May
12

What causes anxiety?

Tight chest, difficulty breathing, racing heartbeat, and persistent worries that spiral out of control? These symptoms are just the tip of the iceberg that is anxiety.

READ: How natural medicine can help anxiety

It’s likely that you have experienced some or all of these common symptoms at some stage in your life. Most of the time this is a fleeting experience that is triggered in response to a stressful situation, such as an exam or public speaking.

Usually this type of anxiety will abate quickly, once the triggering event has passed. However, what if you felt this way continuously?

In cases of clinical anxiety these feelings don’t subside, but persist, day in, day out, making it difficult for sufferers to cope with everyday life. Left untreated, anxiety can become so crippling that it impacts on a person’s ability to work, socialise, maintain relationships, and be an active member of their family and broader community.

Statistics show that one in four people will suffer anxiety at some stage in their life, making it the most commonly diagnosed mental health condition in Australia.

Because everybody experiences stress in their lives from time to time, it is sometimes difficult to tell where everyday stress ends and anxiety begins. This can cause confusion for people experiencing symptoms and may cause a delay in them seeking help.

And unfortunately, as with many mental health conditions, there is a still a stigma associated with anxiety.

The negative language sometimes used to describe a person with anxiety reinforces this. People may say: “You’re such a stresshead’ or “He needs to take a chill pill”. This type of language can trivialise anxiety and make the sufferer feel even more isolated.

What causes anxiety?

The causes of anxiety are multifactorial; usually a ‘perfect storm’ of factors are at play for a period of time prior to the onset of anxiety.

Overwhelmingly, stress plays a role in its development; however, some people may develop anxiety without having much stress in their lives at all.

Chronic stress, such as that experienced in a negative workplace environment or difficult family situation, can trigger the onset of anxiety. Traumatic stressful events can sometimes be the trigger of post-traumatic stress disorder, which is a type of acute anxiety.

Having a family history of anxiety can increase your risk of developing it. This is thought to be due to complex interaction between behaviours learned throughout childhood, combined with genetic factors passed down from our parents. Our hardwired stress response is dictated partly by the genes associated with the production of stress hormones and our cells’ ability to respond to them.

Interestingly, our ability to metabolise stress hormones produced during an anxiety episode relies on a gene called COMT which helps us to ‘clear’ stress hormones from our body once they have been produced. People with polymorphisms of COMT may have much slower enzyme activity, which means their stress hormones stay circulating in their systems longer because their metabolism is slower. In this case, recovery from a stressful event can be very slow.

Polymorphisms of COMT are relatively common and can predispose people to anxiety. Understanding how your genes influence your stress response can be very helpful in the management of anxiety. Australian company, SmartDNA, offers Wellness Genomic testing that covers a broad a range of genes, including those investigating adrenal responses to stress and COMT.

Substance abuse is a common trigger for anxiety. Drugs like alcohol, cannabis, cocaine, ecstasy and other amphetamines have been strongly liked to its development. These types of substances play an initiating role due to the strain they place on the nervous system and adrenal glands and their detrimental effects on neurotransmitter function. They also help to perpetuate anxiety as people try to self-medicate the symptoms with more drugs, which leads to a worsening of the condition and an escalating downward spiral.

Drug withdrawal needs to be supported by a professional team specialising in the field to help manage anxiety. This may include psychologists, specialist drug counsellors and medical practitioners alongside a nutritionist or naturopath. People with certain personality traits are also at higher risk.

Research has demonstrated that people with perfectionist personalities are more likely to suffer from anxiety and become easily agitated as they attempt to control their environment.

Ultimately, anxiety is a failure of the body’s adaptive processes to respond appropriately to stress. Our adrenal glands govern the body’s reaction to stress; they produce powerful hormones that trigger the ‘fight or flight’ response. In an emergency, the sudden release of these hormones produces rapid physiological changes designed to provide us with the blood flow and energy to flee from danger or fight to the death. Our bodies are designed to cope with short periods of acute stress followed by extended periods of recovery; unfortunately the modern world doesn’t work this way.

READ: How natural medicine can help anxiety

Everyday we are faced with a plethora of minor stressors: getting children ready for school, long commutes in heavy traffic, deadlines at work, difficult relationships at work and/or at home, financial pressures … the list goes on. None of these would be considered emergency situations, and yet this type of stress keeps our adrenal glands pumping out stress hormones at higher than normal levels, in order to just get through the day.

This is where things start to go wrong. The adrenal glands and nervous system require a huge amount of fuel and nutrients to function effectively during times of stress, and when the stress is chronic we can have difficulty meeting these demands. This can lead to adrenal dysfunction, which causes abnormal fluctuations in stress hormones and elevations in cortisol and DHEA, which can be associated with anxiety.

10 signs you have anxiety (and don’t realise it)

  1. You feel scared without any reason
  2. You find it hard to relax
  3. You have difficulty breathing, e.g. rapid breathing or breathlessness
  4. You have a rapid heart rate
  5. Your hands tremble often
  6. You have persistent worrying thoughts
  7. You get easily agitated & often feel close to panic
  8. You avoid socialising because of feeling anxious
  9. You get pins and needles in your extremities
  10. You experience hot flushes and cold sweats

If you have experienced any of these symptoms persistently, speak to your health practitioner.

This article first appeared in Nature & Health magazine.
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Apr
29

Boost your immunity, naturally

With winter on your doorstep, learn how to strengthen your body’s defences so you stay sniffle-free. Naturopath Tania Flack reports.

Uh-oh … the irritating tickle at the back of your throat that won’t go away, muscle aches and pains, a dull headache and general feeling of lethargy, followed by the realisation of “Oh no, I’m coming down with something!”

Welcome to the opening scenes of your next bout of flu or a cold, as reliable as the start of the season, as people sniffle and hack their way through offices, trains, movie theatres, and cafes, seemingly eager to spread their germs.

The question is: will you shake it off in a couple of days with only mild symptoms and minimal disruption to your life? Or will you be knocked sideways and end up in bed for two weeks, then spend a further fortnight – or longer – getting back on your feet.

The answer depends entirely on how resilient your immune system is and what you do to support – and the good news is, there is plenty you can do to ward off winter health woes.

Your immune system

This is a highly sophisticated cellular army that is responsible for keeping foreign invaders like viruses and bacteria out of your body. The fever you get in the early stages of a cold or flu is your immune system’s way of trying to make your body an inhospitable place for intruders to settle in and multiply. Immune system cells congregate in the areas that are the main interface between us and the outside world, including the respiratory system – the mucous membranes lining the airways are a key entry point for viruses, and much depends on how well nourished these tissues are and how effectively they are able to act as a barrier.

So, why is it that some people have such effective immune systems that they rarely get sick, while others have a very different experience? Immune fatigue occurs when the immune system becomes so worn down that it is unable to launch a strong enough defence to fight off the next infection. Perhaps the biggest immune system crime you can commit is ‘soldiering on.’ Not allowing yourself the time to rest and recover from your last infection can often be the starting point of immune fatigue. Repeated infection means that your body can’t manufacture a new supply of fully differentiated and primed white blood cells fast enough.

When this happens, the body is forced to release immature white blood cells that are less efficient at fighting off an infection – the immune system’s ‘army reserve’, if you like. Once this starts to happen, you’ll be prone to repeated infection and longer recovery time.

Inadequate nutrition is a key factor in immune fatigue; launching an immune response to an invading organism significantly increases our need for nutrients. You may think you have a good diet, but is it meeting your current requirements?

