Tag: functional medicine

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What does the Liver do? Detoxification explained.

January 11, 2022 1 Comment

We think of our Liver as the MAIN DETOXIFICATION ORGAN. Yes, true. It actually has hundreds of functions including storage of vitamins and minerals, producing and mitigating cholesterol, breaking down fat, making triglycerides, regulating blood sugar, and metabolizing amino acids.  What is detoxification? The liver is responsible for transforming and clearing toxic substances from the blood. “Toxic products” refers to anything from microorganisms, contaminants, drugs, alcohol, pesticides, and our own metabolic end products.  In our modern environment, we are exposed to toxins every day. Sometimes it is these external sources (medications, pesticides, chemicals, etc). But, the majority of toxins we deal with are a normal byproduct of our internal processes.  Regardless of where they come from, our liver processes these toxins in the same way to ‘neutralize’ and eliminate them: a concept we know as DETOXIFICATION.    Phase I Detox Detoxification happens in two phases. The first phase (PHASE I) is a biotransformation reaction facilitated by a specific class of enzymes called Cytochrome P450. Through oxidation, reduction, and hydrolysis reactions toxins are converted into more water-soluble compounds.  Often, Phase I biotransformation creates even more reactive species and an increase of free radicals in the body. We rely on antioxidants during the intermediary stage to ensure our cells are protected.  Nutrient deficiencies, heavy metals, liver damage, and some drugs can impair the CYP450 enzymes, slowing down Phase I detoxification.  Phase II Detox In Phase II detoxification we conjugate the now transformed toxins into a fully water-soluble compound that can be excreted. The biggest four pathways of conjugation are: glutathionation, glucoronidation, sulfation, and glycination. Amino acids (or sulfur) are added to the already partially transformed toxins to “neutralize” them.  Protein is vitally important to complete this phase (as that’s where we get these Amino acid co-factors). When Phase II is impaired, it can result in a ‘backup’ of fat-soluble toxins that get stored in our fatty tissue. Poor Phase II detoxification can mean hormone imbalances, recurrent infections, headaches, chemical sensitivities, and more.  Phase III Detox While not an official phase of detoxification, Phase III is the final excretion of the fully water soluble compounds. They are transported from the liver to the intestines where they can bind with bile (and fiber!!) and excreted via the feces [or the kidney to be excreted through urine].  If you’re constipated, or dehydrated, you are NOT detoxifying well.  Optimal Liver Detoxification – Diet and Beyond Clearing Up Misconceptions The liver is more like a filter than a sponge. It doesn’t absorb toxins and it doesn’t STORE toxins (that happens in fatty tissue). Instead, the liver stores important nutrients like Vitamins A, D, E, and K, Vitamin B12; minerals like iron, copper; and many of the cofactors required for the detoxification process. See why Liver is a SUPERFOOD?! Ensuring Optimal “DETOX” No, you don’t need to go on a juice fast to detox. In fact, when you are consuming only juices or ‘detox’ teas I would argue you’re putting yourself in a MORE reactive state since you aren’t providing the necessary amino acids to complete the conjugation. Further, when you are not consuming enough fiber, you will recirculate end products instead of eliminating them from the body! So, what ARE the best foods and nutrients to support Liver Detox?  For Phase I, we need a number of vitamins and minerals to support the CYP450 enzymes. This includes manganese, Vitamin A, Vitamin B2, B3, B5, B6, B12, and folate. Antioxidants like Vitamin C, Vitamin E, Beta Carotene, Zinc, and Selenium are also important for handling the free radicals produced.  For Phase II, we need the building blocks to attach to the transformed toxins. This includes glutamine, cysteine, methionine, and taurine.  Glutathione is the “master antioxidant” because it plays a role in both Phase I and Phase II detoxification!  The best diet for supporting optimal detoxification is one filled with a variety of colorful plants, nutrient-dense animal proteins, and adequate fiber. If you’re following a vegetarian (or carnivore) diet, you’ll need to be especially cognizant to include essential amino acids!  Want a free resource for increasing PHYTONUTRIENTS in your diet and supporting Liver Detoxification? Click here to get the Phytonutrient Spectrum Guide by the IFM curated by Dr. Deanna Minich. Want to work with a functional nutritionist to personalize your diet? Struggling with hormone imbalance, IBS, weight gain, mood changes? Let’s look at FOOD FIRST. Read more about Functional Nutrition at The Facility here. Click here to schedule a free 15 minute phone consult with Kate!

