Natasha Klemm ND

Combining the wisdom of nature and art of science, Naturopathic Medicine is your healthcare solution.


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What is Happening in My Gut?

The majority of my practice includes patients with digestive concerns. After months and sometimes years of persistent bloating, gas, diarrhea, and constipation, they can ignore the symptoms and discomfort no longer. Digestive disturbances, although very common, often lead to a long list of complications if left untreated. With the essential function of absorbing nutrients, the digestive system is the foundation of your health—any dysfunction can lead to dysfunction and illness elsewhere in the body.

Imbalances in the Gut

Food Intolerance:

A food intolerance occurs when your body produces an inadequate amount of an enzyme needed to break down a specific food. The classic example is an intolerance to lactose; an individual lacks the enzyme, lactase, to break down lactose, a sugar found in dairy products. The food travels along your gut, partially digested, until it contacts gut bacteria. The bacteria feed on the undigested food, causing fermentation and putrefaction. Subsequently, this leads to bloating, gas, pain, inflammation and diarrhea. As we age, our body’s ability to produce enzymes decreases, leading to food intolerances later in life. Excessive stress, rushed eating, as well as coffee, tobacco and alcohol also prevent the body from producing digestive enzymes.

Food Allergy:

Food allergies are the most well-known food reactions. The symptoms are specific—hives, swollen lips, difficulty breathing, anaphylaxis—and they occur almost immediately after exposure to the allergenic food. This overactive immune response occurs because roughly 70% of your immune system is present in the gut. If your immune system sees something you ingest as foreign, it may mount a response by releasing antibodies. The most common allergenic foods include peanuts, shellfish, dairy, eggs, soy, corn, and wheat.

Food Sensitivity:

Food sensitivities are different types of immune responses to food within the gut. Here, antibodies are produced against certain foods, but unlike an allergic reaction, the symptoms are non-specific and delayed, occurring an hour to 2 days after ingesting a food. Symptoms include bloating and gas, bowel irregularity, headaches, brain fog, fatigue, skin conditions, such as eczema and acne, and joint pain. Because these symptoms are non-specific and do not arise immediately, food sensitivities can be difficult to determine through dietary changes alone.

Hypochlorhydria:

This refers to a reduced production of stomach acid. Stomach acid aids in the activation of an enzyme needed to break down protein, while the acidity itself aids the disintegration of tough protein fibres. Furthermore, it provides protection against foreign microbes, like bacteria and viruses, as the acidity can directly kill an infection.

Heartburn is a common condition in North America—just count the number of Tums commercials during a football game—and it’s widely thought that the burning sensation is caused by too much stomach acid travelling into the esophagus. In reality, many individuals with heartburn have low stomach acid production. When you eat, stomach acid acts as the stimulus that closes the connection between your esophagus and stomach, causing food, acid and enzymes to flow in only one direction, down. But with low stomach acid, the stimulus is inadequate and the connection remains open, allowing food, enzymes and what stomach acid is present to flow up. To complicate things further, patients are often given antacids, which suppress the symptoms of heartburn, but in the long-term, exacerbate the depletion of stomach acid. Stomach acid can be reduced for a number of reasons, including excessive stress and medications (including anti-histamines).

Dysbiosis

Your digestive system is lined with over a 1000 different species of friendly bacteria, amounting to over 100 trillion bacterial cells. Each species has a specific function. Some species produce enzymes that humans cannot, aiding in the digestion of food and regular bowel movements. Others produce certain vitamins and minerals, such as vitamin K. Lastly, the bacteria have a major role in our immune system, crowding out foreign and pathogenic bacteria, preventing infection.

dysbiosis-definedUnfortunately, the friendly bacterial population can be disturbed with excessive stress, poor eating habits and food choices, medications, sugar and toxins and esepcially with the use of antibiotics, which kill both bad and good bacteria. When the good bacteria is destroyed, other species of bacteria flourish. This leads to an overgrowth of certain bacterial species at the expense of others. This imbalance is known as dysbiosis: dys = imbalance or dysregulation, and biosis = living organism.

