Alopecia Awareness: Uncovering the Role of Toxic Mold and Autoimmune Conditions

Alopecia Awareness: Uncovering the Role of Toxic Mold and Autoimmune Conditions

Throughout my experience as a naturopathic doctor, I've personally witnessed the devastating effects that toxic mold exposure from water-damaged homes —an issue affecting an estimated 45% of buildings—can have on patients. From fibromyalgia to chronic fatigue and even alopecia, mold illness can trigger a cascade of debilitating symptoms. My passion for environmental health drives me to help people heal from these often-overlooked conditions, particularly mold-related illness, which I’ve received additional training to manage. Naturopathic doctors are uniquely trained in environmental medicine, making us well-equipped to address issues like toxic mold exposure. As we dive into Alopecia Awareness Month, I want to share some insights into the connections between hair loss, autoimmune thyroid disease, and toxic mold exposure, and what you can do to protect your health.

What is Alopecia Awareness Month?

Alopecia Awareness Month is observed every September to raise awareness about alopecia, its causes, and the impact it has on individuals’ lives. Alopecia is a term used for hair loss, which can range from thinning hair to complete baldness. While it’s often attributed to genetics and stress, other underlying health factors such as autoimmune diseases and environmental exposures—like mold—can play a significant role.

The Connection Between Autoimmune Thyroid Disease and Alopecia

Autoimmune disorders, particularly thyroid disease, are commonly linked to hair loss. Thyroid hormones regulate many essential bodily functions, including hair growth. When the thyroid is underactive or overactive, it can lead to hair thinning or even patches of hair loss known as alopecia areata.

Hypothyroidism and Hair Loss

In my practice, I've encountered numerous cases where individuals with Hashimoto's thyroiditis, an autoimmune form of hypothyroidism, experience varying degrees of hair loss. Hashimoto’s leads to a gradual reduction in thyroid hormone production, causing the hair follicles to weaken and fall out. The immune system's role in attacking the thyroid can also extend to attacking hair follicles, which is why autoimmune thyroid disorders are so frequently associated with alopecia. Understanding this connection helps us better support both thyroid health and hair loss in patients.

The Connection Between Toxic Mold and Alopecia

Toxic mold exposure is an often-overlooked contributor to health issues, including alopecia. Mold thrives in water-damaged buildings, and with so many homes affected, it’s not uncommon to see patients who are suffering from mold-related illnesses. These illnesses can manifest in many ways, including fatigue, respiratory problems, and, in some cases, hair loss.

Mold and Hair Loss: What’s the Link?

Exposure to mycotoxins, harmful chemicals produced by toxic mold, can weaken the immune system, leading to systemic inflammation and immune dysregulation. When the body is exposed to mold toxins, it can trigger inflammation in hair follicles, leading to conditions like alopecia. Additionally, mold exposure often disrupts the hormonal balance, affecting thyroid function, which can further exacerbate hair loss.

In cases of mold toxicity, I’ve seen patients struggle with a variety of chronic symptoms that can range from cognitive issues and muscle pain to unexplained hair loss. By addressing mold exposure through detoxification and environmental interventions, many patients have experienced significant improvement, including regrowth of their hair.

The Change the Air Foundation and Their Journey with Alopecia and Toxic Mold

One powerful example of the connection between toxic mold and alopecia is the story behind the Change the Air Foundation. This organization was born out of a family’s experience with mold-related illness, which led their young daughter to develop alopecia universalis, the total loss of all hair on the body. After enduring hair loss and a range of debilitating symptoms, they discovered that mold exposure was the underlying cause. Their journey to recovery, chronicled here, inspired the family to start the foundation. Their mission is to raise awareness about indoor air quality and toxic mold, helping families understand the often-hidden risks of mold exposure and providing resources for recovery. The foundation’s work continues to shine a light on the profound impact that environmental health can have on conditions like alopecia and many other chronic illnesses.

Managing and Addressing Alopecia Linked to Thyroid Disease and Mold Exposure

If you suspect your hair loss is linked to autoimmune thyroid disease or toxic mold exposure, seeking appropriate testing and support is essential. Naturopathic doctors, who receive specialized training in environmental medicine as part of their curriculum, are particularly skilled at identifying and managing mold-related illnesses.

1. Address Thyroid Health

For those with autoimmune thyroid conditions like Hashimoto’s, managing thyroid hormone levels can minimize the risk of hair loss. This may include thyroid hormone replacement therapy, along with a diet rich in essential nutrients like iodine and selenium, both of which support thyroid function and hair growth.

