What is IBD?

Inflammatory Bowel Disease (IBD) is a general term used for a number of similar conditions that affect the gastrointestinal tract, including ulcerative colitis (UC) and Crohn’s disease. In IBD, recurrent inflammation of sections of the gastrointestinal tract leads to tissue damage and the development of painful lesions.  IBD is believed to be a consequence of your body’s inappropriate inflammatory response to intestinal microbes (bacteria and other species that colonise the gastrointestinal tract) when an individual is genetically susceptible.  All layers of the intestine can be inflamed.

In Crohn’s disease the ileum which is the final section of the small intestine, and the colon (large intestine) are typically involved however it can involve any part of the gastrointestinal tract. Ulcerative colitis, on the other hand, involves the colon only. Signs and symptoms of IBD especially in a flare include diarrhoea and urgency, bleeding, weight loss, low appetite, nausea, vomiting, abdominal pain, and even fever. Ulcerative colitis can sometimes also present with constipation.

Other health outcomes related to IBD

Complications and conditions that may arise as a consequence of having IBD may include:

• Joint stiffness and eye inflammation
• Kidney and gallstones
• Fatty Liver
• Osteoporosis
• IBS: even in remission, IBD sufferers can experience IBS (Irritable Bowel Symptoms) as part of daily life such as constipation, diarrhoea, bloating, abdominal pain or discomfort and excess flatulence.
• Small intestinal Bacterial Overgrowth (SIBO) and malabsorption issues of lactose and fructose specifically in Crohn’s Disease
• Nutrient deficiencies: magnesium, iron, zinc, B Vitamins, Calcium and more

Risk Factors of IBD

An interesting fact is that the incidence of this autoimmune disease is rare in developing countries meaning that our western diet and lifestyle has an obvious connection with IBD.

Although it’s not clear exactly why IBD develops in some people, there are several factors that are associated with an increased risk of developing IBD:

• Family history: family history of the disease, especially if someone in their immediate family has IBD, so genetics definitely plays a role.  In Crohn’s disease as an example first degree relatives have a 12- 15 times greater risk of developing this condition.
• Antibiotic use: including exposure in early childhood and recent use.  This leads to Dysbiosis: People with IBD often have far less diversity in the types of microbes found in their guts. This can affect immune function and increase inflammation.
• Birth by caesarean
• Low levels of mucin: Mucin is the mucous substance secreted by cells in the gastrointestinal tract that helps protect your gut lining from bacteria, food particles, and toxins. In IBD, inflammation and antibodies from a dysregulated immune system destroys the mucin, leaving your gut lining susceptible to damage.
• Past gastrointestinal Infection: It’s believed infection (especially when hospitalized) can trigger the onset of IBD.
• Low Vitamin D levels: most likely due to important role in immune health
• Smoking: cigarette smoking increases the risk of developing IBD, particularly Crohn’s disease.
• Appendectomy: Having your appendix removed also increases your risk of developing IBD
• Stress, Anxiety: exacerbates the risk of relapse and flares
• NSAID use (Nonsteroidal anti-inflammatory drugs): increases the risk of relapse flares

Dietary Risk Factors in IBD

• A diet that is high in refined sugar, animal meat & fats, dairy products & high total protein intake
• Low intake of raw fruit and vegetables, wholegrains, and fish
• Low consumption of fibre rich foods
• Formula feeding in early childhood

Naturopathic treatment approaches aim to address the underlying causes of the condition. Whilst some of the above causes (such as family history) can’t be addressed, the strategies in this blog look at addressing some of the other causes, such as diet, restoring healthy gut bacteria species, balancing immune dysregulation, and chronic inflammation, to help you manage your symptoms and improve your daily wellbeing.

Tests that may be required

You are most likely to have been diagnosed by a gastroenterologist via a range of tests that include stool tests to rule out infection as the cause of your symptoms, a colonoscopy, endoscopy, Barium x-ray of your bowel, and CT scans.

As a naturopath, I may also recommend an assessment of the following however it is unique to each individual:

• faecal calprotectin and other inflammatory markers
• Blood tests to assess nutrient absorption issues
• Assessment of bacterial overgrowth

Naturopathic Treatment Objectives

The main focus is on healing the lining of the intestinal tract to reduce disease flares and remission.

Dietary Interventions

This may be done in phases depending on whether you have been diagnosed with bowel motility issues, bacterial overgrowth, or obvious malabsorption issues.

I have specific dietary recommendation for IBD sufferers once I have important information however at some stage in my client’s treatment, suggestions may include the following but will be unique to each individual:

Eliminate or reduce alcohol: it is unknown if alcohol plays a role in triggering disease flares however it is related to worsening pain in some patients.

Lactose free & low Fructose diet: this may be required especially in Crohn’s Disease due to malabsorption of lactose and fructose in some sufferers.  Symptoms of ongoing IBS can be improved.

Low FODMAP diet: may be recommended: depending on bacterial overgrowth status and bowel motility for a period of time.

Increase your intake of fibre and certain prebiotic foods

It is important not to self-prescribe with prebiotic supplements as gas produced may worsen symptoms.

Increase your intake of antioxidants

Antioxidants are important compounds that help to fight oxidative stress in the body. Oxidative stress is a major contributor of chronic inflammation and tissue damage and can trigger immune activation, too. Antioxidants in foods are particularly abundant in fresh fruits, vegetables, herbs, and spices. Fruits and vegetables are also incredibly important sources of vitamins and minerals which are needed for cellular repair and healthy immune function, including vitamins such as A, C, and E, and minerals such as zinc and selenium, which also act as antioxidants in the body.

