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The Healthy and Balanced Vagina

Posted: Thursday, July 17, 2014 at 4:25:02 PM EST by Alyssa Tait

Concerned that your vagina may be ''out-of-whack''?

There is a lot of talk about the importance of health and balance these days – and the vagina is no exception!

What makes for a healthy vagina? When the vagina is comfortable and there are no symptoms of abnormal discharge, unpleasant odour, itching, dryness, irritation or discomfort, the vaginal environment is likely to be in balance. (By the way, there are six key areas to focus on to resolve vaginal dryness).

A normal, healthy vagina contains high populations of good bacteria – mainly lactobacilli. These are similar to the ‘’good bugs’’ present in a healthy digestive system, but may be slightly different species. Higher amounts of lactobacilli are associated with reduced dryness in menopausal women, and those with more diversity of species had more dryness. In women of menstruating age, there is a reduction of lactobacilli during the menstrual period.

The lactobacilli help maintain a protective acidic environment in the vagina. The higher the lactobacilli, the lower the other bacteria. Where there is more variety of bacteria, the pH is higher (that is, the vagina is less acidic). So, the vagina is a case where less variety is actually a good thing! Lower amounts of lactobacilli in the vagina increases the risk of both sexually-transmitted infections and bacterial vaginosis. This can be associated with miscarriage or premature rupture of membranes in pregnancy. An increase in the ‘’bad’’ bacteria is present in what has been recently called ‘’aerobic vaginitis’’, which is a state of inflammation in the vagina.

What helps promote these good bacteria? Firstly, good oestrogen levels. Oestrogen helps promote lactobacilli, which keep the vagina acidic and help to fend off harmful bacteria. Interesting though, oestrogen also promotes the growth of thrush, which is why it is common to increase during pregnancy and while on the Pill. The acidic environment does not therefore fully defend against thrush, but certain species of lactobacillus do help resist Candida albicans (thrush) colonisation.

Secondly, avoiding artificial hormones and implants helps promote normal healthy vaginal flora. The balance tends to shift with the use of not only the oral contraceptive Pill, but the IUD (intra-uterine device). Studies have shown an increase in the harmful bacteria in the vagina, which does not occur when using condoms for contraception.

Thirdly, the balance of gut flora has an influence on the vaginal flora. As the vagina and the anus are in such close proximity, the bowel flora tend to ‘’migrate’’ to the vagina. It is therefore important to have a good balance of gut flora by eating fermented foods and/or taking probiotic supplements, as well as avoiding unnecessary antibiotics. Stress depletes the good bugs within hours, so this is our fourth important factor – improving stress management!

So what do you do when your vaginal flora is ‘’out-of-whack’’? It’s important to have a swab test with the GP if you have any symptoms of itching, irritation, change in discharge or pain with passing urine. There are also naturopathic treatment approaches for unbalanced vaginal flora, many of which have research studies to support them.

It is sometimes hard to know if your vaginal discharge is normal. This depends both on the general characteristics of the discharge, as well as how it might vary from what you've experienced previously. A few guidelines can help you work out if it is part of a healthy pattern of variation or not.

If you are concerned that you are out of balance from the vaginal perspective, make an appointment at Equilibria for tips on how to get this tested as well as possible treatment options.

If you would like to know more about achieving a healthy, balanced vaginal environment, go to our homepage and subscribe to our newsletter via the button below, ticking the box for ‘’Vaginal Health, Thrush and BV’’ for a series of free e-newsletters on the topic.

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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

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

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

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

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.

Paralysed By Choice: Three Steps to Working Out What Diet is Right for You

Posted: Thursday, May 29, 2014 at 8:38:00 AM EST by Alyssa Tait

Gluten-free, Paleo, grain-free, low-FODMAPs, Specific Carbohydrate Diet, GAPs, raw, liver detox, low-salicylate/amine/glutamates, high-fibre, high-protein, low-carbohydrate, anti-Candida, low-oxalate, alkalising, Weston A Price, vegetarian…how do you sift your way through?

Some of these diets can be questionable, especially the way they are described or interpreted on some websites or by less experienced practitioners.

But most of these diets can be helpful – even ideal – for some people for short or long periods of their life. It is rare that one diet will cover all of your needs for your whole life. So where do you start in working out what diet will suit your body’s needs right now?

