Author Archives: Sarina Lusso

Phone and Email Policy, responding to…

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The initial consultation includes a day 5-7 email feedback response. After this however, if you require service, including answering emails, then an appointment is required.

As a general guide, as customer service is considered a high priority and the nature of the relationship may be more personalised than other healthcare providers, the policy of the clinic is such that any phone/email request that requires more than 8 minutes to hear/read and reply to it, requires an appointment to be booked. As a rough guide – this equates to 1, and at maximum, 2 questions.

Please also note – that if your file requires to be drawn, and/or copies made to facilitate a service request, there is a small administration charge of $15 to cover costs, excluding postage.  The clinic reserves the right to make pass on additional charges for excessive photocopying, postage charges or other ancillary expenses to cover any costs.

In managing expectations when requesting service through email or phone, please consider the following –

  1. Is it fair to other customers who book appointments & make time in their day for an appointment, to expect that free service will be given through phone or emails?
  2. As part of this clinic’s professional obligations and duty of care, it may not be possible to provide ethical service through an email or phone response, unless organised as a booked appointment.
  3. Consider whether your case and/or the information you are seeking through an email response is complex or multi-factorial. In which case, it most likely would take longer than the gratis 8 minutes and you should really book an appointment.
  4. Consider whether you would send an email request for service to a GP, a consultant, physiotherapist, counsellor or other healthcare professional? If not, then why would you think it is OK to send this clinic an email or phone request for service?
  5. Lastly, time is a valuable asset with which this clinic uses to provide service & value to all customers, and requesting free service dishonours those who –
    1.  provide the service, and
    2. others who follow the process. After all, would you think it fair that you have to pay and others get service for free?

Adrenal Fatigue – do you have it?

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Sugar, Salt, SexDo you feel flat regularly?

Are you having problems sleeping?

Have you noticed changes in your libido?

Do you have hypertension but there’s no family history?

Do you negotiate feelings of depression and sadness on a daily basis?

Do you get out of bed in the morning with a spring in your step? Or do you drag yourself out of bed?

Have you noticed that you don’t really ‘wake up’ for the day until around 10-11am?

Have you observed having a coffee at a set time because ‘it gets you through the afternoon’?

Do you regularly have a late afternoon stimulant hit of caffeine/chocolate/sugar or sugary products/other?

Are you tired of being tired all the time?

Have you been using the oral contraceptive pill for a long time?

Do you find that you can’t muster the energy to do the activities you really enjoy?

Have you had enough, and need some possible answers?

Then read on……….!

Adrenal fatigue was first described by Thomas Addison (1793-1860) but the term ‘Adrenal Fatigue’ was coined in the 1990’s and one of the first names attributed to recognising (and later writing about it) was Dr James L Wilson. The condition has for a long time evaded medical acceptance because the diagnosis of ‘adrenal fatigue’ didn’t sit nicely within the current paradigm.   You either had Addison’s Disease or Cushing’s Disease – both, at each extreme of the adrenal continuum with a whole spectrum of possible signs and symptoms in between.  In modern clinical practice, the majority of people have some degree of adrenal insufficiency, and unfortunately, my clinic is no different.

What are adrenals.pngWhat are adrenals?

Adrenals are two pyramid like glands that sit on top of each kidney, and are part of the endocrine system because they secrete messenger hormones/neurotransmitters.  They consist of 4 layers encased in a capsule.  The anatomy looks like this –

  1. Medulla – innermost layer > produces adrenalin and noradrenalin
  2. Cortex – outer most layer, has 3 sub-layers –
    1. Zona reticularis – produces sex hormones
    2. Zona fasciculata – produces glucocorticoids to regulate blood glucose levels
    3. Zona glomerulosa – produce mineralocorticoids to regulate electrolytes/minerals

Being part of the endocrine system, they interact with other glands such as the thyroid, parathyroid, gonads, hypothalamus, pituitary, pineal, pancreas and thymus. They interact using a complex biofeedback system reliant on conducting surveillance on levels of hormones/neurotransmitters in the blood and communicating with each other using primarily the chemical messengers we know as hormones or neurotransmitters.

The ‘fatigue’ part of adrenal fatigue occurs where the adrenal glands can no longer continue to produce all the hormones they need to, usually as a result of prolonged stress.

Causes of adrenal fatigue –

factors affecting adrenalsAny number of factors can cause adrenal fatigue, just take a look at the diagram.  However, the key to understanding adrenal fatigue are the concepts of stress and cortisol production – the master stress hormone.  When I ask people in clinic to rate their stress, invariably I get low ratings.  But when I explain that the body has one primary mechanism in its reaction to stress, their ratings change, but also because their definition of stress is challenged.

A little bit of stress is actually quite necessary, however stress, whether physical, emotional, psychological, mental, spiritual, financial, environmental, etc. has one main effect in the initial phase – to increase the activity of your sympathetic nervous system (SNS) and increase your production of adrenalin and noradrenalin (neurotransmitters), otherwise known as the Fight or Flight Response.  One of the many possible reasons why people find that sleep is affected in this phase is because adrenalin opposes the production of melatonin (the sleep hormone that helps you sleep).  Other hormones such as cortisol are also produced in this phase. However, if you are constantly or chronically in a heightened stress response state , also known as SNS Dominance, production of adrenalin and noradrenalin decreases and cortisol increases and stays high.  At this point symptoms such as anxiety, agitation, poor sleep, poor digestion, inability to lose weight especially around the mid-section, or even panic can be experienced.

