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Histamine intolerance is not an illness but rather a symptom of underlying health conditions. It is when the accumulation of histamine is beyond the body’s capacity to process it. The root cause needs to be found and treated. Eating histamine free foods is not treating the root cause. Finding out why the body makes too much histamine, or doesn’t break it down well is finding out the root cause. What is Histamine and why do we get intolerance issues? A vasoactive amine that dilates our blood vessels allowing for an inflammatory response to occur. It plays an important role in the early acute inflammatory response. When we are exposed to substances our body decides shouldn't be there, stored Histamine is released by white blood cells. Those cells can be mast cells which are quick acting and can be anaphylactic. Other cells include basophils and platelets when required. This can be when there is tissue injury; constriction of smooth muscle in our bronchioles (asthma); or constriction of smooth muscle in the uterus (period cramps & pain). Histamine is required to stimulate gastric secretions (HCl) , to stimulate mucous secretion and to stimulate oestrogen. It is also a neurotransmitter that controls and regulates other neurotransmitters. In the brain, it is an excitatory neurotransmitter and there are potential links with excitatory mood issues. It is when histamine is out of balance that we have issues. A low grade, chronic inflammatory response can cause excess histamine for example, and this can happen if our body is trying to remove substances it has determined shouldn't be present, over a long period of time. Some of our modern lifestyle factors can contribute to this. Histamine Intolerance symptoms Many varied symptoms as the graphic shows, including migraines, nasal congestion, anxiety, hives, chronic reflux, insomnia, heart palpitations, nausea, bloating, digestive issues, irregular menstrual cycle, painful menstrual cycle, dizziness, asthma, sinus issues, gas and bloating and many more. Histamine Intolerance can show signs all over the body. Image source What are the many and varied causes of Histamine Intolerance? The graphic shows how Histamine Intolerance can begin. Additionally, the long list below gives an insight into the process of determining the root cause. It can be a slow process to uncover the cause. The multiple causes behind histamine intolerance. Image source When we start investigating the root cause of histamine intolerance, we start in the gut . As Hippocrates said - "All disease begins in the gut". 1. Imbalance of Gut Bacteria – the majority of people have gut issues, where we get increased histamine, and have a reduction of DAO enzyme that breaks Histamine down. Initially we may have gut issues (reflux, bloating, cramping, diarrhoea), and if histamine breaks through gut to the bloodstream we may get hives, migraines, heart palpitations, anxiety, insomnia, and vertigo. Types of gut issues include: a. SIBO (Small intestinal bacterial overgrowth ) , or dysbiosis in the small intestine. Bacteria lodge in the small intestine. They are usually found in the large intestine producing healthy short chain fatty acids - SCFA, and whose job is to break down vegetables/ starches. If they have relocated to the small intestine, and break down fibres, they produce gas (hydrogen, methane, hydrogen sulphide). Hence we can experience bloating, belching, flatulence, abdominal pain, nausea, constipation, diarrhoea, malabsorption, weight loss, and malnutrition. The gases produced reduce the DAO enzyme that is responsible for breaking down histamine, as the gases damage the microvilli in our gut wall that stores DAO. Additionally, excessive harmful bacteria release LPS (lipopolysaccharides) that increases the Histidine conversion to Histamine so this results in an increase in Histamine. LPS can trigger an immune reaction, that triggers inflammation, that damages gut wall cells, that leads to 'leaky gut' allowing histamine to cross into the bloodstream. Zonulin regulates the gut integrity, and it gets released upon insult. Histamine intolerance is therefore related to increased zonulin levels. b. SIFO (Small intestinal fungal overgrowth) - Yeast and Candida contain oxalates that cause tissue damage and subsequent histamine release. Additionally, fungus can act like penicillin antibiotic so it can alter the gut microbiome, and increase histamine release from mast cells. c. Starch and Carbohydrate Malabsorption – Dysbiotic bacteria ferment FODMAP foods (Fermentable Oligosaccharides, Disaccharides, Monosaccharides and Polyols) in the small intestine when this should normally happen in the large intestine. As a result, inflammation can occur in the small intestine. d. Inflammation – Inflammatory 'pathogens' stimulate the release of histamine and cause leaky gut allowing histamine into our blood stream causing systemic symptoms. It requires a well functioning immune system. The majority of our front-line immune response is in our gut known as secretory IgA and if you are low in this, your ability to defend is low. If your secretory IgA is elevated, then this confirms you are fighting inflammation, intestinal permeability, infection or immune dysregulation. e. Leaky gut - Histamine release can damage the microvilli enabling undigested foods to pass into the bloodstream and cause an inflammatory response. f. Overgrowth of histamine producing bacteria – LPS (lipopolysaccharides toxins) that are present on the outer membrane of Gram-negative bacteria e.g H. pylori, E. coli, Klebsiella, Pseudomonas, Campylobacter, Salmonella), can increase histamine. 2. H.pylori – Gram-negative bacteria that releases LPS with subsequent mucosal damage that stimulates mast cells to release histamine. 3. Digestive Enzyme Insufficiency – Digestive enzymes prevent a build-up of histamine as Hydrochloric acid (HCL), pancreatic juices and bile are all antimicrobial. HCl is secreted by stomach, is lovely and acidic, and breaks down food. It also then stimulates bile and pancreatic juices (that contain sodium bicarbonate which is alkaline). They pour into the Small Intestine which is where we want it to be alkaline. An acidic environment in the small intestine is favourable for bacteria we don't want there, so we want good enzymes to help create an alkaline environment. Less HCl breakdown of food = more food for bacteria to eat, enabling them to dominate, and it leads to SIBO. SIBO increases inflammation, reduces DAO activity, leading to increased histamine. In this situation, once histamine is released, THEN HCl gets released that leads to reflux at the WRONG time. Dietary changes can assist improve this. 4. Gluten intolerance – gluten resists digestion, and can cause Zonulin to be released, not only in people with Coeliac Disease. Zonulin can then disassemble tight junctions in our small intestine, and lead to leaky gut. Unwanted pathogens can get through the gut wall, cause inflammation, and histamine can get released. The causes are firstly Coeliac disease, where there is flattened microvilli where DAO is located, so there is a reduced ability to breakdown histamine. Wheat allergy is another cause. Wheat is recognised by the body as an antigen, and the body makes IgE. The IgE binds to receptors on mast cells and basophils, and histamine released (rapidly). This is known as a Type I hypersensitivity reactions (rapid) – that can lead to anaphylaxis, asthma, atopic dermatitis, hives. A Type IV (12-72 hours) reaction can also occur in those people that are non-coeliac gluten sensitivity, and gut inflammation and leaky gut are present. 5. Mast Cell Activation Syndrome (MCAS) - MCAS can occur from mould, heavy metals and glyphosate exposure. Glyphosphate is a weed spray used on crops. It is normal for mast cells to release histamine, but in MCAS they’re hyperactive and release histamine, cytokines, prostaglandins, interleukins, heparin which are all inflammatory. This hyperactive state can’t be switched off, hence chronic inflammation persists and histamine intolerance develops. 6. Oxalates – are found in foods. We also make them when our bodies are under stress, and Candida can produce them. Oxalates can bind up our nutrients and make us deficient. We can become deficient in Calcium, magnesium, and Vitamin B6. You can also get kidney stones from oxalates. Interestingly, unabsorbed fat from bile insufficiency also binds to calcium, and given bile insufficiency can also occur in people with histamine issues, it can become interesting to tease apart. Oxalates can also occur in kidney stones. Interestingly oxalates can get stored in connective tissue where there may be previous injuries that over time get even more painful. It may not been an autoimmune issue with joint pains, but rather an oxalate issue. 7. Candida – Candida comes from a high sugary diet and can liberate oxalates. 8. Inflammatory Bowel Disease (IBD) – inflammation from it leads to a reduction of DAO enzyme, and a subsequent increase in histamine release. More histamine with little ability to break it down. 9. High Histamine Containing Foods – high histamine foods, foods containing other biogenic amines, histamine liberators, and DAO enzyme inhibitors (like alcohol and chocolate can prevent our DAO enzyme from breaking down histamine). A lot of us have resorted to nut milks, and nut flours which all contain oxalates which as we've seen above can cause histamine issues. Enjoy foods in moderation, and eat foods that are seasonal. Live like our ancestors did. 10. Oestrogen – if we are constipated, we may experience detoxification issues with oestrogen, as we need need daily bowel movements to eliminate detoxified hormones. Unfortunately, B-glucuronidase enzymes from certain bacteria in our gut can deconjugate, or uncouple bound up oestrogen, histamine and bile that was ready for elimination. This then results in recirculating oestrogen, now in excess as new oestrogen has been produced by the body. Excess oestrogen down-regulates the DAO enzyme. Oestrogen can also stimulate the release of histamine from mast cells. Histamine also stimulates the ovaries to make even more oestrogen. This cycle goes round and around. Oestrogen leads to Histamine release, that leads to recirculating oestrogen etc. Think of this if you have high oestrogen symptoms like endometriosis, painful and heavy menstrual cycles etc. 11. Methylation issues – if you have histamine issues, gut issues and oestrogen excess, then you won’t be methylating properly, and methylation is required for many purposes in the body. In relation to histamine, methylation is required for the HNMT enzyme (which breaks down histamine in the brain) and COMT enzyme (which detoxifies oestrogen in the liver). Methylation BREAKS DOWN Histamine, and Methylation requires good nutrition. Methylation is needed to break down histamine but without clearing high histamine first, methylated folate, B12 and SAMe supplements can make your histamine issues worse. We take this slowly in treatment. 12. Genetic polymorphisms – MTHFR, DAO, HNMT, COMT are genes that code for enzymes that perform functions in our bodies. Methylation is required for HNMT and COMT to work. If COMT is not working, you can get oestrogen detoxification issues, and increased oestrogen can lead to increased histamine. DAO in particular impacts how sensitive you are to the environment, particularly food and toxins. It impacts your response to histamine, which in turn can influence how sensitive or allergic you are to various foods. Issues with DAO can create itchy skin, hives, runny nose, leaky gut, food sensitivities, SIBO, migraines, nausea/indigestion, pregnancy complications, and irritability. The wonderful news is that genetics can be altered through dietary and lifestyle changes (this is the science of Nutrigenomics). 13. Medications - can interfere with histamine breakdown. 14. Nutritional deficiencies - The DAO enzyme that breaks down extra-cellular histamine needs calcium and copper. The HNMT enzyme that breaks down intracellular histamine in our brain needs good methylation (that needs folate and Vitamin B12 to produce SAMe). The MAO-B enzyme needs Vitamin B2 to continue the HNMT breakdown. Many other vitamins and minerals are required to drive the bodily processes. To make it worse, the methylation process suffers under high histamine conditions as it is in high demand. The required cofactors get easily consumed. Our neurotransmitters, and our most powerful antioxidant Glutathione can start suffering. We can see signs of this on blood tests with our Homocysteine levels. It is easy to see why histamine issues present with so many symptoms. 15. Vigorous exercise - Finally, you may get really itchy or flush easily when you exercise intensely. Who needs an excuse not to exercise so hard? A reminder of the diversity of Histamine Symptoms and their effects Image from: Maintz, L & Novak, N, (2007) 'Histamine and Histamine Intolerance' How to test for Histamine Intolerance? Find out the root cause. Don't jump to conclusions. Not everyone has Mast Cell Activation Syndrome from mould exposure. Start by testing the gut microbiome first as the majority of histamine intolerance stems from inflammatory issues in the gut. Inflammation drives histamine issues. With the majority of our immune system in our gut monitoring us for inflammation, you can understand why testing starts first in the gut. Many, many further additional tests are available depending on your signs and symptoms, and how much information you want to know. It is best to take the investigation of histamine issues step by step and narrow it down. Working with a qualified naturopath who is experienced in dealing with histamine issues can help with this. I can do that for you. Histamine Intolerance Issues - Beyond the why to what next? Once confirmation of the cause has been found, we can work together to repair the situation. A lot simply comes down to dietary and lifestyle changes. If you would like to discuss your Histamine Intolerance issues with me, please make a booking on my website bookings page via the booking link below. I'd only be too happy to assist you. My pathology background means I am very experienced in interpreting general pathology and more detailed functional test results. I can simplify the results so you understand what is going on easily. We can then start assisting you early and with confidence! 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: Histamine Intolerance Dirty Genes - The Histamine Workbook , Dr. Ben Lynch Seeking Health Dirty Gene s Mast Cell 360 Image from: Maintz, L & Novak, N, (2007) 'Histamine and Histamine Intolerance' 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.

