How Optimizing Gut Health Can Keep Your Cholesterol Levels in Check

First off, what is cholesterol anyway?

Cholesterol is a waxy, fat-like substance that is produced by your liver. Cholesterol is actually vital for many different structures and functions in the body such as the formation of cell membranes, hormone production, and the synthesis of vitamin D from the sun. So if it plays all of these key roles, why are we so concerned when cholesterol levels get high?

You may have heard by now that we have “good” (HDL) and “bad” (LDL) types of cholesterol. HDL and LDL stand for high density and low density lipoprotein. These are particles made from fat and protein that attach themselves to cholesterol to transport them throughout the blood stream. LDL is associated with the bad form of cholesterol as its function is to carry cholesterol to the arteries. When LDL levels get too high it may collect in vessel walls and contribute to plaque formation (atherosclerosis) in addition to increasing your risk of heart disease and stroke. HDL on the other hand functions by transporting cholesterol back to the liver – almost like a clean up crew- to prevent blood cholesterol levels from getting too high. So when cholesterol gets returned to the liver – what happens next? In the liver, cholesterol is secreted directly into bile where it is then secreted into the intestines. This is where optimizing gut health comes into play.

Once cholesterol reaches the intestines one of two things can happen. One, the bile is removed from the body via fecal excretion or two, the cholesterol is re-absorbed by enterocytes (cells that line our gut) and returned back to circulation. The intestine typically absorbs about 50% of the cholesterol presented to it – but this can vary from 20%-80% depending on the person. Of the absorbed cholesterol, approximately 80% comes from bile and only ~20% comes from diet (which is why eggs might not be so bad after all). Given that it seems our bodies own production and subsequent elimination of cholesterol seems to be the larger issue, how can we help swing our reabsorption percent from 50-80% down to 20%?

1. FIBER:

   • Soluble fiber can reduce the absorption of cholesterol into your blood stream. Insoluble fiber decreases intestinal transit time thus promoting regular bowel movements to ensure your LDL cholesterol is being eliminated efficiently. It is suggested to consume between 25-30g of fiber per day.

   • Soluble fiber foods: Brussels sprouts, avocados, flax seeds, and black beans

   • Insoluble fiber foods: nuts, beans and vegetables, such as cauliflower, green beans and potatoes

2. Probiotics:

• Probiotics are healthy bacteria found in our gut. Fermented foods contain them and fiber containing foods feed them. Probiotics are suggested to reduce cholesterol by deconjugating bile acids, using cholesterol for nourishment, and/or incorporating cholesterol into the cell wall of the probiotic bacteria. Probiotics also help to keep us regular which decreases the chance for cholesterol to become re-absorbed.

• Sources of probiotics: yogurt, sauerkraut, kimchi, kombucha, miso, tempeh, pickles.

Lastly, outside of gut health and moving more into diet in general, the Mediterranean diet has been shown to be an effective approach to supporting healthy cholesterol levels. The Mediterranean diet includes the following:

Increased Omega 3 consumption:

• Foods high in omega 3’s can increase HDL while reducing triglycerides — a type of fat found in blood — as well as reduce your blood pressure and risk of developing blood clots.

• Omega 3 rich foods: Fish and other seafood (especially cold-water fatty fish, such as salmon, mackerel, tuna, herring, and sardines) Nuts and seeds (such as flaxseed, chia seeds, and walnuts)

Increased consumption of Nuts/Seeds:

• Almonds and other tree nuts can improve blood cholesterol levels by reducing LDL. Almonds have been suggested to reduce LDL levels by reducing LDL reabsorption in the gut, increasing cholesterol and bile secretion into the gut, and regulating enzymes involved in cholesterol syntheses. 

Olive oil:

• Foods that contain monounsaturated fats (including olive oil) may raise HDL (good) cholesterol. The least processed form of olive oil to use is cold pressed extra virgin olive oil.

In health,

Dr. Brittany Pearce, ND., RHN.

References:

Vrins CL. From blood to gut: direct secretion of cholesterol via transintestinal cholesterol efflux. World J Gastroenterol. 2010;16(47):5953-5957. doi:10.3748/wjg.v16.i47.5953

Jesch ED, Carr TP. Food Ingredients That Inhibit Cholesterol Absorption. Prev Nutr Food Sci. 2017;22(2):67-80. doi:10.3746/pnf.2017.22.2.67

Freeman AM, Morris PB, Aspry K, Gordon NF, Barnard ND, Esselstyn CB, Ros E, Devries S, O'Keefe J, Miller M, Ornish D, Williams KA, Batts T, Ostfeld RJ, Litwin S, Aggarwal M, Werner A, Allen K, White B, Kris-Etherton P. A Clinician's Guide for Trending Cardiovascular Nutrition Controversies: Part II. J Am Coll Cardiol. 2018 Jul 31;72(5):553-568. doi: 10.1016/j.jacc.2018.05.030. PMID: 30049315.