• Choose fruits and vegetables in a variety of colours each day to maximise the different types of antioxidants you are consuming – many of the antioxidants in fruits and vegetables are what gives the food its pigment.
  • Red fruits and vegetables – contain compounds such as lycopene and anthocyanins: Tomatoes, capsicum, strawberries, cherries, beetroot, radish, chillis, radicchio, rhubarb, raspberries, cranberries, raspberriesOrange fruits and vegetables contain compounds such as beta-carotene: Oranges, capsicum, pumpkin, apricots, carrots, papaya, persimmons, mangoes, sweet potatoesYellow and light green fruits and vegetables contain compounds such as carotenoids: Capsicum, kiwi fruit, corn, pineapple, lemons, cabbage, celery, limes, pears, avocado, fennel, onion, lettuceDark green fruits and leafy vegetables contain compounds such as lutein chlorophyll and zeaxanthin: Broccoli, Brussels sprouts, kale, Pak choy, spinach, silver beet, asparagus, green beans, peas, leeks, artichokes
  • Purple fruits and vegetables contain compounds such as anthocyanins and phenols: Cabbage, grapes, eggplant, onions, plums, blueberries, blackberries
• Use fresh herbs and spices to flavour your cooked foods, or even mix into salads.

Ensure Adequate Protein

Protein is vital for tissue repair and healing however excess animal protein and fats can be detrimental.  For this reason, it is important to carefully develop a diet that has adequate proteins from a range of sources.  Here is a wonderful blog about plant-based protein options.

Reduce Consumption of Inflammatory Foods

As IBD is an inflammatory condition, it’s important to reduce foods that can trigger or worsen inflammation. The foods listed below should be reduced or eliminated from your diet, as they can increase inflammation.

• High sugar foods: sugar, maple syrup, rice malt syrup, cakes, pastries, cookies, chocolate, lollies. Be wary of processed “healthy” treats such as protein balls, protein bars, muesli, and the like. Many of them still contain very high amounts of sugar.
• Trans fatty acids: found in frozen chips, frozen pizza, pastries, fried foods
• Highly refined carbohydrates: white bread, white rice. Instead, choose whole grain and sourdough varieties (proper sourdough, not the type in plastic in the supermarket)
  • NOTE: If you only tolerate white bread and rice, this is okay, but be conscious not to over consume, and choose lower GI, good quality sources). Alternatively, swap some portions of these foods for other carbohydrate sources, such as potato, sweet potato, pumpkin, carrot, and other root vegetables, or even grains such as oats of quinoa.
• Food intolerances: if you have an intolerance to a particular food, it needs to be eliminated completely from your diet. Be sure to read food labels carefully to prevent accidental exposure.

Ensure Adequate Hydration

Adequate hydration is essential, especially when you are experiencing diarrhoea. Without sufficient water, our cells can’t be plump and healthy and aren’t able to function as they need to.

• If you are struggling to motivate yourself to drink enough water, try adding some flavour with sliced lemon or fresh mint leaves. You can even make your own cold brew iced tea by adding a couple of teaspoons of loose herbal tea into a bottle of water and leaving in the fridge overnight. Try making this with nettle leaf tea, which is an excellent source of vitamins and minerals.
• If you are experiencing diarrhoea, you can also try drinking coconut water, which will help you to replace some of your electrolytes as well as rehydrating you. This is a particularly good option if you are not able to eat sufficient food.

Increase your consumption of omega 3 fatty acids

Omega 3 fatty acids are a powerhouse nutrient for reducing inflammation and for helping build healthy cell walls.

• Fish: choose wild caught salmon or tuna, or sardines. Whilst eating the whole food is best, if you are unable to eat fish, you can use a supplement. Keep in mind that many fish oil supplements on the market are of poor quality and may not be providing you with benefit. Fish oil supplements should not smell rancid! It is best to use the fish oil prescribed to you, to ensure you are getting the most out of taking it.
• Vegan options: Omega 3 fatty acids are found in hemp seeds, walnuts, sunflower seeds, chia seeds, and ground flax seeds, and edamame. Vegan omega 3 supplements are also available and are usually algae-based.

During Acute Symptoms

During an acute attack of symptoms, you may need to eat a very simple diet of easily digestible foods – think well cooked stews and soft vegetables with chicken or fish. Some people may require the Low FODMAP diet during acute disease flares depending on their unique disease state.

Lifestyle Interventions

I spend considerable time supporting my clients in this area however some common interventions include

Reduce stress

Stress can worsen inflammation and has been shown to worsen symptoms in IBD. Address causes of stress in your life and seek ways to minimise the stress you deal with on a daily basis – delegate tasks where necessary and prioritise!

• If you don’t already have a regular counsellor or psychologist, look into finding one. Having someone to talk to about the stresses in your life can help you to work through issues and find positive, constructive ways to work through them.  I have some excellent mental health practitioners in my clinic (link here Courtney)
• Daily meditation and yoga have both been found to be effective methods for reducing stress. Sign up for a local yoga or meditation class or try out “Yoga with Adrienne” on YouTube, and the “Insight Timer” app available through your device’s app store.
• Self-care with a relaxing massage, weekends away, a walk in nature will all support the impacts that stress and emotions have on IBD.

Make time for rest each day

Whilst exercise and physical activity is important, rest is equally so, especially during acute flares. Your body is working hard to heal and needs the time and space to concentrate on doing so! Avoid excessive caffeine consumption and ensure no caffeine is consumed after 12pm. Caffeine has a long half-life of 12 hours, so shouldn’t be consumed too late in the day as this will affect your ability to unwind and sleep.

