Perimenopause as a Hidden Trigger of Migraines

It is well-established that migraine attacks can be triggered by hormone changes. If you’re navigating perimenopause and notice an increase in headache intensity or frequency – you’re not alone. Some women find that migraines worsen during this life phase, while some experience migraines for the first time as their hormone levels shift. While many women with migraines are diagnosed in their teens or 20s, roughly 8 to 13% don’t get diagnosed until they are in perimenopause because their symptoms – including headaches, nausea, and fatigue – become much more intense[i]

Hormones and Migraines: The Connection

It is not clearly known why hormonal shifts can cause an increase in migraines. Some research suggests that changes in estrogen levels make certain cells more excitable – which may make you more sensitive to migraine triggers[ii]. Estrogen doesn’t just impact reproductive health; it plays a vital role in managing pain by controlling key brain neurotransmitters. When levels drop, the brain becomes more susceptible to pain signals, which can make migraines feel more intense and frequent. Fluctuating estrogen can also increase a person’s mast cells – a type of immune cell that triggers inflammation in the brain and often increases headache pain.

Why Estrogen Dominance Matters

Most research is on the effect of low estrogen in menopause (defined as not having a menstrual bleed for a year), but clinically I find that women in perimenopause can be affected even more frequently due to estrogen dominance.

Estrogen dominance happens when estrogen levels are high compared to progesterone. In perimenopause, a decrease in progesterone levels is the most common hormonal shift, usually happening in late 30s or early 40s. This can lead to symptoms like heavier menstrual bleeding, anxiety, and insomnia. But remember – the estrogen levels have not increased, but there is an imbalance.

Your liver also plays a role here. Women are often not metabolizing and eliminating their estrogen efficiently through their liver pathways, which can lead to additional challenges with weight gain, irritability, body pain, and of course, more frequent migraines.

Testing Your Hormone Levels

The symptoms of hormonal imbalance can be very clear, but there is a valuable and objective tool we recommend: the DUTCH Test. Unlike a standard blood test, this advanced 24-hour urine test measures estrogen and progesterone levels over a full day and evaluates how well your liver is metabolizing estrogen. With the DUTCH Test, we can get an in-depth look at your hormonal landscape, helping us create a tailored approach to bring your body back to balance.

Relief is Possible

The good news? Estrogen dominance and its symptoms can be addressed with strategic diet and lifestyle changes and targeted supplementation. Nutrients from cruciferous vegetables (broccoli, cauliflower, brussels sprouts, cabbage, etc.) can support liver health and help balance estrogen levels. Pairing these with dietary tweaks can make a big difference in reducing migraine frequency and severity.

Once you have identified your hormonal imbalance and have a plan, women usually experience improvements within a few weeks. Migraines can significantly affect your quality of life, but with the right support, relief is within reach.

Yours in good health,

Dr. Darlene Reid, ND

[i] Pavlović JM. The impact of midlife on migraine in women: summary of current views. Womens Midlife Health. 2020 Oct 6;6:11. doi: 10.1186/s40695-020-00059-8. PMID: 33042563; PMCID: PMC7542111.

[ii] Reddy N, Desai MN, Schoenbrunner A, Schneeberger S, Janis JE. The complex relationship between estrogen and migraines: a scoping review. Syst Rev. 2021 Mar 10;10(1):72. doi: 10.1186/s13643-021-01618-4. PMID: 33691790; PMCID: PMC7948327.

Breast Health: Prevention, Empowerment, and Wellness

Breast health is a vital aspect of overall well-being for women of all ages. Did you know that breast cancer is the second-most diagnosed cancer in Canada and is the second leading cause of death among Canadian women over 50?[i] This October, as we honor Breast Cancer Awareness Month, we want to empower you to take proactive steps towards your breast health – because it’s never too early to start.

At Saskatoon Naturopathic Medicine, we believe in supporting you with an individualized approach looking at the body’s weaknesses and vulnerabilities that may make you susceptible to disease. Through optimizing nutrition, addressing environmental factors, or supporting your body’s natural defenses, we are committed to providing comprehensive care that treats the whole person.

Know the Risk Factors

Several factors can influence your risk of developing breast cancer. Some are within your control, while others – like family history or genetics – are not. Here are some key considerations:

• Nutrition : A balanced diet plays an essential role in reducing risks. Not only can a healthy diet directly improve our health, but it can also positively interact with many other factors involved in health like inflammation, body weight, hormone levels, and our gut microbiome. It is estimated that 30%-50% of cancers can be prevented through dietary changes.[ii] [iii] [iv]

• Exercise and healthy lifestyle: Lack of exercise contributes to obesity, which in itself is a risk factor for breast cancer. In breast cancer patients, physical activity - both before and after the cancer diagnosis - has been associated with a lower risk of disease recurrence and reduced overall cancer-specific mortality compared to their sedentary counterparts. [v]

• Family history and genetics: Understanding your genetic predispositions can guide proactive prevention.

• Environmental toxins: Exposure to harmful chemicals (including alcohol and tobacco) can contribute to increased risk.

• Dense breast tissue: Dense breasts not only elevate cancer risk but also make it difficult for cancerous lesions to be seen on a mammogram.

Being informed about these factors helps you take charge of your health, empowering you to make choices that align with your long-term wellness goals. Naturopathic doctors can break down these risk factors further to help you understand your vulnerabilities and strategize an individualized prevention plan.

Symptoms to Watch For

Breast cancer can manifest in various ways, some of which may be subtle. If you notice any of the following symptoms, it’s important to reach out to your healthcare provider for further evaluation:

• Changes in breast size, shape, or appearance

• New lumps, nodules, or cysts

• Nipple discharge when not breastfeeding

• Redness, pitting, or dimpling of the skin

• Peeling or flaking of the nipple

• Inverted nipples

Understanding Dense Breasts

Breast density[vi] is not about how your breasts look or feel – it is about tissue. Dense breasts have more glandular and fibrous tissue, making it harder for mammograms to detect cancer. However, having dense breasts is quite common, particularly in younger women. As women get older, their breasts typically become fattier and less dense (but this isn’t always the case). It is important to know your breast density so you can understand the risks and complications and make informed screening decisions.[vii]

You can learn more at www.densebreastscanada.ca.       

