Adrenal Fatigue Syndrome:

L-Reuteri Yoghurt, recipe hints and suggestions for my patients

While there are also other viruses and indeed other factors that can lead to Chronic Fatigue Syndrome, the most common cause would seem to be the Epstein Barr virus that causes Glandular Fever. After the first bout with this virus which can be mild or severe and last for one to 6 weeks this virus which is part of the herpes family will retreat to your spine and stay there. In some people, every now and then it will resurface and try to spread it's joy around the world only to be pushed back by their immune system. Over time the immune system becomes weary and the person becomes increasingly weary. Chronic Fatigue Syndrome is one of the most common conditions I see in my practice and fortunately if we can identify an underlying viral infection as the cause it is not difficult to treat and recovery will begin in a few weeks. So how can you tell if this is a cause of your fatigue? Firstly we look for signs and symptoms. Typically there will be a sore throat, this may be every day on waking but pass as the day wears on, or it may surface every 6 to 12 weeks. The glands in the neck will swell; again this may seem to be daily or may come and go every 6 to 12 weeks. There may be fatigue that puts you in bed for a few days and I have seen some patients when this can last a week or more . Some people will merely note that they feel like they are coming down with something but then it quickly clears up and they move on. The thing that differentiates this from picking up cold several times a year is that the symptoms and duration will always be the same. Cold and flu viruses have their own signature; they appear with certain symptoms that will be the same in all the people they infect but they will be different from other viruses. Another way to confirm you have an underlying virus is with blood tests. You can be tested for antibodies to the Epstein Barr virus and several other suspect viruses like Ross River and Cytomegalovirus. Because these viruses lurk in your body there will always be some antibodies to confirm a past infection. If there is an underlying virus a full blood count will give a few clues with the white blood cells showing as generally low. The Lymphocytes are the cells that fight viral infections and will be elevated in an acute infection however in a chronic condition they will be low, usually below the normal resting level of 2. The percentage of lymphocytes however will usually be high, above 40% which tells us the immune system is struggling to keep up the fight and make enough white blood cells and is putting all its efforts towards making lymphocytes. Another indication is when the Neutrophil to Lymphocyte ratio is below 2. If this is starting to sound like your life story no doubt you would like to know what to do about it. You probably already know that your doctor hasn't been able to help much other than treat the symptoms as they arise. This may be antibiotics for what looks like recurrent tonsillitis, headache pills, anti-anxiety or anti-depression pills, amphetamines to pick you up and pills to put you to sleep. None of these help you with the cause of the problem. How is it treated with Naturopathic Medicine? In my practice I use herbal and nutritional medicine to address the underlying virus and other factors causing the syndrome. I may start with an antiviral treatment or support the patient in other ways first if I think they are too depleted to successfully work with the virus. The herbs I use are antiviral, immune boosting and supportive of the adrenal glands; this treatment is usually continued for six weeks. I will also support the patient with an anti-inflammatory diet and other nutritional or herbal medicine as needed. What can you expect in terms of recovery? You should notice subtle changes in the first week, energy usually starts to pick up in week two to three. By week six you know you are feeling better. Following on there will be an additional treatment for a few months to consolidate the therapy so that you don't experience a relapse. For more information contact Linda Lowen on 8395 2836

When I see three patients misdiagnosed with Hashimoto’s Thyroiditis in 2 weeks it makes me wonder how many are out there? The diagnosis of Hashimoto’s Thyroiditis (HT) relies on the demonstration of circulating antibodies to thyroid antigens (thyroperoxidase and thyroglobulin) and reduced echogenicity on thyroid ultrasound in a patient with supporting clinical features. Most patients that come to me with a diagnosis of HT have not been tested for antibodies or been given an ultrasound. They have merely had elevated Thyroid Stimulating Hormone (TSH) above 4.00mU/L on two consecutive blood tests and in some cases there has only been one test. I will send them back to their doctor for an antibody test before I consider treatment. Typically TSH levels increase when the production of Thyroid hormones fall. In Hashimoto’s a fall in hormone production is due to damage of the thyroid gland by antibodies. The most common cause of elevated TSH in the absence of antibodies is