Urinary tract Infections are to be taken very seriously as if not treated, a kidney infection can quickly manifest which are life threatening and for this reason being on the look out for nausea, fever and pain is critical.

Many of the women that I provide naturopathic treatment for chronic & recuring UTI are often at the end of their tether.  Many are in a cycle of antibiotics, UTI, antibiotics, UTI and the journey goes on, and on and on.  Many have unresolved gut and vaginal symptoms also.  Many can’t have intercourse without fear of a flare or reinfection.

UTI’s range from uncomplicated to complicated where issues arise from some kind of dysfunction of the bladder or from health conditions that are neurological or diabetes, as an example.

The Urinary Microbiome (Urobiome)

Yes, that is correct.  Just like the gut and the vagina – the urinary tract also has a colony of healthy bacteria.  Whilst traditionally it was thought that the urinary tract was sterile, this has been turned on its head and recent science confirms that bacteria do play an important role.  Whilst it is less diverse with less numbers than let’s say the gut or the vagina, certain bacteria are thought to play a protective role such as Lactobacillus crispatus.

It appears that some species overlap between the gut, vagina and urinary tract. This is the reason some cases require advanced testing where I investigates the vaginal microbiome combined with urinary tract microbiome and assess gut symptoms as species from faeces around the anus act as a reservoir for UTI infection. A shift in the urinary tract microbiome plays a huge role in my naturopathic treatment plan and understanding which pathogens are at play, where they come from, and which bacteria are missing are all important to know. 

Often problematic species in the urinary tract may come from the vagina which is why strategies for partners and around sexual intercourse are important for prevention as problematic microbes can be relocated from one area to another.  Women with Bacterial Vaginosis for example have an increased risk for UTI.

What is also known is that there are some species that may cause problems that are not monitored for in conventional testing.  Negative urine cultures are something I see often even though symptoms clearly exist.  Often a diagnosis of Overactive Bladder or Interstitial Cystitis is given in these cases.  Simply put, new theories suggest that many UTI cases are caused not only by species that are not yet identified but by biofilm-like communities.  What are these communities I hear you ask?  They are a community of species that stick to the bladder cells and then can invade inside the cell where they form colonies.  In a way, they can hide, be undetected and avoid antibiotic treatment as they are protected by the bladder wall.

We have all heard of EColi which is a gram-negative bacterium and it is certainly a main culprit in many cases.  Some of the less common UTI culprits include both gram negative and positive species and it is important to rule out these species via advanced vaginal & bladder testing as they may not yet be detected on routine culture testing. 

Some of the risks

This is where a comprehensive naturopathic investigation is required as there can be many factors at play or a “perfect storm” that may include extensive antibiotic use & antibiotic resistance, the gut microbiome, vaginal dysbiosis as mentioned above, food sensitivities, immune dysfunction and hormonal factors such as in prime fertile years, post-menopausal and when on the oral contraceptive pill.  Sexual intercourse is a huge risk factor, and this is due to a number of triggers.

Naturopathic treatment

A comprehensive and methodical approach needs to be taken with both chronic Urinary tract and vaginal conditions.  Of course, symptom relief is key, and this is often in the form of oral and intra vaginal options, specific probiotics, prebiotics, and herbs depending on species identified and history of the condition.  Often antiseptic and soothing herbal teas are prescribed in combination with advanced testing so as long-term strategies can be put into place, one step at a time.

Restoring healthy bacteria, reducing inflammation, restoring the integrity of the urinary tract itself, restoring hormonal imbalance and nutrient deficiencies are all important.  Supporting strategies for partners also plays an important role in some cases.

Education is a huge component of naturopathic medicine, and this is always provided on a case-by-case basis.

If you have been challenged with chronic Urinary tract Infections or symptoms and would like to investigate more from a naturopathic treatment process, please contact me for a complimentary fact finding call or book an initial naturopathic consultation here.

The post Supporting Females with Chronic Urinary Tract Infections (UTIs) appeared first on Performance in Health.

Life is precious.  Life can change at any time with and without warning.  Health & happiness is an important life goal, often ignored. 

In listening to the stories of many people as they share their life and health journeys with me in our naturopathic consultations, it is clear that our bodies speak to us via signs, symptoms, mood and more.  Often the language of our bodies which speaks volumes to let us know that all is not ok – is ignored.  Often the messages from our bodies get louder and louder if we ignore them.  Exhaustion, anxiety, gut issues, skin issues, autoimmune flares, weight gain, sleep disturbances, low mood and the list goes on.

I often say to my clients that our bodies give us warning signs that ultimately, things are out of balance.  Sadly, I see individuals who have ignored these signs and waited mostly because of fear.  Fear of what might come from talking with their GP and going for specialist checks.  Skin cancer checks, mammograms, pelvic ultrasounds, pap smears, gut pain assessments via colonoscopies or endoscopies, bowel cancer stool tests, blood tests to understand cholesterol and blood glucose levels better.

Other times, there is no warning.  Often breast cancer or cervical cancer sufferers have no warning whatsoever and a heart attack is often the first symptom of cardiovascular issues.  For this reason, preventative testing is critical and then survival rates are greatly improved.

As a naturopath whilst I treat conditions naturally including working with oncology patients undergoing various conventional therapies, it is important that I know what I am treating so that treatment strategies can be strategic and worthwhile.

Obviously, a huge part of my role is in preventative health support through lifestyle, dietary strategies, herbs and more.  However early diagnosis of most diseases or high-risk test results picked up early means that there is a lot of room to make a valuable difference to disease progression and ultimately Health & happiness.

I often guide my clients to take the next step in testing when they are afraid or refer them to one of the wonderful mental health practitioners in my clinic so that fear of the unknown is supported wholistically and they can take empowering steps towards health, physically and emotionally.

Natural medicines are beautiful, and I have a passion for the plant kingdom that is tough to describe.  Making a difference to clients at every stage of their life journey is a responsibility that I take seriously.  This encompasses not only a high level of research in developing unique health treatment plans for my clients but a duty of care to ensure that proper testing is done to support long term health.

It is true that as a naturopath I use a variety of tests and laboratories for specialist testing myself however I also work closely with and refer my clients to GP’s and highlight the possible need for specialists & testing in my commitment to “Identifying and treating the cause” and “Prevention is the best cure”.

Your see, the practice of Naturopathic Medicine emerges from six underlying principles of healing based on the observation of the nature of health and disease, and they are as follows:

The Healing Power of Nature

Identify and Treat the Cause, not only the symptom

First, Do No Harm

Treat the Whole Person, not simply their disease.

Education  

Prevention is the Best “Cure” 

With this in mind, this blog is a reminder to us all that life really is precious.  I have had people close to me be diagnosed with various cancers including breast, prostate, and skin, unruptured aneurysms and more and early detection was a key reason for their healthy state today.  Putting in place powerful holistic heath and wellness goals then becomes a priority.

Many of my clients have confirmed with me that facing their fear around symptoms and doing what needs to be done to exclude or include health conditions is an enormously empowering experience and then they are able to happily focus on optimal health with some wonderful life wellbeing goals in place.

Are you at an age where your risk for disease is higher or do you have symptoms that need more attention?  I hope this blog provides you with some support and empowerment to take the next step for peace of mind as life truly is precious.

Please reach out for support either by a fact-finding call or initial naturopathic consultation via my website here or email me on tanya@performanceinhealth.com.au

The post Health and Happiness are Precious: prevention, early detection & life wellbeing goals matter appeared first on Performance in Health.

Summary of PCOS Causes

• Insulin resistance – elevated insulin stimulating excess androgen (testosterone) production
• Excess androgens from non-insulin causes – including adrenal hormones such as DHEA and androstenedione
• Androgen sensitivity – normal testosterone levels, but increased tissue response causing acne, hair growth or hair loss
• Post-pill hormonal disruption – temporary androgen surge after stopping oral contraceptives
• Inflammation – gut issues, autoimmune or inflammatory conditions influencing hormone receptors
• Adrenal conditions – including non-classical congenital adrenal hyperplasia (21-hydroxylase deficiency)
• Hormonal imbalances – high prolactin, thyroid dysfunction or chronic stress
• Nutrient deficiency or under-eating – especially low carbohydrate intake affecting ovulation
• Rare endocrine disorders – such as Cushing’s syndrome

What causes PCOS? Insights from our Sydney Clinic

Whilst insulin driven PCOS that drives elevated testosterone is a common cause, more and more in clinic I am finding women that been diagnosed with PCOS, yet their testosterone levels are normal and when I check insulin at fasting, 1 and 2 hours I find that insulin is also normal.

Often the hair growth or hair loss on the head, acne and fertility issues are the main trigger for women to seek answers as they are all events that can seriously impact quality of life and life dreams.

So, its androgens that are normally to blame but they can be stimulated by not just insulin.  I also see many women with hair growth and male pattern baldness that assume they have PCOS however they are having regular periods and testosterone on a blood test is normal.  Women in these cases can be suffering from a hypersensitivity to a normal amount of testosterone so the support I give is to reduce the impacts of testosterone on hair growth and also on acne and look I depth at why they are so sensitive.

How I diagnose my Sydney clients struggling with PCOS

There are several interpretations of how to correctly diagnosis PCOS, however it absolutely cannot be diagnosed on simply having polycystic ovaries as you must show signs or symptoms of excess androgens.  This may not just be on a blood test but can be acne, hair growth on the face or male pattern baldness.

• Androgens to test:   sometimes total testosterone and free testosterone are normal however our adrenal glands also produce androgens so in some cases, and I look at whether androstenedione and DHEA have also been tested.  I explain the different types of PCOS in my last PCOS blog as even inflammatory conditions in the body such as eczema, arthritis, gut disorders, food sensitivities may be driving the excess androgens due to the impact that inflammatory chemicals produced by your body have on hormone receptors

Other Causes of PCOS

It is important that other causes for androgen excess have been considered and they can include:

• Having just come off the pill = post pill means disrupted hormones and a surge of testosterone
• Non classical congenital adrenal hyperplasia: This is a genetic condition and is an often forgotten cause of excess androgens and I always make sure it has been ruled out.  It is a condition where an important enzyme, 21-hydroxylase that changes progesterone into cortisol doesn’t work as it should and progesterone becomes testosterone and other androgens.  It can look like PCOS and is often diagnosed as PCOS.  The test recommended to know for sure is 17-OH progesterone.
• High prolactin: this can be a cause and be a result of thyroid issues, stress and even excess stomach acid tablets so it needs to be looked at too.
• Lack of nutrients in your diet: Hypothalamic amenorrhea is when you don’t ovulate, and this is common when you under eat especially carbs. 
• Cushings Syndrome: This would be rare however this condition shows similar symptoms to PCOS.

