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The Gut - Thyroid Link (In Under A Hundred Words)

Posted: Wednesday, May 28, 2014 at 2:05:32 PM EST by Alyssa Tait

How do gut problems lead to Hashimoto’s disease? This comes up often with my patients.

The explanation is rather long and convoluted (but fascinating, I promise!) so strap yourselves in for the first leg of the ride, for which I’ll use diagrams to start you thinking. This will be the first in a Gut-Thyroid series of blog posts to help you navigate the territory and apply the knowledge to your own health.

(And yes… this is the only way I could keep within the word count promised!)

Watch this space for more and see also The Thyroid Summit.

Nutrients in Food Are Lower Than You Think

Posted: Tuesday, May 20, 2014 at 10:06:06 AM EST by Alyssa Tait

A Second Reason Why You Can't Get It All From Food

It’s sad but true. While we’d like to think we can get all our essential nutrients from food, it’s not easy.

Last post in this series,  I talked about how our diets are never as good as we’d like to think. Most of us know this intuitively, and research confirms we’re not meeting our nutrient requirements.

For example, a 2014 study of Australian adolescents showed that fewer than 50% of females got enough calcium, magnesium, folate or vitamin D or E, and the males fared no better. 50% of males did not get adequate magnesium, potassium, pantothenic acid, folate, vitamin D or E. A multitude of studies shows inadequate nutrient intakes in special groups of people, including breastfeeding mums, people on a gluten-free diet, and older adults.

So this brings me back to another key reason we are not getting enough nutrients:

We can’t get the nutrients from food if they’re not there.

Australian soils are low in zinc, molybdenum, manganese and zinc.  There has been a dramatic reduction in the amount of nutrients in the soil that grows our fresh food since the 1920s. Magnesium levels in the soil, for example, have declined as the use of fertiliser has risen. This is because increasing levels of phosphate in the soil (from fertiliser) result in the plant taking up less magnesium.

Many heavy metals block the uptake or the action of essential minerals in our body.

Cadmium, which is present in fertiliser, blocks the uptake of zinc. Mercury and lead, which we are exposed to every day, strongly block calcium, iron, zinc, selenium, and other essential trace minerals. 

Other chemicals in our environment also compromise nutrient intake.

For example, the fluoride in our water interferes with iodine and molybdenum, minerals that are both essential to our good health.

This is a reality of 21st century living: even when we try to eat the best quality and freshest produce possible, we can’t rely on the level of nutrients being sufficient for our needs.

Next post in this series will focus on common “nutrient thieves” in your diet and lifestyle, some of which may surprise you.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

How Badly Is Stress Affecting Your Physical Health?

Posted: Wednesday, June 11, 2014 at 8:53:47 AM EST by Alyssa Tait

A Simple Method to Quantify the Effects of Stress on You on a Daily Basis

We all know that stress is bad for our health. Sometimes the pressure to squeeze “de-stressing” in to our already chaotic lives is a source of stress in itself! But how do you know when the stress is so significant that it is a major factor in your low energy, youar sleep problems, or your health issues?

There is a simple test you can do yourself at home without going to your doctor.

This test is especially useful if you have anxiety or depression, insomnia, headaches, low energy, fatigue, hormonal imbalance, infertility, poor immunity or blood sugar problems. I also see evidence of adrenal issues in women with vulvodynia, irritable bowel syndrome and chronic pain. (For more information, see my post on the effects of stress on the gut).

The test looks at your cortisol levels as they change through the day. As you can see from the diagram below, cortisol is high to start the day, then gradually drops into the evening, so that you develop a nice, natural tiredness as a signal you need sleep to recharge your body and mind. Cortisol then begins to slowly rise in the hours before 6am to ensure you wake up again – ideally, bright-eyed and bushy-tailed!

 

A number of things can go out of balance with this system. As stress causes you to release cortisol, if your stress rises towards the evening, the cortisol can spike or fail to drop as low as it should.

This can result in sleep problems:

  • Difficulty falling asleep
  • Unrefreshing sleep
  • Early waking

The last one is especially common. If you have a busy, stressful or active evening, the cortisol spike may result in you waking at 4 or 5am, even though you actually need more sleep for your health.

