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The Thyroid: Our master metabolism controller

The Thyroid: Our Master metabolism controller

What is the thyroid and why should you care? The thyroid gland controls the entire metabolism of all cells in the human body, so when things feel like they are slowing down, the thyroid is likely an area to look into.

The thyroid is a butterfly shaped gland situated on your neck.  The thyroid is the master controller of our metabolism, growth and maturation of the body. When you need more energy, more thyroid hormone is released, when you are cold, it helps heat your body tissues.  There are thyroid receptor hormones on every organ in the body.  This is why when you have an under active thyroid, you feel the effects all over your body. 

Over 60,000 new cases of thyroid disease are diagnosed each year, and this figure is rising.  Thyroid disease effects mostly those designated female gender at birth (over 90%) of cases.  The incidence of congenital hypothyroidism is also on the rise. 

Symptoms of low thyroid function:
  • Weight gain
  • Fatigue
  • Intolerance to the cold, cold extremities
  • Menstrual irregularities such as heavy and irregular cycles and infertility
  • Mood issues such as depression and anxiety
  • Sleep issues
  • Dry skin, brittle nails
  • Hair loss and hair thinning
  • Brain fog, inability to concentrate
  • Gut issues such as constipation or diarrhoea.
  • Increased allergies and food intolerance

How do we test for hypothyroidism?

If you are experiencing a number of the above symptoms then maybe it’s time to check out your thyroid function with a full thyroid blood test. This can help a practitioner get to the root cause for your specific issue, which is important as the drivers of the disease are different for everybody.  A full thyroid panel includes:

  • TSH (this is your pituitary gland asking your thyroid gland for more thyroid hormone)
  • T4 – a pro-hormone, that needs to be converted to the active hormone. If you have been prescribed thyroxine, this is T4, the inactive pro-hormone
  • T3 – the active thyroid hormone
  • rT3 – this is a metabolic break.  In times of extreme stress and eating disorders, our body converts T4 into the inactive hormone rT3 instead of T3
  • Thyroid antibodies – these can tell us if the thyroid is autoimmune (Hashimotos thyroiditis is autoimmune low thyroid function or Graves disease, which is autoimmune high thyroid function)

Diagnosis of thyroid disease is generally made in the late stages of the disease when it has already severely progressed.  This is due to the wide range of the thyroid hormone reference ranges, under testing, and also people just thinking that feeling sub optimal is normal. If you don’t feel right, request more tests, and work with a functional medicine practitioner who will look at the optimal references ranges for health.

How to treat the thyroid?

Once you have a full thyroid panel, look at the things in your life that may be driving thyroid health or disease, and treat this.  If you do not treat the cause and only treat symptoms, the issue will not resolve.

Most thyroid issues are linked to autoimmunity.  Some of the key drivers of autoimmunity are stress, leaky gut, hormonal fluctuations of pregnancy, environmental toxicity (see my blog on environmental pollutants here), heavy metal exposure, a low nutrient diet, lack of sleep and infections.

  • Stress is one of the main drivers of thyroid dysfunction.  You may not be able to remove some stressors from your life (hello lack of sleep with young children), but you can change the way you react to these stressors.  This may mean counselling, therapy, deep breathing exercises, journaling, gentle exercise, sunlight and adequate sleep.
  • Gut health.  This is a big one.  Every case of autoimmunity has gut health and leaky gut as a driver.  Treating the digestive system, and assessing symptoms that tell us that gut health is not optimal such as reflux, bloating, pain, constipation, diarrhoea, undigested food in stool, mucous or blood in the stool. Treating these symptoms can help reduce systemic inflammation and ensure adequate digestion of nutrients needed for thyroid hormone synthesis and conversion.
  • Immune issues.  Having a dysregulated immune system can lead to autoimmunity.  Most of our immune system is housed in the gut, which needs to be adequately functioning. Nutrients needed to sustain immunity such as vitamin D, zinc and vitamin C are also important. 
  • Diet low in nutrients needed to make thyroid hormones.  The thyroid requires iodine and tyrosine to make thyroid hormones, as well as selenium, zinc, vitamin D and vitamin A to adequately convert the inactive thyroid hormone T4 to the active T3.  If your diet is low in nutritional value, or you are not eating foods high in these vitamins and minerals, sustaining thyroid health can be difficult.
  • Chemical exposure.  Some chemicals are called halogens, these have a similar chemical structure to iodine, which is important for our thyroid hormones. These can disrupt thyroid hormone synthesis.  These include bromine in commercial breads, fluoride in toothpaste and our water supply and chlorine in drinking water and swimming pools. 
  • Infections.  This can be a big trigger for many people. This can be something like glandular fever, helicobactor pylori, candida, lymes and herpes virus’. Adequately helping your body to clear or treat underlying infections and the immune dysfunction that may be allowing these to flourish is important.

If you have a thyroid disease, and are only taking thyroxine, you are not treating the cause of your low thyroid function, you are simply supplementing the hormones. Book in with me today to find the cause of your thyroid issue and treat your body holistically.

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How to reduce toxin exposure for a gentle detox

We are bombarded with different environmental chemicals in day to day life that are affecting male and female fertility, over-burdening our livers, causing cancers and contributing to cognitive decline. The thyroid in particular is a very vascular gland that is easily effected and damaged by toxins. Some occupations such as hair dressers, builders, mechanics, nail technicians and gardeners are exposed to various chemicals daily.

Symptoms of a high toxic burden can be weight gain, brain fog, hormonal disturbances, infertility, depression, headaches, skin irritations and dermatitis, acne… the list goes on and on!

Where to start?

Chemicals are in our cosmetics, food, food storage, household goods, cleaning products, tampons, animal products such as meat and dairy. These may be in the form of pesticides sprayed onto food or the food that feeds animals that you eat, it may be additives in foods, or a chemical that helps clean your dishes.

