoms present with hyperinflated histamine levels and/or no way to metabolize it, leading to symptoms such as sinus issues, intestinal permeation, chronic headaches, anxiety, fatigue, hives, nausea, and digestive problems. It's important to clarify that histamine intolerances are very different than mastocytosis and mast cell activation syndrome. In these disorders, patients either genetically produce too many mast cells, or the mast cells are hyper-reactive to triggers and release too much daily histamine. These disorders are managed differently and you should always first speak to your doctor or naturopath for a proper diagnosis. While histamine presents widely throughout the body and serves many functions, the abundance of histamine production and uptake inside the digestive system has led researchers to investigate the root causes of excess histamine and the potential for probiotic treatment in stabilizing it. Probiotics for histamine intolerance offer significant opportunities to reduce histamine production and treat histamine intolerance. What is a Histamine? Histamine release occurs naturally inside your body as one of the five major biogenic amines. These five neurotransmitters, dopamine, norepinephrine, epinephrine, serotonin, and histamine, regulate brain functions and endocrine responses. Your cells produce histamine to send signals from your body to your brain as a part of complex biochemical reactions, particularly in digestion and gut motility. They also produce histamine to stimulate the immune response, activating your white blood cells to defend you from allergens or other threats. What Causes Histamine Intolerance? Your body produces histamine for its own use, and when your body can’t produce enough enzymes to break down all the histamine in your system, your histamine levels rise, creating an imbalance. This causes every mast cell in your body to produce the enzyme to break it down, known as diamine oxidase or “DAO”. DAO is responsible for breaking down the histamine compound in your food, and a lack of it creates a histamine-derived imbalance or build-up. Symptoms of elevated histamine include: itchy, flushed skin diarrhea & abdominal pain nausea headaches congestion, running/itchy nose & eyes dizziness heart palpitations/anxiety You may not be aware of it, but you have relatively high amounts of naturally occurring histamine in your diet every day. Foods high in histamine include: Fermented foods and beverages like Sauerkraut and wine Processed meats Aged cheeses Eggplants and spinach Avocados And dried fruits Some foods, including alcohol, energy drinks, black tea, and green tea, block DAO, preventing it from breaking down histamine. While other factors, including genetics and medications, may lower DAO production, diet factors significantly decreased DAO activity. It's important to recognize that a histamine-rich diet enhances the production of gut bacteria in healthy individuals, and is not an unhealthy way to eat. In fact, histamine-rich foods are usually the highest in naturally occurring probiotics. However, when your system falls out of balance, multiple sources of histamine build up and trigger histamine intolerance. The problem arises when dietary intake and bacterial histamine production combine at such staggering levels that human mast cells can't manufacture enough DAO to process the overflow. Disorders like SIBO, or small intestinal bacterial overgrowth, can also exacerbate histamine intolerance because they not only generate their own histamine release but damage the area of the gut lining that creates a large supply of the body’s DAO enzyme. Therefore, people with small intestinal bacterial overgrowth or SIBO are at a much higher risk of presenting with histamine intolerant symptoms. Antihistamine Probiotics vs. Histamine Intolerance Because histamine production is deeply connected to gut bacteria levels, researchers have been looking into histamine-reducing probiotics as a treatment. Treatment of histamine intolerance focuses on ways to limit histamine intake and remove excess histamine from your system. Diet plays an important role in limiting histamine sources, but research has uncovered more