Natural Fertility

We are waiting until later and later in life to have children, and so more and more couples have concerns about their fertility. Additionally, infertility rates have been on the rise since world war 2 and show no signs of slowing. In order to support natural fertility, we must both address the environmental factors that lead to infertility as well as support the reproductive organs specifically. 

First, let’s talk about what infertility is. A couple is diagnosed with infertility if they are unable to conceive after one year of trying to conceive. While the assumption is that female infertility is normally the cause, somewhere between 40-50% of infertility is actually due to male infertility. 

A woman can have an irregular cycle, endometriosis, PCOS, or other reproductive disease and still be fertile. However, some of these conditions, for instance PCOS, make it harder to conceive due to infrequent ovulation, or in the case of endometriosis, scar tissue can obstruct implantation. So the first step in female infertility is to address these hormonal issues and get her cycle normal and healthy. 

This is an area in medicine where naturopathic medicine really shines. We have a whole host of wonderful herbs and nutrients that can work to regulate cycles, balance hormones, and clear hormone breakdown products. Getting your period should be a painless event, with no PMS, no hormonal acne, no night sweats, no moodiness, and no breast tenderness! You can find more information about fixing your period HERE, but generally the better and more regular your period, the less likely you are to be infertile.

For a man, it is less obvious when he is infertile (except of course in the case of impotence) because men don’t typically get hormonal symptoms like women do to warn them that something is awry with their reproductive system. So for men the first sign of infertility is often the inability to conceive with their partner and subsequent testing to determine whether they are making viable sperm.

For both men and women who want to improve their fertility whether or not they have been diagnosed with infertility, it is critical to decrease environmental factors that disrupt the reproductive system. The cells that make eggs and sperm, called gametes, are very sensitive to toxins like pesticides, phthalates, BPA, and other endocrine disruptors. 

We know this because those who work in industries with more exposure to these chemicals have higher rates of reproductive issues. The CDC lists the following as causes of infertility for women:

• a variety of pesticides

• carbon disulfide (CS2)

• polychlorinated biphenyls (PCBs)

• organic solvents

• jet fuel

• shift work

For men, the list from the CDC is even longer, but this is likely only because it is easier to study male fertility, not because the male reproductive system is more fragile than the female:

• Insecticides

• Lead

• Organophosphates

• DDE

• Manganese

• Phthalates

• Diesel exhaust

• Bisphenol A

• Chromium

• Paraquat/malathion

• Carbon disulfide

• Carbofuran

• Petrochemicals

• Pesticides

• Fenvalerate

• Benzene

• Welding  

• N, N-dimethylformamide 

• Abamectin

We also know that sperm production can impaired by too much heat as in the case of placing a warm laptop in his lap for extended periods of time, and from trauma to the area, specifically bicycle seats.

Recipe for infertility! Yikes!

For men and women a lot of these exposures can be reduced by simple practices like not microwaving anything in plastic, not drinking from plastic bottles that have gotten warm in the sun, buying organic produce when possible, buying organic grains, not using lawn chemicals, and by switching personal care items to natural versions.

However, for some people these chemicals are from their job, for instance, mechanics, farmers, dentists and dental techs, lawn care, nail stylists, and dry cleaning personnel all have high exposures. Living next to a freeway, golf course, farm, or other industry that uses lots of chemicals also puts you at a higher exposure level.

In these situations, it is best to minimize exposure by wearing proper safety equipment, and to minimize the negative effects by increasing your antioxidant status. It is also important to work on optimizing detoxification processes to help get these chemicals out of the body. I wrote a whole post on detoxification which you can read HERE.

There are some antioxidants that have specific research for their impact on fertility. For both sexes grape seed extract, NAC, and CoQ10 can improve gamete quality. Folate and other B-vitamins can also benefit fertility. Woman-specific support includes inositol, melatonin, essential fatty acids like omega 3s, and alpha lipoic acid. Man-specific support includes zinc, arginine, and carnitine.

Of course the dose always matters as does the bioavailability. In order to overcome infertility you’re going to need a higher dose than you would if you are just looking to optimize function. Some antioxidants like CoQ10 are very difficult to absorb from the intestinal tract and so they need special technology to get across the intestinal barrier into the bloodstream. For these sorts of supplements, you get what you pay for insofar as the cheaper supplements won’t actually be providing a nutrient your body can utilize effectively. 

My favorite CoQ10 is CoQMax Omega from Xymogen. This product uses the incredible bioavailability of MaxSimil fish oil (3 times more absorbable than normal fish oil) to carry CoQ10 right into the bloodstream. I love the enhanced bioavailability of this product, but I also love that it delivers half a gram of omega 3s which are so anti-inflammatory.

