Do you have big plans for January? Many of our patients say they’d like to take control of their health in 2020 (New Year, New You, right?). That often includes losing some extra pounds.


However, it’s always important not to get caught up in the numbers on the scale. Instead, a good alternative goal is to focus on lowering your body fat (but only if that would help your general health) and raising your energy levels. In other words, your goal should always be to improve your overall quality of life, not to chase after an often-elusive number on a scale.


No matter why you want to lose weight, it’s important to approach your New Year’s resolution with a strategy. That will raise your odds of success. (Here’s a sobering fact: About 80 percent of New Year’s resolutions are abandoned by February.)


The Run-Up to the New Year
Think about it. We often coast through December, eating, drinking, and neglecting our usual fitness routine. Then January arrives and we expect our body to adjust to an austere new regime. It’s no wonder that many people give up.


Believe it or not, it’s possible to prime your body to get ready for January’s resolutions/yourreallife while still enjoying the holidays. That includes revving up your metabolism so it’s ready to deal with dietary changes. And it’s even possible to do this during the busy month of December. Here are some steps that can help.


7 Ways to Avoid Packing On Extra Pounds This Holiday Season

1. Watch What You Eat. This is not just about how much you eat. The macro and micronutrient choices you make when selecting your food can change how efficiently your body metabolizes fat. In particular, include a source of protein with every meal. One reason for this is that it helps your body maintain muscle tone. (You can lose muscle when you lose weight, which slows your metabolism.) 
2. Don’t Cut Back On Sleep. Since we’re not technically moving during our sleeping hours, it doesn’t seem like that time should impact your base metabolism. However, researchers have found that getting adequate sleep, which for most people is around eight hours, is essential to good metabolism. 
3. Develop a Herbal Tea Habit. While you’re celebrating the holidays, consider switching some of that eggnog and champagne for herbal tea. Not only is it lower in calories, you will be consuming more water, one of the main catalysts for weight loss, and warm water is soothing to your digestive system which improves metabolism. Peppermint tea is particularly good for a stomach that’s complaining about the extra food, whereas Chamomile sets you up for a good night’s sleep, and Rooibos tea is full of antioxidants as well as being a natural energy booster.
4. Get Enough Vitamin D. During the winter, and especially before you make any dietary changes, it’s a good idea to check your Vitamin D levels. In addition to its many other health benefits, new studies have found that vitamin D can help with weight loss. In one study, women with adequate levels of vitamin D in their bloodstream lost more weight than women who were deficient in vitamin D. Note that it can be difficult to get enough vitamin D through diet alone. And at this time of the year, we often don’t get enough sun exposure to generate our own vitamin D. Supplementation is key this time of year. At our office, we offer vitamin D testing, and while not covered by OHIP for most, it gives us valuable insight into your immune function, mental health and digestive health. It is absolutely worth your time to know your number so that you can strategically supplement, as most general guidelines for vitamin D dosing are not enough to get you to optimal vitamin D status.
5. Top Up Your Magnesium. Magnesium helps with many processes in your body, so many that a deficiency of magnesium is quite common. Although it may not directly impact weight loss, having adequate levels of magnesium can help you sleep more deeply, regulate your moods, and control your blood sugar. Those are all important elements to maintaining a healthy metabolism. Good sources of magnesium include leafy vegetables, nuts, beans, and dark chocolate as well as magnesium glycinate supplements. We can help you with this too! 
6. Get Eat Probiotic Foods. Before you even start ramping up your healthy eating routine, get your gut in shape (from the inside!). Healthy gut flora can help with weight control. In fact, the makeup of the gut bacteria of overweight or obese people is typically different than that of people of healthy weight. In addition to fermented foods like kimchi or yoghurt, taking a high quality probiotic supplement in December can boost your gut bacteria levels. Not only can probiotics pave the way for better digestion in January, they also boost the immune system which makes for a healthier social season.
7. Stay Active. Yes, it’s hard when you’re busy. However, continuing to stay active will make it easier to hit the gym when you’re ready to ramp up your routine. Not only will your muscles stay limber, but you’ll also be taking steps to prevent your mind from slipping into a winter funk, which can impact your motivation. The good news is that it doesn’t take too much to maintain your base fitness levels. Remember: It’s better to do a bit, every day, then to be a weekend warrior. So fit in some 20-minute workouts, try a short YouTube cardio video, or meet some friends at yoga (or even walk around the mall!). Your metabolism will be grateful that you did come January. If you’re focusing on sustaining your metabolism so that you can crush those New Year’s resolutions in 2020, make sure you include strength training. Simply put, the more muscle you have, the more efficient your metabolism will be. Even when you’re just sitting still, you’ll burn more calories.