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Things to KNow before starting an Elimination Diet

5 Things to Know Before Starting an Elimination Diet

December 30, 2021 No Comments

Before starting an Elimination Diet, here are some key things to know. The Elimination Diet is a powerful therapeutic tool for better understanding a personal nutrition strategy. It can help you reduce inflammation, restore your microbiome, uncover food intolerances, and live a more balanced life.  In my opinion, the most valuable part of the “diet” is the reintroduction phase. So often, we want to rush through this phase. We get to Day 31 of a 30-Day-Challenge and BAM! Pizza! MacNCheese! Nachos! All at once, we add things back in and we don’t actually take the time to learn WHAT foods work and which ones don’t.  So, I created The Elimination Diet Guide to help you see the big picture: what happens after you’re done eliminating things? What are you looking for as you reintroduce? I want you to be successful and fulfilled in this diet and ultimately find an eating strategy that works FOR YOU.  Thinking you’re ready? – Here are FIVE things to know before starting an Elimination Diet.  Related: Mindful Eating: Finding a Healthy Relationship with Food 5 Things to Know Before Starting an Elimination Diet… 1 – Plan Ahead Don’t jump into the diet simply thinking, “OK, I’ll cut out X,Y,Z for 30 Days and then see how I feel”. Instead, look at the journey from start to finish. Lay out exactly how reintroductions will go, and set your mindset to include that in your “diet timeline”. I think two months is more realistic for the Elimination/Reintroduction. That means 14 days of strict elimination, and beginning to add things in on Day 15. When you’re constantly reintroducing foods, you get novelty and avoid diet fatigue.  It can be helpful to take a serious look at your pantry, refrigerator, and freezer ahead of time. Are there things that will tempt you to ‘cheat’? Do you have plenty of nutritious, approved, satisfying foods? Set yourself up for success by looking ahead and stocking up on foods that will support the diet.  <<Sneak Peak: Click here to preview the Phase II Shopping List + Snacks>> 2 – This is the Gold Standard. Why not do a food sensitivity test? Because the Elimination Diet is the gold standard in determining food allergies/intolerances and sensitivities. A blood test (or other methods) is recognizably unreliable. If you have a Leaky Gut, you will flag for MANY foods that may or may not be problematic for you. If you have an Autoimmune Disease, you are likely to react to a great number of food proteins!  There isn’t a shortcut here. It’s best to put in the effort to do it right the first time, rather than go back and repeat the process when results are confusing.  It can be pretty challenging to sort through Elimination Diets, YES/NO Lists, and other resources available on the internet: They are all so different. How do you decide if the Whole30 or the AIP or the Low-FODMAP or the GAPS Diet is appropriate?!  The Elimination Diet Guide uses elements from all of the above and gives you a clearer picture of exactly what NOT to eat as well as what to EAT. I’ve done the work for you of compiling what I believe to be the broad-spectrum of trigger foods and systematically challenging them.  3 – This is not a weight loss diet. When you replace the Standard American Diet with real, whole, nutritious foods you may find that weight loss is a great side effect. However, it is NOT the focus of an Elimination Diet. Instead, this is a therapeutic eating plan meant to help you resolve inflammation, fix your gut, and minimize negative symptoms that may be attributed to your eating patterns (fatigue, brain fog, mood issues, acne, and more).  There is no restriction on calories, eating windows, or portions. It is a chance for you to get in tune with your body and honor what it is telling you. I provide Sample Meal Plans and Recipes as a starting point; but you’re free to add-in extra snacks and meals as needed. Forget your preconceived notions of the word “DIET” and think of this more as a NUTRITION STRATEGY for better health.  >>Skip The Rest and Check out The ELIMINATION DIET GUIDE<< 4 – This is easier than you think. Often, taking on a new diet can be a major lifestyle overhaul. Starting an Elimination Diet does not have to be that way. (Assuming you follow #1: Plan Ahead) When you focus on all the amazing things you CAN eat, it feels exciting!  Remind yourself of your “WHY” behind the diet. Is it worth devoting 60-days of change in order to minimize your main symptoms? Will you really regret it?  One of the best tips before taking on the Elimination Diet is talk about it! Ask your friends and family for their opinion; I bet you find you have a lot of people willing to support you. Social events, family dinners, and travel plans are not a reason to give up. Use those times as a chance to empower yourself and those around you about PUTTING YOUR HEALTH FIRST.  You will not be eating this way forever, and there will likely be a time in your life that you eat a slice of pizza.  5 – You may find out more than you want. I can guarantee you’re going to learn about yourself through The Elimination Diet. You’ll learn your habits, your priorities, and maybe a little more than you wanted to about your nutrition. Spend some time considering that. What happens if you do the Elimination Diet and uncover that something like ALMONDS are a culprit triggering your migraines? Are you willing to admit when certain foods you LOVE are also bringing you down?  Reframe it as awareness. If you do the diet and discover unpleasant food sensitivities, there’s no one that is checking up on you and giving you a lashing if you slip up. Instead, it’s about having the power.  “I KNOW

