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7 Steps for Optimizing Your Vitamin D and Enjoying the Sun (safely)

6/28/2017

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Picture7 Steps for Optimizing Your Vitamin D and Enjoying the Sun (safely). Keila Roesner ND.
​I was on away on a girls’ weekend recently. A gorgeous sunny day exploring Niagara wine country (this ND enjoys a glass of wine too!), laughing our butts off and trying not to fall off our bikes. It was a perfect opportunity to work on my “base tan” for the year.

As a fair-skinned gal of Irish descent… I’m prone to grow freckles and get very very pink. Unlike my husband who gets a gorgeous tan every year, I have to be careful. But I certainly don’t avoid the sun. Ever.

But wait, isn’t the sun the root of all evil? Skin cancer, melanoma and awful peeling skin? If the sun going to kill me… how come my ancestors survived?


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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,


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Resources:
  1. The Vitamin D Council
  2. Skin Deep Cosmetic Database Sun Guides
  3. DMinder for Android and Apple
On Vitamin D supplementation in food: http://ajcn.nutrition.org/content/80/6/1710S.full
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Dr. Keila's No-Bake Vegan Coconut Energy Bites

2/20/2017

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PictureA delicious, healthy, simple vegan, dairy-free gluten-free make-ahead no-fuss snack.
No-bake energy bites are the perfect healthy snack: easy to make, customize-able based on your pantry ingredients, and they store incredibly well in the freezer. Use this recipe as a guide but feel free to make substitutions based on your tastes. You can easily double – or quadruple this recipe, and kids can help. Perfect for last minute potlucks, people with food sensitivities and to throw together when you’re short on time and energy.

Prep Time: 10 minutes                                           
Chill Time: 30 minutes
Cook Time: nada                         
 
Yield: 20-25 balls
             
Ingredients:
  • 1 cup (dry) oatmeal
  • 2/3  cup toasted or regular coconut flakes (unsweetened)
  • ½ cup nut butter (peanut butter, Nut & Seed butter etc.)
  • ½ cup ground flax seeds
  • ½ cup dried cranberries
  • 1/3 cup honey
  • 1 Tbsp. chia seeds
  • 1 tsp. vanilla extract

Directions:
  1. Mix all ingredients together in a large bowl until thoroughly mixed. If the mixture seems a little dry, add more nut butter or honey. If too gloopy, add more seeds or dry ingredients.
  2. Cover and place bowl in refrigerator for at least 30 minutes (this makes rolling easier!).
  3. Roll into small balls, any size, and store in air tight container in the refrigerator (up to 1 week) or in the freezer (they won’t last that long before you eat them all).

Other ideas:
  • Substitute chocolate chips, pumpkin seeds, sunflower seeds or slivered almonds
  • Use almond extract OR peppermint extract in place of vanilla and add cocoa for a chocolate bite
  • Protein powder can easily be added into the mixture for a post-workout snack
  • Change up your nut or seed butter
  • Change up your sweetener – maple syrup works nicely
  • Omit oats and use ground flax/chia/almonds if grain-free or following a Paleo diet

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10 Obvious Signs Your Body Needs a Reset Detox

10/15/2016

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Your body is ALWAYS trying to communicate with you. The problem is that most of us get so busy that we forget how to listen… so our body needs to scream to get us to pay attention.
 
I hear it all the time. “But Dr. Keila, I’m pretty healthy..”! Meanwhile, you may be taking a few prescription medications to control your blood pressure, thyroid and that random rash that comes and goes. TUMS are in your medicine cabinet and you carry Tylenol in your purse all the time. But that’s all normal, right?
 
Nope. Not at all.
 
There is a BIG difference between common and normal. Common is taking a few prescription medications, having digestive issues and bad knees. Normal is having a good night’s rest, waking with energy and not requiring caffeine. Normal is being able to eat food without feeling awful afterwards, and almost never getting heartburn or headaches.
 
Big difference.
 
Sometimes our body needs a reset. To clear the clutter and figure out what actually is going on.

Here are 10 major signs your body is not functioning “normally” (even though they may be common!).

  1. Your day starts AFTER coffee, and you need it to go to the bathroom
  2. You can’t get through the day without one or two “treats” – be it crunchy, salty and from a bag or sweet and chocolatey.
  3. Your clothes aren’t fitting right OR you have a fat and a skinny wardrobe
  4. You have a noticeable “food baby” bloat after eating
  5. Your skin is acting up and you have acne… and have long passed your teenage years
  6. Weird rashes start taking up residence on your face or body
  7. 3 pm comes and your energy crashes
  8. Migraines or tension headaches are occurring more than once a month
  9. You turn into a dragon-lady just before your period OR you have awful cramps
  10. Insomnia is kicking your butt: you wake at 1-3 am most nights and are exhausted in the morning
 
A good detox should help you address all of these things. It is not meant to “fix” things, but to help your body reset and tune out some of the noise so that you can actually figure out what the heck is going on.
 
