The popularity of saliva testing abounds. You can buy it on Amazon, you can buy it from Direct Labs. Your doctor, nutritionist or acupuncturist may offer this test. Heck, I even used to offer this test.
Saliva testing has long been employed by the alternative health community because it shows the bioavailable free fraction of unbound cortisol. 95% of cortisol in the blood is bound to a protein carrier, but the cortisol in saliva is not bound, thus its popularity
But this free fraction of saliva is only a very small percentage of total production. What you don’t see from a saliva test is total daily production, otherwise known as metabolized (or total) cortisol, which comprises about 80% of total production.
Only having the ability to see free cortisol would be fine if it always matched the metabolized cortisol pattern. But the two markers often do not match.
In fact, a discordant pattern between free and total cortisol is extremely common.
Here’s an example of low free cortisol with high metabolized cortisol:
If the above client had been directed to take licorice root or hydrocortisone for her low free cortisol based on the results of a salivary cortisol (remember, saliva testing ONLY shows free cortisol), without seeing that her adrenals were actually producing cortisol just fine (as shown by her high metabolized cortisol value of over 6000), she probably would’ve felt a lot worse.
The second reason why DUTCH testing is far better than saliva testing is that it shows how your body is breaking down estrogen. Since the ultimate biologic affect of estrogen depends on how you are metabolizing it, this is crucial information. Blood and saliva testing can not show this information, only urine testing.
This above picture is an example of someone who was not creating the good type of estrogen, which is 2-OH. She should be making at least 70% of 2-OH but she was only making 23.2%.
The good thing, is that this is can be changed with diet, lifestyle and targeted supplements.
So, in summary, these are the 2 primary reasons why DUTCH testing is the better
1. It looks at both free and total cortisol. Without the total cortisol measurement, you are left to guess what the adrenals are really doing.
2. It shows how you are metabolizing (or put simpler, what your body is doing with) your estrogen.
Many women seek like the idea of testing because it is proactive. It feels good to be taking your health into your own hands and doing something as significant as testing, to move forward.
Every woman should do a DUTCH test. Don’t waste money on saliva testing. The science has evolved. Lots of books and blogs are outdated….they just don’t know about DUTCH testing yet.
Candida is a form of yeast, also classified as a fungus, that lives in the large intestine and is also found on the skin and genitals. It is only a problem when it becomes overgrown or when an individual has a supressed immune system. The goal is not to totally get rid of it but to deal with the overgrowth and restore balance to your body. Total removal of candida is impossible and the effort to attempt this does your body a disservice. Some candida is fine. A lot is not.
When Candida is overgrown, it can cause:
Incessant sugar cravings
Bloating & gas
Toe Nail fungus
Brain fog, difficulty concentrating
Frequent urinary tract infections
Acne, skin issues, rashes
If you are struggling with any of the above, you are probably eager to find relief and ready to get started. Before you do, read about the common mistakes of candida treatment:
Mistake # 1: You Self Treat without Testing
Many people assume they have Candida overgrowth based on their symptoms or based on the “candida spit test”. This is problematic because most symptoms for yeast overgrowth are non-specific which means they can also be the symptoms for various other health conditions. Diagnosing yourself based on symptoms or a spit test alone is never a good idea. A spit test is just an initial screening.
Candida is a common thing to suspect. Many people browse “Dr. Google” and assume they have it. It could be candida but it could also be a number of other fungal species. It may not even be yeast. It could be a parasitic infections (surprisingly common!), bacterial dysbiosis, leaky gut, autoimmune problems or a number of other disorders that mimic candida.
These conditions are not mutually exclusive. You could have candida plus any of these other conditions at the same time. To self treat candida is to run the risk of never getting to the bottom of your health complaints.
For example, I rarely see candida overgrowth without other gut issues. Yeast is commonly a secondary infection, meaning that some other infection came first and allowed the candida to overgrow. If you do not holiststiclly heal your gut, the likelihood is high that the yeast will return.
How to Test for Yeast
There are a number of different testing options that will identify yeast overgrowth. A microscopy stool test ( a test where a skilled lab technician looks at your sample with a high powered microscope) will rarely identify candida because candida is hard to culture in a petri dish. I like the Diagnostics Solution Lab ‘GI-MAP’ because it can identify several different types of yeast overgrowths, (not just candida) because it uses DNA analysis of gut bugs (as opposed to micoscopy methodology) to give an excellent picture of the GI environment. I also like the ParaWellness Test.
This is the fungi/yeast section of the GI MAP stool test from Diagnostic Solutions Lab. This is my test which showed low amounts of candida species. Believe it or not, even a “low” reading is quite significant.