General Adaptation SyndromeEventually (months in some people, years in others) production of these hormones reduces and you experience many more of the symptoms described in the table below, eventually leading to burnout and ultimately adrenal fatigue, where the adrenal glands can no longer continue to produce all the hormones they need to. This progression is known as the General Adaptation Syndrome (GAS, Hans Selye) and can be shown like this (please note that the timing of each phase is very unique to each individual).

Diurnal Cortisol PatternImportantly, cortisol production has a daily rhythm (also known as the diurnal cortisol pattern, DCP). So when your body continues to produce cortisol for extended periods of time as a consequence of an overactive stress response, the production of other hormones such as your sex hormones (androgens, pregnenolone, DHEA) and the hormones that regulate mineral/electrolyte balance (mineralocorticoids, aldosterone) in the body suffer too.  See next diagram.

Progession of Adrenal ExhaustionNow, cortisol is not all bad.  It is a necessary hormone involved in controlling inflammatory reactions and in particular in managing some white blood cells (amongst others) that if left unmanaged could result in more complicated inflammatory responses.  However, it is the prolonged release of cortisol at consistently high levels that results in symptoms such as decreased immunity, tendency to bruise easily, anxiety, irritability, skin eruptions, poor or compromised  digestion, etc.. BUT, the crucial point is that the DCP can be measured over the course of the day (discussed below), and this has implications for many health complaints including people suffering from insulin resistance/metabolic syndrome, people who have tried to lose weight repeatedly without ever achieving satisfactory results only to find their weight always comes back, suspected thyroid disorders, poor sexual function, blood pressure management, amongst others.

Note – One cortisol test result measurement at a point in time does not accurately convey what is happening or ‘trending’ in your body throughout the course of your ‘stressful’ day that would enable correct identification of management strategy. Please see below for how to test.

Here’s how it works…

Pregnenolone Cortisol StealCortisol is the metabolic end product of a series of biochemical and enzymatic reactions that convert cholesterol (produced in the liver – yes that’s right, our liver produces nearly 85% of the total cholesterol our body needs).  Cortisol is the master stress hormone but is also released in times of low blood glucose concentrations, for example, when the body undergoes a fasting stated at night while sleeping. In the pathway from cholesterol to cortisol, two products that are produced in the sequence are pregnenolone and progesterone. If all the pregnenolone  and progesterone are diverted to produce cortisol, there is very little, if any, product to be used to convert to either DHEA to make sex hormones, or Aldosterone (the hormone that regulates mineral/electrolyte balance).  This is known as the Cortisol Steal or the Pregnenolone Steal.

Hence, the relationship of chronic stress with high cortisol production, low sex hormone production, low aldosterone, poor blood sugar management.   The easy way to remember the relevance of the adrenal glands and the important functions they maintain can be depicted as follows –

  • Sugar (glucocorticoids, cortisol)
  • Salt (mineralocorticoids, aldosterone)
  • Sex (androgens, sex hormones)

What are examples of conditions and signs/symptoms of adrenal fatigue?

The following table summarises many of the diagnosed conditions and preceding signs/symptoms that can be associated with adrenal fatigue.

Conditions

Signs/Symptoms
Fibromyalgia

Alcoholism

Ischaemic Heart Disease

Hypoglycemia or hyperglycemia

Rheumatoid Arthritis

Chronic & recurrent respiratory infections

Alopecia

Chronic Fatigue Syndrome (CFS)

Addictions

Autoimmune disease

Depression

PMS & hormone disorders

Menopause, e.g. early onset

Allergies

Skin conditions – eczema, psoriasis, fungal infections

Hypertension or Hypotension

Metabolic Syndrome

Renal disease

Hyponatremia (low sodium)

Hyperkalemia (high potassium)

Thyroid disorders

IBS and digestive issues

Post Natal Depression

Pre-diabetes or Type 2 Diabetes

Prostate Disorder

Liver Dysfunction

Erectile dysfunction

 Poor or decreased sex drive/libido

Constant fatigue – not relieved by sleep

Craving salt or salty foods

Energy conservation – increased effort to do everyday tasks

Poor or declining memory

Anxiety and/or irritability

Increased recovery time from illness, injury or trauma

Orthostatic hypertension

Decreased tolerance

Decreased productivity

Poor quality of life

Don’t really wake up till 10am, afternoon low between 3-4pm, feel better after evening meal (usually 6pm)

Fat deposits especially around the face, upper back, between the shoulders and mid-section (visceral adiposity)

Weight gain or inability to lose weight adequately

‘Wired’ yet ‘tired

Poor sleep

Hyperpigmentation of the skin

Increased pain perception

Decreased melatonin production

Electrolyte imbalances

Early signs of ageing

Poor digestion

Bone and muscle loss

Sugar cravings

Poor stress management

Mood or behavioural changes

Insulin resistance

Cortisol resistance

Facial hair growth in women

Joint aches and pains

Fluid retention

Heavy metal exposures

How do I test? What do I test?

Adrenocortex Stress Profile - sample

Fortunately, there is a reliable, non-intrusive clinical method of testing for adrenal hormones using saliva.  The attached diagram is a sample report of a person that is unable to lose weight because of long term chronic stress and the impact on the adrenals.  This diagram describes the type of person whose adrenals are struggling to produce adequate levels of hormones and if no intervention takes place, will ultimately end in burnout.