Do any of these sound like you? Comment below!
 
If you are tired of these common, but definitely NOT normal signs, here’s three free you can do:
  1. Get your copy of my Starter Detox fridge guide [click here] 
  2. Check out our webinar on how to detox to look & feel great in 7 days
  3. Book a Health Discovery Session with me to discuss your options

If you found this article interesting please share.

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In health,
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The real reason your Irritable Bowel Syndrome isn't getting better...

7/20/2016

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What if Irritable Bowel Syndrome (IBS) wasn't "just in your head?". This may seem revolutionary for many physicians... and people that don't have IBS. 

Anyone living with IBS knows it's true. Nobody wants to be bathroom bound when they try to leave the house, or have to scan a restaurant menu frantically looking for the one item that won't cause them pain or embarrassing gas within an hour. 

Well, it's true. 

Small Intestinal Bowel Overgrowth (SIBO) is estimated to be the cause of anywhere from 40-85% or more cases of IBS. Clinically, I would say that this number is even higher.

Your Gut is a Garden

There are several types of bacteria within the digestive system. The particular species depend on things like your genetics, your birth type (hospital, home birth, vaginal, C-section), breast versus formula feeding, your diet, medications and stress. They can change over time and the unique combination can markedly affect how you feel. It can be helpful to classify human bacteria into three categories:

  1. Healthy bacteria  - these are the beneficial species, like Lactobacillus, and Bifidobacterium that help to defend against pathogenic bacteria, producing bile flow, keeping unhealthy bacteria from taking hold, releasing vitamins from our food and metabolizing toxins.
  2. Neutral bacteria (Commensal Flora) - these types of bacteria have evolved along with human species and are generally not harmful. However, given the right conditions they can crowd out beneficial bacteria and create problems.
  3. Unhealthy bacteria (Pathogenic) - these are the typical bacteria we think of: E. coli, C. difficile, Shigella flexneri, Salmonella enterica, Vibrio cholera and they can make us sick, cause food poisoning and long term health issues.

Much like a garden, there are a combination of plants that you want like tomatoes, sunflowers, parsley (healthy bacteria), species that show up that can take over if not contained like mint, orange lilies (commensals) and then there are invasive weeds like bindweed, thistles (pathogenic bacteria). Every garden will have a combination of all of these. As in the human digestive system, we want the balance to be tipped in favour of the helpful species, so that the neutral species can exist in manageable amounts, and hopefully ultimately crowd out the weeds. A diligent gardener can also go a long way.

Normally, the majority of bacteria within the digestive system reside within the large intestine where they work on the food you're digesting to produce Vitamins B1, B2, B6, B12 and K2 as well as other substances. Since we have 10 times as many bacterial cells in our body as we have human cells, even a small alteration in our bacterial garden can change our landscapes dramatically.


Our In House Gardener: The Migrating Motor Complex (MMC)

The MMC coordinates electrical wave patterns every 90-120 between meals that sweeps through the stomach and small intestine to helps propel food and bacteria from the ileum (the end segment of the small intestine) to the large intestine. In order to function properly, our body needs to have a break between meals.

In SIBO, these bacteria can migrate backwards, up into the small intestine which normally has far fewer bacteria. This migration can occur with intestinal permeability, certain medications, inflammatory bowel disease (Ulcerative Colitis, Crohn's Disease), Celiac disease, and low stomach acid.

Because competition is less fierce in the small intestine than in the large intestine [Read my previous blog here to review], these bacteria can settle in, replicate and grow without being crowded. This is like freshly tilling your garden and then going on vacation for two weeks only to find that your neighbour's weeds crept under the fence and have taken over. Now you have thistles that are six feet tall.

The problem is that now you have bacteria existing in high amounts where they would not normally be and they are now crowding out healthy bacteria, interfering with your crop and attracting pests.  The overgrowth can be a combination of healthy, commensal or pathogenic bacteria.... it doesn't really matter because you've got a forest on your hands. 

This overgrowth is what contributes to much of the discomfort of Irritable Bowel Syndrome.
Have you ever noticed that flowers are easily pulled but weeds have deep roots? Same story here. The bacteria that takes hold likes to stick around and make a mess. It can throw off the MMC, and instead of helping to digest your food it ferments it.

Fermentation is the process of converting sugars in foods to gases or alcohol, as in beer, wine and sourdough bread. Our bodies are not designed to ferment, and when we do, we bloat. We get gas pains and "I swear I'm not 3 months pregnant!" food babies after eating. Because the food is not breaking down properly, we also get intestinal permeability.

