The emotions of infertility treatments

One of the most difficult aspects experienced by women undergoing infertility treatments is the feeling of uncertainty and lack of control.  Research has shown that these feelings reduce the wellbeing of woman where up to a ¼ of women undergoing IVF treatments will experience emotional distress. For some this distress is so great that IVF treatment is stopped before the dream of having a baby is achieved (1)

Emotional distress and depressive symptoms may also be attributed to some of the medications that are used to treat infertility. Whilst larger scale studies are needed two smaller studies show that 60 percent of women taking leuprolide or lucrin, experienced depression (2), and an observational study of women taking gonadotropin-releasing hormone agonist medication found that depressive symptoms occurred in 75 percent of women (3).

In addition physiological stress may also affect IVF outcomes where a prospective study showed that

  • Stress was significantly correlated with numerous biologic end points, including affecting the number of oocytes retrieved and fertilized, pregnancy, live birth rate, and birth weight.
  • Stress level on the day of the procedure was significantly related to the number of oocytes retrieved and fertilized (4)

Often the most emotionally challenging times experienced during the IVF journey is the lead up to embryo transfer and the dreaded wait between embryo transfer and the pregnancy test. The research tells us that these events lead to pre-treatment anxiety that can remain high up to 3 months following the IVF cycle (1)

Ways to get the best out of your IVF treatment?

Whilst IVF clinics have great support services, these may not be utilised for varying reasons. Some women may feel they do not require such services as psychological distress is not recognised or women may prefer other supportive treatments outside the IVF clinical environment.

Often it is finding what works best for you as there a number of supportive treatments available such as counselling, exercise, mindfulness, meditation, acupuncture, massage and other complementary health approaches.

Studies have found that women overall report an increased sense of wellbeing from using complementary treatments (5,6). In particular Acupuncture is frequently used by women undergoing IVF treatments to increase their wellbeing and reduce stress.

Acupuncture and IVF Treatments

A recent research article has examined the effect acupuncture has on women experiencing infertility and found there were benefits with reducing the stress and anxiety of infertility whilst inducing a state of relaxation and calm. Overall Acupuncture also improved physical health, women had more energy and emotionally functioned better (1)

Regardless of how one is managing IVF treatments don’t underestimate the effect it may be having on your wellbeing not just short term but also long term on you, your partner, family and friends. Seeking supportive services early and managing anxiety and stress are imperative in your fertility journey.

 Want to know more?

If you would like to know more about how we can support you during your fertility journey or during your IVF treatments please contact us or book online

 

References

  1. Smith, C. et al, 2018 The effects of acupuncture on the secondary outcomes of anxiety and quality of life for women undergoing IVF: A randomized controlled trial <https://doi-org.access.library.unisa.edu.au/10.1111/aogs.13528>
  2. Warnock JK, et al 2000, Depressive mood symptoms associated with ovarian suppression. Fertil Steril, 74:984.
  3. Steingold KA et al 1987 Treatment of endometriosis with a long acting gongadotrophin releasing hormone agonist. Obstet Gynecol 69:403.
  4. Domer, AD, 2017 Psychological stress and Infertility <<https://www.uptodate.com/contents/psychological-stress-and-infertility>
  5. Rayner, J, McLachlan, H, Forster, D, Cramer, R. Australian women’s use of complementary and alternative medicines to enhance fertility: exploring the experiences of women and practitioners. BMC Complement Altern Med. 2009; 9: 52.
  6. Lacey, S, Smith, C, Paterson, C. Building resilience: a preliminary exploration of women’s perceptions of the use of acupuncture as an adjunct to in vitro fertilisation. BMC Complement Altern Med. 2009; 9: 50.

Fertility and Hormone Profiling at acumedica

Optimising Preconception, Pregnancy and Post-natal health with the Hormone and Fertility Profile

The Hormone and fertility genetic profile can help reveal the underlying influences affecting your reproductive and endocrine health issues. This profile helps to optimise fertility, pregnancy and post-natal health by identifying the most appropriate forms of nutrients and lifestyle modifications based on your genetics.

Symptoms and conditions best suited to this profile:

  • Couples experiencing difficulties conceiving
  • Couples interested in optimising preconception health
  • People interested in optimising health during pregnancy for mother and baby
  • Poor nutrient status of Vitamin D and essential fatty acids
  • Infertility
  • Women with:
    • History of miscarriage
    • History of mood disorders, depression and post-natal depression
    • History of preeclampsia
    • Endometriosis
    • Hormonal imbalances
    • Irregular menstrual cycle
    • PCOS
    • PMS or PMDD
    • Thyroid issues
    • Menopause

Testing involves obtaining a cheek swab and sending the sample away to be tested, this can be done in clinic or in the comfort of your own home. Results can take approximately 3 weeks to be returned.

Results along with a personalised therapeutic strategy and diet are provided at your consultations to obtain maximum benefit.

If you have any queries regarding the testing please contact the clinic

Best Treatments for Endometriosis

What is the best treatment for Endometriosis?

Treatment for endometriosis falls into three broad categories

    1. Medical treatment with medications such as pain relief and hormonal therapy to suppress estrogen production
    2. Surgical to remove endometriosis. However surgery is unable to remove the microscopic endometriosis and this is why endometriosis is likely to proliferate and grow again.
    3. Complementary treatments such as dietary adjustments, counselling, herbal medicine, physical therapy and acupuncture.

