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Most often, inflammation is rooted in the gut and caused by food sensitivities. These days we encounter an epidemic of chronic health issues resulting from inflammation. By understanding the gut in more detail, we have the capacity to decrease inflammation without the use of medications that have long lists of side effects and don’t solve the underlying issue.

The important thing to realize about inflammation is that it can appear in any part of the body, including hormone systems, the brain, and the cardiovascular system. The evidence for this is unquestionable. This being said, it is very important to identify foods that may be stimulating our immune system and having detrimental downstream health effects.

Testing for food sensitivities has its controversies, but it can be a very useful starting point. IBS and Crohn’s disease respond best to IgG testing but are clinically applicable in many other illnesses. The tests reveal gut complaints, chronic fatigue, depression and anxiety, and autoimmune issues, to name a few.

Limitations of food sensitivity testing:

1. They test only limited immune reactions and do not show non-immune food reactions

Food sensitivity testing is not perfect, as it is only testing a very select part of the immune system. Parts of the immune system most often tested are IgE (true allergy), IgA (mucosal immune system), and IgG (delayed food sensitivities). A negative test does not exclude a reaction by the innate immune system, or a non-immune reaction (like lactose intolerance, FODMAP intolerance, or histamine intolerance).

2. Laboratory standards differ

The accuracy of testing can vary from lab to lab, depending on which controls and which antigens they use. For example, an organic apple may have different reactivity to one that is not organic. Heat and processing or roasting may make an antigen more or less antigenic. Whether the lab uses monoclonal antibodies (from one source) vs polyclonal antibodies (from many sources), can also affect the reactivity of the test.

3. Individual and confounding factors

False positives may result from smoking, alcohol consumption, periodontal disease and other factors. False negatives may result from immunoglobulin deficiencies. Lab tests may not pick up individual differences in immunoglobulins which could also skew results.

Testing often shows reaction to antigens which should be ‘healthy’ foods. This situation is often caused by increased intestinal permeability. Something like gluten may trigger leaky gut, allowing bystanders to leak through the gut layer and stimulate an immune reaction. Gut repair is essential in resolving this.

With all these confounding factors, how do you figure out what you are reacting to?

The gold standard of figuring of food sensitivities is with an elimination diet. This means taking out the common allergenic offending foods for a period of 3-4 weeks minimum and then slowly reintroducing them one by one. A positive test results when a reaction to the reintroduced food occurs.

In an ideal world, every patient with a chronic health condition should go through an elimination diet. Unfortunately, this does not always happen. In many cases, people do not believe that their health condition is related to food and so are not willing to change their way of eating.

The benefits of food sensitivity testing:

Enter the food sensitivity test. Though not all testing is perfect, this can be an extremely useful tool in figuring out major food triggers. Keeping the above limitations in mind, improvements in symptoms should occur with removal of the offending foods. The proof is in the pudding: people very often do get dramatically better when they remove the positive foods on the tests.

When they do not get better after a trial of elimination, a skilled health care professional will guide the patient to work through different steps based on their history, physical examination and testing, to figure out what is causing their symptoms.

Reasons people don’t get better:

Gut healing not done alongside the removal of the problem foods. Much research around gluten removal with or without gut repair, has been done. A large percentage of patients do not improve symptomatically when the gut repair is not undertaken. This involves replacing pancreatic enzymes, gallbladder support, and stomach acid and healing the lining of the gut.
The person is reacting to food in a different way. They may have histamine, salicylate, or oxalate intolerance or a lectin intolerance and respond to a grain and legume-free diet. They could also have fructose intolerance.
They may have dysbiosis, or overgrowth of bacteria/ yeast or parasites (often interrelated with food sensitivities). Because of this they may have FODMAP intolerance (with SIBO) or may react to foods that trigger candida, like sugar.
They have a misunderstanding about which foods contain the antigens they are reacting to or are being inadvertently exposed to. A common example is gluten, found in many spices, teas, toothpaste, etc.
Their symptoms may not be directly related to the gut and can be related to heavy metal toxicity, biotoxin illness (mold commonly causes gut issues) or autonomic imbalance.
They had a false positive test.

