The Why and How of Autoimmune Diseases

Maryanne was diagnosed with 3 different autoimmune diseases. Her fingers ached as she typed her very first email to me.   Even a computer search was difficult because she had also had a bout with Iritis (inflammation of the Iris) along with fatigue because her thyroid was chronically sluggish from Hashimoto’s thyroiditis.

 

When she finally arrived at my office she had been suffering for many years and was taking several prescription medications for her various symptoms.

So where did I focus? So much going on! So much to do! So much to heal!

 

From Multiple Sclerosis to Lupus to Rheumatoid Arthritis, to Hashimoto’s, I have seen so many cases of various autoimmune disorders in my practice. What they all have in common is that they all improve when gut health improves.

So how does one improve gut health? By reducing inflammation, balancing the gut flora and healing leaky gut. Also by eating a therapeutic diet that reduces inflammation and antibodies in the body. This also helps to calm the immune system so that the body stops attacking itself.

 

Many epidemiologists are wondering why suddenly we are seeing more gut health issues as well as an increased frequency of autoimmune disorders. These both seem to be a burgeoning epidemic! And they are related. The answer may be due to a combination of changes to agricultural practices and the food supply as well as environmental pollution and toxic chemical use. Glyphosates (Roundup) use has been implicated in the increase in Celiac Disease, which is a gateway for concurrent autoimmune disorders. GMO’s require heavier pesticide use in order to thrive so with increased growth of GMO crops we are also seeing more concentrations of these pesticides in our food supply. Also, we have changed the protein make-up through agricultural cross breeding and hybridization. Our crops may be more drought resistant and more fungus resistant, but perhaps this has rendered the proteins in wheat, corn , soy and canola ( frequently GMO in origin) indigestible for a larger percentage of the population..

 

People who have compromised detoxification pathways due to the MTHFR gene mutation, other inherited tendencies, or other conditions will be more sensitive to various pesticides, herbicides and GMO foods. Grains are often a large trigger for autoimmune diseases as well as Gut conditions. Some people have also had so much exposure to environmental toxins such as pesticides that without a concerted effort to detoxify, an autoimmune disorder is almost inevitable.  It may be useful to test whether you carry the MTHFR mutation ( a large percentage of the population does!)

 

After just a few short months working together on her health, Maryanne had remarkable improvement with all of her autoimmune diseases. She had less pain and inflammation and was able to work more productively with longer periods of concentration. Her vision improved and she had much less pain in her hands. Her energy levels came up to levels she hadn’t had in decades. Her weight began to regulate as her hormones balanced. She continues to enjoy the improvements in her health! She was able to significantly reduce the dosages of her prescription medications too! Some of the medications she was able to completely discontinue which made everyone, including the prescribing MD, very happy!

 

If you have an autoimmune disorder and would like to get to the root of the problem, a functional medicine approach is often the best choice. We can explore the root causes of your chronic health concerns and formulate a comprehensive plan to get your life back!

My practice focuses on gut health! I would like to invite you to work one on one either in person if you are local, or long distance through video or phone, I am currently accepting new patients. You can also opt to have a FREE 15 minute phone consult with me to see if you and I are a good fit for each other! To schedule any appointment, you can do this online at https://intakeq.com/booking/NaURW8 or by calling my office (303) 443-2206 M-F 8:30-5 Mountain time to speak with my receptionist. I hope to hear from you soon! Be well!

 

How to Recover from the “Stomach Flu” or Enterovirus

How to Recover from the “Stomach Flu” or Enterovirus

Carolyn’s entire family got hit very hard during winter break this year with the “stomach flu”, and just this week over 1/3 of a certain school district in Illinois were felled by this nasty bug. A friend reported on Facebook that her flight was delayed because a sick passenger needed to get off the plane.   The “Stomach Flu” is actually Enterovirus or norovirus, since it is after all, not really a flu per se. First her young toddler came home after a holiday party and began vomiting and having diarrhea, and the illness slowly but surely tore its way through her family of five.

While conventional medicine will tell you there is nothing you can do to speed recovery but “wait it out”, there are actually many things you can do to recover faster.

  1. The homeopathic remedies Veratrum album and Arsenicum album often help with this year’s version of the enterovirus, especially when vomiting is accompanied by diarrhea. I have found Veratrum album to be more indicated this year. It literally stopped my own son’s case of “tourista” in its tracks as he was feeling ill on our way to the airport on a recent trip we took. In the United States, where I live, homeopathic remedies can be found at many natural food stores.
  2. Bone broth. This is the time to make bone broth, and if you are too sick to make some yourself, you can have someone pick some up already made for you. I like Kettle and Fire brand, or if you are local to a broth shop, like Fresh Thymes in Boulder, you can pick up some fresh bone broth there.   Or you can order online here http://www.healyourgutwinatlife.com/shop-affiliates/

To make your own bone broth, which is the most cost effective way to go, here are some great recipes.         http://www.healyourgutwinatlife.com/bone-broth-recipes/

Also I recently sampled a powdered version of bone broth that I found at the Natural Food Store. It definitely needed            a little more flavoring, but it does the job and may be easier to keep around your house for a while without having it go          bad.

          Bone broth is a very healing nutrient dense food. Bone broth contains easily digestible micronutrients and                 minerals to help tissues to repair properly. This is very important when you have just suffered an acute GI                                 inflammation from a viral infection. If you are still feeling nauseated, take small sips as tolerated. Bone broth is also             vital for chronic GI issue recovery, too.

