Probiotics

Functional Testing

Functional Testing Explained

There are many different medical tests to assess how the body is functioning. Conventional medicinetesting blood utilises standard blood tests, urine tests, stool tests, scans, x-rays, MRIs and the like. However, while these tests are very useful, they often are more geared towards picking up pathology rather than dysfunction.

For determining how well a system is functioning, many tests fail to really give a true assessment of organ function unless there is a gross pathology. Functional testing is a whole different branch of medical testing that looks to assess function of different organs. Many of these tests give us a more in-depth look at what is going on behind the scenes. These tests can also pick up abnormalities before they are at the level of pathology, allowing preventative treatment plans to be developed.

Unfortunately in most cases these functional tests are not covered under medicare, so the patient has to pay for them privately.  These can vary from as low as $50 for some tests and can be as high as $500-600. Many tests are around the $100-200 mark. Obviously, functional tests are only recommended when the results gathered from the test will give very specific information that can be used to tailor an individualised treatment plan for the patient. Many of the tests are offered as simple home test kits for collecting urine, saliva, stool and blood spots however some do need blood draws from a pathology centre.

Let's take a look at some of the different functional tests available within a few body systems.

Digestion and Liver Function

Standard testing for digestive issues can include colonoscopy and gastroscopy - where scopes (camera like devices) are used to take a look at the inside of the colon or gut. These can pick up pathology such as polyps, colon cancer, inflammatory bowel disease and gastritis (inflammation and ulceration of the stomach or oesophagus). In some cases doctors will run a PCR test to look for bacteria and parasites in the stool such as blastocystis and giardia. While these tests are useful, there is a whole host of other things that can be tested that give us a really good insight into the digestive system. For example, knowing what levels of good bacteria are present is very important and assessing enzyme levels and short chain fatty acid levels can highlight underlying gut issues and dictate the best treatment strategy. A complete digestive stool test yields lots of information that can give a detailed look at gut function.

SIBO-testingBreath testing for Helicobacter pylori is a standard test now for stomach ulcers and gastritis. The lactulose SIBO breath test is also a very specific functional test to more accurately assess and diagnose the underlying cause of irritable bowel symptoms such as bloating, wind and erratic stools. Food intolerance testing can show what foods might be contributing to health issues - including digestive issues, allergies, sinusitis, eczema and asthma.  Leaky gut can be diagnosed based on the intestinal permeability test. A functional liver detoxification profile takes a look at how efficient the liver is at detoxing certain chemicals - which is far more useful than a standard liver function test which only measures liver enzyme levels - which tend to be elevated with inflammation of the liver and do not determine the cause. We often want to get a sense of how well the liver is functioning in a day to day sense, and the liver detox profile is the best test for that.

Hormones and Reproduction

Standard blood tests are useful for looking at hormone levels, but they tend to give a fairly broad understanding. For example, there are at least 4 different types of oestrogen that can be tested, some of which are more proliferative and linked to breast and endometrial cancers while others are more protective and less damaging. Standard blood tests just give the total oestrogen level and do not differentiate between the different types. Understanding the amounts of different hormones present will also potentially highlight issues with poor excretion of hormones and poor liver function and give specific treatment strategies to reduce risk of disease and treat specific issues such as heavy periods. Functional tests look at salivary levels as well as dried urine to give a more sensitive and detailed assessment of hormone status.

Genetic testing for underlying issues with folate metabolism (MTHFR) is also an important aspect of a fertility workup that Karen undertakes. Polymorphisms (defects) in the MTHFR genes can impair methylation and this has been linked to infertility and miscarriage along with certain cancers and mental health issues.  As the methylation pathway is a nutrient dependent pathway, it is one that specific nutritional supplements can improve.

Adrenals and Thyroid

saliva testThe adrenal glands modulate and support the function of every tissue, organ and gland in your body to maintain balance during stress or illness to help you heal or keep you alive. Many of the hormones produced by the adrenals are essential for good health and vitality, so if your adrenals aren’t functioning well, there can be widespread impacts. Likewise the thyroid is a highly important organ responsible for metabolism and energy in the body. Assessing full thyroid function (not just TSH levels) is important to get an accurate look at the thyroid function. Likewise, a 24 cortisol test can be a good way of assessing adrenal function, whereby salivary cortisol levels are taken 4 times during a 24 hour period to assess how the adrenal functions throughout the day. Other comprehensive dried urine hormone tests can give a lot of information about the adrenal hormones and subsequent adrenal function. For more information on adrenal health click here.