2. Combat Mold Exposure

For patients dealing with mold exposure, the first step is identifying and removing the mold source. When it comes to mold inspection and testing, I’ve found the most thorough results come from professionals with specific certifications such as Council-certified Microbial Investigator (CMI) or Council-certified Microbial Consultant (CMC). These individuals are trained to perform detailed mold inspections, bioaerosol sampling, and lab result interpretation. They can also design effective remediation protocols and conduct post-remediation testing to ensure the mold has been successfully eliminated. By working with professionals who hold these credentials, you can ensure that the mold issues are accurately identified and resolved.

3. Modulate the Immune Response

Since both autoimmune thyroid disease and mold exposure involve immune dysfunction, strategies to modulate the immune system, such as reducing stress, improving gut health, and incorporating immune-balancing supplements, can provide additional support.

Final Thoughts

As we observe Alopecia Awareness Month, it's crucial to remember that hair loss can often be a symptom of deeper underlying issues, such as autoimmune thyroid disease or exposure to environmental toxins like mold. By raising awareness and seeking a proper diagnosis, individuals affected by alopecia can take steps to regain their health—and in many cases, their hair.

With my additional training in mold illness and a passion for helping patients heal from environmental factors, I strive to bring awareness to these hidden contributors to chronic illness and support those on their journey to better health. If you're struggling with unexplained hair loss, it may be time to consider whether thyroid health or toxic mold could be contributing factors.

 

Dr. Sarah Giardenelli is a naturopathic doctor and acupuncturist in Leesburg, Virginia. With a passion for environmental health and a commitment to helping patients heal from chronic illnesses, she utilizes a holistic approach to care. For more information about her practice and services, visit www.collectivehealthcenter.com.

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Colostrum Peptides: A Personal Journey and Clinical Insights

Colostrum Peptides: A Personal Journey and Clinical Insights

Peptides have dominated conversations over the past year, with collagen peptides and semaglutide taking center stage. It seems like everyone is incorporating some type of peptide into their wellness routine, whether it's for bone, hair, skin, nails, or weight loss support. Peptides, small molecules formed by linking amino acids through peptide bonds, are essential components of life processes due to their diverse sequences and structures. They serve a multitude of functions in the body, acting as signaling molecules, enzymes, or structural elements.

My Colostrum Connection

Among the myriad peptide-rich supplements available, colostrum holds a special place for me. Recently, many patients have approached me about colostrum supplementation, often after encountering it through social media marketing. However, my connection with colostrum runs deep, predating its current popularity. Back in 2010, during my residency after graduating from naturopathic medical school, I faced a challenging health issue—severe hives without a clear cause. Despite trying conventional and naturopathic treatments, relief remained elusive until a mentor suggested colostrum.

Peptides in Health

This recommendation stemmed from the mentor's professional background in pharmaceuticals and her awareness of colostrum's rich content of immunoglobulins. She proposed that these antibodies in colostrum could bind to the antibodies involved in the hives, helping to modulate the immune response. After several months of discomfort, colostrum emerged as the solution that finally calmed my immune system. Eventually, I identified the cause of my hives – the prickly plants in my garden.

From Challenge to Solution

This experience not only highlighted colostrum's efficacy but also taught me valuable lessons about immune health. Even with colostrum, it took about three weeks for my hives to fully clear, emphasizing the complexity of immune responses. This personal encounter with colostrum's wonders and its various peptides solidified its value as a clinical tool in my practice. Today, I continue to appreciate its benefits in supporting immune function and overall well-being.

Here's a fun fact: Colostrum shares many similarities across species! From humans to cows to elephants, this special milk contains essential components like immunoglobulins and growth factors, tailored to give newborns a healthy kickstart in life. Most of us are aware of the immune protective properties that human colostrum confers to nursing babies. However, you may not know that there are many different peptides in colostrum that contribute to its immunological, tissue healing, nutritional, and even pain relieving properties! 

