In this episode, Dr. Toni is talking with certified professional recovery coach and intervention specialist Kristin Moore about how substance use disorder, also commonly referred to as addiction, can impact a lot of women and their families, especially in the current pandemic. What is defined as a mild substance abuse disorder may surprise you!
Kristin founded the company Shift Recovery Solutions to support professionals, executives, business owners, their families and colleagues to address substance dependency issues and disrupt the fear, stigma and myths around addiction that exist today.
“Addiction is not a spectator sport”
In this episode, we cover:
How substance use disorder is a mental health issue and how language is important to shift the stigma and shame around addiction
The medical definition of substance use disorder
A primary chronic disease of the brain around reward, motivation, memory and related circuitry with aspects of biology, psychology, social and spiritual inputs
Characterized by continually pursuing reward and/or relief by a substance or behaviour, including shopping, video gaming, etc.
Prone to cycles of remission and relapse with morbidity and mortality involved
Two-fold aspect of mental obsession and physical response, almost like an allergy
The three legs that are often needed in place for you to develop substance use disorder:
genetic or hereditary link
experience of trauma
environmental or social support of unhealthy behaviours eg. drinking culture for university or college students, wine drinking in mommy groups
The key indicators to look for when asking yourself if you or someone you know may have a substance use disorder:
Hazardous use – dangerous for yourself or others eg. driving under the influence
Social or interpersonal problems related to use eg. conflicts
Neglect of major roles and responsibilities at home or work
Withdrawal symptoms when you stop using
Tolerance built up so you need more for the same effect experienced in the past
Larger amounts used for a longer period of time for the same effect experienced in the past
Spend a lot of time using
Start having physical or psychological problems related to your use such as:
You start to skip or give up on your usual activities
Craving or mental obsession
2 or more of above in 12 month period fits a diagnosis of substance use disorder
2-3 = mild
4-5 = moderate
6 or more = severe
How denial around substance use can have you continue the progression of the disorder
How alcohol use makes up a large portion of substance abuse
Canadian drinking guidelines: 10 drinks per week for women, with no more than 3 drinks at one sitting
UBC study links alcohol use in breast cancer; 50% of women are still drinking alcohol within the Canadian drinking guidelines
How substance use can shift from pleasure to coping
Resources online include:
She Recovers https://sherecovers.org/
Thinking About Drinking https://www.tiredofthinkingaboutdrinking.com/
How Recovery Coaching can support the creation of goals around sobriety and a holistic approach tailored to each individual, as well as filling the huge gap that can occur before and after professional medical treatment
How you can support someone else who is dealing with substance dependency
In this episode, Dr. Lisa and Dr. Toni discuss: the reasons why women take the birth control pill; some potential negative side effects and nutrient depletions to be aware of and look out for; post birth control syndrome and what may happen after you stop taking it; other forms of contraception; and what to do to help minimize any side effects if you are taking the pill.
Why you might be on or thinking about starting the Pill:
To prevent pregnancy
To treat acne
To reduce symptoms around period like:
How does the Pill work?
The synthetic estrogen (ethinyl estradiol) and progesterone (progestin) in the Pill suppresses your natural cycle of ovulation, menstruation and hormonal fluctuation. The use of placebo pills for the last 5 days or so of your period (or stopping the Pill briefly) leads to a breakthrough bleed, not a true menstrual period.
The downsides of the Pill include:
Increased risk of clots, leading to deep vein thrombosis (DVT) or pulmonary embolism
Each year, 1 in 1000 women taking birth control pills will develop a clot
The risk of developing a clot increases significantly with a history of thrombosis or clotting disorder like thrombophilia
Shuts down your natural hormone rhythm
You could lose the experience of times in month when you are more creative, want to exercise more, are more social
Choosing a mate on the Pill vs. off the Pill
Would you still be attracted to them if you stop or start the pill?