Make sleep a priority

Sleep is so important for reducing day-time anxiety and stress, but it also supports a healthy and balanced immune system.  If you are not sleeping well, you will be provided with additional naturopathic support on how to improve it and you may be prescribed some herbs to help you.  My previous blog article on sleep gives important tips on why sleep is so important.

Herbs and Supplements

Supplements will only be prescribed based on symptoms and blood test results and may include Vitamin D, Zinc, iron.

Prebiotics: specific prebiotic fibres depending on whether you have Ulcerative Colitis or Crohn’s disease may be prescribed to improve your gut microflora and balance your stools.

Specific strains of Probiotics: broad spectrum probiotics are rarely prescribed especially in a bacterial overgrowth.  Specific strains that perform unique functions are better indicated.

Anti-inflammatory herbs: may include bioavailable turmeric, Boswellia, Wormwood in acute and maintenance dosing.

Omega 3 oils: depending on fish consumption in diet

Whether you suffer from Ulcerative colitis or Crohn’s disease, many treatment strategies are similar however there are significant differences especially if Crohn’s is in the Ileum as opposed to the colon.

For support on managing this chronic condition and to reduce flares and quality of life, please book an initial naturopathic consultation with me or book a fact-finding call.  My passion as a naturopath for digestive issues has meant significant study and research combined with specialist mentoring.  My email address is tanya@performanceinhealth.com.au or call the clinic on (02) 8004 5521.

References

Hechtmann, L. (2014). Clinical Naturopathic Medicine. Chatswood: Elsevier Australia.

The post Living with & managing your Inflammatory Bowel Disease (IBD) appeared first on Performance in Health.

Many people turn to a thyroid naturopath for a deeper, root-cause investigation.  A naturopathic specialising in thyroid health understands that hypothyroidism is a systemic issue, and genuine balance comes from identifying and addressing the underlying triggers of the disease.

The thyroid is a small, butterfly-shaped gland that sits at the front of the neck, under the voice box. The thyroid plays a vital role in many important body functions, including metabolism, growth, and development, and even bone density. It does this by producing important hormones known as thyroid hormones, which it releases in response to signals from the brain, in order to speed up or slow down processes such as metabolism, to help keep the body in balance. Hypothyroidism is a condition whereby the thyroid is underactive and isn’t producing enough thyroid hormones to maintain health. There are two main categories of hypothyroidism that can be seen in a naturopathic clinic:

1. Overt Hypothyroidism

Overt hypothyroidism, often due to the autoimmune condition Hashimoto’s thyroiditis. Overt hypothyroidism is readily diagnosed via blood tests.

2. Subclinical Hypothyroidism

This is another common presentation, especially for a thyroid naturopath. Your blood test results may be within “normal” ranges (but not necessarily within the optimal ranges that a naturopath looks at), but you still have functional signs and symptoms that indicate your thyroid gland is not working as it should be.

The Thyroid Hormones

There are 5 important hormones associated with normal thyroid function. These hormones work in a feedback loop – low levels of one hormone will trigger a response in the body to upregulate its production, and vice versa.

TSH – Thyroid Stimulating Hormone

This hormone is produced in the hypothalamus, a part of the brain. TSH is secreted by the brain when it detects low levels of thyroid hormones, sending a signal to the thyroid that it needs to increase production.

T4 – Thyroxine

T4 is the precursor to active thyroid hormone. It is made by the thyroid using nutrients such as the mineral iodine and the amino acid tyrosine.

T3 – Triiodothyronine

T3 is the active form of thyroid hormone. T4 is converted into T3 by enzymes that rely on nutrients such as zinc and selenium in order to function properly. Some of the important functions of T3 include:

• Rate of metabolism and oxygen use in the body
• Cardiac function and resting heart rate
• Sympathetic nervous system regulation (“fight or flight” mode)
• Bone mineral density
• Muscle, bone, and brain development in children

rT3 – reverse T3

This is a type of inactive T3 hormone that is sometimes mistakenly produced by the body when cortisol levels are too high (such as during periods of stress). See below for more information on rT3.

Symptoms of Low Thyroid Hormones

Due to the broad effects that thyroid hormones have in the body, a thyroid naturopath will look out for common symptoms which are many and varied and can include:

• Fatigue, brain fog, mental slowness, poor memory
• Weight gain
• Cool, dry skin, sensitive to cold temperature
• Hair loss, including eyebrows and body hair
• Constipation, gastrointestinal dysfunction, food intolerances
• Depression, low libido
• Puffiness around the face
• A “hoarse” sounding voice
• Carpal tunnel syndrome, joint and muscle pain, muscle cramps and weakness
• Menstrual irregularities, infertility, miscarriages
• High cholesterol
• Blood sugar imbalances and insulin resistance

Types and Causes of Hypothyroidism

There are a number of different causes of hypothyroidism. In Australia, most hypothyroidism is due to the autoimmune disease Hashimoto’s thyroiditis, however there are other causes, too that a thyroid naturopath will review.