As you can see, PCOS does not always mean inositol and zinc.  It is a deep investigation to make sure you are strategically focussing on the right treatment and strategies.

Personalised PCOS Treatment in Sydney’s Inner West

For support on managing or investigating your PCOS more thoroughly or an investigation as to hair growth/loss or acne, please book your initial consultation at our Stanmore clinic, our Leura clinic, or via telehealth.

The post A Conversation Around PCOS: Insights from a Sydney Naturopath appeared first on Performance in Health.

Like with most conditions, triggers and causes are multi-faceted and it is important to understand the “perfect storm” of triggers for each unique woman.

First, what are Hormonal migraines?

Hormonal migraines, sometimes also called “menstrual migraines”, are headaches that are triggered by hormonal changes. These types of headaches are most likely to occur in the 2 days leading up to your period or in the first three days of your bleed when oestrogen levels are at their lowest. Others may experience hormonal migraines around ovulation when there is a spike in oestrogen levels. Hormonal migraines can also be common in women aged 40-55 during the perimenopausal period, because of the high (and fluctuating) levels of oestrogen at this time.

What Causes Hormonal Migraines?

Hormonal migraines are typically associated with oestrogen, either oestrogen dominance/ excess, or oestrogen withdrawal (sudden decline in oestrogen levels)

• Oestrogen dominance or oestrogen excess migraines typically occur around the time of ovulation
• Oestrogen withdrawal migraines typically occur just before or during your period. This type of migraine may still be due to an overall oestrogen dominance state, which may mean a more severe decline in oestrogen at the end of your cycle.

Oestrogen dominance or oestrogen excess can occur for a number of reasons, including:

• Your body is producing too much oestrogen, perhaps in response to a hormonal condition like PCOS
• Your body is not eliminating oestrogen effectively, perhaps because your liver is working suboptimally or is overburdened
• You are being exposed to xenoestrogens – synthetic oestrogen-like molecules that act as extremely strong oestrogen in the body.  This estrogen dominance article provides some wonderful information
• You are not producing enough progesterone, which is causing a high ratio of oestrogen to progesterone (relative oestrogen dominance). This might occur if there is an issue with ovulation

How Does Oestrogen Trigger Migraines?

High oestrogen levels trigger hormonal migraines by:

• Stimulating immune cells to produce higher than normal amounts of histamine and prostaglandins, which cause inflammation
• Causing rapid declines in oestrogen at the end of the menstrual cycle, which can lead to low serotonin and high glutamate. Glutamate is a neurotransmitter that has been linked to the pathophysiology of migraines. New research suggests it may be elevated glutamate levels acting on the brain that triggers migraines.

Other Causes of Hormonal Migraines:

Periods are not the only cause of hormonal migraines, however. This type of headache can also be caused by:

• The oral contraceptive pill, particularly during the placebo phase of the pill, where oestrogen levels drop
• Menopause – as normal hormone balance is disrupted, hormonal migraines can be triggered
• Pregnancy – particularly in the early stages of pregnancy when oestrogen levels sharply rise

Other triggers that can worsen or be the cause of your migraines:

As part of my thorough naturopathic investigation when identifying things that can impact migraines and headaches, it is important to remember that there are other types of headaches that should be considered and excluded.  Tension headaches, sinus headaches and headaches from your body being misaligned could also be part of your unique picture.

Blood sugar imbalance: low blood glucose levels and high blood glucose levels can be a huge trigger.  Cravings at that time of the month may be worsening your symptoms which is why I always support clients in managing this aspect.   Excess sugar causes hormonal changes, due to cortisol, epinephrine and norepinephrine which change the behaviour of blood vessels in your brain.

Gut dysfunction: especially constipation can increase reabsorption of estrogen metabolites that can trigger hormonal headaches.  Toxins that should be eliminated in bowel movements can also be reabsorbed when constipated.  Nurturing digestion for healthy elimination is critical.

Liver Health: the liver plays a huge role in hormonal balance and toxin elimination, and this may need to be supported for some women.

Low iron levels: Iron deficiency anaemia can cause your brain to receive much less oxygen than it requires for optimal functioning so iron storage levels are important so that headaches or migraines are not triggered or made worse.   When you bleed heavily during menstruation, this is an obvious clue.

Dehydration: your brain needs water to be hydrated and a simple objective of drinking more water, can make a huge difference.

Sinus headaches are also linked to migraines and the forms of headaches, and it is important to exclude the role of sinus issues and allergies as part of the picture.

Caffeine: many people are also sensitive to the effects of caffeine which can have a role in migraine and headaches.

Thyroid imbalance: Research has shown us that hypothyroidism (low thyroid function) is linked to more frequent and severe migraines and headaches which is why I always check levels.

I find from clinic experience that it is often the perfect storm for migraine sufferers as opposed to just one thing.  Many factors can be linked to worsening hormonal headaches.

Naturopathic Treatment Strategies for Hormonal Migraines

Based on what is happening for each client, each strategy is tailored appropriately however some basic recommendations often include:

Dietary Strategies

Include Phytoestrogens in the Diet

A randomised, controlled trial found that the prophylactic use of phytoestrogens significantly reduced the incidence of menstrual migraines after as little as one month of use. Phytoestrogens are molecules found in many plant foods which can bind to oestrogen receptors in the body. Because phytoestrogens have only a very mild oestrogenic effect, they can help to reduce the effects of oestrogen excess by displacing excess oestrogen in the body without triggering symptoms. The excess oestrogen can then be metabolised by the liver and excreted, helping to bring levels back to normal.

Phytoestrogens can be found in a huge range of foods, including:

• Organic soy products, such as tofu and tempeh
• Ground flax seeds, pumpkin seeds, sesame seeds, sunflower seeds
• Chickpeas, mung beans
• Olives
• Buckwheat, whole grains

Increase Fibre Intake

If oestrogen excess is driving your hormonal migraines, upping your fibre intake can help by improving the body’s ability to bind up and remove excess oestrogen from the body. The main way oestrogen is excreted is through the bowels, so it is vital that we are opening our bowels daily to prevent oestrogen from being reabsorbed before it can be excreted. To prevent symptoms of bloating and flatulence, increase your fibre slowly – you can start by adding just a teaspoon of freshly ground flaxseed to your morning smoothie or to a glass of water. Fibre is found abundantly in plant foods – vegetables, fruits, legumes and grains. Include a wide variety of plant foods in your diet and aim to have plant foods with most or all meals.

Drink 2 Litres of (Filtered) Water Every Day

As with fibre, it’s important that you are drinking enough water to maintain healthy, regular bowel movements. 2 litres per day (more on hot days and during physical activity) is a good guide for most people. Choose filtered water if possible, as this will help to reduce the amount of impurities the liver needs to process, leaving it free to concentrate on metabolising oestrogen and other metabolic wastes.

Thoroughly scrub and wash Fruits and Vegetables before Consumption

To avoid pesticides and other harmful chemicals on your fruits and vegetables, it is best to choose organic produce when possible. However, regardless of whether you have organic or not, it is important to thoroughly scrub and rinse your fruits and vegetables before consumption to remove surface toxins and reduce the liver’s workload. To clean fruits and vegetables thoroughly, soak hard-skinned products for 10-15 minutes before scrubbing. Fill the kitchen sink with warm water and add 1/3 cup apple cider vinegar. Alternatively, Dr Bronner’s soap can be diluted and used as a fruit and vegetable wash.

Don’t Store or Heat Food in Plastic

Plastic is made of a litany of chemicals, some of which are known to disrupt hormone balance, such as BPA, which can worsen oestrogen dominance. Plastic food storage containers and cling-wrap can leak these harmful chemicals into your food, especially if you are heating your food in the container or are placing your food into the container when it is still hot. Whilst many plastic food containers advertise as being BPA-free, the majority of them still contain other hormone-disrupting chemicals aside from BPA. Choose glass or ceramic containers to store food in and always reheat foods on the stove. If you don’t want to purchase a whole new set of expensive glass food containers, recycled jars from other foods are a great option! Pasta, pickles, coconut oil, and the like all come in sturdy glass jars that can be readily washed and reused to store food in again and again.

Other tips for safe food preparation:

• Swap plastic cooking utensils with wooden, stainless steel, or silicone types
• Use beeswax wraps as an alternative to cling-wrap
• Choose fresh or frozen fruits and vegetables and dried legumes over canned goods where possible.
• Use a glass or ceramic reusable coffee cup instead of takeaway cups
• Avoid non-stick cooking pans – swap for cast-iron, stainless steel, or ceramic cookware. Always immediately discard Teflon or non-stick cookware that shows any signs of damage

Lifestyle Strategies

Exercise Daily

When we are being physically active, our lymphatic system is able to work 2-3 times more efficiently compared to when we are at rest, helping to move metabolic wastes like excess oestrogen to the liver for metabolism and excretion. Physical activity is also important for healthy bowel movements. One of the easiest gentle physical activities is of course walking, and there are plenty of ways to increase your daily activity by walking more Try parking your care a little further away from work and walking the rest of the way or meet up with friends for walking dates on the weekend. In addition to walking, it’s important to get some more vigorous exercise in as well. This could include team sports, running, cycling, or even aerobics or dancing classes. Not only will these activities promote healthy lung function, but they also improve detoxification by increasing the amount you sweat.

Supplements

Again, this is unique for each person based on triggers and may include:

Vitamin B2 (Riboflavin)

Vitamin B2 can act as a prophylactic, helping to reduce the incidence and severity of hormonal migraines. Treatment typically needs to be for 1-3 months before benefit kicks in. This vitamin helps to prevent migraines by stabilising serotonin levels. A recent review and meta-analysis concluded that high-dose supplementation of vitamin B2 for 3 months is effective in reducing the frequency and severity of migraines.

Omega 3 Fatty Acids

Omega 3 fatty acids are powerful anti-inflammatory agents and have been shown to reduce the duration of migraines. Omega 3 fatty acids are found in fish and other seafoods, as well as in flaxseeds and hemp seeds. Supplements can also be useful but be sure to use a supplement prescribed by your naturopath, as many over the counter fish oil supplements contain poor quality and even rancid oils. Vegan options are available too and are made with algal oil.

