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*This blog is largely in regards to supplementation while trying to conceive or pre-natal care* If you have a concern with this article, please email me. Folate is often supplemented in pre-conception care to reduce the risk of neural tube defects (i.e. the spinal cord and brain) in the embryo development in the first trimester. This is basic pre-natal and natal care and should be continued throughout the period of trying to conceive and the first trimester. Folic acid and Folinic acid are both types of FOLATE, the term also including 5-methylfolate. But, what do the different forms mean? To keep things simple, folic acid is the synthetic version often found in supplements, fortified foods, and pre-natals. There is no natural occurance of folic acid, and so requires more effort for the body to convert this synthetic form to an active form once ingested. The naturally occuring forms of folate are folinic acid and 5-methylfolate are already active. These are found in dark leafy green and cruciferous vegetables (for example). You can find supplements with this version, but it's not as common because it's more expensive to manufacture. Studies within the last 10 years have shown that the 'active forms', i.e. 5-methylfolate, is more bioavailable and better absorbed. This is not hugely important for the majority of people, unless; they have the MTHFR gene which affects the enzyme that helps to activate folic acid and increases homocyestine; or there is an underlying B12 deficiency (due to inadequate intake* or absorption issue); or they have a history of miscarriage (keep reading). B12 deficiency haematology (blood) symptoms can be masked by excess folate - weird I know, but they both help form red blood cells. If you have just found out you are pregnant and are not taking a pre-natal - 5-Methylfolate (as metfolin usually) is the best form to begin with to rapidly boost folate levels to support your pregnancy. Both B12 deficiency and high homocysteine can be risk factors for miscarriage - that's why I recommend seeing a qualified professional if you have the MTHFR gene and are looking to have a baby soon, or have had reoccurant miscarriages and no further investigations yet. To briefly summarise: 5-Methylfolate (as metafolin) is the superior form for absorption to bring up folate status. If you have MTHFR gene polymorphisms, folic acid and 5-methylfolate were shown to be equal, but an activated B complex may be more holistically supportive. *If you are vegan or vegetarian, please begin B12 supplementation immediately .

The mechanics of muscle damage Our muscles are pretty good at adapting to movements we use often, but when we start doing something new (different movement, heavier load, more repititions of the movement, tension - holding the movement) that is a new stressor. These mechanical stressors will over time cause adaptation, but they produce small acute injury to the muscle tissue. "Three main phases have been identified in the process of muscle regeneration; a destruction phase with the initial inflammatory response, a regeneration phase with activation and proliferation of satellite cells and a remodeling phase with maturation of the regenerated myofibers." (3) The [eccentric - lengthening] contraction of the muscle tissue with the added stressor (weight, usually) damages the myofibrils, which are the long filaments that run side by side and make up muscle fibres (1). Textbook imagery makes them look like little tubes... which form to fill a bigger tube called a myofibre. A bunch of these together make a muscle. The trick to making this lengthening movement work effectively to positively damage the muscle is to complete the full range of movement to the fibres lengthen past optimum length (don't over-extend though). The damage to the myofibrils and the muscle cell membranes (usually refered to as microtears because it is literally tiny tears from over stretching the sarcomeres within the myofibre) allows unregulated calcium through the tears which tightens the sarcomeres within the myofibrils; and activates proteases and hydrolases that contribute to muscle damage (1). Calcium is used in your muscle every single time one of your sarcomeres contracts. There's a lot of finer science details which even I don't enjoy reading, so I won't subject you to that. But, basically, muscle tissue lengthens under tension/pressure and tiny tears are created. Sometimes some of the myofibres even die (2). The microtears trigger inflammation as the cells release creatine kinase and myoglobulin (4). Macrophages come to the site to collect debris and pump out Th1 cyotkines (small signalling proteins). Water is brought into the muscles which accounts for the swelling you feel. This peaks around 24 hours post exercise. More (slightly different) macrophages (M2) are called to signal for tissue repair (myoblasts) and regulate the inflammation (1). At this point you might notice decreased perceived strength and range of motion. Your muscle is now full of satellite cells (that will turn into muscle cells), neutrophils, macrophages, T lymphocytes, mast cells, endothelial cells and fibroblasts (4). These will all play a role in repair of the muscle. Some of these cells produce mitogens (to stimulate mitosis) and motogens (to stimulates cell motility) - how fun! The mechanics of muscle repair The repair of muscle tissue begins with the injury that triggers the inflammatory cascade. Remember all those cells that are in your damaged muscle now you've reached peak inflammation. M2 macrophages, CD8 and T-regulatory lymphocytes in your muscle come in between 24 and 4 days after damage and secrete anti-inflammatory cytokines (different signalling proteins to before). The cytokines signal other cells to make more myoblasts (to build myofibres) and satellite cells (4). These satellite cells eventually become myoblasts. Type I/III collagens, laminin and fibronectin form bonds to stabilise the tissue, the same happens after a wound has clotted, but here the bonds provide scaffolding for the myoblasts. Myoblasts stick to the bonds to form new myotubes or fill holes in damaged myofibres (3). The fresh myoblasts that make myotubes mature into myofibres. If you've had a significant trauma injury, it's as this point where your blood vessels are re-established in the new repaired tissue and nerves are complete (3). As a result of the repair process and the increased apparent requirement to do more or lift more, the body grows new mitochondria to make more energy for next time, and then builds more myofibres to house more mitochondria during each repair. This process is completed in approximately 7 days (4). How to assist muscle recovery? 