Staying Well

Travellers’ Diarrhoea

Posted on 04/12/2021 Leave a Comment

Travellers’ Diarrhoea – one way to ruin a holiday

With international borders reopening many people are considering, or even booking, an overseas holiday. Travellers’ Diarrhoea is one of the most common illnesses experienced by people who travel overseas. It’s a generic term that covers anything from a mild stomach upset and loose poo, to severe vomiting and diarrhoea. It’s mostly a self-limiting illness that clears up in a few days. The good news is you can take steps to prevent it, and manage symptoms should they occur.

While tropical and sub-tropical countries, and developing countries, are common places to catch Travellers’ Diarrhoea, you can get it in other more developed countries. When you travel it’s important to be vigilant about hygiene. Carry an alcohol based handwash in our bag and use it before eating and drinking.

Definitions

Mild	Diarrhoea that can be managed and doesn’t interfere with planned activities You feel it’s safe to leave your accommodation
Moderate	Diarrhoea that interferes with planned activities and can be considered distressing You want to stay close to a toilet
Severe	Your diarrhoea is so bad it’s incapacitating You feel quite unwell and may feel weak and/or tired
Persistent	Diarrhoea lasting 2 weeks or more – may be mild, moderate, or severe

Sadly for some people, symptoms persist beyond the holiday and people may present to their GP or a gastroenterologist, weeks, or even months, after the initial infection. Research has indicated that Travellers’ Diarrhoea can have a causative role in the development of post infectious irritable bowel syndrome.

A major cause of Travellers’ Diarrhoea is consuming contaminated food and drink. Risk is particularly high where sanitation is poor.

Prevention

As well as avoiding food and water where there is a high risk of contamination, you can take steps to prevent Travellers’ Diarrhoea.

Intestinal health and the immune system are intrinsically linked – you have more immune cells in your gut that anywhere else in your body. Support the health of your gut by eating a predominantly plant-based diet – choose from a wide selection of colourful vegetables and fruits, perhaps some chickpeas or lentils, and other plant-based wholefoods every day. Avoid foods that you know cause irritation or other gut problems.

A key to preventing Travellers’ Diarrhoea is to maintain the gut barrier. Certain herbs, fermented foods, and probiotics can support the gut barrier and reduce the risk of an infection taking hold; or even reduce the severity of an infection.

Seek advice from an accredited and registered Naturopath – they will guide you through the changes needed to improve your diet, microbiome and, therefore, improve your resistance to microbial strains associated with Travellers’ Diarrhoea. Their professional advice is invaluable. I suggest you seek advice a minimum of 2 weeks before you leave for your holiday.

Managing Travellers’ Diarrhoea

Mild to moderate Travellers’ Diarrhoea can usually be managed with rehydration drinks and, if needed, over the counter antidiarrheal drugs. If symptoms persist beyond a few days, or become severe, seek medical advice (it’s one of the reasons you buy travel insurance for). A severe bout of Travellers’ Diarrhoea may indicate the presence of microbes that need to be treated with antibiotics or other pharmaceutical drugs.

Your naturopath or herbalist will be able to help you with herbs and supplements you can take with you to minimize the risk of an infection taking hold and ruining your holiday.

When Symptoms Persist

Sometimes symptoms persist after you have returned from holiday. Seek medical advice. Your GP may order a faecal PCR test to check whether there are persistent pathogens that are causing ongoing symptoms.

Your herbalist and naturopath will be able to help you with ongoing symptoms as well. They can help with the side effects of antibiotics prescribed to deal with pathogens, and help repair gut cells damaged by infectious pathogens.

My Own Experience

I had Travellers’ Diarrhoea on a trip to one of the pacific islands. It was so bad we had to call a doctor out to the hotel. The next day I was on the road to recover, and had a doctor’s bill for $2000 to pay (remember, travel insurance is really useful when you need it). Since then I take a great deal of care around what I choose to eat. I do eat at food markets (look for where the locals eat), and restaurants that are off the beaten track. The basic rule is – if it looks/smells dodgy, don’t eat there. Don’t let fear of Travellers’ Diarrhoea prevent you for trying local cuisine. One of the joys of travel is trying different food.