There is a wealth of information on the Internet about ideal diets for gut health, thyroid health, autoimmune disease, hormone-balancing, weight loss, best energy, you name it, as well as testimonials from people who are convinced of the benefits of these diets. There are sites galore promoting interstitial cystitis diets, IBS diets, diets for SIBO (small intestinal bacterial overgrowth), anti-Candida diets. But sometimes, the wealth of information can leave you feeling no closer to figuring out what is right for your body’s needs at this stage of your life.

Let me give you a simple formula to work out what is right for you.

Listen to your body.

This may sound obvious, but it’s amazing how often people ignore it. These are just a few of the comments I hear all the time:

“I feel bloated if I eat too much wheat”.

“Too much dairy gives me diarrhoea”.

“When I eat eggs, they go straight through me.”

An integrative nutritionist can help you joint the dots on factors in your history that give important clues. For example, chronic sinus issues are often associated with a dairy intolerance, as is bedwetting in children and acne (in fact, a 2014 review in the Journal of Clinical and Experimental Dermatology) comments on the link between acne and dairy, which requires further investigation). The link between gluten sensitivity and thyroid disease is also well established in the research.

Don’t ignore these clues! Without wishing to oversimplify, it is important to start somewhere – and following the already-established links is a good place to start.

Testing, testing, testing

Going in the direction that has helped others with your condition is only a starting point at best – and at worst, it can take you for a ride on the “health website merry-go-round”, where you half-follow one diet after the other without ever systematically measuring the results.

Working with a practitioner experienced in testing is essential. Choosing the right tests is important, as is choosing the right order of tests. Which are most important? Which ones should you prioritise? Are there key ones you should include before a dietary change? (One example is in making sure you do the right testing before you try going gluten-free.) Some of the key tests in establishing what kind of diet is appropriate to your body include:

  • IgG food sensitivity testing
  • Lactulose breath testing
  • Fructose breath testing
  • Coeliac screening
  • Bioimpedance (Body Composition) testing

In some cases, further important information is gained from tests such as:

  • Functional Liver Detoxification Profiles
  • Hormonal Testing
  • Autoimmune marker testing, such as thyroid antibodies
  • Adrenal Hormone Testing
  • Red Cell Essential Fatty Acids

A functional medicine practitioner will be able to order any of these tests that are appropriate to your situation. Much of this testing is done through what is known as “functional pathology” as opposed to “general pathology”. This usually means reasonable out-of-pocket expense. Some of these tests can cost a few hundred dollars. However, they will probably save you far more in consultation and supplement expenses, not to mention medical expenses over the years as undiagnosed problems turn into more serious medical conditions.

Put your history and test results together with a skilled functional medicine practitioner or integrative nutritionist.

It’s important to find an experienced practitioner to help you navigate the territory. This may be a naturopath, a clinical nutritionist or a medical doctor. Look for someone who uses or understands the terms “functional medicine”, “nutrition medicine” or “integrative nutritionist”. Generally, if they provide rebates, the rebates will be under naturopathy, not dietetics.

Self-treating is a minefield, even when you have good knowledge and awareness of your body. In fact, functional medicine practitioners (FMPs) often see other FMPs to help them with their own health!

Improving your health through optimal nutrition is anything but  a one-size fits all approach. It requires commitment on your part, a skilled and experienced functional medicine practitioner, and the careful collection of information from your history, your symptoms and specific testing. The great news is, you’ll find that the effort pays off, helping you achieve the best health possible.

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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 Probiotics Work?

Posted: Tuesday, December 2, 2014 at 10:22:50 AM EST by Alyssa Tait

A (Greatly Truncated) Response to the Question of Whether Probiotics are Overrated

Probiotics: myth or miracle?

It’s the kind of grab-your-attention, oversimplified, dichotomized headline we are used to in the media. But, I was grateful to be asked for my opinion on an article of this name:

http://www.theguardian.com/lifeandstyle/2014/nov/30/probiotics-myth-or-miracle-prebiotics

So here is the quick 10-minute version of my opinion on this, straight from my Facebook response.

This article is better than I expected from the headline - at least they correctly cited some conditions there is evidence for treating with probiotics, such as IBD and traveller's diarrhoea. Until the concluding line! Just focus on consuming good quality yoghurts, my foot! Do they exist?! Aside from the ones you make yourself, that is. There are two problems with this statement.

Problem number one: numbers in yoghurt are too low.

