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Why are so many people Vitamin D deficient these days? Is it because some of us now have a lifestyle largely spent indoors as we are wary of the effects of sun on our skin? Or is there another possible explanation - like dietary reasons, medication usage and ageing? Let's explore why Vitamin D deficiency is so common. How is Vitamin D produced? Vitamin D actually acts as a hormone rather than a vitamin as its name would imply. Vitamin D3 (cholecalciferol) is produced when the sun and its UVB rays activate the precursor to cholesterol in our skin. This Vitamin D3 gets converted to inactive Vitamin D known as 25(OH)D or calcidiol in our livers, and then to the active form of Vitamin D known as 1,25(OH)2D or calcitriol in our kidneys. The same process occurs if we are supplementing or consuming Vitamin D rich foods e.g. oily fish. If we have Vitamin D levels tested in our blood, it is the inactive 25(OH)D form that is tested first. If this value is considered low, the 1,25(OH)D or active form is then tested. A level of 60ng/mL 25(OH)D (inactive form) is required for disease prevention. This equates to the highest amount generated by the sun. For the production and absorption of Vitamin D to occur in our bodies, we need Magnesium at every step of the way . Given that 2/3 of the population is magnesium deficient, we can start to see why Vitamin D deficiency is now so prevalent. Magnesium deficiency is largely driven by our modern processed food diets lacking in magnesium, and lifestyle choices that may result in the requirement for medications that further deplete magnesium levels. Medications can include antibiotics, diuretics, antacids, steroids etc Being insulin resistant and having high levels of insulin can also interfere with magnesium levels. Ageing is also linked with a gradual magnesium deficiency. In the absence of magnesium, our whole body and its processes is impacted by Vitamin D deficiency. Vitamin D Metabolism and Magnesium Image source Explanation to why Vitamin D Deficiency is so common It is easily seen by the graphic above, that as a start we need to consume more Magnesium to improve Vitamin D deficiency, as magnesium is required at every step of Vitamin D metabolism and absorption. Why are we so depleted of magnesium these days? A diet of processed foods has a major impact here as it increases our phosphate levels in our blood, with subsequent decrease of magnesium. For a full understanding of why so many people are magnesium deficient, please read the blog on Magnesium Deficiency is common. Additionally, we can start to see that if our liver and kidney health is suboptimal, the process won't work efficiently, so our detoxification pathways need to be open and clear, and our organs need to function optimally. Vitamin D deficiency in return plays a key role in Magnesium metabolism, by both stimulating magnesium absorption as well as reducing magnesium excretion from our kidneys. It is a vicious cycle: Magnesium deficiency leads to Vitamin D deficiency, that in turn leads to more Magnesium deficiency. As a reminder, to stop this vicious cycle, we must start with supplementing Magnesium first, as too much Vitamin D supplementation can also induce depletion of magnesium . Unfortunately, as only 1% of magnesium is found in blood, testing for magnesium levels is not a reliable indicator of magnesium deficiency. Symptoms are taken into consideration to assess the extent of magnesium deficiency. Vitamin D link to Calcium in our Bones When we think of Vitamin D, we tend to think of it for calcium and for bone health and strength. Vitamin D is so important for calcium absorption in our bones. If we are Vitamin D deficient, we are often Calcium deficient resulting in a generalised decrease in bone mineral density (BMD) that can result in bone and muscle pain, osteopenia and osteoporosis. Vitamin D deficiency is linked with calcium deficiency. As magnesium is needed for Vitamin D synthesis and absorption, we can now see with magnesium deficiency why so many people have calcium issues and osteoporosis these days. As well as magnesium, we also need to have Vitamin K2 to ensure the calcium that Vitamin D3 helps create ends up in the right spot in our body - in our bones and not our soft tissues (like artery walls). If there is an imbalance between Vitamin D3 and Vitamin K2, excess calcium can end up in our soft tissues instead of our bones as shown by the graphic below. Vitamin D3 and Vitamin K2 are required to direct Calcium into our bones. Synergism between Vitamin D3 and Vitamin K2 Image source Connection between Chronic Inflammation and Vitamin D Deficiency Vitamin D intervenes and regulates our immune system and associated inflammatory processes by balancing the anti-inflammatory and pro-inflammatory pathways in our body. Without sufficient Vitamin D levels, inflammation can be left unchecked, and so the process of low grade chronic inflammation can persist, with ultimate chronic disease association . Vitamin D receptors are present everywhere in our bodies - bones, intestines, brain, breast, prostate, lymphocytes etc. Vitamin D can protect against diabetes, osteoporosis, osteoarthritis, high blood pressure, cardiovascular diseases, insulin resistance and metabolic syndrome, depression, autoimmune diseases, cancer of the breast, prostate, colon etc. Elevated levels of inflammation contribute to an increased risk of mental health issues, cardiovascular issues, metabolic issues etc. The graphic below shows the impact Vitamin D deficiency can potentially have on our entire body. Vitamin D Deficiency Impacts on the Body Image source An analogy for you to remember If we consider the movement of some vitamins and minerals into the cells in our body, it may be useful to visualise this little picture. Consider magnesium as the boat. Without the boat, no movement of vitamins and minerals occurs. Calcium is the load on board the boat. Vitamin D3 (and Vitamin B6) are the engines of the boat Vitamin K2 can be viewed as the dock - receiving and welcoming calcium into the correct port, which is our bone cells, muscle cells, or for heart function (and ensuring calcium is not sent to the incorrect port - our soft tissue cells like artery walls where we can develop atherosclerosis). Our Parathyroid hormone levels act as the wharf controller, and determine if calcium is required in our bodies and determines where the calcium load is deposited, or removed. It relies on the engine, Vitamin D3, to bring the load in. Taurine (an amino acid that is protective of our heart) acts as the handbrake to prevent too much calcium build up in our cells (too much load taken off the boat). Lysine (another amino acid useful for controlling viral replication inside our cells) acts as the wharf clean up team if calcium is deposited by grinding away the membranes of our virus-infected cells, and acting like a fire-retardant on the virus. Viruses need protective barriers around their homes (our cells) for them to replicate inside our cells. Without the membrane protection, they can't replicate, so Lysine is very helpful at the onset of viral infection e.g. cold sore infections and other viral infections. The takeaway message is - start with an adequate magnesium supply . See the link for how to obtain this via our diet. Supplementation may be required. If you would like to discuss your personal circumstances and discuss your Vitamin D and other nutritional needs to get on the road to improving your health, then please don't hesitate to make a booking with me. Sign Up for Further Educational Material If you would like to make sure you don't miss a Blog update from me, or would like to receive more information in the form of upcoming e-Books and Online courses, then please subscribe to my mailing list at the bottom of the Blog front page. References: Reddy P & Edwards L, 2017), Magnesium Supplementation in Vitamin D Deficiency , American Journal of Therapeutics Dominguez L et al, (2021), Magnesium in Infectious Diseases in Older People, Nutrients Izzo C et al, (2021), Vitamin D: Not Just Bone Metabolism but a Key Player in Cardiovascular Disease , Life Remondi Souza A et al, (2023), The Integral Role of Magnesium in Muscle Integrity and Aging: A Comprehensive Review , Nutrients ARTICLE/CONTENT DISCLAIMER The information provided in this blog/article/handout is for your personal or other non-commercial, educational purposes. It should not be considered as medical or professional advice. We recommend you consult with a GP or other healthcare professional before taking or omitting to take any action based on this blog/article/handout. While the author uses best endeavours to provide accurate and true content, the author makes no guarantees or promises and assumes no liability regarding the accuracy, reliability or completeness of the information presented. The information, opinions, and recommendations presented in this blog/article/handout are for general information only and any reliance on the information provided in this blog/article/handout is done at your own risk. Any third-party materials or content of any third-party site referenced in this blog/article/handout do not necessarily reflect the author’s opinion, standards or policies and the author does not assume any liability for them whatsoever.

Eating can be so confusing these days! What am I supposed to eat I often hear? How much of everything should I be eating? It can often be a very confusing minefield understanding what to eat, so let's break it down to make it easy. In essence, for optimal health, we need to eat foods that feed our gut microbiome and protect our liver. What am I supposed to eat made easy A very easy way to consider what you need to eat is simply by looking at your hand, as per below. This means no weighing foods, and is perfect for your body, as a small body frame will have a small hand and smaller consumption needs, while a larger body will have a larger hand with larger consumption needs. Size guides for food consumption Image source What foods to eat with greater explanation Firstly - avoid, or minimise processed foods. If it can sit on a shelf and not 'go off', or it comes with a whole list of ingredients that you know are required to preserve it, or sweeten it, then try to eliminate these from foods you consume. Secondly - minimise or eliminate (depending on your health), gluten, sugar, alcohol, and dairy (milk). These foods are all inflammatory to our bodies. Keep them for special, social occasions. Thirdly - the foods that we are left with are natural, whole foods. Once we are consuming these and restricting processed foods, we can focus on our macronutrients and micronutrients balance. What are macros and micros? Food is broken down into macronutrients and micronutrients. Macronutrients (Macros) Macronutrients are classified as the protein, carbohydrate and fat we must eat, and they provide us with the energy that we need, and building blocks for growth and repair. Protein is our source of meat, poultry, fish, eggs, legumes (lentils, chickpeas, beans etc), seeds (chia, linseeds, pumpkin, quinoa etc), cheese etc. Fat is our butter, avocado, oils, nuts, seeds etc. Carbohydrate is our bread, grains, and includes our fruits and vegetables etc. To make it relatively easy to consider for the average person, we should aim for: Fat - 30% of what we eat should come from fat Protein - intake should be roughly calculated on your body weight (0.75g -1gram of protein/ kg of body weight) Carbohydrate - the rest should be made up of carbohydrate. Proteins Proteins are often seen in a great light these days, with many people consuming protein smoothies. Protein intake is essential, and should aimed to be consumed across the 3 meals of the day, but make sure the amount is just right as too much can lead to kidney issues, while too little can lead to carbohydrate cravings as your body isn't nutritionally satisfied. Proteins are made up of amino acids, of which there are 20. Some of the amino acids are essential amino acids and others are non-essential. Essential amino acids , of which there are 9, cannot be made in the body and so it is essential that we get them from our diets. The essential amino acids are arginine, histidine, isoleucine, lysine, methionine, phenylalanine, threonine, tryptophan, and valine. The remainder are non-essential amino acids meaning we can make them in our bodies and therefore not essential to obtain from our diets. It's a good idea to eat protein spread across all the meals of the day. A vegan diet will usually have some but often not all of the essential amino acids so ensuring you have a variety is imperative to ensure you consume all the essential amino acids. Some foods that do have a complete essential amino acid profile include quinoa, and hemp. Only athletes and extreme exercisers should aim for more protein. Consuming too much protein when you are inactive is actually a negative and can place a burden on your kidneys and liver. Signs of Protein Excess Constipation Liver and kidney overload Calcium leaching from bones Strong body odour Signs of Protein Deficiency Tiredness, weakness, mood changes Poor wound healing Diarrhoea Bloating and poor digestion Fats What is important to consider for fat consumption, is the type of fat consumed. A healthy Omega 3 source is desired. More information is found on the blog discussing healthy forms of fat. Carbohydrates Carbohydrate tends to be either overly represented in a lot of people's food intake, or demonised and under-represented. Carbohydrates are our brains first choice for fuel. As the brain needs it to survive, when we are low on 'carbs' we can have negative mood changes , and feel very tired. Carbohydrate sources include breads , fruits, vegetables, milk (providing lactose), seeds and nuts. We need great sources of fibre via our carbohydrate food sources to fuel our microbiomes needs , not just our tongue. The ideal amount is 1-5g/ kg body weight, depending on the amount of exercise you do. Excess carbohydrate consumed beyond our needs can potentially be stored as fat. The 3 Macronutrients Micronutrients (Micros) Micronutrients are the smaller vitamins and minerals found in our foods, that we need but in smaller amounts. Conveniently, micronutrients are found in the macronutrients we eat. Vitamins Vitamins include fat soluble vitamins Vitamin A, Vitamin E, Vitamin D, and Vitamin E. We need fat in our diets to be able to absorb these fat soluble vitamins. Vitamins also include water soluble vitamins Vitamin B1 (Thiamin), Vitamin B2 (Riboflavin), Vitamin B3 (Niacin), Vitamin B5, Vitamin B6, Vitamin B9 (Folate), Vitamin B12, Vitamin C. The food sources can be found here . Being water soluble means we need a constant supply as they will flush out in our urine on a daily basis. Minerals Minerals include iron, zinc, magnesium, molybdenum, calcium, iodine, selenium, manganese etc. The food sources can be found here. If you would like to discuss your own personal dietary needs, then please don't hesitate to make a booking with me. Sign Up for Further Educational Material If you would like to make sure you don't miss a Blog update from me, or would like to receive more information in the form of upcoming e-Books and Online courses, then please subscribe to my mailing list at the bottom of the Blog front page. References: Macronutrients versus Micronutrients Eating a Balanced Diet starts with your hand Macro Calculator Protein ARTICLE/CONTENT DISCLAIMER The information provided in this blog/article/handout is for your personal or other non-commercial, educational purposes. It should not be considered as medical or professional advice. We recommend you consult with a GP or other healthcare professional before taking or omitting to take any action based on this blog/article/handout. While the author uses best endeavours to provide accurate and true content, the author makes no guarantees or promises and assumes no liability regarding the accuracy, reliability or completeness of the information presented. The information, opinions, and recommendations presented in this blog/article/handout are for general information only and any reliance on the information provided in this blog/article/handout is done at your own risk. Any third-party materials or content of any third-party site referenced in this blog/article/handout do not necessarily reflect the author’s opinion, standards or policies and the author does not assume any liability for them whatsoever.

