Your Complete Guide to Causes of Constipation and Finding Relief – Part 4: Metabolic Disorders - Thyroid & Diabetes

Your Complete Guide to Causes of Constipation and Finding Relief – Part 4: Metabolic Disorders – Thyroid & Diabetes

Your Complete Guide to Causes of Constipation and Finding Relief – Part 4: Metabolic Disorders – Thyroid & Diabetes

Though constipation seems like a simple discomfort that can be easily blamed on something you ate and readily remedied by over the counter stool softeners, it’s actually a condition that shouldn’t be taken so lightly. Recurring constipation is usually a sign of an underlying condition that could be very serious.

Defined as less than three stool movements per week, constipation blocks new nutrients from passing through your body and can lead to compounding health consequences.

So in addition to potential health issues causing your constipation, leaving it untreated could add complications, which can make identifying the original cause of the constipation difficult. This is the compounding nature of constipation due to the fact that it impacts overall gut health, which is why it’s important to bring it up with your doctor.

In this six-part series, we are investigating the different causes of constipation so we can help you identify the problem and find you lasting constipation relief. In parts one through four, we looked at low hydrochloric acid, low bile flow, and dysbiosis (imbalanced gut microflora).

You can read part 1part 2 and part 3 from Dr Klimenko’s blog.

In part four of this series, we are going to look at the different metabolic disorders that can cause chronic constipation. We will examine diabetes and hypothyroidism and examine how we can influence better digestion despite these disorders.

What helps constipation is completely dependent on the underlying cause, so let’s take a closer look at constipation caused by metabolic disorders.

Part 4: Metabolic Disorders

Constipation is the most common gastrointestinal issue in America, impacting as many as 63 million people. Nearly everyone will experience constipation at some point in their life. In fact, you shouldn’t worry about your constipation unless it lasts longer than 10 days or it becomes a reoccurring issue.

A metabolic disorder can occur when there are abnormal chemical reactions occurring in the body (such as hormones), which then alter metabolic processes. Metabolic disorders may be present when you born or may be developed or diagnosed later in life.

Gut microflora is very important to metabolic processes, so it shouldn’t come as a surprise that constipation would be a symptom that commonly accompanies metabolic disorders.

The two metabolic disorders we want to focus on are diabetes and hypothyroidism – these are well known to cause chronic constipation if go undiagnosed and untreated.

Diabetes and Constipation

Constipation in diabetics is a common complication of the disease. Poor blood sugar control, nerve damage, and medications are all factors of diabetes that can lead to constipation.

Studies have found that people with diabetes are 60 percent more likely to experience constipation. When your constipation is related to diabetes, in conventional medicine your treatment will be to focus on long term solutions, which may include stool softeners and laxatives.

When there’s elevated sugar level in a diabetic, this slows down digestion and peristalsis of the intestine so sugar does not absorb into the bloodstream too fast, which further increases overall blood sugar levels. This is your body’s innate defense mechanism trying to reduce the rate of sugar elevation after the meal.

Lifestyle choices regarding diet and aiding your body in metabolism regulation is going to be the solution to helping reduce your constipation episodes. Work closely with your doctor to manage these metabolic processes and listen to your body to work with it, not against it.

If you’re diabetic or suffer from constipation and suspect you’re diabetic, it’s important to make an appointment with your doctor to look into these suspicions. Also keep in mind that the earlier you catch your diagnosis and implement necessary  changes the better because you can prevent damage and work to counterbalance the impact of your diabetes.

Thyroid Disorders and Constipation

Constipation is often one of the first apparent symptom of an underactive thyroid (hypothyroidism). Your thyroid is responsible for producing important hormones that impact your metabolism and when there isn’t sufficient production it can cause the muscles that move your stool through the gastrointestinal system to become weak.

If you have already been diagnosed with an underactive thyroid, it’s also important to look at your gut health if you are experiencing chronic constipation. Certain gut bacteria is essential to converting T4 hormone to T3, which is needed for proper metabolism and digestion. Have your doctor check your thyroid if you experience regular issues with constipation.

Home Remedies for Constipation Caused by Metabolic Disorders

There are some natural remedies for constipation caused by metabolic disorders you can start at home. However, because each disorder is inherently different it’s a good idea to incorporate these suggestions under the supervision of your regular doctor (if she or he know what to do) or seek for a certified functional medicine doctor to get a thorough evaluation. Natural remedies for constipation that are also safe for those with metabolic disorders include:

  • Adding good fiber to your diet
  • Drink more water
  • Increase physical activity
  • Careful blood sugar management
  • Heal your gut microflora imbalance
  • Consider trying gluten and dairy free diets
  • Be sure you’re getting enough healthy fats
  • Take magnesium supplements
  • Try starting your day with warm lemon water

Unlike low stomach acid, where we recommended an apple cider vinegar test, you’ll have to be tested in-office for metabolic disorders. How to get rid of constipation completely depends on the cause, so get tested early and you may save yourself a lot of discomfort down the road.

When to See Your Functional Medicine Doctor for Constipation

Your certified functional medicine doctor is your best ally in helping you figure out how to get rid of constipation once and for all. Treating constipation alone means you’re only treating the symptom and not the underlying cause. If you want long term relief, especially if you suspect your constipation is due to a metabolic disorder, see your doctor and get a diagnosis earlier rather than later.

Check for thyroid issues and diabetes if you experience long lasting or chronic constipation. And be sure to tell your doctor how often and for how long you’re affected by constipation to help them gain a clear understanding of you condition. Your certified functional medicine doctor helps you identify the underlying cause and build a comprehensive treatment plan so you can find lasting comfort and relief.

Elena Klimenko, MD, a certified functional medicine physician, will help you choose the right course of action to identify the root cause and relief your unsettled symptoms. Call today to find out more about functional medicine and speak with Dr. Klimenko at 212-696- HEAL(4325).

If you want more information about Functional Medicine, contact us to receive a FREE copy of Dr Klimenko’s E-book.

