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26/Jul/2022

What is PCOS?

Finding an effective treatment for Polycycstic ovarian syndrome (PCOS) is important to me for two distinct reasons. 5-10% of woman are impacted by PCOS in their lifetime making PCOS a common and treatable condition in my Naturopathic practice. The second reason is that it is a condition that my wife has struggled with for many years therefore making it a syndrome that hits close to home.

PCOS is a bit of a misnomer as it is a continuum of symptoms and doesn’t necessarily have to include ovarian cysts. It is however characterized by several common objective findings including irregular periods, infertility, shifts in hormone balance (DHEA, Testosterone, LH, FSH), hirsutism (hair growth on the lip, chin and abdomen), Hair loss (Male pattern head hair loss), acne (typically on the lower jaw), high levels of insulin due to insulin resistance, and unexplained weight gain (especially around the abdomen).

Although we still do not know all the mechanisms involved as to why some women develop PCOS, there does seem to be a genetic component. Environmental toxins such as BPA seem to play a role, and gastrointestinal dysbiosis (unfriendly bacteria in the gut) plays a role as well.

Conventional Treatment for PCOS

Some of the more common conventional treatments of PCOS include birth control pill (to regulate irregular periods and hormone levels), metformin (a insulin sensitizing drug that helps to control blood sugar levels commonly used in diabetes), and spironolactone (a diuretic that also has the ability to block a type of testosterone formation called DHT). While these treatments can be helpful in the short-term they do not always address the root cause of PCOS and therefore ultimately fail in the long term. Some of these causes include hormone disrupters in the environment and diet, and gastrointestinal dysbiosis (leading to the production of inflammatory compounds that compromise insulin function).

Holistic Treatment for PCOS

Luckily there are relatively easy and low cost solutions to many of the fundamental causes of PCOS. As a Naturopathic Doctor I have the privilege and ability to take a detailed medical history. Doing so can point me in the direction(s) as to where these foundational imbalances are occurring. For instance if the patient has a history of gastrointestinal concerns, (constipation, diarrhea, gastritis, colitis) that informs me to focus investigation on the gastrointestinal tract. If a patients main concern is infertility and irregular periods I will shift focus into hormone balance. It may also be the case that a patient has several concern at the same time, which is not uncommon in PCOS. Once I know where to focus we can run specialized tests such as comprehensive stool analysis, female hormone panels, nutrient level panels, food sensitivity testing and environmental toxins. This aids in narrowing down where to implement the bulk of the treatment protocol. There are some general recommendations that are sure to aid all women with PCOS such as exercise, reduced carbohydrate diets and lowering exposure to petrochemicals. However, the medical history and specialized testing can be a guide for more specific recommendations.

Functional Testing for PCOS

A nutrients panel test can help determine if there are specific nutritional deficiencies such as low levels of vitamin D, vitamin A and omega-3 fatty acids, which tend to be common in PCOS. A female hormone panel can determine if there are specific imbalances with sex hormones. These imbalances can potentially be corrected with dietary recommendations, bio-identical  hormone replacement, and nutraceutical supplements. Evidence of dysbiosis in gut from a stool analysis can be reversed with dietary recommendations that promote colonization of helpful butyrate producing bacteria. Nutraceuticals containing antibiotic herbs can preferentially kill harmful bacteria while protecting good bacteria. Probiotic supplements containing specific strains of bacteria and prebiotic fibre can be very effective. Food sensitivity testing can help confirm if there are specific foods in the diet that are activating an immune response, causing further inflammation in the gut. Environmental toxin analysis would shed light on high levels of exposure to particular toxins, most of which are known hormone disruptors. Even the simple testing of insulin levels and blood sugar can lead to recommendations for easily accessible compounds like inositol, L-carnitine and chromium which can effectively increase insulin sensitivity.

Conclusions

The take home message is that PCOS is an extremely common and often disruptive condition for a significant amount of women worldwide. The conventional treatment of PCOS often does not provide long term solutions and can have significant side effects. Simple and inexpensive solutions through dietary, supplement and lifestyle recommendations can address the root causes of PCOS and bring about significant symptom relief with long-term sustainability. I therefore encourage anyone suffering from PCOS who hasn’t found an effective solution to contact a local Naturopathic Doctor or Functional Medicine Doctor for an assessment. If you would like to contact me, you can do so through the appointment page by clicking the link in the menu bar. The sooner you start to address the root causes the easier and quicker long lasting symptom relief can be achieved. That being said, implementation of a functional medicine approach to PCOS will undoubtably be helpful at any stage and at any age.


