Tips for Dealing with Herxheimer or Die-off Reactions

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Dealing With Yeast Die-Off (Herxheimer) Reactions

  

Yeast overgrowth can happen in response to improper diet, poor immunity, difficulties in digestion and antibiotic use. Poorly digested food can lead to putrefaction (rotting) and encourages the growth of organisms.  Antibiotic use destroys the normal balance of gut flora and leaves an open field for bad bacteria and fungi to move in.  Hormones and steroids can make this condition worse, too.  Most importantly, over-consumption of simple sugars & refined carbohydrates will feed the yeast.  If the immune system is weakened or there are not enough probiotic ("good" bacteria) to combat the yeast, then it begins to grow unchecked and cause symptoms, such as "leaky gut".

In this blog, I am addressing specific patients who are being treated for fungal dysbiosis (yeast overgrowth), who may experience a worsening of their condition after starting a program for yeast control. This may be very unsettling & discouraging if it is not understood.  It must be addressed effectively in order to avoid worsening symptoms. Here are some strategies to minimize the chances of suffering unnecessarily from a Herxheimer (die-off) reaction.

Common Symptoms of yeast die-off include:

Fatigue, brain fog, gastrointestinal distress such as nausea, gas, bloating, diarrhea or constipation, low grade fever, headache, sore throat, body itch, muscle and joint soreness or pain, flu-like symptoms. Other symptoms include: lethargy, intense sweet cravings, rashes, irritability, joint stuffiness, or muscle pain. In susceptible individuals with pre-existing neurological symptoms such as hyperactivity, irritability, tantrums, and difficulty concentrating, their symptoms may temporarily intensify.

Yeast die-off reactions are not necessarily a sign that yeast treatment is succeeding. It may be an indication that yeast cells are dying in large numbers, and an indicator of the body's toxic overload. At that point, more poisons are being released than the body can adequately cope with at one time and may be a sign the system's elimination pathways (liver, kidneys, & bowels) are overburdened or blocked (as in constipation or liver congestion)

If properly undertaken, treatment for yeast related health problems should not lead to severe yeast die-off reactions.  Patients with elevated heavy metal levels may more problems with “die-off” symptoms

Strategies to minimize discomfort & shorten duration of die-off reactions

·       Reduce the dose of anti-fungals: Some patients may have to stop altogether for a few days. Dr Jill will generally start doses slowly and increasing them over time to help you deal with the possible die-off symptoms

·       Enzymes: Adding enzymes with meals may improve the digestion of foods and limit putrefactive short chain fatty acids with enzymes.  Use pancreatic enzymes, NOT fungal or plant based enzymes.

·       Stay hydrated:  Dr Jill recommend 4-6 fluid ounces of warm water every forty-five minutes, throughout the day.  Mineral water may help, too!

·       Get your sleep:  It is imperative to rest when experiencing yeast die-off reactions – 8-10 hours per night is essential.

·       Neutralize toxins:  There are ways to neutralize fungal toxins. Dr. Jill may recommend molybdenum, biotin, pantethine or liver support to accomplish this.  Activated charcoal may also help.

·       Alkalinize:  You may buffer the toxins by taking alkalizing agents immediately upon experiencing die-off symptoms. Such products as AlkaSeltzer Gold. Drinking mineral water may also help.

·       Antioxidants:  Provide extra antioxidants to quench the oxidative reactions created by the toxins.  Dr Jilll may prescribe vitamin C, Vitamin E or A, alpha lipoic acid or N-acetylcysteine.

·       Sauna & baths:  If you have access to a sauna, begin slowly (15 minutes per session) scrub all skin surfaces with a stiff brush and shower immediately afterwards. Another helpful detox regimen is Epsom salt baths – use 3-4 cups in hot bath and soak for 20min every night.

·       Keep your bowels moving:  You must address any issues with bowel elimination if you have constipation – if you are not eliminating, you will reabsorb any die-off toxins being released! 

More remedies for constipation:

·       Use magnesium citrate 500-1000mg daily or until normal, soft bowel movements 1 or more X daily.  You may also add Ascorbic Acid 5-10grams daily to bowel tolerance.

·       Start every morning with a tall glass of warm water.  8 oz of coffee may also be helpful.

·       Try a few tablespoons of extra virgin olive oil, several times daily on an empty stomach.

·       Mix 2 TBSP of ground flax or chia seed into water & stir , let sit for 10minutes, stir & drink on an empty stomach.

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Top 10 Secrets to Fabulous Looking Skin!