  1. Activated charcoal – this product is easily found in your local natural food stores. Not only does it bind and absorb toxins from your gut, but it also slows down the accompanying diarrhea that often goes along with the enterovirus.
  2. Curing pills is also very useful during enterovirus. These are a Chinese herbal medicine blend and are also often stocked in a Natural Food Store. This is an old Chinese formula designed specifically to shut down nausea,vomiting and diarrhea. And it usually works!
  3. Berberine – berberine is a botanical compound from the plant Berberis aquifolium, or Barberry, which has antibacterial qualities. It also has been shown to help eliminate the symptoms of enterovirus
  4. For nausea, I usually recommend teas which contain mints and/or ginger. These herbs have been shown in scientific studies to alleviate the symptoms of nausea from organic causes (such as pregnancy and viral infections of the GI tract).

Reintroducing foods

After a bout of the enterovirus, you want to slowly add in certain foods before you return to your normal diet. As much as I love bone broth, I also recognize that eventually you will want to supplement that with some real food. These are foods I recommend starting slowly with, as tolerated.

  1. Chicken or veggie soup – so this way you are adding in a few more culinary ingredients so that the broth has more nutritional value. I would stick with chicken and veggies ( no grains) in the beginning, or just veggies if you don’t eat meat. This will begin to add easily digested nutrients as well as bulk into the mix.
  2. Apple Sauce. This is a relatively easy to digest and absorb food, and it also contains soluble dietary fiber, which will help to bulk your stools out.
  3. Rice – after a bout of gastroenteritis, white rice (if you tolerate grains at all) will help solidify stools as well as being somewhat less allergenic than wheat as well as give you some physical energy since gastroenteritis can really leave you feeling drained.
  4. Toast. Due to the population I mainly work with, most of my community is gluten free. For those off gluten, a gluten free toast will do. If you are fine with gluten, any whole grain toast will do.
  5. Electrolytes. Remember, you lost a lot of electrolytes during that bout of illness. One of the main dangers of a bad bout of gastroenteritis is that one, especially children, can become dehydrated. This is why something like Recharge (a more natural Gatorade) or even Gatorade or Pedialyte is important for reabsorbing fluids and electrolytes which is vital to our physical health.
  6. Probiotics will also help replenish and balance the microbiome and gut flora which is vitally important after a diarrheal illness.

Prevention – Number one prevention is to keep your immune system healthy by staying well rested and nourished. Avoid sugar, caffeine, alcohol and other junk foods and get good sleep. Also if you are sick, stay home for at least 24 hours after symptoms dissipate to avoid spreading your illness. Wash your hands often, especially if you are in crowded public places much.

My practice focuses on gut health! I would like to invite you to work one on one either in person if you are local, or long distance through video or phone, I am currently accepting new patients. You can also opt to have a FREE 15 minute phone consult with me to see if you and I are a good fit for each other! To schedule any appointment, you can do this online at https://intakeq.com/booking/NaURW8 or by calling my office (303) 443-2206 M-F 8:30-5 Mountain time to speak with my receptionist. I hope to hear from you soon! Be well!

Taking the Plunge!

Healing is Risky!

Yep, that’s me! 

I waded through the cool water to the edge of the waterfall, the strong current rushing around  my ankles and calves as I peered over the edge.   One of our guides held me by the strap of my lifejacket and my red helmet was secured around my head.  I was about to slide down my first waterfall in the Dominican Republic.  Well, actually, my first waterfall ever!

How did I get here? Why on earth did I let my family talk me into this? These were the thoughts rushing through my mind as I was getting ready to make the jump.  But it was way  too late to turn back .  Behind me was a narrow slot canyon and ahead of me was that 30 foot waterfall!  Plus my sons were watching and I didn’t want them to think their mom was a wuss… so… I sat down, held my nose as the guide let go of my life jacket and I  took the plunge!

Often when we are about to make a big healing change, there is a fair amount of fear and anxiety involved. Because, after all, you are taking a risk! Fear of being vulnerable.  Fear of the unknown.  Fear of making the wrong decision.  Fear of failure…. The list goes on and on.  Even something simple like changing one’s diet for most people feels like a huge transition and not actually so simple.  Working with someone new can feel like a huge undertaking.   And for people who tend to “doctor hop”  the challenge and the new thing is to stay the course and listen to their practitioner’s advice.

This past year I have  undergone a lot of transformation in my worklife. I successfully  taught my first University level classes while maintaining my practice.  I have been writing more, ran my first webinars and am  slowly working on my book. And in a month I will be joining a new clinic! I last worked in a large group setting in 1999. I enjoyed working in a group setting back then, but it all  came to an abrupt and unexpected  end when the main MD  suddenly moved out of the clinic because  he was,  unbeknownst to us,  actually  bankrupt!  After that experience I decided to work in situations where I had total control  and so was a solo practitioner for many years.

Last fall an awesome opportunity presented itself to me, and so I am  taking the plunge and moving out of my one office comfort zone into an Integrative Sleep Clinic!  This process for me is exciting and a little scary! After all, I have been a one doc show for so long now, but my real wish was always  to be  part of an awesome collaborative team and I just knew intuitively that this was the right situation and it was time to take the plunge!

Jumping into those 7 waterfalls was symbolic of my own personal transformation.  Each time I jumped I had to trust that nothing bad would happen to my body.  That I would not injure myself or even die! And each time I hit the water and rose again to the surface to take my first breath I realized that I had made it! I did not die! I am still alive!

I suppose being born is a bit like this, though I  have no conscious memory.  Leaving the safety of the mother’s womb or the cocoon, to breathe on your own, to strange lights and strange sounds and learning to be embodied.

So yes, this past year has felt a bit like a gestation with a lot of work growing new cells  in preparation for even more growth in 2017!  So Happy New Years Everyone!