We are more likely to have other problems too:
  • nausea
  • flatulence
  • diarrhea
  • constipation
  • food sensitivities
  • Leaky Gut
  • Fibromyalgia
  • Chronic Fatigue Syndrome
  • Acid reflux
  • Gastroesophageal Reflux Disease (GERD)
  • eczema
  • rosacea

Sound familiar?

In our next blog post, we are going to be covering the key signs to watch out for to tell if you have SIBO and what you can do about it.

If you found this post helpful, please share with your friends and family!

In happy digestive health,

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Fix my bloat!
Dr. Keila

References
​
  1. Sachdeva S1, Rawat AK, Reddy RS, Puri AS. Small intestinal bacterial overgrowth (SIBO) in irritable bowel syndrome: frequency and predictors. J Gastroenterol Hepatol. 2011 Apr;26 Suppl 3:135-8. doi: 10.1111/j.1440-1746.2011.06654.x. http://www.ncbi.nlm.nih.gov/pubmed/21443727
  2. Mann NS1, Limoges-Gonzales M. The prevalence of small intestinal bacterial vergrowth in irritable bowel syndrome. Hepatogastroenterology. 2009 May-Jun;56(91-92):718-21. http://www.ncbi.nlm.nih.gov/pubmed/19621689 www.ncbi.nlm.nih.gov/pubmed/19621689
  3. Littman DR, Pamer EG. Role of the commensal microbiota in normal and pathogenic host immune responses. Cell host & microbe. 2011;10(4):311-323. doi:10.1016/j.chom.2011.10.004. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202012/
  4. Zhang Y-J, Li S, Gan R-Y, Zhou T, Xu D-P, Li H-B. Impacts of Gut Bacteria on Human Health and Diseases. Sugumaran M, ed. International Journal of Molecular Sciences. 2015;16(4):7493-7519. doi:10.3390/ijms16047493. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4425030/
  5. Deloose E1, Janssen P, Depoortere I, Tack J. The migrating motor complex: control mechanisms and its role in health and disease. Nat Rev Gastroenterol Hepatol. 2012 Mar 27;9(5):271-85. doi: 10.1038/nrgastro.2012.57.http://www.ncbi.nlm.nih.gov/pubmed/22450306
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If You Have Ever Experienced These 5 Things, Your IBS Might Be Caused By SIBO.

7/19/2016

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I had a potential new client in my office today who had been diagnosed by her family doctor with Irritable Bowel Syndrome several years ago. When she asked what she should do next, he told her to "go read about it".

Wait, what?! 

There is so much misinformation online: treatments based on outdated science, "it-worked-for-my-sister's-neighbour" stories and down right bad advice. 

Unfortunately, she did not have a medical degree or background in research to be able to decipher the good from the bad. She knew that the info she was seeing on Yahoo forums was probably questionable, she didn't know where to go to find good information. So she was referred by her pelvic floor physiotherapist to me. "Reading about it" had done nothing for her and she was sick and tired of daily diarrhea.

She is not alone. 

One of the most common causes of IBS is a little known condition called Small Intestinal Bacterial Overgrowth (SIBO) - [read my previous blog post here].

While you should absolutely work with a knowledgeable health professional, there are several tell tale signs that your IBS is actually due to SIBO (and not a deficiency in "reading about it").

5 Key Signs You Might Have SIBO:
  1. Raw fruit and veggies make you feel like crap.
  2. You feel worse on a probiotic.
  3. You haven't felt right since that one bad stomach bug/food poisoning/trip to Mexico
  4. You've had a concussion, and haven't felt right since then either.
  5. You have had multiple rounds of antibiotics or have taken antacids in the past.

If any of these sound familiar, let's set up a time to chat. Book your complimentary Health Discovery Session to discuss your options.

Getting the right testing is the first step to getting better. 

The good news is that there are some very good tests you can do to see if SIBO is causing your IBS. Based on your results, we can create a customized plan to get rid of the discomfort, gas, bloating and bathroom embarrassment. Once and for all.

In my next blog, we will talk about some of the testing you should have to finally get rid of your Irritable Bowel Syndrome.

In health,

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You Probably Don't Have Too Much Acid: 5 Common Causes of Heartburn and GERD

6/29/2016

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There's a burning fiery pit in your chest. It's not a heart attack. You've checked with your doctor before.
​
It's feels heavy, uncomfortable and burns. At your last visit you were told that you probable have GERD. And you think, "what a goofy name for something that feels like hell!"

Heartburn, or Gastroesophageal Reflux Disease (GERD) accounts for one out of three primary care visits, and has been increasing quite dramatically over the last two decades (1). It's now estimated that 18-27% of adults in North America experience heartburn at least once weekly (2), and many experience it daily. Which absolutely sucks.