In clinical practice, additional tests may be necessary such as thyroid studies, iron studies, melatonin, vitamin D status, zinc/copper ratio, neurotransmitter status, amongst others, but this is extremely personalised on a case by case basis depending on presenting complaints, case history, and desired health outcomes. Importantly, it is advised that you see a qualified healthcare practitioner if you suspect you may have adrenal fatigue or have been suffering from any of the above mentioned signs/symptoms with no adequate resolution.

What can YOU do NOW?

The first thing you can do is assess lifestyle choices.

  • Are you going to sleep around 9.30-10pm when the adrenal glands should be decreasing in activity to allow you to produce melatonin?
  • Do you need sleep hygiene advice?
  • Are you drinking alcohol every Friday and Saturday night? Or every night?
  • Are you eating a whole food, preferably organic, diet that is low in sugar and refined carbohydrates?
  • Are you drinking enough water?
  • Are you exercising regularly (3-4 times a week aerobically)?
  • Are you self-medicating without identifying the cause?
  • Do you have a positive support network? Or do some of your family/friends ‘stress you out’? If so, you may want to review the health of that relationship!
  • Are you trying to do too much?
    • Parenting duties
    • School runs
    • Working additional hours
    • A punishing exercise routine
    • Running a household
    • Starting or running a business
    • Work in a high-pressure executive role
    • etc., etc.
  • Do you regularly plan in some rest & vital relaxation time?
  • Are you being nurtured in ways that are right for you?

Some key nutrients that help support adrenal glands are:

  • Vitamin C + co-factors – almost 4g of the bodys’ total 5g of vitamin C are used by the adrenal glands on a daily basis, mainly in the production of cortisol!
  • Magnesium – is it the right form of magnesium? (if you’re not sure you may want to check my article on How to Choose the Right Multivitamin)
  • Vitamin B’s – in particular B5 and B6
  • Iodine
  • Selenium
  • Zinc
  • Tyrosine
  • Turmeric
  • Probiotics

There are also some herbal medicines to consider for adrenal support and restoration.  Rehmannia and Licorice are the two best known.

In addition, there are herbal medicines that have adaptogenic actions, i.e. they modulate or adapt the body’s response to stress.  Some good examples are Siberian Ginseng, Withania, Korean Ginseng, Rhodiola, Gotu Kola, and Schisandra. These were traditionally used in Russian athletes.

The last thing that you can do, is get tested.  Once you know the facts, it’s much easier to manage and then monitor changes and results.

Finally, depending on the level of adrenal depletion, therapeutically timed doses of some of these nutrients may be required along with high quality herbal medicines that have been standardised for active ingredients – as not all products are created equal! It’s also important to note that while these supportive measures greatly assist, they should be used in conjunction with a plan to address underlying cause(s), which ultimately has the best chance for delivering long term, quality health outcomes. Further, any prescribed medications may have interactions with undertaking comprehensive nutritional adrenal support therapy, and a qualified professional can help you navigate this in a safe and healthy way.

Special Note – If you are on glucocorticosteroid medication, or ANY medication, you must NOT abruptly stop using the medication as there can be serious health consequences.  Always seek professional medical advice.

If you thought this article was helpful, don’t forget to like on Facebook or share with your friends.

___________________________________________________

Sarina completed her Bachelor’s degree with a special interest in Neuroscience and specialises in reverse engineering your symptoms to identify and address underlying cause(s). She has additional special interests in Functional Medicine since training and practising in the USA as a clinical nutritionist & herbalist (2003-2007). In clinic, specialist laboratories are used that have Australian accreditation.

Resources and References:

Dr James L Wilson, Adrenal Fatigue: the 21st century syndrome, https://www.adrenalfatigue.org/

http://cortisolconnection.com/

http://www.drfranklipman.com/adaptogens-natures-miracle-anti-stress-and-fatigue-fighters/

http://bodyecology.com/articles/adaptogens_how_to_eliminate_stress.php

——

Adrenal Insufficiency, 2013 – http://www.ncbi.nlm.nih.gov/pubmed/25905309

An overview on ashwagandha: a Rasayana (rejuvenator) of Ayurveda, 2011 – http://www.ncbi.nlm.nih.gov/pubmed/22754076

Assessing stress reactivity indexed via salivary cortisol in preschool-aged children, 2011 – http://www.ncbi.nlm.nih.gov/pubmed/21388745

Breakthrough Solutions in Herbal Medicine Adaptogenic Formulas: The Way to Vitality.” Townsend Letter. January 2007, www.townsendletter.com

Defensive coping and renovascular disease risk – Adrenal fatigue in a cohort of Africans and Caucasians: The SABPA study, 2015 – http://www.ncbi.nlm.nih.gov/pubmed/25911265

Inhaled corticosteroids and secondary adrenal insufficiency, 2014 – http://www.ncbi.nlm.nih.gov/pubmed/25674179

Panax ginseng, Rhodiola rosea and Schisandra chinensis, 2012 – http://www.ncbi.nlm.nih.gov/pubmed/22039930

Plant adaptogens, 1994 – http://www.ncbi.nlm.nih.gov/pubmed/23195818

Protective effects of Andrographis paniculata extract and pure andrographolide against chronic stress-triggered pathologies in rats, 2014 – http://www.ncbi.nlm.nih.gov/pubmed/25035059

Salivary cortisol as an indicator of physological stress in children and adults; a systematic review, 2014 –  http://www.ncbi.nlm.nih.gov/pubmed/24951973

Salivary cortisol levels as a biological marker of stress reaction, 2013 – http://www.ncbi.nlm.nih.gov/pubmed/24601177

The gut microbiome and the brain – http://www.ncbi.nlm.nih.gov/pubmed/25402818

Graphics –

http://corporatefunrun.com/are-your-adrenals-in-a-knot/

http://www.nursebuff.com/nursing-mnemonics-and-acronyms-respiratory-endocrine-and-nervous-systems/

http://www.proprofs.com/flashcards/story.php?title=bio-lecture-4-page-12411-lecture-pt-1

My top 5 criteria for selecting a multivitamin.