So you've gotten your pathology results back and your cholesterol is high. What do you do? Contrary to popular belief, cholesterol may not be the best test for predictor of cardiovascular disease. There are 3 myths surrounding cholesterol: Total Cholesterol has no value in predicting heart disease. Cholesterol is the firefighter trying to put out the fire (inflammation in your body) LDL cholesterol isn't always 'bad cholesterol' HDL cholesterol isn't always 'good cholesterol Elevated Triglycerides, from excess consumption of carbohydrate, sugars and alcohol, is the real marker to watch. Triglycerides, along with glucose monitoring markers are now known as the greatest blood predictors of Cardiovascular Disease, Type 2 Diabetes, Insulin Resistance, Metabolic Syndrome and more. Cholesterol & Triglycerides Management Explained Cholesterol & Triglyceride management in the body is very regulated as will be explained. It's when the regulatory processes don't function because they're overwhelmed that we have a problem. What overwhelms them? Let's look at the process, and define the roles of some of the test markers, to find out. Fun fact: Vitamin E relies on the same transport system we will discuss. If this system is shut down with medication, our ability to utilise Vitamin E to protect against oxidative stress is hindered! Dietary fats (lipids) include anything fatty that we've eaten, including foods containing cholesterol, triglycerides, fat-soluble vitamins (Vitamins A,E,D,K) and more. Most cholesterol (75%) is not obtained from our foods , but generated from our bodies as will be discussed below. ApoLipoproteins Are proteins that form part of the 'protective coat' that surrounds dietary fats to enable them to be water soluble. Phospholipids are the other part of the coat. ApoLipoprotein components, which will be discussed below, include: ApoA1 - includes HDL ApoB - includes Chylomicrons, VLDL, IDL, LDL, Lp(a) LipoProteins Lipoproteins = Dietary Lipids + Apolipoproteins (This is the reason why we need to be fasting, so we don't include lipids from our food in our test results). Total cholesterol is the sum of all the Apolipoproteins, plus any dietary fat if we haven't fasted. It is not a very specific marker of what is going on in our bodies. The conversion of dietary fat to Triglycerides and Cholesterol Image source When we eat dietary fats, they get transported to the small intestine. As they are fatty, in a watery environment, they need help to become water soluble. This is where Lipoproteins come in. They join on to the dietary fat. Their jobs are to enable the dietary fats to become water soluble, and to enable triglycerides to be liberated for the body's energy needs. Chylomicrons Chylomicrons from the cells of the small intestine are initially involved, immediately after we've eaten. Chylomicrons, are mostly triglycerides, and get absorbed into our lymphatic system and then into our bloodstream, and their job is to deliver broken down triglycerides (fatty acids and glycerol) from the food we've just eaten. Some of the triglyceride components (fatty acids) get delivered to our muscle cells (for use when we are active), or to our fat cells that get reassembled back into triglycerides (if we are inactive). This is a major reason why going for a walk after we've eaten is so valuable, so we help the lymphatic system . To reassemble into triglycerides, the body needs carbohydrates, or alcohol. This is why people with diets high in either carbohydrates or alcohol can have high triglyceride levels , which is a negative indicator for cardiovascular health. VLDL (Very Low Density Lipoproteins) Leftover remnants of chylomicrons, mostly triglycerides once again, are taken to the liver and incorporated into VLDL whose job is to dispense any further triglyceride out to the cells of the body. IDL (Intermediate Density Lipoprotein) VLDL becomes IDL and squeezes any residual triglyceride out. It is equally high in triglyceride and cholesterol. LDL (Low Density Lipoprotein) These LDL carrier molecules are getting smaller as the triglyceride is now removed, and we are left with mostly cholesterol. Cholesterol has many important jobs. It is the precursor to our sex hormones (Oestrogen, Progesterone, Testosterone), Cortisol, Vitamin D, Bile Salt production, and is important for maintaining all our cell membranes. It's not necessarily the nasty we have heard it is. It is LDL's job to deliver the cholesterol to our body sites that need it. Though not a regular test request, Oxidised LDL is the marker to measure if we are concerned about levels of LDL in the body, as the Oxidised LDL is the real nasty. LDL subfractions can also be tested to make sure you have large bouyant LDL particles and not small, dense atherogenic particles. Lp(a) Consists of an LDL molecule bound to an ApoLipoprotein component, with a strong genetic component to its levels. HDL (High Density Lipoprotein) HDL molecules are made in the Liver and Gastrointestinal tract (GIT). They are mostly protein and their job is to pick up any excess cholesterol not needed for our sex hormone production, cortisol production, Vitamin D, Bile salts and cell membranes, and return it to the liver for detoxification and removal from the body via Bile in our Faeces. This is another reason why all our detoxification pathways must work efficiently. As cholesterol is needed for cortisol production, we can see why elevated total cholesterol levels can occur when we are stressed. Having discussed all the various components of cholesterol, clinically, it has not been shown that improving cholesterol markers improves cardiovascular risk. Other markers have been determined as better to review. These include triglycerides, glucose, insulin, HbA1c, Homocysteine, Liver Function Tests (ALT & GGT), Uric acid, and then looking at the gold star radiology method - Coronary Artery Calcium Score (CACS) discussed below. Glucose, Insulin, HbA1c, and Homocysteine are discussed in separate blogs: Metabolic Syndrome Homocysteine - the Canary in the Mine Triglycerides Elevated triglycerides alert us about the potential for delayed removal of pro inflammation from our cell walls. This is what we need to watch. Coronary Artery Calcium Score The risk of cardiovascular disease is about the risk of plaques in our blood vessel walls. This test measures the amount of calcified plaque in our heart arteries, which may lead to thinning of the blood vessel lumen, shortness of breath (oxygen), as an estimate of the future risk of a heart attack. If you are concerned, this is definitely a test to request from your G.P. Lipid Test Markers Functional Reference Ranges Test Marker Comments Total Cholesterol Familial Hyperlipidaemia, a genetic condition, can see very high results Triglycerides Review for diet, lifestyle when results are high HDL Desirable to be elevated, however too high along with too low is not necessarily good. ​Triglycerides: HDL Ratio ​Seen as a better predictor of heart disease LDL Too low is not necessarily good either Apo B The protein carrier of the combination of Chylomicrons, VLDL, IDL and LDL Apo A-1 The protein carrier of HDL Apo B: Apo A1 Ratio We want more Apo A1 than Apo B Table: highlighting optimal reference ranges for Lipid testing What are the real culprits of cardiovascular disease? The real culprits of heart disease, include excess triglycerides, excess fibrinogen, elevated homocysteine, inflammation from increased belly fat, high triglyceride to HDL ratio, and high glycaemic levels (discussed in another blog). Strategies to improve Cardiovascular Risk The primary goal is to get Triglycerides <1 for absolute optimal health. Keep alert when values rise above that Losing weight - will lower triglycerides, and lower LDL levels Increasing exercise - will increase HDL levels Decrease belly fat will come from taking a walk every day Reduce alcohol intake to special occasions Stopping smoking if that is a factor Reduce inflammation in your body with a holistic health focus Eating more plant based foods so your plate is 2/3 plant based foods to 1/3 animal based foods Eating less sugar, and simple carbohydrates that are heavily processed, and eating more fibre (complex carbohydrates). Take note that the Oral Contraceptive Pill (OCP) poses thrombotic risks in those women who are overweight. Improve Thyroid function. Overt Hypothyroidism increases Cholesterol, LDL, Triglycerides. Overt Hyperthyroidism decreases those markers. Why does this happen? We need good levels of FT3 for Bile Flow to clear cholesterol. Cholesterol is also needed for Bile Salts. The Goldilocks effect once again. Discuss your circumstances with a qualified Naturopath, to obtain nutritional information, along with herbs and supplements that can help. Sitting is the new smoking! Why? Lymphatic clearance is needed at the very beginning of the process . Movement is needed for lymphatic clearance. Daily bowel movements are needed as cholesterol is removed via bile in our faeces. Liver detoxification needs to work well, so it's broken down into bile, and not reabsorbed. We need to burn up what we eat. So we need to move our bodies, and not sit all day. Special note for Menopause Typically in menopause, Cholesterol, LDL, triglycerides all increase, while HDL decreases. If you would like to discuss your personal circumstances, or have your pathology results reviewed in line with your current situation, feel free to make a booking with me on the bookings tab on my website. 