We practice personalized nutrition/medicine.  There is no one diet, supplement regime or immune protocol that is right for everyone.

• You are unique, your biochemistry is unique!

• We have taken markers from some of our most popular panels that relate to nutrients and immune function and layered in a more detailed look at the immune system with actual genes that have been studied relating to mechanisms in viral pathology.

• Now more than ever it is imperative that your health and immune system be working 100%. The best defense besides social distancing and washing your hands is priming your body to work the way it should *optimally*.

• Most data shows the majority of people that move from mild symptoms to a full on cytokine storm have preexisting health conditions or a genetic predisposition that weakens the immune system.

• Knowing your unique genetics, biochemistry and risks is empowering and allows you to have some control over you destiny.

In this panel we will look at the following genetics, along with your labs (if you would like an appointment) to help you navigate the best preventative immune supplements and the best ways to potentially fix/improve impaired systems:

Genes involved in immune function:

• HLA genes involved with influenza:
• Genes involved with your risk for autoimmune disease
• Pro and anti-inflammatory cytokines
• Other genes in the complement immune cascade
• Toll-like receptors and the proteins that activate them

Genes directly studied for SARS1 and genes studied that increase your risk for acute respiratory disorder syndrome (ARDS)

• SARS2 shares 80% of its genome with SARS1 so we do have quite a bit of good research on some of these mechanisms. We are keeping up with research daily and will adjust and add genes in this category as new data emerges!

Genes involved in the RAAS system: (regulates blood pressure and fluid balance)

• ACE2 is the receptor site for the SARS2 virus and is part of the renin angiotensin system (RAAS) but all the genes around this enzyme need to be looked at too. Hypertension or risk for hypertension increases your risk for negative outcomes with this virus.

Genes involved with nutrient levels:   More is not better!

• The most well studied nutrients zinc, magnesium, potassium, vitamin D, A, K and C. Niacin for lung recovery, melatonin etc. there is a gene(s) for that!

• Did you know if you have certain oxalate genes, high dose vitamin C can be contraindicated for you? You can read more about oxalates here.

• Did you know if you have a certain vitamin D receptor gene, high dose vitamin D may increase your risk for autoimmune disease if you are taking too much.

• Did you know that taking too much zinc can upset the balance of copper and iron in your body?

• Did you know that certain immune stimulators like elderberry and medicinal mushrooms are actually contraindicated for those with autoimmune disease or autoimmune risk?

Genes involved in GUT function:

• There is good research around microbial imbalance and a person’s risk for progressing into more dangerous stages of the virus. What can your genetics tell you?  A lot!

Pharmacogenetics for various drugs that may be used to treat SARS2

• Many drugs get metabolized through a CYP enzyme, we have included the ones with some research.

Because we think this is so important we are offering this panel at a reduced price of $250.  This panel includes over 65 genes and 500 variants to help you understand:

• Your risk of the virus entering your body
• How well your immune system might respond
• Are your genes more prone to mount an excessive response or a “cytokine storm”
• What changes you can implement that are right for your unique biochemistry!

Please click here to set up an account in our system.  Here you can let us know that you would like an immune genetic panel run.  You may also contact me via the contact form on this website.  The turn-around time is 1-5 days.  We can send you the completed panel with actions or also include an appointment to review the panel.  We accept MyHeritage and 23andme raw data and if you have not run your genome and need help ordering a gene kit please ask!

Also available are COVID19 antibody tests.  They are made in the US by Raybiotech.  This kit includes IgM (current) and IgG (past) antibodies and it is $100.  You will not be charged until the testing is shipped and you may be placed on a waiting list depending on the availability. Set up an account here to request a kit.

In health,

Michelle

*Disclaimer –  This information does not infer medical advice or complete risk.

The post You Don’t Want to Miss this Personalized Immune Gene Panel! appeared first on .

Do you have any of these symptoms?

• Bladder infections or UTI’s
• Interrupted urine flow
• History of kidney stones
• Painful scalp
• Joint or muscle pain
• Sore eyes
• Fibromyalgic type pain
• Brain fog
• Anxiety or depression
• Panic attacks
• Difficulty waking up
• Pelvic pain
• Disturbed sleep
• Histamine issues
• Carpal tunnel syndrome
• Vulva pain
• Osteoporosis

You may have a build-up of oxalates. What is an oxalate? Oxalates are found in many foods and are there to help the plant bind calcium so that it can grow.  In our bodies it does the same thing (binds minerals-for us this is not good!).  If you have the appropriate environment and functioning enzymes then the oxalates are broken down and eliminated.

We have a few enzymes (genes) in our body that work to breakdown the oxalates found in many of the foods we consume on a regular basis.  The top culprits being spinach, nuts (especially almonds) soy, wheat, potatoes, brown rice flour, chocolate, buckwheat, berries, celery and carrots (there are more).  Oxalates can also be a byproduct of metabolism.  Excess vitamin C gets converted to oxalates!  Sometimes we use mega doses when sick, some people take it to bowel tolerance to help with constipation.  We’ve always been told we will just pee out what we don’t use, but for some people this is not true!  You must avoid high doses of C if you have these genes (or symptoms)

Beware! If there are variations in these genes or you overload the system, the enzymes may not work as well and the oxalates will bind with calcium and other minerals in the body and turn into sharp crystals that can accumulate in the urinary tract (kidney stones) or deposit in joints, muscles, eyes and GI tract causing an overwhelming amount of symptoms.

Symptoms can present when eating high oxalate foods.  I’ve had clients who have immediate shoulder pain after eating.  Sometimes you will have flares, this is when you have a release of stored oxalates for one reason or another.  Some people do not have actual symptoms until they stop eating high oxalate foods, but they may have low minerals, be at risk for osteoporosis, have IBS type symptoms or be on their way to kidney failure etc. this is a storm brewing.  If you have variations in your oxalate genes it is important to take this seriously.

Never remove all these foods at once.  Oxalate dumping is a real thing and can be very painful.  If you have any of these symptoms and have variations in your oxalate degrading genes, you may benefit from removing some of these foods (slowly) with the help of a nutritionist.  Taking specific supplements and probiotics that help bind and break down the oxalates can also be helpful.

Oxalate dumping symptoms:

• At first none! This is the honeymoon phase, this may be the first time in years that your aches and pains disappear, your GI system feels like its working, your brain may not feel foggy.  In some studies austistic children show immediate gains in symptoms.  But beware if you did this abruptly this does not last….
• Oxalates bind to minerals so some of the symptoms of dumping will be similar to low magnesium: muscle aches, twitching, cramps.
• Since B-vitamins are readily being used up, symptoms of low B’s can abound: migraines, skin issues
• Histamine flares
• Constant sinus drainage
• Cloudy urine
• Sandy looking stools
• Black specks in your urine or stool
• GI distress like diarrhea or constipation
• Yeast overgrowth

Currently a high oxalate intake is defined as eating more than 250mg of oxalate per day.  One cup of spinach contains 656mg of oxalates! Eating spinach requires the body to work hard to process those oxalates and uses up a lot of B6 to do this.

Hyperoxaluria Type 1 is coded by the AGXT gene.  When this enzyme is not working properly glyoxylate is converted to oxalate which forms insoluble calcium salts that can accumulate in the kidneys or other organs.  If you have these variations, you are more prone to kidney stones. Hyperoxaluria Type 2 is coded by the GRHPR gene and Hyperoxaluria type 3 is coded by the HOGA1 gene.  These are usually more related to joint pain versus kidney stones.

Biggest culprits:

Source: St Joseph’s Healthcare Hamilton

Harvard T.H. Chan School of Public Health

Here is a searchable data base with 750 foods and their oxalate content

https://oxalate.org

There is some discrepancy in the amount in broccoli, to be safe boiling your broccoli before you eat it and discarding the water removes a large portion of the oxalate content, you can also do this with nuts.

I especially see this as a major problem for people that are juicing regularly, on a paleo diet that includes a lot of almond flour and/or milk, people eating a lot of gluten free products or bars (almost all bars contain nuts!) and vegetarians/vegans that are eating a lot of soy products.

Remember you can still have oxalate build-up with out the genes and trialing a low-oxalate diet may be helpful, but for people that will have a life-long problem knowing your genetic predispostion is important. Magnesium and calcium citrate can be included as a supplement to help bind the oxalates as well as certain strains of probitiocs to help degrade them (calcium should not be daily if CVD risk). Our gut bacteria can also make oxalates!

Think you may have an oxalate issues?  Visit omicsdna.com to run either a mini diet panel that will tell you if you have variations in these genes or a full diet panel with testing.

The post What the Heck are Oxalates? And Why You Should Care appeared first on .

Are you interested in knowing how your genome can be influenced by your nutrition and lifestyle from the comfort of your own home? Then read on!

First lets define what the best things to look at with a direct to consumer kit are:

Genes involved with Nutrigenetics: The way the diet influences the risk of developing a disease

Genes that influence Nutrigenomics: How nutrients effect the genome AND the biochemistry we can measure related to lifestyle choices (this is key!)

From: Basic of Genetics, methylation, MTHFR and DHFR: Understanding the functional applications of nutritional genomics in practice

Snppros.com

*Direct to consumer tests do include some pathogenic (disease causing) SNP’s but not many.  If you are testing for a genetic disease please work with a doctor or genetic counselor.

