diet

CASE STUDY: HEALTHY DIET, ANGRY GUT

Meet Jen

When twenty-six year old Jen first visited Narayani Wellness Medical 8 months ago she felt constantly fatigued and unwell. Most mornings she would rise feeling like she hadn’t slept a wink, despite sleeping a solid 7-8 hours each night. She would wake with what she described as “brain fog” - a mild headache alongside difficulty concentrating, finding words and performing basic mental tasks. Jen likened many of her symptoms to a hang over, recalling a gradual worsening since high school.

Tiny, itchy, fluid-filled blisters had begun to appear on her hands and the skin on her face was flushed and dry. She has always had sensitive skin, though these skin issues only arose in the last few years. She also complained of terrible hay fever in spring and autumn, which she experienced every year for as long as she could remember.

Jen couldn’t understand why she got these debilitating symptoms despite her healthy diet and adequate sleep. She had been to see a couple of GPs who ran some tests, all of which came back normal (besides a mild deficiency in iron). Jen was given a script for an iron supplement, anti-histamines for the hay fever and a steroid cream for the blisters on her hands. Despite these interventions, Jen’s symptoms did not improve.

By this stage, Jen had begun feeling very despondent about her health, questioning whether she would be able to finish her university course and start full time work feeling this way. After reading a blog on gut health that was sent to her by a friend, Jen came to the clinic to learn how her symptoms might relate to her gut i.e. her small and large intestine.

 

What could be affecting Jen?

After some thorough questioning, we suspected that Jen’s issues related to non-coeliac gluten sensitivity. We performed an intestinal permeability test on Jen – a urine test that uses two sugars, lactulose and mannitol, to determine if the gut is “leaky”. Her result was positive, indicating that her gut lining was allowing trigger compounds (e.g. food proteins and toxins from bacteria) to slip through into her bloodstream. Resultantly, her immune system was hyperactive, accounting for her inflammatory skin issues and lack of mental clarity.

We also screened her for intestinal parasites, small intestinal bacterial overgrowth (SIBO) and low stomach acid, some of the most common contributing factors to leaky gut. Her nutritional status was assessed, finding that in addition to iron, she was also low in zinc, vitamin D and omega-3.

We spoke to Jen about her relationship with stress, discovering that she had perfectionist tendencies. She often put a lot of pressure on herself to have all the answers, blaming herself for her poor health. She also liked to perform to a high standard, making even small tasks stressful. Jen didn’t recognise that her day-to-day stressors were affecting her; yet it was having a direct effect on intestinal permeability via her enteric nervous system (the part of the nervous system that intertwines the intestines).

 

What was suggested to Jen?

We suggested Jen completely remove gluten from her diet for a period of time and recommended some supplements to heal her gut lining – zinc, glutamine, probiotics, prebiotics and good fats. We worked with Jen to reduce her stress levels by combining psychological interventions, breathing techniques, meditation, exercise and all-round better self-care.

We explained that you aren’t necessarily what you eat, but what you absorb. Our goal was to improve her intestinal function first by addressing the underlying issues (in her case; gluten, stress and zinc deficiency) and then to ensure her nutritional status was optimised and maintained with supplementation and diet.

 

Jen’s progress

Jen’s mental clarity and energy levels had improved so much within 1 month of removing gluten that she decided to continue eating this way indefinitely. After 2 months of treatments her skin started to settle, and after 6 months her skin was better than it had ever been. The next spring she didn’t need to use anti-histamines at all. Jen is now much better at recognising when she is stressed, so she can manage it before it interferes with her health.

 

With a few simple changes in Jen’s day-to-day diet and lifestyle, she has seen massive improvements to her health. Jen’s story is a fairly common one, however treatment for leaky gut is not one-size fits all. Each case requires tailored treatments that address the underlying factors unique to the individual.

 

By Lucy Mason, Naturopath

Finding balance this Christmas

The magical month of December is here once again. I love the festive season. The days are filled with sunshine, social events and delicious food. But December isn’t here without its difficulties. The array of indulgent treats that cannot be avoided present a problem for many of my clients. So I’ve put together my thoughts on how to find balance this Christmas.

Be prepared

Say you have a specific health issue that you are trying to treat with dietary changes, such as leaky gut (no gluten) or candida overgrowth (low/no sugar). The key to getting through the Christmas season is planning ahead. Initiate an honest conversation with dinner hosts/restaurants about your dietary needs in advance or explain that you will be bringing something for yourself. 

Give yourself permission

While we must honour and nurture our physical bodies, we must also nourish our emotional self. Sharing a meal or a drink with friends and family brings joy into our lives. If you have been working on improving your diet, a day of indulging will not undo all that hard work. On these days, you can counter the negative effects of more sugar, fat and alcohol by adding in some additional digestive and liver support.  Letting go of the strict standards we put on ourselves is part of self-love and in itself can be immensely healing.

Support your digestion

Here are my top tips for optimising your body’s processing of dietary “bad guys”:

  • Drink fresh lemon/apple cider vinegar in warm water each morning to give your digestion a boost. It stimulates the vagus nerve, which is largely responsible for digestive secretions. If your tummy struggles with indigestion and reflux at the best of times, you may benefit from taking betaine hydrochloride and digestive enzymes to get you through.
  • Add in a liver support supplement over the Christmas period. St Mary’s Thistle, Globe Artichoke and Turmeric are among my favourite herbs to support bile acid production (breaks down fat), support detoxification and protect the liver against damage.
  • Take a daily probiotic such as Saccharomyces boulardii to help control gut bugs that are prone to growing out of control when we eat and dink more sugar.
Lucy - self love and standards.png

Support your mind

Stress levels can go up this time of year with more work pressures, increased busyness on the road/at the shops and less free time – which is exactly why we all need to prioritise finding time to calm the mind. Checking in with the breath each hour or a 15 minute morning meditation is enough to switch on your parasympathetic nervous system, the part of your nervous system which is responsible for “rest and digest” activities, such as producing stomach acid.

Don’t let guilt ruin Christmas

Perhaps the appeal of the Christmas spread was a little too good and you ate too much, leaving you feeling unwell and disappointed in yourself. What a perfect opportunity to turn that guilt into something positive and practice self-forgiveness. Holding onto negative feelings toward the self only exacerbates health issues. So let those feelings go and replace them with something positive, such as looking forward to the goals you’re going to kick in 2018!