• Hashimoto’s Thyroiditis: the most common cause of hypothyroidism in Australia. This is an autoimmune condition where the immune system mistakenly creates antibodies to attack the thyroid cells, causing irreparable damage to the thyroid and significantly reducing its function. People with Hashimoto’s thyroiditis may have little or even no remaining thyroid function and must take synthetic thyroid hormones. It is one of the most common autoimmune conditions, affecting around 1 in 33 Australians.
• Iodine deficiency: Iodine is a crucial nutrient for making thyroid hormone. Iodine deficiency as a cause of hypothyroidism in Western countries like Australia was previously considered to be a rare issue, but it is becoming a growing concern again, with new studies showing a rise in mild-moderate iodine deficiency, particularly in children and pregnant women. This is a real concern, as iodine is vital for not only thyroid hormones, but also for cognitive development in children.
• Transient hypothyroidism: This is a type of hypothyroidism that can occur in postpartum women, due to a condition known as postpartum thyroiditis. In postpartum thyroiditis, immune cells attack the thyroid gland, causing inflammation. This causes a temporary rise in thyroid hormone production (hyperthyroidism), followed by a period of low thyroid function (hypothyroidism). It’s not fully understood why this issue occurs, but it is more common in those with a history of autoimmune disease such as type 1 diabetes. 75-85% of patients regain normal thyroid function, but for some, low thyroid function persists long term.

Diagnosis of Hypothyroid

Diagnosis of hypothyroidism by a GP and a thyroid naturopath is through a blood test called a thyroid panel. A thyroid panel assesses the blood levels of several different thyroid hormones, including:

• TSH: In hypothyroidism, this hormone will be high. Often a routine test through your GP will only assess for TSH first, before assessing for other hormones.
• Free T4
• T3: because T3 is the active form of thyroid hormone, it is low levels of T3 that will cause symptoms of hypothyroidism.
• Reverse T3 – rT3 is an inactive form of T3. RT3 is not usually a part of a standard thyroid panel but can be tested for separately if indicated.

General practitioners will commonly prescribe L-thyroxine medication where indicated, which can be taken in conjunction with dietary and lifestyle changes.

A thyroid naturopath’s interpretation of thyroid blood tests is slightly different to the standard medical approach. This is because a naturopath is looking to see whether or not you fit within the optimal range for thyroid function, rather than fitting within the broader “normal” range. Looking at the optimal range means subclinical and mild hypothyroidism is more likely to be identified and treatment strategies used to help intervene earlier, before more serious disease develops. Naturopaths also look at a marker called “reverse T3” (rT3). This is a non-active form of T3. Your body might start producing more rT3 instead of T3 if cortisol levels are too high, such as due to chronic stress. Reverse T3 still binds to thyroid receptors in the body and still sends feedback to the brain that there is plenty of thyroid hormone circulating, but it doesn’t cause a response the way T3 does. If your TSH levels are normal but you have symptoms of hypothyroidism, it is possible you may have high rT3.

Understanding of Thyroid Function by a Thyroid Naturopath

Hypothyroidism and Gut Health

Healthy digestive function is important in the production of active thyroid hormone. Low thyroid hormone levels means gastrointestinal function slows down. This can lead to:

• Slow transit time and constipation
• SIBO and changes to the microbiome
• Inflammation and “leaky gut”

Thyroid and Liver

Thyroid hormones can impact normal liver function, leading to abnormalities in certain liver enzyme levels. Both subclinical and overt hypothyroidism places you at higher risk of non-alcoholic fatty liver disease. This is why a naturopath will also look at your overall liver health and may include treatments to help support your liver if necessary.

Thyroid Function and Chronic Stress

when you experience high levels of stress, the body inhibits the production of active thyroid hormone and symptoms can worsen.  Stress management can play a big part in helping to relieve some of the symptoms of hypothyroidism.

Treatment Strategies for Hypothyroidism

Dietary Strategies

Reduce Your Intake of Goitrogenic Foods

Certain foods are classified as being “goitrogenic” foods. These are foods that inhibit the production of thyroid hormone in the body. Vegetables from the Brassica family are particularly goitrogenic. This includes broccoli, cauliflower, Brussels sprouts, kale, and cabbage. Soy and turnips also act as goitrogens. The thyroid-inhibiting effect of these foods is most profound when they are consumed raw. Limit your consumption and when you do eat them, always cook them first.

Reduce or Eliminate Gluten

Gluten causes inflammation in the gastrointestinal tract and alters immune response in some people, reducing thyroid function. Gluten-containing foods include wheat, flour, rye, oats, and barley. Replace these grains with buckwheat, millet, quinoa, or rice.

Identify and Eliminate Food Intolerances

Intolerances to foods such as gluten, dairy, soy, corn, and more may contribute to hypothyroidism, because of the damage they cause to the gut lining. This gut damage can lead to “leaky gut”, which as discussed above, is closely linked to hypothyroidism. If food intolerances are suspected, a diet diary may be prescribed.

Reduce Excess Caffeine and Alcohol

Both caffeine and alcohol compromise liver and gastrointestinal function and production of active thyroid hormone. Reduce your intake or eliminate entirely. If you do wish to consume caffeine, stick to one or two cups per day and consume before 2pm. If you do wish to consume alcohol, choose wheat-free alcohols such as wine. Red wine can be a good option as it is rich in antioxidants. Stick to no more than one standard drink per day.

Reduce Intake of Processed, Sugary Foods

Processed, sugary foods compromise liver and gastrointestinal function and reduce production of active thyroid hormone. Reducing your intake of these foods can make a big impact! Processed and sugary foods to watch out for include:

• Pastries, cakes, cupcakes, cookies and other sugary baked foods
• Sweets, lollies, chocolate, biscuits
• Chips and processed snack foods
• Sugary yoghurts, ice creams, and other sweet dairy foods
• Soft drinks and other sugar-sweetened beverages

Eat Plenty of organically-grown fruit and vegetables

Fruits and vegetables contain high amounts of vitamins, minerals, antioxidants and polyphenols that can help to reduce inflammation in the thyroid and gut. Fibre can also help to heal gut damage by feeding your beneficial gut bacteria. Follow the below guide for boosting your intake and choosing a wide variety of fruits and vegetables:

• One serve of vegetables = ½ cup cooked or 1 cup raw.
• One serve of fruit = one cup chopped or one whole piece.
  