Step 1: order a kit from a CLIA certified lab (want me to do this for you?  Ask me how)

What the heck does this mean?

It means the raw data that you receive back form the company is RELIABLE!

“All laboratories that perform health-related testing, including genetic testing, are subject to federal regulatory standards called the Clinical Laboratory Improvement Amendments (CLIA) or even stricter state requirements. CLIA standards cover how tests are performed, the qualifications of laboratory personnel, and quality control and testing procedures for each laboratory. By controlling the quality of laboratory practices, CLIA standards are designed to ensure the analytical validity of genetic tests.” https://ghr.nlm.nih.gov/primer/testing/validtest

For direct to consumer testing the only two that I am aware of that currently have this certification are 23 and me and MyHeritage. Please comment below if you know otherwise.

If you are worried about privacy, opt out of sharing your information and do not participate in their research.  (you may have to click decline many many many times).

After you have downloaded your data have it deleted.

There are certain bits of information that will still be kept but your information will not be used for research.  To me the information you will glean from running your genetics far outweighs the risks.

From the New York Times:

“23andMe

To delete your 23andMe data, head to your account settings page and find the “Delete Your Data” option under “23andMe Data.” You can download any or all of your data before you destroy it. If you agreed to have your sample saved, it will also be physically destroyed.

However, 23andMe uses a laboratory that must follow regulations under the Clinical Laboratory Improvement Amendments, or CLIA. This means that some data, including your DNA, sex and date of birth will be retained in order to comply with these regulations. The company will no longer use that information, though. You can read more about the company’s deletion process here.

MyHeritage

To delete data from MyHeritage, log into your account, click your name in the upper-right corner, and choose “Account Settings.” From there, scroll to the bottom of the page and click “Delete Account.” You can also choose to delete your Family Tree Builder projects or sites without deleting your entire account, but this will not necessarily delete your data. Since MyHeritage labs are CLIA-certified, they will also retain some information about you.”

One additional thing to remember:

If you plan on using another company to analyze your data (what I recommend), you DO NOT need to pay for the nutrition reports that these companies offer.  You get a complete raw data file that you can download when you order the ancestry only report and it is cheaper.

So……I’ve received my results… I’m 2% Neanderthal now what??!!

Step 2:. Decide what the heck I’m going to do with this information!

You have some options here. There is software that you can directly load your data into and try to analyze it yourself.  Some options here are Livewello and Prometheus or free software like Genetic Genie.  Do I recommend this? If you have some training, understand biochemistry and have a lot of time on your hands for research then sure.  Otherwise No.

There are a myriad of nutrition panels that you can buy on-line “How to eat for your genes,” blah blah, if this is something you are interested in (ever searched on the web) I’m sure it has popped up on your facebook feed, I’m not going to list them here.  People have brought me many of these, they are pretty reports and give some interesting information but usually when I ask my client was this helpful?  Was it actionable?  Did it improve your health? I get a blank stare….or they say I didn’t really understand it, it was contraindicated in parts, I tried the supplements it recommended and felt worse etc etc.

Most of these reports are made and researched by PhDs, RD’s, Certified nutritionists and Doctors.  They are looking at the correct genes BUT they are templates that are spitting out information and giving recommendations for food, lifestyle and supplement recommendations based ONLY on a variation in your genetic code.

A variation or SNP on a gene does not necessarily = a supplement. It doesn’t even mean that that variation is active!

IT DOES NOT WORK THAT WAY. Gene variations can turn on and off, they don’t change but the way the EXPRESS is influenced by our lifestyle.  This is called epigenetics!

Example: Just because the MTHFR enzyme (gene) makes folate does not mean that you take folate or folic acid because you have a variation!

Step 3:  Find a company or practitioner that uses these reports AND lab data to VALIDATE your genome, uses pathway analysis, symptom analysis and gives you recommendations based on all of this, not just the variation.

Your genome can be your blueprint for optimal health, it is an amazing tool when used correctly, but stressful and confusing when not.

Back in Jan of 2017 I wrote this article, some of these are still available and there are many many more companies now that are providing reporting.  I still am not wild about any of them, so I am now working for the Doctor who taught me everything I know about nutrition and how it relates to your genetics and I have helped create useable panels that are validated with labs.   Our reports are done by hand by an actual human and in most cases (unless mini panels) validated with required lab testing (your own unique biochemistry!) please visit here to see our offerings.  I’m really excited about these!

In Health,

Michelle

The post A Step by Step Guide on how to Look at your Genetic Data at Home (and what not to do!) appeared first on .

p.s. you could probably serve this over rice or use spinach.  In fact the original recipe calls for a base of spinach and corn, so put the fish over whatever you desire, its the yummy sauce that makes everything taste good!

The post Parmesan and Bacon crusted Salmon with Kale and Clam Butter sauce appeared first on .

Sleep deprivation leads to weight gain, it also leads to poor food choices during the day. People with poor sleep have reduced leptin levels and increased ghrelin levels (the hormones that regulate our appetite) you also have a higher risk of having increase Hemoglobin A1c levels and diabetes.

There are medical conditions that disrupt sleep, some of these conditions are ones treated with a drug that may be contributing to the insomnia. Finding the root cause of why you have this condition may help improve sleep. Lets review a few.

Insomnia

Insomnia can be caused by psychiatric and medical conditions, unhealthy sleep habits, specific substances, and/or certain biological factors. Insomnia improves when other symptoms improve. Many medications such as ones for cold and nasal allergies, high blood pressure, heart disease, thyroid disease, birth control, asthma and depression can cause insomnia, finding alternatives or fixing the issue you are taking the medication for may help with better sleep.

GERD

Keeping a gap of 4 hours between your last meal and bedtime may help. Finding the underlying cause of GERD is a better option (food triggers, low stomach acid, H-pylori, SIBO, lack of digestive enzymes etc.) Remember long-term antacid (PPI) use makes you B12 deficient, see below!

Other GI issues like leaky gut

In functional medicine we view the body as a whole so lets look at an example: You cant’ sleep because you are depressed, you are also on an antacid for heartburn (GERD). Bad sleep contributes to depression, but depression contributes to bad sleep. Low serotonin contributes to depression, low serotonin contributes to low melatonin. Guess where most of your serotonin is made? The gut! If the gut is unhealthy because you are eating foods that are punching holes in it, or you have high levels of stress or an untreated parasite, or are on antibiotics and you are not replacing the good bacteria, or you are over-exercising guess what’s going to be low? Serotonin! Guess what else is low when you have gut issues, B12, you need a functioning gut lining (specifically a protein called intrinsic factor) to absorb B12. Guess what a lot of people who are depressed are low in? B12! You have to connect the dots, not just treat one of these symptoms!

Reactions to food

Can contribute to poor sleep-have you tried an elimination diet to get these offensive foods out of your diet?

Pain

Arthritis, headaches, fibromyalgia can make it hard to fall asleep and stay asleep. Addressing these issues with medication short term and nutritional therapies long-term to target and reduce pain can facilitate better sleep.

Anxiety and Depression

This is a biggy! Anxiety makes good sleep very difficult, less sleep increases anxiety. Addressing the root of the anxiety (genes, psychological issues) can help as well as meditation, yoga and other relaxation techniques. Depression improved in sleep apnea patients who used CPAP (the machine to help open airways) Prozac and Wellbutrin may have a negative impact on sleep. Trying natural treatments for depression can be helpful for sleep. These include Vitamin D, Omega 3 fatty acids and neuro-transmitter precursors such as 5HTP (do not take if on an SSRI) Natural treatments for anxiety include most of the same herbs/supplements that are used to treat insomnia! (See the connection?) They are listed below.

Bladder problems

Many things can contribute to waking up to urinate, various medications, a UTI, enlarged prostate, overdoing fluids in the evening, caffeinated beverages (if a slow metabolizer). Some misperceive getting up to urinate as the problem when in reality they are waking for another reason.

Menopause

Sleep problems increase with age in both sexes; women have a drop in estrogen and progesterone, which can reduce sleep quality. Hot flashes may be the issue but falling hormone levels are not the only issue. There is an increase in sleep apnea in postmenopausal women. If you have ongoing daytime fatigue a sleep study may be necessary. If no apnea exists raising levels of hormones with bio-identical therapy or natural products discussed in my hormone article here can help with sleep.

Low levels of melatonin

Melatonin levels drop in postmenopausal women, and older men. Supplementation may be in order but getting some sunlight during the day to start production and avoiding blue light before bed are both helpful rituals to help production. If you can’t get sunlight during the day consider investing in full spectrum light therapy and turn it on first thing in the morning, there is also a light based alarm clock. You can find both on Amazon for under $50. This also stimulates your body to make cortisol in the morning (versus at night), which will give you the appropriate morning energy.

Restless leg syndrome

Is 60% genetic but may be due to abnormal iron metabolism, make sure you have a full iron panel run if you have this, see my article here on which labs to run. Low magnesium may also be a factor.