Any increase in stress, working hours, or even exercise, will automatically increase your nutritional requirements. Eating on the run, poor absorption, a diet high in processed foods and low in fresh wholefoods can lead to nutritional insufficiency, which contributes to immune system fatigue.

Green medicine

Herbs have been used throughout history to modulate and support the immune system and were once all we had to treat infection. The effect of herbs on the immune system has been the subject of intense scientific scrutiny: many have immune-modulating effects, however there are three absolute standouts.

Echinacea: This is one of the most widely used medicinal herbs and its effects on the immune system have been the subject of exhaustive research. Echinacea acts as an immunomodulator, which means it will stimulate a strong immune system and support one that is weakened. It can be used at any stage of infection, but best results are achieved when taken at the first sign of symptoms. It also has anti-inflammatory, antioxidant and mild antiviral properties and has a beneficial effect on the lymphatic system, promoting healing. A large Cochrane meta-analysis, which compared the findings of 16 clinical trials involving a total of 3396 participants, concluded that echinacea is effective in the treatment of the common cold. Two more recent meta-analyses, published in Clinical Therapeutics and the Lancet, support this and also found evidence that it is effective in its prevention, too.

Olive leaf: The olive tree is one of the oldest cultivated plants; its leaves are naturally rich in antioxidants and have antimicrobial and anti-inflammatory properties. Stephen Eddey, principal of Health Schools Australia, has reviewed the research and reports that olive leaf extract has a powerful twofold action against viral infection. “Firstly, it appears to stimulate phagocytosis (the process in which immune system cells engulf and destroy invading organisms), and secondly it interferes with the ability of bacteria and viruses to replicate and cause infection”. Eddey adds that studies have shown its key active constituent, oleuropein, is effective against a range of micro-organisms including influenza and parainfluenza viruses. Australian research has found that olive leaf extract has five times the antioxidant activity of vitamin C. According to Eddey, this potent antioxidant activity helps to reduce the symptoms of colds and flu by minimising the amount of oxidative damage caused by the inflammation associated with viral infection. Olive leaf extract is ideal for both acute and chronic infection and helps to promote immune resilience.

Andrographis: This has a long history of use in Ayurvedic medicine and traditional Chinese medicine, where it is renowned for its ability to help fight infection and reduce fever. It also acts as a stimulant to the immune system and has mild anti-viral and anti-inflammatory properties. Its efficacy in the treatment of viral upper respiratory tract infections has been demonstrated in several clinical trials, reducing both the severity of symptoms and duration of infection. A meta-analysis published in Planta Medica compared the results of seven clinical studies that involved 1765 participants and found andrographis to be an effective treatment for upper respiratory tract infection. Traditionally, it is used to treat the acute phase of infection and should be taken at the first sign of symptoms.

The defensive diet

Your nutritional requirements skyrocket during an infection. Several key nutrients are particularly important to support speedy recovery and build immune resilience.

Vitamin A: Improves white blood cell function to help fight off infection and is vital for healthy mucous membranes. It is found in cod liver oil and eggs or it can be manufactured in the body from beta carotene, which is found in orange and yellow coloured vegetables, such as carrots, red capsicums, pumpkin, and sweet potato.

Vitamin C: Perhaps the best known of all nutritional remedies for colds and flu, it is essential for the formation of collagen, tissue strength, and to promote healing. It also acts as a powerful antioxidant. Infection and inflammation rapidly decrease vitamin C stores in the body. Continually replenishing vitamin C helps to overcome infection and ensure a speedy recovery. Good sources of vitamin C include citrus fruit, red and green capsicums, broccoli, Brussels sprouts, kiwi fruit, and strawberries.

Vitamin D: Although not commonly recognised as an immune system nutrient, vitamin D helps strengthen the immune system as well as our bones. Regular exposure to sunlight will boost production of vitamin D and you can also increase your levels by eating oily fish, such as herring, salmon, tuna, and sardines. If you are struggling with a poor immune system you can have your vitamin D levels checked by your naturopath or doctor, as deficiency is relatively common.

Zinc: This is one of the most important minerals to support a healthy immune system and unfortunately zinc deficiency is common in Australia. It’s linked to lowered immunity, increased susceptibility to repeated infections, and poor wound healing. Eating more zinc-rich foods can help support immune function; they include oysters, shellfish, red meat, eggs, and liver.

5 rules of recovery

Rest: Especially important in the first few days – and it means bed rest, not working from home.

Nourish: Slow-cooked, easy to absorb, nutrient-rich foods, like soups and casseroles.

Hydrate: Fluids are vitally important; aim for two litres per day. Fresh vegetable juices, herbal teas and filtered water are good choices.

Lighten up: Adequate vitamin D is essential for a healthy immune system. Twenty minutes of gentle sunlight, morning and afternoon, will boost your levels

Move: Once you start to feel a little better, gentle exercise, like walking or stretching, will help drain the lymphatic system and revitalise the immune system.

Immune-boosting soup

The chicken provides easily digested protein and valuable minerals; the vinegar releases the minerals from chicken bones; garlic and onions contain allicin, which is an immune stimulant; ginger is anti-inflammatory; the pepper improves absorption of the antioxidant turmeric; and the veggies are rich in vitamin C and beta carotene.
1 kg organic chicken legs
2½ litres filtered water
3 tablespoons apple cider vinegar
2 tablespoons extra virgin olive oil
4 large carrots, grated
1 turnip, grated
½ a bunch of celery, diced
6 cloves garlic, finely minced
2 tablespoons fresh ginger, finely grated
1 teaspoon finely grated fresh turmeric
1 bunch of flat leaf parsley, finely chopped
2 large brown onions, diced
freshly ground black pepper
1. Heat oil in a large saucepan over medium heat. Sauté onions and garlic until translucent, then add turmeric, ginger and pepper and stir until the aromas release.
2. Add water, chicken and vegetables, and bring to the boil. Reduce heat and add vinegar.
3. Simmer for one hour, and then carefully remove the chicken legs with tongs. Discard skin and bones and return meat to the soup, along with parsley.

When to call the doctor

Dr Lyn Tendek is an integrative medical specialist and general practitioner who combines Western medicine with nutritional and herbal medicine in her practice. Tendek often sees patients who are concerned that their upper respiratory tract infection (URTI) caused by common cold or flu virus requires treatment with antibiotics. “I try to reassure them that the majority of URTIs are caused by viral infection and antibiotics will be of no use. In fact, overuse of antibiotics has led to a significant increase in multi-drug resistant bacteria or ‘superbugs’,” she says.

In the case of simple viral infection, Tendek recommends the use of herbs and nutrients and agrees that rest is the best medicine to assist in healing, but she acknowledges that further measures are required when secondary bacterial infection sets in. “There is a definite role for antibiotics in the minority of people who have a bacterial infection or where a secondary bacterial infection develops on top of a pre-existing viral URTI. In this case, the use of antibiotics can be life-saving.” Here’s how to tell the difference between a viral and bacterial infection:

Viral infection: Mild to moderate sore throat, no difficulty breathing, coughing up clear or white phlegm, mild temperature, progressively feeling better over several days or not feeling worse; action – rest and recover.

Bacterial infection: Severe sore throat, difficulty breathing, coughing up green phlegm, high temperature, feeling significantly worse over several days; action – see your doctor.


This article first appeared in Nature & Health magazine.
Download the article

Apr
15

Food allergy or food intolerance?

Food allergies get all the press – but food intolerances tend to fly beneath our health radar, compromising quality of life.

