Treating candida

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Candida is a fungus (a form of yeast) that is found in almost every individual. When in balance with other organisms in the microbiome, candida provides beneficial support to the gastrointestinal assimilation of nutrients, as well as aiding immune function. When the immune system is compromised, however, candida can overgrow and break down the mucosal barrier in the intestines. This then allows the candida to penetrate the bloodstream, releasing toxic by-products that can contribute to a myriad of health issues including depression, chronic fatigue, IBS, migraines and insomnia.

Signs that you may have candida overgrowth

  • Digestive issues such as bloating, diarrhoea or constipation
  • Chronic fatigue
  • Skin and nail fungal infections
  • Difficulty concentrating, ADD, ADHD
  • Eczema and psoriasis
  • Irritability, mood swings, or depression
  • Rectal or vaginal itching, recurrent UTI
  • Severe seasonal allergies
  • Craving for sugar rich foods

Testing for candida overgrowth

Testing for candida overgrowth can be incredibly tricky. Candida is a sterling example of an organism that wants to survive at all costs, and can produce biofilm structures that protect it from your immune system (and many methods of standard pathology detection). Blood testing for candida antibodies will often come back as negative despite clear clinical signs that an infection is present, as the immune surveillance cells are effectively blind to the candida when it is housed in a biofilm.

Stool testing using a CDSA can be more accurate, however there may be no candida present if the yeast is in a dormant state or again is housed in a biofilm structure.

Urine testing for the waste products of candida can be useful, and when combined with the CDSA mentioned above I have found this to be the most reliable method of testing.

Treatment for candida overgrowth

Treating candida overgrowth is probably one of the most complicated (but also the most rewarding) conditions I see in clinic. My approach is multi-faceted, and of course in addition to the protocol discussed here is the need to take into consideration the unique presentation of the individual e.g. I often find that SIBO (small intestinal bacterial overgrowth) is present along with a candida overgrowth. Treating the SIBO first is extremely important to adequately clear the way for an effective candida treatment.

Below are some of the general steps I use to address candida overgrowth, however this protocol and the unique constituents used will vary with the presenting patient:

  • Implement a paleo adapted candida diet (sugar, grain & starch free diet with plenty of animal protein and fat)
  • Clean up environmental toxins
  • Individualised probiotic supplementation
  • General supplemental immune support
  • Implementation of an agent for destroying the biofilm structure
  • Implementation of an agent to break down the cell wall of the candida
  • Implementation of an agent to restrict minerals from the candida
  • General agents for killing the candida
  • Implementation of an agent to absorb toxins
  • Leaky gut healing protocol
  • Bowel transit time stimulation
  • Liver support
  • General antioxidants and antiinflammatories
  • Stress support
  • Regular gentle exercise

In addition I identify and address any other factors that accompany, contribute to, or perpetuate candida (adrenal fatigue, heavy metal toxicity, food sensitivities, hypothyroidism, hypoglycaemia etc.) Maintenance is then required to ensure the candida is not given the opportunity to overgrow again.

If you know or suspect that you or someone close to you has candida overgrowth, I strongly encourage you to see an appropriately trained naturopath or functional medicine practitioner to properly clear the infection and restore health. Be wary of simplistic ‘one stop’ formulas or ‘one size fits all’ approaches to treating this complex presentation, as it is extremely rare for these offerings to properly clear candida overgrowth.

In wellness,

James

Prostate health and testosterone: a new approach

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Prostate cancer is the most common cancer diagnosed in Australia and is the third most common cause of cancer death. 85% of cases are diagnosed in men over the age of 65, however there are unfortunately no reliable screening methods for detecting the development of this cancer at present. Non-specific symptoms such as frequent urination (particularly at night) especially with accompanying pain, blood in the urine or a weak stream, and other general symptoms such as unexplained weight loss, bone pain, or fatigue may all indicate the need for further testing.

Treatment for prostate cancer usually involves one or a combination of the following treatments: surgery, radiation therapy, or androgen lowering therapy. The use of androgen (specifically testosterone) lowering agents has evolved from observations in the 1960’s that physical castration in patients who had been diagnosed with prostate cancer resulted in shrinkage and in many cases disappearance of the cancer. Further research saw the development of synthetic estrogenic agents that could effectively lower circulating testosterone to the point of mimicking androgen levels of castrated men. Other chemical agents have since been developed that can also effectively lower testosterone to these levels, and are widely used in the treatment of prostate cancer.

Unfortunately evidence of the effectiveness of the use of androgen lowering therapy in prostate cancer patients to extend survival rates is limited. Furthermore, there are many anecdotal reports of the use of androgen lowering agents as monotherapy in prostate cancer causing a worsening of survival rates over the long term.