 

Your Complete Guide to Causes of Constipation and Finding Relief – Part 3: Dysbiosis

Your Complete Guide to Causes of Constipation and Finding Relief – Part 3: Dysbiosis

Your Complete Guide to Causes of Constipation and Finding Relief – Part 3: Dysbiosis

Defined as fewer than three stool movements per week, constipation can be uncomfortable or downright painful for anyone. Feeling stopped up, bloated, uneasy, full or as though everything isn’t passing when going to the bathroom can distract from your day and negligence can lead to worse health issues.

Constipation shouldn’t be taken lightly. When stool doesn’t pass fully through your digestive system it’s preventing new food and nutrients from fully entering digestive system.

If you regularly suffer from constipation, you’re not alone. Constipation is the most common gastrointestinal problem in the United States, literally impacting nearly 20 percent of the population.

Even though constipation is an incredibly common condition, many still don’t know how important it is to obtain a proper diagnosis to treat their condition long-term.

When you’re suffering it’s easy to reach for fast relief through laxatives or stool softeners. But these quick fixes could cause you to overlook an underlying condition that may have future health consequences.

In this six-part series, we are looking what causes constipation in order to find you true constipation relief. In the first two parts, we looked at low hydrochloric acid and low bile blow.

In part three of this series, we are going to look at a condition called dysbiosis – a microbial imbalance in the gut. We will examine what causes dysbiosis, suspicious symptoms that may indicate dysbiosis, and constipation remedies when it’s caused by dysbiosis.

Part 3: Dysbiosis

While nearly everyone experiences constipation at some point in their life, constipation becomes a problem when it happens for longer than 10 days or more and when it’s a chronic or recurring condition. How to get rid of constipation completely, depends on correctly identifying the underlying cause.

Dysbiosis refers to when there is a microbial imbalance somewhere in the body, which can be internal or external. In the case of constipation, dysbiosis is referring to an imbalance of your gut microbiota – or your gut flora.

Constipation caused by dysbiosis is most commonly caused by small intestinal bacterial overgrowth (SIBO) or small intestinal fungal overgrowth (SIFO) but it can occur anywhere in the intestinal tract where colonies making up your microbiota are thrown out of balance.

Your gut microbiota contains tens of trillions of microorganisms. Comprised of over 1000 species of known bacteria, which together contain three million genes (150 times more than human genes), your gut microbiota can weigh up to four pounds!

When your gut microbiota is thrown off balance it can lead to a cascade of health problems. Constipation is a common indicator of an unbalanced microbiota that needs attention.

The Importance of Your Gut Microbiota

Your gut microbiota is so important to your overall health, that it is now considered an organ. Interestingly, babies are not born with a microbiota at birth. We acquire this organ as we grow. From the moment you are born, your gut microbiota begins to develop. Colonizing from the birthing process, breastfeeding, and through life exposures. By the age of three, your gut microbiota is similar to an adult’s but it continues to evolve throughout life.

Everyone has a unique microbiota composition but each are composed of similar elements and responsible for the same physiological functions. Some of the most important functions of your gut microbiota include:

  • Aiding in food digestion, especially items your stomach or small intestine haven’t been able to fully breakdown
  • Production of vitamins, in particular vitamins B and K
  • Combat invading microorganisms
  • Maintaining the integrity of your intestinal mucosa
  • Acts as a barrier in the immune system
  • A key factor in an overall smooth digestion process

When your gut microbiota is off balance, you can experience a myriad of uncomfortable and sometimes life impacting symptoms, such as:

  • Irritable Bowel Syndrome (IBS) symptoms – belching, bloating, constipation, diarrhea, greasy stools, abdominal pain, indigestion, heartburn
  • Lactose intolerance
  • Mental fog
  • Chronic fatigue
  • Low libido
  • Joint pain
  • Sugar and alcohol cravings
  • Weight gain
  • Skin problems
  • Yeast infections
  • Thrush
  • Poor nail health
  • Depression
  • Hyperactivity
  • Iron deficiency
  • Malnutrition

When your constipation is caused by dysbiosis – an unbalanced gut microbiota – not only are you directly uncomfortable due to the constipation but it’s probably causing other conditions. Additionally, dysbiosis can also contribute to nutritional deficiencies, even if you’re eating all the right things.

If you are experiencing constipation, it’s important to find out the underlying cause through a diagnosis. If your constipation is caused by dysbiosis, rebalancing your gut microbiota is the only way to truly treat your condition permanently.

Causes of Dysbiosis

 Since dysbiosis occurs when your gut microbiota has become unbalanced, the causes can be anything that would interfere with healthy bacterial and fungal growth of the gastrointestinal tract, including:
  • Antibiotics
  • NSAIDS use (Ibuprofen, Aspirin, etc.)
  • Stress
  • Diets high in sugar and carbohydrates or low in nutritional quality
  • Excessive alcohol consumption
  • Suppressed immune system
  • Intestinal infections
  • Parasite infections
  • Hormone imbalance
  • Exposure to different bacteria or viruses from overseas travel
  • Environmental exposures such as mold, fungus or heavy metals

If you suspect your constipation is caused by gut microbiota imbalance, this should be taken seriously – make an appointment with your certified functional medicine doctor to accurately diagnose the cause of your constipation so it can be properly treated and relieve your symptoms once and for all.

Home Remedies for Constipation Caused by Dysbiosis

What helps constipation completely depends on the underlying cause. Keeping this in mind, here are several natural remedies for constipation caused by dysbiosis that you can incorporate into your habits immediately, including:

Eliminate sugar and simple carbohydrates (completely – at least for a period of time)

Stop drinking tap water because of the fluoride and chlorine damages the good microbes

Avoid antibiotics whenever possible

Don’t casually take medications such as Advil and Aspirin

Add gut healing foods to your diet such as bone broth, raw cultured dairy, fermented vegetables and variety of root vegetables

These changes are a great way to support a healthy gut microbiota but doesn’t replace the advice of a functional medicine doctor. Your doctor can help you incorporate new habits, foods, and supplements so as to fully heal your gut flora. If you experience long lasting or chronic constipation take care of it early, so you can prevent the myriad of illnesses that can occur when dysbiosis goes unchecked.