The good news

The aim is not to be off the offending food forever – the aim is to figure out why someone is reacting in the first place. If you heal your gut and eliminate correctly, you should be able to eat most things again but some people may need to stay off certain foods lifelong. The most common of these are gluten, dairy, and eggs.

The bottom line is that food sensitivity testing is far from perfect, but it is very often a starting point to guide a patient in the right direction and motivate lifestyle changes. The important take home is to ask why the food reactions are happening in the first place. On many occasions, people become frustrated because they follow the elimination of the foods found on their tests and they don’t feel better. It is essential to have an experienced health care provider interpret your food sensitivity test in the context of what your issues are so that you can be guided in the right direction and achieve the best results.

References

Bentz, S., Hausmann, M., Piberger, H., et al., (2010). Clinical relevance of IgG antibodies against food antigens in Crohn’s disease: A double-blind cross-over diet intervention study. Karger – Digestion 81(4), 252-264. https://doi.org/10.1159/000264649

Drisko, J., Bischoff, B., Hall, M., & McCallum, R. (2005). Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probiotics. Journal of the American College of Nutrition 25(6), 514-522. https://doi.org/10.1080/07315724.2006.10719567

Guo, H., Jiang, T., Wang, J., et al., (2012). The value of eliminating foods according to food-specific immunoglobulin G antibodies in irritable bowel syndrome with diarrhoea. Journal of International Medical Research 40(1), 204-210. https://doi.org/10.1177/147323001204000121

Meletis, C.D., & Barker, J. Delayed-onset food allergies (2004). Alternative and Complementary Therapies 9(2), 61-65. https://doi.org/10.1089/107628003321536968

Uzunısmaıl, H., Cengız, M., Uzun, H., et al., (2012). The effects of provocation by foods with raised IgG antibodies and additives on the course of Crohn’s disease: A pilot study. Turkish Journal of Gastroenterology 23(1), 19-27. DOI: 10.4318/tjg.2012.0332

Zar, S., Mincher, L., Benson, M.J., & Kumar, D. (2005). Food-specific IgG4 antibody-guided exclusion diet improves symptoms and rectal compliance in irritable bowel syndrome. Scandinavian Journal of Gastroenterology 40(7), 800-807, https://doi.org/10.1080/00365520510015593

Author

Dr. Michelle van der Westhuizen, MD

The breath is a powerful source of transformation for brain health and breathwork is a practice that improves it. The rate and rhythm of the breath are intimately connected to our mental & emotional states (Brown & Gerbarg, 2012). Just as the emotions and the mind cause the breath to vary, by consciously controlling the breath, we gain control over our mind and our emotions (Trinity College Dublin, 2018).

Anxiety and Stress Eased by Breathwork

Combining this modality of breathwork with the eye gaze by noticing ten things in the room and mentally or aloud saying their colour and what they are, as well as pressing the feet into the floor, will activate your parasympathetic nervous system and bring you into a feeling of calmness (McKay, Wood, & Brantley, 2007).

Depression

On the other hand, when a person is feeling the depths of depression and despair, they may sigh a lot with almost a sense of defeat. The breath here is usually more in the belly. To bring more life force or prana into the body, it is recommended to sit up straight, lengthen the spine, and with an open mouth – breathing deep and forcefully into the upper chest. This activates the sympathetic nervous system and creates a sense of alertness and aliveness (Levine & Frederick, 2005). Taking breathwork one step further, raise both arms above the head as you inhale, allowing the eye gaze to follow the hands while keeping the chin level (Rosenberg, Rand, & Assay, 1987). Five to ten of these breaths and one will feel a tingling in the whole body, with the eye focus becoming clearer and a sense of elation.

How and why does this happen?

The respiratory system is one of the only major systems in the body which is usually involuntary but can be voluntarily controlled via attention (Levine & Frederick, 1997). The rhythm of our heart is thought to be another involuntary system, but if we want to, we can change the speed of our heart by modifying our breath. Should we slow down our breath, for example, this brings the body and mind into a state of calmness and relaxation, thereby slowing the heart rate.

The Breath: A Life Force

Breath is the life force that keeps us going; if we didn’t breathe, we would die. When we are able to control the breath with breathwork, we are able to moderate the way we feel in the moment and develop a sense of control over stress levels.