Relatively recent research is starting to uncover what many naturopaths and functional medicine practitioners have known for decades – that prostate cancer is much more likely to be caused by an excess of oestrogen than an excess of testosterone. It seems however that both hormones must be present to initiate a cancerous change, and this makes sense when the mechanism of action is examined. Excessive oestrogens encourage androgens in the male to mutate into the potentially cancer promoting dihydrotestosterone (think of DHT as ‘unhealthy’ testosterone) rather than the functional healthy form.

This also explains why you will see a shrinkage of the cancer when androgens & testosterone are temporarily removed from the system – there is no substrate left for the oestrogen to work upon and turn into DHT. However this removal of testosterone also further throws out the balance of hormones so that the patient becomes heavily oestrogen dominant. When the course of treatment is finished and the body starts to make testosterone again, conversion to DHT ramps up to levels even higher than before treatment and the likelihood of another cancer forming increases dramatically.

The effectiveness of physical castration seen in the 1960’s also makes sense in light of the information above. Castration permanently removes the predominant source of testosterone in the body, thus levels of this hormone never again rise to levels capable of converting into significant amounts of DHT. Now I’m certainly not advocating for a reintroduction of physical castration as a front line treatment for prostate cancer (my legs are crossed as I type this!). A far more sensible option would be to screen every prostate cancer patient for their hormone levels at the beginning of treatment. If their oestrogen levels are high (and I suspect they almost always would be), then a course of treatment designed to lower these oestrogens and promote the development of healthy testosterone would be advisable.

Of course should this approach ever be adopted by conventional medicine, pharmaceutical companies will rush to develop (or repurpose) a drug that can either remove oestrogen rapidly from the body or block its ability to stimulate its receptors. This would inevitably result in a raft of side effects and complications that would likely result in the co-prescription of other drugs to mitigate these effects (the pharmaceutical industry certainly have developed a robust business model for maximising profits).

Luckily for those who are willing to do some research and embrace a more natural and healthy approach, there are some excellent holistic therapies that can safely lower oestrogens in the body without any adverse effects. In fact the pharmaceutical approach of introducing synthetic oestrogens into the body was partially founded upon the observation that in Japan men who consumed a traditional diet high in phyto-oestrogen (plant forms of oestrogen) containing soy products had much lower incidence of prostate cancer. The misguided assumption was that these phyto-oestrogens protected from cancer development by balancing and lowering testosterone, when in actual fact their effect is to latch on to and more weakly stimulate oestrogen receptors in the body than more powerful self-produced (or synthetically introduced) oestrogens. Thus the more harmful oestrogens are effectively taken out of action and are unable to stimulate the DHT production.

Other agents that may be used to clear excessive oestrogens include indole-3-carbinol, milk thistle, curcumin, and green tea.

Of course prevention is far better than cure, and the following (although by no means exhaustive) list comprises some of my recommendations for decreasing the pool of circulating oestrogens in my male patients:

  • Lose weight and maintain a healthy muscle mass: adipose tissue has been demonstrated to become an endocrine gland when present in excess, and the predominant hormone it produces is oestrogen. Lean muscle on the other hand is an excellent promoter of healthy testosterone production.
  • Avoid the use of plastics: these are the predominant source of xeno-oestrogens, synthetic oestrogenic compounds in our environment. Use stainless steel or glass containers for your drinking water, and never heat food stored in a plastic container in a microwave.
  • Avoid the use of commercial household cleaning products: many of these off the shelf items contain xeno-oestrogens (amongst many other health destroying chemicals). Use natural, environmentally friendly products that do not contain man made chemicals.
  • Eat organic foods as much as possible: many of the chemicals sprayed on food crops have hormone disrupting properties. Conventionally raised animals are often injected with vast quantities of hormone disrupting agents and chemicals.
  • Support your liver: this is your primary organ for clearing oestrogenic compounds from your body. Avoid excessive use of alcohol, tobacco and pharmaceutical drugs. I use a liver detox protocol with many of my patients to help restore function in the liver and clear stagnant chemicals and metabolites.

I hope this helps you to think outside the square when it comes to treating prostate cancer, or even better helps you to make changes now to minimise the risk of developing this condition in the future.

In wellness,

James

The top 3 supplements for cancer prevention

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Cancers have become one of the leading causes of morbidity and mortality worldwide, and according to the World Health Organisation the number of new cases of cancer are expected to rise by 70% over the next two decades. By conservative medical estimates, around one third of cancers are thought to be preventable through basic dietary and lifestyle modification: cessation of smoking and drinking alcohol, increased exercise, increasing the dietary intake of fresh fruit and vegetables, and reduced body mass. I would certainly add to that list the following general recommendations:

  • Decreasing your intake of refined sugars, processed foods, and grains
  • Avoiding consumption of toxic chemicals by choosing organic produce & filtered water
  • Using natural cleaning products & beauty products that are chemical free
  • Avoiding the use of plastics in all areas of your life
  • Practicing a form of stress reduction such as meditation or yoga

I also recommend using some key supplements that are excellent are reducing the likelihood of developing cancer – these are not necessarily to be consumed every day, however either using a course of them several times a year or taking a dose occasionally is in my opinion a wise strategy in the face of the statistics mentioned above.

