What’s My Fish Oil For?

Fish+oil

Most Americans have heard of fish oil and many have tried taking it.  Fish oil and other omega-3 fatty acids are even finding their way in to conventional medical doctors treatment recommendations for treatment of everything from joint pain to cardiovascular disease to depression.  A quick literature search pulls up over 15,000 studies published in the past 40 years documenting the benefits of omega-3 fatty acids.  In my practice, omega-3 fatty acid supplementation is a common prescription but it’s important that my patients understand why they’re taking it.

You’ve probably noticed on your omega-3 fatty acid supplement bottle the words DHA and EPA.  To think about it simply, DHA helps support structural roles (like brain and nervous system development) and EPA supports functional roles.  Depending on your medical condition, a different ratio of these components might be recommended.  Together EPA+DHA decrease inflammation which we understand contributes to nearly all disease processes including cardiovascular disease and chronic pain, improves mood, relieves dry eyes, and increases good cholesterol (HDL) and decreases bad cholesterol (triglycerides), just to name a few.

Flax Oil vs. Fish Oil: 

Omega-3 fatty acids are polyunsaturated fatty acids (PUFA).  Plants contain PUFA in an alpha-linolenic acid (ALA) form, a precursor to the EPA and DHA molecules.  Thus, vegetarians can get therapeutic doses of these fatty acids through oil sources like flaxseed, hemp, sunflower, corn, safflower, canola, borage, or evening primrose.  The body can only take these precursors and turn them into the health promoting fatty acids under the right conditions, however.  The body needs to be supplied with adequate levels of cofactors like B vitamins, magnesium, zinc, and vitamin C to complete the process.  If the body is under stress (diabetes, high alcohol consumption, high cholesterol, or psychological stress) or doesn’t have the cofactors it needs, it will favor a pathway of inflammation and ALA then becomes the pro-inflammatory fatty acid, arachidonic acid (AA).  Seafood, including algae, is the only substantial source of anti-inflammatory EPA and DHA that can not be converted into pro-inflammatory agents.  Research has shown that conversion of plant sources of ALA to EPA and DHA is actually pretty low.  Intake of 2 grams of ALA equate to about 160 mg EPA and 10 mg DHA in the body.  You would have to take about 7 grams of flaxseed oil to even come close to recommended doses of EPA and DHA.  This is why fish oil tends to be favored over things like flaxseed oil.

How Much to Take?

The American Dietetics Association recommends healthy adults consume 250-500 mg per day of EPA + DHA from fish oil and vegetarians consume 2-4 grams per day of ALA plus 100-300 mg per day of DHA.  These numbers increase if you have health conditions that benefit from omega-3 fatty acids, which nearly all conditions do since it modulates inflammation, a common underlying cause of disease.  The American Heart Association is recommending 1 gram of EPA+DHA daily in people with cardiovascular disease and 2-4 grams in people who have elevated triglycerides (cholesterol).  My typical recommendation as long as I’m not trying to modulate cholesterol levels is consistent with Health Canada’s recommendation of 3 grams EPA+DHA daily to reduce inflammation.

Can’t Fish Oil Be Contaminated?

Before you start taking omega-3 fatty acid supplements, check with your licensed naturopathic physician regarding supplement quality and dosages that are right for you. It is important that the source of fish oil be third party tested for quality and contaminants and NDs have access to physician quality supplements that are known for their purity.  If you don’t live in an area that has access to a naturopathic physician, Carlson’s fish oil products or Nordic Naturals can be found at health food stores and undergo thorough testing for quality.

Oh, and that recent study suggesting a link between fish oil and prostate cancer?  That was a horribly flawed study.  A rebuttal can be found here: http://cassmd.com/badly-flawed-study-fish-oils-leaps-wildly-unsupported-conclusions-cancer/

 

 

 

Chronic GI Complaints and SIBO

We each have 1000-2000 trillion organisms living inside our bodies- thats 10-20 times the number of mammalian cells in the human body! We need these microflora for the development of our immune system, the absorption and synthesis of nutrients, and for protection against pathogenic microorganisms.    In the gastrointestinal tract, the microflora is lowest in the stomach and gradually increases toward the colon. Overgrowth of these usually helpful bacteria however, can cause a host of symptoms but the main symptoms are those of Irritable Bowel Syndrome (IBS) including:

  • Gas and bloating (belching, flatulence)
  • Abdominal pain
  • Constipation, Diarrhea, or both
  • Heartburn
  • Nausea

 

What is SIBO?

SIBO stands for Small Intestinal Bacterial Overgrowth. Simply put, it is a chronic bacterial infection of the small intestine of bacteria that normally live in the gastrointestinal tract but have abnormally overgrown.

