If you thought your fingerprint was the most identifying thing about you  – wait until you dive into the vast expanse of your gut microbiome.

The remarkable importance of our gut health as it relates to both disease and wellbeing is an area of medicine that’s only scratching the surface now, and amazing research is coming to light. The human microbiome (which emcompases ALL of our microbes, probiotics and genes) is extremely vast, and is estimated to have a surface area of an entire tennis court. Imagine all of that internal space interacting with the outside world around us.

Our gut is the major way that we interface with the environment that nourishes us.

Through the foods that we eat, the environment we live in, the air we breathe, the water we drink and the pollutants that surround us – the gut microbiome is in contact with all of it. Within our gastrointestinal tract, the collective human gut microbiotia contains over 35,000 bacterial species including fungi and yeast, protozoans and archaea. The intestinal tract alone outnumbers human cells in our bodies by ten to one (some 100 trillion microorganisms). So, in reality, we are ten parts bugs and one part human (cells). Without all of these beneficial bugs, our interactions with the outside world would be much harsher, and we would be subject to almost every passing illness that came our way. This incredible microbial diversity is what is keeping us alive and resilient, and much of our time and attention should be paid to maintaining that diversity and overall balance.

Not only is the gut microbiome essential for our immune protection and digestion, it houses an entirely separate nervous system (the Enteric Nervous System), that operates completely independently from the central nervous system yet communicates directly with it.

The enteric nervous system is extremely active, and 90% of the signals passing along our vagus nerve come from the enteric nervous system including most of our emotional (or “gut reaction”) communications. Not surprisingly, several of our mood hormones are manufactured in our gut (not the brain) including serotonin and dopamine, and our emotional health is dependent on our ability to manufacture these hormones daily. Disruption on the gut microbiota has been linked to mental health conditions, addiction behavior, and even anxiety and depression. This is a common occurrence when folks have been on several rounds of antibiotics over a short time. The antibiotics wipe out the beneficial gut organisms, leaving the body exposed to illness and depleting the immune system, and without proper re-population of the probiotics afterwards, it takes several months (and even years) to regain what was lost.

These carefully curated and symbiotic bacterias in our gut are essential in managing appropriate digestion, including absorbing and metabolizing nutrients in our foods, mediating our immune response to external pathogens, continually developing and repairing our immune system, and creating an intestinal barrier function and overall regulation from the external environment.

Bacteria in the body is not only healthy, but also necessary!

The human microbiome can be likened to garden soil (you can read more about that here). Basically, you want your garden soil to be rich in nutrients, full of beneficial critters like earthworms and bacterias, and you need lots of sunlight and good quality water to keep that soil fresh, hearty and teeming with life. Good soil is essential for good produce. Without all of these environmental inputs, you end up with anemic and nutrient devoid produce. The same can be said when nourishing your gut microbiota. You need diversity in your flora/bacteria (from exposure to lots of different environments and foods), you need perpetual high quality nutrients absorbed from your foods, uncontaminated water, and exposure to the outdoors (especially vitamin D from sunlight). Without all of these inputs, the body becomes weak, absorption of nutrients is compromised and we end up developing disease. This is a constant process, and something we should be thinking about every single day with the lifestyle choices that we make.

Here are some ways to tend to your gut microbiome on a daily basis to continually support your gut health:

• Eat fresh, nutrient rich, whole foods every day (the more colorful, the better!)
• Consume fermented foods daily including sauerkraut, kimchi, kombucha, miso, yogurt or kefir. Fermented foods have naturally occurring probiotics in them.
• Decrease your stress level. Cortisol (our stress hormone) is inflammatory to the gut over time. Decreasing stress = decreasing inflammation in the gut.
• Supplement with a good quality probiotic that has at least 10+ bacterial strains.
• Avoid foods that cause pain, discomfort, gas, bloating or irregular bowel movements.
• Drink filtered water every day. At least half your bodyweight (in ounces) is recommended.

If you are experiencing any digestive issues or are simply looking to improve your gut health, please contact our office at (804) 977-2634 to schedule an appointment with one of our practitioners.

What is PCOS?

PCOS is one of the most common women’s health concerns affecting hormonal balance. The syndrome involves an excess of androgens (what we know as male hormones: testosterone, DHEA), menstrual irregularity, and cystic ovaries.  

