Category: Immune System

Vitamin D: Why Is It Important?

11/11/2020

What Is Vitamin D?

Vitamin D is a fat soluble vitamin, like Vit A, E & K.
Although it is present in foods, it is not present in many foods, nor is it in abundant supply. We can get Vit D from the sun, and this is certainly a good idea, but we will touch on why this is often not enough, especially in colder climates like most of Canada. Supplementing and fortifying foods with Vitamin D is also something that helps, but again the question we should ask ourselves is, are we getting enough?

Inactive vs Active Vitamin D
Vitamin D collected from the sun, diet and some supplements are in the inactive form, which means it needs to be converted by the body to its active form.
- Liver --> Vitamin D --> 25 hydroxyvitamin [25 (OH)D] or calcidiol (D2).
- Kidneys --> physiologically active 1,25 dihydroxyvitamin [1,25 (OH)2D] also known as calcitriol (D3).

What Does Vit D Do in the Body?

There are a number of important jobs that Vit D does:

Promotes calcium absorption in the gut
Maintains appropriate calcium and phosphate levels in the blood
Normal bone mineralization
Ensures that muscles contract properly
Monitor cell growth
Modulate cell differentiation and death
Neuromuscular and immune function
Activation of various genes and their associated proteins

Measuring Vitamin D status
Generally the next question I get from a lot of people is how do I know if I'm getting enough Vit D. Currently the best way to do this is to measure it in the blood by look at the blood or serum concentration of calcidiol (D2). Wait, didn't I say that the active form is calctriol (D3)? The reason is the 1/2 life of D3 is too short to make it a good indicator as well as it being regulated highly regulated by parathyroid hormone, calcium and phosphate. D3 levels also do not normally decrease significantly until Vit D deficiency is severe.

How Much Vit D is Needed?
If we understand how important Vit D is, the next thing my patients often ask is how much do I need?
As we mentioned above, to know if you personally are getting enough, getting your levels checked is going to be the best option. However, there are general recommendations made by the government which are based on what is called the RDA or Required Daily Allowance. This depends on the average of what works best for a healthy population and maintaining basic requirements for health. In the case of Vit D that's enough to bone health and calcium metabolism, and then in addition the RDA is set based on minimal sun exposure as well. All of this combined, the current daily recommendation for adults and children over 4 years is 400 IU.

If we're trying to raise our levels of Vit D, 400 IU is definitely not going to be enough.

Food Sources: Can I get Enough?
There are a few sources of dietary Vit D:
- Fatty fish such as salmon, makerel, and tuna or good quality fish oil products
- Beef liver, egg yolks, and cheese will have small amounts
- Some mushrooms provide D2 in variable amounts

The good news is the body is primed to absorb food dietary Vit D, as it is often in the active form (D3) and this appears to be 5 times more potent that the parent vitamin based on some studies.

Fortification
I know there's lots of foods that have Vit D on the label, doesn't that mean there's Vit D in it? It's true, that in Canada we have been fortifying foods with Vit D since the 1930s. The main sources are milk (35-40 IU/100ml) and margarine (equal to or more than 530 IU/100g). Many other dairy products do not fortify (cheeses and ice cream), while others food products like orange juice, yogurt, and breakfast cereals do. Manufacturers are also not always required to list Vit D or how much, so that makes it challenging to estimate as well.

Can I Get Enough from the Sun?

Most people meet at least some of their Vit D requirements from the sun. However, what most people don't realize is that this depends. You need to be outside at the right time of day, and depending on where you live, time of year as well. We need to be exposed to UVB rays at wavelengths of 290-320 nanometers. Other factors that can affect this are: cloud cover, smog, melanin content of your skin (the darker your skin the more difficult it is to 'absorb' enough sun).