This sharp increase can be attributed to rising rates of obesity, and is more common amoungst smokers and with age.

Common symptoms of GERD include:
  • sensation of hoarseness or lump in your throat
  • dry cough or throat clearing, last longer than 8 weeks
  • burning in esophagus, throat or chest
  • symptoms worse at night
  • trouble or pain with swallowing
  • bitter or sour taste in mouth
  • nausea and regurgitation
(*most common symptoms, although not all need to be present)

A diagnosis of GERD is often made at the physicians office, and then commonly, anatacids (Gavison, Rolaids, Tums), H-2 receptor blockers (Pepcid AC, Zantac) or Proton pump inhibitors (PPIs, like Prevacid, Losec etc.) are recommended to "stop the burning". If it helps, it is assumed that GERD was your problem. 

But we seem to have gotten a little caught up with this idea that burning = too much acid. If you've read my blog "Why Does My Stomach Hurt?" you'll see that it is a little more complicated than that.

Heartburn typically stems from one of four causes:
  1. abnormal esophageal movements - the esophagus acts like a tube to carry food down to your stomach, via gentle muscular squeezes called peristalsis. Sometimes, these movements can become uncoordinated, resulting in spasms. If there has been long term damage (like strictures), it can really throw off this pattern.
  2. weak lower esophageal tone - the Lower Esophageal Sphincter ("LES", also known as the Cardiac Sphincter) acts as a one way valve from the esophagus down to the resevoir, the stomach. Normally, the LES will stay shut, unless there is pressure from above (hello incoming dinner!) for it to relax and open. Once food passes, it should close up tightly again. However, if the sphincter is weakened from too much pressure within the stomach (overeating, too much carbonation, laying down after meals, extra weight, pregnancy etc.) it may open, causing heartburn. Certain foods, like peppermint, spicy foods, coffee, alcohol can tend to aggravate and weaken the LES as well, but are not the cause.
  3. hiatal hernia - a structural condition where the upper part of the stomach and LES actually sit above the diaphragm, which can constrict the passage of food, weaken LES tone and create a pocket of trapped acid
  4. delayed gastric emptying - more common in women and in people with either Type 1 or Type 2 Diabetes, longer retention of food in the stomach (gastroparesis) can increase pressure within the stomach and thus weaken the LES. This occurs in about 40% of GERD cases (3). 
  5. inflammation - a recent study (4) demonstrated that GERD may actually be caused by a cellular inflammation process, rather than by stomach acid burning the esophagus. It was concluded that if stomach acid were truly the cause of erosive damage to the esophagus, the effected area would be the superficial layers of the esophagus (in contact with food and acid) and appear like chemical burns. Instead, it was found that the damage began at the deeper levels and had the appearance of inflammation elsewhere in the body. 
  6. low stomach acid - acid within the stomach is required to properly break down food and protect our body against illness. Stomach acid production tends to decline with age. However, having adequate stomach acid actually stimulates the LES to stay closed. In absence of enough acid, the LES can tend to relax.. and thus we get splash up.

Very rarely have I ever seen increased stomach acid cause heartburn. Rather, it is most likely a combination of low stomach acid, over-eating and a weak lower esophageal sphincter.

Zollinger-Eillison Syndrome is the only known cause of increased stomach acid, and is a very rare condition where one or more tumours in the small intestine or pancreas (gastrinomas) secrete a large amount of the hormone gastrin which then causes the stomach to produce too much acid (5).

In summary, your stomach is probably not too acidic. But something else is going on, making your uncomfortable. Don't you want to find out.. and fix it?

If you or someone you love is experiencing heartburn and want to treat the cause, please book a Free 15 Minute Health Discovery Session with me.

In our next few blogs, I will outline how to know if GERD is part of a larger puzzle and how you can start improving it naturally.

Until then, happy digesting!

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Let's fix my heartburn!
References:
  1. http://www.medscape.org/viewarticle/560076
  2. http://www.ncbi.nlm.nih.gov/pubmed/23853213
  3. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886367/
  4. http://jama.jamanetwork.com/article.aspx?articleid=2521970 
  5. http://www.mayoclinic.org/diseases-conditions/zollinger-ellison-syndrome/basics/definition/con-20024097
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When No. 2 is a No Show.

6/22/2016

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Stopped up. Bunged up. Full of it. Constipated. No fun.

Constipation is something I frequently see in practice, and something I notice that tends to effect women, the elderly and people taking more medication more commonly. Increasingly, I am seeing more issues with young women in their teens and twenties.

Typical recommendations are to avoid constipation is to increase water and fibre, and to consume more leafy greens (again, more fibre). But what if these things aren't helping... or are making the sh*tty situation worse?