When to See Your Certified Functional Medicine Doctor for Constipation

Treating symptoms does not tackle the underlying cause of constipation. Taking stool softeners or laxatives may work temporarily but can leave you struggling with discomfort and other health consequences down the road. If your constipation that lasts longer than a couple of weeks, it’s time to schedule an appointment with a certified functional medicine doctor. We emphasize the fact that a functional medicine doctor should be certified because it means they’ve fully completed their training.

If diagnosed with dysbiosis, your doctor will walk you through the Four R Program – Remove, Restore, Repair, Renoculate. Here’s how this program treats dysbiosis:

Remove – First, it’s important to remove everything that’s contributing to your dysbiosis to give your gut flora a chance to heal. This includes sugar, simple carbs, alcohol, antibiotics, and anything else that may throw your microbiota out of balance. This step may require a proper gut flora restoration treatment — “Weed and Seed”

Restore – Through adding dietary changes and supplements, you can begin to restore your gut.

Repair – Through vitamins such as A,C, and E, zinc, fish oil, and the amino acid glutamine you can support your GI tract as it begins to repair itself. In my practice I use healing the gut treatment — “Heal and Seal”.

Renoculate – Probiotics and prebiotics will help your gastrointestinal tract rebuild it’s microbiota and return the needed balance for a healthy gut.

Constipation caused by dysbiosis is a serious health condition that can complicate other areas of your health. Your functional medicine doctor will work closely with you to identify the exact cause of your constipation and create a comprehensive treatment plan.

Click here to read more about treatment of dysbiosis on our blog. 

Click here to view a video about dysbiosis.

Your Complete Guide to Causes of Constipation and Finding Relief – Part 2: Low Bile Flow

Your Complete Guide to Causes of Constipation and Finding Relief – Part 2: Low Bile Flow

Your Complete Guide to Causes of Constipation and Finding Relief – Part 2: Low Bile Flow

Constipation is incredibly uncomfortable for those who suffer from being stopped up. Often you feel uneasy, bloated, full, as though everything isn’t coming out, and even nauseous.

But constipation is more than discomfort. Stool that doesn’t pass fully through the digestive system actually rots and prevents absorption of nutrients from new food. Defined as fewer than three stool movements a week, it’s the most common gastrointestinal problem in the United States.

When you’re suffering from constipation, it seems easy to take over-the-counter laxatives or stool softeners – but you’d just be treating the symptom, not the underlying cause.

If you only treat the symptoms, you might continue to struggle with constipation for the rest of your life. How to get rid of constipation depends on the underlying causes, which we aim to help you identify in this guide.

In this six-part series, we are looking at the different causes of constipation in an effort to find you true constipation relief. The first part of the series, we discussed low hydrochloric acid or stomach acid levels, an often-overlooked cause of constipation.

The second part of this series, we are going to take a closer look at low bile flow, what causes it, and what helps constipation caused by low bile levels.

Part 2: Low Bile Flow

Bile is a digestive fluid created by your liver and stored in your gallbladder. Bile is important in digestion and absorption of fat in the small intestine. Bile’s makeup includes:

  • Water
  • Bile acids (also called bile salts)
  • Bilirubin
  • Fats (cholesterol and fatty acids)

Fat is digested differently than carbohydrates and proteins, it requires the help of bile to break it down after it passes through the stomach. When fat reaches the small intestine, it looks like large fat droplets. Your bile then breaks down these large fat droplets, with bile salts, which emulsifies (breaks)  them into fatty acids and monoglycerides. These particles are then small enough to pass through the intestine wall. Bile is also important in breaking down bilirubin (old blood cells byproduct) and cholesterol.

When your liver isn’t producing enough bile or it is too thick to flow freely (peanut butter vs water-like) fat can build up in the intestinal wall and cause slower movements via digestive tract therefore cause constipation. If your constipation is due to low bile flow, symptom treating medications won’t help you in the long run. Identifying low bile flow as the cause of your constipation brings you one step closer to lasting relief.

The Importance of Bile Flow

Why is bile so important? Bringing to mind a yellowish, green slime, it’s a common reaction to think of bile as vile, but it’s critical to gut health and smooth digestion. Bile is important in a number of critical roles, including:

  • Aid in fat digestion and absorption (and some digestion of proteins and starches)
  • Emulsify fats (the detergent-like reaction done by bile salts)
  • Assist in absorption of fat-soluble substances, such as vitamins A, D, E, and K
  • Helps regulate your intestinal microflora
  • Encourages fecal matter movement through your digestive tract
  • Serve as a route of excretion of bilirubin
  • Help your liver rid your body of waste products
  • Aid in destroying unwanted organisms that invade the body through the digestive system

When your body isn’t making enough bile, you can experience several uncomfortable and sometimes painful symptoms, such as:

  • Fatigue
  • Mood swings
  • Constipation
  • Acid reflux
  • Acne
  • Gastro-Esophageal Reflux Disease (GERD)
  • Gall bladder disease (stones and inflammation)
  • Migraines
  • Vitamin deficiencies
  • Jaundice
  • Poor gut microflora
  • Impaired liver function
  • High cholesterol
  • Greasy, foul smelling, and light colored stools

If your body has low bile flow, your constipation is also probably contributing to nutritional deficiencies, even if you’re eating healthy. This is why it’s so important to find the cause of your constipation instead of reaching for a quick fix.

Nutritional deficiencies can lead to conditions that may appear unrelated to your constipation. If you experience regular constipation it’s important that you share that information with your functional medicine doctor.