Cohen DE. Balancing cholesterol synthesis and absorption in the gastrointestinal tract. J Clin Lipidol. 2008;2(2):S1-S3. doi:10.1016/j.jacl.2008.01.004

Cartolano FC, Dias GD, Miyamoto S, Damasceno NRT. Omega-3 Fatty Acids Improve Functionality of High-Density Lipoprotein in Individuals With High Cardiovascular Risk: A Randomized, Parallel, Controlled and Double-Blind Clinical Trial. Front Nutr. 2022 Feb 23;8:767535. doi: 10.3389/fnut.2021.767535. PMID: 35281761; PMCID: PMC8905646.

Berryman CE, Preston AG, Karmally W, Deckelbaum RJ, Kris-Etherton PM. Effects of almond consumption on the reduction of LDL-cholesterol: a discussion of potential mechanisms and future research directions. Nutr Rev. 2011 Apr;69(4):171-85. doi: 10.1111/j.1753-4887.2011.00383.x. PMID: 21457263.

Does Sugar Impact Our Immune System?

We all know it’s not ideal to have a diet high in sugar. Most of us know this with respect to managing our weight – but what about the immune system? What about colds, flus, autoimmune conditions, diabetes, cancer – does sugar consumption make us more susceptible? And if it does, how much does it take to make a difference?  Before we dive in, lets do a quick review of the immune system.

Above you’ll notice two main subdivisions of our immune system. We have our innate immunity, which can be thought of as the offense players and the adaptive immunity which could be considered the defence players. The innate immune system is first to respond (within minutes to hours) when there is a foreign invader. It’s the part of our immune system responsible for mounting a fever and initiating inflammation. Inflammation is useful in the short term for acute injuries or illnesses. Long term however, inflammation plays a strong role in the development of several diseases such as autoimmune diseases, cardiovascular disease, diabetes mellitus, chronic kidney disease, non-alcoholic fatty liver disease and neurodegenerative disorders3. The innate immune response has no memory which means it responds the same way to all encountered pathogens. The adaptive immune system, also known as “acquired immunity” takes days to weeks to kick in. It is very specific and diverse to each type of pathogen it encounters which means it mounts a unique response to each pathogen after it has been “primed” or exposed to that pathogen. The adaptive immune system does have a memory which means it will respond faster the next time you are exposed to that pathogen.

How does sugar affect the immune system?

When we consume foods high in simple sugars, we get a post prandial (post meal) spike in the amount of sugar and triglycerides in our blood[1]. This is also known as “post prandial dysmetabolism” and it induces a wide variety of negative changes in the body. Just one high sugar meal can trigger transient effects such as:

Inhibition of neutrophils[2]

o  Neutrophils are part of the innate (first response) immune system. They patrol for foreign invaders and then trap and kill pathogens when discovered. High blood sugar prevents neutrophils from being able to get to the site of microbial infection (inhibition of migration), decreases their ability to trap pathogens (phagocytosis), and furthermore inhibits their ability to kill microbes2.

Increased inflammation and inflammatory markers such as C-reactive protein1

o  Long term inflammation (such as with repeated exposure to a diet high in sugar) can cause a breakdown of immune tolerance which may lead to major alterations in all tissues and organs, as well as normal cellular physiology, which can increase the risk for various non-communicable diseases in both young and older individuals[3]. It can also impair normal immune function leading to increased susceptibility to infections and tumors as well as poor response to vaccines3.

Immediate oxidant stress (free radical production)1

o  Oxidant stress acutely triggers inflammation which negatively impacts the immune system3. In addition, this oxidant stress also increases LDL oxidation, vessel constriction and clot formation, all of which contribute to cardiovascular disease1.

Endothelial (blood vessel) dysfunction1 2

o  High blood sugar decreases blood vessel dilation (reducing blood flow) while simultaneously increasing leakiness of the blood vessels and how quickly the blood clots due to the inflammatory response. This reaction is similar to how a viral infection would trigger vascular inflammation leading to endothelial dysfunction, coagulation and cardiovascular disease[4]. Long term vessel “hyperpermeability” has been associated with increased aging and diseases such as Parkinson’s and Alzheimer’s[5].

Glycosylation of proteins and alteration of tertiary structures of complement2

o  While this might sound complicated, what is important to understand is that these changes make it difficult for the body to recognize foreign pathogens and eliminate them2. Changes in glycosylation may increase the inflammatory response, enable viral immune evasion (ability to escape), and promote cancer cell metastasis[6]. Auto-immune disease development such as lupus and irritable bowel disease involve glycosylation of one or more glycoproteins6.

This diagram shows a summary of how systemic chronic inflammation (SCI) develops and what it can lead to. 

How much sugar does it take?

To provide a little bit of context, the chart below shows the immediate effects of consuming a beverage containing 75g of glucose. This amount of sugar is similar to a cup and a half of white rice (68g). You will notice that within a few hours the amount of glucose and triglycerides increase significantly which leads to immediate oxidant stress (nitrotyrosine), inflammation (C reactive protein [CRP]) and endothelial dysfunction via decreased blood flow via reduction in the diameter of blood vessels (FMD).