Research Highlights on Colostrum Components: 

  1. Immunoglobulin-Derived Peptides:
  • Benefits: Immunoglobulin-derived peptides like lactoferrin and lactoperoxidase found in colostrum provide immune-boosting effects. They combat microbes, reduce inflammation, and act as antioxidants, enhancing overall immune function and preventing infections. (Playford et al., 2000; Ochoa et al., 2007) 
  1. Lactoferrin:
  • Benefits: Lactoferrin, renowned for its antimicrobial properties, also aids in modulating the immune response. It exhibits antiviral and antibacterial effects while fostering gut health through the promotion of beneficial bacteria growth. (Ellison et al., 1988; Telang, 2018) 
  1. Peptide-rich Fractions (PRFs):
  • Benefits: PRFs in colostrum offer various health benefits. They possess anti-inflammatory and antioxidant properties, aiding in tissue repair and bolstering overall well-being. (Korhonen et al., 2000; Ulfman et al., 2005) 
  1. Proline-Rich Polypeptides (PRPs):
  • Benefits: PRPs regulate the immune system, promoting a balanced response. They are particularly beneficial for individuals with autoimmune conditions. (Burgos et al., 2019) 
  1. Growth Factors:
  • Benefits: Colostrum contains growth factors like IGF-1, TGF, and EGF, which facilitate cell growth, tissue repair, and development. These factors contribute to gut health, skin regeneration, and injury recovery. (Playford et al., 2021) 
  1. Opioid-derived Peptides:
  • Benefits: Opioid-derived peptides such as beta-casomorphins in colostrum have analgesic properties. They interact with opioid receptors, potentially alleviating pain. (Chung et al., 2015) 

Clinical Applications of Colostrum

My preferred clinical applications of colostrum include its role as an immune modulator, making it suitable for individuals dealing with allergies and autoimmune disorders. Additionally, its tissue healing properties make it beneficial for those in need of gut healing support. Considering its immune-protective properties, I also see potential for its use in providing general immune support and defense against colds and viruses. However, I tend to favor non-animal derived products like botanicals and probiotics for immune support, for their sustainability and humane qualities. Furthermore, I appreciate that colostrum is generally well tolerated, except for rare cases of sensitivity or allergy. Its mild taste also makes it easy to mix into beverages, making it a convenient option for children. For extra immune support, I occasionally add it to my son’s smoothies. A pro tip: when using colostrum in smoothies, it's best to mix rather than blend to preserve the beneficial peptides.

Concluding Thoughts: Blending Personal Experience with Clinical Insights

In conclusion, as we explore peptides and colostrum, personal experiences blend with clinical insights, enriching understanding of wellness and guiding better health outcomes. While research highlights the potential health benefits of colostrum peptides, it's crucial to recognize the variability of individual responses and the diversity in supplement quality and composition. Therefore, consulting with a healthcare professional before integrating colostrum or any supplements into your regimen is prudent, particularly if you have specific health considerations or conditions. From facing health obstacles to uncovering solutions that work, these insights add depth to our understanding of wellness and guide us towards better health outcomes.

Interested in further exploring the benefits of colostrum peptides in your health journey? Connect with Dr. Sarah at Collective Health Center. With her extensive expertise in naturopathic medicine and acupuncture, Dr. Sarah provides personalized insights and guidance to enhance your well-being through holistic approaches. She offers both virtual and in-person consultations at her clinic in Leesburg, Virginia.

 

References:

  1. Playford, R. J., Macdonald, C. E., & Johnson, W. S. (2000). Colostrum and milk-derived peptide growth factors for the treatment of gastrointestinal disorders. American Journal of Clinical Nutrition, 72(1), 5-14.
  2. Ochoa, T. J., Chea-Woo, E., Campos, M., Pecho, I., Prada, A., & McMahon, R. J. (2007). Impact of lactoferrin supplementation on growth and prevalence of Giardia colonization in children. Clinical Infectious Diseases, 44(2), 241-253.
  3. Ellison, R. T., Giehl, T. J., & LaForce, F. M. (1988). Damage of the outer membrane of enteric gram-negative bacteria by lactoferrin and transferring. Infection and Immunity, 56(11), 2774-2781.
  4. Telang, S. (2018). Lactoferrin: A critical player in neonatal host defense. Nutrients, 10(9), 1228.
  5. Korhonen, H., Marnila, P., & Gill, H. S. (2000). Bovine milk antibodies for health. British Journal of Nutrition, 84(S1), S135-S146.
  6. Ulfman, L. H., Leusen, J. H., Savelkoul, H. F., Warner, J. O., van Neerven, R. J., & van Ieperen-van Dijk, A. G. (2005). Effects of bovine immunoglobulins on immune function, allergy, and infection. Frontiers in Bioscience, 10(1-3), 2355-2363.
  7. Playford, R. J., & Weiser, M. J. (2021). Bovine Colostrum: Its Constituents and Uses. Nutrients, 13(1), 265.
  8. Prosser, C., Stelwagen, K., Cummins, R., Guerin, P., & Gill, N. (2006). Milking efficiency and milk quality of extensively managed, late lactation primiparous ewes milked once daily. Small Ruminant Research, 63(1-2), 146-153.
  9. Marchbank, T., Davison, G., Oakes, J. R., Ghatei, M. A., Patterson, M., Moyer, M. P., & Playford, R. J. (2011). The nutriceutical bovine colostrum truncates the increase in gut permeability caused by heavy exercise in athletes. American Journal of Physiology-Gastrointestinal and Liver Physiology, 300(3), G477-G484.

