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Archive for September, 2018

818 support healthy stomach acid

When we go to the doctor with symptoms of acid reflux, gas, bloating and heartburn, typically the diagnosis of high stomach acid is based purely on symptoms — not a lab test for stomach acid levels — resulting in a prescription for antacids, histamine type 2 receptor agonists (H2 blockers), Proton Pump Inhibitors (PPIs), or even surgery.

For some people these remedies get to the root cause, however for a large percentage they fall far short of the real target and actually serve to increase the problem.

Antacids reduce stomach acid temporarily, then more acid is automatically produced to bring the stomach back to its intended pH level. This only treats the temporary symptoms and does nothing to fix the actual problem.

H2 blockers block a substance in the body that encourages acid production in the stomach. They work more slowly than antacids and are intended to last for longer periods of time. On the down side, they stop production of pepsin, a digestive enzyme necessary for breaking down protein.

Proton pump inhibitors permanently block an enzyme that tells your stomach to produce acid.

All of these methods are linked to serious side effects and can even contribute to the root causes for continued chronic low stomach acid and other serious health conditions.

5 Ways to test stomach acid levels

Because hypochlorhydria isn’t well known to most patients, many never trace it back to their chronic health condition and they continue to suffer.

The good news is multiple options exist for testing stomach acid levels, which will help you create a clear game plan for remedying the situation at its foundation.

1. Gastric acid secretion test. Highly invasive and expensive, this test is typically done if a patient is diagnosed with a stomach ulcer. It can be helpful to track if anti-ulcer medication is working and to see if material from the intestines is coming back into the stomach.

2. The Heidelberg Stomach Acid Test. Considered the gold standard test for hypochlorhydria, a small capsule with a radio transmitter is ingested to measure the pH of the stomach as you drink a solution with baking soda (reduces acidity). The baking soda will naturally neutralize the HCL in the stomach. If the body does not return it to normal, it’s a sign of hypochlorhydria.

This test provides a graph showing your specific stomach response to the baking soda challenge, and can help determine if you have hypochlorhydria, hyperchlorhydria (high acid), or achlorhydria (complete lack of acid). At a cost of about $350, this test is not covered by most insurance plans.

3. CBC and CMP. These are common factors on a metabolic blood panel, typically covered by insurance. A skilled clinician can diagnose hypochlorhydria by taking into account these lab results in combination with your symptoms.

4. Betaine HCl challenge. An at-home test considered to be quite reliable, however false positives are possible so it’s recommended to repeat the test three times. The betaine HCl costs about $20. If you have low stomach acid, you can then take it to help restore your HCl levels.

  1. Buy Betaine HCl with pepsin.
  2. Eat a high-protein meal containing at least 6 ounces of meat (veggies are allowed with this).
  3. In the middle of the meal (not the beginning) take one betaine HCl pill.
  4. Finish the meal and observe what happens.

Possible outcomes:

1. You notice no symptoms. This is likely a sign of low stomach acid.

2. Indigestion. Burning, heat, or heaviness in your chest likely indicate adequate stomach acid levels.

It is recommended to repeat the betaine HCl challenge two or three times to confirm your results. Three positive tests are a good indication of low stomach acid.

False positives are possible if:

  • You consume too little protein. A low protein meal doesn’t require much acid, so the betaine HCl can cause too much increase in acid.
  • You took the capsule before the meal, which can cause indigestion.
  • You have esophageal sphincter dysfunction. A hiatal hernia or poor esophageal sphincter tone can cause increased indigestion symptoms. Rule this out with a medical exam if you suspect it.

5. Baking soda stomach acid test. While not as accurate as the above tests, this is a free at-home test you can use to get an indication of your stomach acid levels. The results can vary from person to person depending on interpretation of the results. Some use it as a baseline measure and to track changes over time.

First thing in the morning, before eating or drinking anything:

  1. Mix ¼ tsp baking soda in 4 to 6 ounces of cold water.
  2. Drink the baking soda solution.
  3. Time how long it takes for a burp to occur. Time it for up to 5 minutes:

If you have not burped within five minutes, it may be a sign of insufficient stomach acid. Early and repeated burping may be due to too much stomach acid (do not to confuse this with small burps from swallowing air when drinking the solution). Any burping after 3 minutes is an indication of low stomach acid levels.