When dysbiosis occurs, the function of the digestive system becomes severely disturbed. Bloating, gas, diarrhea and constipation are very common symptoms, as are skin conditions, brain fog, weight gain, anxiety, depression, nutrient depletion and recurrent infections. IBS, which has no structural or functional cause within the scope of conventional medicine, is associated with dysbiosis.

Candidiasis

Candidiasis is a form of dysbiosis, where the yeast species overgrow at the expense of other microbes. This is often seen after a women takes antibiotics for a bladder infection, only to contract a vaginal yeast infection right afterwards—good bacteria was consequently killed by the antibiotics, allowing Candida to overgrow. Heavy metals and exogenous hormones from birth control pills are risk factors for candida overgrowth.

Endotoxins

Any living organism produces waste products and gut bacteria and yeast are no exception. When dysbiosis occurs, the microbes produce compounds, known as endotoxins, which in excess impede normal function.

Leaky Gut – The Consequence of Digestive Disturbances

The effects of food reactions, impaired stomach acid production, dysbiosis and endotoxins all lead to inflammation within the digestive tract, by stimulating immune cells that inhabit the gut. This inflammation causes the cells of the intestine, which are normally tightly packed together, to pull apart. As these cells pull apart and the natural barrier of your gut is disturbed, food particles, pathogens, and endotoxins can freely travel between the cells (instead of being processed through the cells) where they have direct access to the blood and immune system. This is known as leaky gut syndrome.leakyGut_large

It is the presence of foreign compounds from the gut in the bloodstream that can stimulate inflammation in other parts of the body, and the result is an “itis”–thyroiditis, arthritis, sinusitis. Endotoxins, if not eliminated from the body by the liver, can also deposit in fat tissue, leading to weight gain and muscle leading to pain and weakness.

If you heard that your digestive system is at the root of illness and UN-wellness…now you know why!

What Causes Digestive Disturbances?

The major cause of dysfunction within our digestive system is our diet. Our diet is laden with sugar, which is pro-inflammatory. Our diet contains multiple sources of highly processed, refined and allergenic foods, including gluten, dairy and processed meats. Our diet is covered with pesticides, chemicals and other toxins. And our diet is nutrient poor. This undermines the proper functioning of our digestive system. Add stress and busy lifestyles, which oppose optimal digestive function and you see how easy it is for imbalances to occur. Now add medications, such as antacids, anti-inflammatories, steroids and an over-zealous prescription of antibiotics and the snowball of dysfunction grows larger as it rolls faster down the proverbial mountain of illness.

How Can I Heal My Gut?

A healthy gut starts before birth by maintaining a healthy microbial maternal environment. The infant is first inoculated with good bacteria as she travels through the birth canal. Then, through skin to skin contact and breast feeding, her gut and immune system continue to mature. Avoiding unnecessary antibiotics and medications is extremely important. Sitting down for dinner, chewing food properly and not being rushed are dining skills that should be re-adopted from earlier generations. This places your body in a state of “rest” to digest, which is the opposite of stressed!

The Four Pillars of Healing the Gut

If you suffer from digestive dysfunction, there are four pillars that need to be addressed to gain back your gut’s vitality.

  1. Remove: Remove the injurious foods, chemicals and toxins your digestive system is exposed to.
  1. Replace: Replace the healing nutrients and enzymes that your body is not adequately producing. Also, replace the refined, processed and chemical-laden diet, with a whole foods diet—food is picked from a tree, plucked from the ground or shot in a field.
  1. Reinoculate: Reinoculate the friendly gut bacteria.
  1. Repair: Repair the gut lining and eliminate inflammation.

As you embark on treatment and dietary changes to heal your gut, it is important that you see it as a journey. You will be given the tools to optimize your digestive function and re-establish a healthy norm. These tools are not only meant for you to feel better, but to maintain your digestive health. Knowing the various causes of impaired gut function, you can prevent digestive imbalances from occurring again!