  • Choose fruits and vegetables in a variety of colours each day to maximise the different types of micronutrients and antioxidants you are consuming – many of the antioxidants in fruits and vegetables are what gives the food its pigment.
  • Red fruits and vegetables – contain compounds such as lycopene and anthocyanins
  • Tomatoes, capsicum, strawberries, cherries, beetroot, radish, chillies, radicchio, rhubarb, raspberries, cranberries
  • Orange fruits and vegetables contain compounds such as beta-carotene
  • Oranges, capsicum, pumpkin, apricots, carrots, papaya, persimmons, mangoes, sweet potatoes
  • Yellow and light green fruits and vegetables contain compounds such as carotenoids
  • Capsicum, kiwi fruit, corn, pineapple, lemons, cabbage, celery, limes, pears, avocado, fennel, onion
  • Dark green fruits and vegetables contain compounds such as lutein and zeaxanthin
  • Broccoli, Brussels sprouts, kale, bok choy, spinach, silver beet, asparagus, green beans, peas, leeks, artichokes
  • Purple fruits and vegetables contain compounds such as anthocyanins and phenols
  • Cabbage, grapes, eggplant, onions, plums, blueberries, blackberries
    
• Prioritise non-starchy vegetables (i.e. choose tomato or capsicum over potato, sweet potato, or other root vegetables).
• Eat plenty of leafy greens, like spinach, bok choy, silver beet, and dark green lettuce varieties
• Remember to cook goitrogenic vegetables such as broccoli, kale and cauliflower before consuming.

Eat Plenty of Zinc-Rich Foods

Zinc is a powerhouse nutrient that is vital for healthy thyroid hormone production and balance. Many of us are low in zinc, and zinc deficiency can be a particular issue for anyone on a plant-based diet. Foods that are rich in Zinc include seafood (especially oysters), chicken, beef, liver, oatmeal, nuts (pine nuts, pecans), seeds (pumpkin, sunflower, flax, chia), and spinach.

Eat Plenty of Iodine-Rich Foods

Iodine is essential for thyroid hormone production, but low iodine intake is a problem in Australia, because our soils are low in this mineral. Foods that are higher in iodine include seafood, sea vegetables (nori, kelp, kombu), citrus fruits, and egg yolks. Vegans and vegetarians may need to consider supplementation.

Eat Plenty of Selenium-Rich Foods

Selenium is an important antioxidant and is needed for thyroid hormone production. Brazil nuts are naturally rich in selenium when grown in nutritious soil– just one Brazil nut can contain up to 100% of your daily selenium requirements!

Eat Plenty of Omega-3 rich foods

Omega-3 fatty acids are important for reducing inflammation. Foods rich in omega-3 fatty acids include fish, hemp seeds, walnuts, chia seeds, and flax seeds. This is another nutrient that vegans and vegetarians in particular may need to supplement. Vegan algal oil supplements are a great option.

Lifestyle Strategies

Stress Management

The effect of stress on thyroid function is complex, however altered adrenal function and cortisol levels negatively impact the production of thyroid hormones and it is important to reduce stress if possible. Try the following to help with stress management:

• Mindfulness meditation – even 10 minutes per day of mindfulness meditation can help reduce feelings of stress. Many meditation studios offer online classes, or you can use an app such as “insight timer” for access to thousands of guided meditations for free.
• Yoga or tai chi – as with meditation, these are both wonderful for helping to release stress. There are many apps available online, or you can try YouTube for free videos as well – “Yoga with Adrienne” is a popular YouTube channel with dozens of free videos to try.
• 7-9 hours of sleep each night: prioritising your rest is essential for healthy stress levels. Make your sleep a priority!
• Counselling or psychology – if you don’t already have a regular counsellor or psychologist, it is worthwhile pursuing this. Having someone you can speak to about stressors in your life can make a huge impact on both your physical and mental wellbeing.

Enjoy Daily Gentle to Moderate Exercise

Excess exercise at high intensity may negatively affect thyroid function and cortisol response, especially in early treatment. Choose gentle to moderate-level daily exercises that you enjoy. About 30 minutes per day is a great start. Types of exercise might include walking, hiking in nature, swimming, light aerobics, team sports, yoga, pilates, and more.

Herbal Medicines and Supplements

Herbal medicines prescribed by a thyroid naturopath can be a really useful tool, particularly for mild or subclinical hypothyroidism, and are often prescribed as part of your naturopathic treatment plan to support symptoms, immune and thyroid.   

The right supplements for you will depend on the underlying cause of your hypothyroidism as each person is unique, but might include supplements to:

• Boost thyroid hormone production
• Improve immune function
• Help with stress support
• Help with liver function
• Support gastrointestinal function

Book an appointment with a Thyroid Naturopath in Sydney or Leura

As the naturopath and Founder of Performance in Health Wellbeing Clinic, I have Hashimoto’s and understand symptoms of low thyroid and this health condition very well from personal experience.

If you feel that a thorough naturopathic consultation by a thyroid naturopath might be useful for how you are feeling or your particular health condition, please reach out and email me on tanya@performanceinhealth.com.au or book an initial consultation via our contact page.

References

BioMedica Nutraceuticals. (2018). Herbal and nutritional support for health thyroid function: A focus on subclinical hypothyroidism and autoimmune disease.

