by Amanda Malachesky | Feb 25, 2017 | Digestion, Functional Nutrition, Symptoms
So many of my clients suffer from heartburn, indigestion, belly aches, bloating, gas, constipation, or diarrhea. Are you one of them? I wouldn’t be surprised. Almost everyone has at least one of these symptoms on at least a semi-regular basis.
In particular, heartburn and reflux seem to be the most misunderstood of all. Heartburn is commonly thought, by doctors and regular people alike, to be caused by too much stomach acid. Common recommendations are antacids, and prescription PPIs (proton pump inhibitors), such as Prilosec.
But what would you say if I told you that heartburn is actually caused by too little stomach acid? Allow me to illuminate the physiology that explains why.
The stomach is designed to tolerate an extremely low pH of 1.0-1.5. It naturally creates hydrochloric acid when we begin to smell and think of eating, and while we eat our stomach with food. The hydrochloric acid has two functions: to chemically break down proteins into peptides, and to kill any incoming pathogens, such as unfriendly bacteria or parasites. It also facilitates absorption of vitamin B12 and iron. Vitamin B12 assists many essential processes in your body, and iron is important for energy levels. Do any of my readers out there have indigestion and fatigue?
The sphincter between the esophagus and the stomach (Lower Esophageal Sphincter or LES) maintains its normally-closed state by being exposed to adequate stomach acid. When stomach acid decreases, the LES becomes loose, and allows the acidic contents of the stomach to leak back into the esophagus. Because this material is quite acidic and because the esophagus isn’t designed to handle this acid, the sensitive skin there gets burned by the acid, and causes the familiar chest pain of heartburn.
The unfortunate truth about PPIs and antacids are that they are temporary fixes that may relieve immediate symptoms, but they do nothing to address the underlying cause of the heartburn, and further exacerbate the underlying cause: LOW stomach acid. Possible causes of low stomach acid include:
- Chronic stress
- Lack of pre-meal practices, such as preparing, smelling, and thinking about food (for example, eating convenience food on the run, in a hurry)
- Pathogenic infections
- Aging (we tend to produce less as we age)
- Hormone imbalances
- Consumption of coffee, chocolate, sugar, and alcohol can weaken the lower esophageal sphincter (LES), allowing heartburn to occur.
There are many other possible reasons why digestion may be compromised besides low stomach acid, such as inflammation from food sensitivities which can lead to malabsorption, slow motility, or small intestinal bacterial overgrowth (SIBO), which can lead to severe gas, bloating, and intolerance of certain foods, to name a few. But the phase of digestion that occurs in the stomach is one of the first major steps in the process, and when compromised, every step downstream is more of a challenge than it should be.
Here are some gentle, easy steps you can take to increase your stomach acid, improve digestion:
- Take a few minutes before your meals to look at, smell, and imagine eating your food, and express gratitude for your food, to stimulate saliva and hydrochloric acid secretion.
- Chew your food thoroughly, to help the acid you are making do its job more effectively.
- Consume some lemon or apple cider vinegar in water first thing in the morning, and before a high protein meal. Aim for 30 minutes before eating.
- If you suffer from heartburn and you consume coffee and/or alcohol, try eating some food first, to prevent weakening of the LES.
With these tips, I hope that you will find your digestion, energy, and elimination improving. Add a comment, and let me know if any of these tips made a difference for you.
by Amanda Malachesky | Jan 18, 2017 | Digestion, Functional Nutrition, Nutrition, Uncategorized
Are you thinking I’m talking about the difference between the Standard American Diet (SAD) and a plant-based diet?
Think again.
I have been a dedicated diet experimenter. Not a calorie-restriction dieter, but I have tried being vegan, vegetarian, pescatarian, mostly vegetarian with only familiar meat sources, gluten-free, sugar-free, paleo, keto, to name a few. I was trying all of these diets to try to improve my health problems, which in simple terms translated to hormone issues and fatigue. Some of them improved my health, and some quickly proved problematic.
While appropriate food is absolutely a crucial part of any healing protocol, understanding WHY you choose the foods you do is equally important. And if you are managing long-term symptoms or health problems, this is even more the case. Ultimately, there is no one right diet for everyone. Let me repeat: There is no one right diet for everyone! In other words, your food needs are very individual. Ignore this truth at your peril. Let’s dissect what I’m talking about here.
Quality Food, but Wrong Ratios
A few years ago, feeling bad in more ways than one, I stumbled across some information about the keto-adapted diet. I had already been eating a quality, low-processed-food, organic diet for many years, but I still had a dedication and practical addiction to eating carbohydrate-rich foods, including sugary treats. As long as they were gluten-free, we’re doing great, right?!
The keto dietary theory (and paleo theory, which overlaps in many ways) suggests that our bodies do not need to rely exclusively on glucose (sugar) to power our body, and that we can adapt to burning fat as ketones instead. In a keto diet, you eat a high fat, moderate protein, and low carb diet, which turns out to be absolutely delicious! Bacon, cream cheese, and butter are back on the menu, along with grass-fed meat and low carb vegetables. Grains, sugar, and high starch veggies are avoided, as are fruit, except for a small amount of berries. This diet works really well in a lot of cases to transform blood sugar, inflammation, and insulin issues, and reset metabolism. It often helps people lose weight.
When I found keto, I was ALL in! I had an extra fifteen pounds to lose, and hadn’t been feeling myself, and was sure that if I tried this, all my problems would be solved!
You can probably guess I’m going to suggest something different happened. I did feel good for a while, though not “amazing” as so many others advertised. I did lose the extra weight I didn’t want. But after about 8 months, my painful cycles turned to severely painful. I started sleeping even worse than I had been. And I had absolutely no energy. I could hardly get up off the couch, and folding my laundry had me needing a nap. What was going wrong??
In the end, it turns out that I wasn’t thinking about my health problems functionally. I didn’t consider the WHY behind the weight gain, or the hormonal symptoms I was having any farther than food. And because I wasn’t thinking in this way, the keto diet actually turned out to be the perfectly wrong solution. The dramatic increase in dairy consumption worsened my hormone symptoms, because dairy, even if it comes from dairies that don’t give supplemental hormones, comes from a lactating or pregnant animal. The low-carb aspect of the diet DID enable to me to break my addiction to carbs, but since my body wasn’t actually able to digest fats very well due to hidden infections I learned about much, the increased fat consumption worsened my digestion and acne, and left me without energy, and further stressed out my adrenal (stress response) system.
Basically, even though the diet I had been consuming before wasn’t great, it was holding together a pretty delicate system of adaptations to adversity in my body, and switching it up without laying a proper foundation had pretty dramatic and negative consequences. I got a “A” for effort, but an “F” for understanding the WHY behind my choices and what their effects would be. In short, I was asking the wrong questions.
Good Intentions, Accidental Consequences
After wondering why my acne was so bad, and my pain worse, and my digestion terrible, I decided to tilt things toward paleo. Add some more starchy vegetables, like sweet potatoes, and carrots, and squash back in, also some fruit, and lots of those yummy almond flour treats you read about on Pinterest!
My energy did improve a little with increased carbohydrate intake. But in spite of these good intentions, and thinking I was doing my immune system and inflammatory response a favor, I found my pain was still just as bad, there was no change in my skin, AND my digestion was even worse! So frustrating!
Enter oxalates. Oxalic acid is a naturally occurring substance found in humans, animals, and some plants. In plants, they are a defense mechanism, to dissuade herbivory. When consumed by humans, they are ordinarily broken down, bound to minerals, and excreted in the urine or stool. However, if a person has a permeable gut, and if that person is also deficient in minerals that bind to oxalates, they can enter the bloodstream, and travel anywhere the body, where they create sharp, jagged crystals that can cause joint and inflammatory pain.
It turns out that many of the foods that are very high in oxalates are also foods that are very commonly used in a paleo-type diet: spinach, chard, beets, sweet potatoes, plantains, almonds (and many other nuts), chocolate, and carob, to name a few.
Ultimately, even though these foods are healthy, and fine for many people, they can compromise others with certain physiological conditions, or make things far worse. Once again, I wasn’t considering the WHY about my symptoms and health issues, which was leading me down the wrong path. This is why it is so very important, if you want to use food as your medicine, to work with someone knowledgeable about food and how it affects the body, and to make choices aligned with where the body is at right now.
CAUTION: Do not go on a low-oxalate diet quickly! Consult with a knowledgeable practitioner to slowly work this into your dietary practice, to avoid painful symptoms!
How to Start Thinking Functionally About Food
Because we eat three or more times per day, it is crucially important to be choosing foods that will help your healing process. But how do you know which ones are right? We have to work carefully to find the foods that help, and identify the foods that trigger a problem. There are several ways to go about this. I’ll briefly describe two methods here: elimination diets, and food tracking. Food sensitivity testing is also an option, but because no lab test is perfect, an elimination diet is the gold standard for getting direct feedback about problem foods.
Elimination Diet:
In an elimination diet, you remove common problem foods, such as gluten, dairy, sugar, corn, soy, and eggs for a period of time, usually 2-3 weeks. Then, you carefully trial each food, one at a time, and only one per every 3-4 days, and observe to see if there are any negative consequences. You might be surprised about what causes a reaction, and the range of possible problems. Things like brain fog, achy joints, headaches, stomach aches, or gas might be some of the things that can happen. Once you are empowered with this information, the mysteriousness of some of these symptoms disappears and puts you back in the drivers seat of your life.
Food Tracking:
Food tracking involves journaling your food on a day-to-day basis for a while, noticing your macronutrient (protein, fat, and carbs) ratios, and noting any symptoms you feel, how your elimination patterns change or remain the same, and how your mood is faring, and seeing if you can correlate your responses to what you are eating. This kind of information also empowers you with the knowledge of what is creating an impact, and what is not, and provides focus on where to direct your attention to get the most benefit.
Download Your Food-Symptom Diary Here
by Amanda Malachesky | Jan 4, 2017 | Functional Medicine and Coaching, Functional Nutrition
When you decide you’re going to change something about your life, do you dive in and make drastic shifts all at once? Throw out half your pantry, or drive yourself to exercise obsessively, thinking that this approach will finally, once and for all, create the change you want to see?
While some of us are adept at altering our routines at the drop of a hat and maintaining those changes in the long term, most of us end up reverting to our previous habits within a few weeks. It’s easy to get started, because there is a rush of brain reward with something new and exciting, but when that wears off, we are left wondering what it’s for, and the old, comfortable habits start looking pretty inviting.
This is the scenario if you are going it alone. But when you add an observer, whether its someone you hire, a support group, or your best friend, and they are in on the project, your likelihood of success goes up dramatically. In coaching, we call this person an “accountability coach”, which is really just a fancy term for someone who holds you accountable to what you said you would do.
Furthermore, the changes you make are more likely to stick if you create just a few, actionable steps at a time. Think one to three new changes at a time. To create new, sustainable habits, we need time to try something new, adapt to the newness, and kind of “fake-it-till-we-make-it” until it becomes the new normal.
For example, if your goal is to eat healthier, you could just adopt a dietary theory that you think works. You could throw out all your sugar, chips, and soda, and go forward. But this is a very broad goal, and chances are, you won’t make it very far.
It is far more valuable to first get clear about WHAT you hope to accomplish with the change, and begin your process by imagining specifically how your life would be better if things were different. Once you’re clear on that, the necessary action steps become clear. You begin with a concrete action step like “Each time I want a soda, I will first drink a glass of water, and consider what else my body might be needing,” along with “I will eat sweet vegetables and foods like sweet potatoes, carrots, beets, winter squash, and whole grains regularly this week to crowd out sugar.” You begin creating a new habit without drastic measures. You create an enjoyable alternative, and observe. You encourage yourself to notice what happens. Your increase in sweet vegetables and grains might reduce your need for sugar, without a lot of fanfare and drama.
When you take on changes incrementally, you allow yourself to have a single-pointed focus, and really dedicate yourself to those one or two things that you think will make a difference. Trying to change too many things at once can be overwhelming, and lead to a feeling of hopelessness. Multi-tasking isn’t always better. When you approach making changes in this way, and you introduce something new and different every two weeks, as I have my clients do, within a period of months, you have developed many new habits over time. You might not notice how much has changed, until you look back and consider what things looked like in the beginning!
Through the twelve sessions of a six month program, my clients may have committed to a maximum of 36 goals through their program. That’s a lot of individual changes! Had I told them at the beginning that they would have given up sugar, lost pounds, resolved their sleep hygiene, created a weekly exercise routine, created stress-management strategies, increased the diversity of the vegetables and whole grains in their diets, and explored 10 new foods, they might not believe it! But this is really the secret: to make a big change, we start by taking on one thing at time, and doing it fully and well before we move on to the next thing.
Let me know below how you have manifested something big by taking small steps along the way.
by Amanda Malachesky | Dec 12, 2016 | Functional Medicine and Coaching, Functional Nutrition, Symptoms
Symptoms aren’t permanent, but they ARE a sign that something isn’t right.
A year ago, I was living in a world of continuous and constant symptoms: belly pain, hormonal fluctuations that left me in severe pain, unable to sleep through the night, hungry all the time, with migraine headaches at certain times, recurring diarrhea, frequent anxiety, and severe fatigue. In this state, it wasn’t hard to see and understand that there was something wrong with me that warranted investigation.
I sought out care, and was given some diagnoses, and care suggestions. These included surgery, medications (I refused these, because they weren’t going to address my underlying conditions, but would likely make them worse), psychotherapy, and a few supplements.
What’s interesting to me about this situation is that the symptoms I was experiencing expanded slowly over time. I was aware that things weren’t right, but between my lack of health insurance, lack of trust that doctors would be able help me troubleshoot my whole body system in a holistic way, and profound lack of personal time, since I was a mother of young children, I did what many people do when faced with symptoms: I continued to put up with them, and managed to carry on week to week to week, in spite of them.
If I had paid more attention earlier, I may have spared myself some pretty difficult times, saved myself a hell of a lot of money, and been able to save my uterus.
But if there’s one take home message I’ve learned from my intensive studies this last year, it’s that symptoms are windows into what isn’t working correctly in the body. It’s not normal to have headaches every day at 4 PM, or to regularly be unable to sleep well, or to be constipated every day, or to get regular colds and flus, or to be tired all the time. These symptoms are giving your body vital information that something isn’t right, that something deserves attention and inquiry.
But what do you do to learn what they have to say? First, it’s about beginning to pay attention to the variables we do have control over: our food, our movement routines, our sleep habits, and how we manage stress. Do we always get sleepy after eating a particular food? Do we tend to get constipated when we sit too much all day, or eat something at lunch? If we stay up too late, does it contribute to our migraine headaches? If we watch a movie before bed, does in interfere with our sleep quality? Answering these questions for yourself can give you a lot of power back over your symptoms. If you can evaluate what is causing your problem, you can change the situation, and relieve your difficult symptoms.
If this isn’t enough, it can be helpful to have assistance from a professional who can look for patterns in the symptoms, or evaluate what might be going on in there using lab tests, a health history, or tracking tools. Sometimes, we have to play detective to get to the bottom of things, but with some applied thinking, we can uncover the hidden causes of suffering, and see a path to relief.
Don’t let your un-managed symptoms go, they are messages about imbalance that are best listened to.
by Amanda Malachesky | Dec 12, 2016 | Functional Medicine and Coaching, Functional Nutrition
I’ll be honest with you. Even though I deeply believe in the functional health care model, until last year, I didn’t even know what it was called. You probably haven’t heard of it either. But make no mistake, functional health care is poised to unravel the chronic disease epidemic facing America right now. So what is it?
Functional medicine is a wholistic approach to health that seeks the root causes of what ails you. Instead of trying to collate a person’s symptoms into a pre-defined pigeonhole diagnosis, functional practitioners look at a client’s entire health history and presentation to try to understand the WHY, and work to restore full function of tissues, organs, and systems, upstream of symptoms.
Reason Number 1: You Believe in the Effectiveness of Wholistic, Lifestyle Solutions
We all know that chronic disease is on the rise, with heart disease, diabetes, and cancer affecting a significant portion of Americans. It is now estimated that almost half of Americans will have a chronic disease by the year 2025. These patients account for 76% of doctors visits annually! But what if there was another way? These diseases all have a common root: inflammation and the wrong kind of diet and living.
Functional practitioners rely heavily on a foundation of coaching people to make lifestyle adjustments and create new habits that are proven to restore health and weaken the hold that chronic disease has in our bodies. Working on sleep and exercise habits, stress reduction, and eating the right foods for our unique metabolism are all key to successfully winning against ill health, no matter what your diagnosis. In fact, no amount of medication can perform the same function as targeted lifestyle changes.
The reason to work with a health coach or other practitioner is that making these changes can be difficult to do successfully. It takes time to set up new routines that support your health, and a functional practitioner or health coach can help you do this, seamlessly, over time while you are addressing the underlying causes of your issues.
Reason number 2: Personalized Solutions
Each of us is unique, though you likely knew that! Bioindividuality is a very important concept when it comes to diet. How many of you have had a friend swear by their new diet, only to find that when you try it, it doesn’t work for you at all?
But even more important is the idea that a diagnosis is nothing more than a constellation of symptoms or processes, but doesn’t tell you anything about the why. It is oft repeated among functional practitioners that if you look at ten different people with diabetes, the cause of diabetes in all ten cases can be different. That’s right, my diabetes is likely different than yours.
Furthermore, the medications prescribed by doctors may suppress symptoms, but they don’t do anything to heal the underlying problem leading to out-of-control blood sugar and insulin resistance. For some, they might be eating the wrong foods for their metabolism. For others, they could have an unnoticed gut infection, and for yet another, they could be under excessive stress and its downstream effects.
In the conventional model of health care, with diabetes you are facing a lifetime of medication, which may or may not control the symptoms, while the underlying mechanism of disease continues. When the underlying causes are ignored, they continue to destabilize your health over time! Doesn’t sound appealing, does it? Wouldn’t you like to know how to solve the puzzle at its source?
Reason number 3: You appreciate being listened to.
This reason may not resonate if you are healthy and haven’t had the need to approach a medical doctor recently. But if you are an unlucky sufferer of a chronic or “mystery” illnesses, one with a lot of strange and seemingly unrelated symptoms, or you have multiple medical issues, you still only have 7-15 minutes with your doctor per visit. How much can you possibly convey in those short minutes? What if you realize you forgot to ask about something after you leave their office? How long will it be until you can get another appointment? Did that doctor really listen to you?
Functional practitioners work very closely with their clients, from the first health history consultation and lab test interpretation, to the hourly, regular coaching sessions that follow. They are often available by email or other means inbetween your visits, and will troubleshoot problems with their recommendations. They are always trying to understand how your system is underperforming, and supporting you toward better health. If you like having the luxury of time in a session, functional health coaches are going to be a good fit for you.
To learn more about working with Functional Nutrition, please fill out my short inquiry form, and then schedule a freeStrategy Session, and we can begin the process of solving your health mysteries together.