Vitamin D

Studies into vitamin D status of migraine sufferers show that between 45-100% of people who experience migraines have a vitamin D deficiency. This is particularly relevant in Australia, where vitamin D deficiency or insufficiency is relatively common. Studies have also found the supplementing vitamin D can help to reduce the frequency of migraines.

Magnesium

This is another nutrient where deficiency is linked to migraines. Magnesium protects brain cells from glutamate, helps to improve serotonin function, calms blood vessels and reduces inflammation. Magnesium supplements vary wildly in quality and bioavailability, so it is best to speak with your naturopath about the best options for you. Magnesium can also be absorbed via the skin through Epsom salts in the bath, which can be a great, gentle option for increasing your magnesium levels.

Herbal Medicines

There are many wonderful herbal medicines that can help with hormonal migraines. The best herbs for you will depend on your specific presentation and triggers, as well as any other health conditions you may be experiencing. Below are just a few examples of herbs that may be beneficial.

Feverfew

Feverfew is a powerhouse herb when it comes to preventing migraines and has been used in the treatment and prevention of migraines for centuries. This herb is best taken as a daily prophylactic to prevent the onset of migraines, rather than being administered only when migraines begin.

Turmeric

Turmeric is not only a powerful antioxidant – it is also a liver-supporting herb and an anti-inflammatory and has been shown to be useful in managing migraines. Because of it’s liver-boosting properties, it is particularly good with hormonal migraines, as it can help to improve the body’s clearance of excess oestrogen.

Other herbal medicines may be used for the following:

• Herbs for improving your stress response
• Herbs for reducing anxiety and nervous tension
• Herbs for balancing oestrogen levels and progesterone levels
• Herbs for liver support
• Herbs for supporting better blood glucose balance

Migraines and headaches are a complex condition to navigate.  If you seek a thorough naturopathic investigation in Sydney to reduce the impact that migraines are having on your quality of life, please book an appointment for an initial consultation or fact-finding call.

References

Briden, L. (2022). Natural treatment of menstrual migraines. https://www.larabriden.com/birth-control-cause-headaches-migraines/

Brighten, J. (2017). 20 natural remedies for hormonal headaches & migraines. https://drbrighten.com/16-natural-remedies-hormonal-headaches/

Brighten, J. (2019). Menstrual migraine relief. https://drbrighten.com/menstrual-migraine-relief/

Burke, B. E., Olson, R. D., & Cusack, B. J. (2002). Randomized, controlled trial of phytoestrogen in the prophylactic treatment of menstrual migraine. Biomedicine & Pharmacotherapy, 56(6), 283–288.

Chen, Y.-S., Lee, H.-F., Tsai, C.-H., Hsu, Y.-Y., Fang, Ch.-J., Chen, C.-J., Hung, Y.-H., & Hu, F.-W. (2022). Effect of vitamin B2 supplementation on migraine prophylaxis: A systematic review and meta-analysis. Nutritional Neuroscience, 25(9).

Chhater, S., Karal, R., & Kumar, B. (2018). Review on migraine: Pathophysiology and treatment. American Journal of Biomedical Research, 6(1), 20–24.

Ghorbani, Z., Togha, M., Rafiee, P., Ahmadi, Z. S., & Magham, R. R. (2019). Vitamin D in migraine headache: A comprehensive review on literature. Neurological Sciences, 40.

Maghsoumi-Norouzabad, L., Mansoori, A., Abed, R., & Shishehbor, F. (2018). Effects of omega-3 fatty acids on the frequency, severity, and duration of migraine attacks: A systematic review and meta-analysis of randomized controlled trials. Nutritional Neuroscience, 21(9).

Nattagh-Eshtivani, E., Sani, M. A., Dahri, M., Ghalichi, F., Ghavami, A., Arjang, P., & Tarighat-Esfanjani, A. (2018). The role of nutrients in the pathogenesis and treatment of migraine headaches: Review. Biomedicine & Pharmacotherapy, 102, 317–325.

NHS. (2021). Hormone headaches. https://www.nhs.uk/conditions/hormone-headaches/#:~:text=Many%20women%20experience%20headaches%20caused,tend%20to%20be%20particularly%20severe

The post Hormonal Migraines & Naturopathic Care 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.

So, what is mastitis? Mastitis is an inflammation and/or infection of the breast tissue. It is often due to an underlying blocked duct, and there may or may not be an infection involved. 75-95% of mastitis cases happen during the first 12 weeks of breastfeeding. This is the time during which your body is still regulating supply, which can mean fluctuating milk production levels throughout the day or week.

Symptoms of mastitis include:

• Pain
• Swelling
• Redness of the breast
• Reduced milk production
• A general feeling of being unwell
• Fever

Mastitis can develop and progress very quickly. Without adequate treatment, it may also progress to abscess formation. It’s important to begin treatment for mastitis as soon as symptoms appear to avoid progressing to severe symptoms like a high fever or abscess, which would require urgent medical care.

Causes and Risk Factors

There are a number of underlying causes and risk factors that can contribute to mastitis developing, including:

• Blocked or clogged ducts
• Cracked nipples
• Antibiotic use during pregnancy or breastfeeding
• Attachment and feeding issues, including poor latch or positioning of baby during feeds
• Delayed feeding
• Incomplete emptying of breasts during feeds
• Infrequent nursing, or reduced frequency of feeds
• Oversupply (can be simply due to your body’s overproduction of milk, or can be due to pumping in between feeds)
• First pregnancy
• Age (either under 21 or over 35)
• Poor gut health and dysbiosis
• Compromised immune health
• Wearing tight-fitting bras

When looking to prevent future recurrence, it’s important to address any of the above factors which may have contributed to mastitis developing.

Naturopathic Understanding of Mastitis

Human breast milk naturally contains its own microbiome, in the much the same way as the gut and skin. The good bacteria in breast milk help to maintain the health of the ducts by preventing other bacteria to grow – such as the Staphylococcus bacteria which are associated with mastitis. Naturopathically, we understand that mastitis can be a presentation of dysbiosis (imbalance of the body’s bacterial populations) – the good bacteria naturally found in breastmilk have become outnumbered by the harmful bacteria, resulting in infection, and leading to inflammation and illness. Immune system suppression also frequently plays a role – new mothers’ bodies are under significant stress, with postpartum healing, balancing the mental and emotional stressors of motherhood, and sleep deprivation, too. All of this can cause the body’s defences to become depleted and less able to protect against infection and inflammation.

Naturopathic Treatment Strategies for Mastitis

Dietary Strategies

Avoid Foods that Suppress Immune Function

Healing mastitis requires a robust response from the immune system. Certain foods can supress immune function and so are best avoided during this time. Foods that suppress immune system function include:

• Caffeine – particularly as found in coffee and energy drinks. The caffeine in tea is largely counteracted by the beneficial effects of L-theanine, an anti-inflammatory and immune-boosting amino acid that naturally occurs in tea
• Alcohol
• Deep fried foods and foods high in saturated fats, including chips and many packaged snack foods
• Foods high in trans fats, including cakes, muffins, frozen ready-foods (such as chips and pizza)
• Foods high in sugar, such as chocolate, lollies, baked sweet foods, and soft drinks

Keep hydrated

Adequate hydration is vital for a healthy immune system and for milk production. We need plenty of water to keep our lymphatic fluid moving properly through the body – this is how our immune cells travel around the body. Keeping hydrated is doubly important during mastitis, as we need both milk production and lymphatic flow to help clear any duct blockages that are present. Aim for 2.5-3L of water per day, plus extra when exercising or sweating. In cold weather, or when you’re feeling unwell, it can be difficult to drink this much water cold. Hot tea (including herbal tea) can be a great alternative to keep up your fluid intake – check the “herbal medicines” section of this handout for herbal tea options suited for mastitis.

Eat Well-Cooked, East to Digest Foods

Well-cooked and easy-to-digest foods are ideal, as these foods are easier for your body to break down and absorb vital nutrients. Soups, stews, and slow-cooked curries are all great options, which you can load up with immune-boosting vegetables, herbs and spices, and good quality protein sources. These types of meals are also great options for batch cooking – you can cook large portions and freeze leftovers for later meals.

Eat Protein with Every Meal

Protein forms the building blocks for cells, including immune cells. It is a vital part of a healthy immune system, and we have higher protein requirements during illness. Some good sources of protein include:

• Red meat, like beef, lamb, and kangaroo. Try cooking in a slow cooker until tender, as it will be easier to digest.
• Poultry, including chicken and turkey. Try roasted or baked, and add to soups
• Legumes – lentils, kidney beans, black beans, chickpeas, and more. Be sure to thoroughly soak and wash before cooking, and always cook them until soft – this will ensure they are much easier to digest. Legumes are a great protein option to use in curries and stews.
• Tofu and tempeh – both of these are highly versatile and can be used in curries, soups, stews, and even broths – a low-sodium miso soup with tofu or tempeh and some dried kelp or wakame (seaweed) can be a good, warming option when you have a low appetite. Miso paste is readily available at health food stores and provides a good dose of probiotics to your diet.
• Eggs – free range eggs can be boiled, scrambled, or poached
• Fish – baked, grilled, or even added to curries, fish and other seafoods can be a great addition.

Include Antimicrobial Foods

Loading up on antimicrobial foods can give your immune system a helping hand when it comes to fighting off bacterial infections such as mastitis. Some easy options to add include:

• Garlic, onions, and shallots – can be added to virtually any savoury dish!
• Mushrooms – shiitake and oyster mushroom varieties are frequently available in supermarkets and have great immune-boosting and antimicrobial properties

Supplements and Herbal Medicines

Every mum is different, and a tailored treatment plan will ensure a strategic prescription however some of the more common recommendations include:

Vitamin C

Specific Probiotic strains & prebiotic fibres

Herbal medicines can be a really useful tool with mastitis, helping to support the immune system, promote lymphatic circulation to improve breast duct clearance, as well as providing symptomatic relief. Below are some examples of herbs that may be used in your treatment plan.  If a herbal tincture is provided for oral use, instructions will be provided and may include Echinacea, Poke Root, Oats Green and Comfrey and Parsley Leaf for use as a compress.

Lifestyle Strategies

• Apply warm compresses to the affected area and take warm showers
• Hand express or pump before or after feeding to relieve pain, if needed, or if baby won’t feed on that side
• Use an ice pack after feeding to reduce swelling.