Another study looking at the immediate effects of sugar consumption found that people who consumed 40 grams of added sugar from just one 375ml can of soda experienced an increase in inflammatory markers, insulin resistance and LDL cholesterol[7].

In addition to the above, high sugar containing meals can alter our gut barrier function and drive gut bacteria imbalances (also known as dysbiosis). This can lead to what is referred to as “leaky gut” or intestinal permeability which fuels inflammation and taxes the immune system further[8]. In addition, altered gut bacteria has been suggested to contribute to a multitude of immune-mediated disorders such as irritable bowel disease [9]. Furthermore, as mentioned above, diets high in sugar have been implicated in the development of all kinds of diseases such as cardiovascular disease, type two diabetes, obesity, non alcoholic fatty liver disease, gout and autoimmune conditions such as rheumatoid arthritis[10].

How much sugar should we have and how can we reduce the negative impacts of sugar on our immune system and overall health?

The Heart and Stroke Foundation recommends that you consume no more than 10% of your total calories per day from added sugar – ideally less than 5%[11]. This means for someone with a 2000 calorie/day diet you should consume less than 48g (10%) of sugar. This is slightly more than one can of pop. The following are some key things you can consider doing to reduce the impact of high sugar foods on your immune system and overall health:

Fiber and low glycemic carbohydrates:

o  When eating carbohydrates, try to choose high fiber, low glycemic index (glycemic index <55) foods such as whole grains, beans and legumes, vegetables and berries. Carbohydrates in these forms are much harder to digest thus slowing the rate sugar enters the blood stream.

Protein and fat

o  Ensure you consume a healthy source of protein and/or fat with each meal or snack. The addition of protein and fat also helps to slow the rate sugar is released into the blood stream which prevents a spike in blood sugar. An example might be having almond butter with your banana.

o  Below on the left is an example of how adding whey protein to the same glucose drink reduced the increase of blood sugar after drinking1. On the right we have an example of how adding 90g of almonds to a high glycemic index meal reduced the area under the curve for glucose by 58%1.

Vinegar:

o  Research suggests that 1-2 tablespoons of vinegar added to a meal can lower post prandial glucose by 25%-35% as well as increase post meal satiety by more than two-fold1.

Avoid low glycemic and highly processed foods/beverages

o  Avoid highly processed foods and beverages which often contain high amounts of simple sugars, high fructose corn syrup and white flour.

Walk/Exercise

o  Walk for 10-30 minutes after each meal[12]. Short walks after each meal were found to be more effective for blood sugar control than one-time daily exercise regimes or the use of metformin alone[13] [14].

Reading food labels can help you make an informed decision on the foods you are eating. Remember, the daily recommended amount of sugar is less than 48g.

Ex: Tropicana – One serving of Tropicana juice is 34g of sugar. This is 72% of the recommended daily intake of sugar. In addition, orange juice in general is considered to have a glycemic index of 66-76 which is considered moderately to very high in regard to how much it will raise our blood sugar. 

Another example is BBQ sauce. Bulls Eye BBQ sauce has 12g of sugar/2tbsp. This means that just two tablespoons equal to 25% of the daily recommended sugar intake. However often in meals with BBQ sauce (such as a burger) we are having a bun, and ketchup and french-fries as well. This one meal quickly throws us far over the daily recommended intake.

Working with a healthcare provider can help you pinpoint which risk factors you have and how to safely reduce your risk and support better overall immune health. Be sure to talk with your health care provider before making any drastic lifestyle or dietary changes.

In health,

Dr. Brittany Pearce, RHN., ND.

[1] O'Keefe JH, Gheewala NM, O'Keefe JO. Dietary strategies for improving post-prandial glucose, lipids, inflammation, and cardiovascular health. J Am Coll Cardiol. 2008 Jan 22;51(3):249-55. doi: 10.1016/j.jacc.2007.10.016. PMID: 18206731.

[2] Jafar N, Edriss H, Nugent K. The Effect of Short-Term Hyperglycemia on the Innate Immune System. Am J Med Sci. 2016 Feb;351(2):201-11. doi: 10.1016/j.amjms.2015.11.011. PMID: 26897277.

[3] Furman, D., Campisi, J., Verdin, E. et al. Chronic inflammation in the etiology of disease across the life span. Nat Med 25, 1822–1832 (2019). https://doi.org/10.1038/s41591-019-0675-0

[4] Xu S, Jin T, Weng J. Endothelial Cells as a Key Cell Type for Innate Immunity: A Focused Review on RIG-I Signaling Pathway. Front Immunol. 2022 Jul 5;13:951614. doi: 10.3389/fimmu.2022.951614. PMID: 35865527; PMCID: PMC9294349.