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: Lipid transport, storage and utilisation High Circulating Triglycerides Are Most Commonly a Marker of Ectopic Fat Accumulation: Connecting the Clues to Advance Lifestyle Interventions (AHA) Nutrition Cardiologist opinion 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 numbers of cases of Autism Spectrum Disorders (ASD) is increasing globally. What are the underlying causes of Autism Spectrum Disorders? Are the symptoms that have been known for some time, actually now considered to be the cause ? What can be done to help? Worldwide, there has been a massive increase in the number of autism spectrum disorder (ASD) diagnoses. In 1980 it was estimated that 1:10,000 births would result in an autistic child, however latest data shows that to be 1:36 births. Even worse for Australians, is that Australia is the global leader with the rapid increase in numbers of ASD births. At the same time, the statistics for asthma, food allergies, autoimmune diseases are also rising in a similar trajectory. What is going on, how is our modern lifestyle impacting this rise, and how can we help those affected by the disorder, or wanting to prevent this in their offspring? Before we uncover what is known today about the underlying causes, and ways to assist, we should start with a definition of autism. Definition of Autism The Diagnostic and Statistical Handbook of Mental Health, now on version 5 and known as DSM-5 , states that an autism diagnosis requires persistent deficits in social communication and social interaction across multiple contexts, as manifested by the following deficits in: social-emotional reciprocity in nonverbal communicative behaviours used for social interaction in developing, maintaining and understanding relationships Genetic and Environmental Causes of Autism Spectrum Disorder (ASD) Image source Are Autism Symptoms actually the Cause of Autism? It is known today that biochemical reasons are the underlying explanation as to the casue of the rise in autism cases worldwide. Triggers , result in biochemical disruptions , that result in health issues . What was once considered symptoms of Autism, is now accepted as causes of Autism, and our modern lifestyle is to blame. Autism Triggers include: Toxins whether they be from inside our bodies (endotoxins) or from outside our bodies (exotoxins) Depleted nutrition (from diet or from issues with our bodies biochemical pathways) Excess antibiotic use and the impact that has on our gut microbiome A reduction in social interaction The increase in electromagnetic frequency (EMF) impact from mobile phone use Biochemical Disruptions include: Methylation changes Gut microbiome changes Immune activation (when not required) Brain inflammation Disruption of the Blood-Brain-Barrier (BBB) Autonomic Nervous System Imbalance, like blood pressure and pulse rate increases Mitochondrial Dysfunction from the Cell Danger Response Resultant Health Issues: Autism ADHD Autoimmune Disease Asthma Allergies Anxiety Cancer Cardiovascular Disease Obesity Biochemical Disruptions Associated With Autism 1. Methylation Methylation, or the addition of a -CH3 molecule to chemicals in our biochemical pathways, can turn on, or off, the proteins it gets added to (like our genes, hormones, and enzymes). This is known as epigenetically impacting how our body works. This is all driven by the nutrients from our diet (or supplements). Methylation reactions in our bodies are vital for life. Upregulating or downregulating can occur in ASD cases and we can see that by measuring various test analytes in the methylation cycle using specific functional tests. Methylation Cycle with markers low and high in Autism Spectrum Disorders Image source Inadequate methylation can lead to: Mental health issues - autism, ADHD, schizophrenia, anxiety, bipolar disorder, depression Histamine issues - with the worst case scenario being Mast Cell Activation Syndrome (MCAS) Cancer - cancer promotor genes can be silenced by methylation, and DNA repaired. Recurrent miscarriages Breakdown of our hormones (oestrogen) Liver detoxification issues (Methylation is part of our Phase II Detoxification process) Migraines Circulation problems Inflammation and toxicity increases Midline body issues like tongue tie, and lip-tie Outside of a healthy balanced diet, supplementation, in activated forms, may be required to alter methylation in a favourable way for Folate, Vitamin B12, Vitamin B6, Protein (methionine, creatine, choline), and N-Acetyl Cysteine (NAC). This can assist with symptoms. As well, we can favourably alter genetic predisposition with healthy methylation. 2. Gut Health It has been recognised since 1943 that gut health is a recognised issue in autism, with up to four times the likelihood of constipation, diarrhoea, abdominal pain, leading to irritability, hyperactivity and social withdrawal. Genetic sequencing of gut microbes highlights generally an: Increase in Clostridia species that causes autism-like symptoms A reduction in Akkermansia that can lead to Inflammatory Bowel Disease, Obesity and Diabetes A reduction in Bifidophilus that can cause immune dysfunction Healthy beneficial bacteria promote the formation of good immune balance by our regulating T cells (TReg's). Unhealthy bacteria promote alterations in our immune system function: Inflammation Allergies Autoimmunity Food insensitivities As well as microbiome changes, there is impairment in intestinal permeability and gut barrier protection. We need to let in nutrients, short chain fatty acids, and neurotransmitters, but prevent entry of immune cells, cytokines and antibodies. We need healthy levels of secretory IgA (sIgA), and tight junctions between intestinal cells. Medications, antibiotics, toxins, stress, dietary habits, systemic inflammation, metabolic disorders, pathogens and dysbiosis can all impact on the semi-permeability of the gut. The brain is also impacted by the Gut-Brain-Immune imbalance. Altering our diet can have a positive impact. 3. Mitochondria Toxicity Chronic inflammation, toxicity, chronic infections all cause 'signals' to be generated in our bodies that trigger the Cell Danger Response. Through this, our cells stop communicating with each other to prevent the 'signal' being passed on. This can result in: Mitochondrial signs - weakness, fatigue easily, floppy baby, poor muscle tone Glutathione, our body's major antioxidant being used up very quickly leading to the risk of multiple disorders. Nutrients that disrupt the 'signaling' process may be beneficial. We need to clear and open Liver Detoxification Pathways to adequately deal with the levels of toxins never seen in the world before. The vitamins B2, B3, B6, Folate, B12, and flavanoids, glycine, taurine, glutamine, methionine, glutathione, phospholipids are all required to enable safe and effective removal of toxins via our faeces and urine, else toxins accumulate in our bodies. We can help remove potential reabsorption via our enterohepatic circulation with the use of binders, that block the reabsorption of bile and the recirculation of toxins. Ensuring our detoxification pathways are open and clear can have positive impacts. 4. Cerebral Folate Deficiency Cerebral Folate Deficiency is where the folate that we eat, can't be received in the brain (the folate receptor is blocked by an auto-antibody). This may be medically treated with high dose folate in a certain format. 5. Neuroinflammation Neuroinflammation lies at the heart of autism with the majority of patients. Inflammation activates the Cell Danger Response, which results in inflammation in the brain, that disrupts signaling for speech and awareness. Correcting inflammation and calming down our overactive immune system can assist with this. What Can Be Done To Help? 1. Functional Testing There are some wonderful functional test kits available to help determine the status of someone with autism. They include: Faecal Microbiome testing to determine what the status of the gut microbiome looks like Urine Organic Acids Test to help understand how well methylation is working, levels of Clostridia, candida, mould, oxalates, impacts on neurotransmitters, oxidative stress from low glutathione etc 2. Nutrition and Lifestyle Help Nutrition and lifestyle changes can have positive impacts on someone living with autism. Dietary changes by choosing Gluten free, Casein free (from dairy) foods, no processed foods, with no colourings, no additives, no flavourings, are the quickest way to alter the gut microbiome quickly, and to balance the immune dysfunction. Eating a wide diversity of food types which can often be difficult to do in autism cases, so supplementation may be required. This enables optimal methylation. Ensure adequate fibre through the use of prebiotics. This promotes the feeding of beneficial bacteria. Keeping a calm, predictable environment, with minimal screen time. Diaphragmatic breathing to calm the nervous system. If you would like to get Faecal Gut Microbiome and/or Urinary Organic Acids testing performed for your autism investigations, or discuss your associated concerns, 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: DSM-5 Diagnostic Criteria for Autism Medical Academy of Paediatric Special Needs Methylation 101 Autism Spectrum Disorder: Pathogenesis, Biomarker, and Intervention Therapy World Health Organisation: Electromagnetic fields and public health: mobile phones 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.