Screening: Early Detection Saves Lives

Early detection is crucial, and regular screening is an important part of taking care of your breast health. As of January 2025, you will be able to self-refer for a mammogram in Saskatchewan beginning at the age of 40 (currently, the minimum screening age is 50).[viii]

Read that again – you do not need a doctor’s referral to make an appointment for a screening mammogram!

Just call 1-855-584-8228 to book your screening through the Screening Program for Breast Cancer. With screening centres throughout Saskatchewan (including a mobile unit that serves rural and northern Saskatchewan) accessing this potentially life-saving service is available to you.

How We Can Help

We are dedicated to helping you navigate these complex factors, providing tailored recommendations that fit your unique situation. Whether you are seeking prevention or already managing a diagnosis, our collaborative model works alongside conventional approaches to give you the best outcomes. From optimizing your nutrition and lifestyle to helping you understand your risks, we’re here to empower you at every step of your health journey, You deserve to feel confident, supported, and in control of your health.

[i] https://cancer.ca/en/cancer-information/cancer-types/breast/statistics

[ii] Mentella MC, Scaldaferri F, Ricci C, Gasbarrini A, Miggiano GAD. Cancer and Mediterranean Diet: A Review. Nutrients. 2019; 11(9):2059. https://doi.org/10.3390/nu11092059

[iii] Monllor-Tormos A, García-Vigara A, Morgan O, García-Pérez MÁ, Mendoza N, Tarín JJ, Cano A. Mediterranean diet for cancer prevention and survivorship. Maturitas. 2023 Dec;178:107841. doi: 10.1016/j.maturitas.2023.107841. Epub 2023 Aug 24. PMID: 37660598.

[iv] Rock CL, Doyle C, Demark-Wahnefried W, Meyerhardt J, Courneya KS, Schwartz AL, Bandera EV, Hamilton KK, Grant B, McCullough M, Byers T, Gansler T. Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin. 2012 Jul-Aug;62(4):243-74. doi: 10.3322/caac.21142. Epub 2012 Apr 26. Erratum in: CA Cancer J Clin. 2013 May;63(3):215. PMID: 22539238.

[v] Moore SC, Lee IM, Weiderpass E, Campbell PT, Sampson JN, Kitahara CM, Keadle SK, Arem H, Berrington de Gonzalez A, Hartge P, Adami HO, Blair CK, Borch KB, Boyd E, Check DP, Fournier A, Freedman ND, Gunter M, Johannson M, Khaw KT, Linet MS, Orsini N, Park Y, Riboli E, Robien K, Schairer C, Sesso H, Spriggs M, Van Dusen R, Wolk A, Matthews CE, Patel AV. Association of Leisure-Time Physical Activity With Risk of 26 Types of Cancer in 1.44 Million Adults. JAMA Intern Med. 2016 Jun 1;176(6):816-25. doi: 10.1001/jamainternmed.2016.1548. PMID: 27183032; PMCID: PMC5812009.

[vi] https://cancer.ca/en/treatments/tests-and-procedures/mammography/breast-density

[vii] https://densebreastscanada.ca/faq/

[viii] https://densebreastscanada.ca/breast-cancer-screening-in-saskatchewan/

Managing Hypermobile Ehlers-Danlos Syndrome: A Naturopathic Approach to Whole-Body Wellness

Hypermobile Ehlers-Danlos Syndrome (hEDS) is a connective tissue disorder primarily characterized by joint hypermobility, chronic pain, and a range of other systemic symptoms. Though often underdiagnosed, hEDS can have a significant impact on a patient's quality of life. Naturopathic medicine offers a holistic approach to managing hEDS, focusing on treating the whole person and addressing underlying issues.

What is hEDS?

Ehlers-Danlos Syndromes (EDS) are a group of heritable connective tissue disorders affecting collagen, a key protein that provides structure and strength to various tissues in the body. Hypermobile Ehlers-Danlos Syndrome (hEDS) is the most common subtype, marked by joint hypermobility, musculoskeletal pain, and frequent dislocations or subluxations. In addition to joint-related symptoms, patients with hEDS may experience:

• Gastrointestinal issues (e.g. irritable bowel syndrome – IBS)

• Dysautonomia (e.g. postural orthostatic tachycardia syndrome – POTS)

• Fatigue and sleep disturbances

• Easy bruising and poor wound healing

• Anxiety and mood disorders

The condition can vary widely in its severity, from mild joint hypermobility to disabling chronic pain and multi-systemic issues. Diagnosis of hEDS is primarily clinical, relying on a combination of patient history, physical examination, and established criteria.

Conventional Management of hEDS

Conventional treatment of hEDS often involves a multidisciplinary approach, including physical therapy, pain management, and medications to control symptoms. While these interventions can help manage some aspects of the condition, many patients seek additional support to address the chronic and systemic nature of hEDS. This is where naturopathic medicine can offer valuable adjunctive care.

Naturopathic Approach to hEDS

Naturopathic doctors (NDs) focus on treating the underlying causes of disease while emphasizing lifestyle changes, natural therapies, and patient education. For hEDS patients, a naturopathic approach includes:

1. Nutritional Support

   An anti-inflammatory diet incorporating omega-3 fatty acids to help reduce systemic inflammation can be helpful in managing chronic pain associated with hEDS. Other essential nutrients to include are vitamin C (a key co-factor in collagen synthesis) and zinc (important for tissue repair and immune function).