On any given day, a health practitioner might see patients suffering from a variety of different and seemingly unrelated symptoms, such as fatigue, skin breakouts, bloating, sinus congestion, weight gain, headaches and digestive problems.

Interestingly, this diverse range of health issues may in fact have just one key cause – food intolerances.

Most people are aware of the dramatic and sometimes life-threatening symptoms of food allergies, but few of us understand the potential health impact of food intolerances.

Like food allergies, food intolerances are becoming increasingly common; however, the thing that makes food intolerances more problematic is that symptoms can often take days to appear, long after the food has been eaten. This makes it incredibly difficult to pinpoint reactive foods, which is why most sufferers don’t realise that their symptoms are actually caused by food intolerance.

Intolerance or allergy?

Although both reactions can be caused by the immune system, food intolerances are very different from food allergies.

According to the World Allergy Organisation, an estimated 220-250 million people around the world suffer from food allergies.

Food allergy reactions are caused by the activation of IgE antibodies, which are predominantly found on the skin and in the lining of the nose, mouth, airways, and lungs. Common allergens include peanuts, eggs, tree nuts (Brazil and cashew nuts), and shellfish. Symptoms of food allergies develop rapidly and may lead to anaphylactic shock, becoming life-threatening.

Food intolerances, on the other hand, have several different causes, including a genetic lack of enzymes needed to break down particular foods (as in the case of lactose intolerance) or the body’s inability to absorb certain food constituents (in the case of fructose malabsorption).

People may also react to other food constituents, such as amines (found in chocolate, cheese and red wine) or salicylates (found in some fruits and vegetables). Intolerance to food additives such as artificial colours and flavours is very common and is associated with behavioural problems in children.

The immune system can play an important role in food intolerances. Both IgG and IgA reactions are common causes of food intolerances; these immune-mediated reactions can lead to a slow onset of diverse symptoms, making it very difficult to identify reactive foods.

Both food allergies and immune-mediated (IgG and IgA) food intolerances rely on the activation of specialised antibodies, which are produced by white blood cells in response to foreign bodies entering our system. These symptoms are basically our body’s way of trying to neutralise an invader.

Common culprits

Interestingly, the two main factors governing the development of immune-mediated food intolerances are the amount of a particular food eaten and its ability to stimulate an antibody reaction.

As with food allergies, the most common culprits are wheat, gluten, cow’s milk, eggs, and yeast. These foods are extremely common in the Western diet and can be difficult to avoid if you eat any processed or pre-packaged foods. (Note that gluten intolerance is very different from coeliac disease, which is an autoimmune disorder.)

One of the many benefits of identifying these common irritant and reactive foods is that, in order to avoid them, sufferers switch to a wholefoods diet to avoid processed foods. Not only do they find relief from the intolerance symptoms, but their overall nutrition improves.

There are two main approaches to identifying reactive foods: an elimination diet and immune-mediated food intolerance testing.

An elimination diet can be a very effective strategy, but it may take several months to complete and can be testing for even the most disciplined person. Reactions to certain foods can also be delayed and rely on the amount of food eaten, so it can be difficult to clearly identify reactive foods. People can also react to individual compounds found in a broad range of foods, not just one food, which further clouds the picture.

Pathology testing, on the other hand, investigates your immune system’s reaction to common foods via a simple blood test. The benefit of this approach is that you are screened for a broad range of foods and receive a clear understanding of which ones you are reacting to. Your health practitioner can prescribe pathology testing through companies such as Healthscope Pathology.

The only downside of this approach is that it can’t measure food intolerances associated with other causes.

The fastest and most accurate approach is probably a combination of the two methods. Immune-mediated food intolerance testing clearly identifies which foods you are reacting to, and, if you continue to have symptoms after an elimination diet period of three months, you can experiment with eliminating other commonly reactive foods that don’t fall into the immune-mediated category, like food additives and amines.

The ‘leaky gut’ connection

‘Leaky gut’ is used to describe a state of hyper-permeability of the delicate mucous membranes of the digestive tract. Several factors contribute to this condition, including stress, poor diet, nutritional deficiencies, and some medications.

Leaky gut is also associated with dysbiosis, which is an imbalance of the normal bacteria found in the digestive tract where chemicals given off by gut bacteria irritate the digestive tract lining, contributing to increased permeability.

The immune system acts as the body’s border patrol, waiting just outside the gut wall and guarding against invading pathogens. However, in the case of leaky gut, food particles pass through hyper-permeable mucous membranes before they are properly broken down, causing the immune system to launch an attack to rid the body of a foreign invader.

Not only does this immune attack cause symptoms associated with food intolerance but it also increases gut wall permeability. Over time, the immune system becomes programmed to react every time it comes into contact with that food.

As leaky gut and food intolerances go hand in hand, both must be addressed at the same time. Ideally, once reactive foods have been identified they need to be eliminated from the diet for a period of time. Foods that cause a strong reaction on IgG testing need to be avoided for at least three to six months before a reintroduction can be trialled.

This needs to be done carefully: foods are reintroduced one at a time and symptoms are recorded in a food diary. If no symptoms are present after four days the next food can be reintroduced. In some cases, strongly reactive foods may need to be avoided for even longer.

During the elimination period the leaky gut and dysbiosis must also be addressed. This usually involves treatment with antimicrobial herbs such as Chinese wormwood, barberry and black walnut, followed by reinoculation of the gut with healthy probiotic bacteria and nutrients like glutamine and zinc to support gut repair. Your naturopath or nutritionist will be able to help you get the best results.

* If you are interested in food intolerance testing, your healthcare practitioner will be able to organise testing and advise you on an elimination diet.

Are you intolerant?

If you think food intolerances are signalled by an upset tummy or bloating, think again: in fact, all of these symptoms can be due to a food-mediated reaction.
* Anxiety
* Arthritis
* Asthma
* Bloating
* Chronic fatigue syndrome
* Constipation
* Depression
* Diarrhoea
* Difficulty concentrating
* Fatigue
* Fibromyalgia
* Fluid retention
* Gastritis
* Headaches
* Indigestion
* Inflammatory bowel disease
* Insomnia
* Irritable bowel syndrome
* Lethargy
* Malabsorption
* Migraines
* Mood swings
* Sinus congestion/post nasal drip
* Sleep disturbances
* Skin conditions, e.g. acne, rashes, eczema
* Weight control problems

Case study: Stuart Cooke

Father of three and owner of online health and wellness company 180nutrition, Stuart Cooke, 41, has always been passionate about health and nutrition. But when he started experiencing a range of seemingly unrelated problems, including bloating, sinus congestion, skin breakouts and difficulty sleeping, he was at a loss to understand why. A friend suggested that food might be the problem, so he went to see his naturopath who ordered an IgG food intolerance test*. The result came as a complete surprise: his body was reacting to a range of foods, including gluten, dairy, eggs, and some nuts.

“I had always suspected that wheat and dairy were a problem for me, so I had avoided them anyway. However, the real surprise for me was eggs,” says Cooke. “I had always prioritised good quality lean protein in my diet to help support muscle development, and eggs were a big part of that. However, I then cut them out completely. Since eliminating eggs and the other reactive foods I have noticed a significant difference in my health. My sinuses are clearer, my skin is better and I have had improvements in my health all round.” Cooke has been working with his naturopath to improve his gut function and will start reintroducing foods in time.


Apr
01

Autoimmune disease: how to reduce your risk

Autoimmune disease is a silent epidemic that affects many Australians with numbers steadily growing each year. Tania Flack explains what goes wrong to cause autoimmune disease, and how you can reduce your risk.

