Category: Blog

How to eat mindfully in 4 steps by Dr. Chris, ND

Step 1: Cook real food

Diet is the foundation of health! You have probably heard time and time again that “you are what you eat”. I’ll add to that by stating that not only are you what you eat, but you are what you absorb and what you don’t excrete. Many NDs feel that the root of all illness starts in the gut – heal the gut and you can heal anything.

Everything that passes through your mouth informs your body. In our modern society, we are often missing the first step in the digestive process. Digestion starts with the sense of smell when we are cooking our food and then that sends a signal to the brain that food is coming. The brain then sends a message to the stomach along the vagus nerve to get ready – food is coming. This first step is missing for most of us as we no longer spend 20-60 minutes preparing our food. Instead, most of us unwrap something and down the hatch it goes – and many of us have digestive complaints such as: gas, bloating, heart burn, diarrhea or loose stool, constipation, nausea, etc.

Ideally, cook at least one meal per day. Digestion is a parasympathetic process – which means that we need to be in a calm, relaxed state when we eat in order to get the maximum benefit from the food we are eating. Many health experts focus on the food – which is important – but the mental emotional state you are in when you eat that food is equally important. If you are stressed out, it is unlikely you will get the full benefit from the food you are eating.

Step 2: Support digestion through the Breath

Therefore, step 2 is to take a few deep breaths before you eat to shift you into a parasympathetic state. This is especially important if you haven’t cooked your food. Spend a few extra few minutes thinking about where the food came from, who grew it, made it or prepared it for you, and all the steps involved before the food arrived on your plate. Visualize your stomach being ready to receive the food before you even take one bite. Saying “Grace” or giving thanks before eating is a great way of pausing before consuming.

Step 3: Chew and then chew some more

When you do eat, there are a few key steps involved:

  • put your fork down between bites
  • thoroughly chew your food – as they say for solids: “make your food liquid” and for liquids: “chew your liquids”. I encourage everyone to chew as many times as it takes to make your food liquid – 20, 40, 60, 80, 100 times.
  • Don’t talk with your mouth full – because you are busy chewing and being present with your food
  • If you are full, you don’t need to finish all that is on your plate

Step 4: Relax

The key to relaxing during mealtimes is to sit down when you eat and not do anything else ie don’t multi-task while eating. So when you eat, just eat. Don’t talk on the phone, watch TV, read or work.

I know I sound like your mother 🙂 . The reason for these steps is many are eating unconsciously and the idea behind these four simple steps is it allows you to be present and to eat mindfully. When you do that, you are less likely to over consume and you are more likely to get the nutritional benefit from your food when you are in a parasympathetic state.

You can have a pleasant conversation with someone while eating as long as you continue to stay calm during the digestive process. The other important reason for these steps is the more aware you are and the more time you take to eat, this increases the likelihood that you will recognize the “full” signal when it is activated in you.

There are many myths around eating – some of which might be guiding your beliefs around food, such as:

  1. I need to eat everything I put on my plate
  2. I must eat because the clock tells me to
  3. I have to avoid certain foods because they are bad for me
  4. It is hard to lose weight
  5. Cooking for one person is boring and not fun

Take some time to write in your Beyond the Label journal about any beliefs that may be guiding your eating.

You will notice that I haven’t talked about the actual food you are eating. Instead, I’ve talked about the “state” I’d like you to be in when you eat and the preparation process around eating. Give these steps a whirl and let me know how it goes! ~ Here’s to your health! Dr. Chris

10 steps to a New You

10 Steps to a New You

  1. Breathe: Those who practice deep breathing have better memories and are have an enhanced ability to cope with stress.
  2. Eat your veggies: Vegetables are high in antioxidants so they can slow the aging process, they fill you up and provide much needed fiber for a healthy gut.
  3. Get a good sleep: While sleeping your body focuses on detoxifying your tissues and reversing the harmful effects of pollution, bad eating and stress.
  4. Correct imbalances: Whether lifestyle, energetic or dietary, imbalances use up valuable energy and resources without giving you anything back. Pick one imbalance you can correct –ie drinking more water. And then build on this. Your body will thank you.
  5. Honour yourself:  When you are giving yourself what you need, your body has a wonderful way of healing itself and attracting more goodness into your life.
  6. Exercise and get outside: Increasing your heart rate and moving your muscles increases the bodies ability of to fight stress, illness and injury. Being in touch with the outdoors makes you aware of natural rhythms and improves mood and energy.
  7. Eat organic foods, drink purified water: When you give your body the right building blocks, you build better tissue leading to improved health. Plus it just simply tastes better!
  8. Make connections: Women generally live longer and are happier because of the power of the relationships they form. The number and quality of relationships is directly proportional to the perceived quality of life in several studies.
  9. Detoxify: Exposure to daily hazards leads to a build up of chemicals in the body. Only when these toxins are removed can the body function as it should. Consult with a naturopathic doctor to help with this process.
  10. Play, be creative: As we get older, we forget to really enjoy life. Plan a fun activity every day, whether it is a hobby, watching a 30 min sitcom or chatting with a friend nurture your inner child. You deserve it!

14 Simple Tips to Kick Sugar Cravings

14 Simple Tips to Kick Sugar Cravings by Dr. Chris

Sugar is the one substance that I have a bumpy, rocky, rickety relationship with. I don’t think I am alone in that. It is the one substance that I am able to eliminate for months at a time and then something happens – either a birthday, a chocolate occasion (Valentine’s Day, Easter, Hallowe’en, Christmas) and I have one piece – and then the next thing you know I am craving it again and having a hard time resisting the temptation and back on the sugar roller coaster with blood sugar crashes, headaches, mood swings, acne and weight gain – fun stuff!! It is almost drug-like for me – it is my go to in times of stress and I have to admit, I find it comforting. I am embarking on another “sugar-free” phase and will be incorporating the suggestions below. I hope you’ll join me!!

  1. Watch one or all of the documentaries available on sugar: Fed Up, Hungry for Change, Fat, Sick and Nearly Dead or The Secrets of Sugar. This will increase your awareness about sugar and will provide additional incentive to decrease your dietary consumption of sugar.
  2. Remember your math. On food labels, sugar is quoted in grams. But what does this really mean? I find it helpful to remember that 4 grams of sugar is equal to 1 teaspoon. This gives me a better visual when I am reading labels. For example, if the yogurt you are eating is artificially sweetened, it may contain 24 grams of sugar in ½ cup serving. This is the equivalent of 6 tsp of sugar, which is a lot! In this case, it is better to buy plain yogurt and mix in ½ a cup of fresh fruit.
  3. Eat within your limits. As you are decreasing the amount of sugar in your diet, it is best to figure out what your average daily consumption is by keeping a diet diary. From there, you can make changes. Aim to have 1-2 less teaspoons of sugar per week until it is eliminated from your diet.
  4. Avoid Processed Junk Foods: Sugar is an addictive substance that has a powerful influence on your brain. Eating sugar artificially stimulates a region of your brain called the nucleus accumbens, to produce dopamine, the pleasure neurotransmitter. Soon dopamine levels drop and we start to feel “flat”…or a bit “down”. We crave this pleasant, feel-good feeling again…so we reach for sugar and the cycle of addiction has begun. The best thing you can do is avoid processed junk food which contains sugar to help break this cycle.
  5.  Boost Your Serotonin: Serotonin, also known as “the happiness hormone,” can be raised through a natural low glycemic diet, daily exercise and plenty of deep restful sleep. When you have sufficient serotonin, you are less likely to have cravings for sweets.
  6. Use Stevia to Satisfy Your Sweet Tooth: The all-natural sweetener, stevia, has zero calories, does not raise blood sugar levels despite being 300 times sweeter than sugar. If you have sugar cravings and want to satisfy your sweet tooth, stevia is a safe bet. Stevia comes in a liquid and powder form and is available in most grocery and health food stores.
  7. Stay hydrated with Water:  You may sometimes think that your body is asking for sugar, when in fact it’s dehydrated and really craving water! Remember the rule of thumb with water is to drink ½ your body weight (in pounds) in ounces. If you weigh 125 lbs, the minimum amount of water to drink is 2L. Many complain about the taste of water, so try this simple delicious cravings-buster lemonade: In 8 oz. of water, add the juice of ½ lemon and 5 drops of stevia. You could also try a warm cup of green tea, sweetened with stevia after your meal. This satisfies your sweet tooth and you won’t want a dessert.
  8. Stabilize Blood Sugar levels: Eat several small, healthy meals throughout your day instead of three large portions to avoid dips in blood sugar. Your evening meal should include one of the preferred gluten-free grain-like seeds, such as quinoa, millet, buckwheat or amaranth. If you do this, your body will produce more serotonin, you’ll feel happier and you’ll sleep much better at night.
  9. Have Plenty of Greens: Loaded with nutrition greens help boost your energy and help reduce cravings for sugar and processed foods. Here are some simple green juice recipes it try: a) Celery*, lemon and pear (or apple*);  b) Celery*, cucumber*, lemon (leave the skin on) and pear (or apple*); c) Celery*, cucumber*, kale, lemon and pear (or apple*); d) Celery*, cucumber*, lemon, parsley and pear (or apple*)*ensure organic
  10. Eat More Sea Vegetables: Loaded with vitamins and minerals, seaweed or sea vegetables make for a great addition to salads and meals! They are mineral-rich while eating anything with sugar immediately depletes minerals from your body. Sprinkle dulse flakes on your salad or an avocado. Add seaweed to your soups for a rich salty and mineral flavour.
  11. Eat and Drink More Fermented Foods and Drinks: Fermented foods and drinks are an important way to reduce or even eliminate cravings for sugar. Try live fermented kefir, sauerkraut, kim-chi, kombucha tea, natural plain yoghurt, coconut kefir or any of your favourite fermented foods. You’ll be amazed at how the sour taste of fermented foods and drinks relieves the desire for sugar and processed foods.
  12. Use fresh fruit as a healthy sugar substitute: Summer is such a great time to incorporate healthy fruit into your diet. Remind yourself of what sugary, processed foods really are: dead energy food with no vitality. Compare that to a strawberry that is bursting with flavour or having juicy watermelon – there is no comparison! Enjoy the vitality of fresh fruit first and you will kick your craving for unhealthy sugary foods
  13. Learn Meditation & Stress Reduction Techniques: Meditation can help ward off cravings by helping to reduce stress. Stress creates the hormone cortisol, which increases blood sugar levels. This is a vicious cycle that damages your adrenals and creates sugar cravings. Try a exercise, yoga or meditation class before or after work to calm your body and mind.
  14. Try EFT (Emotional Freedom Technique): If you’re looking to shift the desire for sugar, lose weight, stop a habit of binging or eliminate any addiction, you owe it to yourself to learn about EFT. EFT is an easy tool that anyone can learn in minutes. You simply tap on emotional acupressure points on your body while repeating key statements that help shift your body, mind and habits.

Referenced from: http://www.hungryforchange.tv/sugar-is-a-drug

What is the connection between ice and iron deficiency?