Acts only as a band-aid solution to mask your natural hormonal imbalances
Your problem can still be there, or even be worse than before you started the Pill
Vitamin B2: deficiency can cause you to experience fatigue, dermatitis, headaches, migraines, indigestion, eye irritation, sensitivity to light
Vitamin B6: deficiency can cause you to experience fatigue, carpal tunnel, irritability, depression and confusion, weakened immune function, dermatitis with cheilosis (scaling on the lips and cracks at the corners of your mouth) and glossitis (swollen tongue)
Vitamin B12: deficiency can cause you to experience fatigue, weakness, constipation, loss of appetite, weight loss, numbness and tingling in your hands and feet, difficulty maintaining balance, depression, confusion, dementia, poor memory, soreness of your mouth or tongue
Vitamin C: deficiency can cause you to experience fatigue, poor wound healing, depression, iron deficiency, asthma, increased cancer risk
Folic acid: deficiency can cause you to experience brain fog, heart disease, poor appetite, shortness of breath, tongue inflammation
Magnesium: deficiency can cause you to experience muscle pain, hypertension, migraines, headaches, personality changes, PMS, constipation, insomnia, irritability, osteoporosis
Zinc: deficiency can cause you to experience poor wound healing, lower immunity, hair loss, diarrhea, white spots on your fingernails
Tyrosine: deficiency can cause you to experience low body temperature, hypothyroidism, dry hair, weight gain, flu-like symptoms, fatigue, depression
Mood changes and depression
A research study from Denmark looked at women aged 15 to 34 between 2000 and 2013 found that all forms of hormonal contraception (including the Pill) were associated with an increased risk of developing depression
Higher risks of depression were associated with synthetic progesterone only forms, including the IUD
You need to consider an alternative to the Pill if you:
Are older than 35 years of age and smoke
Have poorly controlled blood pressure
Have migraines with aura
Have a history of deep vein thrombosis or pulmonary embolism
Have a history of stroke or heart disease
Have a history of breast cancer
Have diabetes-related complications, such as nephropathy, retinopathy or neuropathy
Have liver disease
Have unexplained uterine bleeding
Will be immobilized for a prolonged period of time
Common symptoms after stopping the Pill:
Irregular or skipped periods
due to disruption of communication between your ovaries and hypothalamus in your brain
Heavy menstrual bleeding
Pill limits the growth of the uterine lining and blocks ovulation
When you go off the Pill, heavy bleeding can return if you had it before or you can experience it for the first time as your body establishes its own natural hormone balance
Ovulation pain and menstrual cramps
Ovulation is suppressed by the Pill
The Pill also suppresses your body’s production of prostaglandins, which is the natural substance that contributes to menstrual cramps
The Pill reduces the amount of testosterone produced by your body (testosterone is associated with acne)
Common if you started taking the Pill to reduce acne, but also possible if you’ve never experienced acne prior to taking birth control
Progestin acts as a diuretic, so you can retain fluid after coming off the pill
You might also have more bloating while on the Pill, which could improve when you stop taking it
You can be more moody while your body moves away from a carefully controlled daily dose of hormones from the Pill to your own ebbs and flows of your natural hormones
From nutrient depletion and/or disruption in thyroid function
What can you do about symptoms from taking or coming off of the Pill?
Replace missing nutrients
nutrient-dense foods at every meal: dark leafy greens and other colourful phytonutrient-rich vegetables, low-glycemic fruits like berries, pastured and organic animal protein, beans, nuts, and seeds
consider taking a high-quality multivitamin and mineral supplement plus tyrosine
Balance your blood sugar
Research has linked use of the Pill with imbalanced blood sugar and insulin resistance
For tips on blood sugar balance, see
Support your beneficial bacteria
Healthy gut flora contain bacteria that break down and eliminate estrogen
Estrogen-processing organisms form their own community called the estrobolome and play an important role in transforming plant compounds called lignans from vegetables and legumes into phytoestrogens, which protect your body against the risks of excess estrogen
For more info on gut health, see
Support estrogen metabolism and elimination
Foods that help healthy liver function include berries, beets and cruciferous veggies like kale, cabbage, broccoli, Brussels sprouts
Herbs and nutrients that support your liver’s detoxification pathways include N-acetyl cysteine (NAC), calcium-d-glucarate, green tea extract, curcumin (from turmeric), DIM, I3C, schisandra
Get plenty of fibre from vegetables and ground flaxseed to bind up and eliminate your used hormones and other garbage with regular bowel movements
Support your natural hormone balance with herbs like vitex, peony and licorice
If you’re taking the Pill or thinking about taking the Pill, then consider:
Getting baseline lab work done, along with regular follow-up testing including complete blood count, thyroid panel, nutrient status, inflammation and autoimmune markers, ultrasound
Tracking your basal body temperature
Getting genetic testing for clotting factors
Taking regular blood pressure readings
Tracking your cycle and any symptoms before starting and while on the Pill
What are some alternatives to the birth control pill?