1) Get adequate sleep. Sleep is the most significant period of repairs, hands down. 2) Rest. You must find the balance between training and recovery to prevent muscle breakdown exceeding the muscle repair (5). Change the body part your using each time so that section has time to recover and you can still get the endorphins from working another body part. (e.g. upper body exercises day 1, lower body exercises day 2, a walk, repeat). 3) Massage the muscle - foam roll, roll a ball over the length of the muscle, an actual (gentle) massage (4,5) the next day or day after. 4) Cold water immersion improves recovery if you're brave enough (4). 5) Curcumin to act as an anti-inflammatory agents, reduced inflammatory markers and improved muscle function compared to placebo (6). So did [American, Red) ginseng (ginsenosides, rather) and Tart cherry juice. 6) Creatine showed similar effects to curcumin (and far less cost, but must be consistently ingested) (6). 7) Vitamin D3 and Polyunsaturated Fatty Acids (PUFAs) equated to less soreness (6). 3 and 4 have controversial research, 'they' haven't quite determined if it is perceived recovery or if the therapy does speed recovery. I, personally, feel that foam rolling helps reduce the tightness and therefore makes me feel less impacted during the day. What makes this process slower? 1) The number one factors that leaves muscles chronically under-recovered and fatigued it 100% over-use. You cannot go to the gym and smash full body 7 days a week, just as you can't run long distances 7 days a week. You will feel like a train hit you at some point, and if you don't, then I assume your training is not moderate or intense and therefore not damaging the muscle fibres significantly. Which is fine - low impact, light exercise 7 days a week is completely manageable. You know why? Because the muscle damage isn't as significant from light exercise and has sufficient time to repair from that lighter stimulus. Walking, for example, is considered light exercise. 2) Other factors that slow muscle repair could be; lack of protein and other tissue connecting minerals and vitamins (C, zinc, collagen, etc). This would be purely based on resources available for muscle repair, however the body is quite resouceful. 3) An inflammatory diet may contribute to increased use of resources and potentially impact the effect of the anti-inflammatory actions taken when trying to repair muscle (theoretically). 4) genetic propensity of immune system/ regulatory cells/ muscle growth etc. When is it more than muscle fatigue? If you find that you've had a few days off moderate or intense exercise and you are still experiencing doms/soreness/swelling - especially if this type of exercise is not new to you, it might be time to consider if you are really taking good care of yourself. Did you sleep enough? Are you eating the right amount of the right foods? Have you foam rolled/ stretched/ done some light movements? If that isn't effective and this has been the case for months, to the point where you have given up exercising because it's too fatiguing, there may be more to it. Chronic fatigue, lack of motivation, lack of energy to complete daily tasks can be indicators of a few things and is best to see your health practitioner (GP, Naturopath) for futher investigation. References (1) PMID 23733696 (2) PMID 11731568 (3) PMID 27447481 (4) PMID 28035017 (5) PMID 29755363 (6) PMID 30617517

Originally used for a research article, but I thought it was interesting. Alcohol is one of the worlds most used drugs. In cases of addiction, there is more at play than simply habitual routines. Often these (addictive substances) are used chronically as they actively change our brain chemistry. Looking more specifically at alcohol addiction, alcohol modulates the brain reward system that is important in initiating and maintaining behavioural patterns (Tomkins & Sellers, 2001). The medial forebrain bundle (MFB) (connecting the ventral tegmental area to the nucleus accumbens (NAcc)), innervates the amygdala [emotions] and cortical areas [senses]. These areas are responsible for emotional expression, reactions to cues, planning and judgement (Tomkins & Sellers, 2001). Basically, these areas are responsible for assessing motivations, and turning those into actions. In the MFB, neurons respond to dopamine, noradrenaline and serotonin. These are important neurotransmitters connected to feeling good, while noradrenaline helps control blood pressure and heart rate. Serotonin is largely thought of in relation to joy. However, the dopaminergic pathways are mostly associated with the reward connection, pleasure. Issues with dopamine receptors and transporters may increase the likelihood of alcohol abuse. Rewards increase dopamine within the NAcc, but other neurotransmitters do play a role in alcohol addiction, such as GABA [relaxing neurotransmitter], serotonin, glutamate - excitatory neurotransmitters (Tomkins & Sellers, 2001; Banerjee, 2014). There are limited allopathic drugs for alcohol addiction directly, though receptor antagonists may be a consideration - antagonising [blocking] dopamine rather than destroying receptors has shown some improvement in rats (Tomkins & Sellers, 2001; Banerjee, 2014). Short term, alcohol consumption increases dopamine release, even the thought of it, which strongly connects the emotional response to the actions in order to acheive that state again. There are other neurotransmitters that contribute to this process, however dopamine was highlighted due to it's involvement in [all] addictive habits. Hyperexcitability in the NMDA system [mediating learning and memory] occurred following long-term alcohol use, so perhaps neurotransmitters which bind to these receptors, such as GABA or glutamate are a more useful focus to decrease consumption (Tomkins & Sellers, 2001). However, glutamate levels decrease with alcohol consumption, the receptors they bind to (NMDA receptors) are important in alcohol addiction as they relate to neuroplasticity and the neuron reorganisation that happens when an addiction forms (Banerjee, 2014). I.e. because lots of glutamate is used when we form new habits/ new ways of thinking, it is less freely available. GABA and glutamate balance appear important here. Vengeliene, Bilbao, Molander & Spanagel (2008) reports “glutamate receptors appear to adapt to the inhibitory effects of alcohol by increasing their excitatory activity”, hence the hyperexcitability mentioned previously in chronic cases. More specifically, hyperexcitability when sober or in withdrawal - increasing the craving feeling (Vengeliene, et al. 2008). Hyperexcitability of receptors may increase feelings of anxiety, restlesness, and feel pain more intensely. Glutamate receptors becoming more easily activated can result in the degeneration of dendrites and cell death (Mattson, 2019). Disruptions of glutamate uptake from the synapse have been linked to reduced sensitivity to reward, a symptom of depression (National Academies Press (US); 2011). This ends up with loss of brain