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Fatigue an issue?

Top 5 reasons your tired

Fatigue is one of the most common complaints we hear about from our patients. To help them reach their goal of increased energy, we have to better understand what is driving their exhaustion to begin with. Many times, there’s not just one single reason people feel tired, so we really have to engage in critical thinking.

Luckily, there are some common factors involved in fatigue that help us narrow down the contributing factors so that we can get results for our clients. 

  1. Poor digestion and absorption – if the digestive system is not functioning properly it leads to an inability to absorb nutrients effectively. Energy comes in the form of food. If you are not effectively breaking down and absorbing your food, you can be left feeling overly tired. Symptoms like bloating, gas, constipation and loose stool or urgency issues coupled with fatigue can all be red flags indicating you need to find out more about what might be going on.   

Comprehensive testing can not only help us determine someone’s vitamin and mineral status but also helps us understand a patient’s digestive function, allowing us to create a plan of action to correct imbalances and function.  

2. Chronic Stress or anxiety – stress and anxiety interrupt proper digestion and have a negative impact on sleep. Additionally, stress can lead to adrenal insufficiency, a situation where the adrenal glands can’t keep up with the production of enough cortisol. Cortisol is a hormone that is released by the adrenals to help regulate blood pressure. When we are stressed, we release higher amounts of cortisol. The more stress or anxiety we encounter, the more cortisol we use and the system can become overtaxed, leaving us exhausted. 

3. Blood sugar dysregulation – feeling fatigued after meals or repeatedly feeling tired in the afternoons can be signs of blood sugar dysregulation. Sometimes low blood sugar is the issue but insulin resistance could also be at play. If you feel that your fatigue is situational in this way, you should consider having your blood sugar and insulin levels checked by someone that is willing to run the right markers and knows how to analyze them.

4. Thyroid dysfunction – hypothyroidism or low thyroid function leaves people feeling constantly fatigued. Most practitioners will only run a TSH (thyroid stimulating hormone) and maybe T4 blood test, missing very valuable information that helps us fully understand the whole picture when it comes to thyroid function. Adding T3 gives a more in depth look at thyroid function and Reverse T3 is helpful as well. If you are feeling tired all the time, consider working with someone that is a thyroid expert and knows what tests to run and how to approach correcting thyroid function.

5. Not engaging in enough body movement throughout the day – body movement increases circulation and therefore the amount of oxygen we receive throughout the day. Oxygen gives cells the energy they need to break down food which in turn gives us energy.

Our hectic lives and jobs that keep us bound to a sitting position way longer than humans were intended to sit, contribute to less body movement than is beneficial for our overall health and wellness but it also leads to fatigue. It may sound counterintuitive but the more you move your body the more energy you have. The less you move your body, the more tired you feel. And, it doesn’t take an hour of body movement every day to feel more energy. Simply getting up and walking around throughout the work day is helpful. Adding a short walk a few times a week before or after work can work wonders. Start small and work your way up, you won’t regret it! 

As you can see, there are lots of things to think about if you are suffering from fatigue. And, this is a partial list, to be honest. Working with a functional medicine practitioner means you will be asked all the right questions and have access to all the right testing options that can uncover answers to your fatigue once and for all. 

Reach out and schedule a consultation today! We would love to help bring energy back into your life. 

 

 

Inflammation: Fire

Long term inflammation is a major driving factor for the onset of most diseases. We strive to help our clients identify the underlying issues and imbalances in the body that contribute to chronic inflammation and address them, reducing inflammation and restoring health. We also work to prevent long term inflammation. Check out our latest video discussing chronic inflammation now.

 

 

Gallbladder issues?

Gallstones are not the only gallbladder issue that can cause us to feel terrible.

The gallbladder is responsible for the release of bile into the small intestines during the digestive process that helps break down and digest fats. Bile is actually made in the liver and then transported to the gallbladder, basically a holding and concentrating tank for bile until it’s needed. There’s a lot more to bile than this but that’s for another day. 

Most people are familiar with the symptoms of gallstones. According to the Mayo Clinic, they include:

  • Sudden and rapidly intensifying pain in the upper right portion of your abdomen.
  • Sudden and rapidly intensifying pain in the center of your abdomen, just below your breastbone.
  • Back pain between your shoulder blades.
  • Pain in your right shoulder.
  • Nausea or vomiting.

Here are some of the risk factors for gallbladder issues?