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6 Ways to Support the Lungs and the Internal Ecosystem in Fall – The Metal Season

6 Ways to Support the Lungs and the Internal Ecosystem in Fall – The Metal Season

With the major winds and storms we’ve been having in the DMV lately, Fall is OFFICIALLY here and in full swing! Earlier I posted about getting your body ready for the fall season and the Five Elements Theory in Chinese Medicine, and I’m here to reemphasize what that theory is all about and what you can do to help your body function well and stay healthy during the cold weather.

Chinese medicine practitioners look to The Five Element Theory to understand how our body systems interconnect together and are affected by the environment. In this theory, each element has a specific characteristic and connection to a specific season, climate, color, organ system, and emotion. For example, the element Metal is related to the Autumn/Fall season; a dry climate, the color white, the lungs, and the emotions of grief and courage.

But Why Metal?

Metal in the Five Element Theory represents all metals, minerals, gemstones and crystals on earth. The energy of these ‘metals’ is contracted and inward, similar to the dormancy of trees and plants in the winter. Additionally, there is a simplicity and purity needed to produce ‘metals’, a certain type of maturity, like fields ready for harvest in the fall. The metal energy is like the diamond inside of us - clear and pure. These are the characteristics that link metal to the season of fall.

Through the Five Element Theory, we are able to see the connections between the different systems in our bodies and relate them to the connections between the natural world around us; thus helping us understand how our bodies and the environment connect and can work together functionally. We are able to understand how the seasonal changes affect our health – seasonal health issues such as allergies, depression, weight gain/loss.

The Season of Change

With Fall/Autumn being the season of change, back to school, flu season, etc, it is also the season associated with our lungs, a dry climate, and the emotions of  grief and courage. There are so many new things coming into our lives and it is extremely important that we take the time to attend to practices that nourish our lives. Here are some super simple and nourishing tips and tricks that can help our health and minds during this draining and stressful season. 

Tips for your lungs:

1. Releasing excess energy using a “sssssss” sound when breathing out to help clear out our lungs of pathological excess – things that cause stress and disease – building up inside.

2. Taking walks outdoors to get our lungs acclimated to the cold weather – take these in moderation as you don’t want to overwhelm the lungs right away.

Tips for the dry climate:

3. Avoid excessive sweating – perspiration is another way to release our body’s essence, and you want to make sure to store it, especially come winter. This can help keep your skin moisturized and healthy during the cold, harsh weather.

4. Consume moistening seeds like sesame to also keep your body hydrated.

Tips for helping seasonal grief:

5. When waking up, take some time to get your body ready for the new day. Close your eyes, click your teeth, swallow your saliva, rub your hands together to warm them up, put your hands over your eyes suctioning them. This will help our eyes become more bright and illuminated during the season.

6. Getting to bed earlier and waking up at dawn will align your body to the environment’s cycle, causing your body and mind to calm and moderate it to the seasonal blow of colder weather and less sunlight.

These tips are credited to Gao Lian, who was a 16th century poet and medical scholar and thanks to one of my Chinese medicine mentors, Dr. Heiner Fruehauf, PhD, LAc, who translated Gao’s presentation on the four seasons from his Eight Pieces on Observing the Fundamental Principles of Life (Zunsheng Bajian; 1575 A.D.). Gao’s work is considered an all encompassing source of lifestyle information by Chinese physicians.

Interested in learning more ways to help connect your body to the environment? Reach out to me on the form below to create a customized plan based on your needs and goals. Stay tuned for future blogs relating our bodies to the other three seasons!