The other thing to consider is that you can get Travellers’ Diarrhoea eating at a 5 star hotel – it’s about the personal hygiene of the kitchen staff.

I always travel with herbs and supplements for Travellers’ Diarrhoea – if I think I’ve eaten something dodgy, I take the herbs straight away. Your naturopath and herbalist can advise you about this.

Key Message

Prevention is the key when it comes to Travellers’ Diarrhoea. Look after your gut and your gut will look after you. To learn more about gut health, see my Blog on Gut Health.

Healthy Gut Healthy You

Posted on 30/11/2021 1 Comment

Your Gut -The Seat of Health

What is your gut

For many people, the gut is a bit of a mystery – food goes in one end, something happens in the middle, and thensomething else happens at the other end. As long as the gut remains a diligent servant, quietly going about its duties and keeping us oblivious, most don’t give it a second thought.

Where does your gut start and end?

Your gut starts in your mouth and ends at your anus. Your ongoing health and wellbeing depends on the health of your whole gut i.e. it’s necessary to consider the health of your entire gut – oral health to colonic health.

What does your gut do

Your gut is responsible for the physical and chemical breakdown of the food you eat. Along the way nutrients and water are absorbed. At the end waste is expelled.

Accessory glands and organs

You gut doesn’t work alone. Salivary glands in your mouth moisten food and provide enzymes to start the breakdown of starch. The liver, gall bladder and pancreas add other enzymes to aid the breakdown of food to molecules small enough for the body to absorb.

How does it work

Peristalsis is the rhythmic contraction of smooth muscle in along the gut – it starts when our swallow your food and continues on the end. Good gut motility (how much your smooth muscle contracts) is essential to the health and function of the gut.

More Than a Processing Station for Nutrients.

Natural medicine practitioners have long recognisedthe crucial role that the gut plays in our health. Clinical observations and scientific confirmation have revealedlinks with almost every health condition – from depression to diabetes, autism and autoimmunity.

What we are justbeginning to appreciate is that the gut is registering a mindboggling amount of information every day; and we are unaware of it.

Gut Feelings: Who Has Them?

The gut is an essential part of our interaction with the world. As well as happily digesting our food, the gut is working as a sense organ – it’s our primary environmental interface, with more nerves than the rest of the peripheralnervous system put together.

With all this sensing and sampling occurring the gut is the greatest source of microbial and environmental antigens, and our body is keenly interested in their composition

Which brings us to the microbiome

Bacteria are critical for human survival, living both within and on your body.

Having the right types of bacteria in the right place and the right balance can help your body function optimally.

It is estimated that for every one human cell in your body, there are ten bacterial cells; this means you are about 1% human and 99% bacteria! There are billions of different types of bacteria in your body, all playing different roles to keep your health in check. When these bacteria are out of balance, it can make you susceptible to digestive symptoms and conditions, such as irritable bowel syndrome (IBS); as well as having an impact on immunity, allergies, metabolism, and skin health.

When the microbiome becomesunbalanced (dysbiosis) you become susceptible to a range of health conditions – IBS, SIBO, changes to immunity (autoimmune, allergies), changes in metabolism, mood changes, skin health. When your diet is not supportive of your gut, the density of immune and sensory cells can become the gut’s Achilles heel, generating significant inflammation, pain and systemic dysfunction.

Diet is the Key

Eat a predominantly plant-based diet – choose from a wide selection of colourful vegetables and fruits, perhaps some chickpeas or lentils, and other plant-based wholefoods every day.