Being obese or overweight People who experienced a significant loss of weight in a fairly short period of time
Lack of exercise Pregnancy and childbirth
Native and Mexican Americans Women and adults over the age of 40
Having diabetes Low fiber diet
High fat diet High cholesterol intake

If the symptoms for gallstones don’t fit your symptoms but you experience indigestion, bloating after eating fats, acid reflux, or pain under the right rib cage, you may actually be suffering from gallbladder sludge.

What in the world is gallbladder sludge?

It is the buildup of bile that thickens causing the gallbladder to not be able to release it, forming what is known as gallbladder sludge. Over time, this sludge can form stones that can obstruct the gallbladder. Important note, gallbladder sludge isn’t always seen on imaging tests.

The symptoms for gallbladder sludge may seem very familiar to you….

  • Indigestion
  • Bloating and distention when you eat fats
  • Reflux
  • Diarrhea or floating stool
  • Oil in the toilet after a bowel movement

If you have been living with these symptoms and nobody has considered that the gallbladder could be the culprit, you should know that there are some health issues associated with gallbladder problems. Mainly, gallbladder issues can lead to a deficiency in fatty acids and fat-soluble vitamins A, D, E and K which can cause a whole host of health issues like cardiovascular disease, neurodegeneration, and also negatively affect the immune system.

It may be necessary for short term use of supplements that support the liver and gallbladder in order to turn gallbladder issues around. And, body movement can be helpful as well. 

Reach out if you feel like you might need help, I know all too well how gallbladder sludge affects our daily lives! There’s no need to continue to suffer.

 

Food reactions leaving you confused?

Have you ever been caught up in the cycle of eating the same 5 to 10 foods for months at a time?? As in, every. single. day. Are you reluctant to move outside of your comfort zone and add new foods to your diet because you are afraid of how your digestive system might react?

It is not uncommon at all for people with chronic digestive issues to experience what is known as “loss of oral tolerance.” This means that the immune system has a malfunction and is tagging undigested food proteins as foreign. While it is an immune issue, it has its roots in digestive dysfunction.

If you react to lots of different foods and have dwindled down your food selection from eating a wide variety of foods to just a handful, you may be experiencing food sensitivities.

Maybe you thought you had food allergies but when you went to the allergist, you came up empty handed. Maybe you have tried an elimination diet and food journaling with little to no solid leads on what is causing your symptoms? Frustrating, I know.

It could all come down to immune tolerance, the immune system’s ability to not react to chemicals, food proteins or even the body’s own organ tissue.

Luckily, there are ways that you could improve your immune tolerance and start adding new foods back into you diet, just the way it should be!

First, you should know that food allergies differ from food sensitivities.

A true food allergy usually comes on very quickly after even limited exposure to small amounts of the food and happens each time you consume it. Allergies can cause hives, itchy skin or a rash as well as more serious symptoms including shortness of breath, chest pain or even difficulty swallowing. As you can see, the response can affect the entire body, not just your digestive system. Food allergies are what’s known as an Immunoglobulin E (IgE) response by the immune system. Generally speaking, most people with a true food allergy are well aware of it and steer clear of the offending food(s) at all costs.

More common are food intolerances and sensitivities. Here’s a quick overview of the differences between the two:

A food intolerance means the body lacks an enzyme needed to breakdown a specific food which then triggers a response by the digestive system. Think lactose, found in milk. If you don’t produce the enzyme lactase, you can’t properly breakdown lactose, leading to unpleasant symptoms after consuming milk.

Food sensitivities occur when a particular food or group of foods trigger an Immunoglobulin G (IgG) immune response. This type of immune response is usually delayed by up to 72 hours, making it difficult to pinpoint which food caused the reaction. Symptoms can range from bloating, diarrhea, stomach pain and migraines and are not life-threatening like some true allergies can be.

If you have symptoms of loss of oral intolerance and are ready to do a food sensitivity panel or need help better understanding where to start in this seemingly overwhelming process, reach out and schedule an appointment today. Not all tests are created equal (something you will often hear me say) and 99% of food reactivity tests only tell half the story. A lot of our clients never even need a food reactivity test at all. Let us help you move past food reactions!

 

The Human Microbiome

One of the most important, exciting and fascinating aspects in the understanding of human health is the human microbiome (IMO).

Do you remember when the world was waiting on pins and needles for the completion of the Human Genome Project? The research project that began in 1990 endeavored to sequence the human genome to determine how many genes we humans have and the significance of our genetic make-up where health and disease were concerned. What I remember most when the results were released in 2003 was that humans are no more genetically complex than the common fruit fly with roughly 20,000 protein-coding genes. Mind blowing.