Receiving the right treatment will depend on your symptoms, your genetic profile, the severity of the condition and whether you are trying to become pregnant or maintain your ability to have children.

Diet and lifestyle

As endometriosis is an estrogen driven inflammatory condition it is imperative to make diet and lifestyle changes to minimise exposure to environmental and plant based estrogens along with assisting estrogen metabolism and reducing inflammation.

Treatment should be individualised to achieve the best response however some guidelines to assist in the management of endometriosis:

  • Avoid food intolerances and allergens that may exacerbate inflammation. Food intolerance testing is ideal to discover what foods you are reacting too.
  • Avoid foods that are estrogenic such as soy based products.
  • Know your genetic profile and expression of genes such as MTHFR, COMT and PEMT to establish underlying genetic reasons for estrogen issues, immune response and antioxidant production. This will also enable a tailored dietary, lifestyle and supplement protocol for you to assist with estrogen metabolism.
  • Avoid toxins that may mimic estrogens in the body such as dioxins, pesticides and polychlorinated biphenyls (PCB’s).
  • Assist estrogen metabolism with cruciferous vegetables such as broccoli, brussel sprouts and cauliflower. These vegetables are a rich source of sulfur containing compounds known as glucosinolates. When chewed they generate indole-3-carbinol.
  • Ensure good gut and liver health to assist with estrogen and toxin metabolism.
  • Moderate to intense frequent exercise has shown to reduce the size of endometrial lesions in some studies.
  • Stress less as stress may contribute to the development and severity of endometriosis through dysregulation of the hypothalamic-pituitary axis and promoting release of inflammatory markers

Chinese Medicine Approach and Endometriosis

Traditional Chinese medicine alongside conventional medicine utilises a number of different approaches and techniques to treat the symptoms of endometriosis using diet therapy, manual techniques, acupuncture and Chinese herbal medicine. To date research has shown some promising results however more research is required in this area.

Acupuncture has shown to reduce pain and serum markers associated with endometriosis, according the authors of a systematic review. The results showed that acupuncture yielded better reductions in pain associated with dysmenorrhoea, and led to a better reduction in peripheral blood CA-125 (a marker for endometriosis) when compared with control interventions [9].

Whilst a recent research article showed that Acupuncture increase’s the release of endorphins, the body’s own ‘feel-good’ chemicals, which play an important role in the regulation of physical and emotional stress responses associated with pain and digestive issues. [10-11].

Endometriosis the future

The complex nature of endometriosis and misconceptions around menstruation and infertility have led to delayed diagnosis and many hit-and-miss treatments. Myths continue to surround the endometrial phenomena such as ‘surgery will cure my endometriosis whilst medical/surgical classifications continue to evolve as consensus on classification is debated. Meanwhile many women continue to suffer.

It is time for women to take control educate and empower themselves to address the underlying reasons for endometriosis. Finding this can seem overwhelming and can take time. For some it is a matter of months some years. But remember every small step towards change is better than staying where you are.

If you would like to take the first step contact us or book an appointment on line

 

References
1 Pinkert TC, Catlow CE, Straus R. Endometriosis of the urinary bladder in a man with prostatic carcinoma. Cancer. 1979;43:1562–7.
2. Fukunaga M. Paratesticular endometriosis in a man with a prolonged hormonal therapy for prostatic carcinoma. Pathol Res Pract. 2012;208:59–61.
3. Simsek G, Bulus H, Tas A, Koklu S, Yilmaz SB, Coskun A. An unusual cause of inguinal hernia in a male patient: Endometriosis. Gut Liver. 2012;6:284–5.
4. Schenken, R, Barbieri, R, Eckler, K 2019, Endometriosis: Pathogenesis, clinical features, and diagnosis, Up to date 2019.
5.Gustofson RL, Kim N, Liu S, Stratton P. Endometriosis and the appendix: a case series and comprehensive review of the literature. Fertil Steril 2006; 86:298.
6. Jenkins S, Olive DL, Haney AF. Endometriosis: pathogenetic implications of the anatomic distribution. Obstet Gynecol 1986; 67:335.
7. Lasmar, Ricardo Bassil, Lasmar, Bernardo Portugal, & Pillar, Claudia. (2012). Diagram to map the locations of endometriosis. International Journal of Gynecology & Obstetrics, 118(1), 42-46
8. Sourial, Tempest, Hapangama 2014, Theories on the pathogeneses of endometriosis International journal of reproductive medicine 2014.
9. Xu, Wenli, Li, Ahao, Bu, Song 2017, Effects of acupuncture for the treatment of endometriosis-related pain: A systematic review and meta-analysis, PLoS One. 2017.

Understanding Endometriosis

Say no to ENDO……

It is estimated that 176 million women worldwide are affected with Endometriosis, a debilitating condition that can play havoc with mood, hormones, libido, pain, energy levels and infertility.

On average it can take 12 years from the onset of symptoms to a definitive diagnosis and then even longer to address and treat the underlying causes.

This in turn may lead to the condition worsening as endometrial like cells proliferate, invade and implant elsewhere in the body.