Approximately 5-10% of women ages 18-44 years old are affected by PCOS.  Because the criteria that are used to diagnose PCOS are still changing, the exact number is unknown and difficult to estimate. 1 2

What are the criteria to diagnose PCOS?

To be diagnosed with PCOS, a woman must present with two out of the three Rotterdam criteria: 2

• Oligo or anovulation (irregular menstrual cycles)
• Hyperandrogenism (clinical and/or biochemical)
• Polycystic Ovaries (on ultrasound)

What are the signs and symptoms of PCOS? 1 3

• Menstrual Irregularity:
  • Delayed onset of first menstrual cycle
  • Infrequent or absent menstrual cycles
  • Infertility (lack of ovulation)
• Hyperandrogenism:
  • Acne
  • Hirsutism (excess coarse male pattern body hair growth – common on the upper lip, chin, chest, and below the belly button)
  • Thinning hair
  • Skin tags, patches of skin that appear dark brown/black
  • Elevated testosterone and DHEA
• Metabolic Issues:
  • Weight gain (40-85% of women with PCOS are overweight or obese)
  • Sleep Apnea (short periods where breathing stops while sleeping)
  • Insulin resistance (blood sugar imbalance)
• Mood dysregulation:
  • Depression
  • Anxiety
  • Eating disorders

Women with PCOS are at Increased Risk for: 1 3

• Metabolic Syndrome
• Type II Diabetes
• Obesity
• Heart Disease and High blood pressure
• High cholesterol
• Mood disorders
• Endometrial hyperplasia and endometrial cancer

What causes PCOS? 1 3

Currently, the exact cause of PCOS is unknown; this is due to the fact that there are a number of factors that contribute to the development of PCOS.  Genetics do play a role, you have a greater chance of developing PCOS if your mother or sister have it. Excess inflammation, body weight and insulin/blood sugar imbalances also contribute to PCOS.  

How is PCOS treated?

There are a number of medications often prescribed to treat the symptoms of PCOS, these may include birth control pills to regulate your menstrual cycle, spironolactone for the excess hair growth, metformin for blood sugar balance, and/or clomid to induce ovulation.  These are all symptomatic treatments, that do not exactly get to the root cause of the issue. 4

The naturopathic approach to PCOS is quite different.  We look into your whole health history to find out what may have lead to this imbalance in the first place. We will review what lifestyle factors and stresses may be obstacles to your healing. Lab work and imaging will also be reviewed to guide us in rebalancing the endocrine system.  Treatment will include education around lifestyle and dietary changes that can support your body.  And we may use tools including herbs, homeopathy, vitamins, and supplements to regulate your hormones, blood sugar, and mood naturally.

Types of therapies may include:

• Diet and Lifestyle Support:
• • Dietary assessment and adjustment to focus on whole food diet with adequate protein, vegetables, and healthy fats to balance blood sugars, lower cholesterol and modulate weight.
    • Loss of 5% of body weight has been shown to decrease symptoms associated with PCOS. 4

• Herbal Support:
• • Liver supporting herbs such as milk thistle, white peony, or dandelion root may be used to aid the liver in metabolizing and regulating hormone balance.
  • Hormone modulators like chaste tree or saw palmetto may be used to decrease testosterone and balance female hormones.
  • Adaptogens like eleuthroccocus and licorice may be used to buffer your bodies stress response and decrease the impact extra cortisol (the stress hormone) has on blood sugar.

• Vitamin, Mineral, & Nutrient Support:
  • B vitamins are important in all biochemical reactions in the body, they are involved in hormonal metabolism and they feed the adrenal glands (the stress managing gland).
  • Mineral support including magnesium, zinc, chromium and other trace minerals. These minerals play a number of roles in the body, from blood sugar and hormone balance, to proper heart and brain function.
  • Omega 3 Essential Fatty Acids are anti-inflammatory and play an important role in hormone production and modulation of cholesterol.

These are just some of the many options and treatments that may be used in the natural treatment of PCOS.  Naturopathic treatment plans are extremely individualized and are unique to each patient.  Reminder: we are treating the person not the disease.

Disclaimer: This advice is for informational purposes only. It is not meant to replace a consultation with your healthcare provider.  Your naturopathic doctor will choose individualized therapies that are most appropriate for you and for your current needs.