Amino acids like arginine and NAC on the other hand are readily absorbed from the intestines and don’t require any special formulation. For amino acids it’s just the purity of the product and of course the dose that matters. There are slight variations in form, for instance L-carnitine versus acetyl-L-carnitine, but this won’t have nearly as drastic of an impact on absorption as compared to other types of nutrients. Consequently, amino acids tend to be less expensive supplements across brands.

Not sure where to start? Start by talking to your local friendly naturopath (*hint* that’s me) to put together a regimen that works for your body and your specific needs. Want to manage on your own? You can find access to physician quality supplements at www.wholescripts.com using the referral code 202020. Check out the CoQmax omega, ALA CR, Activ-B, and zinc chelate for a really great combo!

Do You Need to Wear Sunscreen

Summer is the best season in Wisconsin! There are lakes to play in, fishing and camping, backyard barbeques and so much more to enjoy. The mosquitoes are out, but at least the sun is too! A lot of my patients ask me questions about the importance of sun exposure, whether they need sunscreen, and how to pick a good brand. Let’s break it down!

Humans, like all animals, are designed to be outside. We actually depend on sun exposure to synthesize vitamin D. The UV rays from the sun trigger our bodies to make all sorts of hormones. Recent research even found that our skin color pigment, called melanin, helps with energy production in our cells. This might be why so many people feel good in the sun!

However, sun exposure is a double edged sword. We know that certain skin cancers are a result of cumulative sun exposure, and that we can get sun spots or age spots and wrinkles from the sun. This means it is important to balance sun exposure so that we get enough to make vitamin D but not so much that we burn and cause damage to cells. Sun exposure itself is good; it’s sunburn that is a problem for our skin health.

The most intense sunlight is midday when the sun is at its zenith, from 11-2 or so, and the further you get from midday, the less intense the sunlight is because it goes through more layers of the atmosphere which filters out increasingly more UV rays. One easy way to avoid burning is to make sure you spend these midday hours out of the sun. 

If you must be out when the sun is strongest, help protect your skin. The easiest way to protect your skin from damage is to cover it. You can use a physical cover like long sleeves and a hat, a chemical cover (sunscreen), or you can try to make your own by getting sun exposure beforehand. Because our bodies are designed to be in the sun, many of us create melanin in response to sun exposure which protects our cells from sun damage. So by getting small amounts of sun exposure we can build up a protective layer of melanin without causing damage to our cells.

Now, some people can’t tan, which means they don’t make much melanin, and if this is you, you will need to rely on physical covers and sunblock to prevent burning. Some people make a lot of melanin, which means they can get a lot of sun exposure without burning, but it also means they need a lot more sun exposure to make adequate vitamin D. If you have dark colored skin or if you tan easily, you might want to check your vitamin D levels yearly to make sure you aren’t deficient.

Additionally, the closer you get to the equator, the stronger the sunlight because the sun is increasingly directly overhead. In Wisconsin we don’t have very intense sunlight, but if you have to take a trip down south, you’ll want to be aware of the increased intensity, which makes it easier to burn even if you have built up a decent tan.

If you are someone who needs to use sunscreen to prevent burning, avoid any sunscreen that contains oxybenzone, which is absorbed by the skin into the bloodstream at very high levels where it becomes an endocrine disruptor. Other ingredients that are very common but have little research are: Avobenzone, homosalate, octinoxate, octocrylene, and octisalate. Sunscreen ingredients generally recognized as safe are zinc oxide and titanium dioxide.

Not sure whether your sunscreen has good ingredients? Just look it up on the Environmental Working Group’s (EWG) website or download their app Think Dirty and scan your product to get information about its ingredients. They rate products based on the research (or lack thereof) for each ingredient.

Something to keep in mind when getting sun exposure is that sunscreen generally is rated by its ability to block UVB rays which are the ones that cause sunburn, but not so much UVA rays, which penetrate deeper into the skin and damage the DNA in cells. This means it is possible to get too much sun even though you won’t get a proper sunburn. Instead you might be red, get a rash, or feel overheated.

In the case you do get a sunburn, topical aloe vera gel can help. Other skin healing herbs include calendula, comfrey, and Saint John’s wort. Because sunburn is a sign of damage to your cells, it is also a good idea to get lots of antioxidants to help your body recover from this damage.

Beat the Bloat

Bloating is quite possibly one of the most annoying digestive symptoms one can experience. Not only is it uncomfortable, it is unsightly and embarrassing. But more importantly, it is a major sign that there is something wrong with the digestive tract. No amount of bloating is considered normal! 

Bloating seems to come in two different forms. The first is your classic “I look like I’m pregnant”, style and the other is “I look fatter for no apparent reason”. Differentiating between types of bloating can help determine what is causing it.