Mistake # 2: You are using the “candida diet”
The candida diet recommends removing sugar, starch, alcohol and refined foods. Since sugar and starches are a primary food source for the yeast, it postulates that by cutting these things out the yeast will go away. Not entirely correct.
By drastically limiting fuel to candida, you are pushing down the overgrowth. By pushing down overgrowth, it may also be harder to kill off candida with herbs. It sounds silly, but you actually have to keep the yeast happy in order to control the overgrowth.
In keeping with my philosophy that there is no one right diet for anyone, this applies to candida treatment as well. Some people may be able to simply cut out sugar to control yeast but other people may need a more comprehensive approach. Some people may fare better on the Specific Carbohydrate Diet, which is based on the molecular structure of carbohydrates and actually allows some sugars, though not many, and not in the beginning phase. The SCD diet may also be better to help heal the lining of the small intestine.
Mistake # 3: Failure to Heal a Damaged Gut
The main reason why people fail to eliminate the candida overgrowth is because they do not address the reason(s) which allowed the yeast to spiral out of control.
Candida is a natural part of you and is kept in check by the other beneficial microflora that reside alongside it. When gut flora becomes depleted from food intolerance, inflammation, alcohol, leaky gut, poor diet, toxic overload or other pathogenic infections, the yeast can move beyond the large intestine and affect other areas of the body.
Yeast is opportunistic. If it has the opportunity to overgrow, it will. Many people diligently do their candida diet, take herbal or conventional remedies but do nothing to address GI imbalance or to repair the mucosal lining of the gut.
If you do not change the environment that coaxed the candida to overgrow in the first place then you will never get rid of the yeast.
Healing candida involves addressing inflammation, restoring beneficial bacteria, and identifying other pathogenic infections.
As always, lifestyle plays a role here as well: Are you getting enough sleep at night? Are you going to bed at a decent time? Are you managing your stress? Do you exercise regularly?
All these things are important in maintaining total body balance and ensuring that yeast is kept in check. It’s never just about killing yeast.
This is a seriously dysbiotic (or imbalanced) gut. This test sample also showed positive for candida as well as multiple other species of overgrown bacteria. Like I said, candida almost never exists in isolation
Mistake # 4: You Opt for the Nystatin from your doctor and think you are done
Herbal medicine to manage candida can be highly effective if done right but it takes longer to manage candida this way and therefore, some people opt for an Rx from their doctor, such as nystatin. I understand this, I really do. And sometimes it can even work. But most people who go the standard treatment route do nothing to heal their gut (mistake #3) and they are back at square one again.
Mistake #5 You Don’t Give Herbal Medicines a Chance to Work
As I said in #4, herbal medicines can be very helpful for managing candida but they take longer than using a prescription and require you to be vigilant in taking your remedies, often up to 3x/day. You are also looking at 40-60 days of doing this versus 2 weeks on nystatin. There are also candida clease packages on store shelves that purport to work in 1 to 2 weeks. This is not nearly long enough to address a candida problem. If you opt for the herbal route, and want to do it properly, you are looking at 1-2 months of treatment and then perhaps another few months of working on gut health.
Remember, working on candida is never just about the candida. It’s about good gut health and assessing lifestyle as well.
As a functional diagnostic nutrition practitioner (FDN-P), I have been trained in functional lab work and holistic protocols. The test that I favor for candida assessment is called the GI-Map. If you suspect you have candida but don’t want to make any of the above mistakes, I encourage you to reach out to me and see if we might be a good fit to work together.
I am honored to have the pioneering Dr. Terry Wahls as a guest blogger for my blog. Dr. Wahls is a clinical professor of medicine at the University of Iowa where she conducts clinical trials. She is also a patient with secondary progressive multiple sclerosis, which confined her to a tilt-recline wheelchair for four years. Dr. Wahls restored her health using a diet and lifestyle program she designed specifically for her brain and now pedals her bike to work each day. She is the author of The Wahls Protocol: How I Beat Progressive MS Using Paleo Principles and Functional Medicine, The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles (paperback), and the cookbook The Wahls Protocol Cooking for Life: The Revolutionary Modern Paleo Plan to Treat All Chronic Autoimmune Conditions.
My future was very clear. The picture was grim. I would end up bedridden and demented. It was only a matter of time.
A very unpleasant milestone was approaching. I was facing medical disability due to progressive multiple sclerosis (MS). In 6 months, I would be reassigned to the traumatic brain injury clinic, where I would serve as the primary care physician on that team. I would no longer supervise residents. Instead I would be seeing patients directly.