If you are constantly busy, overcommitted and stressed, you are under great demand to produce cortisol. Your cortisol may actually be too high, making you feel edgy and overstimulated, and as though you can’t sit still without doing something. If this continues on too long, you start to drain your adrenal glands, a bit like using the mobile phone without recharging it. If your battery starts to run low, you can then, over time, have trouble producing enough cortisol, and approach “burnout”. Classic signs of this include

  • Feeling groggy and unable to get going in the morning
  • Low energy despite plenty of sleep
  • Feeling unrefreshed after sleep
  • Low mood and difficulty getting motivated for anything

A simple test that can track your cortisol rhythm is the Adrenal Hormone Profile.

This is completed at home by spitting into a test tube four times per day – 8am, 12pm, 6pm and 10pm. The cortisol is then measured by the lab.

This test is not ordered by your doctor, who will tend to order only a morning cortisol, which will not give the full picture. The Adrenal Hormone Profile needs to be ordered by an integrative practitioner who is experienced at interpreting the cortisol patterns.

Contact us now if you would like to order this test and gain some insight into the impact of your adrenal function on your health.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

No, You Can't Get It All From Food: Six Reasons Why

Posted: Friday, July 31, 2015 at 4:16:48 PM EST by Alyssa Tait

“I don’t need supplements; I prefer to get it from food”?

Ever heard anyone say that? Maybe you say it yourself! I hear it every day. I’m sorry to say, I just don’t buy it! That’s right: for optimal health, I think we need specific supplements. There are six main reasons why, which I’ll tackle individually in further bog posts.

Before I start, I’d like to emphasise that it’s not a choice between food and supplements. Of course we need an excellent diet to promote ideal health – a diet that is varied, rich in micronutrients, high in fresh unprocessed food and includes fermented food. (We also need a healthy digestive system to properly assimilate the nutrients – but that’s another blog post.) But it’s not about an “either/or” – we can have a faultless diet (which, let’s face it, few people do) and STILL obtain benefits from supplementation. So let’s start with the most obvious one first: our diets aren’t always perfect

A Sometimes Imperfect Diet                                          

It’s well known in nutrition research that people always remember their diets as better than what they actually are! That’s right, even with our best intentions, when we recall our diet, we always conveniently forget the worst bits!

Do this experiment: note down every single thing you eat or drink for three days. At the end of it, can you honestly say that you

  • Ate no packaged food?
  • Ate a mix or fresh and cooked vegetables at two to three meals per day?
  • Didn’t consume sugar?
  • Ate all organic?
  • Consumed only grass-fed meat?
  • Included “live foods”, such as home-fermented sauerkraut or home made yoghurt?
  • Didn’t eat any foods that don’t make your body feel good?
  • Didn’t overeat anything?

There are plenty of other possible criteria for optimal diets, but you get the idea! It's probably kind to say we all have a "sometimes imperfect diet". How often does life get in the way of ideal nourishment?

As a clinical nutritionist, I have done plenty of computerised nutritional analyses of my clients’ diets. One advantage of this is the estimation of what’s known as the RDIs, or Recommended Dietary Intakes, of various nutrients. I’ll talk more later on the relative merit and potential problems of the RDI system, but for now, think of it as a starting point for determining the nutrient richness of your diet. If you fall below the RDI for a certain nutrient, you are not obtaining enough of that nutrient for normal body function (that’s right – not optimal function, but simply normal function).

In all my analyses, I only came across one client who was meeting the RDIs for all measurable nutrients (and keep in mind that most nutrients cannot currently be measured in Australian foods). She was an Olympic longjumper, eating massive quantities of food that would be far in excess of the energy requirements of most of us non-athletes!

Next post, I’ll start getting into the meat of this issue, on the topic of nutrient depletion in our food.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

I've Had A Baby...Can I Ever Exercise Again?

Posted: Thursday, April 10, 2014 at 3:17:36 PM EST by Alyssa Tait

If you are keen to get back into exercise after having a baby, congratulations!