Yes, improving your metabolism can feel like a daunting task this time of the year. However, taking a few simple steps now can help get ready to meet your New Year’s resolutions head on!  

 If you’re not sure how to begin with all these tips, the best plan is to speak with an expert! We’d be happy to help you create a unique plan that suits you and would love to have a complimentary Health Discovery Session with you.

Sources:

1. Leidy HJ, Clifton PM, Astrup A. et. al. The role of protein in weight loss and maintenance. Am J Clin Nutr. 2015 Jun;101(6):1320S-1329S. Epub 2015 Apr 29.
2. ​Diepvens K,Westerterp KR, Westerterp-Plantenga MS. Obesity and thermogenesis related to the consumption of caffeine, ephedrine, capsaicin, and green tea. Am J Physiol Regul Integr Comp Physiol. 2007 Jan;292(1):R77-85. Epub 2006 Jul 13. 
3. Hruby A, Ngwa JS, Renström F et al. Higher magnesium intake is associated with lower fasting glucose and insulin, with no evidence of interaction with select genetic loci, in a meta-analysis of 15 CHARGE Consortium Studies.J Nutr. 2013 Mar;143(3):345-53. doi: 10.3945/jn.112.172049. Epub 2013 Jan 23. 
4. Turnbaugh PJ, Hamady M, Yatsunenko T et al. A core gut microbiome in obese and lean twins. Nature. 2009 Jan 22;457(7228):480-4. doi: 10.1038/nature07540. Epub 2008 Nov 30. ​

Estrogen – it’s not a dirty word.

Estrogen plays an important role through the course of our reproductive lives and beyond. It regulates our menstrual cycle, strengthens our bones, controls our cholesterol, and much more. When our estrogen levels go “out of tune” we experience PMS or menopausal symptoms. But even before menopause, varying levels of this vital hormone can wreak havoc. That’s because estrogen requires a delicate balance with other hormones. When that balance is disturbed, we can experience a wide range of frustrating symptoms.

This hormonal imbalance often occurs during a particularly busy time of our lives, the period from about age 25 through to menopause. As a result, our practice sees many women who are dealing with unexplained weight gain, mood swings, and libido problems. But there is help available. A few simple steps can help you restore balanced estrogen levels and feel like yourself again.

How Do You Know if You Have Estrogen Dominance?

Estrogen dominance can impact many areas of our lives, with symptoms that range from subtle shifts to major disruptions in wellbeing. Many women in this age group assume these issues are a normal part of aging or a consequence of their busy schedules. Just because it is common, does NOT make it a healthy normal!

Even a slight imbalance in hormone levels can lead to a number of problems.
Symptoms can vary greatly by person, but often include:

• Depression
• Brain fog
• Memory troubles
• Insomnia and restlessness
• Anxiety
• Irritability
• Headaches
• Foggy brain
• Water retention (sock lines, puffy fingers and wrists) and bloating
• Increased weight, especially in the belly, hip and bum area
• Heavier periods
• More severe PMS
• Irregular menstrual cycle
• Fibrocystic and painful breasts
• Uterine fibroids
• An increase in fatigue
• Loss of libido

Does that list look familiar? I see many women in my practice each month with complaints like these. I totally understand how frustrating they can be, especially when you’re unable to find effective treatment. And, of course, the complex relationship between estrogen and our emotions can only magnify the frustration. Who wants to feel irritated about feeling irritable?