Optimal Sun Exposure
The factors previously mentioned and current research that's been done still makes it challenging to know exactly what the right amount of sun exposure is for each person. However, these guidelines are helpful to get some helpful exposure:
- In general, approx 5-30 mins of sun exposure between 10am -3 pm twice a week to arms, face, neck. legs or back without sunscreen [NOTE: if you are monitoring risk for skin cancer, than keep in mind any recommendations from your healthcare provider]
- Spring, Summer and Fall are the optimal times of year, particularly those who live in more northern latitudes

Can I Take Too Much?
Generally speaking you would need to be taking a lot of Vit D to cause harm. The general thought currently is taking 10,000 to 40,000 IU a day consistently for a prolonged length of time. The blood level would be more than 500 nm/L that would be considered toxic. The research is still determining what that exact level would be. The symptoms of Vit D toxicity are not very specific: anorexia, weight loss, polyuria (aka peeing a lot), and heart arrhythmias. If you are at all concerned, please do speak to your health care provider.

Take Home Message
- Vit D is important for our overall health, and we're still figuring out the full extent of what this entails
- Vit D is present in the diet, and through exposure to the sun we are able to synthesize Vit D
- The drawback is it's tough to determine how much we're getting, so many of us will need to supplement with it at times
- There are safe and unsafe levels of Vit D, and finding out what works best for us personally is likely going to require getting our levels checked periodically.

Have questions about Vitamin D or making sure you're getting what you need to live your best life? Connect with me and we can get a personalized plan together that takes your individual needs into account.

Note: Talk to your Naturopathic Doctor today about getting assessed and treated if needed, and as always talk to your health care provider before beginning any new medication or supplement. This information is not meant to replace the advice/guidance of a medical professional, nor should it be acted upon by individuals unsupervised by the appropriate healthcare provider.

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Probiotics and the Microbiome

4/14/2017

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There is so much more discussion about probiotics and the microbiome now than ever before. There is research about the benefits for infants, for mood, for digestion, for re-establishing a healthy gut after antibiotics, and so on. Even though there’s plenty of evidence to show that probiotics or good bacteria are good for us, a lot of people still ask me ‘does taking probiotics actually make a difference?’ Obviously, my quick answer would be yes they generally do. However, perhaps it’s easier for you to decide for yourself, with a little more information.

The Gut:
Generally when we refer to the ‘gut’ as a collective we tend to think of our abdominal area only. However, the gastro-intestinal tract or GI tract actually begins in the mouth and ends at the exit point, the anus. For our purposes let’s focus on the small intestine and large intestine since that’s where the majority of probiotics have their most beneficial effects.
In the whole GI tract there are over 100 000 billion bacteria. Different species in different numbers populate the gut. This is why it is actually important to change your probiotic on occasion because there are so many different species to be supported. If there are so many bacteria present, how could a few billion make a difference?

Well that has to do with the composition and state of the small and large intestine. There’s anywhere from about 10-100 billion microbes present in the small and large intestine. This helps us understand why giving a probiotic or eating fermented foods makes a difference, because there’s enough probiotics present in the average capsule to replenish and encourage growth of good bacteria. Also, the small intestine is approximate 20 ft long, so it houses about 95% of the bacteria that live in our intestines. The large intestine on the other hand is only 4 ft long, but because things are moving much slower through the large intestine the bacteria layer in the mucosa can be up to 200 cells thick, compared to 1 cell thick in the small intestine. This allows this shorter stretch of organ to still accommodate 10-100 billion microbes.

Research:
As I mentioned before there are many studies that have been done and are currently being done on the effects of probiotics and the microbiome as a whole. If you did a simple google or pubmed search you would come up with 1000s of results. I can’t summarize all of them, but here are a few highlights:

INFANTS AND PROBIOTICS
Eczema, asthma and allergy have become much more of a problem over the past few decades than they ever were before. In the Swansea baby Allergy Prevention Trial they looked to see if intervening with probiotics at an early age could reduce the incidence of allergy, and atopic conditions by extension. The intervention was given to newborns for the first 6 months after birth. The outcome was a follows:

Placebo group: Almost 10% of infants had atopic eczema at 6 months; Approximately 13% of infants had atopic eczema at 2 years.
Probiotic group: Approximately 3% of infants had atopic eczema at 6 months; almost 6% of infants had atopic eczema at 2 years.

The overall reduction of infants with allergy was 57% at 2 years. Remember, they only received treatment for the first 6 months. This demonstrates that the positive benefit of intervention goes beyond the intervention period.