about the interplay of gut bacteria in health. Using probiotics for histamine intolerance treatment demonstrates improved outcomes for people suffering from histamine intolerance. So much of your gut health depends on your gut biome. These microscopic bacteria coexist in your digestive tract and help your body break down and process foods. Some strains of beneficial gut bacteria, known collectively as probiotics, display histamine-increasing properties, while others offer histamine-lowering effects. The role of probiotic bacteria in curbing histamine overproduction is a rapidly advancing area of mast cell research, and you can find numerous studies connecting probiotic strains to lowering histamine presentations (or increasing it, for that matter). For example, because histamine is a biogenic amine, physicians have been looking to other naturally occurring biogenic amines, such as lactic acid (and lactic acid-producing bacteria) in its role in histamine intolerances. It may come as a surprise, but any of the common ‘good for you’ probiotics from the lactobacillus family are being investigated as possible aggravators due to their high lactic acid production in food. However, the impacts on histamine depend on the strain, so this does not apply to all strains of a specific species or genus. Alternatively, low-histamine probiotics activate anti-inflammatory agents in the mast cells, help stabilize mast cells, and down-regulating the sensitivity of histamine receptors. Many of these flora are found in the Bifidobacterium genus. Some histamine-lowering strains include: ​​ Lactobacillus plantarum Bifidobacterium longum - helps improve gut barrier and assist in histamine degradation Bifidobacterium infantis Lactobacillus rhamnosus And physicians have been looking into the probiotic lactobacillus reuteri, which they derive from histamine itself Moreover, some histamine-increasing probiotics include: Lactobacillus casei Lactobacillus Bulgaricus Streptococcus thermophilus Lactobacillus delbrueckii Lactobacillus helveticus More so, some probiotics are classified as histamine neutral, or helpful at lower doses, such as lactobacillus acidophilus when taken under 1 billion CFU per day. Histamine-lowering probiotics muffle histamine signals and compounds like the probiotic b. longum display clinical benefits in lab tests against allergies. However, people are different, and we all have unique levels of gut flora in our stomachs and intestines, so probiotic supplements don't have a uniform effect on all demographics. An anti-inflammatory diet regimen that avoids histamine-rich foods lays the basis for reducing histamine levels. Incorporating probiotics that assist in histamine prevention or removal can present meaningful improvement and symptom reduction in patients suffering from histamine intolerance. In all cases, you should work with your doctor to confirm your diagnosis and develop personalized treatments for histamine intolerance. Many factors in your health composition and diet limitations affect treatment and results. For example, consuming the aforementioned DAO-blocking foods, such as alcohol, can create confounding impacts when using probiotics to manage histamine symptoms. Learn More About Histamine Intolerance Treatment Research indicates that readjusting your gut flora with low-histamine probiotics can reduce inflammation, alleviate symptoms, and reduce the effects of seasonal allergies. Treatments that include a low-histamine diet combined with histamine intolerance probiotics work together to improve gut health in people diagnosed with histamine intolerance. Most patients with histamine intolerance tend to have an overabundance or bacterial deficiency in their gut flora. The key to resolving symptoms is to eradicate the aggravates (both food and flora) and restore a healthy bacterial balance to the ecosystem. Furthermore, as described above, taking the wrong probiotic supplement can worsen your condition, as they promote histamine production. If you want to learn more about probiotics or the management of histamine intolerance symptoms, contact our Toronto Naturopath, Dr. Courtney Holmberg ND by calling (647) 351-7282 today.

