bloating Archives | Linden and Arc

Are you hot flashing? Having headaches, memory loss, fatigue? And, the dreaded weight gain around the middle? You are not alone!

Menopause can be a difficult time for many women. Symptoms additional to the above can include low libido and anxiety. It’s not the easiest time of life, but there are ways to approach the hormonal shifts. At Linden & Arc Vitality Institute, we are here to help.

What’s up with the hormones?

Hormonal changes begin as ovulation ceases – your progesterone decreases. The balanced ratio of estrogen to progesterone begins to tip toward estrogen. Estrogen is the hormone that makes you feel sexy, happy, and full of life.

Sounds good right? So, what’s the problem?

Changes in estrogen can also affect our thyroid hormones and cortisol levels. Excess estrogen may cause bloating, fatigue, headaches, poor sleep (see Smith, 2010, p. 7 or Somers, 2006, p. 38 for a full list). The balance of estrogen and progesterone is lost during hormonal shifts. The decline in progesterone, which is the hormone that makes you feel calm and relaxed, can cause you to feel more anxious, irritable, and depressed. Imbalances in hormones can impact your brain health, memory, and immune system. That’s why those pesky symptoms start to show themselves.

With a functional medicine approach, where there is a partnership between physician and patient, the menopausal years and beyond can be the best time of your life. The best time of life? Yes, really! Your vital energy can be cultivated by working to balance your hormones.

How is it possible to live the best life during menopause?

Taking a functional medicine and holistic approach, women do not have to suffer the symptoms associated with this stage of life. Anxiety, stress, sleepless nights, and weight gain don’t have to be the fate of the middle years – and your physical middle! Here are some tips towards finding balance by adjusting your lifestyle factors with mind, body, spirit and soul at the center of your healing journey:

Body:

eat a whole foods diet with as much organic fruit and vegetables as possible
make sure to eat enough lean protein and keep sugars to a minimum
add 10 to 15 minutes of body-focused stretching or exercise to your daily routine
add 3-minute breathing practice when you wake up and before bed

Mind:

read a book about your menopausal health; the top two books we recommend and have in stock at Linden & Arc Vitality Institute, are: Ageless by Suzanne Somers and What You Must Know About Women’s Hormones: Your Guide to Natural Hormone Treatments for PMS, Menopause, Osteoporosis, PCOS, and More by Pamela Wartian Smith, MD, MPH.
talk to your physician about hormone replacement therapy and options to consider; read about bioidentical hormones in Somers’ book.

Spirit & Soul:

practice each day that connects you to that which matters most
tune in a few minutes each day with practices such as: walking in nature, touching the leaves of a plant, prayer, meditation

With mindful planning and sustainable routines for body, mind, and spirit, post-menopausal women can come into the fullness of their power, creativity, and joy.

Some bonuses of this time of our lives: Women in their fifties and beyond often talk about no longer worrying about pleasing others, finding their voices, and having the confidence to change intolerable situations. With a balanced body, a sharp mind, and full vitality, life after menopause has no limits. Getting through the trials of menopause can be an adventure and a deep dive into your self – body, mind, and soul.

References:

Somers, S. (2006). Ageless: The naked truth about bioidentical hormones. Three Rivers Press.

Wartian Smith, P. (2010). What you must know about women’s hormones: Your guide to natural hormone treatments for PMS, menopause, Osteoporosis, PCOS and more. Square One Publishers.

Author

Lisa Itzcovitch, MA

The chronic illness called Mast Cell Activation Syndrome (MCAS) describes a process in which mast cells become overreactive. It is a chronic, multi-system illness that can mimic many other diseases. Symptoms include fatigue, rash, foggy thinking, joint pain, palpitations, itchiness, insomnia, thyroid problems, gas, bloating and swollen lymph nodes.

These symptoms often boggle health care professionals who cannot make sense of how they are all related. In fact, doctors sometimes label many patients as having a psychosomatic illness or a diagnosis that these symptoms are “all in their head”. These patients can be puzzling to even integrative doctors, who treat their guts, prescribe chelation therapies, drastically change their diet and lifestyle, and treat chronic infections, only for the patients to not feel better at all.
(Please note that MCAS is very different from mastocytosis, a rare form of blood cancer.)