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Supplements to take for a well balanced diet

The Top Supplements to Complement a Healthy Diet

December 8, 2021 4 Comments

Do we really need supplements? I’m a big fan of getting the nutrients you need from your food. In a perfect world, this would happen effortlessly as we consume nutrient-dense animal products (including organs!), a variety of organic fruits & vegetables, high-quality fats and a plentitude of fish.  But, alas, our modern food environment is so different than the world of our ancestors that supplements can be a helpful tool to “fill the gaps” created.  What are those ‘gaps’? We are exposed to food and environmental toxins from pesticides, medications, and industrialization. We are under increased stress. We have a decrease in sleep quality. We have a reduced connection with nature. We are more sedentary.  All of these things mean we use up our inherent stores of nutrients (or consume less of them); and adding supplements can be a way of hacking our physiology to live longer, happier lives.  Further, certain nutrients are harder to obtain even from a healthy diet (like Vitamin D and Magnesium). Depending on your health status, this list may include things like Vitamin A, K2, Selenium, and Omega-3s.  Related: Mindful Eating: Finding a Healthy Relationship with Food So, What are the top supplements to complement a healthy diet? MAINTENANCE SUPPLEMENTS The key nutrients that I consider for “maintenance” are the ones deficient in most Americans’ Diets. There is very little danger in ‘overdoing it’ with these things and I find them a useful adjunct to a nutrient-dense, whole foods diet.  My top five list is an Omega-3 Supplement, Vitamin D3/K2, Magnesium, Digestive Enzymes, and a Pre-/Pro-biotic.  1. Omega-3 A high-quality fish oil provides essential omega-3 fatty acids, EPA and DHA. These fats act as inflammation resolvants (meaning they are potently anti-inflammatory). Additionally, omega-3 fatty acids are important for proper cardiovascular, respiratory, immune, brain and musculoskeletal health. We simply do not consume enough fish to adequately support omega 3 to omega 6 balance in our diet. Curious about your Omega balance? Check out this at-home test. 2. Vitamin D3 with K2 It is estimated that 88% of the population has less than optimal levels of Vitamin D. This Vitamin is necessary for bone integrity, proper neuromuscular function, normal inflammatory response, muscle strength, calcium absorption, immune response, and mood. Although we are able to produce Vitamin D by converting sunlight, a number of factors limit this conversion. There are few food sources, and most people do well with Vitamin D supplementation. The dose can vary depending on your personal vitamin D status. A word of caution: if you do not know your number, it is best to start with a simple Vitamin D test before turning to supplementation as Vitamin D does have an upper limit and toxicity. If you need help determining an optimal level for you, Reach out to Kate for a consultation. When supplementing with Vitamin D, you should choose the D3 form (cholecalciferol) and it should be paired with Vitamin K2. Here is further reading on that from Chris Masterjohn, PhD. 3. Magnesium Magnesium is a required co-factor for more than 600 enzyme reactions in the body. An estimated 75% of Americans do not meet the FDA’s Recommended Daily Intake. Low magnesium levels can lead to issues with the musculoskeletal system, heartbeat, blood pressure, blood sugar regulation, irritability and mood issues, muscle cramps and fatigue.  There are many types of magnesium. Magnesium Citrate is often used for digestive issues, as it is effective in increasing motility. This means high-doses of Magnesium Citrate can have a laxative effect. Start small, and build up in tolerance. Two forms of Magnesium cross the blood brain barrier: Magnesium Threonate and Magnesium Glycinate. For the most well-rounded benefit I recommend up to 2g of Magnesium Threonate in split doses, with the bulk of it close to bedtime. 4. Pre-/Probiotic Probiotics are beneficial species of bacteria that confer a benefit to the host organism. Probiotics are strain-specific; meaning every strain has a unique benefit for our health. You can find probiotics specific to mood, skin health, diarrhea, constipation, appetite, and more. A multi-strain probiotic is a good starting point for altering the immune response. It is a good idea to vary your probiotic AND use strains in a therapeutic dose. A few weeks of a probiotic supplement is enough to shift your microbiome diversity. >>What is a prebiotic? Prebiotics are fermentable fibers that act as fodder for the species to proliferate (grow and prosper). Many probiotic capsules now contain prebiotics as synergistic enhancers. However, you can also consume plenty of prebiotic foods in the form of insoluble fiber including that from chicory, artichokes, bananas, and guar gum. If you are sensitive to gas/bloating, try SunFiber. As a final note, we can consume fermented foods to get plenty of beneficial probiotics. In fact, functional foods like sauerkraut, kimchi, and fermented dairy are as powerful as a capsule. I recommend food first; but using a probiotic supplement is useful if these things are not a staple in your diet. 5. Digestive Enzymes Our body makes enzymes in the digestive tract including in the mouth, stomach, and small intestine. The largest secretions come from the pancreas. Digestive Enzymes help us break down carbohydrates, fats, and proteins in the diet for proper absorption and use. A lack of enzymes results in malnutrition, nutrient deficiencies, and gastrointestinal symptoms like gas, bloating, and pain. As we age, we secrete less enzymes. Other factors that can diminish enzyme production include autoimmune conditions, overburdened detoxification pathways, and insulin resistance. Digestive Enzyme supplements act the same as our natural enzymes. They should be taken with food. They are safe for anyone to take, regardless of natural enzyme production. In addition to the classic enzymes, you can take enzymes for specific food proteins. This is most commonly seen as Lactase for those with lactose intolerance. If you have issues with gluten or dairy, you can take a specific enzyme to help break down those proteins. I keep a stash of gluten/dairy enzyme supplements in my purse for anytime I’m