Associated tests

Low stomach acid can be associated with other health issues that have far-reaching consequences. If you suspect low stomach acid, ask our office about testing for the following:

B12 levels: Intrinsic factor is a glycoprotein in the stomach necessary for absorption of vitamin B12. When stomach acid is too low, intrinsic factor can’t do its job. This results in vitamin B12 deficiency, which is a serious health concern.

Homocysteine levels: Stomach acid is important for proper absorption of vitamin B12, a key factor in methylation that keeps inflammatory homocysteine at the right levels. When B12 is low, homocysteine elevates.

Supporting healthy stomach acid

Eat protein foods at the beginning of your meal to stimulate the digestive enzymes necessary for digesting protein.

Chew thoroughly. This is one of the most important parts of digestion. Food proteins need to be broken down to be properly digested.

Limit liquid intake during meals until at least 30 minutes after a meal to allow for proper stomach acid production, pathogen sterilization, and protein metabolism.

Stay hydrated between meals to support proper gut motility; this pushes the contents of the intestines out of the body instead of back into the stomach. This is very important for those who are prone to SIBO.

Betaine hydrochloride supplements help support healthy gut function and safely restore normal gastric acidity. (Do not confuse betaine HCl with anhydrous betaine, a methyl-donor nutrient taken to control homocysteine levels.)

Always take the betaine HCL either half-way through the meal or right at the end of the meal. Taking it before a meal may create a false experience of heartburn and can turn off stomach acid production for this meal. Caution: Do not take HCL if you are taking any NSAIDs such as ibuprofen, Tylenol or aspirin.

HCl with pepsin. Add these to your diet when you consume protein. When you feel warmth in your stomach, that means you are taking enough. Then back it down a notch and monitor your response. Some people need one capsule, others need more as everyone is unique.

Pepsin. Typically used in conjunction with HCl, pepsin is considered very safe when administered to assist digestion.

Digestive enzymes help to break down food proteins. Make sure to get a high-quality blend.

Apple cider vinegar. One tablespoon in a bit of water right before a meal can help with digestion.

Fermented foods such as sauerkraut, kimchi, pickles, pickled ginger, and water kefir contain organic acids, enzymes and probiotics to assist with proper digestion. They are also anti-microbial and fight H. pylori, arch enemy of stomach acid production.

Taking the time to improve your stomach acid levels will make a huge difference in your symptoms and quality of life. Please contact my office for more help.

 

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817 cleaning products

New research shows those powerful and toxic household disinfectants do more than kill germs — they also kill off vital gut bacteria and shift your gut microbiome signature to promote obesity.

Our gut microbiome consists of several pounds of gut bacteria and research increasingly shows how powerfully these bacteria influence our overall health.

The composition of the gut microbiome determines much about our immune health, personality, brain function, and weight. In fact, scientists are increasingly discovering a connection between our microbiome signature and a propensity toward obesity.

For instance, being born via C-section, bottle feeding versus breast feeding as an infant, and frequent antibiotic use in childhood has been associated with a much higher risk of obesity.

Also, both mice and human studies shows that inoculating the gut of an obese subject with the gut bacteria of a thin subject causes swift weight loss. The reverse is also true — thin mice quickly become fat when inoculated with the gut bacteria of obese mice.

Now, a new study adds more weight to these findings by showing that multi-surface cleaning disinfectants are another factor that promote an obesity microbiome. Children who grow up in households that use these products regularly are more prone to obesity.

The Canadian study showed that three-year-old children who grew up in homes where these products were used two or more times a week were more overweight than their peers who grew up in homes where these products were used less often or not at all.

The bacterium scientists looked at is called Lachnospiraceae. In animal studies, higher levels of Lachnospiraceae is associated with increased body fat and insulin resistance. Insulin resistance is a stepping stone condition to diabetes and is often found in people with obesity.

Fecal samples from children in homes that used eco-cleaners or detergents free of the bacteria-killing ingredients did not show the same elevated levels of Lachnospiraceae.

It was important in the study to look at the home environments three-year-olds grew up in because microbiome researchers find that our lifelong gut microbiome is largely determined by age three.

Although more work needs to be done in this arena, animal studies have produced similar results.

Can you alter your gut microbiome signature?

Although it looks like the gut microbiome signature we develop in infancy plays a large role in our lifelong health, it is not completely set in stone.

In fact, the gut microbiome is increasingly being viewed as a dynamic organ that can change composition in as little as three days. The foods you eat profoundly influence your gut bacteria.