You need to eat 6-9 cups of vegetables and fruits every day to get the amount of fibre your gut needs. Choose a range of different vegetables and fruits each day – preferably seasonal vegetables and fruits. Variety is the key

Resistance Starch – gold for your gut bugs

Resistance starch is a type of insoluble fibre that behaves more like a soluble fibre – it feeds your gut bugs.By feeding your beneficial gut bugs, resistance starch supresses potential pathogens and is important for metabolic and heart health.

Sources of Resistant Starch

Foods high in resistant starch included legumes (e.g red kidney beans, butter beans, adzuki beans, lentils, black eyed beans, chickpeas); whole grain cereals e.g brown rice; cooked and chilled white rice, potatoes, sweet potato and pasta (cooking and chilling causes modest rises in resistant starch); cashews, green peas, green banana flour, unripe bananas.
Regularly include foods high in resistant starch in your daily diet – your gut bugs will thank you. Remember, happy gut bugs means happy you 😊

Next Steps

Seek advice from an accredited and registered Naturopath – they will guide you through the changes needed to improve your diet, microbiome and, therefore, improve your overall health. Their professional advice is invaluable

Three Stages of Fatigue

Posted on 23/08/2021 Leave a Comment

Three Stages of Fatigue

It’s rare for people to go from feeling ok to feeling fatigued. The journey to exhaustion generally goes through three stages. Recognising and addressing fatigue in the early stages can reduce the risk on moving onto later stages.

Stage One – constantly on alert

· You feel constantly alarmed, even when they are not in stressful situations

· You may experience anxiety – constantly worrying about even trivial things

· Your immunity is low – you catch everything that’s going around

· Insomnia – poor sleep leads to more fatigue

At this stage your cortisol levels may be elevated.

Stage Two – feeling stressed and tired is constant

This stage is when cortisol becomes dominant. Cortisol is fat sparing, so quite often in this phase people feel they are gaining weight and/or can’t lose weight.

· Sleep problems start to escalate, often manifesting as waking through the night, waking up tired, or having trouble going to sleep

· Concentrating on a task becomes more and more difficult

· Energy crashes happen throughout the day

· Other changes to hormones and blood glucose levels can lead to other health problems

Stage Three – exhaustion

Completing even day to day tasks becomes a challenge.

In this stage cortisol levels are often low.

· Fatigue is overwhelming

· Anxiety and depression escalate

· People often have constant body aches and pains

· Immunity is low

Get Help Sooner Rather Than Later

Recognising the Stages of Fatigue is essential to making a recovery before you reach the exhaustion phase.The sooner you ask for help the sooner you will start to feel better.

Seek advice from an accredited and registered Naturopath – they will guide you through the changes needed to address your fatigue, as well as prescribing personalised herbs and nutritional supplements to help you feel better faster. Their professional advice is invaluable.

Tiredness and Fatigue

Posted on 23/08/2021 Leave a Comment

Tiredness and Fatigue: A Crisis in Modern Society

Are you just tired or are you fatigued.

Fatigue can be defined as a generalised malaise that impacts on a person’s physical and mental health. People often lack motivation (and the energy) tocomplete even simple day to day tasks.

People with fatigue may experience:

· Low energy and vitality

· Poor physical performance, along with low stamina and strength

· Mood disorders such as low mood and/or depression

· Poor memory, inability to concentrate

The interplay between physical and cognitive performance is disrupted, and a cycle of physical fatigue leading to cognitive fatigue leading to physical fatigue – the cycle can go on and on.

When defining fatigue, it’s essential to differentiate between daytime sleepiness and fatigue. People with fatigue often say things like ‘I’m exhausted allthe time’, or ‘I can’t concentrate on anything’.

Mitochondria and Fatigue

Fatigue and mitochondria are linked.

Mitochondria are tiny organelles found in most cells of the body that are responsible for energy production.

Mitochondria produce energy. No matter whether you are at rest or exercising vigorously you need energy to function properly. Energy production is a complex process that relies on the Krebs or Citric Acid Cycle, and the Electron Transport Chain. Simply put, glucose goes in one end and energy comes out the other.