 Top 10 Secrets to Fabulous Looking Skin

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1. Keep your gut bugs happy! Take a high-quality probiotic supplement can promote a healthy balance of gut flora and support your immune system.
2. Optimize your vitamin D levels – Vitamin D is crucial for establishing a healthy immune system and to help promote healthy-looking skin.
3. Eliminate sugar in your diet – Like grains, sugar causes an insulin spike which can lead to  skin break-outs and imperfections.
4. Avoid eating grains, especially wheat – Bread, cereal, pasta, rice, potatoes, and corn can cause surges in insulin production. Instead, eat vegetable sources of carbs, which your body digests easier.  Consider a gluten-free diet if you suffer from gluten intolerance, which may help you avoid toxins being pushed through your skin due to the intolerance.
5. Drink plenty of fresh pure water – Hydrating your body facilitates cell growth and regeneration, elimination of wastes, and helps remove dead skin cells.
6. Might you have hidden food allergies?  wheat, milk, egg, and soy are common foods that people are unknowingly sensitive to.  If you don't know, try eliminating all of these foods and sugar for 14 days to see if your skin clears.  If you aren't up to an elimination diet, ask for the IgG/IgE blood test.
7. Eliminate all sodas, juice, and energy drinks – These drinks mostly sugar, artificial flavoring, high fructose corn syrup, artificial sweeteners and artificial colors. As far as juices, eat the whole fruit in moderation instead.
8. Reduce your stress & Get your sleep – Research suggests that changes in skin often correlate with increased stress. And your body's time for rejuvenating (including your skin!) is at night while you sleep.
9. Exercise regularly – Getting plenty of high-intensity exercise helps your body flush out toxins, including those in the pores of your skin. The more you sweat, the better your body can get rid of toxins and impurities
10. Naturally cleanse and moisturize your skin – Avoid toxic skin care products with risky chemical ingredients. They can cause more skin problems than they solve.   For non-toxic products, visit the Environmental Working Group's Skin Deep database.

Constipation Trouble? Here's 5 Tips to Get You Going...

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Here's 5 Simple Tips to Keep You Going...

Constipation is one of those topics few like to talk about. If you've suffered from this problem, though, you know it can be both painful and frustrating.

Almost everyone gets constipated at some time during his or her life. It affects approximately 2% of the population.  Women and the elderly are more commonly affected.

You are considered constipated if you have two or more of the following for at least 3 months:

• Straining during a bowel movement more than one-quarter of the time
• Hard stools more than one-quarter of the time
• Incomplete evacuation more than one-quarter of the time
• Averaging less than one normal formed, but soft stool daily

Common causes of constipation include:

• Inadequate water intake
• Inadequate fiber in the diet
• Disruption of regular diet or routine
• Traveling
• Inadequate exercise or immobility
• Eating large amounts of dairy products
• Stress
• Resisting the urge to have a bowel movement too frequently
• Overuse of laxatives (stool softeners) 
• Low thyroid hormone
• Neurological conditions, like Parkinson's disease or multiple sclerosis
• Too much calcium in supplements or antacids
• Certain medications, anti-depressants, pain killers, and iron supplements
• Depression
• Eating disorders
• Irritable bowel syndrome
• Pregnancy
• Colon Cancer

If you simply treat the causes and the symptoms go away!

Here are five simple natural suggestions to "keep you going":

1. Probiotics - When the wrong bacteria or yeast gain control of the bowels, they slow things down to ferment foods just how they like them. A good quality probiotic like, lactobaccilus or bifidobacter can help change that. You'll want to take a dairy-free brand with at least 25 billion cfu's per capsule daily
2. Dehydration - Without enough fluids to move things through the intestinal tract, the feces becomes hard and your digestion slows way down. Drinking a large glass of water upon waking improves bowel movements in most cases. Drinking a large glass of water few hours of the day can also alleviate IBS symptoms.
3. Fiber - For both constipation and IBS, dietary fiber is the first line of intervention for symptom relief. I usually recommend patients add 2 TBSP of ground flax seed or chia to their breakfast or smoothie.  Another way is to use psyllium caps or powder. 
4. Vitamin C - One symptom of vitamin C deficiency is constipation. Taking vitamin C in amounts just below bowel tolerance (gas, bloating or diarrhea) can definitely improve bowel movements and regularity. Start slow with 3000 mg spread throughout the day and every 2-3 days add another 1,000 mg to the regimen. When you reach bowel tolerance and stools loosen up, back off a little and maintain the dose that works for you
5. Magnesium - if patients I see are complaining of difficulty with constipation, the first thing I usually recommend is adding magnesium citrate at bedtime.  Many patients sleep better, have less muscle pain and bowel function dramatically improves with a little magnesium.  Doses typically range from 300-600mg but may go upwards of 1000mg daily.  

Still no relief?!  If the five suggestions above don't relieve your constipation, then you might have food sensitivities...  A common symptom of food sensitivity is constipation. Studies show that milk can cause constipation and a more recent study also implicates gluten. Constipation is more likely to occur in children fed gluten at at less than six months of age with a 35% increased risk of constipation.  You might try doing a three week elimination diet avoiding the common culprits:  gluten, dairy, sugar, and soy. 

If you have slow moving bowels, bowel pain or both, find the cause and fix it! Treating the symptoms only hides the causes, allowing your problems to grow into bigger problems.

Is Leaky Gut Causing Your Eczema or Psoriasis?

How Leaky Gut is linked to Skin Conditions, like Eczema & Psoriasis...

