Dr. Amanda Fey

Probiotics are supplements containing beneficial live bacterial strains. (I like to think of them as our “good gut bugs”) Studies suggest that they aid in the prevention and treatment of allergic diseases by altering the gut ecosystem.

A 2005 study published in the Pediatrics Allergy & Immunology journal showed that the use of probiotics improved the quality of life in patients suffering from allergies.
90 patients were involved in this randomized double blind study. Over a 30 day period, subjects were given 2 caps/day of the probiotic strain Lactobacillus paracasei versus placebo. The frequency and severity of the allergy symptoms were decreased significantly among the patients in the control group versus placebo.

The mechanism of action is unclear, but probiotics seem to stimulate innate immune enhancing and anti-inflammatory activity.

How to include probiotics in your diet? Fermented foods such as yogurt and kefir contain these “good gut bugs”. It is also possible to obtain probiotics in a supplement form.

I see many patients that are on thyroid medications for treating their hypothyroidism. When I ask the patient if their cause of hypothyroidism is autoimmune, most patients don’t know. With this article, I am hoping to educate patient’s about hypothyroidism and the different causes, so patients can start taking an active role in their health.

Hypothyroidism occurs when the thyroid gland doesn’t produce enough of the thyroid hormones, T4 and T3. The pituitary gland produces TSH (thyroid stimulating hormone) which stimulates the thyroid to make T4 and T3. Your thyroid gland regulates how much T3 and T4 it makes based on the amount of TSH it receives. So, if you have high levels of TSH via your blood work this indicates that your thyroid hormone levels (T4 and T3) are low; in turn, diagnosing you with hypothyroidism.


Hypothyroidism may be due to a variety of different factors but the number one cause found in the US is Hashimoto’s thyroiditis or autoimmune thyroid. This is when the body’s immune system becomes malfunctioned and begins attacking it’s own thyroid gland. To identify this as the cause to your low functioning thyroid, thyroid autoantibodies can be ordered by your conventional doctor.

Conventional medical treatments are the same whether you have autoimmune hypothyroid or just hypothyroidism which is probably the reason why many MD’s do not normally test for the thyroid autoantibodies. Naturopathic medical treatments are different and depend on what the cause of the hypothyroidism is. If it’s autoimmune thyroid, the immune system is treated as well as the thyroid. If it’s not, nutrients helping the thyroid function more optimally are provided.

I often find patients that have been diagnosed with hypothyroidism and still feel low thyroid symptoms of fatigue, hair falling out, and constipation even while on conventional medications. This is due to the lack of immune system support. Let’s think about this… if your immune system is broken and is starting to attack your thyroid gland we need to fix the immune system not just the thyroid, right?!

The naturopathic approach to hypothyroidism consists of dietary changes and nutraceutical support. Diet is a huge part in the treatment especially if it’s autoimmune thyroid. Gluten has been linked strongly to being the possible cause of autoimmune hypothyroidism. The link is so well-established that researchers suggest all people with autoimmune hypothyroidism be screened for gluten intolerance, and vice versa. By removing gluten from the diet I have seen patient’s thyroid antibodies reduce significantly in a 3 month time frame. This indicates the immune system is not overactive and attacking the thyroid gland and therefore the TSH and T4 and T3 hormones become more stabilized and patient’s begin to feel the difference symptomatically.

Nutrients like selenium, tyrosine, zinc, and iodine are all important for your thyroid gland. By eating just 2 brazil nuts a day, you will be giving your thyroid enough selenium for optimal functioning. Foods like cabbage, broccoli, kale, cauliflower in raw form actually inhibit thyroid hormone synthesis, so people with hypothyroidism whether autoimmune or not should avoid eating them. However, if these vegetables are even slightly cooked this negates the inhibition, and therefore can be consumed.

References:
Digestive Diseases and Sciences,February 2000;45:403-406.

Iouroi, R, et al. Prevalence of celiac disease in patients with autoimmune thyroiditis. Minerva Endocrinol. 2007 Dec;32(4):239-43.