Need a few simple, easy practices for a healthier holiday? Here are some tried and true nutrition and herbs to help get you through a nutritionally challenging time of year.

During this time of year, over-eating is quite common, and even with the best “restrictive” or “conscious” eating practices in place, our digestion can use extra support.  This season, feel more in control of your diet with these easy practices.

CCF Tea 

Also known as Cumin Coriander Fennel tea, this simple little herbal blend is such a remarkable aid for your digestion before, during and after meals.  You likely already have these three common herbs in your kitchen pantry, and simply combining ½ tsp of each and steeping in 1.5 cups hot water for 10 minutes creates this deliciously soothing blend. You can also try Pukka’s Detox Tea which is a similar formula in tea bag form.

Switch out your sugars 

Try to avoid the alarmingly high processed sugars that are in almost every packaged/baked good on the market right now. This includes: Sugar, cane syrup, cane sugar, brown sugar, raw sugar, high fructose corn syrup, malt sugar, confectioners sugar, maltose, dextrose, sucrose (almost any ingredient ending in “ose” is a sugar), and beet sugar. 

Instead, keep 2-3 natural sugars on hand to bake/cook with that are far more nutrient dense and less inflammatory to your body and digestive tract. These include honey, maple syrup, dates and date sugar, coconut palm sugar, agave, stevia, or just fruits (which contain natural fructose). Initially, these natural sugars will not taste nearly as sweet as the processed sugars that you’re more used to, but over a few days your taste buds will adjust, and they make excellent substitutes to any dish or dessert where you would normally use processed sugars.

Expand your grains

You may traditionally be baking with the same flour over and over again (likely white or whole wheat flour), and this can get monotonous over time. White and whole wheat flours are still highly processed and often stripped of their innate nutrients during processing.  Give your body some variety and added nutrients by switching up your grain choice to more nutrient dense and less processed options such as spelt, einkorn, oat flour, almond flour, rye, or even buckwheat flour. Whole grains are extremely nutrient dense, containing minerals such as magnesium, potassium, folic acid, fiber, fatty acids and even proteins. Many of these grains can be easily made at home by simply grinding up the whole grain in your food processor until it’s a flour consistency. Otherwise, they are available at most grocery stores or in the bulk sections of health food stores. 

Take your Bitters

Herbal bitters are a life saver for heavy holiday meals and aiding digestion when traveling. Bitters help to stimulate your digestion to naturally create extra digestive enzymes to help the stomach break down your macro molecules (proteins, fats, carbs etc) into small more absorbable pieces once they get to your intestines. They’re also supportive of liver detoxification, pancreatic health and enhance nutrient absorption of your foods! You can try Urban Moonshine’s bitters, or have a practitioner here make you some to keep on hand.

Don’t set yourself up for “failure” 

This is the worst time of year to go on a diet or set restrictive parameters around what you can and can not have. Many people assume that their willpower is stronger than it actually is, or that peer pressure won’t have a persuading effect on them, or that it will be “easy”. All of these are extremely difficult to stick with, and if you set yourself up by taking on too many “goals” – you’re likely to overwhelm yourself. Rather, pick one small change that you’d like to work on and really focus on it. For example, focus on not overeating at meals and only eat until you feel ¾ full. Or pick one meal per day that you can avoid sugars completely. Or bring your own snacks into the office and try to avoid the dreaded candy bowl. One thing really adds up over time, and it’s easier for you to focus on small goal and loads of difficult ones!

If you’d like help with your diet through the holiday season or thereafter, consider an appointment with one of our practitioners by calling the office at (804) 977-2634

The holidays can often be challenging when trying to balance the sweet and savory with the nutritious recipes.

Whether from your garden, market or frozen section, below are some great recipes to try this holiday for some added nutrition and a splash of color!

Uncle Johns Winter Collard Greens
*Collards are definitely in season now, and taste AMAZING after a frost! We collect ours from our garden out back, and local grocery stores should be well stocked this time of year.
1-2 bunches of collards, chopped (1 bunch per 2 people)
1 whole yellow onion, peeled & chopped
5 cloves fresh garlic, minced
3 tbsp olive oil
2 tsp soy sauce
In a large pot, simmer the onions and garlic in olive oil until just tender. Add in the chopped collards, stir and cover with a tight fitting lid. Reduce heat to low and let steam for 25 minutes. Stir occasionally. They will cook down a LOT.
Once cooked, remove lid and add soy sauce. Stir well and serve.