First a little background ... When the body doesn’t tolerate a food or has created antibodies to that food, ingesting it creates a chronic, low-level irritation or inflammation in the gut. Over time, with regular exposure, the irritation worsens and creates spaces between the cells. (Picture the walls of the gut, once tightly knitted together, looking more like swiss cheese!)   This is what is commonly known as, Leaky Gut.  These holes allow bacteria and their toxins, as well as incompletely digested proteins and fats, to “leak” out of the gut and into the bloodstream. Leaky gut syndrome (or increased intestinal permeability), sets the stage for myriad health problems, including rashes and skin problems, like eczema and psoriasis.  The skin is the body’s largest elimination organ so it’s not surprising that it comes under assault when toxins careen through the bloodstream.   A skin rash or eczema is a sign that the body is trying to slough out these toxins.  Some people will also experience increase in acne or be told they have "rosacea".   The body is trying to eliminate the problem the best way it knows how, and unfortunately you may see the nasty effects of leaky gut manifest in skin problems.  In addition, you might also experience gas, bloating, fatigue, sinus congestion, or foggy thinking.  Many other autoimmune conditions are also linked to the underlying problem of leaky gut.

An Elimination Diet Can Heal Your Skin Conditions

An elimination diet is the best way to pinpoint the offending food.   Here's some practical tips and recipes on how to get started.

Don’t know where to start? Foods that are most likely to wreak havoc on the gut include wheat and gluten, dairy products, sugar, soy, eggs, corn and yeast. If you’re highly motivated go off “the big five” for at least 3 weeks: wheat, dairy, sugar, caffeine and alcohol.

Although this isn't easy, you're guaranteed to notice the foods you are reacting to and 90% of patients feel dramatically better after a 3 week elimination plan. You might also consider keeping a food journal. Spend a week or two writing down what you eat and how your body feels in the minutes, hours and days afterward (e.g., an hour after you eat dairy, you feel bloated). It’s about pattern and symptom recognition and connecting the dots which in turn helps you decide which foods to eliminate first.

If you are a "show-me the data" type of person, there are labs that will test the blood for levels of IgG4 against certain foods and may be a predictor of what foods you are the most sensitive to.  In addition, if you have many reactions to a variety of foods, this is almost diagnostic for leaky gut syndrome and you should consult with a functional medicine doctor to start the healing process.

Low SIgA and why it matters to your gut health!

What is SIgA?

IgA is a type of antibody that protects against infections of the mucous membranes lining the mouth, airways, and digestive tract... it is your first line of defense on the mucosal lining and it makes up a majority of your entire immune system.

Some people have a genetic deficiency and present with low levels of SIgA and frequent infections.  Others acquire a low level after their intestinal tract becomes over-run with abnormal microbes.

SIgA helps to shape the composition of the microbes in your gut!

Extraordinary amounts of immunoglobulin A (IgA) are produced in your intestinal mucosa daily, it is known as SIgA and is secreted into the human gastrointestinal tract. SIgA production is driven largely in response to mucosal antigens (bugs or food) encountered by gut-associated lymphoid tissue (GALT).  It is clear that secretory antibodies are directed against at least two broad classes of antigens. The first is associated with enteric pathogens (the "bad guys" or infections) and their virulence factors, or things that the bugs secrete, like toxins.


The second broad class of antigens recognized by SIgA is associated with the intestinal microbes or commensal microflora (the "good" guys, like probiotics). In experimental animal models commensal bacteria are potent inducers of secretory antibodies; in humans, it is estimated that between 25 and 75% of intestinal bacteria are coated with SIgA.  This could explain why one of the most basic ways to improve levels of SIgA is to give a patient probiotics and saccromyces boulardii. 

There is also evidence from mice that secretory antibodies play an important role in shaping the composition of the intestinal microbiota, which in turn can influence your gut's defense against invaders and enhance resistance to the intestinal infections.
  
Profound Role in Intestinal Balance and Your Health

So because SIgA can neutralize the "bad guys" and shape the "good guys" SIgA plays a profound role in intestinal balance and health.  SIgA is the main immunoglobulin in mucus secretions. The intestinal cells produce about 2-3grams of SIgA every day!  And production tends to peak in childhood and start to decline after about sixty years old.

This is our first-line defense against gut pathogens like bacteria, food proteins, parasites, fungi, toxins and viruses. SIgA antibodies prevent micro-organisms, food proteins and cancer-causing substances from binding to the surface of absorptive cells. Effectively, they attach themselves to invading bugs and trap them in mucus to prevent them from going anywhere!

The antibodies also 'tag' foods as acceptable to the body and this suggests why low SIgA levels can be a factor in developing and progressive food allergy and intolerance. Intestinal permeability is also related since, if levels are low, repair of mucosal tissues can be compromised.  This is often referred to as Leaky Gut and can coexsist with low levels of SIgA.

Certain SIgA antibodies have been shown to directly quench bacterial virulence, whereas others help with uptake of SIgA–immune complexes by mucosal dendritic cells and result in down regulation of pro-inflammatory responses normally associated with pathogens and allergic antigens.

In fact it is becoming increasingly evident that human health is inextricably linked to the gut microbiota, intestinal homeostasis, and mucosal immunity. IgA is at the centre of this dynamic. 

Testing your SIgA

Secretory IgA is quite independent of blood IgA levels so just because one is normal, doesn’t mean the other is.   SIgA can be measured in different ways, including stool and saliva. Levels can turn out to be low or high. Stool measurements have traditionally been based on sample extractions from animal models – it is hard to ask a mouse to spit! Salivary samples provide a systemic overview of circulating SIgA.