Chakera, A. J., Pearce, S. H. S., & Vaidya, B. (2012). Treatment for primary hypothyroidism: Current approaches and future possibilities. Drug Design, Development and Therapy, 6, 1–11.

Endocrine Society of Australia. (2019). Hypothyroidism. Hormones Australia. https://www.hormones-australia.org.au/endocrine-diseases/hypothyroidism/

He, W., An, X., Li, L., Shao, X., Li, Q., Yao, Q., & Zhang, J. (2017). Relationship between hypothyroidism and non-alcoholic fatty liver disease: A systematic review and meta-analysis. Frontiers in Endocrinology.

Hechtman, L. (2012). Clinical naturopathic medicine. Elsevier Australia.

Thomas, C. (2018). The naturopath’s guide to hypothyroidism. Herbal Extract Company.

The post The Thyroid Naturopath’s Comprehensive Guide: Addressing the Root Causes of Hypothyroidism and Hormone Imbalance appeared first on Performance in Health.

Endometriosis is a complex, painful female reproductive condition that affects around 1 in 9 women worldwide. So, there is a high chance someone in your friendship circle suffers from it.

We understand that in a normal cycle our tissues respond to hormones and prepares the uterus for pregnancy. When pregnancy does not occur, the lining breaks down, sheds, and creates a menstrual bleed.

For someone with endometriosis, tissue will implant in areas outside of the uterus, usually on pelvic organs such as the ovaries, bladder and bowels, or on other pelvic tissues. These cells grow and form deposits or lesions of tissue. Although not quite the same as endometrial tissue, this tissue reacts similarly to hormonal changes, growing and proliferating and then eventually breaking down, bleeding into the pelvic cavity. The blood and broken-down tissue are trapped inside the pelvic cavity, causing inflammation, irritation, and significant pain.

The condition can significantly impact a person’s life, and what’s worse, diagnosis is often delayed – it takes an average of 6.5 years for a person to receive this diagnosis. Identification of endometriosis is generally via laparoscopy, a type of keyhole surgery that is also used to remove endometriotic tissue.

Signs and Symptoms of Endometriosis

One of the most common key symptoms of endometriosis is period pain, which is often severe and can significantly impact quality of life. In addition to period pain, endometriosis sufferers may also experience:

• Heavy menstrual bleeding
• Bleeding between periods
• Rectal bleeding, or blood in the urine
• Fertility issues
• Pain during or after sex
• Lower back pain
• Painful bowel movements
• Because of the significant impact endometriosis can have on quality of life, it is also associated with increased depression and anxiety

What Causes Endometriosis?

Endometriosis is a complex condition and is not yet fully understood.

One of the most common theories for how these endometrial-like cells find their way into in the pelvic cavity is that of “retrograde menstruation”. This is where small fragments of menstrual blood flow up the fallopian tubes and into the pelvic cavity. It is thought that several different mechanisms, such as hormones, inflammation, genetics, and immune dysregulation, then play a role in these tissues attaching to areas of the pelvic cavity and becoming responsive to the hormonal changes of the menstrual cycle.

Factors that are associated with endometriosis include:

Hormonal Imbalances

Endometriosis is often called an “oestrogen-dependent condition”. Endometriotic lesions respond differently to hormones and can lead to increased production of oestrogen compared to progesterone, also known as “oestrogen dominance”. These higher than normal levels of oestrogen further increase the growth of the lesions in endometriosis and also increase inflammation and pain, and impact fertility.

Immune Activation

Increased levels of a number of different T cells (a type of immune cell) have been shown in endometriosis, suggesting immune dysregulation plays a role in endometriosis. These immune cell changes are associated with increased inflammation and higher than normal levels of inflammatory cytokines. Pre-existing immune dysregulation and autoimmune conditions may be a risk factor for endometriosis.

Leaky Gut and Dysbiosis

Changes to the microbes in our intestines, called dysbiosis, can lead to inflammation and “leaky gut”, where the lining of the intestine becomes less tightly sealed, allowing for harmful inflammatory proteins to enter circulation. Dysbiosis can also affect hormonal balance and immune system function. Studies have shown those with endometriosis to have significantly altered gut microbiome, and a 2020 study showed women with endometriosis have higher than normal intestinal permeability. These studies suggest the microbiome may play an important role in the development of endometriosis and may also be involved in the increased inflammation associated with the condition.

Oxidative Stress

Endometriosis is associated with increased oxidative stress, which may in part be due to intestinal dysbiosis and leaky gut, which increase inflammation and oxidative stress.

Genetics

Family history of endometriosis increases the risk of developing the condition, suggesting that genetics play a role.

How a Naturopath Treats Endometriosis in Sydney

The good news is that there are a range of different naturopathic treatments that can be used to help with endometriosis. The specific remedies your practitioner uses will depend on your overall health, your specific symptoms, as well as other conditions you may also have. As always, it is important to speak with your naturopath before using these treatments, to make sure they are right for you. In our Stanmore (Sydney) and Leura clinics, we focus on a multi-targeted approach.

Dietary Changes

Diet can play a big part in helping to reduce some of the symptoms of endometriosis, by helping to reduce some of the inflammation and oxidative stress.

Antioxidants

With increased oxidative stress associated with endometriosis, including antioxidant-rich foods in your diet is an important step in helping to reduce endometriosis symptoms. Include plenty of fresh fruits and vegetables in your diet and include foods of varying colours to help make sure you are eating a variety of different antioxidant compounds. Specific antioxidants, such as resveratrol (found in grapes and blueberries) and epigallocatechin (found in green tea), as well as vitamins such as vitamin C and vitamin E, can be particularly beneficial.

