In this episode, Dr. Lisa and Dr. Toni are discussing a potential root cause for digestive symptoms like bloating and gas called Small Intestinal Bacterial Overgrowth, otherwise known as SIBO.
SIBO = Small Intestinal Bacterial Overgrowth
-abnormally large numbers of commensal bacteria are found in SI
-bacteria is fed by carbohydrates and produces excess amounts of gas – hydrogen, methane, hydrogen sulfide
-bacterial overgrowth interferes with proper digestion and absorption of nutrients
-gas interferes with proper bowel motility, resulting in constipation and/or diarrhea
Up to 84% of people with IBS also have SIBO, so it’s thought to be an underlying cause
Symptoms of SIBO can include:
Constipation, diarrhea or alternating
Malabsorption issues like anemia, chronic low ferritin (iron stores), fat soluble vitamin deficiency like vitamin D deficiency
Skin issues like eczema, rosacea
Inflammatory conditions like pancreatitis, interstitial cystitis, prostatitis
What causes SIBO?
Conditions affecting intestinal motility and damage to MMC (migrating motor complex), including thyroid issues, concussions, head injuries, chronic high blood sugar
Acute gastroenteritis from food poisoning or “stomach flu”
Use of proton pump inhibitors (PPI) acid inhibiting medications
Low stomach acid, pancreatic enzyme and bile secretion
Ileocecal valve dysfunction, resulting in reflux of colonic bacteria into small intestine
Complications of abdominal surgery, including gastric bypass for obesity and gastrectomy to treat peptic ulcers and stomach cancer, postoperative loop, stricture or fistula
How do you know if you have SIBO?
IBS symptoms get worse when you take a probiotic, especially with a prebiotic
IBS symptoms might get better after antibiotic treatment for another infection
Symptoms worse after eating more fibre – veggies like broccoli, fruit like apples
How can you test for SIBO?
Breath test = most common method of testing for SIBO
-fasting after fibre restricted eating day before
-provocation with lactulose non-absorbable sugar
-breath sample every 20 minutes over 3 hours, tested for levels of hydrogen, methane, hydrogen sulfide in the gas in the sample tube
Small intestinal aspirate culture = currently the gold standard test for bacterial overgrowth. To obtain the fluid sample, doctors pass a long, flexible tube (endoscope) down your throat and through your upper digestive tract to your small intestine. A sample of intestinal fluid is withdrawn and then tested in a laboratory for the growth of bacteria.
Possible alternative: a course of specific antibiotics to see if you’re successful in reducing your symptoms may also be a way to assess if you have SIBO
Comprehensive Approach to Addressing SIBO:
Liver and gallbladder support eg. NAC, dandelion, artichoke, beets, green tea
Herbal or specific prescription antibiotic to lower bacteria levels eg. rifaximin, specific garlic, oregano extracts, berberine, myrrh, thyme, goldenseal, enteric coated peppermint oil
Digestive support for stomach acid, pancreatic enzyme, and bile production, leaky gut eg. bitters like gentian, L-glutamine, NAG, lemon water or D-limonene, topical castor oil pack
Elemental diet – liquid diet for at least 2 weeks to starve and kill off bacteria
Biofilm disruptors like NAC, black cumin, ALA
Today’s Mama Must-Have:
Dr. Lisa loves using apple cider vinegar before meals, as well as adding lemon and lime zest to salads, coleslaw and in water to support her digestion.
Dr. Toni is a big fan of the wet sock treatment to support immune health, especially at the first sign of a cold.
Dr. Toni’s next HypnoBirthing session for expecting parents looking to decrease fear and anxiety to support their natural instincts around labour and birth is happening this summer. Join her at https://www.hypnobirthingcalgary.com/register
Join Dr. Lisa’s new Meetup group Wild Woman Adventures Toronto if you want to get out in nature, connect with other women and push yourself out of your comfort zone. Activities include: sunrise/sunset SUP, tree-top trekking, a new moon workshop and more!
Dr. Lisa’s Wild Collective in Fall 2022: get on the waitlist: wildcollectivetoronto.com
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Stay safe and healthy everyone!