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  • Is your multi helping or hindering?why-you-need-multivitamins
  • Confused about how to choose a multivitamin?
  • Ever heard of multivitamins containing or being made from petrochemicals?
  • Ever heard of the ‘blended standard’[2],[3]?
  • Did you know that most multivitamin products (BOTH retail and therapeutic) are actually synthetic products?

In light of a recent article in the New York Times where 4 large well known retailers were found to be selling retail products that actually did not have the ingredients stated on the label[4], my hope in writing this article is that I can in some way impress upon you the need for quality in choosing products that you decide to ingest.

Having said this, did you also know that the American Medical Association made a revised policy publication in 2002[5] recommending that “given our nutrient-poor modern diet, supplementation each day with a multiple vitamin is a prudent preventive measure against chronic disease”. However, taking a multivitamin/mineral product is NOT a substitute for eating a nutritious whole food diet.

But when choosing a multi, my clinical experience suggests there is one simple ‘rule of thumb’…

  • you get results equal to what you pay for, AND
  • what your body can absorb!

Essentially, my formula for a beneficial multivitamin/mineral product looks like this –

1. Quality – big amounts
+ 2. Bioavailability – liberal amounts
+ 3. Synergy and balance – adequate amounts
+ 4. Potency – levels of…
= 5. RESULTS for YOU!

NOW, if you think this is a load of baloney, and you’re not interested in doing something seriously positive for your health, then DON’T read on. BUT, if you are currently using a multivitamin/mineral formula, and you are interested for your health’s sake, then please DO read on.

I often see clients in clinic who tell me that they’ve been taking a multivitamin product and they can’t understand why they don’t ‘feel any better’. Ironically, they are also sometimes reluctant to accept information from me trying to explain the benefits of different types of multi’s, their ingredients, clinical application and health outcomes that they can and SHOULD expect.

So here are my criteria I use in assessing products that I believe will get the best results for YOU, and my clients (apologies if this sounds a bit technical). Look for…

  1. Quality & Safety – quality and safety is everything!
    • Does the company follow GMP (Good Manufacturing Practises, a global standard)?
    • Where do they source the ingredients?
    • Are ingredients based on petrochemical residue?
    • Do they have a quality assurance program in place? Is this information freely available on their website?
    • Will someone from their technical team freely speak with me and answer my questions? (And yes, for my peers who know me, they know that I am not afraid of calling these companies and asking the hard questions. After all, I’m staking my reputation on getting my clients the results they want!)
    • Is there evidence of recent research or clinical trials (preferably in Australia)?
    • Who owns the product or the company making the product? (See below to find out why!).
    • Does your product actually contain what is stated on the ingredient list[6]?
  1. Bio-availability – you are what you absorb! Bioavailability is a term that refers to how well your body can use the nutrients contained in the product. The key here is to look at the form of the ingredients, as certain nutrients need to be in a particular form to be well absorbed . Here are some examples to watch out for –
    • Magnesium oxide, a common ingredient in many products appears to be the least absorbable and therefore the least bioavailable[7]. It can also produce a laxative effect, which may hinder Zinc absorption (vital for taste, smell, enzymes, immune function, neurological function, etc.) – check yours now! Better forms of magnesium are magnesium orotate or magnesium citrate… also more expensive!
    • Vitamin E occurs naturally as a complex of 4 tocopherols and 4 tocotrienols – how many does yours have? Vitamin E, usually labelled as dl-alpha-tocopherol /tocopheryl in many products, is a synthetic form and does not have the same action as the natural form[8] – D-alpha tocopherol.
    • Vitamin C (also known as ascorbic acid or sodium ascorbate or ascorbyl palmitate), essential for helping produce energy, collagen as well as being a vital antioxidant, actually exists in nature as a complex with enzymes, flavonoids and phytonutrient co-factors that make it more bio-available than synthetic ascorbic acid[9]. Does yours contain any flavonoids, which are known to increase the absorption of vitamin C by up to 35%[10] such as quercetin, hesperidin, rutin?
    • As a last point of mention, in relation to vitamin B’s, if you have a history of digestive issues, malnutrition, leaky gut, IBS or IBD, or undiagnosed ceoliac disease, there may be a good chance you will not be efficiently absorbing these vital nutrients. Research suggests that you may need an entirely different form , called the activated form or precursor form of these nutrients to be absorbed at all. For example, vitamin B6, usually included on labels as pyridoxine hydrochloride, may need to be in the activated form as pyridoxal-5-phosphate to be utilised by your body[11].

In the interest of disclosure, you may find it interesting that –

The TGA only approves the synthetic form of vitamin B12 (cyanocobalamin) for therapeutic use in Australia. In the US however, where I practised for 5 years as a clinical nutritionist, the natural and more biologically active forms of methylcobolamin and hydroxycobalamin are available to consumers. And yes, the cyanocobalamin form does produce small amounts of cyanide in its metabolism, but cyanide also naturally occurs in many fruits and vegetables.

