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What is Leaky Gut? Could you be suffering from this condition?

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Leaky gut syndrome has gained some considerable attention in the health industry, despite still not being entirely recognized by many medical professionals. Leaky gut is the generic term for an abnormally increased intestinal permeability, a medical term for “small holes in the intestines”. This condition results in an abnormal amount of absorption of materials that should not otherwise pass through the intestines and into the bloodstream. Some of the substances that make it through the intestinal barrier may include bacteria, antigens, food particulates and inflammatory mediators which can lead to a host of potential problems. Malabsorption of minerals is another sequele of this condition.  Untreated and undetected leaky gut may be responsible for some acute and chronic health conditions.  Some of the more common conditions linked to leaky gut include:

  • autoimmune diseases
  • diabetes
  • cardiovascular disease
  • multiple bowel-related problems (IBS, IBD)
  • weight gain
  • psychological conditions
  • joint problems

Causes of leaky gut are multi-factorial. Daily stress, non-steroidal anti-inflammatory drugs, alcohol consumption, cow’s milk intolerance, small intestine bacterial overgrowth, pancreatic insufficiency and intestinal infections are all potential sources of inflammation. It becomes quite apparent that intervention is paramount in these cases in order to break the cycle, restore gut health and ideally result in resolution of the associated conditions present.

Assessment strategies for leaky gut syndrome appear to be open to interpretation at the present time. It is largely a diagnosis that is made clinically through the presence of some key indicators.

These key indicators are symptoms such as:

  • bloating
  • gas
  • constipation
  • diarrhea
  • fatigue
  • headaches to name a few.

When a patient presents in my office, I am sure to assess their medical and social history, dietary habits and medication use as these areas can provide keen insights into presence and severity of the condition. Additional assessment tools that are often used to assist in diagnosis are the IgG food intolerance test and the urinary indican test. The indican test is an indicator of intestinal toxemia and  bacteria. Normally urinary indican should be quite low, where elevated levels can signify maldigestion and malabsorption of protein. Keeping in mind that other conditions can raise urinary indican levels such as hypochlorhydria, stomach cancer, insufficient digestive enzymes, malabsorption syndromes, SIBO, intestinal obstruction. If it is high in the correct context without more severe pathology present, it can be a useful indicator of a leaky gut.

IgG food intolerance testing is another popular and widely consumed test that measures the immune system activity in response to the presence of certain foods in the diet.  IgG, commonly associated with type 3 hypersensitivity reactions, is a chronic inflammatory marker that can provide insight into how much and what types of foods are triggering an inflammatory response.   When removing foods that test strongly positive on IgG testing, one is removing an agent directly contributing to inflammation, whether it be the initial cause or a contributing factor.    Once an IgG food intolerance testing has been ordered and adequately interpreted,  guidance can be more uniquely tailored to the individual patient.  These tests can measure up to 220 types of food antigens present in blood as well as the degree of the inflammatory response elicited. It can be a valued assessment tool as previously discussed and also be used to construct unique diet plans.

The typical leaky gut protocol is one that is rich in antioxidants, fiber, mucosal nutrients, fermented foods, is balanced and avoids food sensitivities. If you think this approach will benefit you, reach out for more information. Happy to help you restore your gut and life!

In good health,

Dr. Jennifer Cisternino, Naturopath

416-301-3477

[email protected]

Infertility- A guide to understanding the condition and what options you have

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In this blog, I would like to address an increasing health concern in today’s modern world, infertility. I would like to share some of the latest research and outline some common questions my patients have. If you and your partner are having difficulty conceiving, know that there is help and being informed of the many options is a great start.

What is infertility?

According to the World Health Organization, infertility is a disease of the reproductive system defined by a failure to achieve a clinical pregnancy after 12 months or more of regular unprotected sexual intercourse (Zegers-Hochschild et al., 2009).

Is infertility a common problem?

Infertility is a major problem in modern society and recurs in as much as 20–30% of the fertile female population. The World Health Organization (WHO) reports up to 80 million women world-wide having been affected by this disease to date, with a prevalence of ∼50% of all women in developing countries. (Sylvestris et. Al, 2019)

Is infertility just a woman’s problem?

Infertility is not just a woman’s problem, although most women are the one’s seeking medical care initially. Male infertility accounts for about 40 – 50% of infertility in a couple. Male infertility is a situation where a man is unable to get a fertile woman pregnant after at least one year of consistent unprotected sex. (Onwuli et al, 2014)

What causes infertility in men?