What is ADHD (Attention Deficit Hyperactivity Disorder) and what is the link with the neurotransmitter dopamine? How do our mobile phones impact in a negative way? What is ADHD? Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder seen with issues around focus, hyperactivity and impulsivity. It has also be known as ADD (Attention Deficit Disorder). It is characterised by issues in controlling attention and impulsivity to the point where it impacts someone's life. The manual 'Diagnostic and Statistical Manual of Mental Disorders (DSM-V)' is used for diagnosis. One of the first signs may be when a child has difficulty focusing on one task and shifts between multiple projects with an inability to sit still for long. Young boys can often be seen as being inattentive, while young girls can be overlooked and seen as being overly emotional, having anxiety, or lacking in effort. Adults can present differently in comparison, where the ability to sit still may actually now be present, but the mind can flit between many thoughts and ideas at a rapid pace. Dysfunctional strategies like alcohol, drugs, food etc may be used as compensatory mechanisms to help with problems associated with the confusing emotions. What is Dopamine? Dopamine is a neurotransmitter that serves as a chemical messenger and either upregulates or downregulates our emotional responses, our motivation, and our feelings of rewards and pleasure. It keeps us alert, focused, motivated and happy. The biochemical pathway for dopamine can 'run fast' or 'run slow' according to enzymes that break down the neurotransmitter. Dopamine also works in conjunction with other neurotransmitters and not in isolation. Negative feelings associated with the 'spikes' and then the 'crashes' of dopamine can be seen when: Phone scrolling is not enjoyable but you feel compelled to do it You feel down and unmotivated You struggle to enjoy life's simple pleasures e.g. nature on a walk You consume a lot of caffeine or sugar Life has lost its spark Our phones are the modern-day hypodermic needle delivering dopamine 24/7 The mind of someone with ADHD can appear to be overwhelmed Image source What is ADHD and the Dopamine Link? It appears that in ADHD there are lower levels of the neurotransmitter Dopamine. Issues associated with this are: Reward System Dysregulation Where the 'long-term' value is difficult for people with ADHD to embrace. This is in contrast to instant gratification where you 'want the fix.' You may begin projects, or jobs with 'gusto' but lose interest when the rewards aren't there. The brain has an altered reward system so it struggles to stay motivated when there isn't an immediate reward. Attention Regulation Difficulties The neurotransmitter, Dopamine, plays a key role in attention and our ability to focus. When there is less dopamine, the brain struggles to prioritise, which can lead to concentration difficulties when sustained attention is required. Other more competing stimuli intrude and take precedence, which makes the required task seem uninspiring and difficult to complete. Projects therefore become difficult to start and end. Impulsivity Low dopamine levels can likely lead to a compensatory effect where reward stimulation is sought to counteract the deficit. This can lead to the all familiar 'doom scrolling' on social media, impulsive spending, high-risk activity seeking, high-sugar food consumption etc that all stem from a lack of neurotransmitter balance. What contributes to ADHD? Dopamine - levels of dopamine, as well as dopamine receptors, and the breakdown pathways of dopamine (needing COMT), may all be involved. Environment - exposure to lead and pesticides Genetics - studies show ADHD is strongly inherited As discussed, dopamine is broken down by an enzyme called COMT (catechol-o-methyltransferase), that requires good methylation from good nutrition. Variants of COMT can result in how quickly or slowly dopamine is broken down. Too fast, leads to feelings of: Being unmotivated Reduced alertness Difficulty concentrating Lack of motivation Poor coordination Movement difficulties Inability to feel pleasure As an aside, some serious implications involved with a lack of dopamine include, Parkinson's Disease, and depression. Too slow, leads to feelings associated with: Dopamine build up like anxiety, poor sleep, super stressed, irritability. High levels of dopamine can make people feel very euphoric momentarily. Addictive drugs can increase dopamine and be a reason why individuals begin experimenting with them. Other addictions can also be used in a similar sense. What can be done to help those with ADHD symptoms? Focus on activities that promote a steady, sustained increase in dopamine levels. Good nutrition to drive biochemical pathways for balanced neurotransmitters. This may require supplementation, in particular with activated Vitamin B6 and Magnesium. ( Please note: see a Naturopath for guidance of dosing especially with Vitamin B6 as incorrect dosing can cause harm to the body). Moderate exercise Sunlight exposure Listening to relaxing music Cold showers Getting enough sleep with a good sleep routine Consuming tyrosine-rich foods. Tyrosine is the precursor to dopamine. Foods include: bananas, almonds, avocadoes, eggs, beans, fish, chicken etc Spend time in nature Explore hobbies and interests Surround yourself with great people Establish boundaries on quick dopamine fixes Limit time spent on social media 'doom scrolling' Reduce caffeine Set spending limits on binges Have a 'no phone' rule during mealtimes and designated work times What are the differences between ADHD and Autism? There are striking differences between ADHD and Autism signs, though they can co-exist in an individual. ADHD Autism Need work flexibility Need work routine and structure Impulsive Doesn't like change Easily bored Easily overstimulated Craves social interactions Finds social interactions uncomfortable Has poor time management Sets schedules with good time management Delves into a lot of different interests Has a strong passion for certain interests Table highlighting the differences between ADHD and Autism If you would like to discuss your concerns, and put plans in place to support balancing your neurotransmitters, 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: Improvement of Neuro-behaviour with supplementation B6 Deficiency and ADHD What is ADHD? Dopamine Function in the Brain 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.

Homocysteine is a product of methionine metabolism, and methionine is one of the eleven ‘essential’ amino acids. Essential amino acids are those that must be derived from the diet since the body cannot produce them. In healthy cells, Homocysteine is then quickly converted to other products. Folate, in its active form, and Vitamin B12 are needed to metabolise homocysteine. Therefore, people who are deficient in these vitamins may have increased levels of homocysteine, which may pose a cardiovascular risk. Elevated homocysteine may promote atherosclerosis by damaging blood vessel walls and supporting the formation of inappropriate blood clots. Why is Homocysteine considered the canary in the mine? Homocysteine levels indicate a lot of information clinically. Homocysteine can be described as the 'Canary in the Mine' test as it provides an alert - something which warns of the coming of greater danger or trouble depending on the level. Historically, canaries were placed in mines to alert miners of potentially noxious gases. The canaries deaths in the presence of the gases saved miners lives by alerting them of the need to leave the mine. Like everything in life, balance is key. It's the Goldilocks story - we need the level of Homocysteine to be 'just right'. High Homocysteine levels Homocysteine levels that are high can occur if active folate and Vitamin B12 are low. It may be a predictor of cardiovascular disease. Folate and Vitamin B12 are needed for the process of methylation which is discussed below. Low Homocysteine levels Low Homocysteine levels are definitely not great either. Causes of low Homocysteine can include: Low protein diet Low sulphur intake. This means we become low in Glutathione eventually. Glutathione is our body's primary antioxidant, so our health can begin to suffer at low Glutathione levels, from low Homocysteine levels. To get the mineral sulphur we need to be eating cruciferous vegetables which includes Broccoli, cabbage, Brussel sprouts, cauliflower, Bok Choy, radish, turnip, watercress, kale etc. If these vegetables cause you issues, you may have a Molybdenum issue which is necessary for breaking down sulphites. Poor digestion and absorption of protein. Chew your food, don't drink when eating, be relaxed when eating, and don't take antacids. Minimise the need for Glutathione in your body. Why does your body need so much Glutathione, which pulls from Homocysteine? Inflammation and oxidative stress are the reasons. What can cause that? Mould exposure, oxalates, heavy metal exposure - for example, lead, mercury. Do you have amalgam fillings? Have you been exposed to mould? Do you have oxalate issues (frequent urinary tract issues, sharp pains in your body)? Insufficient Vitamin B6 in its active form (P5P) Overmethylation A canary in the mine was historically used to alert to potentially noxious gases saving miners lives. Image source What is Methylation? Active Folate and Vitamin B12 drive important pathways in our body that result in a methylation 'handshake' process that enables the transfer of methyltransferases. This process drives essential processes in our body. Methylation Map Cycles showing where Homocysteine sits feeding Glutathione Image of Methylation Map from Advanced Clinical Naturopathic Medicine, 2020 Methylation occurs in every cell of the human body, every second of every day. Problems arising from methylation have both genetic and lifestyle causes. Methyltransferases are involved in lipid biosynthesis, protein repair, hormone inactivation, and tissue differentiation; through upregulating or downregulating processes, dependent on the environment encountered. This means that methylation is critical to metabolism, immune regulation, endocrine function, cardiovascular function, neurological function and hepatic detoxification, and whether it's working properly or not, can be detected by the Homocysteine test. That's why Homocysteine is quite simply the 'Canary in the Mine' test! Deficiencies of methylation can occur due to dietary causes, malabsorption, increased excretion, pharmaceutical drugs, increased body needs, and stage of life. Patients with erroneous methylation may present as patients with anxiety, ADHD, diabetes, depression or mood disorders, digestive problems, suppressed immune system, fertility issues, frequent miscarriages, chronic viral infections, cardiovascular disease, insomnia, addictions, fibromyalgia, chronic fatigue syndrome, autism and autism spectrum disorders, allergies or sensitivities, autoimmune disorders, Multiple Sclerosis, neuropathy, Parkinson’s disease, dementia or Alzheimer’s. Diseases can be genetically inherited, but it is methylation that determines whether the diseases are physically expressed through the epigenetic control mechanism. There is a saying that 'Genetics loads the gun, but the environment pulls the trigger', highlighting the importance of a healthy lifestyle and good nutrition. Homocysteine is the test of choice to understand defective methylation. You may also see an accumulation of Histamine with defective methylation, as Histamine is normally deactivated by methylation. Inherited Genetics involved in Methylation MTHFR (Methyl tetrahydrofolate reductase SNP C677T and/or A1298C) - This gene initiates your body’s ability to perform the process of methylation. Mutations may produce possible issues with folate metabolism. Issues with the MTHFR gene can underlie nervousness, brain fog, chemical sensitivity, low mood, elevated homocysteine levels, irritability, heavy periods or cramps, hypothyroidism, and infertility. Do any of these sound like you? MTR (5-methylytetrahydrofolate-homocysteine methyltransferase) - this gene may produce possible issues with Vitamin B12 metabolism. MTRR (Methionine synthase reductase) - this gene may produce possible issues with Vitamin B12 metabolism. COMT (Catechol-O-methyltransferase) - This gene affects the metabolism of the major neurotransmitters that influence your mood, oestrogen levels, energy levels, ability to calm down, sleep, and focus. Issues with it can leave you moody, stressed, distracted, and struggling to get a good night's sleep. Defective COMT may produce possible issues with metabolising neurotransmitters dopamine, noradrenaline, adrenaline we well as oestrogen. Testing for Methylation Status Working with a qualified Naturopath very familiar with Methylation is crucial. Other tests besides Homocysteine, can give even greater detail on what is happening. Testing can include: Homocysteine, as discussed Genetic profiling to include MTHFR and others as discussed above (smartDNA testing) Methylation profile to see how well the genes are actually working (epigenetically) Organic Acids Testing (OATS test) that looks at neurotransmitters, levels of glutathione and other functional markers of nutrition (like folate, vitamin B12, amino acids etc). This is a highly recommended test. Serum B12, Active B12, Serum Folate, RBC Folate as these nutritional markers must become methylated to 'work' in the methylation cycle, so their levels also give us an idea of how well methylation is performing. (These markers are also included in the OATS test). Vitamins and Minerals needed for Methylation Methylated Vitamin B6 (P-5-P), Methylated Vitamin B12 (methyl-cobalamin), and Methylated Folate are all important forms of vitamins required to enable our methylation pathways to operate effectively. In addition to these, Vitamin B2 is required as a cofactor, along with the minerals Magnesium, Selenium, and Zinc. Magnesium can never be forgotten as a required supplement as it's involved in so many processes in the body. Depending on the levels of issues you may be experiencing, Glutathione and its precursor N-AcetylCysteine (NAC) may be required to support antioxidant ability. As always, it's important to supplement under the guidance of a qualified practitioner. Effective Methylation requires good nutrition as highlighted Image source A variety of factors contribute to methylation issues. Do any of these conditions resonate with you? Have you had your Homocysteine levels checked? If you would like to discuss your symptoms and identify causative factors, or order testing, or discuss your Homocysteine and other test results, then please don't hesitate to make an appointment to discuss, on the bookings tab on my website via the booking button below. 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: Homocysteine , Dr. Ben Lynch Bundy, B, (2021), Methylation and MTHFR Testing Webinar Hechtman, L, (2020), Advanced Clinical Naturopathic Medicine, (1st Ed), Elsevier Lynch, B, (2018), Dirty Genes, (1st Ed), Harper Collins Pathology Tests Explained SpectraCell Laboratories , (2019) 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.