For therapeutic effect - that is, not just to "stay healthy" (never mind that most people trying to "stay healthy" have symptoms or conditions they could be treating nutritionally) but to treat a condition, you simply need higher numbers than are in yoghurt - especially standard store-bought yoghurt. Problem number two: strain specificity. While a healthy gut has hundreds of different species and strains (and by extension we can assume we need to be consuming these, unless of course we have a perfect gut microbiome handed down from a mother with a perfect microbiome, have never had antibiotics etc) to actually treat a health condition (such as ulcerative colitis) the specific strains used in the research are necessary. Assuming that taking Inner Health is going to correct all our microbiomial shortcomings is analagous to taking a multivitamin and expecting it to correct the health problems arising from the epigenetic problems from the MTHFR polymorphism (i.e. doesn't work).

probiotics

This article has picked and chosen a couple of conditions there is evidence for. Actually, there is evidence for probiotic treatment of urinary tract infections, thrush, bacterial vaginosis, (for more information on these, subscribe to our newsletter and tick "vaginal health, thrush and BV") allergic rhinitis, eczema, diarrhoea from chemotherapy, cow's milk protein allergy, irritable bowel syndrome, lactose intolerance, diarrhoea from radiation, viral gastroenteritis. The bottom line is strain specificity.

Asking "do probiotics work?" is like asking "does physiotherapy work, or is it overrated?" Work? For what? What kind of physiotherapy approach/technique? We don't give staged basal expansions (i.e. breathing exercise) for patellar maltracking (i.e. a biomechanical problem at the knee). Choose the intervention according to clinical reasoning, basic science, clinical experience and, ideally and where available, the evidence base. We need to remember that a lack of available evidence to show effect is not the same as availability of evidence showing no effect.

And make no mistake: with the very real problem of antibiotic resistance, the price we pay for being too skeptical about probiotic therapy is prohibitively high.

Sure, there's a lot more research to be done. But there is research available, and not making ourselves aware of it (and thus failing to educate our patients) is a mistake. I am so glad to see physios interested in the concept of the microbiome and probiotic therapy. What I find discouraging is the idea that people will read an article like this on probiotics and fail to change their habits (overusing antibiotics, failing to incorporate fermented foods into the diet, not considering probiotics and adjuncts to therapy for their particular health condition) due to a misinterpretation that the probiotic thing is overrated and a fad.

And by the way, as the article points out, prebiotic foods ARE incredibly important...but they can only feed what is there. If you lack bifidobacteria - as I see frequently on stool analyses of my patients - then eating artichokes and onions is not going to make them magically materialise. Take home message: don't just lucky dip and hope for the best. See a functional medicine practitioner! Or at least read their blogs :)

Perhaps start with this one on the role of the microflora in a healthy and balanced vagina.

http://www.equilibriahealth.com.au/Blog/equilibria-blog/Post/the-healthy-and-balanced-vagina

And please…tell me about your experience with probiotics by commenting below!

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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

Chronic Thrush, Painful Sex and Vulvodynia

Posted: Tuesday, August 25, 2015 at 9:47:03 AM EST by Alyssa Tait

When The Likely Suspect Is The Culprit!

Getting an accurate diagnosis of vulvodynia is usually a long and difficult process. You have had burning and stinging pain with sex, you have seen doctor after doctor, and they have put it down to thrush and given you creams and tablets galore, all to no avail. Then you finally see a clinician with experience in vulvodynia and you find out that it isn’t thrush, and no wonder the thrush treatments aren’t working. It’s a completely different pain condition of the vulva called vulvodynia.

That’s the common scenario I see in clinic, day after day. But that’s not what this blog post is about!

This post is about the opposite situation – when it’s been called vulvodynia – maybe they’ve used the word vaginismus as well – but the problem is actually due to chronic thrush. The chronic thrush hasn’t gone away with the medical treatment. But once we manage to get rid of it, your symptoms are gone. Yes, it does happen like this – and more often than you’d think!

Let me give you an example from a recent patient in her mid-forties who developed pain with sex six months before she came to see me after a particularly nasty bout of thrush (or vulvovaginal candidiasis, as it’s technically known). I will call her (for no particular reason) Z. Z had had antibiotics over several months before she developed symptoms. Not one course – not two – but four. Four lots of antibiotics! If something is going to give you a chronic thrush problem, this is it.