PROBIOTICS AND ANTIBIOTICS
Most people are aware that we should take probiotics when we take an antibiotic. However, how much, when and for how long make a difference? One study, The Cambridge Clostridium difficile trial looked at the impact of probiotics to prevent/reduce C. difficile infection and associated diarrhea in patients receiving antibiotics. The outcome was as follows:

Antibiotic/Placebo group: When tested at Day 28 they still had overgrowth or dysbiosis present
Antibiotics followed by probiotic: They had a growth of bacteria up to Day 7, but then at Day 28 there was a significant decrease in bacterial overgrowth
Antibiotics with Probiotics: There was no overgrowth of bacteria at Day 7 or 28 because the probiotics were present throughout antibiotic treatment

This study demonstrates that by taking probiotics while receiving antibiotics you can decrease the chances of bacterial overgrowth occurring at all. However, it is still beneficial to intervene with probiotics later on as it will help to bring bacterial overgrowth under control.

Gut/Brain connection:
One of the newer areas of study that’s been getting a good deal of attention is the impact that a healthy gut can have on our mood. More and more studies are coming out showing a positive impact of probiotics and healing the gut on issues such as depression, and anxiety. This work is still early, but promising. Promising enough that some companies are actually beginning to make probiotic products specially geared at mood.

Choices: Making sense of what’s available on the market
As happens with most things in the market, as they get more popular there tends to be more people interested in developing a product for it. Over the last few years we’ve seen a huge increase in the number of probiotics available at the store. Knowing you have all these choices, how do you make the right choice for you? Well, there’s no short and easy answer to that. There are a number of factors you want to consider:

Do you have any gut problems (eg. IBS or Ulcerative Colitis)?
Are you experiencing symptoms such as gas, indigestion, eczema, etc.?
Do you have any current allergies or sensitivities?
Do you know how many strains are best for you?
Do you know which strains are best for you?
Do you know roughly how many billion you need?

Knowing these things makes it much easier for you to select an appropriate probiotic. If you don’t know the answer to these questions or aren’t sure, then you may want to speak to a Naturopathic Doctor or other healthcare professional. When I go through this process with my patients, we figure out which probiotic (if any) might be best for them so it’s much easier to find what they need when they go to purchase a product from the health food store.

Have questions about probiotics or how to improve your gut health overall? Please email me through the website ‘contact’ page or get in touch with me directly.

Note: Talk to your Naturopathic Doctor today about getting assessed and treated if needed, and as always talk to your health care provider before beginning any new medication or supplement. This information is not meant to replace the advice/guidance of a medical professional, nor should it be acted upon by individuals unsupervised by the appropriate healthcare provider.

References:
Allen SJ et al 2014 Arch Dis Child
Plummer et al 2005, Int J Antimicrob Agents 26

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Dealing with Allergies Naturally

3/31/2017

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Finally Spring is here!

The weather is gradually getting warmer, birds are returning, and pretty soon the winter jackets can be put away for another year. The downside for some of us, with these seasonal changes comes allergies! Yes, all the fun you can have sneezing, congested, blurry eyed and unable to breath. However, what if you could do things differently and get them under control naturally?

The Stats

In the US:
· Number of people in the U.S. who have either allergy or asthma symptoms: 1 in 5.
· Percentage of the U.S. population that tests positive to one or more allergens: 55%.

Internationally:
The prevalence of asthma in different countries varies widely, but the disparity is narrowing due to rising prevalence in low and middle income countries and plateauing in high income countries.

Common Symptoms:

Postnasal drip
Sniffling
Dark circles under eyes (allergic shiners)
Puffiness beneath the eyes
Restlessness
Fatigue
Poor sleep
Headaches
Behavioural problems such as irritability, hyperactivity, poor concentration, whining, and pickiness about food

Why are they more common?
There is no one theory that currently accounts for the rise in allergies/sensitivities. Some of the proposed causes are as follows:

Hygiene Hypothesis: Many children do not get sufficient exposure to a wide variety of microbes, and as result of growing up in an extremely clean environment the body does not learn how to modulate the immune response effectively. There seems to be some credibility for this theory since the significant increase in individuals suffering from allergies has been in the western hemisphere, and we have not seen a corresponding increase in other parts of the globe at the same rate.