The “pregnant bloat” or what I call “gas bloat”, is normally caused by the fast creation of gas in the intestines. If you tap on your belly, it has a hollow resonance. You may have flatulence or burping later as that gas makes its way out of the intestines. Much of this gas will also be absorbed into the bloodstream and exhaled through the lungs.

To accelerate this gas diffusion process, naturopathic doctors (and wise grandmothers) recommend carminative herbs. Carminative herbs tend to be fragrant because they are high in volatile oils, and include peppermint, fennel, cardamom, caraway, chamomile, and lemon balm. Many of these accelerate gastric emptying and bowel motility, as well as relieve crampy bowels. Fortunately, most carminative herbs are tasty and make wonderful teas. 

For the “fat in the middle” bloat, there is less air involved but often more inflammation. Inflammation is an immune process, and when the immune system rushes into an area, a lot of fluid comes with it. In our joints and extremities this is recognized as swelling, but in the intestines we call it bloating. 

To help relieve this style of bloating, we can still use carminative herbs, but it may also benefit from soothing herbs like licorice, and anti-inflammatories like turmeric, greens, and digestive rest (fasting).

These things can help relieve occasional bloating, they are merely palliative. The challenge is to get the bloating to go away and never come back. To do this, you must understand all the things that cause bloating, and then address these underlying causes.

The first common cause of bloating is insufficient digestive enzymes. We need enzymes to break down the carbohydrates we eat. If they are not properly digested, the carbohydrates feed bacteria, who then make tons of gas as they process the sugars. This style of bloating tends to get worse as the day wears on, and resolves overnight.

Carbohydrates may also feed yeast, which is another cause of bloating. Yeast overgrowth may present with some combination of bloating, constipation (usually), sugar cravings, brain fog, anxiety, waking with a coating on the tongue, and yeast overgrowth in other places, like athlete’s foot or vaginal yeast infections.

Unfortunately, yeast is not the only way that the microbiome, the bacteria that live in your intestines, can be imbalanced. There may also be bad flora residing in your intestines that cause bloating. Klebsiella and citrobacter are two species that can be dysbiotic causes of bloating and inflammation. Lack of good flora is also correlated with bloating, with lactobacillus, streptococcus, and bifidobacterium strains all seen in the research to decrease bloating. Microbiome related bloating tends to feel very random, with a few good days followed by a few bad days. 

Bloating may also happen in the presence of a good microbiome if you are eating foods that you are sensitive to, even perfectly healthy foods like almonds, coconut, or broccoli, are unhealthy if you have a sensitivity to them. Sensitivity means that every time you eat that food your immune system goes after it. This can be a huge source of inflammation and subsequent bloating. This presents very differently from person to person, it may be headaches, fatigue, joint pain, gut pain, high blood pressure, and more.

Some individuals have a good microbiome but it migrates from the colon into the small intestine where it gets early access to sugars before they have been fully digested. This is called small intestine bacterial overgrowth, or SIBO. SIBO is a huge cause of bloating, and it is at its heart a motility issue. It often presents with bloating, cramping, and constipation or diarrhea. It will seem like the person has food allergies, but really it is the carbohydrate types in the food that are the issue, not an immune response.

With all the different causes of bloating, no wonder it is so hard to resolve! The most certain way to figure out bloating is to test for food allergies and sensitivities and to do a comprehensive stool analysis to evaluate all of these causes. Because often, it’s not just one thing, but 2 or 3 that are an issue. For instance, it is very common to have low digestive enzymes and food sensitivities along with some dysbiosis.

My thoughts on "Plandemic"

I’ve had multiple people share “Plandemic” with me and then ask for my opinions, so I thought I might create a more cohesive response and share my insights as a naturopathic doctor. I obviously don’t fit into the “narrative” as someone who shuns insurance and drugs as part of my approach to health. But on the other hand, I rely on authorities like the CDC for information and guidance. I have a foot on both sides of the fence on a regular basis, so it is with this bias that I write. Keep my bias in mind as you read, as you should with everything you read. 

First, by writing this I am in no way confirming that what “Plandemic” claims to be true is actually true. I think most of us like to envision the world as a black and white place, but almost everything is actually shades of gray. That is to say, there are certainly some things in the movie that are true, some that are a matter of opinion, and some that are likely false.

You can see this play out very clearly in our mainstream media. You watch CNN and it’s the end of the world, then you watch Fox cast the same story as a moment of triumph, or vice versa. Funny thing is, if you didn’t watch the news, you would be largely unaffected by whatever it was that they were going on about. Partially it’s a matter of opinion, partially it’s how they spin things and your own bias, but part of it is that much in this world is a matter of interpretation. It’s grayscale. Likely, the truth lies somewhere between the two extremes.