2. Digestive Health

   Irritable bowel syndrome (IBS) is a common symptom in patients with hEDS, utilizing probiotics to maintain a balanced gut microbiome, recommending a high fiber diet to support gut motility and identify and eliminating food sensitives can also be beneficial for patients with hEDS to reduce inflammation within the body and alleviate symptoms of IBS.

3. Movement

   Exercise programs that focus on low-impact activities and emphasize gentle, controlled movements to support muscle recovery and alleviate pain would be ideal for patients with hEDS.

4. Nervous System Support

   Using mind-body practices such as meditation, yoga and/or breathing exercises can support the autonomic regulation and reduce anxiety and pain perception in patients with hEDS. Adaptogenic herbs has also been shown to help modulate the body’s stress response.

5. Pain Management

   Anti-inflammatory herbs such as ginger, turmeric or Boswellia can help reduce inflammation and pain. Acupuncture has also been beneficial for some patients who experience chronic pain from hEDS.

6. Sleep Optimization

   Sleep disturbances can be common in patients with hEDS. Utilizing herbal supports and nutraceuticals such as passionflower and magnesium can help promote relaxation and improve quality of sleep in hEDS patients.

Hypermobile Ehlers-Danlos Syndrome is a complex condition that affects multiple body systems. While conventional management is crucial for stabilizing joints and managing acute symptoms, naturopathic medicine offers a comprehensive approach that addresses the underlying causes, supports overall health, and empowers patients with hEDS to take an active role in their care. Through nutritional support, digestive health optimization, nervous system regulation, pain management and sleep optimization, NDs can help patients with hEDS improve their quality of life and manage symptoms more effectively.

 In health,

Dr. Sami Leung, ND

References:

1. Castori, M., Morlino, S., Pascolini, G., Blundo, C., & Grammatico, P. (2015). Gastrointestinal and nutritional issues in joint hypermobility syndrome/Ehlers-Danlos syndrome, hypermobility type. American journal of medical genetics. Part C, Seminars in medical genetics, 169C(1), 54–75. https://doi.org/10.1002/ajmg.c.31431

2. Chopra, P., Tinkle, B., Hamonet, C., Brock, I., Gompel, A., Bulbena, A., & Francomano, C. (2017). Pain management in the Ehlers-Danlos syndromes. American journal of medical genetics. Part C, Seminars in medical genetics, 175(1), 212–219. https://doi.org/10.1002/ajmg.c.31554

3. Demes, J. S., McNair, B., & Taylor, M. R. G. (2020). Use of complementary therapies for chronic pain management in patients with reported Ehlers-Danlos syndrome or hypermobility spectrum disorders. American journal of medical genetics. Part A, 182(11), 2611–2623. https://doi.org/10.1002/ajmg.a.61837

4. Do, T., Diamond, S., Green, C., & Warren, M. (2021). Nutritional Implications of Patients with Dysautonomia and Hypermobility Syndromes. Current nutrition reports, 10(4), 324–333. https://doi.org/10.1007/s13668-021-00373-1

5. Doyle, T. A., & Halverson, C. M. E. (2022). Use of complementary and alternative medicine by patients with hypermobile Ehlers-Danlos Syndrome: A qualitative study. Frontiers in medicine, 9, 1056438. https://doi.org/10.3389/fmed.2022.1056438

6. Guedry, S. E., Langley, B. O., Schaefer, K., & Hanes, D. A. (2024). Integrative medicine for hypermobility spectrum disorders (HSD) and Ehlers-Danlos syndromes (EDS): a feasibility study. Disability and rehabilitation, 1–14. Advance online publication. https://doi.org/10.1080/09638288.2024.2314713

7. Hakim, A. (2004). Hypermobile Ehlers-Danlos Syndrome. In M. P. Adam (Eds.) et. al., GeneReviews®. University of Washington, Seattle.

8. Heds Body System. The Ehlers Danlos Society. (2024, September 12). https://www.ehlers-danlos.com/heds/

9. Langevin, H. M., Churchill, D. L., Wu, J., Badger, G. J., Yandow, J. A., Fox, J. R., & Krag, M. H. (2002). Evidence of connective tissue involvement in acupuncture. FASEB journal : official publication of the Federation of American Societies for Experimental Biology, 16(8), 872–874. https://doi.org/10.1096/fj.01-0925fje

10. Mantle, D., Wilkins, R. M., & Preedy, V. (2005). A novel therapeutic strategy for Ehlers-Danlos syndrome based on nutritional supplements. Medical hypotheses, 64(2), 279–283. https://doi.org/10.1016/j.mehy.2004.07.023

11. Pullar, J. M., Carr, A. C., & Vissers, M. C. M. (2017). The Roles of Vitamin C in Skin Health. Nutrients, 9(8), 866. https://doi.org/10.3390/nu9080866

12. Topan, R., Pandya, S., Williams, S., Ruffle, J. K., Zarate-Lopez, N., Aziz, Q., & Fikree, A. (2024). Comprehensive Assessment of Nutrition and Dietary Influences in Hypermobile Ehlers-Danlos Syndrome-A Cross-Sectional Study. The American journal of gastroenterology, 119(4), 727–738. https://doi.org/10.14309/ajg.0000000000002586

13. Song, B., Yeh, P., Nguyen, D., Ikpeama, U., Epstein, M., & Harrell, J. (2020). Ehlers-Danlos Syndrome: An Analysis of the Current Treatment Options. Pain physician, 23(4), 429–438.

Love the Skin You're In

Your skin is the largest organ in your body. It protects and gives you signals from the environment, and regulates temperature and water. We often don’t think about the functions of our skin until it starts to cause us problems – itching, rashes, acne, discoloration, premature aging, etc – all of which can be a signal of something deeper going on in our body. The skin is also a great absorptive surface, for better or for worse. We can use this effect to our benefit for absorbing certain medications or nutrients applied topically (eg. estrogen, testosterone, magnesium), though the absorptive nature of skin also makes us susceptible to adverse effects from environmental exposures that may be allergic or irritant in nature.

ouTSIDE IN VS AND INSIDE OUT

Whether it’s limiting exposures to harmful substances, or increasing exposure to therapeutic agents, both internal and external approaches can, and should, be used in conjunction to promote optimal skin health.

outside in

Skin & The Immune System —> Allergies

An allergic response occurs when the immune system reacts abnormally to a substance found in the environment. The substance that provokes the reaction is called an allergen.

