31 August 2014

The Hidden Epidemic... Is Yeast Overgrowth Destroying Your Health?

Did you know your gut microbes could be dramatically affecting your health?

Hey guys! ...this is not just for women.  Men, too, commonly suffer from intestinal yeast overgrowth or fungal dysbiosis!

Every day we see new research on the effects of unhealthy gut organisms on the brain, the thyroid gland, the nervous system, the immune system, and the heart and vascular system.  In functional medicine, this is one reason we focus so intently on helping our patients heal their gut and thrive.  Without a healthy bacterial population in the colon, it’s nearly impossible to experience the optimal health we all desire.
Many people are unknowingly fighting a battle against a single-cell fungus in the gut.  Its name is Candida Albicans, although in recent years there has been an increase in non-albicans species of yeast.  Candida is a normal organism that is part of our skin flora, intestinal microbes, and for women, vaginal flora.  Men, this doesn't mean you can't harbor yeast as well!   This seemingly benign player can become hostile if the environment is right.  High intake of refined carbohydrates and sugar, frequent antibiotic or prednisone use, hormones and birth control pills and other medications give the yeast an advantage over the normal protective bugs, like lactobacillus, so that it flourishes.  It has the ability to take over and becomes invasive leading to a host of unwanted symptoms.  Sadly, many conventional physicians do not recognize that the gut can be a reservoir of these fungal organisms.   If you have ever experienced vaginal yeast infections, rectal irritation, white coating on your tongue called thrush, or any fungal skin or nail infections, like onychomycosis, you may also have a large number of these buggers living in your gastrointestinal tract.

I crave sweets and carbs all the time…

One of the most important things that I notice with patients who have fungal dysbiosis is the feeling of being tired and “run down” all the time with intense cravings for sugar or carbohydrates. Many patients don’t believe me when I tell them that if their gut is healthy, they will get to the point of having no food cravings at all!  It’s really true!  And if you are still experiencing intense, uncontrollable cravings, binge eating, or other issues in a love-hate relationship with sugar and refined carbohydrates, you can bet there is a problem with your gut microbes!

Take this quiz to find out if YOU have a problem!

These are common symptoms that may occur with yeast overgrowth in the gut.  Keep in mind, these are not specific to yeast alone, but if you experience them on a regular basis you are likely to have a real problem with fungal dysbiosis, or yeast overgrowth.
 Give yourself 1 point for every one of these symptoms you experience regularly:
  • Weight gain
  • Difficulty losing weight
  • Premenstrual symptoms
  • Fatigue
  • Muscle pain/fibromyalgia
  • Poor focus/concentration
  • Brain fog
  • Irritable
  • Depression
  • Anxiety
  • Headaches or migraines
  • Cravings for sugar or carbohydrates
  • Drowsy after meals
  • Constipation
  • Diarrhea
  • Gas and bloating
  • Rectal itching
  • Vaginal discomfort or burning
  • Low libido
  • Joint pain
  • Crying spells
  • Dizziness or light-headedness
  • Sinus pressure/congestion
  • Trouble sleeping
  • Halitosis (bad breath)
  • Body odor
  • Frequent sore throat
  • Coughing/wheezing/shortness of breath
Scoring
  • > 8 – You may have intestinal dysbiosis
  • > 14 – It is likely you have an issue with intestinal dysbiosis, which could include yeast overgrowth
  • > 20 – It is almost certain that you have fungal dysbiosis or yeast overgrowth