We typically don't give much thought to our gall bladder when we think about digestion or hormones for that matter. While critical to more than just digesting fats, the importance of this tiny organ sitting tucked below our liver is often overlooked. Unless you’ve had gallstones or experienced some form of gallbladder disease, you might not even be aware of its function. ​ While originally thought to be a disorder brought on later in life by obesity and a high saturated fat diet, I’m seeing more and more young, thin and otherwise healthy women in my practice with disease of the gall bladder; from sludge to stones, to full cholecystectomy (removal) by the time they’re 30. This presents questions surrounding the variables causing gall disease and brings us back to their relationship to hormones. ​What is the gallbladder, and what does it do? The liver produces the bile that helps you digest fats, and the gallbladder stores it until it's required for digestion. Because it’s been stored, the bile in your gallbladder is more concentrated than the bile secreted by the liver. Symptoms of gallbladder dysfunction often include: Sudden onset pain just underneath your right ribcage, in your abdomen, occasionally associated with heartburn, nausea, gas, and fullness Pain between your shoulder blades A chronic ache in your abdomen that intensifies after eating complete blockages will result in pale, greasy, floating stools, and dark amber colored urine While it is thought that most of us will develop gallstones at some point in our lives, many of us won’t notice that we have them until we experience intense pain, usually after a rich meal high in fat. But stones are not the other concern. Cholestasis, also known as ‘biliary sludge’, is characterized by a reduced flow of bile into the duodenum from the gall bladder and/or liver, resulting in thicker, more concentrated bile. This increases the chances of stones, biliary colic, and acute pancreatitis. So where do hormones come into play? Well, like any other organ in our body, the gall bladder relies on hormones to regulate its physiological functioning. It is most notably influenced the following hormones: Melatonin, aka our sleep hormone. It regulates our biological clock in response to darkness. It helps prevent gallstones by reducing cholesterol levels in the bile, and by improving the conversion of cholesterol into bile salts (1). Furthermore, studies also show melatonin aids gallbladder contraction by strengthening the neuromuscular junction of the gallbladder walls and may make for a great therapeutic intervention to aid in the recovery of gallbladder attacks. Thyroxine, aka the inactive thyroid hormone. According to a 2016 study, women with thyroid disorders also notably have a higher incidence of gallbladder issues (1). This is because low, or suboptimal, levels of thyroxine (T4) are related to under-functioning bile acid flow and the loss of its resultant effects on the gallbladder. If bile output is compromised, so is lipid absorption and metabolism, leading to a higher likelihood of stone formation in the gland. Estrogen and Progesterone, aka female sex steroid hormones. We know pregnancy, oral contraceptives, and hormone replacement therapy all contribute to the formation of gallstones. This is because estrogen and progesterone lead to slower emptying and increased cholesterol to bile ratio in the gland, leading to supersaturation of bile and more sludge. What’s often overlooked (in my opinion) is bile’s influence on hormone metabolism. Bile is an important component in the elimination of estrogen and its metabolites through the liver, so sluggish function (or even worse, no gallbladder at all) often leads to sluggish hormone elimination and resultant hormone symptoms. This may attribute to high estrogen symptoms like cramping, breast tenderness, water retention, and acne. Cortisol, the stress hormone. When the brain sends stress stimuli down to the adrenal glands, cortisol is produced. Cortisol causes the liver to release glucose. It does this in order to provide energy for the body’s increased needs during stress or in cases of hypoglycemia. Interestingly, evidence shows that blockages in bile flow are also associated with states of dysfunctional communication between the hypothalamus, pituitary, and adrenals (all responsible for and influenced by cortisol)(2) What other variables contribute to gallbladder dysfunction? Eating less often throughout the day can actually lead to gallstones. Since the gallbladder stores bile during fasting states, it becomes super concentrated — along with the cholesterol contained in bile. Gallstones are generally crystallized bits of cholesterol. By eating more frequently throughout the day, your gallbladder has to secrete bile to help digest your food — and flush out stored cholesterol. Rapid weight loss can lead to gallstones, too. While it may be tempting to quickly shed winter pounds, if you want to avoid developing gallstones — or exacerbating the symptoms of an existing gallbladder disorder — try to stick to losing one-to-two pounds a week. Women are more likely than men to develop gallbladder disease or gallstones. Pregnancy, birth control pills, and the natural fluctuations of the menstrual cycle can cause a slowing down of the contractions of the gallbladder, causing bile to sit longer than normal. If you’re currently on hormonal birth control and are experiencing pain, indigestion, burping, gas, nausea, and/or bloating, discuss with your doctor or naturopath if these symptoms may be a result of your contraception method. Maintaining Gallbladder Health A heart-healthy diet is a gallbladder-healthy diet. If you have been diagnosed with gallbladder disease, or gallstones, or just want to minimize your risk of developing gallbladder disease, sticking to a diet that is low in saturated fats and high in mono and polyunsaturated fats is the way to go. Heart-healthy nuts like almonds, brazil nuts, or cashews Avocados Fatty fish like salmon, tuna, or sardines (small spaced out servings, since fish can still be fatty) Flaxseeds Fresh fruits and vegetables Foods rich in fiber, like broccoli, lentils, and legumes If you’re on hormonal contraceptives or hormone replacements therapy, you may want to discuss alternatives. There is some evidence that your coffee habit may help prevent gallstones. Skip the dairy creamers, if you want to keep your coffee gallbladder-friendly, and opt for almond milk instead. If you suspect you might have gallbladder dysfunction, you should visit your MD or ND. You’ll likely need some blood work and imaging. Gallstones can usually be detected on an ultrasound, but other disorders such as biliary dyskinesia (a motility disorder where the gallbladder does not eject bile properly) or cholecystitis (inflammation of the gallbladder) may require additional testing. For more information about maintaining your gallbladder and digestive health, or to discuss its potential influence on your hormones, please contact your Toronto Naturopathic Doctor, Dr. Courtney Holmberg, ND at 647-351-7282 to schedule an appointment today! References: Mohammadi-Sartang, Mohsen, Mohammad Ghorbani, and ZohrehMazloom. “Effects of melatonin supplementation on blood lipid concentrations: A systematic review and meta-analysis of randomized controlled trials.” Clinical nutrition 37.6 (2018): 1943-1954. Swain MG, Patchev V, Vergalla J, Chrousos G, Jones EA. Suppression of hypothalamic-pituitary-adrenal axis responsiveness to stress in a rat model of acute cholestasis. J Clin Invest. (1993) 91:1903–8.

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

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

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

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