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Osteoporosis-it’s not all about calcium

By Natasha Klemm ND

Thirty years ago, calcium supplementation was all the rage. Take it for strong bones, women were told. And yet the risk of osteoporosis continued to climb…

Then the balance with magnesium (ideally 1:1) was better understood. Too much calcium, (found in supplements with 2:1 ratio) or too little magnesium (a common nutrient deficiency) led to muscle cramping and even heart attacks and strokes. And the rate of osteoporosis still did not decline.

Five years ago, when Vitamin D was the greatest thing since sliced bread, its inclusion in bone health products sky-rocketed. Without Vitamin D, calcium cannot be absorbed and utilized by bone. But high-dose Vitamin D can be toxic and even cause magnesium deficiency…

Then, like all things in science and medicine, our understanding of nutrient balance grew. For reduced osteoporosis risk, not only should you be consuming calcium, magnesium and vitamin D in correct proportions, but also Vitamin K2. Vitamin K2, produced by bacteria in your gut, moves calcium to appropriate parts of the body, like bone, keeping it away from blood vessels where it causes vessel hardening and heart disease risk.

No one nutrient is the panacea for all disease. Balance in your diet; balance in your supplements; balance in your life is the key to preventing disease.


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Acid/Alkaline Balance—End the confusion.

If you are confused about acid and alkaline balance in your body, you are not alone. A search on Dr. Google reveals confusing and often heated discussions on the merits of balancing your body’s pH—people feeling “acidic” and others dismissing any relevance. Here are the cliff notes on how acidity and alkalinity effect your health.

Your body wants to maintain a balanced pH in all tissues. pH is the measure of acidity or alkalinity—a value below 7 (7=neutral and the pH of water) indicates an acidic environment and above 7 is alkaline or basic. Each tissue has a pH range for which it functions optimally. When cellular pH experiences an acidic shift, enzymatic reactions are disrupted.

The pH within cells and urine fluctuates, whereas blood pH is tightly regulated. For this reason, blood is not an ideal medium to measure pH. Clinically it is very difficult to measure pH of your cells. Thus, urine strips are used in practice to measure the body’s net acidic load.

The greatest influencer of body pH is your diet. The North American Diet is high in protein, dairy and table salt, which are acidic-forming. Alkaline-forming foods include fruits and vegetables and this has large implications for bone health.

Normally the bicarbonate ion (a component of baking soda) is used to balance acidity within the body, but when the diet is acid-forming, a greater reservoir of alkaline compounds is required. This is where calcium, our bone builder, steps up. Calcium salts, which are alkaline in nature, are leeched from bone to offset the net acidity. This leeching contributes to not only osteoporosis, but also kidney-stone formation.

Many studies have shown that the standard North American Diet contributes to a greater risk of osteoporosis and that a vegetarian diet (ie: alkaline-forming) is protective. By connecting the dots between your existing diet and urine pH, a shift in your diet and potential alkali supplementation is often required. Yet another reason why a plant-based diet is important for optimal health!


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The Bugs We Like

By Natasha Klemm ND

It’s that time of year again…colds and flus become more common than a headline about George Clooney’s love life and docs alike are asked which supplements boost the immune system.

At the risk of playing favorites, I cannot write the Immune Issue and discuss specific therapies to stay healthy during winter, without devoting much of the print to probiotics, especially considering the still rampant and often needless rx of antibiotics.

Exposure to “bad bugs” occurs at all mucosal surfaces of the body—the respiratory, genitourinary and gastrointestinal tracts. For this reason, these mucosal surfaces also contain billions of good bacteria, an integral part of your immune system. At birth, the intestinal immune system and probiotic colonization are poorly developed; but by age 2, both are comparable to that of an adult and are considered mature.

Probiotics are gaining considerable popularity in the academic world because their benefits seem to be infinite—much like their concentration (roughly 100 000 billion). Depending on the strain and dose, different immune reactions are influenced.