tissue in the front cortex, which leads to poorer decision making. With the reduced sensitivity to reward behaviour, things feel very bland, this could cause an increase in consumption in order to chase that original reward feeling (dopamine). Genetic alleles also increase propensity for alcoholism, therefore such efforts will need to be increased (Banerjee, 2014). Creating a balance between GABA and glutamine, by treating with NAC for example, to correct the glutamate dysregulation, may be effective in reversing the neurochemistry changes. To summarise: several important neurotransmitters are involved in alcohol addiction and it cannot be treated through focussing on one; neither on the volume or sensitivity to one. There are chemical changes to the brain’s responses and sensitivity which increase dependence on alcohol, and further worsen the problem. While focussing on dopamine and glutamate helps us understand the disease process, ultimately, they will affect their opposing neurotransmitters too. With aggressive and drug dependent treatment of alcoholism, the idea is to avoid creating compensatory changes to other neurotransmitters. Therefore, we need to heal the dysfunctional neurotransmitters/receptors, encourage excitatory responses for other events and provide necessary nutrients to help cope with detoxification and withdrawal (excitability of some receptors, and lack in others). References: Banerjee, N. (2014). Neurotransmitters in alcoholism: A review of neurobiological and genetic studies. Indian Journal of Human Genetics, vol 20. Issue 1. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4065474/ National Academies Press (US), (2011). Glutamate-Related Biomarkers in Drug Development for Disorders of the Nervous System: Workshop Summary. Institute of Medicine (US) Forum on Neuroscience and Nervous System Disorders. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK62187/ Mattson, M. (2019). Stress: Physiology, Biochemistry, and Pathology. Handbook of Stress Series, vol 3. Chapter 11. Retrieved from: https://www.sciencedirect.com/science/article/pii/B9780128131466000114 Tom, D. & Sellers, E. (2001). Addiction and the brain: the role of neurotransmitters in the cause and treatment of drug dependence. CMAJ, vol 164. Issue 6. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC80880/ Tomko, R., Jones, J., Gilmore, A., Brady, K., Back, S., & Gray, K. (2018). N-acetylcysteine: A potential treatment for substance use disorders. Current Opinion in Psychiatry, vol 17. Issue 6. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5993450/ Vengeliene, V., Bilbao, A., Molander, A. & Spanagel, R. (2008). Neuropharmacology of alcohol addiction. British Journal of Pharmacology, vol 154. Issue 2. Retrieved from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2442440/

Ginkgo is definitely one of my favourite herbs. I had the opportunity to see this mind-growing tree in New Zealand several years ago and the memory of it still gives me awe. It was so overpowering and the light delicately shone through the little brain shaped leaves. So green! If you ever get the chance, I recommend connecting with this particular plant. I was even more intrigued when I learned that Ginkgo is one of the oldest living tree species [1]. A true dinosaur. Medicinally Ginkgo is used for many different conditions ranging from cardiovascular health, male and female reproductive health, brain health and asthma management [2]. The reason it lends itself so well to different body systems is it's potent antioxidant and anti-inflammatory action. Some of the active components in Ginkgo are terpene trilactones, flavonol glycosides, biflavones, phenolic acids, polyprenols... interestingly, there are over 30 genuine flavonoids. It's these flavonol glycosides, like quercetin and kaempferol, that contribute to it's antioxidant power. Amoung these important actions, Ginkgo is also neuroprotectice, cardioprotective and promotes vasodilation. These effects lead to reduced vascular damage, protective effects on circulation, and improved blood flow to peripheral areas... including your brain. Brain fog is almost a silent symptom, you don't notice it begining, but once it clears - OMG. Confusion, forgetfulness, and a lack of focus and mental clarity. Does this sound like you? Now there are a lot of factors that contribute to brain fog. Lack of sleep, stress, poor nutrient status, poor diet, working too much, and food intolerances all cause a similar picture. So why am I talking about Ginkgo? Because this herb has the power to improve your accuracy and performance. Sure there are other actions you can take, and the first step would be to book an telehealth appoinment with our Naturopaths. In a study mapping working memory and brain activity [3] the researchers found two weeks of Ginkgo extract able to improve accuracy on a memory task. They also noted increased synaptic inhibition in the left temporal lobe (understanding language, remembering) and prefrontal cortex (cognitive control). This is a good thing, potentially meaning that your brain has to do less work to get a clear result. That your brain becomes more efficient. Research suggests this might be due to Ginkgo's cholinergic action, but more evidence is needed to be conclusive. To put that into a more modern phrasing, Ginkgo lends itself to being a nootropic. Herbs like this are best taken with meals in order to improve memory and cognitive decline. Other herbs that have similar actions include, Rosemary, Coffee (in moderation), Bacopa, Cocoa, and Guarana. Some of these herbs have other actions too, which may or may not be what you're looking for. It's always best to chat with your Naturopath or GP before beginning any new medicines as Ginkgo for example, doesn't mesh well with blood thinners, being a blood thinner itself. My first recommendation is to chat with one of our Naturopaths, but if you are not on any medication and don't have any health conditions - a cup or two of Ginkgo a day might be a nice addition to your self care routine. [1] https://www.nccih.nih.gov/health/ginkgo [2] Clinical Naturopathic Medicine, 2019 [3] doi: 10.1155/2011/164139