If you would like to work one on one with me to help with your  gut health, inflammatory,  autoimmune issues, or if you have worked with me in the past but it has been a while since we connected,   you can schedule an appointment online here or by calling my office at (303) 443-2206  M-F 8:30-5 Mountain Time to speak with my receptionist.  I also offer a FREE 15 minute phone consult so that we can both see if we are a good fit for each other. Be well and   I hope to hear from you soon!

Hashimoto’s, Thyroid, Gluten and the Gut

Kaitlyn first came to see me suffering with extreme fatigue, insomnia, and a feeling of “unwellness” many years ago. She had a young child and worked part time but felt very fatigued all of the time. She was health conscious and followed a vegetarian diet with her husband and fed her whole family that way.

 

The first thing we did together was to run some bloodwork and to check into how her digestive system was working with Functional Medicine Testing. Through the allergy testing we found that she was allergic to most vegetarian protein foods such as dairy, beans, gluten (seitan – in meat substitutes) and soy. And her thyroid levels were way too low. She decided to add in clean animal proteins (grass fed beef, organic free range poultry and wild clean fish) and she went on prescription thyroid medication and with some fluctuations began to feel better.

 

After a period of stress and adjusting her thyroid medications a few times, we decided to test for Thyroid Antibodies to rule out Hashimoto’s Thyroiditis, an autoimmune disease. Her tests came back positive for Hashimoto’s Thyroiditis. These results were not at all surprising for me and with some more minor tweaks to her protocol, she remains well.

 

Hashimoto’s Thyroiditis is an autoimmune disorder that affects the thyroid. Symptoms can be crushing fatigue, and inability to lose weight, anxiety, depression, insomnia, dry skin and constipation. Often there are associated digestive issues because, as in most autoimmune diseases, the gut and digestive system is intimately involved.  When working with autoimmune disorders, especially Hashimoto’s, gluten must be strictly avoided, even when Celiac disease tests negative. (Nayer et al). Most individuals with Hashimoto’s disease also have leaky gut but may or may not also have Celiac, but most are at the very least gluten sensitive. Since not treating the gut along with Hashimoto’s disease, in my experience, inadequately manages this disorder, the patient will continue to suffer sleep issues, anxiety issues and fatigue issues unless the underlying gut and food allergy/sensitivity issues are also fully dealt with.

 

With some patients, eliminating gluten from the diet just isn’t enough. All grains are inflammatory with this subgroup, and so all grains are activating the autoimmune process and so a Paleo-type diet is indicated. And with some super sensitive patients, the autoimmune Paleo Diet (AIP) which even eliminates nuts and seeds, is the only food plan that helps bring relief. Many patients balk at a restricted diet, but in the long run they find it to be worth it when they begin to truly feel better and regain their energy levels, lose the extra weight and sleep better.

 

 

After changing their diet, it often takes 12-18 months in my clinical experience for the patient to fully heal their gut when using a dedicated protocol. But many who embrace the Paleo type diet recommendations while supporting related adrenal glands (which are usually overfunctioning or downright depleted!) find relief on all levels much sooner. It is the patients of mine who are resistant to making the lifestyle and diet changes who seem to continue to suffer needlessly. Because, as we all know, gluten is delicious.   But if you or someone you love falls into that category, they need to ask themselves what their priorities are. Because sometimes gluten needs to be eliminated and purged from one’s life and home in order to truly heal.

And I do not say that flippantly or lightly. Having taken these steps myself, after initially feeling resistant and overwhelmed, I am glad that I was able to fully embrace the food and diet piece since feeling well, at least for me, is worth never eating gluten again!

 

Kaitlyn felt better initially when we started working together, but it was after we really got to the bottom of her autoimmune disease and made some tweaks to support her healing for this particular issue, that her health and wellbeing really began to soar! She now only needs to see me periodically for minor tweaks to her protocol usually after periods of increased work and stress, which are difficult to fully avoid in this day and age.

So if you know that you have a thyroid issue, but haven’t been checked for Hashimoto’s, it may be useful to take that step. Or even if you are starting from scratch on your journey to wellness and some of these symptoms sound all too familiar!
I work with lots of patients near and far with gut health and/or thyroid issues. Many are finding out that they have Hashimoto’. If you would like to work one on one either in person if you are local, or long distance through video or phone, I am still accepting new patients. You can also opt to have a FREE 15 minute phone consult with me to see if you and I are a good fit for each other! To schedule any appointment, you can do this online at https://intakeq.com/booking/NaURW8 or by calling my office (303) 443-2206 M-F 8:30-5 Mountain time to speak with my receptionist. I hope to hear from you soon! Be well!

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Citations

Naiyer AJ, Shah J, Hernandez L, et al. Tissue transglutaminase antibodies in individuals with celiac disease bind to thyroid follicles and extracellular matrix and may contribute to thyroid dysfunction. Thyroid. 2008;18(11):1171-1178.

Duntas L. Does celiac disease trigger autoimmune thyroiditis? Nat Rev Endocrinol. 2009;5(4):190-191.

Ch’ng CL, Jones MK, Kingham JGC. Celiac disease and autoimmune thyroid disease. Clin Med Res. 2007;5(3):184-192.

The Gut-Hormone Connection

How your Gut Issues are Connected to Hormone Imbalance

Maureen, a 46 year old mother of 3, had recurrent digestive problems and IBS along with acne and irregular, painful periods with a hellish case of monthly PMS. It all began around the time her dermatologist prescribed longterm antibiotic therapy for stubborn acne. While her acne only showed modest improvements with this common approach of prescribing antibiotics for years on end, her digestion got worse and worse until she had almost constant loose stools, bloating and cramping no matter what she ate! As time went on she became even more fatigued as her adrenal glands crashed due to chronic stress during her young adulthood during the many life transitions she went through during her 20’s.