Iron Deficiency Anaemia is described as the most common form of anaemia. Inadequate levels of the essential mineral Iron in the body, lead to a decreased production of haemoglobin. This in turn leads to a reduced production of red blood cell (RBC), resulting in Iron Deficiency Anaemia. Symptoms are then related to the extent of the reduction in RBC. Iron deficiency Anaemia affects RBC in many ways as shown on this peripheral blood smear illustration. Image source Iron Deficiency Anaemia symptoms explained Iron Deficiency Anaemia can present with many signs and symptoms and are explained below: Weakness Fatigue Irritability and mood swings Headache Exercise intolerance Cravings for non-food items (Pica) Pallor Shortness of breath Restless legs syndrome Poor digestion (either by low gastric acid causing iron deficiency, or iron deficiency causing low gastric acid) Hair loss Reduced thyroid function (Hypothyroidism) as iron is needed for thyroid function Impaired immune function Depression Infertility Dizziness Decreased mental and motor function Severe iron deficiency may result in Tachycardia (elevated heart rate) from the lack of oxygen as RBC are required to supply haemoglobin, which is in turn required for oxygen delivery to the body Specific Signs and Symptoms of Iron Deficiency Anaemia: Brittle or spoon-shaped nails (Koilonychia) Swollen or sore tongue Cracks or ulcers at the sides of the mouth Unusual non-food cravings (pica) - for items like ice and dirt Koilonychia (spoon shaped) fingernail specific for iron deficiency anaemia. Image source Laboratory Testing for Iron Deficiency Laboratory test results will provide the differential diagnosis for iron deficiency anaemia. If Iron-Deficiency Anaemia is suspected a Full Blood Count (FBC) and Iron Studies will be performed. A. Full Blood Count (FBC): Full Blood Count (FBC) will show a reduced RBC count, and reduced haemoglobin (Hb) Reduced size of RBC or mean corpuscular volume (MCV) Reduced oxygen carrying haemoglobin concentration or MCHC Reduced haematocrit (Hct) RBC may show anisocytosis (different sizes), and an increased red cell distribution width (RDW) highlighting RBC at various stages of development or past iron treatment RBC reflect microcytic (small), hypochromic (pale) anaemia which is the advanced diagnostic findings of iron deficiency anaemia Platelet levels will begin to rise B. Iron studies: Iron Deficiency Anaemia Iron levels Transferrin TIBC % Saturation Ferritin Results Low High High Low Low Table showing the different markers for detecting Iron Deficiency Anaemia C. Ferritin testing: The intracellular iron storage, Ferritin, is the gold standard testing and will show low Ferritin levels. However, Ferritin levels may be falsely raised in inflammation, lead poisoning and malignancy. D. Other Pathology Tests: Coeliac testing H. pylori investigation Inflammatory Bowel Disease screening Gastric Parietal Cell Antibody screening Faecal occult blood studies C-reactive protein testing for inflammation ESR will be elevated due to anaemia Thyroid Function Tests (see Fun Fact below) Progression of Iron Deficiency in Pathology testing: Stage 1: Characterized by decreased bone marrow iron stores. Haemoglobin (Hb) and serum iron remain normal, but the serum ferritin level falls to < 20 ng/ml. The compensatory increase in iron absorption causes an increase in iron-binding capacity (transferrin level). Stage 2: Erythropoiesis (Red Blood Cell production) is impaired. Although the transferrin level is increased, the serum iron level decreases and transferrin saturation decreases. Stage 3: Anaemia with normal-appearing RBCs and indices develops. Stage 4: RBC microcytosis and then hypochromia develop. Stage 5: Iron deficiency affects tissues, resulting in symptoms and signs. Causes of Iron Deficiency Causes of Iron Deficiency Anaemia can be grouped into the following classifications as either an Increased Iron Need, Decreased Iron Availability, or Refractory Iron Deficiency. 1. Increased Iron Need: Iron loss through RBC loss (menorrhagia, gastrointestinal bleeding, GI tract cancer, peptic ulcers, haemorrhoids, post-partum, ulcerative colitis) Higher iron demands at various stages of life like pregnancy for foetal development, lactation, young children, and teenagers, extreme exercise where increased erythropoiesis is required 2. Decreased Iron Availability: Low intake of iron (malnutrition, vegetarian diet) Poor absorption of iron (inflammation, obesity, Coeliac disease from a defective mucosal barrier, or low stomach HCl. Ingesting competitors that chelate iron such as calcium, lead, cobalt, phytates, tannins, phenolics. Ingesting predators like H.pylori that can cause refractory iron deficiency anaemia, parasites and worms in the GIT. Achlorhydria from gastric parietal cell dysfunction. M edications that alter gastric pH can also decrease iron absorption - these include antacids, proton pump inhibitors, and H2 blockers (Zantac). 3. Refractory Iron Deficiency Anaemia (IRIDA) and Inflammation: Hepcidin is the central regulator of Iron haemostasis. Hepcidin deficiency causes iron overload, while Hepcidin excess is associated with iron-refractory iron deficiency anaemia which is resistant to improvement, inflammation and chronic kidney disease. Oral iron supplemetation upregulates Hepcidin. Hepcidin then limits the absorption of high-dose oral iron supplementation, as the body recognises high dose iron as inflammatory. If there is inflammation, iron will be removed from the blood and taken back to the liver, so it's not available. This is a protective mechanism. If for example we have parasites and they are consuming our iron, then our body in that inflammatory state attempts to starve the parasite of iron. Iron is then stored in cells around our body but mostly in the liver as Ferritin, so adequate Ferritin levels can also be indicative of the inflammation which has caused the iron to be stored. (see Hepcidin discussion below). There is now an understanding that there are opposing aspects of iron absorption. The need for many physiological processes versus the threat it poses by encouraging and ‘feeding’ pathogen growth like parasites for example. Existing data suggests that hepcidin balances the need for iron, against the threat of pathogen growth and infection. Flow chart highlights the various causes of iron deficiency anaemia. Image source Therapeutic goals Treatment involves resolving and improving your iron deficiency, and importantly, understanding, and addressing the underlying aetiology. In people with chronic inflammatory conditions, response to oral iron therapy may be limited by the hepcidin-mediated decreased absorption. As such the objective is to reduce the cause of inflammation first. While medically important to correct iron deficiency, there is increasing evidence that boluses of iron work against the body’s developed haemostasis mechanism. Hepcidin restricts iron availability due potentially to the presence of pathogenic bacteria in the GIT. Hence the need to understand the aetiology, and to not let iron deficiency get so low that an iron infusion is necessary. Fun Fact 1: Iron is involved in Factor VIII in clotting. If you have low iron and are a menstruating female, the fact that you have low iron could be why you have menstrual periods with blood clots. Treatment goals are aimed at: Understanding the reason behind the anaemia, and improve through diet, corrective actions and supplementation Understanding your diet - do you have low protein intake? Understand circumstances (pregnancy, lactation, exercise), or known current diseases (ulcers etc) or any relevant history (colon cancer etc). Is there medication use? Determine if it is: Chronic blood loss from menstruation via a menstruation summary or charts GI bleeding (via faecal occult blood testing) Obtain an understanding of bowel movements and have a Complete Microbiome Mapping from stool sample to understand pathogen presence ( H. pylori, worms, parasites) that may be competing for iron needs. Undertake Coeliac testing to determine if gluten in the diet is destroying the absorption capability of iron, or reason behind poor absorption of iron Understanding your intake of iron for intestinal absorption Administering supplemental iron (if required), and providing therapeutic strategies for the gut to improve poor absorption, reduce inflammation, and enhance iron levels and ferritin stores. Do you chew food properly to stimulate gastric secretion of HCl, and digestive enzymes to break down food so you can absorb the nutrients? Fun Fact 2: Anaemia could be showing that you have thyroid concerns, as the thyroid gland controls all metabolism, including the lifecycle of RBC, and your digestion and absorption of nutrients. Food Inclusions Iron containing foods such as heme and non-heme foods Heme sources – Liver, Oysters, Organic Red Meat Non-heme sources - Legumes, whole grains, nuts, seeds, green leafy vegetables Vitamin C taken at same time as non-heme foods to improve absorption Herbal treatments that kill bacteria and parasites in GIT that feed off consumed dietary iron e.g., berberine, garlic Foods that reduce inflammation to eliminate the hepcidin iron blockade process in the body to allow iron absorption at lower iron levels. This includes eating a diverse variety of colours from naturally occurring fruit and vegetables. Food Exclusions Gluten free diet if positive for Coeliac disease due to inflammatory effects on small intestinal microvilli. Even if testing shows you are negative, an inflammatory state on a heavy bread diet may result in high hepcidin levels that prevent iron absorption. Remove tannins, polyphenols from tea, coffee, cocoa, wine, some spices, dairy, eggs, phytates in legumes, grains, rice, soy protein as they will chelate (bind). As a minimum consume away from iron foods or supplements Separating taking of other supplements like calcium, magnesium, and zinc at different times of the day to iron supplementation as they chelate (bind) iron and prevent absorption Dairy as it inhibits absorption of iron Take iron supplements away from pharmaceutical medications due to chelating effects Remove uncooked plant foods as oxalates compete with iron Remove NSAID use, like Nurofen Specific Dietary focus Increase Gastric HCl by chewing foods better to ensure food is broken down to allow the absorption of nutrients Decrease inflammatory