Abnormal cortisol levels

If an appropriate test shows that you are high or low (I like the Dutch hormone test as it shows free and total cortisol) regulating this can help with sleep. Usually altered coritsol production stems from other problems that also need to be identified but in the short term supplementing to bring levels back to normal can be beneficial. If you have a high nightly cortisol pattern extra vitamin C, B5, B6, zinc and phosphatidyl serine may be beneficial. Low cortisol production suggesting some sort of imbalance in the HPA axis may produce non-restorative sleep and daytime fatigue, in this case it is important to balance blood sugar levels with a higher protein, lower carb diet. Various herbs, glandular formulas or hormone replacement may be beneficial in both cases. You need to work with someone to balance these levels.

Caffeine

Most of us know if caffeine makes us jittery but there is a good part of the population which are slow metabolizers of caffeine (you can find this out on a genetic test like 23 and me) who still drink coffee or soda or chocolate late in the day and may not realize that the slow metabolism of the caffeine may be contributing to their sleep issues. Snapple ice teas have just as much caffeine as coffee, energy drinks much more and many may choose these as a drink with dinner or later in the evening to finish work. There are also drugs that interfere with the metabolism of caffeine. To check your caffeine gene look at your CYP1A2 gene if you have AA you are a fast metabolizer if you have AC or CC you are slow.

Lack of neurotransmitter precursors

Tryptophan is the precursor to serotonin, which is a precursor to melatonin. Low carb diets can disrupt the transfer of tryptophan across the blood brain barrier as it is competing with bigger proteins. Some carbohydrate with your evening meal can help the tryptophan get to the brain. Supplementing with straight tryptophan requires many conversions (first to 5HTP, than serotonin then melatonin) this is a slow conversion so if looking to help with depression (to make serotonin) I’d take 5HTP, to help with sleep I’d just go straight for the melatonin.

Alcohol

Alcohol is a central nervous system depressant and will make you sleepy but for every drink, the sedation is followed by an equal amount of arousal. Excess alcohol leads to restless sleep, elevated coritsol levels occur, as well as body temperature. Proper melatonin actually decreases body temp.

WHAT CAN I DO?

Before treating a sleep disorder as insomnia, identify the root cause from above of what is creating the sleep disturbance. In the short term using medication or one of the following natural sleep aides can be helpful. But if you find that you are using these long-term, working with someone to fix the root cause may be in order.

The following are natural sleep aides:

Chamomile-may help with insomnia, anxiety, digestive and skin problems. A dose of 300mg helps initiate sleep or a cup of good quality tea. People with asthma or ragweed allergies may want to avoid. Chamomile may have a slight estrogenic effect helping women with low hormone status but should be avoided by those with a history of estrogenic type cancers.

Lemon Balm-Usually used in combination with valerian, hops or chamomile but can be use alone. It is thought to be an inhibitor of GABA catabolism, low levels of GABA are linked to anxiety, depression and sleep disorders. Valium and ativan are benzodiazepine type drugs that bind to the GABA receptors and help calm or slow down the body’s central nervous system. They are used for people with anxiety and sleep disorders. Lemon Balm acts on the same receptors.

Valerian Root-Similar modes of action as lemon balm but does not produce the residual morning sleepiness that a benzodiazepine drug may. Usually in a combination of other sedating herbs such as hops, passion flower, lemon balm, chamomile and lavender. Has been shown to help with restless leg syndrome.

Hops-Yes this what is used to make beer bitter! Hops do contain phytoestrogens and may have an estrogenic effect for women experiencing menopausal sleep problems; it also has a sedating effect on the central nervous system. IPA beers do not have enough of the active phytoestrogen constituent to cause problems in men who drink it regularly. But for men with high estrogen levels malt beer may be a better choice just to be safe.

Kava-Has been used for anxiety, insomnia and fibromyalgia. It induces relaxation and may improve cognitive function. It acts on the amygdala in the limbic system, which controls many emotional processes. Kava does not bind to GABA receptors like many sedatives. It was banned in other countries and now contains a warning label in the US because of fear of liver damage. Uncontrolled ethanol extracts were used in the past, which contained illegal varieties contaminated with bacteria or fungi, this warning stems from these products. If you have a compromised liver do not use this, but for most people using a trusted brand can be very beneficial. When using herbs never buy from an unknown company. My two favorite trusted brands in the U.S. are Gaia and Herb Pharm.

L-Theanine-Is an amino acid it causes relaxation but is not necessarily sedative so can be used during the day for anxiety. But because it can lower anxiety it can promote better sleep. L-theanine is also found in tea. If taking a medicine to lower blood pressure consult with your doctor first.

Taurine. Taurine is an amino acid that reduces cortisol levels and increases the production of GABA.  Using magnesium taurate allows you to get both magnesium and taurine with a single pill.  In many sleep formulas. Taurine is also used to treat cardiovascular issue and high blood pressure. 

Magnesium-Helps to maintain the efficacy of the suprachiasmatic nuclei (the location of the bodies biological clock) and the pineal gland that produces melatonin. Magnesium is also involved in may other pathways which may improve symptoms related to fibromyalgia, migraines, chronic fatigue syndrome, helps improve c-reactive protein marker, may help restless leg syndrome. Anyone with sleep issues should safely supplement with magnesium.

Tryptophan/5HTP-both melatonin precursors. Do involve conversion that is sometimes hindered in people. Zinc and B6 are cofactors to make tryptophan work to make serotonin, make sure you are getting enough of these important nutrients.

Melatonin-Is a hormone secreted by the pineal gland in the brain, it decreases with age. Melatonin does not have a negative feedback loop meaning taking it will not quell the body’s natural production. Lower supplemental levels are just as effective (for sleep) as higher levels. Higher levels work like an antioxidant and should only be used for specific purposes (10-20mg). Melatonin lowers the body temp and helps people fall asleep. In studies though, falling asleep quicker does not always improve sleep. Time release at 2mg has actually been shown to improve sleep quality. One interesting fact is that Alzheimer’s patients have a profound reduction in melatonin and melatonin is an antioxidant and neuroprotector.

Other things to try:

• The circadian rhythm is no joke. If you think you are getting decent sleep while sleeping with the TV on, think again. Noise and light both disrupt this pattern. It is imperative that you sleep in a cool completely dark room for this cycle to work properly. To get started, try a night mask or t-shirt over your eyes. A white noise machine can be helpful if you are use to the noise of the TV. Machines are sold on Amazon or use a free app on your phone.

• If you have a spouse that snores, help them to stop by losing weight, utilizing a mouthpiece like snoreRx, surgery or possibly sleeping separate until your sleep pattern is back on track.

• If you sleep with your pet, try wearing a device to track your sleep, you may be surprised at how many times per night you wake up, try to notice if they pet caused this. It is a hard habit to break, but if you are having any sleep issues you may want to consider moving them to a separate rom.

• Try eating some complex carbs with dinner if you are on a lower carb diet. This may help to facilitate tryptophan across the blood brain barrier.

• If you can, avoid TV and devices before bed.  In reality this is sometimes unrealistic so at least set your phone to night mode so the screen is not emitting blue light after 7pm.

• Avoid processed foods during the day; choices of food intake can influence your dream content. Keeping balanced blood sugar can also aid with sleep patterns.

• If you are a wine drinker have your wine while making dinner or with dinner. Having protein with alcohol is very beneficial. Read why here. Avoid a glass of wine before bed as it may help you feel tired, but will make the quality of your sleep low.

• If you are on medications that you cannot come off, work with a practitioner to review any nutrient deficiencies the drug may be causing, this can help pinpoint why the drug may keep you awake and supplementing may help offset some of the negative effects. There is a very complete database that you need a subscription too, but most health practitioners will have access to that gives all herb/drug interactions and nutrient deficiencies caused by drugs. It is called the Natural Medicines Database, ask your practitioner.

• If you are someone that is always congested, which may be disrupting sleep, first try to figure out why (allergy etc) but for the short term trying a natural migraine remedy or a natural anti-histamine may be helpful. A well-studied migraine supplement is called Pentadolex. Natural antihistamines are vitamin C, quercetin or a product called D-Hist, which contains quercetin and a few other things to help clear histamines, which may be causing congestion. Try avoiding dairy and gluten for 21 days.

• Exercise-If you are not making time to do this, try a walk everyday (also a good way to get some sunlight!). If evening is the only time you can fit it in do weight lifting with rest in between or yoga so that your body does not have to work so hard to bring its temperature down, a cold shower or at least some time to cool off is important. Also if possible keep the lights dim and be sure to have the blue light setting on your devices to minimize bright light exposure. Bright lights in a gym are going to tell your body that it’s not time to make melatonin!

Some products to try:

I recommend working with someone to pick the right thing and dosage for you based on symptoms and genes, but I realize not everyone wants to do this. If you decide to try a product and are on any medication please check with your doctor first as some herbs can interact with medications.

Single herb/supplemet varities:

• Organic chamomile extract by Herb Pharm
• Lemon balm extract by Gaia Herbs
• Organic Valerian Root by Gaia
• Time release 1 or 3 mg Melatonin by Natrol
• L-Theanine- by Enzymatic Therapy (Suntheanine)
• Magnesium Glycinate by Metabolic Maintenance
• Magnesium Taurate-Douglas Labs
• 5HTP synergy by Designs for Health
• Kava kava root by Gaia
• Pentadolex (migraine formula)

Formulas:

• Sleep and Relax tea or capsules by Gaia Herbs
• Anxiety soother by Herb Pharm
• Gaba Calm by Source Naturals
• Neurocalm by Designs for health
• Gabatone by Apex Energetics
• Sound sleep by Gaia
• Catecholacalm by Designs for Health
• D-Hist by Ortho Molecular

As a reminder Ambien is a drug that also works on the GABA receptors but with addictive qualities and some very nasty side effects. Read about it here.