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The Veggie Mash

The Veggie Mash

We’ve all been told at least once in our life to make sure to finish all the veggies on our plates, and though they aren’t the most appealing part of the meal for some, they truly do make a world of difference to our health! Vegetables, greens, and even seeds are all packed with the nutrients our bodies need to move and, more importantly, flow the ways they should! There are a couple of different ways you can make sure to get both the right amount and the right types of vegetables into your diet without worrying about making your meals boring.

Since it is October and the “spooky season” I’m going to introduce you to the Naturopathic Doctor’s rendition of the Monster Mash – The Vegetable Mash! Just like that graveyard bash, this is a wonderfully fun concept to get you and your family eating more veggies in a way that is healthy AND delicious! The Veggie Mash is exactly what it sounds like, a blend of veggies that is then frozen and added into different meals such as smoothies and soups! It is a way to easily get our proper intake of vegetables for each meal without actually eating just vegetables.

You may be wondering, wouldn’t that taste overwhelming or not very good? And the answer is simply, no! These cubes of frozen vegetable mash can be served with delicious flavors such as chocolate and coffee to make sure that you actually enjoy the new meal you’re creating with them! Aside from adding to bone broth, soups, and smoothies, some of my favorite dishes to add the mash to are roasted root veggies - can be mixed in with the hot root veggies; warm quinoa - can be mixed in or added to in the very last minutes of when the quinoa is cooked, or to the pesto on top of my rice/ quinoa or almond pasta or spiralized zucchini. 

The Benefits:

So now that you know WHAT the Veggie Mash is, let’s talk about WHY you should utilize it to increase the amount of vegetables in your diet. The well-respected physician, Dr. Datis Kharrazian (link to his website) who inspired the veggie mash, has closely studied the benefits of vegetables in our diets. Some of the studies have shown that most chronic diseases such as diabetes, heart disease, and even Alzheimer’s are all associated with low amounts of vegetables in diet! 

Vegetables are our body’s primary source of fiber in our diets, making them great detoxifiers – leading us to better bowel and gut health. The natural bitters in vegetables naturally stimulate bile production in our bodies. The bile then delivers toxins from the liver to the gut, once there, the bile breaks down dietary fats in small micelles. These micelles then bind to the fiber created allowing them to be excreted from the body through the intestines. Without adequate bile production and fiber from consuming vegetables, toxins will build up in our bodies. The vegetables also create phytonutrients that are needed for our gut microbiomes to stay healthy, more diverse, and more immune robust.

A Clinical Win!

One amazing clinical win that I’ve had in my practice was with a patient who had been constipated for YEARS. This was a patient who already had a stellar diet and lifestyle practices on hand and in use. They had tried so many different approaches to getting regular prior to discussing her issues with me. They had gone through dietary changes, various herbal remedies, supplements, and even enemas and colonics, but nothing seemed to help their situation. When they came across the Veggie Mash, they were a bit pessimistic simply due to all the previous treatments they tried out. However, within a few weeks of simply introducing more vegetable diversity into their diet through this method, they were able to rid themselves of their struggle with consistent constipation! Simply adding more plant diversity to their diet shifted the health of their entire gut and body!

While educating all my patients about increasing their dietary diversity, particularly of vegetables and culinary herbs, can be a bit challenging for most patients to implement, this simple hack has made it much easier! My patients are my best teachers and seeing their success helps me to find more fun and reliable ways to grow my practice and encourage new things to help everyone live a healthier life!

The Veggie Mash Recipe:

Select 15 to 20 of your favorite veggies and culinary herbs - sample list below

Chop them up

Blend in small batches

Mix together in a large bowl

Add to silicone ice cube trays (I like to use the candy molds that craft stores have that come in fun shapes)

Freeze and add one cube to smoothies, broths, soups or other dishes 

  1. 1 beet with greens
  2. 3 asparagus spears
  3. 3 celery sticks 
  4. 3 small brussel sprouts
  5. 1 carrot 
  6. 1 small zucchini
  7. A few heads of broccolini  or 1 small broccoli bunch
  8. 5-6  kale leaves
  9. 1 handful of spinach
  10. 2 Swiss chard leaves
  11. 1/2 head of cauliflower 
  12. 1 wedge of red cabbage
  13. 1 handful of sugar snap peas
  14. 1 handful of green beans
  15. 1 small bunch of basil
  16. 1 small bunch of cilantro
  17. 1 small bunch of rosemary
  18. 3 green onions

Note: For those with food sensitivities or intolerance, the problem veggies can be removed and just increase the amounts of the other tolerated veggies. Other culinary herbs like parsley, thyme, and mint can be used. Other veggies can be used instead as well. For this recipe I typically avoid corn, nightshades (potatoes, tomatoes, eggplant, pepper), which not everyone can tolerate and potatoes and eggplant are just not good raw.

