Was it Something I Ate? Gluten Intolerance and Celiac Disease

What is gluten? Gluten, or gliadin, is a protein found in wheat, barley, and rye. It can also be found in many grains that are processed in the same equipment as wheat, most commonly oats. This occurrence is called cross-contamination.

Those who are sensitive to or intolerant of gluten have an immune reaction. The soldiers of the belly and the rest of the body are designed to keep out the enemy. Gliadin protein is large and generally inflammatory, and when it gets through the intestinal layers without being digested, it will appear as an enemy. The body’s soldiers rise to the occasion and begin to remove this enemy along with any cellular tissue that looks like gluten proteins. Most commonly, this is the tissue of the thyroid, joints, and intestines. Gluten sensitivities may also be exacerbated by genetically modified (GM) foods. GM foods have been related to the following conditions that affect gluten-related disorders: intestinal permeability, imbalanced gut bacteria, immune activation and allergic response, impaired digestion, and intestinal wall damage. A gluten-free diet is the first line of treatment for most thyroid and chronic pain patients.

Individuals have different levels of immune reactivity. IgA reactivity may show only belly symptoms but IgG reactivity usually shows many symptoms throughout the body; IgE is where it crosses the line into Celiac, which is an autoimmune disease. Celiac disease symptoms are the most severe. Gluten intolerance is much more common than Celiac, and symptoms range from tolerable to intolerable depending on the amount consumed. The more gluten-intolerant people eat gluten, the worse things get.

If you feel your body or your child’s body is inflamed, you should consider a six-week trial of a gluten-free diet. Here are some of the health issues a gluten-free diet can help address:

-Behavioral issues in children

-Developmental delay

-Controlling blood sugars

-Autoimmune diseases like MS and Lupus

-Abdominal problems

-Pooping problems

-Fibromyalgia

-Rashes

-Infertility

-Osteoporosis

-Arthritis

-Obesity

-Pain

Tips for the gluten-free diet:

Learning how to follow the gluten-free diet can be challenging. First of all, there is a big learning curve. Gaining awareness of everything that contains gluten and learning how to substitute or make better choices – for example, by eliminating the sandwich or carb snack altogether – is a daunting task. Then, there are the outings and family encounters at which we have to teach our loved ones why we are choosing to buck the cultural norm and go gluten free. Luckily, gluten-free recipes abound nowadays. Just be sure you are not substituting gluten with items high in sugar and low in nutrients. Some less nutritious grains to limit in your diet include rice, corn, potato starch, sorghum, and tapioca. Xantham is often used to make gluten-free bread sticky but is made from fermented corn, wheat, or soy. Aim instead for substitutes that are whole and nutritious such as buckwheat, gluten-free oats, flax, millet, quinoa, amaranth, nut flours such as almond or cashew flour, brown rice, wild rice, or cornmeal. There are many blenders and mills that will grind these in your own kitchen nowadays.

Our Celiac Program is perfect for patients who are wondering how severe their immune reactions to gluten are. Our program includes one first visit and one follow up visit with Dr. Shannyn, a lab draw for the Celiac panel, and $75 toward products. We also offer food intolerance lab panels that test for sensitivities to many different foods.

To set up a free ten-minute consultation with your La Mesa naturopathic doctor, just give us a call!

Homeopathy and Hydrotherapy for Families

Homeopathy can be a great instrument for families to use in dealing with boo-boos and other minor illnesses that come up at home. Many parents are seeking natural treatment options, holistic medicine for their children and ways to self-care. I’ve designed a class specifically on homeopathy for families. In my class, moms and dads learn how to use homeopathic remedies out of a kit in their day-to-day lives.  This is the ultimate natural care for families. Parents will learn ways to use homeopathic remedies for teething, ear issues, cough, menopause, pain and many other ailments and treatments. You will also learn about herbs and other therapy treatments to keep in your natural first aide kit.

Prescribing homeopathic medicine for chronic conditions is best left up to a Homeopath or Naturopathic Doctor, but learning how to use homeopathy for simple ailments is a great tool for a family to have in their first-aide kit.