Extra Resources

Looking for recipes that take into consideration your dietary needs? At Narayani Wellness we love online resources by Teressa Cutter “The Healthy Chef”, Sarah Wilson’s I Quit Sugar and Deliciously Ella, Jamie Oliver and Lola Berry also offer some great ideas in their cookbooks.

By Lucy Mason, Naturopath

When to get help and when to do it alone.

We live in a wonderful time when we can access any information we want with just one easy click of the button.  For example, when I typed ‘gut health’ into Google I got a massive 133 MILLION hits! There is so much benefit to having access to this information, as you can get inspired, cultivate hope and discover some tools to help manage your health. However, having this much information has its down sides and can leave you feeling confused, overwhelmed or can even be dangerous.

In clinic I frequently hear my patients start a sentence with ‘I was reading about…’ or ‘I was Googling the other day and…’ Whilst I love hearing that they are taking an interest in their health, unfortunately the sentence usually ends with ‘now I’m confused’ or ‘I don’t know what to do’.

So, how do you know when you are out of your depth in addressing your health alone and when you need some professional help? To help you decide when you need to close the laptop and pick up the phone, ask yourself these five questions.

Narayani Wellness_low res-74.jpg

1. Does your diet or supplement provide you with an immediate improvement and/or if you were to stop your treatment, would this effect be long-term?

If not, you have probably been providing yourself with Band-Aid support and not addressing the underlying issue. A great example I see a lot in clinic is constipation. Before coming to see me many patients have developed a dependency on strong coffee, laxatives or supplements to ensure a daily bowel motion. It needs to be understood that constipation is symptom of something else going on(1) and can be tricky to treat. There are many causes of constipation including an imbalance of your gut flora, SIBO (small intestinal bacterial overgrowth)(2) or nervous system issues, such as a side effect from a medication or low intestinal serotonin levels. Did you know 95% of the serotonin in our body is found in our gastrointestinal tract? Having enough serotonin is important because it signals the muscles along our digestive tract to contract and relax. This is called motility and it is necessary for regular bowel movements(3).

 

2. Do you feel overwhelmed, stressed or anxious when thinking about your health?

If so, these emotions may be making your symptoms worse(4).  When your body experiences these emotions, it enters a state of fight or flight which causes our nervous system to tip into sympathetic nervous system dominance(5). Our sympathetic nervous system is necessary for our survival, as we use it when we need to escape danger or act quickly. However, this part of the nervous system inhibits our ability to rest and digest properly(6)(because who cares about digesting when you are running away danger). Experiencing daily stress, anxiety and overwhelm regarding your health may only be making you health worse. How ironic! A proven example of this relationship is stress and its ability to worsen or flare symptoms of Irritable Bowel Syndrome(7). 

 

3. You have a sense that there is something else underlying the issue and are finding it difficult to get the big picture?

The perfect example of this is acne and congested skin. I meet many people that have ‘tried everything’; they have invested a lot of time and money into topical treatments, medications and diets without any improvement. Potentially this is because they are only treating one part of the problem.
Acne and skin congestion is considered a complex multi-system disease, rather a skin condition. Our skin is a huge organ and the health of it is a result of your diet, nutritional status, gut health and gut bugs, nervous system, hormones and immune system (8). So whilst the oral contraceptive pill or antibiotics may help manage your skin (9,10) if you stop these, your skin may go back to where it started. To make an effective long-lasting change in your skin, you need a holistic inside-out and outside-in approach.

 

4. Are you following advice that is supposed to help you and yet you feel worse?

You’ve starting eating healthier and have invested in cupboard full of supplements, yet you feel worse than ever with less energy, stomach pains, poor sleep and your mood has taken a turn. What could be going? It’s no surprise that we are all different - what works for someone may not work for you. A great example of this is if you have an underlying histamine issue. Histamine is a naturally occurring substance that we create in our body and is present in many foods. It is especially high in aged foods including bone broths, fermented foods, kombucha and kefir (11) and in some probiotics, which are readily promoted for gut healing (12). If you have tried any of these and feel worse, histamine sensitivity may be your issue. Perhaps you need the guidance from someone who acknowledges or understands the issue of histamine to help guide you back to health.

 

5. Is integrative medicine a better fit?

That is, are you required to take medications or are you under the care of practitioner who has limited understanding, interest or awareness of the role diet and gut healing plays in our wellbeing? If you answered ‘yes’ and you are trying to make supplement and dietary changes alone, you may be putting yourself in danger. Thyroxine (thyroid medication) is a great example of something that needs to be monitored closely. A change in supplements, medications and diet may alter the dosage needed to keep your thyroid in balance. If these interactions aren’t understood and accounted for, you may start to experience symptoms of thyroid imbalance (fatigue, shakiness, anxiety, gut issues)(13, 14). A practitioner that will consider these interactions is important in ensuring you a safe road to good health.

 

Closing Thoughts

Before you have lost all hope and motivation, spent years of your time and a mountain of money, reach out and get some professional support.  We love that you have taken the initiative in trying to help yourself and we want to be there for you to reach your health goals in a safe and effective way.   

By Rachel Larsson

BHSc (Naturopathy), BPH (Nutrition)            

Low FODMAP Winter Warming Soup

You have just discovered the low FODMAP diet and your tummy is feeling much better for it, but traditional Winter food feels so bland without onion and garlic! It doesn’t have to. This delicious soup uses ginger, chilli and high quality chicken stock to give it some serious flavour. These warming ingredients are perfect for cold Winter nights, and the mix of fresh veggies makes it light, healthy and refreshing.

Not only will low FODMAP be gentle on your tummy, but the gelatin in the chicken stock may aid the healing of a leaky gut, which often accompanies FODMAP issues. At Narayani Wellness we encourage the use of high quality organic chicken broth, as pesticides accumulate in connective tissue and are therefore often found in high quantities in non-organic meat broths. You can make your own organic broth or buy it ready made from most health food stores. For a vegan/vegetarian variation of this soup, substitute chicken stock with a homemade veggie stock. Tofu, tempeh or boiled eggs could be used instead of poached meat.

file-2.jpeg

Serves 3-4. Preparation and cook time 30-40 minutes.

Gluten free, dairy free. Vegan/vegetarian option.