Without further ado, here are my top 3 supplements for cancer prevention:

1. Curcumin / Turmeric

To circumvent any confusion upfront, curcumin is the term commonly applied to the active constituents of the spice turmeric. I will use the term curcumin here instead of turmeric, as although turmeric in its whole food form does contain some curcumin it does not contain enough (with enough bioavailability) to address anti-cancer activity.

Curcumin has incredible anti-cancer properties, and actually has the most evidence-based literature supporting its use against cancer of any nutrient. One study showed the ability of curcumin to prevent progression of pre-cancerous lesions to a cancerous state. Another study showed effectiveness of curcumin in the treatment of pancreatic cancer (an extremely agressive form with a generally poor prognosis). Yet another study showed the ability of curcumin to trigger apoptosis in human glioblastoma cells. And this study showed the ability of curcumin to slow the disease progress of those with multiple myeloma.

Clearly this is an amazing nutrient with powerful anti-cancer activity, however it is important to ensure you are taking the correct form to maximise its effectiveness. I recently wrote a post on how to choose the right curcumin supplement, and I highly recommend you read it here to familiarise yourself with this often confusing topic.

I recommend using turmeric liberally in cooking (as even though the gastrointestinal absorption will be poor, there will still be significant antioxidant and anti-inflammatory activity locally in the stomach and bowel). Supplemental curcumin as recommended in the article above should be taken on a frequent basis – a dose every few days would be sufficient. Obviously is you are fighting inflammation or any specific disease process the dose may need to be much higher.

2. Green tea

The key cancer fighting phytochemicals in green tea are a mouthful – Epigallocatechin-3-gallate, Epigallocatechin, and Epicatechin-3-gallate. These belong to a class of polyphenols called catechins, and have powerful antioxidant activity. In laboratory and animal studies, these polyphenols have shown the ability to inhibit cancer cell development by a variety of means:

  • The induction of apoptosis (cell death)
  • The inhibition and angiogenesis (blood vessel growth to cancer cells)
  • Immune system modulation
  • Increased production of innate detoxification and antioxidant mechanisms such as glutathione-s-transferase

As a preventative agent, green tea is best consumed in its natural state – as a refreshing beverage taken a few times a day. It’s important to prepare green tea correctly to maximise its benefits: water should not be boiled, rather it should be heated to 80 degrees celcius. A workaround is to fill your cup with 1/4 cool water then add the boiled water to this, then add the tea itself. Any form of green tea will be beneficial, but I recommend choosing organic as the tea plant has shown a remarkable ability to absorb toxins from its environment.

Supplemental green tea is also available, and it may be beneficial to take in this form during times of increased stress or exposure to environmental toxins. It is also highly recommended if you become sunburnt as green tea has shown the ability to protect the skin from damage associated with UVB radiation. Look for a supplement that is standardised to contain measured levels of the catechin polyphenols mentioned above.

3. Grape seed extract

The skins and seeds of grapes are an excellent source of phytochemicals called proanthocyanidins, powerful antioxidants that can greatly reduce the action of damaging free radicals in the cells of the body. The great benefit in this is in reducing damage to cellular DNA, which is thought to be a major driver of a normal cell becoming ‘rogue’ and progressing to a cancer.

There have been numerous studies done to validate the effectiveness of grape seed extract in preventing and treating cancer, and the consensus is overwhelmingly positive in its effectiveness. This study showed the effectiveness of GSE in the treatment and prevention of colorectal carcinoma. This study showed significant benefit in decreasing and preventing prostate tumor growth. Another study showed powerful initiation of cell cycle arrest in human colon carcinoma cells.

Unfortunately the availability of grape seed extract (and another powerful antioxidant called maritime pine bark extract) is becoming more and more limited due to a coordinated mass buy-up from pharmaceutical companies. If you can source a grape seed  extract supplement, be sure that the proanthocyanidin (often listed as procyanidins or OPC’s) content is standardised (specifically listed as a measured quantity on the label). 150mg of these proanthocyanidins per tablet/capsule would be the minimum dosage I would look for – 200 to 300mg would be ideal. Taking a quality grapeseed extract tablet or capsule once or twice a week would be a sensible measure in reducing the likelihood of cancer formation.

I hope this helps you fight the ever growing epidemic of cancer, and demonstrates to you the true power of a preventative rather than a reactive approach to disease.