Ongoing low levels can help to explain why people can’t shift an immune problem like allergies, chronic skin conditions or infections. It can also explain why they find it hard to get rid of a microbial infection, too. Celiacs and those with IBD can have low levels and chronic stress has a major effect on SIgA levels. Certain medications can lower levels – including anti-inflammatories.   Other factors  includeviral infections (like Epstein Barr viruses), poor nutritional status, food allergies, ongoing stress. Interestingly some studies have shown variations in levels with gender and age – male patients often have lower levels.

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Celiac Disease & Gluten Intolerance... What's up with wheat?

Have you been told you have "gluten-intolerance" or worse... that you have celiac disease?  Many people go for years without knowing the connection between gluten and their gastrointestinal symptoms, autoimmune disease (thyroiditis, arthritis, lupus etc), skin disorder (eczema, acne, psoriasis), and even neurological disorders (epilepsy, ADHD, autism, etc) 

What is gluten?

It's a protein found in wheat grain and part of "gluey" proline and glutamine rich proteins known as prolamines. Prolamines are found in all cereal grains, even rice, corn and oats. Gluten ingestion in susceptible individuals is assosiated with the serious neurological and autoimmune reactions often linked to autism spectrum disorder.  

Historically, we can see a large increase in chronic degenerative diseases, like cancer, heart disease, diabetes, and bone loss/tooth decay when societies start to increase intake of grains and especially wheat.  I have seen remarkable improvement in many patient's illnesses, especially skin disorders and autoimmune disease on a grain-free diet.

 Here is a must watch video from Peter Osborne, D.C. that does a very nice job of explaining the differences between gluten intolerance and celiac disease and explaining how this could be contributing to your symptoms...

If you want to know more about YOUR PERSONAL RISK, just ask Dr. Jill about how you can be tested for HLA typing DQ2/DQ8 genes to determine if you are at risk!

Coffee... Drink and Thrive!!

Many patients are surprised to hear that I drink coffee.  Not just an occasional cup, but every morning at 5:25am my Cuisinart automatic bean-grinding coffee maker whirs to a start, grinding the fresh roasted beans from Silver Canyon Coffee (*Organic Ethiopian Unwashed Sidamo is our favorite)  

*The unwashed or "dry" coffee permits the cherries to dry completely before the seed is milled from the outer pulp and skin. This affords a prolonged contact between the ripe fruit and the seed, and imparts a fruitier, more complex and wine-like coffee flavor.

For years, coffee had a bad reputation. Linked in many people's minds with smoking, coffee is sometimes associated with over-stimulation and sleep-deprived shift workers.  In fact, just ask my husband... in the early years of marriage, I always referrered to his morning cup of java as "black death".  We laugh about it now and share a 12-cup pot that's brewed fresh from the our favorite coffee roasters.

Green tea may get all the glory, but the top source of age-avenging antioxidants in the American diet is coffee! The beans behind your brew—actually the seeds of the coffee tree's fruit—contain the same kind of nutritionally supercharged compounds found in tea and other plant-based foods such as wine and chocolate.

 

Healthy benefits of the bean!

Studies show that coffee can help ward off mental decline, certain cancers, Parkinson's disease, high blood pressure, stroke, diabetes, and even extra pounds. A study published in the Archives of Internal Medicine found that each time you refill your cup of java (caffeinated or decaf) in a day, you slash your diabetes risk by 7 percent and in another study, drinking two to three cups of coffee each day was associated with a 21 percent lower risk of heart disease.

In terms of drinking the brew, it's best to do it in moderation, despite the body benefits. Coffee is a natural stimulant, and high intake can bring on headaches, increase heart rate, or cause insomnia or sleep issues. You will get the most benefit by capping your intake at 4-6 cups per day and stopping before 2pm.  The half life of coffee is about 5-7hours, which means about 6 hours after you drink it, half the caffeine is still around in your body. Many people will still have caffeine in their system 12 hours after consuming it... but rates of elimination and metabolism of coffee (processed in the liver) will vary greatly from person to person.  Caffeine is also a diuretic, meaning that it increases urine output, which can lead to dehydration.

 

Coffee contains antioxidants

While both coffee and tea contain antioxidants, coffee, in some cases might just as good a choice!  There are more antioxidants in a cup of coffee than in a cup of tea.  And with more than half of Americans drinking coffee every day, Americans are getting more of their antioxidants from coffee than from any other dietary source.  Coffee also contains minerals such as magnesium and chromium, which help the body use the hormone insulin, which controls blood sugar. In type 2 diabetes, the body loses its ability to use insulin and regulate blood sugar effectively.  However, coffee may interfere with absorption of certain nutrients, like iron.

 

What about pregnant women?

In August 2010, the American College of Obstetricians and Gynecologists (ACOG) stated that moderate caffeine drinking -- less than 200 mg per day, or about the amount in 12 ounces of coffee -- doesn't appear to have any major effects on causing miscarriage, premature delivery, or fetal growth.

But the effects of larger caffeine doses are unknown, and other research shows that pregnant women who drink many cups of coffee daily may be at greater risk for miscarriage than non-drinkers or moderate drinkers so be cautious.

So be well... and enjoy your cup of the black brew guilt free.  (and in moderation, of course!)