Causes of Low Bile Flow

Since bile is produced in the liver, any impairment to the liver can cause low bile flow. Impairments of the liver include:

  • Jaundice
  • Bleeding in the liver
  • Infection of the liver
  • Liver inflammation
  • Vitamin D deficiency

Additionally, because bile is stored in the gallbladder, any impairment of the gall bladder could lead to low bile flow, including:

  • Gallstones
  • Cholecystitis
  • Gallbladder cancer
  • Gallbladder polyps
  • Abscess

Other causes of low bile flow could include:

  • Obesity
  • Having a high-cholesterol diet
  • Diabetes
  • Old age

If you suspect you are suffering from constipation caused by low bile flow, it should be taken very seriously – schedule an appointment with a certified  functional medicine doctor to get your constipation cause pinned down and be on your way to smooth digestion.

Home Remedies for Constipation Caused by Low Bile Flow

Remember, what helps constipation best is determined by the underlying cause. With that in mind, there are several natural remedies for constipation caused by low bile flow that you can take at home, including:

  • Lemon juice – Lemon juice activates the liver and stimulates digestion. Try this in warm water on an empty stomach in the morning.
  • Healthy, raw oils – Fish oil, olive oil, flaxseed oil, nuts, seeds, and avocados are good sources.
  • Promote good gut health – By reducing sugar, processed foods, and grains you’ll be encouraging a healthy gut.
  • Foods believed to stimulate bile production – Add garlic, beets, radicchio, kale, endive, arugula, celery, and radish to your diet.

There’s also Betafood and Cholachol, two additional natural remedies that your functional medicine doctor may recommend.

  • Betafood** – This is an extract derived from organic beet root and tops. It mobilizes the bile and transforms it from a thick, peanut butter consistency, to a water-like consistency.

With as much as 10 percent of the population suffering from gallstones, this is a great supplement that helps prevent and reduce gallstones and aid in fat metabolism.

  • Cholacol** – These are purified bile salts, which are great for stasis and gallbladder relief. If you’ve had your gallbladder removed, these are a necessity. You’re missing the bolus bile release that occurs during normal food digestion. Those without a gallbladder suffer from fat digestion and therefore lack nutrients that are fat absorbent such as vitamin A, K, D, and E (and many others).

If you’ve had your gallbladder removed (cholecystectomy) and were left disabled in your ability to digest fats and other nutrients, you are not alone. Every year about 700,000 people have their gallbladder removed and require purified bile salts to aid in normalizing digestion.

These foods and supplements are a great way to start supporting your bile production. Be sure to see your functional medicine doctor in the early stages of your constipation issues. By seeing your doctor when constipation starts, prevents low bile production from going untreated and potentially leading to a cascade of conditions.

**To order these products you can call our office at 212-696-HEAL(4325)

When to See Your Functional Medicine Doctor for Constipation

As with many conditions, treating symptoms ignores the underlying cause. Additionally, waiting to see your doctor about your constipation can make diagnosis more difficult and the treatment more complicated. If you experience constipation that lasts longer than a couple of weeks, it’s time to schedule an appointment with your functional medicine doctor.

By working closely with a functional medicine doctor, you can discover constipation remedies that helps stimulate bile production and relieve your constipation discomfort for good.

Elena Klimenko, MD, a certified functional medicine physician, will help you choose the right course of action to identify the root cause and relief your unsettled symptoms. Call today to find out more about functional medicine and speak with Dr. Klimenko at 212-696- HEAL(4325).
If you want more information about Functional Medicine, contact us to receive a FREE copy of Dr Klimenko’s E-book.
Your Complete Guide to Causes of Constipation and Finding Relief – Part 1: Low Stomach Acid (Hydrochloric Acid)

Your Complete Guide to Causes of Constipation and Finding Relief – Part 1: Low Stomach Acid (Hydrochloric Acid)

Your Complete Guide to Causes of Constipation and Finding Relief – Part 1: Low Stomach Acid (Hydrochloric Acid)

Constipation can be uncomfortable or downright painful if left untreated. You may experience few bowel movements, the sensation that everything isn’t coming out, small and hard stools, a swollen belly, pain or throwing up.

But you’re not alone – an estimated 42 million Americans suffer from constipation, making it the most common gastrointestinal problem in the United States.

When you experience constipation, it may seem like a good idea to reach for fast relief like a stool softener or other common constipation remedies such as prune juice – but these are usually just a quick fix that doesn’t solve the underlying cause.

If you want long-term constipation relief it’s a good idea to get to the root of what’s causing your chronic constipation.

There are a number of causes of constipation, which we are going to address in throughout this six-part article series. First, we are going to take a closer look at low hydrochloric acid levels in the stomach – an often-overlooked cause of constipation.

Part 1: Low Hydrochloric Acid

Your stomach acid is made up of three parts: hydrochloric acid (HCl), potassium chloride (KCl), and sodium chloride (NaCl). Hydrochloric acid is the primary acid in your stomach and it plays important roles in keeping the digestive tract running smoothly. Often, stomach acid and hydrochloric acid are used interchangeably.

When your body isn’t producing enough hydrochloric acid, it can cause serious and chronic constipation. Also called achlorhydria or hypochlorhydria, low stomach acid can disrupt several important bodily processes.

The Importance of Stomach Acid

Why is stomach acid so important? Stomach acid frequently gets a bad rap because an overabundance can cause heartburn or ulcers, but it’s just as problematic to have low stomach acid. Your stomach acid is involved in many critical roles, including:

  • Completely digesting food
  • Supporting the immune system
  • Encouraging the pancreas and intestines to produce necessary enzymes and bile
  • Ensuring good absorption of vitamins and minerals
  • Activating pepsinogen – a protein-digesting enzyme
  • Helping to kill unwanted bacteria, viruses, and parasites

When your stomach isn’t making enough hydrochloric acid, you can experience an array of unpleasant and sometimes painful symptoms, such as:

If your stomach has low hydrochloric acid levels, you might experience constipation but also nutritional deficiencies, even if you’re eating a healthy diet. This can make identifying your health issues difficult. In fact, low hydrochloric acid is a condition that is often misdiagnosed or overlooked.

