Tag: fatigue

Are you hot flashing? Having headaches, memory loss, fatigue? And, the dreaded weight gain around the middle? You are not alone! 

 

Menopause can be a difficult time for many women. Symptoms additional to the above can include low libido and anxiety. It’s not the easiest time of life, but there are ways to approach the hormonal shifts. At Linden & Arc Vitality Institute, we are here to help.

 

What’s up with the hormones?

 

Hormonal changes begin as ovulation ceases – your progesterone decreases. The balanced ratio of estrogen to progesterone begins to tip toward estrogen. Estrogen is the hormone that makes you feel sexy, happy, and full of life. 

 

Sounds good right? So, what’s the problem? 

 

Changes in estrogen can also affect our thyroid hormones and cortisol levels. Excess estrogen may cause bloating, fatigue, headaches, poor sleep (see Smith, 2010, p. 7 or Somers, 2006, p. 38 for a full list). The balance of estrogen and progesterone is lost during hormonal shifts. The decline in progesterone, which is the hormone that makes you feel calm and relaxed, can cause you to feel more anxious, irritable, and depressed. Imbalances in hormones can impact your brain health, memory, and immune system. That’s why those pesky symptoms start to show themselves. 

 

With a functional medicine approach, where there is a partnership between physician and patient, the menopausal years and beyond can be the best time of your life. The best time of life? Yes, really! Your vital energy can be cultivated by working to balance your hormones. 

 

menopause-functional-medicine

 

How is it possible to live the best life during menopause?

 

Taking a functional medicine and holistic approach, women do not have to suffer the symptoms associated with this stage of life. Anxiety, stress, sleepless nights, and weight gain don’t have to be the fate of the middle years – and your physical middle! Here are some tips towards finding balance by adjusting your lifestyle factors with mind, body, spirit and soul at the center of your healing journey:

 

Body:  

  • eat a whole foods diet with as much organic fruit and vegetables as possible
  • make sure to eat enough lean protein and keep sugars to a minimum
  • add 10 to 15 minutes of body-focused stretching or exercise to your daily routine
  • add 3-minute breathing practice when you wake up and before bed

 

Mind: 

  • read a book about your menopausal health; the top two books we recommend and have in stock at Linden & Arc Vitality Institute, are: Ageless by Suzanne Somers and What You Must Know About Women’s Hormones: Your Guide to Natural Hormone Treatments for PMS, Menopause, Osteoporosis, PCOS, and More by Pamela Wartian Smith, MD, MPH.
  • talk to your physician about hormone replacement therapy and options to consider; read about bioidentical hormones in Somers’ book.

 

Spirit & Soul: 

  • practice each day that connects you to that which matters most
  • tune in a few minutes each day with practices such as: walking in nature, touching the leaves of a plant, prayer, meditation

 

With mindful planning and sustainable routines for body, mind, and spirit, post-menopausal women can come into the fullness of their power, creativity, and joy. 

 

Some bonuses of this time of our lives: Women in their fifties and beyond often talk about no longer worrying about pleasing others, finding their voices, and having the confidence to change intolerable situations. With a balanced body, a sharp mind, and full vitality, life after menopause has no limits. Getting through the trials of menopause can be an adventure and a deep dive into your self – body, mind, and soul. 

 

References:

Somers, S. (2006). Ageless: The naked truth about bioidentical hormones. Three Rivers Press.

 

Wartian Smith, P. (2010). What you must know about women’s hormones: Your guide to natural hormone treatments for PMS, menopause, Osteoporosis, PCOS and more. Square One Publishers.

 

Author

Lisa Itzcovitch, MA

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:

  1. 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.
  2. 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.
  3. 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.
  4. 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.
  5. 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.
  6. 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 chronic illness called Mast Cell Activation Syndrome (MCAS) describes a process in which mast cells become overreactive. It is a chronic, multi-system illness that can mimic many other diseases. Symptoms include fatigue, rash, foggy thinking, joint pain, palpitations, itchiness, insomnia, thyroid problems, gas, bloating and swollen lymph nodes.

 

These symptoms often boggle health care professionals who cannot make sense of how they are all related. In fact, doctors sometimes label many patients as having a psychosomatic illness or a diagnosis that these symptoms are “all in their head”. These patients can be puzzling to even integrative doctors, who treat their guts, prescribe chelation therapies, drastically change their diet and lifestyle, and treat chronic infections, only for the patients to not feel better at all.
(Please note that MCAS is very different from mastocytosis, a rare form of blood cancer.)

 

What are Mast Cells?

Mast cells are white blood cells that are part of our immune system. You’ll find them in all tissues but most prominently in the mucosa (our first line of defense to the outside world), and vascular tissue. Mast cells are most often seen in tissues of the gastrointestinal tract, skin, and genitourinary system but MCAS can present in all body systems. Each mast cell contains over 200 chemical signals, or cytokines, the most well-known of which is histamine.

 

What is the Function of the Mast Cell?