Autoimmune diseases (AD) are a group of incredibly diverse conditions that have one important factor in common: they are all driven by a confused immune system that identifies the body’s own tissues as a foreign invader and launches a defensive inflammatory attack to try and neutralise the ‘threat’.

Unfortunately, when this occurs we become the victims because instead of protecting the body, the immune system can actually cause significant damage, and in extreme cases can become life-threatening. It really is sabotage from within.

Autoimmune disease is a silent epidemic that affects approximately five percent of Australians with numbers steadily growing each year. There are as many as 80 distinctly separate autoimmune diseases. Common ones include: rheumatoid arthritis (affecting the joints), multiple sclerosis (nervous system), Hashimoto’s or Graves disease (thyroid), type I diabetes (pancreas), and ulcerative colitis, Crohn’s and coeliac diseases (bowel).

Prognosis differs due to individual genetic and environmental factors. Tests which may be used to determine an autoimmune disorder include: C-reactive protein (CRP) (inflammation), erythrocyte sedimentation rate (ESR) (inflammation), antinuclear antibody test (ANA) (measures autoantibody levels and indicates an attack on the nuclei of the cells), specific autoantibody tests (identifies the types of tissue being damaged), and white cell count (assesses immune system function).

Autoimmune disease may go through cycles of exacerbation and remission, go into lengthy or permanent remission or continue on a destructive path.

What causes autoimmunity is one of modern medicine’s most intriguing questions. Although we know that the autoimmune process is triggered and perpetuated by a complex interaction between genes, environment, and hormones, we have few definitive answers; this makes treatment very difficult.

Modern medical treatment is aimed at attempting to control the symptoms and progression of the disease, modulate the immune system and limit tissue damage.

Natural medicine has a lot to offer people suffering from autoimmune disease; it can address some of the underlying drivers, reduce inflammation and modulate the immune system. In the hands of an experienced practitioner, natural medicines can be used in conjunction with medical treatment where necessary, to get the best results.

Pinpointing causes

While the exact cause of autoimmune disease is unknown, several potential contributing factors have been identified. Epidemiological data indicates that there has been an alarming increase in autoimmune diseases in the past three decades, particularly in the developed world; this may be due to:

The cleanliness factor

It seems our fixation with cleanliness and avoidance of germs can actually disadvantage the immune system. Playing in the dirt, romping with a family pet and having everyday exposure to germs from an early age seems to act as a protective measure, helping to train an immature immune system to properly identify what is our own tissue and what is foreign. It is far less common for people who grew up in non-industrialised countries to develop autoimmune disease. So let your kids get dirty and be exposed to everyday bugs, it may protect them in the future.

The leaky gut connection

Approximately 80 percent of our immune cells live just outside the gut wall, waiting in the wings like border control, to apprehend any potential foreign invaders. A perilously thin layer of epithelial cells separate the immune system from the trillions of bacterial cells living inside the gut. These bacteria are collectively referred to as the gut microbiome and they perform various important tasks, including helping us to breakdown food, producing nutrients, and maintaining the health of the bowel wall.
These bacteria are vital to our health, and in a well-balanced system the gut microbiome and the immune system exist harmoniously.

However, a modern diet may significantly interfere with the barrier between the two systems and this is where turf wars triggered by dietary factors can ultimately lead to major immune dysregulation. Tight gap junctions are the microscopic pores through which we absorb nutrients; they also act as a ‘doorway’ between the two systems. They are delicate structures and easily damaged by inflammatory, biological, and chemical insults.

Maintaining a healthy gut helps to strengthen the barriers between the gut microbiome and the immune system and decreases the risk of developing autoimmune disease.

Toxic triggers

Toxins damage the immune system and play a role in autoimmune disease, possibly due to their effect on the genes associated with inflammation. Environmental exposure to heavy metals, such as cadmium, mercury and lead, increases the risk of developing a range of autoimmune diseases, including multiple sclerosis.

Occupational exposure to common organic solvents (e.g. paints, glues, dyes, polymers, pharmaceuticals, printing inks) or pesticides used in farming also increases the risk of developing autoimmune disease. Avoiding these harmful chemicals and supporting detoxification will help to lessen the risk.

Bug wars

Some bacteria, viruses, parasites may actually trigger autoimmunity. This is thought to be due to a phenomenon called ‘molecular mimicry’, where the invading bug has specific proteins that are so similar to our own, the immune system becomes confused and starts attacking its own body tissue. For example, high levels of the inflammatory bacteria Prevotella copri are associated with the onset of rheumatoid arthritis.

Salmonella and other acute bacterial gut infections, such as Yersinia, Campylobacter and Shigella, are clearly associated with the onset of reactive arthritis. Several viruses are associated with the onset of autoimmune diseases, including Epstein Barr virus (multiple sclerosis) and enteroviruses (type I diabetes).

Hormones

There is a definite disparity between the sexes when it comes to autoimmune disease. Of the five to eight percent of the population with autoimmune disease, an estimated 78 percent of those are women. The discrepancy between the sexes is thought to be due to the complexity of hormones in women. Women are at greater risk of autoimmune flare-ups or developing autoimmune disease during times of hormonal change such as pregnancy and menopause.

Protect yourself

Perhaps the most exciting area of research into autoimmunity comes from our growing knowledge of how the bacteria in the digestive tract interact with the immune system and how diet may play a mediating role between the two systems. A recently released paper highlighted the effects of a modern diet on the immune system and identified common foods and additives that may contribute to autoimmune disease via their negative effect on the gut. Here’s what to avoid:

Gluten

Gliadin, found in gluten, may drive autoimmune disease by causing a leaky gut, which allows under-digested foods to be attacked by the immune system. This is found in grains such as wheat, barley and rye, and gets a bad wrap on many levels; not only is it the causative factor behind coeliac disease, it may be a key driver of autoimmune disease.

Gliadin, one of the components of gluten, opens the tight gap junctions in the digestive tract, contributing to a leaky gut. This allows the passage of under-digested foods, wastes and toxins from inside the lumen of the digestive tract out into the circulation where they are immediately set upon by the immune system.

Genetically, some people are more sensitive to gluten than others and more prone to develop coeliac disease. Interestingly, people genetically predisposed to coeliac disease seem to be more prone to other autoimmune diseases, particularly autoimmune thyroid diseases and type I diabetes. Due to its damaging affect on the gut membranes and its potential interaction with genes associated with autoimmune disease, avoiding gluten is vital.

Sugar

A lot has been written about the harmful effects of sugar in the diet and its connection with autoimmunity. Fructose, a type of sugar, has varying negative effects on the body; however, glucose – which has been lauded as a ‘preferred’ sugar – may actually contribute to the autoimmune disease cycle.

Glucose is absorbed mainly via the tight gap junctions in the digestive tract and can enhance gut permeability, which may contribute to leaky gut syndrome. When we eat a processed food it’s difficult to tell how much sugar we are consuming, so avoid processed foods and sugar.

Alcohol

This has also been shown to damage the tight gap junctions, which contribute to leaky gut and stress on the immune system. In susceptible people, alcohol may potentially play a role in the initiation and potentiation of autoimmune disease. Save alcohol for special occasions and avoid it altogether if you have an existing autoimmune disease.

Food additives

There are many that may irritate the immune system. Emulsifiers and surfactants are widely used in processed foods to ensure even consistency; think sauces, dressings, soy and nut milk, ice cream, pasta sauces, bread, chocolate, margarine. Both significantly impact tight gap junctions, breaking down the barrier between the gut and the immune system. Recently, a Japanese study has demonstrated a direct correlation between the annual sales of emulsifiers to the food and beverage industry and the rising rate of Crohn’s disease.