[5] Oakley R, Tharakan B. Vascular hyperpermeability and aging. Aging Dis. 2014;5(2):114-125. Published 2014 Apr 1. doi:10.14336/AD.2014.0500114

[6] Reily C, Stewart TJ, Renfrow MB, Novak J. Glycosylation in health and disease. Nat Rev Nephrol. 2019 Jun;15(6):346-366. doi: 10.1038/s41581-019-0129-4. PMID: 30858582; PMCID: PMC6590709.

[7] Aeberli I, Gerber PA, Hochuli M, Kohler S, Haile SR, Gouni-Berthold I, Berthold HK, Spinas GA, Berneis K. Low to moderate sugar-sweetened beverage consumption impairs glucose and lipid metabolism and promotes inflammation in healthy young men: a randomized controlled trial. Am J Clin Nutr. 2011 Aug;94(2):479-85. doi: 10.3945/ajcn.111.013540. Epub 2011 Jun 15. PMID: 21677052.

[8] Camilleri M. Leaky gut: mechanisms, measurement and clinical implications in humans. Gut. 2019 Aug;68(8):1516-1526. doi: 10.1136/gutjnl-2019-318427. Epub 2019 May 10. PMID: 31076401; PMCID: PMC6790068.

[9] Zheng, D., Liwinski, T. & Elinav, E. Interaction between microbiota and immunity in health and disease. Cell Res 30, 492–506 (2020). https://doi.org/10.1038/s41422-020-0332-7

[10] Moling O, Gandini L. Sugar and the Mosaic of Autoimmunity. Am J Case Rep. 2019;20:1364-1368. Published 2019 Sep 15. doi:10.12659/AJCR.915703

[11] https://www.heartandstroke.ca/healthy-living/healthy-eating/reduce-sugar

[12] Bellini A, Nicolò A, Bazzucchi I, Sacchetti M. The Effects of Postprandial Walking on the Glucose Response after Meals with Different Characteristics. Nutrients. 2022;14(5):1080. Published 2022 Mar 4. doi:10.3390/nu14051080

[13] Pahra D, Sharma N, Ghai S, Hajela A, Bhansali S, Bhansali A. Impact of post-meal and one-time daily exercise in patient with type 2 diabetes mellitus: a randomized crossover study. Diabetol Metab Syndr. 2017;9:64. Published 2017 Aug 31. doi:10.1186/s13098-017-0263-8

[14] Erickson ML, Little JP, Gay JL, McCully KK, Jenkins NT. Postmeal exercise blunts postprandial glucose excursions in people on metformin monotherapy. J Appl Physiol (1985). 2017 Aug 1;123(2):444-450. doi: 10.1152/japplphysiol.00213.2017. Epub 2017 May 18. PMID: 28522762.

Glutathione in the Treatment of Fatty Liver/NASH/NAFLD

Have you been told you have a “fatty liver” despite not consuming high amounts of alcohol? If so, you have NAFLD or NASH.

What is NASH/NAFLD?

>> Nonalcoholic Fatty Liver Disease (NAFLD, Hepatic Steatosis, NASH)

Non-alcoholic fatty liver disease (NAFLD) is a chronic and multifactorial disorder characterized by excessive fatty acid accumulation in liver cells. Associated with metabolic syndromes, NAFLD is increasingly being recognized as a major cause of liver disease. It is a spectrum of liver abnormalities that ranges from nonalcoholic fatty liver to steatohepatitis, cirrhosis, and liver cancer. It is estimated that 25% of the global population has NAFLD, a number projected to continue to rise, and as it does, it is expected that more of these cases will progress to end-stage disease states requiring liver transplantation. A larger percentage of liver cancers in these cases occur before end-stage liver failure, and thus are less likely to be screened for, increasing the tendencies for liver tumors to be larger and more difficult to treat at the time they are diagnosed. Testing and diagnosis of NAFLD may include blood tests, imaging, and biopsy.

What causes it? 

Risk Factors

•    Metabolic syndrome (strongest risk factor)

• increased waist circumference (obesity)

• insulin resistance

• elevations in:

  • blood sugar

  • cholesterol

  • triglycerides

  • blood pressure

  • uric acid

•    Diabetes (up to 75% of individuals with type 2 diabetes have NAFLD)

•    Sleep apnea

•    Gut microbiome effects

•    Genetic factors

Image: Friedman et al. 2018

Why is it important to address?

Patients with NAFLD are twice as likely to die of cardiovascular disease than liver disease as a result of these shared risk factors. NAFLD in itself is an independent risk factor for cardiovascular disease due to its impacts on vascular health and inflammation.

How does it happen & what you can do about it?

Free fatty acids from either adipose tissue (fat), or from the conversion of excess carbohydrate intake, accumulate in the liver cell resulting in oxidative stress, inflammation, and liver injury.

As such, healthy eating habits and regular exercise can reduce the amount of free fatty acids and thereby prevent or reverse NAFLD. Glutathione supplementation can also help in the recovery of NASH/NAFLD.

What is Glutathione?