A Summary Of Functional Tests Currently Available:

  • Comprehensive Stool Analysis - this test is an excellent way of  for beneficial & dysbiotic bacteria, clostridium, candida & yeast, secretory IgA, Lactoferrin, White blood cells, Mucus, Pancreatic Elastase, pH & details of possible food digestion impairment of fats, pH testing etc)
  • Parasite testing (Blastocystis hominis, Dientamoeba fragilis, Giardia lamblia, Cryptosporidium)
  • SIBO (Small intestinal bacterial overgrowth)
  • Helicobacter pylori
  • MTHFR gene mutation tests
  • Methylation testing (Methionine, Cysteine, homocysteine, SAMe, SAH etc.)
  • Pyroluria / pyrroles test (a genetic condition linked to anxiety, depression, addictions and behavioural issues)
  • Saliva Hormone Testing (Cortisol, DHEA, oestrogens -E1, E2, E3, progesterone, androgens, testosterone, melatonin)
  • Thyroid Hormones (TSH, fT4, fT4, Reverse T3, Thyroid antibodies)
  • Nutritional Blood Profiles (Vitamin A, B1, B2, B6, B12/Folate, Vit C, Vit D, Vit E, Co-Enzyme Q10, iron studies, magnesium, calcium, iodine, selenium, copper, manganese, zinc, glutathione, omega 3 levels, etc.)
  • Urine Amino Acids profile
  • Histamine testing
  • Hair Mineral Analysis & Heavy Metal Toxicity Testing (mercury, lead, cadmium, arsenic, aluminium etc.)
  • Environmental Pollutants & Chemical Toxicity
  • Liver Detoxification Profile (Assesses Phase 1 & 2 status with chemical exposure)
  • Metabolic ‘Organic acids’ Testing (36 metabolic acids that may determine causes for fatigue, depression)
  • Urinary Hormone Steroid Profile (Includes testosterone, oestrogens, progesterone, Melatonin, Cortisol, DHEA adrenal hormones)
  • Food Sensitivity & Allergy Profiles:
    • (IgA, IgE & IgG antibodies) 
    • ALCAT food sensitivity test
    • Both food sensitivity methods can test with accuracy the immune response of the body to up to 200 foods, herbs and spices.
  • Celiac Antibody Profile and Celiac Gene Test (HLA DQ2 & HLA DQ8)
  • DNA Gene Profile Testing (Smart DNA, 23 & Me)
  • Intestinal Permeability testing
  • Zonulin testing  - for diagnosing leaky gut syndrome

 

If you would like to discuss the merits of a functional test for your specific health issues or as a simple preventative strategy to optimise your health and vitality, please contact Karen.

 

 

food allergy

Food Allergies & Intolerances

Sneezing, itching skin, watery eyes, digestive disturbances…these are all the tell tale signs of allergies and intolerances. There has been a dramatic rise in allergies over the past few decades, both food related and environmental.

allergy It is important to understand that food intolerance is different to food allergy. In the case of intolerance, the reaction is not immediate and the symptoms can be many and varied, whereas allergies give rise to reactions that tend to be immediate and more severe.

Allergies are common in children and many adults also suffer from allergies. Food allergy has been estimated to occur in around 1 in 20 children compared to only 1 in 100 adults.  However, the incidence continues to rise, with a study released in 2011 finding that 8% of 38,000 children surveyed were allergic to at least 1 food. Estimates for people suffering from food intolerance are far higher.

There has also been a fivefold increase in hospital admissions for anaphylaxis over the past decade. Anaphylaxis is a severe allergy that can be life threatening. Common foods that cause anaphylactic reactions are peanuts, egg and shellfish, while bee stings are another common cause. People with these severe allergies usually carry an Epipen (containing a shot of adrenalin) which can be lifesaving first aid in cases of accidental exposure to allergens.