Adequate amounts of energy are needed by cells and organs in order to function properly and maintain metabolism.

Many drivers of fatigue impact on the health and function of mitochondria.

Drivers of Fatigue

The underlying causes of fatigue are many and varied. Most people who have fatigue often have more than one reason why they are fatigued. Causes include:

· Infection – microbial and/or viral. It’s worth noting that post-viral fatigue is a well-known phenomenon in Naturopathy. Naturopaths and Herbalists have been helping patients overcome post-infection fatigue for decades.

· Nutritional deficiencies can play a major role in fatigue. Mitochondria need more than just glucose to make energy. To make energy each mitochondria needs a mix of B vitamins, magnesium, manganese, cysteine, lipoic acid, iron, copper and Coenzyme Q10. These nutrients need to be in the right proportion – too little and your mitochondria can’t do their job, too much can cause toxic stress. Mitochondria can be damaged by oxidative stress, drugs and alcohol, environmental toxins, ageing and genetic vulnerabilities.

· Low iron, which leads to low cellular oxygen (iron in haemoglobin carries oxygen around the body distributing it to cells)

· Lifestyle factors such as poor sleep habits, lack of exercise, and lack of fresh air can all lead to fatigue.

· Hormonal changes – stress hormones such as cortisol and DHEA, sex hormones such as testosterone

· Gastrointestinal issues – malabsorption, dysbiosis

A major driver of fatigue is thyroid dysfunction. Low levels of thyroid hormones (T4 and T3), poor conversion of T4 to T3, and cellular hypothyroidism are key drivers of thyroid related fatigue. Thyroid and fatigue is a topic in itself, so I won’t cover it in this Blog.

Helping patients with ongoing fatigue is a matter of peeling away at the layers that make up the cause. It is rare that there is one clear driver of fatigue.

Treating Fatigue

Pathology testing is often used to detect changes to biochemistry and nutrient levels which may provide valuable clues to the underlying cause of fatigue. Once nutritional abnormalities are identified, a tailored prescription of nutritional supplements can make a significant change to energy levels.

Common supplements prescribed to help patients with fatigue include magnesium, B vitamins, vitamin D, carnitine, CoQ10, and lipoic acid.

Eating the right food can help as well. Including good fats, fibre, vegetables and fruits (6-9 cups daily), and good sources of protein can provide your body with the nutrients and fuel it needs to function better.

Avoiding refined food, particularly added sugar, and alcohol can be of great benefit.

Specific medicinal herbs can help with fatigue. Different herbs are prescribed depending on what fatigue signs and symptoms to patient has. There is no ‘one size fits all’ herbal prescription for fatigue. What suits one patient, won’t suit another.

Adrenal Fatigue – an overused and misunderstood term

There is a need to move away from the term adrenal fatigue as this does not really describe what is happening. Adrenal insufficiency may be a better description as it does address the completely exhausted phase of fatigue where the adrenal glands do not produce adequate amounts of cortisol. Adrenal dysfunction may better describe what is happening in the adrenal glands. However, as the adrenal glands do not work alone, they are part of the hypothalamus-pituitary-adrenal (HPA) axis. All three have a role to play in fatigue.

It doesn’t matter what we call it, millions of people with fatigue suffer from similar signs and symptoms. Naming a disease doesn’t necessarily change the treatment.

How Long Before I Feel Better?

Most patients who come to see me for fatigue are looking for a quick fix. While it’s possible to have people starting to feel better in a short time, the reversal of fatigue can take some time, and is often dependent on the patient making some diet and lifestyle changes. Many patients need to look at and change their working and sleep habits, for example, before they can truly start to feel better.

It’s essential to find and address the underlying causeof the fatigue. Without doing this it’s an uphill struggle to reverse fatigue.