This overgrowth creates a vicious cycle:

  1. Damage to the small intestinal lining from the overgrowth of bacteria decreases the amount of nutrients (food) absorbed through the small intestinal lining, which you may have heard of as “Leaky Gut Syndrome”. Due to poor absorption of food and fats, deficiencies in nutrients like iron, B12, vitamin A and vitamin D develop.
  2. As the bacteria consumes the food unable to be absorbed, they produce gas, which causes abdominal pain, bloating, constipation, and diarrhea.
  3. Through the damaged lining, larger food particles not able to be fully digested are able to enter the body and cause immune system reactions.
  4. The overgrown bacteria consumes the unabsorbed food, which creates more bacterial overgrowth, and more damage to the intestinal lining.

Testing

Breath testing is available to measure the hydrogen and methane gas produced by bacteria in the small intestine. Both hydrogen and methane are only produced by bacteria, not humans. Abnormally high levels of these gases indicate bacterial overgrowth.

 

Treatment

The main goal of any treatment plan for SIBO is to reduce the number of bacteria, repair the damaged gut, and prevent relapse.  Strategies for this usually include antibiotics, herbal antibiotics, and dietary modification.  The damaged small intestine lining heals on it’s own when the bacteria population is reduced, and is enhanced by diet and additional nutritional supplements.

Some keys to preventing SIBO are having good food hygiene (eating when calm, chewing well, etc.), having adequate stomach acid, removing proton pump inhibitors and antacids (which reduce stomach acid and promote SIBO), and enhance the parasympathetic “rest and digest” nervous system.

 Schedule an appointment with your Naturopathic Physician to identify if overgrowth of normal bacteria in your gut is the cause of your gastrointestinal distress.  For help finding a doctor in your area who specializes in SIBO, I recommend contacting the manufacturer of the Breath Test Machine, Quin Tron, and ask for the names of physicians that order SIBO tests from them.

Sweet Surprise

High fructose corn syrup (HFCS) is everywhere.  It has even made it’s way into “health foods”. Even conservative nutritionists agree- high fructose corn syrup is terrible for you. Here’s why:

Ingestion of fructose increases blood fructose concentrations to a greater extent than the sucrose form of sugar. Unlike sucrose (table sugar) that gets processed in multiple parts of our body, fructose is only processed by your liver. This creates a huge burden for your liver, and in turn causes inflammation, which then may lead to scarring. Liver scarring and inflammation, known medically as non-alcoholic fatty liver disease, has been associated with the consumption of HFCS. While once considered a rare condition, non-alcoholic fatty liver disease is on the rise, affecting an estimated 30% of Americans. Fatty liver disease is a dangerous condition that indicates an overworked and damaged liver. It can lead to serious complications like cirrhosis, liver cancer, and liver failure.

If obesity, diabetes, and the myriad of other dangerous chronic illnesses associated with HFCS doesn’t scare you away, maybe the havoc it wreaks on your liver will. It’s important to read labels, Yoplait Yogurt, Salad Dressings, “Smart” Ice Cream Sandwiches, Special K, and 100 Calorie Snack Packs contain HFCS. Protect your health and the health of your loved ones by avoiding this dangerous food ingredient.

The Dark Side of Agave


The agave craze has caught on in the world of natural cooking and healthy eating.  Agave is a honey colored liquid that tastes sweeter than sugar, is gluten free, and is low on the glycemic index.  Due to it’s low glycemic index rating it’s often marketed as “diabetic friendly”.

What you might not know about this sweetener, is agave nectar is basically high fructose corn syrup masquerading as health food.  The high levels of synthesized fructose put people at risk for obesity, heart disease, high blood pressure, and insulin resistance.  A recent study found that obese individuals who drink fructose sweetened drinks with meals have triglyceride (a form of cholesterol) levels 20 times higher than equally obese individuals who drank glucose-sweetened drinks.

You might be surprised to hear that there really is no such thing as agave nectar.  Agave was developed in the 1990’s in mexico from the starchy root of the yucca plant.  In order to produce nectar, the leaves are cut off the plant and juice is expressed, filtered, heated, and converted to a liquid nectar using caustic acids, clarifiers, and other chemicals.  The end result is a syrup that is 70-92% pure fructose- an even higher amount than what’s found in high fructose corn syrup (which contains 55% fructose).

Coming up next week:  The Burden of Fructose

Effective Acne Treatment (And It’s Natural!)

Scientists say that garden thyme could be a more effective treatment for acne than medicated creams.  Acne is typically caused by an overgrowth of bacteria.  For more physiology of acne, check out the article Understanding Acne.

A new study from Leeds Metropolitan University tested the effectiveness of thyme, marigold, and myrrh botanical liquid extracts (tinctures) and their ability to kill the acne-causing bacterium.  They compared this effectiveness with benzoyl peroxide which is the active agent used in many acne creams.