Causes of Low Hydrochloric Acid

Low levels of hydrochloric acid can make you constipated and uncomfortable but it can also be responsible for a cascade of health consequences, which is why it’s important to address constipation with techniques that treat the root cause and not just the symptom.

Understanding some of the causes of low hydrochloric acid can give you clues to help you determine if low HCl is causing your constipation. Some causes of low stomach acid include:

  • Medications – Some prescriptions and over the counter drugs suppress HCl production.
  • Chronic stress – This is when HCl secretion is inhibited by chronic low-grade worry (acute stress may cause overproduction of HCl, which is associated with ulcers).
  • Older age – Your body tends to decrease HCl production levels as you get older.
  • Vitamin or mineral deficiency – In particular, low zinc and thiamine levels can contribute to insufficient hydrochloric acid levels.
  • H. pylori infection – When there’s an overgrowth in the stomach, H. pylori can cause low HCl levels.
  • Processed foods and refined sugars – These foods are mineral deficient and cause inflammation of the stomach, which alters your gut microbiome and can reduce stomach acid production.
  • Chronic illness – Some chronic illnesses have an increased risk of low HCl production.
  • Antacids – Antacids interfere with your acid levels and can be the cause of low HCl production.

If you are experiencing constipation – other related symptoms – and also have any of the above contributors to low hydrochloric acid, you should test yourself for low stomach acid. There are three simple ways you can test your HCl levels at home before you make a trip to the doctor.

How to Test Your Stomach Acid (HCl) at Home

These three easy ways to test for low hydrochloric acid production in your stomach are much cheaper than a conventional HCl test administered by many doctors. Keep in mind a negative test result for these techniques is not an absolute diagnosis. These methods are simply for seeing if your constipation is caused by your stomach’s inability to produce enough stomach acid.

Self-Exam for Low Stomach Acid

A quick method for checking low hydrochloric acid levels is an old homeopathic trick. Take both your hands and find your xiphoid process – the bottom of the sternum where it meets the ribs – marked in red in the image below.

Then, with both hands slide along the rib cage in both directions while pushing in and under your ribs – on your left and right side of your body.

In people experiencing low levels of stomach acid, it’s common for the left side to be more tender than the right side – this area is marked in blue in the image below. It can be so tender it may cause you to jump when you find the right area – if this occurs you likely have low hydrochloric acid levels.

Apple Cider Vinegar for Low Stomach Acid

Another test you can try at home is taking a teaspoon of apple cider vinegar when you experience temporary symptoms after eating, such as indigestion or upset stomach. If your symptoms are relieved after taking apple cider vinegar, that could be a sign of inadequate hydrochloric acid production.

Betaine HCl Test for Low Stomach Acid

The betaine HCl is another at-home test you can use to check for low stomach acid. Take a betaine HCl capsule during or right before your last bite of a meal containing protein and fat. If you experience indigestion or burning, then you have plenty of HCl and shouldn’t take any more of that supplement. But if you don’t experience any burning, your stomach isn’t producing enough hydrochloric acid.

Home Remedies for Constipation Caused by Low Hydrochloric Acid

The best choice of remedy for any individual’s constipation always depends on the underlying cause. If you’ve determined the underlying cause of your constipation may be low stomach acid, here are a couple of changes you can make:

  • Add fermented vegetables to your diet
  • Reduce processed food consumption
  • Increase zinc intake
  • Reduce chronic stress in your life, especially at mealtime
  • Have a teaspoon of apple cider vinegar in warm water before each meal
  • Add betaine HCl supplements to your diet

These are a couple of remedies that may give you constipation relief. But if you continue to struggle with constipation, you should see your doctor so you can have a comprehensive diagnosis made as early as possible.

When to See Your Doctor for Constipation

As with many conditions, using temporary fixes that relieve symptoms only prolongs the underlying issue. Waiting to treat your condition can cause complications and make it more difficult to treat. If you are experiencing constipation that lasts longer than a couple of weeks, or if one of the three at-home self-tests for low stomach acid appears positive, it’s a good idea to see your doctor.

There is a myriad of ways to treat low hydrochloric acid levels naturally. By working closely with a holistic physician, you can restore balance to your stomach and relieve uncomfortable and widespread symptoms.

Elena Klimenko, MD, a certified functional medicine physician, will help you choose the right course of action to identify the root cause and relief your unsettled symptoms. Call today to find out more about functional medicine and speak with Dr. Klimenko at 212-696- HEAL(4325).

If you want more information about Functional Medicine, contact us to receive a FREE copy of Dr Klimenko’s E-book.

L-Glutamine for Gut Strength

L-Glutamine for Gut Strength

What is L-glutamine?

L-glutamine is the most abundant amino acid (protein building block) in the body; as such, it has a wide range of functions. Critical for removing excess ammonia (a common waste product in the body), glutamine supports the immune system, muscle and organ growth and repair, as well as brain and digestive functions. It’s also been shown to protect against the breakdown of the mucous lining in the gut. Most glutamine is stored in muscles, followed by the lungs, where much of this protein is made.

On a typical day, our body makes enough glutamine to meet ordinary needs. However, when we’re under stress (emotional or physical – from heavy exercise to mental illness, injury or surgery), we may not produce enough glutamine to address the stress hormones flooding our body. That is when taking a supplement comes into play. Additionally, a glutamine supplement is often helpful for individuals with medical conditions such as GERD, inflammatory bowel disease and Irritable Bowel Syndrome, where their glutamine levels may be consistently low.

L-glutamine in Supplements

L-Glutamine supplements are usually in pill form, but you can also find a powder version which should be mixed with a cool liquid. It’s critical to remember: always use cool, never hot foods or liquids. Heat destroys glutamine. Unless otherwise recommended and supervised by your health practitioner, a glutamine supplement is not recommended for children under age 10 or for people with kidney or liver disease, or a history of seizures. Proper dose is crucial to how well L-glutamine works and it should be taken on empty stomach. Always consult with your holistic practitioner before adding a supplement such as glutamine to your diet.