My Homeopathy and Hydrotherapy for Families class starts May 7, Spring 2016! Space is limited in this popular class so be sure to enroll soon!
Homeopathy and Hydrotherapy for Families
San Diego Continuing Education Center City Campus

Saturdays, 9-12
May 7 – June 4
Class fee $75. Materials fee $10

  • Learn the basics and philosophy of natural medicine
  • Discuss specific remedies and common ailments
  • Learn how to use a homeopathic kit for families
  • Water therapy tips and techniques will also be taught
  • The instructor is a Naturopathic Doctor with a Bachelor’s degree in Biomedical Sciences, and a Doctorate Degree in Naturopathic Medicine with research background in evidenced-based medicine.

Follow this link to enroll in Homeopathy and Hydrotherapy for Families.

A Day in the Life of a Doc

Today is research/catch-up/laundry day. Hey, a working mom has to multitask, right?

I begin the day by sorting through business mail and sipping a cup of mint tea. This morning I’m greeted by an unwelcome surprise – a debt collection letter! My clinic negotiated with a new lab and we got excellent prices, but I wanted to make sure the billing process would be smooth for my patients, so I sent in a lab on myself as a trial run. To my chagrin, the lab charged me their full price instead of using our special discount! I brought it up to my rep and was told it was taken care of. By dealing with this collection letter myself, I think to myself, I’ll be able to develop a better system so my patients will never experience this “surprise” like I have! After a round of phone conversations among our lab rep, the billing department, and myself, (along with some aggressive follow-through on the part of my assistant), I resolve the issue, creating a simpler financial process along the way and preventing this from happening to my patients.

It’s experiences like this that they never teach you about in medical school!

The research/catch-up part of my day is supposed to be spent looking into my patients’ challenges and developing new tools to help educate my patients. I sit down at my kitchen table, open my laptop, and begin to type up a handout on food intolerances. I get as far as “Foo-” when my typing is interrupted by the familiar “ping” of my cell phone alert. I’ve received an urgent message from my answering service (a company that answers calls when my private practice is closed). I log into my email account to view the full message. False alarm – it’s a tenacious sales rep who wants to sell me his newest product, and his three messages in a row set off an urgent alert.

Since I’ve already opened my email, I may as well start sifting through the morning’s messages. I see a memo from another doctor needing some input on a patient’s MTHFR status and give the doc a call – I get started on the laundry while talking. Treating MTHFR is something I am good at and I am happy to help other doctors find tools and perspective in their treatment of MTHFR.

Onto the next part of my day. One of my clinics is hiring and I am helping with the process. After cleaning out my inbox (well, mostly), I head over to review resumes and candidates’ initial responses to our questionnaire. This is actually one of my favorite jobs – I love meeting different personalities and seeing whether our skills and passions align. There are a few promising contenders; I look forward to hearing how the final interviews go.

I make it back home and it’s now mid-afternoon. After a quick veggie and chicken lunch, I complete the morning’s task of paying bills. Since I am working from home today, I take a few minutes to water and prune my potted plants. I let my mind wander. My garden is something that nourishes me. It doesn’t need too much from me. The celery is finally starting to grow, the calendula has adapted to its new spot, and the strawberries are happy just lying in the sun. Maybe we should all take a cue from the strawberries and hang out more often.

Back to the list. I remember that today I also have some welcome calls to make. As a part of the membership committee of the California Association of Naturopathic Doctors, or CNDA, it is my job to call new doctors and welcome them to the organization. We discuss practicing in California, benefits of the CNDA, legislative efforts, and any questions they might have.

Now it’s time to go pick up my son from school. I glance over at the still-full laundry basket as I make my way to the door. I know it’s mocking me.

Today it seems like my boy needs a little extra attention from mom, so we make a game out of checking in new supplements at the office before returning home. He gets excited about the chewable fish gels for kids, and I have to remind him that we have to finish the liquid version first.

The sun is already setting by the time we make it back home. I pick a few fresh veggies and herbs from my garden to spice up dinner, which I try not to burn while I simultaneously help the kiddo with his spelling homework. Tomorrow I have a full load of patients and I have to be prepped and ready to go by 9 am sharp, so my work for the day is far from finished. After dinner, I settle down with another cup of tea to review charts and check the rest of the day’s emails (yep, that inbox is full again).

Finally it’s time for bed. After shutting down the electronics and turning out the lights, I drift peacefully into a blissful dream of self-washing clothes.