Before we get into the why and more importantly, what you can do about it, let's back it up (get it?). You will definitely want to check out my digestion post for more in depth specifics on how the digestive system works.

Constipation is defined as infrequent bowel movements that are often difficult to pass and that is lasting a few weeks or more. Many physicians consider constipation to be 3 or less bowel movements per week. On the other hand, Traditional Chinese Medicine and Ayurvedic medicine consider normal frequency to be 1-3 bowel movements per day with any more or less to be abnormal. 

Normal bowel movements should be easy to pass, solid, medium brown in color, with no undigested bits of food, no blood, no mucous, no straining and with only minimal wiping required. Checking your stool every day is a great way to keep tabs on how things are moving.

Constipation can usually be resolved by:
  • Increasing water intake, especially warm water. I like starting the day with a large glass of warm lemon water to help support healthy digestion. Since the majority of your stool is actually made of water, dehydration can definitely make for slow going.
  • Easing up on the caffeine. Coffee acts like a laxative and may create dependence. It is best minimize so your bowels can work on their own.
  • Regular walks and exercise. The movement of our psoas, quadratus lumborum, and abdominal muscles can increase circulation and stimulate your colon.
  • Increase dark leafy greens and other vegetables in the diet. These turn into soluble fibre and will help lubricate the colon to move.
  • Add or back off on insoluble fibre like psyllium, bran and others. These fibres are important to bulk up the stool, but in too high amounts without an increase in water they can sit like a brick. Experiment to see what amount feels good for you and drink lots of fluids.
  • Stress Management. When we are constantly running around, eating on the run with a million things on the brain it can be hard for our body to let go. Practice meditation, allow yourself time to sit on the toilet each day, ideally in the morning, for several minutes without interruption. Yoga, counseling, music and building in down time into your day can also help relax the body.
  • Acupuncture and Massage. Both can work wonders to gently move things along without creating a dependence.
  • Sparingly using laxatives. Frequent laxative can create dependence. While they are sometimes necessary, it is better support the body naturally to get moving and save these only for especially stuck times. 
  • Fixing your posture. Sit with a stool in front of the toilet so that your legs are elevated into a squatting position. This will help align the colon in a more natural shape for efficient elimination.
  • Ruling out other causes. While constipation happens to all of us from time to time, it can also signal other medical issues. 

Constipation can also signify:
  1. lack of exercise ("Vitamin Move")
  2. dehydration
  3. hypothyroidism and autoimmune thyroiditis (Hashimoto's Disease)
  4. Food sensitivity
  5. Irritable Bowel Syndrome
  6. Hormonal imbalances
  7. Small Intestinal Bowel Overgrowth
  8. Hemorrhoids, fistulas
  9. Poor pelvic floor muscle tone (or too much muscle tone)
  10. Food hygiene habits

If you are experiencing frequent or long term constipation, be sure to check with your doctor or Naturopathic Doctor or pelvic floor physiotherapist to rule out the conditions listed above.

You can also book a Free 15 Minute Health Discovery Session with me to learn about your options.

In health & smooth moves,
​

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Why does my stomach hurt? Here's How to Hack Your Digestive System

6/15/2016

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"My stomach hurts all the time", lamented my third client. That is, my 3rd client today alone. She continued, "I'm bloated all the time, even with healthy food. I'm constipated, then I have loose stool. I never feel like I'm getting everything out!". I also work with her father, who has heartburn, a "noisy gut" and suffers from urgent abdominal pain any time he has to go outside of the house.

2 out of 3 clients I work with have digestive issues. 

As long as I can remember, I have had abdominal pain while eating dinner. My immediate family all suffer from Irritable Bowel Syndrome ("Ass Crisis", as we've affectionately deemed it). I have had a vested interest in learning and working with the digestive system from the day I saw my first client.

Fortunately, I have found that most "gut problems" respond extremely well to Naturopathic medicine. If you, or someone you love, has been suffering, this post is for you.

The Digestive System - more than just your stomach

The digestive system encompasses everything from your mouth down until you see it in the toilet (hopefully) the next day.

The Head
Digestion starts in the brain, evoking a physical response long before food passes your lips. When we think about food, envisioning how it will taste and feel and actually let ourselves feel hungry, our body gets to work increasing saliva, stomach acid and digestive enzymes. Like a good seduction, digestion is as much a head game as the act of doing it.
​
Problem Zone 1: eating mindlessly, not letting yourself get hungry, eating in a rush, over-eating etc. so that your body doesn't have time to catch up

The Mouth
Chewing your food thoroughly accomplishes two things:
  1. Mechanical break down of your food into smaller pieces for further break down later on
  2. Secretion of amylase, an enzyme in saliva that helps to break down starches in food

Problem Zone 2: eating without thoroughly chewing, drinking large amounts of fluids with meals that may dilute your digestive enzymes

The Esophagus
The esophagus is a flexible tube that carries food from your mouth to your stomach. At the bottom of the esophagus/top of the stomach is a muscle called the lower esophageal sphincter or the cardiac sphincter. When it opens it allows food from the esophagus in the stomach, otherwise it should stay shut to prevent splash up of acid causing heartburn.
 
