Thyroid Health: Keed to know info! and the 6 thyroid tests you need to ask for from your Doctor

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(adapted from Dr.Aviva Romm, MD, 2014)

I see a lot of patients that complain of weight gain, fatigue, constipation, dry skin, PMS, and complaining of always being cold. All these symptoms point to the possibility of hypothyroidism, or under active thyroid function. Sometimes, their TSH (thyroid stimulating hormone), the most common test for thyroid function, has been tested and may still fall into the “normal range”. However, TSH is only one of the markers for abnormal thyroid function, and many patients are unaware that there are other tests that can give a much better picture of thyroid health and function.

Statistically, hypothyroid is an under diagnosed condition. In fact, in the US only ½ of Americans that have hypothyroidism know it.

What is the Thyroid?

The thyroid is a butterfly-shaped gland that sits at front of your neck and controls your metabolism. It therefore controls your weight, energy levels and also plays a role in cholesterol and hormone production.

When the thyroid is out of balance and not functioning optimally you can gain weight, have sluggish bowels, experience dry skin, have fertility problems, brain fog and feel tired…even if you have a great diet and activity level!

The Key Thyroid Tests

Thyroid tests should be easy to obtain from your primary doctor, naturopathic doctor or functional medicine doc. However thyroid tests do take some skill to interpret and some docs may be reluctant to order more than a TSH test. If this is the case, consider getting a second option by a doctor that is familiar with thyroid health and testing.

Thyroid Test #1: TSH (Thyroid Stimulating Hormone)

TSH is the commonly order thyroid test. This hormone is produced by the pituitary gland (a small gland in your brain). TSH communicates with the thyroid to tell it to produce more thyroid hormones T3 and T4. When all is going well in the body, TSH is in a normal healthy range and so is T3 and T4. When T3 and T4 (those important thyroid hormones produced by the thyroid gland) are LOW, TSH starts to INCREASE, telling the thyroid gland to produce more T4 and T4.

The “healthy TSH range” has become a somewhat controversial topic in medicine. Most Canadian labs consider the upper range of TSH to be 4-5mU/L. However, many experts, including many conventional endocrinologists, consider the upper limit of TSH should be no higher than 2.5-3mU/L. This is based on the data collected on Americans without any hypothyroid symptoms. When they have a TSH test done, this is the common upper range.

Thyroid Tests #2 and #3: T3 (Triiodothyronine) and T4 (thyroxine)

As mentioned above, T3 and T3 are hormones produced by your thyroid gland. T4 is produced in much higher amounts by your thyroid gland, and then is converted into T3 in the periphery. This is important because T3 is the more active form of thyroid hormones and is necessary for proper metabolic function.

Thyroid Tests #4 and #5: TPO and TGAb (Thyroid Antibodies)

As mentioned previously, autoimmune hypothyroidism is the most common cause of hypothyroid. As with any other health condidition, to achieve optimal health we must look at the underlying cause of the problem. If a patient has hypothyroidism, but does not address the autoimmunity (if present), the problem will not be addressed at the root cause. Thyroid antibodies can also be measured every 6-12 months to gauge how thyroid treatment is progressing.

Thyroid Test #6: Reverse T3 (RT3)

Although there is some controversy over the usefulness of this test, I have personally found it of benefit in my practice, especially if hypothyroid symptoms are persisting despite treatment. Sometimes, when the T4 is being converted to T3, it can be converted into RT3, a less active form of T3 that the body cannot use as well as T3. This can happen is one is under a large amount of stress or is sick. If the patient it producing a large amount of RT3, certain medication or supplements can help replenish the body with T3 and encourage the body to produce T3 over RT3.

If you have an inkling that your thyroid health is sub-optimal and your doc is not open or familiar with thyroid testing, consider switching docs or having a second opinion.

Yours in Health,

Dr. Emily

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Infusion Health Stress Reduction Techniques for Corporate Culture: A recap from our corporate wellness seminar in Toronto last week

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Last week Infusion Health had the pleasure of working with BHP Biliton, providing helpful stress reduction tips and tricks.  Here is a recap of some important points from our interactive workshop.

 

1. Cell phones can impact stress levels!

A study by the Families and Work Institute found that 1 in 3 US employees’ feels chronically overworked? Cell phones and email are partly to blame: “Better technology hasn’t meant that we can work from anywhere, anytime,” says Ellen Galinsky, president and cofounder of the institute. “It’s meant that we can work everywhere, every time.” (Families and Work Institute, 2014)

Turing off your phone for even 1 hour can help one to relax and improve mood.