Inflammation/Leaky Gut: Chronic inflammation in the body and the gut lining is unable to heal and permits certain food particles to pass through and interact with the immune system. These particles are tagged as ‘non-self’ by the immune system, and it will react to the presence of these particles every time they are re-introduced to the system. Leading to a cycle of continuous inflammation and slow/no healing of the gut lining.

Genetically Modified Organisms (GMOs)/packaged foods: We have altered certain foods in our food supply so much that our bodies have difficulty recognizing it and breaking it down as ‘food’. There is also a corresponding increase in exposure to preservatives and pesticides that are mixed in or put on these foods.

What Can We Do?
General recommendations:

Remove environmental irritants: Rid the home of common irritants such as dust, perfumes and scented products.
Improve immune response: There are many things that can be done to help optimize the immune system. Eating a balanced diet of whole foods, including sources of omega 3s and fermented foods for probiotics.
Promote rest and relaxation: learning to relax can help decrease tension, and getting to sleep at a reasonable and consistent hour each night can help promote better immune function.

Dietary recommendations:

Identify Food sensitivities: food allergens (eg. peanuts or diary), and chemicals, additives, or oils in processed foods can cause allergies to be worse
Foods rich in Vitamin A and Beta-carotene: the orange and yellow vegetables and fruits tend to be the richest sources
Essential Fatty Acids (EFAs): Fish, flaxseeds, eggs, and evening primrose oil all contain EFAs which are essential to health of cells and decreasing allergic symptoms

Supplemental recommendations:
The following nutritional supplements can improve allergy problems in several ways: boost immunity, reduce inflammation, and enhance intestinal health.

Zinc
Vitamin C
Vitamin B complex

Herbal recommendations:

Astragalus: immune system enhancing herb that is a tonic for the upper respiratory passages. Can be directly beneficial for those with a tendency towards atopic conditions such as eczema or psoriasis, commonly occurring in those with allergy problems.
Nettle: stimulates lymphatic function, decreasing swollen lymph nodes. In its freeze-dried form, nettle is used to stabilize the inflammatory substance histamine produced by our bodies, thus decreasing allergic response.
Elder: This herb has a flower rich in flavonoids, which are anti-inflammatory, anti-oxidant, and immune-stimulating. This combination helps reduce allergic response and improve immune function.

Asian Medicine and Acupuncture

Chinese medicine considers an allergic reaction to be a manifestation of the body's failure to adjust to its environment.
According to the concept of the organs and their functions, weaknesses of the "Lung” or "Liver” could explain these allergic reactions.
By stimulating the energy of the "Lung" and by regulating the "Liver" the acupuncture treatment aims to calm the exaggerated response. This can be done both preventatively as well as acutely.

Suffering from allergies can be a very irritating experience. If you or your child is suffering from allergies, it is best to take them to a Naturopathic Doctor who can perform a proper assessment and form a treatment plan that will address your/your child’s needs. Always speak to your health care provider before beginning any new medications or supplements.

References:
Allergy Statistics and Facts. WebMD. Reviewed by Johnson, K. (2012). http://www.webmd.com/allergies/allergy-statistics
Asthma Statistics. American Academy of Allergy, Asthma & Immunology. http://www.aaaai.org/about-the-aaaai/newsroom/asthma-statistics.aspx
Romm, A. 2003. Naturally Healthy Babies and Children: A Commonsense Guide to Herbal Remedies, Nutrition, and Health. Celestial Arts.
Skowron, JM. 2009. Fundamentals of Naturopathic Pediatrics. CCNM Press. Print.

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Boost Your Immunity Naturally

9/16/2016

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September usually means the beginning of Fall and Back to School for most families. However, have you given any thought to boosting your family’s immune systems yet? The change in weather, and return to their germ infested petri dishes, I mean classrooms, means that your kids and/or you could potentially get sick any time now.

Why is it important to support our body’s natural ability to fight off infections?

