Posted on

What is Dysbiosis – and What You Can Do About It

You have within you trillions of microbes – bacteria, fungi, viruses, even parasites – all living together in your gastrointestinal tract.  This lively bunch of microbes is known as your microflora. Often referred to as “The Garden Within,” your microbial garden can shift out of balance. Think about how a garden can become overgrown with weeds. When that happens, we say a person has dysbiosis.

Three Ways Dybiosis Can Impact Your Gut

  1. Too much of the bad stuff overgrowing in the gut is the most basic imbalance.  An overabundance of “bad,” typically inflammatory, bacteria, or too much yeast (candida albicans is a particularly common and unwelcome yeast in large amounts), are two examples of overgrowth that cause dysbiosis.  An unwelcome virus or parasite can also cause overgrowth imbalance.

    To treat this type of dysbiosis we sometimes prescribe medications to kill unwanted bacteria, parasites, or yeast, but more often we use gentler, broad-spectrum anti-microbial herbs to weed the garden, improving the balance of good and bad bacteria. We also use probiotics and fiber-rich foods to encourage growth of the good while we get rid of the bad.
  2. Microbial undergrowth can be the culprit. It is rarer than the situation above, but sometimes a stool test result shows an under-abundance of all bacteria – good and otherwise.  An under-abundance indicates we need to work on improving the terrain (the gut lining) where the flora will take residence, as well as supporting the growth of the flora we want to encourage. We do this with probiotics, prebiotics, lining supportive supplements like glutamine, and healthy, bacteria-supportive foods.
  3. Your microbiome settles in the wrong place. Living microbes are wanted, but we need them to live where they belong, and not take up residence in places where they cause problems. Most frequently, this type of dysbiosis is SIBO (Small Intestinal Bacterial Overgrowth). SIBO occurs when the gastrointestinal microbiome has shifted from primarily growing and thriving in the large intestines (the colon) to taking up residence in the small intestine in too great a number. This tends to cause digestive problems and bloating, but can be silent as well.  Herbs and antibiotics are our go-to for treating SIBO.

Could you have dysbiosis?

In our medical practice at Blum Center for Health, we suspect an imbalance in the flora (a dysbiosis) in anyone who complains of stomach troubles. Digestive difficulty of absolutely any kind suggests there’s something wrong with the trillions of microbes inside the gut. If you have stomach upset after eating, indigestion, the extremely common GERD (reflux), heartburn, slow digestion, or bloating, we think of dysbiosis.  If you have bowel problems, like excessive gas, lower belly pains, constipation, or diarrhea – then dysbiosis is our prime suspect too.

Dysbiosis as the Root Cause of Seemingly Unrelated Disorders

It surprises many patients that other symptoms, including those that on the surface seem to have nothing to do with the gut, also make me suspect dysbiosis.  We are becoming more and more aware the impact our microbiome has on our whole being – our whole health – and our disease processes.

When I see someone whose health concerns are not primarily digestive in nature – even those who report having a perfect digestive system – I usually investigate their microbiome, and will almost always prescribe a probiotic. Why? Because sometimes dysbiosis is silent gut-wise, while still causing trouble in other areas of your body.

Here are a few examples:

  • Hormonal imbalance – we know that certain bacteria encourage an imbalance in hormones.  
  • Autoimmune diseases show clear links to overgrowth of some bacteria.  
  • Joint aches and pains can be caused by leaky gut, which is usually a consequence of some kind of imbalance in the gastrointestinal microbiome.  
  • Neurological and psychiatric disease is being traced back to problems with our microbes.  
  • Weight loss resistance is often a consequence of over (or under) growth of the bacterial flora.  

Basically, any inflammatory process can be traced back to the gut.  

How do you know if you have dysbiosis?

How does your internal garden grow?  The tests we most often request are simple:  Stool, breath, and urine testing – all of which give us a picture of what your personal microbiome looks like.  We learn from the test results how many beneficial bacteria are growing, and how many malicious bacteria have taken up residence in your gut. We use that information to create your personalized treatment plan.

With some patients we assume dysbiosis without testing – and just get you started on the good stuff  – probiotics and healthy, fiber-rich foods.

Not sure if you have dysbiosis? Take our Assessment and find out!

How did you get this dysbiosis?

There are many reasons we harbor the microbes we do. Our developing microbiome begins at birth – it is different if we are vaginally delivered or born via c-section, for instance. Our food choices (throughout our lives) affect our microbiome, as does any antibiotics we might have taken.  Other medications, both prescription and over the counter, also affect the microbiome.