Do you have signs of Chronic Kidney Disease (CKD)? Without the results of pathology tests, many of us won't know as the signs and symptoms can be quite subtle. Maintaining optimal kidney function is crucial for our longevity, and knowing how to look for signs in your pathology results is crucial. Two types of Kidney Disease There are 2 types of kidney disease: Acute Kidney Injury - where there is lack of blood flow to the kidneys from an injury, infection etc, but recovery back to normal function happens within a 3-month period. Chronic Kidney Disease - is progressive, and is associated with high blood pressure, diabetes, immune dysfunction etc. Whilst it can't be reversed, it can be prevented from progressing further with diet and lifestyle improvements. Signs of Chronic Kidney Disease The below symptoms may be present for other conditions, not just Chronic Kidney Disease. It's important to be checked by your healthcare practitioner. High blood pressure Change in frequency of urination Changes in appearance of urine (e.g. frothy or foaming) Blood in urine Puffiness in legs, ankles, and around eyes Pain in kidney area Tiredness Loss of appetite Difficulty sleeping Headaches Lack of concentration Itching Shortness of breath Nausea and vomiting Bad breath and a metallic taste in your mouth Muscle cramps Pins and needles in your fingers and toes Stages of Chronic Kidney Disease There are progressive stages to kidney disease, and these can be predicted by measuring: Blood Pressure - healthy is now considered <120/80 Estimated Glomerular Filtration Rate (eGFR) - estimated as it is based on our blood Creatinine levels (which is a waste product), your age, sex and ethnicity. The higher your Creatinine level in blood, which is a toxic waste product, the lower the amount is filtered out urine, which reflects the decreased kidney function. This is discussed in greater detail below. Urinary Albumin:Creatinine Ratio (UAC) - healthy kidneys will prevent the leakage of albumin filtering out of our kidneys, while unhealthy kidneys can be shown with albumin present in our urine, even if our eGFR is normal. This is discussed in greater detail below. Estimated Glomerular Filtration Rate The 5 stages of Kidney Dysfunction via the estimated glomerular filtration rate (eGFR) are shown below. Hypertension and Heavy Metal Toxicity have an impact on eGFR, as well as ageing, protein intake and dehydration. Stage 1: >90 Stage 2: 60-89 Stage 3a: 45-59 - this is the level where Chronic Kidney Disease is defined Stage 3b: 30-44 Stage 4: 15-29 Stage 5: <15 or on dialysis Stages of Chronic Kidney Disease by eGFR and UAC Image source Urinary Albumin to Creatinine Ratio The collection of a first void urine is used to calculate how much urinary albumin is released, and is often an earlier marker to change before eGFR does. Urinary Albumin to Creatinine Ratio - normal values are <2.5 for males and <3.5 for females Healthy versus Damaged Kidneys based on Albumin Excretion Image source Other Pathology Tests to Monitor for Kidney Disease There are many other indictors of impending Chronic Kidney Disease. Keeping these markers at optimal levels will help prevent Chronic Kidney Disease. Urinalysis by dipstick - the presence of protein or blood may be a sign even before eGFR impacted. Dipsticks are purchasable form chemists for home checks (as shown by graphic below) Anion Gap (which measures metabolic acidosis, and is a measure of Sodium + Potassium - Chloride - Bicarbonate) - optimal is 10-14 Serum Urea - optimal is 4-7mmol/L Serum Creatinine - often doesn't change until there is up to 50% loss of eGFR Fasting Insulin - optimal is 3-10 mU/L Fasting glucose - optimal is 4.2-4.8 mmol/L HbA1c - Optimal is up to 5.9% HDL - Optimal is 1-1.6 mmol/L Triglycerides - Optimal is up to 1.5mmol/L ESR (Erythrocyte Sedimentation Rate) - Optimal is 0-7 mm/hr C-Reactive Protein - Optimal is 0-5 mg/L High sensitive CRP (hsCRP) - Optimal is 0-1 mg/L Urinalysis Interpretation from a Dipstick Image source Dietary and Lifestyle Improvements While Chronic Kidney Disease cannot be reversed, further progression downwards can be halted with dietary and lifestyle changes like: Give up smoking Eat a diet that focuses on more alkaline generating foods like vegetables and fruits, rather than a lot of acidic producing foods like red meat, sugar, and processed foods. An alkaline diet is called a Potential Renal Acid Load ( PRAL Diet and this can be found in my Resources section ) Minimise/ eliminate alcohol Improve exercise and daily movement If you would like to discuss your own personal kidney results and dietary needs, then please don't hesitate to make a booking with me. Sign Up for Further Educational Material If you would like to make sure you don't miss a Blog update from me, or would like to receive more information in the form of upcoming e-Books and Online courses, then please subscribe to my mailing list at the bottom of the Blog front page. References: Kidney Health Australia National Kidney Foundation BioConcepts Handout: Kidney Function: Using Pathology to assess metabolic and inflammatory markers Urinalysis Dipstick Interpretation ARTICLE/CONTENT DISCLAIMER The information provided in this blog/article/handout is for your personal or other non-commercial, educational purposes. It should not be considered as medical or professional advice. We recommend you consult with a GP or other healthcare professional before taking or omitting to take any action based on this blog/article/handout. While the author uses best endeavours to provide accurate and true content, the author makes no guarantees or promises and assumes no liability regarding the accuracy, reliability or completeness of the information presented. The information, opinions, and recommendations presented in this blog/article/handout are for general information only and any reliance on the information provided in this blog/article/handout is done at your own risk. Any third-party materials or content of any third-party site referenced in this blog/article/handout do not necessarily reflect the author’s opinion, standards or policies and the author does not assume any liability for them whatsoever.

Alopecia is the medical term for hair loss in both men and women. On most days we lose around 100 hairs per day. Greater than this number can be a sign that things are not right with our bodies, and we need to explore why. Stages of Hair Growth and Loss To understand hair loss, we need to understand the normal stages of hair growth and loss. The 4 Stages of Hair Growth Image Source There are 4 stages in the cycle of hair growth and loss. Anagen (Growing Phase) - this stage is highly mitotic (cells are undergoing a lot of cell division), that leads to the production of the hair shaft from the hair follicle. Usually 90% of our hair is in this phase. This stage lasts for years. Catagen (Transition Phase) - where the hair follicles shrink and hair growth slows. The hair separates from the hair follicle but remains in place. This lasts roughly 10 days. Telogen (Resting Phase) - new hair starts to form in the hair follicle to replace the hair about to be shed. This lasts about 3-months. Exogen (Shedding Phase) - where old hair sheds, and new hair growing in the hair follicles (over a 2-5 month period) is ready to replace lost hair. Losing up to 100 hairs per day is normal. When we have more hair moving from the growing phase to the resting and shedding phase, we can see excessive hair loss. This is often seen when our body is inflamed. The point is to understand why our body is inflamed. Why Am I Losing My Hair? There are many causes of excess hair loss. This may help you identify a reason behind your question, 'Why am I losing my hair?' Nutritional needs are not met - like the rest of our body, we need a full complement of vitamins and minerals for optimal hair growth. Sudden weight loss can result in temporary hair shedding. This can be from Iron deficiency, Zinc deficiency, B vitamin deficiencies etc. Stress causing Telogen effluvian  - this is a reversible condition in which hair falls out after a stressful experience. The stress pushes large numbers of hair follicles into a resting phase. Within a few months, those hairs can fall out. In many cases, no treatment is required and the hair often grows back when the stress goes away. Androgenic Alopecia (Reproductive Hormonal imbalance in females) - excess androgens like testosterone can lead to female pattern baldness in conditions like Polycystic Ovarian Syndrome (PCOS) . This can resemble male pattern baldness. Androgens can lead to miniaturisation of the hair follicles. Hair grows in tufts generally, so if the tuft shrinks and miniaturises, it leaves bare scalp between tufts. Thyroid Disease - Hypothyroidism and Hashimoto's Thyroiditis is associated with hair loss, and we often see the outer third of eyebrows lost for example.. Autoimmune Conditions - Alopecia Areata, Alopecia Totalis and Alopecia Universalis are all autoimmune conditions (and discussed below), where an immune response is targeted at hair follicles at certain spots on the scalp causing hair loss in patches (Alopecia Areata), or total hair loss from the scalp (Alopecia Totalis), or where complete loss of hair on scalp, eyebrows, eyelashes, pubic hair, legs, arms, beards, etc is lost (Alopecia Universalis). Finding out what is triggering this is key. People with Alopecia Universalis often present with other immune issues including Eczema (atopic dermatitis), and autoimmune thyroid disease. Autoimmune conditions can be triggered by many external factors including viral infections and this is discussed below. Lichen planopilaris is another autoimmune response where the hair follicle is destroyed and hair loss occurs on the sides, front and back of lower scalp. Trichotillomania - is a psychological condition whereby you obsessively pull hairs out due to stress and anxiety and Obsessive Compulsive Disorder (OCD). Post-Partum - changes in hormone levels post pregnancy can result in hair loss (Telogen effluvium) where hair comes to the end of its cycle quicker and results in widespread shedding of hair where your hair may feel thinner all over. This usually settles after 3 months. Traction Alopecia - Broken hair and sore skin with hair loss from damage or strain to the hair follicles by physical mishandling - straightening hair, tying hair too tightly etc Infections - Syphilis can cause patchy hair loss. Scalp Infections - like folliculitis, fungal infections (ringworm) for example can cause hair loss. Viruses  - studies have shown that many viruses have been implicated in hair loss, and in autoimmune conditions. This is discussed in detail below. Psoriasis - from an overproduction of skin cells that can damage hair follicles and cause hair loss. Inflammation - Seborrheic dermatitis as seen by itchy red patches, that can lead to loss of hair in patches. Menopause - from resultant lower levels of oestrogen. Ageing  - both men and women will lose hair as the cycle of hair growth slows down and volume diminishes as they age. Central Centrifugal Cicatricial Alopecia (CCCA) - a type of scalp scarring that begins in the centre of the scalp and spreads out slowly. Genetics and Hereditary causes  - male and female pattern baldness can be genetically linked. Hereditary hair loss in males for example, is seen by a 'U-shaped' loss of hair as a result of genes passed down from both sides of the family. Medications - Chemotherapy, excessive Vitamin A, antidepressants, oral contraceptive pill, immunosuppressives, anti-clotting drugs (anticoagulants), and medications for lowering cholesterol can all interfere with cell division and growth. Hair loss from chemotherapy usually begins 2-4 weeks after commencement of therapy. Excessive sun exposure - this causes an impairment to the hair shaft from triggering superoxide to form, that pushes hair from Anagen to Telogen phase. Types of Hair Loss Image source Various Types of Alopecia Image source Autoimmune Disease and Hair Loss Alopecia Areata, Alopecia Totalis, Alopecia Universalis and Lichen planopilaris are caused by an autoimmune reaction, which occurs from a dysregulated immune response. Often (but not always) there is a genetic predisposition, but regardless of the genetics there needs to be a trigger to initiate the autoimmune response. Triggering factors can include pathogens, toxic chemicals, diet as well as viral infections. Oxidative stress from either an inadequate antioxidant defence, or an overproduction of free radicals (reactive oxygen species - ROS), can lead to the collapse of the hair follicle and play a role in Alopecia areata. It is well documented as a cause of hair loss. Oxidative stress can be caused by chronic inflammation, hypoxia (lack of oxygen), infections, physical and psychological stress, trauma, chemical reactions etc. Glutathione is our body's major antioxidant able to assist with neutralising reactive oxygen species (ROS). Therefore it is important to ensure our biochemical pathways are running optimally, to obtain beneficial amounts of glutathione. Homocysteine is a test marker that can help us determine how well our pathways are running. It has been reported in scientific literature that Alopecia areata may be a dermatological manifestation of COVID-19, with cases most often appearing 1 to 2 months following infection. Additionally, SARS-CoV-2 infection and its inflammatory sequelae have been reported to affect hair, with the most common association being telogen effluvium. The implicated mechanisms include stress of the disease, pro-inflammatory cytokine release, or direct viral damage to the hair follicles. COVID-19 has also been directly associated with the exacerbation of other autoimmune conditions. Additionally, when viral infections are chronic they can sustain long term inflammation that can lead to autoimmunity. It's important to have a thorough understanding of your history of viral infections to determine if this could be part of your hair loss explanation. Prevention of Hair Loss Healthy hair growth comes from a good blood flow, with nourishing nutrients with lots of beneficial antioxidants. Suggestions include: Eat nourishing meals to ensure you are eating a full compliment of vitamins and minerals. Managing nutrition helps manage our hormones and immune system that may be involved in hair growth and loss. Good hair and scalp hygiene. Scalp massages that stimulate blood flow. Manage your stress levels. Healthy sleep hygiene with consistent sleep hours (in bed by 10pm), and good length of time sleeping (7-9 hours per night). Avoid inflammatory substances like smoking, excessive alcohol, poor eating habits, poor hygiene. Where possible, minimise medication usage that can interfere with cell division. Have pathology testing performed if you start to see excessive hair loss. There can be conditions that need correcting and early diagnosis is key. If you would like to discuss your own personal hair loss concerns, and understand potential causations, then please don't hesitate to make a booking with me. Sign Up for Further Educational Material If you would like to make sure you don't miss a Blog update from me, or would like to receive more information in the form of upcoming e-Books and Online courses, then please subscribe to my mailing list at the bottom of the Blog front page. References: What are the four stages of hair growth? What is alopecia ? Ten most common causes of hair loss Alopecia Areata: A Review of the role of Oxidative Stress Possible Association Between Alopecia Areata and COVID-19 Vaccination and Infection Integrative and Mechanistic Approach to the Hair Growth Cycle and Hair Loss A case of Alopecia Universalis after mild COVID-19 Oxidative stress and Alopecia areata Viral-Induced Rapidly Progressive Alopecia Universalis: A Case Report and Literature Review ARTICLE/CONTENT DISCLAIMER The information provided in this blog/article/handout is for your personal or other non-commercial, educational purposes. It should not be considered as medical or professional advice. We recommend you consult with a GP or other healthcare professional before taking or omitting to take any action based on this blog/article/handout. While the author uses best endeavours to provide accurate and true content, the author makes no guarantees or promises and assumes no liability regarding the accuracy, reliability or completeness of the information presented. The information, opinions, and recommendations presented in this blog/article/handout are for general information only and any reliance on the information provided in this blog/article/handout is done at your own risk. Any third-party materials or content of any third-party site referenced in this blog/article/handout do not necessarily reflect the author’s opinion, standards or policies and the author does not assume any liability for them whatsoever.