Cold and Flu season stats
To start, there are over 200 different viruses cause influenza and influenza-like illness (fever, headaches, aches and pains, coughs, runny nose). According to a recent Cochrane review, the flu vaccine might only be effective against Influenza A and B, which represents about 10% of all circulating viruses (Jefferson et al, 2013). The authors’ conclusion from that review was, “Influenza vaccines have a modest effect in reducing influenza symptoms and working days lost. There is no evidence that they affect complications, such as pneumonia, or transmission.” (Jefferson et al., 2013).

Period of Contagiousness
You may be able to pass on the flu to someone else before you know you are sick, as well as while you are sick. Most healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick. Some people, especially young children and people with weakened immune systems, might be able to infect others for an even longer time.

How Flu Spreads
Most experts believe that flu viruses spread mainly by droplets made when people with the flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby. Less often, a person might also get flu by touching a surface or object that has flu virus on it and then touching their own mouth, eyes or possibly their nose.

What Can We Do?
There are many things we can do to help prevent illness throughout the cold and flu season.

Basic Strategies:
1)Eat fresh whole foods: Eating a variety of fresh whole foods including plenty of colourful fruits and vegetables is essential to proper immune function
2)Avoid refined sugars, trans fats and salt: These foods are known to weaken the immune system.
3)Increase your consumption of vitamin C containing foods: Vitamin C is known to boost immune function and help prevent cold and flus. Increase vitamin C containing foods such as: oranges, lemons, grapefruit, strawberries, raspberries, black currants, peppers, spring greens, brussel sprouts, broccoli, cauliflower, etc.
4)Eat more garlic and onions: Garlic and onions both have anti-viral and anti-bacterial properties, helping the body to fight off any germs it may come into contact with. (Raw consumption provides a greater benefit than cooked)
5)Drink up: Ensuring you are adequately hydrated will help enhance your immune system. Aim for half your weight in fluid ounces. (ex. If you weigh 150lbs, you should consume 75oz. of water a day)

6)Sleep, Sleep, Sleep: Ensure you are getting around 8 hrs of sleep per night and you are sleeping soundly. Too little non-restorative sleep is known to weaken the immune system.
7)Exercise: Engage in at least 20 minutes of physical activity per day. Exercise helps to increase circulation and lympathic flow, both of which help boost the immune system.
8)Breathe: Practice deep breathing exercises to help manage stress. High stress, fear, and worry can weaken the immune system, making you more susceptible to infections.
9)Wash hands: Wash your hands frequently using warm water and a natural anti-bacterial soap to prevent the spread of infection.
10)Cover your Cough: Cough or sneeze into your sleeve to prevent spreading infection and avoid touching your nose, mouth, eyes until hands are washed.

Additional Helpful Measures
Think drinking tea is just for your grandma? Well think again!

Herbal Teas
In a Harvard study, they found that people who drank 5 cups a day of black tea for 2 weeks had 10 times more virus-fighting interferon in their blood than others who drank a placebo hot drink. The amino acid responsible for this immune boost, L-theanine, is abundant in both black and green tea—decaf versions have it, too.

Your optimal dose: Several cups daily. To get up to five times more antioxidants from your tea bags, bob them up and down while you brew.

5 Herbs for Prevention
Astragalus (Astragalus Membranaceous)

A deep immune activator, it’s known for its antibacterial and antiviral properties. From a Traditional Chinese Medicine perspective astragalus helps warm the Wei Qi, which is our defensive Qi or immune system. Can be used in combination with other herbs or by itself. If you do become ill you want to switch from this herb to another that has more active illness fighting properties.
Dose: Decoction: 2-4 tsp/cup 3x/d

Siberian Ginseng (Eleuthrococcus senticosus)

Immune system modulator, helps the body adapt to stress and strengthens the immune system. Also helpful for decreasing inflammation in the body. Often included in immune formulas. If taking long term, it is generally recommended to take periodic breaks from use (eg. 6 weeks on, 2 weeks off).
Dose: Decoction: 2-15 g 1x/d

Cinnamon (Cinamomum cassia)

A nice addition to a tea or hot cereal, this herb not only has antimicrobial properties, it also helps settle the stomach and prevent diabetes. Should not be used in pregnancy as the essential oils may cause uterine stimulation.
Dose: powder: 5-20 grains 3x/d, or to your taste

Dang Shen (Codonopsis pilosula)