All of the botanical extracts were effective at killing the bacteria within five minutes, and it was found that thyme superior in its ability to kill off those date-ruining, acne-causing bacteria.  In fact, thyme even had a greater antibacterial effect than benzoyl peroxide, and was much gentler on the skin due to it’s anti-inflammatory properties.

 

Talk with your naturopath about skin care optionsthat take advantage of nature’s wisdom.  For help finding an ND in your area, check out the Michigan Association of Naturopathic Physician’s link “Find A Doctor”.  If you’re not in Michigan, try the American Association of Naturopathic Physicians.

How to Prevent Allergies from Birth

Bacteria at Birth

When we’re born, we’re born microbiotically sterile.  During birth, the baby becomes “infected” with normal flora.  During a normal vaginal birth, lactobacillus, particularly lactobacillus acidophilus, dominates the vaginal canal and as a result is the first flora to populate the newborn.  In a cesarian section, the baby doesn’t acquire the same microflora.  Instead of the normal vaginal flora the baby acquires the flora dominating the hospital setting, including staph and enterococci.  These infants have a significantly higher risk of developing childhood allergies.  The following two days of life, other organisms including rectal flora like E. coli, streptococcus, and klebsiella populate the baby.

Breastfeed vs. Formula

Following the first two days, microflora depends on breast feeding versus formula feeding.  In breastfed babies there is a rapid increase in the bifidobacter bacteria, making up approximately 95% of fecal flora during this time.  Breast milk contains oligosaccharides that stimulate the growth of bifidobacteria in the lower GI tract an lactobacilli in the upper GI tract.  If the baby is formula fed, only 22% of fecal flora is bifodobacter and the other 70% of bacteria observed in the fecal flora are enterobacteria, flora that are considered to be much less desirable.

Why give probiotics to a baby?

The immune system of the newborn baby is immature and biased toward forming an allergic reaction (this includes eczema, hay fever, allergic rhinitis, and asthma).  The internal bacterial flora train the immune system away from developing an allergic response.  If the baby doesn’t get access to sufficient flora, the re-balancing of the immune system doesn’t take place.  There is almost undeniable evidence and potential benefit by the use of probiotics for a period of 6 months on a daily basis.  Probiotics have the potential to lower the risk of the baby developing allergies.  Even though breastfed babies have higher numbers of bifidobacteria, the actual total numbers of bifidobacteria are lower than they were decades ago, so even breastfed babies can benefit from supplementation.  Using probiotics in newborns can prevent allergies from developing in 25% of cases by supporting the immune system.  We all experience the same environmental antigens, but it is the functioning of our immune systems that determine who develops allergies and who does not.

Get Started

Talk with your naturopathic physician about developing a protocol that is right for you and your baby to prevent allergies from forming in the first place.  Prevention is always easier than cure.  If you are an adult with allergies, I advise asking your physician about starting an individualized probiotic protocol to strengthen your immune system.  Keep in mind, it can take 1-3 months to see benefit, so hang in there and stick with the plan.  Not all probiotics are created equal, in fact some over the counter formulas may contain no actual live bacteria at all.  Make sure you use a company recommended by your health care practitioner to ensure you are taking a quality, third party tested product.

Sunlight and Heart-Health

Could vitamin D just be a marker for sunlight exposure, which contains unknown cardiovascular benefits?  If that’s the case, it makes sense why supplementation with vitamin D doesn’t have the same cardioprotective effects that are seen when people have naturally optimal serum vitamin D levels.  Dermatologist Richard Weller discusses the link between nitric oxide released by UV light and cardiovascular health in this fascinating TED talk.

[ted id=1648]

 

Heart Disease Prevention

Coronary artery disease (CAD) is the leading cause of death worldwide.  Michigan is leading the way with some of the highest death rates due to heart disease in the United States.  A recent study has shown a correlation between increased blood levels of two nutrients, coenzyme Q10 and vitamin B-6, with a reduced risk of developing CAD.

Vitamin B-6 deficiency is rare, however suboptimal levels are relatively common in the U.S. population, leaving the vascular system more susceptible to injury.  Having adequate stores of B-6 also prevent the development of atherosclerosis- the clogging of arteries from plaque accumulation.

Coenzyme Q10 plays an important role in mitochondiral energy production.  As you might remember from biology, mitochondria are the energy powerhouse of the cell.  Impaired endothelial (cardiovascular cell) function is considered an early indicator of atherosclerosis.  Supporting cellular metabolism and function of the endothelium can prevent CAD.

Some other important nutrients for heart heath include magnesium, essential fatty acids, potassium, vitamin E, and many others.  In fact, it is a delicate balance of these and other nutrients along with physical exercise that will provide the best cardiovascular protective measures.  Keep in mind that every person is different, so an individual approach developed by your naturopathic physician for your unique needs will over optimal cardioprotective effects.