 

Elena Klimenko, MD, a certified functional medicine physician, will help you choose the right course of action to improve your nutrition. In her holistic health practice, she uses lifestyle modification, herbal and food based supplements to address the root cause of your medical symptoms. Call today to find out more about functional medicine and holistic health and speak with Dr. Klimenko at 212-696- HEAL(4325).

If you want more information about Functional Medicine, contact us to receive a FREE copy of Dr Klimenko’s E-book.

 

 

References:

  • University of Maryland CAM Database. “Glutamine” Accessed on October 4, 2016: http://umm.edu/health/medical/altmed/supplement/glutamine
  • Rapin, Jean Robert, and Nicolas Wiernsperger. “Possible Links between Intestinal Permeability and Food Processing: A Potential Therapeutic Niche for Glutamine.” Clinics 65.6 (2010): 635-643. PMC. Web. 4 Oct. 2016. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2898551/
  • Larson, Shawn D. et al. “Molecular Mechanisms Contributing to Glutamine-Mediated Intestinal Cell Survival.” American journal of physiology. Gastrointestinal and liver physiology 293.6 (2007): G1262-G1271. PMC. Web. 4 Oct. 2016: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2432018/
  • Weitzel L, Wischmeyer P. “Glutamine in Critical Illness: The Time Has Come, The Time Is Now.” Critical Care Clinics. 2010;26(3).
Zinc and Your Health

Zinc and Your Health

Next to iron, zinc is the most common mineral in the body and is found in every cell. It has an important role in the workings of the muscular system, reproductive systems in both men and women, and proper insulin and thyroid function. Zinc is a catalyst for the vitality of the skin and wound healing. However, zinc is probably best known for supporting the healthy functioning of the immune system.

Several studies have shown that zinc lozenges or syrup reduced the length of a cold by one day, especially when taken within 24 hours of the first signs and symptoms. Studies also show that taking zinc regularly might reduce the number of colds each year, the number of missed school days, and the amount of antibiotics required in otherwise healthy children. New studies are also looking at how the body uses zinc and whether or not taking zinc can improve the treatment of celiac disease, diabetes, and inflammatory bowel disease.

There are several forms of zinc, but not all are easily absorbed or appropriate for every person. The two best forms are zinc gluconate, and zinc citrate. According to the National Academy of Health Sciences, the need for a zinc supplement varies based on age, gender, pregnancy status, and other health factors. Zinc can interfere with the actions of some medications and can even affect the utilization of other minerals, such as copper. It’s best to first consult with your wellness practitioner before taking zinc. Men always require more zinc than women, mostly because zinc participates in production of testosterone and sperm.

Some of the symptoms of zinc deficiency could be frequent colds, decrease testosterone level or low mobility of sperm. One of the most peculiar symptoms is lack of smell and taste. In my office I offer a “taste test for zinc deficiency”. It involves taking a sip of concentrated zinc water and holding it in the mouth for 10-15 seconds. If it tastes like water to you, then you are deficient. If you identify somewhat tart taste, you probably barely making it. The reaction of person with sufficient amount of zinc in the body would be detecting a clear metal taste. Trust me, only few of people passed this test, majority of are deficient in zinc for many reasons. One of them, is that zinc, like no other element, participate in toxic metal detoxification. As you know, we all have exposure and demands on zinc are high.

In my practice I always try to use “food as medicine”. Here are the foods that are high in zinc and if you eat them regularly, you need for supplementation could be reduced. The top 5 are: oysters, beef and lamb meat, wheat germ, spinach and pumpkin seeds.

Eat away and be healthy! Don’t hesitate to our practice if you need advice or looking for guidance to address chronic medical conditions or optimize your health.

Rheumatoid Arthritis Linked to Microbiome Changes

Rheumatoid Arthritis Linked to Microbiome Changes

Here is evidence that our health depends on who we host and what we grow in our guts! It is more them then us, so it is better keep “good guys” and get rid of the “bad guys”. The article below explains that gut bacteria Prevotella copri is directly connected to new onset of rheumatoid arthritis in patients.

Rheumatoid Arthritis Linked to Microbiome Changes

By Kristen Schepker

Rheumatoid arthritis (RA), one of the most common autoimmune diseases, may be triggered by changes in the microbial composition of the gut, according to a recent study by investigators at New York University.

There is a solid body of research indicating that intestinal bacteria affect the development and the severity of autoimmune disorders localized to the gut, such as inflammatory bowel disease (Mathis, D. eLife. 2013. doi:10.7554/eLife.01608).

What’s somewhat more surprising is that gut flora can also contribute to the progression of autoimmune conditions outside the intestinal tract. In one animal study researchers found that autoimmune arthritis could be rapidly induced in previously healthy, germ-free mice by introducing certain pathogenic bacteria into their intestines (Wu, et al. Immun. 2010; 32(6): 815-827).

Following this line of thinking, researchers at the Hospital for Joint Diseases, NYU School of Medicine explored the impact of intestinal bacteria on the “systemic immune response required for joint inflammation.” Specifically, they examined the relationship between specific bacterial clades and rheumatoid arthritis development (Scher, et al. eLife. 2013. doi:10.7554/eLife.01202).

The researchers collected 114 stool samples from RA patients, as well as non-RA control subjects at New York University’s rheumatology clinics. Forty-four of the samples came from patients with newly diagnosed, previously untreated rheumatoid arthritis; 26 samples were from patients with chronic but treated rheumatoid arthritis, and 16 came from patients with psoriatic arthritis, another poorly understood autoimmune condition.

The remaining 28 samples were from healthy people without any form of arthritis.

Unusual Suspect

In performing DNA analysis, the researchers discovered that one specific intestinal bacterium, Prevotella copri, occurred in significantly higher quantities in the fecal samples collected from the new-onset rheumatoid arthritis (NORA) patients than in all other patient groups.

P. copri was present in a striking 75% of newly diagnosed rheumatoid arthritis patients, and in these individuals, Prevotella tended to be highly predominant compared with other bacterial species.