As time went on she noticed that she began to gain a significant amount of weight. No matter what she ate or how much she exercised, it did not come off.

Finally, during her initial visit with me, I suspected that her thyroid levels might be off and due to her digestive issues and her presenting health issues, I decided to run thyroid levels plus Thyroid Antibodies which came back positive. Maureen had developed Hashimoto’s Thyroiditis, an autoimmune disease due to her chronic gut problems.

When the gut microbiome goes awry, the adrenals are stressed. When the Adrenals go, the Thyroid goes. When the Thyroid goes, the Reproductive Hormones go. This is the root of the hormonal imbalance cascade.

  1. Gut health issues and imbalanced flora sends the adrenal hormones into overdrive and increases cortisol levels
  2. Increased Stress increases cortisol levels and worsens sleep.
  3. Increased cortisol levels increase carb craving, insulin resistance and weight gain.
  4. Chronic stress eventually depletes the adrenal glands. Flat cortisol curve eventually happen in Stage 3 Adrenal Fatigue.
  5. Stressed adrenal glands increase inflammation, which eventually attacks the thyroid, joints, kidneys.  It is common to see an increase in chronic pain when the body suffers from chronic stress due to inflammation levels. Inflammation levels can also lead to an increased Cancer risk! The Standard American Diet (SAD) also contributes to this.
  6. Chronic inflammation increases cytokines which increases risk of autoimmune disease – Hashimotos. Can lead to weight control issues.
  7. Thyroid deficiency increases the risk of Estrogen dominance and progesterone deficiency which increases risk of heavy periods, fibroids and estrogen dependent cancers, irregular periods. It causes hormonal imbalance.
  1. Enter Naturopathic Functional Medicine

Many of my patients who fit this hormonal/gut picture have already seen multiple practitioners. They get prescribed pharmaceutical drug on top of pharmaceutical drug and instead of getting better, they get worse. No mention is made of how the gut health and digestion is connected to their hormonal issue. No mention is made of nutritional interventions. And health continues to fail.

 

Imagine how good you could feel if you found a practitioner who could determine and treat the root cause of your current illness!  Hormonal imbalances are often a multifactorial problem. Just treating the hormonal imbalance with hormonal interventions can fall short. One needs to look into the gut function, the adrenals, and not least of all, nutritional interventions.

The first steps often involve Functional Medicine Testing.   Functional Medicine Testing can include in depth Stool Testing, Food Sensitivity Testing, Adrenal Function and Stress Testing, and yes, Hormonal Balance Testing, just to name a few. This is often what we do during the research phase while I am researching and creating an individualized protocol for my patients. Once we have all the information that we need, I can put together a plan that addresses the current health issue as well as treats the underlying cause, thus giving the opportunity for complete healing and health and lifestyle support.

Natural therapies work very well with these issues, and many patients can eventually reduce or eliminate their need for pharmaceutical support.

 

Once you know the root cause, and are willing to make the lifestyle changes, the sky is the limit to how well you can feel, how much energy you will have and what you can accomplish.

 

Maureen eventually discovered that by uncovering and clearing up the underlying gut issues that tanked her adrenal/thyroid function , she was beginning to heal. She was able over 6-12 months time to regain her energy levels, and as her thyroid and adrenals balanced, she was able to begin to lose the weight that she had gained. And her monthly cycles became more in balance. This was a huge change for her since she had been unable to lose weight no matter what she did. She followed a diet that I prescribed for her and began to notice great results.

 


I work with lots of patients near and far with gut health and/or hormonal issues. If you would like to work one on one either in person if you are local, or long distance through video or phone, I am still accepting new patients. You can also opt to have a FREE 15 minute phone consult with me to see if you and I are a good fit for each other! To schedule any appointment, you can do this online at https://intakeq.com/booking/NaURW8 or by calling my office (303) 443-2206 M-F 8:30-5 Mountain time to speak with my receptionist. I hope to hear from you soon! Be well!

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“My Gut hurts and my Brain isn’t Working!”

My gut hurts and my Brain isn’t working!

 

Have you ever felt this way? Janine certainly knows what this is like! “ I have had chronic digestive issues since I was a little girl. And when things are especially bad I would forget simple words, and forget about remembering names! I am only in my mid-40’s! I can’t fathom what my memory and cognition will be like as I reach my 50’s and 60’s! I used to be really sharp, but now not so much! As my digestive issues have worsened, so has my brain! I also have severe mood swings now that I never used to have. I had my hormones checked and they are fine so it must be related to my digestion! Dr. Tara, can you help me?”

 

For many years I have noticed this brain and cognition connection in many if not most of my gut health patients.   I would do my usual work of identifying gut pathogens through stool samples and correcting the imbalance with the correct blend of probiotics. Other more mainstream scientists happily are also noticing this connection too!

 

“Scientists have also gathered evidence that gut bacteria can influence anxiety and depression. Stephen Collins, a gastroenterology researcher at McMaster University in Hamilton, Ontario, has found that strains of two bacteria, lactobacillus and bifidobacterium, reduce anxiety-like behavior in mice (scientists don’t call it “anxiety” because you can’t ask a mouse how it’s feeling). Humans also carry strains of these bacteria in their guts. In one study, he and his colleague collected gut bacteria from a strain of mice prone to anxious behavior, and then transplanted these microbes into another strain inclined to be calm. The result: The tranquil animals appeared to become anxious.” From The Atlantic (When Gut Bacteria Changes Brain Function)

Scientists at UCLA also did a study where they had a group of healthy women consume 1 cups of yogurt per day and the yogurt eaters had a calmer reaction to stimulatory images than non-yogurt eaters.