Prioritise Rest

It’s important to rest as much as possible, to give your body the time it needs to heal. This is especially important if you are still breastfeeding frequently at night and have broken sleep. Both sleep and rest are crucial for healing! Delegate tasks wherever possible, batch cook meals to reduce time spent preparing food, and take the opportunity to nap or rest whenever you can. You can also help to get more restorative sleep at night by turning off overhead lights (use low-light lamps instead) and switch off screens at least an hour before bed each night.

Continue to Feed Baby Often

Continue to feed baby as normal, focusing on draining the breast. It is fine to continue to feed on the mastitis-affected breast, so long as it is not too painful to do so!

Self-Massage

Gently massage the area with oil in between feeds, making sure to wipe off excess oil before you next feed baby. Massage in a circular motion working towards the nipple. This will help to improve circulation and encourage clearance of any blocked ducts. You may also wish to do this while in the shower, as the warm water will further boost circulation and clearance. You can use a pokeroot salve, calendula oil, comfrey oil, or even plain coconut oil to massage.

Use Warmth to Relieve Pain

Warm showers and warm compresses can help to relieve pain and reduce inflammation. A cloth soaked in warm water will do, or a herbal compress like those detailed in the “herbal medicines” section above.

Relieve Pain from Fullness

Hand-express or pump as needed to relieve pain, especially if baby won’t feed from that side. Be sure not to overdo it, though – you don’t want to stimulate more milk production.

Ice Pack for Swelling

If you are experiencing swelling, an ice pack wrapped in cloth applied to the breast will help.

To Reduce Oversupply

If oversupply is an underlying cause of your mastitis, the following tips might help:

• Apply frozen cabbage leaves to your breasts in between feeds – this is also very soothing!
• Drink 3 cups of sage tea per day – discontinue once your supply has balanced out
• Avoid pumping in between feeds – feed baby as needed and always aim to fully drain the breast before moving baby to the next breast. If you are prone to oversupply issues, avoid using a Haka or pump on the other side to catch the “overflow”, as this can signal to the brain to increase supply.

Book in to see me (Tanya Edwards) for Naturopathic support

If you’re struggling with mastitis and breastfeeding your baby, getting some professional guidance can be helpful.  A naturopathic consultation is a good start to help find the best treatment for you.  To find out more, contact Performance in Health today.

References

Amir, L. H., Forster, D. A., Lumley, J., & McLachlan, H. (2007). A descriptive stud of mastitis in Australian breastfeeding women: Incidence and determinants. BMC Public Health, 7(62).

Angelopoulou, A., Field, D., Ryan, C. A., Stanton, C., Colin, H., & Ross, R. P. (2018). The microbiology and treatment of human mastitis. Medical Microbiology and Immunology, 207, 83–94.

Barker, M., Adelson, P., Peters, M. D. J., & Steen, M. (2020). Probiotics and human lactational mastitis: A scoping review. Women and Birth, 33(6), 483–491.

Beim, M. (2022). Mastitis. https://mimbeim.com/mastitis/

Hurtado, J. A., Maldonado-Lobon, J. A., Diaz-Ropero, M. P., Flores-Rojas, K., Uberos, J., Leante, J. L., Affumicato, L., Couce, M. L., Garrido, J. M., Olivares, M., & Fonolla, J. (2017). Oral administration to nursing women of Lactobacillus fermentum CECT5716 prevents lactational mastitis development: A randomized controlled trial. Breastfeeding Medicine, 12(4), 202–209.

Jimenez, E., Fernandez, L., Maldonado, A., Martin, R., Olivares, M., Xaus, J., & Rodriguez, J. M. (2008). Oral administration of Lactobacillus strains isolated from breast milk as an alternative for the treatment of infectious mastitis during lactation. Applied and Environmental Microbiology, 74(15), 4650–4655.

Ojo-Okunola, A., Nicol, M., & du Toit, E. (2018). Human breast milk bacteriome in health and disease. Nutrients, 10(11).

Red Moon Herbs. (2019). Clogged milk ducts and mastitis: Poke root to the rescue. https://redmoonherbs.com/blogs/womens-health-and-herbal-medicine/clogged-milk-ducts-and-mastitis-poke-root-to-the-rescue

Soto, A., Martin, V., Jiminez, E., Mader, I., Rodriguez, J. M., & Fernandez, L. (2014). Lactobacilli and bifidobacteria in human breast milk: Influence of antibiotherapy and other host and clinical factors. Journal of Pediatric Gastroenterology and Nutrition, 59(1), 78–88.

Valls-Belles, V., Abad, C., Hernandez-Aguilar, M. T., Nacher, A., Guerrero, C., Balino, P., Romero, F. J., & Muriach, M. (2022). Human milk antioxidative modifications in mastitis: Furhter beneficial effects of cranberry supplementation. Antioxidants, 11(1).

WIllson, K. (2022). Mastitis prevention and treatment. https://www.pbcexpo.com.au/blog/mastitis-prevention-treatment

The post Mastitis – how a Naturopath can support you appeared first on Performance in Health.

The Benefits of Breastfeeding

There are a huge range of benefits that come from breastfeeding, for both mother and baby. Some of these benefits include:

• Improved immune protection for baby – breast milk contains high levels of antibodies to protect infants from disease. What’s most amazing is that breast milk is dynamic – your body will produce extra antibodies to protect baby against specific pathogens that your body encounters in your environment.
• Dynamic breast milk composition – in addition to changing antibodies, the composition of breast milk changes to suit your baby’s needs. For example, if baby is going through a growth spurt, your breast milk will provide baby with higher levels of protein and fat.
• Protection against illness – breastfeeding has been shown to protect infants against a number of diseases, including asthma, allergies, eczema, diabetes 1 and 2, and even reduces SIDS risk.
• Protects mums against long term illness risk – breastfeeding reduces your risk of developing certain cancers, including breast, ovarian, and endometrial, and also protects against osteoporosis, heart disease, and diabetes.

Supporting Optimal Lactation

Dietary Strategies

Eating well cannot be underestimated. I recently wrote a post on post-natal depletion so have a look at my “Postnatal Depletion” post here for dietary support and strategies.

Hydration

Breastfeeding requires increased water intake. Breastfeeding women require around 3-3.5L of water each day in order to meet their own needs as well as produce sufficient milk. Opt for filtered water where possible, to reduce your exposure to unnecessary toxins and heavy metals from tap water. Good quality water filters are readily available from health food shops, filter suppliers and Bunnings.

Food As Medicine: Oats

Oats are considered to be a galactagogue (help to increase production). Homemade oat bars or “lactation cookies” made with oats can be a great snack to have on-hand. There are some great recipes online, or you can purchase pre-made lactation cookies.

Herbs

There are a number of herbs that are considered to be “galactagogues” and can be great additions to your breastfeeding journey.  It is important that they are prescribed by a trained herbalist however as your babies age and other conditions always need to be considered.

• Fenugreek – a galactagogue, as well as a blood sugar stabiliser, and digestive herb
• Fennel seed – a galactagogue, and also helps to reduce bloating and IBS-type symptoms.
• Goat’s rue – a powerful galactagogue and also helps to reduce high blood sugar (caution in pregnancy)
• Stinging nettle leaf – a galactagogue and amazing nutritive herb that is very high in important minerals such as potassium, magnesium, and zinc.
• Hops – a galactagogue, nervine and phytoestrogen herb. It is also the herb used to make beer and is the reason why some people recommend drinking a stout beer to increase milk supply! (However, alcohol can lower prolaction, the breastfeeding hormone, so it is best avoided.)
• Milk thistle – a well-known liver herb, but also a useful galactagogue!

Many of these herbs are available in herbal liquids and lovely tea blends that can be sipped throughout the day (and can also help you to keep your hydration up!). Fennel and fenugreek can also be added to your cooking (think warming curries and stews) or can be brewed into a chai.

Supplements

Supplements will depend on your individual needs and how depleted you are from pregnancy however during this time it is very important to make sure that you are obtaining the following nutrients via whole foods as much as possible, and by continuing your prenatal multivitamin.  Magnesium, iron, Vitamin D, Zinc, Vitamin C and omega 3 fish oil supplements with vegan options are often prescribed.   My post on nutrition for postpartum recovery gives valuable information.

Additional Tips for Optimal Lactation and Breastfeeding:

• Offer the breast to your baby often – whenever they seem interested, or at least every 2-3 hours.
• Hold baby skin-to-skin frequently through the day
• Avoid giving supplements or “top-ups” with the bottle unless necessary
• Avoid dummies and bottles if possible
• Feed according to your baby’s needs, rather than following a set schedule.
• Stay in bed and rest, particularly in early postpartum, and prioritise feeding on demand. The housework can wait!
• Don’t forget that breastfeeding is more than just nutrition – it is for bonding and comfort as well. It’s okay to also offer the breast whenever you feel baby might benefit.
• Ensure correct positioning and latch – for diagrams and information on optimal positioning and latch, head to https://thepixelfarm.com/iable/membercontent/BFHandouts/IABLE_BF-Ed_Help_Baby_Latch.pdf and https://thepixelfarm.com/iable/membercontent/BFHandouts/IABLE_BF-Ed_Latching.pdf
• See An IBCLC-qualified lactation consultant for assistance with positioning and latch, if required.

Common Breastfeeding Issues

Pain During Breastfeeding

Breastfeeding should not be painful. If you are experiencing pain during breastfeeding, it’s important to seek advice on why this is happening. There are many reasons why breastfeeding might be painful, such as:

• Over or under production
• Structural anomalies in the breast causing latch issues
• Structural anomalies in baby’s mouth (such as tongue and lip ties) causing latch issues
• Mastitis or clogged ducts

At my naturopathic consultations for new mums, we will be discussing how I may support your unique situation.  You may also be speaking to your GP or seeking advice from a qualified IBCLC lactation consultation.