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SIBO: Internal Contribution to Dysfunction

April 1, 2019 7 Comments

Small Intestinal Bacterial Overgrowth (SIBO) is commonly defined as an increased number of bacteria and/or abnormal type of bacteria in the small intestine (Kwiatkowski, et al., 2017).  SIBO plays a role in malabsorption and nutritional deficiencies, altering the body’s homeostatic state (Zeigler & Cole, 2007). The build-up of displaced bacteria can cause an increase in intestinal permeability leading to general malabsorption and alterations of certain water-soluble B vitamins including biotin, folate and B12 (Bures et. al., 2010). Overconsumption of vitamin B12 by the dysbiotic anaerobic flora, can cause deficiency and lead to conditions such as megaloblastic anemia or polyneuropathy (Sachdev & Pimentel, 2013).  Bacterial overgrowth leads to deconjugation of bile salts which appears to irritate the mucosal lining of the intestine and cause malabsorption of fatty acids (Wanitschke & Ammon, 1978). Metabolic absorption of nutrients by dependent organs and bodily systems may be affected, due to altered health of the small intestine.  A recent study found that Non-alcoholic fatty liver disease, which affects 16-30% of the general population, was significantly higher in patients with SIBO compared to patients without SIBO (Fialho et al., 2016).  Dysbiosis of the gut bacteria has also been linked to other autoimmune diseases such as rheumatoid arthritis, type 1 diabetes and asthma (Tremlett et al., 2016). The symptoms of SIBO can have a significant impact on quality of life. The condition can be economically burdensome as patients are likely to spend substantial sums of money on physician visits and medications seeking relief from their symptoms (Yakoob et al., 2011).  Socially, patients may suffer from gastrointestinal (GI)-specific anxiety (GSA) characterized by being fearful of GI symptoms, such as abdominal pain or discomfort, gas, and altered bowel habits. The unpredictability of their condition can lead to self-seclusion and avoidance of public and social gatherings (Lackner et al., 2014). As evidenced by the research presented above, SIBO affects the gastrointestinal and supporting systems in a variety of ways, placing a heavy burden on individuals affected.  Curious about the contribution of STRESS to SIBO (and other digestive dysfunctions)? Check out this article by Chris Kresser. Visceral Manipulation is a therapeutic approach to managing gut symptoms from SIBO. If you are in Denver, consider an appointment with Physical Therapist, Dr. Missy Albrecht who specializes in this bodywork. See more from Dr. Missy @stay_invincible References: Bures J, Cyrany J, Kopacova M, et al. Small intestinal bacterial overgrowth syndrome. World Journal Of Gastroenterology [serial online]. June 28, 2010;16(24):2978-2990. Retrieved from https://uws.idm.oclc.org/login?url=http://search.ebscohost.com.uws.idm.oclc.org/login.aspx?direct=true&db=mdc&AN=20572300&site=ehost-live Fialho, A., Fialho, A., Thota, P., McCullough, A. J., & Shen, B. (2016). Small intestinal bacterial overgrowth is associated with non-alcoholic fatty liver disease. Journal of Gastrointestinal and Liver Diseases: JGLD, 25(2), 159-165. 