So despite the fact that there are still many unanswered questions about autoimmune disease, we have tools that can provide significant benefit to sufferers and, by using an integrative approach, we can provide the best outcome.

Your 10-point prevention plan

1. Go for whole: A wholefood diet can have profound effects on your health. Avoiding all processed foods reduces your intake of chemical additives that damage the immune system. Put some effort into developing a good relationship with your local suppliers, ask about the food you are buying and get a good understanding of where it is grown and how it is farmed – a little bit of knowledge can help you make good choices. Experiment with new recipes and expand your cooking repertoire.

2. Pick plants: Having a high vegetable intake will provide you with valuable nutrients to fuel your health, and natural prebiotic, probiotic, and dietary fibres to keep your gut microbiome happy. A high vegetable intake is anti-inflammatory and will also help to alkalise the body, which may relieve pain. Juicing is a great way to increase your intake. Aim for between 6-9 servings of vegetables and 2 pieces of fruit per day.

3. Go organic: This is definitely the way to go if you have an autoimmune disease; it is the fastest way to decrease your exposure to harmful pesticides and herbicides and reduce your toxic burden.

4. Love your guts: Adding fermented foods such as kefir, sauerkraut and kimchi provide beneficial bacteria to balance the microbiome. Resistant starches are a valuable source of fuel and support the health of gut bacteria; these can be found in potatoes, sweet potatoes, and rice that has been cooked, and then cooled. For best results these foods should be added to the diet slowly, starting with small amounts and building up over time.

5. Pump up your vitamin D: This is one of the most important nutrients for a healthy immune system. It has powerful anti-inflammatory effects and protects against the development of autoimmune diseases. You can get vitamin D from sun exposure and from certain foods, such as oily fish, eggs, and mushrooms. Some people have difficulty maintaining healthy vitamin D levels due to genetic variations, so supplementation is often needed. If you have an existing autoimmune condition, or you are at risk of developing one, you should aim to keep your vitamin D levels in a high healthy range, around 100 nmol/L. As vitamin D is a fat-soluble vitamin, you need to have your levels monitored by your health care provider.

6. Heal your gut: This is essential. Nutrients such as glucosamine, vitamin A, zinc and bioflavonoids will be useful for the repair of the gut wall, as will herbs like slippery elm, marshmallow, and licorice, although these should be prescribed by a professional if you are taking other medications.

7. Dampen inflammation: Eicosapentaenoic acid (EPA), a constituent from fish oils can significantly reduce the inflammation associated with autoimmune disease. Aim for a dose of 1.2 grams daily. Nutrients such as vitamin C and bioflavonoids like quercetin and rutin will help. Herbs such as turmeric, boswellia and cat’s claw are also effective anti-inflammatories.

8. Get specialised advice: There are several herbs which have an immunomodulating effect, and that can be used to control autoimmune disease, including polypodium and hermidesimus. These may not be suitable for every person and need to be prescribed by a professional, especially if you are taking other medications.

9. Control your stress: Sustained stress leads to disruption of adrenal hormones, including cortisol, which under normal circumstances helps us to ward off inflammation. Recent studies show that when cortisol is affected by sustained stress we are less able to modulate inflammation, which is one of the driving factors behind autoimmune disease. Managing stress also reduces pain and protects against depression: two vital survival skills for autoimmune disease. Mindfulness techniques, meditation, tai chi and gentle yoga can all be useful, as can the support of a psychologist specialising in stress management.

10. Keep moving: Exercise is an important part of keeping healthy and even when inflammation and fatigue limits activity, gentle movement can help to reduce stress, improve mood, release pain-reducing endorphins, and help support healthy circulation and mobility.


This article first appeared in Nature & Health magazine.
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Mar
25

Natural pain relief

We live in a fortunate age where we have easy access to pain-relieving pills; however, they do have side effects. Naturopath Tania Flack explores safer alternatives.

Popping a tablet for a headache or period pain is so commonplace we don’t really think about it; after all, pain medication is safe, right?

Common pain medication may be safe when taken as directed; however, they can have harmful effects on the body. For example, paracetamol directly depletes the action of glutathione in the liver and can cause liver damage when taken in high doses. Anti-inflammatory medications like ibuprofen can cause significant disruption to the delicate lining of the digestive tract, while stronger over-the-counter pain medications containing codeine are also often misused, some people may even develop a physical dependence, due to its opiate-like effects.

Pain comes in many guises: the continuous ache of arthritis, the low-grade throb of a dull headache, or the cramping pain that some women experience with their period.

Obviously the best way to address pain is to try to address its cause, but this can take time or may just not be possible, as in the case of chronic degenerative conditions.

Natural medicines can provide relief for acute pain and can be used to help manage chronic pain.

Sprains and strains

Whether it’s a twisted ankle, a sporting injury or you’ve knocked your shin on the car bumper bar, sprains, strains and bruises are common injuries that fall into the category of acute pain. First aid for these types of injuries should always start with rest, ice, compression, and elevation. These all minimise inflammation and pain and allow the body to begin the repair process. Ice numbs the pain, however never apply ice directly from the freezer to the skin – always wrap it in a damp cloth to prevent ice burn. Once this has been done use these options to reduce pain and speed healing.

Arnica: This herbal remedy has been used through the ages to treat swelling, bruising, and inflammation. Research shows that it selectively inhibits inflammatory mediators. It can be taken orally as a homeopathic or used in a topical cream applied directly to the bruise. Clinical trials show that using the homeopathic and topical preparations together significantly reduces pain.

Vitamin C and bioflavonoids: Vitamin C and bioflavonoids, such as quercetin and bromelain, are nutrients found in citrus fruit and pineapple. They have significant anti-inflammatory properties and, when taken together, help to mop up inflammation, reduce pain, and promote healing in soft tissue.

Backache

This is a common problem and can be due to postural imbalance, muscle strain or an underlying structural problem. If backache is a regular occurrence, it must be assessed by a practitioner specialising in spinal health.

Spinal care: Although it’s hard to group three distinctly different modalities together, it is safe to say that osteopathy, physiotherapy, and chiropractic care are all excellent therapies for backache. Gently manipulating the spine and mobilising soft tissues can be the fastest way to get relief. This type of care also provides the benefit of thorough assessment, which can prevent further pain and injury.

Massage: The healing touch of a remedial massage therapist can provide significant pain relief, particularly in the case of muscle tension. Massage relieves pain by increasing blood flow, reducing congestion in soft tissue, and releasing muscle tension.

Yoga and Pilates: While yoga and Pilates may not be the ideal therapy for acute back pain, there is no question that, under the supervision of a qualified instructor, both forms of movement can relieve chronic back pain and help to prevent recurrence.

Comfrey: Once known as ‘boneset’, comfrey has been traditionally used to ease pain and promote healing. It contains a compound that simultaneously stimulates tissue repair and decreases inflammation. Several clinical trials have investigated its effects: in one study, it was reported to be as effective as Voltaren (Diclofenac) gel for pain relief.

Headaches and migraines

Whether it’s the dull throb of a tension headache or the blinding pain of a migraine, headaches are a common reason why people reach for pain medication. Sufferers of regular headaches and migraines often have a high intake of painkillers, which over time may have a negative effect on their health. There are several effective natural remedies that can help to relieve and prevent headaches.