Glutathione (GSH) is a tripeptide made from amino acids, that is present in every cell of the human body, though is highly concentrated in the liver. Known as the ‘master antioxidant’ it directly scavenges reactive oxygen species, protecting your body from oxidative damage, and plays a crucial role in detoxification and cellular health. Reduced levels of glutathione have been associated with increased disease risk and progression, including NAFLD and other liver pathologies.

In addition to healthy diet and lifestyle habits, preliminary studies have shown beneficial effects of supplemental glutathione in the treatment of NAFLD, demonstrating a reduction of ALT–a liver enzyme elevated in liver dysfunction and one of the principal NAFLD biomarkers–after four months of treatment. Other studies demonstrated intravenous glutathione rapidly improved liver function, also evidenced by reduced biomarkers, in the treatment of other liver pathologies including chronic hepatitis B. Various nutrients, amino acids, herbal extracts, and probiotics have also been shown to increase glutathione activity in the body, and may be used in conjunction for enhanced therapeutic effect.

Find out if Glutathione is an option for you!

At Saskatoon Naturopathic Medicine, we offer both oral and intravenous glutathione for the treatment of NAFLD and other conditions, as part of our comprehensive approach to our patients’ unique health history and needs. If you are interested in learning more about how we can assist you, give us a call or book online to connect with one of our naturopathic doctors who would be happy to assess your case and discuss treatment options appropriate for you.

*IV therapy requires a consultation and evaluation by one of our IV doctors to assess patient eligibility and treatment goals. For more information see our IV therapy page. 

Jacalyn Sieben, ND

Sources:

Friedman, S. L., Neuschwander-Tetri, B. A., Rinella, M., & Sanyal, A. J. (2018). Mechanisms of NAFLD development and therapeutic strategies. Nature medicine, 24(7), 908–922. https://doi.org/10.1038/s41591-018-0104-9

Honda et al. (2017). Efficacy of glutathione for the treatment of nonalcoholic fatty liver disease: an open-label, single-arm, multicenter, pilot study. BMC Gastroenterology. 17:96 DOI 10.1186/s12876-017-0652-3. https://pubmed.ncbi.nlm.nih.gov/28789631/

Vairetti, M., Di Pasqua, L. G., Cagna, M., Richelmi, P., Ferrigno, A., & Berardo, C. (2021). Changes in Glutathione Content in Liver Diseases: An Update. Antioxidants, 10(3), 364. MDPI AG. Retrieved from http://dx.doi.org/10.3390/antiox10030364

Qian, L., Wang, W., Zhou, Y., & Ma, J. (2017). Effects of reduced glutathione therapy on chronic hepatitis B. Central-European journal of immunology, 42(1), 97–100. https://doi.org/10.5114/ceji.2016.65894

Seasonal affective disorder & vitamin d

Saskatchewan is known for its long, cold winters. As the temperatures decrease, so do the daylight hours, significantly diminishing the amount of sun we might see each day. To add to that, to avoid the cold, we spend more time indoors and the time we do spend outside has us wrapped from head-to-toe to keep warm. This means less sun exposure and therefore reduced opportunity for us to synthesize vitamin D from its light. For some people, the change in seasons also brings on the “winter blues” also known as Seasonal Affective Disorder (S.A.D.). It is currently thought that a combination of physiologic, psychologic, genetic, and environmental factors play a role in S.A.D., one of them being vitamin D deficiency.

What is seasonal affective disorder?

Also termed “S.A.D.”, Seasonal Affective Disorder is a form of depression that typically occurs in the winter months when our exposure to sunlight is limited. Approximately 2-3% of Canadians will experience S.A.D. at some point and 15% more will experience a milder version of the condition.

There is a natural tendency to slow down in winter compared to the high-energy lifestyles we tend to carry on in summer months. However, if you notice you are feeling particularly low or experiencing the signs & symptoms below, it might be time to consider consulting a healthcare professional for an assessment.

Signs & Symptoms

• Feelings of hopelessness & sadness

• Thoughts of suicide

• Oversleeping

• Cravings for sweet or starchy foods

• Weight gain

• Fatigue/low energy

• Decreased physical activity

• Difficulty concentrating

• Irritability

• Increased sensitivity to social rejection

• Avoidance of social situations

In S.A.D., these signs and symptoms appear and disappear at about the same time each year, and the sad, despairing mood:

• is present most days and lasts most of the day

• lasts for more than two weeks

• impairs performance at work, school or in social relationships

Vitamin D - the sunshine vitamin

Vitamin D, which actually functions more like a hormone, acts on receptors in every tissue in the body including the brain and immune system. As it is a fat-soluble vitamin, we get it through diet from sources such as fatty fish (sardines, salmon, tuna), eggs, and liver; and are also able to synthesize it through our skin when we get sufficient exposure to the sun. As such, vitamin D levels have been shown to fluctuate with exposure to sunlight. Levels tend to decline from fall to winter, and are naturally lower the further north you live from the equator.