 

Tromboncino Squash Soup from Red Wagon Organic Farm

Next stop at the market is Red Wagon Organic Farm, our favorite place for unique produce and leafy greens of all types to add to my morning smoothies.  Last Saturday we were introduced to a new veggie - the Trombocino squash (see photos below).  I couldn't wait to get home and try it - so I altered a fabulous zucchini soup recipe and it turned out quite nicely!

Photographer, Aaron, with his Cannon and Trombocino Squash

Owner, Wyatt Barnes, telling me about the Trombocino Squash history

Checking out ...adding fresh basil, mint and rosemary to my order!

Creamy Summer Tromboncino Squash Soup

The original recipe called for zucchini, but I substituted tromboncino squash.  You can use organic vegetable stock or homemade chicken stock. If you are cooking for one or two people, you may want to freeze half of it for later. The soup should last in the fridge for up to 5 days.

2 to 3 tablespoons extra virgin olive oil
1 large onion, chopped
2 to 4 cloves garlic, chopped
1 teaspoon ground cumin
8 to 10 cups chopped Tromboncino squash
6 tablespoons uncooked white rice
8 cups chicken stock or vegetable stock
1 bunch cilantro, coarsely chopped
2 to 3 tablespoons freshly squeezed lemon juice
REAL sea salt to taste

Heat a 6 to 8-quart pot over medium heat. Add the olive oil, then the onion and saute for 5 to 10 minutes or until onion softens and is beginning to change color. Add garlic and cumin and saute a minute more. Then add chopped tromboncino squash, rice, and chicken stock. Cover and simmer for 15 to 20 minutes or until squash is tender and rice is cooked.

Add cilantro and lemon juice to the pot. Remove from heat and puree in your blender or Vita-Mix in batches.  Pour soup into another clean pot or bowl, stir batches together, and taste. If it needs a flavor boost, add more REAL sea salt to taste.

Aaron's gone this week so he'll have to wait to try some of the soup when he returns.... stay tuned to hear his review :-)
Enjoy!

Gluten-free Peach Cobbler from Ela Family Farms!

Next stop at the Farmer's market is Ela's Family Farms for fresh peaches, dried apples and Aaron's favorite, raspberry peach jam!  The lovely Jeni (pictured above on left) always greets us with a cheerful smile and samples of fresh-cut peaches or dried apples!  This week we picked up a bag of lucious tree-ripened peaches.  Aaron is anxiously awaiting me making gluten-free fresh peach cobbler (see recipe below) and I'll wake up in the morning, slice a fresh peach and pop a few slices raw into my mouth.  Or toss one or two into my morning smoothie!

One of my favorite year-round snacks from Ela Family Farms is their Apples Aplenty dried apples.  Hits the spot for a delicious healthy snack at bedtime with a cup of peppermint tea!  And I can get them at the local Whole Foods market year-round.  They also make a combo dried peaches and apples but my favorite is the Apples Aplenty sweet & tart apple combo.

So here's what you've all been waiting for!  My mouth watering low-glycemic gluten-free peach cobbler recipe!

PEACH MIXTURE:

• 10 whole peaches (peeled & sliced)
• ½ cup organic coconut palm sugar
  
• 1 tablespoon coconut flour or almond flour

COBBLER:

• 1 cup coconut flour or almond flour
• 2 teaspoons organic coconut palm sugar or raw organic cane sugar
• 1 teaspoon aluminum-free baking powder
• ¼ teaspoons xanthan gum
• ¼ teaspoons aluminum-free baking soda
• ¼ teaspoons REAL Sea salt
• ¼ cups organic butter or ghee
• ½ cups coconut milk (get the real stuff, not the low-fat version!)  I use Native Forest Organic Coconut Milk
• ½ teaspoons vanilla
• 2 Tablespoons melted organic butter or ghee
• 2 Tablespoons organic coconut palm sugar (or raw brown sugar also ok)

Gently combine sliced peaches with 1/2 cup coconut sugar and 1 tablespoon coconut/almond flour mix in a bowl. Pour peach mixture into a  8″ x 8″ baking dish (or deep pie plate) sprayed with organic olive oil.

For the cobbler, in a small bowl, whisk together flour mix, coconut palm sugar, xanthan gum, baking powder, baking soda and salt.  Using a pastry cutter, then your hands, cut in butter pieces until mixture resembles coarse cornmeal.  Combine coconut milk and vanilla together then pour into the flour mixture and gently stir until just combined.

Spoon batter over peaches in the pan, leaving some areas exposed. Drizzle melted butter over exposed areas and sprinkle the entire top with the organic palm sugar or raw brown sugar.

Set pan aside for 20-30 minutes while you preheat oven to 375 degrees.
Bake for 40-45 minutes or until top is browned and peaches are bubbly. Cool until just warm and serve topped with vanilla ice cream or for low-glycemic version, use coconut ice milk.

Now is the time when you are shooing your husband and the puppies out of the kitchen as then linger to smell the fresh baking cobbler and salivate with the delicious smell it creates :-)

DO share and enjoy!