Why and which neurotransmitters are affected has yet to be determined through further scientific research, but I can definitively say that improving gut health will also improve brain health, and worsening gut health drives worsening psychiatric health as well as cognitive functioning

 

Functional medicine testing can really pinpoint the imbalance so that treatment can be specifically targeted to balance the gut microbiome which helps to insure that the body is producing enough of the right neurotransmitters for improved wellbeing.

 

Diet also plays a significant role in proper neurotransmitter production. A diet high in refined foods, preservatives, and for many people grains and especially gluten can contribute to brain fog. Dr. David Perlmutter, a reknowned neurologist’s book, Grain Brain, describes the staggering effects of carbs on the brain. Whole grains can cause dementia, ADHD, anxiety, chronic headaches, depression, and much more. This is super great news because this also means that getting certain health symptoms under control can happen through diet modifications rather than prescription medications! The removal of grains from the diet also is very helpful torwards reducing digestive issues such as cramping, bloating, and IBS!

 

Increased carbohydrate intake, especially grains and gluten, increases the amount of inflammation in the gut lining and the entire body. Increased inflammation also has a very strong effect on neurotransmitter levels.

Inflammation in the gut lining and in the body also correlates to brain inflammation. This can also increase such symptoms as brain fog, ADHD, anxiety, depression, and lack of mental clarity. So one of the first goals of any sort of protocol is to reduce inflammation in the entire body, and improved brain function usually follows suit once inflammation is dealt with.

 

Exposure to toxic chemicals also contributes to overall inflammation as well as brain fog and changes in neurochemicals. It is therefore important to limit exposure to environmental chemicals in your food and water. And if you live in an area where there is more environmental exposure, making sure your detoxification channels are open and functioning properly is also important!

So… in summary, heal the gut lining, balance the microbiome, make some dietary changes to lower carbs and grain intake, and make sure that you regularly avoid toxic chemicals and detoxify (sweating is the most effective least invasive method) when indicated. Regular physical exercise is very helpful to support detoxification.

Many if not most of my patients that I treat for chronic digestive issues also unwittingly improve their brain function and cognition as a nice useful “side effect” of adopting a healthier lifestyle and correcting any imbalances in the gut that may be occurring. Clarity of thought and emotional balance is a very nice desireable side-effect of living a healthy lifestyle and avoiding toxic exposures!

 

After working with me for several months, Janine noticed that her brain fog symptoms and cognition gradually improved as did her digestive issues! She was very pleased about this as was I ! We had gotten to the root of her chronic inflammation, her gut health, which was affecting her neurotransmitter balance as a side result. Her overall mood also improved as did chronic anhiness and joint pain.

 

If you have chronic digestive issues with or without associated brain fog, working with me one on one can really help to improve and restore your health. I offer a FREE 15 minute phone consult to see if we are a good fit for each other and a time when you get to ask me questions about my approach to healing. You can schedule this consult by calling (303) 443-2206 M-F 8:30-5PM Mountain time, or online using this link: https://intakeq.com/booking/NaURW8

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I hope to connect with you soon!

Running on Empty? Help for SIBO-D

SIBO-D

Barbara was very very sick. She was having bad diarrhea 10-15 times per day. She was feeling wiped out and isolated as she was too sick to go out. Working was nearly impossible as she could barely concentrate due to severe brain fog not to mention the multiple trips to the bathroom.  She had already taken 2 rounds of antibiotics with no change and this constant chronic diarrhea had been going on for months. She had already seen her doctor multiple times and there had been no change in her health , which was really sad because she actually liked her doctor. She was also suffering from intense bloating which made her look 6 months pregnant. “It feels like something is alive in there!” she told me as she cried in my office.

Chronic diarrhea is almost always caused by either an infectious agent, a chemical agent (chemotherapy)  or a reaction to foods. Her doctor had taken a stool sample but I thought that perhaps the test was not sensitive enough to detect the cause of her problem so I ordered another one from a reputable Functional Medicine Lab. With this particular test I would get a full genetic reading on Barbara’s microbiome (gut bacterial flora) as well as detecting any   fungal or parasitic infections. I also decided to run a SIBO breath test as well as a Food Allergy test, my usual testing trifecta. Before the test results were back, which would take weeks, I had her eliminate all grains and processed foods to see if that would offer temporary relief.

There are several possible causes for the chronic diarrhea. Crohn’s Disease, and autoimmune disorder of the GI tract may be a culprit, as well as untreated Celiac Disease. As well as a bacterial, fungal or parasitic infection.  She had never been tested for any of the autoimmune causes and had been actively consuming gluten so we decided to go ahead and test for Celiac disease too. Often certain foods are a major trigger.

While we were waiting for the test results she was finding some relief with the Paleo/GAPS diet. The bone broth was soothing and allowed Barbara to get some nutritionally dense and beneficial for gut healing food into her system. Her bowel frequency diminished and her stools began to be a bit more formed. She was thrilled!

Meanwhile Barbara’s SIBO (Small Intestinal Bacterial Overgrowth) breath test came back positive. These tests measure Hydrogen produced by the bacteria as well as methane. Her Hydrogen levels were off the chart!   I then knew that we were dealing with a bacterial  overgrowth situation. We started her on a good protocol based upon the stool sample test results and her improvement was marked.