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Dr. Sarah is a naturopathic doctor, acupuncturist, and owner of Collective Health Center in Leesburg, Virginia. She loves helping patients learn how to optimize their modern lifestyle with simple and easy hacks, such as the veggie mash and teaching patients to learn how to use food as medicine. Learn more about her practice by filling out the form below.

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Alcohol, Immune Health and More: A Holiday PSA

Alcohol, Immune Health and More: A Holiday PSA

The holiday season is a particularly stressful time for many people – and this year has been extra, as the kids say. One theme I often see in my patients is a tendency to use alcohol to relax. Most do not realize they are consuming a moderate or heavy amount of alcohol and many are not aware of the various health effects associated with each. Especially during this season and with alcohol sales soaring in Virginia, I feel compelled to provide a public service announcement. On September 3rd, the Washington Post wrote: “The Virginia Alcohol Beverage Control Authority brought in $1.2 billion in revenue during the 2020 fiscal year in a nearly $120 million increase from the previous year, even as the coronavirus pandemic left restaurants and bars shuttered for months.” As a health care provider, while not shocking, this is concerning, especially given the known, deleterious health effects of alcohol on the immune system.

When we talk about alcohol and its effect on the body positive or negative, we really need to consider the amount we are talking about. A standard alcohol drink is 14 grams of alcohol which equals 12 ounces of beer (~5% alcohol), 8.5 ounces of malt liquor (~9% alcohol), 5 ounces of wine (~12% alcohol), 3.5 ounces of fortified wine (ie sherry or port), or 1.5 ounces of liquor (distilled spirits, 40% alcohol). Moderate alcohol consumption for women is, as considered by the USDA, to be no more than one standard alcoholic drink per day and for men no more than two standard alcoholic drinks/day. Heavy alcohol consumption for women is considered, by the USDA more than 7 standard alcoholic drinks per week or more than 3 standard alcoholic drinks in one day and for men more than 14 standard alcoholic drinks per week or more than 4 standard alcoholic drinks in a day.

 

Light to moderate alcohol consumption has some likely effect in cardiovascular disease, where it has been shown to reduce risk of plaque build-up and heart attack and deaths from heart disease. One to two alcoholic drinks/day increases protective HDL and Apo A1 cholesterol, decreases LDL, triglycerides and ApoB (an inflammatory cholesterol fraction), decreases factors that influence blood clotting, may decrease systolic blood pressure, has been shown to reduces inflammatory marker blood biomarker, hsCRP. However, light to moderate consumption does not seem to have any effect in men with already established coronary heart disease. This is a major caveat to be aware of as many people in the US already have evidence of established heart disease and with the obesity epidemic we are seeing heart disease in children. About half of all Americans are at risk for heart disease and heart disease is the leading cause of death in the United States. 

Although red wine has been touted as ‘better’ than other forms of alcohol there is no conclusive evidence from clinical studies. Often people point to the polyphenol resveratrol that is in red wine as a reason to drink. However, you would have to consume a TON of red wine to get any benefit from the resveratrol in it. Most of the resveratrol in supplements is not from grapes, but from Japanese knotweed - an herb that grows like a weed in the US. Also, most of the research on the single ingredient resveratrol is insufficient. However, Japanese knotweed with all of its many phytochemicals is a wonderful herb that has been used in Traditional Chinese Medicine for centuries for its properties that have immune supportive effects and anti-inflammatory effects. 

Additionally, fruits and veggies generally have more polyphenols than wine. Most people would do better to focus on getting 5-10 servings of veggies and a few fruits per day and herbals teas and avoid drinking alcohol. One of my absolute favorite herbals teas of late is Holy Basil or Tulsi – as it has both a calming and gentle energy boosting or stress managing effects as an adaptogen herb.

I have a lot of patients with estrogen dominance, which is having too much estrogen in ratio to progesterone which contributes to many common PMS and other female health concerns. Alcohol only exacerbates these symptoms. Additionally, I have many patients at increased risk for breast cancer, sleep disturbances and symptomatic menopause. I generally advise limiting alcohol in these populations. 