Your rate of breathing and state of mind are inseparable. Using a full yogic breath or other pranayama techniques reprograms your whole cellular memory (Khalsa & Lumpkin, 2015).

History of The Breath

For thousands of years, ancient wisdom techniques from the east have exalted the virtues of breath-focused practices, such as pranayama and meditation for their numerous cognitive benefits, including an increased ability to focus, decreased mind wandering, improved arousal levels, more positive emotions, decreased emotional reactivity, and many other benefits (Yates & Immergut, 2017).

What did they know that we are just now validating scientifically? Well, a new study by researchers at Trinity College Institute of Neuroscience and the Global Brain Health Institute at Trinity, Dublin explains for the first time the neurophysiological link between breathing, cognition, and emotion. The research shows that the way we breathe directly affects the chemistry of our brains in a way that can enhance our attention and improve brain health. This study focuses on changes in the levels of noradrenaline in response to the breath. Noradrenaline is a chemical messenger released in the brain when we are challenged, curious, focused, or otherwise emotionally aroused, and when we exercise. If produced at the right levels, it is essential to help the brain grow new connections (Trinity College Dublin, 2018).

Breathwork: A Scientific Study

Outlined here by a Ph.D. candidate at the Trinity College Institute of Neuroscience and lead author of the study, Michael Melnychuk: “Practitioners of yoga have claimed for some 2,500 years, that respiration influences the mind. In our study, we looked for a neurophysiological link that could help explain these claims by measuring breathing, reaction time, and brain activity in a small area in the brainstem called the locus coeruleus, where noradrenaline is made. Noradrenaline is an all-purpose action system in the brain. When we are stressed we produce too much noradrenaline and we can’t focus. When we feel sluggish, we produce too little and again, we can’t focus. There is a sweet spot of noradrenaline in which our emotions, thinking, and memory are much clearer. This study has shown that as you breathe in, locus coeruleus activity is increased slightly, and as you breathe out it decreases. Put simply this means that our attention is influenced by our breath and that it rises and falls with the cycle of respiration. It is possible that by focusing on and regulating your breathing you can optimize your attention level and likewise, by focusing on your attention level, your breathing becomes more synchronized.”

Breathwork and Brain Aging

Even more exciting in this area of research was the understanding and uncovering of how breathwork and meditation may have an effect on the aging of the brain. Ian Robertson, Co-Director of the Global Brain Health Institute at Trinity College, Dublin, writes:

“Our findings could have particular implications for research into brain ageing. Brains typically lose mass as they age, but less so in the brains of long-term meditators. More ‘youthful’ brains have a reduced risk of dementia and mindfulness meditation techniques actually strengthen brain networks. Our research offers one possible reason for this — using our breath to control one of the brain’s natural chemical messengers, noradrenaline, which in the right ‘dose’ helps the brain grow new connections between cells. This study provides one more reason for everyone to boost the health of their brain using a whole range of activities ranging from aerobic exercise to mindfulness meditation.”

In sum, breathe deep! It’s good for your brain health.

References

Brown, R., & Gerbarg, P. (2012). The healing power of the breath: Simple techniques to reduce stress and anxiety, enhance concentration, and balance your emotions. Shambala Publishing.

Khalsa Kaur, J., & Lumpkin, N. (2015). Enlightened bodies: Exploring physical and subtle human anatomy. Kundalini Research Institute

Levine, P., & Frederick, A. (1997). Waking the tiger: Healing trauma. North Atlantic Books.

Levine, P., & Frederick, A. (2005). Healing trauma: A pioneering program for restoring the wisdom of your body. Sounds True Inc.

McKay, M., Wood, J.C., & Brantley, J. (2007). The dialectical behavior therapy skills workbook: Practical DBT exercises for learning mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. New Harbinger Publications Inc.

Melnychuk, M.C., Dockree, P.M., O’Connell, R.G., Murphy, P.R., Balsters, J.H., & Robertson, I.H. (2018). Coupling of respiration and attention via the locus coeruleus: Effects of meditation and pranayama. Psychophysiology, 55(9). DOI: 10.1111/psyp.13091

Rosenberg, J.L., Rand, M, & Assay, D. (1987). Body, self, and soul: Sustaining integration. Humanics Publishing Group.