Tylenol or Advil PM taken long term will literally punch holes in the lining of your intestines and create “leaky gut” if you have read this far you know that leaky gut causes inflammation, decreased B12 and decreased serotonin which can lead to depression which can lead to poor sleep!

Benadryl is used by some to assist with sleep (basically Tylenol PM is Tylenol with Benadryl) Long term Benadryl use which is an anticholinergic drug blocks the action of acetylcholine. This is an important substance in the body that transmits messages to the nervous system, it is also involved in memory and learning. This study here showed that long-term use was associated with dementia.

Wishing you a restful, restorative sleep tonight!

Michelle

The post Why Can’t I Sleep? Natural Ways to Solve Insomnia appeared first on .

What is going on??

First stage: As we grow older (around 40) our bodies slowly stop being stimulated to produce as much of our sex hormones, primarily estrogen and progesterone. We aren’t meant to have babies anymore and our bodies change to accommodate this fact. Ovulation starts to become intermittent, we might have really heavy or light periods or some of both! Because of these dropping levels of hormones, we get symptoms like hot flashes, sleep problems, mood swings, weight gain and loss of energy. Our brain actually becomes resistant to the estrogen we do have!

Second Stage: (40-45) Pre-menopause

Progesterone is dropping (this stuff gives you that glow during pregnancy) Progesterone is like an anti-anxiety hormone, it makes you feel good and when it starts to go away, we may feel crazy! We experience hot flashes, can’t sleep, and want to kill our husbands! At this stage we usually have higher estrogen than progesterone. It’s important that we keep our progesterone to estrogen (primarily E2 or Estradiol) ratio healthy and watch how we are metabolizing our estrogens (how we rid or recycle them in the body). The DUTCH Hormone test is a good test to assess these levels. Naturally at this point we become estrogen dominant and diet and environmental factors can contribute to this dominance. Not eating enough fiber and being overweight can contribute. Also exposing ourselves to too many fake estrogens or estrogen mimickers like BPA’s, triclosan (toothpaste, hand sanitizer), fragrance in your beauty products, fire retardants, lead, arsenic (can be found in people that eat a lot of rice) mercury (avoid those big fish like tuna), non-stick cookware, pesticides on our food and phthalates in cleaners and beauty products can make the ratios even worse.

Stage 3: (45-50)

Now our estrogen levels start to drop. We experience lower sex drive, vaginal dryness, brain fog, bone loss and possibly depression. Low estrogen can impede the production of serotonin in some women. Low serotonin can affect mood, sleep and appetite. It can also cause constipation. Estrogen is low but higher than progesterone so you have the symptoms from above for estrogen dominance and you also have the symptoms of low estrogen. This may all seem awful and unfair, but menopause is a natural part of the life cycle and if we go in with a positive attitude in the best health we can, symptoms can be reduced. After 12 full months of no cycle you are officially post-menopausal and symptoms mayl go away. The average age for this is 51.

Nutritionally speaking what can we do to combat some of these symptoms?

• Vitamin C naturally boosts progesterone- there are many foods rich in vitamin C (red peppers, kiwi fruit, oranges, strawberries, broccoli, kale, brussels sprouts, cauliflower) you can also supplement.
• Vitamin E (look for a mixed tocopherol) may help to alleviate hot flashes, vaginal dryness and mood swings.
• Magnesium is important in helping reduce hot flashes, and fatigue. It is found in spinach, lentils, oatmeal, bananas, almonds and chocolate.
• Omega-3’s help to reduce inflammation, 2-3 servings of salmon per week or supplementation with a good quality product is recommended.
• A B-complex, specifically pantothentic acid or B5 has been shown to help with stress during this time.
• Maca may act as an endocrine adpatogen (does not contain hormones but may support normal hormone production) helping to balance estrogen levels. 1 Tbsp to start and up to 2-3 a day may help.

Herbs: Remember herbs can act like drugs; they should be used short-term and only from a reputable company like Gaia herbs and other professional supplement companies.   Anything in my recommendations (sign up for a fullscript account with me to see them) are well studied. Also be aware that some classes of herbs can interact with prescription drugs so always check with a health care practitioner before taking.

• Ginseng-another adaptogen that may help with stress and immune function as well as menopausal symptoms.
• Black cohosh contains isoferulic acids which may have anti-inflammatory effects.
• Also plant based phytoestrogens. Other foods and supplements that contain phytoestrogens are tempeh, miso and natto (make sure they are fermented and organic) red clover, daidzen, pycnogenol and genistein. These products can have similar effects (although usually much less) as hormone replacement so make sure to work with someone and get tested if you choose to go this route.

Diet: We’ve all heard it before: cut down on processed food and the white stuff (sugar and refined carbs) but during this time of life it is really important to eat a nutrient rich diet to help with stress, weight (fat is estrogenic and messes with our ratios) and sleep. Also our fatty acid balance is important. Fatty acids are the precursors to prostaglandins (these are things that cause cramps!) that regulate hormone receptor sites. Too much Omega-6 fatty acids and not enough Omega-3’s can increase the production of these prostaglandins, which creates inflammation. But remember it is important to get healthy fats in our diet (olive oil, ghee, nuts and seeds, avocado, coconut oil). Do you know where all sex hormones come from? Cholesterol! Cholesterol is the precursor to pregnenolone the beginning of all sex hormones. Our bodies need healthy fats to make cholesterol. Lastly, for some people reducing their intake of caffeine and alcohol can also help with menopausal symptoms as they both can alter the levels of estrogen, and as we age our bodies hold less water and we become more sensitive to the effects of both.

Exercise the right way! For those with hormone imbalance, intense extended exercise can actually make the problem worse in the short term. Long distance running actually increases the intestinal permeability in your gut, in some this may not be a problem, for others who already have a compromised gut function this can cause major issues, as we will see below. Workouts that include short bursts of heavy lifting may trigger a beneficial hormone reaction.

Heal the gut- GI issues can cause inflammation. Inflammation can suppress the hypothalamus in the brain telling the body to make hormones or suppress the function of the glands actually making the hormones. It can also make you hormone resistant. The receptors on the cells become less sensitive to the circulating hormones and you experience the same symptoms even with normal levels of hormones in your body. Dysbiosis (microbial imbalance) in the gut can increase the production of the estrogen metabolites we want to be lower (4-OH and 16-OH) and decrease the production of the protective (2-OH). The gut really is the center of overall health including balanced hormones. Having dysbiosis during menopause can make the problem that much worse! (We can see markers for dysbiosis on two of the nutrient tests I mention here) and don’t forget 70% of our serotonin is made in the gut. Unhealthy gut=mood imbalances. Healing the gut is a 5-step process that involves removing stressors, replacing enzymes or other things to aid digestion, reinoculating with probiotics and fiber, repairing the lining with supplements and rebalancing our lifestyle in order to keep our GI healthy. If you need help with GI issues please let me know.

Increase your detoxification mechanisms. If we are recirculating estrogen this can contribute to estrogen dominance, they compete with the active hormones and bind at the receptor sites but don’t have the same effect so they are actually blocking the active hormone and disrupting the regulation. We can also look at DNA mutations that predispose people to these detoxification problems (looking at your 23 and me data) this helps us to know where to supplement or support. We can look at detoxification markers on the ION nutrition test mentioned here, we can also look at liver markers on your blood chemistry reports, we can look at symptoms like sensitivity to chemical smells and how you react to medications. Certain supplements can help support the liver like glutathione or liver support supplements. If your estrogen is clearing down the wrong pathway we can give support like the supplement DIM (found in cruciferous vegetables) and/or increase your intake of cruciferous vegetables and things like flaxseeds which contain lingans or phytoestrogens that can help change estrogen metabolism (ps I would not blindly recommend flaxseeds to men without looking at his biochemistry first-men can also do the DUTCH Hormone test!)  The DUTCH Hormone test is an amazing dried urine based hormone test that I think every women should have run.  You can read more about it on their website here.  You can work with me to have this run, please ask.

• You can look under Menopause in my fullscript account to see some of the supplements and herbs mentioned above. I believe in testing instead of guessing but changing your diet, adding some supplementation, exercising appropriately, reducing stress and embracing aging can all be done very easily. If you need help personalizing the right diet for you please let me know.  Fullscript

• In regards to hormone replacement I am supportive of bio-identical hormone replacement. It can be a lifesaver for some women who are not helped with the above methods (but I would try diet/lifestyle/supplements first) you need to work with a doctor who will monitor you every 3-6 months. I would choose a naturopathic or functional medicine doctor who understands all aspects of hormone replacement. If you need help finding one please contact me.