Disclaimer:The information provided is not meant to replace treatment with a licensed health care practitioner. It is for informational purposes only. Consult with a Naturopathic Doctor or other licensed health care professional to determine which treatments are safe for you.
We refer to this past episode from October 8, 2020 so often that we decided to re-release it! Is your thyroid the reason you are exhausted, depressed, constipated, forgetful and gaining weight? We discuss signs and symptoms of hypothyroidism, how to properly diagnose imbalances, how to eat to support thyroid health and how we approach assessment and treatment as Naturopathic Doctors.
One in eight women will develop thyroid disease at some point in their life and women are 5-8 times more likely than men to experience thyroid issues.
As Dr. Lisa shared previously in Episode 3, she realized that her thyroid wasn’t functioning properly after giving birth to her son. It is common for women to discover thyroid issues in the postpartum period. Proper blood work, addressing stress and taking dessicated thyroid were crucial for Dr. Lisa to feel her best.
Why is your thyroid so important?
Your thyroid gland regulates your temperature, energy production and metabolism. When your thyroid is under functioning, it is called hypothyroidism. High thyroid function is called hyperthyroidism.
Symptoms of hypothyroidism include:
Fatigue and exhaustion
Unexplained weight gain
Increased sensitivity to cold and temperature changes
Dry skin and thinning hair
Cravings for sugar and carbohydrates
Muscle weakness, aches, tenderness and stiffness
Pain, stiffness or swelling in your joints
Heavier than normal or irregular menstrual periods
Depression and anxiety
as many as 15% of women on antidepressants have an undetected thyroid problem as the cause of their depression
Brain fog, poor memory and concentration
Studies of women in their 60s have shown that low thyroid function can cause dementia-like symptoms and treatment can improve cognitive function and have a protective effect on the brain
Increased risk of heart attack, cardiac arrhythmias and congestive heart failure due to the regulatory control of the thyroid on heart rate and rhythm
Fertility issues, increased risk of miscarriage and preterm birth
Increased risk of prenatal and postpartum depression
Why do so many women have thyroid issues?
Possible Causes of Your Thyroid Issue Include:
Environmental exposure to different chemicals, xenoestrogens and heavy metals
Certain medications including birth control pill
Vitamin and mineral deficiencies
Iodine, selenium, vitamin D, zinc, iron, vitamin A
Low calorie diets
High cortisol levels due to chronic stress:
reduces thyroid hormone production
inhibits your conversion of the inactive form of thyroid hormone T4, to the active form T3
Leaky gut (also known as intestinal hyperpermeability) and imbalances in your gut microbiome have both been shown to impact hormone imbalances and fluctuations, like when you are postpartum or in perimenopause
Environmental toxins, chronic stress, nutritional insufficiencies, leaky gut, food intolerances and having chronic inflammation are all factors that can contribute to autoimmune disease
Your immune system is triggered to produce antibodies that can attack your thyroid, which is what is happening when you have Hashimoto’s thyroiditis
How do you properly test your thyroid function and the underlying causes of thyroid issues?
Full thyroid panel: TSH, free T4 and T3, thyroid peroxidase antibodies, thyroglobulin antibodies, reverse T3
Vitamin D, iron
Gluten and other food sensitivity
Saliva and urine testing for hormones including cortisol, estrogen, progesterone
Urine testing for heavy metal exposure (eg. cadmium, mercury)
Temperature checks every 3 hours during the day to see if your body is using your thyroid hormones properly
What can you do about an underfunctioning thyroid?
Avoid raw goitrogenic foods – soy and Brassica family veggies like broccoli and cauliflower
Increase your intake of thyroid supporting foods
Seaweed like dulse for iodine, brazil nuts for selenium, pumpkin seeds and oysters for zinc
Reduce toxin exposure
Replace nutrient deficiencies
Consider adrenal and stress support:
Address your throat chakra – speaking your truth, asking for help
Herbal support with ashwagandha, kelp, bladderwrack, Coleus forskohlii
Thyroid hormone replacement with Synthroid or Dessicated thyroid
Take in the morning, on an empty stomach, away from caffeine
Why would you consider dessicated thyroid?