Vitamin D has many functions within the body. It is needed for calcium absorption (healthy bones, teeth), healthy immune function, and also has a role in the release of dopamine and serotonin - signalling molecules that, in the brain, are associated with drive, pleasure, and happiness.

So, how much vitamin D do you need?

Health Canada recommends a daily dietary intake of 600-800 IU’s of Vitamin D for adults. However, according to their statistics, most Canadians are not achieving this. While we also know sunlight does provide Vitamin D, here in Saskatchewan, the exposure we get at our northern location is often inadequate, especially in the winter months. Vitamin D levels also decrease with age, skin pigmentation, liver and kidney disease, obesity, certain medications, genetic mutations and other conditions.

How do I know if I’m getting enough vitamin D?

Luckily, there is a test for that! A simple blood test can assess whether you are getting sufficient amounts of vitamin D, or if supplementation may be indicated–or, in some cases, contraindicated. There can be too much of a good thing especially when it comes to supplementation. Vitamin D toxicity related to excessive long-term intake of vitamin D can cause hypercalcemia and related symptoms such as confusion, apathy, vomiting, abdominal pain, pathological calcification, increased thirst and increased urination. It is also important to note that everyone metabolizes vitamin D differently, so some people can experience vitamin D toxicity even at lower doses that are considered safe for the general population. It is always recommended to consult a healthcare practitioner before implementing any new health regimen to see if it is right for you, including vitamin D supplementation.

If you are experiencing symptoms of the “winter blues” or are curious about your vitamin D status or other natural approaches to mental health, you are invited to book a consult with myself or one of my colleagues to discuss your healthcare options.

We look forward to working with you!

In health, Jacalyn Sieben, ND

References:

1. CAMH. (2019). Seasonal affective disorder (SAD). Retrieved from: https://www.camh.ca/en/health-info/ mental-illness-and-addiction-index/seasonal-affective-disorder

2. Canadian Mental Health Association, BC Division. (2013). Seasonal affective disorder. Retrieved from: https://cmha.bc.ca/documents/seasonal-affective-disorder-2/

3. Health Canada. (2012). Vitamin d and calcium: Updated dietary reference intakes. Retrieved from: https://www.canada.ca/en/health-canada/services/food-nutrition/healthy-eating/vitamins-minerals/ vitamin-calcium-updated-dietary-reference-intakes-nutrition.html

4. Marcinowska-Suchowierska E, Kupisz-Urbańska M, Łukaszkiewicz J, Płudowski P and Jones G (2018) Vitamin D Toxicity–A Clinical Perspective. Front. Endocrinol. 9:550. doi: 10.3389/fendo.2018.00550

5. Melrose S. (2015). Seasonal Affective Disorder: An Overview of Assessment and Treatment Approaches. Depression research and treatment, 2015, 178564. https://doi.org/10.1155/2015/178564

Optimize Your Health During Nutrition Month!

NUTRITION MONTH

March is Nutrition Month! Nutrition is the study of how we, through our diets, get the nutrients we need to live. “Let food be thy medicine and medicine be thy food”, a quote attributed to Hippocrates, is a simple but powerful statement on the importance of our diet. Optimizing nutrition status - making our diets as healthy as possible - is one of the foundational goals in improving our health at every age.

A diet providing all of the nutrients we not only need to live, but need to live healthy lives, is dependent on many factors. We can generalize what a healthy diet looks like for the majority of people, however it is important to be aware of certain factors that can impact an individual’s nutritional requirements. For example, those who are pregnant will have different nutritional requirements than others. Additionally, certain medical conditions, treatments and even some medications can impact proper absorption of nutrients. Optimal nutrition is also a public health issue - for example, low socioeconomic status is associated with poorer nutrition [1] - possibly because it can be difficult to afford or even access healthy foods.

Although the food you eat is one of the most important aspects of nutrition, it is not the only important factor. Nutrition also involves how your food is broken down into nutrients, how well these nutrients are absorbed, how well your body puts these nutrients to use, and finally how well your body eliminates what it no longer needs and protects you from potentially toxic substances. 

How can a Naturopathic Doctor (ND) help optimize your nutrition? NDs have extensive training in nutrition, and can offer a variety of services and assessments to support your individual nutritional needs:

• Lab testing to assess for nutritional deficiencies or conditions associated with nutritional deficiencies

• Education surrounding appropriate diets for your health status and goals

• Expertise on all aspects of digestion, including optimizing the absorption of nutrients and supporting your body’s ability to eliminate waste products

• Assessing your current diet and making recommendations to support an optimal diet

• Addressing obstacles that come up (ie. financial, accessibility, resources) that make it difficult to make healthier changes

• Providing expertise on what nutritional supplements may be helpful for you

Interested in optimizing your nutrition? Book an appointment with one of our Naturopathic Doctors today!

[1] Alkerwi A, Vernier C, Sauvageot N et al. Demographic and socioeconomic disparity in nutrition: application of a novel Correlated Component Regression approach. BMJ Open. 2015; 5(5):e006814.