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Blood Glucose Regulation:                                                                        Optimal Range (female)

Glucose                                                                                                            75-86

Hemoglobin A1C                                                                                              4.5-5.5

Insulin – Fasting                                                                                                 2-5

Renal Markers: (kidney function)

BUN                                                                                                                  10-16

Creatinine                                                                                                          0.80-1.10

BUN/Creatinine Ratio                                                                                        10-16

eGFR Non-Afr. American                                                                                   90-120

eGFR African American                                                                                     90-120

Uric Acid                                                                                                            3-5.5

Electrolytes:

Sodium                                                                                                              135-142

Potassium                                                                                                          4-4.5

Chloride                                                                                                            100-106

CO2                                                                                                                  25-30

Metabolic:

Anion gap                                                                                                            7-12

Proteins:

Protein, total                                                                                                      6.9-7.4

Albumin                                                                                                            4-5

Globulin, total                                                                                                   2.4-2.8

Albumin/Globulin Ratio                                                                                    1.4-2.10

Minerals:                 

Calcium                                                                                                            9.2-10

Phosphorus                                                                                                       3-4

Liver and Gallbladder:

Alk Phosphatase                                                                                               70-100

AST (SGOT)                                                                                                       10-26

ALT (SGPT)                                                                                                        10-26

Bilirubin – Total                                                                                                   0.10-0.90

Bilirubin – Direct: (only run if total is high)                                                            0-0.19

Bilirubin – Indirect: (same)                                                                                  0.10-0.70

GGT                                                                                                                   10-30

Iron panel:

Iron – Serum                                                                                                       85-130

Ferritin                                                                                                                30-70

TIBC                                                                                                                   250-350

% Transferrin saturation                                                                                      20-35

Lipids

Cholesterol – Total                                                                    160-200 (particle size most important)

Triglycerides                                                                                                     70-80

LDL Cholesterol                                                                                              <120

HDL Cholesterol                                                                                             55-70

Fibrinogen                                                                                                      200-300

Cholesterol/HDL ratio                                                                                      <4.0

Triglyceride/HDL ratio                                                                                       <2.0

Lipoprotein subfractions:

An expanded lipid profile measuring lipids, lipid sub-fractions, particle size and number and APO (B) companies: (choose one)

Lipoprotein particles – Spectracell labs

Nuclear magnetic resonance testing – Liposcience (NMR)

Berkely Heart Labs test – Berkely heart labs

Vertical auto profile – Atherotec (VAP)

Full Thyroid panel:

TSH                                                                                                            1.3-3

Free T3                                                                                                        3-3.5

Total T3                                                                                                      90-168

Free T4                                                                                                       1-1.5

Total T4                                                                                                      6-11.9

T3 Uptake                                                                                                 27-35

Reverse T3                                                                                                10-25

Thyroid Peroxidase (TPO) Abs                                                                    0-34

Thyroglobulin Abs                                                                                       0-1

Inflammation/Oxidation:

C-Reactive Protein                                                                                    <4.5

Homocysteine                                                                                           5-7

Nutritional Panel:

Vitamin D (25-OH)                                                                                   40-70

Vitamin B12                                                                                           450-800

Hormone Panel:

DHEA-S                                                                                                275-390

Testosterone, Free                                                                                 1-2.2

Testosterone, Total                                                                                 35-45

Estradiol                                                                                                150-350

Progesterone                                                                                         18-27

CBC/Diff:

Total WBCs                                                                                           5.5-7.5

RBC                                                                                                      3.9-4.5

Hemoglobin                                                                                          13.5-14.5

Hematocrit                                                                                             37-44

MCV                                                                                                      82-89.9

MCH                                                                                                      28-39.10

MCHC                                                                                                   32-35

Platelets                                                                                                 155-385

RDW                                                                                                      11.7-13

Neutrophils                                                                                             40-60

Lymphocytes                                                                                          24-44

Monocytes                                                                                              0-7

Eosinophils                                                                                              0-3

Basophils                                                                                                 0-1

How do you compare? If you would like help optimizing your blood work and therefore your health, or learning more about what these markers mean, please contact me. I have male ranges too! (Their ranges are a little different). Most naturopathic doctors and preventative medicine doctors will run all of these. If your doctor says they are unnecessary you can work with me on picking the most important ones, or there are on-line labs where you can order your own blood work. It is not covered by insurance but is very reasonable and after considering how much your co-pay for an appointment is sometimes even less!

My other favorite Functional Medicine tests I recommend people run to see a bigger picture: 

• DUTCH Hormone test – this uses dried urine at 4-5 points throughout a day. Hormones fluctuate a lot so a point in time blood marker may not be as accurate as a daily average. It also provides useful markers not found in blood. Includes sex and adrenal hormones.

• Individualized Optimal Nutrition (ION) test – The ION Profile is a nutritional analysis that measures over 125 key nutrient biomarkers and ratios that can help identify nutritional shortfalls that may be a root cause of complex chronic conditions. The ION Profile evaluates organic acids, fat-soluble vitamins, Coenzyme Q10, homocysteine, oxidative stress markers, nutrient and toxic elements, fatty acids, and amino acids.

• If you suspect food allergies or intolerances run an IgE panel (immediate immune response) and an IgG panel (a delayed immune response)

(remember if your food intolerance test comes back with more than 10 foods you may just have an impaired gut lining).

• A stool test (yep you poop in a cup) can show us the type of bacteria present with ratios, abnormal bacteria, fungi or parasites (If you have parasites your baso, mono and esonophils on your CBC will normally all be elevated) yeast markers, inflammation markers, immune markers, and digestion markers. As these tests use DNA they can also tell us what conventional antibiotics or botanical medicines will work against whatever dysbiosis they find.

• A DNA test – 23 and me has taken away some of the markers I like to look at but still has a lot we can work with. I find it very helpful with eating psychology, weight, mood, and other things like when we can see “why we are the way we are.” A few examples of nutritional related things we can look at: If you are a vegetarian does your body convert ALA (found in flax) to the EPA/DHA that our bodies need and that is only found in animal products? Will a ketogenic diet work for you to lose weight? Some genes predispose us to not doing well on a keto diet. Do you have high homocysteine? We can look at the enzymes used in this pathway and see where we might supplement. Do you clear your caffeine slow or fast? If you are a slow metabolizer and drink coffee in the afternoons you are probably impeding sleep. And so on and so forth there are so many things we can look at and confirm with nutrigenomics!

*Lab ranges taken from Blood Chemistry and CBC Analysis, Clinical Laboratory Testing from a Functional Perspective by Dicken Weatherby, N.D. and Scott Ferguson, N.D. as well as Dr. Weatherby’s blood chem software which I use in my practice to analyze results.  My analysis looks at prevention and nutritional support it does not diagnose.

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It all starts in the gut! (Doesn’t everything?)

You take that first sip; the alcohol travels through your esophagus into your stomach where it meets your gastric juices. Did you know if your drink is carbonated the effects of the alcohol will be felt quicker? The pressure in your stomach from the carbonation forces the alcohol into the blood stream faster! Did you also know if there is food in there when you have a drink, the effects will be slowed as the alcohol will stay in your stomach longer and be released into the blood slower. Your portal vein connecting your gut to your liver transports alcohol to the liver. The liver is the king of alcohol metabolism. As the alcohol enters the liver it will enter a very complex pathway involving two enzymes called alcohol dehydrogenase (ADH) and aldehyde dehydrogenase (ALDH). ADH breaks down the alcohol into safer products (this is part of phase II detoxification, see here to read my blog on detoxification) like acetate, water and CO2 where it can be excreted out of the body. But imagine what happens when you drink too fast, and too much for your body without food in your stomach. Your livers capacity is exceeded it cannot metabolize or breakdown what’s coming in and your blood alcohol levels rise because the alcohol escapes from the gut and small intestine without being processed by the liver!

This rising level has many effects…if it’s within safe limits say one drink for women or two drinks for men it can be a relaxing, possibly even providing some cardiovascular benefits. Why does drinking relax your body? Once in the blood stream the alcohol travels many different places one being the central nervous system where it interferes with neurotransmitter signals, specifically GABA. When your body produces more GABA it slows down your brain cells. (S) (Xanax and Valium also increase GABA production). This may be one of its beneficial qualities; moderate drinking provides relaxation that can improve blood pressure a known risk for CVD. Might it even have long-term benefits of reducing stress? The reservatrol in red-wine has been touted as a positive effect, there has even been some research on its effects of increasing HDL, but mind you that is from drinking in moderation! When you keep drinking past this moderate level, you now enter the phase of slurred speech and impaired balance. Vomiting may occur because your liver is overwhelmed and your body knows it needs to get rid of this toxin. You have your gut to thank for this! The lining is extremely irritated by all this alcohol and its sending signals to your brain that it should get rid of some of it! You wake up, you curse yourself drink some water and take a few Advil and go on with your day. Fast forward 10, 20 year and this has been going on regularly. Sound familiar?

So what have I been doing to my body?

Your body is designed to cope with moderate levels of toxins. And remember alcohol is a toxin; the body see’s it as poison and produces the enzyme alcohol dehydrogenase (ADA) to help your body rid itself of it. When the alcohol comes into contact with this enzyme it steals a hydrogen atom off the ethanol (alcohol) molecule and turns it into a less toxic acetylaldehye (but still toxic). Your body then sends in acetaldehyde dehydrogenase to finish the job and break down the acetaldehyde into acetic acid (an ingredient in vinegar) and rid your body of it. So really it’s a fight between how much you drink and how fast the enzymes can work. On average one ounce of alcohol can be metabolized every 60-90 minutes. As you can imagine EVERYONE is going to be different. We have male versus female (females make less ADA), age (We make less ADA as we age), how much you ate, whether you take aspirin, your nationality (Asians make less ADA), and your genes (people with impaired detox genes in the CYP genome are affected more!)! Putting that all aside for now lets look at some of the things happening in your body once you’ve moved past moderate drinking.