In wellness,

James

The true cause of reflux

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Gastro-oesophageal reflux disease (or GERD) is one of the most prevalent medical conditions in developed nations today. In line with this, the second highest grossing pharmaceutical drug sold throughout the world is Nexium, an acid-suppressing medication that claims to ‘treat’ reflux. However as I will explain in this article, these acid suppressing drugs are far more likely to worsen and perpetuate the causative factors involved in the progression of reflux rather than provide treatment (beyond a suppression of symptoms of course).

The cause of reflux is a weakened oesophageal sphincter valve, not too much stomach acid

This valve separates the stomach and oesophagus, and under ideal conditions will only allow the passage foods and liquids into the stomach, and gas from the stomach back into the oesophagus. However if this valve is placed under excessive pressure for extended periods of time, it will begin to weaken and will be unable to maintain a fully contracted (ie closed) state, thereby allowing the movement of the contents of the stomach back up into the oesophagus.

The source of this excessive pressure is widely proposed to be from large volumes of gas produced in the stomach and small intestine, and this gas in turn is produced by unchecked populations of microorganisms such as bacteria and yeasts feeding off undigested carbohydrates in these environments.

The logical question then is to ask how these microorganisms have been able to proliferate. The answer is not enough stomach acid.

Reflux is associated with not enough stomach acid, rather than too much

Low levels of stomach acid create an environment that favours the growth of undesirable microorganisms in the stomach or small intestine. Additionally, low stomach acid reduces the secretion of pancreatic enzymes that normally break down carbohydrates in the small intestine, increasing the amounts of the substrates that feed and encourage the growth of these microorganisms. In the process of digesting these carbohydrates, the microorganisms release vast amounts of gasses, which then place a huge amount of pressure on the oesophageal sphincter valve and cause it to weaken. Undigested food, along with hydrochloric acid, is then ejected back into the oesophagus causing the hallmark symptoms of reflux.

But why does taking acid suppressing medication make me feel better?

Even though the levels of stomach acid in a person with reflux are likely to be lower than that of a healthy individual, any acid present in the stomach contents is likely to cause discomfort and corrosive damage in the unprotected oesophagus. Thus taking an acid suppressing medication will eliminate the symptoms of reflux, however as I hope I’ve explained above this will ultimately perpetuate a weakening of the lower oesophageal sphincter through creating an environment favourable to pathogenic microorganism overgrowth. Furthermore, long term usage of acid suppressing medication is associated with a raft of side effects and illnesses including:

  • Malabsorption of crucial nutrients such as B12, B9, B6, B3, calcium, magnesium, iron and zinc
  • Poor digestion of proteins, leading to amino acid deficiencies that can be associated with depression, anxiety and insomnia
  • Overgrowth of detrimental microorganisms such as H. pylori, salmonella, listeria, campylobacter, C. difficile, and Candida
  • Stomach cancer
  • Allergies
  • Diabetes
  • Osteoporosis

How do I treat reflux?

I have found the best treatment for reflux is a combination of therapies designed to increase the production of stomach acid, as well as dietary interventions to reduce the volume of carbohydrates consumed. Often there is the need to re-establish a healthy microbiome in the GIT. Other factors that may come into play include weight loss (obesity is strongly correlated to the development of GERD), elimination of chronic infections, and adrenal support.

Note that in those patients that have been on acid suppressing medications for a long period of time (despite the fact that the medical literature proposes that these drugs are taken for no longer than 5 weeks!), it is very important to wean off the medication slowly as the protocols mentioned above are underway. A sudden cessation of the medication will cause a dramatic rebound production of stomach acid while the lower oesophageal sphincter is still in a weakened state, and severe reflux symptoms will result.

I hope this has cleared up the true cause of reflux, and explained why taking acid suppressing medications is likely to perpetuate rather than treat this all too prevalent health issue.

In wellness,

James

Turmeric (aka curcumin) demystified

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If there was one herbal supplement I would comfortably recommend all of my patients to take on a regular basis, it would be turmeric (botanical name curcuma longa). Turmeric is probably the best natural medicine to address three of the biggest drivers of disease in modern society – oxidation, inflammation and toxicity. It is extremely safe and well tolerated, however it is very important to understand the absorption limitations of this plant in order to maximise its assimilation in the body.

How does turmeric work?

Turmeric displays excellent antioxidant properties, particularly against lipid peroxidation. This is particularly relevant in the context of a processed western diet that contains large amounts of readily oxidised industrial seed oils such as canola, soy and corn. This effect in turn lends turmeric powerful anti carcinogenic properties, and has been demonstrated to limit or even halt progression of cancer cells at all levels of development (primarily through the protection of cellular DNA).