Food intolerance is less severe but far more pervasive and often gives rise to chronic health issues. Common problems such as gluten intolerance (coeliac disease) and lactose intolerance are well known, however food intolerance to other foods is also widespread. Symptoms of food intolerance are the result of an overloaded immune system and often involve poor digestive function.

bloatingHere are some of the conditions linked to food intolerance:

  • digestive issues (bloating, wind, constipation or diarrhoea)
  • headaches
  • hyperactivity
  • restless sleep
  • frequent colds
  • eczema
  • asthma

 

There are many theories behind the rise in food allergies. These include the hygiene hypothesis – which states that we have distorted our immune function through lack of exposure to common bacteria. Our modern day obsession with hygiene and ‘antibacterial everything’ has actually lead to an imbalance in the immune system that favours the development of allergies. Challenges to the immune system by everyday bacteria are necessary for the development of normal immune function, particularly in children. Studies, for instance, have shown that children who live on farms or have pets are much less likely to suffer from allergies. Other theories relate to digestive function and the use of antibiotics, which can upset the normal gut flora and can promote inflammation and increased permeability of the gut to common foods.

FoodAllergiesDiagnosing food allergy or intolerance can involve different approaches. Traditional testing for IgE allergies (including anaphylaxis) normally involves skin scratch tests.   Tests for food intolerance are now available and practitioners specialising in allergy can perform these in their clinic with a small skin prick blood sample.  These food intolerance tests detect IgG or IgA antibodies to a range of common foods. While I use these tests in my clinic, I often find that doing a food elimination process followed by a food challenge will also give clear indications as to what foods are contributing to symptoms. The food intolerance blood tests cost between $250-$400, so the challenge is sometimes more affordable for some patients.

Once an allergen or food intolerance has been identified (either through a test or exclusion process), management normally involves avoiding the food for an extended period of time. In the case of anaphylaxis, normally the food needs to be strictly avoided for life. Though I have had quite a few adult patients who seem to have grown out of their severe food allergies that they had as a child. However, it is clearly not wise to experiment with food allergens that can cause anaphylaxis.

Slippery elm

Slippery Elm Bark - a great gut healing herb

Naturopathic treatment of allergies and intolerances also involves nutrients and herbs for healing the gut and supporting the immune system. Improving the microbiome of the gut is also essential to help heal and reduce inflammation. When done properly, intolerant foods can often be reintroduced without causing a reaction and they can then be included back into the diet. In some cases, however, people do better when they continue to avoid the food or only have it occasionally.

If you have lingering or unexplained health complaints, consider the quality of your diet and the possibility that food intolerance may be a feature. Come in for a visit and I can assess your case and recommend either testing or simple changes to your diet to establish what might be causing your health issues.

bloating remedies

Say Goodbye to Bloating!

bloatingBloating is a common complaint that many people suffer from and depending on the severity can be either inconvenient or quite distressing. Abdominal bloating can be due to a range of different conditions and from a holistic perspective, we always assess the patient from a much larger picture than just a cursory look at digestive function.
Let's look at the causes and some natural bloating remedies.

Probably the most common cause of bloating however, is simple digestive dysfunction caused by eating too much, eating the wrong foods or eating while on the run. One of the major causes of poor digestion and bloating can be a lack of digestive enzymes, including hydrochloric acid, that the stomach and pancreas produce. These enzymes help to break food down and when insufficient, can lead to bloating and fermentation as the food takes much longer to be digested than what is ideal. Digestive enzymes tend to decline with age, but stress is also another major reason for low enzyme levels and poor digestive function. When we are stressed, the nervous system switches over to “flight or fight” mode and in turn the stimulation to our digestive system is put on hold. When we eat while stressed or on the run, we often don’t allow our body to digest our food and symptoms of bloating, wind, reflux and sluggish digestion can prevail. So managing your stress, taking time out and slowing down to practice mindful eating is a good simple way to ensure optimal digestion.

gentian

Gentiana lutea - a classic bitter herb

 

The European habit of having an aperitif before meals is a traditional way of stimulating digestion. Often aperitifs are quite bitter in taste. The bitter taste creates a strong nerve reflex and stimulates release of digestive juices. Naturopaths often prescribe bitter herbs or foods before meals to promote optimal digestion. Gentian is my favourite bitter digestive herb that has been shown to increase gastric secretions.

