When to Test for Blood Sugar and Metabolic Imbalance

This article originally appeared on Healevate.

To tell you that sugar is bad for you would be beating a horse that’s long been dead. We all get it by now. But what exactly does it do that’s so bad?

For starters, it’s a major source of inflammation, tissue destruction, brain degeneration, cardiovascular disease and depression.

Elevated blood sugar literally causes damage everywhere in the body and impacts other hormones, compounding this effect. What’s even worse is that it sets the stage for metabolic syndrome, diabetes and cardiovascular disease.

Low blood sugar doesn’t get as much press, since it doesn’t cause as much damage, but the downstream effects on other hormones are no less important.

Getting your blood sugar and metabolic hormones (such as insulin and cortisol) back in check is essential for reversing inflammation, aging, and many disease processes. Since blood sugar regulation reflects many disorders of metabolism, understanding the symptoms is the first step.

Symptoms of Imbalanced Blood Sugar and Metabolic Hormones

The symptoms of hypoglycemia (low blood sugar) include:

Brain/mood: Lightheadedness, jitters, fainting, dizziness, confusion, headaches, irritability, sadness, blurred vision/double vision, anxiety, hyperactivity, lack of focus.
Energy: Fatigue, weakness, energy surge post-meal or snack, feeling like you’re going to crash when you don’t have food, excessive hunger.
Hormonal: Hormone imbalances, especially low cortisol.
Metabolic: Sweating.

The symptoms of hyperglycemia (high blood sugar) include:

Brain: Brain fog, irritability, difficulty focusing and concentrating.
Neurological: Neuropathy, paresthesia, pins and needles, tingling.
Energy: Lethargy, feeling sleepy post-meal, fatigue.
Skin/hair/eyes: Dark patches of skin on neck, elbows, armpits, and knees (acanthosis nigricans), skin tags, wounds that won’t heal, loss of hair.
GI: Nausea, vomiting, stomach pain, fruity scent to breath, dry mouth.
Metabolic: Increased thirst and urination, rapid heartbeat, shortness of breath, high blood pressure, abdominal fat, high cholesterol or triglycerides, fatty liver.
Hormonal: Hormone imbalances including estrogen, testosterone, and cortisol, PCOS.

How Can I Test for Blood Sugar and Metabolic Hormone Imbalance?

Testing for blood sugar and metabolic hormone imbalance is more straightforward than other types of testing.

The goal is to find out if your blood glucose levels—and the hormones related to blood sugar management and metabolism—are functioning properly.

This can be determined with an initial set of tests that assess blood sugar levels and management, as well as hormone regulation. After initial testing is completed, additional testing may be warranted. If you find that you have elevated blood sugar with poor blood sugar management, evaluating inflammation, lipids, and cardiovascular markers is an important secondary step.

Blood Sugar and Metabolic Testing

Initial testing:

  • Glucose tests: Fasting glucose, 2-hour glucose tolerance test, hemoglobin A1C, and fructosamine.
  • Insulin tests: Fasting insulin and C-peptide.
  • Hormone tests: Adiponectin, leptin, and cortisol.

Secondary testing:

  • Inflammatory tests: Homocysteine, CRP, ApoB, Lp(a)
  • Lipid tests.

Glucose Testing

Fasting glucose (FBG) is the initial test completed when screening for blood sugar abnormalities and diabetes. It measures the levels of glucose in the blood after a period of fasting for at least 8 hours. FBG tells you if your blood sugar is high or low and can reflect metabolic imbalance. Blood glucose levels are largely dependent on 3 factors:

  1. The ability of the pancreas to produce appropriate amounts of insulin, as well the cells having the appropriate response and sensitivity to insulin.
  2. The liver’s storage and breakdown of glycogen (the storage form of glucose in muscles and the liver to be used later as energy).
  3. Adrenal hormone function (cortisol, epinephrine), which also impacts control of blood sugar levels.

Fasting glucose can also be measured daily at home with a glucometer.

A 2-hour glucose tolerance test (GTT) is done to assess how efficiently your body responds to glucose. This test requires an initial fasting blood draw followed by consumption of a 75 mg glucose drink. Two hours later, a second sample is drawn.

Normally, after you consume sugar, your body detects your high blood sugar, which causes the pancreas to release insulin so the sugar can be cleared from your blood and stored. The second measurement should be normal. If you have impaired glucose tolerance or insulin resistance, the blood sugar level will remain high.

Hemoglobin A1c (HbA1c) measures glycated hemoglobin, or glycohemoglobin, in the bloodstream. Glycohemoglobin is formed when circulating glucose combines with the hemoglobin in your red blood cells (RBCs).

RBCs have a lifespan of 120 days, so the amount of glycated (also called glycosylated) hemoglobin is directly proportional to the amount of glucose present in the bloodstream during that period of time.

The process of glycation is irreversible, so the greater the concentration of glucose in the blood, the more it will attach to the RBCs. HbA1c is used to monitor long-term glucose control and assist with the management of high blood sugar.

Fructosamine, similar to HbA1c, forms when glucose binds to serum proteins. Fructosamine levels represent the total amount of glycated protein in the blood. This is an irreversible glycosylation process reflecting the average lifespan of serum proteins—about 14 to 21 days. It’s used to monitor blood sugar control, but it’s less common than HbA1c.

Insulin Testing

Insulin is the hormone secreted by the pancreas in response to glucose in the bloodstream that facilitates the transport of sugars into your cells.

Fasting insulin levels are measured after a minimum of 8 hours without food to detect insulin resistance, as well as high or low blood sugar.

If the pancreas doesn’t produce adequate insulin or the body loses its sensitivity to insulin (insulin resistance), blood sugar will be elevated, while fasting insulin will be low because of the lack of insulin production and high with insulin resistance.

C-peptide levels reflect how much insulin the pancreas is producing. High levels of C-peptide indicate increased insulin production, usually in response to high blood glucose levels or insulin resistance.

This test is useful for monitoring treatment of hypoglycemia and diabetes, since it only measures the body’s insulin production. It can also be helpful in distinguishing between Type I (autoimmune) and Type 2 (metabolic) diabetes, the diagnosis of insulinomas (insulin-producing tumors), and when autoantibodies are produced against insulin. Because of this, C-peptide levels can be difficult to measure.

Metabolic Hormone Testing

Adiponectin is a hormone produced by adipocytes (fat cells) that promotes proper metabolism of sugars (carbohydrates) and fats (triglycerides). It also influences the body’s response to insulin.

High levels are beneficial and indicate efficient cellular energy production. Low levels are associated with metabolic syndrome, obesity, diabetes, and cardiovascular disease.

Leptin is largely produced by fat cells and works in a feedback loop with the brain to regulate appetite and satiety. When sufficient amounts of food are consumed, leptin signals to the hypothalamus, telling the body it’s no longer hungry. Low leptin should signal hunger, and high leptin should signal satiety. The level of leptin you have directly reflects your total body fat.

Leptin deficiency isn’t common, but leptin resistance, much like insulin resistance, definitely is. It reflects the body’s decreased sensitivity to the hormone, resulting in increased production. Even though there are adequate amounts of leptin, hunger is still present since the signal isn’t getting to the brain efficiently.

Cortisol is a hormone produced by the adrenal glands that literally impacts the entire body by decreasing inflammation, regulating the stress response and circadian rhythms, and controlling blood sugar.

If blood sugar is high, cortisol stimulates the storage of sugar in the liver as glycogen. If you have cortisol dysregulation (adrenal fatigue or excess cortisol), your normal regulatory functions don’t occur properly, resulting in blood sugar dysregulation.

Cortisol follows a natural rhythm, peaking in the morning and falling throughout the day. Measuring this curve is best achieved through a salivary or dried urine cortisol test with four measurements.

Metabolic Inflammatory Testing

Homocysteine is an amino acid produced as an intermediate product in the metabolism of the amino acids methionine and cysteine (the process is called methylation).

If methylation doesn’t occur properly due to a lack of key nutrients like B12, B6, and folic acid, or because of a genetic mutation (MTHFR), homocysteine levels can rise in the blood.

Elevated homocysteine is associated with an increased risk of Alzheimer’s, cardiovascular disease, and stroke, since it directly damages the lining of the blood vessels. People with poor blood sugar regulation and diabetes are at an increased risk for elevated homocysteine.

C-reactive protein (CRP) or high sensitivity CRP (hsCRP) is an acute phase reactant protein produced mostly in the liver in response to inflammation. Elevated CRP is highly associated with metabolic syndrome, diabetes, high blood pressure, and cardiovascular disease, as they share the common root cause of inflammation.

Apolipoprotein B (ApoB) is a protein involved in fat metabolism and is a component of low density lipoproteins (LDL), also known as “bad” cholesterol. Elevated levels are associated with insulin resistance, high cholesterol, atherosclerosis, and heart disease.

ApoB100 is an even more specific marker, as only one molecule of ApoB100 attaches to each LDL particle, allowing for the total number of lipoproteins in circulation to be quantified. ApoB100 is a better marker of cardiovascular risk than LDL.

Lipoprotein a (Lp(a)) consists of an LDL particle bound to the protein apoA. Levels of Lp(a) have a significant genetic component, and levels remain relatively constant over your lifetime. Elevated Lp(a) is a risk factor for cardiovascular disease.

Lipid Testing

Lipid testing determines whether or not a person’s cholesterol-carrying proteins are healthy or not. The standard lipid panel that measures LDL (low density lipoprotein), HDL (high density lipoprotein), and triglycerides measures total serum lipid numbers only. It can be a good general marker of cardiovascular disease (CVD) risk, especially when viewed with other biomarkers such ApoB and Lp(a).

Elevated levels of LDL and triglycerides, especially when taken in the context of other biomarkers, are associated with an increased risk of CVD, as is low HDL. This test is available through LabCorp and Quest and in expanded profiles from Spectracell, Genova Diagnostics, and Doctor’s Data.

Lipoparticle protein testing provides a more accurate assessment of your cholesterol and cardiovascular risk, as it measures the particle numbers and density. When considering each lipoprotein, size does matter. For example, LDL particles can be small, medium, or large, and the amount of cholesterol within the particles varies widely. Smaller particles are more predictive of cardiovascular disease and plaque buildup, since they can penetrate the arterial walls where the larger particles can’t.

Remnant lipoproteins (RLP) and intermediate density lipoproteins (IDL) are also associated with increased CVD risk. Large, buoyant HDL (HDL2) corresponds to a decreased risk of CVD. LabCorp and Quest offer this and call it VAP testing. Spectracell calls it Lipoparticle Protein Testing, and Genova has the CV Health Profile.

All testing that we’ve discussed can be done through Direct Labs, who has contracts with the traditional and newer labs. If you’re experiencing any of the symptoms mentioned earlier in this article, it could be worthwhile to get some simple testing done so you can know where you stand and make corresponding changes, if and where necessary.

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How to Test for Hidden Food Allergies or Sensitivities

This article originally appeared on Healevate.

If you’re experiencing a variety of health symptoms and have no known food allergies or sensitivities, you might wonder why you’d need to test yourself for them. You may believe that simply cleaning up your diet and eliminating soda, baked goods, sugar, and processed foods is enough. And while that’s certainly a good start, it’s not nearly enough to eliminate the immune and inflammatory processes that food reactions can cause.

Since eating is such an automatic process for most of us, we never stop to consider whether the symptoms we’re experiencing are related to food unless the reaction occurs while we’re actually eating or very soon thereafter.

If you have brain fog, fatigue, congestion, rashes, joint pain, or headaches, there’s a pretty good chance that your body is reacting to something you’re eating.

For many people, food is the most inflammatory substance they encounter on a daily basis. Because we eat multiple times a day, and because we’re creatures of habit, we tend to consume the same things, giving the immune system the opportunity to react.

Food sensitivities and allergies cause many symptoms, especially if you have a leaky gut. Any symptoms of inflammation or autoimmunity can point to food intolerances, so the list is vast.

Symptoms of Food Allergies and Sensitivities

The symptoms of food intolerance can manifest quickly, as with a swollen tongue or anaphylaxis, but quite often the symptoms are delayed. This makes them hard to pick up on, as well as attribute to a certain food.

Immune/inflammation: Allergies, asthma, runny nose, post nasal drip, unresolved infections, autoimmunity, swelling, wheezing, coughing, anaphylaxis, throat closing.

Skin/hair/nails: Dermatitis, eczema, acne, rashes, scaly skin patches, hives, photosensitivity (sun sensitivity), hair loss, nail pitting, dry eyes, skin, and mouth.

Gastrointestinal: Stomach pain, GERD (acid reflux), IBS, gas, bloating, nausea, diarrhea, constipation, gastroparesis (delayed stomach emptying), canker sores.

Brain and mood: Headaches, brain fog, inability to focus or concentrate, double vision, blurred vision, poor memory, depression, anxiety, irritability, fatigue, lethargy, dementia, insomnia.

Nerves: Tingling, pins and needles, numbness, paresthesia.

Hormones: High or low blood sugar, weight gain or loss, excessive sweating.

Musculoskeletal: Joint and muscle pain, muscle weakness, fibromyalgia.

Liver: Poor detoxification, chemical sensitivity.

Cardiovascular: Low blood pressure, rapid heart rate, palpitations.

The First Food Allergy or Sensitivity Test To Perform

The first method of screening isn’t a lab test at all. It’s an elimination diet. Eliminating the most common sources of food intolerances is a great way to find out if you have an issue.

Removing gluten, dairy, corn, soy, eggs, and nuts from your diet for 4 weeks, then adding them back one single food (not food group) at a time over a period of 3 days should tell you whether your body is reacting to something.

If you have a known autoimmune condition, you may also want to include the nightshade vegetables, such as tomatoes, potatoes, sweet and hot peppers, eggplant, and spices made from these, as well as gluten cross-reactive foods like coffee, chocolate, and the gluten-free grains.

If any of the previously mentioned symptoms appear during that 72-hour window, you should avoid that food for at least 6 months to give your immune system a break and let the inflammation go down.

This method can you help you to identify the source of your food troubles, but for some, reactions can occur to even the healthiest foods, such as blueberries or spinach, especially if they have a leaky gut. To further complicate matters, not only do the foods themselves cause a response, but the additives, colorings and gum resins (binders used in gluten-free foods) do as well. This is where testing can be valuable.

Food Allergies vs Food Sensitivities

Food allergies and sensitivities are very different issues. A food allergy occurs when the immune system identifies a food as a foreign substance and attacks it. This response occurs on a spectrum and can be anything from a swollen tongue to anaphylaxis, which is a potentially life-threatening reaction.

Food allergies are tested by measuring antibodies in the blood against particular foods. IgE and IgG are commonly measured. If you have an obvious response to a food, you can confirm it with this type of testing.

Food sensitivities are the more common and elusive form of food intolerance. They’re more vague than allergies and are considered to be any toxic or inflammatory response to food. Quite often they’re mediated by a lack of enzymes, stomach acid, and/or a leaky gut. Celiac disease is a perfect example, where a severe intolerance to gluten causes the destruction of the surface of the small intestine.