Next, the scientific community can be petty and political just like any other community. I think a lot of people envision scientists as altruistic individuals who just want to make the world a better place through scientific advances. Some are just that, but some really aren’t. Science is highly competitive, we compete for discoveries, government grants, patents, and so forth. 

It is also highly political. You can gain power and influence if you are a great scientist. The way to power and influence in science is to write papers, get them published and establish yourself as an expert in your field, to create something new and patent it so you can profit from it, and then eventually use this to work your way onto advisory boards, peer review boards, dean of a program, and so forth.

Once you are in this position, you can absolutely use that power to control what has been referred to as “the narrative”. Let’s say you are on a peer review board for the publication “Science”. All sorts of scientists submit their papers to you for review in hopes of being published. If your personal bias is that organic foods are no better than conventionally grown food, do you think you would be keen on publishing a paper that compares organic to conventional and finds organic has higher mineral content. Likely not.

Now compound that decision with the knowledge that a conventional food company is willing to pay you a generous sum of money if you send such papers their way before they are published. You would have to be of exceptional character to refuse this offer and publish the paper! We know for instance that the FDA’s food pyramid from the 90’s was largely influenced by certain food lobbyists and in disregard of the science. Read the book “death by food pyramid” if you don’t believe me.

Here’s another example of how healthcare is more political than scientific. We know that cholesterol is a terrible indication of heart health. We have much better markers, like fractionated lipids, Lp(a), PLA2 and so on. We also know that except in rare cases, you don’t raise your cholesterol by eating cholesterol containing foods. We make 90% of our cholesterol ourselves. We even have massive reviews that show that the only population who benefits from prescription of statins is men aged 40-75 who have already had a cardiac event.

Yet everyone “knows” if your cholesterol is above 200 you will be put on a statin drug indefinitely to “prevent” a cardiac event and told to avoid fat. This is despite the fact that a cholesterol of 220 is all-cause mortality protective AND a cholesterol of 140 or lower puts you an increased risk for suicide. Docs do it because they are told to do it. Who tells them? Drug companies and the American Medical Association (AMA). This is a clear example where standard protocol is not driven by science. It may be that our standard of care just lags behind what the research, or it may be something else. This is where your personal bias comes into play and determines whether you say it is “greed and corruption” or “trust the process and eventually the protocols will be revised.” Which one is right? They probably both are to an extent.

This is all to say that I don’t know whether Dr. Mikovits is telling the truth or whether she too has ulterior motives. We can’t really know because she claims that the very system we are supposed to trust is the one lying. However, she could just as easily be trying to save face and taking advantage of the current attitude and distrust of the government to spin a story of corruption that so many of us who are forced out of work are ready to believe. It confirms what we already feel, that the government is not to be trusted, it is corrupt and power hungry.

The bottom line is that you would be naive to think that our scientific boards are unbiased, but it would be just as naive to accept her narrative as gospel truth. Just like what we see in the news, the truth probably lies somewhere in between the two sides. I think for most of us, there has been a lot of cognitive dissonance with all the recent events and their polarizing nature. The best we can do is acknowledge our personal biases, do our best to collect information from various sources, and try to abstain from making emotionally-based decisions. 

We all come to our own conclusions based on our own experiences. It doesn’t make a person bad or good, just different. It’s ok to have a different opinion and still have a dialog about it. Just realize that most things, even the things that seem black and white, are probably gray.

Can Supplements Make You Pretty

There are some cosmetic issues that respond really well to supplementation, and the beauty industry is trying to get in on that. Want nice nails? Take biotin. Want better skin? Take collagen. Thicker eyebrows? Try a growth serum. Take this 8 question quiz and get all the supplements you need to address your health… the list goes on and on.

Unfortunately it is not quite that simple. How many of us have bottles of product on the shelf that we don’t use because our skin just didn’t like it, or we stopped using it because we didn’t notice any changes? Let’s take a deeper dive into 3 of the most common beauty concerns to help guide your next product selection.

First up are fingernails. The nail exam is one of my favorite parts of new patient physical exams because you can learn a lot about a person just from their nails. One of the most common issues with nails is weak, peeling, or brittle nails. Often, the beauty industry suggests biotin for this. While biotin is an integral component of your nails, it is by no means the only one! 

If you find that your nails peel or are weak, you may actually have a more generalized mineral deficiency. Trace minerals are critical to our health, but are very rarely tested or fortified, and so they are commonly deficient. The most bioavailable minerals are chelates made by Albion labs, and the least bioavailable are the oxide form of the mineral.

A chelate is a mineral bound to an amino acid. Because our digestive tract absorbs amino acids with ease, the mineral is taken up into the bloodstream much more effectively than if it was floating around as a free mineral. Before buying a supplement for nail support, read the label and make sure it has the right form of the minerals.