What is Endometriosis?

Endometriosis is an estrogen- dependent, benign, inflammatory disease where endometrial like tissue grows outside of the uterine cavity. The peak prevalence of endometriosis occurs in women 25-35 years of age. However the disease has been reported in younger girls whom have not commenced menstruation, postmenopausal women and even men [1-4].

Where is Endometriosis found?

Histological reports have found endometrial lesions in the following areas of the body

• Reproductive organs
• Gastrointestinal region
• breasts
• Kidney & adrenal glands
• Urinary tract
• Spinal column
• peripheral and central nervous system
• Chest cavity (lungs and around the heart)
• Prostate [5-6]

Symptoms of endometriosis?

The symptoms of endometriosis are different for everyone, the pattern of your pain can often indicate the location of your endometriosis and thus help with treatment options. Although some women have no or minimal symptoms it is still important to have the correct diagnosis to best support your hormones.

1. Pain
2. Infertility
3. Bowel issues such as IBS
4. Bladder problems such as recurring UTI’s
5. Heavy menstrual bleeding
6. Endometrioma (ovarian mass)
7. Chronic fatigue symptoms
8. Emotional disturbances

What Causes Endometriosis?

The cause of endometriosis remains uncertain but appears to be multifactorial. A number of theories have been postulated for further research such as the Sampson theory, Coelomic Metaplasia theory, embryonic rest theory and lymphovascular metastasis theory. Other causes may include one or more of the following [4,7,8].

1. Genetic Factors
2. Immune dysfunction
3. Hormonal imbalance
4. Abnormal endocrine signalling
5. Imbalanced cell proliferation
6. Sampson theory of retrograde menstruation
7. Lymphatic dissemination
8. Infectious or environmental triggers
9. Oxidative stress
10. Inflammation
11. Alterations in the gut microbiota
12. Liver damage
13. Long term hormonal therapy

How is endometriosis diagnosed?

The only way to be 100% certain of the diagnosis is to have a laparoscopy. This is a surgical procedure where a thin telescope is placed into your belly button to allow your gynaecologist to see inside and assess the organs of your pelvis and abdomen whilst taking a biopsy (tissue sample) for diagnosis.

As the cause of endometriosis is multifactorial the treatment approach should be the same to address all facets of the disease and its many causes. Over the years working both in the medical and complementary medicine worlds an integrative approach with the commitment to make the necessary changes and adjustments is required to achieve the best outcome.

Want to learn more or find out how we may be able to assist with symptoms associated with endometriosis contact us or book online.

 

 

References:
1 Pinkert TC, Catlow CE, Straus R. Endometriosis of the urinary bladder in a man with prostatic carcinoma. Cancer. 1979;43:1562–7.

2. Fukunaga M. Paratesticular endometriosis in a man with a prolonged hormonal therapy for prostatic carcinoma. Pathol Res Pract. 2012;208:59–61.

3. Simsek G, Bulus H, Tas A, Koklu S, Yilmaz SB, Coskun A. An unusual cause of inguinal hernia in a male patient: Endometriosis. Gut Liver. 2012;6:284–5.

4. Schenken, R, Barbieri, R, Eckler, K 2019, Endometriosis: Pathogenesis, clinical features, and diagnosis, Up to date 2019.

5.Gustofson RL, Kim N, Liu S, Stratton P. Endometriosis and the appendix: a case series and comprehensive review of the literature. Fertil Steril 2006; 86:298.

6. Jenkins S, Olive DL, Haney AF. Endometriosis: pathogenetic implications of the anatomic distribution. Obstet Gynecol 1986; 67:335.

7. Lasmar, Ricardo Bassil, Lasmar, Bernardo Portugal, & Pillar, Claudia. (2012). Diagram to map the locations of endometriosis. International Journal of Gynecology & Obstetrics, 118(1), 42-46.

8. Sourial, Tempest, Hapangama 2014, Theories on the pathogeneses of endometriosis International journal of reproductive medicine 2014.

9. Xu, Wenli, Li, Ahao, Bu, Song 2017, Effects of acupuncture for the treatment of endometriosis-related pain: A systematic review and meta-analysis, PLoS One. 2017.

Pain and Acupuncture

What is Pain?

Pain is often complex and debilitating affecting jobs, relationships, mental and emotional wellbeing, sleep, ability to exercise and overall health. Managing ongoing chronic pain often involves taking a multidisciplinary approach. Here we provide a guide on the types of pain and some simple ways you can manage pain.

How is Pain Classified?

Pain is defined by the International Association for the Study of Pain (IASP) as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage (1)

Pain can be classified in a number of different ways with some of them overlapping such as

  • Physiological pain due to nociceptive, neuropathic and/or inflammatory response
  • Mild, moderate or severe
  • Acute, Chronic or acute on chronic
  • Type of tissue involved  such as skin, muscles, viscera, joints, tendons, bones
  • Syndromes or disease such as endometriosis, fibromyalgia, cancer, migraine etc.

Pain the signs and symptoms

  • Stinging
  • Burning
  • Ache
  • Sore
  • Stiffness
  • Throbbing
  • Anxiety
  • Depression
  • Moodiness
  • Sleep problems
  • Fatigue and weakness
  • High blood pressure
  • sweating
  • change in skin and body temperature
  • inflammation
  • joint deformity
  • change in body posture

How Pain is assessed?