Do You Crave Ice a lot?

It’s approaching the warmest days of the year and hot drinks are making the transition to iced drinks. We may all want some cooler beverages, but have you noticed you are craving ice much more than usual? Are you chewing ice all the time? Research shows that this is possibly driven by an underlying health condition related to blood iron stores. While not dangerous itself, craving ice could be the first sign of iron-deficiency anemia which can be serious if left untreated. Treating this underlying condition is important, so becoming aware of a strong craving for ice may help you get the treatment you need.

The Connection between Ice and Iron

This ice craving is more than liking ice in your beverages. It is defined as, “an excessive compulsion for chewing ice or consuming iced drinks” and when it reaches this level, it is termed pagophagia1. It is most commonly seen in pregnant women and children, though it can be seen at any age and in any gender2. It has also commonly been observed after patients undergo certain types of gastric bypass surgery3,4. Each of these groups who most commonly exhibit pagophagia are known to either have an increased need for iron or a difficulty in absorbing it. This suggests a mysterious link between ice craving and iron.

Since initial observations of this phenomenon, many case studies have pointed to the connection between iron-deficiency anemia and eating ice2. The connection is not fully understood, but theories include the relief of inflammation in the mouth and throat caused by iron-deficiency anemia, the perturbation of appetite centers in the brainstem from low blood iron levels, and tissue enzyme deficiencies from missing iron as a cofactor4,5. Although the connection may not be perfectly clear, strong evidence shows that excessive ice cravings are resolved when patients are treated for iron-deficiency anemia2,5.

Iron-deficiency anemia

Anemia is simply the condition of not having enough red blood cells. The most prevalent form is iron-deficiency anemia which is caused by insufficient free and stored iron in the body2. A key component of healthy red blood cells is hemoglobin, a protein responsible for the transport of oxygen from the lungs to tissues in the body. Iron is required to make hemoglobin, and so a lack of iron will interfere with the body’s ability to make enough hemoglobin and healthy red blood cells for oxygen delivery6.

The reasons why someone may not have enough iron to make red blood cells include:

  • The body is losing more blood cells and iron than it can replace with diet (ex: chronic bleeding disorders or other excessive blood loss due to chronic heavy periods).
  • The body is not absorbing enough iron, either because of poor iron absorption (ex: gastric bypass surgery) or by low dietary intake (ex: prolonged improper diet).
  • The body requires more than normal amounts of iron and is not getting enough through regular diet (ex: childhood and pregnancy).

Iron deficiency anemia is a significant health condition that can affect a person’s ability to function. Other symptoms include fatigue, low motivation, mood disturbances, shortness of breath, weakness, restless legs, dizziness, a sore tongue, headaches, hair loss, brittle nails, pale appearance and impaired immune function6,7, 8. A simple way check for potential anemia is to look at the inside of your bottom eyelid: is it very pale? If it is, this could be an indication you need natural iron therapy. Check with your health care provider.

It is important to note that there are two types of iron: heme and non-heme. The difference is mainly that heme iron is found in animal products while non-heme is found in leafy greens and other plant sources. About 15-30% of heme iron from animals is absorbed in the human gut, depending on your current iron stores. Meaning, if you are low in iron, you will absorb up to almost a third of what you take in. Sound like a low absorption rate? Unfortunately non-heme iron is even lower, being absorbed only at 2-20% of what is taken in. This absorption rate is less affected by what your stores are like, and more by what other foods and beverages you have in your system at the same time (point 3 below has more information on what affects iron absorption)8.

How to Improve Iron Levels Naturally

The good news is that iron-deficiency anemia is treatable. Using a range of therapies, blood iron levels and body iron stores can be raised to healthy levels and restore proper cellular functioning, oxygen delivery and energy levels. A good treatment plan must also investigate and address the cause of low iron—poor absorption, poor diet, excessive bleeding, etc.

  1. One of the easiest and most important therapy approaches is through diet. Start by increasing green leafy vegetables in your diet, also red cabbage, parsley, beets, alfalfa, watercress, wheat grass, spinach, cucumbers, tomato juice, fish, coconuts, eggs, black strap molasses, black cherry and blackberry juice. If you are not a strict vegan or vegetarian, consider consuming organic red meat especially when you know you are losing blood (for example, during menses).
  2. An important addition for iron therapy is supplementation. There are many different forms of supplements and some are better absorbed than others so it is advised to speak with a naturopathic doctor to determine the best one for you.
  3. Pay attention to other things that may be affecting your iron levels. Some tips9:
  • Taking iron with vitamin C helps absorption, speeding up results for iron therapy
  • Taking digestive enzymes may help you absorb better as well, especially if you have problems digesting dairy and protein properly
  • Taking antacid tablets with calcium can interfere with iron absorption and lead to iron deficiency
  • Coffee, tea and wine contain polyphenols can also reduce the absorption of iron in the gut
  • Low folic acid and B12 levels can look like iron-deficiency anemia, so it might be necessary for you to also supplement with these nutrients.
  • Low stomach acid levels may contribute to low iron by decreasing your ability to digest foods properly. You may want to check with your health care provider.
  • Minerals (calcium, zinc and copper) can affect the absorption of iron so it is best to take your iron supplement with Vitamin C and away from other supplements that contain minerals
  • Phytic acid found in grains, leafy greens, soy and other legumes can inhibit iron absorption
  • Last but not least, parasites in the body can also drastically reduce iron levels. If there is any chance you have picked up a parasite, its eradication is essential to reversing iron-deficiency anemia.

These pointers are here to help you begin to think about how many aspects of your health are connected: how diet, supplementation, and other factors can affect iron levels and therefore cause you to crave ice or have other symptoms of anemia. Be empowered and learn about your body and your habits, but also be sure to discuss with a trusted health care practitioner how you can address this. Iron-deficiency anemia is indicated by many symptoms – from eating ice to brittle nails – but once it is caught, it can be treated to help you move towards a more energetic and healthy way of living.

References

  1. Parry-Jones, B, 1993. Pagophagia, or compulsive ice consumption: a historical perspective. Psychological Medicine(Psychol Med) 22 (3): 561–71. doi:1017/s0033291700038022.PMID 1410082.
  2. Youssef, 2005. Craving for Ice and Iron-deficiency Anemia, a case series from Oman. Pediatric Hematology and Oncology, 22: 127–131, 2005 online DOI: 10.1080/08880010590896486
  3. Kushner and Retelny, 2005. Emergence of Pica (Ingestion of Non-food Substances) Accompanying Iron Deficiency Anemia after Gastric Bypass Surgery. Obesity surgery. November 2005, Volume 15, Issue 10, pp 1491-1495
  1. O’Connor 2010. http://www.nytimes.com/2010/06/22/health/22real.html?ref=health&version=meter+at+1&module=meter-Links&pgtype=Blogs&contentId=&mediaId=%25%25ADID%25%25&referrer=&priority=true&action=click&contentCollection=meter-links-click
  2. Reynolds, 1968. Pagophagia and Iron Deficiency Anemia. Annals of Internal Medcine. 1968;69(3):435-440. doi:10.7326/0003-4819-69-3-435
  3. National Library of Medicine. Iron Deficiency Anemia. https://www.nlm.nih.gov/medlineplus/ency/article/000584.htm
  4. Merck Manual Online for Professionals. Iron Deficiency Anemia.http://www.merckmanuals.com/professional/hematology-and-oncology/anemias-caused-by-deficient-erythropoiesis/iron-deficiency-anemia
  5. Davis, 2013. Considering an Iron Supplement? Be Informed! http://anitadavisnd.com/considering-an-iron-supplement-be-informed/

Williams, 2015. Iron Deficiency and Natural Treatments for Anemia. http://www.drdavidwilliams.com/iron-deficiency-and-natural-anemia-treatment/

10 Ways to Reduce Your Risk of Dementia

What is Dementia?

Dementia is an umbrella term for a set of symptoms that are caused by disorders affecting the brain. Symptoms may include memory loss, and/or difficulties with thinking, problem solving, or language and can lead to changes in mood or behaviour. Alzheimer’s disease is the most common disease that causes dementia but there are other causes, including vascular changes, thyroid gland problems, head trauma, depression, vitamin deficiency, Parkinson’s disease, chronic infections, and medications.1

Dementia can be progressive if the cause is not treatable, which means the symptoms will gradually worsen as more brain cells become damaged. However, some causes are treatable and dementia is reversible, for example if it is caused by vitamin deficiencies, medications, or thyroid problems. If you are seeing signs of dementia it is important to see a health care practitioner to determine and treat the root cause. 

Only a part of dementia can be attributed to genetic predisposition. Much more is due to environmental, physiological, and lifestyle factors. If you or a loved one is worried about developing dementia, the good news is that you can do a lot of truly preventative work now to keep your brain healthy.

There are both modifiable and non-modifiable risk factors for dementia. Here we will focus on the ones we can do something about! We have developed 10 strategies for helping prevent the development of dementia by working on most of the following modifiable risk factors:2

  • Poor diet & vitamin deficiencies
  • Use of medication that contributes to dementia
  • Impaired thyroid function
  • Cardiovascular risks (high cholesterol, high blood pressure, diabetes)
  • Smoking
  • Low physical activity
  • Alcohol use
  • Head injuries