The main job of the mast cell is to connect the immune system to the nervous system, both through direct contact and indirectly, using cytokines. It is the mast cell’s job to sense things from our environment and tell our nervous system whether or not these things are a threat. If we are exposed to an infection or a toxin, the mast cell activates and releases cytokines. Cytokines tell the nervous system to ramp up and eradicate the threat.

 

Mast Cell Activation Syndrome Results from Hyperreactive Mast Cells

Things start to go wrong when the mast cell becomes over-responsive to “non-threats”. It can see something as simple as a food, cold temperatures, a stressful event, or even a smell as being threatening. It then overreacts and explodes, releasing all of the symptom-causing cytokines. What catalyzes this is not often known. In secondary MCAS, the trigger can be something like an infection from mold, Lyme, or a virus. Primary MCAS is usually from earlier on in life and possibly caused by ‘mutations’ in the mast cells. With so many potential toxic triggers in our world today, it’s only a matter of time before mast cells start to misbehave in a susceptible individual. When we don’t know what the cause of MCAS is, whether it be primary or secondary, we call it idiopathic MCAS. The good news is that the management for each kind of MCAS is very similar.

 

How Do We Diagnose MCAS?

In short, we diagnose MCAS with difficulty. You can only measure about 10 of the 200 mediators that the mast cell releases. Additionally, these mediators are in and out of the bloodstream within seconds, even though their effects are long-lasting.

 

Looking at the Symptoms

MCAS is often a clinical diagnosis, looking at the various symptoms that a patient has. It may be the case that the lab tests we are able to do come back as negative, but a diagnosis can still be made. However, diagnosing by symptoms is not straight-forward. Patients may present with seemingly unrelated symptoms, expressed in all systems in the body.
The symptoms will depend on which mediators are released, and in what tissues they are released. The symptoms do not always make sense and are not reproducible by the same trigger. For example, on one day a certain food may trigger a cytokine storm, but on the next day, that same food has no effect. The symptoms sometimes come on without any known trigger, and the effect can be acute or chronic, local, or remote. Patients become very scared of the symptom’s unpredictability. Many patients are misdiagnosed for years and often their entire lives.

 

Mast Cell Chart

 

Treatment options for MCAS

The main steps in treatment are to try find what the initial trigger is and to stabilize the mast cells. In many cases, the trigger is a chronic infection. Mold is one of the most potent mast cell triggers and is more common than you would think. Mold susceptibility is genetically determined. About 25% of people having the genes which make the body unable to recognize and clear mold when exposed. In the case of MCAS, we can stabilize mast cells, but unless we treat the mold as well, patients often won’t get better. Other examples of triggers are Lyme disease, Bartonella (a Lyme coinfection), Candida, and toxic and environmental triggers.

 

Identifying Triggers of MCAS

To help identify triggers, it may be useful to keep a diary of symptoms. You can then trace back the minutes and hours before a flare to figure out what may have been the trigger. In the cases of medication reactions, people often react to the fillers or inactive ingredients and not the medication itself. Sometimes there are many triggers and it is difficult to figure out what they are.

 

Stabilizing Mast Cells

We can stabilize the mast cells using various supplements and medications. Any given patient may respond better either to supplements or to medications, but not often both. One patient may respond beautifully to one supplement and for the next, it will have no effect. Unfortunately, it often takes some trial and error, which can be quite frustrating for patients as many of the treatments fail to work at all. Therefore, when trialing treatments, physicians must do this in a methodical way and the patient should be prepared for the fact that this can take many months to get right. The type, dosage, and frequency of treatment needs to be constantly tweaked, usually, each step taking 2-4 weeks. Also, sometimes the treatments we give for MCAS can trigger more symptoms.

 

Treatments for MCAS

It is important to be realistic about possible treatment outcomes. Not all patients can be completely cured of MCAS and may need treatment lifelong, especially when we do not know what the trigger is. You may not feel perfect and there may be many ups and downs, but most patients will feel better after some trial and error to create a personalized plan.

A low histamine diet may work for some, but not others. Physicians can trial for a period of 2-3 weeks and if no noted differences, will be stopped. Generally, this entails avoiding leftovers and over-ripe fruits, foods with innately high histamine, like fermented foods, aged cheese, vinegar, alcohol, and canned fish. There are also foods that easily release histamine when eaten, like strawberries, spinach, nuts, tomatoes, and shellfish. Doctors encourage patients to begin a low mold diet if mold is involved.

The treatment for MCAS can sometimes be both therapeutic and diagnostic. That is, if you get better with the treatment, you likely have MCAS, even if we have not been able to prove it in any other way.

 

Contact Us

Our team at Linden & Arc Vitality Institute understands that MCAS is a complex and frustrating road to travel. We are equipped to guide you on the path to your best health. If any of the above symptoms sound familiar, please contact us at [email protected] to book an appointment.

 

Author

Dr. Michelle van der Westhuizen, MD

Contact Us

587-390-0180

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