What to do if you suspect you have dysbiosis:

If you live in our neighborhood, make an appointment! In our practice at Blum Center for Health we take a multi-pronged, holistic approach, a combination of medical and lifestyle considerations, to address, diagnosis and treat your condition. We take your health seriously and get to the root of the problem rather than simply throwing medication at it. For more information, call 914-652-7800.

Don’t live nearby?  A great place to start is with our 10-Day or 30-Day HealMyGut program — it’s a total gut reset with a nutritional plan, recipes, just-right supplements, daily email support, and a private online community. Our 30-Day program includes the added bonus of a weekly chat with our Functional Nutritionist to answer all your questions. Find out which program is ideal for you: Take the Assessment

 

Meet Darcy McConnell, M.D.:  Dr. McConnell brings her broad expertise in prevention, mind-body medicine, and women’s health to Blum Center for Health, in Rye Brook, NY. She is board certified in Family Medicine and Integrative Medicine, with postgraduate training from the Institute for Functional Medicine. Darcy lives with her husband and three sons and enjoys the outdoors, cooking healthy meals for her family and friends and is an enthusiastic yogi.

 

Posted on

An Integrative Gynecologist’s Advice for Teens and Young Adults

Gynecological advice for teens

Making the transition from childhood into the teenage years and young adulthood is a tender time for most young women. Navigating the world of menstruation, sexual relations, sexual health, and even understanding how her body works, can create anxiety, wonder, excitement and, inevitably, loads of questions.  How can we best support young women as they make this transition? The answer lies with using a more holistic approach to Gynecology.

Traditional gynecology is solely focused on reproductive health. It can feel cold and medicalized no matter how warm the practitioner is. And, let’s face it, our reproductive system is only a small part of our entire body.

The Integrative (which includes Functional Medicine) approach to Gynecology focuses on the entire body. This holistic way of viewing a woman addresses nutrition, exercise, stress management techniques, and lifestyle choices, all of which positively sets up a young woman for a lifetime of excellent reproductive health. Often, all kinds of issues, like PMS, painful periods, and polycystic ovarian syndrome, can be treated using lifestyle approaches, either alone or coupled with herbs and supplements.

Perhaps the most important difference between me and a conventional gynecologist, is that when I start working with you or your daughter, my goal is to develop a relationship. It is important to create a partnership based on trust and respect in order to most effectively help you, the woman sitting in front of me. What are your goals?  These drive everything. I start with a detailed history, paying great attentiveness to your physical, mental, and spiritual well-being.

In creating a reproductive wellness plan I incorporate nutrition, exercise, mind/body techniques, supplements, and herbs.  I may recommend acupuncture, massage/manual therapies, energy work.  Of course, if birth control is desired also, we do include contraception with or without hormones. Again, it is co-created with you, and It all depends on your goals.

For a teenager or young woman an initial appointment often may not include a pelvic exam.  This is because, truthfully, many questions/concerns don’t require one.  Eventually we’ll get to an exam but first there is benefit in educating you about your own anatomy.

Often our first visit is just a “talk” visit.  I understand that there can be fear surrounding a pelvic exam. My belief is that we don’t need to do anything that is not necessary, especially if it is uncomfortable or anxiety provoking!  Even for mature patients, we are moving away from reflexively doing a pelvic exam at each visit because the evidence shows that it is not always necessary.  I would rather spend our time with education.

So many routines that are started in our youth carry forward.  What better time to take the steps needed to build your bones up, maintain your gut microbiome, establish food choices that support reproductive health and decrease the long term risks of cancer, diabetes, heart disease?  We also teach mind/body techniques like deep breathing, meditation that helps you to handle all the stress that our crazy world throws at us.  As a young woman, the sooner you learn to manage this, the better off you will be.  It’s also important for you to learn about how toxins in the environment, food, plastics, cosmetics impact your reproductive health.  If you take steps early in life to lower the toxic load, we can ensure your future wellbeing.

You can see that I believe strongly that if we can teach the young women of today the principles of nutrition, exercise, stress management and toxin avoidance, they will be a much healthier generation tomorrow!  And my goal is to help make that happen.

Would you like to learn more and live in our neighborhood? Join Dr. Bronwyn Fitz at Blum Center for Health on May 4th at 7pm for her free community talk, An Integrative Gynecologist’s Advice for Teens and Young Adults. Dr. Fitz will describe the Integrative approach to some of the common health concerns that face young women: irregular and difficult periods, birth control, HPV vaccination, sexually transmitted infections.  Register Now 

About Dr. Fitz:

Dr. Bronwyn Fitz is a board certified Obstetrician Gynecologist who is fellowship trained in Integrative Medicine.  In her practice she melds traditional medicine with non-Western approaches, nutrition, botanicals, mind/body therapies and lifestyle interventions to help women address their gynecological and reproductive health concerns. Her interest in mindfulness and meditation led her to pursue a two-year Fellowship at The Arizona Center for Integrative Medicine, under the leadership of world-renowned Integrative physician, Dr. Andrew Weil.

Posted on

Your Microbiome: Caring For What’s Inside You

Microflora

There are literally trillions of bacteria in our digestive tracts.  They make up what is called the microflora, because under a microscope they look like little (micro) flowers (flora).  We refer to it collectively as our microbiome and they play an unbelievable role in synthesizing vitamins, producing natural antibiotics and degrading and eliminating toxins.  There are more of them in our bodies than human cells.

Think about it, we are walking around harboring and supporting this microbiome, an entire ecosystem within us.

Recent science has taught us that the microbiome also dictates aspects of who we are – our personalities, what diseases we will get, our mood, the size of our girth. Most of us are oblivious to it, we pay no attention to it at all except for to take a probiotic, until it hurts.

Internally we are 98.6 degrees, very moist and we have a tube that runs through us that is 30 feet long that has an opening on each end (the mouth and the anus).   This internal environment is the perfect breeding ground for microbes – both good and bad.

Outside, external, influences often upset the balance.  How we control the external influences determines the delicate balance of good and bad players.  It is up to us – we must care for them, it is critical to good health and requires more than a probiotic.

Factors That Affect the Microbiome:

Stress, the food we eat, genetics, how much time we spend outdoors, if the windows of our homes are open or closed, our exposure to animals, toxin and chemical exposure, antibiotic use throughout our lives, how we were born — C-section or vaginally — whether we were breast-fed, how often we bathe – all affect our microbiome.

For most of us, our guts are a mess.  We have created a microbiome that looks very different from what nature intended for each of us.  So how do we get back to the farm?

Increase These Foods to Support your Microbiome :

  • Eat a rainbow of colorful vegetables and some fruit every day. They will provide fermentable fibers that feed our healthy flora.
  • Include coconut products like coconut oil, milk, yogurt and kefir. Coconut is filled with medium chain triglycerides which feed the cells lining our intestines, and has yeast-killing properties.
  • Include Ghee, which is clarified butter. Ghee is filled with butyrate, a critically-important fatty acid for the care and feeding of cells in our colon.
  • Eat organic, non-GMO These foods are low in pesticides and have not been genetically modified, which can alter your flora and damage you intestinal lining, causing leaky gut.
  • Include healthy anti-inflammatory oils like fish, flax, olive oil.
  • Choose grass-fed, pasture-raised, or free-range organic animals when possible. This will limit the hormones, antibiotics, and pesticides that we are expose our microbes to when eating animals raised in typical feed lots.  Also, the meat from grass fed animals have higher quality, anti-inflammatory fats than corn fed animals.

It is Equally Important to Remove These Foods:

  • Processed food high in sugar, white flour, baked goods, food dyes and preservatives. These foods and chemicals promote the growth of the wrong kind of bacteria in our gut.  Eating this way should be a permanent change.  This includes fruit juices, dried fruit, and all added sugar or artificial sweeteners except stevia.
  • Gluten, dairy, soy, corn, eggs and peanuts because these foods are the most common triggers for reflux, constipation and abdominal discomfort, as well as other non-gut related symptoms.
  • Foods high in histamines: Shellfish, processed or smoked meats and sausages, wine.  Many people are affected by histamine intolerance, caused by the body’s inability to break down histamine in the gut causing crazy allergy reactions. Reactions to histamines can look like allergic reactions, including nasal congestion as well as headaches, dizziness and digestive discomfort.
  • All alcohol

 

Live in our neighborhood? If you’d like to heal your, consider joining my HealMyGut 30-Day Program on Tuesday, April 17th at either 10am or 6pm Blum Center for Health. To learn more or enroll, Click Here.

Don’t live near Blum Center?  Try our online HealMyGut program that includes daily email support, a private Facebook group, and weekly live one-hour coaching calls.

About Mary: Mary Gocke, Director of Nutrition at Blum Center for Health, has been successfully using food and nutrition science to treat and heal people with chronic illnesses and acute conditions for over 25 years. When Mary’s not helping people feel better through nutrition, this mother of two grown children can be found practicing yoga, which she has taught for years, or in her kitchen cooking something colorful.

Posted on

Do You have Estrogen Dominance?

Estrogen Dominance

In Functional Medicine we often refer to the relationship between estrogen and progesterone as the “dance of the hormones” or the “hormone orchestra.”

Ironically, what sounds like a beautiful evening at the ballet often plays out each month as a real hand-banging, body-slamming cacophony!

So what gives?  Why is it that we often feel out of control, and sometimes out of body, for days at a time?

The answer could be Estrogen Dominance.

Here are typical symptoms that can be attributed to a relative excess of estrogen in relationship to progesterone:

  • irregular bleeding
  • mood swings
  • depression
  • water retention/bloating
  • painful breasts
  • hot flashes
  • heavy periods
  • painful periods
  • fatigue
  • brain fog
  • sleep disturbance

How did we get here?  Unfortunately, there are many roads that lead to estrogen dominance.  Let’s start at the beginning.

The Typical Menstrual Cycle

During a typical menstrual cycle, the first half of the month, known as the estrogen dominant phase, progesterone is relatively low and estrogen levels steadily rise. Due to some nifty feedback loops that involve the brain and other hormones, ovulation occurs at around Day 14, and an egg is released from the ovary.  During this second half of the menstrual cycle, estrogen levels fall somewhat and progesterone levels rise significantly. This is when progesterone takes the lead in our hormone tango.

5 Roads that Lead to Estrogen Dominance

  1. Irregular Ovulation — One road that leads to estrogen dominance is if ovulation doesn’t occur and progesterone doesn’t have the opportunity to take that lead. We see this type of problem in young girls who haven’t started ovulating regularly, and in peri-menopausal women who are close to the end of their ovarian reserve, and also aren’t ovulating normally.
  1. Any Type of Stress — Often stress can lead to skipped ovulation. Typically we think of extreme episodes of stress such as a severe illness, anorexia/malnutrition, intense athletic training. But commonly, your average woman who goes through a stressful time will notice that her period becomes irregular. Even long standing, chronic stress can take a toll on your female hormones.
  1. Foods and Food Packaging — In this day and age of genetically-modified, pesticide-laced, prepackaged food to go, we are constantly exposed to xenoestrogens. These are toxic chemicals that act like weak estrogens in your body. These nasty chemicals can be found in pesticides, plastics that our food comes wrapped in, that “to-go” coffee lid, even the lining of your canned goods and drinks.
  1. Cosmetics and Household Products — Other examples of endocrine disruptors are phthalates and parabens that are used in hygiene products, cosmetics, and fragrances. This is where women are potentially very vulnerable considering how many bath, haircare, cosmetic, nail, feminine hygiene products we use daily. These just add to your total estrogen “load” that your body sees on a regular basis and that your liver has to metabolize and detoxify.  It turns out that optimal liver function is very important in estrogen metabolism and clearance.
  1. Your Gut Flora — The gut microbiome and your gastrointestinal function is another major player in this hormonal dance that is now looking more like a square dance with all its moving parts. It turns out that the bacteria that reside within our GI tract plays a very important role in helping us eliminate our estrogen by-products once the liver has packaged them up nicely for excretion. Sadly, the average American diet, full of high fructose corn syrup and other inflammatory foods often keep our livers working over-time just trying to detoxify lunch, let alone efficiently remove spent hormones from our systems.  Obesity itself is a problem since estrogen is stored in fat cells.  The fact that 2/3 of Americans are overweight or obese points to how prevalent this form of estrogen exposure is.

As you can see, there are many, many influences that lead to Estrogen Dominance. It’s not just “the way you are.”

The great news is there is something you can do about it.

First, you don’t need to treat Estrogen Dominance with birth control pills!

While birth control pills may help alleviate symptoms, they do not solve the root problem, In fact, taking birth control pills to treat estrogen dominance could possibly lead to more longer-term problems. (There are other excellent uses for birth control pills, such as actual birth control, and it is important to understand a woman’s goals for her health when deciding how to treat her.)

As a fellowship-trained Integrative Medicine and Functional Medicine doctor, I attack this problem of Estrogen Dominance from many angles.  The truth is we have so many ways to help women feel better, without the use of medicine and surgery.  We can, and should, use food as medicine, weight loss, botanicals, mind-body modalities for stress management so that women can actually heal themselves.

About Dr. Fitz:

Dr. Bronwyn Fitz is a board certified Obstetrician Gynecologist who is fellowship trained in Integrative Medicine.  In her practice she melds traditional medicine with non-Western approaches, nutrition, botanicals, mind/body therapies and lifestyle interventions to help women address their gynecological and reproductive health concerns. Her interest in mindfulness and meditation led her to pursue a two-year Fellowship at The Arizona Center for Integrative Medicine, under the leadership of world-renowned Integrative physician, Dr. Andrew Weil.