Chemicals are ever present, and not everyone will get symptoms to chemicals, it’s about age of exposure, length of exposure to a toxin and frequency. Many other factors come into play such as genetics.

Below is a very extensive list of chemicals you may be exposed to, but in general the best way to reduce toxin exposure is to slowly assess different areas of your lifestyle. When one of your “chemical” laden products in the home runs out, replace it with organic/ low tox.  This doesn’t have to be perfect, aim for small changes over time. I started with my body care products first, especially things I use all the time, such as soap, then shampoo and conditioner, then I moved onto nail polish and makeup. I then began replacing our plastic food storage containers with glass, and sourcing out organic produce where appropriate.

Beware of “green washing”

Green washing is when a product tries to appear more environmentally friendly by having the packaging with pictures of trees or nature, using words like natural, eco, organic or earth friendly. These words really mean nothing, it’s all down to whats actually in the product. You can read the label to get a better idea of what is actually in the product.

The big culprits – Avoid

The worst chemicals to affect fertility, the thyroid gland and hormone synthesis are:  

  • Brominated flame retardants: Animal studies show that these disturb liver function and can damage the developing nervous system. These are used to stop certain items in our home catching alight. They are everywhere in furnishings, clothing, computers etc. The best way to avoid these is to air out new furniture, dust frequently (the particles settle in dust) and add plants to the home that help remove these gasses.
  • Dioxins: These are found all throughout the food chain, and are released into the environment constantly. They are stored in animal fats, and are frequently eaten through eating animals, as well as in wool bleaching and tampon bleaching – opt for organic sanitary care products or use a menstrual cup. Also opt for organic meats.
  • Phthalates: these are added to make plastics more pliable, see-through and durable. Frequently used to soften PVC and are found in things like vinyl flooring, cosmetics, soaps, shampoo and hairspray. To avoid these, look for organic personal care products and keep an eye out for these on the label. Also ensure you are not using plastic storage containers or water bottles – always look for glass. The effects in animal studies show that phthalates affect the reproductive system. Human studies show that women have higher levels of phthalates metabolites in their body than men due to the exposure from person care products.
  • Bisphenol A (BPA): Mainly in soft plastics that store food such as water bottles, the inner lining of tins/cans. Avoid plastic food containers, never heat food in plastic, and opt for BPA free cans if you are buying canned goods, or avoid canned goods and buy bottled versions instead. Infants and fetus’ are shown to be the most effected by BPA’s, and this can travel through breastmilk, or be passed on in baby bottles that are not BPA free.
How to avoid:
Reduce exposure
  • Drink filtered water. Different filtration systems filter out different levels of water pollutants such as large particles or heavy metals. I have a reverse osmosis system fitted that I adore.
  • Do not heat or store food in plastic containers and never use non-stick cookware, aim for ceramic where possible.
  • Avoid areas where exposure to chemicals and pollution is high such as heavy traffic areas, bus depots, flight paths, farm land where crops have been sprayed, shipping ports, mining areas and construction sites.
  • Air out new furniture and linen in direct sunlight to help with off-gassing
  • Asses all the products you are putting on your skin and using in your home.
  • Eat local, organic, in season produce.
Make your own

The internet has a plethora of advice on how to make everything from deodorant to cleaning sprays. These are generally cheap and easy and also save costs with ingredients such as vinegar and bicarb as the key ingredients. If you are time poor like me, opt for low tox and organic products. Shops like Biome and Flora and Fauna are fantastic online shops to help source out these products.

Eat organic

When assessing your food, ensure that you are eating organic for the foods that require it most. There is a list called the “dirty dozen” which are the foods that hold pesticide residue the most, and the “clean 15” which are the foods that you can pretty safely eat non-organic and it should be ok. These change each year depending on which are the most sprayed crops, so look these up for this years list.

Detox chemicals from your system

Ensure you can appropriately remove chemicals from your body by:

  • Drink at least 2L of filtered water a day
  • Eat a high fibre diet, high in binders such as chia seeds, flaxseeds as well as fibre in vegetables such as broccoli, onion, cabbage, spinach etc.
  • Sweat by intense exercise or sauna bathing. Sauna bathing also has many other fantastic metabolic effects.
  • Ensure you are passing a stool daily. Constipation can lead to a build up of chemicals in your system and reabsorption of chemicals your body is trying to excrete.
  • Include herbal teas that move your bowels and assist in removing chemicals from your system such as calendula, nettle leaf, licorice, rosemary, lemon and ginger.
  • Herbs that help detox chemicals and heavy metals such as coriander, garlic, turmeric, St Mary’s thistle, garlic and chlorophyl.

Book in with me today to completely assess your whole body health and help open up your channels of elimination to help with reducing chemicals.

Book in HERE

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Iron deficiency in pregnancy

Iron deficiency anaemia affects 42% of pregnant people. Without adequate iron stores, anaemia can develop that effects the mother and unborn child. Iron is needed to form all body cells, building the placenta, increasing maternal iron stores and of course creating all tissues in the unborn child.

Iron forms part of proteins involved in DNA synthesis and energy production, giving women strength and energy through pregnancy and postpartum. Iron is needed for placental function and oxygenation and to reduce miscarriage risk

Positive effects of iron in pregnancy
  • Cognition in the mother and baby: Iron is required to bring oxygenated red blood cells to the brain. As the brain develops, it requires iron for building new brain cells and the nervous system.
  • Fetal brain and organ development: Iron is important for the metabolism and function of nerves in the brain, affecting babies brain function post-birth. During fetal development, iron-dependent enzymes are essential for organ development, particularly the brain, through myelination of nerve cells, neurotransmitter synthesis and gene expression.
  • Immunity: Iron increases the functions of immune cells and regulates enzymes that control the production of antimicrobial cells.
  • Reduced risk of antenatal and postnatal depression: Iron prevents depression and anxiety through adequate neurotransmitter metabolism and myelination of nerves in the brain of the mother.
  • Increased exercise capacity: Iron is a part of red blood cells, transporting oxygen to tissues and is a cofactor in aerobic metabolism, increasing exercise capacity for the mother.
  • Preterm birth prevention: Adequate levels of iron rich haemoglobin reduce the chance of hypoxia induced stress response and oxidative damage in utero.
How much iron do you need?