If your nails are strong but they just don’t grow, that is more likely a thyroid issue and so they won’t be helped by biotin at all. Ridges on the nails are conventionally considered a natural part of aging as the nail thins, but I challenge that assumption and find that it may be from mineral deficiency or from B vitamin deficiency.

The second issue many women supplement for is hair. Over 50% of women will experience hair loss over her lifetime - This is the sort of hair concern that can respond well to supplementation. Thinning hair, very slow growing hair, or hair follicle shrinkage can all be traced back to thyroid function. 

The thyroid is the master gland of metabolism, and so if it is lagging, cells that are the most metabolically active will struggle the most noticeably. You may notice dry skin, thin eyebrows, low energy, and weight gain in addition to your hair loss. In this situation, you don’t need hair support, you need thyroid support and your hair will grow back on its own.

For some women, stress can be a trigger for hair loss as well. However, it doesn’t always correlate exactly with the stressful period. Normally there is a delay of several months, which can make it really hard to track down. Remember that caloric restriction is a stress on the body! Once I had a patient who was experiencing drastic hair loss and she was completely beside herself (understandably). The only change in her life was that she had started a restrictive diet, so when we added in more calories, the hair loss completely stopped!

There is no oral supplement to make your hair instantly shiny, because your hair is dead. You can however, improve its shine over time with hair masks to nourish the scalp and hair follicle. Here  is an example of a scalp nourishing mask. Other things that would be useful for hair quality are omega 3s, protein, and sulfur containing foods.

The last item that women are always looking to work on is skin integrity. Men get wrinkles and they look “distinguished”, women get wrinkles and we look “old”. Not fair! As we age, we lose subcutaneous fat which makes our bony structures more prominent, and there is not much we can do about this besides generally taking care of yourself. Those who age prematurely tend to have had a tough life, emotionally or physically. Antioxidants are helpful here, and something that I like to test if someone is working on overall health or if she is showing signs of premature aging.

For women, hormones actually play an important role in skin health as well. We are all familiar with hormonal impacts on the skin in terms of acne, but it also plays a role in skin aging as well which is most evident after menopause. Balancing hormones and supporting their production in the late 40s and through the 50s can have a positive impact on this transition phase and skin health.

These hormonal changes may be responsible in part for some of the collagen changes we experience as we age. Taking collagen powder doesn’t guarantee that you will make more collagen, but it does at least give your body the building blocks to make more collagen. There is some positive research on particular collagen peptides for skin elasticity and moisture, although there have not been many studies investigating the mechanism.

In summary, there is a lot we can do to improve our appearance from the inside out! If you tried a supplement to help your hair, skin, or nails and it didn’t work, don’t give up hope! It may be that you just got the wrong nutrients and taking a different approach to the concern could still work!

Depression is Linked to Inflammation

One of my least favorite diagnoses is depression. It is often used as an umbrella diagnosis for anyone that just feels vaguely unwell.  Feelings of worthlessness? Depression. Don’t feel like doing anything? Depression. Appetite off? Depression. All of these very different symptoms are treated the same way, messing with the neurotransmitter levels in the brain. I’m not saying that depression doesn’t exist, in fact I’m arguing for the contrary. I think the current medical approach to treating depression is overly simplistic for such a complex disease with a huge array of symptoms.

Let’s say your dog or cat lost interest in eating and playing one day. What do you do? You don’t call them depressed; you assume they are sick and take them to the vet. Not eating and not being active are called “sick behaviors” because our body shuts down these things when we are sick. It has nothing to do with neurotransmitters and everything to do with inflammation. We do humans a disservice when we automatically assume it’s “just depression” and not sick behavior from inflammation.

Our immune system communicates with molecules called cytokines. Different cytokines have different roles. One cytokine that plays a major role in sick behavior is interleukin-1 (IL-1). It is associated with lethargy, sleep and appetite disturbances. Here is a study that talks more about this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5244798/ 

Furthermore, scientists have researched the connection between poor mood and inflammation without sickness. In one study, the subjects who experienced negative mood for over a week had higher levels of inflammation. So in order to adequately address depression, we have to move beyond neurotransmitters to look at inflammation.

Inflammation is not inherently bad. Inflammation is how our body starts the healing process and how it turns on the immune system. Unchecked inflammation or long term inflammation is where we start to run into problems. Because our body has finite resources, the most immediate needs are prioritized, which in the case of endless inflammation our body ends up drained. Here’s an example of what this might look like.