nutritional deficiency. Oops, did I say nutritional? Yes, and there you have the reason why patients are told they need to take a drug to replace a loss of thyroid hormone production (even though it is NOT an autoimmune condition) - Doctors don’t do NUTRITION. What nutrients are needed? The most obvious one is iodine and it was added to table salt in the 1920’s to overcome deficiency in people living in regions with low levels of iodine in the soil. Of course table salt fell out of favour in the 1980’s when it was linked to increased risk of high blood pressure. The next one is tyrosine is an amino acid that forms the backbone on the thyroid hormone. Two tyrosine molecules with 4 iodine atoms is known as thyroxine or T4, enzymes can remove one iodine to form triiodothyronine or T3 the more active form of the hormone. Tyrosine is obtained from eating meat. Selenium is needed by the enzymes that do the conversion, nutrients that are needed in production and function of the hormone include iron, zinc, vitamin A, vitamin C, vitamin D and vitamin B2. In most cases of deficiency a well selected supplement program and dietary change will see significant improvement in 3 months. It will then be determined what nutrients should be supplemented for the long term and what foods need to be consumed regularly. This is a very different outcome to taking a drug for the rest of your life and takes into account the individual patient’s needs. I recently saw a man who had been diagnosed with HT seven years ago and had been taking thyroid hormone replacement since then. He brought in copies of all his blood tests taken over that time. It turns out that he tested negative for antibodies in the beginning and again more recently. The misdiagnosis and poor management of this patient had led to other health problems which severely impacted on this man’s quality of life. He had been bedridden for some time and unable to work for 2 of those years. We are hoping that with some time spent with diet and nutritional supplementation he will be able to wean off the unnecessary medication in a few months. In another case a 48 year old woman had been told she had a “thyroid disorder” and was prescribed thyroid hormone replacement following a slightly elevated TSH level even though T4 levels were not too low. This patient had tried dieting ( including fasting) to lose weight and manage elevated blood glucose levels over the previous few months. The elevated TSH could have been a result of the stress placed on the body and nutritional deficiencies due to the fasting regimen. I didn’t treat this case as a thyroid disorder at all but gave her more appropriate dietary guidelines and prescribed some nutritional supplements. I recommended retesting TSH in 3 months to see how things are going. If you are reading this and beginning to wonder if you have been misdiagnosed the first action to take is contact your doctor and ask if you have been tested for thyroid antibodies. Please contact me if you would like more information. Linda Lowen

In this video I will discuss the anti-nutrients in nuts, seeds, grains, beans and lentils and show you how easy it is to neutralize them with some simple preparation you can do yourself at home. I have included the transcript below. The three most common anti-nutrients are lectins, phytic acid (also called Phytates) and enzyme inhibitors. Grains, beans and lentils contain all three. Nuts and seeds contain less phytic acid and more enzyme inhibitors. In 2008 I became much more aware of the dangers of eating grains and started recommending a grain free diet to all my patients rather than a gluten free diet. Grains are seeds of grass plants and this group includes wheat, spelt, khorasan, kamut rye, barley, oats, corn, rice, millet, sorghum, and teff. All grains contain complex molecules called lectins within the seed coat, lectins are actually a pesticide, and are there to protect the grain from being eaten. Lectins are difficult for us to break down or digest and can puncture holes in the cells that line the digestive tract leading to inflammation and damage, this can lead to food sensitivities, autoimmune disease, in fact any chronic disease. Gluten is a small fraction of the lectin and it is present in all grains although it will have slightly different structures in various grains. When foods containing corn, rice, millet or oats are labelled as gluten free this means they are free of a specific type of gluten called alpha gliadin, present in wheat, rye and barley. Studies have shown that 20% of Coeliacs will react to the form of gluten in corn called zein. Lectins are found in many plant species and the next most troublesome group are legumes, including beans, lentils and chickpeas. Nuts and seeds contain valuable minerals and fats and for people on a grain free diet they can be used to substitute flours in baking. Therefore they may be consuming more nuts and seeds than usual. The anti-nutrients in nuts and seeds of concern are phytic acid and enzyme inhibitors. The phytic acid will bind strongly to the minerals in nuts and seeds making them unavailable to us and will also bind to minerals