In contrast, only 21.4% of the healthy controls carried this organism in their intestinal microbiota. The bug was found in just 11.5% and 37.5% of samples from chronic rheumatoid arthritis and psoriatic arthritis patient samples, respectively.

The NYU researchers further noted that in NORA subjects, an increase in Prevotella species was correlated with a reduction in beneficial microbes, especially Bacteroides, a key genus of bacteria that normally thrive in the human gut, especially in the Western world.

Further exploring the potential connection between Prevotellaand increased inflammatory responses, Scher’s team then colonized a group of mice with a lab-grown P. copri strain.

They found that P. copri colonization in mice induced inflammation in the form of colitis, but not joint disease. They attributed the development of inflammatory bowel disease rather than RA to the fact that the mice were colonized with a different strain of P. copri than the one found in the human subjects.

Cause or Co-factor?

It is not clear whether overgrowth of Prevotella is a triggering event for the inflammatory cascade that ultimately leads to RA, or whether the organism simply thrives in the context of systemic inflammation but is not in and of itself a causal agent.

What does seem clear is that a Prevotella-defined microbiome appears to promote inflammation in the context of a genetically susceptible host.

The connection between Prevotella and joint inflammation seems to be a T-cell mediated process.

The authors note that, “In RA, there is increased production of both self-reactive antibodies and pro-inflammatory T-lymphocytes. Although mechanisms for targeting of synovium by inflammatory cells have not been fully elucidated, studies in animal models suggest that both T-cell and antibody responses are involved in arthritogenesis. Moreover, an imbalance in the composition of the gut microbiota can alter local T-cell responses and modulate systemic inflammation.”

It is interesting that mice with genetic mutations that increase the risk of RA-like changes remain healthy if they are kept under sterile conditions. However, if these mice are exposed to certain species of bacteria sometimes found in the gut, they begin to show signs of joint inflammation (Ivanov et al., 2009Sczesnak et al., 2011).

While the new study’s results cannot conclusively implicate P. copri as the cause of rheumatoid arthritis, they do support a compelling argument that P. copri may predispose both mice and men to chronic inflammatory conditions.

A predominance of segmented filamentous bacteria like Prevotella in an individual’s intestinal microbial ecology predisposes to a reduction in the number and the function if of anti-inflammatory regulatory T cells, thus predisposing the individual towards autoimmunity, the authors explain.

Though not conclusive, this line of research open the door to a new realm of possible treatment options for rheumatoid arthritis.

Conventionally, the disease is treated with pharmaceuticals with often severe and noxious side effects. Should further research confirm the connection between P. copri and rheumatoid arthritis, antibiotic treatments or the use of probiotics rich in beneficial bacteria could become viable alternatives.

At the very least, this new line of work points to the microbiome as a previously unrecognized etiologic factor in the onset of a common but poorly understood disorder.

Probiotics

Probiotics

With 80% of your immune system located in your gut, having balanced intestinal flora is a major factor in defending your body against disease. Balanced gastrointestinal (GI) flora is critical to the functioning of the immune system, synthesis of nutrients, and detoxification. Balanced GI flora is also necessary for regular and normal bowel movements.

Flora imbalances can be caused by poor diet, illness, infections, use of antibiotics, and stress. Symptoms can include persistent gas, bloating, constipation, or diarrhea. To maintain or rebalance GI flora, consider adding probiotics to your diet.

Probiotics are live microorganisms (in most cases, bacteria) that are similar to the beneficial microorganisms naturally found in your GI tract. The most common probiotic bacteria come from two groups, lactobacillus or bifidobacterium, although many other types of bacteria are also classified as probiotics. Scientific evidence shows these boost the immune system by enhancing the production of antibodies; support the synthesis of vitamins and other nutrients; relieve the effects of, and treat, intestinal illness (diarrhea, constipation, IBS); prevent and treat vaginal yeast infections and urinary tract infections; and may reduce the risk of colon or bladder cancer.
Two ways to boost healthy GI flora are to take a probiotic supplement or add probiotic-containing foods to your diet. Probiotic supplements come in liquid and capsule forms and many are sold refrigerated. However, not all probiotics are the same. Studies show that some strains are effective in specific medical issues and some are completely ineffective. That is why it is important to take clinically proven types of probiotics which are not always available in the retail stores. Check with your functional medicine health practitioner to be sure you select a product that meets your personal health needs. It is important to follow the storage instructions for your supplement–failure to do so could kill off the live, healthy bacteria it contains.

If you shop for adequate probiotics in the retail stores look at the label. Ideally three main criteria should be met:

1. Look for multiple species organisms presented in a single dose – 4 to 8 types of bacteria and beneficial yeast.

2. Look for the units specification: professional grade probiotics are measured in colony forming units (CFU).

This is a unit of measurement of live bacteria at the time of EXPIRATION. Mediocre probiotics will have different measurement measure and refer to that “at time of manufacturing”. As you understand it is different from the above.

3. Look got adequate quantity of probiotics, it should be around 10 to 20 billion in a single dose (sufficient in most cases).

Probiotic-boosting foods include vegetables, fermented foods and cultured dairy products. Be sure the food labels state “fermented” or, for dairy, “live and active bacterial cultures.”

Resources

American Gastroenterological Association. “Probiotics: What They Are and What They Can Do for You.” Revised May 2013.
Kiani, L. “Bugs in Our Gut: How Probiotics Keep Us Healthy.” Cambridge Scientific Abstracts: Discovery Guide (October 2006).
Mayo Clinic. “Do I Need to Include Probiotics and Prebiotics in My Diet?” October 15, 2014.
What Your Bowel Movements Reveal about Your Health?

What Your Bowel Movements Reveal about Your Health?