If you’re on monotherapy like Synthroid (T4), you still night suffer from anxiety and depression even if your TSH levels are normal
T4 may not be enough to restore your T3 levels in your blood and target tissues
It contains all four natural thyroid hormones – T4, T3, T2, T1, plus iodine, thyroglobulin
Today’s Mama Must Have:
Dr. Toni loves having a healthy and easy recipe like Egg Muffins from Amanda Naturally that the whole family will eat for breakfast or a snack. Check out Episode 5 for more tips for healthy food habits from Amanda.
Dr. Lisa knows that Dessicated Thyroid is an absolute must have for her!
In this episode, Dr. Lisa and Dr. Toni talk about the causes and therapies for constipation in you and your kids. They discuss what is expected or ideal with respect to your bowel movements, the causes of constipation, and some tests and treatments to consider if you or your kids are experiencing constipation.
What is constipation?
Generally considered when you have less than 3 bowel movements a week, or discomfort, even you have a daily bowel movement.
As naturopathic doctors, we consider at least 1 bowel movement daily with a Type 4 rating on the Bristol stool chart to be ideal. You want your stool to sink without mucus, blood or undigested food (with the exception of corn).
What are some causes of constipation?
Not enough water
Not enough fibre from veggies and fruit
Lack of movement and proper circulation
Stress, especially in the case of irritable bowel syndrome (IBS)
Travel or another break in your routine
High intake of constipating foods: rice, toast, cooked carrots,unripe bananas
Hypothyroidism or sluggish thyroid function – see Episode 42 for more info
Reduced stomach acid, digestive enzyme and bile flow, often caused by stress and stimulation of sympathetic nervous system response
Gut bacterial imbalance
NSAIDs like ibuprofen and opioid pain killers like Tylenol 3
Hormone imbalance or PMS – constipation then possibly loose stools when your period comes is a common pattern in Traditional Chinese Medicine called Liver Overacting on Spleen
Harmful effects of constipation can include:
Discomfort, bloating, just feeling crappy
Reabsorbing toxins and hormones in your circulation
Megacolon or the abnormal dilation of the colon
Encopresis in kids, which is the uncontrollable leakage of stool
Stool testing through specialized labs, like Comprehensive Stool Analysis or GI-MAP
Small Intestinal Bowel Overgrowth (SIBO) breath test
Common treatments for constipation include:
Restoralax or Miralax, also known as Polyethylene Glycol (PEG) 3350
Adverse effects can include abdominal cramps, diarrhea, bloating, gas, nausea
Potential link to development of tremors, tics and obsessive compulsive behaviour
Contamination with small amounts of ethylene glycol and diethylene glycol
Not meant to be used daily and over the long term
The safety and efficacy of Restoralax for use in children under 18 years of age have not been established
Laxative herbs like senna
Side effects can include developing a dependence causing further constipation and other digestive disturbance, electrolyte imbalance, darkening of your intestinal tract called melanosis coli, finger clubbing, kidney inflammation
What else can you do about constipation?
You can try one or more of the following:
Increase fluid, especially pure water
8 oz (250ml) of water multiplied by age (number of years) up to 2 litres daily
Aim for 19g daily for kids 1-3 years, 25g daily for kids 4-6 years, at least 26 g and up to 31g daily for kids 9-13 years and up to 38g daily for kids over 14 years
Beans or legumes – ½ cup = 6 g fibre
Broccoli and other cooked veggies – ½ cup = 4 g fibre
Apples, pears, berries – ½ cup
Prunes or dates – see Episode 45 for more info on sugar balance
Chia seed pudding
Support stomach acid and digestive enzyme production
Bitter foods and herbs like arugula, dandelion root/greens, artichoke, gentian
Start your kids young with small amounts!
Support gut bacteria with fermented foods or probiotic supplement and prebiotic fibre
Magnesium citrate and vitamin C provides osmotic laxative effect
Start with small amount and use only to bowel tolerance
Support proper anatomical positioning with something like Squatty Potty
Slippery elm found in powder, capsules, lozenges and teas, taken away from medications and other supplements
Other herbs and homeopathy for relaxation
Clockwise on belly
I Love You massage
Can use castor oil for extra relief from discomfort
Pelvic floor physiotherapy for kids with constipation