Another good adaptogen, helps the body adapt to stress and strengthens the immune system. Used for weak lungs from a Western and Traditional Chinese Medicine perspective. Considered a milder substitute for Panax ginseng.
Dose: Decoction of root: 9-30 g per day

Schisandra (Schisandra chinensis)

Often combined with other similar adaptogens, it also has effects on the lungs, helping to expel mucous and decrease cough.
Dose: decoction: 6-9 g each day

5 Herbs for Treatment
Echinacea (Echinacea angustifolium/purpurea/pallida)
- Stimulates the immune system to increase phagocytosis by macrophages (cells that kill and eat microbes). Antimicrobial/bacterial/viral properties. Best given at the first sign of infection. Dose: Decoction: 1-2 tsp/cup 3x/d

Ginger (Zingiber Officinale)

Primarily known for its effects on the stomach. Helps to relieve nausea and vomiting, as well as gas and cramping. The warming properties of ginger gently increase the temperature of the body helping to eliminate heat sensitive microbes.
Dose: Infusion 1 tsp/cup as needed

Licorice (Glycyrrhiza glabra)

A sweeter herb that is good for a cough. Helps to soothe a sore throat and get mucus out of the lungs. Has antimicrobial and antiviral properties. Not recommended if you have hypertension or are pregnant/nursing.
Dose: Decoction (root): ½-1 tsp 3x/d

Elder Flower/Berry (Sambucus canadensis)

Used for cough and nasal obstruction (eg. sinusitis), especially good for kids because they generally like the taste. Have anti-inflammatory and antiviral properties. Also helps to induce perspiration with fever so more microbes are killed and flushed out of the system.
Dose: Infusion of flower: 2-4 g /250 mL water

Mullein (Verbascum thapsus)

Primarily used for cough, particularly the dry hoarse cough that causes a lot of irritation to the lungs. Helps to soothe, and decrease the cough while still getting the mucous out. Another one that could be used with kids since it has a milder taste.
Dose: 1-2 tsp/cup

Infusion vs. Decoction
An infusion is a water-based preparation made by steeping leaves, flowers, and other non-woody parts of a plant in either hot or cold water. The traditional cup of herb tea is the archetypal infusion.

A decoction is also water based, but it’s done by gently simmering the herb in boiling water. This method is used for tougher plant parts, such as roots, barks and seeds.

Powders: What are they good for?
Usually when people think of tea they think of the leaves and flowers of the plant in a cup of hot water. However, there are certain herbs that are better made into an infusion using the powdered form. For example, some herbs are rich in volatile oils that are medicinally useful and when boiled will evaporate and be lost. Valerian root is an example of a woody part that would be better ground to powder and prepared as an infusion. The preparation method usually depends on the use of the herb. This is why it is important to consult with a trained practitioner because they can help you select the most appropriate herb and preparation method based on your particular health concerns.

Note: This presentation is not meant to replace the advice of a trained practitioner. In order to formulate a proper treatment plan, you should consult with your Naturopathic Doctor or other health care provider.

Resources:
Center for Disease Control and Prevention. (2013). Seasonal Influenza: Key Facts about Influenza (Flu) & Flu Vaccine. http://www.cdc.gov/flu/keyfacts.htm
Hoffmann, D. (2003). Medical Herbalism: The Formulation and Preparation of Herbal Medicines. Healing Arts Press. Print.
Jefferson et al. (2013). Vaccines to prevent influenza in health adults. http://summaries.cochrane.org/CD001269/vaccines-to-prevent-influenza-in-healthy-adults.
Ontario Association of Naturopathic Doctors. (2013). Staying Healthy in Cold and Flu Season. http://www.oand.org/staying-healthy-in-cold-and-flu-season/
Public Health Agency of Canada. (Nov 2, 2013). Flu Watch: Influenza/ILI Activity (geographic spread). http://www.phac-aspc.gc.ca/fluwatch/13-14/w44_13/pdf/fw2013-44-eng.pdf

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Health advice For The Whole Family

Vitamin D: Why Is It Important?

Probiotics and the Microbiome

Dealing with Allergies Naturally

Boost Your Immunity Naturally

Sarah Connors

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