2. Work is stressing Canadians out!

Work appears to be the #1 source of stress for Canadians

The majority of highly stressed workers (62%) identified work as their main source of stress. Clustered far behind were financial concerns and not having enough time (both at 12%), family matters, and personal and other issues such as relationships, health and generalized worries These proportions are very similar to those reported in 2005(Stats Canada 2011)

3. Try herbal teas, such as holy basil, instead of coffee.

Holy basil (Ocimum sanctum) can help the body’s natural response to physical and emotional stress. Multiple scientific studies have found that supplementation with Holy Basil tea have helped lower cortisol levels in the body (the hormone that is associated with stress). This tea is easily found at most grocery stores in the natural foods section

 

3. Integrate relaxation techniques into your daily life.

It can be deep breathing, meditation, exercise, yoga or another technique to help you relax. Whatever it is, these techniques that help us calm down are so important for our health! Read on for steps on Progressive Muscle Relaxation- this technique has been proven to help relax and improve focus in treatment groups.

PMR is a two-step process in which you systematically tense and relax different muscle groups in the body. PMR brings awareness to tension and relaxation in different parts of your body. Combined with deep breathing, this awareness can help you counterbalance the feelings of stress in your body.

***Warning: Consult with your doctor if you have a history of muscle spasms, back problems, or other serious injuries that may be aggravated by tensing muscles before trying PMR.

Most progressive muscle relaxation practitioners start at the feet and work their way up to the face. Follow the steps listed below for a complete PMR body sequence (adapted from http://ndarc.med.unsw.edu.au/sites/default/files/ndarc/resources/AppendicesCC.pdf)

  • Loosen your clothing, take off your shoes, and get comfortable.
  • Take a few minutes to relax, breathing in and out in slow, deep breaths.
  • When you’re relaxed and ready to start, shift your attention to your right foot. Take a moment to focus on the way it feels.
  • Slowly tense the muscles in your right foot, squeezing as tightly as you can. Hold for a count of 10.
  • Relax your right foot. Focus on the tension flowing away and the way your foot feels as it becomes limp and loose.
  • Stay in this relaxed state for a moment, breathing deeply and slowly.
  • When you’re ready, shift your attention to your left foot. Follow the same sequence of muscle tension and release.
  • Move slowly up through your body, contracting and relaxing the muscle groups as you go.
  • It may take some practice at first, but try not to tense muscles other than those intended.
  • Lower Legs (Left foot/ Left Calf) – point feet towards face, and then curl them downward all toes at the same
  • Thighs – Clench them hard
  • Hips and Buttocks – Press your buttocks together lightly
  • Stomach – Suck it into a tight knot ( looking at the chest and stomach for tension)
  • Back – Arch your back up and away from the chair (or floor)
  • Shoulders – Shrug them ( raise toward your ears)
  • Biceps and Upper Arms – Clench your hands into fists, bend our arms at the elbows, and flex your bicep
  • Wrists and Forearms – Extend them, and bend your hands back at the wrist.
  • Hands – make fist and clench them
  • Chest – Take a deep breath, and hold it
  • Front of the Neck –touch your chin to your chest
  • Back of the Neck – Press Neck against floor, or imagine pressing against a car seat
  • Mouth – Press your lips together tightly ( use only your lips – check your face for tension)
  • Cheeks and Jaws – Smile as widely as you can
  • Eyes and Bridge of the Nose – Close your eyes as tightly as you can ( remove contacts first)
  • Forehead – Wrinkle it into a deep frown

We would love to hear from you! How to you relax?

For more information on Infusion Health’s wellness workshops and seminars please email info@infusionhealth.ca or visit http://www.infusionhealth.ca

In Health,

Dr. Emily

How Naturopathic Medicine Can Help Manage Sleep Apnea

Sleep apnea can be caused by a blocked upper airway (called obstructive apnea), by your brain not signaling your lungs to breathe (central apnea), or by a combination of these two problems.

 

What Causes Sleep Apnea?

Many physical conditions, such as being overweight, or having large tonsils and adenoids, can cause sleep apnea. Sleep apnea is also linked to medical conditions, such as high blood pressure and diabetes.  Additionally, some individuals may have low thyroid function, causing them to gain weight and feel tired. The typical person with sleep apnea is an overweight, middle-aged man with allergies. However not everyone with apnea is overweight!  Apnea can happen at any age, regardless of weight and is found in women as well. Sometimes drugs, such as alcohol, sleeping pills, or heart medications, can trigger apnea. It can also be inherited.

Not getting enough sleep can lead to more problems such as anxiety, depression, brain fog and more weight gain.