It’s not only women who can experience estrogen dominance. You may be surprised to know that men can suffer an excess of estrogen as well. In men, estrogen dominance can manifest a bit differently, with some of these symptoms being common:

• Enlarged breasts (Man boobs)
• Sexual dysfunction
• Infertility
• Depression
• Fatigue
• Midsection fat

What Causes Estrogen Dominance?

To understand estrogen dominance, we have to consider the role of another important hormone, progesterone. Progesterone and estrogen maintain an often tricky seesaw in our bodies. Prior to menopause, the balance shifts at different stages of the menstrual cycle. Estrogen dominance isn’t necessarily a surge of estrogen, but an imbalance in that seesaw. Simply put, estrogen dominance happens when the seesaw tips to one side because there is not enough progesterone to balance out the estrogen. There’s actually no “set” number we can measure that proves an estrogen dominance diagnosis. It’s the overall hormonal profile that is important – the DUTCH test is an extremely valuable tool that I use regularly for assessing this balance.

How does estrogen become dominant? A key factor is the timing. Or, to be more specific, the time of our lives. Consider a normal menstrual cycle during our reproductive years: After we ovulate mid-cycle, our bodies produce progesterone to balance out estrogen.

But as we near menopause, we often have some menstrual cycles when we do not ovulate. As a result, there is not enough progesterone to balance out the estrogen. Enter estrogen dominance -- and its long list of possible symptoms.

To a certain extent, estrogen dominance is a natural part of our aging process. However, recent years have seen a rise in estrogen-dominance complaints, and our busy lifestyle may be a big factor. Environmental and behavior issues can increase estrogen levels, tipping the seesaw even further. What’s to blame? Take a look at this list.

1. Chronic stress will throw off your hormonal balance, often resulting in excess estrogen. In times of stress, your body produces too much cortisol. Cortisol negatively affects progesterone production, so the result is a shortage of progesterone to balance the body’s estrogen [check out my Calm the F*** Down Self Care Guide here].
2. Environmental sources of estrogen in our environment, particularly with regard to plastics and pesticides can negatively affect hormone levels.
3. Excess body fat can increase estrogen levels, since fat cells produce estrogen. Of course, this creates a frustrating cycle for some women, as the fatigue associated with estrogen dominance makes it difficult to lose weight. In men, this excess body fat can convert their testosterone to estrogen... leading to “man boobs”.
4. When we’re not getting enough sleep, our melatonin levels decrease. And melatonin helps regulate estrogen levels. In other words, if we don’t have enough melatonin to keep estrogen in check, we can end up in a cycle of sleep trouble.
5. Hormone replacement therapy that doesn’t take all hormones into account and doesn’t treat with customized dosing, can inadvertently create estrogen dominance. Bioidentical Hormone Replacement therapy, when used as part of a comprehensive treatment plan, however, can be a powerful option.

How Can You Restore Hormone Levels?

Our practice can work with you to re-balance your hormonal havoc. Starting with an accurate diagnosis, we can create a lifestyle plan that works for you. As a starting point, these changes are recommended:

1. Decrease stress. I realize this is easier said than done! But an estrogen-dominant diagnosis might be the wake-up call you need to take a step back and assess your stress levels. Are you doing too much?
2. Choose your health and beauty products wisely. Xenoestrogens have a similar molecular structure to estrogen. Bisphenol A (BPA), which is often used in plastics, is an example of an xenoestrogen. When these substances enter our bodies, our system reacts as if they are actual estrogen. Some simple steps, such as avoiding plastic food storage containers and products with artificial scents, can help reduce your exposure to xenoestrogens.
3. Get moving. Exercise will relieve stress levels and could help reduce body fat. Strength training and yoga are great activities.
4. Get enough sleep. We know - you’re busy. But sleep will help restore your melatonin levels and, subsequently, your estrogen balance. Check out this article for more on improving your sleep quality.
5. Increase your intake of fiber. Insoluble fiber can bind with estrogen in our digestive tract. Ground flax is another great option. As a result, excess estrogen is eliminated with a high-fiber diet.
6. Go organic. Many pesticides have been identified as estrogen disruptors. That means they disturb the natural balance of estrogen. Research is still being done in this area, but the connection is becoming clear. Plus, organic food is delicious!
   
   

Do you think you might have a hormonal imbalance?

Do the estrogen dominance symptoms sound a bit too familiar? Please contact our clinic and we’ll get to the bottom of what’s going on and create a plan of action to bring your body back to good health.

References

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC313802
2. https://www.ncbi.nlm.nih.gov/pubmed/10188197
3. https://www.ncbi.nlm.nih.gov/pubmed/15276966
4. https://www.ncbi.nlm.nih.gov/pubmed/11602005
5. https://www.ncbi.nlm.nih.gov/pubmed/12644393

The link here is Vitamin D.

Vitamin D is an essential hormone and we are designed to get lots of it by being outside in the sun, moving around outdoors and enjoying the world around us. The challenge is that many of us spend our days inside working avoiding the sun between 10-2 pm, wearing sunscreen with a high SPF every day under our makeup and long light layers we can become very deficient.

This is a big deal.

Vitamin D is critical for our immune system. Many of us know about Vitamin D for bone health - Vitamin D helps regulate calcium and phosphorus absorption and excretion in the body. This is why many products are fortified with a synthetic version.

Run of the mill health issues like coughs, colds, allergies, flus and other common issues are related to low Vitamin D levels that compromise our immune function. Vitamin D also keeps our immune system communicating so that we reduce our risk of more serious issues like Type 2 Diabetes, osteoporosis, heart disease, cancers and other autoimmune diseases like multiple sclerosis and rheumatoid arthritis. Low Vitamin D is also related to thyroid disease, mental health issues and hormone health. Adequate vitamin D is essential for digestive health as well, and when we are deficient we get leaky gut.

When we lack Vitamin D our immune system loses touch with itself and we are more likely to get sick.

Who is at risk?

• Indoor workers and kids spending the best part of the day out of the sun
• Older adults, who are less efficiently able to generate Vitamin D ​
• Darker skinned individuals
  • The melanin in dark skin actively blocks Vitamin D conversion in the skin, so the darker your tan, the less efficiently you will be able to absorb Vitamin D. Lighter skinned people and babies absorb much more efficiently. ​
• Canadians (the geography effect).
  • We are only able to effectively absorb it from May-October in Southern Ontario
  • This is related to the angle of UVB light coming from the sun. Sunny winter days offer no opportunity for vitamin D.
  • A good rule of thumb is if your shadow is longer than you are tall, you’re not making much vitamin D. 
• Breastfed infants (sometimes)
  • Formula is supplemented with vitamin D so it is thought that breastfed babies are at higher risk of deficiency
  • Mother’s vitamin D status during pregnancy will affect baby’s levels. Mother’s that have excellent vitamin D status and who breastfeed their babies have babies with vitamin D levels similar to that of infants that are supplementing with Vitamin D  
• Concealing clothing, particularly UV blocking, all the time
  • Long layers can be very helpful, however, once you’ve been outside in the sun to help prevent a burn  
• Digestive issues eg. Crohn’s disease, Ulcerative Colitis, Small Intestinal Bowel Overgrowth (SIBO)
  • 25-OH Vitamin D levels tend to be lower in people with digestive conditions, as Vitamin D helps maintain tight junctions within the intestines. With lower levels suggesting immune compromise, these junction become “leaky” and food sensitivities, inflammation and immune activation result  
• Magnesium deficiency
  • Nutrients rarely act in isolation. If magnesium is low, vitamin D absorption is impaired. If Vitamin D levels are low, calcium is not well absorbed either.

