by Amanda Malachesky | Sep 28, 2018 | Functional Nutrition, Stress
Stress has become a fact of life for most of us.
Maybe you can relate to the following stress story:
One morning recently, I woke up just a little late. My son (who is 7) wanted help getting dressed, and my daughter asked if I could help her with an online order before school.
Once I got my son dressed, I made everyone breakfast, and then collected my son’s water bottle and soccer gear, and made sure he had his weekly homework assignment. Because he’s gluten-free (and also quite picky), I made his lunch. My kids argued with each other over breakfast, which got my blood pressure pumping.
I sent them both off to school, and worked on organizing a meeting I was hosting. The caterer fell through at the 11th hour. Shortly after, I realized that there was an open house at school that evening, during the hour when I normally cook dinner, but 30 minutes after soccer practice ended. My husband was unavailable to cover for me.
By mid-day, I was feeling amped and stressed, and I could hardly focus. My stomach hurt, and I was developing a headache. I was angry at everything.
Maybe this scenario, of overlapping and constant daily stress, plays out with similar events in your life?
But if you’re dealing with an ongoing health challenge, this ongoing stress experience can really impede your progress. Without some kind of method to reduce and calm this stress, you will continue to live in a “fight or flight” state, and spin your wheels.
I say this about a lot of things, but dealing with your stress level is a non-negotiable. By this, I mean that you must actively work to reduce your stress levels regularly, so your body can be PHYSICALLY able to work on repair and healing.
What Stress Does to Your Body
One of the major things that happens when you are under stress is that your brain tells your adrenal glands to produce cortisol and adrenaline. Your body is designed for this.
Your body is designed to respond this way when you are confronted with a threat on your life: a wild animal, a threatening human, a near-accident, a major injury.
When your body makes the surge of cortisol (and adrenaline), your liver mobilizes a store of sugar, so you can physically have the energy to respond to the crisis. You are meant to experience this stress, and then literally either run or shake off the excess energy. This is why when you get really scared, you can’t control yourself from shaking.
But every day in your modern life, you experience many small stresses throughout your day: you double booked your mid-morning hour. You have a pressing deadline at work. Your kid comes down with a cold and stays home, keeping you home from work. There was traffic on your commute. You have a fight with your spouse. Your house is a mess. You have a chronic health condition. Your neighbor is making too much noise. Sometimes it’s all of these in one morning.
Though each of these obviously isn’t a major life-threatening emergency, your body doesn’t know the difference. Your body thinks this stress is a major threat, and it releases cortisol and adrenaline.
It’s reasonable and normal for this to happen every once in a while. But we are experiencing this tens or hundreds of times per day. AND, on the whole, we’re less active, and not discharging all that mobilized energy.
Over time, this continuous stress response can decrease your ability mobilize it. Your adrenal glands get tired! At this point, when your reserve has been worn down, you become less able to mobilize your cortisol.
Without enough cortisol, you feel TIRED. Groggy. But this is just the tip of the iceberg. You also get sick more often. You have new aches and pains. You begin to develop all kinds of symptoms, everything from insomnia, to hormone trouble, weight gain, muscle loss, blood sugar problems, and more.
When you exist in a constant fight or flight stress response, many important body functions shut down.
Brain function declines, immune function gets worse, cell repair doesn’t happen, digestion slows or shuts down, libido decreases, and at the cellular level, your body elevates your blood sugar, leading to chronic inflammation.
In a lot of ways, imbalances with your cortisol stress response can be linked to just about ANY physical sign or symptom. So let’s talk about how you can calm down your stress response, so you can start creating the possibility of healing.
Stress Management is a Non-Negotiable Health Foundation
With all these high stakes, reducing stress is an important foundational health practice.
The 2nd Step of my Roadmap to Recovery (you can grab your copy here) is to Create A Solid Health Foundation. Diving into crazy testing and aiming for the root cause right off the bat is putting the cart before the horse. If your stress is through the roof, no amount of testing, supplements, or food changes are going to fix your health challenge.
So what do you do about it?
It’s true that you can’t always get away from stress. If you are a parent like me, your kids will demand a lot from you. If you work, your job will be stressful. No matter your life situation, you likely experience moments you wish you could forget.
But you CAN work to rearrange some aspects of this. Zooming out from ground zero, you can work to invent creative solutions to handle the stress ahead of time. You can improve your kids’ self-sufficiency by teaching them. You can work on pre-emptively planning things at work to improve your flow.
And you can also work on managing your physiological response to stress. The most common way to get there is by inviting a meditation or mindfulness practice of some kind.
It may feel a little cliché to think about meditation, but it really and truly does WORK. And even if “meditation” makes you think of annoyingly poised people wearing white and sitting on a cushion, and you can’t imagine yourself doing it, you are likely already doing it. It just may look different.
This is what I like to suggest: find something that you absolutely LOVE. What is it for you? Surfing? Walking by a river or lake? Being with someone special? Listening to music? Reading your favorite author or magazine? Eating out? Going to plays? Making love with your partner? A hobby, like knitting? What feeds your soul and makes your heart sing?
TIP #1: If “meditation” as we imagine it doesn’t do it for you, pick that thing you do where HOURS can slip by, and you don’t know what happened. Do this.
And do it regularly. Daily if you can.
What I find really makes the difference is disrupting your brain from the “nothing is going right” thinking pattern. It’s inviting a state of being where you are in the moment. It’s that space where hours can fly by, and you didn’t even notice.
Stress and Digestion
I mentioned earlier that the stress response slows or stops digestion. It’s difficult to properly digest your food and provide your body with the nutrition it needs when digestion is slowed or stopped.
The best way to invite good digestion is to focus on chewing your food well and breathing while you eat! It’s remarkable how relaxing this simple technique is for lowering your stress level.