While many people use alcohol to help relax before bed, the medical evidence shows alcohol to be disruptive to the sleep cycle. Magnesium chelates, Epson salt baths, meditation area some examples of more effective and less harmful choices to help get relaxed before bed or to get relaxed in general. Stress cannot be drunk away, as a culture the research shows that we all may benefit even when a small group of individuals takes some time daily to meditate. No time for meditation? Consider tapping or the Emotional Freedom Technique, which is a simple and often effective method for helping to relieve mild stress and worry. 

Known risks of over consumption or dependence include: central nervous system effects (kills your brain cells, as alcohol is a cellular toxin), cirrhosis (liver inflammation and damage), malnutrition, and mouth/esophageal/ laryngeal/liver cancer. More than two drinks per day can increase the risk of cardiovascular disease and overall mortality. Light to moderate consumption can increase risk of hemorrhagic stroke. In women, one or more alcoholic drinks per day might increase risk of breast cancer by 2 to 15% and increase mortality from breast cancer as much as 30% (especially if daily intake of folate is 300 mcg or less). Alcohol consumption can also increase asthma and migraines in those sensitive to sulfites/ yeast. 

I have many patients with acid reflux who are drinking 1-2 drinks every night, possibly along with caffeine, and often soda. While it is no surprise to me, they are often pleasantly surprised when their acid reflux resolves after eliminating these known triggers. 

Because alcohol increases your liver’s detoxification pathway alcohol consumption, it can disrupt the metabolism of many medications. Birth control is a good example of this, it is not as effective when drinking alcohol, so using a second method of birth control during these times is particularly important if trying to prevent pregnancy. There are many other medications affected by alcohol consumption and if you take medications you should be sure to check with your doctor or pharmacist to see if any can be consumed with alcohol. 

If you have pre-diabetes or diabetes, you might consider reducing your alcohol consumption. While light drinking can contribute to low blood glucose, heavy drinking can cause insulin resistance, which leads to the development of type II diabetes. Heavy drinking can cause inflammation of the pancreas and destroy the pancreas’ ability to make insulin, leading to diabetes. Alcohol is nutrient light and high caloric. “One pint of lager can be equivalent to a slice of pizza.” Over-consumption can contribute to weight gain and obesity, an independent risk factor for many diseases.

A final note during this season is that alcohol consumption weakens the body’s immune system making it more susceptible to disease and infection. Drinking more than 3-4 drinks on a single occasion will suppress the immune system even up to 24 hours later. Chronic drinkers have higher rates of diseases like pneumonia and tuberculosis.

For further reading on this topic, Harvard’s Nutrition Source has a thorough summary of the research on alcohol and its effect on the body: http://www.hsph.harvard.edu/nutritionsource/alcohol-full-story/

Dr. Sarah is passionate about educating patients and getting to the root cause of their chronic, troubling symptoms; often alcohol is often a culprit that has not been thoughtfully considered. Dr. Sarah is honored to be a collaborative partner in her patient’s health at her practice Collective Health Center, in downtown Leesburg, Virginia. As the saying goes, ‘it takes a village’ – particularly when sensitive issues, such as dependence are involved, the primary care provider, the behavioral health specialist, the naturopathic doctor and others may need to work together to help get patients back on the road to wellness.

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B-Vitamins, Not Just for “Energy” – Essential for Immune Support & Resiliency! Part 2

B-Vitamins, Not Just for “Energy” – Essential for Immune Support & Resiliency! Part 2

When we hear B-vitamins, we often think of vitamin B12 and rightfully so, because this is an essential B vitamin for many functions in our body - see Part 1 for some more details and fun facts on vitamin B12 deficiency. However, there are 8 vitamins that make up the complex - these are essential for our cellular, nerve, cognitive, mood, immune health and resiliency! Also, recently I've seen many patients taking high doses of active B-vitamins, this can be problematic - more details to follow.