Let’s say you are allergic or sensitive to broccoli. Everytime you eat broccoli it turns on your immune system and creates some inflammation. If you eat broccoli every day, over time this will wear down your body and may result in fatigue, low motivation, poor mood, and so forth. Inflammation is a process that is supposed to turn on and then off again after the issue has been resolved. This person is not sick, but they still may have the symptoms of being sick.

One of the easiest and most effective ways to decrease inflammation is to change the diet. Some foods like dairy are inherently inflammatory, and so should be avoided entirely while trying to decrease inflammation. Other foods that could be avoided are the most common allergens including wheat, soy, peanuts, and eggs. I always like to do food sensitivity testing as well because sometimes perfectly healthy foods are the issue.

Another simple way to decrease inflammation is to support the immune system. Some viral infections can linger a long time and this low level infection can also drain the immune system. Warts and cold sores are viral in nature and may be a sign that your immune system is not functioning at its best. Other signs include getting sick easily, post nasal drip, and fatigue. Help your immune system work its best by getting adequate sleep, eating a diet rich in zinc and magnesium, and consider using some immune support herbs like lemon balm and echinacea. 

One interesting note is that the brain and inflammation is a two-way street. An emotional disturbance like heartbreak creates an inflammatory state in the body. In fact, broken heart syndrome is heart disease that starts immediately after an emotional trauma. Counselling, which helps with these emotional traumas, may work to decrease inflammation in the body.

These and other tactics to decrease inflammation in the body may improve depression. There are many other natural things that are specific for depression without necessarily addressing inflammation like inositol, magnesium, St. John’s wort, omega 3 fatty acids. Whether you choose these or pharmaceuticals to address depression, I think you are far more likely to have success if you address inflammation concurrently. 

Detoxification

The focus of this article is to explain “detoxification”. This is such a buzzword and the issue is that everyone has a different definition of what it means to detox. Some people say detox and they just mean that they aren’t drinking alcohol for a month. Other people say detox and they mean they are only drinking smoothies for a week. And to some people detox means they buy a kit with some supplements that give them diarrhea. We are going to be using the medical (and therefore most correct) definition of “detoxification”.

 In order to understand detoxification, we first have to understand the “toxification” part of that. Think about all the chemicals you consumed today. Did you use chapstick, toothpaste, a cough drop, lipstick, anything that touches your mouth? Check the label and see if there are any chemicals. I guarantee if you used lipstick today then you ate that lipstick today as well.

 Did you put anything on your skin? Any lotion or deodorant? Perfume? What about your clothes? What did you wash them in? Do they smell like fabric softener? Scents can transfer to your skin and you can also inhale them. 

We all think about the obvious chemicals like cleaning products or industrial chemicals, but it’s the every day exposures for most of us that are the issue. But it’s not just chemicals we need to detoxify. It’s also any drugs we take, essential oils, and our own hormones, to name a few. Essentially anything our body wants to get rid of we have to detoxify it.

 Detoxification is the process by which our liver, and to a lesser extent our kidneys, process all of this “stuff” for removal from the body. This stuff includes endogenous and exogenous chemicals, everything from our own hormones to any medicines or drugs we take, the pesticides we eat, and anything we absorb through our skin. 

The way we detoxify is through the liver. Our liver takes the toxins out of the blood stream and packages them up for removal via the bile. This bile is secreted into our intestines and becomes part of our stool. Minor routes of elimination include being processed by the kidneys and excreted via urine, sweating, and exhalation. So this means we have a limited rate at which we can get rid of stuff from our body.

Imaging a bucket with a hole in the bottom. If you put water in the bucket, it will drain out slowly until the bucket is empty. That’s just like our body. If we get a big exposure, our body will clear this exposure steadily until we are back to normal. However, an issue arises when the bucket fills up faster than it can drain. Water starts to flow over the sides of the bucket. This is just like when our body cannot clear stuff from the blood stream fast enough, then we “flow over” and begin to have symptoms.

 The obvious solution here is to make a bigger hole in the bottom of the bucket, or to stop putting so much water into the bucket. The same translates to us: either get better at detoxifying or stop the exposures.

Most of us realize that we should clean up our environment: stop wearing perfume (it’s a neurotoxin anyways), use natural cleaning products and natural body care. Don’t use air fresheners; they’re toxic. This is the easier part of the detoxification equation.

But how do you improve your body’s detoxification rate? Now that takes some science.  Your liver has two steps to packaging up waste products for removal, aptly named phase one and phase two detoxification. Each phase needs certain ingredients to work. So you can start by making sure these things are replete.

There are herbs that are good for the liver and will provide these ingredients as well as encourage the liver to work better. All brassica vegetables, onions, garlic, dandelion, burdock, milk thistle, and nettles are all great liver support.