Testing for food sensitivities offers a variety of options; antibody and mediator release testing (MRT) are two of the better ones available. No matter what test you choose, be aware that if you have a leaky gut, there’s a good chance you’ll be reacting to many of the foods you eat.

Food Allergy and Sensitivity Tests

There are several types of testing available for identifying food allergies and sensitivities. IgE testing represents the true food allergy test. IgG testing can also identify allergies, but more commonly, it shows delayed sensitivity reactions. The rest of the testing options are for intolerances or sensitivities only.

  • IgE antibody test
  • IgG and IgA antibody test
  • Gluten and gluten cross-reactivity tests
  • MRT test

IgE Antibody Testing for Food Allergies

Antibodies are produced when your body mounts an immune attack on a substance it has identified as foreign, which in this case is food. It creates antibodies against specific proteins (antigens) in that food. Antibody tests measure your body’s immune response to a particular substance or organism.

There are several categories of antibodies. IgE antibodies are created when your body has a true allergic response to a substance, which is why traditional food allergy testing analyzes antibody levels in the blood. An IgE allergy is considered a fixed allergy in that it will almost always provoke an immune response when the food is consumed. This type of food allergy elicits an immediate response.

This test can be completed by traditional labs such as LabCorp or Quest, as well as the specialty lab companies Alletess Medical Laboratory and Great Plains Laboratory. IgE testing can easily be ordered online through Direct Labs.

IgG and IgA Antibody Testing for Food Allergies and Sensitivities

In spite of having an allergy, you can still yield a negative IgE test result. This is why it’s important to test IgG levels as well. IgG antibodies measure a delayed hypersensitivity reaction, which can take up to 72 hours to occur. These are the more difficult reactions to link to a particular food, so testing can be helpful here. IgG antibodies are the most prevalent antibodies in systemic circulation and are the most common form of immune-mediated food responses.

While some IgG responses represent true allergies, most are hypersensitivities or intolerances. Similarly, IgA antibodies also represent delayed hypersensitivities. They can take many hours or days to occur and operate in a low-and-slow manner.

Traditional labs such as LabCorp or Quest will offer this test. Genova Diagnostics offers an IgG test. Alletess Medical Laboratory offers stand-alone IgG testing, combined IgG and IgE testing, and IgA testing. Cyrex Laboratories offers the Array 10: Multiple Food Reactivity Screen that measures IgG and IgA levels. The Array 10 tests raw and cooked foods, additives, gum resins, and brewed beverages.

All of these IgG and IgA tests can be ordered online through Direct Labs.

Gluten and Gluten Cross-Reactivity Tests

If you suspect that you’re sensitive to gluten, or even have full-blown celiac disease, testing is an important piece of the puzzle. Gluten testing involves analyzing the IgG and IgA response to various components of the gluten molecule, including several gliadins, glutenins, gluteomorphins (made during the digestion of gliadin), and the intestinal enzyme transglutaminase. It’s important to note that you must consume gluten for this test to be as accurate as possible.

Once you confirm gluten intolerance or celiac disease, completing gluten cross-reactivity testing is helpful, since these foods elicit the same response from the immune system as gluten does. This means that they contain similar protein sequences as the gluten molecule (molecular mimicry). Milk, whey, chocolate, coffee, soy, potatoes, corn, eggs, and most gluten-free grains (including rice) are considered cross-reactive.

Conventional lab companies offer gluten testing and the Array 4: Gluten Associated Cross-Reactive Foods test. This test can be ordered online through Direct Labs.

Mediator Response Test (MRT)

The MRT utilizes different technology than antibody testing. It quantifies the inflammatory response to specific foods and additives. Mediator release refers to the inflammatory chemicals that are liberated from your cells in response to a sensitizing food.

Instead of measuring antibody production, this test measures your white blood cells’ chemical response to a food. It gauges the cells’ change in volume, which comes from the release of inflammatory chemicals such as histamine and cytokines. A non-reactive food will produce no change, while a reactive food will produce an increase or decrease in cell volume.

This is a blood test and is only offered by Oxford BioMedical Technologies.

The Bottom Line on Food Allergy and Sensitivity Tests

Start with the basics and conduct an elimination diet. That alone will give you new information to work with. From there, spend money only on the testing that could reveal new information that would alter your approach to food. If you’re already 100% gluten-free and are avoiding all cross-reactive foods as well, then gluten testing would be a waste of time and money.

So be smart and be proactive. Discovering hidden food allergies or sensitivities could make a huge difference in your day to day health.

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Why Taking Care of Your Liver Will Leave You Feeling Shiny and New

This article originally appeared on Healevate.

Most of us have felt that special feeling. You know the one. Great night out with friends, maybe even a special someone. And then the next morning rolls around. THAT feeling.

You wake up to a pounding head, nausea, aches, brain fog and an inability to focus. That’s your liver screaming at you.

Those extra few drinks just needed to happen, huh?

So those are obvious signs that we recognize easily, but did you know that when your hormones are out of whack, your blood sugar is erratic, and you constantly feel sluggish, your liver is STILL speaking to you?

Most of us are great at listening to our bodies when we experience something as uncomfortable and excruciating as a bad hangover, but we’re more likely to ignore the signs when they’re less obvious or when they require lifestyle changes that we may not want to make.

The liver is the largest internal organ and has extraordinary resiliency, as it’s bombarded daily with an onslaught of assaults from air pollution, environmental toxins, medications, and microorganisms (bacteria, mold, fungi, and viruses).

We are exposed to 6 million pounds of mercury and over 2.5 billion pounds of chemical toxins each year,” according to Dr. Mark Hyman.4 But the amazing liver isn’t fazed—it has the highest regenerative capacity of any organ in the body.

It’s clear that it takes a lot to knock the liver down, but somehow, in our crazy, high-stress lives, we find a way to do just that.

Impaired detoxification and liver function is the predecessor of many systemic diseases, including liver disease. At least 30 million people, or 1 in 10 Americans, has some type of liver disease.1

If you consider some of the other conditions where liver function is important, including autoimmunity, cancer, cardiovascular disease, diabetes, and high cholesterol, it’s obvious that proper liver function and detoxification are central to health. So it’s important that we recognize the signs of impaired detoxification before it has the chance to become a full-blown condition, because reversing it is much easier than reversing most chronic diseases.

What Exactly is Liver Detoxification?

Detoxification is the process of transforming and removing harmful substances from the body. Normally, the liver takes a toxic substance, then neutralizes and transforms it so that it can be eliminated in a healthy way that doesn’t damage the body.

Once your liver detoxifies and breaks down a substance, it’s excreted to the blood or bile for elimination. Blood products are filtered through the kidneys and eliminated as urine, while bile products are sent to the intestines and eliminated as feces. Some items are also eliminated through sweat and breathing.

When detoxification doesn’t occur efficiently and properly, the liver becomes taxed and sluggish, which impacts almost every system of the body in some way. The liver plays a role (to varying degrees) in most biological functions, being responsible for over 200 tasks. Here is a short list of some other liver functions that detoxification impacts:2,3

  • Conversion of harmful ammonia to urea
  • Clearance of bilirubin (if there’s a buildup of bilirubin, the skin and eyes turn yellow in a condition called jaundice)
  • Storage of essential vitamins and minerals, and conversion to their biologically active forms
  • Regulation of amino acid and protein metabolism
  • Maintenance of hormone balance

Impaired detox results in changes to all of the above processes, which can manifest as imbalanced hormones, high cholesterol, blood sugar abnormalities, decreased immune function, increased inflammation and pain, and a variety of symptoms ranging from fatigue and brain fog to rashes and headaches.

How Does Liver Detoxification Become Impaired?

Impaired liver detoxification occurs when any substance or disease process compromises the liver’s ability to perform its basic metabolic functions.

When your liver can’t function properly, toxins and metabolic waste back up and accumulate in your body, making you feel horrible and causing damage to your cells.

A good way to imagine this is to think about it like taking out the trash. If you empty the waste bins throughout your house daily, even every couple of days, you’re probably in good shape.

But what if you let it pile up for a month, or even a year? Pretty soon you’re looking like you belong on a late-night cable TV show because your house is teeming with bacteria, mold, parasites, and volatile chemicals, soon to be deemed uninhabitable by the health department. When your liver can’t empty the trash on a continual basis, this is what happens inside your body.

Damage to your liver cells can occur through a variety of mechanisms:3

  • Metabolic disorders such as obesity, diabetes, and fatty liver
  • A high sugar and carbohydrate diet or processed foods
  • Illnesses that produce toxins and inflammation or promote malabsorption
  • Infections such as Candida, viral hepatitis, and any GI infection/dysbiosis
  • Drugs and supplements
  • Pollutants, chemicals, and heavy metals such as BPA, parabens, smog, pesticides, fluoride, mercury, arsenic, etc.

What all of these processes have in common is that they damage liver cells in some form, whether from oxidative stress, inflammation, or a lack of the nutrients the liver needs in order to work properly. The damage results in impaired detoxification systems.

Detoxification processes in the liver are controlled by many genes and the Phase 1, 2, and 3 detoxification pathways. In order for detoxification to occur properly, the genes that control the process need the correct nutrients and environment (epigenetics) to properly regulate the enzymes that control the detoxification pathways.

One group of genes that have received publicity lately are the methylation pathway genes (MTHFR, MTRR, CBS, COMT, etc.), and rightfully so. This group of genes plays a central role in detoxification, as well as neurotransmitter, hormone, and amino acid metabolism, cardiovascular health, DNA synthesis, and gene regulation.

Sometimes there are changes in a gene—SNPs, or single nucleotide polymorphisms—that alter the function of the corresponding enzyme that controls a process such as detoxification.

When you have an SNP, it changes the gene’s instruction manual, which alters the way the enzymes work.

For instance, if you have one copy of an MTHFR (methylene tetrahydrofolate reductase enzyme) gene SNP, you’ll have a 30% reduction in the activity of the enzyme. If you have 2 copies of the SNP, you’ll have a 70% reduction in enzyme activity and significantly impaired detoxification. Many people have multiple SNPs in this pathway, resulting in reduced detoxification capacity.

Similarly, the 60 cytochrome P450 (CYP450) family of enzymes that are primarily found in the liver play a significant role in the breakdown of toxins. SNPs affect the CYP450 enzymes as well—especially those involving drug metabolism.

“Depending on the gene and the polymorphism, drugs and supplements can be metabolized quickly or slowly. If a cytochrome P450 enzyme metabolizes a drug slowly, the drug stays active longer and less is needed to get the desired effect. A drug that’s quickly metabolized is broken down sooner, and a higher dose might be necessary to be effective. Cytochrome P450 enzymes account for 70 to 80 percent of enzymes involved in drug metabolism.”5

The Phase I detoxification system is controlled by these CYP450 enzymes and is the first step toxins go through in the breakdown process. Once toxins enter this pathway, the substance undergoes a chemical transformation, producing an intermediate that’s often as toxic or more toxic than the original substance.

This isn’t a big problem if your Phase 2 detoxification pathways are sufficient, but there can be SNPs here too, reducing the process’ efficiency and causing you systemic problems.

Phase 2 detoxification reactions involve the conjugation (coupling) of the Phase 1 intermediate to a substance, making it water-soluble and suitable for elimination via urine and bile (feces).

The Phase 2 conjugation reactions are glucuronidation, sulfation, methylation, acetylation, amino acid conjugation, and glutathione conjugation.

Essentially, what’s happening in all of these processes is that the intermediate is combined with a specific type of molecule that neutralizes it for elimination. For example, in methylation, a methyl group (CH3) is transferred to the intermediate. Once this process takes place, the neutralized substance can be eliminated.

Phase 3 of detoxification takes the neutralized substance and transports it out of the liver cell to be excreted in the urine or bile.

Diet, nutritional status, illness, toxic burden, dysbiosis, and SNPs all affect the efficiency of the detox pathways, and vice versa. Identifying any potential roadblocks and cleaning up your personal environment and/or lifestyle is necessary to have detoxification systems running at peak performance.

Triggers of Impaired Liver Detoxification

We have toxins around and inside us that come in many forms. If we don’t have healthy detox processes, they accumulate and cause damage all over our bodies. Common triggers of impaired liver detoxification are:

Diet: High sugar and carbs, processed foods, charred foods, xenoestrogens, water, GMOs, and conventionally-raised meats contain toxins.

Nutrients: Low levels of necessary amino acids, vitamins, and minerals impede efficient detoxification processes.

Dysbiosis: Infections and an imbalanced microflora produce toxins.

Leaky Gut: Increased intestinal permeability allows toxins into circulation that wouldn’t normally enter the bloodstream.

Toxins: Medications, supplements, alcohol, and environmental chemicals and metals burden the detoxification pathways and can directly damage the liver.

Stress: Psychological stress, toxic relationships, and illness produce biochemical changes that impair detoxification.

Diet

Dietary triggers of impaired liver detoxification are many and significant, since you eat multiple times every day. This provides lots of opportunities to ingest something harmful.

High sugar and carbohydrate diet: When you eat excessive sugar and carbohydrates or refined foods, they need to be stored somewhere if you aren’t using them for energy. They end up stored in the body as fat and in the liver as glycogen.

Over time, if this process continues, the liver becomes inundated with fat, which compromises its function and promotes inflammation and insulin resistance, according to Dr. Mark Hyman.6

Processed foods: Any foods that come from a package may contain trans fats, preservatives, colorings, dyes, additives, and artificial sweeteners that are seen as toxins by your body. Additionally, some foods you think are safe may not be. Most cans are lined with BPA, rendering the foods inside very unhealthy.

According to Dr. Joseph Mercola, “High acidity—a prominent characteristic of tomatoes—causes BPA to leach into your food. BPA is a toxic chemical linked to reproductive abnormalities, neurological effects, heightened risk of breast and prostate cancers, diabetes, heart disease, and other serious health problems.”7

Charred/browned foods: Cooking foods until they have color may impart lots of flavor, but you’re also getting a hefty dose of toxins along with it. Grilling is the worst culprit.

Dr. Mercola says, “Heterocyclic amines (HCAs) are hazardous compounds created in meats and other foods that have been cooked at high temperatures.

Similarly, polycyclic aromatic hydrocarbons (PAHs) form when fat drips onto the heat source, causing excess smoke, and the smoke surrounds your food, transferring cancer-causing PAHs to the meat.”7 HCAs and PAHs are also present in deli meats.

Xenoestrogens: Xenoestrogens are substances that mimic the hormone estrogen. Foods and chemicals are sources of these compounds. Not only are they endocrine disruptors, but also toxins and carcinogens. Soy is the most common dietary source. Consumption of soy is linked to infertility, thyroid disruption, and breast and prostate cancers. Toxins produced in the processing of soy include nitrosamines, lysinoalanine, MSG, and aluminum.7

Water: Water can be one of the most toxic things we consume daily. Water can have microorganisms, chlorine, fluoride, agricultural and manufacturing runoff, pesticides, or heavy metals. Dr. Deanna Minish states, “Current estimates suggest that there are more than 2,000 toxins in tap water.”14 Bottled water is often not much better.