-Alcohol affects the way your neurons get triggered by glutamate. Alcohol gets into the glutamate receptors and hurts their ability to send off their normal messages. This is what impairs your speech, coordination and judgment.

-Alcohol increases the amount of Dopamine (a catecholamine) that creates a feeling of pleasure when someone takes a drink. One interesting note here, when reviewing your DNA results from 23andMe (see here on how to analyze your test) there is a particular gene mutation COMT 4680 which degrades dopamine. I happen to be homozygous (meaning both genes are different from the norm) my dopamine breaks down slower than normal. People with this gene SNP are more prone to searching for a dopamine fix because they have a high accumulation of dopamine and the brains starts to ignore it and needs a bigger and better fix to get that pleasure feeling. This can be dangerous as drinking is increasing the dopamine even more.

-Alcohol interferes with NMDA or N-methyl-D-aspartic acid that is a receptor that helps the brain make memories. Ever forget the whole night when drinking heavily? This may be why.

-Do you have a glass of wine to help you sleep? Yep it might help you get to sleep because of the relax response we talked about before but as you sleep your brain try’s to take back control and it screws up your crucial REM sleep (S), plus you are dehydrated which affects sleep too.

To get rid of toxins from the body the liver needs water. Alcohol is a diuretic and therefore there will not be sufficient amounts in your body. The liver will start diverting water from other organs including the brain that may cause the pounding headache you experience.

When intoxicated, hypoglycemia (low blood sugar)can occur. An accumulation of the coenzyme NADPH that is involved in the citric acid cycle can cause pyruvate to convert to lactate instead of Oxaloacetate (OAA). Pyruvate and OAA are both intermediates for gluconeogenesis, so if both are reduced gluconeogensis cannot occur. Hypoglycemia can occur if glycogen stores are depleted in liver. This will be worse in people who have not eaten before drinking.

Alcohol depletes key nutrients, it also affects the gut and impedes their absorption.

-Folic acid –tetrahydrafolate receives 1-carbon units from numerous amino acids that are depleted when drinking (impairs methylation).

-Pyridoxine (B6) depleted – acetaldehyde messes with the enzymes needed to activate B6, it also makes it less available in food. B6 or P5P is used in many important pathways in your body.

-Thiamine (B1) is depleted – alcohol decreases the absorption in the GI tract and impairs utilization of thiamine in cells, this can contribute to neurological problems.

-Alcohol is hydrophilic and lipophilic and may harm nearly every organ.

-Alcohol increases the NADH:NAD+ ratio and can lead to increased androstenedione conversion to testosterone in the liver, may cause hyperandrogenism and loss of female characheteristics in females who drink heavily.

-Alcohol inhibits Vitamin A synthesis. It provides competition for the alcohol dehydrogenase enzyme we discussed above (blocks oxidation of Vit A by inhibiting ADH).

-This destruction of Vitamin A increases P450 enzyme activity that stimulates hydrolysis and indirectly reduces Vit A in the liver by increasing the mobilization of Vit A to peripheral tissues.

-Amino acids are lower in people who drink, this affects neurotransmitter synthesis, serotonin and dopamine levels are impacted because of low tryptophan and tyrosine. It also affects coenzyme formation and the body’s ability to handle ammonia load in the body.

-The citric acid cycle is impaired because of higher NADH, the liver than has impaired function to oxidize the acetate to CO2 to be expelled. Acetate therefore escapes from the liver into the blood; acetaldehyde can also escape the liver (the more toxic form) and can bind with proteins and nucleic acids and disrupt DNA function.

-Acetaldehyde can also bind and inactivate glutathione causing oxidative stress increasing reactive oxygen species (ROS).

-Our gene CYP2E1 is induced when alcohol intake is high, repeated induction is responsible for alcohol intolerance. This can also increase metabolism of barbiturates, anesthetics, and acetaminophen all by increasing clearance and formation of toxic intermediates (S)

-Alcohol creates a choline imbalance and interference with lecithin synthesis needed for VLDL synthesis (cholesterol) it inhibits 3 enzymes needed for lecithin synthesis.

-Increases serum estradiol levels.

-Alcohol creates deficiencies in most water-soluble vitamins especially Vit C and B3.

-Decreases bone density and increased osteoporosis-defect in hydroxylation step of Vit D product by P450 enzymes in liver.

-Decreased Vit K storage/utilization (also needed for Vitamin D synthesis).

-Depleted minerals from increased urinary loss and decreased ingestion: Zinc, Calcium, Magnesium.

-Alcohol irritates your digestive system. It damages the stomach lining and can cause gastritis (or inflammation of the stomach lining). Initially alcohol increases the production of stomach acid that can damage the lining. This can lead to gastritis that in turn leads to heartburn. Alcohol also relaxes the esophageal sphincter making it easier for stomach contents to escape into the esophagus.

Steps you can take to be healthier if you choose to drink:

-Eat protein, drink a protein shake or protein heavy meal before indulging so your body has amino acids to use, and buffers the effects of the alcohol.

-Keep your stomach full of food when drinking: A full stomach slows down the rate at which alcohol is absorbed into the blood. Absorption from the stomach is much slower than absorption from the intestines. This prevents accumulation in the blood. The decreased rate of gastric emptying gives your liver more time to break down the alcohol before it enters your blood (called first pass hepatic metabolism). As the alcohol moves to your liver more slowly, your liver enzymes don’t become overwhelmed. Food stimulates blood flow to the liver and the production of liver enzymes that also help break down alcohol (ADA and CYP450).  Enough food can substantially decrease the amount of alcohol that reaches your blood. A meal basically lessens the damage from alcohol. The best meal is something that stimulates your liver and delays gastric emptying. That means protein, fiber and vegetables and a high volume of food.

-Drink a lot of water, especially when drinking alcohol. You’ve been told to do this (glass for glass) but now that you see the science of what is happening in your body I hope you will make a concerted effort to drink more water!

-Make sure your body has sufficient vitamin C. Consider keeping something like Emergen-C on hand to take after indulging. It also contains a good dose of B vitamins that can become depleted.

Most people could use more B vitamins, especially if you drink. Find a good B-complex to take (one that contains folate not folic acid) my favorite here. (Search for Metabolic Maintenance B-Complex Phosphorylated)

-Avoid Tylenol (acetaminophen) with regular alcohol consumption. Alcohol interferes with the gene that regulates the way your body processes acetaminophen, it interferes with the enzymes needed to process it and can damage the liver further. If you take Tylenol regularly (Tylenol PM also) you should not be drinking regularly.

-Monitor your yearly blood tests and watch for liver enzymes and other markers that are out of range.  Read here for traditional and specialty tests that can be looked at when assessing risk.

Keep your liver healthy – it is doing a lot of work!

Besides detoxing chemicals like alcohol it does the following:

-Stores glycogen (a form of sugar for energy)

-Helps regulate blood sugar levels

-Production and storage of proteins and substances that aid in protein metabolism

-Production of bile acids to help with the digestion of fats

-Production of blood proteins and substances important to the production of RBC’s

-Regulation of a number of hormones

-Helps to neutralize free radicals with antioxidants

-Stores many vitamins like iron, copper, B12, vitamins A, D E and K

Do you see how stressing the liver with too much alcohol can have a negative affect on all the functions in the body mentioned above? The image of toxins “building-up” in the liver is actually false its just that the liver becomes less effective and toxins entering the liver to be processed do not get acted upon in the most efficient way so they are left to float around in the body or are stored in adipose tissue causing destruction. This is what being toxic means. Love your liver by sticking to a moderate amount of alcohol and when you do over-indulge, follow the rules to lessen the impact the binge will have on your liver health!

My favorite Liver supplement here and here (search for Protocol for Life Balance Liver Detox)

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Deprivation? Starvation? Juicing? Reset? It means something different to everyone. In this post I am going to tell you about the science of detoxification and when and how you should do it safely so that you are not weakening your body or releasing toxins into the blood with no where to go. If you really don’t want to read the background you can skip down to the where it says “what can I do” and start taking some steps to strengthen this process in your body!

Why should we care?

The body is constantly in the presence of potentially harmful agents. Environmental compounds can gain entry through the skin, the GI tract and the lungs. These are outside (or exogenous factors). Within our own bodies we produce endogenous toxins from digestion, metabolism, tissue regeneration and various cellular mechanisms that can become dangerous if not removed form the body effectively. An example would be NH3 (ammonia) that our body produces when bacteria in the intestines break down protein. The combination of these two plus any toxins produced by our microbes is our total toxic load.

In our bodies the process of detoxification is the mechanism of transforming these potentially harmful products into compounds that can be removed from our body through breath, sweat, feces and urine. When our body loses the ability to effectively do this because of weaknesses in a pathway (from enzyme deficiencies due to genetic factors or nutrient deficiencies) disease can result because these toxicants interfere with normal cellular function. So when you think of your liver, kidney or colon and you imagine this sludge of toxins built up in there, it may be a good visual but really it’s more about a process of a weakened system. People may drink olive oil and be able to poop out little stones, drink green juice for 10 days and feel lighter because they released all these “toxins” but scientifically this has not been proven to be the case, it is a matter of strengthening the mechanisms by giving your body a break and replenishing the nutrients and enzymes that aid your body in making the toxins water soluble and able to be excreted in a timely matter from the body.