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31/Aug/2018

Multiple Sclerosis is a complex disease; those living with it need a simple approach. A treatment approach should appreciate the physiology of the disease process without neglecting the human body as a holistic system, and the patient as a person.

Naturopathy is an ideal philosophy of medicine for the treatment of M.S. as it aims to address disease processes and symptoms without loosing sight of the patient as an individual.

I chose to focus in neurological disease early into my professional career and as a result I have come across many complex chronic diseases of the nervous system including all subtypes of M.S. When patients come for their initial visit it is not uncommon to be privy to a long list of life events that have impacted the disease, symptoms that have evolved over years and medications that have been tried, stopped and tried again.

It’s easy to see why the practitioner on the other end of the patient with M.S. can become overwhelmed and confused, loosing sight of the big picture, dismissing the patients needs and goals. Unfortunately, this medical tunnel vision re-aimed at addressing each and every concern translates into complex and confusing treatment plans that most patients cannot comply with. I sympathize with these patients who have to remember to take dozens of pills while also dealing with a life altering condition.

To make matters worse, these confusing treatment plans hardly ever work because they tend to forget that the human body is not a series of islands, rather it’s a society striving to work in harmony and balance. The key to developing a simple, understandable and effective treatment plan is to figure out what is out of balance and how do we bring it back.

A typical treatment plan for M.S. has three parts: Foundations, The Immune System and Specific Symptoms. Since we are working toward bringing the body back into balance it is important to take the time to hear the full story and timeline of how the condition started and progressed. Often during the initial consultation it will become clear as to what type of events precluded the first attack and how these events triggered a physiological imbalance.

Diet therapy in multiple sclerosis

Foundations

It’s a futile effort to try and treat symptoms while the very basics of health and wellness are not fortified. The foundations of health can be summed up into three parts: Sleep, Diet and Exercise.

Sleep is the healing chamber for the body. Recently studies have shown that the brain undergoes a type of detoxification process while we sleep. Many neurodegenerative diseases have been correlated to poor sleeping habits. It is common to see sleeping issues in patients with M.S. In fact I have had a few cases where years of terrible sleep may have contributed to the patient experiencing their first symptoms related to M.S. This makes sense in the light of the new research demonstrating how important sleep is in clearing neurotoxic compounds from the brain.

One of the most important protocols I put together for my M.S. patients is aimed at improving sleep. This is achieved through sleep hygiene education and supplements that have been carefully vetted over my years in practices for their effectiveness in improving sleep initiation and maintenance.

Diet is important for a number of reasons, some are general and some are specific to M.S. The food we eat and its relation to our digestive tract determines our nutritional robustness.

M.S. is a chronic neuro-inflammatory state and therefore patients with M.S. will be using up vitamins and minerals involved in inflammatory processes at a greater rate than in a healthy control group. Therefor it’s important to determine what the nutritional status is of the M.S. patient (through consultation and specific lab tests), bring it back into balance and correct deficiencies. Otherwise the body will be unable to cope with the inflammatory process and the disease will progress.

It is also important to identify any food allergens, intolerances and sensitivities in the M.S. patient for these will perpetuate the inflammation. Chronic inflammation has a detrimental effect on the immune system, which I will discuss further in the next part of the treatment plan.

Another aspect related to diet is the health of the gastrointestinal tract and more specifically the micro-biome (the bacteria of the gut). A healthy micro-biome is important for detoxification, nutrient absorption and immune system regulation. A protocol addressing diet will focus on testing for nutritional deficiencies, food sensitivities, specific dietary guidelines for M.S. and supportive supplements where necessary.