What are Mast Cells?

Mast cells are white blood cells that are part of our immune system. You’ll find them in all tissues but most prominently in the mucosa (our first line of defense to the outside world), and vascular tissue. Mast cells are most often seen in tissues of the gastrointestinal tract, skin, and genitourinary system but MCAS can present in all body systems. Each mast cell contains over 200 chemical signals, or cytokines, the most well-known of which is histamine.

What is the Function of the Mast Cell?

The main job of the mast cell is to connect the immune system to the nervous system, both through direct contact and indirectly, using cytokines. It is the mast cell’s job to sense things from our environment and tell our nervous system whether or not these things are a threat. If we are exposed to an infection or a toxin, the mast cell activates and releases cytokines. Cytokines tell the nervous system to ramp up and eradicate the threat.

Mast Cell Activation Syndrome Results from Hyperreactive Mast Cells

Things start to go wrong when the mast cell becomes over-responsive to “non-threats”. It can see something as simple as a food, cold temperatures, a stressful event, or even a smell as being threatening. It then overreacts and explodes, releasing all of the symptom-causing cytokines. What catalyzes this is not often known. In secondary MCAS, the trigger can be something like an infection from mold, Lyme, or a virus. Primary MCAS is usually from earlier on in life and possibly caused by ‘mutations’ in the mast cells. With so many potential toxic triggers in our world today, it’s only a matter of time before mast cells start to misbehave in a susceptible individual. When we don’t know what the cause of MCAS is, whether it be primary or secondary, we call it idiopathic MCAS. The good news is that the management for each kind of MCAS is very similar.

How Do We Diagnose MCAS?

In short, we diagnose MCAS with difficulty. You can only measure about 10 of the 200 mediators that the mast cell releases. Additionally, these mediators are in and out of the bloodstream within seconds, even though their effects are long-lasting.

Looking at the Symptoms

MCAS is often a clinical diagnosis, looking at the various symptoms that a patient has. It may be the case that the lab tests we are able to do come back as negative, but a diagnosis can still be made. However, diagnosing by symptoms is not straight-forward. Patients may present with seemingly unrelated symptoms, expressed in all systems in the body.
The symptoms will depend on which mediators are released, and in what tissues they are released. The symptoms do not always make sense and are not reproducible by the same trigger. For example, on one day a certain food may trigger a cytokine storm, but on the next day, that same food has no effect. The symptoms sometimes come on without any known trigger, and the effect can be acute or chronic, local, or remote. Patients become very scared of the symptom’s unpredictability. Many patients are misdiagnosed for years and often their entire lives.

Treatment options for MCAS

The main steps in treatment are to try find what the initial trigger is and to stabilize the mast cells. In many cases, the trigger is a chronic infection. Mold is one of the most potent mast cell triggers and is more common than you would think. Mold susceptibility is genetically determined. About 25% of people having the genes which make the body unable to recognize and clear mold when exposed. In the case of MCAS, we can stabilize mast cells, but unless we treat the mold as well, patients often won’t get better. Other examples of triggers are Lyme disease, Bartonella (a Lyme coinfection), Candida, and toxic and environmental triggers.

Identifying Triggers of MCAS

To help identify triggers, it may be useful to keep a diary of symptoms. You can then trace back the minutes and hours before a flare to figure out what may have been the trigger. In the cases of medication reactions, people often react to the fillers or inactive ingredients and not the medication itself. Sometimes there are many triggers and it is difficult to figure out what they are.

Stabilizing Mast Cells

We can stabilize the mast cells using various supplements and medications. Any given patient may respond better either to supplements or to medications, but not often both. One patient may respond beautifully to one supplement and for the next, it will have no effect. Unfortunately, it often takes some trial and error, which can be quite frustrating for patients as many of the treatments fail to work at all. Therefore, when trialing treatments, physicians must do this in a methodical way and the patient should be prepared for the fact that this can take many months to get right. The type, dosage, and frequency of treatment needs to be constantly tweaked, usually, each step taking 2-4 weeks. Also, sometimes the treatments we give for MCAS can trigger more symptoms.

Treatments for MCAS

It is important to be realistic about possible treatment outcomes. Not all patients can be completely cured of MCAS and may need treatment lifelong, especially when we do not know what the trigger is. You may not feel perfect and there may be many ups and downs, but most patients will feel better after some trial and error to create a personalized plan.