10 benefits of turmeric
Image courtesy of Cognitune

The antiinflammatory effects of turmeric have been demonstrated to be as effective as the pharmaceutical drugs cortisone and phenylbutazone, but without the myriad of side effects. The active constituent of turmeric know as curcumin seems to be particularly effective in the treatment of acute inflammation, whereas the complete volatile oil extraction seems to be more beneficial in chronic inflammatory states.

Turmeric can effectively prevent damage to the liver by the wide range of toxins (both self administered and environmental) to which we are exposed on a daily basis. Turmeric also acts as a choleretic, meaning that it enhances the production of bile acids and through this process helps with the elimination of conjugated toxins into the gastrointestinal tract.

Other beneficial effects of turmeric and its active constituent curcumin include antimicrobial activity, healing of the gut mucosa, neuroprotective activity, and cardiovascular protection.

What is the best way to consume turmeric?

The active health promoting constituents of turmeric are notoriously difficult to assimilate. This is due to two factors: firstly, turmeric is very poorly absorbed across the gut wall and into circulation. Secondly, once it is in circulation the liver will process and excrete its active metabolites extremely rapidly. Thus consumption of turmeric in the diet through the use of dried turmeric spice in cooking, or even better grated fresh root, will only yield a very small amount of beneficial constituents in the body. For general health this can provide some benefit, but only if it is consumed on a regular basis and ideally in a meal that contains a large amount of healthy fats (such as the traditional application with ghee and coconut oil in a curry).

Supplemental turmeric can be a far more effective method of obtaining its health promoting properties, but only if you choose the right one. Many supplements on the market simply contain a highly concentrated curcumin or mixed curcuminoid form of turmeric, which still does not address the difficulties in absorption. A suitable comparison would be to pour petrol on the outside of your car when the tank is empty. It doesn’t matter how much of the stuff you pour onto the vehicle, it still won’t help you get it running. What you need is a delivery system that overcomes absorption issues, and ideally also helps to inhibit the liver’s rapid clearance once it is absorbed.

The three forms of turmeric I am comfortable in recommending (that are currently available on the Australian market) are the BCM95, Meriva and Theracurmin forms. BCM95 (Ethical Nutrients & Metagenics) uses the essential oil fraction of the turmeric plant as well as the active constituents, and Meriva (Mediherb, Herbs of Gold, Nutralife) uses a phospholipid technology to bind the actives. Both of these methods help the turmeric cross the intestinal wall. Theracurmin (Bioceuticals) uses a nanoparticle technology to reduce the curcumin molecule size to a degree whereby it can cross the cell wall passively (e.g. it does not rely on the cellular transport mechanisms that are usually the limiting factor).

The main point of differentiation for me between all three of these curcumin/turmeric forms is that while BCM95 and Meriva are effective at a single daily dose, there is very little improved response in the body when you increase this dose due to limiting factors in cellular transport. Basically you wouldn’t get much of a difference in your physical parameters by increasing your dose from one tablet per day to 2,3,4 or even 10 tablets per day. Theracurmin on the other hand will continue to improve physical parameters as you continue to increase the dose because of the ability of the nanoparticle technology to absorb into the cells with no limiting factor. My recommendation is to use the BCM95, Meriva or Theracurmin forms in low to moderate acute inflammatory states or disease processes that are not life threatening, and only the Theracurmin form in severe acute inflammatory states or serious disease processes where a high dosage is warranted.

How do you keep turmeric and curcumin in the body as long as possible?

The best way to overcome the rapid clearance of the turmeric metabolites from the body by the liver is by co-administering piperine, the active constituent of black pepper. Piperine inhibits the process of glucoronidation in the liver, the detoxification pathway by which the turmeric metabolites are cleared. Piperine is available is supplemental form in a capsule or tablet, or if brave you could chew a few peppercorns and swallow them with your chosen turmeric supplement. Unfortunately I am yet to see an Australian supplement that contains either the BCM95, Meriva or Theracurmin forms with piperine (manufacturers take note!). I have seen combinations of the concentrated turmeric mentioned above (remember the petrol analogy) with piperine, however the piperine will be of limited benefit if your aren’t absorbing many of the active constituents in the first place. The only formula example where this combination would be beneficial would be as an adjunct to other primary constituents (e.g. in a combination herbal antiinflammatory formula or glucosamine joint health product) as the concentrated curcumin products are of low volume and can fit into these formulas, whereas the three forms mentioned above would not.

I hope this has somewhat demystified the turmeric / curcumin confusion that seems to be so common these days, and has helped you to understand the many health promoting effects of this amazing spice.