Male infertility is commonly marked as deficiencies in the semen and semen quality. In most fertility tests, the volume, total sperm count and sperm motility are often measured. Infertility affects about 8-12% of the world’s population, and in half of the cases, men are either the single cause or contribute to the couples infertility. (Onwuli et al. 2014)

What increases a man’s risk of infertility?

Some factors that may reduce the quality of sperm cells include the consumption of heavy alcohol, use of certain drugs, cigarette smoking, hormonal imbalance, treatment with certain chemotherapy for cancer, advanced age and environmental toxicants, such as pesticides and heavy metals, which may act as endocrine disruptors. (Onwuli et al. 2014)

What causes infertility in women?

The most common causes for female infertility are smoking, alcohol, irregular ovulation, PCOS, following a high glycemic diet with low nutrients, excessive caffeine, endometriosis, a history of pelvic infection, advanced maternal age, stress and toxicity.

I would say that unabated stress results in high adrenaline and cortisol levels. This leads to other imbalances in the body- hormones and nutrients alike.

Drugs such as marijuana and cocaine, smoking tobacco and alcohol intake have been shown to have adverse effects on all aspects of reproduction, from conception to labour to delivery. Smoking causes significant increases in miscarriage and prematurity. Women who are smokers are less successful with fertility treatments of all kinds than are non-smokers. (Silvestris et al, 2019)

Exposure to environmental pollutants is another large risk factor. The Occupational Safety and Health Administration (OSHA) postulated that long-lasting exposure to chemical agents as organic solvents, heavy metals, aromatic amines, pesticides and vegetal toxins is related to reduced fertility and recurrent miscarriages. (Silvestris et al, 2019)

How will a naturopathic doctor find out if a woman and her partner have fertility problems?

Most people who I see and treat have already been given a diagnosis of infertility and usually come in with a battery of lab tests run through their fertility doctors. Nevertheless, it is important that a thorough medical history be attained for both male and female patients. Questions pertaining to current lifestyle attitudes including sleep, diet, stress, sexual history, menstrual history etc. needs to be understood. Additional ways I assess their health may be through testing of hormone levels through blood or saliva, including estrogen, progesterone, LH, FSH and thyroid hormones.

Commonly, I see many patients who are unsure of the reason they cannot conceive as everything seems to check out fine with medical doctors and so are given a diagnosis of “infertility of unknown cause”. This provides alternative practitioners a great opportunity to address other areas of one’s health that may have been missed or dismissed all together as a barrier to fertility.

How do Naturopathic doctors treat infertility?

The “conventional” management of infertility generally focuses on the body as a hormonal machine and in large part ignores the psychological, emotional and nutritional aspects of one’s health. Here is where alternative therapies are finding their place and for good reason. When the focus in primarily on the pharmacological treatments and technologies currently available for fertility without much concern for the hearts and spirits of those patients, the results can leave a lot of people feeling devastated. I believe that it is extremely important to treat the “whole person” and listed below are some ways I do that.

Counseling: I can’t emphasize enough the importance of really hearing and understanding my patients. This can be a very difficult and stressful time in their lives. Providing emotional support and a place where they can express their fears, hopes and dreams is important. Several studies show that when emotional stress is resolved, pregnancy rates go up.

Hormonal Balance: When assessing for hormonal balance there are many ways to do so either through urine, saliva or blood. In all my years of clinical practice, I have come to trust that when you combine the healthy merits of a balanced diet, stress management and moderate exercise, the body begins to restore hormonal balance.

Nutritional Support: Most infertile patients that I have helped were very minerally depleted and so beginning a prenatal for women with adequate folic acid is important. For men, a multivitamin in addition to vitamin C, vitamin E, selenium and zinc in the right doses may help in sperm production.

Omega 3 Fatty Acids: More research is shedding light on the positive effects of omega 3 fatty acids in both female and male infertility. The effects of DHA and EPA on sperm parameters including total sperm concentration, sperm motility, seminal plasma DHA and sperm DHA have been evaluated in infertile men. Results of the meta-analysis showed that supplementing infertile men with omega 3 fatty acids improved sperm motility and DHA in seminal plasma.  (Hosseini et.al, 2019)In a study byNehra et. al where they evaluated women of advanced maternal age, a diet rich in omega 3 fatty acids showed an effective avenue for delaying ovarian aging and improving oocyte quality.Highlighting the importance of omega 3 supplementation with my patients is essential, not only in conception but also throughout the pregnancy and beyond as it helps with neurological and brain development.