IUD (2 main categories/options)
Copper – non hormonal, can cause heavier bleeding and cramping in some women
Progestin-containing like Mirena or Kyleena with possible side effects including:
Irregular bleeding (which can improve after six months of use)
Cramping or pelvic pain
2. Barrier methods like condoms
4. Tubal ligation
5. Fertility awareness
Today’s Mama Must Have:
Dr. Lisa is a big fan of a good quality basal body thermometer.
Dr. Toni can’t live without one of the many apps for tracking her period, like the basic Period Tracker or MyFlo.
In today’s episode, Dr. Lisa and Dr. Toni are talking about how to be proactive to manage winter blues and seasonal affective disorder (SAD).
SAD occurs four times more often in women than in men, with the age of onset often happening sometime between 18 and 30 years of age.
Where you live can make a big difference. You are most susceptible if you live farthest from the equator in northern latitudes. For example, in the United States, 1% of those who live in Florida and up to 9% of people who live in Alaska experience SAD. In Canada, 15% of the population experience winter blues and 2 to 6% experience SAD.
Symptoms of winter blues and SAD center on sad mood and low energy.
feel sad, irritable, and may cry frequently
feel tired and lethargic
have difficulty concentrating
sleep more than normal
decrease your activity level
withdraw from social situations
crave carbohydrates and sugars
tend to gain weight due to overeating
How you might experience symptoms of seasonal pattern disorders can vary in severity. You may experience a milder form of SAD known as S-SAD or the winter blues. However, others can be severely incapacitated, unable to function and thoughts of suicide may be present.
SAD can be linked with other health issues like depression, other mood disorders, addiction and hypothyroidism.
Given that SAD is a disorder women often experience and one that is triggered by limited exposure to sunlight, nurses and other health professionals who do shift work may be at particular risk
How do you know if you have SAD or the winter blues?
Seasonal Pattern Assessment Questionnaire was developed by South African physician Norman Rosenthal and colleagues who researched circadian rhythms, melatonin and the impact of light. You can fill out the questionnaire and discuss it with your doctor.
Causes for SAD and the winter blues can include:
Low levels of sunshine exposure and vitamin D
Vitamin D plays a role in your ability to produce serotonin
You could be low in vitamin D due to the following causes:
Using sunscreen on all exposed skin when outside
Poor fat absorption
Digestive issues including gallbladder and gastric bypass surgery
Medications like statins, steroids, thiazide diuretics
This neurotransmitter connected with mood balance can be lower if you have higher levels of SERT transport protein
SERT transport protein stays low in the summer, keeping your serotonin levels high
As sunlight decreases in the fall, your serotonin activity can also decrease
This hormone is produced by the pineal gland in your brain and released in response to darkness to promote sleep
You may have higher melatonin levels with shorter and darker winter days, causing sleepiness and lethargy
Your body’s internal clock may be timed differently, making it more difficult to adjust to the seasonal changes, especially with daylight savings time changes
Your rhythm can be thrown off with less exposure to natural light during the day and high exposure to blue light and other light sources in the evening
What can you do if you have SAD or the winter blues?
Treatments can include:
Sunlight – get outside for a minimum of 10 minutes daily, ideally first thing in the morning
Light boxes (also known as Bright Light Therapy or phototherapy) that have 10,000 lux of cool white fluorescent light can be used for 20-60 minutes in the morning while eating breakfast or working at a desk
Counseling and mindfulness
In one study, six weeks of Cognitive Behavioral Therapy (CBT) provided in group format for 90-minute sessions twice weekly was as effective as 30 minutes of 10,000 lux of cool-white fluorescent light each morning for SAD
Yoga, meditation like Transcendental Meditation, walking, exercise
Limit your sugar and starch intake
Limit your caffeine intake, especially after noon if you are caffeine sensitive
Increase intake of whole unprocessed foods, vegetables and other complex carbohydrates, protein
Get your vitamin D levels tested and consider supplementation depending on your blood level
Deficiency: < 30 nmol/L
Inadequacy: 30-50 nmol/L
Sufficiency: 50 nmol/L
Optimal: 75-125 nmol/L
Toxicity: 125 nmol/L and higher
Anti-inflammatory herbs and nutrients like curcumin, omega 3 fish oil
Probiotics and other gut healing nutrients to support the gut-brain connection (see Episode 8)
Mood supportive herbs and nutrients like St. John’s Wort, SAMe, 5-HTP
Lower your stress hormones by connecting with supportive friends and family
Today’s Mama Must Have:
Dr. Lisa loves her new stand up desk at home that she has set up by a window to increase her sunlight exposure during the day.