GMOs: Genetically modified foods contain genes that aren’t native to the original organism, and your body sees them as foreign and toxic. Corn, for instance, might contain Bt toxin or Roundup Ready genes so that it withstands pests better. These toxins degrade the stomach of the target insects and are now found to be harming humans, causing allergies and immune system activation similar to that of inflammatory conditions.8

Further, the pesticide Roundup (glyphosate) has been proven to have harmful mechanisms. According to Dr. Mercola, a recent study found that “glyphosate inhibits cytochrome P450 (CYP) enzymes, a large and diverse group of enzymes that catalyze the oxidation of organic substances.” This, the authors state, is “an overlooked component of its toxicity to mammals (which means humans).

By limiting the ability of these enzymes to detoxify foreign chemical compounds, glyphosate enhances the damaging effects of those chemicals and environmental toxins you may be exposed to.”9

Conventional meat and produce: Food grown or raised with conventional methods (non-organic) has some level of toxicity. Meat, poultry, and fish can be given antibiotics and drugs that affect their growth.

Vegetables and fruit can contain pesticides or be genetically engineered. One potent class, the organophosphates, are linked to infertility and impaired growth and development, and they’re known neurotoxins.

Nutrients: In order for detoxification to proceed the right way, it requires adequate amounts of the necessary raw materials to do so. These include amino acids, B vitamins, minerals, antioxidants, and sulfur-containing compounds. Deficiencies will result in impaired detox processes.

Dysbiosis

Dysbiosis occurs when there’s an imbalance between the beneficial and harmful organisms in your body, especially in the gut.

When this happens, the bad guys can produce toxins themselves or even undo all of the work the liver has done (deconjugation), allowing toxins back into circulation. While many organisms produce toxins (bacteria, mold, yeast, and parasites), here are some examples:

Candida: Yeast ferments sugars into ethanol and acetaldehyde, which are carcinogens that cause alcohol toxicity and hangovers. Candida increases levels of ammonia, which is another toxin.3 Yeast also produces toxins that allow them to bore into the intestinal wall, as some parasites and bacteria do.12

Clostridium difficile: Also known as C. diff, this bacteria produces several toxins that act on the gut and other cells of the body. These toxins are responsible for the awful diarrhea associated with an acute C. diff infection.

Mold: Molds are ubiquitous and often ingested in air and food. According to Dr. Jill Carnahan, “Some molds secrete mycotoxins. Exposure to mold and mold components is well known to trigger inflammation, allergies and asthma, oxidative stress, immune dysfunction, and neurological damage in humans.”13

Leaky Gut

Increased intestinal permeability, also known as leaky gut, occurs when the cells that line the intestinal tract become irritated and compromised, actually spreading apart and allowing particles that wouldn’t normally enter the bloodstream to pass through. This causes the immune system to react to these substances, producing inflammation.

Some of the irritants that cause leaky gut are toxins ingested in medications, alcohol, food, and water, as well as the byproducts of any allergic or sensitivity reaction. Further, dysbiosis and any gut infections compound this effect by the contribution of the toxins they produce.

When you have a leaky gut, your overall toxic burden is increased, because many more substances enter circulation than usual, and your liver has to detoxify all of them. This can place a significantly increased burden on the liver.

Toxins

Toxins are everywhere in our modern society. Unfortunately, our exposure to medications, supplements, chemicals, pesticides, pollutants, petrochemicals, heavy metals, tobacco smoke, and even alcohol are byproducts of contemporary living, and most of us have exceeded our liver’s natural capacity to cleanse us. If we can’t rid ourselves of these toxins, they accumulate and are stored in the body.

Heavy metals are everywhere—in the soil, in our homes and food, and as byproducts of industries, car exhaust, and tobacco smoke, so they’re hard to avoid. Things like lead, mercury, arsenic, cadmium, and aluminum are damaging toxins by themselves, but they also compromise our detoxification pathways, making matters worse.

According to Dr. Mark Houston, “Mercury, cadmium, and other heavy metals have a high affinity for sulfhydryl (SH) groups, inactivating numerous enzymatic reactions, amino acids, and sulfur-containing antioxidants (NAC, ALA, GSH), with subsequent decreased oxidant defense and increased oxidative stress.”15

This means reduced antioxidant and detox capacity. He further states, “Mercury induces mitochondrial dysfunction with reduction in ATP, depletion of glutathione, and increased lipid peroxidation; increased oxidative stress is common.”15

Persistent organic pollutants (POPs) include PCBs, DDT, dioxins, pesticides, flame retardants, Triclosan (the antibacterial chemical in personal care and cleaning products), and other chemicals. Like other toxins, they’re heavily present in food, water, soil, air, and products we use.

Over 80,000 POPs have been released into the environment, and we lack information on how they affect human health. We know they’re particularly toxic, causing infertility and endocrine hormone disruption as well as being immunotoxic, neurotoxic, and carcinogenic.16 They’re also linked to cardiovascular disease, obesity, and diabetes.16

Even medications and supplements can have adverse effects on detoxification by damaging the liver. Certain prescription and over-the-counter drugs list liver damage as a side effect and a risk. Some of these include antidepressants, antipsychotics, corticosteroids, non-steroidal anti-inflammatory medications (NSAIDs) (particularly acetaminophen (Tylenol)), and others.3 Some herbal supplements are implicated here as well since they can be toxic to the liver if not used appropriately, such as kava kava, skullcap, and germander.

Stress

Not only do we have toxins that come from the outside, but we also generate them from within. Psychological stress, toxic relationships, illness, and anything else that disrupts your body’s natural balance produces biochemical changes that impair detoxification. But to fully understand toxicity, you must understand the concept of total load.

Dr. Mark Hyman explains this idea well. “This is a total amount of stressors on your system at any one time, and what happens is like a glass filling over with water. It takes a certain amount to fill the glass, and then, after a certain point, you put more in and it overflows. When our detoxification system is overwhelmed, is overloaded, that’s when we start getting symptoms and get sick, but it may take years of accumulated stress and toxins to get to that point.”18

He further points out that stress is a significant contributor to the total toxic load, including “the mental, emotional, and spiritual toxins that affect us; isolation, loneliness, anger, jealousy, and hostility, which all translate into toxins in our system.”18

Dr. Deanna Minich elaborates on that concept, stating, “When we don’t properly ‘eliminate’ unhealthy emotions, we may experience increased levels of stress. Stress not only causes inflammation, but can elicit poor digestive function. Those who experience chronic stress have a difficult time maintaining a positive outlook on life and are at greater risk for disease and premature death.”17

Chronic stressors cause an imbalance between the sympathetic (fight or flight) and parasympathetic (rest and digest) nervous systems, producing increased levels of the stress hormone cortisol. Over time, the constant cortisol elevation and demand leads to cortisol resistance and diminished cortisol.

Cortisol is the main anti-inflammatory hormone in your body, and when levels are low, inflammation increases. This results in oxidative stress and free radical damage. This in and of itself can damage the liver, but it also increases the toxic load the liver must clean up. Further, these changes can also perpetuate dysbiosis and leaky gut.

Symptoms of Impaired Liver Detoxification

The symptoms of impaired liver detoxification are system-wide in the body.

Inflammation/immune: Pain, weight gain, lipomas (benign fatty tumors/deposits), cellulite, allergies, autoimmune conditions, recurrent infections, stuffy nose

Digestive/gastrointestinal: Gas, bloating, cramping, pain, diarrhea, constipation, inability to digest fats (oil in toilet or greasy stools), reflux (GERD), IBS, gallstones, nausea, bad breath, food sensitivities, allergies

Blood sugar: Hypoglycemia (low blood sugar), fatty liver, Type 2 diabetes, cravings

Brain/mood/energy: Brain fog, dizziness, vertigo, fatigue, lethargy, depression, irritability, poor concentration, headaches, poor sleep, poor memory

Musculoskeletal: Chronic fatigue syndrome, fibromyalgia, muscle pain, joint pain

Skin/hair/nails: Rashes, hives, dermatitis, eczema, pruritis (itchy skin), excess or lack of sweating, acne, rosacea, liver spots (brown spots), red skin, flushed face, red/itchy palms, yellow skin or eyes, itchy eyes, dark eye circles, body odor, hair loss, cankers

Hormones: Hormone imbalances, PMS, severe menopausal symptoms, inability to lose weight, infertility

Detoxification: Multiple chemical sensitivity (MCS), inability to tolerate medications or alcohol, poor tolerance to hormone treatments

Lab Testing for Impaired Liver Detoxification

Liver function and organic acid testing is important so you know the state of your liver and detoxification pathways. When considering toxin testing, you need to be cautious, because some of the tests actually liberate toxins from storage in your cells, which can cause problems, especially if you have a leaky gut.

In general, it’s a good idea to make sure liver function has improved and the gut is healthy before testing and treating toxins.

General tests for liver function and blood sugar:

  • Total bilirubin
  • AST (aspartate aminotransferase)
  • ALT (alanine aminotransferase)
  • GGT (gamma glutamyl transpeptidase)
  • ALP (alkaline phosphatase)
  • Fasting insulin and glucose
  • CMP or comprehensive metabolic panel (will have most of the liver tests on it)

Functional tests:

  • Organic acids
  • Amino acids—urine, blood
  • Heavy metals testing—hair, urine, feces, blood, red blood cell
  • Toxic chemicals (such as BPA, phthalates, parabens, organophosphates, etc.)
  • DNA profiles for methylation and detoxification

Treatment of Impaired Liver Detoxification

Supporting healthy and robust detoxification takes a little effort. Cleaning up your diet,environment, and lifestyle and adding in some supporting nutrients will lighten the load on your liver.

Detoxifying your diet is a good place to start, since we consume foods and liquids many times every single day.

Drink lots of water every day! Have at least eight glasses to flush your system. Add some liver for an added boost.

Eating organic and GMO-free will help you avoid many toxins.

Make sure your diet is rich in phytonutrients. Certain plants are known to support detoxification. The Brassica family, which includes broccoli, cabbage, cauliflower, and kale, contains the sulfuric compounds sulforaphane and indoles (I3C) that activate the Nrf2 gene, which increases many of the detoxification enzymes, especially in Phase 2.10,11,20 Garlic also has sulfur compounds that exert the same effect. Other Nrf2 activators include curcumin from turmeric, capsaicin from hot peppers, and resveratrol from grape skin or wine.11,20

Many leafy green herbs and plants support detoxification, including dandelion greens, cilantro, parsley, watercress, and chard. Use them in cooking, salads, smoothies, and juices.11,19

Artichoke, asparagus, and beets are healing to the liver with antioxidants that prevent liver damage. Artichoke is also one of the best stimulators of bile flow.11,19

Be sure to wash your produce well—even if it’s organic.

Cook with lower temperatures to avoid generating harmful chemicals. If you must grill, marinating with olive oil, lemon, and herbs such as rosemary, thyme, and oregano will help decrease the amount of HCAs and PAHs formed.

Avoid packaged foods as much as possible, including drinks in plastic bottles.

Invest in a water filter that filters out chlorine, fluoride, metals, and microbes. Most sink-mounted and pitcher systems don’t do this.

Drinking green tea also supports Phase 1 and 2 detoxification pathways by increasing CYP activity.11,20

In addition to detox-supporting foods, there are nutrients obtained in supplements that directly support the liver and detoxification process.

Amino acids: This is one of the most critical nutrient groups, as these acids function in the detoxification process itself and serve as antioxidants.

N-acetylcysteine (NAC) is the precursor to glutathione, the master antioxidant of the body and a significant component of Phase 2 detoxification.

Cysteine and methionine contain sulfur and contribute to the sulfation pathways. Methionine is also a methyl donor to the methylation pathway in its activated form, S-adenosyl-methionine (SAMe). Glycine also performs conjugation down the glycination pathway.10,20

Glutathione: Taking glutathione itself as a supplement or through IV therapy is helpful when levels need to be increased.

B vitamins: The B complex vitamins, especially B5, B6, B12, and folic acid are significant co-factors in the Phase 1 and 2 detoxification reactions that help drive the reactions forward. The methylation pathway is also very dependent on sufficient levels of B12 and folic acid.

Minerals: Iron, magnesium, zinc, and selenium are all minerals that support the detoxification process as co-factors or through antioxidant functions.20

Antioxidants: Antioxidants such as alpha lipoic acid (ALA), vitamins A, C, and E, and flavonoids play an important role, since the detox process inherently produces free radicals that need to be quenched.10,11,20

Milk thistle: Silymarin is the polyphenol in milk thistle that promotes detoxification. The antioxidant capacity of silymarin can lower the liver’s oxidative stress associated with toxin metabolism, which has the effect of conserving cellular glutathione levels.11

Calcium-D-Glucarate: This nutrient helps prevent the deconjugation of toxins in the intestines by bacteria, thus preserving them for excretion.

Probiotics: Probiotics will help maintain the balance between good and bad bacteria in the gut, which supports healthy elimination and immune functions that in turn support the liver.

Diet and nutrients can support the detoxification process itself, but the other half of the equation involves cleaning up your world.

Lifestyle changes involve some work, since they require you to read labels, investigate your personal environment, and make some changes, but the benefits to your health are worth it.

Start reading labels: The more you know about what you put in, on, and around your body, the better. If you can’t pronounce it, you should probably avoid it. Knowledge allows you to make healthier choices for you and your family.

Clean up your products: Choose more natural personal care products, toiletries, baby products, home cleaners (especially window and bathroom cleaners), and lawn fertilizers. These products are laden with preservatives and chemicals. Baking soda, coconut oil, white vinegar, lemon, and essential oils can fill many of these roles without the unwanted toxins.

Detox your furniture and home: Furniture, paint, flooring (especially carpet), and building materials also contain chemicals that give off gas, meaning they constantly emit these toxic compounds into the air and you breath them in. Opt for more natural materials like bamboo, latex, wool, and organic cotton.

Get some houseplants: Many houseplants such as English ivy, rubber plants, peace lily, golden pothos, spider plants, Boston ferns, queen ferns, and dwarf date palms are all great at filtering toxins from the air.

Air filters: Having HEPA filtration added to your heating and cooling system will result in more toxins and fine particulates being removed from your home air.

Open your windows: Indoor air can be more toxic than outdoor air, so open your windows and let your home and office breathe.

Shower filter: Invest in a shower water filter or a whole house unit. Your skin is the largest organ in your body (and the liver is the largest organ inside) with a high capacity for absorption. It will absorb toxins in the water you bathe in.

De-stress: Lower your stress levels by finding ways to either decrease your stressors and create boundaries or find appropriate outlets like talking, journaling, or exercising. Getting out into nature can be especially helpful.

Toxic relationships: If you have a person in your life who’s causing you to feel bad, hurt, angry, or frustrated, you should let them know if you can. If you can’t, then try to limit contact with them.

Sleep: Getting 8-9 hours of sleep per night is important, since this is when your body regenerates and heals.

Exercise: Movement is essential in keeping elimination going. Moving keeps your lymph and blood pumping, promotes bowel movements, counteracts inflammatory processes, and lets you sweat.