that have been consumed in other foods, so eating a lot of foods with phytic acid may lead to mineral deficiencies. Enzyme inhibitors prevent all types of seeds from germinating prematurely; they will switch off when the growing conditions are favourable, with enough water and sunshine for germination to proceed. When we consume enzyme inhibitors they can bind to our digestive enzymes making them ineffective and reducing our ability to digest the food. Most people will be fine eating a small number of nuts for example but a large handful can lead to a sensation of fullness, bloating and other signs of indigestion. We can remove a good deal of these anti-nutrients by activating, sprouting and fermenting. All of these processes begin with soaking in water. To remove phytic acid the water should be acidic so we add some vinegar or lemon juice, the acidity will activate an enzyme called phytase that will break down the phytic acid. Because there is less phytic acid in nuts and seeds we add salt which helps reduce the enzyme inhibitors. I generally would recommend patients stay on a grain free diet but for some people we can allow the grains that are easier to digest. The process here is called sprouting and it takes about 24 hours. To sprout brown rice start by soaking the rice in water with some vinegar overnight, in the morning drain it into a colander and give it a good rinse. You can leave it resting in the colander until dinner time. Give it another rinse and cook it in plenty of water. This process will also change the structure of sugars and actually reduce the amount of available sugars while increasing the protein. Without this process cooked rice contains the equivalent of 10 teaspoons of sugar in one cup. These sugars are very difficult to digest and can disturb the balance of bowel flora leading to bloating. You can repeat the rinsing process for another day to increase protein and reduce the sugars a little more. While not technically grains, buckwheat and quinoa can be treated in the same way. Make sure you rinse the quinoa very well before soaking to remove the bitter saponins. Keep rinsing until there are no soap bubbles to be seen. If you like to have oats porridge, soak the oats overnight in filtered water, the next step is simply to cook them in the morning. All grains require cooking so never eat raw oats. The process of preparing nuts and seeds is called activating, they are soaked in water and then dehydrated. Most nuts and seeds will soak in salty water for 12 hours, almonds are best soaked for 24 hours and cashews should be limited to 3 to 6 hours or they will go slimy. You can use a dehydrator to dry them out but I like to dry my nuts and seeds in the sun in summer, I lay them out on a towel covered with a sheer fabric as I found seeds can stick to the towel, another sheer fabric goes over the top to keep them clean and hide them from the birds. In good warm weather seeds can take a few hours, nuts can take a day to a day and a half. In the cooler months I will place them on baking trays and put them in the oven. I keep the temperature at 50 to 70 degrees Celsius. Make sure your nuts are really dry and crisp before you store them. They should be kept cool, I like to keep mine in the fridge. Flaxseeds and chia seeds contain good amounts of soluble fibre which will support the healthy bowel flora and I recommend them to all my patients, especially those with sluggish bowels or constipation as the soluble fibre will also act as a gentle laxative. I often find patients have these seeds at home in their pantry but don’t know what to do with them. Here are a few ideas on how to add them to your breakfast. Chia seeds are soft shelled and don’t need to be ground but flaxseeds do as their shells are very hard and difficult to digest. Chia seeds can hold 9 times their weight in water so it is best to soak them in some water first to create a gel, they can then be added to smoothies or stirred into yoghurt. You can easily add more fibre to your diet by spreading the gel on toast or pancakes. Simply add coconut cream to the gel and you have chia pudding, you could add vanilla and some sweetening or even raw cacao. For an instant porridge add hot water to chia and ground flaxseed and stir until fluffy, I like to add tahina paste for texture. You can incorporate ground sunflower and pumpkin seeds for a smooth porridge or add these seeds whole for texture and crunch. Stir through stewed or chopped fresh fruit, add nuts, coconut and cinnamon if you like it. Ground flaxseed can be used as a flour to make high fibre cookies, muffins, crackers and breads. For simple pancakes with added fibre blend together a tablespoon of ground flaxseeds, buckwheat flour and tapioca flour with a little baking powder. Mix in an egg, you may need a little water. Top them with anything you like, avocado and smoked salmon, berries and coconut cream, or stewed fruit and yoghurt. You can add mashed banana or grated apple to the batter mix for a sweet pancake. Ground flaxseeds can be made as a tea which will act as a gentle laxative for constipated bowels. Grind 2 teaspoons of flaxseed, pour over 