A good dietary resource specific to M.S. is The Wahls Protocol.

physiotherapy for Multiple SclerosisExercise is a powerful health modulator and is under-appreciated for its importance in chronic disease and specifically M.S. Often exercise comes in the form of physiotherapy in progressive M.S. and the first thing I will do with a patient is set them up with one of the physiotherapists in my clinic (if they don’t already have a physiotherapy program). Often patients newly diagnosed with M.S. are neglected by the medical system in terms of exercise. In-patient rehab programs are inadequate, scooters and wheelchairs are promoted over therapy. Exercise and physiotherapy are instrumental in promoting neuroplasticity, decreasing inflammation, improving energy metabolism, maintaining and improving upon range of motion.

My clinic specializes in neurological rehabilitation using the Bobath Physiotherapy approach. Physio-Logic

The Immune System

Multiple Sclerosis is an autoimmune condition and therefore one cannot overlook the role of the immune system. Autoimmunity basically translates to a confused immune system that has targeted healthy cells and tissues rather than disease. The philosophy behind this part of the treatment plan addresses two questions: how the immune system became confused and how to bring it back into harmony.

There are many theories as to the cause of M.S., to name a few: Genetics, Vitamin D deficiency, Environmental Toxin Exposure, Candida Overgrowth, Dairy Protein Antigen Confusion and Leaky Gut Syndrome. There are truths to be told within many of these theories but in reality we just don’t know exactly what causes M.S. Some things we do know are the triggers for symptom activation, and things that reduce the risk of developing M.S. We know that stress (physical and/or emotional) often precipitate symptom relapse and progression. We also know that having adequate vitamin D levels are protective toward the development of M.S.

Vitamin D from SunlightVitamin D is not longer thought of as merely a bone-building vitamin. In reality it is more of a hormone and has a very important role in maintaining the health of the immune system. Step one of addressing the immune system is making sure the patient has optimal levels of vitamin D and if not, to adjust those levels using specific supplemental doses of vitamin D along with calcium and regular follow-up blood work.

Stress, whether it physical or emotional, causes a burden on the body. Most of the time we are able to cope with short durations of stress; however, when the stressful event is severe enough or lasts long enough it can impact the immune system in a negative way. Chronic stress can affect the immune system in two ways: Creating chronic inflammation that harms tissues and suppressing immune cells needed to fight infection.

When the immune system is under prolonged stress it becomes tired and makes mistakes, much like how we feel when under stress. One of these possible mistakes is mounting an autoimmune attack, harming normal healthy tissue rather than disease. Prolonged stress also depletes natural anti-inflammatory compounds like cortisol, allowing inflammation to run amuck. Therefore the protocol built around the immune system is aimed at decreasing stress on the immune system and bringing the immune system back into balance.

Anything that can be causing unnecessary inflammation needs to be dealt with and therefore chronic infections and food sensitivities must be addressed. Specific lab testing is used to investigate infections and sensitivities. Common food sensitivities in M.S. patients include: Dairy, Gluten, Yeast and Egg.

Once the major obstacles to a healthy immune system are removed we can work toward assisting the immune system back into a balanced state. The most important cells involved in bringing the immune system back into balance are “regulatory T cells” also known as “T suppressor cells”. These cells maintain tolerance in the immune system preventing autoimmunity. Part of the protocol is therefore aimed at supporting these cells. Some compounds that influence regulatory T cells are: probiotics, vitamin D, vitamin A, Omega 3 fatty acids and food sensitivities.

Sleep

Specific Symptoms

Treating foundations and immune system irregularities take time, therefore it is almost equally important to address the specific symptoms of the patient. Fatigue, weakness and pain are often obstacles to important foundational concerns like sleep and exercise.

Fortunately, there are many great strategies within Naturopathic medicine to help address the most common symptoms in M.S. namely: Weakness, Spasticity, Fatigue, Pain, Bowel and Bladder issues. There are dozens of supplements that have shown promise in treating the common symptoms of M.S. The art of the practitioner is in choosing the right compounds for the right patient. As an example, medical marijuana can be very effective for spasticity, pain, bladder dysfunction and sleep but can exacerbate weakness. A good practitioner with experience in treating M.S. will know how to choose the appropriate medications for the patients needs.

