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

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.

Movement is Medicine - It's never too late to start if you have (or had) Breast Cancer!

The Importance of Physical Activity in Breast Cancer Patients

The World Health Organization (WHO) recommends 150 minutes (about 2.5 hours) of moderate to vigorous-intensity physical activity per week for adults, which has been shown to reduce the risk of developing cardiovascular disease, diabetes and depression, can improve bone health, and reduce all-cause mortality [1, 2]. Additionally, regular physical activity has also been demonstrated to support breast cancer patients before diagnosis, during treatment and in survivorship.

IMPACT OF PHYSICAL ACTIVITY BEFORE DIAGNOSIS

Research has shown that women who were physical activity before being diagnosed with breast cancer had decreased mortality from breast cancer and all-causes compared to women who were not physically active before diagnosis [4, 6]. One of these studies also found that women who were sedentary (not physically active) before diagnosis but started exercising after diagnosis had a 45% lower risk of death from breast cancer compared to women who were not physically-active before or after diagnosis [6]. This impact was achieved just by engaging in brisk walking 2-3 hours per week!

EXERCISE DURING CANCER TREATMENT IS SAFE AND EFFECTIVE

One study looked at how exercise impacts the health of patients with stage II+ breast cancer. They found that engaging in exercise was safe for these patients, and was associated with improvements in quality of life, fitness level, fatigue, strength, mental health, and weight [3]. Another study conducted on breast cancer patients undergoing chemotherapy found that more intense exercise regimens (50-60 minutes 3 times per week) were slightly better than moderate-intensity exercise regimens (25-30 minutes 3 times per week) in improving pain, hot flashes, and strength, however both regimens were effective in managing side effects from chemotherapy [5].

PHYSICAL ACTIVITY AFTER TREATMENT IS STILL BENEFICIAL

Research on breast cancer survivors has also shown benefit. One study found that breast cancer survivors who practiced 150 minutes of moderate-intensity exercise per week had a 27% decrease in all-cause mortality (ie. dying from any cause) and a 25% decrease in breast cancer mortality, compared to women who had lower levels of physical activity [2].

MOVEMENT IS MEDICINE

So, what does this mean? It’s never too late to increase your levels of physical activity! No matter where you are on your health journey, physical activity appears to benefit health by reducing risk of dying from cancer and other causes and improving side effects during treatments. As always, talk to your doctor to make sure you are engaging in physical activity that is safe for you!

WHAT CAN I DO TO INCREASE MY PHYSICAL ACTIVITY LEVELS?

There are a number of ways to increase physical activity and movement in your daily schedule! An easy way to remember the difference between moderate-intensity and vigorous intensity exercising is talking and singing - at a moderate level of intensity, you can talk but would find it difficult to sing; at vigorous-intensity, it would be difficult to talk. Here’s a few ideas:

• Take the stairs instead of the elevator

• Walk or bicycle to work, or walk the kids to school

• Go for walks before or after work, or during the day

• Take up a sport or hobby that involves movement, like dancing, tennis, swimming

• Raking the leaves, shovelling snow, gardening

• Yoga, tai chi and Qigong

• Household chores like vacuuming, mopping

• Our favourite at Saskatoon Naturopathic Medicine: 15 minute at-home dance session - just turn on your favourite song and dance!

References:

[1] https://www.who.int/dietphysicalactivity/physical-activity-recommendations-18-64years.pdf

[2] Beasley, J. M., Kwan, M. L., Chen, W. Y., Weltzien, E. K., Kroenke, C. H., Lu, W., Nechuta, S. J., Cadmus-Bertram, L., Patterson, R. E., Sternfeld, B., Shu, X.-O., Pierce, J. P., & Caan, B. J. (2012). Meeting the physical activity guidelines and survival after breast cancer: Findings from the after breast cancer pooling project. Breast Cancer Research and Treatment, 131(2), 637–643. https://doi.org/10.1007/s10549-011-1770-1

[3] Singh, B., Spence, R. R., Steele, M. L., Sandler, C. X., Peake, J. M., & Hayes, S. C. (2018). A Systematic Review and Meta-Analysis of the Safety, Feasibility, and Effect of Exercise in Women With Stage II+ Breast Cancer. Archives of Physical Medicine and Rehabilitation, 99(12), 2621–2636. https://doi.org/10.1016/j.apmr.2018.03.026

[4] Lahart, I. M., Metsios, G. S., Nevill, A. M., & Carmichael, A. R. (2015). Physical activity, risk of death and recurrence in breast cancer survivors: A systematic review and meta-analysis of epidemiological studies. Acta Oncologica (Stockholm, Sweden), 54(5), 635–654. https://doi.org/10.3109/0284186X.2014.998275