Lately, I have been seeing more and more patients being diagnosed with a condition called eosinophilic esophagitis (EoE). EoE is an allergic inflammatory condition of the esophagus. Symptoms include, swallowing difficulty, food impaction, and heartburn. Diagnosis is made through biopsy of the esophagus via endoscopy. Conventional medical doctors often prescribe corticosteroids, proton pump inhibitors, and/or antihistamines for treating EoE. However, like many conditions, food intolerances are often times the cause of EoE and once the offending food is identified and removed symptoms disappear.

A study published in the Journal of Pediatric Gastroenterology in 2011, researched six foods, cow’s milk, soy, wheat, peanuts, seafood, and egg, through the process of elimination and reintroduction as the cause of EoE. The most common foods identified as cause were cow’s milk (74%), wheat (26%), eggs (17%), soy (10%), and peanut (6%). Milk was 8 times more likely to cause EoE compared with wheat, the next most common food.

Again, the idea that many Gastroenterologists have about food not being associated to many GI issues is yet again proven wrong through research. As Hippocrates stated so clearly, “Let food by thy medicine.”

References:
Kagalwalla AF, et al. Identification of specific foods responsible for inflammation in children with eosinophilic esophagitis successfully treated with empiric elimination diet.J Pediatr Gastroenterol Nutr. 2011 Aug;53(2):129-30

Attention Deficit Hyperactivity Disorder (ADHD) is the most common behavioral disorder in children, estimated to affect between 5 to 10 percent of children and 3 to 6 percent of adults, according to the Attention Deficit Disorder Association. Children with ADHD tend to be hyperactive, impulsive, and inattentive.

Not everyone who is overly hyperactive, inattentive, or impulsive has ADHD. Since most people answer out of turn, are distracted easily, and become disorganized, how can practitioners tell if the problem is specifically ADHD?

Health care providers can diagnose ADHD with the help of standard guidelines from the American Academy of Pediatrics. The behaviors must create a real handicap in at least two areas of a person’s life such as in the schoolroom, at home, or in social settings. Therefore, someone who shows some symptoms but whose schoolwork or friendships are not impaired by these behaviors would not be diagnosed with ADHD. Nor would a child who seems overly active on the playground but functions well elsewhere receive an ADHD diagnosis.

The cause of ADHD remains unknown however genetics and biological factors which affect neurotransmitter activity in the brain are influential. From a holistic point of view, environmental allergens, nutritional deficiencies, food additives, food sensitivities, and heavy metal toxicities such as lead, aluminum, and mercury all contribute to the cause.

New research is now appearing that shows the link between consumption of food additives by children and ADHD. An online article published in The Lancet in September 2007 found that artificial food coloring and additives commonly located in children’s food exacerbate hyperactive behaviors in children.  The study consisted of 153 3-year old and 144 8/9-year old children. Analysis was based on observation, plus a computerized test of attention for the 8/9-year old children.

Depending on the child’s sensitivity, food additives cause biochemical imbalances in the body which strongly influences the way the brain functions. In the case of ADHD diagnosed children, it alters their behavior making them restless and/or distracted. There are more than 5000 additives in our food supply; therefore, making it almost impossible to completely eradicate them from our diets. However, limiting the intake by preparing meals containing whole foods and by reading labels to identify ingredients shown to exacerbate symptoms can aid in reducing the severity of the symptoms.

Omega-3 and omega-6 fatty acids are crucial to brain development and function. Increasing evidence indicates that deficiencies of these fatty acids might be associated with childhood developmental disorders including ADHD. Omega-3 fatty acids are often lacking in our diets. Studies have indicated that supplementation with omega-3 fatty acids help in the management of the ADHD linked behavioral and learning difficulties. Food sources containing these essential fatty acids are fish such as salmon, halibut and trout and freshly ground flaxseeds, to name a few.

Supplements containing omega-3 fatty acids can also be used. A study reported in Nutrition Journal in July 2007 reported that high-dose Omega-3 fatty acid concentrates improve behavior in children with ADHD. They supplemented children over eight weeks, and results indicated that participants experienced a significant reduction in symptoms without side effects. Caution should be used when buying omega-3 fatty acid supplements over-the-counter. Traces of heavy metals have been found in these supplements; therefore, high potent supplements indicating distillation processes should be obtained.