Folate (aka Vitamin B9): Folate is essential for healthy tissues as it is required in the synthesis of DNA and nerve formation. Deficiency is associated with neural tube and other birth defects in newborns. In the past several years genetics has been found to be a significant factor in human folate levels. There are many genetic variants or mutations that increase need for active or methylfolate in the body. There are common variants, however, some people have a number of these that can lead to a function deficiency of this important B vitamin. However, the solution is not always to supplement with loads of it either. While we need active folate for DNA repair, cellular healing, and detoxification, too much of it can promote pathways of growth that can promote cancer. Both deficiency of folate and excessive supplementation can promote cancer. The same goes for vitamin B12 and excessive supplementation with vitamin B12 as methylcobalamine. One of the most common genetic variants that involves folate is methylenetetrahydrofolate reductase (or MTHFR, and my patients have a few other nicknames for this). MTHFR is a common genetic variant, with at least 50% of the population having at least one genetic variant. When there are two or more variants the risk for issues including elevated homocysteine (which can lead to cardiovascular disease) increase as well as mental health concerns of anxiety, depression, and even schizophrenia. Just because one has a variant or even two of MTHFR does not mean that they need to supplement with methylfolate. It is important to look at the totality of variants related to methylation and to also consider clinical signs and symptoms. Small amounts of active or methylfolate as in a multivitamin or prenatal vitamin are likely safe, but amounts over 1 gram I have not seen to be clinically useful or helpful for the majority of my patients. On multiple occasions I've seen higher doses cause aggravations of anxiety and a few occasions I've even seen the amount in a multivitamin be aggravating. Rarely, there are patients whose genetic need does require a higher dose of supplementation. The bottom line is that it is important to consider genetic methylations in totality, rather than just looking at a single variant to inform possible supplementation and work with a provider who has some training around this. Additionally, lifestyle, including a wholefoods diet, adequate sleep, positive outlook, and exercise all have positive impacts on genetic function, and should be the foundational approach to wellness generally. Folate takes its name form foliage, and green leafy vegetables, along with asparagus, broccoli, and brussels sprouts are all great sources of folate along with legumes. Heating foods does cause significant looses of folate. 

Thiamin (aka Vitamin B1): Thiamin is extremely important for blood sugar regulation in the body and a healthy nervous system. Thiamin is require for formation of its coenzyme, thiamin pyrophosphate (TPP), which helps to convert sugars and ketones into energy. I have seen this to be consistently deficient in patients with Type I diabetes, and in many patients with Type 2 and pre-diabetes. I have additionally seen deficiencies in those who consume alcohol daily or regularly. Patients on dialysis, tube feeding, and those with chronic infections are also at risk for deficiency. The main food sources of thiamin are unrefined grains, meats, nuts, and legumes. Deficiency, as I've seen it clinically, typically presents with cognitive deficits (brain fog, memory loss, easily confused) and neuropathy in the hands or feet. Cardiovascular symptoms such as edema or swelling and rapid heart rate can also occur with deficiency. When the blood sugar is elevated we can end up with neurologic issues from cellular damage - thiamin is an important, but often under-considered B vitamin in blood sugar management and amid such symptoms. As with many of our B vitamins genetics can play a role in how well we bind TPP - so some folks who are at high risk for deficiency due to genetics will be at even higher risk for deficiency and related neurologic deficits with regular alcohol consumption.

Niacin (aka Vitamin B3): is essential for the synthesis of coenzymes required for the energy production cycle. Simply stated, without this we cannot produce energy. Thankfully, I rarely see deficiency of this in practice, as it is widely available from common meat, fish, poultry, vegetable (tomatoes, mushroom, corn, and potatoes), grain (wheat, barley, rice) sources and peanuts. Because of the importance of niacin, along with riboflavin, niacin and iron and the fact that the milling of grains results in a loss of it, in the early 1940s the US government established enrichment standards for processed grain products such as bread, pasta and cereals. I recommend wholefoods as the primary source of food, then loss of nutrients at least through processing, is not such a concern.

Riboflavin (aka Vitamin B2): Like niacin, riboflavin is essential for the synthesis of coenzymes required for the energy production cycle. I rarely see severe deficiency of riboflavin in practice. Common food sources are dairy products, enriched grains, meat and eggs, with smaller amounts in some vegetables (spinach, mushrooms, soybeans). Those on vegan diets are more at risk.

I will write more about one of my favorite B vitamins, pyridoxine (vitamin B6), and another favorite pantothenic acid (vitamin B5), as well as biotin (vitamin B7), in my next blog.

I highly recommend working with a provider who is specifically trained in nutrition, including nutritional supplementation. While it may seem harmless to take an over-the-counter, generic vitamin supplement, nothing beats sage advice from a skilled provider. Naturopathic doctors are the only healthcare providers specifically trained in drug-herb and drug-nutrient interactions.

Sarah Giardenelli is a naturopathic doctor and acupuncturist with over 10 years of experience. She enjoys working with patients to solve their complex health concerns. She is a considers the whole picture, recommends the least invasive, natural approaches first and considers lifestyle approaches as foundational for health for her patients at Collective Health Center.

 

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