It is amazing how much just slowing down and preparing properly to eat a meal with awareness will enhance digestion. Chewing our food well and eating slowly also helps to predigest our foods and prevents overeating. Following the Okinawan habit, known as “hara hachi bu” of eating to 80% full is a good idea.

 

IBSBloating may be connected to a condition called irritable bowel syndrome (IBS). This disorder is very common and presents with one or more of the following symptoms - bloating, wind, cramping, diarrhoea or constipation. IBS is a diagnosis often given to patients, when a range investigations fail to find any underlying pathology or reason for the symptoms. Many patients I have seen over the years had all the tests and were told by doctors that there was nothing wrong with their gut, and yet they still had symptoms that were quite debilitating. IBS is a very common condition and thought to affect up to one in eight people. There is no standard medical treatment for IBS, but I always find herbs and dietary change can make a big difference to the symptoms of IBS. Food intolerance to foods such as wheat and dairy products is quite a common cause of IBS and bloating. Not surprisingly IBS is often associated with stress and people suffering from anxiety have a high incidence of IBS.

 

Gut bacteria is an important component of digestive health. Whether we have a good array of beneficial bacteria or a collection of unhealthy bacteria will to a large extent determine our digestive function. Ongoing research into the human microbiome (gut flora) continues to display important ibs triggerslinks to many, often seemingly unrelated conditions, such as immune issues and mental health disorders. A relatively recently discovered condition called SIBO can also be a major cause of intestinal bloating and wind. SIBO stands for small intestinal bacterial overgrowth and occurs when bacteria that are normally only present in the large intestine, migrate to the small intestine thereby causing havoc. These bacteria feed on carbohydrates in the diet and produce a range of gases such as hydrogen and methane, which in turn can cause bloating, discomfort and wind. Patients with SIBO will often feel worse after having fruits and other fermentable carbohydrates, often grouped as FODMAP foods. FODMAP is an acronym for specific fermentable sugars and carbohydrates – oligosaccharides, disaccharides, monosaccharides and polyols. These foods include many fruits, certain vegetables, legumes, wheat and dairy foods. The low FODMAP diet is often used to help treat SIBO and IBS sometimes along with conventional antibiotic treatments or herbal therapies when necessary.

 

So there are many possible causes of the dreaded abdominal bloating! Starting with a good look at your diet, eating practices and stress levels is the best place to start. If that doesn’t help then consider a full health assessment and we can do comprehensive functional testing for food intolerance and bowel issues as well as look at prescribing some herbal digestive remedies, enzyme supplements and more.

Remember while you are what you eat…you really are what you digest!

 

 

apple cider vinegar

ACVApple cider vinegar (ACV) is one of those natural remedies with little science to back up the claims, yet mountains of anecdotal reports, going back thousands of years, praise its powers.

There are many folk medicine claims that ACV will cure just about anything! Some of the popular uses for ACV include for weight loss, blood sugar imbalances, digestive dysfunction, high pressure and cholesterol, skin complaints and a host of inflammatory conditions.

Historical Uses of ACV

Apple cider vinegar has a long history of use - as far back as in Ancient Egypt where it was used as a preservative. Hippocrates (around 400 BC), was one of the first to extol its virtues medicinally where he recommended it for bacterial infections. In many other cultures ACV was used for strength, endurance and health. In modern times, ACV has recently made a bit of a come back and is used and recommended by both natural therapists and lay people alike.

oak vinegarThere are many types of vinegars, and apple cider is just one of them. The word “vinegar” comes from the French words “vin aigre”, which means sour wine. This is reference to the fact that vinegar is often made from grapes but in fact vinegar can be made from many types of fruits or grains. Basically anything that has a sugar base can be fermented into a vinegar. Asian cultures often use rice, coconut and cane sugars as a base, while Europe has favoured fruits such as grape, which gives us the popular balsamic and red/white wine vinegars as well as apple cider.

The bacterial culture that is added to the fruit or grain grows slowly over weeks or months and produces a cloudy sediment known as “the mother”. In most commercial vinegar production, the mother is filtered out as some people may find the cloudy residue suspicious. Pasteurisation is then performed to kill the bacteria prevent more cloud forming. Unfortunately, pasteurisation kills off the beneficial probiotics (good bacteria) as well.  So there is more benefit from including the live cultures and enzymes so always source a vinegar that is raw (unpasteurised) and includes its cloudy mother!  Given how much apples are sprayed, you really want to get an organic product as well!