10 Ways to Help Reduce the Risk of Dementia

  1. Minimize use of anticholinergic medication: Many prescription and over-the-counter sleep aids, heart medication, antidepressants, and allergy medicines (among others) have moderate to strong anticholinergic activity in the body. A recent large, long-term study has shown that cumulative high-dose anticholinergic use is associated with higher risk of developing dementia. Efforts are being made to help health care providers educate patients about which medications have this effect, how much is dangerous, and how to reduce their use. Don’t stop taking these medications right away if you are, but be aware and be sure to have a conversation with your doctor about how to limit their usage or change medications3,4 Follow link to see list of common medications with anticholinergic properties: http://www.virginiageriatrics.org/consult/medications/medsList.html
  2. Take vitamin D: Both animal and pre-clinical human studies have shown a correlation between low levels of vitamin D and cognitive decline leading to symptoms of dementia. Supplementing animals with Vitamin D is protective against processes that lead to dementia and Alzheimer’s disease. More large-scale human trials are on the way, but all evidence is pointing to the protective benefit of Vitamin D. Getting out in the sun may not be enough, especially in winter months; taking a supplement is the most effective way to get optimum vitamin D levels for the prevention of dementia.5
  3. Take fish oil: Decosahexaenoic acid (DHA) is one of the main fats in fish oil. Lower DHA levels are associated with increased cognitive impairment and poorer scores on memory tests in older adults. Studies show that supplementing with fish oils is most effective at the early stages of dementia or even before showing any signs to help prevention. To make sure you are getting the brain-boosting effects, take enough fish oil (commonly a combination of EPA and DHA) to get at least 1000mg of DHA per day.6,7 As always, talk with your doctor before starting fish oil as incorrect supplementation can have unwanted effects.
  4. Take a B complex vitamin: B vitamins are cofactors in many cellular processes. In this context, they are very helpful in lowering levels of a molecule called homocysteine (HC)- especially vitamin B12, B6 and folate. HC is known to damage the vascular system and having a high level can contribute to risk of heart disease, stroke, or other vascular problems leading to age-related cognitive decline. Something as simple as taking a B complex that includes 500mcg of B12 (methylcobalamin) can effectively lower HC and reduce its damaging effect on the body.8
  5. Be physically active: Regularly getting your blood moving and your heart pumping is one of the most effective ways to strengthen your vascular system. This is preventative medicine for nearly all chronic health concerns! It doesn’t need to be an intense workout regime; thirty minutes a day of moderate activity like walking, biking, or gardening is enough to see the health benefits of exercise. Increase the benefits even more by doing your exercise outside. Connecting with nature is inherently healing and has been shown to reduce blood pressure and weight faster than exercise indoors.8,9
  6. Challenge your brain by trying something new, doing crosswords, word puzzles, or learning a new language: Sound incredible? This really is preventative. Studies show that being bilingual, for example, delays the onset of symptoms of dementia by almost 5 years compared to elderly adults who speak only one language10. Another study has shown that doing regular crossword puzzles can delay the onset of memory decline by 2.5 years.11
  7. Control alcohol intake and quit smoking: The oxidative damage done by smoking and excessive alcohol intake is almost unparalleled, and is what leads to many chronic disease processes. The evidence is strong that current daily smokers are at a 45% higher risk of developing Alzheimer’s disease when compared to non-smokers or former smokers. When looking at risk due to alcohol consumption, people who drink moderate amounts of alcohol have the lowest risk of developing dementia. Those who don’t drink any alcohol at all have a slightly higher risk, and those who drink excessively have the highest risk. These results can be explained by the slight antioxidant power of moderate alcohol intake, mostly from red wine. Moderate drinking is generally considered no more than one drink per day.2
  8. Protect against head injuries for your whole life: Wear a helmet on a bike, no ifs, ands, or buts about it. If you ever suffer a concussion, ensure to not further damage your brain while it is in an already-aggravated state. Be extra careful to protect it and avoid successive concussions.2
  9. Stay connected socially and interact with others regularly: Having a social network that is reliable is one of the best defenders against many health conditions. Regularly interacting with others can protect against the adverse effects of isolation and loneliness. Combine this with physical activity or nature and get extra benefit!2
  10. Track your numbers: keep your blood pressure, cholesterol, fasting blood glucose, and weight within recommended ranges : All of these measures of cardiovascular and metabolic health are some of the most important predictors of dementia. These are big categories that affect your risk of not just dementia, but heart disease, stroke, and other diseases, so it really is in your best interest to control these parameters of your health. Your metabolism is a part of this too- adults who develop type-2 diabetes in mid life are twice as likely to develop Alzheimer’s as those who don’t. Tackle these with the help of your health care provider and natural approaches.2

These are some, but not all, of the ways you can help protect yourself and your brain from age-related decline and dementia. Be sure to rule out other health concerns like thyroid dysfunction or depression with a health care provider. While you should consider these suggestions, don’t forget that just having a regular healthy diet with fish, nuts, seeds and leafy greens is very helpful for preventing dementia and for so much more. What’s stopping you from taking care of yourself now so you and your beloved brain can live to a healthy old age? Give yourself some self-care and pick up these habits.
References

  1. Alzheimer’s Society of Canada. Risk factors for Dementia. http://www.alzheimer.ca/en/About-dementia/Alzheimer-s-disease/Risk-factors
  2. Alzheimer’s Society of Canada. What is Dementia? http://www.alzheimer.ca/en/About-dementia/What-is-dementia
  3. Gray et. al., 2015. Cumulative Use of Strong Anticholinergics and Incident Dementia, A Prospective Cohort Study. JAMA Internal Medicine, 2015 175:(3) http://archinte.jamanetwork.com/article.aspx?articleid=2091745
  4. CNN online. April 18, 2016. Author Ben Tinker. Common over-the-counter drugs can hurt your brainhttp://www.cnn.com/2016/04/18/health/otc-anticholinergic-drugs-dementia/
  5.  Landel et. al., 2016. Vitamin D, Cognition, and Alzheimer’s Disease: The Therapeutic Benefit is in the D-Tails.J Alzheimers Dis. 2016 May 11. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/27176073
  6.  Yurko-Mauro, 2010. Cognitive and cardiovascular benefits of docosahexaenoic acid in aging and cognitive decline. Curr Alzheimer Res. 2010 May;7(3):190-6.http://www.ncbi.nlm.nih.gov/pubmed/20088810  
  7. Hashimoto et. al., 2016. Beneficial effects of dietary docosahexaenoic acid intervention on cognitive function and mental health of the oldest elderly in Japanese care facilities and nursing homes. Geriatr Gerontol Int. 2016 Jan 28. doi: 10.1111/ggi.12691. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/26822516
  1. Food For the Brain, Action Plan for Dementia and Alzheimer’s, http://www.foodforthebrain.org/nutrition-solutions/dementia-and-alzheimer%E2%80%99s-disease/action-plan-for-dementia-alzheimer%E2%80%99s.aspx
  2. Logan and Selhub 2012.Your Brain on Nature. https://www.amazon.ca/Your-Brain-Nature-Eva-Selhub/dp/1443428086
  3. Alladi et. al., 2013. Bilingualism delays age at onset of dementia, independent of education and immigration status.Journal of Neurology 2013 vol. 81 no.22
    https://www.newscientist.com/article/dn24537-learn-another-language-to-delay-three-dementias/
  4. Pillai et.al., 2011. Association of crossword puzzle participation with memory decline in persons who develop dementia.J Int Neuropsychol Soc.2011 Nov;17(6):1006-13. http://www.ncbi.nlm.nih.gov/pubmed/22040899

 

Could it be SIBO?

By Dr. Candace Haarsma

What is SIBO (‘see-bo’)?

SIBO, or Small Intestinal Bacterial Overgrowth, is a chronic bacterial overgrowth of the small intestine with bacteria that normally live in the gastrointestinal tract but have abnormally overgrown in a location not meant for so many bacteria.

What are the symptoms of SIBO?

The main symptoms of SIBO are those similar to irritable bowel syndrome (IBS), including:

  • abdominal bloating, pain and cramping
  • excessive gas/flatulence
  • constipation, loose stool or alternating bouts of loose stool and constipation
  • nausea
  • heartburn and/or regurgitation of food
  • slow digestion and sensation of fullness

Causes

The primary cause of SIBO is thought to be a dysfunctional migrating motor complex (MMC). A migrating what…? The MMC is like a house keeping process that sweeps remaining debris through the digestive tract in a cyclic, repeating pattern approximately every 3 hours. With a functional MMC, food waste and, importantly, bacteria are pushed from the small intestine into the large intestine and towards the rectum.

Secondary causes and compounding factors include low stomach acid, bile insufficiency, pancreatic enzyme insufficiency, intestinal strictures, ileocecal valve disorders and small intestinal inflammation and/or damage.

Associated conditions

Many conditions are associated with SIBO. These can include:

  • GERD/heartburn
  • iron deficiency
  • vitamin B12 deficiency
  • rosacea
  • eczema
  • acne
  • gastroparesis
  • gallstones
  • intestinal permeability

What are the concerns with SIBO, besides symptoms?

Our normal digestion and absorption of food is disrupted, and the bacteria are associated with damage to the lining of the small intestine.

Problems in SIBO

  • nutrient deficiency, such as vitamin B12 and iron
  • accumulation of gas produced by the bacteria after eating our food contributing to symptoms (bloating, pain, belching, flatulence)
  • decreased normal fat absorption through bile deconjugation, which can cause deficiencies of vitamins A and D and fatty stools
  • increased excretion of acids by the bacteria which can cause cognitive and neurological symptoms
  • food sensitivities

Testing

There is a non-invasive test frequently used in SIBO-based research, which is a breath test measuring amounts of certain gases produced by the bacteria over a three hour time period. This test is available at our clinic.

Treatment goals

The goals of treatment for SIBO include treating the overgrowth and recovery and prevention (which includes correcting the underlying cause, providing nutritional support, healing the intestinal lining and addressing any compounding factors).

References

About SIBO and Treatment. (n.d.). Retrieved July 05, 2016, from http://www.siboinfo.com/about-sibo.html

Hill, A., Dr. (n.d.). Identifying correlations between small intestinal bacterial overgrowth and micronutrients. Lecture.

Khangura, P., ND, & Saunders, L., ND. (2016, February/March). Superseding SIBO. Lectures.

How exercise helps your mental health

The Mood Disorders Society of Canada put out a startling statistic in 2009: 1 in 5 Canadians will experience a mental illness in their lifetime1, including depression, mood disorder, anxiety disorder, bipolar disorder, schizophrenia, attention deficit hyperactive disorders and dementia (with anxiety and depression being the most common by far). If 20% of our population will experience such an event, it is very likely you or someone you know is, has been, or will be affected by mental illness. Rates have been climbing in Canada steadily for several decades and are expected to continue increasing2. Within a generation, it is estimated that more than 8.9 million Canadians will be living with a mental illness.

If you or someone you know struggles with mood regulation, anxiety, bipolar disorder, or depressive episodes, chances are you’ve heard of the many options available for treatment—everything from pharmaceuticals to nutraceuticals to acupuncture. There are so many approaches to mood support it can be hard to know what’s right for you.

Nearly 10% of our country’s population is using some form of prescription antidepressant medication3. This first-line conventional treatment is not cheap—a conservative estimate of the cost of mental illness in Canada in 2011 was $42.3 billion in direct costs and $6.3 billion in indirect costs2. With so many Canadians living with mental illness, together with such high treatment costs, it’s a wonder that one of the most effective, safe and inexpensive tools for mood regulation is so underused as a prescriptive treatment for mental illness: exercise.

When I lecture and speak to patients, I share this quote: ‘Pharmaceuticals (anti-depressants) are the most over utilized prescription for depression and anxiety and exercise is the most underutilized”. exercise goodI go on to explain that I understand how difficult it is when you are in the pit of depression & despair to exercise. I also share that there have been times that THAT is all that I have “accomplished” in a day. The struggle to get myself out the door has been agony at times. It has taken me several hours – 2, 4, 6, 8 or 10 hours at times – to move from my bedroom to the door. When I am depressed, the battle between the side of me that wants to get well and the side of me that is stuck in depression and defeat can be paralyzing and it can take hours to muster up the courage to do all the steps required to get me out the door:

  1. get out of bed
  2. get dressed
  3. brush my teeth or hair if I am not able to take a shower
  4. get to the door
  5. put my shoes on
  6. open the door
  7. take one step
  8. take another step
  9. take another step
  10. repeat steps 8&9 for a minimum of 30 minutes

Sometimes I have sat at the door for over an hour just struggling with the contemplation and action of putting my shoes on. But, I can tell you this – as much as I didn’t want to go – I have never once, come back from exercising outside feeling worse than when I began. Never. Once. The endorphin benefit may be short-lived and not sustain me to the next morning, but I believe that there is a cumulative effect of exercise and if repeated enough times on a weekly or daily basis, that you can’t help but feel better.