Magnesium: Sometimes described as ‘the miracle mineral’, this has significant benefits for headache sufferers. Changes in blood vessel diameter in the brain cause the throbbing associated with migraine and headache; magnesium helps to control this while relaxing the muscles around the head and neck. Magnesium deficiency contributes to headaches and migraines, and studies show that migraine sufferers have low brain levels of magnesium during an attack. Chronic migraine sufferers who take regular magnesium supplements can reduce the frequency of attacks by 41 percent.

Acupressure: This ancient technique uses gentle pressure applied to specific points, which stimulate the release of the body’s natural pain relieving neurochemicals, endorphins (see box “Acupressure points for headaches”). Studies show that regular acupressure provided better relief for headaches than regular muscle relaxant medication. Bonus: you can do it yourself at the onset of a headache to control symptoms.

Lavender: Who doesn’t love the scent of fresh lavender? Lavender essential oil has a soothing effect on the nervous system and is ideal for treating tension headaches. Studies confirm its analgesic and anti-inflammatory properties. A cloth dipped into cool water with a few drops of essential oil can be applied to the forehead to help relieve headaches.

Meditation: Meditation, mindfulness and relaxation techniques can be used by anyone to help control pain and are especially useful for treating and preventing headaches and migraine. Meditation alters our perception of pain and can significantly decrease stress hormones and inflammatory mediators that contribute to pain. Plus, once you learn you can meditate anywhere, so you’ll have a pain-relieving technique to employ at the first sign of a headache.

Toothache

Local anaesthetic is without a doubt a blessing when it comes to undergoing invasive dental procedures. However, that nagging pain that you may experience while waiting for your next dental appointment can be significantly relieved with some simple natural medicine strategies.

Ginger tea: This is one of the most effective pain-relieving and anti-inflammatory herbs we have, due to its effects on prostaglandin release. Gently swirl the warm tea around the mouth and across the affected area, and pain will slowly start to ease. Keep sipping the tea until pain is manageable. This is also an excellent treatment for the pain of a sore throat or sinus infection.

Clove oil: This old-fashioned remedy was once all that we had to relieve toothache and it still stands the test of time. Cloves contain eugenol, which has proven analgesic and antiseptic properties. A few drops of clove oil applied to the affected area can relieve pain. If you don’t have the oil handy, you could make clove tea. Lightly crush whole cloves and add hot water, allow it to steep for seven minutes, and then swirl gently around your mouth.

Nerve pain

Nerve pain can be excruciating, and doesn’t necessarily respond well to standard pain medication. Nerve pain usually follows a defined path across the body, be it the shooting pain down the legs caused by sciatica or the constant irritating pain around the side of the body or face caused by an attack of shingles.

St John’s wort: This herb is probably best known for its antidepressant effects; however its effects on the nervous system are more far-reaching. Specialised compounds in St John’s wort, namely hypericin and hyperforin, have been found to provide relief from nerve pain due to anti-inflammatory and direct analgesic effect on the nervous system, acting on opioid pathways. St John’s wort may interfere with the way some medications work so it should be professionally prescribed for the management of nerve pain.

Acupuncture: One of the oldest and most effective treatments known to man, acupuncture is suitable for many different types of pain, including nerve pain. Like acupressure, acupuncture stimulates the flow of qi, or life force, working to rebalance the body and change our perception of pain. It stimulates the release of endorphins and is so effective people have even used it to undergo minor medical procedures.

Period pain

This can be a common occurrence for some women, especially in teenage girls, perimenopausal women and any woman suffering from endometriosis.

Homeopathy: There are several excellent remedies: Caulophyllum is useful for spasmodic, labour-like pains; Cimicifuga is prescribed for sharp pain; Belladonna can be used for congested heavy pain, which starts before the period; and Pulsatilla and Sepia can help to regulate the cycle. A qualified practitioner will prescribe the most effective remedy.

Ease the ache

Arthritis affects 3.85 million Australians and is one of the leading causes of disability and chronic pain. Pain, inflammation, and joint degeneration caused by arthritis can lead to loss of mobility and a significant decrease in quality of life, so managing pain and inflammation is crucial. Natural medicine can be used alongside standard pain relief medication under professional supervision if needed.

Fish oils: Omega-3 essential fatty acids are renowned for their anti-inflammatory effects. Fish oils contain two main constituents, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA). EPA is the major anti-inflammatory constituent and directly down-regulates inflammation. Fish oils have been shown in clinical trials to reduce pain, increase mobility and decrease the duration of morning stiffness associated with arthritis. While it is important to eat fresh fish, arthritis sufferers also need to supplement; Arthritis Australia recommends 2.7 grams of fish oil (containing both EPA and DHA) to manage the pain and inflammation of arthritis.

Turmeric: Considered a sacred spice throughout Asia, turmeric is used widely for culinary, medicinal and religious purposes, with good reason! The major therapeutic constituents, curcuminoids, have remarkable health benefits including potent anti-inflammatory and antioxidant effects. Animal studies confirm turmeric is more effective than some non-steroidal anti-inflammatory drugs and has direct anti-arthritic effects. Professionally prescribed, high dose turmeric supplements can be useful in managing arthritic pain. Adding turmeric to the daily diet will also down-regulate inflammation.

Anti-inflammatory herbs: There are a wealth of powerful anti-inflammatory and pain-relieving herbal medicines containing compounds that down-regulate inflammatory pathways in the body, so relieving pain and reducing joint damage. They include boswellia, cat’s claw, willow bark and devil’s claw. Herbal medicines should be professionally prescribed for the individual.

Tai chi: Moving is often the last thing arthritis sufferers feel like doing; pain, stiffness and joint restriction can cause them to avoid exercise. However, controlled movement can make a big impact on the level of pain experienced. Tai chi is a gentle form of exercise based on martial arts principles that involves flowing movements which stimulate the movement of qi, or life force, around the body. This promotes relaxation, stimulates blood flow, releases endorphins and helps maintain strength and flexibility. Regular tai chi has been shown to help manage chronic arthritis pain.

This article first appeared in Nature & Health magazine.
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Mar
19

With the Health Rebates about to go – what does this mean for your health?

As many of you now know, from 1st April 2019 Naturopathy, among other natural therapies, will be excluded from the definition of private health insurance. General treatment will no longer receive the private health insurance rebate, a decision which has been made by the Australian Government.

As reported by Your Health Your Choice, a new study by researchers at Southern Cross University has found favourable evidence for Naturopathic Medicine in the treatment of a wide range of chronic conditions after assessing its clinical benefits.

The study, a world-first systematic scoping study conducted by Professor Stephen Myers and Vanessa Vigar published in the February 2019 issue of the Journal of Alternative and Complementary Medicine, summarised the current state of research evidence for whole-system, multi-modality Naturopathic Medicine.

Its findings demonstrate the effectiveness of Naturopathic Medicine in a wide range of chronic conditions including cardiovascular disorders, musculoskeletal pain, type 2 diabetes, PCOS, depression, anxiety, chronic pain, hepatitis C, menopausal symptoms, bipolar disorder, asthma and in increasing cancer survival time.

We want to continue to offer Complementary Medicine as it has become an important part of our healthcare system and can offer so many benefits not only to diet and lifestyle but also for the many chronic conditions we assist in treating for our patients.

Whilst this has been a disappointment to our industry, we want to encourage you all to manage your health and wellness and continue to take preventative steps to keep yourself and your families healthy.

To read more, and to sign the petition to call for a Senate Inquiry, please follow this link:

Your Health Your Choice

If you have any questions or concerns, please feel free to call the clinic on 02 9386 5163

Mar
10

Win the Ultimate Wellness Testing Package!