Anti-Inflammatory Foods

Similarly, focusing on increasing anti-inflammatory foods (and reducing foods that trigger inflammation), is important. Choose fresh fruits and vegetables, nuts and seeds, and quality sources of protein such as legumes, lean meats, and fish. Avoid foods and drinks such as alcohol, caffeine, excess sugar, and saturated or trans-fatty acids, which can all increase inflammation.

Fibre

Fibre is important for helping to maintain hormonal balance, as it binds excess oestrogen in the body so that it can be excreted. Fibre also provides fuel for healthy microbes in the gut, so can help to improve the gut microbiome. Increase fibre intake slowly, to avoid exacerbating symptoms of bloating, which can contribute to abdominal pain. Try adding psyllium husk or ground linseeds to your smoothies or sprinkled on top of Greek yoghurt. Eating fruits and vegetables with their skins on can also help boost your fibre intake (but be sure to thoroughly wash them first!).

Omega 3 Fatty Acids

Omega 3 fatty acids are important for reducing inflammation and inflammatory pain. Including omega 3 fatty acids in your diet can help to reduce the inflammation and pain associated with endometriosis. In fact, a recent double-blind pilot study found supplementation of omega 3 fatty acids for 8 weeks helped to reduce pain and improve quality of life in women with endometriosis. Choose fish such as salmon or sardines, as well as walnuts, chia seeds and flax seeds.

Vitamin D

Vitamin D is an important nutrient for immune regulation, and studies have shown that women with endometriosis have lower than normal levels of vitamin D. Sunlight exposure is the best way to boost your vitamin D levels – even 15 minutes per day can be beneficial. Vitamin D can also be found in free range eggs and oily fish such as salmon. If your vitamin D levels are very low, you may benefit from supplementation.

Probiotics

As discussed above, the gut microbiome may play a role in endometriosis, so helping to improve the microbial balance in the gut is important. Probiotics can also help to reduce bloating, which may exacerbate abdominal pain.

Iron

If you experience heavy bleeding because of endometriosis, you may be at risk of iron deficiency. Speak to your naturopath about whether an iron supplement may be right for you.

Herbal Medicines

In addition to dietary changes, there are also specific herbal medicines that can help with endometriosis.

Lady’s Mantle

Lady’s mantle is a herb with astringent qualities, that can be very useful in helping to reduce heavy menstrual bleeding.

Wild Yam

Wild yam is a herb used for its pain-relieving properties and is helpful for cramping pains such as menstrual pain.

Rehmannia

Rehmannia is a Chinese herb that has several important properties that make it useful in endometriosis. The herb is anti-inflammatory and also helps with immune regulation. Rehmannia is also useful for supporting liver function, so that the liver can detoxify and remove waste products, such as excess oestrogen.

Vitex

Vitex is a hormone-modulating herb. It can be used in endometriosis to help balance hormones and reduce elevated oestrogen levels.

What to Expect When Seeing a Sydney Endometriosis Naturopath

• Thorough assessment & pathology review
  A detailed review of your symptoms, cycle history, pain patterns, fertility goals and relevant blood tests to identify hormonal, inflammatory, immune and gut-related drivers.
• Personalised treatment strategy
  An individualised plan using targeted nutrition, lifestyle guidance and naturopathic support to help reduce inflammation, balance hormones and manage pain.
• Tailored herbal & nutritional prescriptions with follow-up care
  Practitioner-only herbal medicines and supplements, with ongoing appointments to refine treatment as your symptoms and cycle change.

Book an appointment at our Stanmore (Sydney Inner West) or Leura clinic, or access endometriosis naturopath support via Telehealth.

References

Abokrhais, I. M., Denison, F. C., Whitaker, L. H. R., Saunders, P. T. K., Doust, A., WIlliams, L. J., & Horne, A. W. (2019). A two-arm parallel double-blind randomised controlled pilot trial of the efficacy of omega-3 polyunsaturated fatty acids for the treatment of women with endometriosis-associated pain (PurFECT1). PLOS One, 15(1).

Anderson, G. (2019). Endometriosis pathoetiology and pathophysiology: Roles of vitamin A, estrogen, immunity, adipocytes, gut microbiome and melatonergic pathway on mitochondria regulation. Biomolecular Concepts, 10(1).

Chapron, C., Marcellin, L., Borghese, B., & Santulli, P. (2019). Rethinking mechanisms, diagnosis and management of endometriosis. Nature Reviews Endocrinology, 15, 666–682.

Endometriosis Australia. (2020). Endo facts. https://www.endometriosisaustralia.org/research

Hechtman, L. (2012). Clinical naturopathic medicine. Elsevier Australia.

Marquardt, R. M., Hoon Kim, T., Shin, J.-H., & Jeong, J.-W. (2019). Progesterone and estrogen signaling in the endometrium: What goes wrong in endometriosis? International Journal of Molecular Sciences, 20(15).

Svensson, A., Brunkwall, L., Roth, B., Orho-Melander, M., & Ohlsson, B. (2021). Associations between endometriosis and gut microbiota. Reproductive Sciences.

Vigano, D., Zara, F., Pinto, S., Loddo, E., Casula, L., Soru, M. B., D’Ancona, G., D’Alterio, M. N., Giuliani, C., Angioni, S., & Usai, P. (2020). How is small bowel permeability in endometriosis patients? A case control pilot study. Gynecological Endocrinology, 36(11).

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The post Autoimmune Protocol Diet | Eliminating & Reintroducing Explained appeared first on Performance in Health.