What are these toxins you speak of??

Here is a short list of a few of the things that come into your body that need to be dealt with on a daily basis!

Heavy Metals – this can be as simple as small amounts of arsenic from rice or chicken to large amounts of lead from paint or battery exposure. Other examples: aluminum in deodorant, mercury in certain cuts of fish.

Xenobotics- compounds not produced in a biological system, examples would be pesticides, phthalates in food packaging and cosmetics, PCB’s in plastic.

Latrogenics – pharmaceuticals like prescription medication or OTC like acetaminophen that lowers hepatic glutathione (an important amino acid), alcohol.

Plant sources – like nicotine

Microbial – bacterial overgrowth, yeast and fungi overgrowth from high carbohydrate and sugar diets.

Endogenous – an example is AGE’s or advanced glycation end products which can be present in foods we eat, like charred barbecue meat, but the majority of these happen within the body.

How do I know if I’m toxic?

In the world we live in most humans will be carrying some toxic burden. The way our body’s handle this will differ from person to person based on what we eat, our health, our environment and our genes. (s) Children, the elderly, individuals with poor nutrition or those that are physiologically stressed will be more affected. Skeptics to detoxing will say, that’s what our liver is for! and it does a darn good job at ridding our bodies of unwanted things. And they are right…..in a perfect world. But we do not live in a perfect world, and sometimes our bodies become weakened and overloaded and this process does not work the way it should. (s) In a dysfunctional detoxification system we may see disease states like impairment on childhood development, brain disorders, cancer, heart disease, skin disorders, infertility, rapid aging, and pulmonary disease. Besides actual disease, long-term exposure to low level of toxicants can contribute to DNA regulatory interference or damage, enzyme disruption, oxidative stress, immune hypersensitivity, autoimmune diseases, brain fog and fatigue. Testing on the safety of toxins are done individually, and yes, if our bodies were exposed to one chemical in small doses one at a time our liver could easily make it water soluble and we could just pee it out but we are exposed to a multitude of things daily and it becomes more complicated than that. So in reality we could all stand to give our bodies and livers some love, so lets look at how to do that safely…..

How our body detoxifies itself:

 Barriers like skin protect us, but if something gets in, the body will mobilize than excrete the toxin. This happens in two phases. Phase I is an oxidation step where molecules are converted to substrates for Phase II by enzymes like Cytochrome P450 (CYP). Phase II is called the conjugation pathway and the liver adds another substance (like glycine) to make it less harmful and makes it water-soluble so it can be excreted. Endogenous toxins, diet-derived or pharmacological compounds are converted primarily by liver enzymes to more water-soluble forms in order to be removed from the body. Detoxification involves mechanisms that can make your body more tolerable to exposure, increase the conversion rate of the toxin and/or induce the excretion of the toxin. Each of these steps can be addressed by clinical interventions.

Do I need to do testing?

If you are having major symptoms and want to see what your recent exposures may have been, or to find out what your response is to a toxin and the ability of your body to handle the exposure to know what nutrients to focus on, then yes. Hair, blood and urine testing (all with different pros and cons) can show toxic metals because these metals bind to many tissue proteins and tend to accumulate with repeated exposure. The half-life of metal-binding proteins is somewhat slow, so testing done even months after exposure can reveal elevated tissue levels. It does not show what is stored in your adipose tissue or bone and the only way to find this out is to have a fat biopsy. On the other hand organotoxins (like phthalates) are a challenge because these toxins are removed promptly from body fluids, converted to derivatives and stored in adipose tissues. So only recent exposure will show on a test. One way to circumvent this is to measure urinary products of liver detoxification that can reveal the level of trapped compounds still being processed through the liver long after the first exposure. One thing to remember is that the heavier you are or the more body fat you have the more stored toxins you have in your adipose tissue and when losing weight or detoxing for obese individuals the risk of a reaction to released circulating toxins is greater. (s)

Types of testing:

A few simple blood tests that your doctor runs on you at your yearly check-up can be used as a start. (My ranges will be different than those on your lab slips. Ranges for functional blood tests are a little different than for acute-care medicine. The acute-care model ranges are set to identify and diagnose disease and to fit 95% of the population. Clinically normal ranges are very large and have little practical value except for extreme cases. I look at optimal ranges that reduce the range in which you are declared normal. Functional ranges are used to identify conditions before they become a full-fledged problem.)

Blood urea nitrogen or the marker called BUN (optimal range 10-16 mg/dl) shows the detoxified form of ammonia, so if this is elevated you may have increased ammonia loading and conversion in the urea cycle.

Bilirubin (optimal range 0.1-0.9 mg/dl) will be elevated if impaired glucoronidation (Phase II metabolism of drugs, pollutants, bilirubin, androgens, estrogens, mineralcorticoids, glucocortocoids, fatty acid derivatives, retinoid and bile acids)

Creatinine (optimal range 0.8-1.10) mg/dl Increased creatinine can indicate kidney damage due to an autoimmune disease, congestive heart failure, atherosclerosis or complications in diabetes, even slightly raised should be a major consideration for evaluating toxins because this is a major route of removal.

ALT/AST/GGT (10-26 u/l) – if high may indicate impaired liver detoxification capacity.

Other tests usually run by an N.D. , nutrition professional or functional medicine M.D. if needed:

To show exposure:

Heavy metal testing via hair, urine or blood

Oral cavity mercury vapor (to test fillings)

Metabolites in urine – organic acids test

Microbial products – organic acids test

Porphyrinurias in urine (This pathway to heme is highly active and any disturbance will cause a fast and large accumulation of these intermediates, these enzymes are also widely distributed inhuman tissue and are highly sensitive to many different toxins. These porphyrins can serve as biomarkers of the toxic effects of heavy metals and some drugs).

Assessment of detoxification capacity:

Amino acids and organic acids test

Challenge test (given in high doses to challenge pathway) of caffeine, salicyluric acid, sulfate, cystiene or glucuronide

Assessment of nutrients protective in detox pathways

Sulfur amino acids

Glycine (amino acid)

Minerals – magnesium, zinc, copper, selenium, manganese

Antioxidants – A,E, beta caroteine, COQ10,

B-vitamins

Genetic testing – CYP, UGT, GSTP, NAT and SULT genes (to name a few) can show if you have a possible reduction in the clearance of various toxins or if you have reduced ability of clearing a certain type of drug. These abbreviations represent an enzyme used in the pathway to clear a specific toxin. You can read more here about DNA testing.

What can you do? 

1. Nutrition plays a key role in toxin management. Detoxification pathways are metabolically demanding! If you are deficient in various nutrients, your body may have a hard time with toxicant clearance. Your nutrition status will dictate your response to exposures. (s) Clinical tests can guide nutritional interventions, but if you want to make sure your body is primed and ready to get rid of toxins that enter your body this is a list of the most essential nutrients it will need:

Vitamin C-antioxidant protection (Phase 1)

 B-complex vitamins for liver enzyme cofactors and methylation (Phase 1 & 2)

Lipoic acid for liver protection and antioxidant regeneration (Phase 2)

N-acetylsysteine (NAC) – for formation of glutathione (a key amino acid in detoxification Phase 2)

Cystiene-a sulfur amino acid to be used in sulfation reactions (Phase 2)

Methionine- methyl donor and sulfur supply (Phase 2)

Glycine –  used in liver conjugation (Phase 2)

Essential amino acid mixtures – mitochondrial energy production (Phase 2)

Calcium (Don’t forget you need Vitamin D to absorb calcium) – protection from lead (Phase 1)

Magnesium-liver and other effects (Phase 1)

Selenium – glutathione regeneration and protection from mercury (Phase 1)

Manganese, copper – glutathione regeneration (Phase 1)

Zinc – glutathione regeneration and cadmium protection (Phase 1)

Milk Thistle – supports normal liver function, liver cell regeneration and glutathione production

Curcumin – promotes activity of glutathione s-transferase (an enzyme in Phase 2)

There are many different liver support formulas. This and this (search for Protocol for Life Liver Detox) are two of my favorites.

2. Avoid and remove xenobotics (pharmaceuticals, plastic, cleaning supplies, mold, cosmetics, lotions, perfume ect ect), this may mean modifications of home and work environments.

3. Remove and repair microbial overgrowth like small intestinal bacterial overgrowth, see my post here to read more.

4. An elimination diet can provide a period of absence of food-based and endogenous  toxin exposures. (s) This could be a water fast or a juice fast, but remember those with high body burden must be very careful with fasting. The absence of food can increase mobilization of stored toxins and this heightened detoxification will demand extra nutrients (including protein!). Get your nutrient levels high and your overall health in check (including pooping!) before attempting various juice diets.  I would rather see someone do a fast that includes a healthy diet (like intermittent fasting) rather than juicing alone. This can limit the number of new food-based toxins entering your system and help you shed weight.  Fasting may have some mental health benefits, and of course, fasting can have spiritual benefits; it is often a religious practice.  But you need to be careful.