Ingredients:

  • Thumb sized piece of fresh ginger, finely grated
  • One fresh chilli finely chopped (seeds removed)
  • 1 tbsp oil (we like olive, coconut or ghee)
  • 1 large carrot, grated
  • 1 large zucchini, seeds removed and grated
  • ½ large capsicum, thinly sliced
  • 4 stalks/1 cup broccolini, chopped
  • 500g organic meat of your choice (I used chicken drumsticks) (optional)
  • 1.5 L organic chicken stock
  • Salt and pepper to taste
  • Fresh coriander to serve

 Method

  1. In a large pot, saute the chilli and ginger in oil for 2 minutes on medium-high heat
  2. Add the chicken stock.
  3. If using meat, add it now to poach in the stock
  4. Remove the meat with tongs once cooked through and place on a cutting board to cool
  5. Turn pot down to a simmer, add the vegetables and cook until just soft
  6. Meanwhile, shred the cooked meat with a couple of forks or chop into small pieces
  7. Add the meat back to the pot
  8. Serve into bowls, salt and pepper to taste and top with fresh coriander!

Created by Lucy Mason

BHSc (Naturopathy)

Are prebiotics good or bad in SIBO?

Since my previous blog about IBS and SIBO I have had so many questions from my patients wanting to know more about SIBO. What stands out to me the most is a confusion around what to eat, with the most common questions surrounding prebiotic, fibre rich foods and if they help or hinder SIBO.

 

What is a prebiotic food and what does our gut do to it?

A prebiotic is a non-digestible food ingredient that it is not broken down or absorbed in the higher parts of our gastrointestinal tract(1). There are a lot of foods with prebiotic properties including chickpeas, legumes, leeks, rye bread, garlic and cashews(2). They play a special role in our health - they act as food to our gut's good bacteria, increasing their numbers (lactobacilli and bifidobacteria(3)) and improving our overall health(1).  

 

Why do these healthy foods cause discomfort?

In SIBO, the overgrowth of bacteria causes inflammation and hurts your gut wall affecting your ability to breakdown and digest food. The bugs themselves play havoc with your own enzymes and body processes. For example there is loss/decrease in an enzyme called disaccharideses, which is important for breaking down carbohydrates and sugars. This means that any food, like a prebiotic food that contains fructose, lactose and sorbitol, may not be digested properly, resulting in those uncomfortable symptoms you experience(4).

 

Treating SIBO… with prebiotics?!

You may notice that some of the foods that cause your discomfort are also considered to be high FODMAP foods. FODMAP describes a group of of short-chain carbohydrates and sugar alcohols comprising of fructose, lactose, fructo- and galactooligosaccharides (fructans, and galactans), and polyols(5).

To provide symptom relief from SIBO we may suggest avoiding these high FODMAP prebiotics foods (looking at you apples, onions and garlic!) for a short period of time. It is really important to know that excluding these foods long term is not the answer and will not fix SIBO(6). A healthy gut is dependant on you eating a fibre rich, highly diversified diet so restricting these foods for a long period of time will only worsen your situation and increase your sensitivity to more foods(7). It's not uncommon that we see patients tolerating only a handful of foods and it's best to avoid this! 

Garlic, a wonderful prebiotic food.

Garlic, a wonderful prebiotic food.

As part of our treatment for SIBO we use certain types of prebiotics in combination with probiotics and specific antimicrobials (bug killers). These types of prebiotics have beneficial roles in our gut health that are important for restoring your gut health.

The following are four common prebiotic supplements on the market, three of which we use regularly in the treatment of SIBO. The fourth is not advised!

1. Lactulose

Lactulose is made up of two sugars, galactose and fructose, which is not broken down or absorbed in our small intestine. Lactulose increases our good bugs like bifidobacteria(8) and decreases the bad ones like clostridia(9). It is generally well tolerated, however you can take too much of it and end up with loose bowels(8)

2. Partically Hydrolysed Guar Gum (PHGG)

PHGG is a natural water soluble fibre that has been broken down by an enzyme to make it smaller and to decrease the amount of galactomannon (10). PHGG increases the good bugs Bifidobacterium and Lactobacillus species and decreases nasty waste products such as ammonia(11). PHGG can also give softer stools to assist constipation(12). Studies also show that PHGG in combination with an antibiotic to treat SIBO was more useful in eradicating SIBO compared with the antibiotics alone(13), how amazing!

3. Galacto-oligosaccarrides (GOS)

GOS is formed by breaking down lactose, a common sugar found in dairy. GOS is known to increase the good bugs bifidobacteria and reduce the bad bugs, clostridia and bacteroides. Another benefit of GOS alone or in combination with a probiotic is that it can support our immune system. GOS used in its recommended dosage range is well tolerated. Again, too much of a good thing can lead to problems; abdominal discomfort, cramping, flatulence and diarrhoea(14)

4. Inulin

Inulin is beneficial to out gut because it supports our good bugs bifidobacteria. However, because it is made up fructans(15), it can be really uncomfortable to consume if you have SIBO. Studies have found inulin increases flatulence, rumbling, stomach and gut cramps, and bloating(16). So best to avoid this one! 

Take home messages

Prebiotics are very powerful and beneficial for SIBO. But remember, not all prebiotics are the same.

If certain foods are causing you pain, bloating, constipation, or diarrhoea, this is your body communicating to you that your digestion system is struggling. Ironically the foods that cause discomfort are the same foods that are important to your health. Instead of excluding these foods, we need to improve your digestive system so you can tolerate these and improve your health in the long run. This can be impossible to navigate by yourself so get a professional on board to help correct your bugs, restore your gut wall and find the diet and fibre that is right for you.

After this, you may even be able to handle eating delicious lentils, onion, garlic and apples!

By Rachel Larsson

BHSc (Naturopathy), BPH (Nutrition)

Prebiotics for health

The exciting possibilities of prebiotics for a variety of digestive, immune and mood related complaints are only just being discovered. Prebiotics are receiving more attention with the increasing understanding of the human microbiota (all of the bacteria, viruses and fungi that live on and in us), as the two together can have an incredible impact on our health.

 

What are prebiotics?

Essentially, prebiotics are ingredients found in whole, unprocessed vegetables, fruits, legumes, grains, nuts and seeds which are not digestible to us, but provide the perfect food for beneficial gut bugs living within us(1). These ingredients are broken down by the microorganisms in the digestive tract into compounds that have a beneficial effect in multiple areas of the human body, which can include altering the activity of the same bugs that created them! Most prebiotics are carbohydrate fibres, and it’s the knock-on effect of eating them that makes them so special.

 

How do they relate to probiotics?