You see, a healthy immune system’s job is to protect you from foreign invaders such as viruses, bacteria, fungi, parasites and cancer cells. It innately knows not to attack itself. Unfortunately, in autoimmune disease, your immune system becomes terribly confused and it begins attacking your own cells as if they are a foreign intruder. If you are someone that has an autoimmune disease or know someone close to you with one, you will know the pain and anguish autoimmune dishes out. Organ & tissue destruction and dysfunction is not a joy to live with. This is why following an autoimmune diet is vital to managing your condition. 

Interestingly, autoimmune disease is the third most common disease after cancer and heart disease with women affected at a rate of 75% more than men. Surprisingly, I see so little written about it in comparison. 

What does an autoimmune disease do to my body?

Autoimmune disease happens to be on the increase, with certain types given a name in line with the organ or body tissue that is being attacked. An example is the autoimmune disease that I personally live with, day-in-day-out. I have Hashimoto’s Disease which is related to the destruction of the thyroid gland, named after the scientist who discovered it. Basically, autoimmune diseases can attack nearly every part of your body including the nervous system, heart, muscles, joints, gut, lungs, liver, kidney, eyes, thyroid, joints, and skin. Sadly, once you have one autoimmune condition you are also more at risk of having another autoimmune condition or further tissues on target for attack.

Some people have autoimmune conditions that attack multiple tissues. For some people this is so serious that they are prescribed strong drugs which weaken the immune system, this is to make sure that their body does not destroy itself as it can be life threatening. These people are of all ages.  These are the people we need to protect from COVID-19 because an immune system that has been supressed on purpose, cannot fight this terrible virus. 

What are some common types of autoimmune diseases?

Whilst around 80-100 different autoimmune diseases have been identified, here are some common ones you may have heard of:

Then there are autoimmune conditions that affect multiple tissues including lupus (systemic lupus erythematosus) which attacks the joints, skin, kidneys, blood cells, brain, heart and lungs and Sarcoidosis which destroys the lungs, skin, and lymph nodes. 

Autoimmune is a huge subject, far bigger than this blog could possibly cover, so I will do the best I can in explaining it to help you better understand your condition, and the importance of following an autoimmune diet. 

Why do people get autoimmune diseases? 

Simply put, scientific research highlights that it is a combination of genetics and environmental triggers. These triggers include being exposed to bacterial, viral & parasitic infections, stress, exposure to protein components present in certain foods, toxic chemicals, certain medications, and low levels of Vitamin D. 

For the rest of this blog, I will focus on the dietary triggers of autoimmune because one of the most important and powerful factors of autoimmunity is your diet. This is where autoimmune sufferers have real power to help themselves. 

So how does eating certain foods initiate an attack on your body by your immune system? 

It is all about molecular mimicry. This is where the food protein has a very similar structure to some of your own tissue. Normally when the gut lining is healthy, most of these food proteins cannot get through. However when this gut barrier has been breached undigested food proteins are able to enter the bloodstream. Your immune system is not accustomed to these large food particles entering the body and it mistakes them for a foreign invader and will mount a response to attack. Unfortunately, some of these food proteins look very similar in structure to human self-tissue and your body then produces antibodies against itself and starts attacking tissues. As a result, every time that food is eaten the immune system goes into attack.  

How will seeing a naturopath help me manage my autoimmune disease?

As a naturopath, one of the most important aims when working with an autoimmune sufferer is the healing of the gut so that the gut lining becomes strong and non-leaky and undesirable food particles cannot get through. In addition, the health of your gut microbiome (bacteria) is also involved. 

An autoimmune disease diet and lifestyle program are also a focus to help sufferers reduce the attack on self, balance immune dysregulation, improve gut permeability and reduce inflammation. Foods to avoid with autoimmune disease include gluten, grains, dairy, eggs, beans & legumes, nightshade vegetables (white potato, eggplant, tomatoes, capsicum, and spices chilli, paprika, goji berries). 

The good news is that eliminating some of these foods for many people does not have to be a life-time sentence due to the reintroduction of certain foods following an elimination period. As an autoimmune sufferer, I have spent hours experimenting with recipes where I supplement ingredients. An example is the use of tapioca flour & green banana flour instead of normal grain flours when baking bread, muffins, and cakes.   

Keep an eye on my next blog which will discuss the autoimmune diet and recipes in more detail. If you feel that you may benefit from advice on managing your condition more strategically, please book a consultation.

References

Fasano A. (2012). Leaky gut and autoimmune diseases. Clinical reviews in allergy & immunology, 42(1), 71–78. https://doi.org/10.1007/s12016-011-8291-x 

Richard-Eaglin, A., & Smallheer, B. A. (2018). Immunosuppressive/Autoimmune Disorders. Nursing Clinics of North America, 53(3), 319–334. doi:10.1016/j.cnur.2018.04.002

Vojdani A. (2015). Molecular mimicry as a mechanism for food immune reactivities and autoimmunity. Alternative therapies in health and medicine, 21 Suppl 1, 34–45.  https://pubmed.ncbi.nlm.nih.gov/25599184/ 

Vojdani, A., Gushgari, L. R., & Vojdani, E. (2020). Interaction between food antigens and the immune system: Association with autoimmune disorders. Autoimmunity reviews, 19(3), 102459. https://doi.org/10.1016/j.autrev.2020.102459 

Wang, L., Wang, F. S., & Gershwin, M. E. (2015). Human autoimmune diseases: a comprehensive update. Journal of internal medicine, 278(4), 369–395. https://doi.org/10.1111/joim.12395 

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