If you're surprised to hear that up to 1/4 of Canadians experience heartburn on a daily basis (Alimentary Pharmacology 2008), just think of the last family get together or social event you attended - did anyone pass around the TUMS, excuse themselves, complain about eating too much or show signs that their meal didn't agree with them?  Was it you? ;)

Almost everyone that I meet has some kind of digestive symptom - heartburn, bloating, gas, constipation, loose stools - but I want you to know that even though these issues are extremely common they are not normal.  Every time our body speaks to us, through symptoms, it's trying to tell us something isn't right.

Symptoms of Heartburn & GERD

• ​burning in chest (be sure to check for other causes of this)
• regurgitation
• vomiting
• dry cough
• sore throat
• bloating
• feeling full right after eating
• trouble swallowing
• lump in throat

With the high numbers of people experiencing these symptoms, Pantoprazole, a medication meant to reduce acid levels in the stomach and help with symptoms of GERD (gastric esophageal reflux disease), was the 5th most commonly prescribed medication in 2011 (Canadian Family Physician 2017), and that's not including the other medications that could be prescribed like ranitidine, esomeprazole (Nexium), or over the counter medications - which are probably the most common way people treat their heartburn.  The recommended course of treatment for a medication like this is a 4 week protocol, but the reality is that I see a lot of people continuing to take antacids for YEARS at a time, way longer than their intended use.

The problem with prolonged use of antacid type medications is that they impair digestion and nutrient absorption (especially magnesium and B12)  in the long run. You could have loose stools or an increased risk of hip fractures.  They also increase your risk of infections (C. difficile and H. Pylori).  You see, the stomach works best at a pH of about 2-3.  At this level of acid, enzymes can break down proteins and intrinsic factor can bind vitamin B12.  With insufficient acid levels (as what occurs when taking an antacid) bacteria, viruses and parasites can escape the environment unscathed and take up residence in your body.  Not good.  

Of course, the damage caused by acid to the esophagus is important to avoid - uncontrolled GERD causes cellular changes that increase the risk of esophageal cancer so it's a very bad idea not to deal with your reflux.  What I'm saying though, is that there is another way to manage heartburn in a way that allows your body to actually prevent and heal from it altogether.

Your body will be well when given the right tools.  The problem is that we don't listen to the signs of struggle, and if we do, we don't know what to do besides use band-aids.

The first thing to consider when it comes to digestive issues is to eliminate the triggers, and this is something you may have heard of before.  If triggers aren't dealt with, you will be fighting an uphill battle.

Common Heartburn Triggers

• alcohol
• caffeine
• tomatoes
• citrus fruits
• food sensitivities (as identified by an elimination diet or IgG test - often gluten, dairy)
• being overweight (pressure on the area)
• structural changes (like a hiatus hernia, pregnancy)
• smoking
• high fat, processed foods (eg. French fries, bacon)
• chocolate
• peppermint
• high carb, low fibre diets

Helpful Lifestyle Strategies

• elevate bed 4-6 inches
• stop eating 4 hours before bed
• chew your food well
• allow time to eat, try not to eat on the go
• weight loss
• prepare your own food - the first step of digestion is smelling and thinking about food, allowing digestive juices to be released
• ginger (teas are great)
• eat until you are about 80% full - often we overeat because it takes time for the "full" signal to reach the brain

These strategies are helpful while your body takes the time it needs to heal, but not all of them are the cause of your symptoms.

Mind blowing truth:  your stomach needs to be at its ideal pH in order for the lower esophageal sphincter (LES) to keep the top of the stomach closed.  Most heartburn is actually from not having enough stomach acid, not the reverse.  So in reality, taking medications that inhibit or neutralize acids will temporarily help the burning feeling, but they will not address the cause of heartburn and can actually make it worse in the long run.