The motivation to exercise after having a baby is a great thing. If you can be keen to exercise amidst a life turned upside down by a wee new arrival, that’s a great start! Returning to exercise after baby has so many potential benefits:

  • improved energy and resilience to stress
  • keeping up with the physical demands of kids
  • a better body image
  • help with your libido

But wait…what about the pelvic floor?

What about wetting yourself on the trampoline, what about your pelvic organs falling out?  Is exercise going to be detrimental to pelvic floor function? Could it even cause irreversible damage?

Some women return to exercise after the baby only to suffer serious setbacks; the mum who returns to netball and becomes incontinent, the mum who starts Pilates and develops a prolapse. These are serious side effects and not only impact on your ability to exercise, but can cause a major blow to your self-esteem. It’s essential that your return to exercise takes into account your pelvic floor “situation” and is graded accordingly.

But how do you know what is safe – how much your pelvic floor can take?

There is no one-size-fits-all approach here. That’s the bad news. Any general advice you hear does not take into account your individual circumstances, such as:

  • Your episiotomy tear took a while to heal and still hurts
  • Bub had a huge head and weighed over 4kg
  • You had pubic symphysis pain during the pregnancy
  • You had a five-finger abdominal separation (diastasis rectus abdominis muscles)
  • You did yoga until the day before you gave birth
  • You’ve been a runner for ten years
  • You put on 20kg during the pregnancy
  • The vacuum didn’t work and they ended up using forceps

All of these factors influence exercise suitability after birth.

The great news is, you can be given an individualised, progressive exercise program based on your pelvic floor risk.

Very recent research allows us to now measure how “risky” a pelvic floor you have after childbirth. Some aspects of this risk, such as your pelvic floor muscle strength, can be changed. An individualised assessment with a pelvic floor physiotherapist trained in this approach can answer such questions as:

  • Am I safe to return to netball?
  • Can I ever run again? If not, how can I keep fit?
  • Is Pilates going to be good for me?
  • Can I do stomach crunches?
  • How can I reduce my risks to the pelvic floor?
  • What other alternatives are available to me – I’m bored with swimming and walking!

If you would like to find out exactly what exercise you are able to do without harming your pelvic floor, give us a call.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Do You Understand Your Fertility?

Posted: Tuesday, April 1, 2014 at 8:16:15 AM EST by Alyssa Tait

Normal fertility is a key part of good health as a woman.

Naturally, the definition of normal fertility changes depending on the stage of life you are in. If you are approaching menopause, then declining fertility is absolutely normal. If, on the other hand, you are a teenager, then normal fertility can take some time to develop, but is usually in place two years after your periods start. Whatever your life stage, understanding your fertility is important to understanding your health.

Luckily, the body gives us clear signs of normal fertility, if we are trained to look out for them. Unfortunately, most of us do not receive this training as part of our journey into womanhood. There is no rite of passage in our culture that teaches us the signs of normal fertility and how to work with them. However the onset of menstruation in young girls is approached, the approach rarely includes teaching the signs of fertility.

Understanding the signs of fertility is a very useful skill. Not only can it help us to manage our fertility (i.e. avoid unwanted pregnancies, and achieve desired pregnancies) but it can also be an important signpost to reproductive issues that need looking into, when we see an unexpected change that does not fit with what we would expect in our life stage.

So what is the most important sign of fertility?

Most people’s first guess would be menstruation; the regularity of our bleeding. Even many doctors would think this is the case. And certainly, lack of regular bleeding, as in amenorrhea and polycystic ovarian syndrome, is not a good sign in your fertile years.

However, bleeding (whether regular or irregular) is not a reliable sign of fertility. Bleeding can happen – in fact it can even be regular – without ovulation occurring. This is common in the perimenopause, where bleeding often continues for quite a time after ovulation has ceased. All that is required for bleeding is sufficient fluctuation in hormone levels. Another good example is when on the Pill, where bleeding occurs due to withdrawal of hormones, even without ovulation occurring.

So is it blood level of hormones, then, that is the best sign of fertility?

No, it’s not that either. Blood levels of hormones are a snapshot in time, and fertility is by definition based on cyclical changes. So while blood tests can be useful – and are sometimes essential – they are not the be-all-and-end-all of fertility awareness, by any means.