Trinity College Dublin. (2018). The Yogi masters were right — meditation and breathing exercises can sharpen your mind: New research explains link between breath-focused meditation and attention and brain health. ScienceDaily. Retrieved from www.sciencedaily.com/releases/2018/05/180510101254.htm

Yates, J., & Immergut, M.. (2017). The mind illuminated: A complete meditation guide integrating Buddhist wisdom and brain science for greater mindfulness. Hay House Publishing.

Author

Charmaine Husum, DKATI, RTC, CT

Why are DHEA & Testosterone Important?

Testosterone is a male hormone, right? True, but females need it just as much as males do, just in smaller amounts. Not only is necessary for a healthy libido and sexual satisfaction, but it is also essential for bone health, brain health, muscle health, and heart health. It needs to be in balance with the other female hormones, estrogen, and progesterone (sex steroids), thyroid hormones, as well as our major stress hormone, cortisol, in order to function optimally. The Androgen DHEA is a feel-good hormone. It gives one a feeling of well being, libido, good sleep, muscle strength, and exercise tolerance.

What are the common symptoms of DHEA deficiency?

Common symptoms of DHEA deficiency include reduced sex drive, reduced sexual sensitivity, difficulty achieving orgasm, painful intercourse, low mood and excessive anxiety, poor coping ability, reduced muscle tone and strength, joint pain, back pain, dry skin, poor memory or concentration and urinary incontinence. The symptoms can overlap with hormonal and other medical conditions. Thus, androgen deficiency often goes under-diagnosed and is not often thought to be relevant in females.

Cortisol Steal

So where does it all go wrong and why are we seeing so many women, young and old, with deficiency these days? Cortisol steal. This is exactly what it sounds like. Cortisol is stealing the substrates that our sex steroids and DHEA need to be formed because it is being produced in excess. DHEA becomes depleted and because this is upstream from testosterone (and estrogen), these downstream hormones also become depleted. So it’s the stressed women that get more hormonal issues. It is not the hormones’ fault. They are just responding appropriately to other imbalances in the body. Why would you need to reproduce or have sex for that matter, if you are running away from a lion?

Stress and Hormones

The body interprets internal and external stress as the same thing. It doesn’t know the difference between having a fight with someone vs candida overgrowth in the gut, for example. It responds by releasing cortisol and other stress hormones and neurotransmitters from the adrenal glands. When cortisol is produced in excess, the hypothalamus in the brain perceives a threat. It switches off signals to the adrenals and cortisol is no longer produced. Alongside this, high cortisol triggers DHEA release, which tries to balance the high cortisol. With DHEA and cortisol levels low, the patient experiences stage 3 adrenal fatigue. The new term for this is HPA axis dysfunction/ dysregulation.

Replacing DHEA and Testosterone in Women

DHEA and testosterone can be replaced alone, or alongside each other in women. It should be ensured that the other female hormones are also optimal. In our practice, we prescribe bioidentical hormones, which are hormones that behave in an exact way as our own hormones. They are still laboratory-made but are chemically identical to our hormones. The bad rap that hormone replacement has is from synthetic hormones, which confuse our hormonal systems – like putting the wrong key into a lock. Testosterone is most often prescribed topically, or in certain cases intramuscularly/ subcutaneous. DHEA is most often prescribed sublingually or by mouth, but can also be given topically.

The key to safe hormone replacement is testing your levels (24 hour urine hormone is the best test for this, but blood levels can be used when resources are limited). Once on the treatment, levels should be monitored by an experienced health care professional in order to find the dose that is right for you. This can vary tremendously between women, depending on genetics, underlying factors that caused the hormone deficit and lifestyle (a very active woman requires more DHEA or testosterone, often). You can find your optimum dose by looking at your levels alongside your symptoms.

What else can you do to improve your levels besides taking hormones?

Hormone replacement is not the only answer but in every case, should be done alongside root cause treatment and lifestyle changes. Hormone replacement does not fix the adrenals and other hormones. It is just another patch if done alone. Some women even feel worse on hormones, which tells us we need to work on these root causes.