The treatment of sleep apnea often requires breathing devices, dental devices or surgery. However, Naturopathic medicine can be a great adjunct therapy to increase your overall well being.

Dr. Emily Lipinski, ND uses a combination of evidence based therapies, including dietary and lifestyle changes, supplements, botanicals and acupuncture to treat the underlying cause of the disease.

Conditions treated include:

Weight loss

Allergies

Hypertension (high blood pressure)

Hypercholesterolemia (high cholesterol)

Insomnia                                                                                            

Diabetes

Hypothyroid

Depression/Anxiety

Stress

Working on proper sleep hygiene (i.e. no watching TV or looking at computers right before bedtime!) can also greatly benefit the ability to fall asleep and the quality of sleep.

Take care of yourself! Find a Naturopathic Doctor that can help you have a more restful sleep so you can lead a happier life!

Linoleic acids and Gamma Linolenic Acids (GLAs)

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Studies have found that consumption of linoleic acids (an essential fatty acid) and vitamin C decrease drying and wrinkling of the skin.  Linoleic acid plays a key role here because once ingested, linoleic acid turns into gamma linolenic acid also known as GLA. Through a series of steps, GLA is eventually converted to prostaglandin 1, which has an anti-inflammatory effect on the skin and is also effective in regulating water loss and protecting the skin from damage. You can also supplement with evening primrose oil or borage oil, both contain high amounts of GLA.  Watch my video with the wonderful Kristen Ma to learn more about evening primrose oil here: http://www.youtube.com/watch?v=O-ClA89C-K0.

Walnuts contain both linoleic acid and omega 3 fatty acids.  This is excellent because in our western diets we tend to have a higher amount of omega 6 fatty acids compared to omega 3 and this can cause an imbalance.  Additionally, some of the major sources of omega 6 fatty acids in the western diet come from corn, wheat and soy bean oil.  These have been heavily modified and now cause digestive and health problems for many individuals.

A handful of walnuts make a great snack, or can be added on top of a salad or are great additions when baking healthy treats.

Why green tea (camellia sinensis) is Great

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I’m sure most people have heard that green tea is good for you.  It’s well known that green tea MAY encourage weight loss (there is conflicting evidence on this) and that it is high in antioxidants. However you may not be aware of how GREAT green tea is for health. Camellia sinensis contains a group of flavonoids called “catechins”.  One particular catechin called epigallocatechin 3 gallate (EGCG) is thought to play a critical role in many of green teas benefits.  Here are 3 more reasons why this tea is so great:

  1. CANCER PREVENTION: drinking green tea is associated with a reduced risk of pancreatic, esophageal bladder cancer and ovarian cancer.  In fact, one study showed that woman who drink 2 or more cups of green tea a day have a 46% lower risk of developing ovarian cancer compared to those who do not regularly drink green tea.  Research continues on various other anti-cancer properties and applications of green tea.
  2. CERVICAL DYSPLASIA: Green tea applied topically or taken orally appears to reduce cervical dysplasia caused by the HPV virus
  3. Protection against harmful UV RAYS: oral and topical applications of EGCG from green tea may help protect photo-aging from the suns harmful uv rays

It is best to use water no higher than 80 degrees Celsius to brew your green tea, as higher temperatures can make the tea taste bitterer and also may decrease some of its healthy properties.

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Works Cited:

Ohno Y, Aoki K, Obata K, et al. Case-control study of urinary bladder cancer in metropolitan Nagoya. Natl Cancer Inst Monogr 1985;69:229-34.

Wakai K, Ohno Y, Obata K. Prognostic significance of selected lifestyle factors in urinary bladder cancer. Jpn J Cancer Res 1993;84:1223-9.

Bushman JL. Green tea and cancer in humans: a review of the literature. Nutr Cancer 1998;31:151-9.

Nemecz G. Green tea. US Pharm 2000;May:67-70.

Mitscher LA, Mitscher LA, Jung M, Shankel D, et al. Chemoprotection: a review of the potential therapeutic antioxidant properties of green tea (Camellia sinensis) and certain of its constituents. Med Res Rev 1997;17:327-65.

Larsson SC, Wolk A. Tea consumption and ovarian cancer risk in a population-based cohort. Arch Intern Med 2005;165:2683-6.

Ahn WS, Yoo J, Huh SW, et al. Protective effects of green tea extracts (polyphenon E and EGCG) on human cervical lesions. Eur J Cancer Prev 2003;12:383-90.