The best strategy to promote a healthy gut microbiome that favors fat burning over fat storage, healthy immunity, and balanced brain function is to eat a large and diverse array of produce, mainly vegetables, at every meal. It’s important to eat many different kinds of produce on a regular basis. Gut bacteria health is based on diversity, which is created by a diverse produce-based diet.

Gut bacteria also respond positively to regular exercise, an environment and diet as free of environmental chemicals as possible, and consumption of fermented and cultured foods and drinks, such as kefir water, kimchi, and sauerkraut.

Ask my office for more ways to promote a healthy gut microbiome.

 

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816 hypochlorhydria

While most doctors prescribe antacids to lower stomach acid for heart burn and acid reflux, the real culprit may be that your stomach acid is already too low. This is called hypochlorhydria and it plays a role in autoimmune diseases such as Hashimoto’s hypothyroidism.

Sufficient stomach acid, or hydrochloric acid (HCl), is necessary to:

Protect the body from pathogens. When we consume food, bacteria and other microorganisms come along with it. Stomach acid helps neutralize the ones we don’t want in our bodies. HCl also acts as a barrier against bacterial and fungal overgrowth of the small intestine. This is important to preventing inflammatory compounds into the bloodstream where they can trigger Hashimoto’s hypothyroidism.

Activate pepsin. HCl triggers the production of pepsin, which helps break down proteins to be absorbed in the small intestine. When proteins are not adequately digested, they can escape into the bloodstream where they trigger inflammation food sensitivities.

Digest proteins. If you have ever made ceviche or marinated meat in vinegar or lemon, you can see how acid breaks it down. Our stomach acid works much more quickly and efficiently than this.

Activate intrinsic factor. Stomach acid helps activate intrinsic factor, a glycoprotein made in the stomach that is necessary for absorption of vitamin B12.

Stimulate delivery of bile and enzymes. Adequate stomach acid stimulates release of bile from the liver and gall bladder and digestive enzymes from the pancreas. This also supports digestion of carbs, fats, and vitamins A and E.

Close the esophageal sphincter. Located between the stomach and the esophagus, the esophageal sphincter protects the delicate tissue of the esophagus from the strong acids of the stomach.

Open the pyloric sphincter. Stomach acid helps open this gateway between the stomach and the small intestine.

Absorb vitamins and minerals. Absorption of folic acid, ascorbic acid, beta carotene and iron are made more bioavailable by HCl in the digestive tract. Low stomach acid can cause poor absorption of calcium, magnesium, copper, chromium, manganese, selenium, vanadium, zinc, molybdenum and cobalt.

The gut is the seat of the immune system and all of these functions are vital for healthy gut function that can help you manage your Hashimoto’s hypothyroidism and prevent inflammation and flare ups.

Hypochlorhydria is under diagnosed

An estimated 90 percent of the population suffers from hypochlorhydria (low stomach acid), yet most of us have never heard of it.

When stomach acid is too low your body cannot digest food thoroughly. The food in the stomach begins to rot and putrefy, the small intestine attempts to reject it, and the rotten food moves back up into the esophagus. While the food is not acidic enough for the small intestine, it is far too acidic for the esophagus.

In addition, low stomach acid leads to bacterial overgrowth, gut inflammation, increased food sensitivities, and higher risk for inflammatory disorders such as Hashimoto’s hypothyroidism.

Key hypochlorhydria signs and symptoms include:

  • Burping, bloating, gas after meals
  • Upset stomach after eating
  • Nausea when taking vitamins and supplements
  • Indigestion, heartburn, acid reflux
  • Diarrhea
  • Desire to eat when not hungry
  • Undigested food in stool
  • Fatigue
  • Gut infections
  • SIBO (small intestine bacterial overgrowth)
  • Iron deficiency anemia
  • Deficiencies of vitamin B-12, calcium, and magnesium

Taking supplemental HCl can help support your own production and help you better digest your food. Take just enough so it doesn’t cause burning. If taking even a little bit causes burning, you may have ulcers and an H. Pylori infection, which are not uncommon with hypochlorhydria.

Ask my office for more advice on improving your digestion, relieving your heartburn symptoms, and managing your Hashimoto’s hypothyroidism.

 

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815 avoid afternoon thyroid test

If you’re getting your TSH levels checked to monitor your thyroid health, it’s best to get that done in the morning. Otherwise your results may come back normal even though you have hypothyroidism.

All the body’s hormones follow a daily rhythm, including thyroid hormone. This means there are times of the day when it naturally higher or lower. Researchers tested the blood of hypothyroid subjects both before 8 a.m. and again between 2 and 4 p.m.