Stay tuned for more recipes and more local favorites..
~Dr Jill

Fresh Lamb from Triple M Bar Ranch

First off I'd like to feature the folks at Triple M Bar Ranch, David & Mary (a.k.a "the lamb lady")   These lovely people were our first stop this weekend to pick of some fresh lamb pieces for stew.  My husband is the happy recipient of my cooking endeavors and swears that lamb makes the very BEST stew ever (see my recipe below)

Here's some great info from Mary, "the lamb lady"

"Triple M Bar Ranch lamb meat is all natural, which means we do not use growth hormones or antibiotics. Our meat is lean and a good source of protein, vitamin B12, niacin, zinc, selenium, in addition to iron and riboflavin.  Our meat has a unique, mild flavor due to the feed used to grow our lambs. They begin on grass pastures then go to melon and vegetable pastures, including cantaloupes, watermelons, tomatoes, chilies, peppers, onions, okra, and eggplant. The lambs also graze on crop stubble during winter months. The lambs are processed when they are less than 1-year old at a USDA-inspected facility in southern Colorado."

DR. JILL'S LAMB STEW

• 1 package lamb stew meat
• Fresh herbs - rosemary, basil, oregano
• Small bunch of grilling onions chopped into bite-size pieces
• Bag of new baby white or red potatoes, cut up into quarters 
• Fresh rainbow carrots from market, cut into bite-size pieces
• Fresh chopped parsley
• Fresh chopped or freeze dried garlic 1-2 TBSP
• REAL sea salt to taste
• 1-2 cups of water

 Place thawed lamb in bottom of crock pot, sprinkle fresh herbs (especially rosemary) directly onto lamb meat pieces and layer potatoes, carrots and fresh herbs.  Finally pour water on top of mixture and salt well.  Turn on HIGH heat setting for 1 hour and then LOW for 8-9 hours.

I served to Aaron with a slab of thick-sliced Canyon Bakehouse Caraway gluten-free bread and organic butter.... and now he thinks I'm the best wife ever!

Bon Appetit!

Boulder Farmer's Market Favorites!

Hey readers... please stay tuned!

This week I'll be blogging about some of my favorite venders and fresh produce at the Boulder Farmer's Market...  and encouraging YOU to support your local organic and sustainable farms.

I'll be featuring delicious recipes, insider tips to get the best produce, and introducing you to some of my favorite venders...

• Triple M Bar Ranch - Colorado grown lamb
• Aspen Moon Farm in Hygeine, CO
• Isabelle Farm in Layfayette, CO
•  Red Wagon Organic Farm in Longmont, CO
• Ela Family Farms in Hotchkiss, CO
• Rocky Mountain Salsa
• Silver Canyon Coffee

 And... if you don't want to miss any of the great recipes, just click "join" on the right to get email updates right to your inbox!

Ten Simple Rules to Healthy Grocery Shopping Habits!

Are you boggled by the confusing array of suggestions for a healthy diet?  Are you overwhelmed when shopping for your family and trying to feed them good food?  Well, here are ten simple rules when eating that may simplify your life!  Eating REAL, fresh food, will treat and even reverse many chronic illnesses.  Just take note and follow these simple steps to a healthy YOU!

1. Ideally eat only food without labels in your kitchen or foods that don’t come in a box, a package, or a can. There are labeled foods that are great, like sardines, artichoke hearts, or roasted red peppers, but you have to be very smart in reading the labels. TWO THINGS TO LOOK FOR:
   Where is the primary ingredient on the list? If the real food is at the end of the list and the sugar or salt is at the beginning, beware. The most abundant ingredient is listed first and the others are listed in descending order by weight.
2. If a food has a label it should have fewer than five ingredients.  Beware of food with health claims on the label. They are usually bad for you – think ”sports beverages.”  I recently saw a bag of deep-fried potato chips with the health claims “gluten-free, organic, no artificial ingredients, no sugar” and with fewer than 5 ingredients listed.  Sounds great, right?  But remember, cola is 100 percent fat-free and that doesn’t make it a health food.
3. If sugar (by any name, including organic cane juice, honey, agave, maple syrup, cane syrup, or molasses) is on the label, throw it out. There may be up to 33 teaspoons of sugar in the average bottle of ketchup. Same goes for white rice and white flour, which act just like sugar in the body. 
4. Throw out any food with high-fructose corn syrup on the label. It is a super sweet liquid sugar that takes no energy for the body to process. Some high-fructose corn syrup also contains mercury as a by-product of the manufacturing process. Many liquid calories, such as sodas, juices, and “sports” drinks, contain this metabolic poison. It always signals low quality or processed food.
5. Throw out any food with the word hydrogenated on the label. This is an indicator of trans fats, vegetable oils converted through a chemical process into margarine or shortening. They are good for keeping cookies on the shelf for long periods of time without going stale, but these fats have been proven to cause heart disease, diabetes, and cancer. New York City and most European counties have banned trans fats, and you should, too.
6. Throw out any highly refined cooking oils such as corn, soy, etc. Avoid toxic fats and fried foods.
7. Throw out any food with ingredients you can’t recognize, pronounce, or that are in Latin.
8. Throw out any foods with preservatives, additives, coloring or dyes, “natural flavorings,” or flavor enhancers such as MSG (monosodium glutamate).
9. Throw out food with artificial sweeteners of all kinds  (aspartame, Splenda, sucralose, and sugar alcohols—any word that ends with “ol” like xylitol, sorbitol). They make you hungrier, slow your metabolism, give you gas, and make you store belly fat.
10. If it came from the earth or a farmer’s field, not a food chemist’s lab, it’s safe to eat. As Michael Pollan says, if it was grown on a plant, not made in a plant, then you can keep it in your kitchen. If it is something your great grandmother wouldn’t recognize as food, throw it out (like a “lunchable” or go-gurt”).  Stay away from “food-like substances.”