Here is the short-list of probiotic benefits on the immune system:

  • Directly influence the release of inflammatory compounds from intestine cells, reducing inflammation.
  • Increase macrophage activity to recruit other immune cells to fight an infection.
  • Stimulate Natural Killer (NK) cells to cause cell death in infected immune cells and certain tumor cells.
  • In the elderly, who have a greater risk of infection complications, a greater response of macrophages and NK cells occurs with probiotic consumption.
  • Stimulates IgA production locally and systemically—the antibody that acts as your first line of defense against pathogens.
  • Pushes a Th1-dominant immune state, which is present in inflammatory/autoimmune conditions, like Crohn’s, colitis, rheumatoid arthritis and multiple sclerosis, towards Th2, reducing inflammation.
  • Pushes a Th2-dominant state, responsible for allergies and atopic dermatitis (eczema), towards a Th1 state, reducing atopy.
  • Certain strains can physically breakdown casein, the protein in dairy which responsible for many food allergies and sensitivities.

As practitioners, we used to think that after taking a round of probiotics, the good bugs would colonize the gut and continue to replicate. Now we know that after 2 weeks of stopping a probiotic, your body can revert back to the probiotic population and concentration that existed before you started treatment. This winter season, don’t let the bad bugs win. Find a probiotic that is right for you!


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To Juice or Not To Juice

By Natasha Klemm ND

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That is a very common question, with multiple, confusing answers.

Juicing has gained much TV and print time, claiming to provide your body with concentrated levels of vitamins, minerals and antioxidants. And for individuals that do not like fruit or vegetables, juicing may help them consume their much-needed “nutrient rainbow”.

Some research has looked at the benefits of juices on chronic disease. One such study demonstrated that individuals, who consumed juice more than 3 times a week, were 76% less likely to develop Alzheimer’s than those that drank less than once a week. The authors suggest that a group of antioxidants, known as polyphenols, protects the brain.

Additionally, pomegranate juice may improve blood perfusion in individuals with heart disease, while grape juice causes vasodilation and reduced LDL (bad) cholesterol oxidation, improving heart disease risk.

Lastly, some studies have demonstrated that juice consumption, by enhancing antioxidant status, reduces damage to DNA and stimulates the immune system, causing its inclusion in many anti-cancer diets and protocols.

That all sounds great! So what is the issue?

Despite the higher concentration of some nutrients in juices, many vital nutrients are lacking when the pulp and skin are eliminated. Particularly fibre, a vital component to healthy digestion and weight loss is removed.

Many detoxification and weight loss programs include only juices. The problem occurs because juices are a very concentrated source of calories, from sugar. Sugar itself is harmful to the liver—your major detox organ. And with no protein or fibre your blood sugar levels experience a rapid roller coaster, leaving you hungry to consume more calories.

For example, one cup of fresh apple juice is made from roughly 5 apples, depending on the size. Each apple contains 15-19 grams of sugar. This translates to nearly 500 calories in one cup of apple juice and all the calories are from sugar.

Lastly, the unopposed sugar poses a problem for many individuals with digestive concerns, such as IBS and dysbiosis. The sugar can directly feed any imbalance in gut bacteria, leading to increased bloating, gas and discomfort.

The bottom-line is to be cautious and not take any fad to the extreme. Juicing can provide you with vital nutrients, but should never be a substitute for whole (i.e.: need to chew) food.


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Top 5 New Year’s Resolutions

As the clock struck midnight, did you make a resolution? Or have you sworn the tradition off because you know they stick as well as cream eye shadow on a hot humid day? The start of the New Year is a great motivator for change, fostering a “new you”. But too often the intended change is superficial or made for the wrong reason. Instead, resolutions that focus on awareness promote lasting personal growth and wellbeing.

Here is my list of the top 5 resolutions to make instead of hitting the gym or throwing away all the carbs in your cupboards.