While great advancements in human health and science have been made because of this research project, they seem small (to me) compared to that of the Human Microbiome Project that followed in 2007.

The Human Microbiome Project was established to identify the collection of microorganisms that reside in and on the human body that is referred to as the microbiome. Aside from labeling our roommates, researchers also wanted to understand the role they play, both individually as well as collectively, in human health and wellness. It was initially slated to be a five-year, worldwide effort but the research continues and has been the catalyst for an explosion of studies outside of the original project. My guess is that it will continue for as long as humans exist. In fact, over the past five years, there were more than 50k studies published on the human microbiome! What I love about the current research is that it has become more focused.

Some amazing information has come out of these studies and many of them show that imbalances in our internal ecosystem are directly related to clinical and chronic illness.

Of particular interest to me as a Nutritionist that works with people suffering from chronic digestive issues is the ongoing research on Inflammatory Bowel Disease as well as the intimate connection between the trillions of bacterial organisms that make up the microbiome and the function of the immune system.

Studies like this one published in Cell (2020) show that the immune system is reliant upon proper signaling by the microbiome before it will initiate an immune attack on undesirable organisms.

In October of last year, this study was published in Science Translational Medicine. It is a great example of the current research going into understanding how dietary habits may be contributing to the onset of Inflammatory Bowel Disease.

The list could go on and on but what I want you to take from this is that we have learned an enormous amount about how proper function of the human body is reliant upon the balance of some 40 trillion microorganisms.

Research has determined that the healthiest people have the most diverse microbiomes. So, how do you achieve a diverse microbiome? Here are three things that greatly impact the diversity and balance of the microbiome:

1. Eat a diversified diet packed full of as many fruits and veggies as you possibly can each week. Want a challenge that could be more difficult that training for a marathon?? Try seeing if you can eat 30 different fruits and veggies in a week. That seems to be the magic number.

2. Check your sleep cycles and stress levels. Both of these are naturally connected; if you don’t sleep well, you get stressed and if you are stressed, you don’t sleep well. A vicious cycle. The microbiome is very much affected by lifestyle factors such as these. Start a new practice of checking in on both of those items and come up with a plan to address either or both if necessary. Your gut will thank you!

3. The human gut microbiome can be easily disturbed upon exposure to a range of toxic environmental agents. Try to limit the usage of antibiotics, pharmaceuticals (if possible) and chemical exposure such as pesticides, food additives and flame retardants, just to name a few. Check out the Environmental Working Group to find out more about where harmful toxins might be lurking.

I will leave you with this:

Growing up I recall thinking that bacteria was a bad word, something harmful and scary. And they can be but what we have learned over the course of the last 100 years and more significantly, over the last decade proves that not only do we need bacteria to function properly, but we are also (genetically at least) more microbe than human!

Now, don’t forget to love your bugs.

 

Do you suffer with bloating?

I had never experienced what it felt like to not be bloated until about 7-8 years ago. We’re talking about decades of bloating!

I tried to pinpoint what might be the culprit to this uncomfortable and embarrassing symptom. I started paying closer attention to what I was eating and then began implementing some new strategies. The moment came as I was putting on a pair of pants. The pants were not new but this time, things felt different. There was no struggle and no super snuggle. I just stood in the closet and felt a sense of huge accomplishment.

What I learned over the years was that there are several different reasons someone might be experiencing bloating after meals:

  • If you feel bloated after a meal with protein, you might be low in something called Hydrochloric Acid
  • If you feel bloated after a meal high in starches, you could be low in pancreatic enzymes.
  • If you feel bloated after a meal that has a lot of fat (good or bad, makes no difference) you could have gallbladder issues. (more on this topic soon)
  • There are some people that actually say they are bloated after every meal, regardless of what they eat. All foods cause issues. You might be looking at a case of what is known as Small Intestine Bacterial Overgrowth or SIBO for short. More on this in a future post.
  • If your bloating is dependent on portion size, you could be looking at an issue with the Gut-Brain Axis.
  • Lastly, chronic constipation can lead to dysbiosis (imbalances in the microbiome) which can cause bloating.

To be honest, it can be tricky to determine which of these (or groups of these) could be the cause of your discomfort.

My first course of action would be to start journaling. I recommend including what you ate throughout the day, how you felt before and after each meal, snack or even fluid intake, consistency and frequency of your bowel movements, daily exercise, stress and any other symptoms you may have experienced throughout the day.

No fancy journals are needed (although if that motivates you, go for it). Just use a post it note or pad of paper, your calendar, even an app if you are technically inclined. Journaling can bring awareness to so many of our daily habits that we aren’t even thinking about and in turn, you could uncover some areas that might be causing your symptoms!