How does Autoimmune Disease occur, and there is anything that can be done to help deal with it? The immune response in autoimmune disease acts exactly as it would against infection, with the big exception being that the target is the body's own (self) antigens. These become the target of the adaptive immune response. This drives a chronic inflammatory process that disrupts the normal function of the tissue. The clinical progress of autoimmunity is often marked by a relapsing and remitting course. This occurs because there is both a continuing pro-inflammatory, disease-causing drive (in the form of a persistent antigen), and an opposing anti-inflammatory regulatory aspect. Autoimmune Disease Targets and Possible Causes Image source Symptoms of Autoimmune Diseases Different autoimmune diseases may have similar early symptoms, and also be seen in non-autoimmune conditions. These can include: skin rashes fatigue dizziness low grade fever muscle aches swelling trouble concentrating numbness and tingling in your hands and feet hair loss It's important to be tested, but not panic if you have the above symptoms as they can be come from many sources, and not always autoimmune issues. Types of Autoimmune Diseases Autoimmune responses can be localised to specific organs, or widespread and systemic. Connective Tissue Disease Connective tissue diseases are rheumatic diseases and include Systemic lupus erythematosus, systemic sclerosis, Sjogren’s syndrome and myositis . The autoantibodies are directed against target antigens located in the nucleus (anti-nuclear antibodies) and include nucleic acids, cell nuclear proteins and ribonuclear proteins. The gold standard pathology test is to screen for this with an ANA test (anti-nuclear antibody test). This is initially preformed by an immunofluorescence (IIF) test against human epithelial cells (HEp-2) which is known for its high sensitivity and specificity. Hence you may see a pathology result that reads as the screening pattern and the screening dilution that it stops fluorescing. Vasculitis Vasculitis is a general term that refers to inflammation of the blood vessels. It is used to describe a family of rare diseases, characterised by narrowing, weakening or scarring of the blood vessels, which can restrict blood flow and damage vital organs and tissues. Hence the condition is serious. In Vasculitis, autoantibodies are directed against antigens found in the cytoplasm of neutrophils (and monocytes), specifically the cytoplasmic granules. These are known as anti-neutrophil cytoplasmic antibodies (ANCA). You may see a pathology result with the type of pattern seen (p-ANCA, c-ANCA) and the screening dilution it stopped fluorescing at. Coeliac Disease Coeliac Disease causes severe inflammation and damage to the mucosa of the small intestine via an autoimmune process. This results in nutrient absorption issues and potentially malnourishment, and is often a typical test screened for when you are iron deficient for example. The effects of Coeliac Disease on the villi of our small intestine Gliadin (a protein that makes up the majority of gluten in bread), can only be partially digested in the small intestine. Should there be intestinal epithelial gaps (leaky gut or intestinal permeability); which is common from eating gluten; then the partially digested gliadin makes its way through to the underlying connective tissue. Here, the enzyme known as tissue transglutaminase (tTG) deamidates the amino acids in the gluten to deamidated gliadin peptides (DGP), allowing the body reason to mount an immune response. This is the reason you will see pathology results for tTG IgA and DGP IgG if you are screened for Coeliac Disease. In individuals with the presence of human leucocyte antigens (HLA) DQ2 and DQ8, their B lymphocyte cells form antibodies against DGP (IgG) and their body’s tTG (IgA auto-antibodies). In addition, T cells secrete proinflammatory cytokines, causing inflammation. As tTG IgA antibodies are tested for, you must also be evaluated for IgA deficiency which is quite common. If you are IgA deficient, this will alert the practitioner to any negative result with clinical suspicion. Genetic screening for HLA-DQ2/ DQ8 rules out the possibility of Coeliac Disease should you be negative for those HLA types. It is the best method of evaluating Coeliac Disease. Gastrointestinal Disease Inflammatory Bowel Disease (IBD) includes Ulcerative Colitis (UC) and Crohn’s Disease (CD). Ulcerative colitis shows an immune reaction against the colon and rectum which can spread continuously from the anal region upwards. Crohn’s disease shows an immune reaction against the small and large intestine but can be found in the oral cavity to the anus. It appears as non-continuous attacks. Differentiation between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS) is done by testing for Faecal Calprotectin and will be positive in IBD but negative in IBS. Autoimmune gastritis is a chronic inflammation of the stomach hindering Vitamin B12 uptake. Pernicious anaemia (B12 deficiency) develops over time. Autoantibodies against gastric parietal cells of stomach (GPCA) and Intrinsic Factor (IF) deficiency that are needed to bind Vitamin B12, are tested when Pernicious Anaemia is suspected.  Autoimmune Liver Disease Autoimmune Hepatitis (AIH) needs to be ruled out from hepatitis viruses. If untreated it will lead to cirrhosis of the liver. It can include Autoimmune Hepatitis, Primary Biliary Cholangitis, or Primary Sclerosing Cholangitis . Anti-phospholipid Syndrome (APS) If you have anti-phospholipid syndrome (APS), you may clinically present with: vascular thrombosis premature births miscarriages eclampsia Your pathology results may show antibodies against: Cardiolipin (ACA) B2 glycoprotein (anti-B2GP1) Positive lupus anticoagulant (LA) To be classified as having APS you just have both a clinical and pathology confirmation. Rheumatoid Arthritis Rheumatoid arthritis is characterised by painful, swollen joints, movement restriction and progressive joint destruction from the formation of immune complexes. Approximately 70% of patients develop earlier autoantibodies against cyclic citrullinated peptides (CCP). Autoimmune Skin Diseases Pemphigus is a rare group of autoimmune diseases. It causes blisters on the skin and mucous membranes throughout the body. It can affect the mouth, nose, throat, eyes, and genitals. Pemphigus vulgaris is the most common type of pemphigus. Pemphigus vulgaris . This type usually begins with blisters in your mouth and then on your skin or genital mucous membranes. Pemphigus foliaceus . This type causes blisters on the chest, back and shoulders. The blisters tend to be more itchy than painful Bullous pemphigoid is a rare skin condition that causes large, fluid-filled blisters. They develop on areas of skin that often flex — such as the lower abdomen, upper thighs or armpits. Bullous pemphigoid is most common in older adults and can be life threatening. Autoimmune Thyroid Disease In autoimmune thyroid disease , antibodies can occur against thyroid microsomes, mainly thyroperoxidase (TPO), and thyroglobulin (TG). Gluten has been implicated in autoimmune thyroid disease through molecular mimicry. Hashimoto’s autoimmune thyroiditis (AIH) from autoimmune-mediated lymphocytic infiltration that leads to the destruction of the thyroid tissue and consequently reduced thyroid hormone production (hypothyroidism). Autoantibodies found can include anti-TPO (90% of cases), TSH receptor (TRab 6-60% of cases), and anti-TG (45-60% of cases).. Grave’s disease – is autoimmune hyperthyroidism. TRab found in >90% of cases with high titres associated with severe disease; anti-TPO (80%), and anti-TG (30%) of cases. Post-partum thyroiditis can also occur which usually resolves within 12-months post birth. Neurological Diseases Paraneoplastic Neurological Syndromes (PNS) are diseases of the central and peripheral nervous system, that occur in direct relation to tumour development (but are not caused by the tumour, or therapy). Depending on the type of tumour, different intracellular antigens get expressed which can induce the formation of specific autoantibodies (Hu, Yo, Ma) etc Autoimmune encephalopathies exhibit autoantibodies against neuronal cell surface antigens (glutamate receptors) – NMDA, AMPA, GABA B, DPPX, voltage gated potassium channels (VGKC) etc Since these antigens play a role in synaptic signal transduction, the associated autoimmune conditions present clinically as seizures and neuropsychiatric symptoms . Other types of autoimmune diseases can include Autoimmune Alopecia , Type 1 Diabetes, Psoriasis, Multiple Sclerosis, Addison's Disease, and many more. A Complete list of autoimmune diseases  can be found here. Whilst the trigger is often difficult to determine, there is evidence that autoimmunity can follow infection, but that more than one infection can initiate disease. Other environmental factors are also relevant but are not well defined and may include mercury, silica, smoking, pesticides etc. Infections linked with Autoimmune Diseases Bacterial infections potentially linked to autoimmune disease Strep throat Scarlet Fever Food Poisoning Lyme disease Sexually transmitted infections  potentially linked to autoimmune disease Chlamydia Hepatitis B Herpes Simplex Virus 1 HIV Viral infections potentially linked to autoimmune disease Infectious Mononucleosis (EBV) - Glandular Fever COVID-19 - recent studies have shown that infection may reactivate EBV in some people, and that EBV has been found to be linked to autoimmune disease. Cytomegaloviris Measles German measles (Rubella) Hand, foot, and mouth disease Mumps Influenza Zika virus West Nile virus Chickenpox Parvovirus B19 Rotavirus Hepatitis A Hepatitis C Viral infections and Autoimmunity Viruses have unique ways in which they can cause autoimmune diseases which is not helpful to humans. In the graphic below we can see the mechanisms: a. Following the steps around the first graphic - Viruses infect our cells. The viral antigens are presented to T-helper cells alerting the body we have an invader. The T-helper cells release cytokines which notify the cytotoxic T lymphocytes to release granzymes that are cell death inducing enzymes. This enables our bodies self-antigens to leak out and become another source of danger that the antigen presenting cells present to T cells for target. This unfortunately means other cells in our body that have these same leaked antigens can become targeted. b. A process of molecular mimicry where T cell receptors recognise both viral antigens and self antigens that are structurally similar, and deal with them in the same toxic way. c. Bystander activation whereby cells just being in close proximity to viral infected cells that are being targeted by the immune system, also get injured and die. The inflammation that happens around the cells after the attack also impacts on localised cells. The Role of Viral Infections in the Onset of Autoimmune Disease Image source Immune Imbalance Autoimmune Diseases can show imbalanced T helper 1 (Th1) or T helper 2 (Th2) cells. Imbalance between T helper cells Potential natural remedies to rebalance Th1 and Th2 cells Th2 Stimulating Compounds Green Tea, Resveratrol, Curcumin, Quercetin. Th1 Stimulating Compounds Echinacea, Astragalus, Licorice Root, Ashwaganda, Panax Ginseng, Mushrooms (Maitake, Reishi, Shiitake), Chlorella, Grape Seed Extract. Autoimmune testing is complex. Ensuring you are having the results interpreted by someone qualified who really understands the complexities of your health journey is important. I have worked in the autoimmunity sector for a large part of my career meaning I am qualified to assist you. If you would like to discuss your own personal autoimmunity concerns, and understand potential causations, then please don't hesitate to make a booking with me. Sign Up for Further Educational Material If you would like to make sure you don't miss a Blog update from me, or would like to receive more information in the form of upcoming e-Books and Online courses, then please subscribe to my mailing list at the bottom of the Blog front page. References: British Society for Immunology - Immune Dysfunction Can infections cause Autoimmune Diseases Multiple early factors anticipate post acute COVID-19 sequelae Investigation of Long COVID Prevalence and Its Relationship to Epstein-Barr Virus Reactivation Transcription factors operate across disease loci, with EBNA2 implicated in autoimmunity Everything you need to know about Epstein Barr Virus Pathogen infection and Autoimmune Disease The Role of Viral Infection in the Onset of Autoimmune Disease Epstein Barr Viris and Autoimmune Disease Viral reactivations and co-infections in COVID-19 patients: a systematic review ARTICLE/CONTENT DISCLAIMER The information provided in this blog/article/handout is for your personal or other non-commercial, educational purposes. It should not be considered as medical or professional advice. We recommend you consult with a GP or other healthcare professional before taking or omitting to take any action based on this blog/article/handout. While the author uses best endeavours to provide accurate and true content, the author makes no guarantees or promises and assumes no liability regarding the accuracy, reliability or completeness of the information presented. The information, opinions, and recommendations presented in this blog/article/handout are for general information only and any reliance on the information provided in this blog/article/handout is done at your own risk. Any third-party materials or content of any third-party site referenced in this blog/article/handout do not necessarily reflect the author’s opinion, standards or policies and the author does not assume any liability for them whatsoever.