3 Categories of Allergens:

• Ingested allergens - reactions to food or things consumed orally

• Inhaled allergens - reactions to substances we breathe in

• Contact allergens - reactions to substances applied on skin or mucus membranes (lips, mouth, groin)

Skin Allergies

1. Allergic reactions tend to happen after repeated exposure to a substance. The reaction never happens to the first exposure because the immune system must first become sensitized to the chemical.

2. Once you have been sensitizes, you will always be allergic to it.

3. Sudden development of allergies is possible.

4. Even small amounts of allergen can trigger a reaction that can last for several weeks.

5. With each new exposure, the reaction becomes stronger.

6. The reaction can spread beyond the exposure site.

7. A reaction need not happen immediately - it can take hours or days to present.

Allergy Testing

• Prick testing - for allergens ingested or inhaled

• Patch testing - for contact allergens

Top Allergens in Personal Care Products

1. Fragrances

2. Preservatives

3. Hair dyes

4. Lanolin

5. Synthetic detergents

6. Botanicals

7. Nail cosmetics

8. Sunscreens

Skin and The Immune System —> Irritants & Intolerances

Skin irritants elicit non-allergy reactions, that may be immediate, dose-dependent, and/or cumulative.

Irritant Reactions

• Irritation is dose-dependent - the more you are exposed, the more severe the reaction.

• Irritation is cumulative - multiple exposures, multiple chemicals.

• Irritation can happen after a single exposure.

• Irritation does not necessarily happen after every exposure (cumulative exposures impact the outcome).

• An irritant reaction can happen immediately after exposures and can resolve quickly after exposure ends.

Top Irritants in Personal Care Products

1. Water

2. Soap and detergents

3. Fragrances

4. Botanicals

5. Alcohol

6. Abrasive scrubs

7. Vitamin A derivatives and Alpha-Hydroxy Acid (AHA)

8. Shampoos and conditioners

inside out

Your skin is also reflective of what is going on within your body. We see this often with certain conditions that have dermatologic manifestations, such as Celiac disease (dermatitis herpetiformis), systemic lupus erythematosus (malar erythema), PCOS (acne) and many others. Aside from diagnosable pathologies, functional imbalances and other factors can also impact the quality and health of our skin. These may include:

• Inflammation

• Hormonal imbalances

• Diet

• Digestive issues

• Food sensitivities

• Sun exposure

• Stress

• Nutrient deficiencies

• Immune dysfunction

• Medications or supplements

• Smoking

• Infections

Skin problems are often multifactorial, and as such often require a multi-factorial approach. Whether you are addressing the symptoms of chronic disease or looking to improve the appearance and health of your skin overall, optimizing and correcting any one or several of these factors may be necessary to achieve desired results.

THE FIRST STEP TO TREATMENT IS A PROPER ASSESSMENT.

Deciding where to start can be overwhelming. With no shortage of information online, many times patients are confronted with information and option overload. A detailed history taking with a health professional can help to narrow down areas to focus on and get you started on a treatment plan tailored to your individual needs to help you love the skin you’re in.

In health,

Dr. Jacalyn Sieben, ND

PS - for more information about a holistic Outside-In approach I highly recommend the book referenced below.

Reference:

Skotnicki, S. (2018). Beyond soap: The real truth about what you are doing to your skin and how to fix it for a beautiful, healthy glow. Penguin Random House.

TIPS FOR A HAPPY, HEALTHY BACK-TO-SCHOOL

As the back-to-school season approaches, many parents are busy buying new clothes, school supplies, and signing their children up for activities. But there is also the transition of sleep schedules, planning for healthy lunches, and implementing some immune supports to help battle the inevitable cold and flu season to come. We get it - this time of year can be both exhilarating and a challenge.

With a few simple naturopathic strategies, you can set the stage for a successful school year. Here are some tips we hope you’ll find helpful.

Restoring Routine: Getting Your Children’s Schedule Back on Track

After long summer days, getting back into a school routine can be challenging, but so important for a great first week back – both mentally and physically. Here are some ways to make the transition smoother:

• Gradual adjustment - As fun as it is to spend the September long weekend enjoying some last few late nights, a week or two prior to back to school is a good time to start slowly moving the kids to an earlier bedtime. Gradually shift these times by about 15 minutes each day until they align with your school schedule. This helps reset your child’s internal clock without causing undue stress. The earlier sunsets are there to help us.

• Evening wind-down – Establish a calming bedtime routine to help your child relax before sleep. Activities such as reading, taking a warm bath, and practicing deep breathing can signal to your child’s body that it is time to wind down. And of course – screens off for an hour before bed.

Nutrition for Success: Easy Breakfast, Lunch, and Dinner Ideas

Proper nutrition is essential for your child’s cognitive function, energy levels, and overall health. There is no singular “right” way to eat depending on unique dietary needs, but here are some tips for balanced healthy meals which include protein, healthy fats, and lots of vegetables:

• Breakfast ideas - Granola and coconut yogurt, toast and a fried egg, banana with almond butter, almond flour blueberry muffins.

• Lunch ideas - Wraps made with leftover chicken or beef, pita pizzas with sausage, veggies and cheese, chicken Caesar salad (P.S. – invest in a kid-sized Thermos to keep leftovers nice and warm!)

• Smart snacks - Veggies and hummus, fruit and cheese, raisins and pumpkin seeds, dates stuffed with goat cheese, rice crackers and almond butter, quick energy balls (Nut-Free).