To celebrate World Health Day on 7th April, we are offering the chance to win an AMAZING health package of DNA and Microbiome testing valued at $1200!

Learn what your DNA tells you about your health, and what active steps you can take to reduce your risk of chronic diseases. Discover your ideal diet personalised to your genes and find out how your gut microbiome may be affecting your health.

READ: How can genetic testing improve your health?

The Ultimate Wellness Package Includes:

  • A SmartDNA Nutrigenomic Wellness test;
  • A SmartDNA Gut Microbiome test;
  • A 1-hour consultation with senior naturopath Tania Flack to discuss your results;
  • A 1-hour appointment with nutritionist Brooke Schiller to tailor your individualised diet plan;
  • A Bioimpedance analysis to reveal the state of your cellular health;
  • Total prize value: $1200

To win this package, simply follow the Bondi Health and Wellness Facebook page and Instagram account and like the Ultimate Wellness Testing Package competition post.

REALLY want to win? Sign up to our mailing list, share this post on Facebook or Instagram, and tag a friend for bonus entries!

We’ll announce the lucky winner on Monday 8th April.

Good luck, everyone! Here’s to living your best possible life in vibrant health.

Mar
04

What’s in your health future?

Naturopath Tania Flack talks to Dr Margaret Smith, pioneer of the Wellness Genomic test that allows people to tailor their diet according to their genes.

DNA testing has become common since the release of the findings of the human genome project in 2003. While DNA testing performed in a hospital is used to diagnose and prevent disease, second-generation genomic and nutrigenomic testing, available from naturopaths, nutritionists and GPs, is designed specifically for use in personalised healthcare.

During March 2019 we’re offering the chance to win a Genomic Wellness test, along with a Gut Microbiome test, and two consults with our naturopaths to discuss your results and tailor an individualised diet plan. More details here.

Meet Dr Margaret Smith, molecular geneticist and scientific director of smartDNA, a provider of nutritional and genetic testing in Australia.

How can genetic testing improve our health? 

Understanding your individual genetic profile allows you to make healthier choices now. DNA testing provides people with comprehensive information about their unique genetic profile. Genomic Wellness testing investigates genes that influence specific biological pathways and how they impact a person’s health over their lifetime. It is the ultimate in personalised, predictive and preventive healthcare.

What about weight management? 

A range of genes impact body composition and genetic variations of any number of these genes can influence how easily weight is gained or lost. For example, the FTO gene can affect a person’s ability to sense when they are full, so variations in this gene can lead to poor leptin signalling and overeating. Other gene variations increase the risk of carrying weight around the middle, snacking or addictive food behaviours. High protein diets are popular for weight loss, but may not be the best choice for everyone: the success of this approach may rely on individual genetic expression. Designing a diet that takes individual genetic variations into account helps people manage their weight effectively.

What about the Mediterranean diet? 

This diet is known to reduce cholesterol and overall cardiovascular risk. However, studies show it may actually increase cholesterol and contribute to cardiovascular risk for people with certain genetic variations. For example, some people are more sensitive to saturated fats than others and some have genetic variations that predispose them to elevated low-density lipoproteins (‘bad’ cholesterol).

Do genes impact detoxification? 

Our body’s ability to detoxify chemicals and pesticides and to safely metabolise hormones relies on genes controlling the detoxification pathways. For example, variations in genes associated with oestrogen metabolism may increase the likelihood of oestrogen-dependent conditions, like fibroids and fibrocystic breast disease. If a woman has variations of these genes, then further testing can measure her ability to safely metabolise oestrogen.

Can testing help us make better dietary choices? 

There is a range of genes that control our ability to effectively metabolise nutrients from food. Variations of these genes may explain why some people become nutritionally depleted more easily than others, despite having a healthy diet. Understanding how genes affect your ability to utilise certain nutrients lets you tailor your diet to your individual needs.

Can genetic testing improve sports performance? 

Genetic variations associated with oxygen delivery, fast and slow twitch muscle fibres, and lactic acid removal have an impact. Other genes, such as those associated with cortisol and inflammation, are important in exercise recovery. Knowing your individual expression of these genes lets you tailor your training to reduce risk of injury, promote recovery, and optimise performance.

Case study: Matty Clarke

Athlete Matty Clarke has forged a successful career on the Australian Ironman circuit. He was looking for something to give him an edge in competition, and decided to get DNA testing done. “The test showed I needed to change certain aspects of my diet and training, and support glutathione production for muscle recovery,” he says. “I worked with my practitioner to fine-tune my nutrition and drop some supplements I had been taking and, since then, I have increased my weightlifting ability by 12 percent.”

DNA Wellness Genomics is the ultimate in predictive, preventative, personalised health care and will provide you with information on several key areas of health.

Discuss taking a DNA test with one of our practitioners today.

This article first appeared in Nature & Health magazine.

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Feb
25

How to treat PCOS

Like a hormonal stealth bomber, polycystic ovarian syndrome (PCOS) can strike a woman at any stage in her reproductive cycle. 

Sarah (27 years) started to notice her periods were becoming irregular around the time she got a promotion at work; prior to that her cycle had always been perfect, so she just put it down to the stress of her new job. She was incredibly busy in the first year of her new role, so when she stared to gain weight she decided it was probably because she didn’t have enough time to exercise and eat properly, so she vowed to address this as soon as things settled down at work.

It wasn’t until she started to develop deep cystic acne and excess hair growth around her jawline that she realised that something was going horribly wrong with her hormones. A trip to the doctor and a range of tests ultimately lead to a diagnosis of polycystic ovarian syndrome (PCOS), a common condition that has the potential to cause complications with fertility and metabolism.

So what is PCOS and how can we restore hormonal health and fertility once it has been diagnosed?

Like a hormonal stealth bomber, PCOS can strike at any stage of a women’s life, and while some women experience symptoms from puberty, other women only experience problems later on in life, often after a period of stress.

According to the Medical Journal of Australia, PCOS affects between 12-21 percent of Australian women of reproductive age and is more common in women who are overweight or of indigenous background. It is also the most common cause of anovulatory infertility in Australian women. However, its impacts on fertility are only part of the story.

Women are often prescribed the Pill to minimise symptoms of PCOS; however, this may cause further deterioration of glucose tolerance.

What are the signs of PCOS?

  • Irregular or absent periods
  • Weight gain
  • Cystic acne
  • Excess hair growth
  • Male pattern hair loss

Increased risk of:

  • Obesity
  • Metabolic syndrome
  • Gestational diabetes
  • Type II diabetes
  • High triglycerides
  • Vascular disease
  • Endometrial cancer

What’s in a name?

The term polycystic ovarian syndrome (PCOS) is a misleading name for what is essentially a multifaceted metabolic condition that has broad ranging systemic effects which impact hormonal and metabolic health. A more appropriate term for the condition would be polycystic ovarian spectrum, as some women may have only a few signs of PCOS, while others may experience the full range of symptoms.

A diagnosis of PCOS comes as a shock for most women and its potential to lead to fertility problems can be terrifying. However, natural medicine along with dietary and lifestyle modification can achieve great results. With the right type of support, PCOS can be successfully managed and symptoms can be completely reversed in some cases.

The cause of PCOS remains poorly understood. There is no single triggering factor; rather it is the result of a complex interaction between genetics and environment.