References

Part II - Diagnosis and Treatment of Leaky Gut...

So now you've read all about leaky gut and may be wondering if you have it...

Food allergies, toxins, sugar, antibiotics, parasites and stress can wreak havoc with your gastrointestinal system, upsetting the balance in your intestine as well as allowing harmful substances
to enter the system. Gas, bloating, diarrhea, constipation or abdominal discomfort may be the first clue that something is wrong with the digestive tract, but did you know allergies
or even lack of energy and fatigue can often be traced to digestive problems as well?

Normally the gastrointestinal epithelium provides a semi-permeable barrier with allows nutrients to be absorbed while preventing larger molecules from crossing into the bloodstream.   When this lining becomes inflamed or damaged, then the barrier becomes "leaky".  The fallout results in larger, undigested food molecules and other “bad stuff” (yeast, toxins, and all other forms of waste) that your body normally doesn’t allow through, to flow freely into your bloodstream.

Common causes of increased intestinal hyperpermeability or "leaky gut":

1. Medications (NSAIDS) like ibuprofen and motrin
2. Microbial overgrowth or infection
3. Parasite infection
4. Fungal overgrowth (Candida)
5. Ingestion of allergenic foods
6. Maldigestion/malabsorption (pancreatic insufficieny or low HCl)
7. Radiation therapy or chemotherapy
8. Stress
9. Aging
10. IgA deficiency
11. Chronic alcohol intake
12. Excessive or strenuous exercise
13. Inflammatory bowel disease - Crohn's or Ulcerative colitis

The small and large intestines contains numerous dietary and bacterial products with toxic properties. These include v bacteria, bacterial cell wall particles, peptides, and bacterial antigens capable of inducing antibodies which may cross-react with human tissues.... when these antibodies react, they may form systemic immune complexes which can circulate and deposit in tissues far away from the gut.

Abnormalities of the gut lining barrier lead to increased uptake of inflammatory molecules and pathogenic bacteria. With inflammation & injury to the gut lininng, mucosal absorption of normally-excluded substances increases dramatically.  Intestinal inflammation enhances the uptake and distribution of potentially injurious bacteria and proteins .

"Leaky Gut" is seen in disorders such as:

• Inflammatory bowel disease (Crohn's & Colitis)
• Inflammatory joint disease
• Food allergy
• Celiac disease
• Rheumatoid arthritis 
• Ankylosing spondylitis
• Reiter’s syndrome
• Eczema & psoriasis
• Bipolar, depression and schizophrenia
• Allergies and asthma
• Autoimmune thyroiditis
• Multiple sclerosis
• Autoimmune liver & gallbladder disease

So how do we test for "Leaky Gut"?

Small molecules (glucose or mannitol) readily penetrate cells and passively diffuse through them. Larger molecules such as lactulose are  normally are normally not able to diffuse through the cell.  If the tight junctions between the cells are functioning properly, they will prevent the lactulose from leaking through.  The  Intestinal Permeability Test directly measures the ability these two sugar molecules—mannitol and lactulose—to permeate the intestinal mucosa.

Mannitol is readily absorbed and serves as a marker of transcellular uptake.   Lactulose is only slightly absorbed and serves as a marker for mucosal integrity (ability of those "tight junctions" to keep out the bad stuff)  The test is a 6 hour urine test that compares ratios of the two substances.

For more info:
Genova Diagnostics Intestinal Permeability Assessment
You will need to contact your functional medicine physician in order to order the test.


Now for some treatment options for this leaky gut!

Nutritional Support

1. Glutamine, an amino acid, has been shown to reverse intestinal mucosal damage from various insults. Glutamine is the principle fuel used by the upper intestinal tract to repair and heal.
2. Agents that stimulate protective mucus secretion may also help with the healing.  Some common ones I use are marshmallow root extract and deglycyrrhizinated licorice (DGL) extract.  
3. Probiotics are essential!  Lactobacillus casei, bifidobacter species, and saccromyces boulardii, a beneficial type of yeast are all important to restore gut health.
4. Fish oil can be very helpful in the treatment of intestinal inflammation by decreasing inflammatory prostaglandins.  EPA and DHA should be used in the range of 2-4gm daily
5. Quercetin functions as a natural mast cell stabilizer and decrease release of histmine which contributes to inflammation & injury.  To be effective, quercetin should be used in powder form and taken 3-6gm daily.
6. Vitamins A and D are critical to supporting secretory IgA function and restoring the mucosal immune system.  Ask your doctor for specific doses...

To Decrease Toxic Load:

1. Eliminate all known foods that you are sensitive to.  This can be determined through a comprehensive elimination diet or IgG/IgE food tests on the blood.
2. Avoid alcohol, NSAIDS (ibuprofen, motrin, alleve), and minimize other OTC medications.
3. Bentonite clay, a colloidal aluminum silicate, is a well-known intestinal adsorbent
   which absorbs numerous toxins, endotoxins and bacteria.  Its value in permeability alterations may result from lowering the toxin load in the lumen, thus facilitating repair.
4. HCI and digestive enzymes such as plant enzymes, pepsin and pancreatin might help to lessen the antigenic load or toxic molecules being presented on the intestinal lining.