Blood volumes increase by 40-50% by the 24th week of pregnancy, meaning an increased demand for iron. Below are the recommended dietary intakes of iron for pregnant and non-pregnant women.

Pregnant womenNon-pregnant women
Age groupRDIRDI
14-18 years27 mg/day15 mg/day
19–30 years27 mg/day18 mg/day
31-50 years27 mg/day18 mg/day
Recommended dietary intake (RDI) of iron for pregnant women and non-pregnant women
Consequences of iron deficiency in pregnancy
  • Symptoms in the mother: reduced cognition, pale skin, irritability, breathlessness, heart palpitations, hair loss, tinnitus, headaches and dizziness.
  • Consequences for the pregnancy: As the need for iron progresses, the pregnancy is effected with increased risk of premature delivery, intrauterine growth retardation, gestational diabetes, preeclampsia, postpartum haemorrhage, birth asphyxia and even infant and/or maternal death.
  • For the fetus: Iron deficient neonates can have a lower birth weight, have significantly reduced cognitive abilities and behavioural abnormalities that can persist even after iron repletion post-birth.
FoodIronFoodIron
Fortified weetbix14mgFlaxseeds5.73mg
Chicken/lamb liver11mgOctopus5.59mg
Pumpkin seeds10mgCashews5mg
Lentils (dry)9.1mgLamb5mg
Fortified breads8.23mgEgg 4.8mg
Navy beans6.4mgKangaroo4.2mg
Sardines6.1mgVegemite4.03mg
Peas5.9mgSpinach3.58mg
Beef5.8mgTofu2.9mg
Iron content of foods per 100g of intake
How can we prevent iron deficiency in pregnancy?
  • Some forms of iron in food are more readily absorbed, for example the iron from meat has better absorption than plant sources of iron. A diverse diet of meat and vegetables together is recommended to increase iron levels in pregnancy.
  • Vegan and vegetarian mothers are more at risk of iron deficiency than meat eaters, as are women from limited socioeconomic backgrounds. Teen-mothers are also at a higher risk due to the iron needs for their own growth. If you are at risk, more frequent check-ins with your healthcare team is warranted to reduce chances of iron deficiency.
  • Reach the RDI by eating a variety of iron rich foods throughout pregnancy.
  • Legumes, rice and beans can bind to iron, therefore avoid intake of supplements at the same time.
  • Intake of iron can be increased by taking it at the same time as vitamin C.
  • See your doctor to get blood tests during preconception and throughout pregnancy to determine if you have iron deficiency.
  • Do not supplement iron without first being tested for deficiency, as high iron can have detrimental effects to mother and baby.
  • If you are severely deficient in iron, an intravenous iron transfusion can be used in the third trimester of pregnancy to bring iron levels to within range.
  • Space out your supplement dose to 2–3 times weekly, as opposed to daily, as this is as effective as daily supplementation, with fewer side effects.

If you would like pregnancy, preconception or postpartum nutritional or naturopathic care, book in with me HERE via zoom or in person in Brisbane, QLD.

References:

  1. Cusick SE, Georgieff MK, Rao R. Approaches for Reducing the Risk of Early-Life Iron Deficiency-Induced Brain Dysfunction in Children. Nutrients [internet] 2018 Feb 17 [cited 2021 May 9];10(2):1-4. Available from: https://doi.org/10.3390/nu10020227
  2. Di Renzo GC, Spano F, Giardina I, Brillo E, Clerici G, Roura LC. Iron deficiency anemia in pregnancy. Womens Health (Lond) [internet] 2015 Nov [cited 2021 May 12];11(6):891-900. Available from: https://doi.org/10.2217/whe.15.35
  3. Raffaeli G, Manzoni F, Cortesi V, Cavallaro G, Mosca F, Ghirardello S. Iron Homeostasis Disruption and Oxidative Stress in Preterm Newborns. Nutrients [internet]. 2020 May 27 [cited 2021 May 10];12(6):1-21. Available from: https://doi.org/10.3390/nu12061554
  4. Nairz M, Weiss G. Iron in infection and immunity. Molecular aspects of medicine [internet]. 2020 Oct [cited 2021 May 5];75(2020):1-18. Available from: https://doi.org/10.1016/j.mam.2020.100864
  5. National Health and Medical Resource Council, Nutrient reference values for Australia and New Zealand including recommended dietary intakes [internet]. National Health and Medical Research Council. c2006, [updated 2017; cited 2021 May 10]; 171-174. Available from: https://www.nhmrc.gov.au/about-us/publications/nutrient-reference-values-australia-and-new-zealand-including-recommended-dietary-intakes#block-views-block-file-attachments-content-block-1
  6. Brannon PM, Taylor CL. Iron supplementation during pregnancy and infancy: uncertainties and implications for research and policy. Nutrients [internet]. 2017 Dec 6 [cited 2021 May 12];9(12):1-17. Available from: https://doi.org/10.3390/nu9121327
  7. Abu-Ouf NM, Jan MM. The impact of maternal iron deficiency and iron deficiency anemia on child’s health. Saudi Med J. [internet] 2015 Feb [cited 2021 May 10];36(2):146-9. Available from: https://doi.org/10.15537/smj.2015.2.10289
  8. Milman N, Paszkowski T, Cetin I, Castelo-Branco C. Supplementation during pregnancy: beliefs and science. Gynecol Endocrinol. [internet]. 2016 Jul [cited 2021 May 9];32(7):509-16. Available from: https://doi.org/10.3109/09513590.2016.1149161
  9. Means RT. Iron deficiency and iron deficiency anemia: implications and impact in pregnancy, fetal development, and early childhood parameters. Nutrients [internet]. 2020 Feb 11 [cited 2021 May 12];12(2):1-15. Available from: https://doi.org/10.3390/nu12020447
  10. Stuetz W, Gowele V, Kinabo J, Bundala N, Mbwana H, Rybak C, et al. Consumption of Dark Green Leafy Vegetables Predicts Vitamin A and Iron Intake and Status among Female Small-Scale Farmers in Tanzania. Nutrients [internet]. 2019 May 7 [cited 2021 May 9];11(5):1-18. Available from: https://doi.org/10.3390/nu11051025
  11. National Health and Medical Resource Council [internet]. Canberra; c2017. Nutrient reference values for Australia and New Zealand What are nutrient reference values? 2017 Sep 22 [cited 2021 May 17]; [about four screens]. available from: https://www.nrv.gov.au/introduction#:~:text=RDI%20%3D%20EAR%20%2B2SDEAR,that%20greater%20variation%20is%20probable.
  12. Food Standards Australia and New Zealand [internet], Australian Food composition database, release 1.0. c2019. [cited 2021 May 17]; [about six screens]. available from: https://www.foodstandards.gov.au/science/monitoringnutrients/afcd/Pages/foodsbynutrientsearch.aspx?nutrientID=FE
  13. Cerami C. Iron Nutriture of the Fetus, Neonate, Infant, and Child. Ann Nutr Metab. [internet] 2017; [cited 2021 May 13];71(3):8-14. Available from: https://doi.org/10.1159/000481447
  14. Yılmaz E, Yılmaz Z, Çakmak B, Gültekin İB, Çekmez Y, Mahmutoğlu S, et al. Relationship between anemia and depressive mood in the last trimester of pregnancy. J Matern Fetal Neonatal Med. [internet]. 2017 Apr [cited 2021 May 9];30(8):977-982. Available from: https://doi.org/10.1080/14767058.2016.1194389
  15. Garzon S, Cacciato PM, Certelli C, Salvaggio C, Magliarditi M, Rizzo G. Iron Deficiency Anemia in Pregnancy: Novel Approaches for an Old Problem. Oman Med J [internet] 2020 Sep 1 [cited 2021 May 10];35(5):1-9. Available from: https://doi.org/10.5001/omj.2020.108
  16. Achebe MM, Gafter-Gvili A. How I treat anemia in pregnancy: iron, cobalamin, and folate. Blood [internet]. 2017 Feb 23 [cited 2021 May 15];129(8):940-949. Available from: https://doi.org/10.1182/blood-2016-08-672246
  17. Wiegersma AM, Dalman C, Lee BK, Karlsson H, Gardner RM. Association of Prenatal Maternal Anemia With Neurodevelopmental Disorders. JAMA Psychiatry [internet]. 2019 Dec 1 [cited 2021 May 9];76(12):1294-1304. Available from: https://doi.org/10.1001/jamapsychiatry.2019.2309
  18. Auerbach M. Commentary: Iron deficiency of pregnancy – a new approach involving intravenous iron. Reprod Health [internet]. 2018 Jun 22 [cited 2021 May 17];15(96):109-115. Available from: https://doi.org/10.1186/s12978-018-0536-1
  19. Col Madendag I, Eraslan Sahin M, Madendag Y, Sahin E, Demir MB, Acmaz B, et al. The Effect of Iron Deficiency Anemia Early in the Third Trimester on Small for Gestational Age and Birth Weight: A Retrospective Cohort Study on Iron Deficiency Anemia and Fetal Weight. Biomed Res Int. [internet] 2019 Nov 22[cited 2021 May 8];2019:1-4. Available from: https://doi.org/10.1155/2019/7613868
  20. Vashishth A, Ram S, Beniwal V. Cereal phytases and their importance in improvement of micronutrients bioavailability. 3 Biotech. [internet]. 2017 May [cited 2021 May 9];7(1):42. Available from: https://doi.org/0.1007/s13205-017-0698-5
  21. Api O, Breyman C, Çetiner M, Demir C, Ecder T. Diagnosis and treatment of iron deficiency anemia during pregnancy and the postpartum period: Iron deficiency anemia working group consensus report. Turk J Obstet Gynecol. [internet] 2015 Sep [cited 2021 May 7];12(3):173-181. Available from: https://doi.org/10.4274/tjod.01700
  22. Zhang Q, Lu XM, Zhang M, Yang CY, Lv SY, Li SF, et al. Adverse effects of iron deficiency anemia on pregnancy outcome and offspring development and intervention of three iron supplements. Sci Rep. [internet]. 2021 Jan 14 [cited 2021 May 9];11(1):1-11. Available from: https://doi.org/10.1038/s41598-020-79971-y
  23. Mishra A, Marwah S, Divedi P, Dewan R, Ahluwalia H. A Cross-Sectional Study of Barriers in Prevention of Anemia in Pregnancy. Cureus [internet]. 2021 Jan 20 [cited 2021 May 9];13(1):1-10. Available from: https://doi.org/10.7759/cureus.12802
  24. Frayne J, Pinchon D. Anaemia in pregnancy. Aust J Gen Pract. [internet] 2019 Mar [cited 2021 May 10];48(3):125-129. Available from: https://doi.org/10.31128/AJGP-08-18-4664
  25. Dewey KG, Oaks BM. U-shaped curve for risk associated with maternal hemoglobin, iron status, or iron supplementation. Am J Clin Nutr. [internet]. 2017 Dec [cited 2021 May 9];106(6):1694S-1702S. Available from: https://doi.org/10.3945/ajcn.117.156075
  26. Froessler B, Gajic T, Dekker G, Hodyl NA. Treatment of iron deficiency and iron deficiency anemia with intravenous ferric carboxymaltose in pregnancy. Arch Gynecol Obstet [internet]. 2018 Jul [cited 2021 May 12];298(1):75-82. Available from: https://doi.org/10.1007/s00404-018-4782-9
  27. Pena-Rosas JP, De-Regil LM, Gomez Malave H, Flores-Urrutia MC, Dowswell T. Intermittent oral iron supplementation during pregnancy. Cochrane Database Syst. Rev. [internet]. 2015 Oct 19 [cited 2021 May 12];10:1465-1858. Available from: https://doi.org/10.1002/14651858.CD009997.pub2
  28. Madendag IC, Sahin ME, Madendag Y, Sahin E, Demir MB, Acmaz B, et al. The Effect of Iron Deficiency Anemia Early in the Third Trimester on Small for Gestational Age and Birth Weight: A Retrospective Cohort Study on Iron Deficiency Anemia and Fetal Weight. Biomed Research Int. [internet]. 2019 Nov 22 [cited 2021 May 15];2019;1-4. Available from: https://doi.org/10.1155/2019/7613868
  29. Taylor CL, Brannon PM. Introduction to workshop on iron screening and supplementation in iron-replete pregnant women and young children. Am J Clin Nutr. [internet]. 2017 Dec [cited 2021 May 9];106(6):1547S-1554S. Available from: https://doi.org/10.3945/ajcn.117.155747
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Omega-3, pregnancy and preterm birth