foods like gluten, dairy, and sugar to reduce inflammation and hence hepcidin levels that prevent iron absorption Specific Nutrients Iron Lactoferrin as assistance to iron absorption Vitamin C to assist with iron absorption in non-heme foods Garlic and Berberine for their antibacterial effects, removing competitive chelators Broccoli for its antibacterial and antiviral effects, removing competitive chelators Green tea inhibits the adhesive affects of H. pylori, is anti-bacterial and is also a powerful antioxidant Red wine in moderation. Resveratrol is anti-bacterial Liquorice for treating peptic ulcers and inhibiting colonisation of H. pylori Manuka honey for anti-bacterial effects, removing competitive chelators Probiotics to increase beneficial bacteria and compete with potential pathogenic bacteria that may be utilising iron. M embers of the Lactobacillaceae and Bifidobacteriaceae families that have no requirement or a very low requirement for iron are the most beneficial Get Vitamin D from the sun to lower Hepcidin levels Anti-inflammatory herbs to lower hepcidin levels Zinc Fun fact 3: Low Ferritin can actually be a sign of Zinc Deficiency! Additionally, iron deficiency can cause zinc deficiency. Fun fact 4: High Ferritin can simply be a sign of inflammation which is not desired. Lifestyle Modifications Lose weight if applicable, as obese people have greater systemic inflammation and circulating hepcidin levels and subsequent inability to absorb iron Home-prepared meals versus highly processed inflammatory foods to reduce inflammation Give up smoking, recreational drugs, minimise drinking alcohol if applicable for reducing inflammation Spread-out coffee and tea consumption throughout the day if applicable, and consume away from food Ensure chelating dietary choices are taken away from iron supplementation or iron containing foods As Iron-deficiency anaemia can cause shortness of breath, tiredness and dizziness, exercise should be undertaken slowly. Hopefully you've realised that iron deficiency is not as straight forward as supplementing with iron. Determining the causes is a huge component to identifying the right strategy. If you would like to discuss your personal circumstances, or have your pathology results reviewed in line with your current situation, feel free to make a booking with me on the bookings tab on my website. 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: Cappellini M, Musallam K, Taher A (2019) ‘Iron deficiency anaemia revisited’ Journal of Internal Medicine Vol 287, Issue 2 pp153-170 Goddard, A, McIntyre, A, Scott, B (2000) ‘ Guidelines for the management of iron deficiency anaemia’ BMJ Journals Gut Vol 46, Issue suppl 4 Higdon J, Drake V (2011) An Evidenced-Based Approach to Vitamins and Minerals, Linus Pauling Institute, Thieme Iron Deficiency, Clinical Practice Guidelines , accessed 4th July 2021 Iron Deficiency Anemia, The Calgary Guide to Understanding Disease , accessed 4th July 2021 Iron, Nutrition Australia , accessed 4th July 2021 Ning S, Zeller M, (2019) ‘ Management of iron deficiency’ Haematology, ASH Education Program (1): 315-322 Physicians Committee for Responsible Medicine (2021) ‘ Nutrition Guide for Clinicians – Iron Deficiency Anaemia ’ accessed 4th July 2021 Red Cell Indices, Lab Tests Online AU , accessed July 4th 2021 Treating Anaemia and Managing Iron , National Blood Authority, accessed 4th July 2021 Trickey, R, (2011), Women, Hormones & the Menstrual Cycle (3rd Ed.). Trickey Enterprises Walker, A et al (2004), ‘Hepcidin: what every gastroenterologist should know’ Gut 53 (624-627) 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 Zinc and Copper results we see on our blood tests, need to be reviewed as a ratio. Zinc needs to be roughly in a 1:1 relationship with Copper levels, meaning they need to be close to equal values. If copper levels are higher, as is often the case in our modern lifestyle, then issues may present themselves. However, Copper is not the evil mineral it is often thought of as will be discussed. The solution is once again to eat fresh organic foods, drink filtered water, and keep everything in balance. The Goldilocks effect once again! Let's discuss Zinc first. Zinc is an essential trace element, more easily obtained from animal products. It is absorbed in the small intestine, but essentially it requires stomach acid (Hydrochloric acid - HCl) to be able to do that. Zinc and Copper Ratio levels on a blood test Desirable Zinc levels are >14umol/L Zinc deficiency shows up when plasma Zinc levels are <12umol/L Low albumin levels often mean low zinc While laboratories give reference ranges for copper, the important point is that copper levels should be in a 1:1 ratio with zinc to be considered healthy. Copper deficiency is defined as <11umol/L Neutropenia may be a sign of copper deficiency, or Vitamin B12 and Folate deficiencies A good way to measure your zinc:copper metabolic balance is via Hair Tissue Mineral Analysis (HTMA). Caeruloplasmin levels, the major transport form of copper (binding to copper in the liver and transporting to the blood), are often elevated in inflammatory states, infections, tissue damage etc as it is an acute phase reactant Iron metabolism is intrinsically linked to Zinc and Copper levels, as well as Vitamin A. How much Zinc do we need per day? 8-14mg/day Supplementation should not exceed the upper limit of 40mg else it starts competing with iron, magnesium, calcium, and copper. Higher levels may cause nausea, vomiting or discomfort in the gastrointestinal tract. Zinc supplementation should not be taken on an empty stomach as it may cause nausea and vomiting. Zinc levels below optimal levels may cause some of the symptoms seen below. Zind Deficiency shows across many parts of our body. Image source What is Zinc needed for? Zinc is required for more than 100 enzymatic reactions in the body, and deficiencies may be seen in the following situations: 1. Immunity Zinc is an antioxidant which means it protects us from nasty oxidative processes that occur in our body. Zinc protects us from both physical and mental stress, infections, and toxins that may include excess copper, mercury, cadmium for example. Did you know that if you have any leaking dental amalgams in your mouth, that only 1 mercury molecule will trap up to 1000 zinc molecules! A low zinc level, can also predispose you to Candida. Frequent sore throats, colds and sinusitis, ear infections, gastroenteritis, thrush, boils, pimples, delayed healing of wounds, prolonged infections, conjunctivitis may all be signs of zinc deficiency. You may see low zinc levels on a Full Blood Count (FBC) with a low White Cell Count (WCC) present. 2. Digestion Zinc is key for effective digestion. Zinc, along with Vitamin B1 and B6 are needed for stomach acid (HCl) production that then stimulates pancreatic enzyme secretion. Hydrochloric acid (HCl) is needed for Zinc absorption, but conversely, if you don't absorb Zinc you don't make sufficient stomach acid (HCl). This results in the condition called hypochlorhydria. This may then predispose you to small intestinal bacterial overgrowth (SIBO) which allows bacteria to be present in the small intestine when they shouldn't be. Zinc therefore corrects wind, bloating and intestinal urgency. Zinc deficiency may result in a loss of taste, smell, and appetite. Zinc is also protective against Helicobacter pylori (H.pylori). Zinc is important for our folate metabolism. Good levels of Vitamin B6 is needed for good levels of Zinc. 3. Brain function and moods Zinc is needed for abstract thinking, alertness, multitasking, mood and memory. It is needed for effective production of our neurotransmitters - Serotonin (Happiness), Melatonin (going to sleep well at night), Dopamine (appropriate motivation), and noradrenaline (keeping anxiety under control like the conductor of an orchestra). Therefore, disrupted sleep, poor memory, moodiness, depression, poor coping with stress, and temper outbursts can all be signs of zinc deficiency. Children can present as being hyperactive, fidgety and have temper tantrums. 4. Skin Zinc is needed to activate Vitamin A which helps skin conditions like dermatitis, dry skin, eczema, psoriasis, pimples, hair loss, tinea, thrush, and warts. We also see redness at elbows and knees as early signs of zinc deficiency. As an aside, Vitamin A is needed to load copper into caeruloplasmin to make bioavailable copper needed for iron absorption. Good Hydrochloric acid (stomach acid) from chewing foods well, plus good B vitamin complex status, plus minimal stress, is needed for healthy Zinc levels, which is needed for Vitamin A, which is needed for Copper, which is needed for Iron! 5. Cholesterol management Zinc as discussed, needs to be in a 1:1 relationship with copper in our body. If this ratio tips in favour of being higher copper, then cholesterol levels may rise. 6. Sex hormone management Zinc is used not only for cholesterol management, but for the flow on sex hormones that are produced by cholesterol. Importantly for females, progesterone is needed to minimise a lot of female reproductive issues; and for males zinc is needed for testosterone production. As such, sexual function, loss of libido, infertility, and menstrual issues are often seen in zinc deficiency. 7. Allergies Allergies are affected by an altered Zinc: Copper relationship - when copper levels are higher. This may be seen as hay fever, runny nose, and itchy skin. 8. Hair and Nails Brittle nails, hair loss and early greying hair are signs of Zinc deficiency. Nails may be brittle with classic vertical white ridges on them, as shown below. White horizontal flecks on nails are often present in Zinc deficient people.. Image source 9. Metabolism If you have low blood sugar within 3 hours of eating (postprandial hypoglycaemia), and are craving foods, you may very well be zinc deficient, or suffer from blocked zinc activity. Additionally, if you have alcohol intolerance you may have zinc deficiency (discussed below). People may be iron deficient , because they are Zinc deficient, because they are HCl deficient, which is often related to stress ! Metabolism of minerals is an intricate affair. 10. Liver function Zinc is needed for the formation of the liver function enzymes alkaline phosphatase (ALP), lactate dehydrogenase (LD), and alcohol dehydrogenase for metabolising alcohol. Hence if you're deficient in zinc, you may not tolerate alcohol well. 11.Respiratory conditions Asthma, bronchitis, pneumonia, chest infections may all present themselves in individuals with zinc deficiency. 