Diet and Cancer

Posted on 23/08/2021 Leave a Comment

Diet and Cancer: Choosing the Eating Plan (diet) that’s Best for You

Put ‘diet and cancer’ into your internet search engine and you will be overwhelmed by the number of results. He is some answers to common questions about diet and cancer.

To start with, there is no one size fits all answer to the question. A better way to think about diet and cancer is to frame the question around the person who has the cancer diagnosis and ask what is the best diet for them. Even then you will probably be overwhelmed by the number of results.

Information that can inform the choice of diet plan for people with cancer includes:

· The person themselves: age, gender, overall health, current diet, their medical history, even their ethnicity may have an influence

· The type of cancer the person has – what stage are they at? Has the cancer spread? What treatment are they having or have they had? How did they react to that treatment?

· Support network: who will support them in changing their diet, socio-economic factors (can they afford to change their diet)

· How willing are they to change – motivation to change can be the key.

It’s worth noting that often when a person changes from a less healthy diet to one which is more focussed on getting the right nutrition into the body there can be benefits. For example, body composition may change, blood glucose levels may stabilise, patients may have improved energy, blood lipid profiles may improve. These factors together may lead to an overall improvement in prognosis. These benefits may happen regardless which particular diet the person chooses to follow.

Cancer Diets and Research

Research into diets and cancer is limited. When choosing a diet for cancer take into account the research that has been done.

Ketogenic Diet

This is the diet I am asked the most about when it comes to cancer.

The theory behind a ketogenic diet is that the low carb nature of the diet will ‘starve’ cancer cells of the glucose they rely on to proliferate.

In the past 50+ years there has been a limited number of human studies into the benefits of a ketogenic diet in cancer. While encouraging, current research into ketogenic diets and cancer does not draw an overwhelming positive conclusion. While there may be clear benefits in some cancers, the same cannot be said for all cancers.

This doesn’t mean a ketogenic diet won’t be of benefit.

Changing to a ketogenic diet can be challenging. The change to complex carbohydrates, and vegetables that have a moderate or high amount of carbohydrate can feel limiting. Generally, carbohydrates in the diet are replaced with fats and protein. You can still eat vegetables like spinach, zucchini, kale, cabbage, cauliflower, eggplant, green beans, lettuce, cucumbers and avocado (for example). Foods like bread, pasta, crackers and biscuits, potatoes, carrots, beetroot, onions, and parsnips, and legumes are to be excluded.

It’s worth noting that once starved of sugar, cancer cells my start looking elsewhere for nutrients.

Mediterranean Diet

This diet is high in plant foods and low in animal foods. Food is fresh, seasonal, and diverse. There is very little refined foods. Eating a Mediterranean diet provides a balance of food factors that can influence (lower risk, and/or slow progress) the development, progression and invasion of tumours.

Research has indicated that the Mediterranean diet does reduce the risk of certain cancers: i.e gastric, colorectal, liver, and breast cancers. For other cancers there are mixed results.

Like the ketogenic diet, research into the Mediterranean diet and cancer is currently limited.

Changing to a Mediterranean diet is often seen as relatively easy. The emphasis on the wide variety of fresh vegetables and fruits, and legumes, is often easier to adjust to. The emphasis on vegetables and other plant foods can reduce the amount of carbohydrates in the diet.

Plant Based or Vegetarian Diet

Similar to the Mediterranean diet without the meat. High in plant fibre (good for the gut), antioxidants and anti-inflammatory foods.

Difficulty with this diet is getting adequate protein (plant-based protein foods need to be correctly combined to ensure people get a full range of essential amino acids).

Some nutritional deficiencies are more common with a plant-based diet. People would benefit from having their nutritional status assessed to ensure they are not deficient in key nutrients.

Low Fat Diet

A low fat diet may be combined with other diets, e.g low fat plant based diet.