Spring Break and Restoring Balance

It was so much fun hanging out with my boy over spring break! We explored our city, each others’ interests, and new foods. He did ask me what a vending machine was, which at age 7, seems to represent the low level of processed foods in our life. My boy is really into plants versus zombies at the moment, so we created clay figures of pea shooters, made up zombie songs, and had carnivorous plant conversations. Blowing up balloons and letting them collapse while flying around the room takes days and days to get over laughing about, evidently, as does family dancing to Madagascar’s Afro-circus, Afro-circus, polka dot, polka dot! We also visited the spring break locations that have been on our list like the indoor playground, the new library, and downtown museums. We even found time to help out at our local homeless shelter. We talked a lot about how all these places fit into society.

I think it is important for kids to know how they fit into society, too. As babies, our kids think the world is just mom and food; their idea then expands to include the home and frequently traveled paths. As the world gets bigger for them, they go back and forth between feeling comfortable in their world and panicking when they realize it is even bigger! I tell my son what ‘a lucky duckie’ he is to have me to teach him how to be well and how he fits into the world.

There is a recent study in Nature that describes how social structures for kids can affect how long they live. Those kids growing up in advantaged homes have longer ‘telomeres,’ which represent the ability of the body to repair damaged DNA. Shortened telomeres show more damage, less repair of DNA, and thus shorter life. Kids from lower income households, less educated parents, harsh parents, and unstable family structures consistently had shorter telomeres.

There are other studies that show that perception has a lot to do with the internalization of stress by children. If they feel they have the resources they need, they are more likely not to be adversely affected by their circumstances. On the other hand, if they are constantly worrying about instability and are in need, excess stress is put on the body and psyche. Some children grow up always searching for what they perceive they need and continue to look for it as adults. Gratitude and resourcefulness within a low income family with less funds can lower the stress impact on a child. You can indeed feel rich, blessed, lucky, or whatever your word may be regardless of situation. We have all heard the stories. Many of us have lived them. The take home message is that our children need nourishment in so many forms: food, confidence, stimulation, understanding, using the resources that they do have and oh… what is that word? Love!

Spring break for us was a great time for me to talk about balance with my munchkin. Balance in trying new things while keeping some routine. Balance in the foods our body needs daily with a few treats (like gluten free-pizza!) that come with life. Balance in being content with what we have, helping others, and saving or striving for the things we really, really want. Balance in getting the chores done or ‘getting bossed around’ and then getting to make the planned schedule for ‘family time.’ Breaks are a great time to reinvest in the balance of things. Connection with all our relationships is so important and kids are often more cooperative and invested in the family when we just take time. I hope your spring break was full of exploration, nourishment, and balance!

Natural Tools for Pneumonia and Other Infections of the Lungs

It doesn’t take long to get pneumonia. It can creep up on you within 24 hours. Unfortunately, healing from it can take a long time and can leave us unable to enjoy work or family life. (Super frustrating!) Most of us have responsibilities and rely on healing quickly to get back to our routines.

Pneumonia can start as a cold, sinusitis, fatigue, or pain in the chest or back. Symptoms can include shortness of breath, cough, fever, having the shakes or the chills, feeling fatigued or tired, and unclear thinking. Differentiating pneumonia from other respiratory infections or problems is done by listening to the lungs, running blood tests, or examining x-ray images. “Is pneumonia contagious?” is a common question. The answer is yes – any virus or bacteria of the respiratory tract can be contagious. Pneumonia occurs when the body is unable to properly expel bacteria or viruses from the lungs.

Naturopathic medicine shines when it comes to respiratory infections. I have seen many of my patients respond well to natural treatments, even patients who have been sick with pneumonia for up to six months and for whom antibiotics based on lung biopsy cultures were ineffective. After some natural tools geared toward their individual characteristics, these patients tend to feel better within days. What, exactly, can black bag medicine offer for pneumonia? Whether they’re facing bacterial pneumonia or viral pneumonia, my patients can rely on the following top three tools for healing:

Homeopathy

Homeopathy helps the body focus on balance. Keynotes of a remedy range from a painful dry cough to a cough that sounds like a seal’s bark. Homeopathic remedies can help treat a range of ailments; whether the patient suffers from a simple cough or from deep-seated infection, homeopathy offers an effective treatment for pneumonia. Doses are usually given twice a day for three days and, with the correct remedy, coughing should subside quickly.