• Hydration – A cute water bottle can go a long way. You can make water more exciting by adding in lemon juice and liquid Stevia plus a mint leaf, or strawberries and cucumbers plus a squirt of lime juice. Biosteel is a healthy, sugar-free, color-free option as well. Be creative!

• Quick dinners - Meal prepping goes a long way towards a less stressful, balanced week of dinners. Sundays are a great time to get the kids involved in washing, chopping, bagging…which can also improve the likelihood of actually eating the healthy meals!

 Crockpot meals are a great way to have dinner ready for any time – beef stew, turkey chili, pasta with meat sauce, honey garlic chicken thighs, butter chicken, or chicken tortilla soup are all great options to start. As an added bonus – if you prefer to have the nicer finish of an oven-roasted meal with the slow cooker convenience, just quickly broil it up for a minute or two to add the brown and the crisp.

Naturopathic Immune System Support: Strengthening Your Child’s Defenses

• Probiotics – A strong immune system starts in the gut. Back to school is a great time to top up your kids’ healthy bacteria. Good bacteria is found in yogurt, kefir, sauerkraut, and cultured coconut. You might also consider a high-quality probiotic supplement in chewable form that has added vitamins.

• Vitamin D – Most children living in Saskatchewan have suboptimal vitamin D levels. A single drop of a vitamin D supplement goes a long way in supporting a healthy immune response.

• Vitamin C and Zinc – These nutrients are essential for immune health. Encourage your child to eat plenty of fruits and vegetables high in vitamin C such as oranges, strawberries, and bell peppers. Zinc is also anti-viral and found in foods like pumpkin seeds, chickpeas, and cashews.

• Herbal supports – There are many herbs that support the immune system. There are many kid-friendly immune tonics which include astragalus for prevention.

 Back to school season is an excellent opportunity to re-establish healthy habits that will benefit your child all year long. By focusing on a consistent routine, healthy nutrition, and immune supports, you’re equipping your child with the tools for a fantastic year of learning and fun. We are here to help you with personalized, evidence-informed care so don’t hesitate to reach out if you have questions or need further guidance.

In good health,

Dr. Darlene Reid, ND

Clearing the Haze: Naturopathic Approaches to Addressing Postpartum Brain Fog

The journey from pregnancy to parenthood is a transformative experience, filled with joy, challenges, and profound changes within the body. During pregnancy and the postpartum period, the body undergoes significant hormonal changes that affect neurotransmitter levels within the body. Estrogen is a hormone that is known to influence our serotonin levels (ie. the natural “feel-good” chemical), which affects mood and cognition. Throughout pregnancy, estrogen levels are at an all-time high; during the postpartum period estrogen levels decrease, which leads to mood swings, symptoms of anxiety, and cognitive difficulties…commonly referred to as postpartum brain fog. However, other factors can contribute to a decrease in cognitive function (hello, sleep deprivation and stress!), so it is important to keep things in perspective.

As naturopathic doctors, we look at the intricate web of factors contributing to the postpartum brain fog phenomenon and offer holistic approaches to support cognitive function and overall wellbeing during this important time. One of our main goals is to address the root cause and support overall health through personalized, comprehensive care. Here are some ways we can help:

Addressing Hormonal Imbalances

This is a fundamental aspect of naturopathic medicine and care. Hormonal imbalances can include things like decreased estrogen levels, but also things like thyroid dysfunction or adrenal fatigue. It is important to discern where the impairment in cognitive function stems from so that an appropriate treatment plan can be formulated for your individualized needs. NDs can run functional lab testing to pinpoint the root causes of your brain fog; as well, we are also able to requisition common (and naturopathic-specific) blood tests to dig deeper and get a clearer picture of what is going on in your body.

Nutritional Support

Ensuring proper nutritional intake is essential to both maternal and child health during the pregnancy and postpartum period. Proper nutrition also plays a vital role in supporting cognitive function. When discussing nutrition for cognitive health we want to emphasize an anti-inflammatory diet and increase the consumption of whole grains, fruits, vegetables, and healthy fats to lower inflammation levels within the body. Omega-3 fatty acids (found in fish oil and flax seed) are particularly important for maintaining healthy neurotransmitter levels.

Lifestyle Changes

Cortisol is a stress hormone released by the adrenal glands and helps your body deal with stressful situations. Cortisol levels within the body tend to decrease during the postpartum period due to sleep deprivation and an increase in stress levels, so we want to find that sweet spot where you can function optimally without living in “fight-or-flight” mode.

• Practicing mindfulness and stress reduction techniques such as deep breathing exercises or meditation can help manage the mental load of parenting.

• Engaging in regular physical activity (with your medical provider’s clearance) can also help enhance mood levels and cognitive function by increasing blood flow to the brain. It doesn’t have to be complicated – walking, yoga, and impromptu dance parties are good for the body AND the spirit!

• Aiming to establish a sleep routine and seeking support from family and friends can also alleviate the burden of sleep deprivation and stress. Sleep during this period is undoubtedly unpredictable, so any measures you can take to create good sleep hygiene is essential for success. Harvard’s Stress and Development Lab has a useful checklist you can use to help set up better habits.

Parenthood is a very exciting and joyful time for most people, but it can also be a stressful and disheartening experience. We understand the underlying factors of postpartum brain fog and employ holistic approaches to help support new parents in reclaiming their cognitive function and enhance their overall well-being. In the simplest terms – we are here to help you survive AND thrive.