However, it was unlikely I had the physical strength or stamina to do that job. Because of MS, I had been steadily declining for seven years. I was too weak to sit up in a regular chair and I was beginning to struggle with brain fog. I was worried about how much longer I would be able to work.
The people I worked for were too; this reassignment was probably my chief of staff’s way of telling me that the VA and the University were done redesigning my job to accommodate my illness. Once I was expected to see patients directly instead of teaching residents, I wouldn’t be able to function well enough to complete my workload. Seeing patients would be too much for me, and I would have to apply for medical disability. There was nothing more to do other than start my new position and accept that I would be unable to do the work. Then I’d apply for disability and hopefully get it, though there were no guarantees.
For 7 years, I had been getting progressively more disabled, despite taking the newest, latest drugs, including the newest biologic drugs. I was in a tilt-recline wheelchair, with no hope of restoring my ability to walk.
During my steady decline, I began to read the scientific literature about the basic science on neurodegenerative diseases and the mitochondria. At first I focused on drug studies. Then I realized I should read about the basic science of things that I could access–things like vitamins, supplements, stress reduction, and exercise. Based on the literature, I created an intensive program to support the health of my brain cells and my mitochondria, the power plants of the cells. I did all of this not to recover, but instead to slow my decline.
All of my neurologists at the Cleveland Clinic and the University of Iowa had told me that progressive MS is steady and irreversible. There would be no spontaneous recovery, only decline, and functions once lost were gone forever. So my goals were simple. I wanted to keep what I had, to be able to walk a few steps, for a few more years.
Miraculously, that is not what happened. My intensive diet and lifestyle program did the impossible. Three months after starting my program, my fatigue was gone. So was the brain fog. After six months, I was walking without a cane. After one year, I could bike 20 miles with my family.
I have changed the focus of my clinical practice and the focus of my research. I ran a therapeutic lifestyle clinic where we used these principles to treat people with autoimmune disease, metabolic diseases (like diabetes, obesity, and fatty liver disease), traumatic brain injury, chronic pain, and mental health problems – all with remarkable success. For many of our patients, pain declined, blood pressure and blood sugar normalized, and symptoms reduced. The need for medications also steadily declined. All because of diet and lifestyle changes.
We have conducted pilot clinical studies testing my protocol in others with progressive MS. These studies show that people can implement the diet and lifestyle program and experience a reduction in pain and improvement in energy, mental clarity and mood, and motor function.
The key message is that the food we eat creates the health we have or do not have. We teach people how a lifetime of diet choices and environmental exposures create health or disease, depending upon how our genes interact with our environmental exposures. Then we teach them why and how to eliminate inflammatory foods (especially sugar, gluten, and casein) and which foods will help them heal (green leafy vegetables, sulfur-rich vegetables, and deeply pigmented vegetables and berries).
I have made it my mission to teach the public that their health depends not on their physician, their health insurance companies, or the government. Their health depends on their decisions about what to eat and what to do each day. If you want to learn more about the Wahls Protocol® and how to implement these concepts in your lives, you can attend in person seminars that I offer to the public, or pick up my book, The Wahls Protocol: A Radical New Way to Treat All Chronic Autoimmune Conditions Using Paleo Principles, and the companion cookbook, The Wahls Protocol Cooking for Life. Begin your healing journey today.
Instead of becoming bedridden, I am riding my bike. Instead of being demented, I am writing books and grant proposals and conducting clinical trials. My terrible future was rewritten not by drugs, not by stem cells, not by surgery. It was rewritten by changing what I ate and what I did. You could do the same.
You can learn more about her work from her website, www.terrywahls.com. She conducts clinical trials that test the effect of nutrition and lifestyle interventions to treat MS and other progressive health problems. She also teaches the public and medical community about the healing power of the Paleo diet and therapeutic lifestyle changes that restore health and vitality to our citizens. She hosts a Wahls Protocol Seminar every August where anyone can learn how to implement the Protocol with ease and success. Follow her on Facebook (Terry Wahls MD) and on Twitter at @TerryWahls. Learn more about her MS clinical trials by reaching out to her team MSDietStudy@healthcare.uiowa.edu.
Clinical trials in which my team is participating
The links to our National MS Society funded research
Two studies in Bastyr University that are asking patients with MS or Parkinson’s disease about whether they are following the Wahls diet.
It’s Valentines Day….which is all about love and romance. But does your libido need a search and rescue team? A healthy libido is a sign of a healthy woman.
Is your libido missing in action?
Being libido-less is a modern issue caused by several things, but most notably by physiological and mental stressors. Something tells me that our ancestors enjoyed a romp in the hay far more frequently than we do today.
Why might that be?
Being constantly connected to our phones.
Working long hours in soul sucking jobs.