Detoxification and elimination of toxic exposure: In my office my patients usually order a hair mineral and heavy metal test which is key in highlighting toxicity, and as the research states, this is very important to address as it can be a barrier to fertility. Proper detoxification of heavy metals must occur and retesting to show complete elimination from the body prior to conceiving is important.

Acupuncture:  Acupuncture can also help a couple conceive depending on the reason for infertility.I have had some success in treating infertility with acupuncture treatments. Acupuncture can help a patient to lessen stress which can aid in hormonal balance and it can also improve uterine blood flow in the female.

Dietary suggestions: It is important to understand what type of diet my patient is following. Removing refined sugars and eating a low glycemic diet is best. In addition, following an anti-inflammatory diet rich in fruits and vegetables is also effective. An IgG Food Sensitivity Test is usually ordered here if I suspect food sensitivities and impaired digestion.

Exercise: For some couples, weight loss can do great things for the hormonal system. If you or your partner are overweight, counseling around weight loss and exercise is important and can make the difference, especially in women who have PCOS and other ovulatory disorders.

Keep in mind that each patient and couple will differ in their reasons for infertility. This is not a “one size fits all”. Booking an appointment to better understand your particular health reasons is always best.

Thank you for reading. Reach out for further help.

Much love,

Dr. Jen Cisternino, Naturopath

416-301-3477

Let’s Get Your Immune System Ready for Cold and Flu Season

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First off, I am so excited that fall is here. Fall is my favourite season for many reasons like pumpkin spice latte’s, warm scarves, wool socks, apple picking, cozy book reading, pumpkin patches, thanksgiving….and most importantly, a return to routine, schedules and getting healthier! Do you share the same sentiment?

Although there is much to enjoy when it comes to fall, as it pertains to health, we must be ready to brave colder temperatures, which means cold and flu season is also approaching.

In this blog post, I would like to highlight some of the ways you can help prepare your immune system to have a more enjoyable, energized fall – minus the cold and flu!

One of the best ways to prevent against the cold and flu virus is proper hygiene and hand washing. Always wash your hands before eating or touching your face as this can aid in reducing 80% transmission of germs. 

Sanitize your home and work station often to keep germs at bay. Did you know that germs can last on surfaces for up to a few hours?  Did you also know that virus’ that are airborne (after someone has sneezed or coughed) can also hang around for hours in the air? Unless you are wearing a mask, chances are, if someone around you is infected, you could be walking into a virus cloud and contracting what they have. If you are sick, it is best to stay home and rest. Quarantine yourself and enjoy some rest and relaxation. Your co-workers will thank you.

Get good sleep. Getting enough sleep and resting well are important when it comes to helping your immune system, especially if you are fighting off the cold or flu virus. Aim to get 7-8 hours of sleep a night.

Probiotics have been highlighted in several research articles suggesting a causal link between healthy gut integrity and enhanced immunity. Did you  know that more than 70% of our immune system is linked to our gut? With this information, we must then be mindful of our digestive habits, which are tightly linked to our food choices. If you suffer with indigestion, bloating, pain, constipation or diarrhea, these are some signs that your gut health is in need of some support. Naturopathic doctors do a great job at helping people get to the root cause of their gut issues. In my office, we are proactive in determine food sensitivities, removing sources of inflammation, healing the gut and restoring normal function.

Are you vitamin D deficient? Getting your daily dose of vitamin D may help you ward off the cold and flu. Also known as the “sunshine vitamin”, vitamin D is an important immune booster.  As the days become shorter in the fall, we are being exposed to less sunlight and therefore less vitamin D. Vitamin D has so many wonderful benefits in the body. Not only does it help keep our bones strong, but several studies suggest vitamin D helps prevent colon cancer, prostate and breast cancer. Other studies may suggest it helps prevent heart disease, diabetes and multiple sclerosis. There are many ways you can get vitamin D into your body, whether it be sun exposure, diet or supplementation.  

Some foods that are highest in vitamin D are:

  • Cod Liver Oil
  • Swordfish
  • Salmon
  • Tuna
  • Orange Juice fortified with vitamin D
  • Milk fortified with vitamin D
  • Egg yolk

Eating these kinds of foods is not always easy for some people and this is where supplementation can fill in the gaps. Before getting on supplemental vitamin D, I would recommend that you have your levels assessed to know how much your body needs. Vitamin D is a fat soluble vitamin, meaning that if you take it in excess, it will be stored and can be potentially toxic. This is why it is important to know your current levels before supplementing.