  1. Synergy – is the product complete and balanced?
    • Does the product contain the full range of common B vitamins (1,2,3,5,6,9 and 12), or is it missing one of them? The full range of Vitamin B’s work together in the body but if one of them missing, it is like expecting your car to go with only 3 wheels[12].
    • Does it contain antioxidant co-factors such as alpha-lipoic acid, co-enzyme Q10, bioflavonoids? Quite often multi’s don’t include these more expensive ingredients such as co-enzyme Q10 (a vital nutrient in the production of energy and your cellular functioning).
  1. Potency – refers to the amount of the nutrient required to produce an effect. Generally, retail products contain significantly less of the nutrients than therapeutic brands. For example, vitamin B’s, which are essential nutrients for making energy, DNA, neurotransmitters, lots of enzymes, enzymatic processes, and neurological function (amongst others), usually have between 2mg and 30mg in retail products, for vitamins B1, B2, B3, B5 and B6. This compares to 50mg and upwards in therapeutic products. Similarly, for vitamins B9 (folic acid) and B12, retail products can have as little as 2mcg versus 400mcg+ in therapeutic products. Be aware, that you may be paying good dollars and getting ‘peanuts’!
  1. Results – how are you measuring results?
    • Did you feel a difference in energy levels? Do you still experience fatigue that prevents you from living a life of vitality and quality? Are you still fatigued?
    • Did your skin clear up? What continuum are you using to actually measure results?
    • Were you so malnourished that even a little bit of something made you feel a bit better, but is that actually what normal should feel like for you?
    • Were you able to walk 100m without feeling like you’ve drained your tank versus only being able to walk 15m and feeling wiped out?
    • Have your moods normalised? Did you get the desired effect of reduced PMT before your last period?
    • Has your acne disappeared? Do you still have rough skin on your fingers, palms and your feet?
    • Do you still have achy joints and muscles? Are you now able to lift a 2kg dumbbell without feeling like you don’t have to use all your reserves?
    • Are you still bruising easily?
    • Have your digestive symptoms eased up?

There are so many variations to measuring results, however, the above are all common questions I ask clients in my own practice. So maybe you might want to ask yourself the same questions. After all, you don’t want to be wasting your time and hard-earned money!

Now, if you have reached this point and you’re still not convinced, a simple and very general test is to put a product sample in a glass of water and time it for one hour. If it looks the same in one hour and hasn’t broken down – you’ve wasted your money! If it’s completely broken down, discoloured the water and you can drink it without choking on ‘big bits’, then you’re probably onto a winner.

Some other things to keep in mind when choosing a multivitamin –

  • Supplements, serve to ‘fill in the gaps’ especially in times of stress, poor vegetable/fruit options for purchase (i.e. if they are chemically laden), choices are limited, or there is some condition that does not allow you to eat a wide range of whole foods or completely absorb nutrients from food. (If you need a refresher on what is a Whole Food Diet, please see my article here).
  • Did you know that some retail multivitamin products are ‘owned’ by pharmaceutical companies, for example, Centrum is now part of the Pfizer Corporation, a pharmaceutical manufacturer. Similarly, Sanofi-Aventis, another pharmaceutical manufacturer, owns the popular retail ranges known as Ostelin, Nature’s Own, Bio-Organics, Golden Glow, MicroGenics and Cenovis.
  • There have been previous arguments suggesting that ‘vitamin studies’ and their use is worthless, however, many of the studies have used isolated synthetic ingredients, low quality products that use synthetic ingredients and also contain toxic fillers, had conflicts of interest, or simply used such low doses that did not actually achieve therapeutic levels for results[13],[14]. Hence, my argument for checking the quality, bio-availability and potency. I encourage you to do your own research.
  • There are conditions and cases in which it is not advisable to take vitamin products, and in fact, can be quite unsafe to do so, however, a trained healthcare professional will be able to advise you.
  • Multivitamin products can produce amazing results despite their ‘one size fits all’ design. However, the skill comes in choosing the right one for the right person for the right outcome, or even potentially a combination of products that can get the clinical results you want.

Most people remain blissfully unaware of the technical aspects of choosing a multi-vitamin, let alone ever considering that their favourite multi contains ingredients made from petrochemicals or coal tar residue. Hopefully, this article has made you aware of the fact that industry respected leaders have attempted to ‘standardise’ criteria for the assessment of effective quality products based on clinical evidence; but also, that this article has sparked a sense of curiosity about whether what you are taking is actually good for you, and whether it is actually giving you the results you want.

Lastly, I am not affiliated with any one company or supplier for products and I have not been paid to write this article. This article is provided for public education purposes only and the way I choose to practise is with impartiality, independence and focused on client outcomes. If you know of a product, or believe that there is a product I should research or try in a clinical setting, I would be happy to hear from you. Please send your information and contact details (optional) to Sarina as I always like to credit my sources.

________________________________________________________________________

Citations –

[1] The term ‘multivitamin’ is used interchangeably throughout with ‘multi’, multivitamin/mineral product, or product.