Yours in good health,

Dr. Sami Leung, ND

1. Aparicio, E., Jardí, C., Bedmar, C., Pallejà, M., Basora, J., & Arija, V. (2020). Nutrient Intake During Pregnancy and Post-Partum: ECLIPSES Study. Nutrients, 12(5), 1325. https://doi.org/10.3390/nu12051325

2. Ball, L., De Jersey, S., Parkinson, J., Vincze, L., & Wilkinson, S. (2022). Postpartum Nutrition: Guidance for General Practitioners to Support High-Quality Care. Australian Journal of General Practice, 51(3), 123–128. https://doi.org/10.31128/ajgp-09-21-6151

3. Barba-Müller, E., Craddock, S., Carmona, S., & Hoekzema, E. (2018). Brain Plasticity in Pregnancy and the Postpartum Period: Links to Maternal Caregiving and Mental Health. Archives of Women’s Mental Health, 22(2), 289–299. https://doi.org/10.1007/s00737-018-0889-z

4. Buckwalter, J. G., Buckwalter, D. K., Bluestein, B. W., & Stanczyk, F. Z. (2001). Chapter 22 Pregnancy and Postpartum: Changes in Cognition and Mood. Progress in Brain Research, 303–319. https://doi.org/10.1016/s0079-6123(01)33023-6

5. Deems, N. P., & Leuner, B. (2020). Pregnancy, Postpartum and Parity: Resilience and Vulnerability in Brain Health and Disease. Frontiers in Neuroendocrinology, 57, 100820. https://doi.org/10.1016/j.yfrne.2020.100820

6. Guo, Y., Kehoe, P., Pimentel, P., Rousseau, J., Axelin, A., Rahmani, A. M., & Dutt, N. (2021). Exercise and Stress in At-Risk Women During Pregnancy and Postpartum. MCN: The American Journal of Maternal/Child Nursing, 46(4), 217–222. https://doi.org/10.1097/nmc.0000000000000722

7. McGrattan, A. M., McGuinness, B., McKinley, M. C., Kee, F., Passmore, P., Woodside, J. V., & McEvoy, C. T. (2019). Diet and Inflammation in Cognitive Ageing and Alzheimer’s Disease. Current Nutrition Reports, 8(2), 53–65. https://doi.org/10.1007/s13668-019-0271-4

8. Qiu, T., Wen, H., Liu, Z.-X., Pan, X.-P., & Zeng, T. (2021). Investigation Regarding Early Cognitive Function of Women in the Postpartum Period and the Analysis of Influencing Factors. Risk Management and Healthcare Policy, Volume 14, 3747–3754. https://doi.org/10.2147/rmhp.s309553

Unlocking Relief: How A Naturopathic Approach Can Help Prevent Migraines

Migraines can be debilitating. In Canada alone, 25% of households have someone affected by migraines;[1] as well, migraines are the 2nd most common cause of disability worldwide. [2] This disease can affect people’s quality of life enormously.

As Naturopathic Doctors, our approach is not to treat the migraines – but rather to treat the person living with migraines. This involves considering what may be the root cause(s) of the development of the painful episodes in the brain.

People living with migraines commonly have a genetic predisposition to them. While genetics are the “gun”, environmental factors “pull the trigger” and cause a migraine. These factors include hormonal imbalances, food sensitivities, nutrient deficiencies, mitochondria dysfunction, stress, and suboptimally-functioning pathways of detoxification.

Food Sensitivities vs. Food Triggers

Foods that commonly trigger a migraine for people include caffeine, chocolate (tyramine), MSG (glutamate), processed meat (nitrates), and wine (sulfites).

A food sensitivity does not trigger a migraine to develop, but if you are eating the food regularly and it is creating low-grade inflammation in your body, it is more likely to cause a migraine to develop. These food sensitivities can lead to the development of a migraine when there are additional variables at play such as weather changes OR hormonal decreases before your menstrual flow. If a person can identify foods that cause low-grade inflammation in their system and then avoid them for several weeks, they can reset their levels of inflammation and eat the foods less often. This approach has been helpful for countless patients.

So – how do you know which foods are increasing your likelihood of developing a migraine? There are two ways:

1. If you are unfortunate enough to have migraine attacks daily, or every few days, you can do an elimination diet for 2 weeks to see if the migraines lessen or stop. This involves avoiding the most common food sensitivities including dairy, all grains, egg whites, nuts, and yeast. Often, we can give patients a shorter list of foods to avoid based on what their diet has been comprised of and considering other health concerns they may have.

2. A food sensitivity test is also a very helpful option. Your Naturopathic Doctor can collect a small amount of blood through a finger prick and send the sample to Rocky Mountain Analytical (RMA) – a division of LifeLabs.  RMA can report on IgG antibody levels of between 120-225 foods that our immune systems may react to. A 2007 research study found that 43/65 patients with migraine headaches had complete remission of headaches after one month of eliminating reactive foods. Another study in 2010 found a significant reduction in the number of headache days and migraine attacks with the elimination of reactive foods. [3] [4] [5]

If a food sensitivity is identified, we can provide many options for food substitutions and can guide you on how long to avoid your trigger foods before reintroducing it in small amounts. If food sensitivities exist due to a “leaky gut” – an impaired permeability of the digestive tract – we can develop a plan to heal the lining using simple strategies.

Food sensitivities are not always a factor for patients who have migraine attacks, but it is a common one. When these foods are identified, a patient can experience improved health outcomes in many different areas including digestion, skin, immunity, and metabolism. It’s a win-win all around.

Altering your diet is not always easy, but with some compassionate support and expert guidance, many of our patients have found enormous success. We are here for you with an individualized, multi-faceted approach to help you break free from the cycle of pain.

In good health,

Dr. Darlene Reid, ND

[1] https://migrainecanada.org/wp-content/uploads/2023/05/languageguide-onepager-EN-finalweb.pdf

[2] https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-020-01208-0

[3] Drisko J, Bischoff B, Hall M, McCallum R. Treating irritable bowel syndrome with a food elimination diet followed by food challenge and probiotics. J Am Coll Nutr. 2006 Dec;25(6):514-22. doi: 10.1080/07315724.2006.10719567. PMID: 17229899.