Physical examination is only one aspect of pain assessment. Self-reports are the most reliable indicators of pain and no one tool should be used as an absolute measure of an individual’s experience. There are, however, various assessment tools such as the visual analogue scale, abbey pain scale for people whom are unable to verbalise and the Wong-Baker faces tool (often used in children over three years of age (2)

 

The Wong baker faces scale

 

 

 

 

 

 

How many Australians suffer with Pain?

  • In 2007-2008 approximately 67% or 11.1 million people in Australia aged 15 years and over reported experiencing bodily pain. (3)
  • More Australian adults experienced chronic pain in 2007–08 than in 1995. Rates of overall body pain has increased from 57% to 68%, whilst severe/very severe pain increased from 7% to 10%. (3)
  • The average cost of chronic pain is estimated at $34 billion dollars
  • Arthritis and back problems are the most common reason people drop out of the work force
  • More than 700,000 women suffer from crippling symptoms of pelvic pain and conditions such as endometriosis including severe period pain at a cost of $6 billion per year in Australia (3)

Common Pain conditions we treat?

  • Back pain
  • Shoulder pain
  • Hip pain
  • Headache
  • Migraine
  • Plantar fasciitis
  • Knee pain
  • Fibromyalgia
  • Arthritic pain
  • Sciatica
  • Digestive Pain
  • Pelvic Girdle pain in pregnancy
  • Symphysis pubis dysfunction
  • Painful Periods
  • Endometriosis

Treatment Options for Pain?

Alongside conventional treatment there are also a number of complementary treatment options to consider for managing pain such as diet, relaxation and acupuncture.

Diet

A well balanced diet with plenty of fresh fruit and vegetables is important for general health and wellbeing. However for pain it is important to take a more targeted individualised approach to efficiently manage inflammation. Here is what some recent research provides to efficiently manage inflammation

  1. Support Gut Health with the correct prebiotic and probiotic’s to modulate immune function, support digestion and reduce intestinal hyperpermeabiilty (leaky gut) as it is noted as a contributor to inflammation. One reason is due to the passage of lipopolysaccharides (LPS). LPS are endotoxins (present on the cell wall of gram-negative bacteria) that may elicit an immune/inflammatory response. Consuming soaked then cooked legumes, fruits, and vegetables such as chicory and Jerusalem artichoke are good sources of prebiotic fibres (4)
  1. Proteolytic enzymes, such as bromelain, papain and trypsin assist in the breakdown of numerous inflammatory by-products such as bradykinin, making them useful in addressing the symptoms of inflammation and injury. Proteolytic enzymes can be used for swelling, pain, redness and recovery during intense training and exercise. It is important to ensure you are taking the correct enzymes for your condition, dosing correctly and taking at the correct time for pain management.  (5,6)
  1. Anti-inflammatory diets inclusive of foods such as fish for their omega-3 fatty acid content and herbs such as curcumin/turmeric. Research has shown that curcumin blocks inflammatory cytokines and enzymes, including cyclooxygenase-2 (COX-2), the target that the pharmaceutical medication Celebrex targets, without the side effects (7). However turmeric contains only 2-6% of curcumin so check the standardised amount of curcumin.
  1. Magnesium reduces pain and is necessary to breakdown substance P (a compound responsible for the sensation of pain) (9). Foods containing magnesium include legumes, nuts and seeds, green leafy vegetables such as kale and spinach.

Relaxation techniques to manage pain:

Relaxing your muscles and mind are important in managing pain this may include actives such as mindfulness, meditation, listening to music, gardening, gentle exercise, massage and acupuncture.

A recent research article showed that Acupuncture increase’s the release of endorphins, (11) he body’s own ‘feel-good’ chemicals, which play  an important role in the regulation of physical and emotional stress responses such as pain, heart rate, blood pressure and digestive function. (12, 13, 14, 15).

Acupuncture for Pain

There is substantial clinical evidence to support acupuncture for the relief of both acute and chronic pain according to a number of systematic reviews and randomised controlled trials (16,17,18,19,20,21).

In china and other countries acupuncture for pain relief is provided daily as part of the medical system to ease the symptoms of conditions such as:

  • Osteoarthritis and rheumatoid arthritis
  • low back pain
  • fibromyalgia
  • sciatica
  • Migraine
  • Painful periods

If you feel this information may help a friend or you would like more information about acupuncture, diet therapy and additional pain management strategies please Contact us or you can make an appointment on line BOOK online.