Sauna: Sweating is also a critical component of detoxification. You can do it through exercise or using a sauna. Saunas increase circulation and metabolic rate. Studies show that many metals, especially cadmium and nickel, are eliminated through sweat at higher levels than through urine.15

Bowel movements: Make sure you have 1-2 bowel movements per day. Daily elimination through the bowels, urine, and sweat are vital for proper detoxification.

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How Nutrient Testing Could Reveal The Root Cause of Your Symptoms

This article originally appeared on Healevate.

Why would you want to test your nutrient levels, you ask?

Most micronutrients, such as vitamins, minerals, amino acids, and fatty acids, don’t get much notoriety (except for vitamin D and omega-3 fatty acids), but they should. These nutrients are the building blocks of every single process in your body, and without them, disease and dysfunction ensue.

Scurvy is a great example. Lack of vitamin C in the diet of British sailors during the 18th century caused bleeding gums and mucous membranes, poor wound healing, and spots on the skin. If left untreated, they would die from blood loss.

Vitamin C is essential for the formation of collagen in hair, skin, and nails, blood clotting, nerve and muscle function, and is an important co-factor in many biochemical reactions.

We take for granted that getting the correct balance of nutrients is required for maintaining good health. Even a small deficiency in one nutrient can have major consequences in the long run. Conditions ranging from acne to heart disease start with some type of nutrient deficiency or excess.

The symptoms are seemingly limitless, since almost every symptom has a nutrient component. So understanding the important ones is crucial to good health.

Symptoms of Nutrient Deficiency or Excess

Skin/hair/nails: Brittle or dry skin, hair, or nails, lines on nails, bleeding gums, rashes, acne, rosacea, hair loss, spots on skin, darkened skin

Inflammatory/immune: Poor wound healing, recurrent infections, pain, autoimmunity, asthma

GI/digestion: Inability to taste, canker sores, constipation, diarrhea, reflux

Brain/mood/energy: Impaired sight, smell, or taste, hyperactivity, ADD/ADHD, malaise, lethargy, headaches, brain fog, inability to focus, depression, irritability, poor memory, poor sleep

Nerves: Neuropathy, paresthesia, pins and needles, numbness, tingling

Hormones: Sex hormone, thyroid, and adrenal imbalances, PMS, PCOS, severe menopause/andropause symptoms, inability to lose or gain weight, infertility, intolerance to cold or heat, excessive or diminished sweating

Musculoskeletal: Chronic fatigue, fibromyalgia, restless leg syndrome, muscle pain or twitching, joint pain, brittle bones, osteopenia/osteoporosis

Liver: Poor detoxification, chemical sensitivity, intolerance to alcohol or medications

Cardiometabolic: High or low blood sugar, fatty liver, atherosclerosis, palpitations, arrhythmia

Which Test Do I Choose for Nutrient Deficiency or Excess?

When considering the possibility of nutrient imbalances, people often start by assessing symptoms and trying to guess which individual nutrients might be associated with them. This is a less efficient way to do things, as you might miss important nutrients.

For instance, if you have neuropathy or tingling in your legs, you might look at vitamins B6 or B12, since they’re important for nerve function. But if the underlying cause is high blood sugar, you’d also want to know your magnesium, zinc, chromium, inositol, carnitine, lipoic acid, biotin, and vitamin B3, C, D, and E levels as well to have a more complete picture and treatment plan.

Since symptoms of nutrient deficiency and excess are vast, starting with a test that looks at many nutrients in an expansive panel is often a better way to go. The panels available now allow you to check multiple nutrients simultaneously, giving you greater knowledge of your body and the ability to rebalance nutrient levels properly.

Balancing nutrients appropriately is crucial, since too much of one and not enough of another can cause further trouble.

Nutrient Tests

There are many different types of test panels you could choose for analyzing your nutrient status. Depending upon your symptoms, condition, and health goals, you may want to select a smaller panel.

Or, if you’re unsure, a more expansive panel that looks at everything is a good choice.

Nutrient Panels:

  • Organic acid testing
  • Amino acid testing
  • Fatty acid testing
  • Combination nutrient testing

Organic Acid Testing

Organic acids (OA) are the end products (metabolites) generated by your metabolic processes, and they are easy to measure in urine. Organic acid testing provides an indirect way of measuring nutrient status, since all of your metabolic processes require certain vitamins, minerals, amino acids, and other micronutrients to function properly. It you are deficient in specific nutrients, it will show up as increased or decreased metabolites in the urine.

Nutrient deficiencies have several effects on metabolic reactions. First, serious deficits will impede biochemical reactions from occurring at all, giving a result that is below test detection limits.

Deficiencies can also cause a reaction to be limited/inefficient—producing low levels of metabolites—or cause a backup (think log jam) because there isn’t enough nutrient cofactor to propel the reaction forward. This results in an excess level of metabolites in urine.

Organic acid testing assesses the nutrients involved in driving metabolic processes forward:

Fatty acid metabolism requires carnitine, B2, and lysine.

Carbohydrate metabolism requires thiamine (B1), B complex, lipoic acid, chromium, vanadium, magnesium, manganese, and CoQ10.

Energy production requires arginine, cysteine, CoQ10, B complex, lipoic acid, magnesium, and manganese.

B-vitamin metabolism requires B-complex vitamins (B1, 2, 3, 5, 6), lipoic acid, and biotin.

Methylation cofactors require B12 and folic acid.

Neurotransmitter metabolism requires tyrosine, 5- hydroxytryptophan (5 HTP), phenylalanine, B6, and magnesium.

Oxidative stress markers show the need for antioxidants such as vitamin C, vitamin E, and lipoic acid.

Detoxification requires glutathione, N-acetyl cysteine (NAC), taurine, arginine, aspartic acid, glycine, magnesium, B-vitamins, and antioxidants.

Dysbiosis markers indicate the need for glycine, glutamine, and an amino acid complex.

Organic acids testing is available from Genova Diagnostics and Great Plains Laboratory.

Amino Acid Testing

Amino acids are the building blocks of proteins. When you eat protein, your body breaks it down into usable units, or amino acids, that are vital to life.

Non-essential amino acids can be made in your body, but some must be obtained through the diet. These are called essential amino acids. As individual amino acids, or linked as chains called peptides, they have many functions:

  • Building blocks of all structural tissue (bone, skin, muscle, etc), hormones, neurotransmitters, and enzymes
  • Pain control
  • pH regulation
  • Detoxification
  • Fat and cholesterol metabolism
  • Control of inflammation and immune function
  • Digestion

Amino acids can be assessed in the urine or blood. Genova Diagnostics, Doctor’s Data, and Great Plains Laboratory offer amino acid testing.

Fatty Acid Testing

Fatty acids are the technical term for what we typically think of as “fat.” For example, fish oil is comprised of the omega-3 fatty acids EPA and DHA. Like amino acids, fatty acids can be essential or nonessential, and they play a critical role in sustaining life.

Having the proper balance of omega-3, 6, and 9 (polyunsaturated, monounsaturated, and saturated fats) is critical for maintaining health. Among other things, fatty acids:

  • Generate cell membrane structure and regulation
  • Ensure healthy blood pressure and lipid (cholesterol) levels
  • Provide immune and inflammatory response and regulation
  • Decrease blood clotting (coagulation)
  • Decrease oxidative stress
  • Compose the structural tissue of the brain and nerves
  • Provide energy for metabolism

Fatty acids are analyzed from a blood sample. Genova Diagnostics, Doctor’s Data, and Great Plains Laboratory offer fatty acid testing.

Combination Nutrient Testing

Several companies offer comprehensive test panels that allow you to see nutrients, amino acids, fatty acids, and organic acids in different combinations, depending upon your needs.

Great Plains Laboratories can provide many different panels based on your condition or health goals. Basic and comprehensive panels for autism, ADD/ADHD, fibromyalgia, Tourette’s, mental health, and wellness options are available.

Genova Diagnostics offers a fat-soluble vitamin profile, ION profile, NutrEval, and ONE (Optimal Nutritional Evaluation) FMV, all of which analyze different combinations of nutrients, amino acids, fatty acids, and organic acids.

Spectracell Laboratories offers the Micronutrient Test, which assesses 30 key vitamins, minerals, antioxidants, amino acids, and fatty acids that are essential to health and often indicated in disease. Additionally, it provides assessment of total antioxidant function, an immune response index, glucose-insulin interaction, and fructose sensitivity.

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Why Autoimmunity Is Keeping You Sick And How To Reverse It

This article originally appeared on Healevate.

Do you feel fatigued even after you get a full night of sleep? Do you have achy muscles and joints, brain fog, an inability to concentrate, or insomnia? Do you get rashes, eczema, hives, or skin irritation? Do you have a hard time tolerating cold or heat? Do you get diarrhea, bloating, constipation, or stomach pain?

If you answered “yes” to several of these, there’s a good chance you have an autoimmune condition. Many people suffer for years with a vague set of symptoms that look like many other conditions but can’t be clearly defined or put in a box. Today we know this previous gray area actually defines the symptoms that precede or are involved in the process of autoimmunity.

This inflammation-based condition is a hot topic receiving lots of press right now in the health world, especially in holistic functional medicine and natural medicine spaces. This is partially because some AI conditions are now easier to diagnose, but much is due to the fact that we now understand the role of the gut and root causes as mediators of autoimmunity, not just a breakdown of immune function. This is a message practitioners, patients, and researchers want to get out, as autoimmune diseases are so prevalent—they affect at least 50 million Americans.1

Until recently, it was standard thinking that AI couldn’t be reversed, but now we know differently. Identifying the root causes and reversing intestinal hyperpermeability (leaky gut) are at the core of reversing the autoimmune process in the body. Doing this, combined with some diet and lifestyle changes, could have you healing and feeling like an elevated version of yourself.

What Exactly is Autoimmunity?

Autoimmunity, at its core, occurs when the immune system attacks healthy tissues that it’s mistaken as a foreign invader.

Previously, science believed that it was purely immune dysfunction or an overactive immune system that caused autoimmune conditions. Knowledge has advanced now, and we know that there are lifestyle triggers that lie at the heart of immune system dysfunction. These triggers, combined with genetics and epigenetics (the environmental influence turning genes on or off) are what regulate the AI process.

There are more than 90 diagnosable autoimmune conditions today.2,6 Some of the more common conditions are ankylosing spondylitis, Addison’s disease, Celiac disease, Crohn’s disease, Graves’ disease, Hashimoto’s thyroiditis, Lupus (systemic lupus erythematosus or SLE), myasthenia gravis, multiple sclerosis, psoriasis, rheumatoid arthritis, Sjogren’s disease, ulcerative colitis, and Type I diabetes, as well as allergies, asthma, dermatitis, and eczema.

This is only a short list of the conditions that have been described and categorized. In reality, you can have an autoimmune assault on any tissue in your body, and that process may not yet be defined, which can make diagnosis frustrating for you.

Even though there are many different types of AI conditions that are on a vast spectrum, they share one thing in common—that they’re all inflammatory in nature.

Chronic systemic inflammation sets the stage for an upregulated immune system that causes the body to attack itself.

The good news is that getting to the bottom of the root causes and making lifestyle changes can have a profound impact on the course of the autoimmune process, meaning that an AI disease doesn’t necessarily have to be defined to start reversing the process and healing.

How Does Autoimmunity Occur?

Dr. Amy Myers, MD, explains, “Autoimmune diseases are born when your body is working hard to defend itself against something potentially dangerous, such as an allergen, a toxin, an infection, or even a food, and it fails to differentiate between the intruder and parts of your own body. Mistaking certain types of tissues for harmful substances, your body turns these antibodies against itself, wreaking havoc on your organs.”1

The origin of autoimmune conditions is multifactorial and additive, in that it takes a genetically predisposed person in the right environmental circumstances with a leaky gut to develop an improper immune response. Family history accounts for one-third of the risk for developing an AI condition, as certain genes have been identified that directly affect the immune system and play a role in its hyperreactivity.14

Dr. Alessio Fasano, MD, the director of the Center for Celiac Research & Treatment at Massachusetts General Hospital for Children, has spent decades researching autoimmunity and how the immune system malfunctions, which led him to deduce that every autoimmune disease has three basic ingredients: a genetic predisposition, an environmental trigger, and a leaky gut.8,14

He explains that identifying the first two components was easy, since science has long known that AI conditions tend to run in families and that they can be triggered by infections, but the leaky gut component wasn’t identified until 2000, when he and his research team isolated the protein responsible for regulating gut barrier function, zonulin.14

Leaky gut, or increased intestinal permeability, arises when gut barrier function is compromised, allowing large particles that don’t normally enter the bloodstream to pass through. These particles are then triggers, causing the immune system to respond.

The environmental triggers are food sensitivities, allergens, toxins, and stress, which turn on the genes that initiate the AI process. This also generates chronic inflammation that perpetuates leaky gut and immune system activation.

Once the environmental triggers have entered the bloodstream, the immune system becomes primed and ready to defend, launching a biochemical war.

This war creates inflammation that activates certain genes, sustaining the immune response and allowing it to continue. As the war rages on and the immune system is on high alert, some confusion may arise, and the body may begin to attack itself.

One of the mechanisms believed to fool the immune system into thinking your body’s cells are pathogens is molecular mimicry. Molecular mimicry arises because there are specific protein sequences, or antigens, on the surface of certain microbial cells or foods that are similar to certain body cells such as the thyroid, intestinal cells, or nerves, essentially tricking the immune system. It loses its ability to clearly discern between self and non-self.

According to the ‘Thyroid Pharmacist’ Dr. Izabella Wentz, “This inadvertently causes a cross-reaction with our ‘self’ antigens, i.e., our own cells. This case of mistaken identity is thought to trigger the start of autoimmunity.”4

Similarly, another mechanism of autoimmunity occurs when toxins alter DNA and cause gene mutations. These mutations change the structure of tissues, causing the immune system to identify them as foreign and producing an assault on your body.

Triggers of Autoimmunity

The triggers that produce autoimmunity often occur together with the immune system responding to multiple ‘insults’ at the same time, since chronic inflammation mediates this process. Identifying the triggers and eliminating them is the key to reversing inflammation, calming the immune system, and shutting down the AI process. Common triggers of autoimmunity are:

  • Leaky gut
  • Dysbiosis and infection
  • Food sensitivity
  • Toxins
  • Stress

Trigger of Autoimmunity: Leaky Gut

Intestinal hyperpermeability, or leaky gut, starts when a trigger such as toxins, dysbiosis, stress, or food sensitivity creates inflammation, causing a dysfunction in zonulin, which regulates gut barrier function.

Fasano states, “Zonulin works like the traffic cop of our bodies’ tissues. It opens the spaces between cells, allowing some substances to pass through while keeping harmful substances out.” 6,8

Intestinal hyperpermeability occurs when there’s a breakdown in the function of zonulin, allowing larger particles such as bacteria, toxins, and partially-digested food particles through the intestinal walls to the bloodstream, where the immune system generates a reaction to clear them out. In genetically-susceptible individuals, these substances can eventually elicit an exaggerated or erroneous response, and the body can begin to assault its own tissue.