1 cup of boiling water and stir. Let it sit for 10 minutes to draw out the soluble fibre, you can add a T Bag to flavour it or stir in cocoa for a hot chocolate. This is so gentle you can strain it and add it to a bottle for a baby or give it to toddlers. Finally we will take a look at beans and lentils. These are extremely difficult to digest and take the most time to prepare. Essentially all you have to do is put the beans or lentils in a jar, add pure water, vinegar or lemon juice, then let sit overnight. The acid medium serves as a catalyst to initiate the culturing/fermenting process that enables phytase to be released. Use 1 tablespoon for every cup of water. Cover the jar with a cloth rather than a tight lid, or you can simply leave them in the colander. Let them sit for a 2 to 3 days, rinsing every 6 to 12 hours. They are ready to cook when they have grown a root fibre at least 5 mm in length. They can be dried off and stored in a container in the fridge for a few days or cooked and frozen. You can use a seed sprouter to grow sprouts that you can add to salads. The basic technique is the same, start by soaking overnight, rinse then transfer to your sprouter. You can sprout broccoli, mustard, alfalfa, kale, or sunflower seeds, mung beans, lentils and more. Keep rinsing 2 or 3 times a day until you get a root fibre, a stem and two leaves. Now you know how easy it is to activate and sprout these whole foods you can really improve your diet for better health.

These inflammatory conditions of the skin are slightly different conditions, but the terms are often used generically for any itchy, red, scaly skin problem. While psoriasis is known as an autoimmune condition eczema is referred to as an allergic condition. The important thing is that neither of them are actually skin conditions they are both mediated by an imbalance in the immune system and made worse by poor detoxification and elimination by the liver and kidneys. Conventional wisdom will tell you that these conditions are “ poorly understood ”, “ may have a genetic origin” and that “ there is no cure ” but with medication (for the rest of your life) & expensive creams that don’t really seem to work your condition “ can be controlled ”. Hydro-cortisone cream or ointment is the most commonly prescribed conventional treatment for eczema and psoriasis. This is a strong and toxic medicine of limited effectiveness. Long-term use of steroid creams can result in side effects, such as thin, fragile, dry skin and even suppression of the adrenal glands. For these reasons, medications of this kind can only be used for short periods of time, which is not very helpful to the chronic sufferer. I recently saw Riley, a 9 year old boy who had been suffering with eczema since he was born, his parents were offered very little hope as the problem was obviously hereditary; his father, grandfather and uncle all suffered with it. Some people had suggested that he might “grow out of it” so Mum patiently waited but after a severe flare-up that required oral cortisone and no end in sight she sought my help. The rash was all over Riley’s body again and had recently extended to his face. It was very itchy and prevented him from getting off to sleep. We made some general changes to his diet by eliminating dairy and wheat products and sent off a hair sample for our Bio-Compatibility test to see what foods were really causing the trouble. After 4 weeks of dietary changes and treatment with one specific probiotic strain Riley’s rash was all clear from his face, chest and back. His arms had a little left inside the elbows and there was still a small amount on his legs. To his Mum's surprise Riley had participated in the annual school swimming program for a week without the usual exacerbation. Riley understood the connection between food and the skin after a serve of ice cream, which had tested as not compatible, had caused a flare up. He was now reading food labels himself and had become aware of how many additives and preservatives were in common everyday foods. Changing his diet hadn’t been easy, especially for Mum, but Riley had noticed other things were improving that made it very worthwhile; he was doing much better in school and was really able to concentrate in lessons and with his homework, his hay fever and sinus congestion had cleared up, his morning backache was gone, headaches were less often and his rumbling tummy had settled. Riley’s Bio-Compatibility test showed that he was reacting to these common foods; Banana, nectarine, strawberries, tomato, capsicum, pork, cola, lemonade, honey, curry powder, milk, ice cream, cheese, white and wholemeal bread. Riley will need to avoid these foods for 6 months in which time most of them should correct and may be added back into the diet. Because Riley had suffered with chronic eczema for almost ten years he will most likely have to follow a fairly strict gluten free/dairy free diet for the long term. Riley's story is just one example of how Eczema and other skin conditions can be treated successfully with dietary changes, herbal and nutritional medicine. For more information contact Linda Lowen .