So again, what sign does the body give us that we can tune into for most reliable information about our fertility?

It’s mucus – that is, vaginal discharge.

That’s right, it’s the moisture that you perceive at the vulva, which undergoes changes during different parts of a fertile cycle. When you are in a life stage where these fluctuations are not occurring – such as in the early breastfeeding period, or around the time of menopause – it’s this lack of changes that gives you important information about your changing fertility.

If you are like most women, you have never learned how to work out if your vaginal discharge is normal.

So where do we learn this important way of having insight into our fertility?

The best structured method is by learning the Billings Ovulation Method, a technique based entirely on observations of moisture changes at the vulva. The Billings Ovulation Method can be used contraception (with a 99% effectiveness rate, without drugs or chemicals); in can be used to help achieve pregnancy; or it can simply be used as a way of being aware of an important signpost of your health: your fertility, and your changes in fertility through your life. It has quite accurately been described as providing

“Knowledge of her body that every woman ought to have.”

The Billings Ovulation Method cannot be reliably learned from a book or the Internet. It needs to be taught by an accredited teacher of the Billings Method, which is inexpensive. You can find an accredited teacher in your area by phoning Billings Australia on the toll-free number 1800 335 8601800 335 860. You can find more information at http://www.thebillingsovulationmethod.org/. Beware of imitation sites, which often provide inaccurate information.

As an Accredited Teacher of the Billings Ovulation Method, I can teach you the Billings Method via a combination of face-to-face and Skype or e-mail consults.

If you need help with your fertility as a whole, you may be interested the unique combined approach to fertility that we use at Equilibria Physiotherapy & Nutrition.

 

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Small Intestinal Bacterial Overgrowth: Could This Be Behind Your IBS?

Posted: Tuesday, March 25, 2014 at 1:45:19 PM EST by Alyssa Tait

Ever felt that everything you eat makes you bloat?

Have your symptoms been dismissed as irritable bowel syndrome? You could have SIBO.

SIBO  - that is, small intestinal bacterial overgrowth. Research is slowly growing on this common cause of abdominal bloating and pain. However, as with all early research, it won’t necessarily have found its way into the mindset of your local GP or gastroenterologist yet.

Research shows that SIBO is common to develop in people who have been put on proton pump inhibitors (for example, Nexium, Losec and Pariet). SIBO may also be present after bowel surgery, which may lead to changes in motility (i.e. the movement through the gut). (On the former topic, there are a number of unwanted side effects of reflux medications, or proton pump inhibitors).

Some research shows SIBO is present in around 40% of people with IBS, but it may be even higher. Common symptoms are diarrhoea (more common than constipation), abdominal pain and bloating. Longer term symptoms can be nutrient deficiencies, leading to low iron (for example) or even iron-deficiency anaemia,

So what is SIBO – how can you find out if you have it – and what can you do about it?

To understand SIBO, you need to know a little about the normal gut. It is normal to have large numbers of normal bacteria in the colon, or the large intestine. However, numbers of normal bacteria in the upper gut, or small intestine, should be much lower. In SIBO, there is an increase in the numbers of normal bacteria in the small intestine. These bacteria are not the “bad guys” – so it’s not the same as having an infection – rather, there are simply too many of them in the wrong place. In this situation, using probiotics (“good bacteria”) is a bad idea. It won’t help, and can possibly make the problem worse.

This increased number of bacteria in the upper gut causing increased fermentation when you eat, leading to the common symptoms of irritable bowel syndrome, especially bloating and pain.

Interestingly, though, SIBO may contribute to symptoms in a whole range of other conditions as well, from fibromyalgia to interstitial cystitis.

Here’s what you need to know about diagnosing SIBO.

SIBO cannot be diagnosed via a blood test or stool test. It can’t be diagnosed via an endoscopy. This also means it cannot be ruled out by an endoscopy. So if you have had a normal endoscopy, and your gastroenterologist says “you’re fine, it’s just a little bit of irritable bowel syndrome”, SIBO is a possibility.