Where can you get it?

• Sun – our best source
• Fatty fish, like canned salmon with bones
• Egg yolk
• Mushrooms
• Beef liver
• Fortified foods like dairy, and non-dairy alternatives like almond milk
• *Supplements

 
 
Next Steps:

1. Test your vitamin D (25-OH) to get a baseline
   • Naturopathic Doctors and family doctors can test, however, OHIP doesn’t cover testing, unless you have osteoporosis. It costs about $36 in Ontario to test blood 25-OH Vitamin D
   • Your levels should ideally be around 100-200 nmol/L. Even lower levels within the normal reference range can put you at increased risk for other health conditions
2. ​​Get daily sun, outside in nature.
   1. If you can’t get outside, at least sit near a window
   2. Daily sun time for 10-15 minutes with maximal skin exposure, or roughly half the time it would take you to burn
3. Take a vacation somewhere sunny in the winter
   1. ​Travelling somewhere hot and sunny in the winter months can be helpful, as Vitamin D has a half-life of 2-4 weeks (ie. Your trip to sunny Cancun will help elevate your Vitamin D levels for 4-8 weeks afterwards) 
4. Track exposure via DMinder, a great free app
   1. Can track blood levels of Vitamin D, skin tone, sun exposure and supplement intake so that you know how much vitamin D you are absorbing each "sun session"
   2. I love this option because you also get burn warnings and sunscreen reminders and notifications for your best sun opportunities where you live
5. Be sun smart
   • Know your tolerance.
   • Use shade and wear long layers AFTER you've been out in the sun ie. before you start to burn.
6. ​​Sunscreen should be your LAST line of defense, not your only one!
   1. Use a good quality natural sunscreen that you like using natural blocking ingredients like zinc or titanium oxide.
      1. I like Goddess Garden for beach time, and Cocoon Apothecary Reflector for my face
   2. Avoid sweat-proof, dry touch sunscreens that disrupt hormones, containing ingredients like oxybenzene, retinyl palmitate
      1. High SPF sunscreens do not offer substantially increased protection
   3. Reapply every 1-2 hours and after sweating and swimming
   4. Do your reseach. Check out the Skin Deep Cosmetic Database – a research-driven review of personal care products – publishes an annual sunscreen guide. Check it out to see how yours stack up.
7. If you choose to supplement KNOW your baseline levels
   1. Vitamin D over 1000 IU per day is a prescription in Ontario and self-prescribing is NOT recommended
   2. Work with a licensed health care provider to help determine your ideal levels based on your blood levels and your lifestyle.

 
Vitamin D keeps your brain sharp, skin glowing, immune system humming along and is an essential part of your life. Practice safe sun, but don't fear it!

Keep on the sunny side,

• ​Fatigue is more than feeling groggy because you stayed up too late watching Netflix and missed your morning coffee.

 
It is a persistent ache-in-your-bones feeling, like walking through mud every day and struggling to do the little things. It is the disorientation of not feeling like yourself for the past few weeks, months or years. It clouds your brain, steals your sense of humour and weighs heavily on your relationships. And then there’s the guilt and self-judgement about why you just can’t seem to get it together.
 
One of the biggest struggles that people with persistent fatigue face is that outwardly they look normal. Coworkers, friends and families may offer “helpful” suggestions about being more organized or going to bed earlier (a great point, but not THE point) or completely fail to understand. Even physicians may struggle to help once the basic blood work comes back “normal”.
 
Lifestyle factors can and do play a massive role, so it is critical to ensure that you are getting enough good quality sleep, eating well, exercising, managing stress and taking good care of yourself. Working with a therapist, registered massage therapist, personal trainer and your health team can be helpful to make sure you’re covering your bases.
 