Painful, Cracked and Bleeding Nipples

Nipple pain is a common issue but is not a normal part of breastfeeding and shouldn’t be ignored. If you have cracked or bleeding nipples, it’s important to uncover the cause of the issue to prevent further pain and nipple damage from occurring. Common causes of painful, cracked and bleeding nipples include:

• Poor latch or positioning
• Incorrect use of breast pump, such as incorrectly sized flanges
• Nipple thrush
• Oversupply, causing baby to bite down on your nipple

Once the underlying cause has been determined and addressed, nipple pain shouldn’t be an issue. To lessen pain in the meantime and encourage healing:

• Use lanolin ointment on your nipples after feeds to protect and encourage healing.  A cream made specific for you wither herbs including calendula may be appropriate.
• Gently wipe breastmilk onto your nipples to assist in healing
• Keep nipples dry between feeds by using clean cloth nipple pads

Clogged Ducts

A clogged duct occurs when milk is not draining sufficiently out of a particular duct in the breast. This can present as a swollen, lumpy and sometimes painful area in the breast and can be accompanied by redness in the affected area. If you have a clogged duct:

• Continue feeding baby at the breast often
• Pump or hand express between feeds
• Firmly massage the area to help move the lump towards the nipple
• Apply a warm compress onto the affected area
• Try changing baby’s feeding position – move baby so their nose or chin is pointing towards the clogged duct, as this will help to drain this area more thoroughly

Mastitis

Mastitis is an inflammation and/or infection of the breast tissue, often due to a clogged duct. Symptoms of mastitis include pain, swelling, redness, a general feeling of being unwell, and fever. If you suspect you have mastitis, you will be provided with a specific handout on mastitis causes and herbal treatment such as echinacea, probiotics, poke root, vitamin C however some basic advice includes:

• Continue to feed baby often
• Apply warm compresses to the affected area and take warm showers
• Gently massage the area during feeds
• Hand express or pump before or after feeding to relieve pain, if needed
• Use an ice pack after feeding to reduce swelling.

If fever and pain persist, or you notice a red line spreading outwards from the site of inflammation, seek urgent medical care.

Low Supply

Under-production or low supply is a common concern for many breastfeeding mothers; however it is often easily remedied by addressing the underlying cause. Some common causes of low initial supply include:

• No breast changes during pregnancy – most women experience at least some changes to their breasts during pregnancy, such as increased breast size, or darkening of the nipples and areolas. A lack of changes in the breasts during pregnancy can sometimes coincide with low supply.
• Low levels of breast tissue – insufficient glandular tissue, also known as breast hypoplasia, can make breastfeeding difficult
• PCOS: some women with PCOS have difficulties with supply, however others are able to breastfeed successfully.

If you have already established breastfeeding and have previously had a good supply, but are now finding your supply is dropping, it may be due to issues such as:

• Not enough feeding – supply follows demand when it comes to breastfeeding. Offer baby the breast frequently (every 2 to 3 hours in the beginning and then 8-12 times every 24 hours)
• Feeds are too short – avoid timing feeds and simply allow baby to feed as long as they need to until they come off the breast by themselves. Some babies may only feed for 5-10 minutes, but others might spend up to 30 minutes or more. (Note: newborns need to have sufficient rest in between feeds. If your newborn is spending extended periods of time feeding and you feel they are not getting enough, seek advice from an IBCLC.)
• Topping up with formula – Supply follows demand, so if your baby is getting additional feeds with formula top-ups, there will be less demand for breast milk, causing a drop in supply.
• Hormonal changes – some women find their supply drops during ovulation and menstruation.
• Maternal illness – sometimes women may find their supply drops temporarily if they are ill.
• Substances – certain substances such as caffeine, nicotine and alcohol can affect supply and let down.

To help increase your supply:

• Follow the “optimal lactation” steps listed above
• Try offering additional “snack feeds”
• Offer your baby the breast for comfort, instead of using a dummy
• Offer both breasts – but be sure to fully empty the first breast before offering the second. Generally, it is best to wait until baby comes off the breast by themselves and then swapping sides.
• Ensure baby is positioned well and has a good latch – if you are unsure, speak to an IBCLC
• Feed baby in a comfortable, relaxed position away from distractions and noise.
• Massage your breast, working towards the nipple, or compress the breast as baby feeds, to help fully empty the breast.
• Remember that even if you are not able to exclusively breastfeed your baby, any amount of breastmilk is giving your baby amazing benefits!

Over Production and Engorgement

Sometimes women will produce too much milk, causing pain for the mother and frustration for baby. Signs of over production include:

• Baby is very fussy and restless during feeding and may arch their back and cry
• Baby bites down on your nipple (in an attempt to slow down milk flow)
• Baby may be very cough and splutter during feeding, especially during let-down
• You may feel a very forceful letdown
• You may experience frequent clogged ducts or mastitis
• Your breasts don’t feel like they are sufficiently empty after feeding

Causes of oversupply include:

• Overactive thyroid
• Excessive, frequent pumping – some women will pump early and often in order to build up a bank of frozen milk
• Timing feeds and switching sides after a set number of minutes, not letting baby fully drain the breast
• Baby breastfeeding frequently for comfort can also increase supply
• Some mums simply produce more milk than others!

This over supply can lead to engorgement or hardening of the breast as it becomes very full of milk. To relieve engorgement:

• Apply a warm cloth to breasts or have a warm shower before feeding to help soften the breast and encourage let-down. If your breasts are extremely hard and engorged, do not use heat – cold applications only.
• If baby is having trouble latching because of breast fullness, hand express some milk or use a breast pump for a few minutes first before feeding.
• Gently massage your breasts between feeds
• Hand express between feeds to relieve some of the pressure, but don’t overdo it – you don’t want to further increase supply!
• Apply cold cabbage leaves or cold packs to breasts for 15-20 minutes after feeds

Supporting new mums on restoring health & nutrients after baby is born is critical for a heathy breast feeding experience.  Breastfeeding issues  can be terribly distressing for any new mum and for baby, so I offer guidance and treatment and introductions to other specialists where needed.

Contact me today for more information or book an appointment at our award winning naturopath in Sydney‘s Inner West.

References

Australian Breastfeeding Association. (2022). Australian Breastfeeding Association. breastfeeding.asn.au

Australian Breastfeeding Association. (2022). Polycystic ovarian syndrome and breastfeeding. https://www.breastfeeding.asn.au/resources/polycystic-ovarian-syndrome-and-breastfeeding

Bone, K. (2003). A clinical guide to blending liquid herbs: Herbal formulations for the individual patient. Elsevier.

Institute for the Advancement of Breastfeeding & Lactation Education. (2017a). Breastfeeding after a Cesarean Birth. https://thepixelfarm.com/iable/membercontent/BFHandouts/IABLE_BF-Ed_Cesarean.pdf

Institute for the Advancement of Breastfeeding & Lactation Education. (2017b). Latching. https://thepixelfarm.com/iable/membercontent/BFHandouts/IABLE_BF-Ed_Latching.pdf

Institute for the Advancement of Breastfeeding & Lactation Education. (2017c). Positioning to help your baby latch well. https://thepixelfarm.com/iable/membercontent/BFHandouts/IABLE_BF-Ed_Help_Baby_Latch.pdf

Killings, N. (2020). Plugged ducts and mastitis. https://www.lactationtraining.com/resources/handouts-parents?task=document.viewdoc&id=45

Krumbeck, E. (2015). Herbs to increase supply: A guide to galactagogues. https://naturopathicpediatrics.com/2015/07/15/herbs-to-increase-milk-supply-a-guide-to-galactagogues/

La Leche League International. (2022). La Leche League International. llli.org

Rosenblum, N. (2022). Breastfeeding 101: Q&A with lactation expert Nadine Rosenblum. https://www.hopkinsmedicine.org/health/wellness-and-prevention/breastfeeding-101-qanda-with-lactation-expert-nadine-rosenblum

The post Breastfeeding: Supporting Optimal Lactation & Dealing with Common Issues appeared first on Performance in Health.

Restoring nutrient stores especially if your diet prior & during pregnancy was not optimal is a critical KPI for your health and wellbeing.

As a naturopath, supporting women throughout preconception, pregnancy and post-partum recovery is important for mum, baby, and the whole family. 

Whilst the baby blues is quite common following the first week after delivery, it usually begins to subside by week two or thereabouts. Postnatal depression on the other hand is a different condition entirely and can appear in the first 6 months after delivery and strike a debilitating blow for many, making motherhood an incredibly challenging time.

Supporting women so that they may understand and be aware of some of the signs of post-natal depression is critical in getting support early and recognizing when it’s time to ask for help.

In my clinic, we have mental health professionals to support women at this time working alongside myself and it’s important that your GP is fully aware of what is occurring for you also.  Having a wholistic team to nurture you back to physical and emotional can be very important.

The postpartum period is a time of immense physical and emotional change, as you not only recover from pregnancy and childbirth, but also move into a brand-new phase of life: motherhood. This is a period that can bring stress, exhaustion and overwhelm, but for some, the postnatal period can also lead to mental health challenges too, with postnatal depression (PND) affecting 10-12% of postpartum women in Australia. This handout looks at postnatal depression, its underlying factors, and naturopathic strategies for coping with PND.

About Postnatal Depression

The Baby Blues vs. Postnatal Depression

The baby blues is an extremely common experience – between 50-85% of women experience the baby blues, which is a period of increased emotional sensitivity and teariness, peaking at around 4 or 5 days after giving birth. Post-natal depression, however, is a more significant mental health condition. PND can begin any time after delivery and up to one year after giving birth. Post-natal depression can be debilitating, yet many mothers delay seeking treatment.

Risk Factors and Underlying Causes

Some of the risk factors and underlying causes for developing postnatal depression include:

• Antenatal depression (depression that begins during pregnancy) or a history of depression
• Being in poor physical health
• Experiencing financial hardship
• Lack of partner support or relationship issues
• Lack of social support
• Having a Caesarean section delivery or a negative birth experience may also increase the risk
• Hormonal changes – significant changes to your hormones, including a drastic drop in oestrogen levels, can lead to depressive symptoms.
• Nutritional deficiencies – many women are nutritionally depleted following pregnancy and childbirth. Nutrients such as vitamin B12, folate, vitamin D, zinc, iron, and omega 3 fatty acids are all commonly depleted in postpartum women and are associated with an increased risk of developing PND.

Symptoms

Symptoms of postnatal depression include:

• Low mood and severe mood swings
• Excessive crying and sadness
• Brain fog, difficulty concentrating
• Fatigue, low energy, insomnia, or excessive sleeping
• Difficulty with remembering or concentrating
• Trouble bonding with your baby
• Loss of appetite, or significantly increased appetite
• Loss of interest in things you sued to enjoy & normal activities
• Feelings of hopelessness, worthlessness, shame, or guilt
• Feeling like you’re not a good mother
• Feelings of anger – towards self, children, and/or partner
• Extreme concern & worry about your baby
• Thoughts & fear about harming yourself or your baby

It is important to know that many of the symptoms mentioned above may also overlap with common depressive disorders, so if you do have a history of depression or a mental illness, it is important that you reach out for support as your risk factor in development post-natal depression is higher.   For those mums without previous depression however, you are still at risk.