Leaky gut provides an easy access gateway to the immune system, when normally these particles would be kept out of the bloodstream. Under normal circumstances, when you encounter a typical foreign invader, such as a virus, bacteria, parasite, fungus (mold and yeast), or toxin, your immune system should answer by generating a response to anything it perceives to be a threat to your survival. In the case of autoimmunity, these large particles that have entered the bloodstream through a leaky gut cause an immune response that produces antibodies to the particles themselves and to the tissues of your body.

The causes of leaky gut must be eliminated and intestinal barrier function properly restored in order to reverse autoimmunity.

Trigger of Autoimmunity: Dysbiosis and Infection

Dysbiosis is the product of an imbalance between the beneficial and harmful organisms in your body, especially the gut. Healthy individuals have lots of the good guys within the GI tract that assist with digesting food, producing nutrients, and protecting from harmful organisms and inflammation.

When there’s a general imbalance between the good and bad flora, or when there’s an infection present, such as SIBO (small intestinal bacterial overgrowth), Candida (yeast), parasites, or mold, dysbiosis will arise. This imbalance allows for leaky gut to occur, since chronic inflammation develops as a byproduct, and it contributes to the deterioration of the intestinal barrier.

Native (commensal) and infectious organisms, like large particles leaked from the gut, can also trigger autoimmunity through molecular mimicry. Your body mounts an immune response, which is great when it zeroes in on a cold virus that shouldn’t be there, but it’s a problem when it mistakenly assaults your thyroid while it’s attacking H. pylori.4

There are many organisms implicated in the molecular mimicry process of autoimmunity, such as H. pylori (causes stomach ulcers and GI infections), Yersinia enterocolitica (causes GI infections), and Borrelia burgdorferi (causes Lyme disease), which may trigger Hashimoto’s thyroiditis.4

When the immune system sees Klebsiella pneumoniae, Shigella, Chlamydia trachomatis, and several other gram-negative bacteria, it ‘recognizes’ the self protein HLA B27 and attacks, inducing spondyloarthropathies, which are inflammatory conditions that include ankylosing spondylitis, psoriatic arthritis, and reactive arthritis (Reiter’s Syndrome).5 Viruses can also be triggers, as with multiple sclerosis and lupus, as well as the Epstein-Barr virus (EBV).5

Many other AI conditions can have a molecular mimicry component as well.

If you have an AI condition, it’s worth investigating to see if you have dysbiosis or an infection that may be perpetuating the process.

Trigger of Autoimmunity: Food Sensitivities

Food sensitivities are very common in those with autoimmunity. The usual suspects are gluten, dairy, eggs, nuts, soy, and corn, although you can have a reaction to any food you eat, especially those you consume frequently. Lectins, which are proteins found in legumes and grains, also activate the immune system and are implicated in autoimmunity.

These sensitivities generally arise when the partially-digested food particles enter the bloodstream through a leaky gut. Additionally, under the right circumstances, a cross-reactive process may ensue as well.

In another case of mistaken identity, foods produce a cross-reactive response through the same antigen-antibody-mediated process that the microorganisms produce.

According to PhD scientist Sarah Ballantyne, aka The Paleo Mom, “For those 20% of us with Celiac disease or gluten-intolerance/sensitivity (whether diagnosed or not), it’s critical to understand the concept of gluten cross-reactivity. Essentially, when your body creates antibodies against gluten, those same antibodies also recognize proteins in other foods. When you eat those foods, even though they don’t contain gluten, your body reacts as though they do. You can do a fantastic job of remaining completely gluten-free but still suffer all of the symptoms of gluten consumption—because your body still thinks you’re eating gluten.”7

Gluten is one of the most sensitizing substances we consume, and eating the cross-reactive foods can be just as bad, since they elicit the same response. Common cross-reactive foods are rye, barley, spelt, Polish wheat, oats, buckwheat, millet, sorghum, amaranth, quinoa, corn, rice, potato, hemp, soy, teff, milk, chocolate, yeast, coffee, sesame, tapioca, and eggs.7

When you have an autoimmune condition, you’re best served by eliminating gluten completely and any cross-reactives that are triggers for you. There’s no middle ground here—it’s all or nothing, because even one little bite will provoke a potentially hazardous flare-up.

Trigger of Autoimmunity: Toxins

When it comes to autoimmunity, you need to be concerned with the toxins inside and outside the body.

Toxins are all around us in the air, water, soil, and our food supply. We’re exposed to astounding amounts of pollution. Over 80,000 chemicals have been introduced into our society since 1900, and only 550 have been tested for safety.9

Dr. Donna Nakazawa, MD and author of The Autoimmune Epidemic, calls these environmental toxins “autogens,” since they create a reaction against the self.9

The toxins we take in can alter our DNA, producing gene mutations that change tissues. The immune system can attack these tissues since they’re not identical to your healthy tissues. Furthermore, the toxins can alter gene expression by turning on genes that promote inflammation, which can then produce autoimmunity and leaky gut. These are some of the more common toxins:

Heavy metals: Mercury, lead, cadmium, bismuth, arsenic, tin, and aluminum

Plastics: BPA, BPS, BPF, and phthalates

Food: Pesticides, herbicides, BT toxin (from GMOs), preservatives, additives, colorings, Teflon (non-stick cookware), and aflatoxins on peanuts and grains

Environmental chemicals: Chlorine, fluoride, bromine, xylene, dioxin, toluene, and PCBs

The organisms that normally reside within us, as well as the pathogenic invaders, can also produce toxins. Mold produces mycotoxins. Bacteria have two toxic mechanisms—the excretion of toxins called exotoxins and the endotoxins on the cell membrane of gram-negative bacteria. These toxins activate the immune system and produce inflammation.

Trigger of Autoimmunity: Stress

Chronic stress has many negative impacts on health, especially with regard to autoimmunity.

Chronic stress produces constant activation of the sympathetic nervous system (fight or flight) and increases levels of the stress hormone cortisol. Over time, constant cortisol elevation leads to cortisol resistance, where the body has to produce more and more to achieve the same response. When this happens for prolonged periods of time, cortisol levels become chronically low, and adrenal fatigue develops. Cortisol is the primary anti-inflammatory hormone in your body, and when levels are chronically low, low-grade inflammation rages, paving the way for autoimmunity.

Additionally, chronic stress alters immune function over time, causing some aspects to be amplified and others to be diminished, producing dysregulation.

A 2009 study on autoimmunity revealed that “most interestingly, the release of endogenous glucocorticoids [cortisol] is critical in regulating the severity of disease activity in patients with inflammatory conditions such as rheumatoid arthritis (RA). Blocking of cortisol production results in a flare-up in disease activity in RA patients, while surgical removal of the adrenals in patients with Cushing’s disease has been reported to exacerbate autoimmune disease.” This clearly illustrates cortisol’s critical role in immune function and inflammation.10

Chronic stress produces physiological changes such as decreased blood flow, oxygenation, motility, enzyme output, and nutrient absorption that directly impact the intestinal flora and gut function.11 Since 70-80% of the immune system is within the gut, this means decreased gut and immune function, which can impact autoimmunity. Further, stress diminishes immunity by depleting the antibody secretory IgA (sIgA) as well as essential hormones, and it promotes inflammation, which can all result in a leaky gut.12

Symptoms of Autoimmunity

Autoimmune conditions are characterized by a myriad of symptoms that can be vague and varied, waxing and waning, making diagnosis difficult. Inflammation, being central in the AI process, is the root of many of these symptoms.

Immune: Allergies, asthma, chronic or recurrent infections that won’t resolve, or yeast infections

Skin/hair/nails: Dermatitis, eczema, acne, rashes, scaly skin patches, hives, photosensitivity (sun sensitivity), hair loss, nail pitting, or dry eyes, skin, and mouth

Gastrointestinal: Food sensitivities, food allergies, stomach pain, GERD (acid reflux), IBS, gas, bloating, diarrhea, constipation, or gastroparesis (delayed stomach emptying)

Brain and mood: Headaches, brain fog, inability to focus or concentrate, double vision, blurred vision, poor memory, depression, anxiety, irritability, fatigue, lethargy, dementia, or insomnia

Nerves: Tingling, pins and needles, numbness, or paresthesia

Hormones: Poor blood sugar regulation (high or low blood sugar), weight gain or loss, cold intolerance, imbalanced female and male hormone systems, poor sleep quality, thyroid imbalances, adrenal imbalances, or multiple miscarriages

Cardiovascular: Palpitations, hypertension (high blood pressure), high cholesterol, anemia, or blood clots

Musculoskeletal: Joint and muscle pain, muscle weakness, or fibromyalgia

Liver: Poor detoxification, elevated liver enzymes, or chemical sensitivity

Lab Testing for Autoimmunity

Lab testing for autoimmunity can be exhausting and broad, since there are so many options. It’s best to start with the basics first and consider general blood tests.

General AI Tests:

ANA (anti-nuclear antibody)
ESR (erythrocyte sedimentation rate)
CBC (complete blood count)
CRP (C-reactive protein)
APA (antiphospholipid antibodies)
RF (rheumatoid factor)

GI Infections:

Stool analysis (general)
CDSA (comprehensive digestive stool analysis—looks at organisms, inflammation, and leaky gut)

Food Sensitivities/Allergies:

IgE test for allergies
IgG or IgA test for sensitivities/intolerance
Mediator release testing

Once you’ve pursued these avenues, testing for specific conditions may be in order, such as TPA (thyroperoxidase antibody) and TGA (thyroglobulin antibody) for Hashimoto’s. Cyrex labs has several tests specifically designed for autoimmunity, food intolerances, and intestinal permeability. The Array 5: Multiple Autoimmune Reactivity Screen tests twenty-four different tissues for AI activity.13

Treatment of Autoimmunity

Treating autoimmunity can be easier than you think. Many people get some level of resolution with lifestyle changes and even further resolution when specific lab testing uncovers hidden infections, toxicity, or low cortisol levels that can be treated.

The easiest way to work your way through treatment is to take a systematic approach so you can more easily see what’s working and what isn’t.

Diet: This is the best place to start, since you’ll need some time to identify which foods you should be avoiding; making permanent dietary changes can yield massive benefits when it comes to autoimmunity.

The first step is to begin a 30-day elimination diet. You can make this basic and eliminate the usual suspects that trigger reactions like gluten, dairy, corn, soy, and nuts, but you’d be better off eliminating known AI triggers as well. These include seeds, eggs, legumes and grains (because of the lectins), and nightshades (all varieties of peppers, potatoes, eggplants, etc). You may even choose to stop eating gluten cross-reactive foods as well if you know you have issues with gluten. After 30 days, you can begin the re-introduction phase to see if you have any reaction to each food.

If you want to jump right into a diet change, Paleo can be a good place to start, since it naturally eliminates many of the AI triggers. The first study ever completed on autoimmunity and the Paleo diet was published in 2014 by Dr. Terry Wahls, MD and author of The Wahls Protocol. Although it was a small study, it illustrated the beneficial effects of adopting a Paleo diet in relation to AI disease—especially a reduction in fatigue.3,15

The Autoimmune Paleo diet takes it one step further and eliminates all food triggers of AI. Dr. Ballantyne has the Paleo Approach, and Dr. Datis Kharrazian both have versions of this that are great resources. Dr. Kharrazian’s AI diet focuses on gut healing and is a simple version that includes many meats, vegetables, fermented foods, coconut, certain herbs and spices, low glycemic fruit, and some condiments.16

With all of the diet information out there, knowing what to eat can be very confusing, but with some work you can do it. As with any diet, you need to tailor it to your own specific biochemical needs. This means that some of the foods on the “avoid” list might be okay for you, and some acceptable foods may not be.

You need to figure this out to optimize your diet and health. Find your “you” diet.

Nutrients and Supplements: There are so many different nutrients necessary for treating autoimmunity and inflammation. The following are some examples of anti-inflammatory and gut-healing nutrients you can start with:

Magnesium, vitamin D, and EPA/DHA (omega-3 fatty acids) are recommended by Sarah Ballantyne for their important anti-inflammatory and immune-modulating effects.3,17

Vitamins C and E, zinc, and selenium function as antioxidants and protect against oxidative stress.17

Glutathione is a critical nutrient, as it’s the master antioxidant in the body, and there’s a significant breakdown with its function in AI. Taking supplemental glutathione (or its precursor, NAC (n-acetyl cysteine)) with alpha lipoic acid (ALA) and glutamine will help recycle glutathione efficiently. ALA also functions as an antioxidant and supports healthy mitochondrial function. Glutamine is an essential nutrient for intestinal cells and helps repair leaky gut (along with glutathione).18

Probiotics (“good bacteria”) increase the levels of healthy bacteria in your gut, which reduces inflammation and combats leaky gut.17

Digestive enzymes and betaine HCL are often necessary, since nutrient malabsorption plays a role in leaky gut and AI.17

Clean up your life: Eat organic foods, avoid GMOs, and choose more natural cleaning and personal care products to reduce the toxic burden on your body.

Reduce your stress levels: Stress is one of the main contributors to inflammation and poor immune function. Identify and manage your stressors. Reduce stress by creating boundaries, honoring your feelings, and organizing your life.

Relax: Take time-outs during the day to unplug and rest. Schedule downtime to give your body a rest by journaling, yoga, or meditation. Do what speaks to you.

Get into nature: Nature has significant healing benefits, so try to get out and enjoy it at least once per week.

Sleep: Getting adequate sleep is essential to healing. Avoid blue light stimulation from TVs, phones, and tablets for at least 2 hours before bed. Aim for a minimum of 8 to 9 hours per night, and try to get to bed by 10 PM. Sleep in a dark, cool, and quiet room for the most restful results.

Exercise: Moving your body is important to maintaining health and the healing process, but know your limits. Pushing too hard or too fast can delay your recovery. Give yourself adequate rest time, and only do what your body is telling you it can handle. In general, long-duration endurance exercises deplete cortisol and promote inflammation, so it may be best to avoid this and opt for walking, hiking, yoga, pilates, or weight lifting.

Empower yourself: Knowledge is power, so educating yourself on your condition makes you your best advocate. This knowledge will equip you with the best opportunity to manage your AI condition to give you the best quality of life.

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3 Natural Eczema Remedies to Start Healing

Have you tried the drug store potions, over the counter (OTC) medications, or even prescriptions only to have little to no improvement in your eczema?

This is a common theme in my virtual clinic. We see many people that’ve tried everything, including things we recommend like diets or supplements, only to have a small change in their eczema. So, what’s going on??

The truth is that eczema, like any other chronic inflammatory or autoimmune condition, is complex and the causes are different for each person. This makes it difficult to treat, especially self-treat.

Super frustrating, right?

There’s a small percentage of people that can eliminate the common food triggers and take a couple of supplements, and achieve resolution of eczema. However, this is rare. If they don’t maintain their diet or have a major stressor, the eczema usually returns because they haven’t addressed the underlying causes.

You might be thinking- what do I do?

Addressing the root causes like stress, hormone imbalance, diet, gut infections, nutrient/vitamin deficiencies, and immune dysfunction provides long term resolution, but in the meantime here several natural eczema remedies to help control the symptoms and start healing.