Multiple Sclerosis is a complex condition with many subtypes and many different ways it affects the individual patient. Naturopathic medicine aims to treat the root cause of disease while also addressing the individual concerns of the patient. The treatment plan can be summed up into three areas: Foundations, Immune System and Specific Symptoms. This helps direct the practitioner toward the right approach and simplifies the philosophy behind the treatment, improving upon compliance and therefore patient outcomes.

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09/Aug/2018

Do you give your kids probiotics?

Every year it seems like the back to school commercials start to pop up earlier and

earlier in the summer months. Although these commercials are aimed at bringing

parents into office supply and clothing stores in prep for their kids returning to

school, as parents we can also use this time to implement nutritional strategies to

help our kids excel during the school year.

Besides the obvious beneficial lifestyle approaches like eating a balanced nutrient

rich diet and daily exercise, there are a few specific recommendations that may help

your kids have the edge when it comes to starting school.

Probiotics Kids Back to School

[banner ]Probiotics[/banner]

Probiotics are live bacteria cultures that seem to have varying health benefits when

introduced into our gastrointestinal tract. Probiotics are naturally found in many

fermented foods such as yogurt, kefir, miso, tempeh, sauerkraut and kombucha. It is

believed that as a species, fermented foods played a larger role in our diet as we

evolved and our bodies have grown to rely on these bacterial cultures for optimal

health and wellbeing. Our modern “western” diet has been relatively low in these

fermented foods and there have been hypothesis relating many chronic diseases of

the gastrointestinal tract and immune system back to imbalanced gut bacteria.

Subsequently we have witnessed a surge in probiotics being offered in supplemental

form as a way to help restore this balance. It is important that I stress the fact that

probiotics alone are not the complete picture with regard to a healthy

gastrointestinal and immune system but research has suggested that they do play a

part.

 

Probiotics help boost the immune system – with kids heading back indoors and

spending large amounts of time in classrooms with each other (including daycare),

there is a dramatic increase in germ exposure and potential for kids to fall prey to

illness. In one study, 326 children aged 3-5 years were randomly assigned to

receive, in double-blind fashion, probiotic supplementation. Treatments were given

twice per day in divided doses for 6 months, including the winter season. Compared

with placebo, the probiotic group had the following results; fever reduction 53-73%,

cough reduction 41-62%, decreased runny nose 28-59%, decreased need for

antibiotics 68-82%, reduced absence from school 28-32%.

 

Probiotics help with allergies – Heading back indoors can trigger many kids who

are especially allergic to dusts and molds. With regard to asthmatic children with

allergic rhinitis, studies have shown the use of probiotics resulted in a significant

reduction in the inflammatory immune chemistry produced by peripheral blood

mononuclear cells. Further studies have shown specific down-regulation of T cells

(immune cells), which beneficially alter the balance of pollen specific antibodies in

seasonal allergic rhinitis. In short – probiotics lower the allergic load and decrease

inflammation.

 

Probiotics help with mood – Recent research is showing new gut-brain

connections as happy gut ecology seems to make for happier brains. In one

particular study, anxious mice dosed with probiotics showed lower levels of anxiety,

decreased stress hormones, and even increased brain receptors for

neurotransmitters vital in curbing worry, anxiety and fear. With better mood comes

greater ease and ability to learn in school settings and beyond.

Stay tuned for part 2 which will focus on cold/flu prevention and treatment.

Book a consultation with our Naturopathic Doctor Shawn Meirovici for

more information on child-friendly probiotic strains and dosages.

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Leyer, GJ et al. Probiotic effects on cold and influenza-like symptom incidence

and duration in children. Pediatrics 2009; 124-179.

Walker, WA. Mechanisms of action of probiotics. Clin Infect Dis. 2008; 46 (Suppl

2): S87-91.

Yang, G et al. Treatment of Allergic Rhinitis with Probiotics: An alternative

approach. N Am J Med Sci. Aug 2013; 5 (8): 465-68.

Javier, AB, Forsytthe, P & Cryan, J. Ingestion of Lactobacillus strain regulates

emotional behavior and central GABA receptor expression in mice via the vagus

nerve. Proc Natl Acad Sci USA. Sep 20, 2011; 108(38): 16050-55.


dr_shawn

Patient focused integrative health care. Utilizing effective natural approaches designed to be used alone or to compliment conventional medical care.


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