Understanding changes in your body that occur at this time

There are a number of changes in your reproductive & stress hormones that play a part in post-natal depression and when combined can lead to the “perfect storm” of post-natal depression.

Estrogen and progesterone: Bothof these reproductive hormones go into sharpdecline following the birth of your baby.

Oxytocin: this hormone has a huge role in bonding with your baby which is why it is known as the love hormone.  Lower levels of this important hormone is thought to play a role in post-natal depression.  As breast feeding is associated with higher mean oxytocin levels in scientific studies, breastfeeding may have a positive impact.

Cortisol:  this stress hormone increases throughout pregnancy with a drop after birth until it fully normalises over several months.

Naturopathic Testing in Postnatal Depression

With post-natal nutrient depletion being so common, some standard tests that may be ordered due to their role in mood, energy and recovery may include:

• Full blood count
• Iron studies
• Thyroid panel
• Serum vitamin D
• Serum vitamin B12 and folate
• Hormonal profile including progesterone (depending on how long ago you gave birth)

Dietary Strategies for Post Natal Depression

From physically recovering after childbirth, to accounting for the increased nutritional demands of breastfeeding, your body is in great need of vital nutrients after giving birth. Supporting yourself nutritionally is also important for your mental health – studies have shown that deficiencies in key nutrients, including folate, iron, vitamin D, and essential fatty acids, can increase the risk of postnatal depression. Please refer to my postpartum recovery blog here for detailed nutritional suggestions, and my blog on post-natal depletion which also highlights specific nutrients.

Specific Nutrients for Post-Natal Depression

These are unique to each person however common deficiencies include iron, Vitamin D, B vitamins and magnesium.  It is important you seek professional advice especially if you are breast-feeding.

Herbs for Postnatal Depression

As with supplements, herbs need to be prescribed with an understanding of where you are at with breastfeeding, however the following herbs are all generally considered safe during postpartum and breastfeeding and may be prescribed to help you.

St John’s Wort

St John’s wort is a wonderful mood lifting herb that works by increasing your serotonin levels. It also reduces anxiety and promotes a feeling of calm. Be aware that St John’s wort is not safe to take at the same time as conventional anti-depressant medications.

Ashwagandha

Ashwagandha is a wonderful restorative tonic. This herb can help you to cope with the new stressors in your changing life, improve your immune response, and can also help to boost your iron levels, too.

Nettle

Nettle leaf is considered to be one of the most nutritive plant foods known, with a high content of many important minerals such as zinc, calcium and magnesium, so it makes a wonderful herb for replenishing your nutrient status in the postpartum period. Nettle can be taken as a herbal extract or as a tea.

Oats Seed

Oats seed extract is a wonderful, nutritive and restorative herb. It can also help you to feel calmer and less anxious and is healing to the nervous system.

Skullcap

Skullcap is a gentle nervous system restorative herb that can help to reduce feelings of anxiety and boost mood.

Lifestyle

Enjoy Daily Exercise

Daily physical movement or exercise is a must for mental health. If you are still in the early recovery phase of your postpartum journey, please be mindful that you are recovering from a major physiological event and should treat your body with care while you are healing. Go slow and build up as you feel up to it. Gentle activities such as walking, and yoga are ideal at this time. If you can, combine your physical movement with some morning sun exposure, as this will help you to boost your vitamin D levels, balance your cortisol, and will also be beneficial for baby as they establish their circadian rhythm. If you are feeling physically recovered and are past the fourth trimester phase, you can push yourself to do higher intensity activities, including team sports, jogging, swimming, HIIT, and even weightlifting. Find activities that you are motivated to participate in and enjoy, as this will make it easier for you to commit to doing them each day. Lean on your partner, family, and friends to help you with childcare while you exercise or look into joining a gym with a creche.

Prioritise Rest, Especially in Early Postpartum

During the first 12 weeks postpartum, bonding with baby and resting often should be the priority. Delegate tasks to other people in your life as much as possible, so that you can keep your focus where it is needed. Beyond the fourth trimester, resting when you need to is still important! Sleep is needed not just for physical health but for mental health, too. When we are asleep our brains repair and renew themselves, reducing inflammation and clearing away toxins. Without adequate sleep, these processes can’t be properly done, which can worsen mental health symptoms. Prioritise sleep and don’t be afraid to nap when you need some extra rest. Negotiate with your partner a schedule that works for both of you to get enough sleep.

Speak to a Professional

If you don’t already have a regular counsellor or psychologist, it is worthwhile pursuing this. Cognitive behavioural therapy has been found to be an effective treatment strategy for women with postnatal depression and speaking to a professional psychologist or counsellor is an important step for anyone experiencing postnatal depression. Here at Performance in Health we are lucky to have many great mental health professionals on the team who can help with both in-person and virtual appointments.

Share the Parenting Workload

Many new mums try to take on the additional workload of parenthood on their own, or try to keep partner support to a minimum, especially if their partner is back at work. However, this can make your workload overwhelming. Speaking to your partner about how you can both share the workload in a way that works for you both is important. Likewise, your baby will benefit from receiving care from both parents. This includes nappy changes, bathing, feeding (if not exclusively breastfed), and settling.

Make Time for Social Engagement

Motherhood with a newborn can feel isolating, especially if you are a new mum, but social connection and support are vital for lasting mental wellbeing. We are social creatures and need that connection in our lives Making time for social engagement and connection can help you to feel less alone. Friends and family have a positive influence and finding friends who are in a similar life stage to you can make a big difference. If you don’t have friends who are also parenting babies and young children, try reaching out to your local play group to find other local parents.

Additional Tips for Coping with Postnatal Depression

• Remember that this is a challenging experience for all new parents – you are not alone in feeling the way you do!
• Accept help from family and friends and don’t be afraid to delegate tasks to visitors when they come by, so that you can focus on rest, bonding with baby, and self-care. Tasks such as hanging out washing, emptying the dishwasher, and even cleaning the bathroom can be easily delegated!

Additional Resources

The following additional resources may be useful to you:

PANDA

PANDA (Perinatal Anxiety and Depression Australia) is a dedicated organisation for helping parents coping with perinatal anxiety and depression. They have a dedicated helpline that you can call Mon-Sat on 1300 726 306 and offer lots of useful information on their website – www.panda.org.au

Beyond Blue

Beyond Blue have a 24/7 helpline that can connect you with a mental health professional any time. Call 1300 224 636

Lifeline

If you need urgent crisis support or are having suicidal feelings, Lifeline is available 24/7 by calling 13 11 14

For thorough naturopathic support in nurturing your body back to health, please reach out for an initial consultation or fact find call via my contact tab here

References

Amer, C. (2022, June). An RD’s guide to postpartum nutrition, plus easy postpartum meals. https://www.humnutrition.com/blog/postpartum-nutrition/

Ball, L., de Jersey, S., Parkinson, J., Vincze, L., & Wilkinson, S. (2022). Postpartum nutrition: Guidance for general practitioners to support high-quality care. Australian Journal of General Practice, 51(3).

Bell, A. F., & Andersson, E. (2016). The birth experience and women’s postnatal depression: A systematic review. Midwifery, 39, 112–113.

Bone, K. (2003). A clinical guide to blending liquid herbs: Herbal formulations for the individual patient. Elsevier.

Elwood, J., Murray, E., Bell, A., Sinclair, M., Kernohan, W. G., & Stockdale, J. (2019). A systematic review investigating if genetic or epigenetic markers are associated with postnatal depression. Journal of Affective Disorders, 253, 51–62.

Huang, L., Zhao, Y., Qiang, C., & Fan, B. (2018). Is cognitive behavioural therapy a better choice for women with postnatal depression? A systematic review and meta-analysis. PLOS One.

Minerva Natural Health and Fertility. (2021, November). Postpartum nutrition goals. https://minervanaturalhealth.com.au/2021/11/14/postpartum-nutrition-goals/

Ogbo, F. A., Eastwood, J., Hendry, A., Jalaudin, B., Agho, K. E., Barnett, B., & Page, A. (2018). Determinants of antenatal depression and postnatal depression in Australia. BMC Psychiatry, 18.

Ou, C. H. (2018). Anger in the context of postnatal depression: An integrative review. Birth Issues in Perinatal Care, 45(4), 336–346.

Rochford, T. (2022). Simple postpartum diet and nutrition tips. https://tararochfordnutrition.com/simple-postpartum-diet-and-nutrition-tips/

Sparling, T. M., Henschke, N., Nesbitt, R. C., & Gabrysch, S. (2017). The role of diet and nutritional supplementation in perinatal depression: A systematic review. Maternal and Child Nutrition, 13(1).

Sparling, T. M., Nesbitt, R. C., Henschke, N., & Gabrysch, S. (2017). Nutrients and perinatal depression: A systematic review. Journal of Nutritional Science. https://doi.org/10.1017/jns.2017.58

Whitley, J., Wouk, K., Bauer, A. E., Grewen, K., Gottfredson, N. C., Meltzer-Brody, S., Propper, C.,     Mills-Koonce, R., Pearson, B., & Stuebe, A. (2020). Oxytocin during breastfeeding and maternal mood symptoms. Psychoneuroendocrinology, 113, 104581. https://doi.org/10.1016/j.psyneuen.2019.104581

The post Postnatal Depression appeared first on Performance in Health.

Physical Healing in the Fourth Trimester

Your body has been through a lot in the last 9 months and is now in the important healing and recovery phase. Pregnancy and giving birth are both intense, physically demanding journeys and, depending on your birth experience, you may now have significant physical healing to do. Loss of nutrients and blood following pregnancy and birth, combined with significant sleep deprivation and stress, can leave you in a vulnerable state that can negatively affect your recovery and wellbeing. Your immune system function can also be supressed, and healing may be compromised. For this reason, it’s important to prioritise your healing where possible during this time, to avoid further health issues down the track.

Emotional Healing in the Fourth Trimester

Pregnancy, birth, and new motherhood are periods of considerable emotional upheaval. Perhaps you have journeyed from Maiden to Mother for the first time, or maybe you are learning to mother a newborn whilst also parenting older children, too. Your birth experience can also bring up strong emotions that may need to be processed throughout the fourth trimester period. Not only are there big changes in your life to process, but the hormonal fluctuations that occur post-birth can also contribute to the emotional rollercoaster of the post-partum period. It’s no wonder then that looking after your emotional health is just as important as looking after your physical health at this time.