Topicals

Don’t: Petroleum jelly goes under many names such a Vaseline®, petrolatum, mineral oil, or paraffin, and it’s a byproduct oil refining that contains compounds such as hydrocarbons that are harmful to health. It also seals the skin, trapping potentially harmful bacteria and letting the skin breathe.

Even worse, it can cause collagen breakdown which is the opposite of what you want if you have eczema.

Do: Shea butter, cocoa butter, coconut oil, and jojoba oil are all great options and each their own benefits. Some people find they work well alone, but in practice we’ve seen that people usually benefit from a combination.

You can purchase one like Moon Valley Organics EczaCalm (there are many other options available and we’ll be doing a review of our favorites so stay tuned).  You can also customize a blend of your own with our Healing Salve recipe. The recipe can be altered with different base butters, oils and essential oils.

Remember, topicals help soothe the skin, but real healing comes from inside the body.

Supplements

Supplements seem to be an obvious starting place for natural eczema treatment, but in reality are a complex task to tackle, especially alone.

Don’t: Sadly, we see many people that are either on 20-30 supplements at once (YES…this is real unfortunately) and have no relief and lots of wasted money!!

The truth is this could be making the situation worse since you don’t know what ingredients are helping or hurting. Plus, there are the fillers, binders, and additives to consider as well as the active ingredients that could be causing issues.

Do: Start simply. Use single or few ingredient products that are clean, well sourced, and have a good reason for you to invest in them.

Here are two great options that have worked well in our clinic:

Collagen Protein has many benefits. It’s a critical building block of our skin that is compromised with eczema and it helps heal the gut which is a primary root cause in eczema and other autoimmune conditions.

Bifidobacterium based probiotics reduce histamine and can help heal the gut. This 2008 study shows using B. infantis and B. longum reduced histamine signaling which can translate to less itching.

Diet

Again, diet is often difficult to navigate on your own (even harder than supplements). We’re all different and for some just taking out a couple of foods or food categories may work, but no one will ever respond to the same exact diet (not even identical twins).

Don’t: Taking on too many dietary changes at once can be overwhelming and lead to unnecessary (and unwanted) stress. Don’t try removing gluten, dairy, salicylates, and histamines all at once. This will leave you with nothing to eat and likely cause confusion.

Do:  Take baby steps with diet and monitor closely so you know what’s going on. An easy stepping stone is to remove all gluten or dairy products for 3-4 weeks minimum (you can do both if you’re willing). When you re-introduce them watch for reactions not only on your skin, but digestion, headaches, runny nose, fatigue, and achy muscles or joints.

Eggs, soy, corn, or nuts might be good options for you to test eventually too. If you find the main food allergens and sensitivities aren’t your problem, then it might be time to look at broad categories like salicylates or histamines.

The Bottom Line

These are all good, natural eczema remedies to start with and are things we recommend in the clinic while we’re working on reversing the root causes since the ultimate goal is healing on the inside and outside.

We’d love to hear what natural remedies have worked best for you?

7 Interventions to Stop the Eczema Flare Before It Erupts

Get out of the Stress-Eczema Flare-Clear Skin-Repeat Cycle 

Is your life causing your eczema flares? Read on to find out if it is…

I believe it’s possible to teach old dogs new tricks. Yes, I’m referring to myself as an ‘old dog’ even though I’m not that old! However, it’s a fitting phrase to describe when I decided to retrain myself not to get stuck in the cycle of stress-eczema flare-clear skin-repeat.

My pattern was pretty obvious. I take good care of myself on every front except…drum roll…stress management. This is true for most of us, but this is a huge part of what I do to help heal people.

Yet, I wasn’t doing it for myself.

I was too focused on my job, side projects, and raising my son who was a baby at the time.

I dove into everything head first and never said no. I was all GO, GO, GO, 24/7.

Until my body would hit the wall from stress and I’d start get flare ups on my hands, wrists, forearms, stomach, and thighs. Tingling would turn into little red spots that itched so bad they’d spread out like an oil spill. Broken, inflamed skin would leave ugly patches.

I was especially embarrassed of my hands, wrists, and arms because people could see them. The palms of my hands and wrists were the worst unfortunately and people would sometimes look a little too long when I handed them payment, opened doors, or waved hello.

It’s amazing how many things our hands are involved in and how self conscious you can become once you’re aware that people are looking.

Gloves year round, anyone???

My usual approach was once I got sick of dealing with it, I’d really dial in my diet, take anti-inflammatory herbs, and engage in some stress reduction. That usually did the trick.

The itching would soon begin to subside, redness would retreat, and the bumps and patches would fade. After several weeks of being “good,” my skin would be clear again. AWESOME!!!

Then, I’d go back to my normal routine and inevitably have a flare up within a couple of months that was worse than the one before. It also started to get harder to treat.

Clearly I had a very short memory and I wasn’t learning from my past history!

Breaking the Cycle

After this cycle had been going on for over a year, I decided something need to change (there’s a longer version of this story that I’ll save for another day, but I’ll share the most important piece now).

The key change in retraining myself was managing my stressors. I needed to practice what I preached to my patients. Priority number one was establishing boundaries and stepping away from being a “yes” girl. I started to say “No” to many opportunities when I felt I had too much on my plate or felt I couldn’t give 100%. I also said “No” to social and family events if I was busy or starting to feel like I was being pulled in too many directions.

I also did a better job of decompressing and taking care of me, which meant giving myself breaks to exercise and have some quiet down time daily to do some deep breathing, journaling, or meditate (even if I had to sneak away to the “bathroom” to get it 😉). I also made consistent sleep a priority as much as I could with a nursing baby.

These are habits I’ve maintained to this day, except I don’t have to hide in the bathroom anymore for peace and quiet!

Stress management was the single biggest change I made to break the cycle, but I also developed strategies to tame a flare if I felt one coming on that I’m going to share with you.

7 Interventions to Stop Your Flare Before It Erupts

1. Clean your diet up. Most of us let our diet go when we’re under stress. Naturally, our bodies crave sugar and carbs to fuel our stress response (but we’re not running away from tigers and lions anymore). Sugar in general promotes inflammation, but so do gluten and dairy. I recommend eliminating these first if you haven’t already. Eating a diet focused on whole foods- meat, fish, eggs, veggies, fruits, and healthy fats will be supportive of calming inflammation.

If you’ve already pared down your diet, you might be sensitive to something else you’re eating. Start paying attention to how you flare responds to food. Do certain ones make you itch more? Do they give you other symptoms of inflammation like mucus production or joint pain? Is the response immediate or delayed?

Using a diary requires some effort, but it’s the best way to track the effects of diet and lifestyle. When I feel a flare come on, I open up an spreadsheet on my computer. I make columns for meals, immediate and delayed reactions, supplements, exercise, stress, sleep, and observations. I record everything that was notable and if nothing is notable I leave that spot blank. This way I can identify immediate issues, but also patterns that may otherwise be hard to see. This is actually how I figured out that I had a histamine issue.

2. Avoid Histamines. These nasty chemicals are produced in the inflammatory response and are part of the reason you itch. You can be consuming them in food or supplements like probiotics. There is a detailed list in my free triggers guide “Eczema: Seven Sneaky Sources Making Your Flare Worse.” Additionally, fish, seafood, cured and deli meats, aged cheeses, dried fruits, citrus fruits, pickles, and any fermented foods such as yogurt, kefir, kombucha, and sauerkraut. Basically, if it’s aged in any way- pickled, preserved, fermented, dried, salted or cured, it contains histamines. That makes left overs a no-go too.

Unfortunately, bone broth which is very healing, also contains high histamine levels, so watch out for any histamine related symptoms including itching, runny nose, mucus or phlegm, redness, etc.

Some strains of the probiotic group Lactobacillus (L. casei and L. bulgaricus) are known to produce histamine which may aggravate your eczema. From my clinical experience, I’ve also seen patients have a histamine reaction to other probiotics too, so pay attention to how your body responds to them. Remember- everyone is unique and we’ll all have different reactions to different substance.

3. Consume anti-inflammatory foods (or their supplement form). I’m a big fan of food as medicine. Some of the best anti-inflammatory foods are herbs and spices, specifically turmeric, ginger, and garlic. Together, these are pack a triple threat anti-inflammatory, antimicrobial, and gut and skin healing punch. They can be consumed easily in meals- especially any Asian or Indian recipes, added to smoothies, pre-made tea bags, or in this healing tea/infusion recipe.

The supplement forms can be used too. Sometimes you’ll find an anti-inflammatory combo with all or a few of these ingredients or they can be used separately. I prefer to use them for specific actions when using them as separate often highly concentrated supplements. In this capacity is use turmeric (curcumin) for inflammation, ginger for gut healing and calming, and garlic as an antimicrobial.

4.  Avoid extreme temperatures. Whether you’re indoors or outdoors, or doing things like bathing or exercising, really hot or cold temperatures can have a negative effect on eczema. In the past, I’ve had a histamine reaction during exercise that resulted in extremely red and itchy legs in both summer and late fall. It’s really hard to workout when you stop to scratch every 10 seconds (plus people stare at your tomato red legs)!

Similarly, hot showers will do the same to me. I know when I’m in a flare to keep showers lukewarm or even cold.

5. Take a timeout. Not the kind where you sit in the corner and think about what you did wrong, but to similarly be still and contemplate. A couple of times each day take 10 minutes to just sit in silence while deep breathing. This doesn’t have to be a full on meditation (although if you want to- go for it because it’s amazing for stress reduction). The point is to let your mind quiet down and focus your intention to calmness and healing.

We spend all of our time in a stressed out, fight or flight mode (a.k.a. sympathetic nervous system ), which promotes inflammation, rather than the rest, digest, and reproduce mode (a.k.a. parasympathetic nervous system), which promotes healing. Chilling out, naps, eating, and sex are way more appealing anyway!

6. Laugh and play. Similar to the previous point, taking time to laugh and play does wonders for inflammation and counteracting the effects of the sympathetic nervous system. If you’re in a flare you might need to take a “personal day” from work.

Send the kids to school (if you have them) and just chill out watching funny movies or meet a comedic friend for lunch. When the kids come home, do something fun like playing games or something you all enjoy together. If you don’t have kids, grab a spouse, partner, or friend do your favorite activity.

The goal is enjoy life and put a smile on your face. There are lots of positive chemical effects that occur in your body when you smile, laugh, or share intimate moments with those you’re close with.

Bonus tip– if you’re a stay at home mom with a baby or small kids it’s hard to take a personal day. Instead of calling in sick to your boss, call a friend or family member to watch the kids for a couple hours (or more if possible) so you can focus on some fun or alone time. No running errands or chores- this time is for you to enjoy yourself!!

7. Pamper your skin with healing moisture. Once you get out of your not-too-hot shower, be sure to apply moisturizer ASAP. I’m a fan of my healing salve recipe, however, there are many options, especially if you’re just into the beginning of a flare. Coconut oil, shea butter, or a combination of the two may just be enough to get your skin going in the right direction. If you start to develop lesions, bumps, or extreme redness, the salve might be a better choice.

There are also many choices available online now too. I’ve had many clients tell me about creams and lotions that have worked for them. The key here is to get a clean and green one- avoid synthetic chemicals, dyes, and scents. Many of the good natural formulas have a base of coconut oil, shea butter, beeswax, and/or tallow (usually from beef) combined with essential oils or healing herbs. Going with a blend like this will help avoid topical reactions on the skin.

What remedies have you tried that have helped calm your symptoms down? Let us know in the comments section. Thanks!

Is Your Favorite Morning Beverage Causing Eczema

(Spoiler: There’s a healing swap-out suggestion with an Eczema Healing Tea recipe included)

Does Caffeine Cause Eczema

Who doesn’t love their morning cup of caffeine? Coffee and tea consumption have become a significant part of American society. The cafe culture is a multi-billion dollar industry. This isn’t anything new…many civilizations for centuries have worshiped them too. But do these beloved brews contribute to eczema?

This is a question I’ve had to tackle for years in my practice with patients and for myself. Like any issues related to food or root causes of eczema- it’s a matter of individuality and how it’s affecting the inflammatory process in your body.

Personally, I love both tea and coffee for different reasons- I’ve been a lifelong tea drinker (thanks Grandma), but in my early 30’s I discovered coffee. I’d always loved the smell, but didn’t care for the taste. But as I began changing my diet to be cleaner and gravitated to Paleo/Primal, my taste buds changed.

Suddenly, I really liked coffee. I enjoyed the slight bitterness, dark chocolate, and fruity notes, much like a good wine. I hear this from patients too- they report liking bitter things such as coffee and really dark chocolate as they lose the taste for sugar.

I can drink it black, but I really love a warm cup of joe with grassfed butter and coconut oil in the morning. That’s heavenly for me!

So when the question of caffeine consumption and elimination arises, the reaction is similar for most of my patients- complete horror (even for a short duration). I’m often met with comments like: “there’s no way I can do that!” Or else, “you want me to do what!! And, for how long???”

I get it. The thought of giving up my tasty, warm beverages (especially considering that I live in Minnesota) gave me slight panic too.

Caffeine is America’s number one drug of choice. Some of us like it for the taste, mental boost, or the purely for the energy surge. But sadly, your favorite pick-me-up can be counterproductive if you have a condition like eczema that has roots in inflammation.

I don’t ask patients to drop the mug to torture them (although some may strongly disagree). I do it because I understand the many ways caffeine alters the immune and inflammatory response.

How do Coffee and Tea Cause Eczema

At first thought it may seem crazy to consider coffee and tea as causes of eczema, but they can alter the inflammatory response in ways that play a role in the process of developing eczema. Once you have eczema, they can contribute to the vicious cycle of exposures (foods, infections, toxins, etc.) that perpetuate the condition until they’re removed.

Here are the most significant ways that coffee and tea promote eczema:

1. It spikes adrenal hormones just as stress does. I generally suggest stopping if someone has HPA axis dysfunction (also know as adrenal fatigue) because of caffeine’s effects on the inflammatory process. Caffeine sends a signal to the brain which sends a signal to the adrenal glands to pump out cortisol and adrenaline (epinephrine), effectively putting your body in constant fight-or-flight mode. Not good if you have eczema and need your cortisol for its anti-inflammatory effects.

2. Elevated cortisol contributes to Leaky Gut. The chemicals secreted during the stress response are linked to intestinal permeability (leaky gut), inflammation, overgrowth in bad bacteria, and decreased microbial diversity that can alter immune function. These are significant root causes of eczema that need to be addressed to completely heal it.

3. You can react to the mycotoxins found in coffee. Mycotoxins are toxins produced by fungi and the 2 commonly found in coffee are ochratoxin A and aflatoxin B1. These compounds are known to be immunosuppressive, carcinogenic, and brain damaging among other health problems. Chronic, low level exposure can build up in your system causing an immune response that can promote inflammation.

Swap Your Caffeine with a Warm Drink That Will Help Heal Eczema

I hate to tell patients that they must avoid something forever. In some cases this is necessary, like a Celiac sufferer avoiding gluten, but generally, most people can handle some caffeinated beverages once they’ve healed their eczema and gut.