It’s always important to get the main medical things ruled out first. Other conditions with overlapping symptoms include inflammatory bowel disease, coeliac disease, non-coeliac gluten sensitivity and FODMAPS malabsorption. As I have said in another blog post, it's ideal to aim for an accurate diagnosis before excluding gluten from the diet. Symptoms of coeliac disease vary, and there are essentials you should know if suspecting coeliac disease in your child. It may also help to understand the effects of stress on irritable bowel syndrome in more detail.

But if you have had these things ruled out, you may wish to investigate SIBO.

If SIBO is confirmed, there is a very effective herbal antimicrobial and specific dietary regime available for treatment. We are trained in the this at Equilibria.

If you would like more information on whether you could have SIBO, contact us.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Going Gluten-Free: What You Should Do First

Posted: Tuesday, December 17, 2013 at 5:04:05 PM EST by Alyssa Tait

Gone are the days (I hope) that people believe gluten-free is just the latest fad.

It’s undeniable that many people, for many different reasons, feel much better on a gluten-free diet.

It is important that a person has a coeliac screen before going gluten-free. The reason for this is that if they go on a gluten-free diet and feel fabulous, they are likely to never let so much as a wheat cracker pass their lips again (which is great) - but this precludes ever doing a coeliac test again, as you need to be eating wheat in fair quantities for a coeliac blood test to be reliable.

 So why does the coeliac test matter?

It matters because there IS a difference between being coeliac and non-coeliac gluten sensitive. Coeliac disease brings with it some well-documented significantly increased risks of things like bowel cancer and osteoporosis. Non-coeliac gluten sensitive doesn't (though keep in mind research is in its early days.

So you need to know why you are removing gluten.

If you are coeliac, you need to be much stricter in order to avoid these risks. If you are non-coeliac gluten sensitive, you may choose not to consume gluten, but chances are, the occasional crumb from someone else's toast is going to find its way into your butter, and that may not do you serious  harm. If you are coeliac, this WILL do you harm, and you need to take extra measures to avoid it.

The second comment is this: non-coeliac gluten intolerance may be on the rise, but so is FODMAPS intolerance, which also causes digestive symptoms when bread is consumed. In one recent study of a group of patients with functional gastrointestinal disorders (e.g. irritable bowel syndrome), 60% had a FODMAPS intolerance! It is important we don't label ourselves as "non-coeliac gluten intolerant" when it is actually a FODMAPs intolerance we have, as this creates confusion and  scepticism about the concept of gluten intolerance, which doesn't help the kid with autism, the kid with diabetes, and all the rest of the people with genuine non-coeliac gluten intolerance. This is a bit like the impact that "pescovegetarians" or fish-eating vegetarians have on the genuine vegetarian movement - it dilutes the concept and makes it much harder for genuine vegetarians to defend their stance.

By all means let's get rid of the wheat and/or gluten out of our diets because it's great for our health and makes us feel good.

 But - let's leave it at that and not use research that may not apply to us to convince others. Or, alternatively, get yourself tested - make sure you are not coeliac, which carries its own special health risks due to unintended ingestion of tiny amounts of gluten - and see if the reason you feel better without wheat is a FODMAPs intolerance, which may then lead you to realise you also feel a lot better on a true low-FODMAPs diet, which requires exclusion of more than just gluten-containing foods.

I do need to add the caveat that coeliac testing is not as straightforward as it appears to be either. But that’s the topic for another post.

In the meantime, here is a link to a great educational web-event called the Gluten E-Summit, part of which is still being aired free, for around the next 24 hours. For access to an economical digital package which I would thoroughly recommend as providing some of the most up-to-date information on gluten from some top researchers, click here.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Nutrition: Nothing In Moderation (Except Moderation)

Posted: Wednesday, December 18, 2013 at 11:37:14 AM EST by Alyssa Tait

“You’re a nutritionist, tell us what we should all be eating!”

Well, I might be a nutritionist for short, but in actuality I’m a nutrition medicine practitioner.

Nutrition medicine: I’ve been practising this for nine years now, but still struggle to explain to people what it is. My patients know – because they are collaborating in a treatment program involving it. But the elevator spiel to the person next to me? I have yet to perfect it, or even create it.