 Some people are really slow at phase two detoxification. These people tend to be the sensitive ones that get a headache from strong smells or that react to everything or that need only half the dose of a medication. There are certain herbs that will actually speed up their phase detoxification process. But you have to be careful because if you push this process too fast you’ll end up feeling worse. 

I did that to a patient once. I correctly identified that she needed to detox, but we went too fast and she felt terrible. Big black circles around her eyes, body aches, the whole 9 yards. So we stopped for a week to let her recover and then we started detoxing again at a fraction of the speed and she was able to tolerate this much better. Within a few months she was feeling markedly improved and was super stoked to have her energy back. I never made that mistake again.

 Now, let’s say we have the liver working great, but remember, stuff leaves the body through bile and the stool. These systems have to also be in good working order to detoxify the body. If you are constipated, you are not detoxifying well. In fact, if you have any digestive issues at all, you might not be detoxifying your body well because your microbiome, the bacteria that live in you, might be dysbiotic. Dysbiotic flora will sit and undo all that hard work your liver did to package stuff up, and then your intestines reabsorb whatever is not packaged and flagged for removal.

One last aspect that many people overlook is the bile. Bile needs to be in sufficient quantities for detoxification to be efficient. If your stool is not dark brown, you may not be secreting enough bile, which means you are not getting stuff out of your body, and likely not absorbing your fats very well either. Again you need to have the right ingredients to make bile, and there are also some herbs that help, like artichoke and chionanthus. 

So to recap, to clear toxins your bowels must be moving and you need to be secreting enough bile. Your liver must have all the proper ingredients to process stuff for removal and needs to be functioning at a reasonable speed. If any of these is not in place, the body won’t be detoxifying very well, and there will be a build up of toxins eventually leading to symptoms.

When I say someone needs to detoxify, I mean that they need to get stuff out of their body better. We evaluate this entire process trying to determine where the weak link is and address the issue accordingly. Additionally, I recommend everyone do a proper detox once or twice a year. This is a period of time where you place extra emphasis on optimizing this process to make sure your toxic burden doesn’t build up to the point where you are suffering from it.

Why You Can't Sleep and What to Do About It

Sleep is so incredibly important. One patient I had was an 18 year old young man, and he didn’t sleep. He would be awake for 24+ hours at a time until eventually he got so exhausted he would collapse. When he finally did sleep, it was irregular in timing and duration. It was impossible for him to stay enrolled in school, and he couldn’t keep anything more than a part time job.

Now this is an extreme example of what poor sleep can do to your life, but even lesser sleep disturbances can have a huge impact on your life. Insufficient sleep impairs memory, attention, and decision making, essentially turns you into a stupid version of yourself. It also makes you more likely to make poor food choices, slows down metabolism, and can even lead to a buildup of beta-amyloid plaque, the same plaque you see in alzheimer’s disease.

Normal sleep patterns are defined as falling asleep within 30 minutes of getting into bed and being able to sleep through the night without waking. The normal adult needs around 8 hours of sleep, give or take an hour. A normal adult should wake every morning feeling rested and ready to start the day, and should not need a nap. If you fall asleep while driving, in meetings, watching TV, or in church on Sunday, or if your fatigue is preventing you from doing things you would like to do, then you likely aren’t getting enough sleep.

The first step in correcting any sleep issue is making sure you actually allot enough time for sleep. So if you wake up at 6am every morning, you need to be sleeping by 10pm, not just in bed, but sleeping. So you need to aim to be in bed by 9:30, especially if it takes you a minute to fall asleep. 

Ok, so you’re laying in bed, but sleep just isn’t happening. Now what? Obviously you need to avoid anything that revs you up at least an hour before bed. This includes anything that emits blue light (think screens), mental work, and even exciting novels. Some people can play on their phone while watching an action movie and fall asleep the minute their head hits the pillow, but a lot of us are more sensitive than that.

Now that you’ve removed all the stimulatory things from your bedtime routine, pay attention to what it feels like in your body while you’re laying in bed (trying to sleep). Is you mind racing with the problems from the day or tomorrow’s to-do list? Does your back ache and keep you from getting comfortable? Is your partner or dog snoring? 

If you find that your mind races in bed, then surprise: stress is keeping you from sleeping. The best way to beat stress is to quit your job and find a permanent residence on a warm beach somewhere. If you can’t do that, try a cup of calming tea. Look for a blend that has valerian in it. This herb is specific for that overworked mind that won’t calm down, and has been seen in research to decrease the amount of time it takes to fall asleep. Lavender, passionflower, chamomile, and oats are all lovely herbs for sleep as well.

Hate tea? Try deep breathing instead. There are tons of apps for deep breathing, but you’re not supposed to be on your phone because of the blue light and all that, remember? Try 4 square breathing instead. Breath in for 4 seconds, hold for 4 seconds, exhale for 4 seconds, and rest for 4 seconds. Repeat until you fall asleep.