Elmets C, Singh D., Tubesing K. et al, Photoprotection from ultraviolet injury by green tea polyphenols. J Am Acad. Dermatol 2001;44:425-432

Suggestions for Chronic Pain and Inflammation

Pain is a very complex phenomenon that combines information from the nervous system with emotions, thoughts and social context.  Pain is also highly individual and subjective and can be related to depression, anxiety, diet and stress.  There are also many conditions that cause for chronic pain.  These include but are not limited to: rheumatoid arthritis, osteoarthritis, irritable bowel disease, fibromyalgia and chronic headaches.  The pathophysiology of chronic pain is complicated,  not wholly understood and also differs dependent on the individual and thier underlying condition. Therefore, I am not going to get into these details  in this post.  However, I am going to offer some alternative suggestions for pain management.

1. Food Sensitivities

A food sensitivity is different than a food allergy. Individuals with food sensitivities have DELAYED reactions to specific foods that are triggered by IgG antibodies.  In an IgG reaction the IgG antibodies attach themselves to a food antigen creating a antigen antibody complex. If present in high amounts these complexes can accumulate in cells and can lead to inflammation, in turn promoting pain or disease.  Many naturopathic doctors and some medical doctors can run tests to measure your levels of IgG in regards to various different foods. Additionally, special diets can also help to identify specific foods that may be causing an IgG reaction.  If you have IBS, IBD or any other condition associated with inflammation discuss the possibility of food sensitivities with your naturopathic doctor.

2. Cognitive Behavioral Therapy (CBT)

CBT helps individuals to identify and develop skills to change negative thoughts.  It also encourages a problem solving attitude and involves homework to keep track of thoughts and feelings associated with pain. CBT has been shown to be effective in alleviating jaw pain, migraine headaches, and in rheumatoid conditions.

3. Trans cutaneous Electrical Nerve Stimulation (TENS machine)

The TENS machine produces an electric current that stimulates the nerves over or around the area of pain.  It has been shown to be effective for some individuals in helping to control acute and chronic pain by either interfering with the pain response or by desensitizing the nerves involved in pain signalling. It is best to try the TENS machine with your ND, MD or physiotherapist to explore if this method of pain management is of benefit to you.  If so, you can purchase one from some drugstores or online and use frequently at home.

4. Acupuncture

Acupuncture is a procedure that involves the stimulation of specific point on the body be inserting fine needles into the skin.  According to Traditional Chinese Medicine, acupuncture corrects the imbalance of qi, or vital life force, that flows through us and thereby promoting wellness.  In a review article of 24 studies, acupuncture has been shown to have a 70% efficacy in treating pain compared to placebo.  Both naturopathic and traditional chinese medicine doctors can administer  acupuncture in Ontario.

5. Supplements

There are various supplements that have been shown to be effective in managing pain and decreasing inflammation.  However, appropriate and effective supplementation is based on the individual and their underlying conditions.  Talk to your naturopathic doctor about what supplements would be best for you.

  1. Van Delmen AM, Fennis JF, Bleijenberg G. Cognitive Behavioral group therapy for irritable bowel syndrome, effects and long term follow up. Psychosom Med 1996;58:508-514.
  2. Dworkin SF. Behavioral and educational modalities. Oral Surg Oral Med Pathol Oral Radiol Endod 1997;83:128-133.
  3. Arathuzik D. Effects of cognitive-behavioral strategies on pain in cancer patients. Cancer Nurs 1994;17:207-214.
  4. Johnson M, Martinson, M (2006). “Efficacy of electrical nerve stimulation for chronic musculoskeletal pain: A meta-analysis of randomized controlled trials”. Pain 130 (1): 157–165. doi:10.1016/j.pain.2007.02.007
  5. 5. Reichmanis M, Becker RO. Relief of experimentally induced pain by stimulation oat acupuncture loci: a review. Comp Med East West 1977;5:281-288.
  6. Photo Creds: thediarymom.blogspot.com, http://www.istoppain.com, http://www.building-muscle101.com, http://www.supplementfarmer.com

SPRING DETOX

Happy First week of Spring!!

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Despite the snowfall in Toronto at the moment, it is in fact SPRING!  And, spring time means cleansing time 🙂  I am excited to be giving a talk on the ins and outs of detoxing on APRIL 10th at 7:30 at ECOEXISTENCE, located at 766 ST. CLAIR WEST TORONTO.  It is free to attend so just show up if you would like to learn more about why we need to detox, how our bodies detox and the best medicines, supplements and lifestyle tips for detoxing !

I recently wrote a guest blog for the wonderful Kristen Ma of Pure + Simple on detox.  If you would like to read what I will be talking about April 10th find it here:

http://www.holisticvanity.ca/detoxification-debunked/