If after you have tried to pinpoint the culprit, you come up empty handed, give us a call! There is usually more to the story than meets the eye and we can guide you through the process of moving past your bloating once and for all. 

 

 

Constipation could be connect to thyroid function

No two cases of constipation are precisely the same. There are many potential underlying issues that could be at play with constipation. 

Interestingly enough, one of those underlying issues is unmanaged hypothyroidism. 

The contractions that move food through our digestive tract (aka Intestinal motility) are dependent upon thyroid hormones and therefore proper thyroid function. 

A lack of sufficient amounts of thyroid hormone negatively affects the time it takes for food to move through all the processes necessary to breakdown, extract nutrients and send out waste for elimination. This process is called transit time. 

Transit times slow with low thyroid, leaving us with a much greater chance of bacterial and yeast overgrowths as well as imbalances in the gut microbiome which is home to trillions of organisms that affect our health and wellness.

Even if you eat extraordinarily healthy, if you deal with chronic constipation where you reach for caffeine, laxatives, or magnesium (or even enemas) to maintain regular bowel movements, you would want to get your thyroid checked by a thyroid expert. This means someone that will run all the right tests and develop science backed strategies to get your thyroid functioning as it should. 

If you are dealing with constipation, reach out so we can help you uncover the type of constipation you have and build a plan to help you move past constipation and avoid future digestive issues.

 

What is Hydrochloric Acid?

The stomach has a unique environment where the pH is substantially different from anywhere else in the digestive tract. Stomach acid (Hydrochloric Acid or “HCl”) acts as a protective mechanism that helps to kill incoming pathogens that make their way into the body via food and fluids. 

This highly acidic environment requires a pH of between 1.5-2.5. When the pH drops below 3.0, it initiates the closure of the LES (lower esophageal sphincter – the valve between the stomach and esophagus), preventing the contents of the stomach from traveling back up the esophagus, which cannot tolerate the high acid contents of the stomach. Not producing enough stomach acid is much more common than over production and is, we now know, the main cause of heartburn, acid reflux and GERD. 

That said, HCl does so much more than simply protect us from pathogens. It plays other very important roles in digestive processes. 

HCl acts as a signaling agent for the release of bile and digestive enzymes. Bile emulsifies fats and digestive enzymes break down starches (plants and carbohydrates). HCl itself works to break down protein. Without proper HCl, we are left with ineffective breakdown of all three macronutrients (protein, fats and carbs). This leads to vitamin and nutrient deficiencies. Remember, the digestive system is responsible for providing nutrients to every cell in our bodies, it is the way we get energy to cells to perform the countless tasks they have every moment of our lives. Low stomach acid prevents cells from optimal performance, impacting our entire body. 

When we fail to properly break down food, we increase our risk of maldigestion and malabsorption, both of which leave us vulnerable to developing food reactions or sensitivities. When we encounter an increase in food reactions it means our immune system has been involved in tagging food proteins as foreign which is the beginning of a whole host of issues including chronic inflammation and the potential for developing autoimmune disease. 

Aside from food reactions, low stomach acid also contributes to an inability to properly sterilize the small intestines which can lead to small intestinal bacterial overgrowth (more on SIBO in another post). This altered pH status in the stomach also negatively affects the large intestinal environment which is home to trillions of bacteria, allowing for limits in microbiome diversity and the overgrowth of organisms in the large intestines. (check out more about the microbiome now). 

Hypochlorhydria is the clinical term for low stomach acid, an under-researched and dangerous condition. Every time you take antacids, H2 blockers or PPIs, you are contributing more to this problem (which may be one reason you develop heartburn in the first place). 

As you can see, what might seem like a simple issue at the top of the digestive tract can snowball into a much larger, systemic issue if left unchecked. 

 

Helicobactor Pylori – a pesky stomach bacteria you should know about

Helicobacter Pylori or H. Pylori is a type of gram-negative bacteria that can cause serious issues in the stomach.

How does someone develop a H. pylori infection?

It can be passed from person to person living in the same household through saliva, vomit or fecal matter. Or, you can be infected by drinking contaminated water or eating contaminated food.

Wondering what the signs and symptoms of a H. pylori infection are? Let’s take a look:

  • Burning in the stomach or a stomachache
  • Nausea and vomiting
  • Abdominal pain that gets worse when you don’t eat
  • Loss of appetite
  • Unintentional weight loss
  • Bloating
  • Heartburn and acid reflux

Health concerns with H. pylori you should know about:

Aside from symptoms listed above, (which, by the way, are not common for many people. In fact, some people are asymptomatic and don’t realize that it could eventually cause other health issues) an H. pylori infection can cause considerable health issues.