TIP #2: This may take a little bit of practice, but here’s how to eat for stress relief and good digestion:
- Choose a place to sit down to eat. Don’t eat standing, on the run, or in your car. Outdoors is best, especially if you work indoors.
- Remove all distractions: put away your phone, your iPad, reading, everything. Focus on EATING and nothing else.
- When you sit down, take a deep breath, and make a statement of gratitude for your food. For example, “Thank you for this delicious, nourishing food.”
- Think about eating your food. Smell it, and look at it, and think of how good it’s going to taste. This should encourage salivation and your enzymes, which will improve your digestion.
- Dive in to eating. Take a bite, set your fork down, and thoroughly chew, allowing your food to mix with your saliva. Aim for 20-40 chews per bite. Really experience the flavors!
- Each time your mind begins to wander to other things, return your attention to your food. If you remember something important you need to do, keep some paper handy to write it down. You can deal with it after your meal!
I promise that eating in this fashion will feel great, restore your peace of mind, AND improve your digestion. I like to think of these moments as a mini-vacation. We don’t need to go to Hawaii or the Bahamas to experience rest and relaxation, we only need to bring our awareness home.
Remove Hidden Sources of Stress: Toxins
When I use the term “hidden stressors”, I’m often referring to underlying infections that may have been left unaddressed. But there are other kinds of hidden stressors that are important to be aware of.
One that you can work on in your own life is electronic pollution, from EMFs, wifi, and cellular radiation. Reducing exposure to these stress sources as you are able helps your body cope better with the other stress it’s dealing with.
TIP #3: Try these tips to reduce your hidden toxin sources:
- Turn your cell phone off, or to airplane mode at bedtime.
- Unplug any electronics with power packs in your bedroom.
- Turn off wifi routers while not in use, and overnight. If possible, use a cord to connect to the internet.
- Use headphones on your cell phone or cordless phone, instead of holding the phone to your ear.
Another hidden stressor is chemicals in cleaning products, hygiene products, and housewares, like pots and pans, furniture, and carpet. They can be present in your soaps, detergents, air fresheners, cleaners, shampoo, toothpastes, deodorants, and more.
An easy way to reduce the burden on your body is to replace these with non-toxic formulas as you are able, or to make informed choices when buying new furniture or housewares. See the Environmental Working Group’s consumer reports for more information.
Conclusion
It may seem like stress is insurmountable, but with some dedicated intention, you can get it under control, and create the conditions your body needs to heal.
Though it can be tempting to get excited about the next best thing when it comes to fixing your health challenges, focusing on foundations is essential, and sets you up for success. You need to take a serious look at your stress, and create new approaches to reducing stress in your life and on your body.
If I didn’t mention your preferred stress reduction method, please leave a comment and share it below!
To find out about the other essential health foundations you need to allow your body to heal, and the 7 steps to get to your personal remission or long-term management plan, get your copy of Roadmap to Recovery here.
Or, if you need support identifying your underlying stressors that are contributing to your symptoms, so you can make a plan, I invite you to meet with me for a 30-minute Assessment Session. Here, I can help clarify where you are on YOUR Road to Recovery, and provide guidance about your next steps.
by Amanda Malachesky | Sep 10, 2018 | Diet, Functional Nutrition, Nutrition
I was recently invited to write a guest blog post for The Unchargeables, a support network for people with chronic illness. They wanted to hear about easy, accessible dietary practices for people with chronic illness. I wrote about how to use food as medicine when you have a chronic illness. You can read it here:
14 Ways to Use Food As Medicine for Chronic Illness
And really, the dietary advice I wrote about works for anyone, no matter their illness. But the TRUE work, besides simply substituting foods, or removing or adding foods, is to understand which of these changes is RIGHT for your body, and which ones aren’t.
If you’re new to making dietary changes for your health, this list could seem intimidating and overwhelming. If that’s you, never fear. Just start somewhere. Choose the one or two things that stand out most to you and begin there.
Once you have gotten comfortable with that, then think about adding something new. The process of learning how to live with the body you’ve been given is a long-term process. Using food as medicine takes time to learn. You won’t figure it all out or get it all right overnight. There is no magic pill.
Though this is the case, there is A LOT of benefit to identifying the foods that trigger your symptoms. This can make your symptoms less random, and give you a lot more control.
Getting clear on how to use your food as medicine is Step 3 on my Roadmap to Recovery (you can download that here). When you’re ready for some in depth support and guidance on YOUR Road to Recovery, you can schedule a free 30-minute session with me. Together, we’ll get clear on where you are in the process right now, and what your next best steps are.
by Amanda Malachesky | Sep 10, 2018 | Chronic Illness, Functional Nutrition
DISCLAIMER: The content of this article does not constitute medical advice. Before adding any nutritional vitamins or supplements, consult with an appropriate professional.
Vitamins and supplements are a multi-million dollar industry, and it seems like most people use at least basic supplements. I’d like to illuminate how the RIGHT vitamins and supplements can support your journey back to health, as well as how to figure out which ones are right for YOU.
You’re likely aware that taking vitamins and supplements can be helpful, but you may not know all that much about them or how they work. Biochemistry was the class my science-friends all feared in school!
But when you’re dealing with a health condition, biochemistry is your friend.
What if one of the obstacles in the way of your body getting well is simply the lack of enough of a certain nutrient? Wouldn’t you want to correct that ASAP?
Why You Need Vitamins and Supplements
Your body needs various raw materials to do its jobs. Imagine trying to run your car without gasoline, or transmission fluid. You won’t get very far without these essential components!
Your body is continuously performing chemical reactions, and it uses vitamins, minerals, and enzymes to make them happen.
For example, your liver requires many different vitamins and mineral co-factors to successfully detoxify your blood, including vitamins A, C, E, certain B vitamins, vitamin D, magnesium, calcium, amino acids such as glycine, glutamine, taurine, and cysteine, sulfur, and glutathione (the master antioxidant).