Other Lifestyle Improvements

So what can you do to help these hormones in your day to day life? Your overall aim is to decrease inflammation and stress on the HPA axis.

Diet

An anti-inflammatory diet is a good place to start. Many hormone disturbances start in the gut, because of a constant onslaught of foods that increase inflammation, upregulate our immune system, change our microbiome, and impact our gut-brain connection. Sugar, carbohydrates, and dairy are big contributors to poor hormone health.

Exercise

Make sure you are getting exercise that is appropriate for your condition. Don’t run a marathon when your adrenals are shot.

Sleep

Make sure you get at least 7-8 hours of sleep each night. Good sleep hygiene is essential and your health care professional may recommend supplements and medications for this.

Stress Management

Make sure you are identifying and managing stress – we cannot always change our stressful circumstances but we can change how we perceive them and what we do every day to find our calm.

We recommend 2 books to find out more: The Hormone Handbook by Dr. Thierry Hertoghe; and, What You Must Know About Women’s Hormones: Your Guide to Natural Hormone Treatments for PMS, Menopause, Osteoporis, PCOS, and More by Dr. Pamela Wartian Smith.

About the author:

One of Dr. Michelle’s greatest passions in life is to help people help themselves. She understands that your current health tells a story and that when you have symptoms of disease, your body is already out of balance. She believes that we should not have to settle for anything other than our most vital self and that her job is to figure out how to put you back on track. To book an appointment with Dr. Michelle, contact [email protected]

The Anxiety Disorders Association of Canada reports that one in four Canadians will suffer from an anxiety disorder at least once during their lives (1). For many patients, the only treatment previously sought has been anxiolytic prescription drugs. Unfortunately, these medications often carry severe side effects and some of them, such as benzodiazepines like Valium, Xanax, etc, can be addictive.

If you suffer from anxiety, you are not alone. Functional medicine offers positive treatments but first, we must not only deal with anxiety but have continued success. Starting with being aware of our anxiety will help us take the proper action with more clarity. Let’s start by exploring the root causes of anxiety and the stress response humans exhibit when they experience it.

The Root of Anxiety

The root of anxiety lays in ‘fight or flight,’ or stress response. It is an evolutionary trait highly useful to animals, as it was to our ancestors and is still present in humans today. This response is natural, common, and without taking special measures, almost entirely involuntary. In other words, anxiety is not due to a shortcoming or defect from within.

The stress response kicks in when there is a perceived danger or threat. Regions in the brain known as the amygdala rapidly interpret certain stimuli as a threat. These stimuli can vary greatly, the growl of a lion, a light switching off in a dark alleyway, or a scowl on your manager’s face. Triggering memories, including those responsible for post-traumatic stress disorder (PTSD), are stored in the amygdala. No matter the stimulus, the result is the same – activation of the hypothalamic-pituitary-adrenal (HPA) axis.

The action of the HPA axis starts with the hypothalamus (another brain area that is actually a small gland). The hypothalamus then signals another tiny gland; the pituitary via chemical messengers. Finally, the pituitary sends messages to the adrenal glands that sit atop your kidneys, causing them to produce adrenaline. Adrenaline is the hormone that’s responsible for the physical aspects of the stress response, including a rise in heart rate, increased energy, pupil dilation, and slowed digestion (2).

Social anxiety

Anxiety & the Stress Response in Modern Life

The stress response associated with anxiety was wonderful for our ancestors. It helped keep them alert and aware of their surroundings and capable of fleeing immediate physical dangers.

The problem with the stress response in contemporary life is that the response is autonomic, meaning it is almost wholly involuntarily. The response cannot distinguish between the threat of immediate physical harm and something like the longer-term dangers of a low savings account balance. Work stress, family quarrels, or even a traffic jam are just as likely to trigger the stress response as finding an angry bear in your living room.

The Stress Response as a Short Term Process

Furthermore, the stress response is supposed to function as an acute or short term process. In a life-threatening situation, you typically would only need a few minutes to flee or fight. The rush you get is short-lived, similar to the thrill of riding a roller coaster. Unfortunately, our modern lives often cause an extended stress response as we continually struggle with everyday demands and frustrations.