Squash Posh
6 – 7 yellow squash sliced and steamed
2 large carrots, slices and steamed
½ crown broccoli, chopped and steamed
(Yes, you can steam them all together at once!)
1 onion, sliced and sautéed lightly in butter (substitute earth balance for dairy free)
2 – 6 cloves garlic, minced
1/2 – 1 cup grated cheddar cheese (Substitute nutritional yeast for dairy-free)
large scoop of mayonnaise (Substitute veganaise for dairy free)
2 eggs
Combine mayonnaise, eggs and cheese in a large bowl; add steamed vegetables, sautéed onions and garlic; mix well. Pour into a baking dish. Bake at 350º for 30 – 45 minutes.

Simple Steamed Broccoli
1-2 broccoli crowns, chopped into bite sized pieces
½ lemon (juiced)
2 tbsp parmesan cheese
1/4tsp salt
In a large pot or steamer, steam the broccoli until a vibrant green (about 12 minutes). Remove from heat and transfer to a large bowl. Sprinkle the lemon juice, parmesan cheese and salt on top, mix well and serve piping hot for a splash of green!

Sweet Potato Casserole
This one is basically our dessert – a real sweet treat!
6 medium-size sweet potatoes
¼-1/3cup cup brown sugar (can substitute 1/3 cup honey if desired)
2 eggs
1 teaspoon vanilla extract
1/3 cup milk (unflavored coconut milk makes a nice substitute for dairy free folks)
1/2 cup butter (or earth balance if dairy-free)

Cook sweet potatoes in boiling water 45 minutes to 1 hour, or until tender. Let cool to touch; peel and mash. Combine sweet potatoes, sugar/honey, eggs, vanilla, milk, and 1/2 cup butter; beat at medium speed of an electric mixer until smooth. Spoon into a lightly greased 12″ x 8″ z 2″ baking dish.

Optional Topping (if you really want this to be dessert…)
1/3 cup firmly packed brown sugar
1/3 cup finely chopped pecans
2 Tablespoons all-purpose flour
2 Tablespoons butter
Combine brown sugar, pecans, flour, and 2 tablespoons butter; sprinkle mixture over casserole. Bake at 350º for 30 minutes. Serves 8.

If you are interested in refining your diet and receiving helpful guidance, please contact our at (804) 977-2634 to book an appointment with our Nutritionist, Dr. Viktoriya Beliy.  Have a safe and happy holiday!

Traveling with your food allergies can be a tricky task, especially when you’re confronted with lots of new foods at the table of family and friends.

Tis the season for lots of food, family gatherings and plenty of travel time!  It’s best to prepare ahead and allow yourself plenty of time to search for ingredients or chart your travel course (what foods are available along the way).

Here are some tips for keeping yourself well fed and feeling great while on the road or away from home:

1. Familiar snacks are your new best friend. While you’re still at home, find some travel friendly/shelf stable snacks that you can take with you on the road.

2. Prepare allergy-friendly recipes before you travel and gather ingredients to take with you if you’re contributing a dish to the holiday table. Don’t expect unique ingredients to be available at every store around the country – sometimes they can be impossible to find especially around the busier cooking times of year.

3. Digestive enzymes can rescue you from un-expected foods that sneak in. If you have a specific food allergy that can be aided by the use of digestive enzymes, make sure to keep a small bottle with you in case you accidently ingest something that can cause some problems later. Herbal bitters are another great option!

4. Keep a list of ingredients that are “off limits” so if you’re out in a new city at an unfamiliar grocery store you can easily cross-reference food labels. This can also help your host/hostess know if their foods are OK for you to eat and if not, how much extra foods you will need to provide for yourself.

5. Prepare a quick and compassionate response to all of the questions you will get in regards to you refusal of offered foods. This can be something like, “Thank you, but I have a food allergy to XYZ and need to be careful about what I eat around the holidays.”. or, “Fortunately I have finally found what foods really trigger some digestive issues and XYZ is one of them. Thank you so much for offering!”.