I often hear prebiotics being confused with probiotics. While they act very similarly in the gut, they are in fact different. Probiotics are live organisms that we take in supplement form, where the species of bacteria are known and measured(2) Much like the gut bugs that have been living in us since the first few days of life (our microbiota), probiotics also love to munch on prebiotics. You will often find probiotics and prebiotics in combination in a supplement to enhance the products therapeutic quality. A lot of the research around prebiotics looks at how they interact with two of the most common probiotics, Lactobacilli and Bifidobacteria(3).

 

What’s the difference between fibre and prebiotics?

Most prebiotics are fibre, however not all fibres are prebiotic. Fibre is often classified as insoluble or soluble, which also provides a good basis for distinguishing which ones are prebiotic.

Insoluble fibres do not get broken down by us or by our gut bugs, however they do bulk out the stool, helping to keep us regular(4). These are the stringy fibres that give a lot of foods their rough texture, such as the skin of nuts, seeds, fruits and vegetables.

Soluble fibre, found in a variety of whole foods, cannot be broken down by us, but are easily fermented by bacteria. Those that exert a proven beneficial effect on us are termed prebiotics.

 

Types of prebiotics

Here is a little bit of extra information for the science lovers out there. A clear cut catagorisation of what is and what isn’t a prebiotic has not yet been established as it is still a young area of science. If we consider what has the potential for prebiotic activity, the following fibres and their respective foods are included:

  • Non-starch polysaccharides such as beta-glucans (mushrooms), pectins (pear, apple, plum, citrus), gums (guar gum, xanthum gum), hemicellulose (psyllium husk) and cellulose (broccoli, cabbage, kale, cauliflower).
  • Non-digestible oligosaccharides such as galactans (legumes) and fructans, primarily inulin (onion, garlic, artichoke, asparagus, leek, chicory root, banana).
  • The disaccharide lactulose (only found in supplement form).
  • Sugar alcohols including sorbitol (pears, plums, dried fruits) and mannitol (button mushrooms).
  • Resistant starch, which is starch that resists digestion in the small intestine, making it available in the large intestine for fermentation (potatoes, legumes, whole grains).
Prebiotic gut health

How do prebiotics improve our health?

Prebiotics selectively stimulate the growth of beneficial bacteria that are indigenous to our guts, including the well-studied Bifidobacteria and Lactobacilli species. These bacteria, when thriving, help to seal the barrier between the intestine and bloodstream, improve our immunity and keep potential bad bacteria/fungi (such as clostridia and candida) to a minimum.(3). With a healthy microbiota, improvements are noted in mood, skin, allergies and autoimmune conditions, just to name a few.

In addition, bacteria create short chain fatty acids (e.g. butyrate, propionate and acetate) from prebiotic fibres, which have beneficial effects throughout the body. For example, butyrate, made by Lachnospiraceae and Ruminococcaceae bacteria, is a major energy source for the cells that make up our colon. Propionate acts at the liver to suppress cholesterol synthesis and acetate is utilised by the heart, brain, kidneys and muscles(1).

 

When prebiotics can be problematic

For people that have certain intestinal issues, such as Small Intestinal Bacterial Overgrowth (SIBO) or Irritable Bowel Syndrome (IBS), eating the wrong types of prebiotics can make symptoms worse. For example, fructans and sugar alcohols (which are both considered FODMAP foods) are known to cause bloating, flatulence and discomfort in certain people(5). However, complete avoidance of prebiotics deprives healthy gut bugs of food and can make the situation worse in the long run. If you fall into the SIBO or IBS, or are unsure, an appointment with us can help minimise symptoms while still making sure your good bugs are fed! 

By Lucy Mason

BHSc (Naturopathy)

Warm sweet potato and lentil salad

This gluten-free, dairy-free, vegan and vegetarian friendly recipe, developed by our naturopath Rachel, is the perfect meal or side dish to your favourite protein. 

There are so many elements to this salad that nurture and support your gut health with our favourite being fibre!

Adequate intake of fibre for men is 30g/day and women is 25g/day (1), which most Australian's fail to meet (2). High fibre intake is proven to have health-protective effects and disease-reversal benefits including heart disease, stroke, hypertension, diabetes, obesity, and certain gastrointestinal diseases (3). Resistant carbohydrates and dietary fibre, from sources like sweet potato and lentils, influences the variety and number of bacteria we have in our gut, as well as their bacteria's metabolic abilities (4), which influences so many aspects of our health, including mood and immune function. So dig in to this delicious recipe and feed your gut some fibre.

FullSizeRender.jpg

Serves 4-5. Preparation and cook time 1-hour 20min

Ingredients

  • 800g sweet potato cut into 2 cm cubes
  • 2 cloves crushed garlic
  • 1 ½ C bite sized broccoli florets
  • 150g snow peas, cut into thirds
  • 1 can (400g) brown lentils, drained and rinsed
  • 1-2 handfuls of rocket
  • Coconut oil 
  • ½ lemon juiced
  • 2 tsp seeded mustard
  • 2 Tbsp olive oil
  • 1 tsp dried oregano
  • Salt and pepper to taste
  • Feta or parmesan (optional)

Method

  1. Preheat oven to 180 degrees celsius.
  2. Add sweet potato to a lined baking tray and coat in coconut oil, garlic, salt and pepper. Place baking tray in oven and bake for 1 hour or until golden brown.
  3. In a large bowl add snow peas, rocket and lentils. Sit this aside.
  4. To make the salad dressing, in a small bowl add lemon, mustard, olive oil, oregano, salt and pepper. Stir until combined and pour into the large bowl.
  5. After the sweet potato has been in the oven for 45 minutes, add the broccoli florets to the bake try and bake for the remaining 15 minutes.
  6. After the baked vegetables are done, add them to the large bowl and mix well.
  7. Serve in your favourite plate or bowl with the option of adding your favourite parmesan or feta.

Dish created by Rachel Larsson

Seven ways to care for your thyroid

When I was sixteen I was an avid runner who loved competing in long distance events. One day I collapsed at the finishing line, pale as a ghost, with my heart beating too slowly and not pushing enough blood around my body. I felt terrible and it was all rather dramatic.

Leading up to this day, I had been having funny turns at school. At the time, with the wisdom of a sixteen year old, I thought it was funny to be having these “drop –attacks”. They occurred while I was walking along and then bam! I’d find myself on the ground. Along with this I felt irritable, had gained weight and was feeling extremely tired. My teachers and family put this down to “raging hormones” or “growing pains”, shrugging it off as normal adolescent behaviour.  