 

 

References:

  1. Pain, IASP terminology. International Association for the Study of Pain 2018, https:// www.iasp-pain.org/terminology?navItemNumber=576#Pain
  2. Garra G, Singer AJ, Taira BR, et al. Validation of the Wong-Baker FACES Pain Rating Scale in pediatric emergency department patients. Acad Emerg Med 2010;17(1):50-54.
  3. ABS, National Health Survey, Characteristics of bodily pain in Australia, 2007–2008 http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/4841.0Chapter12011
  4. Rodes L, Khan A, Paul A, et al. Effect of probiotics lactobacillus and bifidobacterium on gut-derived lipopolysaccharides and inflammatory cytokines: an in vitro study using a human colonic microbiota model. J Microbiol Biotechnol 2013;23(4):518-526. 3
  5. Bucci LR. Nutrition applied to injury rehabilitation and sports medicine, CRC Press, Inc, Florida: 1995.
  6. Bromelain monograph. Altern Med Rev 1998;3(4):302-305
  7. Arthritis Foundation 2018
  8. Weglicki WB, Chmielinska JJ, Tejero-Taldo I, et al. Neutral endopeptidase inhibition enhances substance P mediated inflammation due to hypomagnesemia. Magnes Res 2009;22(3):167S-173S
  9. Lam M, Galvin R, Curry P. Effectiveness of acupuncture for nonspecific chronic low back pain: a systematic review and meta-analysis. Spine (Phila Pa 1976). 2013 Nov 15;38(24):2124-38.
  10. Manyanga T, Froese M, Zarychanski R, Abou-Setta A, Friesen C, Tennenhouse M, et al. Pain management with acupuncture in osteoarthritis: a systematic review and meta-analysis. BMC Complement Altern Med. 2014;14:312.
  11. Da Silva AN. Acupuncture for migraine prevention. Headache. 2015 Mar;55(3):470-3.
  12. Qin 2015 (SR & MA of 11 RCTs; 10 acupuncture vs medications; 1 acupuncture vs sham): Acupuncture may be superior to drugs and may enhance the effect of drugs for patients with sciatica; low quality evidenc
  13. Xiang, A., Cheng, K., Shen, X., Xu, P., & Liu, S, 2017, The Immediate Analgesic Effect of Acupuncture for Pain: A Systematic Review and Meta-Analysis. Evidence-based complementary and alternative medicine : eCAM2017, 383719
  14. Liu T, Yu JN, Cao BY, Peng YY, Chen YP, Zhang L. 2017, Acupuncture for Primary Dysmenorrhea: A Meta-analysis of Randomized Controlled Trials. Altern Ther Health Med. 2017 Nov 7

How histamine can lead to allergies

You’ve probably heard of antihistamines. We use them when we are experiencing an allergic reaction.  The role of antihistamines is to block a chemical released by the immune system called histamines, but exactly what are histamines? 

Apart from its role in allergies, gastric acid secretion to assist with digestion and the inflammatory response histamine serves an important function as a neurotransmitter in the central nervous system.  As a neurotransmitter, it communicates important messages from your body to your brain where it controls pituitary hormone secretion, arousal, wakefulness and cognitive functions.

Because it travels throughout your bloodstream, histamine can affect many body systems such as your gut, lungs, skin, brain, heart, circulation, reproductive organs, and hormone production therefore contributing to a wide range of problems often making it difficult to pinpoint and diagnose.

Foods and Histamines

If you have a food allergy, histamines are in on that response process, too. When you accidentally eat or drink something you shouldn’t, they’ll work in your gut to trigger your allergies. Thus, the importance of both food allergy and sensitivity testing.

Some foods are also naturally high in histamines. These include aged and fermented foods and alcohol (especially red wine). Some people may be sensitive to that.

Are you histamine intolerant?

Do you experience unexplained headaches, migraines or anxiety? What about irregular menstrual cycles? Does your face flush when you drink red wine? Do you get an itchy tongue or runny nose when you eat bananas, avocados, or eggplants? then you could have a histamine intolerance.

What Causes High Histamine Levels?

  • Allergies (IgE reactions)
  • Small Intestine Bacterial overgrowth (SIBO)
  • Leaky gut (increased intestinal permeability) 
  • Gastrointestinal bleeding
  • Fermented alcohol eg. wine, champagne, beer
  • Diamine Oxidase (DAO) enzyme deficiency
  • Histamine N-methyltransferase (HNMT) deficiency
  • Histamine-rich foods
  • Too much oestrogen
  • Progesterone deficiency

Diet

In addition to the histamine produced inside your body, there are also a variety of foods that naturally contain histamine, cause the release of histamine, or block the enzyme that breaks down histamine, diamine oxidase.

Histamine-Rich Foods:

  • Fermented alcoholic beverages, especially wine, champagne and beer
  • Fermented foods: sauerkraut, vinegar, soy sauce, kefir, yogurt, kombucha, etc
  • Vinegar-containing foods: pickles, mayonnaise, olives
  • Cured meats: bacon, salami, pepperoni, luncheon meats and hot dogs
  • Soured foods: sour cream, sour milk, buttermilk, soured bread, etc
  • Dried fruit: apricots, prunes, dates, figs, raisins
  • Most citrus fruits
  • Aged cheese including goat cheese
  • Nuts: walnuts, cashews, and peanuts
  • Vegetables: avocados, eggplant, spinach, and tomatoes
  • Smoked fish and certain species of fish: mackerel, tuna, anchovies, sardines

Histamine-Releasing Foods:

  • Alcohol
  • Bananas
  • Chocolate
  • Cow’s Milk
  • Nuts
  • Papaya
  • Pineapple
  • Shellfish
  • Strawberries
  • Tomatoes
  • Wheat Germ
  • Many artificial preservatives and dyes

DAO-Blocking Foods:

  • Alcohol
  • Energy drinks
  • Black tea
  • Mate tea
  • Green tea

How do I break down histamine?