Waking in the middle of the night is a sign that your cortisol is not balanced. Cortisol should spike in the morning to get you out of bed, and then decrease gradually through the day. Chronic stress wears this pattern down, until it becomes a flatline. Without the change in cortisol, the body starts to lose its circadian rhythm, which is what had happened to the patient in the story above. While calm teas and deep breathing before bed may help, often I see type of sleep issue respond the best to adrenal support in the morning and then a cortisol dampening blend in the evening to help restore a healthy cortisol pattern.

What about that patient I mentioned who didn’t sleep? Well, it took several months, but we were able to shift his body back to a healthy sleep schedule and he enrolled in college later that year!

What is the Microbiome

Did you know you are a minority in your own body? You have more visitors in your body than you have of your own cells, up to 3 times more. These visitors include bacteria, eukaryotes, viruses, fungi, and even archaea and are collectively referred to as a “microbiome”. In exchange for a warm home and food, the microbiome makes vitamin K, helps break down food, modulates our immune system and supports a healthy mood. So obviously the microbiome is super important for health. Disturbances to the microbiome are implicated in many health conditions:

• Heart disease

• Irritable bowel syndrome

• Inflammatory bowel disease

• Depression

• Anxiety

• Asthma

• Acne

• Eczema

• Obesity

• Type 2 diabetes

• Psoriasis

• Rheumatoid arthritis

This is by no means an exhaustive list. How the microbiome can impact such disparate aspects of the body is not completely understood, but we have a pretty good grasp of several mechanisms: immune modulation, neurotransmitter creation and degradation, and synthesis of nutrients.

Whenever I have a patient with an autoimmune disease, one of the first things we do is a stool test to evaluate her microbiome. Why? Well, somewhere around 80% of our immune system resides in the gut-associated lymphoid tissue (GALT), which is a fancy way of saying the immune system’s home base is in the gut. So because the immune system is the issue, we have to go to the source, therefore we look at the gut.

The immune system’s job is to recognize stuff that isn’t part of you, and to attack and destroy anything it finds and identifies as ‘not you”. If you want to calm down the immune system, as in the case of autoimmune disease, you need to identify what is revving the immune system up. For instance, in rheumatoid arthritis, oral bacteria such as Porphyromonas gingivalis (P. gingivalis), Proteus mirabilis (P. mirabilis), and others like Epstein–Barr virus (EBV) and mycoplasma have all been implicated as causal agents. If you want to get to the root cause of rheumatoid arthritis, you look at the microbiome, and so it goes for any autoimmune condition.

The immune system is constantly surveilling the intestines, sorting through what is food, what is friend and what is foe. When the microbiome is imbalanced and you have bad bacteria, the immune system reacts (as it should), but there is often collateral damage. Much like the stuffy nose you get with a cold, the symptoms are from our own immune system, and not so much the invader. If you’re interested in reading more on this topic, here is a great journal article: http://jem.rupress.org/content/216/1/20 

The next big job of the microbiome is to create and degrade neurotransmitters like serotonin and histamine. There are actually lots of serotonin receptors in the GI tract, and it plays an important role in GI motility (pooping daily). But these neurotransmitters also travel up the vagus nerve and can impact brain health, hunger and satiety, and even stress levels. Here’s a cool research article on this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5859128/ So whenever I have a patient with any sort of seemingly brain issue, I always ask about digestion.

Lastly, the microbiome impacts our nutritional status. We’ve known for a long time that many B vitamins and vitamin K are made by bacteria. But bacteria are also vital for the proper breakdown of carbohydrates. Bacteria make short chain fatty acids (SCFA) from these carbohydrates, which serve as the main fuel source for colon cells. SCFA’s also prevent heart disease, and should there be a cardiac events, it is less damaging. Bacteria also create amino acids like threonine and lysine, which is important for the immune system. So if you don’t have a healthy microbiome, it doesn’t matter how great your diet is, you will still be missing out on key nutrients.

I’m certain we will discover more ways that the microbiome impacts our health, but even with just the three we talked about, there is still a massive impact on our health. One of the best ways to promote a healthy microbiome is to feed them the proper food. Bacteria love fiber, so a diet high in fiber promotes good bacteria. You can also help reinocculate your gut with good bacteria by eating foods with live cultures, playing in the dirt, and having pets!

Sometimes these easy changes are enough to make a big impact on health, but sometimes the microbiome is so disrupted that we need to do a stool analysis to see what is throwing the microbiome off. It could be anything from yeast to pathogenic bacteria to low digestive enzymes. Once you know what the problem is, it is relatively easy to restore the microbiome to a healthy status, which in turn supports your whole body.