Problem Zone 3: eating too quickly so that food gets stuck or the stomach becomes overloaded; heartburn that creates pain in the esophagus

The Stomach
In the stomach, hydrochloric acid (HCl) is produced by the parietal cells in the stomach. Another enzyme called pepsin begins to work on the food as well, breaking down protein. An acidic environment is required to breakdown our food and prevent pathogens (bacteria, fungi, parasites and other food borne illnesses) from taking hold. After churning in the stomach, the partially digested food (now called chyme) moves past the pyloric sphincter at the base of the stomach and empties into the upper small intestine.

Problem Zone 4: inadequate stomach acid causing poor digestion of food, heartburn and increasing risk of illness, ulcers

Liver/Gallbladder/Pancreas
As food enters the upper portion of the small intestine, it passes nearby to the liver, gallbladder and pancreas, which all make enzymes to help us digest fats, proteins and carbohydrates (lipase, protease, amylase and others like lactase for digesting lactose, renin, sucrase etc.). This will result in further breakdown of our food.

Problem Zone 5: inadequate fat in diet to stimulate production of lipase and bile, not enough protein in diet to make these enzymes, blood sugar issues that compromise the pancreas' ability to manufacture amylase and keep blood sugar in check, poor functioning of the liver and gallbladder

The Small Intestine
The small intestine has three parts: the duodenum, jejenum and ileum and collectively is about 6 meters (20 feet) long in humans. As it passes through each of these, food interacts with the lining of the intestines, is absorbed and utilized by the rest of the body. Nutrients from our food are absorbed along the small intestine and breakdown continues.

Problem Zone 6: food sensitivities create inflammation along the lining of the small intestine resulting in poor digestion and impaired absorption of nutrients. These can create very dramatic digestive symptoms, and malnutrition.

Colon Issues
The mostly digested food enters the large intestine, where water is reabsorbed back into the body along much of its 1.5 meters (5 feet). Different kinds of bacteria work on breaking down the remnants here.

Problem Zone 7: poor bacteria in the colon can cause bloating, gas, distention and pain.

Rectal Issues
Finally, stool exits the body. Stool is mainly water, combined with food remnants, dead bacteria and cellular waste. If there is inflammation here or in the colon, the remaining material may not be broken down properly.

Problem Zone 8: Hemorrhoids and anal fissures (small cracks around the anus) can block the passage of stool and create pain, bleeding and tearing of the delicate tissue.

Putting It All Together (The Digestive Dream!):
You feel a rumble in your belly, and realize it's lunch time. You start to think about your lunch, looking forward to what you are about to eat. As you are heating it up, you take a few deep breaths, happy to have a little break. When your food is ready, you sit down at the table, looking at the plate in front of you. You say grace, or take a few more deep breaths, looking forward to savouring the meal instead of wolfing it down, even though you are hungry. You chew your first few bites slowly, enjoying the taste and texture of the food in your mouth. You have a a sip or two of water - but just enough to moisten your mouth - and enjoy your meal. Maybe you chat with your family or coworkers, or your enjoy the fresh air outside or the nice music in the background for a leisurely 20-30 minute meal. Work and the rest of the afternoon are the last thing on your mind. When you finish, you feel good. Your belly feels happy: flat, pleasantly full and quiet. In between meals, you sip on lots of water. Sometimes fresh water, other times you opt for herbal tea. You make sure to get lots of breaks in at work to move around, and enjoy a daily walk. You have 1-3 bowel movements each day that are very easy to pass, formed, in one piece. Afterwards you feel great. ​
Top 10 Tips to Hack YOUR Digestive System:
  1. THINK about your food before you eat - how it looks, smells, will taste, how it was prepared
  2. Pause before eating. Say grace, take 3-5 deep breaths.
  3. Take 1 tsp-1 Tbsp of raw, unpasteurized apple cider vinegar 10 minutes before meals, to help improve stomach acidity. Digestive bitters and other supplements recommended by your Naturopathic Doctor may also be helpful.
  4. EAT and ONLY Eat. No distractions - TV, phone, computer. This will help avoid over-eating, under-chewing and promote better digestion.
  5. Chew your food thoroughly until is it liquid before swallowing. A good rule is 10 chews per bite of food.
  6. Avoid liquids before and with meals, except to moisten mouth. This will help to avoid dilution of stomach acid and enzymes so that they can work effectively.
  7. Take your time eating. Enjoy your meal.
  8. Don't eat when stressed, angry or emotionally upset. Eating, like any other kind of work, can be affected negatively by a negative state of mind.
  9. Check your stool. Is it formed, watery, soft, sticky or breaking apart? Knowing these details makes it easier for other health care providers to assist you.
  10. Test your Stool Transit Time every few months. On an empty stomach in the morning, take 2 Tbsp of white sesame seeds, chewing lightly before swallowing. Then time how long it takes before you seem them again in your stool. This will give you a rough estimate of how long it takes food to pass through your system. Retest in a week to see if this varies.