Omega-3, pregnancy and preterm birth

Preterm birth (birth before 37 weeks gestation) is leading cause of neonatal mortality. Infants born preterm generally require care in neonatal intensive care, and can have an increased risk of a number of potentially serious complications such as cerebral palsy, respiratory distress syndrome, intraventricular haemorrhage, necrotising enterocolitis and blindness. Preterm birth cannot be easily predicted, however we can do everything in our power to prevent it.

Nutritional status during and prior to pregnancy is an important determinant of fetal health through pregnancy. Observations of populations with higher fish consumption found increased lengths in gestation. So what does fish have that potentially decreases risk of preterm birth? Fish is high in an essential fatty acid, omega-3. Omega-3 is hard to come by in any other food source, so our friends in the sea are one of the only places we can find it. There are a few omega-3’s:

  • Eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA) and docosapentaenoic acid (DPA): found almost exclusively in oily fish and seafood.
  • A-linoleic acid (ALA): found in some nuts, linseed and canola oil, legumes and small amounts in leafy greens. ALA is generally inactive until converted to EPA and DHA, of which it only converts very small amounts.

Omega-3’s, specifically EPA and DHA play key roles in the development of the fetus, modulating inflammation and the synthesises of prostaglandins. Prostaglandins are substances that play a role in blood flow, the induction of labour and gestational length through reducing the inflammatory pathway which is linked to spontaneous preterm birth. During labour omega-3’s play a crucial role in the inflammatory cascade, blood flow and cervical ripening.

In fetal development, omega-3’s have been shown to impact the fetal brain, retina and respiratory system. Higher near-birth DHA levels in the fetus are associated with increases in brain volume that correlate with increased language and motor scores in preschool age children. Supplementation during pregnancy reduces the incidence of asthma and improves heart rate variability, with low levels of omega-3 through childhood being postulated to be a risk factor for autism spectrum disorder.

So how do I get omega 3?

  • Intake of fatty fish – especially sustainably wild sourced and of a good quality.
  • Supplement a good quality fish oil, that is rich in DHA. Poor quality fish oils can be contaminated with heavy metals, come from low quality processing facilities and may even be rancid. Quality is everything with omega-3 supplementation.
  • Some omega-3 can be from a marine algal source, which can also be excellent – just ensure that this is a high EPA/DHA marine algae.

How much do I take?

There have been a lot of studies on supplementation in pregnant women with doses of 750-1000mg/day shown to be safe and effective.

Although there are studies on omega-3 and fish oil supplements being safe and effective for most pregnant women, always consult with your healthcare professional before starting any new supplements. There can never be a guarantee that any one supplement will prevent preterm birth for your specific situation. There is no one size fits all approach to pregnancy care, always have a team of professionals assessing your nutrition, supplements and lifestyle.

Further reading:

  1. Olsen SF, Halldorsson TI, Thorne-Lyman AL, Strøm M, Gørtz S, Granstrøm C, et. al, Plasma  Concentrations of Long Chain N-3 Fatty Acids in Early and Mid-Pregnancy and Risk of Early Preterm Birth, 2018, eBioMedicine, 2018 Sep 01, 35(2018);325-333, DOI:https://doi.org/10.1016/j.ebiom.2018.07.009.
  2. Lizewska B,  Teul J,  Kuc P, Lemancewicz A, Charkiewicz A, Goscik J, et al., Maternal Plasma Metabolomic Profiles in Spontaneous Preterm Birth: Preliminary Results, Mediators of inflammation, 2018; 1-13, https://doi.org/10.1155/2018/936282
  3. Makrides M, Best K: Docosahexaenoic Acid and Preterm Birth. Ann Nutr Metab, 2016 Nov 01, 69(suppl 1);29-34. https://doi.org/10.1159/000448263
  4. Ramakrishnan U, Stein AD, Parra-Cabrera S, et al. Effects of Docosahexaenoic Acid Supplementation During Pregnancy on Gestational Age and Size at Birth: Randomized, Double-Blind, Placebo-Controlled Trial in Mexico. Food and Nutrition Bulletin. 2010;31(2_suppl2):S108-S116. doi:10.1177/15648265100312S203
  5. National Health and Medical Research Council, Australian Government Department of Health and Ageing, New Zealand Ministry of Health. Nutrient Reference Values for Australia and New Zealand. Canberra: 2006 National Health and Medical Research Council; (cited 2021 April 4); 31p. Available from: https://www.nhmrc.gov.au/health-advice/nutrition
  6. Imhoff‐Kunsch B, Briggs V, Goldenberg T, Ramakrishnan U, Effect of n‐3 Long‐chain Polyunsaturated Fatty Acid Intake during Pregnancy on Maternal, Infant, and Child Health Outcomes: A Systematic Review. Paediatric and Perinatal Epidemiology, 2012(26); 91-107. https://doi.org/10.1111/j.1365-3016.2012.01292.x
  7. Makrides M, Gibson RA, McPhee AJ, et al. Effect of DHA Supplementation During Pregnancy on Maternal Depression and Neurodevelopment of Young Children: A Randomized Controlled Trial. JAMA. 2010;304(15):1675–1683. doi:10.1001/jama.2010.1507
  8. Carlson SE, Gajewski BJ, Valentine CJ et al. Assessment of DHA on reducing early preterm birth: the ADORE randomized controlled trial protocol. BMC Pregnancy Childbirth 2017, 17(62):1-16, https://doi.org/10.1186/s12884-017-1244-5
  9. Kamino D, Studholme C, Liu M, Chau V, Miller SP, Synnes A, et al., Postnatal polyunsaturated fatty acids associated with larger preterm brain tissue volumes and better outcomes. Pediatr Res. 2018 Jan;83(1-1):93-101. doi: 10.1038/pr.2017.230.
  10. Carlson SE, Colombo J, Gajewski BJ, Gustafson KM, Mundy D, Yeast J, et al., DHA supplementation and pregnancy outcomes, The American Journal of Clinical Nutrition, 2013 Apr; 97(4):808–815, https://doi.org/10.3945/ajcn.112.050021
  11. Olsen SF, Secher NJ, Tabor A, Weber T, Walker JJ, Gluud C. Randomised clinical trials of fish oil supplementation in high risk pregnancies. Fish Oil Trials In Pregnancy (FOTIP) Team. BJOG. 2000 Mar;107(3):382-95. doi: 10.1111/j.1471-0528.2000.tb13235.x. PMID: 10740336.
  12. Oken E, Kleinman KP, Olsen SF, Rich-Edwards JW, Gillman MW, Associations of Seafood and Elongated n-3 Fatty Acid Intake with Fetal Growth and Length of Gestation: Results from a US Pregnancy Cohort, American Journal of Epidemiology, 2004 Oct 15;160(8):774–783, https://doi.org/10.1093/aje/kwh282
  13. Harper M, Thom E, Klebanoff MA, Thorp J Jr, Sorokin Y, Varner MW, National Institute of Child Health and Human Development Maternal-Fetal Medicine Units Network. Omega-3 fatty acid supplementation to prevent recurrent preterm birth: a randomized controlled trial. Obstet Gynecol. 2010 Feb;115(2 Pt 1):234-242. doi: 10.1097/AOG.0b013e3181cbd60e
  14. Middleton  P, Gomersall  JC, Gould  JF, Shepherd  E, Olsen  SF, Makrides  M. Omega‐3 fatty acid addition during pregnancy. Cochrane Database of Systematic Reviews 2018, Issue 11. DOI: 10.1002/14651858.CD003402.pub3.
  15. Ahmed S, Middleton P, Gomersall JC, Gould JF, Shepherd E, Olsen SF, Makrides M. Omega-3 fatty acid addition during pregnancy. Cochrane Database Syst Rev. 2018 Nov 15;11(11):CD003402. doi: 10.1002/14651858.CD003402.
  16. Leventakou V, Roumeliotaki T, Martinez D, Barros H, Brantsaeter A-L, Casas M, et al., Fish intake during pregnancy, fetal growth, and gestational length in 19 European birth cohort studies, The American Journal of Clinical Nutrition, 2014 Mar, 99(3):506–516, https://doi.org/10.3945/ajcn.113.067421

Collagen: Is it really going to make me beautiful?

Everyone seems to be taking a collagen supplement, but do they work?  Is it the miracle cure-all for aging we have been looking for?  Collagen is the primary protein in skin connective tissue, acting like a scaffold to hold tissues in place.  So sure, it’s important, but eating more brains doesn’t make us just have more brain in our skull, so does eating more collagen automatically make our skin structurally better?

Skin is the largest organ in the human body.  We can sometimes think skin is simply a superficial layer to keep us looking beautiful, but it has a lot more important functions than that: skin has a sensory role, it provides a physical barrier against environmental factors, vitamin D is synthesis happens in the skin, absorption of topical applications, as well as playing a role in regulating body temperature. 

Collagen isn’t just for beauty, collagen-derived peptides control lots of functions in our cells – such as cell shape, differentiation (differentiation is when cells change from one type to another) and synthesis of proteins throughout the body.

Skin

One study with supplementation of 50ml of collagen a day for 60 days showed noticeable reduction in skin dryness, wrinkles and nasolabial fold depth. In addition, a significant increase in collagen density and skin firmness was observed after just 12 weeks. The data from this study suggests that collagen can counteract some of the signs of natural ageing.  Another study with 10g supplementation over 6 weeks had improvements in skin hydration, decreased formation of deep wrinkles and improved skin elasticity. This study noted that the anti-aging effect was more obvious in women aged more than 30 years.

As well as providing improved structural integrity of the skin, hydrolysed collagen has been found to enhance the activity of antioxidants in the body, which in themselves act as anti-aging molecules by reducing free radical damage. 