Sitting in traffic and the pollution it generates.
Taking on too many commitments and responsibilities.
Not eating enough vibrant, whole, fresh food.
Being exposed to toxins in our personal care products that confuse our endocrine system.
There’s more, but you get my drift…
All of this happens at the expense of our sex life.
Being “in the mood” requires a good, safe relationship that allows desire to happen, but it also needs properly functioning hormones.
Beyond the distractions and stress of everyday life, there is actually something more going on behind the scenes that causes a loss of libido – Out of balance hormones.
The hormone that mostly drives sexual desire is testosterone but estrogen, progesterone and oxytocin (the “love” hormone) all play a supporting role in libido.
Where does cortisol (the stress hormone) fit into this?
When we are under constant stress our body is continuously releasing cortisol in response. Our body becomes more preoccupied with keeping us alive and maintaining essential balance while non-essential functions (such as sex, digestion and growth) are thwarted.
That’s right…. Chronic stress kills libido every time. That stress can be mental (fight with your spouse, errant teens, office drama at the workplace) or physiological (gut bugs, inflammation, unadressed food sensitivites)
In addition to stress affecting our testosterone, estrogen and progesterone, a high output of cortisol also suppresses oxytocin, the love hormone.
Oxytocin is released with orgasm, while playing, laughing, hugging and giving and positive affirmation.
There is hope for your low libido, but it takes intention and attention!
It is possible to nurture your libido back, and it not about just topping off lost hormones, ie. slapping on some testoerone cream.
To get your sexy back, you must address what is causing your cortisol to be so high while also getting oxytocin on the scene more often.
Here’s how nto stimulate oxytocin…
- Stare deeply into the eyes of someone you love
- Go upside down (throw your legs up on the wall, do a yoga pose)
Think this sounds too simple to be helpful? Here’s why this stuff works: They help you get out of “fight or flight” mode and instantly relieve stress. Even just a few minutes a day can have a huge impact on your overall health and thus your libido
To reduce even more chronic stress and cortisol release, you can also:
- Eat an anti-inflammatory diet free of gluten, dairy, sugar and soy
- Get in bed by 10pm
- Try yoga or chi-gong once or twice a week
To better understand your cortisol and hormone balance as it relates to your sex drive, you can also do a simple urine test in the comfort of your own home.
Testing your cortisol and sex hormones gives you insights on how to improve your health and libido by using food, sleep, exercise, stress reducing tools and targeted supplements.
However, hormone tests are not all created equal. To truly evaluate cortisol balance you need to be able to see the rhythm of your cortisol throughout the day. A urine test is best as it allows you to take several different samples during the day to see the rhythm and flow versus a blood test that only shows your morning cortisol, a small piece of the picture and just not enough data to draw any meaningful conclusions about your cortisol levels.
Understanding the health of your cortisol rhythm will assist you in getting your sexy back! My favorite way to help women is by using the DUTCH test. If you would like to find out more about this can help you, you can book a complimentary consultation with me right here.
Menopause is when you’ll get hot flashes, sleep problems, lose your sex drive, feel unsexy and put on weight, right?
So at 43, you are wondering “Why do I have all that plus the added insult of heavy periods and worsening PMS”?
Perimenopause is a time of great opportunity to do a whole life assessment
Photo by Anne Lanphear
Most women associate menopause with problems, but fail to realize that the period of 10-12 years preceding menopause, known as perimenopause, is where the real challenge is due to shifting and unpredictable hormone levels.
As someone who is fully settled into menopause and is happier and healthier than ever before, I wanted to share with you how you can take charge of your health in perimenopause in order to have an easier menopause later on.
Perimenopause Equals Hormone Imbalance
Perimenopause can begin anywhere from 35-45 and is a challenging time because the ovaries (which produce progesterone and estrogen) are starting to go into retirement. As opposed to menopause, where your sex hormones don’t shift anymore, and are at new low, steady levels.
What Happens To Estrogen In Perimenopause
Estrogen is not in decline in your perimenopause years, it is shifting. It surges one month and drops the next month. Estrogen in perimenopause is unpredictable and unstable. When it is high (termed estrogen dominance), it can cause heavy periods, PMS, bloating and irritability. When it is low, it can cause the blues, hot flashes, cravings and night sweats.
What Happens to Progesterone in Perimenopause
Progesterone, our soothing hormone, is in a free fall and once it drops, it never returns. We become permanently progesterone deficient in perimenopause, at a time that we need it the most.