How does our immune system work, and how can we see on regular pathology tests if there are signs it's not working well, and when to be concerned about possible immune issues, whether they be potential acute or chronic causes? How does our Immune System work? The immune system as a whole is made up of cells, chemicals and processes that protect us from bacteria, fungi, parasites, viruses, toxins and cancer cells. Let's find out how our immune system works. Our immune system is comprised of two parts to its defence: the innate immunity and adaptive immunity. Both sides work intimately together, but if there is a defect in any aspect, from illness, disease, or inappropriate inflammation, then autoimmune, immunodeficiency disorders and hypersensitivity reactions, can occur. The innate and adaptive immune responses are not mutually exclusive, but rather operate together in a complementary way. Defects can occur in either side and result in inappropriate responses. In the graphic below we can see the Innate Immune System on the left, divided by the vertical dotted line from the adaptive immune system on the right. The adaptive immune system is further divided by a horizontal dotted line separating the Cell-Mediated immune response from the Humoral immune response. What is happening in this cartoon graphic shows exactly what happens in our immune response, and is described in detail below. The interconnections between the Innate Immune System and the Adaptive Immune System Image source Innate Immunity Innate immunity is the first line of defence and it acts within hours of sensing an inappropriate intrude r. The innate immune system uses barriers like our skin, and mucous membranes, along with body temperature, pH and chemicals to prevent entry into our bodies. It also uses cells to eat invaders (phagocytosis), as well as to release toxins and inflammatory responses (the complement system activation, pro inflammatory cytokines etc) to hinder the invaders entry into our bodies. Cells also talk to each other by communicating via cytokines and chemokine's which you may have heard of during the recent epidemic e.g. Interleukin-6, and tumour necrosis factor (TNF). While it was once thought that the innate immune system was non-specific, approaching each pathogenic invasion as a naive experience, it is now recognised that innate immunity can be upregulated or 'trained'. This training occurs when microbe -associated molecular patterns (MAMPs) are recognised by the immune cell, allowing it to develop a memory of the pathogen, and a more rapid response to a subsequent exposure. β-glucans, which are the structural components of yeast and fungal cell walls, present as MAMPs to the innate immune cells in a similar fashion to pathogenic microbes, creating a comparable increase in cellular 'fitness' or readiness for pathogenic invasion. With all the mould exposure from heavy rainfall in Australia, it is little wonder we are seeing more immune system issues. As well as MAMP's, the innate immune system can act the way it does by recognising receptors on pathogens (Pathogen Recognition Receptors or PRR), as well as pathogen associated molecular patterns (PAMP's). Examples could include if we had lipopolysaccharides in our gut microbiome  from a fatty diet, or if we had RNA present from virus replication. There are many other examples. The innate immune system also initiates the inflammatory response, where we see temperature increase, pain, redness, swelling, and potentially loss of function to contain the infection. All of this is controlled by the 'project manager' (who's scientific name is NF-kB) that gets initiated and sets off the pro-inflammatory response. We would see an increase in our CRP (C-reactive protein) from IL-6 release, if this response was an acute response. Cells involved in the innate response include macrophages, monocytes, neutrophils, basophils, eosinophils, mast cells, natural killer cells (NK), and innate lymphocytes. If you see an alteration in any of these cell types on your Full Blood Count (FBC) , or in lymphocyte subsets, it may mean you have an immune system imbalance. For example, often we see, chronic elevation of monocytes that live for a long time for example. Mast cells and basophil elevations can be seen with allergies or asthma. Eosinophils can highlight the presence of parasites. Elevations of Natural Killer Cells may be because they are trying to play a role in destroying cells infected by viruses. Secretory IgA (sIgA) provides the first line of defence against pathogens, blocking adherence to the epithelial surface by binding to and trapping the pathogen in the mucous lining. The pathogen then gets discarded. We see low sIgA in all sorts of gut issues including Irritable Bowel Syndrome (IBD), and Inflammatory Bowel Syndrome (IBS), chronic stress, sleep disturbances, autoimmune diseases, after intense exercise, and from the use of some medications. The liklihood of infections, allergies and autoimmune conditions increases in low sIgA situations. The immune system must be able to recognise us versus the pathogens. In other words 'self' versus 'non-self'. It does this by utilising major histocompatibility complexes (MHC's). MHC's are classified as either class I or class II. MHC Class I (also termed Human Leucocyte Antigens or HLA's) are either A, B or C and are found on all cells with a nucleus. MHC Class II (or HLA DP, DQ, DR) are present on a limited number of cell types (macrophages, dendritic cells, and B lymphocytes). You may be familiar with seeing MHC testing - if you have the genetic predisposition for Coeliac Disease you will have tested positive for HLA DQ2/ DQ8. Now you have some idea what that means. Adaptive Immune System The Innate Immune Response and Acute Inflammation can only hold things at bay for so long before the Adaptive Immune System is called in (a.k.a. the SAS). Dendritic cells, otherwise known as antigen presenting cells, 'show' the offender to both sides of our immune system. The adaptive immune system kicks in when the defences of the innate system have been ineffective. The pathogen is presented by dendritic cells that have gobbled up the pathogen, and so they display 'non-self flags' to our naive T-helper lymphocyte cells. Once the naive T helper cell sees the MHC II flag, and another protective mechanism (B7) as a second alert has been triggered, the green light is given for more advanced activity to occur by our adaptive immune system. Two sides of the Adaptive Immune system include: T Helper 1 cells (Th1) are engaged when the pathogen is inside cells (intracellular) e.g. mostly against viruses, while T Helper 2 cells (Th2) are engaged when the pathogen is outside our cells (extracellular) by producing antibodies (IgE, IgG, IgM etc) e.g most against bacteria, fungi, parasites. Extracellular infections –> TH2 –> humoral immune response with B lymphocyte cells and antibodies e.g. bacteria, fungi, parasites Intracellular infections –> TH1 –> cell-mediated immune response with activated APCs and cytotoxic T lymphocyte cells e.g. viruses The fine balance between the Th1 and Th2 response is modulated by T-Regulator cells. Th17 cells are a relatively newly discovered subset and are associated with ongoing inflammatory responses like chronic infection and disease. Some viruses have unique abilities to slip between intracellular and extracellular locations to evade being targeted by our immune system e.g. Epstein Barr Virus (EBV) Adaptive Immunity is unique to each individual and it can remember if it has seen a pathogen before. When we vaccinate, we are calling on the memory ability of the adaptive immune system. Diseases associated with a Depressed Immune System Inherited (Primary) Immunodeficiencies - e.g. Severe Combined Immunodeficiency (SCID), and Common Variable Immunodeficiency (CVID) Acquired (Secondary) Immunodeficiencies - e.g. HIV Diseases Associated with Overactive Immune System Type 1 - IgE Mediated Hypersensitivity from B cells e.g. Systemic Anaphylaxis, Seasonal Allergies, Food allergies, Eczema Type II - IgG Mediated Cytotoxic Hypersensitivity from B cells e.g. Blood transfusion mismatches, autoimmune haemolytic anaemia Type III - Immune Complex Mediated Hypersensitivity (Antigen-Antibody complexes) from B cells e.g. Rheumatoid Arthritis (RA), Systemic Lupus Erythematosus (SLE), Glomerulonephritis Type IV- Cell Mediated Hypersensitivity from T cells where Th1 cells cause activated macrophages to accumulate at a site in the body e.g. autoimmune diseases, Multiple Sclerosis, Rheumatoid Arthritis, Contact dermatitis Simplified diagram of the Adaptive system determinant based on the type of cytokine. Pathology Tests as Indicators of Immune Issues As starters, regular pathology result abnormalities can be indicators of potential acute or chronic immune function issues. Do you recognise these signs of chronic, low grade inflammation? Full Blood Count (FBC) with changes in White Cell Count, Neutrophils, Lymphocytes, Monocytes, Eosinophils, Platelets Erythrocyte Sedimentation Rate (ESR) and C-Reactive protein (CRP) elevations Lipid studies -elevated cholesterol is actually a healing molecule, so remove the cause of inflammation and cholesterol will lower. Cholesterol is the firefighter, not the fire. There is only a minimal 10% of the population that have genetic abnormalities with cholesterol management. Elevated triglycerides. Decreased HDL is a sign of insulin resistance. Iron Studies with % Transferrin Saturation and Total Iron Binding Capacity (TIBC) changes from poor iron regulation from Hepcidin Vitamin B12 levels decreased Vitamin D levels decreased Liver Function Tests with altered Albumin and Globulin ratio, and elevated GGT levels Thyroid Function Tests not optimal Insulin - is elevated and with poor glucose regulation, that makes plaque in our arteries sticky like toffee. Remove simple carbohydrates from your diet, and if you've become insulin resistant unblock that first. See my blog on Metabolic Syndrome Abdominal fat - we hold toxins in our abdominal fat. This fat build up is an inflammatory organ generating disease. Hence why we need to lose abdominal fat. Fatty liver Gout Leaky gut (Intestinal Permeability) - remove the inflammation, and heal the gut Pathogens in your microbiome - crowd out the pathogens with good bacteria, remove the pathogens and nourish your body. Low Libido - it can be a side effect of all the above. The immune system is complex. Pathology results give us indications as to what is going on. Ensuring you are having the results interpreted by someone qualified to look for the nuances is important for understanding the complexities of your health journey. If you would like to discuss your own personal immunity concerns, and understand potential causations, then please don't hesitate to make a booking with me. Sign Up for Further Educational Material If you would like to make sure you don't miss a Blog update from me, or would like to receive more information in the form of upcoming e-Books and Online courses, then please subscribe to my mailing list at the bottom of the Blog front page. References: An introduction to Immunology and Immunopathology Immune Response Summary British Society for Immunology Bio-Practica Immune System article ARTICLE/CONTENT DISCLAIMER The information provided in this blog/article/handout is for your personal or other non-commercial, educational purposes. It should not be considered as medical or professional advice. We recommend you consult with a GP or other healthcare professional before taking or omitting to take any action based on this blog/article/handout. While the author uses best endeavours to provide accurate and true content, the author makes no guarantees or promises and assumes no liability regarding the accuracy, reliability or completeness of the information presented. The information, opinions, and recommendations presented in this blog/article/handout are for general information only and any reliance on the information provided in this blog/article/handout is done at your own risk. Any third-party materials or content of any third-party site referenced in this blog/article/handout do not necessarily reflect the author’s opinion, standards or policies and the author does not assume any liability for them whatsoever.