[4] Alpay K, Ertas M, Orhan EK, Ustay DK, Lieners C, Baykan B. Diet restriction in migraine, based on IgG against foods: a clinical double-blind, randomised, cross-over trial. Cephalalgia. 2010 Jul;30(7):829-37. doi: 10.1177/0333102410361404. Epub 2010 Mar 10. PMID: 20647174; PMCID: PMC2899772.

[5] Arroyave Hernández CM, Echavarría Pinto M, Hernández Montiel HL. Food allergy mediated by IgG antibodies associated with migraine in adults. Rev Alerg Mex. 2007 Sep-Oct;54(5):162-8. Erratum in: Rev Alerg Mex. 2010 Mar-Apr;57(2):49. Echevarría Pinto, Mauro [corrected to Echavarría Pinto, Mauro]. PMID: 18693538.

From Cloudy to Clear: Naturopathic Approaches to Combat Brain Fog

Have you noticed that your brain has been feeling like a haze lately? Maybe you’re having concentration difficulties or can’t recall familiar places or items as easily. Have you been repeating parts of a conversation over and over again?

You might be experiencing what is known as “brain fog” - a term often used to describe a state of mental cloudiness or cognitive dysfunction which can significantly impair one’s ability to function optimally in daily life. Brain fog is commonly associated with conditions like fibromyalgia, hormonal imbalances, and chronic fatigue syndrome, and underlying causes can vary widely from person to person. As naturopathic doctors, our approach involves diving deeper in the root causes of brain fog and utilizing various tools and tests to uncover underlying imbalances and provide individualized treatment strategies.

The tools that a naturopathic doctor may use to investigate can include the following:

Hormone testing – hormonal imbalances, such as thyroid dysfunction or adrenal fatigue can lead to impairments in cognitive function.

Metabolic assessments – blood sugar imbalances and insulin resistance has been shown to affect cognitive function, so your ND may want to test fasting blood glucose, fasting blood insulin, and HbA1c.

Nutrient deficiencies – screening for low iron, vitamin B12 or Vitamin D levels is recommended.

Markers of inflammation – hs-CRP and ESR may be tested within the bloodstream since inflammation has been shown to be triggered by various poor diet and lifestyle choices and external stressors and infections. 

Food sensitivity tests – food sensitivities which are IgG-mediated can lead to inflammation within the body and manifest as cognitive symptoms.

Environmental exposures – exposures to heavy metals, pesticides, mold and other toxins have been shown to impair cognitive function.

As naturopathic doctors, our focus lies in identifying and addressing the root causes of brain fog using a combination of conventional laboratory tests, functional assessments, and lifestyle modifications. By addressing these nutritional deficiencies, hormonal imbalances, metabolic dysregulation, inflammation, food sensitivities and environmental exposures, we can help patients regain mental clarity and improve their overall well-being.

In good health,

Dr. Sami Leung, ND

References

1. Ettleson, M. D., Raine, A., Batistuzzo, A., Batista, S. P., McAninch, E., Teixeira, M. C. T., ... & Bianco, A. C. (2022). Brain fog in hypothyroidism: Understanding the patient’s perspective. Endocrine Practice, 28(3), 257-264.

2. Fog, W. C. B. Causes of Brain Fog: Does Brain Fog Begin In Your Gut?

3. Lucius, K. (2021). “Brain Fog”: Exploring a Symptom Commonly Encountered in Clinical Practice. Alternative and Complementary Therapies, 27(1), 23-30.

4. Schmidt, S. (2019). Brain Fog: Does air pollution make us less productive?

5. Wilson, L. (2008). Brain fog. The Center for Development. Retrieved on October 9, 2009.

6. Yoshimura, H. (2023). Functional Medicine for Mental Clarity: Combating Brain Fog Naturally. Mental Health.

Harnessing the Power of Fibre

It is easy to overlook the importance of dietary choices in safeguarding against various ailments. One such silent protector in our diet is fibre, a nutrient with profound implications for our digestive health and, notably, in the prevention of colorectal cancer. Colorectal cancer is the 4th most diagnosed cancer in Canada[i], and lifestyle factors such as diet can play a significant role in its development.

At Saskatoon Naturopathic Medicine, we practice a comprehensive approach to wellness, and understanding the role of fibre in colorectal cancer is paramount.

What is fibre?

Fibre is the portion from plant-based foods that our bodies cannot fully digest and end up being fermented or broken down by the bacteria that live in our digestive tracts (called the gut microbiome).

The fermentation of fibre by our gut bacteria produces short-chain fatty acids (SCFAs) including butyrate, which is the main source of energy for colon cells.

Why is fibre important?

Fibre helps move substances through our GI system, thereby facilitating the elimination of carcinogenic substances. Additionally, the SCFAs (including butyrate) have anti-inflammatory, immune-modulating, and anti-carcinogenic effects on the cells of our colon and help slow the growth of colon cancer cells.

Gut Dysbiosis

Our diet plays an important role in balancing the bacterial populations that make up our gut microbiome. Diets that are higher in fibre help to promote bacteria that produce butyrate and reduce inflammation. Diets low in fibre can lead to gut dysbiosis (a decrease in the beneficial bacteria and an increase in bacteria that promote inflammation).

We believe in empowering our patients with actionable steps to optimize their health. Here are some practical tips for incorporating more fibre into your diet:

• Embrace whole foods over refined, highly-processed options.

• Load up on produce, aiming for a colorful variety to maximize your nutrient intake.

• Snack smart to curb cravings and boost fibre intake throughout the day.

• Experiment with legumes in soups, salads, and stews.

Great sources of fibre for fermentation, butyrate production, and promoting microbiome diversity include soluble fibres such as:

Beta-glucans – oats, barley, sorghum, rye, mushrooms

Pectins – Apples, oranges, apricots, white beans, black beans

Inulin – Agave, artichokes, asparagus, bananas, chicory root, garlic, onions, leeks, wheat

A diet rich in a variety of dietary sources of fibre is beneficial for health – it helps substances move through the gut, balances sugar and cholesterol levels, and promotes a healthy gut microbiome. Aim for 30 grams of fibre per day from foods including grains, vegetables, fruits, legumes, nuts and seeds.