Substitutions for some common food allergies:

Gluten Free: Pamela’s Bread mixes – excellent for almost anything you can bake gluten free! http://www.pamelasproducts.com/products/

Dairy Free: Daiya Cheese makes a great alternative to cheesy dishes: http://us.daiyafoods.com/
Coconut milk is an excellent alternative to regular milk for cooking and baking.

Eggs: 1 tablespoon ground flax seeds with 3 tablespoons water = 1 egg. Grind together in a food processor until thick. Place in the refrigerator for 15 minutes.

Sugar: Some alternatives to regular granulated sugars are maple syrup, honey, molasses or dates.

If you would like more assistance with your diet, consider an appointment with our Nutritionist, Dr. Viktoriya Beliy.  You can contact our office at (804) 977-2634 to make a Nutrition appointment.

Fall is a season of change.  Colorful leaves emerge and then make their way back to earth.  It reminds us that every now and then, we need to take stock and work on letting go of the things that no longer serve us.

This sounds easy enough but can actually be quite challenging to execute.  Why is that?

It’s normal to want to hold onto behaviors, objects, or even people.  On one hand, this is about convenience.  The familiar is comfortable.  It requires little thought.  We reason that this way of thinking or this object has worked for me in the past so it must work for me now.  We may not even be sure why we continue this behavior, but continue to do so anyway, not taking the time to reevaluate and adjust as needed.

The other rationale stems from fear.  Fear around not having enough. This is not so much about greed or wanting more, but holding on to what we already have.  This scarcity mentality focuses on short-term benefits and gives us a false sense of comfort.

So where do we go from here?  To begin, we let go.  We let go of our thoughts, our old scripts, our expectations, and our judgment.  

NEGATIVE SELF TALK

”Talk to yourself like you would to someone you love.”  Brene Brown

Being a little self-critical can be beneficial, but once the self-talk turns negative, the effects can be damaging.  Sometimes we can be a real bully-to ourselves!  Where does the compassion, patience and understanding we show others go when we view ourselves?

When you find your self-talk becoming harsh and critical, ask yourself the following questions…

•      Is there validity to my negative thinking?
•      Is this negative self-talk motivating me to better myself?
•      Would anyone who cares about me ever say these negative things about me?
•      Is this type of self-talk serving me?

If you answer no to these statements, it is time to let go of the negative self-talk.  Make space for compliments, words of encouragement, and self-acceptance.  

OBJECTS

“It all depends on whether you have things, or they have you.” Robert A. Cook

It’s normal to collect objects over time.  Some are gifted, some are purchased, and some are created.  You may even hold a few special possessions near and dear to your heart due to their nostalgia.  Unfortunately though, keeping everything can become a hindrance in progressing forward.  When we cling to the past we become unavailable to the presen.

Take stock of your belongings.  Explore your closets, cabinets, garage, etc. and ask yourself the following:

•      Do I really need this item?
•      Do I really want it?
•      If it needs repaired or fixed, am I willing to spend the time and energy to do so?
•      Could it serve someone else better?
•      Does this object bring me joy?

Let your answers guide as to whether you should pitch, donate, or sell these objects.  You may find that releasing such objects allows you and your space to feel lighter and more open to new possibilities!

NEGATIVE HABITS

“The secret of change is to focus all of your energy not on fighting the old, but on building the new.”  Socrates

Sometimes we actively engage in negative habits even though we know they are bad for us.  Even after reaping the consequences, we rationalize and stubbornly cling to our old ways.  Then we beat ourselves up after the fact for not adhering to the desired new behavior.  This can become a frustrating cycle and can be harmful to ourselves and others.

When faced with a decision to act out a negative habit that you know no longer serves, try the following:

•     Pause and take a deep breath in and a deep breath out.  Take as many as you need to create enough space to give yourself the chance to CHOOSE how you want to respond.
•     Ask yourself WHY you are clinging to this negative behavior?
•     Is there a way to replace this negative habit with a positive one?
•     Can you imagine how good it will feel to know that you’ve shed this negative habit?

To break a bad habit, first commit to stopping the behavior by creating a plan, and develop self-discipline and self-awareness so that you can stay on track.

Also, choose the right approach for dealing with it, reward yourself when you do well, and involve others in your efforts.