Why is what you eat related to your mental health? There's a little truth in every wives tale and "you are what you eat" is no exception. The food that you choose to put into your mouth has a run on effect to your gut health, and in turn, your mental health. The term "mood food" has been popping up on government websites and in research for a few years. This is largely based around nutrition research which shows the benefits on mood from eating a whole food, Mediterranean style diet full of fresh vegetables, fish, quality low refined oils, and fruits. This kind of diet is also highly antioxidant and anti-inflammatory and can reduce your risk of depression by up to 42% (3). Some would say that depression is inflammation of the brain - research pending, but you can see why a diet so anti-inflammatory would have positive effects on an inflammatory state (1). Depression seems to affect approximately 20% of the population at any one time, likely more so in the last year (2). It is particularly prevalent among young adults and individuals with a disability - those more likely to be isolated and under stress (1). The rising number of prescription anti-depressants/ sedatives, with numerous side effects and low reported efficacy is worrying, when there is so much that can be done around habits and lifestyle (often without spending much). So I'm going to give you the low down on how to support your mental health with food, and with lifestyle. After all, naturopath principle #4 is "Doctor as teacher" (Docere). Food as medicine Here's the 'you are what you eat' part. A modified Mediterranean diet has shown the most benefit for depression, relieving symptoms for up to three years (2). In fact, fresh fish consumption was directly correlated with a reduced risk of depression in several studies (2). As fruits and vegetables make up a large portion of any healthy diet, they contain antioxidants and *may* positively affect serotonergic (happy neurotransmitter) status (2). Fast food and ready-to-eat meals were negatively associated with mental health status, likely due to their pro-inflammatory ingredients and super processing. Pro-inflammatory dietary patterns are high in in "sugar-sweetened soft drinks, refined grains, red meat, diet soft drinks, and margarine and low in wine, coffee, olive oil, green leafy, and yellow vegetables" (2, 3). Basically, this diet helps to downregulate inflammation and therefore neuroinflammation. Plus, you get all these wonderful hormone building and stress reducing components... The brain is largely made up on fat (self-made cholesterol, and polyunsaturated fatty acids) and uses approximately 400 calories a day worth of energy (3). The production of neurotransmitters, such as serotonin, uses amino acids (from protein), B vitamins, zinc, iron and a few other co-factors. Therefore - to assist your brain in functioning optimally, you need to eat sources of these foods, in addition to carbohydrates to fuel that energy use and antioxidants to prevent the precious fatty acids from oxidizing. Fish and seafood do hit most of those components, but vegetables such as kale, beans and legumes also contain good quality folate and are naturally anti-inflammatory (2, 3). While these are best included rather than not, there are daily and weekly targets to hit if you want this to be a 'therapeutic' diet. If you perfer list forms: - Fatty fish - 2 times per week - Fruits and vegetables of varying colours (++ antioxidants) - minimum 2 fresh cups everyday - High tryptophan foods (amino acid used to make serotonin) are cheese, pumpkin and sesame seeds, chicken, turkey, oats, and eggs - include everyday - Quit smoking and high sugar foods - all they do is deplete your nutrient stores and create oxidative stress. If you require more assistance, please book an appointment. Humans are too different from each for a whole treatment protocol to be the same. Probiotics I can't even list to you the importance of a balanced microbiome in treating mental health, but one important thing to remember is that a healthy gut produces the majority of your serotonin (your happy neurotransmitter). Our neurotransmitters are what tell our brain what emotions we feel and can be influenced by our gut microbiome. They (scientists/naturopaths) call the gut our second brain for a reason. A review of research shows that some probiotics (strains of microbes) can change the neurotransmitter balance in our brain. Bifidobacterium adolescentis NK98 and Lactobacillus reuteri NK33 increase brain-derived neurotrophic factor (BDNF) contents (2). This is important because BDNF has a role in brain plasticity and neurotransmitter sensitivity - i.e. how resilient our brain is and how responsive is it to our neurotransmitters. An increase in BDNF appears to decrease depression behaviours. So our gut health changes the way our brain responds to stressors and makes important neurotransmitters. We can support our gut health in three ways: eating a wide variety of fruits, vegetables and grains; eating plenty of plant fibre; probiotics if needed. *If you have any gut issues like food intolerances, IBS, painful bloating - your gut might need some extra loving with guidance from a naturopath* Lifestyle Vitamin D - helps protect our brain and modulate inflammation through the immune system. Vitamin D deficiency is scarily common (3). So many studies have shown improvements in mental health with a simple 10-15 minutes of sun exposure a day as it helps to balance serotonin levels (3). How nice does drinking your morning tea/coffee in the sun sound? Sunshine, done. Social interaction - find someone/ some people who you feel comfortable with, and just spend time with them. Social interaction allows for expression of emotions and thoughts, allows room for growth, and usually you feel better for it. Stress management - whatever this means for you (saying no, meditation, me time, breathing techniques, exercise, reading etc). Chronic stress changes how our brains are wired so our responses are more controlled by fight or flight rather than reasoning, and prevents us from creating new neurons (to rewire our brain)(2). Stress also breeds inflammation, and as I mentioned, inflammation is not fun for the brain. Supplements Fish oil - acting as an anti-inflammatory agent and also balancing the pro-inflammatory mediators that come from a lot of western foods (fried, packaged, high sugar foods) (3). Fish oil supplementation was shown to improve depression symptoms for up to 3 months after stopping the fish oil (2). Hint: you can also just eat fatty fish regularly too. Omega 3 fatty acids are anti-inflammatory. Sources include: fatty fish, seafood, grass fed beef, and less so in flax seeds. Omega 6 is pro-inflammatory. Sources include: processed oils - vegetable, canola & corn oil, as well as packaged food as they need to make the product cheaply. The balance between these two fatty acids is one of the reasons why I have recommended fish oil. It is largely omega 3 fatty acids and therefore anti-inflammatory. If you feel medication is the best course of action for you, this article by no means suggests otherwise. I merely recommend additional options. There is so much more I could talk about on this topic, but we would be here all day! So, for now, here's a sneak peak into some of the things that go into a mental health plan in regards to diet. References: (1) linked here (2) linked here (3) linked here (4) linked here