In hypothyroid patients both untreated and on thyroid medication, TSH dropped was substantially lower during the afternoon test. This means an estimated 50 percent of people with hypothyroidism are not being diagnosed.

In the untreated group, TSH was 5.83 in the morning and 3.79 in the afternoon. In the treated group, TSH was 3.27 in the morning and 2.18 in the afternoon.

2004 study also showed late morning, non-fasting TSH was 26 percent lower compared to early morning, fasting TSH. This means even a late morning blood draw could result in a failure to diagnose.

TSH blood test timing and functional medicine ranges

The timing of your blood draw plays an important role in reading a thyroid panel. However, there is more to it.

Even with an early morning blood draw, many doctors will still fail to diagnose hypothyroidism because they use lab ranges that are too wide and that do not reflect genuine thyroid health.

Many doctors still use a hypothyroidism TSH range of 0.5 to 5.0 e

ven though the American Association of Clinical Endocrinologists recommends 0.3 to 3.0.

In functional medicine we use an even narrower range of 1.8 to 3.0. We also know that only looking at TSH can miss hypothyroidism.

For example, TSH may be normal but other thyroid markers are off. That’s why it’s important to order a thyroid panel that includes total and free T4 and T3, reverse T3, free thyroxine index (FTI), T3 uptake, and thyroid binding globulins. Many conditions can cause poor thyroid function, including inflammation, hormonal imbalances, and chronic stress. Ordering these other thyroid markers provides more insight into such imbalances.

Always include a test for autoimmune Hashimoto’s hypothyroidism

In addition to these markers, anyone with symptoms of hypothyroidism should also test for Hashimoto’s, an autoimmune disease that attacks and destroys the thyroid gland.

Why? About 90 percent of hypothyroidism cases in the US are caused by Hashimoto’s. To screen for Hashimoto’s, order TPO and TGB antibodies.

Thyroid medications may be necessary to support thyroid function, but they do not address the autoimmunity attacking the thyroid gland. Failing to manage Hashimoto’s increases the risk of developing other autoimmune diseases such as pernicious anemia, rheumatoid arthritis, vitiligo, and Type I diabetes. It will also make it more difficult to manage your symptoms.

Ask my office how to properly test and manage your thyroid function.

 

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814 high altitude suicide

Emerging research reveals that higher-altitude living contributes to higher risk for depression and suicide. While studies continue to look into the mechanisms behind this trend, it’s clear a variety of factors come into play. From the unique effects that altitude has on the brain to social and psychological aspects of life in the high country, many of these factors are influenced by your lifestyle and dietary choices.

In the United States, the highest suicide rates are in the intermountain area — in particular Arizona, Colorado, Idaho, Montana, Nevada, New Mexico, Utah, and Wyoming. Wyoming comes in first with two times the national suicide average, and the other states on this list consistently score in the top ten nationwide.

Resort town life: A recipe for desperation and impulsiveness?

While some studies reveal physiological factors behind the altitude-linked descent into suicidal depression, the experts say social, economic and cultural factors can also play a role.

Mountain community is transient by nature. The mountain resort-town life revolves around two seasons: winter and summer. Ski season and summer tourist season are the main busy times separated by two off-seasons that locals like to call “mud season.”

During mud season, while everything is either buried in spring snowmelt or autumn rain, the tourists disappear, locals have little to no income, and one’s sense of displacement, isolation, depression, and uncertainty can increase dramatically. Having to make it through this tough time twice a year, every year can cause high levels of stress and depression.

Social isolation. These remote communities are spread far apart, breaking up the interconnectedness that people have in more populated areas. In addition, many residents come and go during “mud season,” making it hard to develop strong social bonds. This undermines the creation of the well-established intergenerational relationships, deep social connections, and the resulting support systems known for supporting mental health and stability.

Financial struggle and uncertainty. When we think of resort towns, we think of enjoyment and freedom surrounded by natural beauty. However, the reality for many residents is a life of working two to four jobs during tourist season, the twice-yearly mud-season of unemployment, unaffordable housing that changes frequently, and constant financial worries. This puts enormous stress on individuals, families, and relationships.

Party culture and substance abuse. Resort towns are notorious party towns, and the use of alcohol and other drugs is more prevalent. According to Mental Health America, substance abuse is likely a factor in half of all suicides, and the lifetime rate of suicide among those with alcohol problems is three to four times the national average.

Altitude’s effect on the brain may increase suicide risk

A recent Harvard study analyzed previous studies linking life at higher altitudes to increased risk of depression and suicide.