But until that joyous day when you can imbibe again, here’s an alternative that’s equally as tasty and will help heal your eczema and gut.

Eczema Healing Tea

I enjoy this drink because it’s reminiscent of my favorite morning coffee, but it also incorporates the spiciness of ginger and turmeric that I love. It’s also warming and soothing on cold days. Prep is quick and easy too- usually 5 minutes from start to finish.

Ingredients

  • 1-2 inches peeled, fresh turmeric
  • 2 inches peeled, fresh ginger
  • 1 garlic clove peeled- don’t worry, the other flavors mask the garlic 😉
  • 2 tablespoons coconut oil
  • 1 tablespoon raw honey
  • 1 serving collagen powder
  • 8-12 ounces hot water

Tip: If you want to have a speedy process, peel and portion out the turmeric, ginger, and garlic for several days. I keep mine in a mini mason jar or glass container in the refrigerator. If you prep too much it can start to dry out, so placing a small damp towel or cloth on top can help prevent that.

Instructions

1. Get your water heating up before you start prepping so that you can pull if off and let it cool if necessary before you pour it into the mixture. I like to use a kettle to warm mine up.
2. Remove the skin from you turmeric, ginger and garlic. You can use a knife or spoon (scraping down the sides) to get rid of the skin. Note: spoon scraping gives a slightly better yield but is more time consuming than using a knife. Place them in the blender.
3. Add in the coconut oil and honey.
4. Pour the water over the mixture. Warning: don’t blend it up if it’s too hot and steaming because the pressure could build up and burn you when the lid is removed.
5. Add the collagen in last (truthfully, it probably doesn’t matter when it’s added, but I try to keep the collagen from clumping or sticking to the sides of the blender cup or carafe).
6. Blend up until all ingredients are fully incorporated. It should take 15-30 seconds for most high speed blenders.
7. Pour into a mug and enjoy!

The beauty of this recipe is that it can be adjusted to taste and needs. Don’t like turmeric- don’t add it. Have a sensitivity to collagen powder? Leave it out. Got Candida or a fungal issue? You may want to adjust or eliminate the raw honey. You can customize this as you wish.

I actually make variations on this recipe often. I’m a ginger lover so I’ll add a huge 3-4 inch piece in sometimes. I’ll bump up the collagen if I feel more stressed. I don’t always have raw turmeric on hand, so I make it without it. If I’m feeling congested or sick from a cold, I’ll decrease the water by 2-4 ounces and add in the juice of one lemon and/or raw apple cider vinegar (ACV). Be careful using this variation if you’re in an eczema flare as the histamines in lemon and ACV can make symptoms worse.

Eczema Healing Tea is a Healing Bomb and Inflammation Buster

The elixir is packed with several anti-inflammatory, immune boosting, antimicrobial, and skin supporting ingredients. Coffee and tea definitely can’t claim that. Here’s a breakdown of the benefits:

1. Turmeric is a member of the ginger family which is why they share similar characteristics. However, the curcuminoids are what give turmeric it’s superior inflammation fighting power. The journal Oncogene published a study that found turmeric to be one of the most potent anti-inflammatories in the world, even beating out NSAIDs. It can also help heal the lining of the intestines which is critical for resolving eczema.

2. Ginger, like turmeric, supports immune and anti-inflammatory pathways in the body. Ginger is a great antimicrobial too, acting against a wide range of bacteria and fungi like Candida. It’s widely supports the gut too- relieving nausea, bloating, constipation, and acid reflux which are symptoms that often accompany eczema root causes like dysbiosis, GI infections, and food sensitivities.

3. Coconut oil is considered to be the “motherlode” of healing foods. One of best features is the broad antimicrobial activity of lauric acid- helpful for addressing bacterial, fungal, and viral infection, but also maintaining daily health. The antioxidants in coconut oil are well documented to combat inflammation. It also has pain relieving (analgesic) capabilities. The same properties that make it amazing for internal use also apply to the skin. Externally it can be used as a cleanser, moisturizer, and as an ingredient in a healing salve or ointment.

4. Garlic in its raw form is a close second to coconut oil in it’s ability to protect against the “bad bugs,” having potent antibacterial, antiviral, and antifungal properties. The sulfur containing compound allicin is effective against the opportunistic staphylococcus (staph) bacteria which is thought to play a role in eczema for many individuals. Personal note- when I did stool testing on myself during the peak of my symptoms I had a slight overgrowth of staph that had to be treated.

5. Raw honey is an antioxidant powerhouse. It contains several classes of polyphenols and flavonoids that support the immune system. In addition, it contains 22 amino acids, many of the B complex vitamins, and 27 minerals including magnesium, potassium, iron, zinc, selenium, calcium, and phosphorous.

6. Collagen is the most abundant protein in the body and a critical building block of the skin. Using supplemental collagen powder has been shown to improve skin quality by increasing the barrier function meaning better elasticity, moisture, and texture. Good news if your skin is damaged from eczema! Another reason collagen is great is that it heals leaky gut, which is a primary root cause in eczema. It’s benefits are similar to what’s seen on the skin externally- it “seals and heals” the intestinal barrier breakdown that’s the hallmark of leaky gut.

Doesn’t all this goodness make you want to brew up a batch right now?? You may not ever want to go back to coffee or tea! Maybe….. 🙂

Leave a comment below about your caffeine swaps!

Eczema: The Autoimmune Disease Everyone Seems To Be Overlooking

The No Cause, No Cure Paradigm for Eczema is Wrong

I’ve always been a questioner. This is why I believe eczema can be healed and reversed (and new science backs this). When I was a little kid, I asked lots of questions because I wanted to know how and why things worked. Conversations I’d frequently have with my parents would go something like this:

Me: “Why does my tummy hurt?””

Parent: “Probably because you just swallowed your gum.”

Me: “Why would gum make my tummy hurt?”

Parent: “When you swallow your gum it can stick to your insides.”

Me: “Why would it stick to my insides?”

Parent (frustrated): “Oh, I don’t know, it just does!”

At this point I usually stopped the dialogue because I was clearly annoying my parents and I was frustrated that I didn’t get the answers I desired. Even as little kid I couldn’t understand why gum wouldn’t be digested like the rest of my food?? It also didn’t make sense to me that it would stick to my insides. There is always a reason why (even if not everyone know the answer).

Those same feelings of frustration and disbelief came to the surface for me when I was told I had Eczema. I was instantly transported back to my childhood when I heard the words “there is no known cause or cure.” It was so infuriating and disheartening.

No cause. No cure. Yet, you’re still miserable, with a very real rash that makes you crazy because you want to keep scratching it incessantly and your doctor hasn’t provided you with any help at all. This is exactly how I felt.

The majority of conventional medicine still clings to the old idea that eczema, also known as atopic dermatitis, is purely a topical rash that makes your skin red and itchy, causes lesions, and is related to allergies.

And if you’ve ever had an eczema breakout you know that this isn’t just something to brush off, or something you should have to live with-  it’s a problem that affects the way you look and feel too.

I’ve never accepted the no cause, no cure paradigm- there’s always a reason why something is happening. Your body just doesn’t start to malfunction- it’s way too smart for that. There are complex physiological processes that occur over time that culminate in conditions like eczema. We’ll get into the details of that later.

Those of us in the functional medicine community, as well as many researchers, are redefining what eczema actually is. In December 2014, this groundbreaking study published in The Journal of Allergy and Clinical Immunology confirmed what many of us suspected all along- that eczema is indeed an autoimmune condition. The study showed that by blocking 2 key proteins involved in the body’s ability to fight off bacteria and viruses, the eczema was reversed. In the process of eczema, these proteins mistakenly target the body’s own tissues, causing an autoimmune reaction which can result in the body attacking the skin. That sounds like a cause to me!

But before we get into the details of how eczema develops as as autoimmune (AI) condition, let’s review what eczema is and briefly discuss the types.

What is Eczema?

As an inquisitive and frustrated kid, I’d reach for the encyclopedia when I got one of those “it just is” answers from an adult. Encyclopedias helped, but were still limited in information on many topics.

Now we have an overabundance of information coming at us 24/7 thanks to the internet, but it’s hard to digest and make sense of it all. So, let’s break eczema down.

Eczema is more commonly referred to as Atopic Dermatitis (AD) clinically. That term is very telling since atopy or atopic is Greek for “being out of place” and dermatitis is “inflammation of the skin”. What’s interesting is that in my graduate training (which was conventional medical clinical pathology) we learned that atopy refers to an allergic reaction or hypersensitivity occurring in a part of the body NOT in contact with the allergen. Based on this definition you’d think that conventional medicine would’ve realized the cause of eczema isn’t occurring on the skin level, but that hasn’t been the case.

Eczema or Atopic Dermatitis (AD) is defined by the Mayo Clinic as “a condition that makes your skin red and itchy. AD is long lasting (chronic) and tends to flare periodically and then subside.” It’s the most common type of eczema and research suggests that a family history of atopic conditions such as eczema, allergies, asthma, and hay fever is a predisposing factor in developing it. The data compiled from my research analyzing over 7,000 patients shows that 1 in 5 people with a family history of eczema have eczema. 20% is significant.

Eczema: The Autoimmune Disease Everyone Seems To Be Overlooking

Typical symptoms include:

  • Itching, which may be mild to severe, especially at night
  • Raw, sensitive, swollen skin from scratching
  • Small, raised bumps, which may leak fluid and crust over when scratched
  • Weeping wounds
  • Thickened, cracked, dry, scaly skin
  • Red to brownish-gray patches, especially on the hands, feet, ankles, wrists, neck, upper chest, eyelids, inside the bend of the elbows and knees

Eczema symptoms and appearance differs from person to person. A mild form might look like red, irritated, and slightly speckled skin, to more severe forms where the skin is significantly inflamed, with lesions that are bloody and weeping. Discolorations often occur during the outbreaks and as the skin heals.

7 Types of Eczema (Yes, …there’s actually more than one)

There are many different types of eczema according to various sources. You could go a little crazy researching them all on Dr. Google, so we’ll cover the most common ones here.

Most varieties of eczema are named for where they occur or because they look slightly different than your typical atopic dermatitis. Regardless of where it located or how it looks, it’s still eczema.

  • Contact Dermatitis occurs when an irritant or allergen contacts the skin causing redness, burning, swelling and sometimes blisters. It can be caused by things such as frequent hand washing, solvents, chemicals, foods, metals, animals, pollen, and plants like poison ivy. For the record, I don’t believe contact dermatitis should be classified with these other forms of eczema as the cause is external contact and can happen to anyone regardless of health conditions and family history. It doesn’t appear to be AI in nature.
  • Dishydrotic Eczema occurs on the palm side of fingers, palms of hands, bottom of toes, and soles of feet. It presents as red spots, bumps, or blisters. Scaly patches, flaking, and deep cracks can form from damage to the skin. This type is 2 times more common in women. I can vouch for that since this one type that I had in a very classic presentation which makes it easier to distinguish from some of the other types.
  • Hand Eczema is different from dishydrotic in that it occurs on the back of your hand and fingers, as well as the webbing between fingers. It visually looks more like typical atopic dermatitis.
  • Neurodermatitis, also called Lichen Simplex Chronicus, which is similar to AD in that there’s significant itching but differs in that the surrounding skin is healthy. It occurs in isolated patches that look thick, discolored, dry, scaly or flaky and can be mistaken for psoriasis. There can be underlying dysfunction of the nerves in this area.
  • Nummular Eczema, also known as Discoid Eczema is characterized by coin or circular shaped lesions that can be raised. Inflammatory reactions occurring in the body and dry skin are thought to play roles in developing this type of eczema. It can look like ringworm which is a fungal infection so it’s worth ruling that out.   
  • Seborrheic Dermatitis, Scalp Eczema, or Cradle Cap typically occurs in areas where there are high concentrations of oil producing sweat glands including the scalp, face, neck, upper back, shoulders, and chest. Individuals with immune system dysfunction are at increased risk for seborrheic dermatitis. It can have an oily or greasy appearance, unlike the other types of eczema, with white to yellow flakes.
  • Stasis Eczema/Dermatitis, also called venous stasis dermatitis, is a special type of eczema that occurs in areas where there’s decreased venous blood flow resulting in pressure build up causing fluid leakage from veins. Red, swollen, flaky, itchy skin occurs initially and if not taken care of can progress to ulceration, infection, and/or permanent thickening or scarring of the skin.

What Causes Eczema

If you type in ‘causes of eczema’ in Google, you’ll get a variety of answers like:

  • No true known cause
  • Dry or irritable skin
  • Genetic variant that affects the skin’s barrier function
  • Stress
  • Immune system dysfunction
  • Hormone Fluctuations
  • Bacterial or viral infections or imbalances
  • Environmental conditions such as cold, dry weather or humid, hot weather
  • Allergens

Unfortunately, while many of the above are absolutely true, most conventional doctors still treat it like it’s a condition that only occurs on the surface and don’t address most of that list. They’re likely to suggest topical treatments and possibly tell you to avoid a couple of foods, allergens, and hot or cold weather. They neglect the impact of the true root causes beneath the surface.

The worst fact of all is that some doctors are still of the old school thinking that there is no cause or cure for eczema.

Thankfully, research is evolving and know we know otherwise.

Given that eczema is now considered an autoimmune condition, we know the conditions need to be ‘just right’ for one to manifest.

These are the 3 key factors that come together to initiate autoimmunity:

  1. A genetic predisposition/family history
  2. Intestinal permeability (leaky gut)
  3. Environmental triggers such as stress, infection, gut or skin dysbiosis (imbalance between the good and bad bugs), food sensitivities or allergies, trauma, hormone imbalances, toxins, and nutrient imbalances.

With autoimmunity, the immune system mistakenly targets a body tissue and tries to attack it like it’s a foreign invader. If you have eczema, this means that the autoimmune process is attacking your skin. And to get rid of eczema, you need to address each of your root causes, which are covered in numbers 2 and 3 above.

For me, the perfect storm for eczema flares was high stress levels, hormone imbalances, GI infections and dysbiosis, leaky gut, and food sensitivities. Histamine containing foods, exercise, and hot showers made it even worse. This scenario is very similar for most of my clients as well.

A New Paradigm for Eczema

Just like when I was a kid, I wasn’t satisfied with the explanation of what causes eczema, so I developed my own process to explain the cycle of how it occurs.

Stage 1: Flare Up

You know when a flare up is coming because your body send you little signals in the form of tingle, slight itchiness or a burning sensation. On the inside the panic begins to set in and you’re thinking, “Oh no, not again!” These are the subtle hints that you’re body is unhappy and it’s trying to tell you. The flames have been stoked and a fire is beginning to burn inside.

From a physiological standpoint, your immune system is activated from one or more triggers like foods, chemicals, toxins, or microorganisms (bacteria, fungi, parasites, viruses) and has begun attacking your body tissues. Having a genetic predisposition toward eczema or autoimmunity, and a leaky gut make this the perfect storm.

At this point, trying to stop or slow the flare is a good idea as it will help begin to reverse the inflammatory process. Start with your diet as many significant triggers for eczema are food related. At a minimum go gluten and dairy free, but likely you’ll find other foods that need to be avoided while you heal.