How to treat PCOS

Like many complex conditions, there is no one quick fix and we must address all of the driving factors simultaneously in order to get the best results. These are:

Genetics

Undoubtedly genetics play a role in PCOS. We all carry subtle genetic polymorphisms (or variations) that may predispose us to certain conditions, especially if those genes are triggered by our environment. In the case of PCOS, it seems that stress and poor diet can trigger genes that influence insulin signalling, hormone metabolism, and the production of androgen hormones from both the ovaries and the adrenal glands, which can contribute to the development of PCOS. However, everyone is individual, and what triggers PCOS in some women may not impact another. The type of treatment required to restore metabolic health needs to be individualised for each woman, as one size does not fit all.

Insulin resistance

Insulin resistance is a major driving factor behind PCOS and the main focus of research. Insulin is a transport molecule that escorts glucose into the cells in order to provide energy. When women are insulin-resistant, their cells are less able to receive fuel from the bloodstream, so the pancreas makes more and more insulin to compensate. Instead of being transported into the cell for energy, glucose remains in the blood, which leads to weight gain. Ovarian follicles are stimulated prematurely when insulin resistance is present, causing the appearance of multiple ovarian follicles (cysts). It is estimated that 50-80 percent of all women with PCOS have some degree of insulin resistance. Women are often prescribed the oral contraceptive pill to minimise the symptoms of PCOS; however, this is not necessarily the best option as it may cause further deterioration of glucose tolerance.

Once only associated with obesity, normal weight women with PCOS can also have insulin resistance; however, overweight women are more likely to experience more pronounced menstrual irregularity, infertility and signs of androgen excess, such as acne and hair growth. The development of insulin resistance relies on several factors including diet, stress, and inflammation. Some women are more sensitive to a diet high in refined carbohydrates, due to individual genetic susceptibility. So an average Australian diet, which is usually high in refined foods, can be enough to trigger insulin resistance in some women. We should never assume that a woman with insulin resistance has made bad dietary choices: there can be a complex array of triggering factors and genetic influences here.

Stress

Stress can play a significant role in the development of PCOS due to its ability to alter glucose metabolism, insulin sensitivity, and impact the production of adrenal hormones. In fact, it has been suggested that there is a separate subtype of PCOS – “adrenal PCOS” – that tends to surface in women who are over-exercising, have a highly stressful lifestyle, and are fundamentally burning the candle at both ends. These women may have significant signs of androgen excess, including acne and hair growth, and despite their exercise regimen they may experience insulin resistance and weight gain.

In women, both the ovaries and the adrenal glands produce hormones that act as androgens. In the face of chronic stress and exhaustion the adrenal glands start to produce higher levels of a range of androgenic hormones, including one called dehydroepiandrosterone sulfate (DHEA-S) which can be used as a marker to assess how stress and adrenal function is contributing to PCOS. The treatment of these women needs to be handled very differently from women who have spiralled into PCOS due to a strong genetic tendency towards insulin resistance. When chronic stress and burnout have played a role, it must be addressed differently – and more exercise is not the answer. These women require adrenal support, stress management and lifestyle modification, along with hormonal regulation.

Inflammation

Inflammation is an often overlooked causative factor in PCOS; it acts as a double-edged sword, driving both insulin resistance and the production of androgens from polycystic ovaries. There are many causes of low-grade systemic inflammation, and one of the most common is poor digestive function and leaky gut. Leaky gut is a common condition caused by an overgrowth of normal bacteria (dysbiosis) irritating the pores through which we absorb nutrients. This creates a hyper-permeable gut and leads to the absorption of toxins into the bloodstream, causing low-grade inflammation. Causes of dysbiosis include: a refined, high sugar diet; herbicides, pesticides and additives in food; antibiotics and other medications, including the oral contraceptive pill; and most importantly, stress. Healthy bowel function is imperative for hormone metabolism, so if you have sluggish gut function, bloating or irregular bowels, this needs to be addressed. Treating leaky gut can improve insulin sensitivity and jump-start weight loss.

Take back control

The first line of treatment for women with PCOS is dietary intervention designed to normalise insulin responses and support weight loss. A low glycaemic index diet that avoids all refined carbohydrates and sugars is essential. Carbohydrate intake should be well controlled and include only small amounts of whole grains, such as quinoa, buckwheat, and red rice. Legumes are a great source of low glycaemic index carbohydrate that is rich in fibre to support bowel health and inositol to regulate hormones.

The main focus should be on an anti-inflammatory diet: that is, one which is high in plant foods, with a moderate intake of fish, seafood, and nuts and seeds to provide healthy fats.

Saturated animal fats from dairy and red meats should be kept to a minimum, due to the increased risk of metabolic syndrome and elevated triglycerides.

If this type of diet fails to improve insulin sensitivity and support weight loss, then you may wish to consider overnight extended fasting. This type of eating plan means you fast, usually between the hours of 8 p.m. until noon the following day, and this helps to sensitise insulin and increase weight loss.

It’s important to note that not all women who present with PCOS have obvious problems with insulin resistance, however this type of clean eating plan can support hormonal health for all women with PCOS. For best results speak to your nutritionist or naturopath for an individualised eating plan.

Overnight fasting helps to reduce insulin sensitivity and support weight loss. Exercise is an important part of any PCOS recovery program, but must be individualised for each woman. Overweight women with PCOS primarily driven by insulin resistance should exercise for 45 minutes four to five times per week. This will improve insulin sensitivity, weight loss and all other metabolic markers when combined with a carbohydrate- and calorie-controlled diet.

Women with primarily stress-induced PCOS need a modified exercise plan. And, while not all women with PCOS are overweight, all will benefit from a healthy nutrition and exercise program. An appropriate exercise and nutrition program will help to improve insulin sensitivity, regulate BMI and promote fertility. Studies have shown that, in overweight women with PCOS, even a weight loss of five percent can lead to significant improvements in fertility and a reestablish regular ovulation.

Nutritional medicine

Inositol is a compound found naturally in legumes and fruit. Research has shown it regulates insulin and follicle-stimulating hormone (FSH), promotes glucose uptake into the cell, and protects the quality of women’s eggs. In one study, PCOS insulin resistant women took 500mg of inositol per day for 12 weeks. Lutenising hormone (LH) and FSH:LH ratios improved, as did insulin sensitivity and glucose tolerance. It was also noted that the women all lost weight without any changes to diet or exercise regimes.

N-acetylcysteine is another nutrient that improves insulin sensitivity. In a randomised clinical trial, women taking 1,500mg daily, for 24 weeks, experienced a significant decrease in body mass index, fasting insulin, and testosterone levels, and their menstrual cycles regulated. Magnesium, chromium and lipoic acid can also be used to help regulate blood sugar levels.

Peony and licorice have been used in combination for centuries in traditional Chinese medicine to treat menstrual irregularities. Peony is a key fertility herb that regulates ovarian function and improves ovulation. Licorice is a powerful adrenal herb that helps to regulate the production of adrenal hormones, modify the effects of stress, and reduces the production of androgens in the ovaries. It exerts an anti-androgenic effect on the hair follicle and may help to reduce symptoms of excess hair growth. Together, these herbs have been shown to reduce testosterone levels and improve pregnancy rates with prolonged use.

Tribulus is another fertility herb, which acts as a reproductive tonic and regulates the production of oestrogen and androgens. Chaste tree supports ovulation and regulates progesterone, and may be useful to help re-establish a regular cycle in some circumstances. Other herbs that can be used to improve insulin sensitivity and glucose tolerance include gymnema, goat’s rue, and bitter melon.

Herbal medicines should always be professionally prescribed.

This article first appeared in Nature & Health magazine.
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