The Baby Blues

The baby blues is an extremely common experience – between 50-85% of women experience the baby blues, a period of increased emotional sensitivity and teariness, which peaks around 4 or 5 days after giving birth. If you experience the baby blues, give yourself grace and allow yourself to feel your feelings, knowing that you will come back into balance soon.

Post-Natal Depression

Post-natal depression, on the other hand, is a more significant mental health condition that develops up to one year after giving birth. Post-natal depression can be debilitating, yet many mothers delay seeking treatment. While there are many different risk factors for developing perinatal depression, including having a history of depression and other mental health conditions, nutrition certainly plays an important role here. Studies have found that low levels of important nutrients such as vitamin D, selenium, folate, iron, zinc, and fatty acids, are all associated with an increased risk of developing postnatal depression. Many of the dietary strategies in this blog – Click here and provided during my naturopathic consultations will help you to replenish these important nutrients to help you with both your physical and emotional recovery and help reduce your risk of postnatal depression.

Naturopathic Testing in Post-Natal Depletion

If post-natal depletion is suspected, there are a range of tests that may be recommended for you, to help get a clear picture of your current health and to assess for targeted treatment with supplements and herbs.  I may look at your iron levels, thyroid, blood sugar levels, B12, folate, vitamin D as an example due to their role in energy, mood and overall recovery.

Dietary Strategies for Post Natal Depletion

From physically recovering from childbirth, to accounting for the increased nutritional demands of breastfeeding, your body is in great need of vital nutrients during this time, and careful nutritional support can be immensely helpful in coping with this stage of life. This blog on nutrients at this stage provides a basic level of guidance as to some of the key nutrients to consider for helping to support your recovery during the months that follow childbirth, as well as some general guidelines for a healthy diet that supports both you and baby.  Each person is unique depending on their diet pre and during pregnancy, any issues experienced such as sleep, stress & nausea, so this is a broad overview.

Your energy and nutrient needs are increased during the fourth trimester, as your body undergoes significant healing and recovery with energy needs increased even further if you are breastfeeding so now is not a time for calorie-restriction and losing weight – your priority should be with healing.  There are many easy to prepare and nutritious meals on my recipe section of the website which will ensure adequate protein, carbs and fat at this time

Specific Nutrients for Post-Natal Depletion

If you are breastfeeding, depending on the age of your newborn there are certain herbs and supplements that can be prescribed for you however during this time it is very important to make sure that you are obtaining the following nutrients via whole foods as much as possible, and by continuing your prenatal multivitamin.  Magnesium, iron, Vitamin D, Zinc, Vitamin C and omega 3 fish oil supplements with vegan options are often prescribed.  If you are not breastfeeding, you are then at a stage where more varied and additional herbs & supplements can be prescribed to assist you in restoring your optimal nutrient levels.

Herbs for Post-Natal Depletion

As with supplements, many herbs may not be suitable while breastfeeding, however a range of beautiful herbs are generally considered safe during postpartum and breastfeeding and may be prescribed to assist in your recovery.  Some of my favourites are Ashwagandha, Nettle, Oats Seed Shatavari, Skullcap and Reishi.

Galactagogue herbs for breast milk production may also be required if you are having problems with breast milk production which is a common issue for mums and naturopathic herbs to improve volume and flow may include Goat’s Rue, Hops, Fenugreek.  Fennel tea is also supportive.  Again, self-prescription is never recommended with lactation herbs.

Lifestyle

Enjoy Gentle Daily Movement

Whether you had a vaginal delivery or caesarean section, you are recovering from a major physiological event and should treat your body with care while you heal. Gentle movement each day, such as a gentle walk through the neighbourhood, will help to keep you active without placing undue stress on your body. This can also be a great opportunity to get some vitamin D and to rebalance your cortisol levels at the same time, whilst also being beneficial for baby developing their circadian rhythm. Many women will feel ready to slowly reintroduce exercise after around 6 weeks, however this will depend on your pregnancy, delivery circumstances, and the type of exercise you are wishing to do.

Prioritise Rest

Bonding with baby and resting often should be the priority for these 12 weeks. Delegate tasks to other people in your life as much as possible, so that you can keep your focus where it is needed.

Speak to a Professional

Whether your pregnancy and childbirth experiences were easy and blissful, or perhaps more challenging, there can be a lot mentally and emotionally to unpack from what you have been through. Speaking to a professional can be of tremendous help in working through emotional issues that have come to the surface, or for talking about any negative or challenging experiences you encountered. A psychologist or counsellor is a great place to find. We have wonderful mental health professionals on the team at Performance in Health who can help you, with both in-person and virtual appointments available. View details about our team here.

Additional Tips for The Fourth Trimester and Post-Natal Depletion

• Don’t try to do it all yourself – accept offers of help and have friends and family go food shopping and cook meals for you.
• Listen to your hunger cues and eat when hungry – the fourth trimester is a time to focus on recovery, not weight reduction.
• When you do cook, choose meals that you can easily cook in large batches, so that you can freeze extra portions for later.

References

Amer, C. (2022, June). An RD’s guide to postpartum nutrition, plus easy postpartum meals. https://www.humnutrition.com/blog/postpartum-nutrition/

Ball, L., de Jersey, S., Parkinson, J., Vincze, L., & Wilkinson, S. (2022). Postpartum nutrition: Guidance for general practitioners to support high-quality care. Australian Journal of General Practice, 51(3).

Bone, K. (2003). A clinical guide to blending liquid herbs: Herbal formulations for the individual patient. Elsevier.

Minerva Natural Health and Fertility. (2021, November). Postpartum nutrition goals. https://minervanaturalhealth.com.au/2021/11/14/postpartum-nutrition-goals/

Rochford, T. (2022). Simple postpartum diet and nutrition tips. https://tararochfordnutrition.com/simple-postpartum-diet-and-nutrition-tips/

White, C. (2021). Common nutrient deficiencies in postnatal depletion. https://www.spacetoflow.com/journal/common-nutrient-deficiencies-in-postnatal-depletion

The post Post Natal Depletion appeared first on Performance in Health.

As a naturopath, my unique treatment plans for each client will be developed around the type and causes of your acne however certain dietary and lifestyle strategies are appropriate for all acne cases as mentioned below in this blog.

So, what is Acne?

Acne vulgaris, more commonly known simply as acne, is an extremely common inflammatory skin condition that affects primarily the face, chest, shoulders, and back. It most commonly affects teens, although it can occur at any age. Symptoms range from mild to severe – some people may experience only a spot or two around the time of their period, while others may have significant inflammation, pimples, and boils over large areas of their skin.

There are four key steps in the process of acne:

• Hyperkeratinisation

Too much keratin (the protein our skin and nails are made of) is produced, leading to blocked pores. This process occurs as a protective measure by the skin due to inflammation.

• Increased sebum production

High levels of sebum (skin oil) are produced, including inside the blocked pores. This high sebum production is triggered by high levels of testosterone and DHT, two “male” type hormones (also known as androgens). Our oil glands are larger and more active on our face, chest, back and shoulders, which is why these are the most typical areas for acne to occur.

• Bacterial proliferation

Bacteria on the skin – specifically the Cutibacterium acnes species – proliferate inside the blocked pores, as it uses the sebum as an energy source.

• Inflammation

The body responds to the bacterial infiltration inside the pore by initiating an immune response and increasing inflammation in the area. It is this immune response that leads to the redness, swelling and pus formation seen in acne lesions.

Causes and Triggers of Acne

1. Hormonal Imbalance

Hormonal imbalance is a common underlying issue when it comes to acne. High testosterone (or an increased sensitivity to a normal amount of testosterone) is the typical underlying factor when it comes to hormonal acne. Testosterone and other androgens (“male” type hormones) signal to the skin to increase sebum production, directly worsening acne. Hormone imbalances can occur for a number of reasons, including:

• Overproduction of androgens – either the ovaries are overproducing testosterone, or the adrenal glands are overproducing DHEA. Both testosterone and DHEA can contribute to acne. This is often seen in PCOS and can be due to underlying insulin resistance.
• Underproduction of oestrogen, which leads to a high androgen to oestrogen ratio.
• Rapid changes in hormone levels can also play a role in acne, which is why acne may be worse at certain times of your cycle (such as during menstruation) or may be worse during pregnancy or menopause.
• Hormonal birth control with a high androgen index (high levels of “male” hormones), such as the Mirena IUD, Nexplanon implant, Nuvaring, and certain birth control pills.
• Poor liver function – the liver produces an important molecule called SHBG, which is needed for transporting excess hormones out of the body via the gut. If insufficient levels of SHBG are being produced, hormones can become unbalanced and both testosterone and oestrogen can become too high.

2. Inflammation

Chronic inflammation is another common trigger for acne. Inflammation can occur because of:

• Diet: inflammatory foods such as dairy, wheat, and sugar
• Food intolerances
• Digestive issues, IBS, coeliac disease
• Dysbiosis

Dysbiosis, e.g. high levels of “bad” bacteria and lower levels of “good” bacteria in the gut. This can be due to a huge number of reasons, including:

• IBS, coeliac disease, Crohn’s disease, or other digestive disorders
• Antibiotic use
• Diet low in fibre-rich foods (fruits, vegetables, nuts, seeds, legumes)
• Slow gut transit (constipation)
• Coming off the pill

3. Post-Pill Acne

Post-pill acne is a common sub-type of acne. Certain types of hormonal birth control pill, suppress the production of sebum to abnormally low levels – this is one of the reasons why they are prescribed to women with acne. Unfortunately, when you stop taking these pills, the skin responds by turning up oil production in the skin, sometimes for many months after you’ve finished taking the pill. At the same time, your hormone levels can become unbalanced, as your ovaries begin producing higher levels of hormones again. This combination of higher sebum production and higher testosterone levels, while temporary, can cause issues for up to a year or more after you stop taking the pill.

The withdrawal process from your sebum supressing oral contraceptive drug will take some time however it will come to an end which is good news.  The peak of symptoms over this 12 month period is normally at 3-6 months after coming off the pill which is why preparing to come off the pill for 3 months is always recommended for clients as this will support a less aggressive reaction from your body.  You may need to use barrier contraception if androgen reducing herbs and supplements are prescribed as this may impact the effectiveness of your oral contraception over this preparation period.  As a naturopath, I work closely with a lot of women who want to come off the pill, have a track record of acne and want to minimise their acne severity.