A low histamine diet may work for some, but not others. Physicians can trial for a period of 2-3 weeks and if no noted differences, will be stopped. Generally, this entails avoiding leftovers and over-ripe fruits, foods with innately high histamine, like fermented foods, aged cheese, vinegar, alcohol, and canned fish. There are also foods that easily release histamine when eaten, like strawberries, spinach, nuts, tomatoes, and shellfish. Doctors encourage patients to begin a low mold diet if mold is involved.

The treatment for MCAS can sometimes be both therapeutic and diagnostic. That is, if you get better with the treatment, you likely have MCAS, even if we have not been able to prove it in any other way.

Contact Us

Our team at Linden & Arc Vitality Institute understands that MCAS is a complex and frustrating road to travel. We are equipped to guide you on the path to your best health. If any of the above symptoms sound familiar, please contact us at [email protected] to book an appointment.

Author

Dr. Michelle van der Westhuizen, MD

What is SIBO?

Small Intestinal Bacterial Overgrowth (SIBO for short) is a condition that affects 60% of people with IBS. It involves the overgrowth/accumulation of bacteria in the small intestine, an area of the intestinal tract which under normal circumstances (unlike the large intestine) hosts hardly any bacteria at all.

SIBO is not only prevalent in patients with Irritable Bowel Syndrome (IBS). 67% of patients with Celiac disease, 81% of patients with Chronic Fatigue Syndrome, up to 88% of patients with Crohn’s disease, 93% of patients with Fibromyalgia and the list goes on:

Diabetes mellitus – 8-44%
Immunodeficiency syndromes – 30-50%
Obesity – 70%
Parkinson’s disease – 54%
Rosacea – 46%
Ulcerative colitis – 81%
Interstitial Cystitis – 81%

If SIBO is so common, why is it rarely talked about?

It is only in the last decade that the importance of our intestinal bacteria and bacteria overgrowth has become fully recognized. The year in which the Human Microbiome Project was launched (2007), knowledge of the human microbiome expanded. Prior to this ‘pro microbiome era,’ western society had an extended love affair with hygiene, cleanliness, and anti-bacterial products. Our germ-aversion fuelled by a growing consumer market for anything anti-bacterial led us to believe all bacteria are bad.

Our Growing Knowledge of the Microbiome

With our growing knowledge of the human microbiome, we now appreciate that certain bacteria are not only beneficial to us, they are essential to our survival and ability to thrive as a human species. A whopping 90% of Serotonin, our happy hormone neurotransmitter, is produced by the bacteria in our gut?

However, it is not only the number of intestinal bacteria that impact our health so dramatically, it is also the diversity, the balance between beneficial and potentially harmful bacteria, and, very importantly, which part of the gut they are colonizing.

This fairly recent understanding has led scientists to recognize SIBO as one of the most common underlying root causes of intestinal dysbiosis, and of irritable bowel syndrome.

Unfortunately, highly sensitive and specific testing to confirm the diagnosis of SIBO has not yet become widely available. As a result, SIBO has been one of the most common but also most underdiagnosed digestive problems.

What are the Signs & Symptoms of Small Intestine Bacterial Overgrowth?

Abdominal cramps
Bloating
Diarrhea
Constipation
Gas
Floating / greasy stools
Vitamin B12 malabsorption
Weight instability

What to do if you suspect you have SIBO

If you think you have SIBO, talk to your health care provider expressing your intention to gather more information. This small gesture is so beneficial in maintaining a trusting relationship. Who knows, you might encourage your physician to join you in learning more about this common condition!

Learn More About SIBO

Click here to read this article is a good starting point for health care providers who would like to learn more about SIBO. There are some basic principles to follow when treating SIBO. However, it is crucial that the underlying root cause (why you developed SIBO in the first place) is properly identified and addressed in order to prevent a recurrence. This is why it makes sense to seek help from a functional medicine-trained health care provider.

If you suspect you might have SIBO, or struggle with undiagnosed digestive concerns, contact Linden & Arc Vitality Institute, Our collaborative care team can support you in finding the root cause and healing your gut! Email us at [email protected] to schedule an appointment.

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