In wellness,

James

 

Understanding SIBO: Causes, Symptoms, and Treatments

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Small intestinal bacterial overgrowth (commonly abbreviated to SIBO) is a condition involving the overgrowth of commensal bacteria normally found in the large bowel up into the small intestine. It can also less commonly be caused by an increase in the population of the bacteria that naturally reside in the small intestine. SIBO can have a negative impact on both the structure and function of the gastrointestinal tract, contributing to leaky gut and the myriad of health issues that may ensue from this all too common presentation. SIBO can also adversely affect the absorption of key nutrients in the small intestine, which can also have knock on effects throughout other organ systems of the body.

What causes SIBO?

Small intestinal bacterial overgrowth can be caused by a number of factors. Low stomach acid is one of the big drivers, particularly when the individual has been on stomach acid reducing medication for reflux over a number of months or even  years (something I often see). This creates a more desirable environment for the population of bugs that normally would not be found in the small intestine. Slowed intestinal transit time (ie constipation) is also a very strong driver, and inflammatory bowel disease and IBS seem to also predispose and individual to developing SIBO. Overuse of antibiotics is definitely a strong causative factor, as is diabetes (both type 1 and 2). Moderate to high alcohol consumption increases the risk for developing SIBO, as does prolonged use of many prescription medications and the oral contraceptive pill.

How do you know if you have SIBO?

One of the most common symptoms that I see in my patients is significant bloating and discomfort in the upper digestive region after eating. This is in contrast to bloating and discomfort in the lower digestive region that is more indicative of general dysbiosis of the large bowel or IBS/IBD. Diagnosis is usually confirmed by a combination hydrogen / methane breath test which measures the volume of these gasses that have diffused into the blood for expiration by the lungs. The amount of gas is measured over a 2 to 3 hour period which correlates with small intestinal transit time. Elevations of these gasses outside of the normal reference range indicate a proliferation of undesirable bacteria in the SI and thus SIBO. Note that both glucose and lactulose may be used as the ingested agent for measuring a SIBO reaction, however in my practice I prefer the use of lactulose as it is better able to ascertain SIBO impacting the distal portion of the small intestinal tract (which is a far more common presentation).

Treatment options for SIBO

Conventional treatment of SIBO involves the use of antibiotics, however studies have shown this to be only moderately effective. My preferred method of treatment is to use natural botanical antimicrobial agents, along with dietary modifications to reduce the foods that feed these undesirable bacteria in the small intestine. After eradication, rebuilding a healthy gut flora through appropriate probiotic therapy and functional foods is crucial. Most important, however, is to address the underlying cause/s to eliminate the possibility of the SIBO recurring (as so often is the case in conventional treatment).

If you suspect you may have SIBO I strongly recommend seeking advice from a qualified naturopath or functional medicine practitioner to create a plan that can address your individual presentation and get you back on the path to good digestive health.

In wellness,

James

Why artificial sweeteners could be worse for you than sugar

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By now, the connection between a diet high in refined carbohydrates and the development of type 2 diabetes is widely accepted by most if not all of those involved in medicine and public health. What is now becoming clear, however, is that the chemical sweeteners commonly recommended as a replacement for these sugars may in actual fact be a stronger driver of diabetes than the sugars themselves.

A report in the American Journal of Clinical Nutrition discussed findings from a French study that demonstrated an increased risk of type 2 diabetes in those who consumed artificially sweetened beverages that was more than twice the amount of those that consumed traditional sugar sweetened beverages. The main theory in play is that these artificial sweeteners may inhibit a typical satiety response whilst also driving the stimulation of adipose tissue formation, a recipe for weight gain and hormonal dysregulation.

Furthermore, Israeli researchers have demonstrated the ability of artificial sweeteners to alter the gut microbiome in ways that encourage increased appetite and weight gain.

Note that the ability to induce type 2 diabetes is not the only pitfall of artificial sweeteners. Other serious health issues include:

  • Aspartame’s ability to form formaldehyde, a highly potent carcinogen, upon consumption
  • Neurotoxicity from the conversion of phenylalanine (the major constituent of aspartame) into excitory neurotransmitters
  • The tendency for sucralose to stay in the body for extended periods of time, potentially triggering allergenic symptoms and other health issues

When it comes to sugar alternatives, I’m really only comfortable recommending stevia as a viable option (and even then in moderation). Stevia is an all natural botanical compound, and has a highly concentrated sweetness flavour profile (meaning you only need very small amounts to invoke a sweet taste response). Unfortunately I have seen sugar alcohol alternatives like xylitol wreak havok on many of my patients with gut issues, especially younger children that seem to be less able to process them.

Really the best advice is to wean yourself off your need to consume sweetened foods by focusing on nutrient dense whole foods and increasing your intake of healthy fats such as coconut and olive oil. It’s amazing how the need for sweet things goes away when your body is actually getting the nutrition it craves.