Fungal Dysbiosis and Leaky Gut Syndrome

If yeast becomes dominant in the gut, it may take over and overwhelm the good bacteria.  This is called Fungal Dysbiosis.  The situation becomes dire when yeast or abnormal gut microbes proliferate and dysbiosis occurs.  The problems start when yeast changes from a benign one cell organism to the more invasive hyphe form.  These forms can secrete enzymes, like proteases and phosopholipases that break down cell membranes and contribute to intestinal permeability or “leaky gut”.  As the gut becomes more permeable, toxic metabolites, such as acetaldehyde, leak into the blood stream and cause symptoms such as brain fog, fatigue, or depression.  Did you know that this chemical yeast produces can make you feel hungover?  Alcohol, when metabolized by the liver, also produces acetaldehyde which causes that "hangover" feeling.  The yeast bugs also drive cravings for the very foods that allow them to survive –sugar, refined carbohydrates and sometimes fermented foods or alcohol.  I’m always amazed by the number of people who were struggle with alcohol craving or addiction that have yeast overgrowth in their gut.  In addition to the toxic materials that leak into the blood stream, partially digested food may also leak through the lining of the gut and create food sensitivities.  Many people with chronic yeast overgrowth will experience sensitivities to common foods, like gluten, dairy, sugar, corn, and soy and may even experience improvement in symptoms when they go on an elimination diet.  Yeast also produces more than one-hundred other toxins that may leak into the blood stream and affect thyroid and hormone function, brain function and even neurotransmitter production.

Fungal Dysbiosis and the Connection with Autoimmune Diseases

This invasion and consequent problem of a leaky gut may also trigger the immune system to become confused in a process called “molecular mimicry” when the bacteria or yeast in the gut or cross over where they don’t belong into the blood stream and trigger creation of antibodies by the immune system.  These antibodies may cross-react to joint tissue, skin, thyroid, or even brain and create autoimmune diseases.  It is very common to see some of the following autoimmune conditions occur in someone with fungal dysbiosis:
  • Psoriasis
  • Rheumatoid arthritis
  • Hashimoto’s thyroiditis
  • Crohn’s disease
  • Ulcerative Colitis
  • Celiac Disease
  • Meniere’s disease
  • Raynaud’s disease
  • Lupus

 So What Causese Fungal Dysbiois?

Here are some of the most common factors that upset the balance of gut microbes and contribute to yeast overgrowth or fungal dysbiosis
  • Chronic stress, which impacts your immune system, also contributes to yeast overgrowth
  • Diabetes (due to abnormal blood sugar)
  • Pregnancy (due to change in hormone levels)
  • Eating too much sugar and too many grains. Sugar is the main fuel for yeast.
  • Taking antibiotics, which kill both your good and bad bacteria.
  • Exposure to environmental toxins, which can lower your immune system’s ability to keep yeast in check.  Mercury is especially problematic with yeast overgrowth
  • Taking other medications, such as birth control pills and steroids, which are both known to increase yeast

How Does My Doctor Diagnose Fungal Dysbiosis?

Well, the first step is finding a functional medicine trained physician or naturopath who understands the importance of having a healthy gut microbiome.  There are many physicians who understand vaginal yeast infections or the more severe systemic candidiasis, where candida enters the blood stream and can be life threatening but ignore the possibility that you could have too many yeast bugs living in your gut.  Even when we are looking for a problem it can often be hard to detect.  I commonly use a combination of clinical history and symptoms and the following lab tests:
  1. Serum Candida antibiodies (IgG, IgM, IgA)
  2. Organic Acids in urine, such as Arabinose
  3. Comprehensive Digestive Stool analysis for candida culture and sensitivity
By combining a patient’s symptoms with the testing above, it becomes relatively easy to determine if a patient has fungal dysbiosis or not.  Other red flags are someone with  inflammatory bowel disorder or other bacterial dysbiosis, such as SIBO (small intestinal bacterial overgrowth) as the two can co-exsist.

So Tell Me How to Get Rid of it!