Even though it is much maligned, fat is an essential part of our 'balanced diet' as one of our three important macros - fats, carbohydrates, and proteins. Fats provides fatty acids that are 'essential' to our health. They are termed 'Essential' Fatty Acids , as our bodies can't make them. We have to get them from food sources, and they play vital roles in keeping us healthy. What do Dietary Fats do for us? Let's discuss fats in general before we review Essential Fatty Acids. Fats perform vital functions like: They help our body absorb vitamins that require fat to become soluble for absorption (fat soluble vitamins). These are Vitamins A, E, D, and K They provide a source of cholesterol which is important for the production of Vitamin D, our sex hormones, and our adrenal hormones like cortisol, cortisone, aldosterone. Cholesterol also maintains our cell membranes which are vital for our health. Cholesterol also makes bile salts that digest dietary fats. They provide sources of Omega 3 and Omega 6 Essential Fatty Acids that we cannot produce ourselves. Different Types of Fat Fat can be broken down into Saturated fats, Monounsaturated Fats, Polyunsaturated Fats, and Trans Fats. The below graphic describes them in detail and for the chemistry nerds out there, describes how they get their names from the ways they are constructed. Saturated, Monounsaturated, Polyunsaturated, and Trans Fats differences. Image from: https://www.compoundchem.com/2015/08/25/fat/ Examples of Different Types of Dietary Fat Classification of Fatty Acid Omega type Examples Monounsaturated Fatty Acids Omega 9 Olive oil, avocado oil, some nuts, almond butter Polyunsaturated Fatty Acids Omega 3 Oily Fish, Fish oils, Walnuts are an excellent nut source, Flaxseed (or Linseeds) are an excellent seed source, Chia seeds, Sesame seeds, Soybean, Green leafy vegetables, avocado. ​ Omega 6 Meat, poultry, eggs, vegetable oils, most nuts, sunflower seeds, pumpkin seeds Saturated Fatty Acids ​ Animal fats, meats, cheese, dairy Trans Fats ​ Artificial sources like margarine, fried foods, cakes, commercially baked goods etc What are Essential Fatty Acids (EFA's) Essential Fatty Acids (EFA's) are fats that can't be made by the body in sufficient amounts to be beneficial. We must eat them in the form of Polyunsaturated fats. Polyunsaturated Fats provide Omega 3 and Omega 6 Essential Fatty Acids. The end products of the Omega 3 and Omega 6 Pathways Image from: https://www.researchgate.net/figure/Omega-3-fatty-acid-metabolism-The-end-products-of-the-omega-3-pathway-include_fig1_305735297 The end products of Omega 3 and Omega 6 metabolism, are compounds called eicosanoids, of which there are 4 classes listed below. Eicosanoids from Omega 3 sources are anti-inflammatory, while eicosanoids from Omega 6 sources are pro inflammatory. Pro-inflammatory responses participate in immune responses to injury and infections, but the response needs to be at 'appropriate' times, and not for chronic low grade inflammation commonly from our lifestyle and food choices. Anti-inflammatory responses are vital for lowering blood pressure, preventing blood clotting, protecting against irregular heart beats, and reducing inflammation. Additionally, Omega 3 acts to tone down Omega 6. The 4 Classes of eicosanoids are: Prostaglandins (PG) - producing hormone-like behaviour at sites of injury Prostacyclins (PC) - promoting vasodilation and inhibits platelet aggregation Thromboxanes (TX) - promoting vasoconstriction and platelet aggregation Leukotrienes (LT) - playing a role in allergic disease, like asthma The anti-inflammatory Omega 3 end products are: EPA - Eicosapentaenoic acid which helps in cardiovascular health DHA - Docosahexaenoic acid which is essential for brain or neurological health Fun fact: Anti-inflammatory medications act by blocking receptors on the right-hand side of the diagram above, under arachidonic acid. Aspirin and NSAID's like Nurofen block COX receptors and Ventolin blocks LOX receptors. In this way they are blocking the pro-inflammatory pathways. Essential Fatty Acid Deficiency Certain conditions can become evident if we don't have diets providing essential fatty acids. Issues can occur with: Skin lesions and dry, scaly skin rashes Neurological and cognition issues Vision issues Reproductive issues Growth issues Susceptibility to infection Poor wound healing Chronic fat malabsorption Pro-inflammatory conditions Testing for Essential Fatty Acids To determine if your diet is balanced as far as Essential Fatty Acids are concerned, we can order an Omega 3 index test, which looks at the composition of Omega's in our red blood cell membranes. It is calculated as the percentage of: (Omega 3 EPA + Omega 3 DHA)/ Total Fatty Acids expressed as a percentage If you eat a lot of meat, and don't like oily fish, then please consider adding walnuts and linseeds to your diet to boost your Omega 3 levels - they are essential fatty acids for your health. If you would like to discuss your diet and whether you are getting a balanced intake of Essential Fatty Acids, then please don't hesitate to make a booking with me. Sign Up for Further Educational Material If you would like to make sure you don't miss a Blog update from me, or would like to receive more information in the form of upcoming e-Books and Online courses, then please subscribe to my mailing list at the bottom of the Blog front page. References: A guide to the different types of fat, https://www.compoundchem.com/2015/08/25/fat/ Essential Fatty Acids and Eicosanoids, https://courses.lumenlearning.com/suny-nutrition/chapter/2-34-essential-fatty-acids-eicosanoids/ The end products of the Omega 3 pathway, https://www.researchgate.net/figure/Omega-3-fatty-acid-metabolism-The-end-products-of-the-omega-3-pathway-include_fig1_305735297 Essential Fatty Acids, https://lpi.oregonstate.edu/mic/other-nutrients/essential-fatty-acids ARTICLE/CONTENT DISCLAIMER The information provided in this blog/article/handout is for your personal or other non-commercial, educational purposes. It should not be considered as medical or professional advice. We recommend you consult with a GP or other healthcare professional before taking or omitting to take any action based on this blog/article/handout. While the author uses best endeavours to provide accurate and true content, the author makes no guarantees or promises and assumes no liability regarding the accuracy, reliability or completeness of the information presented. The information, opinions, and recommendations presented in this blog/article/handout are for general information only and any reliance on the information provided in this blog/article/handout is done at your own risk. Any third-party materials or content of any third-party site referenced in this blog/article/handout do not necessarily reflect the author’s opinion, standards or policies and the author does not assume any liability for them whatsoever.

Many people are once again turning to herbal remedies for the same sort of health promoting benefits that have been long used in history, as described below. Yet, how do these herbs actually work to promote better health? Th is blog explores the world of herbal remedies and delves into the science behind their therapeutic effects, answering the question 'how do herbal remedies work?'. 10 Commonly Known Herbs that have Medicinal Benefits Image Source Mechanisms of Action: How Do Herbal Remedies Work? At the core of all herbal remedies are active constituents that interact with our bodies in various ways. These active constituents give herbs their 'method of action'. Understanding these active constituents, and their method of action, is part of the study of herbal pharmacognosy, where qualitative and therapeutic monographs of the key indications for use, their mechanism of action, the part used and active constituents, contraindications, dosage restrictions, and safety of herbal remedies, is recorded in herbal reference books. The British Herbal Pharmacopoeia is an example of such a record. The active constituents of herbs are phytochemicals, or natural compounds produced by plants that have a definable physiological or medicinal effect on the body . Common categories include flavonoids, which are potent antioxidants found in fruits and flowers; alkaloids, known for their bitter taste and interaction with the digestive system; volatile oils (essential oils), responsible for the aromatic qualities of herbs like peppermint and rosemary; saponins, which lather in water, and tannins, which are astringent.  An example of a powerful alkaloid is morphine from the opium poppy, known for its strong pain-relieving properties. In contrast, flavonoids found in chamomile can reduce inflammation and promote relaxation. By understanding these active compounds, naturopaths can tailor herbal remedies to meet specific health needs more effectively. A brief summary of some of the mechanisms of action of herbal remedies include: Herbal Action Mechanism of Action & Examples Adaptogen Improves the body's ability to deal with stress e.g., Withania (Ashwaghanda), Licorice, Ginsengs Alterative/ Depurative Improves the body's ability to eliminate waste e.g., Cleavers, Burdock, Yellow Dock, Dandelion Analgesics Help with pain relief e.g., Californian Poppy, Jamaican Dogwood Anti-microbial Eliminates parasites e.g., Garlic, Black Walnut, Wormwood, Thuja. Eliminates fungus e.g., Pau d'arco. Eliminates bacteria e.g., Echinacea, Garlic, Thyme. Anti-inflammatories Help the body control inflammation e.g., Calendula, White Willow, Boswellia, Turmeric Anti-spasmodics Help ease cramps in the body e.g., Cramp Bark, Wild Yam, Ginger, Peppermint Astringents Tightens tissues e.g., Shepherd's Purse, Ladies Mantle Bitters Trigger a bitter sensation in the mouth which stimulates digestion e.g., Gentian, Dandelion Root, Oregon Grape Carminatives Regulate digestive contractions e.g., Fennel, Dill, Peppermint, Chamomile Choleretics/ Cholagogues Stimulate flow of bile from the liver into gall bladder (cholagogues) and release from gall bladder (choleretics) e.g., Dandelion Root, Globe Artichoke Demulcents To heal mucous membranes e.g., Slippery Elm, Flaxsee, Marshmallow Diaphoretic To promote sweating and control the fever process e.g., Yarrow, Elderberry, Ginger Diuretics Relieve fluid retention e.g., Dandelion Leaf, Corn Silk, Celery, Parsley Expectorants Help to clear mucous from lungs e.g., Mullein, Elecampagne Hepatics Aid the work of the liver in detoxification e.g., St. Mary's Thistle, Oregon Grape, Dandelion Root Hormone Balancers Affect circulating levels of sex hormones e.g., Chaste Tree Berry (Vitex), Black Cohosh, Sage, False Unicorn Root, Wild Yam, White Peony Immune Enhancers To boost the immune response e.g., Astragalus, Echinacea, and the mushrooms: Reishi, Turkey Tail, Shitake Laxatives To stimulate bowel movements e.g., Senna, Cascara, Psyllium, Flaxseed, Marshmallow Nervines For beneficial support of the nervous system e.g., Oats, Valerian, St. John's Wort, Chamomile, Passionflower Stimulants To quicken the physiological processes of the body e.g., circulatory stimulants help with blood circulation e.g., Ginger, Cayenne Tonics and Specifics Act on specific organs in the body, or for specific circumstances e.g., Eyebright (Eyes); Gingko (Brain); Golden Seal (Mucous Membranes); Hawthorn (Heart); Feverfew (Headache); Rehmannia (Adrenal Glands), Chaste Tree (Increases Progesterone); Damiana, Tribulus, Shatavari (boost for libido); Saw Palmetto, Nettle (BPH); Black Cohosh, Sage (Menopause); Goat's Rue (Diabetes); White Peony, Licorice (PCOS), Shepherd's Purse, Ladies Mantle (Menorrhagia); Thuja (Growths); Turmeric (Oxidative Stress); Valerian (Sedative); Withania (HP Axis management) Vulneraries Wound healing e.g., Calendula Table showing Herbal Methods of Action History Of Herbal Medicine Herbal remedies have been a cornerstone of traditional medicine for thousands of years. The history of herbal medicine use can be traced back to many ancient civilisations. Traditional Chinese Medicine (TCM) recognised the importance of balance and promoted the use of herbs like ginseng to enhance cognitive function, reduce fatigue, and help with stress adaptation . Ayurveda is the ancient Indian science of life and emphasises the interconnectedness of mind, body, and spirit, utilising herbs, diet, lifestyle adjustments, and spiritual practic es for holistic well-being. In Ancient Greece, herbs were integral to daily life, used in cuisine to enhance flavour and as medicine to heal , with Hippocrates  (the father of medicine) famously advocating "Let food be your medicine". A lot of the culinary herbs we use in meal preparation today come from ancient Greek civilisations use which was often regarding supporting digestion (e.g., oregano, mint). Ancient Egyptians used garlic and onions for strength. There are many more examples, and the history is deeply fascinating. Herbal Remedies Used in Pharmaceutical Preparations You may be surprised to find out that modern pharmaceutical preparations often have the active ingredient from herbal medicines. While herbal remedies are organic in nature and only minimally processed, pharmaceutical medications become synthetic even if the active ingredient is herbal, and are highly processed. Often the effects are much greater than in original herbal format. Some examples of pharmaceuticals medications derived from herbs: Aspirin:  A precursor to aspirin, salicylic acid, is found in willow bark.  Cardiac Medications:  Digoxin, a cardiac stimulant used for heart failure, is derived from the beautiful foxglove plant Digitalis.  Antimalarials:  Quinine, used to treat malaria, comes from cinchona bark.  Cancer Therapeutics:  Vinca alkaloids from Catharanthus roseus and camptothecin from Camptotheca acuminate are used in tumour therapy.  Antibiotics:  Penicillin and erythromycin are examples of antibiotics that are derived from fungi.  Antihypertensives:  Reserpine, a drug used to treat high blood pressure, is sourced from Rauwolfia species.  Statins: Lovastatin used to lowers blood cholesterol comes from a fungus.  Organophosphorus poisoning: Atropine is derived from Atropa belladonna and the injection is used to treat poisoning caused by organophosphorus nerve agents. Safety of Herbal Remedies While herbal remedies can be beneficial, it's essential to approach them thoughtfully, and should be undertaken via a qualified Naturopath or Herbalist . The effectiveness and safety of herbs can greatly depend on their source, dosage, and individual health situations. For example, St. John's Wort is effective for mild depression but can interact with various medications, including antidepressants. Consulting with a naturopath or herbalist before starting any herbal remedy is vital to avoid potential complications. Conclusion If you’re looking to alleviate specific ailments you may have, then herbal remedies can be a very effective and safer choice. If you would like to discuss your current circumstances to see how herbal remedies may be of benefit, then please feel free to make a booking to discuss. Sign Up for Further Educational Material If you would like to make sure you don't miss a Blog update from me, or would like to receive more information in the form of upcoming e-Books and Online courses, then please subscribe to my mailing list at the bottom of the Blog front page. References: Herbal Actions ARTICLE/CONTENT DISCLAIMER The information provided in this blog/article/handout is for your personal or other non-commercial, educational purposes. It should not be considered as medical or professional advice. We recommend you consult with a GP or other healthcare professional before taking or omitting to take any action based on this blog/article/handout. While the author uses best endeavours to provide accurate and true content, the author makes no guarantees or promises and assumes no liability regarding the accuracy, reliability or completeness of the information presented. The information, opinions, and recommendations presented in this blog/article/handout are for general information only and any reliance on the information provided in this blog/article/handout is done at your own risk. Any third-party materials or content of any third-party site referenced in this blog/article/handout do not necessarily reflect the author’s opinion, standards or policies and the author does not assume any liability for them whatsoever.