It seems almost too easy to think that something so simple could make a real impact on mental illness, but strong evidence speaks loudly. Studies on the neurobiochemistry of mental illness show exercise is an effective treatment for mental illness.

What kind of exercise?

Aerobic, resistance and strength training, recreational, and “green exercise”

Many studies investigating the beneficial effect of exercise on mental health are done on aerobic exercise, generally 60-300 min/week of aerobic activity: jogging, cycling and other such high-intensity activities. Research reviews on aerobic exercise show significant reductions in depression and anxiety scores, improved cognition, and improved self-perception; features central to many mental health improvements4-7. A 2016 meta-analysis on regular aerobic exercise as a treatment for depression shows it is statistically equally as effective as treatment with antidepressants without any of the cost or adverse effects of such medication8,9. When exercise is used in combination with medication, response is better than either treatment alone. Several studies have also shown aerobic exercise to be effective at reducing psychiatric symptoms in individuals diagnosed with schizophrenia, bipolar disorder, attention deficit hyperactive disorder, and obsessive-compulsive disorder10-13.

Fortunately, it’s not just running and aerobics that improve mental health. Studies have also shown the psychological benefit of regular strength and resistance training without aerobic fitness improvement14,15. Regular weight lifting, playing sports and other types of active exercise can improve mood and decrease anxiety and depression scores as well as rigorous high-intensity running15. These improvements to mental wellbeing can begin to be seen with as little as 20 minutes, three to five times a week of brisk walking, tennis, dancing, weight training or anything else that gets your heart rate up or your muscles pumping.

A review of population-wide studies in the U.S. and Canada tells another interesting story about what type of exercise is best for the brain—it’s more beneficial when it’s recreational. Compiling data and comparing between groups of people who use similar amounts of energy in household chores versus recreational exercise shows a greater psychological benefit in the group engaging in recreational exercise16.

Finally, to get the most out of exercise, take it outside. It is known that both physical activity and exposure to nature separately have positive effects on physical and mental health. Research is now showing they have a synergistic effect on parameters of mental health when experienced together. Their combination is being called “green exercise” and is proven to be more beneficial than exercise without exposure to nature17. A 2010 study shows that the perceived greenness of an exercise area is proportionally correlated with reductions in anxiety after exercising there18. In other words, the greener the environment of your run, the less anxious you will feel after you’ve done it. Another study by Pretty et. al. (2005) reports significantly improved blood pressure, mood and self-esteem after running in pleasant natural environments versus control environments (running on a treadmill without a screen) or in unpleasant environments19. A meta-analysis shows that one of the populations most affected by the presence of nature during exercise are those suffering from mental health concerns17.

Who benefits from exercise?

The significant, measurable psychological effects described above are seen in both clinical populations (those with a diagnosed anxious or depressive disorder) and in healthy populations, pointing out that exercise benefits both those with mental illness and those wanting to prevent it20. This effect is seen in all ages, shown by studies in ages from adolescents to the elderly7,21.It is interesting to note that the positive effect of exercise on parameters of mental health is independent of economic status, age, gender, and physical health status. This means that a person can start wherever they are—fit or not, young or old, and still feel the psychological benefits of exercise16.

How it works to support mental health

Various mechanisms are responsible for the mental health benefits of exercise. The first and perhaps most obvious physiological changes that happen during exercise are increased heart and breath rate. This allows for higher oxygen delivery to the whole body, including the brain22. Increased cerebral vascular flow sends nutrients, energy, and other benefits to brain cells to support their function during the strain of physical exertion. It even changes patterns of neuronal activity post-exercise. For example, changing blood flow and brain metabolism through exercise has been shown to alter symptomatic neural response in adults and children with bipolar disorder. Several studies are suggesting physical activity as a new early treatment of this condition13,23.

Increased blood flow to the brain is also serving to activate metabolic pathways that replenish depleted neurotransmitters; depleted neurotransmitters being a state common to many mental health disorders. Dr. Richard Maddock, a professor in the Department of Psychiatry and Behavioral Sciences at the University of California Davis, explains, “From a metabolic standpoint, vigorous exercise is the most energetically demanding activity the brain encounters, much more intense than calculus or chess, and one of the things it’s doing [with all the energy] is making more neurotransmitters.”24. This is directly beneficial to many mental health concerns. A major depressive episode, for example, is often characterized by depletion of glutamate and GABA. Both of these neurotransmitters have their pathways turned on by exercise24.

Exercise affects not only blood flow and brain metabolism, it also physically changes the brain. Olson et. al. (2006) show that regular aerobic exercise creates new neurons and increases mass in the hippocampus, a part of the brain responsible for memory and thinking25. In addition, when cells in the body are stressed by exercise, they release growth factors in the brain: improving the health of existing brain cells, growing new blood vessels in the brain, and even improving the survival of new brain cells26. Deslandes et. al., (2009) discuss the protective effect of exercise against changes in the physical brain associated with aging, concluding that exercise is an essential part of long-term optimal brain functioning, ultimately decreasing the chances of developing age-related cognitive decline27.

What you can do

You can start today. It doesn’t take much and you don’t have to become fit overnight. But committing to a goal of regular exercise to get your heart rate up or your muscles engaged can be enough to support your mental health for the long term. If possible, get even more benefit by exercising outside in a green environment. Going for a walk three times a week is enough to begin to feel a change without any side effects or costs to you. If it helps, find a group of like-minded people and get moving together. This not only improves your mental health in the ways discussed in this article but the sense of community, companionship and friendship also has a beneficial impact on mood. lenadurhamI credit tennis to lifting a depression that had been weighing me down for several months in 2008. A friend asked me to play and we started playing a few nights a week. I was now engaging in a social activity with a friend, getting outside in the fresh air, getting sunlight/Vit D and was stimulating my appetite because of the exercise. After 2 months of this, I was no longer depressed!

Supporting mental health is an increasingly important goal for our personal future and for our future generations. Exercise is an inexpensive, effective, and safe treatment option and needs to be included as part of a comprehensive wellness treatment plan for mental health concerns. If we as a nation participate and engage in exercising our bodies, we can work to manage the mental health concerns of our present and future society.

References

  1. Quick Facts on Mental Illness and Addictions in Canada (3rd Edition). (2009). Mood Disorders Society of Canada. http://www.mooddisorderscanada.ca/page/quick-facts
  2. Smetanin, P., Stiff, D., Briante, C., Adair, C.E., Ahmad, S. and Khan, M. The Life and Economic Impact of Major Mental Illnesses in Canada: 2011 to 2041. RiskAnalytica, on behalf of the Mental Health Commission of Canada 2011. http://stg.mentalhealthcommission.ca/English/system/files/private/document/MHCC_Report_Base_Case_FINAL_ENG_0.pdf
  3. Statistics / health at a glance / 2013 /. (2013). Organization for Economic Cooperation and Development (OECD) Retrieved July 14, 2016, from http://www.oecd-ilibrary.org/sites/health_glance-2013-en/04/10/g4-10-04.html?contentType=&itemId=/content/chapter/health_glance-2013-41-en&containerItemId=/content/serial/19991312&accessItemIds=/content/book/health_glance-2013-en&mimeType=text/html&_csp_=2f6481becc176514dc3acbdcffc1daaa
  4. Craft, L. L., & Landers, D. M. (1998). The effect of exercise on clinical depression and depression resulting from mental illness: A meta-analysis.Journal of Sport and Exercise Psychology, 20, 339-357.
  5. Petruzzello, S. J., Landers, D. M., Hatfield, B. D., Kubitz, K. A., & Salazar, W. (1991). A meta-analysis on the anxiety-reducing effects of acute and chronic exercise. Sports medicine, 11(3), 143-182.
  6. Den Heijer, A. E., Groen, Y., Tucha, L., Fuermaier, A. B., Koerts, J., Lange, K. W., … & Tucha, O. Sweat it out? The effects of physical exercise on cognition and behavior in children and adults with ADHD: a systematic literature review. Journal of Neural Transmission, 1-24.
  7. Carter, T., Morres, I. D., Meade, O., & Callaghan, P. (2016). The Effect of Exercise on Depressive Symptoms in Adolescents: A Systematic Review and Meta-Analysis. Journal of the American Academy of Child & Adolescent Psychiatry.
  8. Kvam, S., Kleppe, C. L., Nordhus, I. H., & Hovland, A. (2016). Exercise as a treatment for depression: A meta-analysis. Journal of affective disorders,202, 67-86.
  9. Mead, G. E., Morley, W., Campbell, P., Greig, C. A., McMurdo, M., & Lawlor, D. A. (2009). Exercise for depression. The Cochrane Library.
  10. Beebe, L. H., Tian, L., Morris, N., Goodwin, A., Allen, S. S., & Kuldau, J. (2005). Effects of exercise on mental and physical health parameters of persons with schizophrenia. Issues in mental health nursing, 26(6), 661-676.
  11. Abrantes, A. M., Strong, D. R., Cohn, A., Cameron, A. Y., Greenberg, B. D., Mancebo, M. C., & Brown, R. A. (2009). Acute changes in obsessions and compulsions following moderate-intensity aerobic exercise among patients with obsessive-compulsive disorder. Journal of anxiety disorders, 23(7), 923-927.
  12. Callaghan, P. (2004). Exercise: a neglected intervention in mental health care?. Journal of psychiatric and mental health nursing, 11(4), 476-483.
  13. Souza de Sa Filho, A., Marcos de Souza Moura, A., Khede Lamego, M., Barbosa Ferreira Rocha, N., Paes, F., Cristina Oliveira, A., … & Wegner, M. (2015). Potential therapeutic effects of physical exercise for bipolar disorder. CNS & Neurological Disorders-Drug Targets (Formerly Current Drug Targets-CNS & Neurological Disorders), 14(10), 1255-1259.
  14. Martinsen, E. W., Hoffart, A., & Solberg, Ø. (1989). Comparing aerobic with nonaerobic forms of exercise in the treatment of clinical depression: a randomized trial. Comprehensive psychiatry,30(4), 324-331.
  15. Stathopoulou, G., Powers, M. B., Berry, A. C., Smits, J. A., & Otto, M. W. (2006). Exercise interventions for mental health: a quantitative and qualitative review. Clinical Psychology: Science and Practice, 13(2), 179-193.
  16. Stephens, T. (1988). Physical activity and mental health in the United States and Canada: evidence from four population surveys. Preventive medicine,17(1), 35-47.
  17. Barton, J., & Pretty, J. (2010). What is the best dose of nature and green exercise for improving mental health? A multi-study analysis.Environmental science & technology, 44(10), 3947-3955.
  18. Mackay, G. J., & Neill, J. T. (2010). The effect of “green exercise” on state anxiety and the role of exercise duration, intensity, and greenness: A quasi-experimental study. Psychology of Sport and Exercise, 11(3), 238-245.
  19. Pretty, J., Peacock, J., Sellens, M., & Griffin, M. (2005). The mental and physical health outcomes of green exercise. International journal of environmental health research, 15(5), 319-337.
  20. De Moor, M. H. M., Beem, A. L., Stubbe, J. H., Boomsma, D. I., & De Geus, E. J. C. (2006). Regular exercise, anxiety, depression and personality: a population-based study. Preventive medicine, 42(4), 273-279.
  21. Lisanne, F., Bolandzadeh, N., Nagamatsu, L. S., Hsu, C. L., Davis, J. C., Miran-Khan, K., & Liu-Ambrose, T. (2015). Aerobic Exercise Increases Hippocampal Volume in Older Women with Probable Mild Cognitive Impairment: A 6-Month Randomized Controlled Trial.British journal of sports medicine, 49(4), 248.
  22. Querido, J. S., & Sheel, A. W. (2007). Regulation of cerebral blood flow during exercise. Sports Medicine, 37(9), 765-782.
  23. Metcalfe, A. W. S., MacIntosh, B. J., Scavone, A., Ou, X., Korczak, D., & Goldstein, B. I. (2016). Effects of acute aerobic exercise on neural correlates of attention and inhibition in adolescents with bipolar disorder. Translational psychiatry, 6(5), e814.
  24. Wood, J. (2016, February 28). Hard exercise can boost brain chemicals sapped by depression | Psych central news. Retrieved July 14, 2016, from Psych Central, http://psychcentral.com/news/2016/02/28/people-who-exercise-have-better-mental-fitness/99703.html
  25. Olson, A. K., Eadie, B. D., Ernst, C., & Christie, B. R. (2006). Environmental enrichment and voluntary exercise massively increase neurogenesis in the adult hippocampus via dissociable pathways. Hippocampus, 16(3), 250-260.
  26. Godman, H. (2014, April 9). Regular exercise changes the brain to improve memory, thinking skills – Harvard health Blog. Retrieved July 14, 2016, from Harvard Health, http://www.health.harvard.edu/blog/regular-exercise-changes-brain-improve-memory-thinking-skills-201404097110
  27. Deslandes, A., Moraes, H., Ferreira, C., Veiga, H., Silveira, H., Mouta, R., … & Laks, J. (2009). Exercise and mental health: many reasons to move. Neuropsychobiology, 59(4), 191-198.
  28. Sparks, A. (2015). Lena Dunham on exercise: “It Ain’t about the Ass.” Retrieved July 14, 2016, from Psych Central Blogs, http://blogs.psychcentral.com/your-mind/2015/04/lena-dunham-on-exercise-it-aint-about-the-ass/