Iron deficiency has also been shown to contribute to the cause of ADHD. Low iron levels have been indicated in research to create abnormal dopamine synthesis in the brain yielding ADHD symptoms. A study published in the journal Archives of Pediatric and Adolescent Medicine showed that serum ferritin levels indicating iron stores in children ages 4 to 14 years old were abnormal in 84% of the children with ADHD. In addition, low serum ferritin levels were correlated with more severe ADHD symptoms and greater cognitive deficits. These results suggest that ADHD children may benefit from iron supplementation.

If your child has been diagnosed with ADHD, remember that pharmaceutical drugs aren’t the only solution available. Supplementing with critical nutrients and improving children’s diets have proved to be extremely beneficial in many scientific research studies; therefore, making it a sensible alternative solution for parents to explore.

I have been explaining to my patients the connection between diet substances and the inflammatory response involved in pain for years. However, when talked about with their rheumatologist they deny the connection.

In a recent study published in the peer reviewed journal Rheumatology what I have been “preaching” all these years has been proven.

Sixty-six patients with arthritis were put on a vegan diet free of gluten (38 patients) or a well-balanced non-vegan diet (28 patients) for 1 year. All patients were instructed and followed-up in the same manner. They were analyzed after 3, 6 and 12 months. In addition,  lab tests of immune antibodies were were assessed and radiographs of the hands and feet were performed throughout the year.

The results indicated that 40.5% showed improvement in the vegan/gluten free group compared to only 4% in the non-vegan group. Immune antibodies via blood work decreased in the vegan/gluten free group but not in the non vegan/gluten free group.

CONCLUSION: The data provides evidence that dietary modification may be of clinical benefit for certain RA patients, and that this benefit may be related to a reduction in immunoreactivity to food antigens eliminated by the change in diet.

References:

Hafstrom, Ringhertz A vegan diet free of gluten improves the signs and symptoms of rheumatoid arthritis: the effects on arthritis correlate with a reduction in antibodies to food antigens. Rheumatology (Oxford). 2002 Aug;41(8):950-1

Stephen and his family arrived at my office in 2007 exhausted. Exhausted from the rigors of conventional treatment without the satisfaction of improving symptoms. Stephen was a 32 year old man who had been battling ulcerative colitis for 5 years. He had tried a multitude of conventional treatments ranging from steroids to immune suppressant medications to no avail. The only option left was surgery on his colon, which was something he did not want to do. Unfortunately for Stephen, he still required to wear a maxi-pad daily to collect the constant dripping of blood from his anus and was experiencing sometimes up to ten urgent bowel movements every morning before he left for work. In addition, he couldn’t exercise, and if he tried he would develop a fever causing him to retire to his bed for multiple days to recover. This was not the life he or his family wanted to live, so they came to me for hope which I knew I could give them.

Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) located in the large intestine or colon. The symptoms of active UC are frequent and urgent diarrhea mixed with blood and abdominal pain. UC is associated with an increased risk of colon cancer particularly in patients with extensive colitis of long duration. Characteristically, UC involves ulcers or open sores located in the colon often seen via diagnostic imaging.

There are many theories regarding the specific cause of ulcerative colitis, although none have been proven. Most likely it is a variety of factors that work together to bring about the disease. These factors range from genetics, faulty immune system reactions,  environmental influences, and diet. For example, some people are genetically at risk for ulcerative colitis (it runs in their family), and an infection or other toxin may cause an abnormal immune reaction which then causes ulcerative colitis.

One of the goals in treating patients with ulcerative colitis is to reduce inflammation.    Naturopathic therapies complement conventional therapies in achieving this goal.   Inflammatory compounds such as leukotrienes are greatly increased in the colonic mucosa, blood, and stool of patients with UC. Eliminating pro-inflammatory foods from the diet and uncovering any possible food intolerances are important in managing the chronic intestinal inflammation.  Fish oil has also been shown to be important. A study published in the World Journal of Gastroenterology showed that dietary changes along with fish oil supplementation had direct anti-inflammatory effects in UC patients.

Herbs have been used historically in the treatment of ulcerative colitis. In UC, a dramatic decrease in the mucus content of the mucus-producing goblet cells has been associated with an increase in the severity of the disease. Demulcent herbs such as slippery elm, marshmallow root, and deglycerinated licorice (DGL) can be used to soothe irritated mucus membranes and promote the secretion of mucus.