While saturated fat in the diet is linked with increased risk of some cancers, a low fat diet is not necessarily beneficial to people with cancer. A better way to think about fat in the diet is to look at saturated versus unsaturated fat. People with cancer may benefit from limiting saturated fat in the diet. Saturated fat is commonly found in animal based foods, as well as some vegetable based foods like coconut.

Fasting

No discussion on diet and cancer is complete without looking at fasting.

Fasting is defined as no food for periods of time lasting 12 to 72 hours.

Research on fasting and cancer is still in the early stages, However, early evidence indicates that positive changes in metabolism may be beneficial to cancer management.

Different types of fasting include:

· Time restricted eating where the person abstains from food for 12 to 16 hours. Another way to look at this is to only eat during an 8-10 hour window

· Whole day fasting is when a person doesn’t eat for 24 to 72 hours

· 5/2 diet is where the person eats a normal diet 5 days a week, then only eat 500-600 calories on the next 2 days.

Which type of fasting you choose is up to you. For many people time restricted eating the is easiest, while others prefer to fast for 1-3 days at a time. The key with fasting is to choose a regime that suits you. While fasting, it’s essential to follow a healthy diet in between. Fasting doesn’t mean a free for all when you do eat. Continue to eat a wide variety of plant based foods and animal protein (if you choose to eat meat), avoid saturated fats, processed foods, added sugar, and excessive carbohydrates.

There is some evidence that fasting around some chemotherapy treatments is beneficial to the efficacy of the treatment.

Fasting is not recommended for people who are losing weight or have suffered significant weight loss.

Seek Professional Advice

Before you start on a new eating plan or diet consult a qualified nutritionist – someone who has experience with people with cancer.

Be wary of anyone who offers a ‘miracle’ diet. If a diet looks too good to be true it probably is. While some people get excellent results following a particular diet, this does not mean you will as well.

Questions to ask if a clinician recommends a particular diet for you

What studies are they basing the recommendation on?

Are these studies in vitro, animal or human studies?

What clinical evidence do they have to support the diet they recommend?

Were the studies conducted in patients with the same or similar cancer to you?

More Information

The Cancer Council provides quite a bit of useful information on diet, exercise and cancer.

TeleHealth and Face to Face Appointments Available – Clinic Open for Business

Posted on 18/08/2021 Leave a Comment

Naturopathy is considered to be part of the allied health system within Australia. There has been no Government decision to close naturopathy from practice, and Government has encouraged naturopaths to continue to practice and to support the health of patients, and to reduce the demand on the medical system.

The current Covid19 crisis has had no regulatory impact on my naturopathy practice. Having said that, I understand that some patients may be reluctant to come onto the clinic for face to face appointments. To support these patients I am offering TeleHealth appointments.

This means that instead of seeing me in person, your consultation will be via the internet. I can assure you that the TeleHealth system I use is safe and secure.

Booking a TeleHealth Appointment

You can book your TeleHealth appointment at https://entirephysio.com.au/entire-physio-booking-page/

Scroll down and choose a Telehealth option for a consultation.

If you prefer, you can telephone Entire Physio on 6299 5183.
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What Patients Need for TeleHealth

To participate in a TeleHealth appointment you will need to have a stable internet connection and a device that supports video and audio. Most computers, laptops, tablets and mobile phones will support audio and visual function. Make sure this function is turned on for your device.

Prior to your appointment you will be sent a link to your TeleHealth appointment in either your appointment confirmation email or reminder, and that will open up your video session with me.

Dispensing Herbs and Supplements

I will be dispensing herbs and supplements via the online dispensary vital.ly. Once I have added your prescription to vital.ly, you wil receive an email giving you access to the site. You wil then be ale to order your herbs and supplements, and choose the delivery method. Your herbs and supplements will be delivered to your door.

I know we are living in challenging and difficult times. I hope you and your family are safe and well. My goal is to continue to help patients with their ongoing health and wellbeing. Queanbeyan

Face to face consultations will be available at my Queanbeyan clinic only due to travel retrictions between NSW and the ACT.