There are 12 vital minerals (tissue salts) in the human body and a proper balance is necessary for normal cell and bodily functions like digestion and metabolism. These minerals include amongst others, calcium and magnesium. Tissue salt preparations of these minerals, also known as cell salts, have been used for a long time. Tissue salts are homeopathic preparations or micro doses, that are assimilated rapidly into our bloodstream and hence our cells ensuring the minerals don’t overpower the body. This can enhance healing without the side effects often attributed to synthetic supplements. Tissue Salts can be utilised as a single preparation for a specific purpose ( see below ), or they can be found in various combinations according to the body's needs e.g., insomnia, menstrual pain, or even as as a general tonic that encompasses all the tissue salts. While traditional nutrients can support acute, short-term health needs, tissue salts can be seen as crucial for long-term wellness. By maintaining cellular harmony , these salts are believed to prevent future health issues rather than merely alleviating the current health issue. Which Tissue Salt is Right for Me? Pick the Tissue Salt (or combination) to help support your needs. Image Source You may well be asking the question now, 'Which Tissue Salt is Right for Me?' The 12 primary tissue salts and the benefits they offer are: 1. Calc fluor (Calcium fluoride) The Elasticity Salt 'Hardens or tightens what has softened (teeth, bones, sprains) and softened what has hardened (callouses, calcifications)' strengthens tooth enamel and bones gives elasticity to connective tissue, skin (stretch marks) can help elasticity of veins ( haemorrhoids, varicose veins) can help hernia pain 2. Calc phos (Calcium phophate) The Bone Salt supports growth and vitality all over assists with blood disorders e.g., anaemia as it supports the production of all cell types speeds healing of fractures helps the digestive system as it assists with gastric juices rebuilds physical strength post-illness 3. Calc sulph (Calcium sulphate) The Blood Cleansing Salt purifies blood and detoxifies chronic conditions reduces infection and wounds that won't heal treats skin disorders such as pimples, acne and prevents blemishes by dissolving pus used at first sign of sore throat 4. Ferr phos (Iron phosphate) The First Aid Salt reduces inflammation (redness, pain, fever) and supports immune response boosts oxygen carrying capacity of red blood cells used to reduce fever and secretions for all stages of respiratory infections accelerates healing 5. Kali mur (Potassium Chloride) The Glandular Salt supports sluggish systems needing lymphatic drainage supports immunity by purifying the blood from any inflammatory condition helps in first stage of respiratory infections to reduce fever reduces swelling of lymph nodes aids digestion assisting the production of saliva, and ongoing metabolism 6. Kali phos (Potassium Phosphate) The Nervous System Salt supports nervous system health. mental energy and alertness reduces stress and anxiety , irritability supports sleep and reduces fatigue aids poor concentration and memory retention relieves headaches and nerve pains 7. Kali sulph (Potassium sulphate) The Skin Balancing Salt helps with the recovery from of skin conditions e.g., skin rashes psoriasis, Athlete's foot heals mucous membranes supports skin cell turnover and flaking balances metabolism conditions your pancreas 8. Mag phos (Magnesium Phosphate) The Muscle Relaxing Salt quick to relieve muscle cramps, aches, spasms (menstrual as well as muscle) eases pain (stabbing, shooting pains) relief for sciatica relieves tension headaches improves cellular metabolism by activating hundreds of enzymes in the body helps promote regular bowel movements 9. Nat mur (Sodium chloride) The Fluid Balance Salt assists dryness like dehydration, constipation, cracked lips, dry eyes assists excess fluid like hayfever, clear nasal discharge, watery eyes promotes hydration and supports uptake of other minerals into cells balances bodily fluids for steady energy and reduces water retention hydrates dry skin and supports moisture balance, treats eczema aids digestion as it supports stomach acid production activates the senses of taste and smell (it's like salting our cooking or meals) 10. Nat phos (Sodium phosphate) The Acid Neutraliser Salt alkalises acidity which is the crux of chronic disease aids acid indigestion, heartburn, reflux relieves sea-sickness supports joints and assists arthritis 11. Nat sulph (Sodium sulphate) The Water Eliminating Salt for fluid retention as it eliminates fluid from the cells for deep cleansing (e.g., cellulite) for cleansing of the pancreas, and kidneys ensures adequate healthy bile that supports gall bladder and liver function and is very important for liver detoxification helpful for flu symptoms 12. Silica The Cleansing & Eliminating Salt all skin and connective tissue conditions sometimes called 'the surgeon salt' as it allows the body to cut a passage for ejection of splinters, debris, pus from pimples, boils and styes, ingrown toe nails cleanses the blood strengthens hair, skin and nails Why Tissue Salts Shine Enhanced Absorption One significant difference between tissue salts and traditional nutrients is the level of absorption. Nutrients obtained from food often require digestive acids and enzymes to be adequately absorbed in the gastrointestinal tract. Factors like poor digestion and individual metabolic rates can significantly affect nutrient bioavailability. In contrast, tissue salts bypass many of these hurdles. Because they work at a cellular level, the body can absorb them quickly and effectively in the mouth. This makes them a more pragmatic choice for individuals with digestive system absorption issues or those who maintain specific dietary restrictions. Safe One of the common risks associated with traditional nutrients is the potential for overdose. Certain vitamins and minerals can lead to adverse effects when consumed in excess. Tissue salts, on the other hand, are renowned for their safety. The homeopathic nature of these salts ensures that they are essentially non-toxic, even in larger doses. This can provide peace of mind, especially for those managing complex, chronic conditions with pharmaceutical medications, or seeking natural options for recovery. They have no known cross reactions and are considered safe in pregnancy, for children and animals. Conclusion Whether you’re looking to alleviate specific ailments or foster a more general sense of wellbeing, considering tissue salts may just be your best move yet. If you would like to discuss their inclusion into your health goals, then please feel free to make a booking to discuss. Sign Up for Further Educational Material If you would like to make sure you don't miss a Blog update from me, or would like to receive more information in the form of upcoming e-Books and Online courses, then please subscribe to my mailing list at the bottom of the Blog front page. References: Schuessler Tissue Salts Guide The twelve tissue remedies of Schüssler   Martin & Pleasance Tissue Salt Range and Combinations ARTICLE/CONTENT DISCLAIMER The information provided in this blog/article/handout is for your personal or other non-commercial, educational purposes. It should not be considered as medical or professional advice. We recommend you consult with a GP or other healthcare professional before taking or omitting to take any action based on this blog/article/handout. While the author uses best endeavours to provide accurate and true content, the author makes no guarantees or promises and assumes no liability regarding the accuracy, reliability or completeness of the information presented. The information, opinions, and recommendations presented in this blog/article/handout are for general information only and any reliance on the information provided in this blog/article/handout is done at your own risk. Any third-party materials or content of any third-party site referenced in this blog/article/handout do not necessarily reflect the author’s opinion, standards or policies and the author does not assume any liability for them whatsoever.

The potential causes of elevated PSA (Prostate Specific Antigen) levels, how PSA levels rise, an understanding of how to interpret PSA pathology results, and guidance on herbal, nutritional and lifestyle solutions to help are all discussed in this blog. Prostate Specific Antigen (PSA) is a protein produced by cells in the prostate gland. It plays a role in the male reproductive system to liquefy semen. It is normal for small amounts of PSA to leak into the bloodstream. PSA levels are measured in the blood, and PSA tests are used to evaluate prostate health. Elevated PSA levels may indicate concerning prostate issues, but there are also other less concerning causes. Ensuring you get tested under optimal times and conditions (as discussed below) will assist with ensuring the results are more relevant, and often less concerning. Possible Causes of an Elevated PSA Result Image Source Elevated PSA Causes & Solutions There are many possible causes of elevated PSA (Prostate Specific Antigen) levels. They include: Prostate Cancer One of the most well-known reasons for elevated PSA levels is prostate cancer. While many men with high PSA levels do not have cancer, it is one of the primary concerns that drives further diagnostic testing such as biopsies and imaging studies. Elevated PSA levels on their own cannot be used to diagnose prostate cancer. Benign Prostatic Hyperplasia (BPH) Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate gland. This condition is prevalent in older men and can lead to elevated PSA levels. BPH can cause urinary issues such as: a frequent and urgent need for urination difficulty starting urination a weak urine stream that stops and starts an inability to completely empty the bladder dribbling at the end of urination increased desire for urination at night (nocturia) It is often heard said by urologists that 'men with BPH will likely die with an elevated PSA level, but not from it'. Prostatitis Prostatitis, or inflammation of the prostate gland, can also elevate PSA levels. This condition may be acute or chronic and often comes with symptoms such as pain during urination, pelvic discomfort, and flu-like symptoms. Other Factors Age is an undeniable factor affecting PSA levels. As men age, PSA levels tend to rise as the prostate gland itself gets larger with age and squeezes the urethra (the duct conveying urine from the bladder out of the body), causing the urination issues. Other contributing factors for elevated PSA levels can include urinary tract infections (UTI's), recent medical procedures involving the prostate (rectal examinations), certain medications like non-steroidal anti-inflammatories (NSAID's) e.g., Ibuprofen, vigorous exercise like bike riding, recently having had sex and ejaculated, or rectal prostate stimulation. Why Does PSA get Elevated in Older Men This is a little focused on the science (hang in there), but important to help understand the remedy. The male hormone testosterone gets converted to dihydrotestosterone (DHT) under the action of an enzyme called 5-alpha reductase type 2. DHT is far more potent than testosterone and has a particular affinity to receptors on the prostate with nasty growth factors being released that result in the enlarged prostate. The best way to block the conversion of testosterone to DHT is by reducing the impact of the 5-alpha reductase type 2 converting enzyme - in fact this is what pharmaceutical medication for men with BPH targets. As PSA gets released by the prostate, we will see an elevated PSA level as an enlarged prostate releases more PSA. Elevated PSA Herbal and Nutritional Solutions Should you have an elevated PSA associated with BPH (and not Prostate Cancer), and be looking for natural solutions, the following may be of help: There are herbs that act in the exact same way as pharmaceutical medications reducing 5-alpha reductase type 2 enzyme. These herbs are Saw Palmetto and Nettle. The other good news, is that 5-alpha reductase type 2 becomes stimulated under conditions of weight gain, insulin resistance and type 2 diabetes, so modifying your diet and lifestyle can be of great benefit in stemming the growth of the prostate, and reducing PSA levels. These solutions do not have a negative impact on your testosterone levels, sex drive or semen, but do have a positive impact on reducing the more dangerous converted form of testosterone (DHT) which causes the enlarged prostate. Understanding the PSA Test Results PSA exists as two forms in the blood: free PSA (not bound) bound PSA (bound to other blood proteins) Together the two forms make up the total amount of PSA (Total PSA). Types of PSA Blood Tests: Total PSA = sum of free (unbound) PSA and bound PSA. This is the test used primarily as a front-line screening test. The PSA ratio which utilises free PSA and total PSA results. The PSA Ratio is calculated when total PSA levels are slightly elevated and sit between 4 to 10 ug/L. The test measures the amount of free PSA versus total PSA in your blood. This helps to distinguish between benign prostate conditions and prostate cancer. A lower PSA ratio (below 10-15%) suggests a higher chance of prostate cancer. This is because in this scenario, free PSA is not bound to 'safe' proteins. Summary An elevated PSA result can stem from various conditions, ranging from benign to serious. It is essential to understand that elevated levels do not immediately imply cancer but warrant further investigation. Lifestyle changes that can support overall prostate health may include a balanced diet rich in colourful fruits and vegetables, and healthy fats ( Omega 3 ), reducing processed food and sugar consumption, regular exercise, maintaining a healthy weight, and the inclusion of herbs like Saw Palmetto and Nettle. If you would like some advice on herbal, nutritional, and lifestyle factors that may be supportive of improving elevated level PSA results and prostate symptoms, once it is confirmed by your medical practitioner that prostate cancer is not the cause, then please feel free to make an appointment. Sign Up for Further Educational Material If you would like to make sure you don't miss a Blog update from me, or would like to receive more information in the form of upcoming e-Books and Online courses, then please subscribe to my mailing list at the bottom of the Blog front page. References: 8 Causes of an Elevated PSA that are not Cancer Prostate Specific Antigen Explained ARTICLE/CONTENT DISCLAIMER The information provided in this blog/article/handout is for your personal or other non-commercial, educational purposes. It should not be considered as medical or professional advice. We recommend you consult with a GP or other healthcare professional before taking or omitting to take any action based on this blog/article/handout. While the author uses best endeavours to provide accurate and true content, the author makes no guarantees or promises and assumes no liability regarding the accuracy, reliability or completeness of the information presented. The information, opinions, and recommendations presented in this blog/article/handout are for general information only and any reliance on the information provided in this blog/article/handout is done at your own risk. Any third-party materials or content of any third-party site referenced in this blog/article/handout do not necessarily reflect the author’s opinion, standards or policies and the author does not assume any liability for them whatsoever.