  • It can suppress our parietal cells which release Hydrochloric Acid (HCL). Reducing HCL can lead to iron, B12 and calcium malabsorption, contributing to anemia, malnutrition and osteoporosis.
  • Additionally, low HCL can reduce diversity in our microbiomes and eventually contribute to Small Intestine Bacterial Overgrowth.
  • If that isn’t enough, it can also lead to increased risk of cancer, autoimmunity, gastritis, type 1 diabetes and cardiovascular disease.

How to determine if you have H. pylori

Anytime you have recurring stomach pain or digestive issues, you would want to reach out to a trusted practitioner. There are different ways of assessing whether or not you have contracted H. pylori.

A blood test can be run to see if you are producing antibodies for H. pylori. Honestly, this is the least effective option but can still be useful for starters.

You can speak with your GI Specialist about an upper endoscopy. This is a procedure that requires light sedation. They thread a long, flexible tube with a camera through the upper part of your digestive tract, down into your stomach where H. pylori can be found. They are able to visually see any inflammation and also take biopsy samples to test.

If you do have an H. pylori infection, your doctor will likely prescribe antibiotics. If you don’t want to go that route, there are botanical protocols that can serve the same purpose. Creating an environment that H. pylori finds it difficult to thrive in by working with a practitioner who can help determine your levels of HCL and the right supplemental dose for your body is really important as well.

In our opinion, the best option is a comprehensive stool test that can detect proteins associated with an infection related to H. pylori. It is very reliable, and not only detects the bacteria but also quantifies it. All stool tests are not created equally by the way. We only run gold standard stool tests. 

One thing that is sometimes helpful for people experiencing the symptoms above, is to reduce your intake of spicy foods, alcohol and caffeinated beverages like sodas, coffee, and some teas. This can help ease symptoms if you have any. That said, this is not the fix, it is only a means to relieve symptoms that are really trying to tell you that something needs your attention. Heed the warnings. 

Eating small meals more frequently can also be beneficial if you experience stomach pain or burning when you haven’t eaten.

If you have unexplained upper GI issues, reach out and let’s chat!

 

Acid Reflux? Heartburn? GERD?

Roughly 1/3 of the adult population in the U.S. suffer from acid reflux. That’s a lot of unhappy people!

If you are one of them, you have almost certainly been prescribed a proton pump inhibitor (PPI). Prilosec and Nexium are two PPI brands you might recognize. A PPI is used to reduce the amount of hydrochloric acid (HCL), sometimes called stomach acid.

The acid reflux, heartburn and/or indigestion you experience could mean your HCL is too high. But, it’s more likely that your HCL is too low.

Let’s take a step back real quick.

What does HCL even do in the body?

  • It helps break down, digest, and absorb nutrients. 
  • It serves as a first line of defense against incoming pathogens.
  • Creates a sterile environment for the gut.
  • Changes the pH balance in the digestive tract.
  • Impacts microbiome diversity.

What are some of the causes of low HCL?

 If you are over the age of 65, that could be a major contributing factor as HCL gradually decreases over our lifespan. Other reasons include things like chronic inflammation in the gut, gluten sensitivity, stress, thyroid issues, diet, and medications. One of the more common reasons is a Helicobacter Pylori (H. Pylori) infection. I will be speaking about this pesky bacteria soon.

How do you know if your HCL is high or low?

If you find that your acid reflux symptoms are not subsiding and you reach for acid blockers frequently, it’s a strong indication that you probably are not producing sufficient hydrochloric acid and it would be wise to supplement with HCL. That said, if you decide to take HCI and feel discomfort,  you could actually have stomach inflammation or even ulcers caused by an H. Pylori bacterial infection.

We all have low levels of H. Pylori but nearly 50% of Americans have an over abundance of H. Pylori. It is wise, if you have these issues, to run a comprehensive stool test and have it interpreted by someone trained to do so. We can help out if you are interested.

As a side note, if you have indigestion but not necessarily acid reflux, it may be due to gallbladder sludge. There will be more to come on the gallbladder soon! 

Regardless of high or low HCL or gallbladder sludge, it is imperative to get to the bottom of your acid reflux, indigestion or heartburn once and for all. Acid blockers are not long term solutions and can actually do more harm than good. 

Comprehensive blood work and stool testing helps us better understand the causes of your acid reflux. It’s best to test and not guess.