12. Joints Zinc is needed for synovial fluid viscosity to cushion our joints so arthritis may be present in zinc deficiency. 13. Eyes and Night Vision Zinc deficiency is associated with a decreased release of Vitamin A from the liver, which may contribute to symptoms of night blindness. Where do we get Zinc from? Sources of Zinc include: Shellfish like Oysters are very good sources of zinc Red meat Sunflower seeds, pumpkin seeds Eggs Whole grains and legumes Kale, Broccoli Note: Meat, eggs and seafood are great sources as they come with the cysteine and methionine needed for zinc absorption. These foods also do not have the inhibitors to zinc absorption, as can happen in plant sources. Oysters in particular have great levels of zinc, copper and iron in the correct ratio for the absorption from the body, along with the amino acids methionine and cysteine needed for zinc absorption. Oysters are an excellent source of Zinc (and Copper and Iron)!! Image source How do we lose Zinc? It is relatively easy to lose zinc via sweating, semen ejaculation, menstrual bleeding, urine, faeces, stress, diabetes, breast feeding, and pregnancy. Medications like antidepressants, oral contraceptive pill, hormone replacement therapy, ACE inhibitors for high blood pressure, diuretics, anaesthetics, NSAID's like Nurofen, antibiotics, anticonvulsants also contribute to zinc loss. A high fibre diet can also affect zinc absorption, as the grains have phytates that may inhibit zinc absorption. Raw spinach, chocolate, tea and berries also have oxalates that may also inhibit zinc absorption. Everything in moderation is the key!. What about Copper in the Zinc and Copper Ratio? Copper often gets seen in a negative light, but it is also an essential mineral that is integral for protecting us against oxidative stress. The issue with copper is when it is out of balance and then it can become highly toxic. We want the majority of copper to be bound and incorporated into ceruloplasmin to prevent free copper ions from catalysing oxidative damage (think rust). Ceruloplasmin, acting as the enzyme ferroxidase, loads iron onto transferrin (again to prevent free iron ions from participating in reactive events). Transferrin will release iron stores in times of need. As noted in my blog on Iron Deficiency Anaemia , the iron released is then regulated by Hepcidin (which is also activated by copper). Special note: Hepcidin will not allow iron to be released in times of inflammation! Elevated Copper Levels Copper is consumed from similar food sources as zinc. It is actually very important when in balance with Zinc. However, elevated copper levels impact negatively on the maintenance of healthy Zinc levels. Elevated copper levels may present as Iron Deficiency Anaemia , Metabolic Syndrome , Hormonal imbalances, Thyroid dysfunction , Fatty Liver , Sluggish bile, Gallstones, flushing, red skin, infections, delayed healing, constipation, arthritis, depression, mood swings, early greying hair and hair loss etc. Xenoestrogens, in our modern lifestyle that come from pesticides sprayed on our food crops , plastics, hormones, hormone mimickers, petroleum etc in our lives, impact our body's ability to excrete copper. Tipping the balance in favour of copper may lead to hormonal imbalances, joint pains, chronic fatigue, anxiety and depression as described above. Our modern lifestyle may mean we have issues with excreting Copper which means we may easily get out of balance with Zinc levels. How do we protect ourselves against excess Copper? We need Metallothionein (as the storage depot for Zinc) to protect our body against the effects of excess copper. How do we get metallothionein? Sufficient zinc, along with the amino acid cysteine from our protein sources, is needed for the production of metallothionine. To ensure we understand how fine this balance is, prolonged high doses of zinc interfere with metallothionein! The message is to keep zinc supplementation levels within specified guidelines. Cysteine is important for the body's antioxidant ability. If it is deficient, the body will break down glutathione in order to obtain it . As discussed in my blog on Homocysteine , Glutathione is our body's major antioxidant protecting us from free radicals, so deficiency may set up the body for potential health issues. Cysteine is found in most high protein foods, such as chicken, turkey, yogurt, cheese, eggs, sunflower seeds, and legumes. Good amounts of Cysteine and Glutathione, with zinc at optimal dose, will help zinc get absorbed, which helps us keep copper in check. Metabolism is a finely tuned machine and wherever possible we should be getting our nutritional sources of these minerals from our organic foods as 'Mother Nature' knows the correct balance. Nutritional balance is so important for optimal health. If you would like to discuss your personal circumstances, or have your pathology results reviewed in line with your current situation, feel free to make a booking with me on the bookings tab on my website. 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: Hidden J & Drake V, 2012), An Evidence-based Approach to Vitamins and Minerals, 2nd Ed, Thieme DrTisDigital, (2015),Visual Textbook of Nutritional Medicine First signs of low Zinc Copper and Iron 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.

Gout is an inflammatory condition either from excess uric acid build up in your blood, or from the reduced ability to clear uric acid from your blood. On pathology results, we often see an elevated Uric Acid level in the blood, that may then crystallise and lodge in our joints, with the base of big toes being the most common location. Crystallisation doesn't always occur, but if it does, the condition is known as Gout, and the crystals are of monosodium urate (MSU) origin, and should not be confused with oxalate crystals . Normally, uric acid is excreted in our urine, and poop, but excess uric acid can be caused by diet and lifestyle factors such as a heavy red meat, cured meat or shellfish diet, and excess alcohol consumption. Genetic factors discussed below can also be involved in the predisposition for gout, but can be effectively managed to reduce the likelihood of it occurring. Symptoms and Treatment of Gout Image source Risk factors for Gout Being overweight Metabolic Syndrome Eating red meats, shellfish, organ meats, cured meats (these foods are high in purines which are the nitrogenous bases found in DNA that are also found in meat as it was a live animal with its own DNA) Excess alcohol consumption (especially beer) which depletes folate necessary for methylation discussed below High blood pressure Diabetes Heart disease potentially related to elevated homocysteine levels from low Vitamin B12 and folate intake Poor kidney function Certain medications (low-dose aspirin on a regular basis, diuretics) Recent surgery, or trauma (where uric acid released from cells) Gut dysbiosis , SIBO and an imbalanced digestive status can contribute to problems in the breakdown of uric acid Thyroid hormone problems can be associated with elevated uric acid levels ( Cell Danger Response ) Gout and MTHFR Link Why can some people have elevated uric acid levels in their blood, but not go on to form Gout? The possibility that the progression from increased uric acid levels to gout flares (uric acid crystallisation with episodes of acute, intense pain), is thought that it may be related to our genetics, where there is a strong familial history of gout. As always, even if you have a genetic link to gout, you can control the likelihood of getting it via dietary and lifestyle changes. Your ability to methylate via the MTHFR gene may be compromised in people with MTHFR C677T gene variant. One of MTHFR gene's jobs is DNA methylation that regulates inflammation that can occur from cytokine production (which can be induced when our immune cells see elevated uric acid in our blood). This leads to oxidative stress. Poor DNA methyaltion, can mean poor inflammation regulation, and resultant oxidative stress, can contribute to gout flares. Methylation is speculated to be 'the link' between genes predisposing people to gout, and their dietary and lifestyle factors. Studies have shown that taking methyl-folate can help as folate inactivates Xanthine oxidoreductase (XOR) which is the enzyme responsible for the conversion of hypoxanthine to xanthine to uric acid. Knowing your MTHFR gene status can be informative to understanding your predisposition to Gout, and how to control it. Symptoms of Gout Intense pain in joints that flares suddenly at night Swollen, stiff and hot joints Pain that lasts days or weeks Complications of Gout Destruction of joints Kidney stones - that cause intense, pain, inability to pas urine, and potential infection Damage to kidneys Damage to nerves Secondary infections What you can do to avoid Gout Treating gout is aimed at reducing painful flare-ups by addressing nutrient deficiencies, gut dysbiosis, SIBO, and lowering uric acid levels in blood. This is done by: Address underlying causes through good nutrition and lifestyle changes Reducing purine foods (shellfish, red meat, organ meats, yeast) Eating an anti-inflammatory diet rich in Omega-3 (including wild caught salmon, nuts and seeds), citrus fruits (containing citric acid to make the urine more alkaline), celery, sour cherries. Eliminating alcohol as alcohol dehydrates and reduces the ability to excrete uric acid Keeping hydrated with water to prevent crystal formation Supplementation with the correct form folate may assist in people with MTHFR C677T gene variant. It is best to see a practitioner for guidance on this. Recommended food for 'anti-gouty' mechanism Image source If you would like to discuss reasons behind why you may have developed gout, or to discuss or test your MTHFR status, then please don't hesitate to book in for a consultation. 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: Genome alterations in Gout MTHFR and Gout Link Connection between Gout and Genetics Natural treatments for Gout Gout and Diet: A comprehensive review of mechanisms and management Xanthine oxidoreductase: One enzyme for multiple physiological tasks 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.