1. DIET

The most important starting point is diet.  In fact, I frequently tell patients that no amount of anti-fungal drugs or herbal medications can overcome a high sugar, high carbohydrate diet.  In order to eradicate the yeast, one must do the following:
  1. Eat a diversified, whole foods (in as natural and fresh a state as possible) diet, emphasizing non-starchy vegetables, proteins, like fish, organic chicken, turkey, lamb, wild game and organic grass-fed beef.  Healthy oils, like coconut, grape seed and olive are also essential. Include pastured ghee or butter as well for a rich source of Vitamin K and other fat-soluble vitamins
  2. Chose organic, free-range meat and be sure they do not contain added growth hormones or antibiotics.  I advise all patients to avoid cow’s dairy due to lactose content, which is a sugar that yeast likes.
  3. Avoid all foods that feed the yeast!  That would include all forms of sugar (honey, molasses, maple syrup, agave, xylitol, and artificial sweeteners, like aspartame, splenda)
  4. Avoid all dried fruits and fruit juices.  Stevia may be used to sweeten teas and beverages.
  5. You may need to eliminate fruit in the beginning or at least stick to no more than one serving of low-glycemic fruit per day – best bets are berries, green apples, or citrus.
  6. Eliminate any allergenic foods – these commonly include gluten, dairy, egg, soy, corn, and cane sugar
  7. You should also eliminate the following: alcohol; vinegar (and anything containing vinegar, like salad dressing and sauces); all bread (which contains yeast); high starchy vegetables, like carrots, potatoes and beets; peanuts and corn (due to high mold content); mushrooms (fungus); and aged or moldy foods, like blue cheese.
  8. Drink plenty of purified water daily.  If you are feeling dizzy, add some electrolytes (ElectroMix or Elyte Sport) to your morning water.
  9. Get some form of daily exercise (walking, hiking, yoga, bicycling). Pick an activity you enjoy and try to get in 30-40min every day.
  10. Make time for rest and relaxation.  Epson salt baths can be especially helpful for the yeast die-off symptoms.  Use 2-3 cups of salt in warm bath and soak 20min.

2. AVOID ANTIBIOTICS

3. DECREASE STRESSORS

4. IDENTIFY AND ELIMINATE FOOD ALLERGIES

5. TAKE A PROBIOTIC!  (my favorite is Klaire Labs Detox Support, which you can order here)

6. TREAT ANY DIGESTIVE IMBALANCES (like insufficient pancreatic enzyme production or low stomach acid)

7. MEDICATIONS

  • Fluconazole
  • Itraconazole
  • Nystatin
  • Compounded Oral amphotericin B

8. HERBAL REMEDIES

  • Caprylic Acid
  • Undecylenic acid
  • Berberine
  • Garlic (Allicin)
  • Oil of Oregano
  • Olive Leaf Extract
  • Pau D-Arco
  • Grape Seed Extract

9. OTHER ESSENTIAL NUTRIENTS

  • Vitamin D
  • Vitamin A
  • Biotin
  • Essential Fatty acids
  • Probiotics
  • Pantethine
  • l-Glutamine
  • Coenzyme Q10
  • Magnesium

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28 August 2014

Top 5 Scientific Benefits of Beets

I've been picking up fresh heirloom beets at the Farmer's Market from Red Wagon Organic Farm every week anticipating the delicious complex flavor they add to my smoothies (recipe coming soon!) and the boost in energy from the nitric oxide they can produce when consumed. So I thought I'd share with you some of the great benefits of this yummy root veggie.

Scientific Benefits of Beets

  1. Improve athletic performance. Pre-exercise consumption of nitrate rich beetroot juice (200gm) improved and enhanced running performance in this study.  In another study, six days of 140ml of concentrated beetroot juice (loaded with nitrates) reduced pulmonary oxygen usage (VO₂) during cycling and improved performance in professional cyclists.  And yet another study showed enhancement of muscle contraction after consumption of  beetroot juice.
  2. Decrease oxidative stress.  Beets contain a new class of antioxidants called Betalains, which decrease oxidative stress and aid in detoxification.  Regular consumption of 300ML daily of red beet in this study showed decrease in oxidative stress markers and may prevent chronic degenerative diseases.  Red Betalain pigment are not very heat stable so best if eaten raw or juiced.   If you choose to cook your beets, steam them for less than 15minutes or roast them for less than 45minutes.
  3. Increase nitric oxide. Beets contain nitrates which are a precursor of nitric oxide.  Nitric oxide helps our blood vessels dilate appropriately, improving vascular function in conditions such as heart disease, high blood pressure, and erectile dysfunction.  In this study, overweight men who drank beet juice had increases in nitric oxide levels after consumption.
  4. Prevent Cancer.  Betalains, the antioxidant in beets, has been shown to have anti-cancer effects!  This study showed the antioxidant from beets caused death of leukemia cells.  And another study suggested beet juice consumption may prevent lung and skin cancers.
  5. Improve detoxification. Regular consumption of beets which contain betaine and polyphenols in this study enhanced the liver's ability to product glutathione and superoxide dismutase, both key factors in daily detoxification.  Because of their powerful ability to enhance detoxification this study showed a protective benefit against toxic chemicals, like carcinogens.