In wellness,

James

Gut healing for kids

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There is more and more science validating the ancient naturopathic principle ‘It all comes back to the gut’. Restoring the integrity of our digestive system is crucial in the process of reclaiming health for so many disease sufferers, and for all of my adult patients suffering from leaky gut I have a healing protocol that does a great job of improving gut structure. When it comes to my pint sized patients, however, convincing them of the benefits of consuming bone broths and probiotics can be a challenge. That’s why I created my special gut healing jellies for these little munchkins – they’re packed full of gut healing goodness and they taste great too!

Ingredients

3 Tbsp Great Lakes gelatin powder

1/3 cup water

1/2 cup orange juice

1 large chopped banana

1 Tbsp coconut palm sugar or honey (or a few drops of stevia if you are avoiding sugar)

4 tsp probiotic powder (I use Nutrition Care Polybac 8 or Ethical Nutrients Inner Health for Kids)

4 tsp glutamine powder

Method

Put gelatin powder into a small bowl and add water. Stir quickly until combined (the mixture will become very stiff and rubbery). Set aside.

Place the orange juice, banana and sugar into a saucepan, stir and heat until starting to steam (you don’t want the liquid to simmer or boil).

Add the gelatin lump and stir until it dissolves.

Take the mixture off the heat and when it is cool enough to touch add the probiotics and glutamine. Use a stick blender to liquify the mixture, then pour into a silicon mold (I like to use silicon chocolate molds with different shapes and characters to make gut healing even more exciting – who would have thought it was possible!). Place the molds in the fridge and allow to set (about 1 hour).

Turn out your fresh made gut healing jellies and dole them out to the kids. With the assumption a jelly is about 2cm squared, dose as follows: For little ones under 4, two jellies a day. Ages 4-8 should have four jellies per day, and 8-12 should have six jellies per day. Teenagers can have up to ten of these little treats, and big kids (i.e. adults that refuse to take their medicine) can eat them by the handful!

In wellness,

James

 

 

My top 3 recommendations for boosting immune health

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Winter is a challenging time for our family’s immune health. With one of our kids attending preschool, and our other younger child regularly sharing toys and food with his big sister, the cycle of germs seems at times never ending. Practicing a preventative approach to cold and flu becomes crucial at this time of the year, however my top recommendations for a strong immune system may not be what you would expect.

#1 – Fermented cod liver oil

Ask anyone over the age of 60 about cod liver oil and you will most likely see a reaction that involves a shudder and involuntary gag reflex. A regular dosing of a spoonful of cod liver oil to ward off colds and flu was part and parcel of growing up for that generation, however it is unfortunately a practice that has been largely relegated to the past. Cod liver oil is amazing for boosting immune health, however it is crucial to get the correct form for it to be effective.  Most cod liver oil you can buy these days had been distilled and heated, with naturally occurring vitamins such as A and D destroyed or removed in the process (as well as destabilisation of many of the essential fatty acids). Synthetic vitamin A and D are then added back into the oil before sale.

Fermented cod liver oil on the other hand uses time honored tradition of cold temperature fermentation to extract the natural vitamins and oils from the liver over many months, preserving the nutrition and increasing the bioavailability of these immune boosting elements. I love the Green Pastures brand and take it on a daily basis. Note that because of the cold extraction processing this oil has a strong fishy flavor, and the high level of enzymes present can provoke a mild itchiness on the palate when consumed (consider this a small price to pay for maintaining health through the winter months).

#2 – Bone broth

More and more research is showing the powerful link between the integrity of your digestive system and your state of immune health. Weakness in the barrier of cells that line the gut wall can allow the translocation of both large food complexes and pathogenic organisms into the bloodstream before being appropriately dealt with by digestive processes or local immune defences. This in turn allows these materials to provoke a more severe immune response at the very least, or potentially travel to other tissues or organs where a disease process can take hold. Keeping the integrity of your gut lining in tip top condition is crucial for immune health, and bone broths are a great way to accomplish this. You can view my recipe for bone broths here. Note that beef bone broths are best for healing the gut lining, however chicken bone broths are also excellent for boosting immune health via the excellent provision of cysteine (crucial for a robust immune system).

I recommend working bone broths into your daily dietary routine as a stock base in any soup, stew or risotto. Adding some herbs and spices and drinking it straight can taste pretty good as well!

#3 – Probiotics

In direct contrast with the medical over-prescription of contraindicated antibiotics for the treatment of mostly viral caused colds and flus, the preservation and cultivation of a healthy gut bacteria (called the microbiome) is foundational to a healthy immune system. These little critters can perform many health providing activities in the body, and perhaps their most beneficial when it comes to immune health is the ability to mildly stimulate an immune response on an ongoing basis. Thus your immune system gets a daily ‘work out’ to keep it in good shape (especially the secretory IgA arm of your immune system that resides on the mucous membranes that line your respiratory and digestive system). When a potentially pathogenic infective agent is either inhaled or ingested, your immune response is robust and thorough, mopping up the infection before it gets a chance to breach your barrier defences (that are hopefully in good shape from all the bone broths you are consuming!). Congratulations, you have just remove the potential source of a cold or flu without even getting a symptom.