With SIBO-D the purpose of the initial phase of the protocol is to kill off the offending organism – whether it is a bacteria, fungus or parasite. This can take several weeks with an herbal protocol. Usually the patient notices improvement before that phase is complete. But it is very important not to stop there!  The second and third phases have to do with regulating the excessive motility and peristalsis of the gut as well as healing the nerves so that the movement of the colon is down and out through the rectum and anus and not “backwashing” up into the small intestine. When bacterial overgrowth occurs in the small intestine, you often get gas, bloating, fatigue, brain fog, and it can also exacerbate inflammation in the joints as well as other areas of the body.

Barbara found amazing relief with the protocol. The entire active phase of the protocol took about 6 months, even though she felt better within days. She is now on the maintenance part of the protocol where she eats a very low carb paleo and FODMAPS diet and uses specific herbs as needed.

If you have been suffering from chronic diarrhea or loose stools along with bloating and brain fog and have not yet found relief, and if you are interested in working with me one on one, I offer a FREE 15 minute phone consult to see if we are a good fit for each other. You can schedule that by calling my office M-F 8:30-5 Mountain Time at (303) 443-2206 or you can also schedule online at your convenience by clicking this link https://intakeq.com/booking/NaURW8

Be well and I look forward to connecting with you!

Constipation: Are You Clogged?

Jennifer was getting frustrated. No matter what she tried, she was only able to have a small hard bowel movement every 3-5 days which only offered a slight improvement in how she felt.  In between bowel movements she was horribly uncomfortable. She felt like her intestines were full of cement!    She tried various laxatives as well as changing her diet to no avail. The only thing that reliably cleaned out her colon was having periodic colonics (colon hydrotherapy).   But that was getting expensive and Jennifer couldn’t help but think that there was a better way for her move her bowels more naturally without an expensive treatment.

 

Constipation is a growing problem. There are many causes, including increased levels of stress and the Standard American Diet (SAD). The Standard American Diet is full of processed foods which contain little to no fiber. And stress stimulates the sympathetic nervous system. Our sympathetic nervous system evolved to help us run fast (fight or flight) to escape a predator, and when you are running from an attacking lion, there is no time to stop and poop, is there?   However most modern day stresses are psychological rather than escaping from an imminent danger. The problem is that our body creates an identical physiological response to outrunning a predator as it does trying to meet a deadline or commuting in traffic! So it is still difficult to poop! And with chronic stress, you will often have chronic constipation.

 

The intestines are a primary way the body processes and absorbs nutrients as well as eliminates waste products of metabolism.   When the bowels aren’t moving properly, the body incomplete in its detoxification of metabolic byproducts. Chronic constipation causes these toxic by-products to build up in the body. When toxic metabolites build up, one can experience skin problems, fatigue, brain fog, headaches, mood issues such as depression, irritability and apathy, muscle and joint inflammation as well as an overall malaise. And let’s not forget to mention the bloating and clogged feeling that is always causing discomfort in the gut!

Sometimes the fix is very simple. Sometimes it is a matter of forgetting to drink enough water. In that case all that you need to do is to be more conscious and mindful of hydration levels . And sometimes a little bit of electrolytes such as sodium and potassium helps the person to hold the water in their colon longer so that the stool is not so hard. When the solution is this simple, drinking more water is an amazing transformation! Most people just don’t drink enough water. One should ideally drink 64 oz of good purified water per day. Or 2/3 of your body weight in oz.

 

Sedentary lifestyle habits also contribute to the bowels not moving regularly. Think of it: if you are sitting in a chair all day, then your bowels are getting reduced movement and bloodflow. Peristalsis, the involuntary movement of the gut muscles slows down. If you sit all dain front of a computer and forget to drink water, or drink more soft drinks and caffeinated drinks which are diuretics (increasing urination) then you may not be moving your bowels often enough which hinders detoxification.   It comes as no surprise that “sitting is the new smoking” according to recent research studies!

 

Eating more water- soluble fiber (as in fruit pectin) is sometimes a quick fix for chronic constipation. Water-soluble fiber is found in most fruits and vegetables. While grains and legumes also contain fiber, some people find them to worsen to a bad case of constipation, while others find grains necessary. Increasing water, dietary fiber and moving your body can be a crucial first step to preventing constipation.

 

Emotional holding patterns also contribute to chronic constipation. Imagine the physical control that it takes to hold back anger, sadness and other negative emotions. Young children often hold back their stool as a method of control. If you are expending all of that extra energy to hold back emotions, it can also translate into extra tension in the abdomen or bowel area.

 

Sometimes the problem is bigger, deeper and more complex. There are difficult cases where drinking water, taking magnesium, eating fiber and moving the body doesn’t do enough to correct the problem. These cases may be due to SIBO (Small intestinal bacterial overgrowth, undetected food allergies, Celiac disease (especially when also accompanied by bloating and stinky gas). This is the sort of case where Functional Medicine testing to uncover the root of the problem is usually necessary. I like to order the following trifecta of tests, SIBO test (Bacterial Overgrowth of the Small Intestine), a Comprehensive Stool Analysis and a Food Allergy test. And if the patient has been actively eating gluten I will also test for Celiac Disease. Once I have done the research I have a good idea about how to approach a complicated case. Sometimes the gut flora is off kilter and a great probiotic is helpful, sometimes a diet change is helpful. Sometimes the nerves in the intestines have been damaged and repair and restoration of the nervous system is indicated. This may involve prokinetics which are substances that improve peristalsis, or the involuntary movements of the small and large intestines.   Various supplements may be required to repair and restore the function of the nervous system .   Chronic gut motility problems may take several months or years to resolve.