1) Practice Detach2015_desk_calendar_pc_103721ment

Fame or Self: Which matters more? Self or Wealth: Which is more precious? Gain or Loss: Which is more painful? He who is attached to things will suffer much. He who saves will suffer heavy loss. A contented man is rarely disappointed. He who knows when to stop does not find himself in trouble. He will stay forever safe. -Tao Te Ching

Detachment is an important concept in spiritual teachings and awareness. In North America, we are driven by our desires. We desire the white picket fence; we want the latest gadget; we lust for the tall, dark and handsome; and we strive for the bikini body. These desires perpetuate like a hamster on a wheel, creating worry, restlessness and internal struggle. Detachment is the answer. As a process, detachment involves letting go of desires and creating a heightened sense of acceptance just as things are. When you are no longer attached to an outcome, (or a person, place or thing), you find fulfillment in the moment and in your life.

2) Forgive Yourself

You forgave your neighbor for cutting your hedge, but have you forgiven yourself for serving take-out to your children? Not forgiving ourselves leads to guilt. Guilt that we haven’t used the treadmill in the basement or guilt we treated our ex poorly. Guilt is the Lucifer of personal growth and contentment. We may think that feeling guilty is our penance; in actuality, guilt prevents us from actively finding a resolution.

3) Be Grateful

Gratitude is not only the greatest of the virtues but the parent of all others – Cicero

Gratitude is the emotional expression of appreciation for what is around us. Studies show that gratitude increases wellbeing, happiness, empathy, and energy. But with our busy lives, we fail to look around and appreciate what we have. When we wake on the wrong side of the bed, gratitude has the power to create optimism. Take a moment everyday to identify at least 3 things you are grateful for. As this becomes habit, you start to see the world differently—instead of traffic jams and nylon snags you see abundance and positivity.
4) Listen to your body

We feel exhausted but we finish watching the movie; we feel bloated, but we eat more chips; we feel anxious and we drink more coffee. We have become increasingly disconnected from our bodies that we fail to recognize the signs that guide our health. Instead we behave in ways that further hinder our wellbeing (more coffee anyone?). Taking a moment to connect with how our body can guide our healthy choices and actions. If one is tired, go to sleep; if one is hungry, eat a well-balanced meal; and if one is anxious, breathe deeply.

5) Love Yourself

To be beautiful means to be yourself. You don’t need to be accepted by others. You need to accept yourself. -Thich Nhat Hanh

All the resolutions above are intimately tied to loving oneself. Without loving oneself, we allow guilt, want, and distractions to take over. Throughout life, our experiences and disappointments shape our negative self-talk. It penetrates every corner of our subconscious and unknowingly causes behavior that negatively impacts our growth and happiness. We develop “I cant’s” and “I’m not worthy”. And instead of being in a loving and respectful relationship with oneself, we focus on our partner or our job or that piece of cheesecake. To shift negative self-talk, start journaling. Write any negative self-talk, such as “I am not good at this job”, “my husband doesn’t find me attractive” and beside each phrase, write 3 reasons why this is not true. The same negative self-talk may occur repeatedly, but at the same time positive affirmations will develop that quickly dispel them.

New years resolutions carry the best intentions, but they do not always work. Especially when personal growth and awareness is neglected. As the New Year signals a new start, allow the new you to come from within.

 


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The Medicalization of Menopause and Your Treatment Options: Part 2

As a follow-up to my previous blog post on conventional hormonal therapy for menopause, I wanted to share the types of natural therapies—diet, lifestyle changes, nutrients and herbs—that have been proven to ease symptoms.

Menopausal symptoms, such as hot flashes, mood swings, and changes in libido should not be brushed aside as frivolous concerns, nor manufactured as a chronic illness. Postmenopausal women are often viewed as being fragile or volatile on TV, movies and even within their own family. But this can be an exciting phase in one’s life, coinciding with career advancements, growing extended family and more balance. Women can lead a healthy and happy life after menopause and when given the tools, can focus on optimizing their health, not addressing “disease”.

Entrance into menopause occurs naturally when the female body no longer produces a mature egg, causing a decline in hormones: estrogen, progesterone, testosterone, and DHEA, eventually leading to complete cessation of a period. From an evolutionary perspective, this prevents women from becoming pregnant at an age when fetal genetic abnormalities are more prevalent.