The intestinal microflora is another aspect of ulcerative colitis that requires attention. The concentrations of beneficial bacterial flora have been shown to be significantly reduced in patients with inflammatory bowel disease. A study published in the journal Gut in 2004 proved probiotics to be as beneficial as the gold standard medication mesalazine in maintaining remission in patients with ulcerative colitis. Furthermore, this demonstrated the pathogenic significance of intestinal microflora.

Whenever the intestines are inflamed you can guarantee that nutrients are not being absorbed optimally. Without proper nutrient assimilation how can the body heal?Replenishing lost nutrients due to this chronic inflammation is also a critical part of overcoming ulcerative colitis. Clinically, I find that until the gastrointestinal inflammation is better controlled utilizing high quality multiple vitamin and mineral supplements are required.

Like many who have been diagnosed with inflammatory bowel conditions, Stephen was also experiencing rashes that come and go, headaches, vertigo, asthma. anxiety, and extremely low energy. As the inflammation of the colon subsides and the nutrients are supplied for better absorption, I find that many of these additional symptoms reduce in severity.

For Stephen after just one month of using naturopathic therapies he noticed a difference in his symptoms. In seven months he was no longer using the maxi-pads and his bowel frequency and urgency normalized. Now it has been three years, and Stephen has not had one flare up since the first time I met him in 2007.

I have treated many patients like Stephen with ulcerative colitis. Each one was a unique case. I have not found any cookie cutter protocol for treatment. It is truly individualized. Unlike Stephen, who was not utilizing any conventional treatments at the time of his visit, many patients I work with are. Either way there are many naturopathic therapies to assist patients like Stephen to gain control of there life again and overcome ulcerative colitis.

Carol was a 32 year old woman who had been suffering from daily migraine episodes for almost 10 years. She had been through all the standard conventional medical examinations and imaging procedures all indicating no pathology. There was a familial component to the migraines which in conclusion lead her to believe that migraines just ran in the family and this was something she would have to live with for the rest of her life. She was currently managing her symptoms using acupuncture and pharmaceutical medications.

As with all of my patients, close examination of their daily diet is part of their naturopathic consultation. Specifically with migraine sufferers, I find there is a huge association between food intolerances and migraines. I have repetitively seen the removal of a food significantly lessen or completely resolve migraine episodes.  The most common food triggers I see clinically for many is not the typical chocolate, alcohol, aged cheeses, or MSG, but instead being dairy, gluten, and eggs. As for Carol it seemed that gluten was the possible suspect.

Gluten is a protein found in the grains: wheat, barley, rye, kamut, and spelt. It’s the part of these grains that gives dough its elastic consistency. Gluten intolerance is when the body’s immune system is intolerant of gluten and its sub-protein gliadin in the diet and is forming antibodies or displaying some other evidence of an inflammatory reaction. The symptoms of gluten sensitivity are so varied, many people who have health issues may be unaware that their suffering may be due to gluten.

For Carol, her health issue didn’t involve any gastrointestinal (GI) symptoms so it was hard for her to believe that gluten could be causing her migraine episodes. Since 1966, scientific evidence has been accumulating regarding gluten sensitivity without the classic GI symptoms. During the past five years, many scientists have begun to re-evaluate the notion that gluten sensitivity is solely a disease of the GI tract due to the overwhelming evidence indicating otherwise. Other organs suspected of being involvement with gluten intolerance include: joints, heart, thyroid, bone, brain, and neuronal synapses. Conditions like rheumatoid arthritis, Hashimoto’s thyroiditis, Huntington’s disease, autism, cardiomyopathies, dermatitis herpetiformis, dementia, and osteoporosis have all been shown in the literature to be connected to gluten.

While there is data to suggest that a certain percentage of migraine sufferers react to gluten, few medical doctors routinely test their patients for it. In 2003 a study published in the American Journal of Gastroenterology indicated that of the 90 patients who were diagnosed with idiopathic migraine, 4.4% had celiac disease compared to 0.4% of the 23 controls. The patients were treated for six months with a gluten-free diet and their symptoms decreased or were eliminated. The patients also showed an improvement in their cerebral blood flow on a gluten-free diet that was confirmed with diagnostic imaging.

There are many blood tests to confirm your diagnosis of gluten intolerance. If you do decide to ask your doctor and he/she agrees be sure to not start eliminating gluten from your diet until after the testing is done. The test could come back negative if you are not actively eating gluten.