A study conducted in 2018 showed that supplementing with vitamin D showed a reduced duration of those suffering with upper respiratory tract infections, cold severity and improved quality of life. Another study showed that vitamin D supplementation protected against cold virus’ and those patients who were deficient in vitamin D and not getting high dose supplementation experienced the most benefit.

Natural Immune Booster 

  • Back again in popular demand, I am offering “natural flu shots” for my patients.
  • Safe and effective for all ages
  • Combination of Echinacea and several other active ingredients great for immune strengthening.
  • Oral dose and well tolerated
  • Great for prevention and treatment of cold and flu symptoms.

Reach out if you would like to get “immune prepped” this fall.

Happily here to help you feel your best.

Dr. Jen Cisternino, ND

416-301-3477

5 Tips to Have a Healthy Summer!

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Relax. Refresh. Renew

Summer vibes are in the air. The sun is feeling warmer and the nights are getting longer, which we must take advantage of. Beach days, pool parties, BBQ fun and late night summer breezes is sure to put us in a “chill mood”…or at least it should. Let’s make sure that you are not “too chill” this summer, where your health goals fall to the wayside…

The truth is, there is never a good time to stop taking care of yourself. Your body will always remind you to get back on track before it’s too late. I see too many people get into bad habits over the summer and have regret once it is over, hence my motivation for writing this blog. Prevention is the best medicine. Let this read act as your warning 😉

Here are a few things to stick to. I call them my non-negotiable health actions.

  1. STAY HYDRATED: I cannot emphasize enough the importance of drinking pure water. If you are unsure how much you should be drinking, I will tell you MORE than you already are. Take your weight in lbs and divide it by 2. This is the amount of water in ounces that your body needs to maintain optimal function. Now, for every cup of coffee/tea/alcohol you drink, you must drink an extra 2 glasses (16 ounces). Take some time to do the math and ensure you are drinking enough water. The other thing to consider is water lost through perspiration. If you are active in the sun and sweating, you must add more water to match the deficit. Dehydration is a risk factor in the summer months. Headaches could be your first sign. Don’t take this risk lightly.
  2. EXERCISE DAILY: With the weather being nicer and days longer, it is natural to want to be out more and to have a bit more energy. Use these summer days to commence or continue an exercise routine. Some outdoor activities for you to try: bike rides, hikes (choose different locations to keep you engaged and exploring new terrain), tennis, basketball, rollerblading, outdoor runs, walks, and any sport that you love to play. Some of my favorites are soccer and tennis. You can be sure to find me on the soccer field and tennis court! With the extra calories burned while being active, you can enjoy a few treats without the guilt.
  3. KEEP SUGARS/CARBS TO A MINIMUM: Bathing suits, crop tops, dresses, shorts and tanks all reveal more skin than winter months. A sure way to cut weight and bloating is to minimize sugars. Try to cut out all refined sugars, breads, pastas, baked goods, pop etc. These foods can be consumed occasionally, if you desire, but not a daily basis. You will feel lighter and more confident in your clothes if you do this during the summer.
  4. ALCOHOL NEEDS TO BE LIMITED/AVOIDED: Are you someone who drinks a beer a day or a glass a wine a day? Are you someone who binges on the weekend or at parties? Ask yourself why? Any amount of alcohol in the body creates stress in the liver and other organs, and gets metabolized as sugar. From my experience, alcohol intake, at any rate, can increase weight gain, bloating and increased fatigue. Drink responsibly and be aware of alcohols’ negative impact on your well-being.
  5. PROTECT YOURSELF FROM THE SUN: The allure of having bronze, sun kissed skin seems tempting. The sun today is much more damaging than 20 years ago. Sun burns increase your risk exponentially of getting skin cancer. Please invest in some SPF 60 and be sure to apply this everyday, even if you are not directly in the sun. Catching rays while driving is a thing. If you are going to be outside for extended periods, wear a hat. If you have sensitive skin, please wear protective clothing to ensure that you won’t get burned. Rates of skin cancer are on the rise and no one is immune. Please do your best to protect yourself from the harmful effects of the suns damaging rays. Your future self will thank you! BONUS * Best way to prevent aging prematurely*

Hope these 5 tips help keep you healthy this summer. If you require a bit more motivation, feel free to reach out to set up an appointment. I am available throughout the summer. I am happy to help you feel your best!

In good health,

Dr. Jen Cisternino, ND

416-301-3477