Herbs

Herbs can soothe a cough, help with spasms, or help the patient cough up mucus. Different herbs are appropriate for different situations. For example, for a dry cough, we would look to anti-spasmatic and soothing herbs. For a wet or mucus-containing cough, however, we do not want to use anti-spasmatic herbs because we want to get the discharge out. Herbs can help disarm bacteria or viruses and provide nourishment to the lungs, and constituents from the herbs help the body take action such as coughing up mucus. No matter their unique properties, herbs are best taken in tincture or tea form for respiratory complaints.

Mustard Packs

Mustard packs or hydrotherapy can help increase the circulation within the lungs, which allows for the transfer of debris, bacteria, viral components, and mucus. White blood cells act as warriors against invading pathogens and accumulate in areas of the body when they receive signals that they are needed. For this reason, opening up blood flow in the lungs allows the immune system to arrive on the scene and fight the infection. A paste consisting of mustard and flour can be applied to a cheesecloth on the back or chest for 15 minutes daily to help clear the mucus. Follow your doctor’s instructions carefully to avoid burns. Although they’re effective in adults, mustard packs are not for children. Alternating hot and cold compresses can effectively increase the heat and circulation in the chest for children.

Plenty of fluids, a clean diet, clean air, and rest are crucial for healing from a respiratory illness. It often takes 6 weeks to recover from pneumonia. Remember that each person is unique and can experience pneumonia symptoms differently – I can help you determine the best course of action for your specific condition.

Is there hope for MTFHR polymorphs?

Is there hope for Methylene Tetrahydrofolate Reductase Enzyme Deficiency or in short known as MTFHR polymorphs?

These conditions are associated with MTHFR genetic mutation in research: Several can be considered a genetic disorder since treating the mutation will resolve the illness. There continues to be correlations of health problems with MTHFR that are not mentioned here.

Atrial Fibrillation ALS
Alzheimers Anemia
Anxiety Arthritis
Autism Bipolar disorder
Blood clot Breast Cancer
Chronic Fatigue Syndrome Colorectal Cancer
Connective Tissue Disease Diabetes
Down Syndrome DVT
Epstein Barr Virus Fibromyalgia
Gluten intolerence Heart attack
Heart Murmurs Heavy metal toxicity
Hemolytic anemia High homocysteine
Homocystinuria Hunnington’s
Infertility in both men and women Insulin resistant diabetes
Leukemia Lupus
Meniere’s Disease Migraine
Miscarriages MMA
Multiple Chemical Sensitivity Multiple Sclerosis
Myalgic encephalomyelitis Neural tube defects
Neuralgia Non Hodgkin Lymphoma
Panic Attacks Parkinson’s
Post eclampsia Pre eclampsia
Pulmonary Embolism Retinal Vascular Occlusive Disease
Schizophrenia Spina bifida
Stroke Thyroid disease
Tongue Tie Vaccine Injury

What is gene mutation, MTHFR (methylenetetrahydrofolate reductase)?

Explanations for MTHFR can get very complex so let’s try to keep it simple.

The –ase in the name tells us that it is an enzyme.  This enzyme is at the center of the activity of so much of your biochemistry, from turning homocysteine into methionine, making the most important antioxidant in your body, glutathione and converting neurotransmitters like dopamine that will affect your mood.  The enzyme also makes the active form of folate, called methylfolate.  The active form of folate is able to get around the body better and is the only form that is absorbed in the gut properly and can adequately be used in the brain.  As you can see, being able to make methyl-folate is very important for nervous system function, growing babies and much, much more.

The two little sections that code for the enzyme are known as MTHFR C677T and MTHFR A1298C.  If we remember back to biology class, there are two letters that determine outcome of a particular trait in the Punnett square.  Capital letters general indicate the wild type or normal variant of a gene.  Little letters indicate a mutation.  Two of the same letters indication homozygous and one of each indicates heterozygous.