Dr. Lisa and Dr. Toni are back talking about alternate forms of sugar (“natural” and artificial). They discuss how fructose and high fructose corn syrup can lead to fatty liver and metabolic syndrome; how and why you can still gain weight from drinking diet soda, and tangible ways to decrease your sugar cravings.
Check out our previous conversation about sugar at Episode 45
2 categories of sugar:
Naturally occurring sugar: found in food, eg. fruit, milk
Fibre, protein and fat also found in that food will slow down release of sugar into bloodstream for better blood sugar balance
Nutrients needed to process sugar already included
Added sugar: refined sugar added to processed foods eg. pop, baked goods, yogurt, salad dressings, salsa and other sauces
What is Sugar?
Sucrose – table sugar from sugar cane or beets
Fructose, glucose, lactose and anything ending with -ose
Other Sweeteners Include:
Honey – minimally processed natural sweetener with some health benefits, such as for coughs, sore throats, antimicrobial action
Source of glucose and fructose
More dense than sugar with trace amounts of vitamins, minerals and antioxidants, especially if raw
Source of sucrose
Contains small amounts of minerals like zinc
Beware of maple-flavoured syrup which is not pure maple syrup!
Agave nectar or syrup – highly refined
Source of fructose
Easily converts to fat in your liver, increasing your risk of heart disease and diabetes
Can cause you to experience gas, bloating, digestive upset
Brown rice syrup
Source of glucose
Higher levels of arsenic in rice may contaminate the syrup
Source of sucrose
Contains trace amounts of minerals like potassium and the prebiotic fibre inulin that feeds your microbiome
High fructose corn syrup aka glucose-fructose
55% fructose and 45% glucose (compared to regular sugar that is 50:50)
Higher levels of fructose can increase your chances of developing fatty liver
Can cause you to experience gas, bloating, digestive upset
Chemicals such as aspartame, sucralose, acesulfame potassium
Don’t raise your blood sugar levels, but could still lead to weight gain, insulin resistance, metabolic syndrome, diabetes and addictive behaviour
Research has shown that daily consumption of diet drinks was associated with 36% higher risk of metabolic syndrome and 67% increased risk for type 2 diabetes
Studies showed most rats who were exposed to cocaine would choose artificial sweetener saccharin over cocaine if given the choice
Extracted from plant
Can be 200-300 times sweeter than sugar
Research has shown possible positive impact on blood sugar and cholesterol balance, though different extracts are questionable
Likely best to use whole plant
Creates less blood sugar and insulin response than other forms of sugar
Erythritol has less impact on gut than xylitol and sorbitol
Xylitol and erythritol has to shown to prevent dental cavities, though in high amounts
Monk fruit extract (Luo Han Guo)
Newer natural sweetener available with less impact on blood sugar
How do you know if a sweetener is increasing your blood sugar or insulin?
Consider testing your blood sugar at home with a glucometer or the following blood work at a lab through your medical or naturopathic doctor:
Lipid panel (cholesterol, triglycerides)
Liver enzymes (GGT, ALT, AST)
Ask yourself why you are reaching for sugary or sweet foods:
Using it as a reward?
Out of habit or boredom?
Addicted or want to feel better?
Looking for a dopamine or serotonin boost from sugar
Not enough sleep?
Poor sleep can increase ghrelin hormone that increases sugar cravings
How you can change your taste buds:
Making the decision to shift your mindset and change your behaviour around sugar can be an important first step
Either go off sugar and alternatives cold turkey or slowly reduce the amount you take in
Mixing sugary foods with healthy fats so you feel more satisfied from your food
Using nutrients like L-glutamine, chromium, 5-HTP or the herb gymnema
Make one small change at a time. Start slow and identify an area you can improve upon. Choose one type of food at a time, like bread, salad dressing or salsa, and pick an option that has less sugar in it.
Today’s Mama Must Have:
Dr. Toni is a big fan of having L-glutamine in combination with other gut healing nutrients like NAG on hand at home to help with decreasing sugar cravings and supporting digestive health (for more info on leaky gut and your microbiome see Episode 8)
Dr. Lisa likes using a light box in the morning when meditating for improving mood and energy as the days get shorter.