If you have been diagnosed or suspect you have PCOS, this could be a big eye opener for you. There have been several research studies clinically linking Polycystic Ovary Syndrome (PCOS) and subclinical hypothyroidism (not yet full blown hypothyroidism, as in diagnosable through testing) (Ding, et al. 2018). Meaning, you may personally experience the symptoms but your blood tests don't show enough of a irregularity to be diagnosed hypothyroid. Usually, it's common to see PCOS presenting with metabolic and cardiovascular conditions, such as insulin resistance, however, autoimmune thyroid disease has been reported in <40% of diagnosed PCOS individuals (Romitti, et al. 2018). Autoimmune thyroid (hashimoto's) and hypothyroid are different in how they are caused and treated, but the symptoms are the same. If you are experiencing these symptoms, autoimmune conditions should be ruled out: symptoms “such as poor ability to tolerate cold, tiredness, constipation, depression, and weight gain” as they relate to thryoid function (Ding, et al. 2018). Romitti, et al. (2018) suggests dysregulation of the hypothalamic-pituitary-ovary(gonadal) axis (HPG/HPO) as one of the mechanisms underlying PCOS. Potentially this is in addition to autoimmune causes with antiovarian auto-antibodies - this is not well supported, but more likely still causes immune dysregulation. Basically, the organs and glands which control a lot of bodily mechanics aren't communicating with each other clearly because; a) a gland or its product is not working appropriately or b) a gland is under immune attack = not able to do its job. Now, how is thyroid connected to PCOS you ask..? Ding, et al. (2018) and Romitti, et al. (2018) both suggest the oestrogen ‘dominance’ present in PCOS over stimulates the immune system and heightens the risk for autoimmune conditions. In more direct relationships, Lam (2020) discusses the OAT (ovarian-adrenal-thyroid) axis which controls the connection between your reproductive hormones, stress response and thyroid hormones. This axis is relatively unexplored as of now, however Lam suggests the imbalance in reproductive hormones (i.e. the ovaries and relative oestrogen dominance seen in PCOS) affects the adrenals and thyroid. He suggests the mechanisms include increased thyroid-binding proteins (= less active thyroid hormone), and interfering (stimulating) with cortisol release, cortisol-binding protein, and (inhibiting) metabolism, which are supported in the research papers (Santin & Furlanetto, 2011; Yates, 2010). This directly interfers with your thyroid function and stress response = a slower metabolism and higher chances of weight gain due to how cortisol and insulin interact. More independent research is needed to clarify (with data) the OAT axis and its implications, however the link between PCOS and hypothyroidism has been demonstrated over and over. Imbalances anywhere in the body affect other organs/systems so it is reasonable to suggest such organs communicate frequently. If you have any questions/comments, please leave them below and I'll do my best to answer them. Bonus note: There are different immune responses associated with different autoimmune thyroid conditions... though skip this part if you don't need the details. Th1-mediated autoimmunity is associated with Hashimoto’s, and relating to PCOS - androgens that are elevated in PCOS reduce areas of the immune system yet enhance T suppressor cell activity and Th1 response (Romitti, et al. 2018).

Article originally published for the May edition of Embrace Magazine. Ginger, the wonderful and warming spice, is a rhizome that originates from Southeast Asia. The plant belongs to the same family as turmeric, cardamon and galangal. The flowering portion looks amazing during Spring and Summer. While you may know this plant largely for its use in the kitchen, did you also know that it can be a healing medicine too? In the world of a Naturopath, Ginger is used for it’s circulation boosting effects, it’s warming digestive properties, and to improve nausea. The active components of ginger include; zingiberene, ar-curcumene, beta-sesquiphellandrene, beta-bisabolene, and gingerols (this one is responsible for the ginger smell). Some of these components help ginger to be a great gastrointestinal aid. If you have an upset stomach, cramps or ate something that didn’t agree with you - a bit of ginger tea can work wonders! Not only does it actively encourage food breakdown by stimulating digestive enzymes, ginger also speeds up the processing time of your food. Meaning, it helps to move food out of your stomach a little bit faster and it’s antispasmodic effects help calm down muscle spasms in your digestive system (read: bloating, discomfort, diarrhoea). This same antispasmodic effect, in combination with it’s warming circulation promoting effect is also a home remedy for period cramps. Something you may not know about Ginger, is that it can also improve your blood lipid levels and may improve triglyceride levels. So if you or a loved one has high cholesterol, try including more ginger in your diet. You can even get the pre minced ginger if you must. Chuck it in stirfry’s, marinades, sauces, in stews and soups, everything! A study by Alizadeh-Navaei et all (2008) demonstrated Ginger, at 3 grams per day, significantly lowered lipid levels; triglycerides and LDL cholesterol were down and HDL had returned to normal after just over a month. If you happen to have Type 2 Diabetes, or are prediabetic/ insulin resistant - Ginger is also for you. Not only are you more likely to have altered cholesterol and triglycerides due to diabetes, but Ginger can help improve your insulin response and your serum glucose. Remember I mentioned gingerols as an active component in Ginger? Well, those little compounds are the hero here. They are one of the main constituents responsible for improving insulin sensitivity (which means more glucose is absorbed rather than sitting in your blood stream). Among those very important actions that Ginger has, we should all know by now that this pure source of plant magic has more tools in its toolbox. Ginger is also antifungal, anti-viral, anti-inflammatory, anti-microbial, anti-oxidant, acts to reduce pain, AND helps protect your liver. Anyone fancy a cup of ginger tea now? All those actions are perfect for cold and flu prevention and recovery. As it’s now getting a bit chilly and cold’s are appearing throughout workplaces, I’ll give you my not-so-secret ginger tea recipe. Ginger tea for 2: ● 2 cups water ● 1⁄2 teaspoon ground turmeric ● 1⁄2 teaspoon chopped fresh ginger ● 1 tablespoon honey (raw or manuka if you like) ● 1 lemon wedge Bring this to the boil in a small saucepan and then simmer with the lid on for up to 10 minutes. Drink throughout the day for therapeutic effect. You can make a bigger batch or keep simmering down (lid off after 10 minutes) to a more syrup consistency (like a concentrate) which you then add to hot water when you want more tea! Feel free to add echinacea root or elderberries if you would like more immune support.