On the other hand, eliminating gluten from the diet is a easy way to determine if it’s the cause of your migraine episodes.  As in Carol’s situation this is what she did, and after 4 weeks of eliminating gluten she noticed a significant improvement in her migraines. They weren’t as frequent or long lasting. In addition to eliminating gluten from her diet she also supplemented with beneficial nutrients such as magnesium and riboflavin which have also been shown to be helpful in managing migraines.

Like many patients that I see who have gluten intolerance, it may take months of not eating gluten before their symptoms completely resolve. Carol has been gluten free now for 8 months and on average experiences one headache a month. In comparison to her daily migraine episodes in the past this a dramatic improvement, and for her a great enough reason to never look at gluten again!

Have you ever felt “butterflies in your stomach” in anticipation for something? This is the network of neurons lining your stomach that some scientists have nicknamed “our second brain”. This little brain in our innards, in connection with our big brain in our skulls, influences our mental state and plays key roles in certain diseases in our body.

The second brain contains some 100 million neurons, more than in either our spinal cord or our peripheral nervous system.

Dr. Mayer, a professor from UCLA, states a big part of our emotions are influenced by the nerves in our gut. Over 95% of our serotonin is found in our bowels. Because antidepressant pharmaceuticals increase serotonin levels it’s not a surprise that medications meant to cause chemical changes in the mind often provoke GI issues as a side effect. He also stats that Irritable Bowel Syndrome (IBS) afflicts more than 2 million Americans and could be perhaps regarded as a “mental illness” in our GI tract.

Scientists are also learning that serotonin made by the gut may influence other surprising diseases. A study done in Nature Medicine found that the GI tract could regulate bone mass to the extent of curing osteoporosis in rodents. Higher levels of serotonin counteracted the bone deteriorating disease.

In addition, scientists found a connection between gut health and autism in regards to serotonin secretion.

Scientists are also looking into how the second brain mediates the body’s immune response. After all, at least 70% is aimed at the gut to expel and kill foreign invaders. These trillion probiotics in our gut “communicate” with the nervous system cells.

Dr, Mayer also states that in the coming years in psychiatry there will be a need to treat the second brain in addition to the one atop the shoulders.

Full article published on www.scientificamerican.com.

What’s the difference between a food allergy and an intolerance? This is a question I get asked all the time. So let’s become clear on the differences.

A true food allergy involves your body’s immune system.  When the body identifies the food as harmful, it produces antibodies directed against that food. The next time that food is consumed the body mounts an immune response with the release of histamine and other chemicals that trigger allergic symptoms. A common food allergy example is peanuts.

Food intolerances are different because they do not involve the immune system. They are a digestive system response rather than an immune response. A common example of this is lactose intolerance.

Only 6 to 8% of children under the age of 3, and only 2 to 4% of adults have true food allergies. Food intolerances are much more common.

A study done in Great Britain showed there was a 10-fold increase in food intolerances in the past 25 years. Why the rise? Scientists hypothesize that our environment is the cause; poor soil quality and pollutants, intensive farming, food additives and stressful lifestyles. We don’t seem to be feeding our children real food anymore, most of the food in stores today have been developed in a laboratories. In addition, the rise in the use of antibiotics in the last 25 years has caused our gut’s immune system to become compromised and therefore also contributes to the rise in food sensitivities.

Food allergy symptoms can be similar to food intolerances such as, skin rashes, nausea, vomiting, abdominal pain to name a few, but also can be as severe as anaphylactic shock requiring emergency care.

Food intolerance reactions may not be seen or felt for 2-3 days after eating the problematic food. This is why it is often times harder to identify food intolerances. In addition, food intolerance reactions can contribute to a variety of health conditions, common ones are as follows: migraines, joint pain fatigue, fibromylagia and IBS symptoms.

Conventionally, doctors use skin prick tests to identify possible food allergies. This will not detect food intolerances however. Elimination diets are an easy, affordable way to identify food intolerances. Our office is also using Alcat testing to help determine possible food intolerances and work great for the people that don’t want to go through the rigors of eliminating favorite foods to identify the problematic ones. You can call our office to ask more about the Alcat food intolerance test or visit online at www.alcat.com.