Pain affects everyone at some point, but its complexity can make it feel like a lonely battle. If you find yourself asking, "Why am I in so much pain?" understanding the reasons behind pain can bring hope and insight. One compelling way to look at pain management is through the 'Gate Control Theory of Pain'. This theory sheds light on how pain signals travel through our bodies and how we might control those signals. Pain scales are an individual experience Image Source Understanding Pain Pain is more than just a physical sensation. It is a multifaceted experience shaped by emotional, psychological, and social factors. For instance, studies show that individuals dealing with anxiety as well as pain, often report a 20% increase in pain perception compared to those with more positive emotional states. This variation helps explain why two people with the same injury can have widely different experiences of pain. The Basics of Gate Control Theory At the center of the Gate Control Theory is a "gate" mechanism in the spinal cord. This gate can either allow pain signals to reach the brain or block them. When the gate is open, we feel pain. When it is closed, pain signals are inhibited, leading to relief. Several key factors influence whether the gate is open or closed: Physical stimuli : Non-painful sensations like touch or pressure can help close the gate. For example, applying ice to a sprained ankle can ease pain not just through cold therapy, but also by stimulating surrounding nerves thorugh touch and pressure. Emotional state : Negative emotions such as anxiety and stress can open the gate. Research indicates that stress can amplify pain perception by up to 50%. Meanwhile, positive emotions or relaxation methods can help to close this gate. Attention and distraction : When we concentrate on pain, it often feels worse. Engaging in other activities can distract us and help close the gate on pain. The Gate Control Theory reshaped our understanding of pain. It shows that pain does not arise solely from injury; rather, it is influenced by how our nervous system interprets and processes pain signals. Types of Pain 1. Nociceptive Pain – pain that arises from actual or threatened damage to non-neural tissue (not nerves) and is due to the activation of certain receptors in our body called nociceptors. There is continuous damage and inflammation of bodily tissues present. The pain is described as aching, throbbing, tender, and sore. Examples include sports injuries, external injuries. 2. Neuropathic Pain – pain from nerve damage caused by a lesion or disease of the part of the nervous system that feels sensations (somatosensory nervous system). Described as burning, tingling, shooting, stabbing, and electric. Examples of peripheral neuropathic pain include diabetic nephropathy, and phantom limb syndrome, while examples of central neuropathic pain include multiple sclerosis, and spinal cord injury post-stroke. 3. Nociplastic (Psychogenic) Pain –  it can be defined as chronic pain leading towards an altered nociceptive function despite no clear evidence of actual or threatened tissue damage . This type of pain comes from a malfuntioning pain system that needs retraining. Examples  include Fibromyalgia, chronic lower back pain , Irritable Bowel Syndrome pain, bladder pain syndrome. The Role of the Nervous System The nervous system is instrumental in the Gate Control Theory. It uses two primary pathways to transmit pain signals, the ascending pathway (bottom up - how we feel pain like touching something sharp), and descending pain (top down pain modulation after inhibition or stimulation by neurotransmitters - why some people can tolerate the same pain as others are intolerant to). Pain is sent up to the brain to be processed to accentuate the possible perceived pain (gate is open) , or Pain stimuli is attenuated at the spinal cord, and restricted from travelling to the brain to perceive pain (gate is closed). The spinal cord is therefore a ”pain control box” modulating pain signals. If the gate is open, pain signals can pass through and will be sent to the brain and pain will be felt.  If the gate is closed, pain signals will be restricted from travelling up to the brain, and the sensation of pain won't be perceived. What Opens and Closes the Pain Gate? You may well be very interested now in what opens and closes the gate for your own pain perception. The gate opens through stress, lack of activity, mental health concerns. The gate closes through relaxation, mental health factors, and activity. The secret with pain relief is controlling the neurotransmitters that govern the opening and closing of the pain gate. What Can Help with the Pain? Understanding how the Gate Control Theory works can lead to effective pain management strategies. Here are some actionable methods to help 'close the gate' and lessen discomfort: 1. Physical Therapies Physical therapies such as massage, vibration, acupuncture, and chiropractic care stimulate non-painful sensory pathways, closing the gate. For instance, many patients report a decrease in pain intensity of around 40% after a few sessions of acupuncture. A TENS machine (Transcutaneous electrical nerve stimulation) is very useful here. 2. Mindfulness and Relaxation Techniques Practices like meditation, deep breathing, and yoga can foster relaxation and ease stress. These techniques allow individuals to shift their focus from pain, effectively helping to close the gate. 3. Distraction Techniques Participating in enjoyable activities—be it reading, painting, or socialising—can distract us from pain. Research shows that distraction can decrease pain perception by over 30%, making it a valuable tool in pain management. 4. Cognitive Behavioural Therapy (CBT) CBT helps individuals reshape their thoughts and reactions concerning pain. By addressing negative thinking and promoting effective coping strategies, CBT can close the gate and significantly improve pain management. There are even Apps that can help you especially with chronic, unresolved pain. 4. Natural Therapies There are some natural supplements that you can take that are specifically designed to help with different types of pain. Specifically, they address nerve pain, joint pain, inflammation, muscle aches, reduce transmission of pain, reduce neurotransmitters involved in transmission, creams and homeopathic options. Describing how you feel pain is key to helping with the most appropriate pain relief for your individual circumstances . The Importance of a Holistic Approach to Pain Management While the Gate Control Theory provides invaluable insights, a holistic approach is vital for successful pain management. Pain is a complicated experience, influenced as discussed by physical, emotional, and psychological factors. If you find yourself grappling with the question, "Why am I in so much pain?" remember you are not alone. Effective methods are available to help you manage pain and enhance your quality of life. With the right strategies and support, pain management is possible. Developing a personalised plan that meets your unique needs is critical, and can take some time to determine what is best for you, but it would be time well invested. By combining various methods like physical therapies, mindfulness practices, psychological support and natural therapies, you can create a robust pain management strategy. If you’re experiencing unresolved pain and you would like to discuss your current circumstances, 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: Gate Control Theory of Pain 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.

Key Points: Cellular Metabolism is the elimination of metabolic rubbish from our cells Without efficient Cellular Metabolism, we can induce Oxidative Stress, and Inflammatory changes in our bodies Our cells sense this danger and the 'Cell Danger Response' is initiated, with subsequent Dis-ease following Just like we as humans eat our food, drink, and get rid of our waste - so too do our cells. Every cell in our body consumes and excretes. This process is known as cellular metabolism. The cells exit their waste into the lymphatic system, and the lymphatic system takes that garbage and transports it to our blood circulation for detoxification and excreted via our poop and urine. The lymphatic system doesn't move unless we do, hence the importance of not sitting all the time but including exercise. If we don't move, and our lymphatic system doesn't move, then our cellular waste sits and causes inflammation, much like a stagnant pond allows bacteria to grow and flourish. Yuk! So if we lead 'inflammatory' lifestyles, are exposed to too much pollution, heavy metals, have too much chronic stress (physically and mentally) in our lives etc and it's just too much for our bodies to deal with, then we can end up initiating the Cell Danger Response, and this is when we start seeing symptoms, and this is the start of disease. Oxidative stress leads to Inflammation which leads to the cascade of the Cell Danger Response. Our body recognises signs of inflammation and this is the basis of our health concerns and how they begin. Our cells, which are the smallest building blocks of our body, sense danger and so they adapt. This is primarily a great thing if it's short acting (in acute scenarios). If the danger continues long term and becomes chronic, that's not a great thing. As a consequence our body starts to let us know things aren't right. Signs may be: impaired vision, weight issues, diabetes, cardiac issues, and many more. In essence, if you don't eat nutritiously the majority of the time, don't get enough sleep, don't drink enough water, don't move your body (gently), sit too long, don't breathe correctly....we can experience what's known as the 'cell danger response', and subsequently the beginnings of dis-ease. We can see early signs, feel early symptoms, and can see it in our pathology results well before our results are 'out of range' and needing medical treatment. Mitochondria are the power stations of our body where important cellular functions assure. Mitochondrial malfunctions show up as signs of illness and dis-ease. Graphic source How can I rectify my health concerns and where do I begin? A lot of the time our health concerns are all linked. Some simple steps 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 Looking after the genes we've inherited are all steps we can take. "The journey of 1000 miles starts with the first step" It may sound boring, but the cell danger response and 'dis-ease' is is where we may all end up if we don't look after ourselves. Remember - none of us are perfect - committing to change 80% of the time is a good goal, being consistent with that commitment, resting our mind and moving our body more are all achievable goals. If you feel you would like to discuss your personal circumstances with me 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: 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 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.

Key Points: If we don't detoxify and eliminate toxins then we accumulate them Toxins have external or internal sources Detoxification organs are our kidneys, intestines, liver, skin, lungs and lymphatics This is a simple overview of the processes of elimination and detoxification throughout our body. It is elimination and detoxification 101. A simple message is "If we are not eliminating or detoxifying or draining toxins, then we are accumulating toxins. This means we are becoming more toxic and our body will begin to not function properly, and with that begins dis-ease". Keeping the elimination channels open and clear so detoxification can occur is crucial to wellbeing. Elimination & Detoxification Pathways 101 Toxins either enter our body from two sources - external or internal sources. External sources include food, alcohol, cigarettes, smoke, heavy metals etc. Internal sources can include recirculating cholesterol, hormones, histamine etc. The toxins must make their way to the liver where they can be transformed from fat soluble toxins that can't be excreted from the body, to water soluble toxins that can be. As shown in the flow chart below, they are then eliminated as faeces, urine, perspiration, or breath. Each of the separate elimination channels are discussed in individual blogs. Our bodily pathways to eliminate toxins. Image source The Process of Detoxification and Elimination As shown in the picture below: Excess fat-soluble toxins like pesticides, hormones, or heavy metals get stored in our fat cells, brain, central nervous system, bone marrow and liver. Excess water-soluble toxins like nicotine, and other chemicals get stored in our joints, muscles, blood and body tissues. How toxins can accumulate in certain body parts if not eliminated or detoxified correctly. Image source Symptoms from detoxification and elimination issues: Acne and skin issues Allergies Arthritis and joint pains Autoimmune disease Cardiovascular disease Chronic fatigue Constipation Diarrhoea Diabetes Fibromyalgia Headaches Hormonal imbalances Inflammation Inflammatory Bowel Syndrome (IBS) Obesity and weight issues Neurological disorders If you would like assistance with any of these symptoms for your own personal circumstances, please don't hesitate 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. 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 colour of your urine provides a lot of meaning. The kidneys are one of the elimination pathways for the removal of toxins from our bodies. Importantly, the kidneys regulate our fluid and electrolyte balance in our bodies and in doing so they regulate our blood pressure. Colours of urine and what it may mean for your hydration and health status. Image source. Kidney Function The kidneys regulate the acid-base balance in our bodies via bicarbonate which dampens down acidity, much like a fire extinguisher dampens flames. Kidneys filter our blood of toxic waste and send it to the bladder for elimination. We lose 2-3 litres of water per day just to perform basic functions like extracting the nutritional components from our food, disposing of the waste, and to keep our temperature stable. If we don't drink enough water, our physical and mental performance can suffer, and long term our kidney health can suffer. Sodium, calcium, potassium, chloride, phosphate and magnesium are all electrolytes that we absorb from the foods we eat. The levels of electrolytes in our body constantly adjust to the changing fluid levels in our blood, so if we dehydrate or over-hydrate we can affect electrolyte levels. They can become too low or too high. Electrolytes (mineral salts) are essential for maintaining the health of our blood volume and blood pressure, for maintaining the acid-base balance of our body, for the electrical conduction of signals throughout our body ('electro-lytes'), and for enabling us to perform tasks we need to do. Sometimes we drink and drink and yet still don't feel hydrated. Our urine is often clear at this point. That is because we haven't got enough electrolytes to enable cellular exchange of fluid and electrolytes. This means our cells don't get enough water or hydration and so you still feel dehydrated. Putting a tint few specks of salt in a glass of water and drinking will rectify this situation. Ensure you have a good amount of water and electrolytes - there's nothing like getting muscle cramps at inconvenient times! What specifically does the colour of your urine mean? Take a look at your urine colour and compare to the picture above for a quick and easy visual to see if you're looking after your kidneys and consuming an adequate volume of water and electrolytes. Orange urine means you're not only lacking hydration, but you've lost electrolytes and so the critical bodily functions described above will start to become ineffective. Keep hydrated (approximately 2 litres for women, 2.5 litres for men), and eat nutritiously which will keep your electrolytes in balance. There is always a reason behind ensuring you drink enough water and eating well! Symptoms you may be experiencing with Kidney Detoxification Issues may include: Dark circles under your eyes Puffiness and fluid retention Smelly, cloudy urine Skin problems like acne, eczema, psoriasis Gout Blood pressure issues Urinary Tract Infections Kidney Stones If you feel you would like to understand this further for your personal circumstances, please feel free to make an appointment 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: Fluid and Electrolyte Balance: Medline Plus 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.