In women, there are two regulatory reproductive hormones that get a lot of attention: oestrogen and progesterone. Now, while these are incredibly important in fertility and regular cycles - we'll leave that for another day. We're here to learn about what else they do. After all, there are receptors for these two hormones all over the body. Oestrogen and progesterone are produced endogenously (inside/by your body) by the adrenal cortex and the ovaries from cholesterol. They are classed as steroid hormones, similar to the ones found in contraceptives - however those are exogenous (from outside the body) and not exactly the same. Oestrogen has responsibilities in other parts of your body besides your uterus, such as, your cardiovascular system, your bones, immune system, epithelial cells (skin), and your central nervous system. As an example, oestrogen communicates with the islet beta-cells in your pancreas to regulate insulin secretion. This is one reason why metabolic syndrome and diabetes come hand in hand with reproductive hormone disruption. Oestrogen is also important in energy regulation; oestrogen alpha-receptors in the brain talk to this funny thing called POMC to discuss food intake and also with SF1 (in your hypothalamus) to talk about how much energy you should use and where you should store fat. Without these receptors working properly or enough oestrogen, you would kinda want to eat all of the time. Of course, oestrogen isn't the only controlling factor here - but hormones are the master messengers. So what else does oestrogen do? Oestrogen keeps your skin young! (along with hydration and good doses of healthy fats). Your skin changes during your cycle, the thinnest point being when your menstruating - when oestrogen and progesterone are low. The thickness builds as oestrogen increases, just like the utrerine lining! This is also why skin care after 30 is so important, as oestrogen levels naturally fall (v slowly) and collagen synthesis is less stimulated. Skin firmness, elasticity, thickness and hydration all changes with oestrogen. Keratinocytes, which make up the majority of our outermost epidermis skin layer, are more active and more proliferative with healthy levels of oestrogen. They are also protected from excess inflammation by oestrogen (to an extent), as this magical hormone inhibits production of a signalling protein (chemokines) which triggers an inflammatory cascade. All the more reason to give your natural hormones free reign. What about progesterone then? Well, Progesterone is largely made after ovulation by your corpus lutem - this is the scar tissue where your ovulated egg just came from. If you don't ovulate, i.e. are on the pill, then good luck making this good stuff without it being in your pill. As part of reproduction, progesterone's main role is to maintain a pregnancy - low progesterone contributes to miscarriage risk greatly. During this time, progesterone also inhibits high levels of prolactin (to prevent lactation), stimulates hair growth, and prevents contractions through the relaxing GABA receptors. This gives a clue to other actions of progesterone, whereby it has an anxiety-relieving effect. This could be through three mechanisms. Progesterone gets metabolised (broken down) and it's metabolites positively modulate GABA-alpha receptors = relax mode. Regulation of gene expression for inflammatory mediators and neuroprotectivity. Activation of certain signaling cascades to change mitochondrial functioning. If your progesterone is low, you may experience more anxiety in the second half of your cycle, as this GABA-alpha receptor interaction is just one of the ways progesterone affects our mood. Progesterone (metabolites) also helps build strong myelin sheaths over your nerves, this helps protect nerves and enables them to pass signals on faster. Another thing progesterone helps to build, is bone. Oestrogen and progesterone both contribute to the formation of bone tissue through directly decreasing bone resorption and promoting osteoblast activity, respectively. That's a lot of information, and by no means the end of it. I just wanted you to see the cool parts. Did you learn anything new? Let me know in the comments what shocked you most! *Research papers have been hyperlinked, that's why some words are green.

Within saturated fats, we have further breakdown: monounsaturated and polyunsaturated. Monounsaturated fats come from olive oil, canola oil, peanut oil, and most nuts. They remain liquid at room temperature but will also solidify if cooled. Polyunsaturated fat includes omega-3 fatty acids (like what's in salmon, alpha-linoleic acid) and omega-6 fatty acids (found in soybean oil, linoleic acid). Polyunsaturated fats remain liquid at all temperatures. These are found in foods like vegetable oils (like olive, sunflower, and avocado), nuts, and seeds. Most plant sources are generally a mix of the two. The two types of fatty acids that our bodies need in order to function optimally, omega-3 and omega-6 can be found in plenty of places. The ratio of the two is just as important as the amount of each, since a diet high in omega-6 fatty acids has been linked to increased incidence of heart disease. Generally, omega-6 follows more pro-inflammatory pathways in our body, where omega-3 follows more anti-inflammatory. The ideal ratio is 4:1 omega 3 : omega 6. Let's break down some our most used sources of fats so you can make more informed choices about which kinds of fats you want to eat. Butter (organic to be specific) Butter is about 80% fat, and the rest is mostly water. It’s basically the fatty portion of milk that has been isolated from the protein and carbs. Butter is one of the most complex of all dietary fats, containing more than 400 different fatty acids. It is very high in saturated fatty acids about 70%) and holds a fair amount of monounsaturated fatty acids (about 25%). Polyunsaturated fats are only present in minimal amounts, consisting of about 2.3% of the total fat content. Other types of fatty substances found in butter include cholesterol and phospholipids. Around 11% of the saturated fats in butter are short-chain fatty acids (SCFAs), the most common of which is butyric acid (can be beneficial and anti-inflammatory). Organic butter tended to have slighter better omega ratios, compared to conventional or purely grass-fed [2]. Other nutritional components of butter include: Vitamin A. It’s the most abundant vitamin in butter. One tablespoon (14 grams) provides about 11% of the Reference Daily Intake (RDI). Vitamin D. Butter is a good source of vitamin D. Vitamin E. A powerful antioxidant, vitamin E is often found in fatty foods. Vitamin B12. Also called cobalamin, vitamin B12 is only found in foods of animal or bacterial origin, such as eggs, meat, dairy products, and fermented food. Vitamin K2. A form of vitamin K. Canola Oil Canola oil contains 7% saturated fat and 63% unsaturated fat (of which 11% is polyunsaturated). It's one of the best choices for cooking due to its mild flavor and high smoke point (the temperature at which it begins to burn). Both monounsaturated and polyunsaturated fats can improve cholesterol levels and lower your risk of heart