The thrush she developed was so persistent, Z needed to have the antifungal tablet (fluconazole) once a week for 6 months. When she stopped the tablet, the thrush came back. This is the point she was referred to me to help with her “vaginismus” – that is, the tightness/protectiveness in her pelvic floor muscles she’d developed from being so uncomfortable for so long.

Well, on examination it was clear that her poor old pelvic floor muscles were doing what was only natural when everything is so irritated. Her vestibule – the area outside the vaginal entrance – stung to touch (vestibulodynia), and the labia stung when touched as well. There were signs that the thrush was still present, despite being on strong antifungal medication. The problem was, the enemy was being gradually defeated, but the clean-up operation had not yet begun.

Z had a lifelong history of constipation. Four lots of antibiotics was enough to wipe out her protective flora, which left the vulva and vagina vulnerable to an enemy invader – thrush. Lack of a Peace Corps (the protective flora) meant that when the enemy numbers had been reduced (via the antifungal treatment) there was no one there to restore and maintain peace, which meant the enemy invader could continue to go out of control.

So, we started to restore her Peace Corps. We used a combination of a probiotic containing bacteria that live in the vagina. She took this by mouth as well as vaginally. She took a particular prebiotic that feeds the good flora. She took a mineral supplement that suppresses yeast growth. Getting a healthy and balanced vagina is an important part of comfortable sex.

Over a few months, pain with sex completely disappeared. Also, the itch that she had been experiencing over certain parts of her cycle drastically diminished. And despite her diagnosis of vaginismus, we didn’t need to do any work on her pelvic floor muscles, aside from making sure she had good awareness of relaxing when she wanted to relax.

Pain with sex can have many causes. Sometimes there is more than one cause. Sometimes the cause is complicated, as in vulvodynia with sensitisation of the nervous system. But sometimes the cause is straightforward. How will you know? The only way you’ll know is to see a clinician with experience in this area.

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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

Thrush Issues? Time to Ditch the Sugar!

Posted: Friday, March 3, 2017 at 9:25:35 AM EST by Alyssa Tait

Vaginal thrush and sugar…do you really need to cut it out?

Thrush loves sugar, Candida loves candy: it’s a piece of naturopathic wisdom. Or is it just folklore? Is there any real evidence for it?

Many women who have experienced chronic or recurrent vaginal thrush suspect it: Sugar is not the vagina’s friend. I treat women with ongoing thrush problems all the time, and when I regretfully bring up the sugar issue, they stop me even before I have finished.

“I know, I know…I’ve got to get rid of the sugar. It’s just so hard!”

But gynaecologists will rarely tell you to cut out the sugar, or watch the carbohydrate load in your diet. Why is that?

Modern medical practice is ruled by research evidence, and there just isn’t that much evidence for sugar and thrush in humans.

Back in 2002, a study looked at the effects of sugar on Candida in women.

They looked at the link between Candida in the mouth and faeces of women who eat differing amounts of carbohydrate, and didn’t find a connection between high-carb and Candida. Then they got the women to eat high-sugar diets, and reported a “limited effect” on Candida counts. But when looking at the fine detail, they did find that in some women with high Candida in their mouth, the high-sugar diet increased the Candida in the faeces. So even back then there were signs that sugar was not completely neutral when it comes to Candida.

Now this has been confirmed. A recent study using pretty fancy DNA technology to analyse gut microorganisms did confirm what we suspect: Candida was higher in those with higher carbohydrate diets, and lower in those with diets higher in fats and protein. The highest likelihood that they would find thrush? If you just ate carbohydrates.

Yes, it appears that Candida loves sugar.

So why doesn’t every woman have raging thrush, considering our society’s sugar addiction? Well, maybe many women do. Maybe overgrowth of Candida is a part of foggy brain, low energy, gut symptoms as old naturopathic folklore tells us. But that’s a discussion for another time.

For now, suffice to say that women with thrush issues probably handle sugar worse than women who don’t.

A study found that women with recurrent thrush actually had impaired glucose tolerance – the same thing you find in pre-diabetes! And could this be the reason why so many women with polycystic ovarian syndrome (PCOS) have chronic thrush issues? PCOS is linked with blood sugar dysregulation and insulin resistance.

It seems pretty clear. If you have recurrent thrush issues, it’s time to ditch the sugar.

If you need help working out a diet that allows you to feel satisfied and get healthy while tackling your thrush issue, that is exactly the kind of thing I help women with all the time at Equilibria - just contact us for an appointment. Skype appointments available!

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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
Tags: thrush,
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