Eventually I was diagnosed with thyroid disease due to an autoimmune condition called Hashimoto’s Thyroiditis. I started taking Thyroxine, a synthetic form of thyroid hormone and began to feel better. I was traveling along reasonably well until I woke one morning and found that half of my face was paralysed. Yep, paralysed. I wasn’t even able to fully close my eyelids on that side. 

Can you imagine how horrific it was to see only the right side of my face moving as I screamed out to my mum? 

This time I was diagnosed with yet another autoimmune disease called Bell’s palsy. This is a condition in which the facial nerve, supplying the muscles of my face, was attacked by my own immune system. After a course of strong steroids, I was one of the fortunate ones who fully recovered after 6 weeks. For others it can take months or even years to recover. 

Prior to this double whammy of “bad luck” I had been a fit and healthy girl. Being a farm girl, I was more active than most. However I loved eating fruit and tomatoes, and this habit took its toll on my teeth. Six months prior to falling ill, I needed to have several dental fillings and in those days it was mercury amalgam. Was it just a coincidence that I fell ill with two auto-immune conditions after getting several mercury fillings? Had I known then what I know now, I would have avoided mercury fillings (aka silver fillings) at all costs . I explain my reasons for this below. 

As an Integrative GP who has lived with thyroid disease and clearly remembers living with Bell’s palsy, I’ve been intrigued as to why I had this “bad luck”.   There is so much more to autoimmune thyroid disease than just treating it with Thyroxine and this is a quick summary of what I’ve learnt.

1. Never look at the thyroid in isolation

In my case it’s clear that my immune system was going ballistic. It didn’t know what was friend or foe, and it is a good idea to ask why.

2. Start with gut health

Over 85% of our immune system lives in the gastrointestinal tract and there is very exciting emerging evidence that links gut health to a range of conditions including auto-immune diseases. Don’t worry I’ll be sharing this with you soon!

My general approach is to start with diet and nutrition, and whilst I believe no one diet fits all, I generally recommend removing any food allergens, especially gluten. I know. I get it. I too had a carb addiction, and it took me four months to quit the habit. Yet, there is evidence that patients with thyroid autoimmune disease have autoimmunity suggestive of coeliac disease (gluten allergy) and type 1 diabetes. It is definitely best to avoid gluten to prevent further problems, and for a number of my patients I have seen their thyroid function improve as a result. 

Next is healing the gut, which is one of the most exciting and interesting areas of medicine. Call me crazy, but I feel everything from depression and autism to arthritis and asthma, relates to gut health. For some, healing the gut means incorporating bone broths (or glutamine/glucosamine/turmeric supplements), and herbs like slippery elm, omega 3, and probiotics into your routine. Often there are accompanying mineral deficiencies such as magnesium and zinc, which when corrected contribute to the healing process. 

I recommend seeing a dietician/nutritionist who has training in GAPS or paleo diet to really help you fine-tune your diet and treat the cause of autoimmunity.

3. Manage the adrenal gland

During medical school I learnt very little about the adrenal gland. I got the impression that they were somewhat insignificant glands that hung out above the kidneys, rarely causing trouble.  How wrong that was! 

When supporting the thyroid gland, we can’t ignore the adrenals. They are responsible for producing our stress hormones (cortisol, adrenaline, noradrenaline), DHEA, sex hormones and mineralocorticoids (aldosterone; responsible for salt/water balance). Cortisol excess impairs thyroid function. As the gross majority of us live in a chronic state of stress, the constant fight or flight response, increases demand on our adrenal glands and in turn our thyroid gland. 

The adrenal gland is key to the mind/body connection and I will endeavour to explore the adrenal gland in future articles as a holistic approach for managing and supporting the adrenal gland is required. 

4. Remove the triggers!

There are a number of known factors that inhibit proper production of thyroid function. These are called “goitrogens” and include mercury, pesticides, lead, cadmium, halogens (fluoride etc.) and medications such as lithium. These are known “endocrine disruptors” and taking the steps to educate yourself about environmental pollutants so you can limit your exposure is so very important. If your thyroid is under strain, eating excessive amounts of certain foods such as isoflavone phytoestrogens from soy and thiocynates in cruciferous vegetables (broccoli, kale, cauliflower, cabbage) can tip the balance, impairing thyroid function. Best not to consume too many kale smoothies if your thyroid is strained! 

5. Support the thyroid – give it the fuel it needs.

The thyroid gland needs iodine for production of thyroid hormone. The majority of the Australian population are iodine deficient and will require supplementation or review of dietary intake. Unfortunately, an excess of iodine can also interfere with thyroid production, so getting your levels right is essential. It is best to do this under the care of trained integrative medical doctor or naturopath, who may choose to check levels (known as a corrected urinary iodine level). Iron and vitamin D are critical for proper production of thyroid hormones, and levels need to be optimised in management, alongside a number of other essential nutrients including vitamin E, B, and C. 

6. Gotta love zinc and selenium!

When it comes to thyroid health, zinc and selenium are the top two minerals that I prescribe. The production of thyroid hormone and the homeostatic feedback loop takes a bit of patience and perseverance to fully understand. A key point is that the thyroid releases T4, a mostly inactive hormone, which requires conversion to the active form T3. Zinc and selenium are essential in this conversion, with zinc also improving the responsiveness of cells to the thyroid hormone. If you are zinc and selenium deficient this pathway won’t be running at full steam, and I know I felt much better after optimising my own zinc and selenium levels. 

The thyroid contains the highest concentration of selenium, an essential trace element and powerful antioxidant, in the body. Studies have proven that selenium deficiency worsens autoimmune disease. Other research suggests that selenium is protective in prevention of disease also, especially against the harmful effect of mercury.

NB. I encourage you do to your own research on mercury (a good resource to start is http://thegooddoctors.com.au/health-podcast/dental-mercury-amalgam-an-environmental-and-health-issue/doctors) and if you elect to have it removed, do so with a dentist trained in safe removal. In a future article I will share my experience of getting mercury safely removed.