So now let me make an attempt with a short anecdote.

I was in Melbourne recently, presenting at a conference on constipation and herbal medicine. I was on the bus back to the airport eavesdropping on a conversation next to me between an older man and a younger woman. The woman was a sports nutritionist, and the man was interested in the relevance of this to his horses.

The woman had to race off before the bus set off, as she’d left a package on her last bus. She got back on just in time and we exchanged joking pleasantries about her close call. The older man then chided her on the nature of the package, which was chocolate. The young woman defended herself by saying

“I’m a dietitian – I preach everything in moderation!”

Now I’m not sure whether she was speaking for all dietitians, but I thought this an interesting place to start on trying to explain what nutrition medicine is – and how it differs from dietetics.

I would describe nutrition medicine as an approach that counsels the opposite, that is:

Nothing in moderation (except maybe moderation)!

Nutrition medicine is based on individual nutrient requirements. I don’t recommend one diet for all people at all times. In fact, I am not in the business of giving general guidelines at all – and the closest I would go to this might be “eat more vegetables, especially greens”.

We are not all identical. We have different genes, different health issues and different “weak spots”. Nutrition medicine is about pinning down which of these weak spots are impacting on our health. Technically, we aim to identify what processes in the body are malfunctioning to allow symptoms to arise. These might be neurological (e.g. neurotransmitter production), endocrinological (e.g. thyroid hormone action) or biochemical (e.g. nutrient availability in the relevant tissue). All of these – not just the last – are influenced by the raw materials we provide the body with (that is, food and, specifically, nutrients). We can influence these pathways by the way in which we facilitate the availability of different nutrients.

That’s why I don’t believe in moderation.

Several pieces of fruit a day? Not if you have fructose malabsorption-related irritable bowel syndrome.

400ug folate for all? Not if you have the MTHFR gene polymorphism.

Daily protein requirement = body weight x 0.8g? Not if you’re recovering from surgery.

Just take a multivitamin? Not if you have a relative copper overload.

Six slices of wholegrain bread a day? Now, don’t get me started…

Nutrition medicine is a rational, scientifically-based adjunct to physiotherapy (or any medical, paramedical or non-medical therapy, for that matter) based on individual requirements. These individual requirements are determined from a combination of general or functional laboratory testing and the clinical picture. Yes, they are guided by research…but then modified for the individual.

But if anyone can come up with a good elevator spiel on what nutrition medicine is, I would be very open to hearing it!

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

How Do I Know If My Vaginal Discharge Is Normal?

Posted: Wednesday, December 18, 2013 at 11:38:15 AM EST by Alyssa Tait

Vaginal discharge, vaginal mucus, vaginal secretions…whatever you call it, it’s a normal part of being female.

Even so, there aren’t many women around who haven’t wondered at some stage whether their vaginal discharge is normal.

But how do you tell if your vaginal discharge is normal? It’s not exactly something you discuss in everyday conversation. 

If you have discharge that you’re concerned about, you should discuss this with your health professional. However, I’ve put together a few tips to figure out whether it’s likely to be normal or not.

In your reproductive years (that is, between puberty and menopause) it is normal to have cyclical changes in vaginal discharge. This is because rising oestrogen levels lead to the cervix producing mucus to nourish and protect the sperm to help them travel the distance to the fallopian tubes, to help fertilise the egg. Whether you want a pregnancy at the time or not doesn’t affect the fact that you produce fertile mucus during a part of your cycle (usually for several days around 2 weeks before your period). This cervical mucus trickles down to the entrance to your vagina, where you experience is as vaginal discharge. However, it is technically known as mucus, to distinguish it from other types of vaginal discharge that do not come from the cervix. As a general rule (with exceptions!), fertile mucus tends to be thinner, clearer, stretchier and wetter than other types of discharge. Cervical mucus is an important part of your fertility, and a healthy sign. Cervical mucus is no longer produced when you are no longer fertile. Therefore, after menopause, you will not experience cyclical changes in vaginal secretions anymore. You would expect any discharge (if you have it) to be fairly similar day after day when you are no longer ovulating.