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Leaky Gut - The Syndrome Linked to Many Autoimmune Diseases...

"Leaky Gut" Syndrome

Hyperpermeability or "leaky gut" syndrome is the name given to a very common disorder in which the cells lining the intestines become "leaky" due to inflammation. The abnormally large spaces present between the cells of the gut wall allow the entry of toxic material into the bloodstream that would normally be eliminated.

The gut becomes leaky in the sense that bacteria, fungi, parasites, undigested protein, fat and toxic waste normally not absorbed into the bloodstream in the healthy state, pass through a damaged, hyperpermeable gut membrane. This can be verified by special gut permeability urine tests or microscopic examination of the lining of the intestinal wall.

Common Causes of Leaky Gut

• Infections - fungal overgrowth, parasitic infections
• Drugs like
• NSAIDS, chemotherapeutic agents
• Crohn's disease or Ulcerative Colitis
• Celiac disease
• Chronic alcoholism
• Strenuous exercise
• Food allergies

Leaky Gut and the Connection to Autoimmune Disease

Leaky gut syndrome is almost always associated with autoimmune disease. In fact, reversing symptoms of autoimmune disease depends on healing the lining of the gastrointestinal tract. Any other treatment is just symptom suppression. An autoimmune disease is defined as one in which the immune system makes antibodies against its own tissues. Diseases in this category include lupus, alopecia areata, rheumatoid arthritis, polymyalgia rheumatica, multiple sclerosis, fibromyalgia, chronic fatigue syndrome, Sjogren’s syndrome (dry eyes & dry mouth), vitiligo, thyroiditis, vasculitis, Crohn’s disease, ulcerative colitis, urticaria (hives), type 1 diabetes and Raynaud’s syndrome. Fortunately doctors are beginning to realize the essential role that the gut plays in these disease. Understanding the leaky gut phenomenon helps us see why allergies and autoimmune diseases develop and how to design therapies to restore intestinal integrity and reverse leaky gut.

Inflammation is a key trigger for leaky gut

Inflammation causes the spaces between the cells of the gut wall to become larger than usua. Then protein molecules are absorbed before they have a chance to be completely broken down. The immune system starts making antibodies against these larger molecules because it recognizes them as foreign, invading substances. Antibodies are made against these proteins derived from previously harmless foods. The immune system becomes hyperstimulated and over-reactive to substances that are not necessarily supposed to be dangerous.

Human tissues have proteins & antigens very similar to those on foods, bacteria, parasites, candida or fungi. The antibodies created by the leaky gut phenomenon against these antigens can get into various tissues and trigger an inflammatory reaction in that tissue when the corresponding food is consumed or the microbe is encountered. Autoantibodies are thus created and inflammation becomes chronic. If this inflammation occurs in a joint, autoimmune arthritis (rheumatoid arthritis) develops. If it occurs in the brain, myalgic encephalomyelitis (chronic fatigue syndrome) may be the result. If it occurs in the blood vessels, vasculitis (inflammation of the blood vessels) is the resulting autoimmune problem... and so on.

If the antibodies end up attacking the lining of the gut itself, the result may be colitis or Crohn’s disease. If it occurs in the lungs, asthma is triggered on a delayed basis every time the individual consumes the food which triggered the production of the antibodies in the first place. It is easy to see that practically any organ or body tissue can become affected by food allergies created by the leaky gut. Because the foods can trigger delayed reactions, it can often be very hard to pinpoint the triggering entity.

 
Leaky gut may cause increase risk of infection and sensitivity to environmental chemicals

This ongoing inflammation also damages the protective coating of antibodies normally present in a healthy gut called IgA. Since IgA helps us ward off infections we become less resistant to viruses, bacteria, parasites and candida. These microbes are then able to invade the bloodstream and colonize almost any body tissue or organ. In the clinic we often find patients with leaky gut or autoimmune disease also have microbial infections ongoing in the gut.

Not only can leaky gut create food allergies as the proteins we consume are activating antibodies, but the microbes in the gut can cross over into the blood stream creating a toxic burden that overwhelms the liver's ability to detoxify. Often in severe cases of leaky gut, patients will develop sensitivities to perfume, cigarette smoke or other environmental chemicals. Common complaints are also "brain fog", confusion, poor focus/concentration, or memory loss.

Leaky gut also causes malabsorption and nutritional deficiencies

Finally, leaky gut may contribute to a long list of mineral deficiencies because of the ongoing inflammation and damage to carrier proteins. The most common are iron deficiency, vitamin B12 deficiency, magnesium deficiency which can lead to fatigue, neuropathies or muscle pain. Zinc deficiency due to malabsorption can result in hair loss or baldness as occurs in alopecia areata. Copper deficiency can occur in an identical way leading to high blood cholesterol levels and osteoarthritis. Further, bone problems develop as a result of the malabsorption of calcium, boron, silicon and manganese.

Part II - Diagnosis and Treatment of Leaky Gut...

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