Narayani Wellness_low res-38.jpg

7. Never forget the mind body spirit connection

is a risk factor for autoimmune thyroid disease. There is clearly a link between our stress hormones and thyroid hormones. Thyroid hormone has the same precursor, tyrosine, as our stress hormones including noradrenaline and adrenaline. When under stress, Tyrosine is preferentially used for production of stress hormones, impacting normal thyroid function. High cortisol (seen in stress) and low cortisol levels (seen in adrenal fatigue resulting from prolonged stress) have a negative impact on thyroid production and how the tissues respond to the thyroid hormone. 

A holistic approach to autoimmune thyroid disease includes addressing the impact that stress has on our body, especially our gut health, as this is where the majority of our immune system lies. Meditation, exercise, living a soul driven life and having fun is all very important in stress prevention and ensuringa healthy body, including a healthy thyroid gland. 

Om Namo Narayani,

Dr. Fiona

Why your IBS could actually be Small Intestinal Bacterial Overgrowth (SIBO)

Picture this.

For years you have been suffering from Irritable Bowel Syndrome (IBS).  You may have experienced abdominal pain, discomfort and bloating, frustrating bowel motions and reactions to ‘healthy’ food.  You have tried diets, supplements and medications yet you are still suffering. How frustrating!!

But perhaps there is something else going on.

In our experience, many of our patients don't just have IBS but actually have Small Intestinal Bacterial Overgrowth (SIBO), which can be tested for and treated. Symptoms of SIBO are similar to symptoms of IBS, which is why it may have been overlooked (1).

SIBO explained

SIBO occurs when there is an increased number of bacteria in your small intestine (1). Having an increased bacterial load can cause havoc to your gut wall and can lead to trouble with digestion, poor nutrient absorption, immune dysfunction and reactions to food (2).  SIBO left untreated has also been linked to nutrient deficiencies, depression, anxiety (3), fibromyalgia (4), hypothyroidism (5) and rosacea (6).

How did I get this?

The risk factors for developing SIBO are far and wide and are commonplace in today’s society. They include low stomach acid, which can naturally happens as we get older or through nutrient deficiencies that may occur if you have an underlying gut issue, chronic illness or poor diet. You also increase your risk of developing SIBO if you have used antibiotics or the oral contraceptive pill, if you drink alcohol or experience stress (1)

Can you relate to one or two of these?

Digestive Health Diet

How can I find out if I have SIBO?

In clinic, I regularly hear patients say things like ‘after a meal I look and feel four months pregnant’ or ‘I react to so many foods’. These statements make me consider SIBO as part of the their problem. The SIBO test is wonderful as it identifies its presence and helps us choose the most appropriate treatment for you. It is a test that can be performed at home or in a laboratory. After drinking a sugar, the breath test measures hydrogen gas and methane gas when you exhale, which indicates if SIBO is present, the type you have (methane dominant or hydrogen dominant) and how severe SIBO is for you.

To get SIBO under control we use a gentle combination of herbal, nutritional and dietary interventions. We follow a principle of 'do no harm' and we make sure we are supporting you and any the good bugs that are already in your gut. In addition we address risk factors that caused your SIBO to give you the best chance of it never returning and to live a life free of digestive distress. 

If this sounds like something you or someone you know has experienced, it's time to take the next step forward to get you back to good health.

It’s time to beat the bloating and get our bugs back in balance!

Rachel

BHSc (Naturopathy), BPH (Nutrition)

Leaky Gut. Do you have it and what to do about it?

Leaky gut, also known as increased intestinal permeability, is linked to a whole bunch of common health complaints that we tend to just put up with or accept as being normal for my body. It has been linked to food intolerance's, acne and skin conditions, allergies and hay fever, asthma, fatigue and thyroid conditions. In addition to this, it can be associated with digestive symptoms such as constipation, diarrhoea and irritable bowel syndrome(1). Clearly, it is very possible that you, or someone close to you, is suffering from leaky gut.

How is this possible?

To understand how leaky gut may be at the root of your symptoms, you need to know a bit about the gut. Our gut has many roles including digestion and nutrient absorption, and is an important protective barrier that monitors our internal and external environment. It also plays a massive part in the function of our immune system. For example, did you know that about 75% of our immune cells live there(2)? It also has an intimate relationship with our nervous system. Have your ever noticed that when you feel stressed or anxious, you may experience a change in bowel movements? Nervous tummy anyone?

Why do we get leaky gut?

In a healthy gut, our gut wall cells are triggered to open up and absorb good things like nutrients and keep our bad bugs and toxins out. Our digestive system is always getting triggered to open up and close but can usually keep a happy balance and recover from any minor insults. When the gut is in contact with nasty triggers like medications, parasites, chemicals and certain foods, it’s ability to close up starts to struggle. If exposure is for a short time, the barrier can return to normal, however if these stressors continue, this barrier is strained. Then the immune system, which lies beneath the gut lining, becomes overwhelmed. It loses sense of what is self and what is a potential allergen, toxin or baddie. This dysfunction starts to cause trouble to the point of developing autoimmune conditions. Remember all the conditions mentioned at the start? Yes, the gut connection is real(3)!

Nutrient diet about leaky gut

What can I do about leaky gut?

Gut health and gut healing can be a tricky, especially if other conditions are present. A great place start would be:

1.     Probiotics

Probiotics help with leaky gut because of their beneficial role in supporting the immune system in the gut wall. This is evidence of their support in a vast array of health conditions. It’s so important to understand that not all probiotics are the same and this is where clinical expertise can really help. If you react to fermented foods (a good source of probiotics) or probiotic supplements something else maybe going on including histamine intolerance. This is why it is helpful to work with someone experienced in treating gut issues(4).  

2.     High fibre foods

After putting in all the good bugs into our system, we need to feed them. High fibre foods really means a vegetable rich diet. Great fermentable foods include sweet potato, lentils, pumpkin leek, garlic, asparagus, onion. Think high FODMAP foods. Delicious(5)!

3.     Reduce aggravating factors

We don’t want to keep giving our gut triggers that upset inflammation and immune function. Our body needs the time and environment to heal. This means limit alcohol, gluten, eat organic where possible and get rid of refined carbohydrates and sugar… put down the donut(6)

4.     Manage stress – yes this can be the hardest thing to do.

We live a lifestyle that fuels the fight and flight response and neglects our rest and digest nervous system – which is hugely important for our digestive ability.  Ever experience diarrhoea when you feel anxious or constipation when feeling stressed? Whether it is journalling, deep breathing, yoga or walking, it is important to find a way to manage your emotional and mental health(7).