DAO (diamine oxidase) is the main enzyme responsible for breaking down ingested histamine. So if you’re deficient in DAO, you likely have symptoms of histamine intolerance.

Causes of Low DAO

  • Gluten intolerance
  • Leaky Gut
  • SIBO
  • DAO-blocking foods: alcohol, energy drinks, and tea
  • Genetic mutations (common in people of Asian-descent)
  • Inflammation from Crohn’s, ulcerative colitis, and inflammatory bowel disease.
  • Medications:
  • Non-steroidal anti-inflammatory drugs (ibuprofen, aspirin)
  • Antidepressants (Effexor, Prozac, Zoloft)
  • Immune modulators (Humira, Enbrel, Plaquenil)
  • Anti-arrhythmics (propanolol, metaprolol, Cardizem, Norvasc)
  • Antihistamines (Zyrtec)
  • Histamine (H2) blockers (Zantac)
  • Hormonal Imbalances

Although histamine blockers, a class of acid-reducing drugs, seem like they would help prevent histamine intolerance, these medications can actually deplete DAO levels in your body.

Elimination/Reintroduction

Remove the above high histamine foods for 30 days and reintroduce them one at a time to identify your triggers.  You may not have to avoid the foods forever but it can be a solution until your histamine or DAO levels return to their optimal levels.  

Testing for Histamine

Consider having whole blood histamine and DAO tested along with other cofactors that can increase or affect the breakdown of histamine in your body.

Food Sensitivity testing will pin point the exact foods that are causing the allergic response thereby reducing allergy symptoms and inflammation in your body.

Acupuncture shown to be effective at treating Allergies

A systematic review of 13 randomized controlled trials concluded that acupuncture could be a safe and valid treatment option for allergic rhinitis. Whilst the Clinical practice guidelines for allergic rhinitis published by the Otolaryngology Head Neck Surgery Foundation in 2015, recommended that clinicians may refer to a clinician who can offer acupuncture, for patients with allergies who are interested in non-pharmacological therapy as a safe and effective treatment. 

Foods to eat

Sample diet

Breakfast: Millet porridge with poached pear and seeds

Lunch: Salad of red cabbage, celery, green beans, brown lentils, chopped parsley and olive oil

Snack: Celery sticks with tahini

Dinner: Steamed fish with garlic, rice and steamed vegetables

 

 

References
1 .McDondald and Janz 2017, The Acupuncture Evidence Project: A Comparative Literature Review
2. Nuutinen, S and  Panula, P 2010, Histamine in neurotransmission and brain diseases. Adv Exp Med Biol. Vol. 709:95-107.

Acupuncture working on reducing allergy symptoms

Preliminary research indicates that acupuncture may help allergy and eczema symptoms.

In 2012, an article was published, which summarised a multi-centre, randomised clinical trial conducted in Korea and China, which involved 238 patients (3). Acupuncture reduced the nasal symptoms of hay fever significantly better than the ‘false’ acupuncture.  In case of symptoms, which were not related to the nose, both acupuncture and ‘false’ acupuncture resulted in a significant reduction of those symptoms, compared to patients who did not receive the acupuncture treatment. This study concluded that acupuncture is a safe and effective therapy. 

The effect of acupuncture on the molecular mechanisms of inflammation in the nose may be due to its impact on the hormonal activity of the HPA axis, increasing the secretion of ACTH and corticosteroids which may lead to reduced swelling of the nasal mucosa (4). 

Another study was conducted by Brinkhaus team and covered 5237 patients (1). It has shown that acupuncture in addition to routine treatment of patients, also brings both statistically and clinically significant benefits. The results of this team were published in 2013 in the “Annals of Internal Medicine” (2). The study involved 46 specialised doctors from 38 centres.  422 patients were recruited and divided into three groups for two months: one group received acupuncture treatment, the second received fake acupuncture, with needles placed in random, meaningless spots on their bodies, and the third group only took antihistamines. At the end of the study, the group that received acupuncture reported greater relief from symptoms than the other two groups.

However, the group receiving the fake acupuncture treatment also reported relief of their symptoms, though not as much as the group receiving acupuncture. Furthermore, four months later, as a follow-up, the difference between the effectiveness of the real and fake acupuncture treatment groups was less pronounced. This suggests a placebo effect may have taken place with the people receiving acupuncture, in anticipation of its beneficial effects.  In addition, the German ACUSAR research shows that acupuncture is an effective method of improving the quality of life of patients suffering from allergic rhinitis (5).

In a review of published trials, researchers concluded that there is some evidence to support the claim that acupuncture is beneficial and cost-effective as an additional treatment for seasonal allergic rhinitis. However, at this time, there is insufficient evidence to conclude that acupuncture is effective as a stand-alone treatment (6).

Other studies have looked at the effectiveness of acupuncture as a treatment for atopic dermatitis (7). They found that acupuncture significantly reduced itchiness in some patients. They noted that preventative acupuncture did not work as well as concurrent acupuncture.

In summary, acupuncture may be a safe, cost-effective option for those who are interested in non-pharmalogical therapy and for those looking for extra support to current treatment.