 

 

7 Birth Control Options Besides “The Pill”

7 Birth Control Options Besides “The Pill” by Dr. Christina Bjorndal and Lachlan Crawford

The combination oral contraceptive pill (OCP) is typically a combination of estrogen and progestin taken orally to prevent female fertility and pregnancy. It was first introduced in 1960 and since then it has undergone many modifications and has been used by millions of women ocpworldwide. Of Canadian women who use contraception, 32% use the OCP as their method of birth control1. It is one of the most used forms of contraception in Canada, but more and more women are looking to alternatives to oral hormonal contraceptive methods. What follows is an overview of some of the most common alternatives to “the pill”. Birth control is a personal choice and it is your right to be informed of the options available for safe and effective contraception.

The Copper IUD (ParaGuard)

A copper IUD is a small medical device that is inserted into the uterus and remains there as an effective form of contraception for 5 to 12 years2. This IUD releases copper ions into the uterine cavity that interferes with sperm so that they are no longer viable to travel or to fertilize an egg, although the mechanism for this is not well understood3. Copper IUDs have become more popular in recent years because it is highly effective (only 2% of women will have unplanned pregnancies within the first year), relatively low-maintenance, and cost-effective over the long-term. It contains no hormones and is preferred by women who cannot take hormonal birth control methods.CUIUD However, copper IUDs can increase cramping, pain and spotting in the first 3-6 months after it is inserted. A woman with a copper IUD will still get her period every month. In fact, the copper IUD is known to increase menstrual bleeding significantly, and has been shown to increase risk of iron-deficiency anemia. For this reason it is not recommended to women with low blood iron, ferritin or hemoglobin4. Different versions of the copper IUD are effective for varying time frames, with the ParaGuard being approved for the longest – 10 years. New studies are showing it to be effective at preventing pregnancy for up to 12 years, but should be changed at that point to ensure proper copper levels for efficacy2.

Mineral levels in the body are tightly regulated and have significant effects on body processes if levels are too high or too low. In fact, an excess of one mineral can antagonize other minerals and lead to a broader mineral imbalance. Different research groups looking at the effects of the copper IUD have found that blood levels of copper are raised to varying degrees, with newer data suggesting significant increases in serum copper5,6,7.

Copper is an essential mineral that is used in many body processes, but at excessive levels it is harmful to the body and negatively impacts the level of other essential mineral. A mineral imbalance caused by an increase in copper affects may physiological systems and can lead to hypothyroidism, emotional lability, problems with memory and concentration, poor blood glucose regulation and an increase in inflammatory conditions8. According to Julie Casper, L. Ac., and Rick Malter, Ph.D., of nutritional balancing.org, symptoms of copper excess include:

 

Fatigue, exhaustion Headaches, migraines Depression Constipation PMS
Hypothyroidism Pounding heart/palpitations Dry skin Arthritis, calcium spur0s Aching muscles
Concentration and memory problems, brain fog Supersensitive, “over-emotional” Feelings of loss of control or of hopelessness Recurrent yeast infections Low blood sugar and blood pressure
Chocolate cravings Cold hands/feet Mood swings Eating disorders Obsessive thoughts

“As copper increases in the body, potassium levels will be lowered and calcium levels will increase. This shift has a tendency to slow the activity of the thyroid gland. With the lowering of the potassium, the Na/K (sodium: potassium) ratio will increase, thereby putting the individual in a more chronic “fight” or “flight” response. Sodium may increase with a corresponding drop in magnesium levels. Therefore, a buildup of excess copper will tend to contribute to more intense feelings of fear and anger in a person. As more and more excess copper builds up, it will lead to a shift from anger and fear to rage and terror or panic. Such intense emotion involving rage and terror or panic will leave such a person feeling “out of control.” This is a very common reaction of a person with high copper levels.”8

Although researchers have not agreed on the possibility of copper toxicity from this contraception device, case studies are pointing to possible adverse effects, from emotional to physical9. Research on human copper toxicity remains “surprisingly sparse,” says Terry Gordon, a professor at New York University’s department of environmental medicine9. Animal studies show damage to cervical and ovarian cells from high local concentrations of copper ions from the IUD10. Perhaps the most significant study done on this topic on humans showed increased systemic biomarkers of oxidative stress and inflammation, and the authors concluded the copper IUD should be used for no more than 2 consecutive years11 as opposed to its usual recommendation of up to 5 years. New research on the etiology of psychological conditions is showing inflammation plays a significant role in the development of mental health concerns. This link shows how copper, inflammation and emotions are all connected.

In terms of mineral imbalances, serum Iron levels have been shown to decrease12 likely due to increased blood loss from heavier menstruation, as mentioned above. Serum zinc levels have actually been shown to increase with use of a copper IUD6,12, which is surprising since copper is known to be a zinc antagonist in the body – the mechanism of action of how this occurs remains unknown to researchers. On hypothesis is that serum levels of any mineral other than iron aren’t meant to be high in the blood as they are used by the body at the tissue level. As such, it would make more sense to analyze mineral deficiencies using a tissue sample (ie hair) or urine source and perhaps the research is misguided because the wrong medium is being measured.

It is important to get a good idea of what your chosen method of contraception means for your body in the short and long term. The copper IUD is growing in popularity because of its convenience, effectiveness and absence of hormones, but a broad body of research on it is still lacking. Many women have had successful and satisfactory contraception with the use of a copper IUD. It may still be a good option for you if you are sensitive to other hormonal treatments or prefer it to barrier methods, but it is important to be aware of the link between excess copper, inflammation and emotions. The best suggestion is to get your mineral levels tested by a Naturopathic doctor prior to having an IUD inserted to determine what your pre-existing levels of copper and other essential minerals are. Based on the results, an individualized mineral supplementation program can be created which will help prevent potential side effects that may result after the insertion of the copper IUD. The cost to do a hair essential mineral test is approximately $110.

The Hormonal IUD (Mirena)

The hormonal IUD, Mirena, is similar to the copper IUD in that it is a small device inserted into the uterus and remains there as long-term birth control for up to 5 years, though like the copper IUD, in some circumstances it may be used for longer. It is designed to release small amounts of a form of the female hormone progestin, like that in the oral contraceptive pill, into the uterus. While it is unclear how this inhibits female fertility, it is thought to work by thickening cervical mucus (to prevent sperm from entering the uterus and reaching or fertilizing an egg) and thinning the lining of the uterus (to make it less hospitable to egg implantation if there is fertilization)13. In the first 3-6 months after insertion, bleeding and spotting may be irregular but over time many women experience lighter and shorter menstrual bleeding than before insertion, however, some may even see a complete cessation in menstruation13.

MirenaMirena is 99% effective in preventing pregnancy and, like the copper IUD, is low-maintenance and cost-effective over the long term versus other methods of birth control. It does contain the hormone levonorgestrel (progestin), but because it is in the uterus the hormone levels are less than is used in the oral contraceptive pill and is effective without having systemic exposure to synthetic hormones.

Less than 1% of women with a Mirena IUD inserted in the last year will become pregnant. However, if pregnancy does occur, it is more likely to be an ectopic pregnancy wherein implantation occurs outside the uterus. This is a potentially life-threatening concern requiring emergency care. Equally unlikely but important to know, the Mirena can also embed itself into or perforate through the lining of the uterus and migrate into the abdomen, causing serious complications requiring surgery. These risks occur in less than 1% of women who are using the Mirena IUD, but they are serious and important to calculate in your decision for birth control. The most common side effects of the Mirena are irregular bleeding (52%), headaches (12%), breast tenderness (3-9%), acne (15%), inflammation of the vulva/vagina (20%), development of ovarian cysts (13%), loss of periods (1-12%), mood changes (4%), and pelvic pain (12%)14. New studies are claiming that it is effective at preventing pregnancy even up to one year after its FDA-approved time of 5 years, though this may result in more difficulty conceiving after its removal15. Use beyond 6 years is not recommended as it may be ineffective and lead to unwanted pregnancy.