Research

There are a few studies on the benefits of vinegar, but like many herbs and nutrients that have been around forever, there isn't a stack of research as products that can’t be patented can't make any money! A few studies however, have confirmed some of the folk claims for apple cider vinegar which is always a good thing.

sushicook-rice-400Several studies have shown vinegar to be useful in diabetes and insulin resistance. In one study, 20mL of white vinegar in salad dressing reduced by 30 per cent the glycaemic response to a mixed meal containing 50g of carbohydrate.

A Japanese study found that including pickled (fermented) vegetables or vinegar decreased the blood sugar surge from white rice by 20–35 per cent. Other research has found that taking vinegar before meals significantly increased insulin sensitivity and dramatically reduced the insulin and glucose spikes that occur after meals. Those with insulin resistance saw the most benefit, achieving around 50% reduction in their blood glucose readings.

Other studies have found that vinegar might help people to feel full and can help with weight loss. For example, in one study different groups drank a 500mL drink containing 30mL, 15mL or no vinegar every day for 12 weeks. Those in the vinegar-drinking groups had modest weight loss, ACV weightlossaveraging 1.2kg in the 15mL group and 1.7kg in the 30mL group. They also had lower BMI, visceral fat area, waist measurement and serum triglycerides. Other studies have shown vinegar to reduce triglycerides and increase "good" cholesterol and also lower blood pressure.

Increased research into fermentable foods and the benefits of good bacteria on the microbiome of the gut may give credence to the folk reputation of raw apple cider vinegar on many aspects of health.

How To Use

The general dose of ACV is to take a tablespoon before meals in about half a glass water. If  you don’t enjoy the taste of apple cider vinegar on its own, you can instead use it to make a really delicious salad dressing (see below for my recipe) or make it more palatable by adding a little bit of honey. Avoid taking it neat (undiluted) as it is too acidic and may corrode tooth enamel or burn the throat and avoid adding it to hot water as it will destroy the good bacteria!

 

 

 

 

 

 

Probiotics & Fermented Foods

 

Exploring the Many Health Benefits of Probiotics & Fermented Foods

Our digestive tract contains hundreds of different species of bacteria that may be either beneficial to our health or harmful. 

The good bacteria are involved in many functions including the production of vitamins, maintaining the growth and health of gut cells and boosting immunity.

The harmful bacteria can contribute to candida (thrush), weight gain, immune and behavioural disorders.

More than 70% of our important immune cells live in the gut and are dependent on healthy bowel flora!

 

History of Fermented Foods 

Most cultures around the world include some fermented foods in their traditional cuisine. From fermented dairy in Europe to lacto-fermented pickles such as sauerkraut in Germany, kimchi in Korea and miso soup in Asia.  Any properly fermented food generally contains bacteria that are beneficial to health.

Unfortunately, our culture has slowly moved away from sourdough breads to yeasted breads and our diet contains very few foods rich in healthy flora – other than yoghurt.

 

 

You only have to walk down the refrigerated aisle at the supermarket to see the massive range of yoghurts and cultured dairy products. However, it is essential to know that there is a big difference between many of the yoghurts on the market!

Most of the commercial yoghurts contain sugar, fruit or artificial flavours and may or may not contain any added bacteria.  Always look for a natural yoghurt that has no additives or sugar and has added probiotics, such as acidophilus and bifidobacteria.

Sugar is added to improve flavour but may cause a decline in the potency or health benefit of yoghurt.  Many yoghurts (especially low fat ones) contain as much as 10-15% sugar which has the potential to contribute to weight gain and aggravate diabetes.

 

Children and adults alike, can sometimes be reluctant to enjoy a sour taste when they are used to sweetness.  If you are weaning children off sweeter yoghurts on to a healthier natural yoghurt, you can always add a small amount of freshly diced fruit or honey to add sweetness until they acquire a taste for sourness.

It may also be worth trying different brands of natural yoghurts as some are creamier and less sour than others.  I find my homemade yoghurt to be delicious and naturally sweet and creamy without the intense sourness.  My kids are happy to eat it plain - it is normal yoghurt to them.  They find it hard to stomach much of the regular sweetened yoghurts when they have them occasionally (at the grandparents)!