In 2014 Tina consulted her Doctor, she was feeling tired, rundown, wasn’t sleeping well and while she had a history of feeling anxious she had recently become more irritable. After five minutes of listening to Tina the Doctor prescribed Cymbalta a drug used to treat major depression, it is a serotonin and noradrenalin reuptake inhibitor. Despite suffering many of the known side effects every day including diarrhoea, nausea, dry mouth, constant headache and brain fog, Tina continued to take the drug because her husband felt she was less irritable and easier to live with. She was still feeling anxious, tired and run down and wasn’t sleeping well, the constant headache and daily diarrhoea had become draining and worsened her inability to cope. Tina came to see me desperately seeking a solution to her symptoms. After listening to her story I discovered she had experienced hormonal imbalances dating back to her teens with irregular, heavy painful periods and migraine headaches. She had been through a traumatic first marriage and divorce with court proceedings continuing for three years. She stayed in a very stressful job for 7 years and then had three job changes in 2 years, she also remarried and built a new home. Tina had been pushing through on very low cortisol levels for 4 or 5 years, she felt ungrateful because she still wasn’t happy despite a new home with a new supportive husband. She did her best to conceal her high anxiety but it would erupt as irritability. I suspected Tina was suffering from adrenal fatigue , her Doctor didn’t recognise it on her first appointment or indeed on any of her subsequent appointments because as I said in a previous post the mainstream medical community doesn’t recognise Adrenal Fatigue as a real condition. Adrenal fatigue is related to the deficiency of one particular hormone called cortisol. Cortisol is your daily energy hormone, it is a long acting hormone and you get lots of it in the morning when the sun comes up, this breaks your sleep cycle and you wake up. It begins to fall off around 5.30 pm allowing serotonin to rise, this is your relaxing and digesting hormone (just in time for dinner) and this will covert to melatonin your sleeping hormone. Cortisol is also your stress coping hormone and it helps you to adapt to stressful situations and it will convert to cortisone to dampen inflammation. If a stressful situation continues the body will increase cortisol production, if it goes on too long the adrenal glands will fail to produce enough to support your energy and help you cope with stress. Tina had decided to stop taking the Cymbalta and had been weening off them with her GPs guidance for 4 weeks when I first saw her, she was very worried and in a state of high anxiety. Her GP had suggested she go back onto her original dose but she didn't want to turn back. After explaining the role of her adrenal glands and putting her life events into perspective she gained confidence and we put in place some dietary and lifestyle changes along with a prescription of appropriate herbal and nutritional medicine. In Tina’s case it was very important to address her female hormone imbalance; Tina described her PMS as feeling evil and she suffered with period pain and migraine headache for 2 to 3 days each month. After 5 weeks Tina was feeling very much better. She was sleeping well, the night sweats had stopped, her bowels were normal, the brain fog had lifted, she was waking in the morning feeling more refreshed, her energy had increased and she had just begun exercising regularly. Her period was better with no PMS and only a slight backache. Her headaches were different, she was feeling some slight tension but there had been no migraines. She was feeling much better emotionally with a huge reduction in her anxiety. On her first appointment with me Tina’s Blood Pressure was high at 140/95 with a heart rate of 85 beats per minute, this was a clear indication of the stress she was under. After 5 weeks it was down to 130/86 with a heart rate of 65. Adrenal fatigue can be treated successfully with herbal and nutritional medicine, it may take several months to regain optimal function but significant improvement can be expected in a few weeks.

The aim of the Naturopath is to find the underlying cause of the illness and support the patient with the right diet and nutrition while Nature cures their disease.

While stress is a part of everyday life, fatigue, anxiety and other symptoms that go with it do not have to be.