disease. This ratio is quite good, to be fair, but the high smoke point can denature those healthy oils so keep the temperature down! Additionally, canola oil is super high in omega-6 which we know is inflammatory, so keep its use to an absolute minimum. Canola oil should not be confused with rapeseed oil (contains very high levels of erucic acid, a compound that in large amounts can be toxic to humans). "Butter is one of the most complex of all dietary fats, containing more than 400 different fatty acids." Ghee What's in ghee? Ghee is a type of clarified butter. It is made by heating butter until the milk solids separate, and then removing them. The resulting product has a higher smoke point than regular butter, so you can use it to cook at higher temperatures without worrying about burning it. Generally the nutritional content is not that far from butter, as ghee also contains butyric acid. The ratio of omega-6 to omega-3 is 1.5 canola oil. Ghee is popular in Indian cuisine, specifically in Ayurvedic medicine, where it is used as a cleansing agent. Ghee also has omega 3 fatty acids, which are generally only found in seafood—so if you're vegetarian you can still get these heart-healthy nutrients from ghee! It also has vitamin A, vitamin K2 (the kind that helps with bone density), and conjugated linoleic acid (CLA), which is known for its anti-inflammatory properties. It's linoleic acid and DHA content is what saves it, in addition to it's higher smoke point. Olive Oil Olive oil is a healthy source of fat because it contains mostly unsaturated fat. Yes, it has saturated fat too, but in much lower amounts than you'll find in food like butter or lard. So if you're diet is heavy on fatty steaks and pork, you may want to reach for this one over your butter or ghee. Olive oil contains less than 20% saturated fat and over 70% unsaturated fat. We know some saturated fats have been linked to increased risk of cardiovascular disease, so olive oil is generally considered good for your heart. Olive oil is also a rich source of omega-3 fatty acids, which have been shown to reduce the risk of heart disease, depression, cancer, and many other health problems. Margarine Margarine is a processed food that is designed to taste and look similar to butter. It is often recommended as a heart-healthy replacement, however don't let that fool you. Modern types of margarine are made from vegetable oils, which contain polyunsaturated fats that may lower the “bad” LDL cholesterol when used instead of [excessive] saturated fat. Since vegetable oils are liquid at room temperature, food scientists change their chemical structure to make them solid like butter. Hydrogenation increases the oil’s saturated fat content, but unhealthy trans fats are formed as a side product. If you are vegan or watching your cholesterol, you're better off just using olive oil or butter. The Takeaway Now that you understand that there are three categories of fats: saturated fat, unsaturated fat, and trans fats you are more able to make health conscious decicions based on your medical history. Ultimately, we cannot attribute all disease to a singular food. But it may be wise to limit not only our consumption of processed vegetable oils (see maragarine, i.e. nuttelex), but also excessive amounts of saturated fats. Cooking and consuming a mix of oils higher in unsaturated fats and animal products with saturated fats helps keep the balance. Resources for further reading: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2846864/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5409314/

Prebiotics and probiotics have been buzz words for the past couple of years, and as a naturopath and oestopath, they are incredibly important in a lot of my client care. In this article I'll briefly discuss what each are, where you can find them, and their benefits. Soon you'll be a gut expert! Probiotics - probably the most booming industry right now, probiotics are live bacteria or yeasts that benefit your digestive system and gastrointestinal tract (Gut). They are tiny, like the bugs that get you sick, but specific families and strains of bacteria/yeasts actually contribute to your good health in big ways. Most people would have consumed probiotics in some form recently - whether this be in their morning yoghurt, kombucha, saurkraut, miso, kimchi, sourdough or cheese. These are all examples of traditional foods which use fermentation to change the texture or taste of foods. Probiotics support healthy colony size of beneficial bacteria. Research suggests you should eat at least one to three different sources of probiotics each day. You can try a new one each week! Just be aware that not all probiotics mesh with your current microbiome (the incredibly unique combination of bacteria that inhabit you). If you experience increased gas, bloating, or discomfort - this is a sign that this is not the probiotic for you and you may have more luck with prebiotics. Prebiotics - these are the natural fibres found in fruit, vegetables and plants that feed your microbiome. Your microbiome break down and ferment those fibres which allows them to produce short-chain fatty acids (very important for a healthy intestinal lining) and some bacteria even produce necessary nutrients, such as Vitamin K and B12. The bacteria that make up your microbiome help you break down your food to get the most nutrition. The most notable families that benefit humans include Bifidobacterium and Lactobacillus generas. The strains and volume of these families are different in everyone, and can change depending on inflammation levels and largely - diet*. Since prebiotics are so various and easy to access, all you need to do is keep up your vegetable intake. The only catch being - you have to have variety. Variety is paramount to microbiome diversity and wellbeing. This is key as there are different types of prebiotics. *Fructans (FOS & inulin) - found in plants from the onion family, and banana. *Galacto-Oligosaccharides (GOS) - found in legumes, cashews, pistachios, some root vegetables, and dairy. Starch and Glucose-derived Oligosaccharides (see further down)^ Other Oligosaccharides (e.g. POS) - found where there is pectin, i.e. fruits. Non-carbohydrate Oligosaccharides (e.g. flavanols) - found in some cocoa, tea, grapes and red wine. FOS and GOS (the first two types) are by far the most used in clinical treatments, either via supplementation or via food. As you can see from their food sources the majority are found in the Allium (onion) family, legumes and vegetables. One vegetable stirfry (with shallots/onions), served with cold rice, red wine, and an apple hits all of the prebiotic groups. I'm not suggesting you eat this all the time, but as an example, you can see the implementation of variety of prebiotics is not difficult. Prebiotics should be eaten at minimum everyday , if not multiple times a day. Do you see any of your favourite foods match a prebiotic sources? Notes: *Specifically, intake of these prebiotics. ^Special note should be given to resistant startches which are a type of prebiotic. These are found in cooked and cooled grains/legumes, under-ripe bananas, and cooked and cooled potatoes.