If you experience gas, bloating, heartburn, diarrhea, constipation or other digestive concerns and are interested in learning more, please schedule your Free 15 Minute Health Discovery Session with me.

In health & happy digestion,
​
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How to Get Rid of Seasonal Allergies!

6/25/2015

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"Dr. K, I'm doing great... except that I want to scratch my eyes out, my nose keeps running and I'm going to start charging that frog in my throat rent!" lamented one of my patients this week.

And she isn't alone.

Seasonal allergies affect 1 in 25 Canadians, according to the Canadian Allergy, Asthma and Immunology Foundation. Allergic rhinitis, or "hay fever", or these damn allergies can present as watery itchy eyes, runny nose with clear mucous, sinus congestion and pressure, itchy tongue and palate, a dry scratchy throat, feeling fatigued, poor concentration. This means lower productivity at work, an increased risk of asthma and an expensive trip to the pharmacy or health food store trying to find relief.

Windsor and Toronto are some of the worse cities in Canada to live in with respect to pollution and ragweed. Here in Stratford, we are surrounded by a lot of farmland and trees, which also translates to pesticides and tree pollen. Despite being convenient for travel, this Highway 401 corridor that I and my patients call home can cause some decided health issues from early spring until late fall.

So what's an allergy sufferer to do?

1. Catch the culprit
Most seasonal type allergies are IgE-mediated immune reactions. A simple skin or blood test can be ordered by your family doctor or Naturopathic Doctor to determine the cause of your symptoms. Common culprits are tree pollens, ragweed, moulds, and dust mites. These can be made worse by certain foods, particularly food sensitivities.

2. Support your immune system
Eat a diet high in fresh fruits and vegetables for lots of Vitamin C, good quality probiotics recommended by your health care provider, fermented foods like kombucha, sauerkraut or kefir, and healthy fats. Minimize sugars, processed foods and alcohol as they will suppress your immune function and can contribute to mucous production.

3. Create a customized plan
Your family doctor or allergist might also recommend avoiding the allergen if possible, antihistamines or decongestants. Please be aware that decongestant nasal sprays often cause rebound congestion once you discontinue their use, so these should only be used short-term.

In my practice, I recommend an individualized supplement program including homeopathics, and nutraceuticals, dietary support and at-home care. I like to recommend using a neti pot filled with a warm sterile saline solution to rinse out the sinuses twice daily during allergy season. It really works!

BONUS
I also recommend Allergy Booster "shots" preventatively for patients that predictably experience symptoms at this time of year. A simple, low-cost oral solution that can help to improve our immune function and reduce the severity, this is one of my favorite ways to stay on top of allergies. Many of my patients have experienced a dramatic improvement in their allergy symptoms after only a few doses and no longer need to rely on allergy medication.

If you or your loved ones are suffering from seasonal allergies, you can book a free 15 minute health strategy session to learn more about treating your allergies.. naturally.

In health,
Dr. Keila




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Food Allergies vs Food Sensitivities vs Food Intolerance... what's the difference?

7/16/2014

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When most of us picture a food reaction, we think of the classic peanut allergy: one whiff of the stuff with the Teddy bear (or Squirrel, depending on your family's preference) and that one kid in class would break out in hives, have difficulty breathing and someone would dig out the epi-pen. 

That's why I often have to explain to my patients that not all food reactions are like that. Here's why.


Food can be the perfect medicine... or the best poison.

Our body does the best it can and can only run off the fuel we give it. While most of us try to eat healthily the majority of the time, sometimes the "good" foods we are regularly recommended can make us feel ill. If we are taking in foods that don't agree with us, regardless of which Food Guide or expert recommends them, our body will mount a reaction in order to tell us that we shouldn't eat it. If we continue to consume these foods, the body turns up the dial until we have to listen.