Steps to Heal Your Heartburn or GERD
Once triggers have been eliminated, and structural issues like a hiatus hernia or other issues have been ruled out with diagnostic testing, it's time for the real healing to begin.  Consult your Naturopathic Doctor about which of these treatments will be best for you.
    1.  Remove triggers (see above, plus...)
          - keep a journal of your diet and digestive symptoms in order to determine your unique triggers
          - eradicate infections (eg. H Pylori bacteria) or bacterial overgrowth
          - change up your diet - fewer carbohydrates and more vegetables, prebiotic foods
          - watch the artificial sweeteners and other chemicals - hard to digest

     2.  Support the LES (keep the top of the stomach closed) and digestive environment
          - zinc 
          - melatonin 3-6 mg at bedtime
          - digestive enzymes, often containing betaine HCL (remember, heartburn is often from not enough stomach acid...     ask for help with this)
          - bitters - herbs that stimulate digestion

    3.  Heal the tissues and replace nutrients
          - DGL (deglycyrrhizinated licorice) - available as chewable for on-the-go relief
          - aloe vera juice
          - marshmallow root tea
          - L-Glutamine 
          - mastic gum
             (I often use a product that contains all of these in one powder or capsule)
          - Vitamin B12
          - Magnesium (the type I use depends on other patient health concerns)
          - probiotics

In a 2006 study (Journal of Pineal Research), people who took a combination of B vitamins, melatonin, betaine, and methionine had 100% resolution of GERD symptoms in 40 days.  How amazing is that?

Keep in mind that everyone has their own unique makeup so it's important to work with a professional to guide you through your best treatment plan.  If you're ready to listen to your body's messages, let the healing begin, and really understand what's going on in your body I'd love to meet with you.

Have a great day,
Dr. Christa

What is stress?

Basically anything that challenges the normal steady state is considered stress.  There can be emotional, physical, chemical, structural or environmental stressors, but the one we think of most when we hear the word "stress" is the emotional state of overwhelm.

Some people actually thrive on a little bit of excitement, like paramedics or stock brokers.  Those people are exposed to stress, but it doesn't bother them as much as it might someone with a different personality.

The thing is, we all have difference levels of tolerance, and different levels of perception of stress; which is what makes the impacts of stress incredibly difficult to figure out on your own.
Signs you might be stressed

• trouble sleeping, either falling or staying asleep
• muscle tension, especially the neck, shoulders & back
• change in your weight or appetite
• hair loss
• headaches
• racing heart beat
• feeling dizzy
• a sense of overwhelm
• sweating
• low energy
• digestive issues: loose stools, constipation, heartburn, nausea
• weak immune system (getting sick often)
• loss of libido
• racing thoughts
• easily irritated, low tolerance
• jaw clenching or teeth grinding
• inability to focus or concentrate
• constant worry
• forgetfulness
• trouble being optimistic
• feeling down or low mood
• procrastinating
• nervous behaviours like nail biting, pacing
• increased dependence on substances like alcohol, drugs

Whoa, that's a long list.

The thing is, stress affects many, many body processes because of the far reaching effects.  You see, the stress response is designed best to handle immediate and urgent danger.  If we were to encounter a bear in the woods, we need our heart rate to go up, we need energy available to us, we need quick thinking, we need or muscles to tense up and act rapidly to get us out of there - fast!

Our modern stressors are often very different; they are constant, and less physical.  Over time, the systems that protect us from immediate danger start to degrade or work against us when we're dealing with unrelenting issues like rush hour traffic, busy lifestyle, work deadlines, shift work, raising teenagers or caring for elderly parents.  It is at this point that stress becomes impactful on our health.What can I do?You know me, I don't like highlighting problems without offering solutions.  To get you started with managing your stress levels, I have found these things to be extremely helpful.  Choose the ones that resonate with you the best.

• gratitude journal - record 1-3 things you are grateful for each day (to change your perspective)
• make to-do lists and then prioritize (not everything needs to be done today, and not everything is important, this also frees your mind of clutter)
• move your body - walk, kickboxing, yoga, spinning (get that negative energy OUT)
• keep a regular bedtime, preferably 10-10:30pm
• deep breathing or guided imagery - there's lots of Apps, Books or other resources for this to help get out of that fight-or-flight mode (e.g. Headspace, Calm, read Jon Kabat-Zinn)
• recognize your own needs (e.g. sleep, food, me-time, social time, baths)
• epsom salt baths
• diffuse lavender essential oil
• chamomile or licorice root tea
  
  

I think I need more

You're right, those suggestions might not be enough.  I like to begin with lifestyle adjustments because they're easy and they help maintain balance.  If you are at a point where you are definitely out of balance, though, more strategic tactics might be needed to support and nourish your body back into harmony, in addition to the ideas mentioned above.