Perhaps it is time to shift our thinking from holding on to letting go.  In our letting go, we create an emptiness, a space in which new ideas, new objects and new behaviors can grow and flourish. We encourage a flow and exchange of energy.  

Making a positive shift through mindfulness…

Mindfulness is a term that is popping up more frequently in everyday conversation, self-help blogs, and research studies; and with good reason. Mindfulness, as defined by Psychology Today, is a state of active, open attention on the present. It embraces living in the present moment and taking in as much of the experience as possible. It is important to remember that as we are being mindful, we are simply observing any thoughts and feelings that come up, as opposed to judging them negatively or positively.

Some of the Benefits of Mindfulness

Mindfulness-Based Stress Reduction (MBSR) is a program that uses a combination of mindfulness meditation, body awareness, and yoga to help people become more mindful and find relief from many chronic disorders or diseases. (#1) The techniques taught in this program can help people have a more appropriate response to stress, increase happiness in their life and find relief from chronic pain(#2), irritable bowel syndrome (#3) and anxiety and depression (#4) to name a few.

Additionally, new research is coming out suggesting that regularly practicing mindfulness effects NF kappa b – a protein complex that acts as a “master switch” affecting the body’s response to stress, cytokine and free radical production and response to bacterial or viral antigens. Altering NF kappa b can lead to a positive shift in our immune system function, glucocorticoid-mediated responses and replication of DNA. (#5)

You can actually alter how your body is replicating its DNA and which genes get expressed simply by giving attention to the present moment! And for more good news, our brain responds well to short bursts of mindfulness throughout the day, so even if you only have a few minutes per day your body will be thanking you.

4 Ideas To Add Mindfulness Into Everyday Life:

1. Take Advantage When Life Gives You A Pause: If you’re stopped at a red light, in line at the grocery store, in the waiting room for an appointment these are all excellent opportunities to observe yourself (energy and mood) and your surroundings.
2. Explore Your Senses: We are too often on the go that we forget to take in our surroundings with all of our senses. Pick a moment and give attention to each of your senses. Are you feeling warm or chilly in the moment?  How do your surroundings look? Are there any particular scents in the air? Is your mouth wet or dry? What do you hear? Consider choosing one sense for the day and paying particular attention to what it picks up in various situations. Brushing your teeth or cooking dinner may actually be more interesting than you’ve ever thought.
3. Be Kind and Compassionate: To others and to yourself. Give someone a compliment. Accept a compliment from someone. Congratulate yourself on something you did well or are proud of each day, and smile.
4. Don’t Forget To Breathe: Check in with your breaths throughout the day. Frequently we’re holding our breath without knowing it. With each check-in be sure to take a deep inhale and longer exhale before your attention strays away from your breath again.

Resources:

1. Mindfulness-based interventions for chronic pain: a systematic review of the evidence.
2. Mindfulness-based stress reduction for the treatment of irritable bowel syndrome symptoms
3. Baseline and Strategic Effects behind Mindful Emotion Regulation: Behavioral and Physiological Investigation.

If you are interested in exploring mindfulness as a component of whole-body health

contact our office at (804) 977-2634 to schedule an appointment with one of our naturopathic doctors.

During the darker, colder winter months, it’s not uncommon for people to present with lower Vitamin D levels due to lack of sun exposure.

Without exposure to sunlight daily, we become deficient in Vitamin D, and not surprisingly, it’s one of the most common deficiencies in North America today. Vitamin D influences almost every body system in some way, including the immune, endocrine, cardiovascular, reproductive, and digestive systems.  It is continually researched concerning autoimmune diseases and even the progression of some cancers. It’s so important in our body that we actively make it ourselves, but we need sunlight’s key ingredient to make it happen.

Essential Roles at a Glance:

• Increases calcium absorption in the small intestines. You need vitamin D to keep your calcium levels constant
• Supports bone health, especially during infancy and through puberty
• Modulates the immune system response and may play a key role in the prevention of some autoimmune diseases
• Reduces incidences of infection
• Fertility support
• Blood sugar regulation
• Mood hormone regulation / seasonal affective disorder / cognitive function

Nutritional Perspective:

Vitamin D is absolutely essential for appropriate calcium absorption throughout our life, leading to optimal bone health over time. If you don’t have enough Vitamin D, it’s extremely difficult for the body to absorb needed amounts of calcium. Vitamin D is also one of the fat soluble vitamins, meaning it needs a healthy fat to get it where it needs to go in the body, making it all the more important to keep eating your healthy fats on a daily basis.  Such fast include avocados, coconut and olive oil, walnuts, flax seeds, chia seeds, fatty fish and high quality dairy products.