The intricacies of thyroid testing discusses whether you have a thyroid issue, or contentiously, if the thyroid is simply responding to a range of underlying conditions, as it can in Hypothyroidism (an underachieve thyroid). It is important that you should always respond medically to Hyperthyroidism (an over-functioning thyroid) as it is an acute medical situation, or if you have noticeable swelling around your thyroid at the front of your neck. The differences between Hypothyroidism and Hyperthyroidism and their symptom pictures are discussed later in the blog, while the graphic below can show you a quick visualisation of some of the symptoms. Symptoms of Hypothyroidism and Hyperthyroidism Image source Damage to the thyroid gland can be from the long-term effect of altered physiology to the thyroid gland, from a process called the 'cell danger response ' in our bodies. The cell danger response is often from chronic, low grade inflammation which is a prominent condition in today's society, and its presence causes our cells to sense danger and alter their function. Our thyroid can be reacting in an adaptive, defensive and protective function to these chronic, low grade inflammatory stressors . The thyroid regulates the metabolism of virtually all cells and organs, and as such is the messenger of everything going on in your body . As our body systems don't act in isolation, if we were to ignore the messages, this may well result in eventual damage to the actual thyroid gland. This is not the beginning of the issue, but the end stage. Intricacies surrounding Thyroid Testing What are we really looking at when we test for thyroid physiology? For Hypothyroidism, you may be surprised to know that it's less about what's happening in the thyroid, but what is actually happening in all the cells in our body. Thyroid issues are 'the end game', not 'the start' of issues. In other words we are generally not born with a problematic thyroid gland. The thyroid gland is simply conveying messages that all is not well in our bodies. Often, issues with the thyroid are more about fixing other issues in our body, and as a result, thyroid issues will correct themselves after the other issues are treated. In this light, the thyroid is simply the messenger of bad news. It requires digging deeper to find out where the bad news is coming from. What is the Thyroid? The thyroid gland lies in the middle of our neck, and contains tissue filled with sticky colloid which is where our thyroid hormones are produced. While the thyroid has a big job of maintaining our body's health, issues with the thyroid can stem from parts of our body far away from the thyroid. Thyroid Disorders can be broken down into disorders of the thyroid gland, and disorders away from the thyroid gland. Disorders of the Thyroid Gland: Hyperthyroidism - where too much thyroid hormone is produced. Hyperthyroidism and Grave's Disease (an Autoimmune cause of Hyperthyroidism) can be fatal if not treated medically. See below for symptoms and ensure you see a medical doctor. Hypothyroidism - where too little thyroid hormone is produced. The most common cause is Hashimoto's Thyroiditis (an autoimmune disease). Iodine deficiency can also cause hypothyroidism, but iodine levels need evaluating before jumping to therapeutic conclusions as incorrect iodine supplementation can actually cause thyroid issues or make existing thyroid issues worse . As you'll read below there are far more common causes of hypothyroidism, and this is where a qualified naturopath can assist you. Thyroid Cancers - any swelling in the neck (goitre), or lump (nodule) should be investigated medically. Most cases are not cancerous, but need investigating medically. Disorders of Thyroid Physiology away from the Thyroid Gland: Central Hypothyroidism - issues from the pituitary or hypothalamus (both in the brain) impacting on the thyroid. Needs investigating medically. Euthyroid Sick Syndrome (also known as non-thyroidal illness syndrome or low T3 syndrome) - where low levels of T3 are found. This would be assessed medically. How does the Thyroid work? Many steps are involved in the generation of thyroid hormones: The hypothalamus in the brain releases a hormone that stimulates the pituitary in the brain to release TSH (Thyroid Stimulating Hormone). This TSH hormone is what is assessed as a screening test when you have your thyroid hormone checked. TSH is released into our bloodstream and targets the thyroid gland to release thyroid hormones via a number of steps: TSH triggers the transport of iodine into the thyroid Thyroglobulin (TG) is produced and transported into the thyroid. Thyroglobulin is the backbone of thyroid hormone. An enzyme called thyroid peroxidase enzyme (TPO) links the iodine to thyroglobulin. After the iodinated thyroglobulin is transported to a different area of the thyroid gland, it is broken down into individual thyroid hormones - Thyroxine (T4) and Triiodothyronine (T3). T4 and T3 are released into the blood and bound to carrier proteins (a.k.a police-guard), that are produced in our liver, like albumin and thyroid-binding globulin, to be transported to our cells all throughout our body. When T4 and T3 arrive at the cells, they are separated from the carrier proteins and become free T4 (FT4) and free T3 (FT3) and are the hormones that have a physiologic effect on us. Note: The deiodinase enzymes activate or deactivate our thyroid hormones. For example, if the enzymes sense the environment isn't safe they will store the hormone FT3 in a 'safe parking lot' called reverse T3 (rT3). It is this sensing that is critical to the functioning of our thyroid hormones, and is the link to the 'cell danger response'. The health of the liver, the gastrointestinal tract (GIT), as well as our muscles, are pivotal in determining how these enzymes work! The roles of Thyroid Hormones The thyroid hormones influence our metabolism, they control gene regulation, the production of reproductive hormones and other enzymes, and ensure we remain 'sensitive' (able to respond) to other substances like adrenalin and noradrenaline. Additionally, they are crucial for healthy foetal development. In terms of our metabolism, thyroid hormones control our metabolism by binding to receptors in our mitochondria located in our cells. Mitochondria are the suppliers of 'fuel' for energy for our body. Thyroid hormones turn on genes that regulate how we burn calories with the fuel (metabolism) in a process called glucose oxidation. Thyroid hormones functioning well are critically important for our overall health, not just the health of the thyroid. Testing of the Thyroid When you are initially medically tested for thyroid issues, you will only be tested for TSH as a screen. If it's abnormal, then further testing of Free T4 and possibly Free T3 hormones will occur. When TSH is abnormal, but FT4 and FT3 are normal, it is considered subclinical. Once TSH, FT4 and FT3 are all abnormal, it is considered clinical. If TSH appears 'normal', no further testing will occur medically. Sometimes, TSH appears normal, but there are symptoms present, and sometimes underlying autoantibodies. It's complex. It is important to know more about the TSH cut-off value for what is considered 'normal' or not. Although a subject of debate in scientific literature, there is contention around what the upper limit of TSH should be set at. Medically, TSH is set at around 4.5mU/L at which point values above will be managed with medication. Naturopaths however, are looking at prevention, and looking at your symptoms, and are looking to address sub-clinical Hypothyroidism at a TSH level greater than 2.0 mU/L, and to understand the possible causes in the attempt to ward off the necessity for medication, and to prevent thyroid dysfunction. Act early before you have a thyroid issue. Thyroid issues, in particular Hypothyroidism issues, are the end stage of stressors occurring in your body, and not the beginning. To comprehensively test for the underlying causes of thyroid issues it is best to test for TSH, FT4, FT3, rT3, Urinary Iodine, Plasma Selenium, and thyroid autoantibodies - TPO and TG (for Hypothyroidism) and TSI (for Hyperthyroidism). Iodine and selenium are essential nutrients for thyroid health as discussed below so we need to know their levels. Additionally, a full work-up of other routine pathology markers is required for supportive evidence on the underlying causes. TSH FT4 FT3 Interpretation Normal Normal Normal Normal thyroid function Elevated Normal Normal Sub-clinical Hypothyroidism Elevated Decreased Decreased (or Normal) Hypothyroidism Decreased Normal Normal Subclinical (or mild over-active) Hyperthyroidism Decreased Elevated (or Normal) Elevated (or Normal) Hyperthyroidism Decreased Decreased Decreased Non-thyroidal illness (central hypothyroidism) Table highlighting Thyroid Results The secret to understanding thyroid-related issues is to understand the underlying stressors, and focusing on that, while at the same time supporting our cells, thyroid and full body to recover. The use of supplements should also never be seen as a forever therapy, as they, like medication, don't fix the problem. What are the Stressors of the Thyroid? If stressors aren't dealt with and become chronic scenarios, we can end up with thyroid issues. Some of the stressors include: Insulin Resistance Obesity (BMI>30) as excess fat is considered a goitrogen (a disruptor of thyroid hormones) Over consumption of carbohydrates (Obesity) Polycystic Ovarian Syndrome (PCOS) Very restrictive consumption of carbohydrates (Starvation) Malnutrition (insufficient provision of required nutrients) Heavy metals e.g. mercury amalgams, lead pipes Mould and mycotoxin exposure Anaemia Endocrine disrupting chemicals e.g. fragrances, candles, plastics Fluoride (in unfiltered water) Fatty liver (either alcoholic or non-alcoholic causes) Poor phase II liver detoxification (glucuronidation, sulphation) Pesticide exposure e.g. glyphosate Acute and chronic illness Post-partum Sarcopenia (loss of muscle mass from inactivity) Medications (Glucocorticoids, amphetamines, beta blockers, antidepressants etc) Insufficient sleep and poor sleep regulation Over-consumption of green smoothies with high goitrogen levels Over-consumption of cured meats with nitrates in them e.g. bacon Gut dysbiosis with beta-glucuronidase enzyme producing bacteria Post viral infections and resultant potential high levels of inflammation from IL-6 Perimenopause and menopause Smoking Excess soy consumption Chronic Fatigue Syndrome (or mitochondrial dysfunction where the energy powerhouse doesn't work well) Sleep apnea Unhealthy food and lifestyle choices Nutrients required for Optimal Thyroid Performance Nutrient Comments Iodine Thyroid hormone production relies on sufficient amounts of iodine. Too little iodine can cause issues with our ability to form thyroid hormones that can lead to goitre and hypothyroidism. It can also lead to mental retardation which can be seen in developing countries. However, excess iodine can similarly cause issues with our immune response regulation (TReg cells) and invoke autoimmune disease. CAUTION: Too much or too little Iodine can cause serious issues so please don't self prescribe. A Urinary Iodine test that is corrected for Creatinine needs to be performed to assess levels. Seaweed (Nori flakes) sprinkled in meals helps boost levels naturally. Selenium Selenium is a vital co-factor for the enzyme that converts T4 to T3 (which is the active hormone we need). Selenium is a nutrient we use a lot of when our body endures oxidative stress. It supports glutathione production (our body's major antioxidant). Without adequate Selenium, our body is subject to destruction from inflammation where hydrogen peroxide is produced, and in the thyroid this means the thyroid gland is destroyed. It is best to understand what is causing this oxidative stress while supporting with Selenium. CAUTION: Once again, Selenium can be toxic at a high daily dose level, so please don't self-prescribe. Eating just 1 Brazil nut a day to boost levels naturally can help. Vitamin B2 (Riboflavin) Vitamin B2 is required for iodine absorption, and is best utilised in the active form (and taken in a B-complex formula if supplemented) when there is an under-active thyroid issue. Iron Iron is needed to enable the effectiveness of iodine for the creation of thyroid hormones (T4). Oysters are a great source. Zinc Zinc is needed as a cofactor for T4 and T3 production as well as TSH. Zinc needs to be in a 1:1 ratio with Copper. Zinc deficiency drives reductions in iron, HCl acid to break down our foods, Vitamin A which the drives copper and iron deficiency. If you're zinc deficient, we need to find out why. Oysters are a great way to balance zinc and copper and help iron. Vitamin A Required for TSH production. Enjoy your orange vegetables. Vitamin D Acting more as a hormone, Vitamin D is needed to protect against autoimmune issues. Get some sun in the early morning or late afternoon to avoid skin cancer. Magnesium Required for mitochondria in our cells. Magnesium is required in nearly everyone and may need supplementation in our modern world. Inositol (sometimes referred to as Vitamin B8) Influences the regulation of hormones, including regulating insulin resistance, which can be a trigger for thyroid issues. It also regulates reproductive hormones including androgens which may be in excess, especially if you are insulin resistant. It can also lower triglycerides present in fatty liver. Enjoying your citrus fruits can help. Table highlighting the required nutrients for thyroid hormone production Thyroid Symptom Picture Hypothyroidism Hypothyroidism symptoms, can be present for a long time before your pathology results go awry. As well, there is the contention over what the upper limit of TSH sceening results should be. Symptoms of Hypothyroidism can include: Low Basal Body Temperature (<36.4 degrees Celsius) Weight gain Fatigue Thinning hair Nails won't grow Brain fog Constipation Voice becomes hoarse Speech slows Muscle weakness and aches and pains Cold intolerance Cold hands and feet Depression and other neurotransmitter disorders Joint pain Goitre Dry, and thickened skin Poor memory Puffy face, eyes, hands and feet Thinning of outer third of eyebrows Menstrual disorders Fertility problems Poor digestion and motility Gut dysbiosis GORD (Gastro Oesophageal Reflux) Low libido Fatty liver disease Elevated cholesterol and elevated LDL If Hypothyroidism is present but there are sufficient levels of iodine, then Hashimoto's Thyroiditis, the autoimmune condition may be present. What's triggering that? Autoimmune diseases are generally described as the body going rogue and attacking itself, but what is the real reason? Our immune system relies on knowing what should be in certain parts of our body, and what shouldn't be. If something (a stressor) is present where it shouldn't be, we mount an acute inflammatory response. This is good and clears infections etc quickly. If the presence of the 'stressor' remains and is chronic, be it an organism, a toxin, a food, emotional stress, too much physical stress etc, then the body will continue to mount an inflammatory response. This can trigger an imbalanced immune response resulting in an autoimmune response. Hashimoto's thyroiditis typically occurs as a protective mechanism against long term chronic cellular stressors. The result is a slowed down metabolism, and autoantibodies against TPO and TG which can be seen in our blood tests, often before any