Perimenopause is the time prior to menopause, when the release and maturation of an egg is infrequent and the menstrual cycle becomes irregular. This occurs because of the fluctuations in progesterone and estrogen. Progesterone declines first while estrogen levels may experience significant increases before falling dramatically. Some of the symptoms of perimenopause are due to the rapid change in estrogen levels as well as the balance between progesterone and estrogen, rather than the absolute diminished level of estrogen itself. Women enter menopause when they have not had a period for 12 consecutive months.

In addition to the solo-Bahamian vacation-like hot flashes, women experience mood changes, poor memory and concentration, insomnia, fatigue, lower sex drive, painful intercourse, acne, and changes in hair texture and growth. Osteoporosis and heart disease become considerable health concerns.

Diet

In addition to a whole foods diet, consuming foods that are high in phytoestrogens can significantly improve symptoms. Phytoestrogens—specifically known as isoflavones—are plant-derived compounds that bind to estrogen receptors, having both a weak estrogen and anti-estrogen effect. This teeter-totter effect balances the body’s response to fluctuating hormone levels.

Soy is the most widely known isoflavone-containing phytoestrogen and has demonstrable benefit on hot flashes, vaginal dryness, lipid levels, mental function and even prevent breast and uterine cancer. Japanese women, who consume large amounts of soy, have the lowest incidence of menopausal symptoms. Unfortunately, many soy products are manufactured in a way that removes the beneficial isoflavones. In addition, some individuals may have difficulties digesting and processing soy supplements. Products that are standardized to the isoflavones, genistein and daidzein, are the most effective.

Flaxseeds can also be useful, as they contain high concentrations of lignans, another phytoestrogen.

Bioflavanoids

Most often used for their anti-oxidant and anti-inflammatory effects, the bioflavonoids—hesperidin, quercetin and rutin—when consumed with Vitamin C, have reduced and even eliminated hot flashes.

Evening Primrose Oil

Although EPO is ineffective at reducing hot flashes, studies demonstrate consistent relief from breast pain and tenderness that results from fluctuating hormone levels.

Pyridoxine

This B vitamin is extremely important for the production and balance of serotonin, your feel-good brain chemical. B6 levels can be low for women experiencing depression or on HRT. And deficiency can lead to insomnia and irritability—symptoms common in menopause.

Herbal Medicine

Black cohosh has been extensively studied in Germany as an alternative to HRT. After 4 weeks of consuming 160 mg of a standardized extract, patients reported significant improvements on hot flashes, depression and vaginal atrophy. While black cohosh may cause side effects, such as digestive concerns, headaches and weight changes, studies have not shown proliferative or concerning effects on estrogen-positive cancers.

Stress Management

Addressing stress is an integral part to balancing hormones at any age and this becomes increasingly important in menopause when the adrenal glands are the primary source of steroid hormone production. The adrenal glands not only produce cortisol, your stress hormone, but also testosterone, and androstenedione, a precursor to estrogen. Progesterone, being the precursor to cortisol, is still produced in the adrenal glands and when stress is high, cortisol production increases at the expense of progesterone production. High cortisol levels also cause a reduced production of DHEA, the precursor to androstenedione. Chronically high cortisol production may lead to adrenal exhaustion, which further jeopardizes hormone production. For this reason, stress management, adequate sleep and gentle exercise are extremely important for the mature woman, as are adaptogenic herbs, which balance the stress response.

Ginseng is a common adaptogen that improves the body’s ability to cope with physical and mental stress. It has also been studied for its benefit on mental and physical fatigue, and vaginal atrophy.

Licorice is often the panacea of all herbs. Not only does it contain phytoestrogens and have progesterone-like effects, but it is also useful for the type of fatigue related to adrenal exhaustion and cortisol dysregulation. As a caveat, those with high blood pressure should avoid licorice as it can further elevate levels.

Focusing on the restoration of health allows a woman to experience perimenopause and enter menopause with grace and a quality of life that is not promoted when treatment focuses on disease. Dietary changes, lifestyle modifications, nutrients and herbs can ease the transition into a new chapter of life and vitality.

 

 

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