Supplementation & Diet:

There are two different sources of vitamin D supplementation: Vitamin D3 and Vitamin D2. Vitamin D3 is synthesized from sun-exposed skin and is more bioavailable for humans. Generally, a vitamin D3 supplement is sourced from cholecalciferol or lanolin, derived from sheep wool, and is highly absorbable for humans. Fungi synthesize Vitamin D2 (ergocalciferol) and is plant-sourced, often from lichen (many vegans will supplement with D2 instead of D3). Vitamin D2 is not quite as well absorbed by humans, however there is still benefit to supplementing with this form, as both D2 and D3 supplementation have been shown to increase serum levels of 25(OH)D.

Vitamin D is transported through general circulation to the liver, where enzyme 25 hydroxylase converts it to 25OHD. Further conversions within the kidneys change 25OHD into 1, 25 OH2D3, which is the active form of Vitamin D. Dietary sources of Vitamin D are relatively few but do include cod liver oil and fatty fish such as salmon, mackerel, swordfish, sardines, and tuna as well as some mushrooms that are UV-irradiated and eggs. Other foods may be fortified with vitamin D (non-naturally occurring) such as milk, yogurt and sometimes processed grains and cereals.

Who may be most at risk for Vitamin D deficiency:

• Populations with darker skin. Darker skin is characterized by an increased level of the pigment melanin, which reduces the skin’s ability to produce vitamin D from sunlight.
• Women who have breastfed for a prolonged period of time without the RDA supplementation of Vitamin D during that time.
• Populations living in limited sun-exposed regions or overcast environments.
• Office workers or shift workers who do not have daily exposure to sunlight (at least 15 minutes of direct sun exposure).
• People with lower GI, small intestine malabsorption issues or Irritable Bowel Disease.
• Elderly populations who remain predominantly indoors. Also, our ability to manufacture Vitamin D from sunlight through our skin decreases as we age.

One of the best ways to increase your vitamin D levels daily is to ensure you’re getting direct sun exposure for at least 15 minutes every day. This may shift seasonally and will also depend on your current vitamin D levels and skin color/pigmentation. You should also consider getting your vitamin D levels tested annually before implementing a Vitamin D supplement so that you know the appropriate dose to begin taking.

Still, have questions or curiosities about how Vitamin D may be influencing your health? Click HERE to be contacted by a representative to book an appointment.

Resources and References:

National Institutes of Health: Vitamin D

Vitamin D for Health: A Global Perspective

Vitamin D, pregnancy & depression

The Risks & Benefits of Sun Exposure

What are the adrenal glands and why are they so important?

The adrenal glands are two small, pyramid-shaped glands that sit on top of the kidneys.  Conventional medicine rarely addresses these glands unless there is a frank disease state such as Cushing Syndrome (hyper-functioning adrenal glands usually caused by a pituitary tumor) or Addison Disease (hypo-functioning adrenal glands usually resulting from an autoimmune disease).

Here are some of the areas in which the adrenal glands play a major role:

• Blood pressure and fluid balance
• Blood sugar and glucose control
• Stress response and cortisol levels
• Circadian rhythm
• Energy levels
• Mood stability
• Reproductive hormone balance
• Thyroid function
• Metabolism
• Inflammation and pain control

As you can see, these little glands play a big part in how we feel on a day-to-day basis and that is why they are KEY to achieving and maintaining health and well-being.