[2] MacWilliam, L. Comparative Guide to Nutritional Supplements, 4th Edition, Professional Edition

[3] The Blended Standard – a list of eighteen different health criteria against which industry leaders and independent published authors in their respective scientific, medical and naturopathic fields, have made recommendations for nutrients and the required amounts to achieve health outcomes. For more information look at http://www.comparativeguide.com/~nutrisea/index.php?option=com_content&view=article&id=53&Itemid=9#Blended_Standard and http://www.comparativeguide.com/index.php?option=com_content&view=article&id=50&Itemid=8

[4] http://well.blogs.nytimes.com/2015/02/03/sidebar-whats-in-those-supplements/?_r=1

[5] Fletcher, Dr R & Fairfield, Dr K, Journal of the American Medical Association, June 19, 2002

[6] http://well.blogs.nytimes.com/2015/02/03/sidebar-whats-in-those-supplements/?_r=1

[7] Braun & Cohen, Herbs & Nutritional Supplements, 3rd Edn, 2010, p686

[8] Ibid, p1002

[9] http://www.ncbi.nlm.nih.gov/pubmed/3414575

[10] Osiecki, H, The Nutrient Bible, 9th Edn,

[11] http://autisme-montreal.com/wp-content/uploads/2014/09/Woody-McGinnis-MD1.pdf, p5

[12] Please note, in certain clinical cases, a single vitamin in the B group may need to be prescribed, however, this should only be conducted under the care of a qualified healthcare professional.

[13] http://search.ebscohost.com/login.aspx?direct=true&db=awh&AN=7584844&site=ehost-live

[14] http://ajcn.nutrition.org/content/69/5/842.short

Providing a urine sample for your initial consultation

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How to collect your sample

1. Collect your urine sample in a clean, sterile specimen container (preferably a disposable cup).

2. Your urine sample should be collected as near to your appointment as practicably possible. Samples older than 2 hours, or not at room temperature, can affect the test results.

3. If you unavoidably can not collect your sample as near to your appointment time, you must store the sample in a fridge (preferably in a plastic bag, not near food and observing hygiene safety principles).  Please advise this at the time of your appointment.

4. Do NOT freeze your sample.

5. Do NOT place your sample in direct sunlight.

Note – specimen containers may be purchased from chemists or pharmacies.

 

Posted in FAQ

What is Naturopathy?

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Naturopathy is a wholistic health framework that respects the body’s ability to heal the impact of stressors (real & perceived, environmental, physical, mental, emotional, amongst others) and the impact of personal choices on health & wellness. The practise of naturopathy is guided by six core principles:

  1. First do no harm
  2. The healing power of nature
  3. Find and treat the cause, not just the symptom
  4. Treat the whole person
  5. ‘Doctor’ as teacher
  6. Prevention

And six core healers, most of which have already been adopted in mainstream medicine:

  1. Food
  2. Water
  3. Exercise
  4. Fresh air
  5. Sunlight and
  6. Rest/Sleep

Naturopathy has a long history drawing on traditions from early Greek medical philosophy, including Hippocratic health to more recent Western herbalism practices. A naturopath will seek to assess a person’s vitality and wellness utilising a variety of tools, including:

  1. Health goals
  2. Symptom presentation
  3. Blood & urine tests
  4. Functional pathology tests
  5. Live blood analysis
  6. Iridology
  7. Tongue & fingernail analysis
  8. Subjective questionnaires

A naturopath will endeavour to piece together causal factors of disease from the many different aspects of a person’s circumstances (mind, body, spirit, emotional, genetic, environmental, nutritional, significant life events, medical history, etc.). Naturopathic treatment aims to find and treat the cause of the health condition and increase a person’s vitality and wellness, which ultimately impacts on quality of life. Options used to assist a person’s unique healing process, health outcomes, health choices and health responsibility, include:

  1. Nutritional medicine
  2. Herbal medicine
  3. Homeopathic medicine
  4. Lifestyle advice, including sleep and exercise
  5. Stress management
  6. Detoxification
  7. Meditation
  8. when required, referrals for complementary treatment support, e.g. massage, physiotherapy, specialist medical, counselling, etc.

Naturopathy is increasingly being recognised by mainstream medicine as a valuable and effective system for treating a variety of disorders including (but not limited to)¹:

  • Fatigue
  • Digestive complaints
  • Mood disorders and depression
  • Allergies and sensitivities
  • Behavioural problems
  • Chronic fatigue syndrome
  • Musculoskeletal complaints such as arthritis
  • Cardiovascular (heart and blood vessel) problems
  • High blood pressure
  • Fertility problems
  • Endocrine disturbance
  • Hormonal imbalances, such as premenstrual tension and menopause

¹(https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/naturopathy ). If you would like to stay up to date with health topics from Nature’s Medicine, sign up to the Newsletter here.

Toxicity & Detoxification – so what!

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‘Toxicity’ refers to the degree to which a substance is poisonous; and ‘detoxification’ is an important metabolic function that the body automatically undertakes to prevent substances from becoming poisonous. Detoxification is one of the most powerful tools a Naturopath has in their wellness toolkit.

There are primarily five channels used by the body for detoxification and elimination – colon (faeces), liver (bile), kidneys (urine), lungs (gas exchange) and skin (sweat).

Between individuals, toxicity can occur from different biological mechanisms such as:

  • oxidative damage (free radical production)
  • molecular mimicry – hormones or neurotransmitters
  • blockage of nutrient absorption
  • blockage of receptor sites
  • blockage of cellular transport mechanisms
  • interference with enzyme function

Sources of Toxins

There are external (exogenous) and internal (endogenous) sources.

External sources include – occupational, personal care products, car fumes, diesel particle emissions (DPEs), lead from lead pipes, alcohol, nicotine, pesticides, herbicides, radiation, food additives, solvents, heavy metals, pharmaceutical and recreational drugs.

Internal sources include – poor dietary choices, metabolic by-products (including hormones, adrenalin, cortisol, carbon dioxide, urea, lactic acid, intermediary detox metabolites, inflammatory cytokines), undigested foods, lipopolysaccharides (LPS), stress, excess fat/adipose tissue, polymorphisms and genetic predispositions.