Progesterone is made my the ovaries when we ovulate. Although you may still be menstruating regularly, you are likely experiencing anovulatory periods, which means that you are not ovulating. When you don’t ovulate, you don’t make progesterone. There is nothing wrong with you, this is simply your body’s way of moving towards the natural stage of life where you become infertile. But it does mean less progesterone and that can be very problematic for some women because progesterone helps your thyroid function better, is protective against those estrogen surges and it calms anxiety.
What Happens to Cortisol in Perimenopause
Cortisol, our main stress buffering hormone, is made in the adrenal glands and is secreted in various amounts throughout the day.
As women transition through perimenopause, overnight cortisol levels can increase. This is linked to problems with sleep-wake patterns, hunger, energy levels and immune system health.
There is also some evidence that cortisol can elevate in the presence of exogenous and endogenous estrogen levels, and remember those estrogen levels are like electrical power surges in perimenopause. Rising cortisol levels are associated with poor health and more severe hot flashes.
Perimenopause is a great wake up call and time to do a thorough life assessment. If you’ve not tended to your own needs on a physical and emotional level, menopause will likely hit you over the head and you’ll be beset with multiple and uncomfortable symptoms.
4 Simple Things You Can Do in Perimenopause Now To Have an Easier Menopause Later:
- Get the inflammatory foods out of your diet. Things like commercial dairy, gluten, GMO corn and sugar are inflammatory for everyone. Other foods such as grains can be inflammatory for others. If you find the right way of eating for you, you will lose stubborn weight, feel better and be able to deal with the challenges of shifting hormones that are a given in perimenopause.
- Take some magnesium, especially if you suffer with hot flashes. Magnesium is a mineral that we can easily become deficient in due to stress because the body dumps it when we are under stress. A good amount to start with is 300-400 mg per day, preferably with dinner as part of your wind down ritual.
- Know your baseline hormone levels-A DUTCH hormone test will tell you not only your absolute estrogen level but also show what your body is doing with the estrogen (this is called estrogen metabolites). It will also give you a more thorough look at the adrenals than a saliva panel does and can also look at your melatonin. It’s a great all around hormone test for perimenopausal women who want to take ownership of their health.
- Do an honest life assessment-Where are you now? How is your health, really? Do you sleep? Are you happy in your job, relationship? What can you do to make things better? How can you nurture your spirit and body?
Need some help navigating the rough perimenopause waters? Are you struggling with putting your finger on exactly what is going on in your body and life? Well, I’ve been through perimenopause and menopause and am here to tell you that you can be healthy and well balanced in your 40s, 50s and beyond and can help you make sense of this time of your life.
Women who are ready to take control of their health but just need a little guidance can book a complimentary, no-strings-attached, 20 minute session with me right here to find out more about how I work to help you get your hormones back into balance.
I will say it straight up front here….estrogen is not bad. Given the widespread fear of estrogen that most women have these days, it bears repeating…estrogen is NOT bad. It is a wonderful female hormone that gives us breasts and hips and helps to keep skin dewy and youthful looking. It also maintains our heart and bone health.
The problem is when estrogen is out of balance. That is where the problems start.
An example (from the DUTCH method of testing) of estrogen out of balance
Here are 6 ways that you can minimize your exposure to bad estrogen:
1. Store your leftovers in glass receptacles. If you must use plastic, be sure not to pour hot soup into plastic containers. Let hot foods cool first.
2. Change up your beauty routine. Check your labels…do your products have parabens, pthalates and sodium laurel sulfate? These ingredients are known endocrine disruptors. I use and love Beautycounter because they ban over 1500 chemicals from their products.
3. Go organic as often as you can. Glyphosate, otherwise known as round-up by Monsanto has been shown to activate the estrogen receptor in women. This can cause a cascade of confusion for your entire endocrine system.
4. Eat more cruciferous vegetables. Cruciferous vegetables are things like broccoli, cauliflower, cabbage, kale, brussels sprouts, and arugula to name a few. These help your body to make the good type of estrogen, 2-Hydroxyestrone. My advice to my client who had the poor estrogen metabolism as seen in this picture below was to have as many cruciferous vegetables as she could tolerate.
This is an example of low 2-hydroxestrone, which is not good. It should be 70%!
5. Eat flax seeds. The lignans in flax seed can block estrogen signalling and lower excessively high blood levels of estrogen. This is great news for women with too much estrogen, also sometimes referred to as estrogen dominance. Flax seeds are best ground. They can be put in smoothies and baked goods.
6. Reconsider your method of birth control. If you are on hormonal birth control, you are getting exposure to synthetic estrogen and progestins. In one animal study, ethinyl estradiol, which is a form of synthetic estrogen commonly used in the pill, caused toxic effects on the liver. Since the liver is crucial to balancing hormones, anything that causes it harm should be avoided.