Other cool points that are beyond superficial anti-aging:

  • Osteoarthritis: Studies show that collagen supplementation reduces pain in patients suffering from osteoarthritis, due to its role in cartilage matrix synthesis.
  • Wound healing: Collagen has been shown to accelerates wound healing.
  • Brain function: Hydrolysed collagen has the ability to cross the blood brain barrier, and promote neurogenesis
  • Type 2 diabetes: A study showed that over a 3 month period, collagen supplementation had a significant reduction in fasting blood glucose and HbA1C, as well as improved insulin sensitivity.
  • Bone mineral density: Collagen supplementation was shown in one study to increase bone mineral density in post-menopausal women with primary, age-related reduction of bone mineral density. Additionally, supplementation was associated with a favourable shift in bone markers, indicating increased bone formation and reduced bone degradation.
  • Skin tear: One study looked at elderly populations prone to skin tears and found improvement over an 8 week period in the skin elasticity.

Read the label

The most common sources of collagen production are bovine hide, bone, fish and pigskin. This means our vegan and vego friends (or those who find this information gross) need to carefully read the labels.

The lower molecular weight hydrolysed collagen have been shown to have better results in studies on skin aging and appearance.  Hydrolysed collagen has smaller molecules and has been found to cross the gastrointestinal wall easier better than earlier collagen supplements.

Beauty begins in the gut

For collagen to be able to be active in the skin and provide it’s benefits, we need to be able to absorb it, meaning it needs to cross through the intestines and reach blood circulation.  If you experience issues with digestion (bloating, gas, IBS, constipation, diarrhoea etc.) you may not be getting all the benefits of collagen (or from really any supplements).  If you want the benefits, try working on your digestion with a naturopath. 

My take on collagen

As we age, our skin is bombarded with sun damage, varying diets and nutrients (or lack of nutrients), hormones, chemicals and just the regular decline in our body’s ability to repair with normal ageing.  Studies on nutrition and skin appearance are everywhere, with diets higher in vitamin C and linoleic acid and lower intakes of carbohydrates and fats showing improvements in skin appearance (wrinkled appearance, senile dryness and skin atrophy).

Eating a better diet overall has a more significant effect than any supplement or topical application.  Fill your plate with antioxidant colourful vegetables, drink more water and wear sunscreen to see the biggest improvements in anti-ageing outcomes. Even more important for me is knowing that ageing is a natural part of our life, with wrinkles and spots not making us less beautiful.

If you are interested in reading where any of this info came from, here are the super interesting studies I found the info at.

Benadiba, M., Serruya, R. & Maor, Y (2018). Bioaccessibility of Shore Magic® collagen, a low-molecular-weight collagen supplement, in different in vitro barrier models. Heliyon, 4(9), https://doi.org/10.1016/j.heliyon.2018.e00821

Borumand, M., & Sibilla, S. (2014). Daily consumption of the collagen supplement Pure Gold Collagen® reduces visible signs of aging, Clinical Interventions in Aging, 2014(9), 1747–1758. https://doi.org/10.2147/CIA.S65939

Borumand, M., & Sibilla, S. (2015). Effects of a nutritional supplement containing collagen peptides on skin elasticity, hydration and wrinkles. J Med Nutr Nutraceut, 4(1), 47-53. https://doi.org/10.4103/2278-019X.146161

Miyab, K.B., Alipoor, E., Vaghardoost, R., Isfeedvajani, M.S., Yaseri, M., Djafarian, K., Hosseinzadeh-Attar, M.J. (2020). The effect of a hydrolyzed collagen-based supplement on wound healing in patients with burn: A randomized double-blind pilot clinical trial, Burns, 46(1), 156-163. https://doi.org/10.1016/j.burns.2019.02.015

König, D., Oesser, S., Scharla, S., Zdzieblik, D., & Gollhofer, A. (2018) Specific Collagen Peptides Improve Bone Mineral Density and Bone Markers in Postmenopausal Women—A Randomized Controlled Study, Nutrients, 10(97), 1-11. https://doi.org/10.3390/nu10010097

Hongdong, S. & Bo, Li. (2017). Beneficial Effects of Collagen Hydrolysate: A Review on Recent Developments, Biomed J Sci & Tech Res, 1(2), 1-4. https://doi.org/10.26717/BJSTR.2017.01.000217

Tatsuya, N. & Shinji, I. (2020). Effect of an Oral Nutrition Supplement Containing Collagen Peptides on Stratum Corneum Hydration and Skin Elasticity in Hospitalized Older Adults: A Multicenter Open-label Randomized Controlled Study, Advances in Skin & Wound Care, 33(4) 186-191. https://doi.org/10.1097/01.ASW.0000655492.40898.55

How stress affects your hormones

Stress and fertility

Is stress contributing to your infertility and hormonal problems?

The short answer is that if stress is a major factor in your life, it is most likely having an effect on your hormones.

Our body adapts to stress very quickly, adaptability is what has ensured human survival. However long-term adaptation to stress tells our monkey brain “hey, it’s not a good time to reproduce, I’m too busy running away from a woolly mammoth” (were we alive at the same time as woolly mammoths?  Look, I’m a naturopath, not a historypath).  This “quick, run from the mammoth” is called the fight or flight response. Our body is meant to be in fight or flight for short periods of time, however modern day stress has us in this state more frequently than we are programmed for.  When we are constantly in fight or flight instead of rest and digest, our body increases stress hormones that block hormonal release from our reproductive system.

Stress is more than just long days and deadlines to meet at work.  Over-training at the gym, under-nutrition, chronic illness, and psychological stress all contribute to hormonal dysfunction and infertility.  We are constantly challenged with stressors in daily life from big things like the death of a family member, a relationship break up, not being able to cover rent, living through a pandemic (hello 2020), to smaller issues like being caught in traffic or queueing in line for too long.  Our bodies cannot tell the difference between physical and psychological stress and the stress hormone release (adrenaline and cortisol) is the same for a break-up as it is for a run from a lion.