• 300mg per day of Magnesium glycinate - helps to reduce muscle tension and support the adrenal glands (that manage the stress response)
• 100mg per day of Rhodiola rosea - nourishes mood and reduces the feeling of overwhelm 
• 300mg of Ashwagandha - supports the adrenal glands and thyroid, feel more resilient
• 100mg L-Theanine - brings a feeling of calm
  ... and many other options depending on your unique needs, be sure to discuss the best action plan for you with your practitioner
  ​
  

How do I really know if stress is an issue for me?
There are some wonderfully informative tests that really help to break things down for us.  One is a saliva test that measures 4 samples over the course of the day to determine where and when our cortisol (stress hormone) levels sit when we wake up, in the morning, afternoon, and evening.  Another test is a urine test that also checks the 4 times of day, but also looks at other hormones and neurotransmitters that can be at play as well.  The interesting thing about hormones is that they are not stationary, they are actually released in different amounts all the time.  This is why blood tests aren't the best way to get a full assessment of what's going on with our hormones.  Your practitioner will help you to figure out which test is right for you.

I believe that stress management is one of the areas where Naturopathic Medicine really shines.  There are many different herbs called Adaptogens that help your body to manage the stress response with ease, while you implement strategies to build a more balanced life.  The reality is that some aspects of our life are not quite controllable (yet) and we need to be able to support ourselves in the meantime, in order to function at our best.

Stop feeling like you are on a tight rope, and do not accept that you are destined to live with these symptoms.  There's another way.

Take good care,
Dr. Christa

Calcium is regarded as an important nutrient because if its relationship to bone health.  In fact, the whole dairy industry has capitalized on our need for calcium and positioned dairy products as the most convenient way to meet our dietary requirements for calcium.  There are, however, other foods that contain calcium, which is important to know since many of you have learned you have a dairy intolerance or don't metabolize cow's milk very well.  There is also some researching pointing out that we might not be able to absorb a lot of the calcium in dairy because of the interference from the protein.

How Much Calcium Do I Need?

• Toddlers >700 mg per day
• Kids 4-8 years  >1000 mg per day
• Teens 9-18 years  >1300 mg per day
• Adults 19-70 years 1000 mg per day
• Adults 70+ years 1300 mg per day
  
  

Factors That Increase Risk of Calcium Deficiency

• postmenopause (estrogen loss increases bone loss, and reduces calcium absorption)
• women without menstrual cycles (athletes, those with eating disorders have less estrogen, reduced intake of calcium, or increased excretion of calcium)
• food sensitivities, lactose intolerance, other digestive diseases (poor nutrient absorption)
• imbalanced diet or inadequate intake
• vitamin D deficiency 
• prolonged use of medications: laxatives, corticosteroids, proton-pump inhibitors (antacids), statins, diuretics, depoprovera
• kidney disease
• high intake of acidic drinks like pop and coffee, tea or alcohol
  
  

Why Does Calcium Matter?
We are familiar with the relationship between calcium and bones, where calcium is used to manufacture strong bones.  We reach peak bone mass by age 30, so there is an increased need to focus on calcium intake during childhood and early adulthood, to ensure lasting bone structure and also provide adequate stores for calcium.  We also use calcium for muscle contractions (including the heart beat) and blood clotting, but also the relaxation of blood vessels.  So, even though we aren't making a lot of bone after the age of 30, without adequate calcium intake we borrow calcium from its largest reservoir, our bones, in order to carry out these physiological actions.

It is significant to mention that since we reach our peak bone mass at the age of 30, our focus after this age should be geared towards maintainingbone mass (see below).

Non-Dairy Sources of Calcium

• leafy greens (collards, spinach, kale, bok choy)
• salmon & sardines (canned with bones)
• soy beans
• white beans, black eyes peas, navy beans
• sesame seeds (including tahini)
• almonds
• blackstrap molasses 
• fortified milk alternatives (eg. soy, almond, cashew, coconut milk)
• broccoli
• figs
• oranges
• seaweed

Nature packages our foods with other nutrients that it needs to help with absorption and utilization of its constituents, which is incredibly valuable when trying to achieve balance in our diet.  This is why it is so important to strive for nutrients from foods first, and then supplement as a bonus.

Calcium Supplements
There are some things to know about calcium supplementation.  Even though calcium used to be recommended right away when women went through menopause (to counter the effects of lower estrogen on bone mass), we've now learned that taking calcium on its own may be detrimental to other systems.  