As there is a chance you may stop your period altogether while using the Mirena, it is a good idea to decide if you feel comfortable with this possibility. Although the Society of Obstetricians and Gynecologists of Canada (SOGC) and the Association of Reproductive Health Professionals (ARHP) state there is no evidence that suppression of periods is harmful, it is important to note that there are no long-term studies to specifically investigate this16,17. Menstruation, contraception and fertility are deeply intimate topics that have been debated by politics and religion for generations. As a result they can hold cultural significance in addition to their biological purpose. Fortunately women now have the ability to choose the significance for themselves and make that a biological reality. For an in-depth discussion of the history, pros and cons of missing periods, please read the article “A Brief History of your Period and Why you don’t have it” by Psychologist Valerie Tarico in the feminist magazine Jezebel.

“The Ring” and “The Patch”

The ring and the patch are two variations on the combined oral contraceptive pill and therefore have much the same risks, side effects and contraindications as “the pill”18. Products such as the NuvaRing and Evrapatch deliver female hormones (both estrogen and progestin) for three weeks to block ovulation and prevent pregnancy18. theringThe ring is inserted into the vagina whereas the patch is placed on the skin. After three weeks of hormone delivery, the ring or skin patch is removed and allows for a withdrawal bleed that imitates a period, like the oral contraceptive pill. These methods work differently than the Mirena because the method of action is to block ovulation and does not necessarily modify the cervical mucus or uterine lining. patchWith perfect use, both the ring and the patch are 99.7% effective at preventing pregnancy and with typical use, 92%19.

The Diaphragm

This is a barrier method that involves no hormones and no future impact on fertility. The diaphragm is a flexible latex or silicone dome-shaped device filled with spermicide and inserted into the upper vagina covering the cervix. It creates a spermicidal barrier at the cervical opening and must be used with the spermicidal gel to be effective. Women can insert the diaphragm up to 6 hours before intercourse and should leave it in place for at least 6 hours after (up to 24 hrs)18. If there is more than one occurrence of intercourse in the 24 hours without removal, more spermicidal gel can be added to be sure.

Used correctly and consistently, the diaphragm is 94% effective at preventing pregnancy, though with typical use is 84%. For full effectiveness, the diaphragm does require active participation from the woman: proper hygiene habits and regular insertion, cleaning, removal and storage. Using a diaphragm may increase the incidence of urinary tract infections due to the manual insertion and removal. In the past, it needed to be fitted by a physician as well to ensure comfort and effectiveness.

Up to 25% of married women in 1955 were using the diaphragm19, but when the birth control pill was introduced and women had the option to have contraception with much less maintenance, the popularity of the diaphragm dropped dramatically. diaphragmAccording to the Canadian National Contraception Survey in 2009, only 0.2% of women using contraception choose the diaphragm21.

Due to its lowered popularity, there has been limited access to the diaphragm in Canada in recent decades. However, more women are now looking for alternatives to hormonal treatment and the diaphragm is seeing resurgence. New diaphragm products are coming onto the market that are designed to manage some of the drawbacks to the old designs. A new product called Caya, for example, is designed to fit most women and eliminates the need for fitting by a physician. The advantages remain the same as other barrier methods: no hormonal modification or changes to fertility of either party, and the disadvantages are relative to other methods available; the diaphragm requires more active participation from the woman but with proper use is just as effective as using male condoms19.

Male condoms, with and without spermicide

The use of male condoms is one of the most common methods of birth control. With perfect use it is 98% effective at preventing pregnancy, though this rate drops to 85% with typical use19. Perfect use means applying the condom before any sexual contact, being sure that it does not slip or tear, and removing it immediately after male ejaculation – and this must be done consistently and correctly every single time. Therefore, technique and consistency is key for this method – it requires commitment from both you and your partner to ensure you are both as protected as possible.

condomUsing additional spermicidal gel or foam can increase the effectiveness of this method, though it’s not confirmed exactly how effective typical use with extra spermicidal protection is. The advantage of condoms is that it is hormone-free and also very effective at protecting against sexually transmitted infections and HIV. It is a lifestyle choice that requires engagement from the male partner and can offer opportunity to talk about sexuality, safety and concerns with each other. Note that it is important not to use latex-based lube with latex condoms or to use two condoms at once as both of these may increase the risk of breakage19.

Fertility Awareness Method (Rhythm Method)

Fertility Awareness is a way to predict your body’s fertile and infertile times during your cycle. Based on the knowledge that the body shows visible and detectable signs of hormonal changes throughout the cycle, a female can know the date of ovulation, and therefore, know when they are fertile and when they are not. During the fertile periods during the cycle, one must abstain completely from sex or use another effective method to prevent pregnancy. This is a wonderful way to get to know your body as you track cycles and get in touch with what is happening and when. It can be extremely effective if you are diligent and consistent. With theoretical perfect use (meaning you are very good at knowing exactly when you ovulate) it is 95-97% effective. However because this method requires consistent and careful monitoring, typical use falls to about 75%19.

fertilityawarenessThe fertility awareness method is based on the fact that an egg is released once in each menstrual cycle, usually around mid-cycle, and can live for 12 to 24 hours, waiting to be fertilized before menses flushes out the egg and the uterine lining. Sperm can live in the female reproductive tract up to 6 days and fertilize an egg. Therefore, a female is fertile for as long as six days before ovulation and two or three days after ovulation, a total of seven to eight days of fertility in her cycle each month22. During these fertile days, other contraceptive methods must be used, and outside these days, she is considered infertile and unable to become pregnant. Of course, this method does not protect against sexually transmitted infections.

There are different approaches to detecting ovulation that are available to learn, including using a calendar to track cycles, assessing cervical mucous thickness, checking basal body temperature daily, and breast tenderness22. Keep in mind that your cycle itself can vary depending on many factors such as stress, change, trauma, illness and allergic reactions, making it sometimes difficult to be certain of timing. If you are interested in the fertility awareness method, be sure that both you are your partner(s) are committed and there is consistency in the tracking. If done properly this is a natural and effective way to prevent pregnancy.

Making an Informed Decision

Birth control is an important and intimate decision. If you are looking for alternatives to the oral contraceptive pill, know there are options available for you. Your body does not have to follow any method but what is right for you. Talk with your health care provider about your options, be informed of all the effects of each method and determine what is safe and comfortable for you at this time in your life.

 Relative Effectiveness of Birth Control Methods at Preventing Pregnancy19

Method used EffectivenessPERFECT USE EffectivenessTYPICAL USE
OCP/The Pill 99.7% 92%
The Patch 99.7% 92%
The Ring 99.7% 92%
Hormonal IUD, Mirena 99.9% 99.9%
Copper IUD, ParaGuard 99.4% 99.2%
Diaphragm with spermicide 94% 84%
Male Condoms + spermicide 99% No confirmed data
Male condoms alone (no spermicide) 98% 85%
Fertility Awareness Method 97-95% 75%
Withdrawal (pulling out) 96% 73%
No birth control 15% 15%

References

All photos used are under a Creative Commons Attribution-Non Commercial-NoDerivs License from the Association of Reproductive Health Professionals at http://www.arhp.org/

  1. Society of Obstetricians and Gynecologists of Canada, Canadian Contraception Consensus, SOGC Clinical Practice Guidelines, 2004. http://sogc.org/wp-content/uploads/2013/01/143E-CPG2-March2004.pdf
  2. Doyle, K., 2014. IUD Effective for Longer than Recommended. Reuters Health News. http://www.reuters.com/article/us-iuds-effective-idUSBREA2C1B320140313
  3. Island Sexual Health, Copper IUD, Beyond the Talk.ca http://beyondthetalk.ca/birth-control-pregnancy/birth-control/ec/copper-iud/
  4. Andrade et. al., 1987. Quantitative studies on menstrual blood loss in IUD users Jul;36(1):129-44. http://www.ncbi.nlm.nih.gov/pubmed/3311622
  5. Prema et. al.,1980. Serum copper in long-term users of copper intrauterine devices. Fertil Steril.Jul;34(1):32-5 http://www.ncbi.nlm.nih.gov/pubmed/7398904
  6. Imani et. al, 2014. Changes in copper and zinc serum levels in women wearing a copper TCu-380A intrauterine device. Eur J Contracept Reprod Health Care. Feb;19(1):45-50 http://www.ncbi.nlm.nih.gov/pubmed/24304153
  7. De la cruz et. al., 2005. Blood copper levels in Mexican users of the T380A IUD. Contraception, Vol.72; Issue 2, Pgs. 122–125 http://www.contraceptionjournal.org/article/S0010-7824(05)00075-2/abstract
  8. Julie Casper and Rick Malter for Nutr.balancing.org, 2016. Copper Toxicity.http://nutritionalbalancing.org/center/htma/science/articles/copper-toxicity.php
  9. Scilla Alecci for Women’s News, 2015. In Online Forums, Women Share Copper IUD Fearshttp://womensenews.org/2015/03/in-online-forums-women-share-copper-iud-fears/
  10. Grillo et. al., 2010. Does over-exposure to copper ions released from metallic copper induce cytotoxic and genotoxic effects on mammalian cells? Vol.81;Issue 4, Pgs 343–349 http://www.contraceptionjournal.org/article/S0010-7824(09)00521-6/abstract
  11. Arnal et al., 2010. Alterations in copper homeostasis and oxidative stress biomarkers in women using the intrauterine device TCu380A. Toxicology Letters. Vol.192;Issue 3, Pgs 373-378 http://www.sciencedirect.com/science/article/pii/S0378427409015264
  12. Fahmy et. al., 1993. Serum and endometrial copper, zinc, iron and cobalt with inert and copper-containing IUCDs.May;47(5):483-90. http://www.ncbi.nlm.nih.gov/pubmed/8513675
  13. Official Mirena website, 2016. Bayer Pharmaceutical Company. http://www.mirena-us.com/about-mirena/how-mirena-works.php
  14. Medscape 2016. Levonorgestrel intrauterine (Rx) Adverse Effects. http://reference.medscape.com/drug/mirena-skyla-levonorgestrel-intrauterine-342780#4
  15. Lawson, A., 2015. Research Shows IUDs May Prevent Pregnancy Longer Than Expected. Surgical Watch.http://surgicalwatch.com/2015/02/research-shows-iuds-prevent-pregnancy-longer-expected/
  16. McQuillan et. al., 2013. Menstrual Suppression in Special Circumstances. Clinical Guidelines for the Society of Obstetricians and Gynecologists of Canada. http://sogc.org/guidelines/menstrual-suppression-special-circumstances/
  17. Kaunitz et. la., 20018.. Understanding Menstrual Suppression. Association of Reproductive Health Professionals (ARHP) http://www.arhp.org/uploadDocs/understandingmenstrualsuppression.pdf
  18. Association of Reproductive Health Professionals (ARHP) , 2014. Choosing a Birth Control Method.http://www.arhp.org/Publications-and-Resources/Quick-Reference-Guide-for-Clinicians/choosing
  19. Options for Sexual Health, 2009. Relative Effectiveness of Birth Control Methodshttps://www.optionsforsexualhealth.org/birth-control-pregnancy/birth-control-options/effectiveness
  20. CDC, 2002. Use of Contraception and Use of Family Planning Services in the United States: 1982-2002.http://www.cdc.gov/nchs/data/ad/ad350FactSheet.pdf
  21. Black et.al., 2009. Contraceptive Use Among Canadian Women of Reproductive Age: Results of a National Survey. J Obstet Gynaecol Can. Jul;31(7):627-40. http://www.sexualityandu.ca/uploads/files/National_Contraception_Survey.pdf
  22. Options for Sexual Health. 2009. Fertility Awareness Method. https://www.optionsforsexualhealth.org/birth-control-pregnancy/birth-control-options/natural-methods/fam