Cervical mucus can be affected by a lot of things, including being on the Pill, surgery to the cervix (e.g. for abnormal cells or CIN), and terminations. These things may result in a reduction in the amount or type of mucus your cervix produces, or it may change from being cyclical to being constant. When this occurs, your cervix is not at its most healthy, and its function is being affected. A lack of the cervical mucus (that is, the cyclical production of mucus, which increases over several days two weeks before your period, and has fertile characteristics) is a sign of your fertility being compromised. The Mini-Pill works in exactly this way for contraception: it changes the quality of the mucus to make it unfriendly to sperm, resulting in rapid death of the sperm, as occurs in the usual non-fertile times of your cycle.

Non-fertile discharge doesn’t come from the cervix, but rather the walls of the vagina. This vaginal discharge occurs in many women in the early part of the cycle. In the early part of your cycle, before your fertile time, this discharge (if you do have it) is normally the same day after day. It is not until oestrogen starts to stimulate your cervix to produce mucus that your experience of vaginal discharge changes. Vaginal discharge is due to circulation changes, as well as normal cell turnover by the healthy cells of your vagina.

Vaginal secretions are also produced when you are sexually excited or stimulated. These secretions are produced from a number of places: the vaginal walls, due to an increased blood flow to your sexual organs; glands called the Bartholin’s glands, around the vaginal entrance; and possibly the Skene’s glands, which are around the entrance to the urethra. Other things that increase the circulation to the vagina can result in an increase in discharge, such as a Pap Smear.

Normal vaginal secretions, whether mucus or discharge, is white, yellowish or clear, and has a faint musky smell. Vaginal secretions of a different colour, or odour, or accompanied by symptoms such as vulval or vaginal itching, pain with passing urine, or pelvic pain, should be investigated by your doctor.

Vaginal discharge that is new or different to what you have previously experienced may warrant investigation. This is especially the case when it cannot be explained by a change in circumstances, such as starting or stopping chemical or physical contraception such as the Pill or an IUD, including the Mirena; changing time of your cycle; or new phase of life, such as pregnancy or menopause.

It’s a helpful skill to know how to spot what is normal for you with your discharge. An excellent way of doing this is learning to chart changes through your cycle. Teachers of the Billings Ovulation Method tend to be experts in vaginal discharge – or rather, very good at helping women become experts in their own discharge. This is because it is a natural method of contraception, of promoting pregnancy, and of monitoring reproductive health, which is based on the woman’s experience of moisture at the vulva (the entrance to the vagina). Although the primary focus of this method is on the sensations of moisture you experience, it encompasses increased insight into the vaginal discharge as a whole, and is an excellent method for all women of reproductive age to learn, as part of knowledge of their bodies.

In summary, vaginal discharge is usually normal if it:

  • Follows a cyclical pattern that can be related to your hormonal changes (this may require the help of an Accredited Billings Ovulation Method Teacher to interpret)
  • Does not have an offensive smell or unusual colour, and is not associated with symptoms such as itching, pain with passing urine or pelvic pain in general
  • Does not suddenly change without explanation, in quality, colour or amount

For help with interpreting your vaginal discharge, contact us at Equilibria.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter

Why Aren't You Taking Fish Oils?

Posted: Wednesday, December 18, 2013 at 12:04:22 PM EST by Alyssa Tait

There is really only one good answer to this question.

But in order to get to that answer, we need to understand what  omega-3s are.

Omega 3 fatty acids belong to a group known as essential fatty acids. This means exactly what it sounds like: our bodies cannot function effectively without them. (Compare this with essential amino acids, the building blocks of protein that we must take in for growth and repair of our cells).

Here is a very summarised list of potential effects of low essential fatty acids:

Reproductive problems, dry, scaly skin, depression, anxiety, learning difficulties, behavioural problems, coronary artery disease, inflammation.

Our bodies are very versatile, and can often make substances from other substances. For example, if you don’t get enough vitamin B3, your body can make it from the amino acid tryptophan. However, the important point about essential fatty acids is this:

Your body is unable to make essential fatty acids.