Health Effects of Toxicity

Some conditions and symptoms resulting from a greater ‘toxic load’ include:

Conditions

Symptoms
  • autoimmune disease
  • allergies, asthma
  • inflammatory bowel diseases
  • reproductive disorders
  • chronic fatigue syndrome (CFS)
  • atherosclerosis
  • autism
  • multiple chemical sensitivities (MCSs)
  • endocrine disorders
  • fibromyalgia
  • neurodegenerative disorders
  • cancers
  • recurrent headaches
  • recurrent injuries
  • recurrent infections or inflammatory conditions
  • muscle aching and weakness
  • paraesthesias and neuralgia
  • infertility & menstrual disorders
  • allergies
  • digestive disorders
  • chronic fatigue and lethargy
  • weight gain or difficulty losing fat
  • skin disoders (eczema, acne, psoriasis)
  • anaemia
  • poor memory, mood and concentration
  • depression

What can you do?

  1. Keep your liver and gall bladder healthy.  The liver has metabolic pathways that help to detoxify toxins depending on the type (eg. aspirin is detoxified in a different pathway to paracetamol). Each pathway is reliant on specific nutrients to efficiently ‘detoxify’ them and make them ready for excretion by the body. Some nutrients that can help include – St Mary’s Thistle, globe artichoke, green tea (organic), fibre, garlic, onions, brassicas (broccoli, cauliflower, cabbage, brussel sprouts), spirulina, chlorella, glutathione, and probiotics.
  2. Drink water (filtered if possible).
  3. Open your bowels daily and urinate when the urge requires.
  4. Exercise daily.
  5. Minimise exposure to any of the above sources of toxins.
  6. Detoxification is personal. Seek professional advice for conducting detoxification programmes. Trying to eliminate metabolic toxins when all the channels of elimination are not working properly can lead to recycling of toxins (auto-intoxication/endotoxemia) or deposition in certain tissues (e.g. brain or fat tissue), which may result in more harm than good.

Whole Food Diet – from a naturopathic perspective

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A question I often get asked in clinic is, “what is a whole food diet?”.  Here is a summary of my typical response with a few interesting facts thrown in.

A whole food diet is part of a health-promoting lifestyle AND allows you to LIVE a healthy life with quality, enjoyment and satisfaction. Two medical doctors, Denis Burkitt and Hugh Trowell (circa.1981), and independently one dentist, Weston A. Price (circa. 1900), are credited with making the connection between diet and chronic disease[1], and hence whole food principles have been around for some time.

Essentially, a whole food diet and modern naturopathic nutritional advice has evolved from some of these principles and can be summarised as follows:

  1. Food Groups – Consume food consisting primarily of fruits, vegetables, legumes/beans, whole grains, nuts and seeds that are preferably in season and non-genetically modified. A good diet (rich in fruit and vegetables) is considered a factor in preventing many chronic diseases[2].
  2. Unprocessed – Eat a rainbow of fruits and vegetables as unadulterated as possible, i.e. whole food! Anything that is contained in packaging is a ‘food product’ and does not satisfy this criterion.

Interesting Fact – Soy milk in cartons is also a processed food.

  1. Animal Foods – Do not over consume animal foods.
  2. Organic where possible – Try to eat organic where possible – reducing your exposure to pesticides, herbicides, fungicides, heavy metals, food additives, preservatives, and synthetic chemicals as much as possible. If this is not an option, choose to limit your exposure by choosing wisely. The Environmental Working Group (EWG) has a published list of fruits and vegetables that concentrate these chemicals.  See here for the list of ‘clean’ and ‘dirty’ foods.

Fact – Sulfite/sulphite (a food preservative; numbers 220-228 on food labels) sensitivity is a common trigger for asthma attacks in asthmatics[3].

  1. Water – Drink sufficient water daily (filtered if possible, although reverse osmosis is best).
  2. Sugar – Manage total blood sugar levels and avoid concentrated sources such as sugar, sweeteners (natural and synthetic), corn syrup and high fructose corn syrup, carbonated/soft drinks, ice cream, lollies and sweets.
  3. Avoid – hydrogenated/trans fats, fast foods, bakery products , too much caffeine, table salt (also a processed food product), processed meat products containing nitrites/nitrates (numbers 249-252 on food labels), burnt & charred BBQ foods[4].
  4. Replace – pots and pans that have Teflon or non-stick coatings (I prefer 18/0 gauge stainless steel pans; ‘0’ meaning that they have no nickel in the metal); and avoid microwave cooking[5] (we actually have no microwave in our household).

I also mention to clients the following important points:

  1. You have to “live within your environment” – so there’s no sense in creating more stress if you can’t achieve all of the above. A little is better than nothing at all.
  2. You have “choices” to make every day. Whatever choice you make regarding what you consume or do, will either work for you or against you, and irrespective, it’s still your choice.
  3. Other factors like exercise, fresh air, sunshine, sleep, and levels of stress also play a part in your overall healthful lifestyle, but again, it’s your choice.

Eating whole food, and foods that don’t contain many ingredients, doesn’t necessarily need to be a chore, but if you are not used to it, then it will require some mental and taste bud re-adjustment. The most significant benefit to you is that you consume valuable fibre, enzymes, protein, carbohydrates, fats and nutrients in the way that nature intended which will ultimately lead to better health, wellness and longevity.