In short, the human body has not caught up with our modern circumstances. This near-constant state of stress wears our bodies down with chronic conditions (like high blood pressure). It’s like driving a car at top speed for hundreds of kilometers. You damage the engine and take years off the car’s life.

How to Deal with Anxiety & the Stress Response

There is hopein dealing with anxiety and stress response using natural methods. With some effort, education, and the guidance of a Functional Medicine physicians at Linden & Arc Vitality Institute, you can achieve control of your anxiety and the underlying stress. We encourage you to take the following steps to deal with anxiety.

Be Aware of Signs of Anxiety

First, become more mindful and be aware of when you’re actually feeling stressed out. This is important both in brief situations, (eg. when a flight is delayed), as well as during long term stressful situations (such as working to meet a deadline at work).

Physical Signs of Anxiety

Be mindful of the physical signs of stress which include rapid heartbeat, perspiration and jaw clenching. Then, begin to address your stress immediately by practicing exercises for stress reduction. Some stress reducing activities include taking deep slow breaths, relaxing the jaw, and thinking calming thoughts.

Non-Physical Signs of Anxiety

There are also non-physical manifestations of stress and anxiety-like a tendency to worry, dwell, or exhibiting a short temper. Take time to reflect on any non-physical manifestations and take a mindful approach to reduce those as well.

Finally, attune yourself to any symptoms you may have of long term stress – such as difficulty sleeping, heartburn, and digestive issues. Prolonging these types of symptoms in life can wear on the body and eventually lead to chronic illnesses.

Take Action Against Anxiety

After noting the reactions you have to stress, it is time to take action. There are several techniques that can help to immediately reduce your stress and prevent anxiety. These include deep ordered breathing, meditation, and HeartMath.

The Benefit of HeartMath

HeartMath is an electronic training system that focuses on and relaxes the nervous system. Classes are offered to Dr. Murfin’s patients. The use of HeartMath, especially in conjunction with a trained instructor, has shown positive effects on emotional stability (3).

Relaxation Techniques in Stress Management

To ensure continued success in reducing anxiety and managing stress requires an ongoing plan. Lifestyle changes are required. These come in the form of frequent meditation, relaxation techniques, journaling, and mindful positive thinking. Don’t underestimate the effectiveness of these actions. A 2013 controlled study found a correlation between positive emotions and better physical health in a research group (4). This same study also found evidence supporting an increase in vagal tone (the regulation of the body at rest with positive emotions).

Increase Your Vagal Tone

As one of the cranial nerves, the vagus nerve is responsible for many automatic functions in your major organs -including the heart and lungs. Tone, or tension, of this nerve, is a good indicator of the level of your emotional control and the effect of that control on your body’s critical functions. One of the best ways to increase your vagal tone is through mind-body practices like controlled breathing, centered humming, and meditation. The Journal of Investigative Medicine published a study showing mind-body techniques have a positive effect on PTSD (5). Good vagal tone also has benefits beyond emotional control, such as playing a part in reduced inflammation and good digestion (6).

Improving Nutrition and Increasing Activity

Nutrition and physical activity also play integral roles in anxiety reduction and stress management. Under the care of our physicians, the use of natural herbs and supplements, as well as exercise, helps replace and enhance your body’s missing nutrients while restoring proper function. This, in turn, helps reduce stress and anxiety. It’s a cycle. When you feel better, you’re less stressed and vice versa.

Guidance from a Funtional Medicine Practitioner

Functional Medicine treatment, especially in conjunction with guidance from a Vitality Advisor at our clinic, aids in the change of thinking patterns. When you’re stuck in a cycle of negative emotions, your stress levels increase and cause harmful effects on your health. This can aggravate existing conditions such as fibromyalgia and other chronic pain syndromes. Emotional control, mindfulness of your body, and positive thinking are vital for good health (7).

Next Steps

While there’s no way to fully shut off your stress response, nor would you want to do such a thing, it’s absolutely controllable. Consulting with an experienced Functional Medicine physician is the next step. With adherence to your doctor’s advice, commitment, and some dedication, you can get a handle on the stress in your life and the resulting anxiety you feel.

References: