Uncategorized
Apr
16
Insulin-Resistance

Blood sugar imbalance is a commonly undiagnosed problem. 

Are you struggling with excess weight, fatigue after meals, too much body fat, constant hunger, frequent urination, difficulty losing weight, or sugar cravings?

These symptoms might be the red flags of blood sugar imbalance. 

The early recognition of these symptoms will help you prevent excessive and unnecessary inflammation, and will give you the opportunity to take effective measures to reclaim your health. Glucose serves as your brain’s fuel and fuel for the cells throughout the body. When you do not have stable blood sugar (glucose), you comprise your overall health and your brain health.

Blood sugar imbalance can relate to (chronically) low or high blood sugar. Some people experience both, fluctuating blood sugar levels between low and high. Drops in blood sugar are known as hypoglycemia and high blood sugar spikes can refer to insulin resistance. Hypoglycemia is discussed in another post.

Why insulin resistance is problematic?

Many people are unaware that they have blood sugar imbalance and insulin resistance is a silent blood sugar problem. It is widely undiagnosed and if not managed it increases the risk for prediabetes, type 2 diabetes and a host of other serious health problems, including heart attacks, strokes, polycystic ovary syndrome (PCOS), hypertension, and hyperlipidemia known as metabolic syndrome, and cancer.

Let’s take a moment to talk about Insulin Resistance.

INSULIN RESISTANCE

Insulin is a hormone made by the pancreas and its job is to help glucose in your blood (blood sugar) to enter the cells in your body, where it’s used for energy. Glucose comes from the food and drinks you consume. When blood glucose levels rise after you eat, your pancreas releases insulin into the blood. Insulin then helps to lower blood sugar (glucose enters the cells) to keep it in the normal range.

Insulin resistance is a condition when cells of the body don’t respond properly to insulin and they can’t easily take up glucose from the blood. As a result, it is more likely that glucose will build up in the blood leading to elevated blood sugar levels.

A growing body of evidence has consistently shown that insulin resistance is linked to low-grade systemic inflammation.

When the body becomes resistant to insulin, it tries to cope by producing more insulin (hyperinsulinemia), therefore people with insulin resistance are often producing more insulin than healthy people.

Insulin surges promote inflammation in the brain and in the body. Interestingly, blood sugar/insulin levels impact the brain’s ability to make neurotransmitters and are elucidated to play a role in neurodegenerative diseases such as Alzheimer's disease. Thus, unstable blood sugar affects brain’s biochemistry, causes inflammation and compromises your brain health.

Becoming insulin resistant does not happen over-night, it typically takes years to get there. Most common reason includes a diet high in sugars, sugary foods, sweets, cookies, sodas, bread, pasta, pastries, excess rice & potatoes, and grains. In addition, high stress, poor sleep and lack of physical activity. Being obese on itself increases insulin resistance as well. However, it is possible to be insulin resistant without being overweight or obese.

Insulin resistance initially presents no or mild symptoms and can easily go unnoticed

Insulin resistance develops in stages. During the initial - compensated phase of insulin resistance, insulin levels are higher, and normal blood glucose levels are still maintained. If compensatory insulin secretion fails, then either fasting or postprandial glucose concentrations increase. Eventually, type 2 diabetes develops when glucose levels become higher and the resistance increases and compensatory insulin secretion fails. The inability of the pancreatic β-cells to produce sufficient insulin in a condition of hyperglycemia is what characterizes the transition from insulin resistance to type 2 diabetes.

The symptoms become more pronounced once secondary effects such as higher blood sugar levels occur.

The symptoms may include:

  • thirst or hunger
  • feeling hungry even after a meal
  • increased or frequent urination
  • tingling sensations in hands or feet especially when insulin resistance progresses to type 2 diabetes
  • feeling more tired than usual
  • feeling sleepy after meals
  • frequent infections
  • difficulty concentrating (brain fog)
  • weight gain around the middle (belly fat)
  • high blood pressure
  • high cholesterol levels
  • Some people may have darkened skin in the armpit or on the back and sides of the neck, a condition called acanthosis nigricans
  • Polycystic Ovary Syndrome (PCOS) might be a red flag to consider insulin resistance

How can insulin resistance be diagnosed?

There is no single perfect test used in clinic for diagnosis. But the easiest screening way, next to the clinical presentation, is to do a blood test for (fasting) blood serum glucose and insulin (and often other markers like Ab1c, cholesterol, triglycerides).

There are also helpful tools for insulin resistance assessment such as the Quantitative Insulin Sensitivity Check Index or a Homeostatic Model Assessment of Insulin Resistance (HOMA-IR).

 

Eating to balance your blood sugar might fix the problem

If you suspect you may have insulin resistance or prediabetes, there are things you can do to reduce inflammation and to be healthier.

Golden tips include avoiding sugary foods and drinks, avoiding processed foods and drinks, and having balanced meals consisting of real foods. Plant foods (veggies, fruits) rich in phytonutrients such as polyphenols-flavonoids with their anti-inflammatory and anti-oxidative powers should be plenty full on your plate. Keeping a moderate carbohydrate intake is also recommended. Think of a Mediterranean like diet. Some people also benefit from a ketogenic diet.

Most people will do well keeping following proportions on their plate:

  • About 50-65% of non-starchy vegetables
  • About 15-25% of quality protein
  • About 15-30% of healthy fats
  • About 5-15% of healthy starches
  • Herbs, spices and salt

Healthy eating also includes eating fruits but preferably have them as a snack or a dessert.

Food groups: vegetables, fruit, protein rich foods, fat rich foods, herbs and spices, and heathy starches

Find your carbohydrate tolerance

First of all, having nutritious breakfasts with high quality protein and fat, (low-carbs) can be very powerful to stabilize your blood sugar.

For many people having little bit carbs for breakfast, a little more for lunch and even more for dinner will do the trick in keeping your blood sugar stable.

To find your carbohydrate tolerance monitor following: if you feel sleepy or crave sugar after you eat, you probably have eaten too many carbohydrates. But in case of severe insulin resistance you may feel sleepy even if you haven’t eaten any starchy or sweet foods. Let’s say you had beef and a salad for lunch and you still feel sleepy after eating. It might suggest that you are at the advanced stage of insulin resistance. In this case, it’s worth working with a professional who can help you correct the problem with nutrition and nutraceuticals.

Stable blood sugar is essential to overall health.

Information provided below is meant for educational purposes only, and does not constitute medical or nutritional advice or act as a substitute for seeking such advice from a qualified health professional. 
Reference list
  1. Rhea EM, Banks WA. Role of the Blood-Brain Barrier in Central Nervous System Insulin Resistance. Front Neurosci. 2019;13:521. Published 2019 Jun 4.
  2. Spinelli M, Fusco S, Grassi C. Brain Insulin Resistance and Hippocampal Plasticity: Mechanisms and Biomarkers of Cognitive Decline. Front Neurosci. 2019;13:788. Published 2019 Jul 31.
  3. Tao L, Liu H, Gong Y. Role and mechanism of the Th17/Treg cell balance in the development and progression of insulin resistance. Mol Cell Biochem. 2019;459(1-2):183–188.
  4. Ren N, Kim E, Li B, et al. Flavonoids Alleviating Insulin Resistance through Inhibition of Inflammatory Signaling. J Agric Food Chem. 2019;67(19):5361–5373.
  5. Gołąbek KD, Regulska-Ilow B. Dietary support in insulin resistance: An overview of current scientific reports. Adv Clin Exp Med. 2019;28(11):1577–1585.
  6. Yaribeygi H, Farrokhi FR, Butler AE, Sahebkar A. Insulin resistance: Review of the underlying molecular mechanisms. J Cell Physiol. 2019;234(6):8152–8161.
  7. Ballak DB, Stienstra R, Tack CJ, Dinarello CA, van Diepen JA. IL-1 family members in the pathogenesis and treatment of metabolic disease: Focus on adipose tissue inflammation and insulin resistance. Cytokine. 2015;75(2):280–290.
  8. Barazzoni R, Gortan Cappellari G, Ragni M, Nisoli E. Insulin resistance in obesity: an overview of fundamental alterations. Eat Weight Disord. 2018;23(2):149–157.
  9. Zand H, Morshedzadeh N, Naghashian F. Signaling pathways linking inflammation to insulin resistance. Diabetes Metab Syndr. 2017;11 Suppl 1:S307–S309.
  10. Maciejczyk M, Żebrowska E, Chabowski A. Insulin Resistance and Oxidative Stress in the Brain: What's New?. Int J Mol Sci. 2019;20(4):874. Published 2019 Feb 18.
  11. Petersen MC, Shulman GI. Mechanisms of Insulin Action and Insulin Resistance. Physiol Rev. 2018;98(4):2133–2223.
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Uncategorized
Apr
14
low blood sugar

During the day, depending on various factors, blood sugar (glucose) levels fluctuate slightly at physiological levels. This is normal.

Glucose is the main source of energy for our body and brain. Glucose comes from foods and drinks. One of the hormones involved in glucose utilization, is insulin. Insulin’s job is to help glucose enter our cells where it’s used for energy. The levels of circulating blood sugar should not be too low and not too high. The standard normal lab range is around 3.5 and 6.0 mmol/L (63 to 108 mg/dL).

A stable blood sugar level is essential to our overall health.

If blood sugar falls below the healthy range, it’s called HYPOGLYCEMIA. Then, you might not feel well. There are several reasons why this can happen; the most common is a side effect of drugs used to treat diabetes. Diabetics are under a medical care and are educated about the risk of hypoglycemic symptoms so I am not going to talk about hypoglycemia in relation to diabetes management. Hypoglycemia can happen in people who do not have diabetes.

Here, I cover some aspects of non-diabetic hypoglycemia. It’s relatively common but many people are not aware of it.

Typical symptoms of hypoglycemia include:
  • feeling hungry
  • feeling dizziness and light-headed if meals are missed
  • feeling shaky, jittery
  • feeling tired and eating to relieve fatigue
  • becoming easily irritated, upset, tearfull and nervous
  • craving for sweets between meals
  • increased energy after meals
  • weakness
  • tingling lips
  • a fast or pounding heartbeat (palpitations)
  • poor memory, forgetfulness
  • anxiety
  • blurred vision
  • paleness

Some people experience hypoglycemia also during sleep. If that happens, they may cry out or have nightmares, sweat excessively, feel tired, irritable, or confused after waking up.

Symptoms of hypoglycemia can differ from person to person. You may have one or more mild-to-moderate symptoms.

Why some people feel anxious, they sweat, or have thumbing heart when their blood sugar levels drop? Because low blood sugar triggers the release of stress hormones (to promote glucose release from its storage form like glycogen) and puts the body in the “fight-or-flight” mode. Moreover, at the point of glucose shortage (combined with a lack of ketones) the brain will not get enough glucose which can be manifested as drowsiness, difficulty concentrating, confusion, blurred vision, slurred speech, or numbness.

To know whether you are experiencing low blood sugar, you need to check your blood sugar. If you are experiencing symptoms and you are unable to check your blood sugar for any reason, you can try to treat hypoglycemia and best discuss it with your general practitioner.

What causes non-diabetic hypoglycemia?

There are two types of non-diabetic hypoglycemia:

  • Fasting hypoglycemia: may be related to a disease (liver disease, hypothyroidism, eating disorders), certain medications, herbal supplements such as fenugreek, ginseng, cinnamon, or to alcohol, malnutrition, or exercise.
  • Reactive hypoglycemia: which happens within a few hours of eating a meal, the causes may be unknown but possibly include: hyperinsulinemia (elevated insulin levels), meals high in refined carbohydrates such as white bread or foods high in sugar, prediabetes. And it’s more prevalent in women with polycystic ovary syndrome (PCOS).

In addition, low blood sugar can be caused by a low carbohydrate intake as well as by a high carbohydrate intake. Chronic high carbohydrate consumption (especially simple sugars) can cause over production of insulin and insulin helps our body to “insert” glucose into the cells where it can be utilized as energy. Some people make too much insulin (inappropriate levels for the level of blood glucose) and if insulin is able to effectively “insert” glucose into the cells, blood sugar can drop too much causing hypoglycemia.  The possible risk of high insulin levels includes a high risk of brain issues because insulin inhibits lipolysis and ketogenesis, thus preventing the generation of alternative brain substrates (such as ketone bodies), the brain might be deprived of the fuel then.

NOTE. If you started a low-carb diet and you experience some of the symptoms mentioned above, you might be getting too little fuel (energy from carbs and/or fats). Meaning that your carbohydrate intake went down but your fat intake did not increase to balance the fuel intake which can lead to hypoglycemic episodes. It’s quite common to follow a low-carb diet without a proper consideration of providing the fuel for the body and the brain.

How to prevent low blood sugar?

  • Have small amount of protein every 2 - 3 hours. This does not mean eat a full meal every two to three hours – a few bites will do. The idea is to keep your blood sugar stable without activating your adrenals to release stress hormones and raise blood glucose. Suggested proteins include nuts, seeds, a boiled egg, or meat, or a low-carbohydrate protein drink. For some people, eating 5 to 6 small meals each day instead of 3 large meals and snacks works best.
  • Avoid refined carbohydrates such as white bread, cakes, cookies, regular sodas, syrups, and candy.
  • Avoid drinks or foods that contain caffeine and alcohol. Caffeine and alcohol may cause you to have the same symptoms as hypoglycemia, and may cause you to feel worse.
  • Avoid sweets before bed. If you have a tendency to hypoglycemia, your blood sugar will crash during the night, long before your next meal is due. Chances are your adrenals will kick into action, creating restless sleep or that 3am wake up with anxiety.
  • Eat diversity of healthy foods. In a nutshell, foods that should be on your menu include vegetables (various vegetables which will provide complex carbohydrates, polyphenols, anti-oxidants and other nutrients), protein source (mushrooms, poultry, fish, nuts, meat, seeds, legumes, eggs, alternatively a protein powder), healthy fats (extra virgin olive oil, flax seed oil, avocado, coconut fat, goose fat, duck fat, borage oil, evening primrose, and ghee/grass-fed butter), healthy (resistant) starches (sweet potato, rice, buckwheat, quinoa, tubers) in moderation, and various herbs and spices.
  • Check your carbohydrate intake. If you are on a very low-carb diet (and not on a ketogenic diet), you might be getting too little carbs to sustain a stable blood glucose.
  • Track your symptoms and situations in which they happen. Pay attention when your symptoms occur, is it before meals or when you skip a meal? Write down your symptoms, time the episodes and relation to food ingestion, comorbid conditions, medications and social.
  • In case of severe hypoglycemia, have a sugary drink or snack – try something like a small glass of fruit juice or a small handful of sweets.

Treatment of hypoglycemia

Treatment depends on the cause of the hypoglycemia. For example, if a medicine you take is causing hypoglycemia, you need to discuss it with your health care professional. If hypoglycemia is caused by low hormone levels, you may need to take hormones.

Information provided below is meant for educational purposes only, and does not constitute medical or nutritional advice or act as a substitute for seeking such advice from a qualified health professional. 
Reference list
  1. Desimone ME, Weinstock RS. Non-Diabetic Hypoglycemia. In: Feingold KR, Anawalt B, Boyce A, et al., eds. Endotext. South Dartmouth (MA): MDText.com, Inc.; 2000.
  2. Kittah NE, Vella A. MANAGEMENT OF ENDOCRINE DISEASE: Pathogenesis and management of hypoglycemia. Eur J Endocrinol. 2017;177(1):R37–R47.
  3. Kandaswamy L, Raghavan R, Pappachan JM. Spontaneous hypoglycemia: diagnostic evaluation and management. Endocrine. 2016;53(1):47–57.
  4. Scheen AJ. Central nervous system: a conductor orchestrating metabolic regulations harmed by both hyperglycaemia and hypoglycaemia. Diabetes Metab. 2010;36 Suppl 3:S31–S38.
  5. Diabetes Canada Clinical Practice Guidelines Expert Committee, Yale JF, Paty B, Senior PA. Hypoglycemia. Can J Diabetes. 2018;42 Suppl 1:S104–S108.
  6. Mumm H, Altinok ML, Henriksen JE, Ravn P, Glintborg D, Andersen M. Prevalence and possible mechanisms of reactive hypoglycemia in polycystic ovary syndrome. Hum Reprod. 2016;31(5):1105–1112.
Uncategorized
Apr
12
obese and diabetic corona virus

COVID-19 is a new disease caused by a novel coronavirus. There is still limited information on the risk factors for severe disease but as COVID-19 thrives around the globe, we see that obese and diabetic corona patients have worse outcomes and a more challenging time in dealing with the infection.

Realizing that the coronavirus will hang around, the best contingency plan is to do whatever we can to lower our risk of complications. Now is the time to make ourselves resilient to pull through, especially for individuals who are above their ideal weight and/or have diabetes (type 2).

Obesity is a critical risk factor for insulin resistance, and insulin resistance increases risk for type 2 diabetes, hyperlipidemia, cardiovascular disease, and some types of cancer. Obesity is a complex disease involving an excessive amount of body fat. Although there are genetic, behavioural, metabolic and hormonal influences on body weight, obesity occurs most commonly due to a combination of excessive food intake and lack of physical activity. When your body receives more calories than it needs and than it is able to burn, your body stores these excess calories as fat.

Below, I briefly touch upon inflammation and oxidative stress in relation to obesity and diabetes. Inflammation at physiological levels plays a protective role and is needed (for fighting infections and wound healing for example), however CHRONIC SYSTEMIC INFLAMMATION IS HARMFUL. Obesity and diabetes promote systemic inflammation and systemic inflammation in the light of COVID-19 complicates matters because the immune system, trying to fight the virus, goes into overwork. This can create a brutal cycle driven by cytokine molecules promoting a cytokine storm, an overwhelming inflammatory body state.

Why that happens? It’s a multifactorial and complex process but one aspect is known, a baseline inflammation and oxidative stress level is high.

OBESITY ADDS THE EXTRA INFLAMMATORY LOAD GENERATED BY ADIPOSE TISSUE

Excess fat cells results in excess pro-inflammatory cytokines, and it results in excess inflammation.

Fat tissue cells (adipocytes) secrete adipokines, aka cytokine molecules, to communicate with the body regarding long-term energy storage, reproductive function, blood pressure regulation, energy homeostasis, the immune response, and many other physiologic processes. The adipokines possess pro- and anti-inflammatory properties and play a critical role in integrating systemic metabolism with immune function. As adipose tissue expands during the development of obesity, this balance shifts to favor proinflammatory mediators. The pro-inflammatory adipokines are increased whereas the anti-inflammatory adipokines are decreased. Consequently, it creates and perpetuates a vicious cycle of low-grade inflammation in white adipose tissue (WAT), and metabolic disorders associated with obesity.  The higher concentration of pro-inflammatory cytokines in the bloodstream, the higher chance of the body going into the cytokine/inflammatory storm in an event of an inflammatory insult, such as infection.

What’s more, obesity and production of inflammatory adipokines suppress insulin signaling resulting in insulin resistance. Simply put, obesity increases insulin resistance and it’s called obesity-mediated insulin resistance. The mechanism of it is not completely understood but it’s likely related to adipose tissue dysfunction/lipotoxicity, inflammation, mitochondrial dysfunction, and hyperinsulinemia. What’s worth knowing is that insulin resistance precedes diabetes.

INSULIN RESISTANCE IF NOT MANAGED CAN PROCEED TO DIABETES (type 2)

Taking the right measures on time can prevent diabetes, yet many people are unaware of having insulin resistance. WHY? The tests are not typically done and the symptoms are not always recognized, especially if you are not aware of what you should pay attention to. People are often diagnosed when already being (pre)diabetic, this is when their fasting blood sugar is abnormally elevated. If you want to learn more on the topic of insulin resistance, do check my other blog.

Type 2 Diabetes is a complex chronic inflammatory condition characterized by multiple metabolic and vascular abnormalities that can affect the response to pathogens. One of diabetic hallmarks is low-grade systemic INFLAMMATION. The body produces excessively pro-inflammatory cytokines (like TNF-α) and proinflammatory monocytes whereas there is decreased activity of anti-inflammatory cytokines such as interleukin- (IL-) 10. As a result, there is an imbalance between pro- and anti-inflammatory activities. Diabetes and uncontrolled glycemia are found to be significant predictors of severity and deaths in patients infected with different viruses.

Possible Scenario: existing systemic inflammation + infection

Now imagine: when virus infects you, the body responds by making pro-inflammatory cytokines (which is good) but if you already have high baseline inflammation, generating even more INFLAMMATION - on the top of existing low-grade inflammation - will be overwhelming for the body and more difficult to regulate, as a result can cause complications. The mechanism of the coronavirus pathogenicity hasn’t been completely deciphered yet but one of possible reasons why people with underlying health conditions (chronic inflammation) do not survive, is related to the cytokine storm (cytokine release syndrome), where excess inflammation and poor regulation of inflammation is devastating.

Cytokine storm refers to excessive and uncontrolled release of pro-inflammatory cytokines. Cytokine storm syndrome can be caused by a variety of diseases, including infectious diseases, rheumatic diseases and tumor immunotherapy. It is commonly manifested as systemic inflammation, multiple organ failure, and high inflammatory parameters.

OXIDATIVE STRESS

Next to excess inflammation it’s also common to have excess oxidative stress in a disease state.

Both, oxidative stress and chronic inflammation are known to play a role in metabolic diseases, including diabetes. Just as with chronic inflammation, oxidative stress is triggered by the imbalance between oxidative and antioxidative systems in the body. Imbalance results from overproduction of oxidative-free radicals and associated reactive oxygen species (ROS), and reduced anti-oxidant activities to clear ROS. In relation to coronavirus, it’s good to know that infections also increase oxidative stress.

To counteract the effect of free radicals, antioxidants can scavenge and neutralize ROS. For example, many foods like vegetables and fruits contain naturally occurring antioxidants including vitamins, minerals and phytonutrients. Another good reason to eat your veggies.

ROS are chemically reactive molecules containing oxygen, they are formed as metabolic byproducts. Examples include hydrogen peroxide, superoxide radicals, singlet oxygen, hydroxyl radicals and peroxynitrite anion. Excessive levels of ROS can be harmful because ROS can alter the structure and function of proteins and lipids. These altered proteins and lipids can impair the function of our cells leading to dysfunctional metabolism, and overall poorer biological activity, immune activation and inflammation.

HERE IS WHAT YOU CAN DO

Reduce unnecessary inflammation and support antioxidative defenses.  

Unnecessary inflammation is inflammation resulting from poor diet, poor lifestyle, lack of physical activity, stress, lack of sleep, various metabolic and hormonal imbalances, and disease. Necessary inflammation helps us to deal with certain stressors such as infections, wounds, allergies, or toxins by creating an inflammatory response to protect us.

Knowing that obesity is a risk factor for COVID-19 complications and that proper management of obesity will first of all help you prevent developing type 2 diabetes, and second of all will help you reduce unnecessary inflammation and oxidative stress: you should take this opportunity now and use effective lifestyle interventions to reclaim your health. Don’t wait. The earlier you act the better.

Dietary changes, increased physical activity and behaviour changes can help you lose weight. And weight loss can improve or prevent the health problems associated with obesity.

If you feel overwhelmed, take it step by step and work with a professional who can guide you in the process.

Don’t make excuses, just take the first step. For example, if your diet is low in vegetables – start increasing portions of vegetables with your lunch and dinner, and have more diversity of it. Adding veggies will provide anti-inflammatory and anti-oxidant molecules that your body can utilize to counteract inflammation and oxidative stress. If your diet is already healthy and balanced and you can’t lose weight or stabilize blood sugar, contact a professional for tailored made recommendations.

Want to learn more about healthy and nutritious meal composition? Check my blog about creating a healthy plate.

Information provided below is meant for educational purposes only, and does not constitute medical or nutritional advice or act as a substitute for seeking such advice from a qualified health professional. 
Reference list
  1. Bloomgarden ZT. Diabetes and COVID-19. J Diabetes. 2020;12(4):347–348.
  2. Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?. Lancet Respir Med. 2020;8(4):e21.
  3. Karczewski J, Śledzińska E, Baturo A, et al. Obesity and inflammation. Eur Cytokine Netw. 2018;29(3):83–94.
  4. Muniyappa R, Gubbi S. COVID-19 Pandemic, Corona Viruses, and Diabetes Mellitus [published online ahead of print, 2020 Mar 31]. Am J Physiol Endocrinol Metab. 2020;10.1152/ajpendo.00124.2020.
  5. Maddaloni E, Buzzetti R. Covid-19 and diabetes mellitus: unveiling the interaction of two pandemics [published online ahead of print, 2020 Mar 31]. Diabetes Metab Res Rev. 2020;e33213321.
  6. Barazzoni R, Gortan Cappellari G, Ragni M, Nisoli E. Insulin resistance in obesity: an overview of fundamental alterations. Eat Weight Disord. 2018;23(2):149–157.
  7. Mraz M, Haluzik M. The role of adipose tissue immune cells in obesity and low-grade inflammation. J Endocrinol. 2014;222(3):R113–R127.
  8. Hussain A, Bhowmik B, Cristina do Vale Moreira N. COVID-19 and Diabetes: Knowledge in Progress [published online ahead of print, 2020 Apr 9]. Diabetes Res Clin Pract. 2020;108142.
  9. Karam BS, Chavez-Moreno A, Koh W, Akar JG, Akar FG. Oxidative stress and inflammation as central mediators of atrial fibrillation in obesity and diabetes. Cardiovasc Diabetol. 2017;16(1):120. Published 2017 Sep 29.
  10. Rani V, Deep G, Singh RK, Palle K, Yadav UC. Oxidative stress and metabolic disorders: Pathogenesis and therapeutic strategies. Life Sci. 2016;148:183–193.
  11. Lefranc C, Friederich-Persson M, Palacios-Ramirez R, Nguyen Dinh Cat A. Mitochondrial oxidative stress in obesity: role of the mineralocorticoid receptor. J Endocrinol. 2018;238(3):R143–R159.
  12. Mancuso P. The role of adipokines in chronic inflammation. Immunotargets Ther. 2016;5:47–56. Published 2016 May 23.
  13. Longo M, Zatterale F, Naderi J, et al. Adipose Tissue Dysfunction as Determinant of Obesity-Associated Metabolic Complications. Int J Mol Sci. 2019;20(9):2358. Published 2019 May 13.
  14. Mehta P, McAuley DF, Brown M, et al. COVID-19: consider cytokine storm syndromes and immunosuppression. Lancet. 2020;395(10229):1033–1034.
  15. Newsholme P, Cruzat VF, Keane KN, Carlessi R, de Bittencourt PI Jr. Molecular mechanisms of ROS production and oxidative stress in diabetes. Biochem J. 2016;473(24):4527–4550.
  16. Carr AC. A new clinical trial to test high-dose vitamin C in patients with COVID-19. Crit Care. 2020;24(1):133. Published 2020 Apr 7.
Uncategorized
Jan
26
Could dehydration be the missing link in your diagnosis?
The easiest way to stay healthy: HYDRATE YOURSELF PROPERLY Let’s talk about the most basic nutrient: WATER, something so simple yet so powerful. I am constantly amazed how proper hydration helps me and my clients to feel better and to function better. Proper hydration is key to your overall health. Water is a major compound in the human body. About 70% of what we have within our bodies is water. Water is essential for our life. We can’t live without. When we provide too little water we will function but function poorly. Water facilitates many important processes to keep our body and mind in shape. I start my day with a large glass of (warm) water with a bit of sea salt or Himalayan salt dissolved in it (you can add a pinch of salt in your glass of water or if you want to be more precise about a quarter teaspoon of salt per 1 liter water. Do not overdo salt however; your total daily salt intake on average should not exceed 2-3 grams) or with a glass of warm water with a freshly squeezed lemon juice. It sets a good hydration start for the rest of the day. Sea salt enhances hydration, helps to balance electrolyte levels, and offers many other benefits. Through the day I will have a smoothie, drink more water (with and without salt), will have 2-3 herbal teas, and on some days a soup or bone broth. I recommend drinking ambient temperature water or warm water. Why do you need this basic nutrient? Water is your:
  • It serves as a solvent for ionic particles such as salts, glucose, amino acid. Thanks to water, various ions and molecules can move and reach various destinations within your body.
  • Building block. Water molecules occupy every space not taken by other molecules, within our cells and outside our cells. Water also facilitates the folding of amino acids to proteins to form proteins of proper structure and integrity.
  • Lubricant. Together with other molecules water lubricates surfaces and protects tissues functioning. Think of synovial fluid in joints, mucosal lining in GI tract, tears, or saliva.
  • Medium for biochemical reactions. Water as a medium facilitates the biochemical reactions constantly happening in your body. Water as a reactant also actively participates in the hydrolysis of proteins, carbohydrates and fats. Water is also a by-product of protein, carbohydrate and fat metabolism.
  • Transport medium. Water carries nutrients and waste products that need to move from one location to another location. Water helps nutrients reach cells and helps waste products on their way out of cells and out of the body. Water is the most basic nutrient of your blood and facilitates the functioning of the cardiovascular, respiratory, nervous and urinary systems.
  • Thermo-regulator. Water - thanks to its capacity to absorb heat, to hold it, to help to release it (perspiration) and to resist temperature changes - supports body homeostasis by maintaining body temperature.
  • Shock absorber. Water acts as a sort of gel assisting cells to maintain their shape and form and as a sort of cushion assisting tissues against the shock of movement. It provides the cushioning effect.
How do you know you drink too little water?  If you experience the symptoms listed below there is a high chance your body is not properly hydrated.
  • Headache
  • Fatigue and weakness
  • Dry skin
  • Dry mucus membranes in the nose, mouth or throat
  • Nosebleeds (especially in dry air)
  • Dark and concentrated urine produced in small quantities
  • Constipation
  • Intestinal cramps
  • Nausea
  • Irrational behavior
  • Irritability
  • Low blood pressure
  • Shallow, rapid breathing
  • Weak, irregular pulse
How do you lose water? Via Skin, kidneys, respiratory and digestive tract. How much water do you need? Your optimal water intake may be affected by physical activity, exercise, metabolism, diet, health status, humidity and ambient temperature. If you sport and sweat you obviously need to drink more water. The average recommendation for adult females is about 2,5 liter daily, for adult males about 3-3,5 liter daily. When do you need even more water? If you lose more water, for example when you have a fever, you vomit, you have diarrhea, you have a respiratory discharge; you need to drink more water to compensate for the loss. Also get adequately more water if you follow a high protein diet, take diuretics, are on a plane, or live in a warm/hot climate. What about water versus other beverages? If you want to stay properly hydrated, pure water should be your first choice because of its highest osmotic power due to the least amount of solutes. It hydrates the body at the cellular level. Osmosis is reduced when you drink coffee, tea, sodas, or drinks containing sugar, protein, or artificial additives. Some common conditions can be improved by water Dehydrated body can’t function optimally. Point. As mentioned above, water facilitates a lot of important processes in your body so if you have too little of it, these processes will be impaired, impaired at the cellular level. If you are chronically dehydrated, at some point you will start experiencing signs and symptoms (listed above) of your body craving water. Just listen to your body. Take care of proper hydration in particular if you struggle with:
  • Hypertension
  • Low stomach acid and peptic ulcers
  • Arthritis
  • Low back pain
  • Coronary heart disease
  • Headaches (non-migraine, migraine, hangover)
  • Constipation
  • Colitis
  • Obesity
  • Edema of unknown origin
  • Chronic fatigue
  • Asthma and allergies
Sources:
  1. “Water: the most basic nutrient and therapeutic agent” Herb Joiner-Bey. Natural Medicine text book, fourth edition. J. Pizzorno & M Murray. Elsevier 2013.
  2. “Thirst and hydration status in everyday life” Mindy Millard-Stafford et al. Nutrition Reviews. Volume 70, Issue suppl_2, 1 November 2012, Pages S147–S151.
Uncategorized
Jan
11
Why you need stomach acid and why it is good for you
I want to share with you some stomach acid know-how essentials. It may surprise you that many health issues, not only digestive ones, are related to low stomach acid. Many people who come to see me have low stomach acid. I used to have it as well, without realizing it. Changing my eating habits and using some of the tips below helped me to restore my gastric acid production and as a result to feel better. Why do you need this acid for? Gastric acid (hydrochloric acid HCl) found in your stomach facilitates digestive enzyme secretion and protein digestion. Your stomach (muscular sac) acts as a sort of blender breaking your food physically (churning action of the stomach muscle) and enzymatically (the right gastric pH and activity of digestive enzymes). Low pH (1,5-2,5) of gastric acid is essential for digestive enzymes to become active and to digest. Apart from facilitating digestion, we need gastric acid as a first line of defense against food poisoning (Campylobacter, Salmonella), parasitic (Giardia, worms), bacterial (Helicobacter pylori, Small Intestinal Bacterial Overgrowth), and fungal (Candida) infections. Without adequate acid, we do not digest our food, we are at risk of mineral and vitamin deficiencies, and we are more vulnerable to various infections. Low stomach acid compromises our immunity. Therefore, you need stomach acid and it’s good for you. Low stomach acid (hypochlorhydria) has been associated with many common health problems. What symptoms to look for in association with low gastric acid?
  • Bloating, burning, burping, and flatulence right after meals
  • Abdominal fullness after meals
  • Poor appetite
  • Stomach upsets easily
  • Diarrhea or constipation 
  • Undigested food in stool
  • Nausea after taking supplements
  • Reactivity to foods (food allergies, food sensitivities)
  • Iron deficiency
  • Chronic intestinal infections
  • Chronic candida infections
  • Acne
What can you do about low gastric acid? Improve your digestion and restore your gastric acid production. Imagine that if you are not able to properly digest your food and absorb the nutrients, cells within your body will not get the fuel, the nutrients they need for proper functioning. Because of impaired digestion and absorption you may experience some health issues. Digestion process starts even before you eat. When you see food, smell it, or think about it your senses are triggered, your brain is triggered, your digestive system is triggered. You may start producing saliva, gastric acid, hormones, and other molecules to prepare you for a meal. This is how digestion process begins. Compare it with a scenario when you sit on a coach in front of TV, and while watching an interesting move you pop something in your mouth without realizing what and without realizing you eat. How well will your digestive system be prepared then to perform the task of digestion? Expectedly, not that well as if you eat mindfully. It reminds me of something. One of my former colleagues years back, an Indonesian women, was always eating very mindfully. She was eating slowly and chewing her food very well. When she indulged few bites of her meal, my meal had already vanished. I was eating like it was a race and it always stroke me why she was eating so slowly, too slowly I thought then. But she simply knew that to digest well you need to eat well. In cultures where food sources are limited, people tend to eat more mindfully and slowly. They chew every single bite very well simply to extract as much nutrients as possible and to properly switch the digestive machinery on. Sound simple to do, right? Yet, in the current era of constant rush and stress it can be quite a task to do. Let me provide some guidelines that can change how you feel. How can you digest better?
  • Chew your food thoroughly. Proper chewing is essential in order to promote gastric acid production and digestion. Try to chew your foods 20-30 times before swallowing. Eat smaller meals so the body can process your food properly and has possibility to heal. You may consider fasting or intermittent fasting as an additional boost for your general health and stomach. Part of your body healing is letting it recover. If you’re continually eating food from morning to sundown every day, your body doesn’t have the time to recover and heal.
  • Eat mindfully and relax. Relaxation promotes digestion whereas stress inhibits digestion.
  • Add bitterness to your menu. Include bitter herbs, bitter foods and bitter drinks. Bitterness increases secretion of saliva, gastric acid, pepsin, bile, and digestive enzymes so all we need to digest properly. Check your health-food stores for bitter/digestive herbal teas or bitter tinctures (Swedish bitters).
  • Drink adequate amount of (salty) water. Drink water with sea salt/Himalayan/Celtic salt every day to promote healthy gastric lining. You can mix 1-1,5 liter of (purified) water with about 1-1,5 gr of salt and drink it through the day (best after waking up, 30 min before lunch and before dinner, and before going to bed).
  • Avoid drinking (large quantities) during meals or shortly after your meals.
  • Have Apple cider vinegar (ACV). Some people find that ACV makes wonders for their digestion. Drink about 50-100 ml of water with 1-2 tablespoons of ACV 15-20 min before your (protein) meals. You can also add some ACV to your salads. You may need to gradually increase the amount of vinegar until you get the desired effect. Note: do not use ACV if you have histamine intolerance.
  • Take Digestive enzymes. Another help is to take digestive enzymes prior meals, also possible to take them with the apple cider vinegar. Digestive enzymes will help breaking down the nutrients (protein, fat, carbohydrates) you take in. Too high stomach pH does not allow for efficient food (protein) digestion. Take the enzymes until your stomach acid balances out.
  • Add betaine HCL (with Pepsin) with protein rich meals. If above tricks do not work, consider taking betaine HCL (with pepsin). Now, the trick with betaine HCL is you want to take the right amount, always start off with one capsule and see how you feel. Gradually increase the dosage from 300-750 mg to 1000-2000 mg per meal. When you get warmness/discomfort in your stomach, cut back by one capsule per every next meal. If you feel discomfort because of too high betaine HCl intake, you can neutralize the acid by drinking water or milk with 1 teaspoon of baking soda. Some people need one capsule; other people may need to take up to few capsules of betaine HCl. Once you have established a dose, continue this dose. It may however change over time as your digestion is improving, so stay vigilant and decrease the dosage when needed. With smaller meals, you may require less betaine HCl. Take betaine HCl only if you’re eating protein dense meals (with meat). Important: if you feel discomfort (heartburn) at the lowest dose of betaine HCl, it suggests you have a healthy response, no issue with low stomach acid and no need to take betaine HCl.
  • Try umeboshi plums. Umeboshi plums are salted and pickled plums helpful to relief indigestion. You can get them in Asian food stores, use them as umeboshi vinegar, as the base for tea or add as a salad dressing instead of salt and vinegar. ‘
  • Try acupuncture and/or chiropractic care.
  • Avoid processed foods and overeating.
Antacid? Many people think they have too much stomach acid and therefore they take antacids. Antacids may relief some symptoms but most of the time the problem is not in too much acid in your stomach but in the fact that your stomach acid may just be in the wrong place, where it does not belong such as in esophagus. It may lead to acid reflux. I realize that the symptoms of too much and too little acid are similar, such as belching, burping, feeling of fulness after meals but be aware that too low acid is most of the time to blame for the symptoms described above. Low stomach acid may be caused by pernicious anemia, chronic Helicobacter pylori, long-term term treatment with proton-pump inhibitors, autoimmune gastritis, or stress. If your symptoms do not resolve after applying provided here tips, do consult it with you physician.
Uncategorized
Jan
05
Manage your acid reflux without medications
At first, let’s clear one common misconception about acid reflux: acid reflux is not necessarily that you have too much gastric acid but rather acid is in the wrong place. The majority of people suffering from acid reflux have rather hypochlorhydria (lack of or too little stomach acid) than hyperchlorhydria (too much stomach acid). Acid reflux is a common gastrointestinal complain with symptomology of heartburn, a burning pain in the lower chest. It’s driven by stomach acid flowing back up to the esophagus (the food pipe). It can happen for example when increased intra-abdominal pressure overpowers the lower esophageal sphincter (LES, a ring muscle), as seen in people with hiatal hernia or obesity. The esophageal sphincter acts as a valve preventing stomach acid, stomach content from backing up into esophagus. When this system fails we may experience the symptoms of acid reflux. Noteworthy, reflux of gastric contents into the esophagus is normal physiology. However, when reflux (occurring frequently) leads to symptoms, esophageal mucosal injury, or both we talk about gastroesophageal reflux disease (GERD).

Symptoms

Heartburn is a common symptom and some patients perceive this as angina-like chest pain. Functional heartburn has the same symptoms without signs of reflux. Some people experience regurgitation which is a rise of gastric content into the mouth with sour/bitter tasting, without associated nausea or retching. Other symptoms of reflux may include hoarseness, cough, and asthma as well as pharyngitis, sinusitis, pulmonary fibrosis, recurrent otitis media, and sleep apnea. Some individuals will also experience bloating, burping, difficulty swallowing, hiccups, or nausea. Interpret these symptoms as your body sending you signals that there is something going on. Do not “treat” them with anti-acids and over-the-counter drugs (H2 blockers, aginate drugs, or proton pomp inhibitors), it may help relieving the symptoms however will not address the underlying cause.

How to fix acid reflux?

At first try to find the underlying cause. Sometimes your own detective work will be enough and sometimes you may need testing to find out what’s behind it. One of the most effective ways to reduce acid reflux is to invest in healthy eating habits. If your diet is based on fast foods, just change it and start eating real foods. If you are overweight, start working on losing extra weight, a professional or a supportive community will help you in achieving this goal. Common drugs used for acid reflux do not treat this condition, they just manage the symptoms.
  • Eat healthy foods. If you want your digestive system to heal, a healthy diet is a must. Make your own meals by using fresh, real foods and by skipping processed foods. Go back in thinking about cooking before the convenient foods existed, what would you eat them? Home-made soup or the instant powder soup? There is a difference not only in taste, but also in nutrient vs crap content. Reduce consumption of grains (especially refined and especially wheat), sugar, and refined oils. Also avoid CRAP: processed foods, alcohol, sodas, artificial sweeteners, fried foods, spicy foods, and in addition chocolate and coffee.
  • Have on your menu bone broths, healthy fats (avocado, coconut oil, olive oil), vegetables (green leafy vegetables, cucumbers, asparagus, artichokes), fermented foods and drinks (pickles, sauerkraut, kombucha, kefir, yogurt, kombucha), wild fish (salmon, sardines), meat (grass-fed beef, free range chicken), healthy starches (squash, sweet potato, red beet), nuts (almonds), parsley, ginger, fennel, apple cider, aloe vera, and raw honey for some sweetness. Eat simple and healthy meals consisting of real foods, it will help your digestive system to do its job - to digest. Replace pasta, rice, bread partly or entirely with vegetables.
  • Drinking chamomile or ginger tea, or cabbage juice may help to relive acid reflux symptoms.  
  • Avoid large meals. Don’t overeat. Don’t eat 2-4 hours before going to bed, especially heavy to digest meals.
  • Use adequate hydration. Some people experience that as little effort as increasing their daily water intake can resolve acid reflux. Try it out!
  • Improve gastric acidity. Eat bitters, bitter foods and herbs to promote gastric acid production and digestion.
  • Chew your food well and eat slowly. Eat in a relaxed environment, eat mindfully without rushing. Take the time to chew your food properly (20-30 times before swallowing).
  • Take right supplements. Consider taking digestive enzymes, HCL with pepsin, probiotics, magnesium, zinc, or apple cider vinegar. Try slippery elm bark tea or chew on the bark, it has been used for generations to relief acid reflux.
  • Be active by enjoy moderate exercise, something you like doing.
  • Sleep with your head and upper body slightly elevated.
  • Consider stress management activities such as yoga, psychological therapy, relaxation, exercise, mindfulness if you feel like stress is overtaking your life.
  • Consider chiropractic adjustment, osteopathic care or acupuncture.

What can hide behind acid reflux symptoms?

  • Eating unhealthy. Eating too much. Typical western diet rich in simple carbohydrates (sugars and starch), processed foods, and little vegetables promotes dysfunction of the digestive system and as a consequence acid reflux may occur. If you suffer from acid reflux, portion matters - do not over eat and stop eating before you are full. 
  • Obesity. Obesity is commonly associated with acid reflux and GERD. The access weight can put extra pressure on the valves and sphincter causing stomach acid release.
  • Hiatal hernia. Hiatal hernia is an abdominal abnormality observed when the upper part of the stomach and lower esophageal sphincter (LES) move above the diaphragm. In this scenario, acid can move up into the esophagus causing acid reflux symptoms. The diaphragm is a muscle helping to keep gastric acid in our stomach. Consider osteopathic or chiropractic care.
  • Overtraining. High impact exercises and overtraining can put extra pressure on your abdomen triggering acid reflux.
  • Wearing tight-fitting clothes, lying down, bending over.
  • Smoking cigarettes. Smoking increases acid production therefore avoid it if you suffer from GERD or acid reflux.
  • Certain medications and supplements such as antibiotics, muscle relaxers, blood pressure drugs, ibuprofen, potassium and iron supplements can affect the functioning of the digestive system and cause acid reflux.
  • Helicobacter pylori gastric infection. Infection with H. pylori can manifest itself with heartburn. If you suspect it may play a role in your complaints, get yourself tested.
  • Low magnesium. Low magnesium can influence muscle tension and impair the function of the esophageal sphincter by not retaining the acid in the gastric cavity.
  • Chronic cough, stress, sensitivities to gluten or other foods can also contribute to acid reflux.
  • Digestive issues. Think of reduced saliva causing decreased digestive buffering, poor digestive esophageal motor function causing reduced food clearance, poor gastric emptying causing increased refluxate.
  • Aging and underdeveloped GI tract as by babies may also promote acid reflux/GERD because digestive tract does not work optimally.
  • Pregnancy. During the pregnancy growing fetus can put extra pressure on the esophageal valve and this may promote the release of gastric acid and symptoms of heartburn.
If your symptoms do not subside after adapting your eating habits and lifestyle, please seek medical help to properly evaluate the underlying cause. Long-term acid reflux (GERD) can lead to Barrett’s esophagus, manifested as esophageal scarring and constriction which leads to swallowing disorders.
Uncategorized
Dec
10
What can promote underactive thyroid?
DO YOU SUSPECT HAVING THYROID ISSUES? Thyroid issues are quite common especially among women, with hypothyroidism as the most common thyroid disorder. It is characterized by mental slowing, weight gain, constipation, dry skin, hair loss, cold intolerance, irregular menstruation, infertility, muscle stiffness and pain, depression, dementia, and a wide range of other symptoms. Actually, every cell in our body has receptors for thyroid hormone. These hormones are responsible for the most basic aspects of body function, impacting all major systems of the body. Thyroid hormone directly acts on the brain, the G.I. tract, the cardiovascular system, bone metabolism, red blood cell metabolism, gall bladder and liver function, steroid hormone production, glucose metabolism, lipid and cholesterol metabolism, protein metabolism and body temperature regulation. One of the biggest challenges facing those with hypothyroidism is that it is often under- and misdiagnosed, as many patients with thyroid symptoms have “normal” lab results, yet not optimal if you interpret them properly.   What can promote LOW THYROID HORMONES:
  • IMPAIRED GUT HEALTH (poor diet, impaired digestion, low stomach acid, poor bile production, intestinal dysbiosis such as Candida overgrowth, increased intestinal permeability)
  • IMMUNE DYSREGULATION (auto-immune attack)
  • INFLAMMATION (inflammation suppresses the hypothalamus-pituitary-thyroid HPT axis, inflammation decreases both the number and sensitivity of thyroid hormone receptors, inflammation decreases the conversion of T4 to T3. T4 is the inactive form of thyroid hormone. The body has to convert it to the active T3 form before it can be used)
  • CHRONIC STRESS (chronically elevated cortisol contributes to under-conversion of free T4 to free T3)
  • MALNUTRITION (lack of nutrients to allow hormone synthesis, conversion, and functioning, think of selenium, iodine, zinc, vitamin C, tyrosine)
  • BLOOD SUGAR IMBALANCES (hypoglycemia, insulin resistance, healthy thyroid function depends on keeping your blood sugar in a normal range, and keeping your blood sugar in a normal range depends on healthy thyroid function)
RECOMMENDED BASIC TESTS TO ASSES YOUR THYROID HEALTH:
  • Blood serum TSH, free T4, free T3, anti-TPO, anti-TG
  • Thyroid ultrasound
In a process of supporting thyroid functioning it’s important to look for the underlying cause(s) of its dysfunction. If you need more, please feel free to get in touch with me via info@probioticdigest.com
Uncategorized
Apr
05
Why bile matters? The magic of BILE: fat digestion and detox
Do you have any of the following symptoms? Fatigue, constipation/diarrhea, incomplete digestion/absorption of fats, headaches, light colored or/and fatty stools, gas and bloating, hormonal imbalances/thyroid disease, detox problems, sleep problems, ear ringing (tinnitus), nausea, bitter taste in the mouth, sciatica like pains, low serum albumin levels, decreased absorption of nutrients, growth failure in children, weight loss, gallbladder issues or your gallbladder was removed. If yes, then read on. Why do we need bile? Bile is a soap-like substance vital for optimal (fat) digestion. It is a complex and unique aqueous product of the liver hepatocytes which is further modified by the activities of the bile duct epithelium. Then bile is collected, concentrated and stored in a gallbladder to be delivered to a small intestine when needed. Bile helps digesting fats and supports removal, flow and metabolism of various substances. Bile is composed in about 95% of water, the remaining constituents are bile salts, cholesterol, amino acids, bilirubin phospholipid, steroids, enzymes, vitamin, porphyrins, as well as heavy metals, environmental toxins, and drugs. Without quality bile we are at risk of developing health issues as bile is critical for metabolic conversions and flow of vital nutrients as well as elimination of toxic substances:
  • Bile is a major route to excrete harmful substances, toxins
  • Bile salts function to emulsify dietary fats and facilitate their digestion and absorption
  • Bile helps eliminating cholesterol
  • Bile stimulates intestinal innate immune system and supports immunity by excreting immunoglobulin A (IgA), inflammatory cytokines
  • Bile is vital for chole- and entero-hepatic circulation
  • Bile is essential carrier for some hormones and some hormonal conversions, estrogens, vitamin D3 metabolite, prolactin or insulin are excreted with bile
  • Bile excretes vitamins (folate, B6, cyanocobalamin) and contains glutathione, glutamic acid, pheromones and other vital components
  • Bile helps make calcium and iron more absorbable
Common gallbladder and bile related complaints Fat digestion may be impaired as a result of impaired digestive enzymes production and/or impaired bile production. Common symptoms include burping, bloating, nausea after high-fat meals. Impaired fat digestion contributes to malabsorption of fat soluble vitamins (A, E, D, K). In addition, gallstones can form and typically they are a result of saturation and precipitation of bile component(s) such as cholesterol, pure pigment of calcium bilirubinate, or minerals. Gallstones may be asymptomatic or cause biliary colic with regular pain free intervals of days or months. Real-time ultrasonography is used to diagnose gallstones. How to support bile production? Number one is to eat anti-inflammatory real foods, mostly plants and avoid pro-inflammatory processed foods, access sugar and fried foods. You need nutrients from real foods in order to produce bile, a package of chips will not provide them. DIET: Include diversity of dietary fiber rich foods such as (raw) vegetables and fruits in your diet as a source of valuable nutrients for you and prebiotic fiber for your gut microbiota. Your liver and bile will benefit from eating cholagogic foods like artichoke, dandelion greens (leafy greens), radish, chicory, from bitter tasting foods, as well as potassium rich foods such as avocado, tomatoes, sweet potatoes, banana and from eating sprouted seeds and nuts. Some of the important components supporting bile production include choline (eggs, meat, shrimps, fish, chicken, shitake), taurine (fish, meat), betaine (beet root, spinach, quinoa, amaranth), vitamin C (fruits and vegetables), vitamin E (dark leafy greens, almonds, sunflower seeds, avocado, olive oil). Worth to mention is that our gut microbiota is involved in bile acids metabolism and formation, therefore taking care of these little gut creatures by feeding them prebiotic rich foods is of importance. Some people experience a significant improvement after elimination of eggs, pork, onions, or milk from their diet because of the possible allergic component. SUPPLEMENTS: You may consider supplemental and herbal support to improve liver health, decrease inflammation and promote bile production by including following: turmeric, milk thistle, dandelion root, artichoke, activated charcoal, lipase enzyme, bile salts or ox bile. Consult with your physician or nutritionist before start taking the supplements. Last but not least, engage in regular physical activity and don’t forget that consumption of enough (six to eight glasses) water daily is necessary to maintain the water content of bile. Sources:
  1. “Bile Formation and Secretion” James L. Boyer. Compr Physiol, July 2013, 3 (3); 1035-1078.
  2. “Gallstones” M. T. Murray. G Natural Medicine text book, fourth edition. J. Pizzorno & M Murray. Elsevier 2013.
  3. “Metabolism of Cholesterol and Bile Acids by the Gut Microbiota” Philippe Gérard. Pathogens 2014, 3, 14-24.