5.     Eat a colourful, nutrient rich diet.

For our body to function at its best, it needs good sources of nutrients from a wide range of fresh, unprocessed foods. Fill your diet with good quality protein sources, a colourful variety of vegetables and fruits and you are on your way from getting all the nutrients and antioxidants you need for a healthy gut. We give a special shout out to amino acids like glutamine and nutrients like zinc and vitamin A, which the gut just loves.

How can I find out if I have leaky gut?

If you or someone you know suffer from the above mentioned conditions, then you should be considering the health of your gut and determining if you have leaky gut. As a practitioner who just loves all things gut health related, one of the first steps I take with my patients is testing for leaky gut. My inner nerd is thrilled by this test as it a brilliant way to measure how much healing needs to be done and can be tested again to assess progress. Once we identify if you have leaky gut, it is important to determine how to treat it holistically. Not only can you experience a positive shift in your current symptoms, but also prevent complications such as autoimmunity and chronic disease in the future. Isn’t that great?

If you are interested in finding out more about this or would like to be assessed, please get in touch. Let's get to the bottom of this!

Rachel Larsson

BHSc (Naturopathy), BPH (Nutrition)

Fermented Beet Kvass

One of our favourite gut loving recipes is beet kvass. Beet kvass is type of fermented drink, you know, similar to kefir or kombucha. Kvass has so many health benefits and is great for your gut. Due to it's fermentation process it is a wonderful source of probiotics which can help the health of your gut and immune system, it is also rich in antioxidants with is excellent for your liver. Using beetroot is traditionally known for it's blood cleansing properties, in addition to being a great source of nutrients.

Kvass typically has a tangy, salty flavour which can be an acquired taste. Using beetroot also gives it a wonderful earthy flavour. If beetroot isn't your thing, you can use other foods to ferment like fruits (strawberries and raisins) and herbs (mint). 

 Ingredients        

  • 2-4 organic beetroot
  • 1-2 tsp sea salt or Himalayan salt
  • Filtered water
  • A few tablespoons whey, dripped from yoghurt or milk kefir (optional)
  • 1-1.5 litre glass jar

Directions

1. Wash unpeeled beets and chop into large cubes

2. Place beets in a jar and add salt and optional whey (if not using whey add an extra tsp of salt)

3. Fill jar with filtered water, you want to cover the beetroot by at least two inches

4. Seal with lid and leave on the counter at room temperature for 4-7 days to ferment (4-5 days in summer)

5. Transfer to fridge

6. Have about ¼ cup daily on own or dilute with water

Image: Courtesy of CERES Fair Food.

Image: Courtesy of CERES Fair Food.

How your gut is connected to hay fever and allergies

I bet you are wondering, ‘how can my water eyes, running nose and sneezing be connected to my gut?’. As you may have noticed today, there are studies coming out linking all sorts of conditions and diseases to the health of your gut. Allergic rhinitis, commonly known as hay fever, is no different. 

For starters our digestive system plays a huge role in the balance of our immune system. Almost 70% of our entire immune system is located in our gut(1). For hay fever and other allergic diseases the ‘hygiene hypothesis’ was thought to have a role in the increase in allergies, with the lack of exposure to microbes in early life increasing the risk of allergies in later life(2). Now something called the 'microbiota hypothesis' is thought to play a role, meaning a change in our gut bugs influence the development of our immune system(3). Although allergies are also influenced by genetics, some of the environmental and lifestyle factors that change your gut bacteria and increase your risk for allergies include infant use of antibiotics, formula feeding and being born by caesarean section(4,5). Oppositely, growing up with pets(6), growing up on a farm(7), being born through vaginal delivery and being breast fed has been linked to positively influencing your gut’s flora to include more ‘protective strains’(4,5).

What your body does in an allergic reaction

For an allergy to exist, allergen sensitisation must first occur. Special immune cells present in the mucosal surfaces of the body such as nose, lungs and gastrointestinal tract, detect the allergen. One type of immune cells comes into contact with the allergen which are then displayed on the cell's surface. This cell then lets other immune cells know to produce antibodies (IgE) specific to the allergen. From then on, if you are exposed to that allergen, an allergic response is triggered. The allergen is identified by antibodies (IgE) causing immune cells to release inflammatory mediators, such as histamine (8). Histamine is responsible for the itchy nose and runny nose, red watery eyes and dry cough.

The gut-lung connection

The lining of your gut is structurally very similar to lining of your lungs. If you are someone with allergies, inflammation will tend to happen in both areas, as it is thought that leaky gut may have a role in 'leaky lungs'. Our gut flora are also likely have a major impact on the integrity of the lung tissue(9).

Histamine and your gut

You may think histamine is the bad guy because it is linked to your allergies, but in fact is extremely important for mood, stomach acid, blood vessels, and muscle functions (10). The problem with histamine is for some people they can be suffering from histamine intolerance. This means they produce excess histamine and/or have a deficiency in the enzyme that breaks it down. When it comes to our gut, some of our microbes are capable of producing histamine. These microbes produce an enzyme, which converts histidine into histamine. The more of these microbes you have, and the more histidine you consume, the higher the amount of histamine you can produce. Histamine can be then be absorbed and taken around the body, exacerbating allergic symptoms (11).

Balance Immune System

How to improve your allergy symptoms

1. Heal your gut. Gut health and healing isn't straight forward and may require a professional to guide you. There may be other gut issues at play, like Small Intestinal Bowel Overgrowth (SIBO) driving gut inflammation and increased intestinal permeability (leaky gut), which will also need to be addressed.

2. Balancing gut flora can balance your immune system. This means probiotics from capsules or fermented foods. Be careful with fermented foods if you are histamine sensitive though, as they are a source of histamine. If you feel worse on bone broths or foods like sauerkraut then get in touch with a trained professional to help you refine your diet and introduce these gut healing foods slowly. Some strains that can help reduce histamine include Bifidobacteria infantis and Lactobacillus plantarum (12, 13).

3. Eat fermentable fibre. Eat a diet full of complex, fermentable fibre as it helps intestinal microbiota make short chain fatty acids (SCFAs). SCFAs help regulate the immune system and decrease allergic airway inflammation (14). 

4. Try eating low-histamine diet. Following a low-histamine diet can help reduce the severity of allergy symptoms. Foods to avoids that are high in histamines include canned and ready meals, fermented foods, aged and matured foods like cheese, fish, shellfish, avocados, spinach, cocoa and leftover meat (15).