• Insulin Resistance

Acne is sometimes to referred to as “the diabetes of the skin”, because it is so often tied to underlying insulin resistance issues. Insulin resistance causes oestrogen to be converted into androgens like testosterone, DHT, and DHEA. As seen above, androgens are a significant problem when it comes to acne, so insulin resistance needs to be addressed to reduce acne symptoms.

• Poor Digestion and Elimination

The skin is the body’s largest organ and is one of several important channels of elimination in the body, which includes the bowels, the kidneys, and the lungs. If one of these other elimination channels aren’t working optimally, there can be increased pressure on the skin to eliminate toxins and metabolic wastes from the body, leading to congestion in the skin. Symptoms such as constipation may indicate that your digestive system isn’t working as it should and might be contributing to your acne symptoms.

• Stress

Stress can make acne worse, as cortisol not only causes increased levels of androgens, but can also stimulate the production of sebum directly.

Naturopathic Treatment Strategies for Acne

Testing

Possible testing that may be ordered for you including hormones, blood glucose and more.

Dietary Strategies

Eliminate Dairy

Dairy, and especially A1 dairy (which contains the inflammatory protein casein) should be completely eliminated from the diet as it increases the production of Insulin Growth Hormone Factor (IGF-1), which leads to high sebum production in the skin and worsens acne.

Reduce Sugar Intake and Eliminate Added Refined Sugar

All forms of refined sugar should be eliminated from the diet. Sugar consumption leads to high blood sugar and insulin levels, causes IGF-1 levels to spike, and is a highly inflammatory food. Read the labels of foods and be wary of wording on ingredient lists. Even “natural sugar” as an ingredient means extra sugar has been added to the food and home-made smoothies & protein balls can also cause trouble if not made well.  Check out the blog post here for more info.  Working with you on your diet and hidden sugars is always an important part of an acne treatment plan.

Cutting sugar from your diet can be tough, but is crucial and once we have balanced insulin, you will be able to enjoy the occasional sweet treat again I promise and some substitutes for the journey.

Eliminate “diet” foods and artificial sweeteners

Whilst these foods are typically low in sugar, they still negatively impact gut bacteria and contribute to high blood sugar levels and worsen insulin resistance. Foods such as diet soft drinks and “low sugar” lollies are particularly bad culprits, as well as “equal” and “sweet n’ low”.

Reduce Alcohol Intake

Another inflammatory food, and one that is generally full of sugar, too. Limit alcohol intake to no more than one standard drink per day and try to have plenty of alcohol-free days. When you do drink, choose low-sugar and high-antioxidant options, such as an organic red wine – there are plenty of great organic wines available these days.

Consider Eliminating Wheat

As with dairy, wheat is a highly inflammatory food, and one that is found in a huge number of food products. To best approach reducing acne, it is worthwhile considering eliminating wheat from your diet, and choosing wheat- and gluten-free foods. Wheat is used in bread, cake, cookies, biscuits, crackers, and pastries, and is also an ingredient in many processed foods.

Identify and Eliminate Food Intolerances

Exposure to food intolerances triggers inflammation as the body reacts to the “threat” of the food you are reactive to. Over time this can lead to significant chronic inflammation and gut damage and can worsen issues like acne. Common food intolerances which often impact those with acne include dairy and gluten/ wheat, but there are many other foods that can cause issues. A thorough naturopathic consultation will help understand what you may be reacting to.

Avoid Inflammatory Vegetable Oils

Certain vegetable oils increase inflammation and can make acne worse. These include sunflower, canola, soy, and corn oils. Instead, choose extra virgin olive oil, avocado oil, hemp seed oil, and avocado oils for use in cooking, and for making your own salad dressings.

Reduce Caffeine Intake

Caffeine triggers our “fight or flight” response and increases cortisol levels, which can upset normal hormonal balance and worsen your acne. Reduce your overall intake (ideally no more than one coffee per day) and be sure to consume caffeine in the morning, to reduce its impact on your sleep. Caffeine is primarily found in coffee, tea, chocolate, and energy drinks.

Eliminate high histamine foods

Foods high in histamine can increase inflammation, making acne worse. For more information on histamine, see our blog post here.

Eat Plenty of Anti-Inflammatory Fruits and Vegetables

Fresh fruits and vegetables provide many of the building blocks necessary for fighting inflammation, acne, and improving skin health, such as antioxidants, vitamins, and minerals, and even fibre for gut health and a healthy microbiome. Choose fruits and vegetables in a variety of colours to maximise your intake of different nutrients. For vegetables with edible skins, eating with the skin on can further increase insoluble fibre intake – but be sure to choose organic varieties and scrub the skins well before eating. Aim for 5 or more serves of vegetables or pulses each day, and 2 serves of fruit.

Eat Phytoestrogen-Rich Plant Foods

Phytoestrogens are molecules found in many plant foods which can bind to oestrogen receptors in the body. Phytoestrogens have a bad rap in Western culture as being damaging to our health, but this unfortunate misconception is due to a misunderstanding of how these molecules really work. They are actually able to re-balance oestrogen levels in the body, so can be very helpful with hormonal acne.

Phytoestrogens can be found in a huge range of foods, including:

• Organic soy products, such as tofu
• Ground flax seeds
• Chickpeas
• Linseed
• Mung beans
• Olives
• Pumpkin seeds
• Parsley
• Buckwheat
• Whole grains
• Sesame seeds
• Sunflower seeds

Eat Anti-Inflammatory Omega 3-Rich Foods

Omega 3 fatty acids are wonderful anti-inflammatory fats that can help to reduce some of the inflammation that makes acne worse. Omega 3 fatty acids are found in fatty fish (salmon, tuna, anchovies, sardines), walnuts, hemp seeds and hemp seed oil, flax seeds, and chia seeds.

Drink at least 2 litres of (filtered) water each day

Water is absolutely vital for ensuring your body can remove toxins. This is particularly important if your acne symptoms are associated with reduced elimination channel function, such as liver issues or constipation. Many of the herbs used to help with acne increase detoxification pathways, and without adequate hydration to move these toxins out via the kidneys and bowels, acne symptoms can be aggravated as the skin tries to remove toxins.  Avoid tap water due to small amounts of heavy metals like lead and copper, and both bottled and tap water contain microplastics.   Filtered water is the best option.

Eat Protein and Healthy Fats with Every Meal

Quality protein and healthy fats with every meal will help to balance blood sugar levels and promote healthy insulin functioning, too. Choose a variety of protein sources and remember not to overdo the animal-based products (meat and eggs). Good quality sources of protein can be found in legumes (lentils, chickpeas, black beans, kidney beans, cannellini beans), tofu, tempeh, edamame beans, quinoa, nuts (walnuts, almonds, cashews, Brazil nuts), seeds (hemp seeds, sunflower seeds, chia seeds, pumpkin seeds), and mushrooms. Be sure to build your meals and snacks around the protein source to make sure you’re not accidentally consuming too much carbohydrate. Add a good quality source of healthy fats as well – avocado, extra virgin olive oil, olives, or some nuts and seeds are all great options.

Use fresh herbs and spices

Herbs and spices are a fantastic source of antioxidants and are important for improving insulin functioning and fighting inflammation. Some spices, such as cinnamon, also directly increase the body’s sensitivity to insulin. Add to cooked meals, or even chop and use raw in salads and smoothies. There are a huge range of herbs and spices out there that are readily available fresh, so get creative! Some particularly good ones to try and include are turmeric, garlic, ginger, rosemary, coriander, basil, parsley, dill, chives, etc, can all be found in the fresh food section of the supermarket or are very easy to grow in a kitchen garden. Herbs can be used in soups, stews, homemade sauces, to flavour baked vegetables, or added fresh to salads.

Eat regularly and avoid skipping meals

Eating regularly through the day helps to prevent blood sugar levels from dipping and spiking throughout the day, which can make it more difficult to stabilise insulin secretion. Try eating snacks between your 3 main meals, or switch to eating 5 smaller meals per day. To prevent skipping meals, try keeping a snack on hand – such as a handful of nuts and seeds in a container – so that you’re not caught out when you’re out and about through the day.

Eat Plenty of Zinc-Rich Foods

Zinc is a powerhouse mineral that is involved in hundreds of processes in the body, and is a vital nutrient to consider when it comes to zinc, because it can:

• Reduce inflammation
• Helps the skin to heal by promoting collagen production
• Reduces overproduction of testosterone back to normal levels
• Kills bacteria, including those associated with acne
• Helps to heal the lining of the gut, reducing the effects of bacterial overgrowth and dysbiosis
• Reduces cortisol and the stress response

Zinc can be found in foods such as red meat, poultry, oysters, whole grains, pumpkin seeds, sunflower seeds, legumes (lentils, chickpeas, beans), cashews, and almonds.

Lifestyle Strategies

Reduce Stress

Stress has a huge impact on hormone health, as high cortisol (the stress hormone) disrupts healthy hormonal balance. Chronic stress also triggers inflammatory pathways in the body and has been shown to worsen symptoms of acne. You can help to combat the effect of stress with the following:

• 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.
• 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.

Skin Care

The following tips can be helpful with acne:

• Use cosmetics sparingly, to avoid further blocking pores
• Wash face gently with an unscented cleanser – avoid harsh cleansing agents and perfumes which can irritate already sensitive and inflamed skin
• Avoid picking at or squeezing pimples, as this can spread bacteria and worsen inflammation
• If you shave your face, use a new razor blade each time to reduce the risk of infection

Naturopathic Herbs and Supplements

Each naturopathic treatment plan is unique depending on what has caused and is sustaining your acne and may include the following:

Supplements 

• Zinc
• Vitamin A
• Omega 3 or fish oil
• Supplements that reduce androgens such as testosterone
• Magnesium
• Inositol, chromium and other blood glucose balancing nutrients

Herbs

There are many wonderful herbs that can help with acne. As with supplements, these will be individualised and tailored to your unique needs depending on the cause of your acne, but may include:

• Hormone-balancing herbs, such as peony, liquorice, vitex, or saw palmetto
• Liver herbs, such as dandelion root or globe artichoke
• Herbs to support insulin resistance such as olive lead, cinnamon
• Herbs to support the channels of elimination, such as burdock, nettle, or calendula
• Herbs to support circulation, such as rosemary
• Herbs for nervous system support, such as oats seed, skullcap, Siberian ginseng or ashwagandha

Acne is a complex condition and can often be the “Perfect storm” of a number of contributing factors.  An initial naturopathic consultation with Tanya, founder of Performance in Health Wellbeing Clinic is a very thorough investigation so that a comprehensive treatment plan can produce lasting results for you. 

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