Lower Blood Sugar and Cholesterol and Improve Heart Health with Berberine!

BERBERINE AND CARDIOMETABOLIC HEALTH

Berberis Vulgaris (Barberry)

Berberine is a bright yellow-coloured alkaloid compound found in many plants, some of the more common ones including Hydrastis canadensis (goldenseal), Berberis vulgaris (barberry), Coptis chinensis (Chinese goldthread), and Berberis aquifolium (Oregon grape). Berberine has been used traditionally to combat inflammatory disorders, infectious diseases, diabetes, digestive disorders and many others, and has demonstrated benefits on blood sugar metabolism, cardiovascular effects, cholesterol and atherosclerosis.

Berberine appears to exert its cardiovascular effects through various mechanisms that play a role in protecting the blood vessels, decreasing inflammation and modulating levels of cholesterol and blood sugar. Berberine has been shown to affect the modulation of an enzyme called adenosine monophosphate-activated protein kinase (AMPK). AMPK is responsible for maintaining healthy blood vessels through a variety of different mechanisms, including the regulation of another enzyme, called endothelial nitric oxide synthase (eNOS), which is responsible for producing nitric oxide in the cell layer lining our blood vessels. Nitric oxide is important in regulating how our blood vessels dilate (which plays a role in our blood pressure), platelet and white blood cell activation and adhesion (which plays a role in the development of arterial plaques), and antioxidant functions (which is important for preventing damage from free radicals like glycated blood sugar, which is prevalent in diabetes). In simpler terms, AMPK and eNOS are important for maintaining a healthy cardiovascular system. When eNOS is not functioning properly, it can contribute to the development of high blood pressure, diabetes and high cholesterol. Berberine has been found to increase the production of nitric oxide through enhancing activity of eNOS [1, 2, 6, 7].

Current research on berberine has been focused on its metabolic and cardiovascular properties. A research study suggested that berberine was shown to decrease levels of total cholesterol, triglycerides and LDL cholesterol levels, while increasing HDL-cholesterol (which is thought to be protective, or the “good” cholesterol). A meta-analysis demonstrated that the addition of berberine to simvastatin, a cholesterol-lowering drug, resulted in a greater reduction of triglycerides and total cholesterol, and a reduction in the number of side effects, compared to the use of simvastatin on its own [5].

Berberine also benefits blood sugar levels and reduces body fat mass. A research study on diabetic patients showed that those who were given berberine had a reduction in blood sugar levels and cholesterol levels, and those with metabolic syndrome also experienced a decrease in their body mass index (BMI) and waist circumference [3]. A study on women with polycystic ovary syndrome (PCOS), a disorder characterized by insulin-insensitivity, obesity and high cholesterol, found that berberine decreased waist circumference and waist-to-hip ratio, insulin sensitivity and blood sugars and cholesterol levels comparable and/or superior to that of metformin [4].

Berberine is generally well-tolerated, and side effects of usage are usually mild in nature, such as abdominal discomfort, diarrhea, constipation, decreased appetite, and dermatological rashes. Berberine may interfere with certain medications and may not be suitable for everyone. As always, with any natural health product it is important to consult with your naturopathic doctor to see if berberine is safe for you.

References:

[1] Neag M, Mocan A, Echeverria J, et al. Berberine: Botanical Occurrence, Traditional Uses, Extraction Methods, and Relevance in Cardiovascular , Metabolic, Hepatic, and Renal Disorders. Front Pharmacol. 2018; 9:557. https://pubmed.ncbi.nlm.nih.gov/30186157/

[2] Hoffmann D. (2003). Medical Herbalism: The Science and Practice of Herbal Medicine. Healing Arts Press.

[3] Pirillo A, Catapano AL. Berberine, a plant alkaloid with lipid- and glucose-lowering properties: from in vitro evidence to clinical studies. Atherosclerosis. 2015; 243(2): 449-61. https://pubmed.ncbi.nlm.nih.gov/26520899/

[4] Wei W, Zhao H, Wang A, et al. A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome. Eur J Endocrinol. 2012; 166(1):99-105. https://pubmed.ncbi.nlm.nih.gov/22019891/

[5] Zhang LS, Zhang JH, Feng R, et al. Efficacy and safety of berberine alone or combined with statins for the treatment of hyperlipidemia: a systematic review and meta-analysis of randomized controlled trials. Am J Chin Med. 2019; 47(4):751-767. https://pubmed.ncbi.nlm.nih.gov/31094214/

[6] Affuso F, Mercurio V, Fazio V, et al. Cardiovascular and metabolic effects of berberine. World J Cardiol. 2010; 2(4):71-7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2999047/

[7] Bagade A, Tumbigeremutt V, Pallavi G. Cardiovascular Effects of Berberine: A Review of the Literature. Journal of Restorative Medicine. 2017; 6: 37-45.