Generally, your body does a pretty good job of automatically maintaining function. If you’re in good health and you eat a nutrient-dense diet, you are probably able to get most of the vitamins, minerals, and enzymes you need from your food.
But once you begin to present with symptoms, your body is telling you its needs aren’t being met. By the time you have a diagnosis, organs, tissues, or functions may be damaged, and need support.
A major part of the process of restoring health is bringing these deficiencies to sufficiency, so that your body can take care of itself with ease. This is Step 4 on my Roadmap to Recovery (If you haven’t gotten your copy yet you can download it here).
Deficiencies are common, and can be created by:
- A damaged digestive system, from infections, medication side effects, food sensitivities, or radiation exposure, which can compromise your ability to absorb nutrients.
- A diet full of nutrient-poor or processed food.
- Genetics, which may compromise your ability to create or absorb enough of a nutrient.
- Inflammation, which can use up stores of important nutrients to repair the damage.
- Certain disease processes. For example, the heavy bleeding common with fibroids or endometriosis can lead to iron deficiency.
- Missing co-factors for absorption. For example, adequate stomach acid is necessary to absorb Vitamin B12 and iron.
While you are investigating your health challenges and seeking answers, it’s important to get clear on where your deficiencies are likely to be, and to work to bring them to sufficiency.
How to Determine Nutrient Deficiencies
Many modern people are deficient in several common nutrients, especially if they are eating a standard American diet. These include Magnesium, omega-3 fatty acids and short-chain fatty acids, B vitamins, and antioxidants, like vitamin A, E, and C. Vitamin D deficiency is also very common, which can be an underlying cause of immune challenge if you are struggling with your health.
Figuring out which basic vitamins and supplements you need to support your body in regaining sufficiency and recovering is quite simple. A standard blood chemistry test (Complete Blood Count and Metabolic Panel) as well as some symptom clues can give you good direction. You can also monitor particular nutrients via direct testing, as with Vitamin 25-OH D.
Functional Medicine and Functional Nutrition practitioners read these tests within a narrower range than your standard MD might. I am looking for optimal function, as opposed to a severe disease state.
For example, on the CBC, there are several markers that note the condition of the red blood cells, and are used to monitor anemia. Values of these markers can indicate not only problems with iron and anemia, but also your status of Vitamin B6 and B12, Vitamin C, and stomach acid.
Markers on your metabolic panel can also give us good indicators about B vitamins, zinc status, micronutrients like molybdenum, as well as your digestive status, helping you understand whether you need additional support in that area.
Beyond blood chemistry testing, there are other functional tests available that can help illuminate what’s going on. Organic Acids testing can show your status of vitamins, antioxidants like CoQ10 and glutathione, and neurotransmitters like dopamine and serotonin.
But though these fancy tests can be useful, there is no substitute for looking at the basics, and supporting the body in performing its normal function. Sometimes, with some minor dietary changes and the addition of supportive nutrients, people experience a really dramatic shift for the better.
A recent client came to me with frequent stomachaches, pain, fatigue, and stress. As part of my assessment, it appeared that vitamin B12 and B6, magnesium, and omega-3s were likely deficient. Their digestive function appeared to need support, as well.
They carefully included these basic vitamin and supplement supports to their routine, and within a few weeks had significant relief from their stomachaches and fatigue. They were feeling better, so they stopped the supports, only to find the symptoms returned.
Sometimes, small changes provide that little nudge of support that can make the difference between symptoms and no symptoms.
Start Vitamins and Supplements One At A Time
Equally important to including vitamins and supplements to plug nutrient leaks and bring deficiency to sufficiency is working to carefully observe whether or not they are helping or hurting and to adjust accordingly.
You may have decided you needed certain vitamins or supplements, or been told you should use certain types by your health provider. Many people in this situation buy a big order of supplements, and just start taking them all at once.
I don’t do this in my practice, and you shouldn’t either. It’s best to start vitamins and supplements one at a time. This is especially true if you are already someone who has a lot of food sensitivities.
The reason is two fold. You want to be able to carefully work up to the right dose for your body, AND be aware of any adverse reactions. If you take five new supplements on the same day and then develop a headache or nausea, you won’t know which vitamin or supplement is responsible.
I have tried a lot of supplements over these last several years, and there are many I have found that I couldn’t tolerate. I wait to incorporate something new until I know my body isn’t reacting to anything, and then test it. If I consistently experience a negative symptom, I stop for a few days, and then try it one more time.
Not only does this help you understand which supplements are best left out of your routine, it gives you more information about your case. Is there an additive in the supplement or vitamin you react to? Is the form of the supplement difficult for your body to absorb? Is it the dose the problem? Answering these questions helps you learn more about your body’s unique biochemistry and the best way to support it.
For example, I had a doctor prescribe me a high-potency Vitamin B12 supplement with SAMe (an enzyme). I was concerned about the high dose of B12 because I had experienced anxiety from too high of a dose of B12, and voiced my concern. But the doctor said she thought the reason I had had trouble before with B12 was because I wasn’t taking it with SAMe.
When I started the supplement, I didn’t experience anxiety, but I started having really pressing headaches, like I had a heavy bowling ball sitting on my brain between my eyes. I tried reducing the dose to a half capsule, but that didn’t work either. So I stopped using it, and the headaches went away.
Maybe for MOST of this doctor’s patients, they did fine with a high B12 dose with SAMe, but for me, it didn’t work. We need to listen to our bodies.
More Isn’t Always Better
More isn’t always better! Because every body is unique and different, dosage is bioindividual. A recommended dosage on a bottle of vitamins or supplements is a generalization. I recommend clients start at a small, low dose, and gradually increase, if they don’t experience any symptoms or side effects. This not only helps you see those side effects more clearly, but also helps you find YOUR body’s best therapeutic dose.
Using these two guiding principles will help you make the most beneficial use of your vitamins and supplements.
Why Vitamin and Supplement Quality Matters
Many people want to cut costs and buy cheap vitamins and supplements from suppliers like WalMart and Costco. While this is understandable, using quality, medical-grade supplements is a much better idea to support the best outcome.
Many inexpensive brands of supplements are cheap because they are mostly fillers, or in some documented cases, are actually not what is advertised.
Fillers can often be a problem for people dealing with challenging health issues, if they are unlabeled allergens. Many of the clients who come through my office are sensitive to gluten, dairy, eggs, and other common allergens. But many low-end supplements have ingredients with these sources. Despite the needed nutrients, these ingredients may set clients back.
I always source gluten-, dairy-, soy-, nut-, egg, shellfish-free supplements for my clients, and even choose specific supplements for them depending on their known or suspected sensitivities. For example, I’m sensitive to corn, so I can’t use any supplements that have corn sourced ingredients. This may include things like dextrose, a common additive in many supplements.
Though they may be more expensive, choosing supplements free of ingredients that may harm your forward progress on your road to recovery, or that truly contain what you are hoping to buy, is worth the investment.
Reputable vitamin and supplement companies often provide 3rd-party verification of stated ingredients, as well as certification that their products are free from allergens, such as gluten, dairy, soy, and so on.
Here is a partial list of supplement suppliers that provide high-quality, therapeutic grade supplements include:
Conclusion
Supporting your body with the right nutrients to restore function is an important part of walking your road to recovery. Provided you correctly identify the vitamins and supplements your body needs help with and you use them properly, they can be an essential support during your healing process.
Supplementation is only ONE part of a multi-faceted approach I use to support my clients in getting well. If you are ready to learn more about what nutrients your body may need in the context of YOUR Road to Recovery, I invite you to download your copy of Road to Recovery: How to Move Beyond Your Symptoms and Create a Personalized Plan to Restore Your Health HERE. I look forward to connecting with you.
by Amanda Malachesky | Aug 31, 2018 | Functional Medicine and Coaching, Functional Nutrition, Uncategorized
As a Functional Medicine Nutrition Practitioner, I am drawn to work with people who have confusing, complicated cases. I LOVE sitting down with a stack of labs, an interview, and a case history, and working to help a client connect the dots, so they can create a path out of their health-challenge-wilderness. They want a root-level solution.
Many people who are experiencing a complex health challenge WISH someone would do this for them.
This is where Functional Medicine and Functional Nutrition providers fill the gap left open by the insurance-model of health care, because not every health problem fits into the diagnose-prescribe-treat model. A 7-12 minute office visit simply isn’t sufficient to gather the information needed to create a root-cause resolution solution for complex illnesses.
While Functional providers are trained to make sense of complexity, there is no reason why YOU, as a client or patient, can’t play this game as well. You can uncover important details about your own health challenge, and be an integral player on your health team.
But how do Functional Medicine and Functional Nutrition providers do this work? What can you, a patient or client learn about your own case by doing some of your own legwork?
The Functional Nutrition Timeline and Functional Nutrition Matrix are two tools you can use to do this.
I’d like to share more about these two simple but radical health care tools, so you can play with them yourself and work to unlock your case mysteries and clarify your healing path.
The Right Functional Medicine Tools are Key for Success
Before I was introduced to these two tools by my mentor and teacher Andrea Nakayama of the Functional Nutrition Alliance, I was using a complicated spreadsheet that tallied a client’s self-reported symptoms with points.
Not only was it hard for both me and my clients to use, but the clinical value of the information was hard to glean.
The Functional Nutrition Timeline and Matrix are two user-friendly and intuitive tools that help clinicians think into a case systematically. Nakayama adapted the Functional Medicine Timeline and Matrix that The Institute for Functional Medicine teaches in its clinical training coursework for use in her Functional Nutrition clinic and training programs.
One of the most important things she noticed was needed when you are struggling with a complex health challenge is a framework to help clarify what is happening in your body and why. You need to discover where to look upstream for source problems. The Timeline and Matrix are the tools that help us do this.
The Functional Nutrition Timeline
The Functional Nutrition Timeline is essentially what it sounds like: it’s a chronological map of your health issues throughout your life, including detailed information all the way back to your parents’ and grandparents’ health.
This is often intuitive for people looking for answers about their difficult health problem. Those of us with puzzling symptoms have been known to pore over all the details, hoping to reveal a new clue to reveal answers. We think if we can note enough details, the picture will become clear.
I once interviewed a woman with Ehlers-Danlos Syndrome (EDS), a connective tissue disorder. When she presented a timeline she created of her illness to her doctor, he looked at her a little funny and said, “I had another patient do the same thing, and they were my only other EDS patient.”
In most cases, the emergence of a more chronic health problem is not something that just happens out of the blue. There is often a confluence of many events that collectively created it.
Correctly identifying these triggers can help you to understand where you need to work to resolve your issue at its most upstream location. The Functional Nutrition Timeline helps you do this.
To create a Functional Nutrition Timeline I use an extensive health history and interview with my clients. In the health history, I ask them about their background: their birth, childhood, teen years, significant life events, injuries, illnesses, travel, stresses, potential environmental threats, like indoor air quality in their place of work or in their home, and so on.
But as you live inside your own body, you can review your own situation and your own history. You know it better than anyone.
You want to note not only the health events you have experienced, but you also want to make note of what may have triggered those events. Anything that you feel is important should be noted.
You must also explore the particularities of your situation. How did your condition evolve and change over time? When did it begin? When did it get better or worse? What other conditions are contributing?
This information may be useful in and of itself, but provides a whole new perspective when collated onto the Functional Nutrition Timeline.
I am regularly surprised by the power of making connections on the timeline. For example, a client shared that they began having seizures at one point in their history. I suspected environmental toxins as a cause, and asked about them. But later, I asked whether there had been any history of car accidents.
The client had been in a significant car accident 3 months previous to the onset of seizures. The client had never made this connection, nor had the various doctors to whom they had gone trying to figure out the issue.
Understanding the specific demons we are confronting helps us craft effective solutions! In this client case, the missing connection between the seizures and a likely traumatic brain injury kept them from the most appropriate care. To best help yourself heal, you must understand the breadth and depth of what you are facing, and how it came to be.
TIMELINE ACTION STEP:
You can create your own Functional Nutrition Timeline by mapping out significant health events in your own life. Map them out in any way that makes sense to you.
Once you have things mapped out chronologically, consider what you know to be true about what might have triggered those events: Were you recently sick? Was there a recent stress event, like a change of job, sick child, divorce, money stress, or whatever else you can think of? Did the onset of symptoms correlate with another health event, like a pregnancy or surgery? Note the potential triggers on the timeline.
What can you learn about the evolution of your health challenge throughout your life? Make some notes, and consider asking your trusted health provider about this at a future visit.
The Functional Nutrition Matrix
Functional Medicine practitioners keep a holistic view, and no detail is too small to take note of. While creating the Functional Timeline helps you understand the big picture of what we’re dealing with and why it’s happening, creating the Functional Matrix helps you understand which body systems need attention, and helps you craft the skills to address them.
I like to refer to the Functional Matrix as your case map. First, it summarizes the top highlights of the Timeline on the left-hand side by noting the Antecedents (family history), Triggers, and Mediators.
In the center area, we make note of your current symptoms and relevant lab results, and mark them in the body area that is affected: Gut, Immune, Mind-Spirit-Emotions, Oxidative Stress and Fatigue, Hormones and Neurotransmitters, Structural Integrity, Environmental Inputs, and Detoxification.
Looking at your case details in this way helps you organize the complex, overlapping symptoms, and helps you prioritize your approach.
On the right hand side, we add in the all-important realm of skills, which represent the actual on-the-ground actions we will take to work on shifting the terrain of illness. This includes Sleep & Relaxation, Exercise & Movement, Nutrition & Hydration, Stress & Resilience, and Relationships & Networks.
This one sheet of paper can summarize your case history, your current situation, and what you’re already doing to help yourself, and where you want to go. It can help you see clusters of symptoms, and help them feel less random.
Having a completed Matrix can also help make the most of that short office visit with your other providers by giving them the most important context of your illness. It can save them the time of needing to work hard to discover all of this via interviewing, so they can focus on crafting care solutions.
Not only that, but I find that it helps educate clients about the physiology of what is happening inside their own body. For example, many clients don’t understand that food cravings can indicate a hormonal or neurotransmitter problem, or that fatigue can be an indicator of liver health. Understanding these connections can open the doorway to solutions that you hadn’t previously imagined.
But even more important than the Timeline and Matrix themselves are the conversations that open up between you and your providers to help connect the dots. Ultimately, the best Functional Medicine tools position you in a new relationship with your body, highlighting self-knowledge, personal empowerment, and connection to the intricate inner workings of your body and psyche.
MATRIX ACTION STEP:
Draw an 8-arm star in the center of a piece of paper (see the picture above for an example). Label them with Gut, Immune and Inflammatory, Environmental Conditions, Oxidative Stress and Energy Levels, Detoxification, Hormone and Neurotransmitters, Mind/Spirit/Emotions, and Structural Integrity.
Note your varied symptoms in each area of the Matrix. Is there a particular area (or areas) where your symptoms cluster? See if you can take an action to lessen the burden of the symptoms in that area.
To learn more about how I can help you use Functional Medicine tools like the Timeline and Matrix to help you walk your own personal Road to Recovery, grab your copy of Roadmap to Recovery here
When you’re ready to learn more about creating your own Functional Nutrition Timeline and Matrix with my support, schedule a free 30-minute Assessment Session with me. We’ll discuss how I can help you make sense of the complex details of your case, and create a plan for moving forward.
by Amanda Malachesky | Aug 13, 2018 | Chronic Illness, Digestion, Food Intolerance, Functional Nutrition, Testing
Though there is often confusion about what actually constitutes constipation, I’m sure you know it when you have it! I can’t think of one good thing to say about it.
Constipation has been a significant part of my chronic health problems, but feeling bad when I have it is only one of the reasons it’s a pain in the butt (pun intended!). Making sure we can poop easily and regularly is a main pillar of a healthy life, and can improve all manner of health challenges.
The bloating, pain, foggy head, gas, straining, and worse might be no big deal every once in a while. But when you face constipation frequently on an ongoing basis, it’s time to dig down and start unraveling the puzzle.
In my own case, I had to dig for answers. Adhesions from endometriosis, which caused gut dysbiosis (including methane-dominant SIBO), inactivity due to fatigue, and food sensitivities all played a role.
Constipation is not only uncomfortable and a challenge in its own right. It can also compound other health problems in our chronic illness picture.
Clearing up constipation is of utmost importance.
There are likely many possible causes for your constipation. The key to solving your personal constipation puzzle is discovering your personal reason(s). Once you figure out the cause, you are much more likely to be able to create a reliable relief action plan.
What Is Constipation?
Technically, constipation is defined as irregular and infrequent or difficult bowel movements.
Though your normal may vary from the next person, we should be pooping at least once per day, and passing stool should be easy. I consider a person constipated when they have less than one bowel movement per day OR they have difficulty eliminating stool, even if they go once or more per day.
Our body only has a few ways to clean itself out, and pooping is one of them. (The others include urinating, sweating, and breathing.) It’s essential for this normal detox function to work well to keep us healthy, happy, and strong.
Pooping regularly is important because our body releases toxins in the stool. If we retain stool longer than necessary, we not only can re-absorb toxins, but the bacteria in the stool can begin to ferment. Hello gas and farts.
I have noticed that if I go longer than 24 hours between movements, my brain function declines. I become crabby and snappy with my kids and husband. I’m more tired. And my belly becomes swollen and painful, which never helps my patience, self-esteem, or confidence.
Some of these suggestions may resonate, others may not, and that’s ok. Everyone’s body is different. Follow up on the ones that seem to make the most sense for you. Start with simple interventions, and only try the more complicated or expensive options if the easier options don’t work.
One thing I find true again and again is that there often isn’t ONE magic pill, but that several things in combination together CAN make a difference. Experiment and see which tips move the needle, no matter how small.
Here are my top 9 tips for getting to the bottom of your constipation, so you can create a solid plan.
#1: Remove Inflammatory Foods to Relieve Constipation
Eating the specific foods that your body is sensitive to can cause constipation. Many people experience constipation when they eat dairy products, eggs, and gluten. But ANY food can be causing a problem. For example, I discovered that every time I ate broccoli, I became constipated for TWO days!
If you know that your body becomes constipated by eating a certain food, avoiding that food will obviously help. But how do you figure out which foods are causing the problem?
An elimination diet is the gold-standard for identifying problem foods. By eliminating suspected foods for a period of 3-4 weeks, and the reintroducing them one by one and observing the effects, you can create a diet that is customized for you to reduce symptoms.
The key tool to go along with this process is a Food-Symptom Diary, where you track your food intake alongside your symptoms.
IgG food sensitivity testing or Mediator Release Testing may also be helpful in this situation, but it is usually more useful for checking for an immune response to certain foods (though constipation could be an immune response as well).
#2: Add Nutrients to help Constipation
These three nutrients fall more into the relief-care realm. But while you are sorting out your root causes of constipation, it can be helpful to have support to encourage your body to poop.
Magnesium citrate, vitamin C, and ginger can all help stimulate the bowels to move. You will want to experiment with a dose to find the one that produces a bowel movement. Start low and go slow, until you find the appropriate dose for your body.
Additionally, psyllium husk, soaked in some water, can help bulk up the stool. But too much can cause bloating, so go slow!
#3: Increase Dietary Fat (With Caution)
Fat helps lubricate the digestive tract and move things along. If you aren’t consuming enough dietary fat, it can be difficult for your intestines to function properly.
The challenge here is that many people have compromised fat digestion. Some natural health coaches encourage people to eat spoonfuls of coconut oil or ghee at bedtime as a remedy for constipation.
Though this may help relieve symptoms in the short term, it could cause other problems downstream. If you plan to increase your fat consumption to remedy constipation, it is important to support fat digestion as well with enzymes, bitters, and other liver/gall bladder support. Start low and go slow!
#4: Increase Dietary Fiber to Relieve Constipation
Fiber has long been promoted as way to keep the bowels moving and to reduce long-term risk of colon cancer. Eating a low-fiber diet can be a significant contributor to constipation.
The key element to understand about fiber is that it is the insoluble fiber that helps keep the bowels moving. It absorbs water, increases stool bulk, and swipes the walls of the colon clean.
Sources of insoluble fiber include:
- Bran
- Whole grains, like brown rice, millet, quinoa, and buckwheat
- Seeds
- The skins of fruits and vegetables, including tomatoes, peppers, apples, etc.
If you eat a diet low in fruits, vegetables, whole grains, and seeds, see if you can gain some relief by incorporating an increase in whole fiber foods. Start low and go slow! Too much change in your fiber budget can lead to bloating and gas.
If you find that increasing high fiber foods seems to worsen your constipation, you may have sensitivity to certain high FODMAP foods. FODMAPS are Fermentable Oligo-, Di-, Mono- And Polyols. They are types of starches present in certain foods.
#5: Assess Your Microbiome
We can’t talk about the gut without considering the state of your microbiome. The community of bacteria and other microorganisms has a significant effect on how things move through your intestines. We want to investigate how your microbiome is doing, and how it may have changed recently.
Many people find that their constipation began with a shift in their microbiome terrain. This can happen from things like a course of antibiotics, a new medication, or a major stress event, like a death in the family, change of jobs, moving, or marital troubles.
Consider what else was happening at the time your constipation started. Did you experience a major stressor around the same time?
If it seems that the microbiome piece of the story is important in your case, evaluating yours is a helpful step. Completing a GI-MAP stool test (or similar stool test, like Doctor’s Data, Genova, or BioHealth 401H) to check for parasites, bacteria, and yeasts, can help you understand what specific bugs you are dealing with and can inform your approach.
Another very common microbiome cause of constipation is methane-dominant SIBO, or Small Intestine Bacterial Overgrowth. If you have an overgrowth of methane-producing bacteria in your small intestine, the methane exerts a powerful paralyzing effect on your small intestine.
Properly addressing dysbiosis, whether from parasites or SIBO or yeasts, is a very powerful way to resolve chronic constipation.
Some people find constipation relief with the addition of probiotic foods or supplements (or both), while others find that probiotic foods and supplements make their constipation worse. You will have to experiment for yourself to figure out what works right for you.
If you find that you react to the commonly available varieties on the shelves at your local health foods store, you may want to try spore-based probiotics, like MegaSpore Biotic, soil based probiotics, like Prescript Assist. You may also have better luck with a blend that does not include histamine-producing probiotics. I like Klaire Labs Ther-Biotic Metabolic Formula.
If you can’t find a probiotic that seems to work, this is a sign that you have some cleaning work to do before you are ready to repopulate your gut microflora. Dig for answers to understand your gut flora picture, and work a plan to reset your flora.
#6: Break Down Adhesions with Physical Therapy
Adhesions are internal scar tissue that can bind up tissue and organs inside the body. They can occur anywhere, and can cause problems no matter where they show up. This is nowhere more true than in the gut.
Possible reasons for adhesions include:
- Abdominal surgery
- Inflammatory disease, like endometriosis, gastroenteritis, diverticulosis, hepatitis, or colitis.
- Injury or blunt trauma (think car accident, sports injury, etc.)
- SIBO
- Appendicitis
- Gall bladder trouble
- Pelvic inflammatory disease
If adhesions are impeding the function of your gut organs, no amount of other help you throw at the problem will last indefinitely. Specialized abdominal massage, like that offered by the Clear Passage clinics, or physical therapy can help a lot with constipation.
When I had my wide-excision endometriosis surgery two years ago, one thing we discovered was that my colon was adhered to the wall of my abdomen. No wonder I suffered from constipation! The surgery likely created more adhesions as well, just in different places. For this reason, avoiding surgery unless absolutely necessary is important, to avoid creating more adhesions!
#7: Support Vagus Nerve Function
The vagus nerve is the largest nerve bundle in the body and controls automatic body functions like digestion, respiration, stress response, etc.
Because our digestion is highly regulated by the vagus nerve, and the vagus nerve function can be affected by the microbiome, sluggish vagus nerve function can be an underlying reason for constipation or slow motility (movement of food through the digestive system.)
The vagus nerve can be damaged by food poisoning, which can lead to chronic SIBO.
Fortunately, there are many easy and fun things to do to support the vagal function! They include:
- Singing loudly (shower or car time, anyone?)
- Jumping on a trampoline or rebounder
- Gargling
- Exercising
- Belly massage
- Yawning
See if incorporating any of these ideas regularly helps relieve your constipation, in addition to your work supporting a healthy microbiome.
#8 Assess Thyroid Function
One of the most common underlying causes of chronic constipation is poor thyroid function. The digestive tract, like all other body tissues, requires thyroid hormone to function properly.
Especially if your constipation occurs with other common thyroid symptoms, such as weight gain, depression, cold hands and feet, heart palpitations, dry skin, consider having your health provider evaluate your thyroid function.
Because of insurance payment standards, many doctors will only check your Thyroid Stimulating Hormone (TSH) levels. But to truly look at how the thyroid gland is doing, it’s important to look at a complete thyroid panel, including:
- TSH
- Free T3
- Free T4
- Reverse T3
- Thryoid Peroxidase Antibodies (TPO)
- Thyroglobulin Antibodies (TG)
If your doctor won’t order these, or your insurance won’t pay for them, you can order them directly from a direct-to-consumer service like Life Extensions or DirectLabs.
#9 Assess Your Current Medications
Many medications have either a direct or indirect effect on intestinal motility. Be sure to check your product inserts, or check with your pharmacist if you have concerns about a particular medication.
If you think a medication is contributing to your constipation, have a conversation with your doctor to explore possible alternatives. It’s important that you keep pooping!
I hope by now you can see that solving the root causes of your constipation is unlikely to come from just one source, but many. Finding the pathway to resolution requires some questioning, some digging, sometimes some deeper investigating, and experimenting to find the proper combination of solutions.
But even if it takes a little while, finding your particular solution means less long-term loss of quality of life, less symptoms, less lost work time, less lost pleasure time, less medications, and a whole lot more comfort.
When you’re ready for help to make sense of your constipation, I invite you download your free copy of Roadmap to Recovery. Inside, I detail the steps you can take to unravel your health challenges, so you can find the RIGHT solution for YOUR body.
When you know you are ready for some more robust support, I encourage you to schedule a free 30-minute Assessment Session with me.
by Amanda Malachesky | Jul 30, 2018 | Chronic Illness, Functional Nutrition, Inflammation, Nutrition, Stress
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Blood sugar imbalance is one of the biggest American public health epidemics of our time. According to the CDC, approximately 10 % of Americans have Type 2, or adult onset diabetes. Even worse, 33% have pre-diabetes, and most of them aren’t aware that they are pre-diabetic.
Diabetes is caused by excess sugars or glucose in your blood. Normally, when our blood sugar is too high, our pancreas produces more insulin, which helps the sugars enter body cells.
When the body can’t produce enough insulin, or can’t use insulin as well as it should, this is called diabetes and insulin resistance. A diabetes diagnosis is made when your body can no longer control blood sugar in a normal range without intervention.
But blood sugar handling occurs on a spectrum. There is a range of normal blood sugar levels. Pre-diabetes means that your circulating blood sugar is a little higher than normal, and that your blood sugar is trending higher than normal, but that it hasn’t yet reached diabetes levels.
The excess circulating blood sugar in pre-diabetes and diabetes leads to a suite of health problems including cardiovascular disease, obesity, vision problems, peripheral nerve pain and degeneration, and kidney disease. There is also a growing correlation between blood sugar imbalance and Alzheimer’s Disease and cognitive decline.
But although Type 2 Diabetes is one of the most common chronic illnesses, it’s also one of the most possible-to-treat chronic illnesses with diet and lifestyle modifications. Though the changes can feel challenging if you’re used to eating and living a certain way, you CAN often reverse Type 2 diabetes with diet and lifestyle changes.
And even if you don’t have diabetes or pre-diabetes, it’s important for you to keep reading, too. Even if your body is handling your sugars just fine for the time being, excess sugars in the body promote more generalized inflammation. This inflammation has a role in many chronic diseases, not just diabetes.
Here is what you need to know to bring your blood sugar into balance, without medication.
How to Balance Blood Sugar
Balancing sugars is one of the first steps of getting a handle on chronic illness, no matter your diagnosis. And even if your health challenge isn’t a diagnosis, balancing your blood sugar is a foundational practice. Keeping your sugars balanced helps support the health of your adrenal glands, manages your weight, keeps your brain clear, and helps keep your moods stable.
Excess circulating blood sugar that can’t get into your cells leads to inflammation. It increases inflammatory cytokines, and also causes oxidized fats to damage your arteries. In plain speak, that means you may gain body fat (especially around your middle), and experience increased pain, declining brain function, and increased risk of cardiovascular disease.
There is no debate: keeping blood sugar balanced throughout the day using diet is both doable and is an effective way to promote health.
From a Functional Nutrition perspective, the first question to explore and answer is: What foods are elevating your blood sugar too high?
The common American diet is full of foods that can aggravate blood sugars. Added sugars in all manner of packaged foods are a problem, but processed carbs, starchy vegetables, and fruits can also be culprits. Even a healthy, therapeutic diet can have foods that elevate sugars inappropriately.
The key is discovering which specific foods are problematic for YOUR unique body. Tracking food intake alongside blood sugar readings taken with an at-home glucometer is the best, most specific way to identify your blood sugar triggers.
How to Track Blood Sugar
Tracking your blood sugar requires using a glucometer, or sugar meter. You can buy one online or at your local drugstore. Make sure to buy test strips along with your meter. If you are a diagnosed diabetic, insurance will usually pay for your meter and test strips, but the cost isn’t too prohibitive to buy out of pocket.
Grab a sheet of paper or an online tracking app, and take note of what you ate and when during the day.
You’ll want to take your blood sugar at several intervals through the day. Add these values onto your food log.
- Immediately after waking, first thing in the morning (functional range: 78-88 mg/dL)
- 40 minutes after breakfast (functional range: <135 mg/dL)
- 40 minutes after lunch (functional range: <135 mg/dL)
- 20 minutes before dinner (functional range, if >2 hours since last food: 78-88 mg/dL)
- Just before bed (functional range, if > 2 hours since last food: 78-88 mg/dL)
If you find values above these ranges, it’s time to evaluate what you had for your previous meal. Were there ingredients or products with added sugar? Were there foods with a high glycemic index, like breads, tortillas, pasta, crackers, or baked goods? Even white or sweet, white rice, winter squash, legumes, grains, or beets and carrots could be triggers.
Certain fruits or fruit juices could also be a problem, but will likely cause a delayed elevation of blood sugars, because the fructose must first processed in the liver before being broken down into glucose. Dried fruit can be a particularly strong trigger, as it is a concentrated food and it’s easy to overdo it.
Alcohol and caffeine can also be blood sugar destabilizers. Drinking alcohol in the afternoon and evening may contribute to elevated waking sugars. Caffeine may lead to blood sugar problems near lunchtime if you drink coffee first thing in the morning.
The triggers will likely be different for everyone. To manage your sugars well, you need to get curious and become a detective. If you feel like you’ve identified a blood sugar trigger, remove it for a week and keep tracking your sugars.
Do your numbers stabilize? Or are they still elevated? If they’re still elevated, get curious about what OTHER foods might be triggers. Do removal trials until you identify the culprit(s).
Common blood sugar triggers include:
- Bread, pasta, or tortillas
- Chips, pretzels, and other snack foods
- Baked goods, like cake, cookies, pastries, pie, etc.
- Boxed cereal
- Potatoes (plain, or French fries, potato chips, etc.)
- Fruit juice
- Dried fruit
- Even healthy foods like grains, legumes, or starchy veggies could cause a problem for some people.
Lifestyle Can Affect Blood Sugar
Lifestyle choices, including when we eat, how much we sleep, and how we manage our stress can affect our blood sugar.
Two hormones, leptin and grehlin, are responsible for signaling our appetite and turning it off. Grehlin is produced in the stomach, intestines, and kidneys, and tells us we’re hungry.
When we don’t get enough sleep, our grehlin output increases, which increases our appetite. Fructose (fruit sugar) consumption will also increase grehlin, and therefore appetite. So you can see a self-reinforcing pattern developing here: don’t sleep enough —> increased grehlin —> increased appetite —> eat not great food choices, including sweets or drinks with high fructose corn syrup —> increased grehlin —> repeat… you get the idea. This pattern increases the likelihood of overeating, reaching for quick energy foods like sodas, caffeine, and treats that elevate blood sugar.
Conversely, when our body determines we’ve eaten enough, it releases leptin, which tells us to stop eating. But your cells can become leptin resistant and stop responding to the signals.
Guess what encourages leptin resistance? Fructose, including fruit juice, corn syrup, and agave syrup.
In this indirect way, lack of quality sleep can drive us to have an increased appetite, and can encourage poor food choices. Do you ever notice you have a bottomless pit of hunger when you didn’t sleep well the night before?
One simple way to help prevent this pattern from starting is to get to bed earlier, ideally well before midnight.
Stress and Blood Sugar
When we experience stress, our body mobilizes resources to meet that threat to our well-being. The “fight or flight” response tells the body, “it’s time for action”. To allow this response, the body releases stored energy, and elevates blood sugar.
We want this to happen if we are being chased by a mountain lion. This is the reason average sized people are able to lift a car off of their trapped child, or do seemingly superhuman feats when their life is threatened.
But when our body is experiencing this pattern many times daily, in response to stressors both big and small, this can have a significant effect on blood sugar. It can lead to highs and then lows.
Successfully managing stress, whether it’s from your boss, your kids, your commute, or your financial situation, is absolutely essential for balancing blood sugar. Inviting stress relief practices, such as meditation, mindfulness, walking in nature, spending time with friends, or doing things we enjoy can help us not only feel better, but improve our actual health data and statistics.
No matter your health challenge or diagnosis, making sure your blood sugar is in balance is a key part to healing or maintaining your good health.
When you are ready for help understanding which foods are blood sugar triggers, what to do with your blood sugar readings, or how to successfully manage your blood sugar with diet and lifestyle changes, please schedule a free Assessment Session with me to find out how I can help. You can also grab your free copy of Roadmap to Recovery: How to Move Beyond Your Symptoms and Create a Personalized Plan to Restore Your Health to learn more about how I would support you. I look forward to meeting you…