5. Eat foods high in quercetin or take a supplement. Quercetin is a natural antihistamine and can be found in foods like grapefruit, onions, apples, black tea, leafy green vegetables and beans. Some herbs like Ginkgo biloba and Sambucus spp. are also sources.

6. Zinc. Zinc is a key nutrient involved in maintaining a healthy immune system. It is also necessary in healing and maintaining a healthy gut wall. Supplementing with zinc could significantly help in the healing of leaky gut(16). To find out your zinc levels and get the safest, and get most appropriate zinc supplement, see one of our professionals. Eating foods rich in zinc can also help including grass-fed beef, oysters, lamb, chickpeas, pumpkin seeds, cashews, chicken, spinach and mushrooms.

7. Eat local, raw honey. Raw honey contains both beneficial bacteria and trace amounts of pollen picked up by the bees from local plants. By eating raw honey, you can 'educate' your immune system to tolerate these local pollens (16). By local we mean the neighbouring suburbs, postcode or city. Australian honey isn't considered 'local' as the plants in Perth are very different to that in Melbourne, for example. 

8. For symptom relief try clearing your nasal passage using a neti pot. If any allergens are stuck in the passage this can clear them out and give some temporary relief.

How seeing a naturopath can better your health.

As a naturopath, we often see patients that have suffered years of ongoing, unresolved complaints and have been searching for answers without any luck. You may have a feeling that 'something more can be done', looking for a natural approach or are sick of getting prescribed antibiotics for the common cold. What about a desire to understand your body or wanting to have optimal, thriving heath and not feeling like you are just surviving? Does any of that sound familiar? If so, naturopathy may be for you. 

Naturopath's have the exciting, complex and rewarding job of looking and treating you as a whole person. What does this actually mean? This means that when you come in with a concern, for example you feel tired all the time, we will look beyond how much sleep you are getting. We will also consider your personal health history, family history, blood tests, medications, stress levels, physical examination, diet, allergies and so much more. We do this because we want to understand your unique situation as we appreciate the many causes that contribute to you feeling this way. An understanding of who you are is so important in giving you the best treatment.

The beauty of naturopathy is that the therapies we use are well tolerated and can actually be a support to conventional medicine. Although our remedies have traditional beginnings, many of them have substantial scientific evidence that support there use and efficacy. Naturopathy is also wonderful and unique in that there is no 'one fix' approach to a problem. It has a broad scope of treatment and can use the following remedy options according to your circumstance. 

  • Herbal medicine as liquids, tablets and teas
  • Dietary advice to promote food as medicine and nutritional supplements
  • Lifestyle and environmental advice to promote mindfulness and wellbeing
  • Flower essences have an energetic basis and can enhance the emotional aspects of healing.   

Using the example above, if your 'feeling tired all the time' was caused by high levels of stress we could look at using one or a combination of diet modification, herbal medicine, nutrient supplementation and mindfulness techniques. Interestingly this means that if your friend were to need help because they also felt tired all the time due to stress, we may actually consider completely different herbs, nutrients and dietary advice because we would consider their unique circumstances.  

In essence, naturopathy is based on the principle that the body has an inherent ability to heal itself. We follow these six philosophies when treating you:  

  1. The healing power of nature  (Vis Medicatrix Naturae)
  2. Identify and treat the cause (Tolle Causum) 
  3. Treat the whole person (Tolle Totum)
  4. Do not harm (Primum Non Nocere)
  5. Doctor as teacher (Docere)
  6. Prevention (Preventare)
Herbal Medicine in melbourne

At Narayani Wellness, your naturopathic experience is truly unique as we have a supportive community of passionate naturopaths and integrative doctors working together. We believe more can be achieved by having these two approaches as it has greater potency and efficacy than doing things separately. Our approach to patient care embraces the combination of traditional philosophy with functional testing, and we find we get better results with our patients with the addition of functional testing. Functional testing allows us to look at the finer processes that occur within our bodies. This includes looking at how our cells function, our energy production pathways, how we clear toxins, how we make our brain chemicals, hormone profiles and how we can achieve healthy bowel functions. Our focus is to put you first and we realise the best relationship is one built on trust. All of this keeps us on our toes which motivates us to do professional development and stay current with research to continually benefit you.

We realise that Spring is a time we focus on our health and 'recover' from Winter woes. For some, this means the annual struggle of hay fever or a time to address old health issues that flared up from a change in your diet and exercise. With Spring well and truly here and the excitement of warmer days coming, maybe this is the right time for you to see a naturopath and regain your health. 

The perks of pregnancy; what you can do to help your morning sickness

There's nothing like a personal experience to help give some perspective on what my patient's might be going through. I'm not going to lie, my first four months pregnancy has been tough! Fatigue and all day nausea and vomiting is exhausting, not to mention unpleasant. I went through all sorts of feelings during this time, while being absolutely over the moon to be growing a baby, it was difficult to stay positive while having to stay so close to a bucket and carry a sick bag everywhere I went! I felt the guilt that I wasn't supplying my growing bub with adequate nutrition. All I wanted to eat was fruit, something I generally try to limit to one serve per day, and even supplements were difficult to keep down. 

Pregnancy Diet

My advice:

1. Don't be too hard on yourself. A few months of a less than ideal diet isn't going to undo all the good nutrition you put in prior. So far in my pregnancy, I ate a lot more fruit than I would usually, but it's better than nothing! And now that the nausea is over (thank goodness) I am weaning myself off slowly and increasing my intake of nutrient dense foods like eggs, meats and butter (things I went off completely for a few months). 

2. Eat little and often. I wasn't great with this one and would often forget or get too busy to eat. Preparation is key here, have ready to eat snacks on hand - nuts, fruit, vege sticks or rice crackers with hummus/pesto work well.

3. Try healthy foods in different forms. I usually don't eat too many raw vege's in winter but veggie sticks with hummus was the only way I could get my veg in. 

4. Preconception care. If you can, aim to spend 3-6 months preparing your body for pregnancy. This should include personalised advice from a qualified practitioner, a super nutrient dense diet for both mum and dad and prenatal vitamins and minerals.

5. Correcting nutrient deficiencies such as vitamin B6 and zinc. This is easier to do prior to pregnancy to potentially prevent morning sickness and should be part of your preconception care.

From one mum-to-be to another, good luck!
 

Abi Walker

BHSC Naturopathy, PGDIP Dietetics, BSC Human Nutrition