Your Cheat Sheet to Food Reactions:

Food Allergy (IgE)

  • an IgE-type reaction - immediate hypersensitivity
  • Reactions generally occur within minutes of eating reactive food and can be life-threatening
  • Body has initial exposure to the allergen, fights it off, and keeps those weapons ready on hand for the next encounter 
  • eg. Peanut or shell-fish allergy

Food Sensitivity (IgG)

  • an IgG-type reaction - delayed hypersensitivity
  • Reactions can take hours or days (or even longer) to develop
  • Body attacks the allergen, forming an immune complex that when present in large enough numbers, become difficult for the body to remove, If enough complexes accumulate, they can deposit in various parts of the body and release inflammatory chemicals that contribute to a variety of symptoms and conditions
  • eg. gluten, dairy sensitvity causing eczema

Food Intolerance

  • thought to be non-immune mediated (unlike food allergies or sensitivities) and the body reacts to a different part of the food molecule
  • can cause immediate or delayed reaction, depending on the food and the person
  • eg. lactose intolerance, MSG reactions

Timing is everything

One reason it can be so difficult to identify a food reaction is that we may react hours, days or even weeks after ingesting the food in question. If you tend to eat a highly varied diet or eat the same foods over and over, pin-pointing that one meal can be a challenge, particularly if you started to feel crummy a few days later.

Trust your gut..but look for other clues.

The gut is the gateway to the rest of the body. If a food reacts in our gut, it impacts not only our digestive function, but the rest of our body as well. In particular, the immune system, neurological and reproductive systems get involved.

Symptoms of a food sensitivity can include:
  • Digestive disturbances: gas, bloating, diarrhea, constipation, blood in the stool, heartburn/reflux, difficulty swallowing, ulcers, Irritable Bowel Syndrome
  • Headaches: migraine, cluster and/or tension
  • Neurological: numbness, tingling sensations
  • Mood: anxiety, depression, mood swings, autism, ADHD
  • Fatigue, low energy, no motivation, insomnia
  • Skin issues: acne, eczema, psoriasis, swelling
  • Joint pain
  • Muscle aches
  • Weight gain
  • Hair loss
  • Hormonal: fertility issues, PMS, menstrual cramps, low sex drive

Your symptoms may evolve over time as well. 

For example, I notice with myself that when I eat gluten I start to feel very sleepy and have an immediate-onset brain fog. If I continue to ignore my body and eat more - I am the first to admit I am very human and not immune to a fresh slice of bread from time to time - I get some pretty intense stomach cramps and constipation. Since I so seldom eat it, I notice this right away. When I was in university on a tight student's budget, I tended to a lot of pasta (it was cheap, quick and filling) I suffered from debilitating sleep attacks plus all those digestive symptoms, weight gain around the middle and acne. Eventually I realized from trial and error that it was worth spending a few extra bucks, saving the gluten/starch binges for a very occasional treat in order to be more productive, focused, energetic and healthy.

As you can see, it certainly goes beyond the digestive system!

So how do I know if there's a problem... and what can I do about it?

If you're asking yourself this, you've come to the right place! 

Working with your family doctor or allergist, standard allergy testing is often recommended to test for IgE-type reactions. Treatment then involves taking an antihistamine (Reactine, Benedryl etc.), epinephrine (eg. carrying an Epi-pen) and/or complete avoidance.

However, by now you will realize that IgE reactions are just a small part of the picture. 

Here is how I treat food reactions:

  1. Review. The first step is examining your eating habits. I have all of my patients complete a diet and lifestyle diary for several days to get a baseline for their diet and habits relating to how they feel. In our visit, we discuss these and make recommendations based on what I see (inevitably, it is someone's birthday during that time and I hear "I don't usually eat like this!!!"). 
  2. Identify. If it is appropriate, I may recommend cutting out some foods entirely for a few weeks to see if their symptoms improve.
  3. Test. Alternately, we can run a Food Sensitivity Panel testing for food allergies (IgE) and/or food sensitivities (IgG). This is a great way of determining which foods you are reacting to right now and how much of a reaction your body is mounting. 
  4. Heal the Gut. Once the offending foods are identified, we begin a process of eliminating them in order to allow the gut to heal and give your body a break. There are several supplements that I regularly use that help your body to heal as well.
  5. Reintroduction. This is the exciting part, where we reintroduce the foods one by one in order to see how your body uniquely responds. Sometimes there is a very clear reaction (migraine headaches, worsening of skin or mood symptoms for example). Other times, it can be difficult to tell (hair loss in particular is tricky because it can takes months to see a difference).
  6. Reinforcement. With a tailored supplement protocol, good stress management and a diet specific for you, you may not react to the same foods in time.

If you or someone you know is suspects that a food reaction might be contributing to feeling unwell, I would like to offer you a complimentary 15 minute consultation with me to discuss your concerns. 
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Connect with Dr. Keila Roesner, Naturopathic Doctor
Dr. Keila Roesner, 
Naturopathic Doctor

The Space Within

35 Market Place
Stratford ON
N5A 1A4


www.TheSpaceWithin.ca
(519) 275-2187 ext. 7
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