In Jennifer’s case she had developed SIBO-C (constipation) and the protocol took over 6 months to really consistently resolve her constipation. She noticed a significant amount of improvement immediately, thankfully, so she was very motivated to continue the protocol. She is currently on a maintenance plan to help prevent a recurrence of the SIBO-C. Much of our work together was eliminating the overgrowth of bacteria using natural substances and then taking several months to heal her nerves in her GI tract.

If this sounds familiar to you, first try basic things such as making sure you are hydrated and consuming enough fiber. Also be sure that you are adequately managing your stress. Maybe add in some probiotics. If the problem is persists, you probably want to work with someone like me.   We can get to the root of the problem. If you are interested in working one on one with me, I offer a FREE 15 minute phone consult to see whether we are a good fit for each other. I can work with you whether you are local to Boulder/Denver or long distance through secure video conferencing. You can schedule either by calling my office M-F 8:30-5 at (303) 443-2206 or by scheduling online anytime using this link. https://intakeq.com/booking/NaURW8

 

Be well and be in touch so that we can keep it moving!

Take a Pause and Do the Research

Take a Pause and Do the Research

 

She called my office on a Friday afternoon. And urgently wanted me to call her back that day. She was not a current patient of mine but I called her back anyway because she sounded so scared and so desperate and wanted me to help her. Even my receptionist was concerned. She said she didn’t think she could last through the weekend and wanted to know what she should do. I gave her very basic guidance,   but in my opinion she really needed to be hospitalized or at least go to the Emergency Room and I strongly told her so.

 

I often get very complicated cases in my practice. I am sometimes the next of a succession of practitioners the patient is seeing for their complex problem. Patients are desperately looking for answers and are often in crisis. They want me to fix their problem right there on the spot. This is difficult if not impossible. Now it may be that the patient has been tested out the wazoo with various functional medicine tests and they are now on about 18 (or more!) different supplements. In these cases I usually like to simplify their protocol and “clean out” and try to eliminate many of the supplements because obviously they aren’t working or the patient would be seeing improvements. The fact that they are now bringing me onto their health care team usually means that they aren’t getting better.

 

It is especially difficult for any practitioner when patients come in crisis and want advice right then on how to handle an acute situation. Counter-intuitively that is often when we all need to take a pause and do the research. Otherwise I just feel like I am throwing various supplements and herbs at them without any evidence of efficacy to put out a fire.   And often, if emergency treatment is not needed, the fire is put out by simplifying the protocol. Especially with digestive and autoimmune issues too many herbs in the mix can complicate and exacerbate the situation. When the digestive system is already compromised, adding in very strong herbs to treat a concurrent condition such as Lyme can exacerbate the situation and cause a whole lot of misery.

 

So I often take a break from creating a protocol and giving out supplements and run laboratory tests. I want to know exactly what is causing the symptoms before I treat so that I can treat much more effectively and efficiently, saving patients both time AND money.

 

Why the rush? Many patients by the time they enter my practice are really at the end of their rope. They are desperate. They don’t want to waste any more time or money on something that doesn’t work. While I wish that I was a magician or wizard and could wave my magic wand and make all their symptoms quickly go away, I am not and I can’t. Guesswork has really no place in treating chronic disease. So instead I like to do the research through functional medicine testing. This takes time to do the testing, and second of all get the results and thirdly to interpret the results and create an effective protocol.

I have said before that cookie-cutter medicine is rarely effective. Each patient is unique so even for a disease of the same name, why would 2 different patients need the exact same approach? Sure, there are usually similarities that are measurable through science, but a more nuanced approach for each individual is mostly what patients who seek out my expertise want and need. They want the problem fixed and nobody else has really helped them work through the maze of the illness towards their healing. Many times, especially after taking a massive amount of pharmaceutical drugs, their condition is much worse than it would have been had they just stayed home and done nothing! Pharmaceuticals in the right situations are absolutely lifesaving, but all too often they are ineffective for chronic diseases, which is mainly what I see in my practice. I see patients whose gut flora has been completely decimated from repeated dosages of strong antibiotics. I see patients with fibromyalgia and adrenal exhaustion from chronic stress who are placed on multiple antidepressants, and don’t get me started on pain medications and opioids. The appalling frequency they are prescribed has directly contributed to the heroin scourge affecting many urban and suburban areas.

 

Stress is a major contributor for chronic digestive issues as well as most other chronic diseases. Americans have a much higher level of stress than other developed countries due to relative economic instability and lack of social safety nets. This must also be taken into account when treating the chronically ill. A big part of healing is learning how to develop strength and resilience when it comes to dealing with life stresses. Diabetes, obesity, cardiovascular diseases, Fibromyalgia and Chronic Fatigue Syndrome as well as Depression and Mood Disorders all have chronic unremitting stress as a major contributory factor.

 

To unravel and treat their complex illnesses, when there is so much going on at once often takes prioritization and research. How do you deal with the complex digestive issues when their stress levels are chronically high? And which came first? The stress or the digestive problems? They feed into each other and worsen each. Digestive issues make you stressed and stress worsens the digestive issues? What is going to be the lynchpin that breaks the cycle? That is what the research is for. Find what is most pressing and work with that and the idea is that eventually the crisis lessens and real deep life healing can occur.

I don’t think I was able to help the woman who called that day. She cancelled the appointment we had squeezed into my packed schedule because she was “too sick” and again I thought she really needed emergency intervention and hopefully she went that route. Had she come in sooner, and had we had time to do all of the testing and the research needed there would have been an increased likelihood that I could have helped her.