While discussion of poop is probably not a hot topic in your household, in our home it is the most important topic of discussion. “Honey,how was your poop today? Did you have a good one?” Jokes aside, composition of what you deposit into the toilet has important implications for health. Did you know the features of fecal matter–such as the size, color, shape, odor, and consistency indicate how well the gastrointestinal (GI) tract is functioning? Those same features also provide clues about how your body is (or isn’t) faring against threats of infection and more serious diseases like celiac disease, hepatitis, urinary tract infections, malabsorption disorders, inflammatory bowel disease (IBS), pancreatitis, and cancer.

To give you an idea of what healthy, normal stool looks like, check out the Bristol Stool Chart (see attached picture and diagnosed yourself). The healthy range for fecal matter is of a consistency that is not too hard, not too soft, and mostly solid–as opposed to lumpy, pellet-like, or liquid. Normal stool color is in the light-to-medium brown range and is not offensively odorous. Also, bowel movements (BMs) should pass easily from your body to the toilet.

5 BMs that Require Medical Attention (Unless you are aware of dietary changes or a medication that could produce the following types of stool, it’s advisable to seek medical attention if you observe the following changes in BMs).

Stool that is hard to pass, requires straining, or is accompanied by abdominal pain.

Black, tarry stool might indicate infection or GI bleeding, while bright red stool could indicate infection and/or bleeding in the GI tract or anus. Seek immediate medical attention.

White, pale, or grey stool could indicate problems with the liver, bile ducts, or pancreas.

Yellow stool could indicate serious infection or gallbladder problems.

Mucus in the stool can indicate inflammation, infection, or even cancer.

How Often Should You Go?

How frequently you have a BM is important, too. And, what’s typical for you may be different for other people in your family. For most people, daily BMs are considered the norm. No matter how often you poop, you should not have to strain or experience pain while excreting. Additionally, be aware that the appearance and frequency of BMs will vary based on what’s in your diet, sleep and exercise patterns, hormonal changes, travel, stress, hydration level, medications or supplements you are taking, and exposure to toxins (from nicotine to industrial toxins).

How Low Should You Go?

There’s also evidence that the position you take to evacuate the bowels has health implications for the physical structures of the GI tract. So much so that some scientists indicate sitting to poop is a contributing factor in the development of colon and pelvic diseases. Before potty training, young children squat to poop in their diapers–they don’t sit. Yes, there’s a difference between squatting and sitting. The modern toilet places the thighs at a 90-degree angle to the abdomen, whereas squatting has a much deeper angle that gives more motility to the intestinal muscles and organs. Evacuating the bowels is much easier on the body in the squatting versus seated position. Toilet position should be a consideration for everyone over the age of five, but is especially important for the elderly, the disabled, and individuals with compromised mobility.

You can learn more about proper toilet position in this video:

https://www.youtube.com/watch?v=5P8L0r4JVpo

Resources

Mercola, J. “What You See in the Toilet Can Give You Valuable Insights into Your Health.” Accessed February 2015.

Monastyrsky, K. “Gut Sense: What Exactly Are Normal Stools?” Accessed February 2015.

Sikirov, D. “Comparison of Straining During Defecation in Three Positions: Results and Implications for Human Health.” Abstract. Digestive Diseases and Sciences 48, no. 7 (July 2003): 1201-5.

Step and Go. “Step and Go Ergonomically Correct Toilet Position.” Accessed February 2015.

 

Small Intestinal Bacterial Overgrowth SIBO

Small Intestinal Bacterial Overgrowth SIBO

Have you been bloated and gassy lately? No matter what you eat you feel like your stomach swells like a balloon few hours after you have eaten?

Pay attention: you might suffer from condition called SIBO – small intestine bacterial overgrowth.

Bacterial overgrowth of the small intestine, otherwise known as small intestine bacterial overgrowth (SIBO), is a digestive disorder that causes chronic bowel problems and intolerance to carbohydrates. Its main symptoms include excess gas, abdominal bloating, diarrhea and/or constipation, and abdominal pain shortly after meal.

Both the small intestines and colon naturally house bacteria, creating a balance within your digestive system. The types and amount of bacteria that reside in the small intestine and colon are very different. The colon contains roughly 100,000 times more bacteria than the small intestines. SIBO occurs when the bacteria from colon migrate to small intestine and because there is a lot of not fully digested food in small intestine, the bacteria multiply and overgrow uncontrollably.

Since the main purpose of the small intestine is to digest and absorb food, any disruption in its role affects the absorption and utilization of nutrients into the body. Thus, if SIBO is left untreated for too long – various nutritional deficiencies may occur. It can manifest as anemia, various vitamins deficiencies (vitamin D and B), calcium malabsorbtion causing weakening of the bones, etc.

SIBO is often overlooked as a cause of these digestive symptoms, because it so closely resembles other disorders. In fact, SIBO is theorized to be the underlying cause of IBS (irritable bowel syndrome), since up to 84% of IBS patients have tested positive for SIBO. SIBO is associated with many other disorders as well, either as an underlying cause or as an aftereffect of the pre-existing condition. This includes parasites, pancreatic problems, and Crohn’s.

The two major factors contributing to development of SIBO include insufficient gastric acid secretion and lack of intestinal motility (movement of intestinal content through the lumen). Since both of these mechanisms naturally decline with age, those over 70 years old are especially susceptible. Anything that slows down motility can contribute to overgrowth of bacteria in the small intestine, because there is no outlet for the waste.

Gastric acids (hydrochloric acid of the stomach) is another important factor. It helps to break down food and activate digestive enzymes. Without the production of hydrochloric acid or pancreatic enzymes, we can’t digest and sterilize food sufficiently. To help with gastric acid secretion, supplementation with betaine hydrochloride during meals is recommended. People who chronically taking gastric acid suppressing medications are at higher risk to develop SIBO.

If you think you may be suffering from SIBO, please call our office for evaluation. Together we can determine if your condition warrants further assessment. Depending on your particular condition there are several options for treatment: specific diet, probiotics and natural or pharmaceutical antimicrobials. The longer SIBO is left untreated, the more damage can be done to your body. Although a serious condition, it is treatable once properly diagnosed.