5 Easy Steps to Prevent Cervical Cancer

There are an estimated 20 million Americans currently infected with the Human Papilloma Virus, commonly referred to as HPV.  Some strains of the HPV virus cause genital warts and can be easily removed using topical agents, minor surgery, or a method of freezing called cryotherapy.  These strains don’t usually progress to serious diseases.  High-risk strains of HPV on the other hand are the known cause of nearly all cervical cancers and some throat, oral, and anal cancers.

More than 23% of women in the US are infected with the high-risk strains of HPV, with approximately 10,800 new cases of HPV associated cervical cancer diagnosed each year.  It is the third most commonly diagnosed cancer and fourth leading cause of cancer death in females worldwide.

What can you do to prevent cervical cancer?  The answers are simple:

  • Keep your number of sexual partners low.  Studies show that lifetime sexual partners greater than 3 have increased risk.
  • Don’t smoke cigarettes.  Tobacco has an immunosuppressive effect in addition to a high level of carcinogens.  This can prevent your body from clearing HPV infections and cause direct DNA damage.
  • Use protection during intercourse, especially if you are not in a monogamous relationship.
  • Practice stress management.  Higher levels of perceived stress are associated with lower clearance of HPV viruses and increased development of cancer.
  • Schedule regular paps.  If you’re under 30 and have never had an abnormal result, you should repeat your pap every three years.  If you’re over 30 years of age and have never had an abnormal pap, repeat your pap every five years and add on a high-risk HPV test.

January is National Cervical Cancer Awareness month.  If you are a woman and haven’t had a pap in a while, schedule an appointment with your physician.  We can prevent cervical cancer by following the routine screening guidelines and with lifestyle modification.   If you have been diagnosed with cervical cancer or pre-cancerous changes, schedule an appointment with your naturopathic physician.  There is an extremely effect oral HPV protocol that uses high doses of antioxidants like green tea extract and vitamin E to support your body and rid it of HPV.  There is also vaccination using the Gardasil vaccine that may benefit some individuals.  Talk with your naturopathic doctor to determine the best approach for you to prevent cervical cancer.

 

Folate for Heart and Brain Health

In honor of National Folic Acid Awareness Week which just passed (January 6-12), I thought I’d shed some light on the importance of this water-soluble B-vitamin.  Folic acid and folate are not the same.  Folic acid is the synthetic form of folate used in supplementation and fortified food, while folate (also called methylfolate) is the active form of this vitamin.

Folate is important because it acts as a methyl-donor, playing a crucial role in DNA and RNA formation, nervous system function, homocysteine metabolism, and liver detoxification.  Low folate may be associated with mood disorders, anemia, heart disease and stroke, autism, dementia, and cancer.

Some causes of folate deficiency include alcoholism, pregnancy (the need for folate doubles by the third trimester), malabsorption, a genetic mutation causing the inability to convert folic acid to it’s active form, or medications like anticonvulsants, oral contraceptive pills, and the diabetic medication metformin.

Did you know that folate is needed to build neurotransmitters like serotonin, dopamine, and norepinephrine?  Low levels of these neurotransmitters are associated with depression, anxiety, and other mood disorders.  A mutation in the gene that converts folic acid to active folate is estimated to be present in up to 70% of people suffering from depression.  In these cases, supplementing with methylfolate has shown great improvement in symptoms.  Extremely high rates of the genetic mutation have also been found in children with autism.

Folate breaks down homocysteine, an amino acid that circulates in the blood and is associated with heart disease, stroke, and peripheral vascular disease.  Ensuring adequate folate either through the diet, folic acid supplementation, or methylfolate supplementation if a genetic mutation is present, may reduce the risk of heart disease.

If you have a personal and/or family history of early heart disease, mental illness, cancer, or frequent miscarriages, you may want to ask your physician about testing for a MTHFR genetic mutation (the enzyme required to convert folic acid to active folate).

Getting B-vitamins through the diet is the best choice and will be adequate for most people eating a healthy, whole-foods diet.  Supplementing with folic acid will be beneficial if you don’t get enough folate through foods as long as you don’t have a MTHFR genetic mutation.  Choosing a supplement may be difficult as there are a lot of options out there, and the form of the folate does matter.  When you’re reading the back of supplement labels, 5-MTHF is active methylfolate.  Occasionally the form will be specified.  When it is, you’re looking for the L-methylfolate.  Don’t choose blends of D-methylfolate and L-methylfolate because the D form decreases activity of the L form.  Deplin is a prescription only form of methylfolate that comes in 15 mg tablets.  Deplin may be covered by insurance if genetic testing reveals MTHFR mutations.  Talk to your naturopathic physician to see if supplementation with B-vitamins will benefit your health, and to determine the appropriate dosage and forms for your unique needs.  Remember, long term supplementation with a single B-vitamin may cause depletion of other important B-vitamins, so it’s important to work with your doctor to achieve optimal health.