3 Reasons why Prolotherapy treatments surpass cortisone injections

3 Reasons why Prolotherapy treatments surpass cortisone injections By Dr. Michael Mason-Wood

Have you ever injured yourself? Torn a ligament? Twisted an ankle? Separated a shoulder? If you weren’t healing and were experiencing inflammation, the likely treatment option offered by your medical doctor would be a cortisone injection. Cortisone is a powerful anti-inflammatory injection. But, what if this treatment is actually counter-productive to the long term healing effects you are seeking. Enter Prolotherapy. Prolotherapy also known as “nonsurgical ligament reconstruction” is a treatment for chronic musculoskeletal pain. The word “Prolo” is short for proliferation as Prolotherapy treatment enhances the growth and formation of new ligaments, tendons and cartilage in areas where there is weakness or excess scar tissue. There are three reasons why prolotherapy treatments surpass cortisone injections:

  1. Prolotherapy rebuilds tissue and over the long term, cortisone can be destructive to tissue. With prolotherapy the initial reaction of the treatment is localized inflammation triggering a wound healing cascade leading to increased blood supply and flow of nutrients and growth factors. This stimulates the tissue to repair itself by deposition of new collagen, the material that ligaments and tendons are made of. The new collagen then shrinks as it matures leading to ligament/tendon tightening and increased strength.
  2. There are no negative side effects to prolotherapy and cortisone injections can cause long term nerve damage. I recently had a patient who had a cortisone injection in January 2016 and eight months later, he is still experiencing numbness in his patellar tendon where the cortisone was injected. Other long term consequences of cortisone injections include1: thinning of the skin, easy bruising, weight gain, puffiness of the face, higher blood pressure, cataract formation, thinning of the bones (osteoporosis) and rare but serious damage to the bones of the large joints (called “avascular necrosis”).
  3. A prolotherapy treatment is not as painful as a cortisone injection while it is administered. While many are nervous about injection therapies, administration of a prolotherapy treatment is not very painful. Many patients are pleasantly surprised with the treatment, especially if they have previously had a cortisone injection. There may be pain and discomfort after the treatment as the healing process is activated, but this is typically short-lived.

Call 587-521-3595 or book online to set up an appointment today – it is time you are pain free!

References:

  1. http://www.webmd.com/arthritis/what-are-cortisone-shots

8 Health Risks of Low Cholesterol

8 Health Risks of Low Cholesterol – by Dr. Christina Bjorndal and Lachlan Crawford

It’s commonly known that elevated cholesterol in the blood is a risk factor for developing heart problems. In fact, high cholesterol is recognized as a major contributor to cardiovascular disease, the #2 leading cause of death in Canada, second only to cancer1. To combat this major public health concern, over 38 million prescriptions for statin pharmaceuticals to lower cholesterol were written in Canada in 20122. With so much effort to lower cholesterol, you might think it advantageous to get your levels as low as possible. Having too-low cholesterol, however, has its own risks, calling into question the trending practice of prescribing statins to anyone even at risk of elevated levels. New insight into the effects of low cholesterol are showing the importance of staying within a healthy optimal range and not falling into low levels – a state called hypocholesterolemia.

What is Cholesterol? The Good and the Bad

Cholesterol is a lipid (fat molecule) that is made by the body (mostly the liver) and also consumed in the diet. Our total blood level of cholesterol is a combination of what’s made ‘in-house’ and what’s picked up in our food. Cholesterol has a specific molecular structure consisting of four rings of atoms. This structure makes it a sterol (type of fat) that is the building block for many other physiological molecules, including our hormones.

There are two main types of cholesterol in the body, namely HDL cholesterol (commonly called “the good cholesterol”) and LDL cholesterol (commonly dubbed “the bad cholesterol”). HDL stands for high-density lipoprotein and is considered good because this is the form that is thought to play a protective role in our cardiovascular system. HDL is a bundle of molecules that includes cholesterol, and it moves cholesterol from the body’s vascular system to the liverwhere it can be processed and made into something else. If the cholesterol stays in the vascular system it can become oxidized which is damaging to blood vessels. This contributes to plaque formation in the vessels which causes heart disease. Therefore, when cholesterol is in the HDL bundle, it is good because it is moving away from where it can cause damage. Conversely, LDL (low-density lipoprotein) is a bundle of molecules that includes cholesterol and it moves cholesterol from the liver to the peripheral body and blood vessels, keeping it where it is more likely to be oxidized and cause damage. This is why the LDL-bundled-cholesterol has a bad reputation.

Why is Cholesterol Important for our Bodies?

Cholesterol is used in countless physiological processes, but here is a list of some of the major categories of its wide range of use:

  1. First, cholesterol is an essential part of our cell membranes. Every single cell in your body requires cholesterol to keep its fluidity and integrity to function properly at body temperature. Having insufficient cholesterol can make cell walls rigid and lead to premature cell death.
  2. Second, its sterol structure is the building block for many important hormones, including estrogen, testosterone, progesterone, cortisol and aldosterone, to name a few highly important examples3. With cholesterol dipping too low, the body can compensate for a time by making its own cholesterol, but at a point it cannot compensate for all the demands of cholesterol and some hormonal functions may be impacted.
  3. Cholesterol is also the precursor to bile salts. Made by the liver and stored in the gall bladder before being released into the small intestine, bile salts are compounds used in the digestive tract that allows for the absorption of fats.
  4. Finally, cholesterol is important for proper nerve function. Neurons in the central nervous system require cholesterol for the formation of synapses, the parts of neurons that facilitate neuronal communication4, the formation of myelin sheaths for neurons, as well as being essential for the synthesis of some neurotransmitters5. Therefore, having sufficient cholesterol is important to ensure smooth neurotransmitter flow in the brain and spinal cord.

After taking a look at its importance in the body, we might expect some adverse effects if our cholesterol level dips too low. But what should we look out for?

What Happens when Cholesterol is Too Low?

First off, frank hypocholesterolemia (where levels are below the 5th percentile of the normal human population, or around 3.1mmol/L) is uncommon and usually seen only in patients with other severe conditions or infections, multiple physical traumas or just after surgery6. However, many studies have been done that show cholesterol levels at or slightly below the low end of the normal range may have adverse conditions. Many compare healthy controls to patients that are ill and find significant differences in cholesterol levels. Ideal total cholesterol is 5.2 mmol/L, a level below 4.7 mmol/L can be a problem for some, and total cholesterol below 3.1 mmol/L indicates a serious problem.

Part I: Cholesterol and the Brain

Depression, Suicidality

A number of studies have found a relationship between low serum cholesterol levels and mood disorders. Rafter et. al. found that those with low serum cholesterol levels scored significantly worse on depression assessments than those with normal cholesterol7. In patients diagnosed with depression, low blood cholesterol levels have been associated with suicidal ideation and suicide attempts, with some studies showing a direct correlation: the lower the cholesterol, the more likely a patient would be to have suicidal thoughts or to make an attempt5. The magnifying effect of low cholesterol on low mood has also been documented in people who suffer from seasonal affective disorder and post-partum depression5. However, still other studies have shown no correlation between mental health markers and cholesterol levels, showing the relationship is likely a partial one, or that cholesterol levels play a part in the mental health outcomes of only certain populations. So although it may not be a perfect predictor for all populations, it is nonetheless important to note cholesterol plays a role in significant mental health outcomes. If you are concerned about taking cholesterol-lowering drugs and their effect on your mental health, the research is still out. As with the data on depression, conflicting data show a correlation between anti-cholesterol drugs and psychiatric symptoms while other studies show no correlation5. More studies are being done to determine the nature of the relationship between cholesterol, pharmaceuticals and mental health.

Neurodegenerative Disorders

Epidemiological studies show cholesterol levels also have a correlation with neurodegenerative diseases of the aging brain. Many investigators are working to determine if these relationships are simply a correlation or are causative, in other words if low cholesterol contributes as a risk for developing dementia or Alzheimer’s. Mostly this work is leaving conflicting evidence. When looking at studies in which cholesterol level was assessed in middle age and follow-up for neurodegenerative outcomes was 20 to 30 years, a positive association with Alzheimer’s and high cholesterol was found8. Based on these studies, statins were given to those in mid-life with high cholesterol and resulted in less cognitive decline in later life9. The relationship between high cholesterol and Alzheimers is due to cholesterols role in the development of amyloid plaques.25 On the other hand, when cholesterol levels are measured later in life, Alzheimer’s and dementia is associated with low cholesterol. For example, Dimopolous et. al. showed significantly lower cholesterol levels in elderly patients with dementia10, and Kuussisto et. al. found a correlation with Alzheimer’s disease11– both studies measuring cholesterol in late life. Discussions around these results gave rise to a hypothesis that low cholesterol may be a secondary effect of neurodegeneration and not its cause. A 2008 literature review on the relationship between cholesterol and neurodegeneration presents this topic as conflicting and needing more evidence to report sound conclusions8.

Parkinson’s Disease

Previously, the research around Parkinson’s disease and cholesterol was also inconclusive, but new evidence is sparking interesting and important new discussion. In recent years the prevailing theory was that high cholesterol was the very culprit for developing Parkinson’s. This has led to clinical studies to test a statin drug as direct treatment for Parkinson’s, such as the four-year clinical trial from The Plymouth University Peninsula Schools of Medicine and Dentistry in the UK that is in its final year, pending results in 2017. Systematic reviews of evidence for this theory, however, have uncovered confounding reasons why this may not hold truth12. Correcting for these confounding factors, a large prospective study published in 2015 followed patients in the USA for 10 years and found that statin use may be associated with a higher risk of Parkinson’s disease, whereas higher total cholesterol levels is actually associated with lower risk13.

Autistic Spectrum Disorder

New studies have highlighted a particular group of children with Autistic spectrum disorder (ASD) as having very low cholesterol. Specifically, children with the condition SLOS (Smith-Lemli-Opitz syndrome), that have an inability to make cholesterol, are much more likely to develop ASD than children with regular cholesterol synthesis14. Although SLOS is only present in a small percentage of children with ASD, it provides important insight into the role of cholesterol metabolism in the development of ASD in the rest of the population, and future possibilities of treatment15. Children with ASD and SLOS treated with cholesterol management therapies show improvement of symptoms, giving hope that this may help others with ASD.