This means that the only way you are going to get these substances (which, don’t forget, are essential to human health) is to take them in through your diet. The only meaningful sources of omega-3s in the diet are oils from cold water fatty fish, including salmon and sardines, and flaxseed or linseed. There are also small amounts of omega-3s in dark leafy greens. (You can imagine how small these amounts are, as leafy greens are not exactly what you’d describe as oily).

So that’s easy! You eat salmon (or its less effective cousin, tuna) three times a week already. Safe!

If only it were that simple!

Eating other fats and oils interferes with the amount of omega-3s that reaches your cells. There are two major fatty acids that compete. One is called arachidonic acid. This is a non-essential fatty acid, the major source of which is meat. The second is the other group of essential fatty acids, the omega-6s. Omega-6 fatty acids are found in all nuts and seeds, and all oils made from nuts and seeds.

That’s lucky, you might think. You don’t eat almond oil, or sunflower oil, or sesame oil, or peanut oil, and only eat nuts occasionally.

Even if this is the case, you may be getting a lot more omega-6s than you think. Anything marked “vegetable oil” will almost certainly be high in omega 6s. This includes “blended vegetable oil”, all margarines and soft butter blends, and also the increasingly popular rice bran oil. It also includes any packaged items that contain vegetable oil. Have a look at the packet – even when they’re baked, not fried – you might be surprised to see that many packaged foods contain vegetable oil.

Furthermore, the trans fats present in any oil-containing food that has been heated at a high temperature also compete with omega-3 in the body.

So getting enough omega-3s is not just about eating omega-3 rich food regularly.

Doing that is rarely enough. It is much more so about reducing the competitors to omega-3s in the diet, including vegetable and seed oils, margarine, nuts, seeds and any food containing these, such as muesli. In fact, reducing the omega-6-rich foods can have an enormous impact on cellular levels of omega-3.

Reducing omega-6 intake to just 2.5%  of daily calories can increase tissue levels of omega-3 by over 50%(that's without taking any fish oil tablets!) On the other hand, we may need over 3000mg of omega-3 EPA and DHA to counter high intake of omega-6s in the diet. This is not a "one-size-fits-all" approach.

It’s worth doing a close study of your diet to see whether the balance of omega-3s to omega-6s is as good as you think it is. There is a website where you can go to find the “omega-3 score” of a huge number of foods. This is a score that takes into account both its omega-3 and omega-6 content – in other words, that which adds points and that which takes points away!

Go to www.fastlearners.org and see whether your diet consists of foods in the positive or in the negative.

 If your diet is made up of a lot of the positive foods, it increases the likelihood that your tissue levels of omega-3s are good, but it doesn’t guarantee this. The only way to really know what your tissue levels are like (which depend on your lifetime eating habits) is to have a blood test done through a functional laboratory. I can order this for you here at Equilibria.

And that brings us to the answer to the question.

The only reason to not be taking omega-3s as a supplement is that you are confident of your tissue levels of omega-3s, and you are eating a diet that will maintain them. This diet would consist of a high intake of oily fish – probably daily – and some flaxseed. ALA from flaxseed has some benefits, but does not convert well to the required EPA and DHA. The enzyme that aids this conversion can be slowed down by lack of zinc, magnesium, B vitamins and vitamin C.

If, like most of us, maintaining this diet at times becomes a little too arduous, you should be taking omega-3 supplements, ideally from fish oil or algae rather than flaxeed. Your skin, your brain, your heart and arteries, your memory and your hormones will thank you.

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About Alyssa Tait

Alyssa runs Equilibria Physiotherapy & Nutrition, a clinic focusing on integrative solutions for pelvic health issues including all types of pelvic pain, bladder and bowel control issues, fertility, and irritable bowel syndrome.

Alyssa’s website www.equilibriahealth.com.au is an information hub related to all things relating to the function of the female pelvis.

She aims to help as many people as possible restore balance to their pelvis through education, effective treatment and empowering lifestyle choices.

Alyssa enjoys playing the clarinet and rollerblading, though (much to the gratitude of her patients), not while she is consulting.

Connect with Alyssa  |  Facebook  |  Google Plus | linkedin | Twitter
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