If you are already addressing these areas and still feel like something is missing, Naturopathic Medicine can be a great solution. The next step is digging deeper and doing a thorough investigation to determine the cause of the fatigue and how these factors might be affecting your overall health.
 
Here are some of the most important lab tests that we run to assess the fatigue you’re experiencing.

Ferritin and iron panel – ferritin, % saturation, serum iron and total iron binding

• Iron is essential as it is required to help our body transport oxygen. Adequate levels are critical for optimal thyroid function. Ferritin is a measurement of stored iron and so can be very useful in seeing what’s in the bank. If you are also dealing with inflammation ferritin becomes less reliable as it will artificially inflate. Running a full iron panel can be helpful to discern whether the issue is actually low iron or inflammation.

Vitamin B12

• Low vitamin B12 levels are associated with fatigue, anxiety, depression and other mood disorders as well as neurological sensations like pins and needles. B12 deficiency can be caused by acid blocking medications like proton-pump inhibitors and antacids.

Thyroid Panel – a full panel includes TSH, free T4, free T3, reverse T3 and anti-TPO

• The thyroid sets the pace for every cell in your body aka your metabolism. If this rate is slowed down, everything is going to feel harder and you will most likely feel fatigued, have brain fog, weight issues as well as many other issues. This is one of the most under-diagnosed and poorly managed areas I see in practice. Getting the FULL panel is critical and the only way to give us the full picture.

DUTCH Hormone Test

• This is the most comprehensive hormonal evaluation available and gives a big picture view of how your hormones are working. One of the more common imbalances we see is either very high or low cortisol. This can greatly contribute to fatigue, as well as anxiety, insomnia and is a harbinger for other chronic health conditions. Your sex hormones progesterone, estrogen, testosterone and DHEA also play an important role in keeping you going and even small imbalances here can wreak havoc on your energy and mood.

Autoimmune and Inflammatory Markers – hs-CRP, ESR, ANA, rheumatoid factor, tissue transglutaminase IgG and/or IgA

• Low grade inflammation and undiagnosed autoimmunity as in Celiac disease, Hashimoto’s thyroiditis, lupus, psoriasis, rheumatoid arthritis as well as chronic pain take a lot of your body’s energy to keep under control. Sometimes fatigue is main presenting sign of autoimmune disease. These markers can also serve as a useful baseline to track your treatment progress.

Organic Acids Test

• The Organic Acids test gives us an intricate overview of how your body is physically making energy, if there are any bacterial and/yeast overgrowth concerns, and if you are deficient in some of the major nutrients required to keep your body functioning properly. I highly recommend this test for anyone that has been experiencing chronic fatigue, mood disorders, autism, ADHD and chronic pain.

 
Other factors to consider:
 
You know yourself best. If you feel that something is off, you are probably right. It is better to know where you stand and choose to work with a health care provider that can offer you the evaluations you need to get to the bottom of things.
 
A thorough investigation is important, but it is even more important to have a plan in place to address what you find.
 
Diet and lifestyle factors like how you eat, how you move, how you sleep and managing your stress will ALWAYS need to be a part of any treatment plan you undertake. It can be easy to get caught up in a complicated regimine of supplements and medications, but focusing on a strong foundation is what really determines your outcome.
 
If you have “tried everything”, have you been consistent enough? Being fatigued IS exhausting and it is only natural to get excited about the next newest thing… but nothing will work if you don’t give it a fair shot.
 
You need a team. The support of a partner or friend or online community can make a world of difference when you are suffering from an invisible illness. Work together with your health care providers to get the right assessments and guidance to help you recover. If you feel unsupported, unheard or like you are bothering your provider, find another professional to work with that will take your concerns seriously.
 
Working with a Naturopathic Doctor to address the causes of chronic fatigue can be invaluable to your recovery by helping you systematically address each of the areas above and make a concrete plan based on YOU.

In health,