 

So if you have something chronic going on with your health and you are hesitating and procrastinating addressing it, OR if you aren’t getting helped with the care you are currently receiving, don’t wait until it is a crisis! Do it now! Make that call! And if you are interested in seeing if you and I are a good fit for each other, you can schedule a FREE 15 minute phone consult by calling my office at (303) 443-2206 Mountain time 8:30-5, OR you can schedule online using this link https://intakeq.com/booking/NaURW8

Be well! And again, don’t procrastinate with your health or those little whispers in your body may become screams.

Do all People with IBS have SIBO?

Do all people with IBS have SIBO?

 

The first time it happened was when I was pregnant. I was visiting my parents and I had just eaten a cookie my mother had served. My belly suddenly filled up with air and I was in intense pain. I drank some peppermint tea and the air moved through and I chalked it up to pregnancy doing weird things to my body. It happened again a few years later during a Thanksgiving gathering with friends. I had just enjoyed a nice dinner with friends when suddenly my gut filled with air. The pain was so bad that I could not stand up all the way! Again, peppermint tea and it passed. Then it started happening after almost every meal, not right away sometimes but a few hours after. And sometimes immediately after eating. I eventually got my food allergies tested and discovered I had a major case of leaky gut and food allergies.   Once I eliminated the allergens and started repairing my leaky gut, these episodes stopped. Did I have SIBO? Probably not. I didn’t test for it and since it went away without antibacterials it doesn’t  fit the pattern of SIBO.

 

Fast forward a few years and lately I have been reading a lot of misinformation about SIBO (Small Intestinal Bacterial Overgrowth) and that it is actually considered by some to be synonymous with IBS (Irritable Bowel Syndrome) , or more famously, the blanket statement that “all people with IBS actually have SIBO”. I thought this would be a great opportunity to clear up this gross misconception. To put it in a nutshell, IBS is a waste -basket diagnosis. It means that the person has chronic digestive issues but nobody really knows what caused it or how to treat it. A diagnosis of IBS doesn’t actually elucidate any specific cause. IBS symptoms can in fact be due to parasites, bacterial overgrowth (yes SIBO), infection, candida overgrowth, any imbalance in the gut bacteria, food allergies, leaky gut, celiac disease (before diagnosis, because after diagnosis you would simply call it “Celiac Disease”)and many other conditions.  With functional medicine testing for “IBS” we can pinpoint the exact cause and treat the cause. And then IBS actually gets a new name!

 

So much in medicine is not absolute. The treatment of almost any disorder needs to be nuanced and tailored to the individual. Treatment decisions are often made in haste especially with insurance based practices due to time limitations.  The tendency is to treat all people with a certain named condition with an identical protocol . There is the human desire to want to make something absolute and one –size- fits- all using a cookie cutter diagnosis and a cookbook protocol for all people with a similar condition. Those broad sweeping diagnoses are dangerous and ultimately they fail. Just glance at health forums online for almost any condition and you will see thousands of chronically ill people frustrated with lack of progress in their healing

 

Enter SIBO (Small Intestinal Bacterial Overgrowth) . SIBO is really a thing , it DOES exist, AND it needs to be positively identified through breath testing, not guessing. Not because it MAY be SIBO and the doctor THINKS it is SIBO. Only a definitive breath test can discern this. And the best treatment is certainly not throwing strong expensive antibiotics at it. I can understand the tendency to want to deal with symptoms this way. Give a magic drug and the problem is solved! End of story! They just needed that drug! Tragically, too many people who have been given this approach will tell you how it just didn’t work for them and they are back to square one searching for a new practitioner.

 

Treating digestive issues is complex and the Western medical community has often been stymied when they don’t get their desired results.   When the latest diagnoses comes along – such as SIBO, then EVERYONE with a digestive disorder suddenly gets that diagnosis has and are prescribed gobs of antibiotics, which doesn’t always solve the problem and often creates new problems that are even worse.

 

The trouble is not all bloating or gut disturbance is SIBO, it is sometimes something else. And SIBO isn’t always gas and bloating (though it often is!)

 

Traditional medicine treats SIBO (real and suspected) cases one way only. They prescribe strong antibiotics. And when the course of antibiotics is finished and the next breath test (if there is one) comes back negative, they declare it “cured”. The only problem is often patients still feel sick in their gut. Or if they get relief it is only temporary. Recurrence is common with SIBO especially when diet changes are not adhered to. Many practitioners don’t make any nutritional or diet recommendations, or they put patients on a plan so stringent that it is not sustainable. It is important to work with a practitioner who will give you a nutritional plan as well as a protocol to help with peristalsis or the movement of the bowels ( a prokinetic) as well as rebuilding the damaged nerves of the digestive system. When the nerves that control peristalsis are damaged from long history of stomach inflammation, you will have a higher risk of the gut bacteria migrating into the small intestine. In an ideal world, the gut bacteria stays in the lower intestine and does not migrate up. When it does, people often experience cramping and bloating.

 

IBS on the other hand by definition means that the patient experiences digestive difficulties for no apparent reason. So IBS as a diagnosis is useless in itself to determine the proper therapeutic path to healing, IBS is often used in insurance coding but after that it becomes pointless. All SIBO is considered to be IBS but not all IBS is SIBO.

 

If you have had chronic, baffling or treatment resistant digestive issues I would love to help you feel well again! I have been in practice for over 26 years and have helped many patients get well as fads came and went. I stick with what is real while keeping up with the latest research. Together we can find an accurate diagnosis for your problem and target it with an individualized plan of action. I can work either in person if you are local to Colorado or I can consult long distance. If you are ready to take action on your health issues and are interested in working with me one on one you can schedule a FREE 15 minute phone consult using this link https://intakeq.com/booking/NaURW8  or you can call my office M-F 8:30-5 at (303)443-2206.   Hope to hear from you soon!