Are you feeling super tired, lethargic, low, and wondering why? It could be one of a few things. You could be suffering from any of the following: food intolerance, leaky gut, stress, low cortisol, cortisol dysregulation, or hormone imbalances. Leaky Gut (and Dysbiosis) You may have a food intolerance or 'leaky gut', which is when allergens leak through the intestinal wall and into your bloodstream, triggering inflammation that makes you feel pretty crappy. Not to be confused with true allergies. Increased intestinal permeability needs to be dealt with as it affects your microbiome balance *negatively* and puts you at risk for disease. Nutrients like glutamine, zinc, quercetin, gelatin and collagen help heal the gut lining. While herbs such as green tea and turmeric support closing tight junctions and reducing inflammation. You might note other symptoms such as: Fatigue and brain fog Migraines Bloating Abdominal pain/cramping Nausea Gas/diarrhea/constipation Cortisol Dysregulation You may be stressed out a lot, and you might even be dealing with low cortisol or cortisol dysregulation. Cortisol is the hormone your body releases when it's under stress, and it can cause some serious mental changes if you're not careful. The response of cortisol helps to regulate sleep, appetite, and mood so we're not here to demonise this useful hormone. Cortisol dysregulation occurs when the body does not properly control the release of cortisol. The feedback loop is broken, which could be a result of the adrenals ignoring signals, or the receptors becoming desensitised. This can lead to negative effects on health, including poor sleep quality (!!), changes in weight and appetite, and mood disorders such as depression and anxiety. Please know that you don't have to be at the level of depression or anxiety to have altered mood. Low cortisol (often after chronic high stress) presents as: Anxiety Irritability and over-stimulated Inability to handle stress Fatigue and A feeling of being overwhelmed However, high cortisol can also look like mood swings, exhaustion and a low sex drive. Whichever you feel, we are able to sort it out. Testing just helps the process move a little faster. The image below shows the range for cortisol and the patient with low cortisol output. Some would note this as adrenal fatigue. Hormone Imbalance Lastly (but certainly not least!) it could be something to do with your hormones. If you've been feeling a little off lately, it could be due to the levels of certain essential hormones in your body. Hormones like estrogen, progesterone, and testosterone are responsible for many of our bodily functions—from appetite control to sexual response—and when they get off balance, they can cause a slew of unpleasant symptoms. We also must consider your thyroid function too. The thyroid often slows or stops the production of essential hormones, which can cause weight gain, dry skin, hair loss, fatigue, constipation, and cold sensitivity in hypothyroid. You're cold, constipated, and tired. You feel like you're living in a fog. You can't remember a time when you felt good. Hypothyroidism is more common in women than men, especially as they get older. But no matter why you feel tired all the time, know that we're here for you! We care about YOU—and we want to help you make things better! The most important thing to take away is that you are feeling like crap for a reason. It's not in your head and it's not because you didn't get enough sleep (though this might be possible too). If you related to any of the above, I urge you not to live with it, but do something about i and book an appointment. To here more about this topic - watch my live I recently did with Jessica Cox from JCN.

The postpartum period can be overwhelming, and often times you can become exhausted or suffer from nutrient depletion. This is a serious issue, so it's imperative that you pay close attention to your nutrition during this time. Many women experience weight loss, energy loss, mood swings and feeling depleted often around 3 to 6 months [or longer] after childbirth. The depletion is due to low levels of key vitamins, minerals and amino acids. With the prevalence in women seeking help and remedies to enhance their fertility, it has become an increasing concern. We'll discuss nutrient depletion in a nutshell, then go over ways to reduce the risk of depletion and to help you recoup your lost nutrients after child birth. During pregnancy the growing foetus/ then baby uses you as a source of nutrition. Everything you eat, they eat. While aiming to eat the best you can, sometimes the needs of a growing baby can be so great you have to dip into your personal nutrient reserves to properly nourish them. Vitamins and minerals such as magnesium, iron, choline, fatty acids and folate are needed throughout the pregnancy. In the last trimester typically large transfers of iron and vitamin D are provided for your baby. This can often leave new mothers with less than optimal levels, feeling fatigued. While in this state, it is an essential time to focus on your nutrition. If you choose to breastfeed, this depletion can worsen. Postpartum is an opportune time for disease, such as depression of hypothyroidism to set it. Nourishing yourself with nutrient dense wholefood should be a top priority. A focus on wholefoods is absolutely necessary. If nutrient deficiencies exist, they need to be addressed. There is so many great resources out there for pregnancy and post-partum. Lily Nichols book 'Real Food for Pregnancy' has excellent recommendations for such a time. Nutrients to focus on post-partum: Iron B12 Omega 3 Choline Vitamin D Now, considering two of these are common deficiencies in all women, I would highly suggest asking for blood testing before, during and after pregnancy. Why? Iron, choline and vitamin D are all essential nutrients needed for brain development. B12 and omega 3's are necessary for memory, nerve function and growth. Not only for your child, but for you. Deficiency in iron can appear as anxiety, fatigue, trouble sleeping, hair loss, thyroid dysfunction, and poor memory. Vitamin D and Omega 3's are so important for reducing the risk of postpartum depression. Herbally, to nourish and rebuild from an intense period of growth there is much we can do. Nettle to support iron levels Withania to provide deep nervous system nourishment Motherwort Siberian Ginseng to gently stimulate energy Oats to nourish the nerves Fennel to build milk supply Bare in mind that all these herbs should be used only under the direction of a qualified practitioner (such as our naturopaths) to ensure the correct dose and formula. Now that you know a little more about the demands of pregnancy and the postpartum risk of depletion, you can begin putting steps in place to reduce the risk. Meal prepping and freezing, ordering ahead of time, having a support network to help with household chores and care, and allowing for true rest. These are all positive steps to preventing disease postpartum and ensuring you have a positive experience. If you have questions about anything mentioned or would like to book in for our expertise, please contact mickayla@rosemarynaturopathy.com.au