[5] Courneya, K. S., McKenzie, D. C., Mackey, J. R., Gelmon, K., Friedenreich, C. M., Yasui, Y., Reid, R. D., Cook, D., Jespersen, D., Proulx, C., Dolan, L. B., Forbes, C. C., Wooding, E., Trinh, L., & Segal, R. J. (2013). Effects of exercise dose and type during breast cancer chemotherapy: Multicenter randomized trial. Journal of the National Cancer Institute, 105(23), 1821–1832. https://doi.org/10.1093/jnci/djt297

[6] ​​Irwin, M. L., Smith, A. W., McTiernan, A., Ballard-Barbash, R., Cronin, K., Gilliland, F. D., Baumgartner, R. N., Baumgartner, K. B., & Bernstein, L. (2008). Influence of pre- and postdiagnosis physical activity on mortality in breast cancer survivors: The health, eating, activity, and lifestyle study. Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology, 26(24), 3958–3964. https://doi.org/10.1200/JCO.2007.15.9822

Eating to Prevent Chronic Disease: The Mediterranean Diet

Eating to Prevent Chronic Disease

What is a Mediterranean Diet?

The Mediterranean diet is a diet high in fish, legumes, whole grains, vegetables, fruits, nuts, seeds, and olive oil. It is low in high fat meats and dairy products.

If you want to be on a healthy Mediterranean diet you should try eliminating cream, butter, margarine, carbonated and/or sugared beverages, and processed foods such as pastries, industrial bakery products, industrial desserts (puddings, custard), French fries, potato chips, cakes and sweets.

It is a good idea to limit your consumption of cured meats, red meats, and cured and fatty cheeses. When choosing animal products, choose healthy sources (Grass fed, Free range, wild etc) that have minimal contaminates and a good balance of omega-3 and omega 6 fatty acids.

The Mediterranean diet is also characterized by a high intake of b-carotene, B vitamins, vitamin C, vitamin E, folic acid, polyphenols and a wide variety of phytochemicals that are found in the various plant foods frequently consumed (1).

Research shows adherence to Mediterranean diet is effective in prevention of cardiovascular disease, depression, metabolic syndrome and Type 2 Diabetes. The information to follow summarizes a bit of the research.

Supporting Research

Cardiovascular Disease

The Mediterranean diet has been ranked as the most likely dietary model to provide protection against coronary heart disease. (2)

 In a 2018 study involving persons at high cardiovascular risk, the incidence of major cardiovascular events was lower among those assigned to a Mediterranean diet (Med Diet) supplemented with extra-virgin olive oil or nuts than among those assigned to a reduced-fat diet. (3)

• 3 groups studied

o   Low-fat diet

o   Mediterranean Diet with added nuts

o   Mediterranean Diet with added olive oil

• Risk of combined heart attack, stroke and death from cardiovascular disease compared to low-fat diet was reduced by 30% in the Med Diet + Olive Oil and 28% in the Med Diet + Nuts.

Good adherence to a Mediterranean diet resulted in a more favorable health status as reflected by improved cardio vascular disease risk factors, such as lipid profile, blood pressure, and glucose, especially in persons with diabetes and compared with a low-carbohydrate diet. (4)

Higher adherence to a Mediterranean diet was associated with lower mean levels of blood pressure after 6 years of follow-up. (4)

Diabetes

Mediterranean diet supplemented with extra virgin olive oil (EVOO) or mixed nuts has shown to reduce the incidence of type 2 diabetes by 40% and 18%, respectively, compared with a low-fat control diet. (5)

Depression

High adherence to a Mediterranean diet high in whole grains, fruits, vegetables, nuts, lean meats and olive oil was protective for depression at all ages throughout the lifespan. Even moderate adherence to a Mediterranean diet was protective in younger individuals. For older individuals, the research showed that the benefit to mental well-being and depression prevention was only associated with those individuals who adhered to a more strict Mediterranean diet. (6)

A 2017 study examined 56 men and women with major depression who all had a very poor diet containing lots of highly refined foods, very few fruits and vegetables, and few lean types of meats. Implementing a Mediterranean diet that was high in whole grains, fruits, vegetables, nuts, lean meats and 3 TBSP of olive oil per day led to 32% of participants no longer meeting the criteria for depression after only 12 weeks! (7)

Metabolic Syndrome

Metabolic syndrome is a cluster of 3 or more related cardiometabolic risk factors:

• Central obesity (determined by waist circumference)

• Hypertension

• Hypertriglyceridemia

• Low HDL cholesterol levels

• Hyperglycemia.

Research has shown that olive oil supplementation can decrease central obesity and elevated fasting glucose levels. Supplementation with nuts (rather than olive oil) has also been shown to reduce central obesity. (8)

Interested in changing your diet to a Mediterranean Diet? Below is some good information to help you get started!

References