Background information:

The adrenal glands (or “adrenals”) are multi-layered glands, which produce a variety of hormones and substances which have various widespread effects. Here are the major compounds and their effects:

• Adrenaline (epinephrine) and noradrenaline (norepinephrine) – this is the name-giving substance produced by the center of the adrenal glands, in response to the sympathetic (aka “fight or flight”) mode of the nervous system. If you see a lion in your midst, this is what you’re feeling coursing through your veins. Epinephrine and norepinephrine are the neurotransmitters that give you quick-burst energy, excitability, responsiveness, etc.
• Aldosterone – this steroid hormone talks to the kidneys primarily to regulate blood pressure, blood volume and electrolyte concentration.
• DHEA – sometimes referred to as the “youth hormone,” this is the precursor to most sex hormones produced by the adrenal glands, including testosterone and estrogen. It has a balancing effect on cortisol and becomes of primary importance with aging, as adrenal gland production of sex hormones increases relative to declining ovary or testis function.
• Cortisol – this is the famous “stress hormone.” Similar to epinephrine and norepinephrine, this is also secreted in response to an acute stressor, but it is also produced and excreted in response to low-level and/or chronic stress (after the adrenaline is used up or wears off). Like most things in the body, we need some cortisol but not too much. In the right amounts, cortisol has the following actions in the body:
  • Wakes us up in the morning (major player in our circadian rhythm)
  • Raises blood sugar when it dips
  • Maintains blood pressure (especially when standing)
  • Reduces pain and inflammation
  • Provides resistance to acute or chronic stressors (like infection, extreme temperatures, trauma, etc.)

However, over time, too much cortisol can lead to issues like:

• Weak connective tissues and difficulty healing
• Weak bones
• Growth inhibition
• High blood pressure
• Mood, cognitive and memory issues
• Blood sugar dysregulation
• Low libido
• Low sex hormone levels – including infertility and menstrual disorders
• Thyroid dysfunction
• Abdominal adiposity
• Skin thinning
• Immune suppression

Interfering factors:

As with most biological molecules, the hormones produced by the adrenal glands eventually need to be processed (metabolized) and, for the most part, excreted from the body. The majority of this processing occurs in the liver and the majority of the excretion happens in the kidney. Hence, liver and kidney function are paramount to maintaining proper levels of adrenal hormones.

Here is a more inclusive list of factors that can interfere with adrenal function:

• Medications – especially steroid-hormone-based meds like prednisone, hydrocortisone and the birth control pill
• Thyroid issues (both hyperthyroidism and hypothyroidism)
• Diabetes and blood sugar dysregulation
• Malnutrition (especially low protein levels and low cholesterol)
• Liver dysfunction
• Kidney dysfunction
• Pregnancy
• Abdominal adiposity
• Genetic issues affecting enzyme function
• And more!

The Big Picture:

Chronic stress, whether it be physical or psychological, initially causes adrenal “hyperfunction” where the glands are firing at a high level at random times during the day (or all the time!). If you were to measure the cortisol output here, it would be high. What typically happens next, is the adrenal glands get “fatigued” and start to putter out. This is what alternative medicine practitioners refer to as “adrenal fatigue.”  Common symptoms associated with adrenal dysregulation include: low energy, difficulty sleeping, lack of motivation, chronic inflammation and/or sickness, poor recovery from illness, low blood pressure, low libido, menstrual irregularities, blood sugar problems and cravings for salt, fat and stimulants.

What To Do:

Once we have determined where someone is on the adrenal health spectrum, we can decide how to best support this person in the healing process. This typically involves a combination of:

1. Lifestyle recommendations, such as stress management techniques and circadian-rhythm supporting habits
2. Blood-sugar control via dietary modifications
3. Nutritional support for the adrenal glands (with vitamins like B3, B5, B6, Folate, B12 and C and minerals like copper, zinc and magnesium – all of which are used by the adrenals)
4. Herbal therapies – particularly with a group of herbs called “adaptogens” – aptly named because they help the body “adapt” to and handle stress by supporting the adrenals. These include licorice, holy basil, ginseng, rhodiola, ashwaganda, astragalus and eleutherococcus
5. Glandular therapies specific for the adrenal glands
6. Endocrine support – support for other major endocrine glands like the ovaries or testes, thyroid and pituitary is commonly needed to achieve proper hormone balance

Recovery time varies depending on the person, but most people report a marked decrease in symptoms and an increase in feelings of well-being after addressing adrenal health issues. In addition, many take the lessons of maintaining adrenal health with them, and can heed-off future issues by implementing the lifestyle habits they have developed during this process.

If you think you might be struggling with adrenal dysfunction and you live in the Richmond area, contact our office at (804) 977-2634 to schedule an appointment with one of our practitioners.