10.15403/jgld.2014.1121.252.iwg Retrieved from https://uws.idm.oclc.org/login?url=http://search.ebscohost.com.uws.idm.oclc.org/login.aspx?direct=true&db=mdc&AN=27308646&site=eds-live Kwiatkowski, Laura, Rice, Elizabeth, Landland, Jeffrey (2017). Integrative Treatment of Chronic Abdominal Bloating and Pain Associated with Overgrowth of Small Intestinal Bacteria: A Case Report. Alternative Therapies, 109(4), 56-61. Retrieved April 26, 2018, from http://content.ebscohost.com/ContentServer.asp?T=P&P=AN&K=125093181&S=R&D=awh&EbscoContent=dGJyMNLe80SeqLQ4v%2BbwOLCmr1CeprdSs6q4Sq%2BWxWXS&ContentCustomer=dGJyMPGvrkiyq7NNuePfgeyx43zx Lackner, J. M., Gudleski, G. D., Ma, C., Dewanwala, A., & Naliboff, B. (2014). Fear of GI symptoms has an important impact on quality of life in patients with moderate-to-severe IBS. The American Journal Of Gastroenterology, 109(11), 1815-1823. doi:10.1038/ajg.2014.241.Retrieved from https://uws.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=25223577&site=eds-live Sachdev, A. H., & Pimentel, M. (2013). Gastrointestinal bacterial overgrowth: Pathogenesis and clinical significance. Therapeutic Advances in Chronic Disease, 4(5), 223-231. 10.1177/2040622313496126 Retrieved from https://uws.idm.oclc.org/login?url=http://search.ebscohost.com.uws.idm.oclc.org/login.aspx?direct=true&db=mdc&AN=23997926&site=ehost-live Tremlett, H., Fadrosh, D. W., Faruqi, A. A., Hart, J., Roalstad, S., Graves, J., . . . Waubant, E. (2016). Associations between the gut microbiota and host immune markers in pediatric multiple sclerosis and controls. BMC Neurology, 16(1), 182. Retrieved from https://uws.idm.oclc.org/login?url=http://search.ebscohost.com.uws.idm.oclc.org/login.aspx?direct=true&db=mdc&AN=27652609&site=eds-live Wanitschke, R., & Ammon, H. V. (1978). Effects of dihydroxy bile acids and hydroxy fatty acids on the absorption of oleic acid in the human jejunum. The Journal of Clinical Investigation, 61(1), 178-186. 10.1172/JCI108916 Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/3386  Yakoob, J., Abbas, Z., Khan, R., Hamid, S., Awan, S., & Jafri, W. (2011). Small intestinal bacterial overgrowth and lactose intolerance contribute to irritable bowel syndrome symptomatology in Pakistan. Saudi Journal Of Gastroenterology: Official Journal Of The Saudi Gastroenterology Association, 17(6), 371-375. doi:10.4103/1319-3767.87176. Retrieved from https://uws.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=22064333&site=eds-live Ziegler, T. R., & Cole, C. R. (2007). Small bowel bacterial overgrowth in adults: A potential contributor to intestinal failure. Current Gastroenterology Reports, 9(6), 463-467. Retrieved from https://uws.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=mdc&AN=18377796&site=ehost-live

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