Getting stress under control right now is key as it’s often what pushes you over the edge into a flare. It’s hard to eliminate it, but try to manage stressors by maintaining boundaries, saying no, or asking for help. If you can completely eliminate a stressor (like avoiding a toxic person or situation) even better! Also, finding an outlet like journaling, deep breathing, meditation, or walks in nature can profoundly reduce the stress response.

Stage 2: Outbreak

Your flare up transitions to a full blown outbreak when the tingle, burn or minor itch escalates to constant itching causing red, inflamed skin with welts, wounds, and/or blisters. At this point it can appear to be treatment resistant since all of the root causes likely haven’t been addressed.

The outbreak occurs when the inflammatory process mediated by the immune system goes unchecked. The inflammatory chemicals have kicked up and are peaking resulting in your extreme discomfort and many symptoms. During this phase eczema can interfere with life, making social gatherings, work, sleep, and sanity difficult due to the incessant itching. There’s a full blown inflammatory fire raging inside.

Getting to the bottom of all of your triggers and root causes is essential now so you can heal.  Addressing diet and stress may do the trick for some, but others may require deeper digging or testing which is easiest with assistance of a trained professional. Even though I do this for a living, I call upon my friends and colleagues to make sure I’m not missing anything. We can all use some help now and then!

If you haven’t begun dialing in your diet- there isn’t a better time. You need to focus on taming the fire burning within. Anti-inflammatory supplements and foods are super important now. This blog article I wrote provides a recipe, as well as 6 healing foods and supplements to help put out the flames.

Topically, some people may benefit simply from coconut oil, but I personally didn’t and many of my patients echo that sentiment. The same can be said of shea butter. However, by combining these an easy and wonderful healing salve can be made.

Eczema Healing Salve Recipe

  • ½ cup unrefined, organic coconut oil
  • ½ cup unrefined, organic shea butter
  • 10 drops calendula essential oil
  • 10 drops yarrow essential oil
  • 10 drops rosemary essential oil
  • 5-10 drops frankincense essential oil

Mix these together in a bowl by hand or with a mixer. It will be hard and clumpy at first, but eventually will soften and everything will come together. Note: you can play with the essential oils as some people respond better to certain ones than others. If you can’t some of these, that’s fine too. These all have healing, calming or anti-inflammatory properties.

The most important thing to remember in the outbreak phase is the root causes. If you don’t identify and address them all, your eczema is likely to return at some point.

Stage 3: Healing

Relief is in sight!  This is when you start to feel better and symptoms are less severe, but still present. You may or may not be itchy. Your skin still shows signs of irritation, but no open wounds and blisters. It may also appear thick, leathery, scaly, dark, or ashy now. The fire within is now just smoldering embers.

Your immune system is now ramping down and under control, but in physiological time things go slow which is why there are still visible signs (think of how long it takes to completely heal a cut or broken bone).

Steering clear of dietary triggers or any other triggers you’ve identified through self investigation or testing is still a must to maintain healing. Continue use of natural topicals to protect the skin and help rebuild integrity. Nutrients like vitamins A,C, D, and E, biotin, zinc, selenium, and collagen support healing and skin structure.

Stage 4: Clear Skin

Hooray!! When you’re suffering through an eczema flare you often don’t think this day will come, but it is possible to completely reverse eczema and have clear skin again. You’re skin is fully healed and looks great again. No more hiding in long sleeves or gloves!

Think of this stage as maintenance or dormancy. You immune system is finally calmed down and balanced so the attack on skin is over. The fire is out completely!

Maintaining a healthy diet, stress levels, and getting adequate sleep will help keep you here in your happy place.

Common Treatments for Eczema

Again, if you look eczema treatments up in Google, you’ll get a list that looks like this:

  • Over-the-counter medications such cortisone cream, Benadryl cream, or antihistamines (Benadryl, Claritin, and Allegra)
  • Prescription medications topical corticosteroids, oral steroids, and oral antihistamines.  
  • Moisturizers that contain petroleum jelly, mineral oil, or synthetic emollients like lanolin or glycerin
  • Special baths with bleach, salt (sea salt or table salt), baking soda, epsoms salts, oatmeal, or apple cider vinegar.  
  • UV Light/Phototherapy
  • Wet Dressings
  • Stress Reduction

While the medications may be helpful at first for managing symptoms, they don’t address the root causes and the eczema returns. Long term, the topical creams can damage the integrity of the skin and the topical steroids and oral medications shut off the body’s natural inflammatory response which is counterproductive to healing the body.

The moisturizers typically suggested sometimes work and other times cause more irritation due to the ingredients. Unfortunately, if they do work it’s only addressing issues at the skin level and not what’s beneath the surface.

Special baths can definitely be helpful in managing symptoms, but some need to be use with caution. I am personally not a fan of the bleach baths, ever. Sea salt, table salt and apple cider vinegar can be great, however should be tested first since they could irritate open wounds. Oatmeal baths are also very soothing as long as you know you don’t have Celiac or it’s skin variant called Dermatitis Herpetiformis. If you do, you should probably avoid oatmeal completely as it’s often contaminated with gluten.

Phototherapy from the sun is my preferred use. While using phototherapy lamps that emit UV light definitely have benefit, there are a few more risks associated with them due to broader spectrum of the light rays, such a burning, blistering, accelerated aging/breakdown of the skin, and skin cancer. More recently narrow band UVB therapy, which uses a smaller spectrum and thus less radiation, is a better option for artificial light therapy.

Wet dressings can be very helpful in healing eczema when used with natural moisturizers. However, topical corticosteroids are often used and I believe they’re a bad long term strategy for the reasons given above.

My Methodology for Healing Eczema

While some of the commonly used treatments listed above can be helpful at soothing or even resolving some symptoms, they’re all missing the most important factor: addressing the ROOT CAUSES.

Even if you’re in remission and asymptomatic, you’re still at risk for a flare up because you haven’t addressed the important factors lingering beneath the surface. You’re trigger might be work, family, or financial stress, a stomach virus or infection, passing of a loved one or pet, a divorce or separation, moving to a new town or job, or even injuring yourself exercising.

My major trigger was always work related stress (or not addressing it) as it is for so many that suffer from eczema.

The good news is that I healed my eczema and we, together, can heal yours too.

My process starts with a detailed history, from birth until now, that identifies all of the contributing factors to your eczema and what potential root causes need to be investigated.

Next we order the appropriate tests to identify your specific and individual underlying causes.

From there, I design a comprehensive program based on your results and history that addresses all of your root causes in a systematic way. We don’t throw the kitchen sink at you all at once and hope it works. Instead, the plan is outlined in a step-by-step manner that makes it easy for you to follow and allows your body to heal.

If you’re tired of living in the eczema cycle of remissions and flare ups, or have an active, raging outbreak that itches so bad and looks so horrible it’s affecting every aspect of your life and you don’t think it will ever end, I invite you to work with me and my team to heal your eczema for good.

We’ll work together to put the pieces of your health puzzle in place. We’ll guide you at every step with a plan of action to get your body healing and skin happy again.

If you’d like 1-on-1 support troubleshooting which root causes are contributing to your Eczema, and get a specific plan to reverse it, the first step is to book a 1-hour “Eczema Root Cause Troubleshooting Session”.

 

 

 

Strict Elimination Diets are Possible- Part 4 of 4 (High Points, Personalization, & The Next Phase)

My 28 day Autoimmune Paleo Rotation diet is complete! This was a great learning experience for me since I haven’t done an elimination this long in 2 years, and even more, never one this strict.  This diet was more stringent than a typical rotation diet since it didn’t give any variability within each day as you’d normally get in a rotation. This makes it easier to plan and execute, in my opinion. You don’t have to think too much, kind of like wearing a uniform to school or work!

I feel great! I estimate my symptom reduction in the ballpark of 90-95%.

Itchy red bumps on my skin, random itching all over my body, light acne (associated with hormone fluctuations), and occasional headaches were my primary symptoms. I also tend to get ringing in my ears and a sore tongue or cankers with certain foods. The skin and tongue issues had been getting progressively worse, and if you recall from the beginning of my journey, I actually got a true hive. That was what I was afraid of all along! As often is the case in the healing process, sometimes things get worse before get better which I expected.

Now I only get the occasional itchy spot, not even every day. There’s no redness associated with it either. I haven’t had a headache (other than the virus) during the entire process.  My tongue is much less reactive, and I realized might be my canary in the coal mine. It seems to be one of the first symptoms to show up when I have a reaction to a food. Similarly, my soft palate may also burn. Any symptoms related to hormones have significantly reduced too. I have more energy and better sleep too. I’d say this was a successful experiment!!

The High Points

New Baseline Established. This is a really important point. Now that I’ve had a significant reduction in symptoms, I have established a new baseline. When I reintroduce new foods and observe for symptoms, I’ll use this as my new set point to gauge any reactions.

The big take-away here is that your baseline can and will fluctuate with therapeutic interventions. At the beginning of the rotation, I’d say mine was a 7 (with 10 begin horrible symptoms), and now it’s a 1.5. It’s always important to have an idea where you’re at so you and any practitioner you work with can measure progress.

Simple Food Tastes Really Good. I’ve always been a fan of bold flavors, but I realized that eating food prepared in a simple manner can be amazing too. A “hash” of ground buffalo, kale, and sweet potatoes with a little sea salt and oregano is really tasty, as are many other combinations. Eating this way gives the opportunity for high quality ingredients to sing.     

I Never Felt Deprived. This was probably the biggest revelation of all for me. I thought I’d miss having elaborately seasoned dishes with lots of ingredients, but even more, I thought I’d be starving. Neither were the case. I was surprisingly satiated the entire time. I made adjusts for increased physical demands on workout days, but I was never, ever starving. Nor did I ever feel like I was missing out by not being able to eat certain foods.

Symptoms Can be Confusing to Navigate Even for a Trained Professional. When you have lots of symptoms that fluctuate on a daily basis, especially at the beginning, it can be difficult to figure out what’s causing them. During those times, I relied heavily on my diary to track what I thought the likely culprits were. When I ate those foods again I knew to look out for reactions. I also knew not to combine them with the other suspect foods. I still don’t know with 100% certainty about a few foods. I’ll consider testing for them when I’m through the entire process if I think they’re still a possible issue.

The Healing Capacity of the Body is Amazing. I’d been experiencing my symptoms on and off for almost a year and a half. I’d take a couple foods out of my diet or try certain supplements, but nothing seemed to make them completely go away because I wasn’t doing the right things. I knew the first step was to do an elimination diet to get the food situation under control.

I’m shocked at how rapidly my symptoms declined. At the 2.5-3 week mark I largely felt as good as I do now. That’s pretty darn fast.

The Process Really Wasn’t Difficult.  One of the biggest ways we tend to psych ourselves out is to think that doing something different will be hard, which often delays or prevents us from starting new things.

Once I wrapped my brain around what I needed to do and got into the groove, I was set. The first 2-3 days were a little rough, but I made it through and then it became my new routine. I plan on maintaining these new routines as they are since it was so easy to follow.

The Hard Truth…You Are The Only Thing Standing in Your Way. We are in control of ourselves- period. We often sabotage our goals with negative self-talk or excuses. We can come up with all sorts of reasons why it isn’t a good time to do an elimination diet, lose weight, or quit sugar, gluten, or smoking, but they are purely justifications to make ourselves feel better about not doing what we know we need to do.

We all have lives. There will always be work, events, holidays, finances, stress, etc.- that won’t change. What can change is how we think about things. That is what will allow you to achieve any goal you have.

During my month long elimination I had St. Patrick’s Day, Easter, and my birthday, as well as everyday life and a day long road trip. I decided not to let that stop me. I planned so that I could successfully make it through the process.

The Next Phase

Since I’m feeling so good I’m staying on the rotation in an expanded way for 2 more months. My plan is to add more foods back in systematically. I’ll test them on day one, and won’t add anything else new in for 2-3 more days. If I react to a food, I’ll keep it out of my diet for 3-6 months. If I don’t react, it will become part of my rotation.

In general, when adding foods back in, I usually start with things I like that I don’t seem to react to. I usually save possible problem foods for later.

I’m starting with eggs because I don’t think I react to them and REALLY miss them. So far, so good. No immediate reactions, so I’ll eat them again today two more times. I’ll watch for delayed responses to the eggs over the next 2-3 days. After that I’ll probably test walnuts, then pumpkin seeds. I’m not sure after that?? I’ll also continue to record everything.

I know in the past I may have had some type of reaction to tomatoes- usually cooked in combination with a high protein meal. That will probably be one of the last things I test since I know I’ve had issues in the past. I will also test raw tomatoes in a salad and see if I handle those in a different way since the preparation can be a factor as to if you’re going to have a reaction as well. For certain foods, it’s a good idea to test raw and cooked variations.

It’s never a good idea to jump back into your old habits or patterns that you had when you weren’t feeling well. Some people are just “dying” for certain foods and an alcoholic beverage. If that’s the case, you really need to check in with yourself and figure out where you’re feeling deprived or unfulfilled in your life because there’s a good chance you’re filling a void. No, you don’t need bread or cheese or ice cream, or beer, or whatever…. you want them. There’s a big difference.

Personalization

I believe another key to success and enjoying a diet of any kind, but especially a rotation diet, is to eat foods you like that are allowed on the program. There is always room for personalizing the menus to suit your tastes. Don’t be afraid to try new things either. I realized I liked lamb and collard greens, but don’t like dandelion greens.

Adjusting quantities to meet your caloric demands is also important. A 125 pound woman that does yoga and walks will need substantially less than a 125 pound woman that lifts heavy weights or trains for triathlons, or 225 pound guy that competes in strongman competitions.

Supplementation is another opportunity for personalizing. As discussed in the previous post, digestive enzymes and betaine HCL are good support supplements for a program like this, but many other types of supplements would work well here to support healing.

Once you’ve gone through the process of a 30 or 60 day elimination and still have some symptoms, testing may be the next logical step. GI infections are often the root cause of leaky gut and food intolerances, so identifying and treating them will often provide the last piece of the puzzle you need to heal and feel amazing.

I previously worked on Candida and some dysbiosis, so I’m focusing on rebuilding and supporting my flora as an ongoing part of my program.

Final Thoughts

This was an awesome experience that was long overdue because of my own procrastination. Once I get through the next month or two of the expanded rotation and testing foods, I’ll take what I’ve learned and apply it to my normal diet. I’ll keep the rotation feature in because I think it’s a bad idea to get into the habit of eating the same food daily. I’ll also expand my diet as wide as possible since I believe in varied nutrition- somewhere in the realm of Paleo-AIP plus. I add the “plus” because I know I handle certain foods well that aren’t considered Paleo or AIP. For example, I tolerate certain legumes and quinoa when prepared properly. While I don’t think it’s a great idea for me to eat them daily, I will eat them on rare occasion with no issues.

The take home message is to tune into your body and listen to what it tells you. Make adjustments as you need to. There’s a whole lot of wisdom and guidance at your fingertips every single day- you just need to be open to hearing it.