While more than 80 percent of US suicides occur in low-altitude areas, that’s because most of the population lives near sea level. Adjusted for population distribution, suicide rates are almost four times higher at high altitude versus low altitude.

A possible physiological explanation for this trend has been considered: Chronic hypobaric hypoxia, or low blood oxygen, might alter serotonin and dopamine metabolism in the brain as well as negatively influence how energy is transferred in cells and tissues.

Lowered serotonin production. Studies also show high altitude reduces serotonin levels, which is associated with mood and anxiety disorders. And the higher you go, the greater your risk for suicide.

In fact, Salt Lake City residents have a 30 to 40 percent higher risk of suicide just based on their altitude compared to those at sea level. Nearby Alta and Snowbird — both ski resort towns — have a suicide rate two times that of the national average.

Raised dopamine production. On the other hand, altitude increases the production of dopamine, the brain neurotransmitter associated with pleasure-seeking and risk-taking.

This is complicated by the fact high altitude living attracts outdoorsy risk-takers who may already have increased dopamine levels that make them prone to the impulsivity associated with suicide.

Support your mental health with dietary and lifestyle measures

While we need more research into the altitude-suicide connection, it’s clear that high-mountain living presents many challenges to mental health. If you live in a high-altitude location, be aware of the factors below to see if your risk for depression and suicide may be higher.

Symptoms of impaired serotonin activity:

  • Loss of pleasure in hobbies and interests
  • Feelings of inner rage and anger
  • Feelings of depression
  • Difficulty finding joy from life pleasures
  • Depression when it is cloudy or when there is lack of sunlight
  • Loss of enthusiasm for favorite activities
  • Not enjoying favorite foods
  • Not enjoying friendships and relationships
  • Unable to fall into deep restful sleep

Symptoms of high dopamine activity:

  • Agitation
  • Anxiety
  • Impulsiveness
  • Heightened cognitive acuity
  • Hedonism
  • High libido
  • Hyperactivity
  • Insomnia
  • Mania
  • Paranoia
  • Lack of self-control

Anti-inflammatory diet to support brain health. Ongoing research reveals a strong link between brain inflammation and various depressive disorders. Support your body’s ability to quell inflammation with a diet free of common allergens and reactive foods.

Symptoms of blood sugar dysregulation. Imbalances in blood sugar can be at the root of many mood issues.

Signs and symptoms of low blood sugar include:

  • Increased energy after meals
  • Craving for sweets between meals
  • Irritability if meals are missed
  • Dependency on coffee and sugar for energy
  • Becoming light headed if meals are missed
  • Eating to relieve fatigue
  • Feeling shaky, jittery, or tremulous
  • Feeling agitated and nervous
  • Poor memory, forgetfulness
  • Blurred vision

Signs and symptoms of high blood sugar include:

  • Fatigue and drowsiness after meals
  • Intense cravings for sweets after meals
  • Constant hunger
  • General fatigue
  • Waist girth equal to or larger than hip girth
  • Craving for sweets not relieved by eating them
  • Frequent urination
  • Increased appetite and thirst
  • Difficulty losing weight
  • Trouble falling asleep

Support your stress response with adrenal adaptogens and phosphatidylserine.

  • Panax ginseng
  • Ashwagandha
  • Holy basil leaf extract
  • Rhodiola
  • Boerhaavia (Punarnava)
  • Pantethine (B5) and B vitamins
  • Phosphatidylserine liposomal cream that delivers 2000mg per day

Moderate your caffeine intake. Caffeine can stress your adrenals, making it harder to cope with high stress.

Support serotonin levels with 5HTP (a serotonin precursor) or L-tryptophan.

Support brain bioenergetics with creatine.

Use moderate exercise to manage stress levels and support brain health.

Stress management practices such as meditation, chi gong, and yoga help to moderate stress and relieve depression.

Actively build community and social connections by joining a volunteer group, drama club, book club, or other organization.

Know the signs of increased social isolation in yourself and loved ones.

If you have substance abuse issues, please contact my office for a referral for assistance.

Check for deficiencies in vitamin D, B2, and iron, all of which can affect mood.

High altitude life has many joys and benefits, and it doesn’t have to be a recipe for depression disaster. To learn more about how you can support your well-being while living at altitude, please contact my office.

For emergency help, contact the National Suicide Prevention Hotline at 1-800-273-8255 or suicidepreventionlifeline.org.

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