 

References

1 Brinkhaus B, Witt, CM,  Jena, S, Liecker, B, Wegscheider, K and Willich, SN,  “Acupuncture in patients with allergic rhinitis: a pragmatic randomized trial,” Annals of Allergy, Asthma and Immunology, vol. 101, no. 5, pp. 535–543, 2008.
2 Brinkhaus B, Ortiz M, Witt CM, Roll S, Linde K, Pfab F, Niggemann B, Hummelsberger J, Treszl A, Ring J, Zuberbier T, Wegscheider K, Willich SN. “Acupuncture in patients with seasonal allergic rhinitis: a randomized trial.” Ann Intern Med. 2013 Feb 19;158(4):225-34.
3 Choi SM, Park JE, Li SS, Jung H, Zi M, Kim TH, Jung S, Kim A, Shin M, Sul JU, Hong Z, Jiping Z, Lee S, Liyun H, Kang K, Baoyan L. “A multicenter, randomized, controlled trial testing the effects of acupuncture on allergic rhinitis.” Allergy 2013; 68: 365–374.
4 McDonald,  JL, Cripps, AW, Smith, PK, Smith, CA, Xue, CC and Golianu, B “The Anti-Inflammatory Effects of Acupuncture and Their Relevance to Allergic Rhinitis: A Narrative Review and Proposed Model,” Evidence-Based Complementary and Alternative Medicine, vol. 2013, Article ID 591796, 12 pages, 2013. doi:10.1155/2013/591796
5 Reinhold T, Roll S, Willich SN, Ortiz M, Witt CM, Brinkhaus B. “Cost-effectiveness for acupuncture in seasonal allergic rhinitis: economic results of the ACUSAR trial.” Ann Allergy Asthma Immunol. 2013 Jul;111(1):56-63
6 Witt, CM and Brinkhaus, B “Efficacy, effectiveness and cost-effectiveness of acupuncture for allergic rhinitis – An overview about previous and ongoing studies.” Auton Neurosci. 2010 Oct 28;157(1-2):42-5.
7 Pfab, F et al., “Acupuncture compared with oral antihistamine for type I hypersensitivity itch and skin response in adults with atopic dermatitis: a patient- and examiner-blinded, randomized, placebo-controlled, crossover trial.” Allergy. 2012 Apr;67(4):566-73.

Food sensitivity testing to reduce allergy symptoms

Image source: longevitymedical.com

When people complain of symptoms such as headaches, bloating or mouth ulcers after eating, it can often be a sign of food sensitivity. A food sensitivity or intolerance does not cause a severe allergic reaction to food – known as anaphylaxis.  Sometimes substances within foods can increase the frequency and severity of allergy symptoms and inflammation in the form of migraine headaches, rashes (such as hives) or the stomach upset of irritable bowel. 

The best approach is to first consult your healthcare professional to:

1. Determine whether dietary (or other) factors play an aggravating role

2. Identify individual triggers to be avoided.

Food sensitivity testing

IgG or food sensitivity testing is meant to work as a simple means to identify food sensitivities or food intolerances. The test checks a person’s blood for immunoglobulin G (IgG), an antibody created by the body to fight a certain allergenic food. Drawn blood is exposed to a panel of foods and food components. The degree of total IgG antibody binding to each food is measured to determine if any of the foods create an immune response. The degree of sensitivity is then graded by a classification scale.

This provides a guide on which foods you may be more sensitive to and therefore to be avoided as part of the elimination or rotational diet to reduce your symptoms.  This can help to eliminate the uncertainty and narrow down what might be the cause of you symptoms for faster results.  

It is important to note that this does not test for food allergy and anaphylaxis reactions.

A Quick Guide to Healthy Eating

What is healthy?  Healthy eating is about consuming food for a more than adequate nutritional profile. Here are a few tips to ensure you eat foods high in nutrients rather than empty calories.

Focus on real food

Real food is fruits, vegetables, meat, seafood, nuts, seeds, wholegrains and beans.  Concentrating on these foods means reducing your consumption foods that a processed and come in a packet, box, jar or can.

Consume healthy fats

Healthy fats are found in avocados, nuts, seeds, fatty fish and oils like olive oil.  These will keep you feeling fuller for longer and is essential to help lower cholesterol and keep your skin and hair looking good.

Eat quality protein

Quality protein is lean meat, tofu, fish, pulses and nuts/seeds.  Protein is very important macronutrient required for our body to grow and function.  Protein breaks down into amino acids which form building blocks for DNA, cells, muscle, organs and more!  When it comes to processed meats such as salami and mettwurst remember…focus on real food.

Eat the rainbow

I suggest trying to incorporate at least 3 differently colours of fruit/vegetables in each meal.  This ensures you get a variety of nutrients your body needs.

Portion control

This is often the hardest for people.  A couple of strategies is to portion your meals before eating and pack away leftovers so you are not tempted to go back for seconds.  Another strategy is to pack you plate with vegetables. I like to cook extra vegetables with my meals and try to have at least half of my plate in vegetables.

Cut back on sugar

Sugar found in fruit is fine but it’s the added sugar that is the problem.  Sugars are hidden in processed food which is another reason why I recommend to eat real food.  Sugar raises insulin levels which leads to weight gain, hormonal issues and more.