AA Homozygous

Aa  Heterzygous

aa  Homozygous

The MTHFR section of the chromosome in a gene test with normal variants of amino acids should looks like this:

C677C   A1298A

It is possible to have 1 or 2 gene mutations between these 4 amino acids.  We will use DNA below.  Some tests done by saliva use RNA so the amino acids are different.

One gene mutations or Heterozygous MTHFR:

677: CT   1298: AA   This is heterozygous 677.

(One cytosine amino acid has been changed to tyrosine and reduces the ability to make the enzyme by 30%.)

677: CC  1298: AC  This is heterozygous 1298.

(One adenosine amino acid has been changed out for a cytosine reducing the enzyme being made by 30%.)

Two gene mutations or Homozygous MTHFR:

677: TT   1298: AA   This is homozygous 677.

(Both cytosine amino acids have been changed to tyrosine which means this is only 30% chance or so of making the correct coding for making the enzyme.)

677: CC   1298: CC   This is homozygous 1298.

(Both adenosine amino acids have been changed to cytosine which means this is only 30% chance or so of making the correct coding for making the enzyme.)

677: CT   1298: AC   This is compound heterozygous.

(One cytosine has been switched and one adenosine has been switched in each gene.)

What does it mean?

Simply, this genetic mutation decreases the ability for your biochemistry wheels to spin.  Throughout our bodies we have ferris wheels that are used to turn one molecule into another.  The enzyme is like the worker who loads the ferris wheel.  Without adequate enzymes the ferris wheel doesn’t turn or gets clogged up and you can end up with a crowd of people in one section of the ferris wheel or a crowd of metabolites who cannot go the next step.  This crowd of metabolites can cause symptoms- a myriad of symptoms that are endless.

MTHFR is at the center of your biochemistry wheels and interact in so many wheels.  If you are positive for a MTHFR mutation or polymorphism, it means that your body has less enzyme to help those biochemistry wheels turn and less active folate or methylfolate being made.  If you are not able make active folate, it can clog up the gears causing many of the common symptoms of MTHFR.

MTHFR disorders are treatable.  I find 80% of patients improve immediately with the right treatment.  MTHFR is one of the most satisfying conditions that I treat because patients get so well when their treatment is focused.  There are a number of other mutations, such as COMT, CBS, MAO that can complicate treatment.  Some patients are so sick that we have to address other health problems before they are able to tolerate treatment.

How is it treated?

Many people believe only homozygous MTHFR needs to be treated.  I beg to differ and find that even heterozygous MTHFR will find that their health problems can be resolved by treating MTHFR.  Treatment of MTFHR is often very hopeful.

In general, treatment is nutritional.  The goal is to work toward lifestyle changes and a maintenance dose of a multi-vitamin with methyl-folate in it and avoidance of synthetic forms of folate.  It can take some stepping stones to get to the maintenance dose as we tweak your body’s ability to spin biochemistry wheels and make the gears more efficient.  We want to spin them at the right speed, not too slow and not too fast causing detox.  Some patients see immediate life changing results while others see results consistently but more slowly especially if things have been going on for a very long time.

Any medications that involve folate pathways are generally contraindicated with a decrease in your enzyme.

Who should be screened?

If there is a family history of MTHFR or methylation defects in your family, you should be screened.  It is estimated that over 40% of the population has this particular mutation depending on ethnicity, therefore it is wise to screen for it whenever there is chronic disease, infertility, or in pregnancy.  Proper detoxing is important in all chronic disease and prevention of chronic disease.  Growing a baby involves adequate active folic acid so screening in pregnancy MTHFR is essential as is taking the methylated form of vitamins.

There is a very long list of chronic diseases that are linked to MTHFR but in short, I often screen for it in my La Mesa Naturopathic Medical Clinic if there is some family history of heart disease, cancer, diabetes, any clots, depression and/or addiction.  I also screen in more unusual conditions such as sensitivity to caffeine, a feeling of something creeping up such as a panic attack, estrogen dominance such as fibroids and autoimmune conditions.  In the first patient visit, we are creating a painting of the person’s well being and if the picture fits MTHFR, a screening is well worth it.

Screening can be done in our La Mesa Naturopathic Medical Clinic by blood test. There are kits offered online for blood and saliva testing.  I do counsel patients on the best option for them depending on their finances, health goals and concern for genetic testing and data mining of the information.

BBM web link