Welcome Nicole Loran

Meet Nicole Loran! She is a 4th year student finishing her training in Naturopathic Medicine at the Southwest College of Naturopathic Medicine (SCNM) in Tempe, Arizona. Nicole is a dedicated and hard working student who currently holds a Bachelor of Science degree in Physiology and Pharmacology as well as a Arts and Science degree in Religion and Culture from the University of Saskatchewan. Nicole is involved in ongoing research through SCNM for psoriasis and is currently class Treasurer and Vice President of the Aesthetics Club at SCNM.

Education is extremely important to Nicole and she continually strives to further her knowledge in many areas including anti-aging, integrative, and functional medicine. She incorporates what she learns into her daily practice and strives to empower the patients with knowledge on how to improve their health.

Nicole has 2 years of clinic experience with a focus on general, naturopathic community and internal medicine, women and men’s health, endocrinology, botanical medicine, nutrition, nature cure, acupuncture, IV therapy, heavy metal toxicity and addictions.

Her interests include: endocrinology, women’s health, nutrition, weight loss, gastrointestinal health, metabolic disorders, stress, chronic fatigue and acupuncture.

Nicole is originally from Saskatoon. She is looking forward to spending one of her final months as an intern under the supervision of Dr. Velichka ND. Once her schooling is complete, she plans on moving back to Saskatoon to start her practice as a Naturopathic Doctor.

You can book in to see Nicole at our clinic ever Monday, Wednesday and Friday during the month of May. Nicole has experience in creating diet plans for patients with diabetes or PCOS and those who require FODMAP, anti-SIBO or ketogenic diets. Nicole will be assisting Dr. Velichka ND in her acupuncture services.

We are excited to have Nicole be a part of our clinic over the next month. We hope you get to enjoy the benefits from having her involved in your care!

RECIPE FOR BREAST HEALTH

October is Breast Cancer Awareness Month!

Our doctors at Saskatoon Naturopathic Medicine can help you learn to eat foods to prevent breast cancer or reoccurrences of the disease.

Cruciferous vegetables contain nutrients that help with healthy estrogen metabolism and breast health. This family of vegetables includes the following: Arugula, Bok Choy, Broccoli, Brussel Sprouts, Cabbage, Cauliflower, Collard Greens and Kale. Indole-3-carbinol and sulforaphanes are the phytonutrients found in these vegetables that have anticancer properties. Aim to eat one serving per day of cruciferous vegetables and keep your breasts healthy!

Here is one of Dr Velichka’s favorite recipes which incorporates these vegetables into your diet.

Mashed Cauliflower with Kale

1 medium to large head of cauliflower

5 medium leaves of kale, washed and chopped

½ tsp fresh or dried dill

1-2 Tbsp of olive oil, ghee butter or coconut oil

Salt and pepper to taste

Parsley for garnish (optional)

Bring half a pot of water to boil. Add head of cauliflower and boil for 5 minutes until cauliflower is quite tender. Strain water from pot. Mash cauliflower with a vegetable masher or blend in blender. Mix in chopped kale and let wilt with the heat from the hot cauliflower. Add oil or ghee butter, dill, salt and pepper. Garnish with parsley. Enjoy!

This is a quick and simple way to include an extra serving of non-starchy vegetables to your main meal.

MYERS COCKTAIL

What is a Myers Cocktail?

One of the most common IVs provided by naturopathic doctors across North America is a Myers cocktail. 

What is in this popular IV and what can it be helpful for? 

The Myers cocktail is an intravenous mixture of minerals and vitamins that is administered directly into a vein and is infused over a timespan of 30-45 minutes. It can be effective against asthma symptoms, migraines, fatigue, fibromyalgia, acute muscle spasm, upper respiratory tract infections, chronic sinusitis, seasonal allergic rhinitis, and cardiovascular disease. 

The vitamins in the Myers cocktail include vitamin C, vitamin B complex, vitamin B12, magnesium, and calcium. It is a fairly simple formula. However, taking these nutrients intravenously means they are 100% absorbed into circulation which is dramatically more than the absorption through the gut with oral supplementation. Though the high levels of nutrients provided by a Myers cocktail will only last a few hours in circulation, the benefits can be profound over the long-term. 

Some patients may receive the Myers cocktail weekly or monthly. Naturopathic doctors may recommend this option when a patient has trouble with absorption (including patients with IBS or IBD) or when a patient is chronically ill and a less invasive nutritional plan is not effective.  Naturopathic doctors work with their patients with complex health conditions to identify root cause issues and assess an individuals need for advanced nutritional IV therapy.  Patients who are a candidate for this treatment will be assessed by their naturopathic doctor to ensure safety and to consider any individual modifications to the formula that may be required. 

To learn more about the effectiveness of the Myers cocktail including its history, applications, theory, and research please read the following review by Dr. Alan Gaby, MD —> Intravenous Nutrient Therapy: The “Myer’s” Cocktail.

To find out more if this or other nutrient IVs might be appropriate for you, contact our office to book an IV therapy consult with your naturopathic doctor!