When we take vitamins or minerals, we assume that our body will put the nutrients where we want them to go, but this isn't always the case.  When calcium is absorbed in our in our digestive systems, it enters the blood.  Without a clear plan in place, calcium gets deposited all over, including our vascular system.  The problem is, calcium left within our arteries make them stiff, which can lead to high blood pressure or other cardiovascular concerns.  Luckily, there is a solution.  Vitamin D helps guide calcium where it needs to go, and so it is important to incorporate D3 into any calcium supplementation plan.  

It's also important to ensure you are getting enough magnesium (most likely you're not) in a ratio of at least 1:2 with calcium, to ensure proper muscle function.

One final note on calcium supplementation, it must be taken away from thyroid hormones or medications like Synthroid.

What About Osteoporosis?
When we talk about calcium what we're really concerned with is Osteopenia or Osteoporosis.  In order to preserve or encourage bone integrity I have several suggestions.  It is so much easier to work on preventing bone loss than it is to try to rebuild bone (although I have worked with people who have seen improvements on their bone scans, or at least maintenance of their T-scores). 

1. Weight lifting or resistance exercises
   - muscle pulling on bone strengthens the bone structure
   
   
2. Eating an antiinflammatory, or alkaline diet (find out more about pH levels, or if you're too acidic here)
   
   
3. Avoid pop
   - the acidity causes bones to leach minerals
   
   
4. Maintain adequate vitamin D level
   - ask your family doctor or me for a blood test
   
   
5. Know your risk (in addition to the factors listed above)
   - if your mom, grandma, or siblings have had concerns with their bones
   - if you've ever had chemotherapy or taken other medications (listed above) for prolonged amounts of time
   ... it's even more important to start working on your skeletal health now
   
   
6. When you know you have bone loss, I suggest bone support supplements that support their complex architecture.  Good products contain calcium in the MCHC form, with other crucial elements of bone health like Vitamin D3, Strontium, Phosphorus, Boron, Manganese, Zinc, Vitamin K2
   - Osteo SAP (NFH)
   - Ortho Bone (AOR)
   - Bone Health (MegaFood)
   - Bone Basics (AOR)

I hope you now have a better understanding of the vital role of calcium in the body as well as having resolved some misconceptions.  I love educating on health, so if you have any topics you'd like me to address please feel free to reach out with suggestions.

Warmly,
Dr. Christa

I get this question a lot.

The answer is, it depends.  

Some people are more sensitive to chemicals in foods because of other factors in their health, like autoimmune conditions, gut issues or liver problems.  In certain cases, your body may be less tolerant of having one more thing to detoxify and the chemicals used in food production are just another thing for a burdened body to do.  It can even put that person's health over the edge, while others are more resilient.

What is the difference between Organic & GMO?

Organic agriculture practices are those that do not utilize chemical fertilizers, pesticides or other agents; however, they may use 'natural' substances to increase growth and crop yields.  

Genetically modified organisms (GMOs) are those that have had their DNA altered in a laboratory, and often include genes from other species.  One of the reasons that crops have become genetically modified is in order to withstand direct application of pesticides (eg. glyphosphate ready corn).

What is the issue with GMOs?

We don't totally know the full implications of artificially changing genes.  However, one point that is gaining traction in the media is the fact that crops that are grown to withstand direct contact with pesticides will contain those chemicals even after harvest and manufacturing.  (Remember the articles about Roundup in Cheerios?)

Apart from concerns about the high levels of exposure to chemicals in food, and how this is overwhelming our liver and other modes of detoxification, we also need to consider the impact that these chemicals are having on our natural healthy bacteria.  It is thought that regular exposure to chemicals like glyphosphate are changing our gut bacteria - which we know to be critical to our immune function, nutrient absorption and mental health. 

New research is revealing more and more on these topics all the time, so we might have to wait a bit longer for more information.  There are even some studies pointing to the idea that gluten intolerance (which many are experiencing) is actually glyphosphate sensitivity.  Hmmm interesting....

How do I implement an Organic diet?

In order to reduce chemical exposure, I suggest focusing on eliminating GMOs and the crops with the highest levels of pesticide residue, if you can.  Each year the Environmental Working Group updates their list of the "Dirty Dozen" and the "Clean Fifteen" and today they released their list for 2019.