Don't forget the greens!

The leafy greens attached to the beet roots are delicious and can be prepared like spinach. They are incredibly rich in vitamins and minerals as well as  beta-carotene and lutein/zeaxanthin.

Tips for storing and preparing

To clean, rinse gently under cool water and avoid tearing the skin  which helps keep the health-promoting pigments inside.
Cut beets into quarters leaving 1-2 inches of root and a small bit of stem.
I like to throw them raw into green juices or smoothies for most nutritional benefit.  However, if you cook them, I recommend lightly steaming or baking on low heat to maximize nutritional benefit.  Steam for no more than 10-15min or until you can easily insert tip of fork into beet.
  • Grate raw beets into salads or as garnish on main dish
  • Marinate steamed beets with olive oil or ghee, sea salt and fresh basil and thyme
  • Sauté beet greens like you would spinach or swiss chard or mix them all together for a fresh take on salad

DETOX BORSCHT

2 cups finely shredded cabbage                                    2 cups boiling water
½ cup chopped onion                                                       2 Tbsp olive oil
2 tsp caraway seed                                                              1 tsp honey, if desired
3 Tbsp lemon juice                                                              Salt and pepper to taste
1 pound cooked small beets, peeled, chopped (save the cooking water)                   
1 quart chicken or vegetable stock (gluten-free)
Cook the cabbage for ten minutes in boiling, salted water. Cook the onion in the oil for a few minutes, without browning. Drain the beets, saving the cooking liquid, and finely chop. Add the chicken or vegetable stock to the onions. Upon boiling, add the cabbage and its cooking liquid back in. Add the beets, one cup of beet cooking liquid, caraway seeds, honey, and salt and pepper. Simmer for ten minutes, skimming carefully. Remove the soup from the heat. Add lemon juice and heat just to the boiling point. Serve with dill weed garnish. Eat soup hot or cold.

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21 August 2014

Why I'm a fan of Bulletproof Coffee...

Smell that coffee... mmmm!

I wake up around 4:50 am to the sound of my automatic Cuisinart coffee maker grinding fresh Upgraded coffee beans into the filter for a delicious fresh brew.   There is nothing better than rubbing your eyes, rolling out of bed, and padding across the cool hardwood to the kitchen as the amazing aroma of fresh brewed coffee fills the air.  Those pre-dawn hours are my absolute most productive and favorite time of day!
I thought I'd share a few of the things I've learned along the way for how to maximize the health benefits of your coffee.  I'm proud to say that I enjoy Upgraded beans because I can literally feel the difference in my mental clarity when I drink it instead of non-organic, pesticide laden, mycotoxin filled alternatives like Starbucks (oh, yes you heard me, right!).  While many of you may not be environmentally sensitive to chemicals like I am, you should really give it a try as the brain power you get from a cup of the really pure stuff will blow your mind!

Shop UpgradedSelf.com

Travel Tips?

And when I travel I take along Upgraded coffee cartridges, empty one into a 16oz cup, and pour boiling hot water over it for an instant "french press" brew.  After letting it steep for 2-3 minutes, I pour the brewed coffee out into a new cup careful to leave the grinds in the old one and viola!... delicious amazing, mycotoxin-free coffee anytime, anywhere.  Last time I was in an airport asking for a large glass of hot water, the man on the barstool next to me asked if I was performing a science experiment!?  Haha!  I just smiled and said, "yes".   It didn't help that I dug in my purse and pulled out my travel vial of SweetLeaf English toffee stevia drops and a few shakes from a purse-size organic cinnamon powder which I also carry with me at all times.  I've become accustomed to the funny looks I get and I really don't even care ;-)

Upgraded Brain Octane Oil

My not-so-dirty little secret for amazing brain power at 5am!