 

You can also use probiotics supplements to restore the healthy gut flora.  Probiotics contain either a single species or a range of live microbial agents to help colonise the gut and restore balance in the body. These are essential following any gastric disturbance such as diarrhoea but are also essential following antibiotics when good and bacteria are destroyed.  Because probiotics are living organisms that are sensitive to heat and light, they should be kept refrigerated and most types should be sold from a fridge in the clinic or shop (except freeze dried preparations).

 

There are specific health conditions and illnesses that have been shown to improve with probiotics. 

These include the digestive disorders:

  • ulcerative colitis
  • Crohns disease
  • irritable bowel syndrome
  • colon cancer
  • gut infections

 

It seems obvious that the function of the bowel may be improved with correct levels of bacteria, however there are other conditions that are also benefitted by probiotics. These include autoimmune diseases such as MS and rheumatoid arthritis and behavioural issues such as ADHD and autism.

 

Allergies can also be improved when the bowel flora is correct and studies have shown that pregnant women can prevent allergies in their babies by supplementing with probiotics during pregnancy.  Babies are naturally exposed to flora in the birth canal that help to colonise their immature guts after birth. Thus with caesarean birth, the baby misses out on this exposure and is more prone to allergies and gut issues.

 

Interestingly, breastfeeding also helps to colonise the infant gut with good flora and will go a long way to improving and preventing allergies, gut disorders and will boost generally immunity.

 

Clearly our overall health is directly related to bacteria in our environment and our gut. While some bacteria are harmful, the vast majority play an essential role in maintaining and supporting our health.

Try some traditional lacto-fermented condiments or natural yoghurt to boost the good guys in your gut on a daily basis and supplement with a probiotic if you have a health complaint that might benefit from this.

 

 

 

 

Digestion is the Cornerstone of Good Health

It's all in the Gut!

The health of our digestive system is fundamental to our overall health. Signs of digestive disturbance can give rise to symptoms such as constipation, diarrhoea, cramping, bloating and nausea. Other more serious conditions inflammatory bowel disease such as Crohn’s Disease and Ulcerative colitis also involve the immune system.

Packed with immune and nerve cells, the digestive system plays a delicate role in ensuring we have robust immunity and healthy moods and energy.  Allergies, behavioural problems, chronic immune weakness and stress have all been linked to digestive dysfunction.  Other things that can have a detrimental impact on digestion include pharmaceutical drugs such as antibiotics, oral contraceptives and steroid drugs.

Good digestion is the cornerstone of good health.  Without a healthy gut function, our capacity to be optimally nourished is compromised. Our digestive system is the primary tool for processing our food and absorbing nutrients.  Eating the healthiest diet in the world will be useless unless our digestive system is operating well.

The key to good digestion starts with, of all things - bacteria. Our digestive tract contains hundreds of different species of bacteria that may be either beneficial to our health or harmful.  The good bacteria are involved in many functions including the production of vitamins, maintaining the growth and health of gut cells and boosting immunity. While the presence of harmful bacteria can contribute to candida (thrush), weight gain, immune deficiency and behavioural disorders. Many unhealthy strains of bacteria produce toxins which can circulate and cause health complaints far away from the gut.

Making healthy dietary changes, identifying allergies and intolerances and restoring normal gut flora are essential ingredients in creating a healthy gut function.  I have helped many clients overcome digestive problems and restore their energy and vitality through a combination of dietary change and lifestyle advice.  I also have great success with herbs and nutritional supplements that can help treat bloating, wind, pain and irregular bowel function.  Well known herbs such as Chamomile and Fennel can help with many digestive disturbances.

Digestive issues can really impact on quality of life - so it is great to be able to support a return to good gut health!

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To me Karen is an absolute angel! I highly recommend Karen to anyone who is going through the whole ‘roller coaster’ journey of IVF. It was so lovely to actually have someone that actually listened to me, it was in 2010 when we decided we would give IVF one last go before having a break. Karen put me on a super tonic which I call her ‘magic potion’ and after a few weeks in taking this my FSH levels dropped dramatically and this was my lucky month and my dream had finally came true. I always feel so positive every time I leave Karen’s rooms, I’m so glad that I found her I can never thank her enough for my positive out come!
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