other result is abnormal (including a TSH above 2.0 mU/L. If your are experiencing Hypothyroid symptoms and you want to be screened comprehensively, please see a qualified naturopath experienced in this like myself. Hypothyroidism has been additionally linked to: GIT issues Bile issues Fatty Liver issues Glucose regulation issues Adrenal hormone issues Immune system issues Sex hormone, ovulation, fertility issues Neurotransmitter issues Hyperthyroidism A serious condition that needs urgent medical treatment due to the implications on the heart. Symptoms of Hyperthyroidism: Increased heart rate (tachycardia where there is >100 beats/ minute) Heart palpitations Heart arrhythmia Shortness of breath Increased sweating and heat intolerance Unexplained weight loss Increased appetite Insomnia Irritability, nervousness, anxiety Tremors More frequent bowel movements Thyroid Eye Disease (bulging) Like Hypothyroidism, something in the body can trigger the immune response to produce antibodies to the same triggers - physical, emotional, chemical, microbial etc. An autoimmune response can be triggered. In hyperthyroid conditions this is called Grave's Disease and is where an autoantiantibody (TSI) mimics TSH thereby overstimulating the thyroid gland to produce excessive amounts of thyroid hormones. Hyperthyroid conditions seen by the symptoms above should always be assessed by a medical doctor. Summary If you can see that there is a bigger picture where thyroid issues are more often linked to stressors like inflammation, obesity, insulin resistance, fatty liver, chemicals, hormone disruptors, mould exposure, heavy metal exposure, which are often lifestyle related issues, then you would be understanding that treating thyroid issues comes back to treating those underlying stressors. Other pathology results can be indicators of stressors indicating inflammation and oxidative stress, showing potentially that multiple systems have been impacted. These may include: Elevated cholesterol and triglycerides Elevated MCV and RDW in a FBC Uric acid elevation Ferritin levels >25 (Ferritin is an inflammatory marker as well as an indicator of iron storage) Elevated CRP, ESR, IL-6 Elevated Homocysteine Elevated albumin Low or elevated Bilirubin Elevated fibrinogen Low Vitamin D Low B12, folate, iron, zinc, magnesium Elevated HbA1c, insulin Elevated prolactin Elevated liver function enzymes ALT, AST, GGT while low ALP and LDH Low sodium Decreased eGFR Fun facts and cautions Did you know that the time of day you have your blood collected can also impact on your TSH and FT3 results? Aim to be at the collection centre before 9am, and less than 10 hours after you've fasted, ensuring you've had a glass of water beforehand and not performed strenuous exercise in the days prior. Delaying the time of collection is almost pointless as it can make hypothyroid cases look normal or even hyperthyroid. Additionally, if you check your thyroid results annually, try to ensure you are testing at the same time each year as the results can be affected by the seasonal changes. What to do if you have thyroid issues A lot of the time our health concerns are all linked. Some simple steps to begin to rectify this connection can be: Eating whole foods and in season Sleeping well and making it a priority Diaphragmatic breathing and consciously not sitting and shallow breathing Not letting stress live 'rent-free' in your head Gentle exercise (not stressful) Committing to small changes is usually the biggest thing we can do A clean environment as much as we can control Metabolic fitness by looking after our biochemical pathways with nutrition Looking after the genes we've inherited, and nutritionally altering the not so good genes we've inherited, are all steps we can take. "The journey of 1000 miles starts with the first step" If you would like to discuss your personal circumstances and discuss your thyroid concerns, get comprehensive thyroid testing performed or review your existing results, and get on the road to improving your health, then please don't hesitate to make a booking with me. Sign Up for Further Educational Material If you would like to make sure you don't miss a Blog update from me, or would like to receive more information in the form of upcoming e-Books and Online courses, then please subscribe to my mailing list at the bottom of the Blog front page. References: R.K. Naviaux, "Metabolic Features of the Cell Danger Response," Mitochondrian 16 (May 2014):7-17, doi:10.1016.j.mito.2013.08.006. Pubmed 23981537 'The Thyroid Debacle' by Dr. Eric Balcavage & Dr. Kelly Halderman Pathology Tests Explained Clinical Foundations Hypothyroidism, Bioconcepts Engage Education ARTICLE/CONTENT DISCLAIMER The information provided in this blog/article/handout is for your personal or other non-commercial, educational purposes. It should not be considered as medical or professional advice. We recommend you consult with a GP or other healthcare professional before taking or omitting to take any action based on this blog/article/handout. While the author uses best endeavours to provide accurate and true content, the author makes no guarantees or promises and assumes no liability regarding the accuracy, reliability or completeness of the information presented. The information, opinions, and recommendations presented in this blog/article/handout are for general information only and any reliance on the information provided in this blog/article/handout is done at your own risk. Any third-party materials or content of any third-party site referenced in this blog/article/handout do not necessarily reflect the author’s opinion, standards or policies and the author does not assume any liability for them whatsoever.

Non-Alcoholic Fatty Liver Disease (NAFLD) is a disease of the liver not related to alcohol consumption, but rather from our diet and lifestyle that results in fatty deposits in the liver. It is now often referred to as Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD). How to fix Non-Alcoholic Fatty Liver Disease? Changing your diet to reflect a Mediterranean Diet can be a real life saver. What is Non-Alcoholic Fatty Liver Disease? Liver disease is the spectrum of liver damage ranging from Non-Alcoholic Fatty Liver Disease (NAFLD), to Non-Alcoholic SteatoHepatitis (NASH), to Cirrhosis and Hepatocellular Cancer (HCC or Liver Cancer.) NASH is the more aggressive form of NAFLD, is irreversible, and as a consequence places the person at significant risk of death from liver failure. Non-Alcoholic Fatty Liver Disease (NAFLD) is present in approximately 30% of the world's population. It coexists with the majority of people who are obese and have Type-2 Diabetes (T2DM) and is characterised by increased triglyceride and increased insulin levels. It is the manifestation of Metabolic Syndrome in the liver. Difference between NAFLD and NASH and HCC NAFLD - there is fat accumulation in the liver cells plus insulin resistance in NAFLD. Importantly, this is a reversible condition . NASH - where there is further oxidative stress, endotoxins and inflammatory cells infiltrating the liver. From this point on it is an irreversible condition . HCC - 'ballooning' of the liver in the presence or absence of fibrosis. This is an irreversible condition . Cirrhosis is a complication of NAFLD and NASH from the liver trying to prevent inflammation, where scarring (fibrosis) occurs. Fibrosis occupies more space in the liver, hence why you can 'see' an inflamed liver underneath peoples clothing. Statistics: 30% of NAFLD progresses to NASH 20% of NASH progresses to Cirrhosis Reversible and irreversible paths in Liver Disease Image source How does Non-Alcoholic Fatty Liver Disease Develop? There are several mechanisms believed to be behind the formation of NAFLD. These include: Fatty Acid Metabolism Imbalance Excess fat consumption and excess food consumption in general leads to excess fatty acids and glucose, causes insulin resistance. This causes fatty deposits in liver cells. It is important to note that fatty deposits do not just come from fat consumption. Excess fat consumption can also cause potential issues with oxalate formation (kidney stones and painful arthritis-like symptoms). Endotoxin Behaviour Certain bacteria in our gut microbiome (Gram negative bacteria with endotoxins in their cell walls), trigger our innate immune system , resulting in the release of pro-inflammatory cytokines (IL-6, IL-1, TNF-a) which is not desirable. How do we get these gram negative bacteria in the first place? Dietary choices we make like meals high in red meat, saturated fat, processed foods etc and low in dietary fibre. If we combine this with a leaky gut (intestinal permeability) which occurs in settings where there may be nutritional or environmental issues, or diabetes for example, then the endotoxins are able to cross directly into our blood circulation via the portal vein, which has direct access to the liver. So this means inflammatory substances go straight to the liver, which is not desirable. Often there is bacterial overgrowth in our gut microbiome that is pro-inflammatory from dietary choices, setting us up for inflammation in the liver. This is one reason why we test the gut microbiome to test what sort of microbiota you have hanging out. Oxidative Stress Pro-inflammation from the gram negative bacteria results in oxidative stress, which means the production of reactive oxygen species (ROS) which is again not desirable. The products of this lipid peroxidation go on to alter our mitochondrial DNA, and trigger NFkB (a.k.a. the project manager of inflammation) that upregulates TNFa that leads to even more pro-inflammatory changes and even further mitochondrial reactive oxygen species (ROS). Think - bushfire! It is known that the microbiota that live in the distal colon (last part of the colon), absorb short chain fatty acids ( SCFA ) from fibre - which is a good thing. In the absence of a diet high in dietary fibre, the distal colon will absorb protein which results in harmful products like ammonia, branched chain fatty acids (BCAA), hydrogen sulphide, phenols etc. If we absorb SCFA then we get the positive effects of insulin secretion, feel satiated, and we stimulate anti-inflamatory processes - a great thing! However if we absorb the harmful effects of protein in a heavy meat, low vegetables and fruits diet, then we get harmful inflammation of the liver, and fat accumulation in the liver a.k.a the beginnings of NAFLD. Dietary changes to include more fibre need to happen to prevent this from progressing further down the spectrum of liver disease. Remember that at this atge it is reversible, but if ignored it will be irreversible, and on a negative final trajectory for your life. Prebiotic fibre can assist greatly, as can ensuring you have lots of vegetables and fibre to 'outweigh' the heavy protein diet. Increasing fibre provides a mix of prebiotic fibres to prevent obesity, NAFLD and T2DM. Supplementing with prebiotic fibre is crucial at this point. How eating can predict if you are going to develop NAFLD based on gut microbiome inhabitants Image source Symptoms of NAFLD Often there are no signs and symptoms at all, but can include: Fatigue Malaise Pain in upper right rib area Conditions associated with NAFLD include obesity, insulin resistance, obstructive sleep apnoea, hypothyroidism, hypertension, polycystic ovarian syndrome (PCOS from Insulin Resistance) Symptoms of NASH Itchy skin Ascites Shortness of Breath Swelling of legs Spider veins beneath skin Enlarged spleen Red palms Yellowing of skin and eyes Complications can include swollen veins in oesophagus (oesophageal varices that can result in deathly bleeding), sleepiness, slurred speech, Liver cancer and finally Liver failure. How to Fix Non-Alcoholic Fatty Liver Disease? Dietary choices designed to follow a Mediterranean Diet Increase fibre for prebiotic effects Minimise protein from red meat sources Eats walnuts, chia seeds and oily fish for omega-3 (anti-inflammatory) Eat seeds for antioxidant effect from Vitamin E Consume unsaturated fats (olive oil, avocados, nut butters like almond butter) Eat green, leafy vegetables to prevent fat build up Lower blood lipids (Bergamot, Aged Garlic) Lower blood sugar dysregulation (Berberine) Supplements to consider As shown by the graphics below, there are suitable supplements to incorporate into your diet that should be discussed with a qualified practitioner before use. For example, globe artichoke may cause problems if you have gallstones which are often found with NAFLD. Supplements as well as Interventions, Testing, Diet, Lifestyle for NAFLD Image source Actions of supplements shown on the progressive spectrum of NAFLD and how they intervene is shown in the graphic below. The 4 stages of NAFLD progression with supplement interventions that can be life saving Image source Pathology results Pathology results can give amazing insight into liver conditions. Markers to watch for fatty food consumption or excess glucose consumption are triglycerides and fasting insulin. Liver enzymes can become elevated, and ALT should be 'watched like a hawk'. It often begins to rise in insulin resistance. AST also provides valuable insight. A marker that can give a clue to excess protein consumption is ALP, which is required to break down protein. If your diet is high in protein and low in dietary fibre, then you may have an elevated ALP level, and be on the path to developing NAFLD. Pathology results should always be viewed closely by a qualified practitioner. If you would like to discuss your concerns around elevated liver enzymes, or concerns about your diet and lifestyle, or about non-alcoholic fatty liver disease (NAFLD), and put plans in place to correct this reversible condition before it becomes irreversible, then please don't hesitate to make a booking with me. Sign Up for Further Educational Material If you would like to make sure you don't miss a Blog update from me, or would like to receive more information in the form of upcoming e-Books and Online courses, then please subscribe to my mailing list at the bottom of the Blog front page. References: Metabolic Spectrum of Liver Failure in Type 2 Diabetes and Obesity: From NAFLD to NASH to HCC Gut microbial metabolites in obesity, NAFLD and T2DM Non alcoholic fatty liver disease Nutraceutical approaches to non-alcoholic fatty liver disease (NAFLD): A position paper from the International Lipid Expert Panel (ILEP) Rethinking healthy eating in light of the gut microbiome ARTICLE/CONTENT DISCLAIMER The information provided in this blog/article/handout is for your personal or other non-commercial, educational purposes. It should not be considered as medical or professional advice. We recommend you consult with a GP or other healthcare professional before taking or omitting to take any action based on this blog/article/handout. While the author uses best endeavours to provide accurate and true content, the author makes no guarantees or promises and assumes no liability regarding the accuracy, reliability or completeness of the information presented. The information, opinions, and recommendations presented in this blog/article/handout are for general information only and any reliance on the information provided in this blog/article/handout is done at your own risk. Any third-party materials or content of any third-party site referenced in this blog/article/handout do not necessarily reflect the author’s opinion, standards or policies and the author does not assume any liability for them whatsoever.