Let me share with you my secret for 5am productivity like you've never experienced before.  After brewing a pot of this delicious black velvet, I add in a few little "brain helpers".  I was having coffee with a friend today and telling her about it so I thought I would write a blog and share with you, too.   You can get the Dave Asprey's original Bulletproof Coffee Recipe here but here is my version:



Dr. Jill's 5am Brain-Power Brew

  • Pour 1/4 to 1/2 cup full-fat organic unsweetened coconut milk into your favorite mug
  • Add fresh-brewed, hot Bulletproof coffee leaving 1/4 inch from top of mug
  • Add 5 drops of Sweet Leaf English Toffee or Vanilla stevia (if you like a carmel or vanilla "latte" flavor)
  • Add 1 teaspoon of Upgraded Brain Octane Oil 
  • Generously sprinkle organic cinnamon powder into your coffee
  • Add 1 scoop of Upgraded Collagen Powder and stir!  (you won't believe what the collagen will do for you joints and skin... truly amazing!)
  • If you like it frothy, you can whip it all up in a blender with heat-safe blades,  but I just drink mine as is.
  • If I'm feeling a little more adventurous, I'll might add a tablespoon of toasted organic shredded coconut in, too
Upgraded Collagen

A few cool facts about coffee

  1. Chronic coffee consumption may alter your gut microbes and is associated with lower body weight and lower percent body fat.
  2. This article discusses benefits of polyphenols, especially from coffee and cocoa, on your gut microbiome.
  3. The bioactive components in coffee may have synergistic effects on brain cognition.
  4. In this study, coffee decreased boredom and fatigue associated with repetitive tasks.
  5. Caffeine intake associated with improved working memory in middle aged males.
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18 August 2014