We stand committed to guiding you on your journey to vibrant health, one fibre-filled meal at a time.

[i] https://www.colorectalcancercanada.com/colorectal-cancer/statistics/

Sources:

Fratila, T. D., Ismaiel, A., & Dumitrascu, D. L. (2023). Microbiome modulation in the prevention and management of colorectal cancer: A systematic review of clinical interventions. Medicine and Pharmacy Reports, 96(2), 131–145. https://doi.org/10.15386/mpr-2526

Madrigal-Matute, J., & Bañón-Escandell, S. (2023). Colorectal Cancer and Microbiota Modulation for Clinical Use. A Systematic Review. Nutrition and Cancer, 75(1), 123–139. https://doi.org/10.1080/01635581.2022.2108468

Rinninella, E., Mele, M. C., Cintoni, M., Raoul, P., Ianiro, G., Salerno, L., Pozzo, C., Bria, E., Muscaritoli, M., Molfino, A., & Gasbarrini, A. (2020). The Facts about Food after Cancer Diagnosis: A Systematic Review of Prospective Cohort Studies. Nutrients, 12(8), 2345. https://doi.org/10.3390/nu12082345

Holscher, H. D. (2017). Dietary fiber and prebiotics and the gastrointestinal microbiota. Gut Microbes, 8(2), 172–184. https://doi.org/10.1080/19490976.2017.1290756

Bashir, K. M. I., & Choi, J.-S. (2017). Clinical and Physiological Perspectives of β-Glucans: The Past, Present, and Future. International Journal of Molecular Sciences, 18(9), 1906. https://doi.org/10.3390/ijms18091906

Ross, J. K., English, C., & Perlmutter, C. A. (1985). Dietary fiber constituents of selected fruits and vegetables. Journal of the American Dietetic Association, 85(9), 1111–1116.

Tosif, M. M., Najda, A., Bains, A., Kaushik, R., Dhull, S. B., Chawla, P., & Walasek-Janusz, M. (2021). A Comprehensive Review on Plant-Derived Mucilage: Characterization, Functional Properties, Applications, and Its Utilization for Nanocarrier Fabrication. Polymers, 13(7), 1066. https://doi.org/10.3390/polym13071066

Dhingra, D., Michael, M., Rajput, H., & Patil, R. T. (2012). Dietary fibre in foods: A review. Journal of Food Science and Technology, 49(3), 255–266. https://doi.org/10.1007/s13197-011-0365-5

Recipes For Happiness

The foods we eat give us the nutrients necessary for good health. Our body runs on biochemical machinery (like the engine of a car) which requires the right fuel for optimal function. The neurotransmitters in our brain that contribute to our well-being and happiness require the right nutrient raw materials for their synthesis and conversion to help us stay happy, calm, and motivated to live our best lives.

We’ve gathered some recipes for happiness that have all the right nutrients to support these neurotransmitters and keep you fueled for wellness and success!

serotonin

Serotonin contributes to well-being and happiness, and helps with sleep cycles and digestive system regulation. Serotonin is made from the amino acid tryptophan, which can be found in high amounts in chia seeds, whole milk, sesame seeds, yogurt, pumpkin seeds, prunes, spirulina, raw cacao, wheat bread, and edamame beans.

Image source - Oh She Glows website

(Happy) health chia seed pudding:

https://ohsheglows.com/healthy-chocolate-chia-pudding/

*This recipe is made with chia seeds and cacao, which are both rich in tryptophan. Chia seeds have 202mg of tryptophan per ounce, and cacao has 18mg per ounce. Top with pumpkin seeds (121mg/oz) and sesame seeds (189mg/oz) for a tryptophan-packed snack when you need a serotonin boost!

dopamine

Dopamine is associated with feelings of pleasure and motivation; people tend to repeat behaviours that lead to dopamine release, so it is also associated with addiction. Dopamine is made from the amino acid tyrosine (which our bodies are able to make), but they require another amino acid - phenylalanine - in order to do so. Phenylalanine is an amino acid our bodies don’t make, so we need to obtain it through diet. Phenylalanine is found in high amounts in many high-protein animal products such as chicken, beef, eggs, fatty fish, dairy products, legumes, nuts, seeds, and spinach.

Image source - Against All Grain website

(dopamine-driven) healthy chicken parmesan

https://againstallgrain.com/2011/04/21/chicken-parmesan-with-spaghetti-squash/

*This recipe is made with chicken (1310mg of phenylalanine per 100g) and parmesan cheese (1870mg/100g). Add in some spinach and get ready to take on the day!

GABA

GABA is the calming neurotransmitter. GABA is made from the amino acid glutamate, which is excitatory and can actually increase feelings of anxiety. Vitamin B6 is necessary in the conversion of glutamate (excitatory) to GABA (calming) to help you maintain a relaxed and balanced mood.

Inage source - Nadia’s Healthy Kitchen website

crunchy (calm) pistachio bars

https://nadiashealthykitchen.com/5-ingredient-crunchy-pistachio-bars/

*This recipe is made with pistachios, which have 2.1mg per cup, which is the highest amount of Vitamin B6 per 100g - even compared to animal products. With a bit of serotonin-promoting chocolate, this is a happy snack!

Happy, healthy eating!

Dr. Jacalyn Sieben, ND

resources:

1. Mosconi, L. (2018). Brain Food.

2. https://ohsheglows.com/healthy-chocolate-chia-pudding/

3. https://againstallgrain.com/2011/04/21/chicken-parmesan-with-spaghetti-squash/

4. https://nadiashealthykitchen.com/5-ingredient-crunchy-pistachio-bars/