How does it work?

The hypothalamic-pituitary-adrenal (HPA) axis (how our brain and adrenal glands talk) directly inhibits the hypothalamic-pituitary-ovarian (HPO) axis (how our brain and ovaries talk to each other).  So basically when we are stressed our body pumps out excess stress hormone, and this inhibits our reproductive hormones.  Long-term stress suppresses luteinizing hormone (LH) release from the brain.  LH is the trigger that releases the egg from the ovaries during ovulation.  When LH is suppressed, ovulation is thrown out of whack, or sometimes doesn’t happen at all.

Everyone’s response to stress is different, depending on the type and duration of stress, personality type, stress coping mechanisms and their genetics (even depending on how stressed your parents where while you were in the womb can affect your HPA axis!).  Ovulation, sexual behaviour and embryo implantation are the areas most effected by stress.

Acute stress is a stress that only lasts a few hours, but if this carries on for months, even at low levels, it’s called chronic stress.  Acute stress impairs reproduction if it happens during critical times in the menstrual/ovulatory cycles, whereas chronic stress impairs reproduction in general. 

Chronic stress can progressively lead to decreased lean muscle mass, decreased wound healing, increased visceral fat (the bad fat around your organs) and insulin resistance.  There is a big link between chronic stress and PCOS due to the insulin resistance, anovulatory cycles and increased body mass.

What you can do to reduce stress, and normalise reproductive hormones:

  • Nutrition – Eat healthy, high fibre, balanced meals and avoid processed, high sugar foods.
  • Avoid stimulants – Coffee and energy drinks will automatically increase your cortisol.
  • Sleep – Aim for at least 7 hours a day to reduce stress and ensure adequate rest.  Hormones are released during sleep that help our body to repair and recover.
  • Exercise – Exercise moderately at least 5 days a week, for half an hour a day.  Alternate exercise types and challenge your body.
  • Deep breathing – This is my favourite, breath in for 5 seconds, imagining a balloon inflating under your diaphragm, and then out for 10 seconds.  Repeat this whenever you are feeling stressed, or at least twice a day for 2 minutes. This actively brings your body out of fight or flight and into rest and digest.
  • Grounding – Basically this involves taking your shoes off, walking in nature and letting our feet touch real soil/grass (it surprisingly doesn’t happen much unless you take the time to connect with nature and the earth in this way).
  • Speak to a professional – This one is close to my heart.  Please don’t bottle up your feelings, and let them swish around in your head and fill it up, call Lifeline 24 hours a day on 131114.
  • Bring joy into your life – do one thing before lunch every day that you actually enjoy.  Write a list of things you enjoy and do them!  Here are some things on my list: gardening, face-masks (the pampering type), yoga, reading, patting my cat, kissing my baby, phone free time talking to my fiancé over breakfast.
  • Herbal medicines that help you adapt to stress such as Withania, Schisandra and Rehmannia
  • Calming herbal tea, baths, aromatherapy with essential oils such as lavender, meditation, journalling… Find the things that specifically calm you, and incorporate them into your life.

This study was the basis for much of my research, click here for further science-y talk on the topic

Click here to book in with me for help on your fertility journey.

Who am I?

I am here on my laptop while my 10 month old is eating a tiny piece of old cheese she found under the fridge. I guess that’s what being an adult is all about: deciding that your baby can eat cheese scraps while you try to learn how to use WordPress. Just like my mother did for me, and my grandmother did for her.

Before I get into a multi-generation lecture on eating old cheese, here is a little about me and why I choose naturopathy for my health and career (to heal my gut from years of old cheese scraps?).

I was raised in a huge, old Queenslander in Toowoomba, with an abundant vegetable garden and a flock of happy chickens. My parents were health-conscious and made sure we ate a varied diet. My mum was a nurse and homebirth midwife, and utilised both her background in conventional medicine, and natural medicine to grow and heal us.

In my teen years I got my first job and money… and access to Red Rooster. My late teens consisted of alcohol, partying and late nights, followed by early mornings and long days at my managerial job in retail. And so the spiral went. Lack of sleep and poor nutrition was having an affect on me I wasn’t yet aware of. Through my 20s my skin was breaking out,  I became overweight and was frequently sick. I had dandruff, a huge list of gastrointestinal complaints and periods that were unbearably painful. At 22 I got Ross River Fever, and could barely get out of bed. My health was spiralling.

I had been going to so many doctors, but no one seemed to be able to get to the root cause of why I was so fatigued, depressed, overweight, with skin that just would not quit (not in a good way).

At 26 years old, I was at the end of my tether when a good friend recommended I went to see her Naturopath. They took a super thorough health history and connected the dots of diet, lifestyle and my previous health complaints. Here she created a super simple, wholefoods diet plan, and prescribed a herbal formula.

This naturopath changed my life. I cannot overstate how much of an impact this amazing woman had on me. My skin cleared up, my energy returned, and I was feeling radiant for the first time in years. I ranted about my naturopath to anyone that would listen. Within a year I was at Endeavour College to study a naturopathy degree so I could help people in the same way she helped me. 

What I’ve learned in the subsequent 7 years of study was the huge range of ways naturopathy can be life changing, and how treating the root cause of an issue is the only way to resolve it. Just giving paracetamol for period pain doesn’t solve the reason why the pain is there, and treating the underlying hormonal dysregulation is the long-term solution.

One of the foundations of naturopathy is “Doctor as teacher”, meaning that I don’t just hand my clients a herbal and dietary prescription, I teach them why their health is disrupted, exactly how to get back on a path to health, and why these herbs will help them. Most importantly, how to achieve real change and not be on a prescription forever.

This brings me to the present day, a fruitful, happy life lived with intention and meaning, with a real excitement to help others.