Everything You Need To Know About Vitamin B12 Deficiency

Photo courtesy of www.freedigitalphotos.net

Do you suffer from any of the following symptoms?
  • Weakness, tiredness, or light-headedness
  • Rapid heartbeat or difficulty breathing
  • Poor memory or difficulty concentrating
  • Depression, anxiety, mania
  • Numbness and tingling of hands or feet
  • Difficulty with balance, poor coordination
  • Pale skin
  • Sore tongue
  • Easy bruising or bleeding gums
  • Upset stomach or weight loss
  • Diarrhea or constipation
  • Depression, irritability, paranoia, mania, hallucinations
If you answered “yes” to any of the above, it may be time to get tested for B12 deficiency.
Vitamin B12 (cobalamin) is a water-soluble vitamin that is crucial to normal neurologic function, red blood cell production, and DNA synthesis. Vitamin B12 is essential for three enzymatic processes: the conversion of homocysteine to methionine; the conversion of methylmalonic acid to succinyl coenzyme A; and the conversion of 5-methyltetrahydrofolate to tetrahydrofolate, a process necessary for DNA synthesis and red blood cell production. It cannot be manufactured by humans and must be regularly obtained from the ingestion of animal proteins or fortified food products. Gastric acid liberates vitamin B12 from animal proteins, after which it combines with intrinsic factor produced by gastric parietal cells and is absorbed in the terminal ileum.
How common is vitamin B12 deficiency?
B12 deficiency is common and reported to affect up to 25% of the U.S. population. Up to 20% of people over the age of 60 years old show marginal B12 status.  The CDC reports, one out of every 31 Americans over 50 are B12 deficient.  Sadly the current lab values of serum B12 grossly underestimate the incidence by using a cut-off range far too low. The current ranges for a common commercial laboratory, which I use are 211-946pg/ml. Many researchers propose that we raise the lower limit of normal to 550pg/ml, which is what I use for optimal levels. In my clinical practice, I have seen many patients who have significant symptoms of low intracellular B12 and they still show “within normal range” on serum lab values. Serum homocysteine and methylmalonic acid are much more sensitive markers as they may show a deficiency earlier than serum B12.
So what causes B12 deficiency?
The main causes of B12 deficiency include inadequate dietary intake and malabsorption issues. Vitamin B12 deficiency may occur if you have certain conditions, such as:
  • Pernicious anemia, which makes it hard for your body to absorb vitamin B12 (characterized by a lack of intrinsic factor - individuals cannot properly absorb vitamin B12 in the gastrointestinal tract)
  • Atrophic gastritis or inadequate production of stomach acid (occurs in 10-30% of older adults!)
  • Helicobacter pylori infection in the stomach
  • Surgery that removed part of your stomach or small intestine including bariatric surgery (Surgical procedures in the gastrointestinal tract, such as weight loss surgery often result in a loss of cells that secrete hydrochloric acid and intrinsic facto
  • Alcoholism
  • Autoimmune conditions, such as Grave’s disease or Lupus
  • Malnutrition or eating disorders
  • Long term use of medications
    • Proton Pump inhibitors
    • H2 blockers
    • Metformin
    • Certain antibiotics
  • Conditions that affect the small bowel, such as:
    • Crohn’s disease
    • Celiac disease (up to 41% of patients with celiac disease will have B12 deficiency)
    • Small intestinal bacterial overgrowth (SIBO)
    • Parasite infections, such as giardia, tapeworm
    • Chronic pancreatitis
Who should be tested for B12 deficiency?
  • Anyone over age 60 years old
  • Anemia with elevated MCV (mean corpuscular volume)
  • Neurological symptoms, such as numbness, tingling, difficulty with walking or balance issues
  • Changes in mental status, confusion, or disorientation
  • Early dementia or Alzheimer’s disease
  • Bipolar, mania, or schizophrenia
  • Gastrointestinal disorders with malabsorption, like pancreatic insufficieny
  • Patients who have had gastrointestinal surgeries or gastric bypass
  • Restricted diets: vegans, vegetarians, macrobiotic diets
  • Autoimmune disorders
  • Children with autism spectrum disorders or developmental delay
  • Breast fed infants of mothers at risk
  • Eating disorders
  • Family history of pernicious anemia
  • Chronic use of PPI medications (Nexium, Prilosec, prevacid, etc) or Metformin
  • Occlusive vascular disorders (heart attack, stroke, blood clots)
Children may present differently from adults and should be tested if any of the following symptoms occur:
  • Developmental delay or regression
  • Apathy or irritability
  • Weakness
  • Tremor
  • Seizures
  • Lack of coordination
  • Lack of appetite or failure to thrive
  • Poor socialization or poor motor skills
  • Speech problems or language delay
  • Anemia
You can request following blood tests from your doctor to determine if you are deficient:
  1. Serum B12
  2. Methylmalonic acid
  3. Homocysteine
  4. Complete blood counts – anemia with elevated MCV may be due to B12 deficiency
So what if I do have a B12 deficiency?
B12 is nontoxic and water soluble so if you are deficient the good news is it is easy to replace! Traditionally B12 has been given in the form of intramuscular injections to ensure absorption but studies have shown that sublingual forms may be equally effective. B12 may come in the form of cyanocobalamin, methylcobalamin, hydroxycobalamin, and adenoxylcobalamin. You can discuss with your doctor which form is best for you. I typically start patients with sublingual methylcobalamin in lozengers or drops at 1000-5000mcg daily. Some patients require subcutaneous or intramuscular injections, which can be taught in the office and given by the patient at home. Depending on how severe the deficiency, I will typically prescribe 5000mcg anywhere from once per month to 2-3X per week initially. Liver stores of B12 are usually repleted with a half a dozen or so doses but full repletion may take up to 20 doses. Once a patient’s symptoms are improving, maintenance of B12 may occur with as little as one injection every 2-4 weeks. There are now forms of B12 available orally, sublingually, intranasally, transdermally and through injection.
Dietary Sources of B12
Vitamin B12 can be found in large quantities in animal products, including meat, poultry, fish, seafood, eggs, and dairy products; and the consumption of these products is the most longstanding method by which human beings have taken vitamin B12 into their systems.

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Reference:
  1. http://ajcn.nutrition.org/content/89/2/693S.full
  2. http://www.ncbi.nlm.nih.gov/pubmed/8856015
  3. http://www.aafp.org/afp/2011/0615/p1425.html