Should you snack?

Technically, unless you are burning a lot of calories because you are a professional athlete you don’t really need to snack.  It is ok to feel a little bit hungry every now and then.  In fact, a substantial break between meals allows your gut to rest and detoxify.  You may also find after a couple of weeks of no snacking that your blood sugar levels will be more stable, you will no longer have the urge to snack and you might also say goodbye to the 3pm slump.  If you can’t wait for next meal I suggest choosing real food options like veggie sticks, fruit or nuts.

Plan your meals

We are all time poor which is why meal planning is so important.  Once you have done it you will see how much time it saves you and how much cheaper it is. The key is to choose easy recipes that you know don’t require too much fuss especially after a long day at work.

  • Take 15-20min on the weekend to pick out 4 meals (you can choose more or less depending if you want to have a night out)
  • Write them on a calendar or meal planner for dinner
  • double or triple the recipes according to your family size so you at least have leftovers for lunch the next day
  • Write your shopping list.  This also helps to prevent impulse buying especially when that block of Lindt chocolate is on special.
  • Cook your first scheduled dinner and portion out your dinner plates and lunches

 

Polycystic Ovarian Syndrome (PCOS) and Infertility

The prevalence of PCOS is thought to be 5-10% and is a contributing factor towards infertility.

PCOS is diagnosed when 2 of 3 criteria are met:

  • oligo-ovulation (less than 8 periods/year) and/or anovulation (no ovulation occurs)
  • Excess androgen activity (determined via blood test)
  • Polycystic ovaries (diagnosed with gynaecological ultrasound)

Obesity can contribute to the development of PCOS and can also be a cause of infertility.  Both PCOS and obesity increases your risk of diabetes, hypertension, dyslipidemia and cardiovascular disease.

Hyperinsulinaemia (elevated insulin) leads to increased fat – particularly around your mid-section.  Elevated insulin levels contribute to abnormalities of the hypothalamic-pituitary-ovarian (HPO) axis that lead to hormonal imbalances associated with PCOS.

One of the common hormonal imbalances in women with PCOS is increased testosterone production and free androgen index. These hormones lead to acne and hirsutism (excessive face and body hair growth).  The adrenal glands also produce hormones and therefore stress can over-stimulate the adrenals, thereby adding further to the hormonal imbalance.

 

Source: Healthstatus.com

Why Weight?

Although not all women with PCOS are overweight, in those who are, weight loss is an essential part of PCOS treatment.  Not only can weight loss result in dramatic improvement in the condition, weight loss has also been shown to be more effective than current medication for insulin resistance.

As little as 2-5% reduction in weight can be enough to improve metabolic and reproductive indices in women with PCOS.  A healthy lifestyle to lose weight has been shown to lower testosterone production, improve insulin resistance and decrease hirsutism in PCOS.  Even in those without PCOS, weight loss for obese people will also slow obesity related co-morbidities.  Furthermore, for overweight/obese women, a 5kg weight loss can increase the chance of pregnancy by 50%.

I advocate long-term modest weight loss which is far more effective than drastic weight change which incorporates dietary counselling, acupuncture and exercise.

PCOS can be a difficult condition to manage, therefore treatment for PCOS is ongoing. In some cases, it can be months before a client’s initial menstrual bleed.  Reduction of hirsutism can also take up to 3 months before changes are observed.  Counselling and practitioner support can be helpful for continued monitoring of improvement of signs and symptoms .  This not only allows you to track your progress but can help you to stay motivated to achieve a regular menstrual cycle and allow ovulation to occur to improve your chances of becoming pregnant.

 

References

Barry, J, Kuczmierczyk, A & Hardiman, PJ 2011, ‘Anxiety and depression in polycystic ovary syndrome: a systematic review and meta-analysis’, Human Reproduction, Vol. 26, No. 9, pp. 2442-2451, viewed 12 October 2015, <www.ebscohost.com>

Bhattacharya, SM & Jha, A 2010, ‘Prevalence and risk of depressive disorders in women with polycystic ovary syndrome (PCOS).’, Fertility and sterility, vol. 94, no. 1, pp. 357–9, viewed 12 October 2015, <http://www.sciencedirect.com/science/article/pii/S0015028209037042>

Johnson, N 2014, ‘Metformin use in women with polycystic ovary syndrome’, Annals of Translational Medicine, Vol. 2, No. 6, pp. 1-7, viewed 23 October 2015, <www.atmjournal.org>

King, LK, March, L & Anandacoomarasamy, A 2013, ‘Obesity & osteoarthritis’, Indian Journal of Medical Research, vol.138, pp. 185-93, viewed 25 May 2014, <www.ebscohost.com>

Sarris J & Wardle J 2014, Clinical Naturopathy: An evidence-based guide to practice, 2nd edn, Churchill Livingstone Elsevier, Australia

Sirmans S & Pate K 2013, ‘Epidemiology, diagnosis, and management of polycystic ovary syndrome’, Clinical Epidemiology, Vol. 6, No. 1, pp.1-13, viewed 23 October 2015, <http://www.ncbi.nlm.nih.gov/pmc/>