Unfortunately the reality today is that many have a substandard microbiome. The over-prescription of antibiotics mentioned above, along with excessive alcohol and drug usage (both prescription and illicit), stress, processed foods, sugar, and over sanitisation mean that our microbiomes are a shadow of their former selves. The good news is that you can restore a healthy and effective microbiome. Short term, this can be achieved through supplementation with a good quality probiotic formula, however long term microbiome restoration is only possible through the use of fermented foods and effective pre-biotics (such as fiber rich foods and resistant starches from cooked then cooled potatoes and rice) to help build healthy colonies. You can view my previous post on fermented foods to find out more on fermenting your own vegetables.

So those are my top three recommendations for preventing colds and flu this winter. I’m sure many have their own special recipes and concoctions to do the same – please share your approach in the comments so that we can all have a disease free winter this year!

In wellness,

James

Food sensitivity and its role in disease

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In mainstream medicine, understanding the role of food in possible alterations to immune function is largely confined to food allergy. This is an immediate onset immune reaction to foods, mediated by a class of immunoglobulins called IgE, that can result in severe and sometimes life threatening symptoms such as hives, bronchial constriction, and anaphylaxis. What is often misunderstood (or even worse completely ignored) is the far more prevalent and insidious role of food sensitivities in immune alteration and disease progression. Food sensitivities are mediated by a class of immunoglobulins called IgG, and it is primarily through a misunderstanding of the activity of these IgG immunoglobulins that mainstream medicine often discredits their presence as a marker of immune dysfunction.

IgG antibodies are an important part of the immune system – they bind to pathogens such as bacteria, viruses, and fungi, making it easier for them to be identified and destroyed. However the presence of IgG to particular food proteins, especially in high quantities, is an indication that something is amiss. Ideally  foods are consumed and digested properly before they are absorbed into the bloodstream. For food proteins, this means the larger protein structures should be broken down into their constituent amino acid building blocks before crossing the gut wall into circulation. However poor digestion (either from mechanical issues such as inadequate chewing, or from a lack of digestive juices and enzymes) coupled with an increased permeability of the gut wall (aka leaky gut) leads to the larger food proteins entering circulation. Over time, the immune system will view these food proteins as a pathogen and mount an immune response to them. This will involve the binding of IgG to the protein complexes, and ideally a clearance of these complexes from the body. However when these IgG food protein complexes reach high levels in the blood, and especially if the immune system is under stress, they are not adequately cleared and can deposit throughout the body. This can then initiate an inflammatory reaction either locally or systemically, producing a range of possible symptoms from sinus inflammation and headache, all the way through to autoimmune disease processes such as rheumatoid arthritis or Hashimoto’s thyroiditis.

It is important to note that the foods themselves are not the drivers of disease – gut dysfunction is the mediator of larger food proteins entering circulation, and not until the causes of this dysfunction are discovered and addressed will true healing take place. However a crucial step on the road to recovery is to identify those foods to which the immune system is mounting a robust IgG response, and remove them from the diet while healing is in progress. The consumption of these foods will perpetuate a chronic inflammatory process and prevent healing from occurring. Often a low to moderate reactivity food can be reintroduced once gut dysfunction has been addressed, however care must be taken to ensure the immune system has re calibrated to avoid hyper-responsiveness to the food protein in question (especially in the case of long standing high sensitivity reaction).

Trying to ascertain IgG sensitivity through dietary consumption and symptom observation is incredibly difficult, owing to the fact that most IgG reactions are delayed (sometimes by a few days) hence tracing a symptom to a particular food is often close to impossible. An accurate way to measure IgG sensitivity is through an ELISA panel test involving a simple process of obtaining a small quantity of blood through a skin prick and mixing this sample in solution. The solution is then applied to a panel of separated food proteins, onto which a reagent solution is added. If there is IgG present in the blood to the food proteins in the panel, the cell containing that protein will stain. Depth of staining indicates the degree of reactivity to that protein. Removal of these reactive foods will be necessary while causes of gut dysfunction are determined and addressed.

If you suspect you may have food sensitivities, testing for specific IgG reactivity to a range of foods is highly recommended as the first step on the road to recovery. Many complementary health practitioners are able to perform this test (I use a 59 food protein panel in my clinic), and I consider it a crucial component of the healing process for many of my patients.

As per the old naturopathic proverb “It all comes back to the gut”.

In wellness,

James