Part II: Cholesterol and the Body

Hormone health and Fertility

This is one of the major categories where cholesterol dysregulation has an affect on the body and its functions. Because cholesterol is a precursor to all steroid hormones, it is understandable that hormone levels are directly affected by cholesterol. Many studies show decreasing levels of estrogen, progesterone, testosterone, cortisol, aldosterone and other hormones with low levels of cholesterol16,3. Having low steroidal hormones can affect female fertility by not preparing the ovaries or uterus properly for implantation or fetal growth. A startling result from a study looking at the effect of statins on embryo development after fertilization showed marked embryotoxicity caused by the cholesterol-lowering drugs leading to failure of a fertilized embryo to implant for growth17. Low cholesterol also affects male fertility – low synthesis of total testosterone from low cholesterol stores leads to lower sperm counts and can decrease libido as well18. A 2009 literature review calls for more research while acknowledging the possible blunting of the adrenal and/or sex hormone function in both males and females19.

Immune health

Cholesterol also affects the immune system in a significant way. People with low cholesterol also have lower-than-normal counts of immune cells that are necessary to fight off even the most basic infections20. The downstream effects on the immune system also predispose a patient with low cholesterol to more severe inflammation from bacterial invasion. Studies have shown that having low cholesterol before a surgery makes it more likely to have post-operative complications including sepsis21. Epidemiologic studies have also identified a relationship between hypocholesterolemia and increased mortality from all causes22. Overall, low cholesterol is associated with a higher rate of mortality in all hospitalized patients, in comparison to those with normal or high cholesterol levels. Though these findings may mislead some to think that cholesterol should be raised indiscriminately, it is instead shown here to illustrate the pitfalls of lowering it too far, below what is necessary to upkeep important cellular and metabolic functions.

Stroke

A low level of total cholesterol is associated with an increased risk of intracerebral hemorrhage (a type of stroke) for people over the age of 6523. While the mechanism for this is unclear, it is thought that low levels of cholesterol may decrease blood platelet activation, which is needed to stop bleeding if it were to occur. Decreasing platelet activity makes a person more prone to bleeding, in this case perhaps even leading to a stroke24.

Cancer

Cholesterol deficiency also is being investigated as a risk factor for colorectal cancer. Because of the role it plays in the production of bile salts for the absorption of fats, it is observed that low cholesterol leads to improper fat absorption. This leaves more lipids in the digestive tract, which can then be oxidized in the colon, leading to cell damage in the colon wall. A large Japanese study also found very low cholesterol levels to be a risk for developing liver malignancies20. Beyond being a risk factor for developing cancer, low cholesterol levels predict lower survival rates for any blood or solid organ malignancy20.

Part III: What You Can Do

The most important thing is to be aware that cholesterol is an important molecule for proper functioning of our bodies and minds. This is meant to help you be your own health advocate by giving you valuable information about your body’s chemistry. Do not stop taking statin medication if you are currently taking it. Have a conversation with your health care provider about your concerns and to have your cholesterol checked. If you find it’s on the lower side and want to take some action to raise it into a healthier range, you can do it naturally. Here are some tips to help you achieve optimal cholesterol:

  • Eggs: Very simply, include more organic eggs with their yolk in your diet. Egg yolk is one of the best sources of cholesterol- one large hard-boiled egg provides 71% of your recommended daily intake
  • Olive oil: Just 2 tbsp of uncooked olive oil a day is effective at raising HDL cholesterol and improving total cholesterol levels. It’s as easy as one homemade salad dressing
  • Fish Oil: Supplementing with this oil not only gives you a source of cholesterol, but helps with omega-3 and -6 balance of fats for an excellent overall lipid profile and protection against many mental health concerns and degenerative and chronic diseases
  • Animal products: Include organic chicken, beef and pork in your diet to ensure you’re getting the proper fat profiles on a daily basis. Include real, unsalted, organic butter too.
  • Control insulin spikes: Eat a diet that has a low glycemic index and low glycemic load. This means your insulin levels will be more level, your blood glucose control will be better and your cholesterol and lipid profiles will improve
  • Vitamin D: This vitamin is actually synthesized from a molecule in the cholesterol family, 7-dehydrocholesterol. Supplementing with vitamin D will free up cholesterol precursors for other uses or for cell membranes
  • Supplement cholesterol: New Beginnings Nutritionals makes a purified cholesterol supplement that will effectively raise levels. Be sure to talk with your health care provider as this product requires their referral
  • Supplements containing beet concentrate and taurine thins bile allowing easier flow out of the gallbladder to help our bodies absorb fat
  • Gall Bladder Support: Your cholesterol could be low because your gall bladder is not releasing bile into the digestive tract, meaning you have a hard time absorbing fats. Consult with a Naturopathic Doctor who address gall bladder health. There are herbs that facilitate proper bile flow and fat absorption, effectively helping your body regulate its cholesterol and fat levels on its own

Sources:

  1. Anderson, Robert N., and Betty L. Smith. “Deaths: leading causes for 2001.” (2003). http://www.statcan.gc.ca/tables-tableaux/sum-som/l01/cst01/hlth36a-eng.htm
  2. Statistics Canada (2012) Health Facts Sheet: percentage of Canadians with unhealthy cholesterol. http://www.statcan.gc.ca/pub/82-625-x/2012001/article/c-g/desc/11732-01-desc-eng.htm
  3. Berg, J. M., Tymoczko, J. L., & Stryer, L. (2002). Important Derivatives of Cholesterol Include Bile Salts and Steroid Hormones. http://www.ncbi.nlm.nih.gov/books/NBK22339/
  4. Pfrieger, F. W. (2003). Role of cholesterol in synapse formation and function. Biochimica et Biophysica Acta (BBA)-Biomembranes, 1610(2), 271-280. http://www.ncbi.nlm.nih.gov/pubmed/12648780
  5. Sansone, R. A. (2008). Cholesterol quandaries: Relationship to depression and the suicidal experience. Psychiatry (Edgmont), 5(3), 22. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2710104/
  6. Mouzouri, E. (2011). Hypocholesterolemia. Curr Vasc Pharmacol. Mar;9(2):200-12.
  7. Rafter, D. (2001). Biochemical markers of anxiety and depression. Psychiatry research, 103(1), 93-96. http://www.ncbi.nlm.nih.gov/pubmed/11472794
  8. Duron, E., & Hanon, O. (2008). Vascular risk factors, cognitve decline, and dementia. Vascular Health and Risk Management, 4(2), 363. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2496986/
  9. Sjögren, M., & Blennow, K. (2005). The link between cholesterol and Alzheimer’s disease. The World Journal of Biological Psychiatry, 6(2), 85-97. http://www.ncbi.nlm.nih.gov/pubmed/16156481
  10. Dimopoulos, N., Piperi, C., Salonicioti, A., Psarra, V., Mitsonis, C., Liappas, I., … & Kalofoutis, A. (2007). Characterization of the lipid profile in dementia and depression in the elderly. Journal of geriatric psychiatry and neurology, 20(3), 138-144. http://www.ncbi.nlm.nih.gov/pubmed/17712096/
  11. Kuusisto, J., Koivisto, K., Mykkänen, L., Helkala, E. L., Vanhanen, M., Hänninen, T., … & Laakso, M. (1997). Association between features of the insulin resistance syndrome and Alzheimer’s disease independently of apolipoprotein E4 phenotype: cross sectional population based study. Bmj,315(7115), 1045-1049. http://www.ncbi.nlm.nih.gov/pubmed/9366728
  12. Bykov, K., Yoshida, K., Weisskopf, M. G., & Gagne, J. J. (2016). Confounding of the association between statins and Parkinson disease: systematic review and meta‐Pharmacoepidemiology and Drug Safety. http://www.ncbi.nlm.nih.gov/pubmed/27527987
  13. Huang, X., Alonso, A., Guo, X., Umbach, D. M., Lichtenstein, M. L., Ballantyne, C. M., … & Chen, H. (2015). Statins, plasma cholesterol, and risk of Parkinson’s disease: a prospective study.Movement Disorders, 30(4), 552-559. http://www.ncbi.nlm.nih.gov/pubmed/25639598
  14. Tierney, E., Bukelis, I., Thompson, R. E., Ahmed, K., Aneja, A., Kratz, L., & Kelley, R. I. (2006). Abnormalities of cholesterol metabolism in autism spectrum disorders. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics,141(6), 666-668. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2553243/
  15. Aneja, A., & Tierney, E. (2008). Autism: the role of cholesterol in treatment. International Review of Psychiatry, 20(2), 165-170. http://www.ncbi.nlm.nih.gov/pubmed/18386207
  16. Kische, H., Gross, S., Wallaschofski, H., Völzke, H., Dörr, M., Nauck, M., & Haring, R. (2016). Clinical correlates of sex hormones in women: the Study of Health in Pomerania. Metabolism. http://www.ncbi.nlm.nih.gov/pubmed/27506736
  17. Alarcon, V. B., & Marikawa, Y. (2016). Statins inhibit blastocyst formation by preventing geranylgeranylation.Molecular human reproduction, gaw011. http://www.ncbi.nlm.nih.gov/pubmed/26908642
  18. Vangeepuram Satakopan, Cholesterol Levels May Influence Male Fertility. Sexual Health. https://sexual-health.knoji.com/cholesterol-levels-may-influence-male-fertility/
  19. Hulisz, D. (2009). Do Statins Reduce a Patient’s Hormone Levels? Medscape Multispecialty. http://www.medscape.com/viewarticle/709320
  20. Elmehdawi, R. R. (2008). Hypolipidemia: a word of caution. The Libyan journal of medicine, 3(2), 84. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3074286/
  21. Leardi, S., Altilia, F., Delmonaco, S., Cianca, G., Pietroletti, R., & Simi, M. (1999). [Blood levels of cholesterol and postoperative septic complications]. Annali italiani di chirurgia, 71(2), 233-237. http://www.ncbi.nlm.nih.gov/pubmed/10920496/
  22. Shores, J., Peterson, J., VanderJagt, D., & Glew, R. H. (2003). Reduced cholesterol levels in African-American adults with sickle cell disease.Journal of the National Medical Association, 95(9), 813. http://www.ncbi.nlm.nih.gov/pubmed/14527048
  23. Iribarren, C., Jacobs, D. R., Sadler, M., Claxton, A. J., & Sidney, S. (1996). Low total serum cholesterol and intracerebral hemorrhagic stroke: is the association confined to elderly men? The Kaiser Permanente Medical Care Program. Stroke,27(11), 1993-1998. http://www.ncbi.nlm.nih.gov/pubmed/8898804
  24. Aviram, M., Davidai, G., & Brook, G. J. (1991). [Platelet hypoactivity in hypocholesterolemia].Harefuah, 120(4), 177-179. http://www.ncbi.nlm.nih.gov/pubmed/2066015/
  25. Sjogren, M., Blennow K. (2005). The link between cholesterol and Alzheimer’s disease. World J Biol Psychiatry 2005;6(2):85-97. http://www.ncbi.nlm.nih.gov/pubmed/16156481