5. While reducing our toxic load you must remember that eliminating the toxins is just as important, if they are left to float around in the blood they will cause damage. Use of dietary oils may stimulate bile flow (especially olive oil) and help with gall bladder emptying.

6. High fiber diets can help speed intestinal transit time and assist toxin removal through the feces. This may help avoid re-acquisition via hepatic recycling. If you are not regular, a detox diet is probably not for you as you will not be able to eliminate the toxins appropriately. Magnesium citrate before bed can help move the bowels.

7. You can eliminate toxins through the skin! Exercise, sauna and massage can help stimulate toxin loss the increased blood flow and sweat.

8. Alcohol detoxification is a whole other blog that I will be writing soon stay tuned!! But remember alcohol inhibits a lot of the enzymes we discussed above and can weaken the body’s detoxification capacity. Limit to 1 drink per day for women and 2 drinks per day for men.

Do I think you should do chelation therapies, extreme juice fasts, coffee enemas, gall bladder cleanses ect ect? Before attempting any extreme measure do your research, talk with a nutrition professional and look at the pros and cons. Can you achieve the same (or better and safer) results by first attempting to clean up your diet, reduce your exposures, add in some nutrients, lose some weight? That is for you to decide. I’d like to do a post on the scientific research behind these modalities (although there is not much) but that is for another time….for now work on your overall health so your body can do what its suppose to (and wants) to do!

In Health, Michelle

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23andMe is a saliva-based direct-to-consumer personal genome test. It’s a fun way to learn about your ancestry and genetic traits that explain why you are the way you are! What is a genome? A genome is an organism’s complete set of genetic instructions. These instructions tell our body how to make proteins and molecules essential for growth, development and health.

Although the data 23andMe gives you is very interesting, you probably already knew that you have blue eyes or that your pee smells when you eat asparagus (you will find this out if you get the $199 test). Some interesting things you might not know is whether you have slow or fast twitch muscles. As a former marathon runner I guess I instinctively knew that I wasn’t really cut out for 26 miles and that all my running friends seemed to have greater success on the same running plan. It was nice to confirm that my muscles are more suited for sprinting! You can also find out if you metabolize caffeine fast or slow…don’t you hate those people that can drink coffee at 9pm and have no problem falling asleep! Or how about whether you are more likely to move in your sleep and even if you are more prone to be lactose intolerant!

There are 41 carrier status reports, which could be useful if you are planning on getting pregnant. From the website: “Carrier status tests detect genetic variants that can cause inherited conditions. These variants are often found primarily in certain ethnicities. Being a carrier means you have one variant for the condition. Carriers typically don’t have the condition but can pass the variant to their children”.

The ancestry section is pretty cool and gives you a good breakdown of your ancestry composition. If your mom and dad get the test too, you can merge your data to see how much of your ancestry composition came from each parent. I gave both of my parents the kit for Christmas and am looking forward to reviewing their results. Overall for $199 (sometimes on special for $149) it is a pretty interesting test, especially if you are a data nerd like me. If you want to just find out ancestry and still get the raw data file just pay $99!

Buy a 23andMe test here.

The Basics

DNA contains instructions for how your body works; it is made up of 23 chromosomes in pairs of two, one from each parent. It is made up of smaller units or building blocks (usually seen as A, T, C or G) when you combine these units into sequences they are called genes. One DNA sequence might tell your body how to make protein; these proteins might go on to build muscle fiber. In humans most of our DNA sequences are the same. It’s the 1-2% that makes us different. These differences are called variants or SNP’s (single nucleotide polymorphism) and this is what a DNA test shows, the differences that affect our ancestry, traits and health.

Let’s talk about limitations

The information on 23andMe is put together in neat reports, but beyond the limited data they present to you on-line, you enter more of the unknown. In 2013 the FDA shut down 23andMe because they were giving too much health/medical information. In 2015 they came back and the data they now give is useful but limited. But…you can download your raw data file with thousands of results to many websites that will interpret your data for you (you get the raw data file with the $199 and $99 test). But here’s the thing, just because you have a specific abnormal trait does not automatically mean anything is wrong with you. It may mean that there is a greater likelihood that the enzyme that gene produces won’t function as well but it is not a given. I see people bringing their genetic SNP reports they got on-line to their doctor convinced that this is what is wrong with them. I also see practitioners supplementing based just on one SNP. Take our Methylation pathway for example, the MTHFR SNP has gotten a lot of press lately as approximately 40-60% of the population (I see differing statistics everywhere) has at least one gene that contains a polymorphism. Practitioners are loading their patients with folate and B vitamins to help the pathway, which will help some people but if you don’t look at the big picture and some of the other related genes and environmental factors you may be affected negatively. It’s a new science and I believe it’s the future, but it’s newish and we need to proceed with caution. Find someone with experience and a working knowledge of metabolic pathways in the body to work with before jumping to conclusions. Having said all that, it is really fun to run these reports (for data nerds and people who can handle it.) If you are prone to being a hypochondriac proceed with caution!

How to read most reports you can run on-line:

There are two copies of each gene in your genetic profile, one copy from each parent. When both copies have a specific polymorphism it usually reads +/+ and is called homozygous (red in a lot of reports). If you have one copy from only one parent it will read +/- and is called heterozygous (yellow in a lot of reports). The + and the – specification refer to whether the gene has a change from what the report determines is the norm (and why occasionally reports/labs will vary depending on what reference database they use). If you see -/- (green in a lot of reports) then that means your DNA for that particular SNP is deemed “normal”. In some cases having a +/+ will actually increase the strength of the enzyme that gene produces and is considered abnormal but good and in some cases it decreases the efficiency of that enzyme and will be considered bad (not all reports make this designation and hence why some are hard to read unless you know what you are looking at).

Links to sites I liked and a short review

Again proceed with caution if you do this alone! Research your butt off before you draw conclusions or find someone to help you interpret, and remember it is for educational and informational purposes only unless you work with a genetic counselor, but have fun, this is some really interesting data to dig into!

https://athletigen.com – Exercise and athletic characteristics, free! Here is an article in USA today about how the Baylor Football team is using this genetic information to create individualized training programs for their players.

https://codegen.eu – Tons and tons of information, easy to use, Loads directly from 23andme, free!

http://www.compass.dna.land – easy to load file, takes awhile to process up to 24 hours, once loaded you must download a VCF and TBI file on to your computer. There is a lot of data but a little cumbersome to use, you have to know what you are looking for! Free!

https://www.dnafit.com -Nice website, you can sign up to get 14 daily emails about various genetic topics. Personalized fitness and nutrition genetic reports, cheapest report is $159. I did not buy one.

https://www.foundmyfitness.com Connects directly to 23andMe. Small amount of information but its good info. Free or you can make a donation. Report has most of the common single nucleotide polymorphisms that Dr Rhonda Patrick likes to talk about in podcasts and during presentations, a lot of relevant videos/news on the website.

https://www.gedmatch.com/ Easy to load, takes a few days to process. Data matches you to people with similar traits and/or genealogy. You can be public or private.

http://www.geneheritage.com All reports are $2. Only presents 8 genes, can compare to family members.

http://geneticgenie.org Only gives information on methylation and detox SNP’s so if you just want to know if you have the MTHFR SNP use this. Easy and free!

https://genoomy.com I like this report, they have a sample to look at. It color-codes your traits so you know if it’s good or bad and gives references. $19 for one report. (did not order)

http://www.impute.me Easy to load, decent report categories but hard to decipher what is bad and good. Free!

https://www.infino.me Easy to load, this is a project to try and understand the relationship between genetics and obesity, you can also connect a fitness tracker to join the study. The gene reports are presented in graphs. It’s a lot of info but need to know what you are looking for; association reports are presented if they exist.

https://knowyourgenetics.com One of my favorites, easy to use, supplement info on your methylation pathway. Also books and lectures available about genetics written by Dr. Amy Yusko.

https://livewello.com $19.95 for a gene variance report, paid subscription for more in depth nutrition reports. One of the more popular user-friendly sites.

https://www.nutrahacker.com Good methylation and detox plus supplemental recommendations, free. 4 other paid reports. Easy to load data.

https://opensnp.org For sharing and finding people with similar SNPs

https://promethease.com A lot of free information, report is $5. Information pulls form Snpedia. This site was recommended to me as the best by someone with genetic experience.

https://www.selfdecode.com Great reports, selfhacked.com is the founders website full of great information on genetics and health. $19.99/month but cancelable

https://seekinghealth.org/product/strategene/ The website of Dr. Ben Lynch. He does a lot of training in gene education to practitioners and the public. This report mostly focuses on a few main pathways with drawings. $45 for one report. (I did buy this $45 report)

Let me know if you have found any other sites you like. Don’t forget, you only have to run this report once your DNA will never change. The way it expresses itself though is up to you. The field of epigenetics has shown that lifestyle factors: what you eat, where you live, how much you exercise ect. can influence the way your genes are expressed. You can actually change the way your genes are expressed without actually changing the underlying DNA sequence. It is never to late to improve your health and teach your cells to read your genes in better ways. Don’t let a history of heart disease or Alzheimer’s in your family create your destiny. Find out the genes that might influence these disease states and whether yours are active and use nutrigenomics (how food and supplements effect gene expression) to optimize your nutrition based on your genotype. Genes are cool!

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