[1] Murray & Pizzorno 2012, Textbook of Natural Medicine, 3rd Edn., p50

[2] http://www.health.gov.au/internet/main/publishing.nsf/Content/chronic#com, viewed 30 July 2014

[3] http://www.allergy.org.au/patients/product-allergy/sulfite-allergy, viewed 30 July 2014

[4] http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Cancer_and_food, viewed 30 July 2014

[5] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2722699/, viewed 30 July 2014

Self-Care Toolkit – what’s in yours?

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How many of us make time for this? How many of us even know what this means? How many times do I see blank faces staring back at me in clinic when I even mention this term? Did you know that there is an Australian organisation whose vision states “Better health through responsible Self Care”[1]? What benefit do you get by practising self-care?

Before proceeding, a definition of ‘self- care’ is required and the World Health Organisation offers a valuable description –

“Self-care is what people do for themselves to establish and maintain health, prevent and deal with illness. It is a broad concept encompassing:

• hygiene (general and personal);
• nutrition (type and quality of food eaten);
• lifestyle (sporting activities, leisure etc.);
• environmental factors (living conditions, social habits, etc.);
• socioeconomic factors (income level, cultural beliefs, etc.);
• self-medication”[2] and they are activities “… undertaken by lay people on their own behalf, either separately or in participative collaboration with professionals.”[3]

Health is ultimately your responsibility! I know from personal experience that if you don’t or can’t find time for yourself with good food, exercise and spiritual sustenance, then your joy for life, compassion and core self can wither leaving you in a dark place and feeling very isolated.

A good analogy for self care is the emergency instruction given on a plane of putting on your oxygen mask on before assisting anyone else. Essentially what this means is that, if you want to be able to look after family, relationships, work, etc. you need to be able to look after yourself first.

Thanks to the recommendation of another healthcare professional/friend/peer, I recently read a book titled ‘The Art of Extreme Self-Care’ by Cheryl Richardson (New York Times best-selling author). The title sounds a bit intense, granted, but as one tool in your ‘Self-care Toolkit’ it is a great start and it’s an easy read. I know, you’re probably saying right now, ‘I don’t have time’ and frankly, that is probably the number one objection I have to negotiate in a clinical setting when discussing this topic.

What I say to clients (and to you) is this, “How much do you value your quality of life?” and “What are the consequences if you don’t invest in yourself?”

The table below lists some starter self-care suggestions. Ask yourself “what are you doing now?” and “what would you like to do?”. Try just one and you may be surprised with the results. What have you got to lose?

Starter self-care suggestions to add to your toolkit, divided into 4 self-care areas. You can choose whichever you feel you can do, and implement any one of them immediately:

Physical Emotional Psychological Spiritual
  • Make an appointment with yourself
  • Eat regular meals daily
  • Eat a balanced, whole food diet
  • Sleep when you feel the need
  • Schedule a massage or facial
  • Plan a holiday
  • Take a bath
  • Daily exercise, even a walk around the block
  • Reduce stress
  • Gardening
  • Be kind, gentle and accept yourself
  • Take time for laughter
  • Spend quality time with family
  • Spend quality time with good friends
  • Schedule some ‘me’ time
  • Lose negative situations & people
  • Replace negative thoughts and feelings – make the choice to change
  • Mindfulness
  • Ask for help*
  • Learn when (and how) to say ‘no’
  • Identify work/life balance
  • Acknowledge your thoughts, beliefs, attitudes and feelings
  • Learn how to recognise and express anger in constructive ways
  • Learn something new
  • Find or create a support group
  • Practise mindfulness
  • Develop curiosity

 
  • Spend time in nature
  • Make time for reflective practice
  • Live by your values
  • Make time for uplifting  activities for you – e.g. music, meditation, singing, dancing, literature, sculpture, painting, art, playing an instrument, prayer, yoga

*Support from family and friends is not always practical and from experience, both personal and professional, asking for help from objective, qualified professionals, independent resources and specialist organisations can, in certain circumstances, yield better support outcomes.

Useful links –

http://www.higginspsych.com/HPS.com/Wellbeing_Information.html

http://socialwork.buffalo.edu/content/dam/socialwork/home/self-care-kit/self-care-assessment.pdf

http://socialwork.buffalo.edu/content/dam/socialwork/home/self-care-kit/stress-warning-signs-and-symptoms.pdf

http://stress.about.com/od/lowstresslifestyle/tp/self_care.htm

References – 

[1] ASMI, http://www.asmi.com.au/home/default.aspx

[2] http://apps.who.int/medicinedocs/en/d/Jwhozip32e/3.1.html, 1998, viewed 31 July 2014

[3] http://apps.who.int/iris/bitstream/10665/70092/1/HED_84.1.pdf?ua=1, 1983, viewed 31 July 2014

Image credit – http://its-fitting.com/2013/10/oxygen-mask/ 

I’ve just been to another naturopath, do I need to pay for the 1.5hr initial consultation?

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Naturopaths, like all professional service providers, have different experience, strengths, working preferences and skills.

Whilst we can request a copy of your healthcare notes from your previous provider (with your written permission), it is in your best interest to undergo the thorough and extensive initial consultation that Nature’s Medicine offers, to assist you in your health goals. For this reason, you will need to pay for the 1.5hrs.

Check here to see if you qualify for a discount.

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DEXA – what does this mean?

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DEXA, now condensed to DXA, is an abbreviation for the term dual-energy x-ray absorptiometry. This technology is typically used in hospitals and research facilities to measure primarily bone mineral density (BMD).  As secondary technology to hydrostatic weighing, DXA can also be used to measure body composition and fat content.

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