Dirty Dozen 2019
Clean Fifteen 2019

I share this with you so that you can more confidently choose which foods to prioritize or invest in.  Please let me know if you'd like to discuss your individual needs in more detail.  I always suggest eating vegetables and fruits, regardless of the source.  The lists provided are to help you to fine-tune or elevate your healing journey.

The Dirty Dozen

1. Strawberries
2. Spinach
3. Kale
4. Nectarines
5. Apples
6. Grapes
7. Peaches
8. Cherries
9. Pears
10. Tomatoes
11. Celery
12. Potatoes

The Clean 15

1. Avocados
2. Sweet corn (unless it is GMO)
3. Pineapples
4. Sweet peas (frozen)
5. Onions
6. Papayas (unless it is GMO)
7. Eggplants
8. Asparagus
9. Kiwis
10. Cabbage
11. Cauliflower
12. Cantaloupes
13. Broccoli
14. Mushrooms
15. Honeydew melons

To make the process of eating more organic foods sustainable, have a look at some of the local farms offering CSA shares for the growing season.  If you think you would enjoy a weekly box of fresh, local produce it could be a great option for you.  They are taking orders now.

Happy spring,
Dr. Christa

I know what it's like - I have every good intention of loading up my shopping cart with a variety of fruits and vegetables and then when I get to the grocery store everything looks .... blah. 

We are far from the days where Canadians developed scurvy in the winter from a lack of Vitamin C, but we do still rely on imported produce to satisfy our nutritional needs.  Spring is around the corner but it will still be a little longer before we see beautiful, fresh fruits and vegetables on the shelves.

The new Canada Food Guide emphasizes exactly what I've been promoting for years - HALF of our diet should be comprised of vegetables and fruits.  In order to accomplish this in the winter, I have the following tips:

1.  Frozen Vegetables

• steam green beans, broccoli, cauliflower, carrots
• add any vegetables to soups
• cauliflower boiled and then mashed or added to boiled potatoes to lighten the carb load is delicious
• pepper & onion, kale or diced veggie mixes are lovely for a quick stir-fry 
  
  

2.  Frozen Fruit

• smoothies (of course)
• Seed 'Granola' Bowl
  - 1/4 cup frozen raspberries or blueberries
  - 1 tbsp ground chia seeds
  - 1 tbsp hemp seeds
  - 1 tbsp ground flax seeds
  - add boiling water to reach desired consistency, top with nuts or coconut chips
  
  

3.  Eat What's in Season or Stores Well from Autumn Harvest

• apples
• pears
• beets
• cabbage
• carrots
• fennel
• garlic
• grapefruit
• kiwi
• leeks 
• mango
• mushrooms
• onions
• oranges
• parsnips
• potatoes
• rutabaga
• squash
• sweet potatoes
  (rutabaga, sweet potato and parsnips are great in stew or baked into fries)
  
  

4.  Canned (BPA-free cans, if possible)

• pumpkin - works well in pancakes, oatmeal, muffins, shakes, chili
• tomatoes - stews, casseroles, chili, pasta sauce
  ​

5.  Farmer's Market

• Orangeville and other Farmer's Markets are still running in the winter on a reduced schedule

Coming Soon...
In April we can look forward to asparagus, radishes, fiddleheads, spinach, rhubarb, peppers, tomatoes & strawberries (from the greenhouse)

Please let me know if you have any other ideas, I'd love to share them :)
Dr. Christa

​ In the summer we get hot and thirsty, so it's a little more natural to reach for a glass of water.  But what about the winter?  Today I'm inspired to write about hydration because I've been hearing from patients saying that lately their water intake, while normally good, has been severely lacking or non-existent.

The thing is, regardless of season, our bodies are made of 60% water, by weight.  This percentage goes down if we have extra adipose tissue (muscle holds more water than fat), or when we don't drink enough.  Adequate water in our bodies keep the blood thin, which takes pressure off the cardiovascular system.  It allows for proper elimination through the lungs, kidneys, and bowels.  It curbs food cravings and reduces pain.  Proper hydration also increases energy levels dramatically, and it's one of the first things I ask about when someone is concerned about fatigue.

How much is enough?  There isn't a downside to drinking more - other than regular bathroom trips (unless you have a kidney issue).  However, there are a few signs to look for that point to dehydration:

• dry skin
• foggy thinking
• fatigue or energy crashes
• headaches
• constipation
• muscle cramps
• skin that lacks lustre
• concentrated yellow or cloudy urine

Adults and kids are frequently dehydrated, and this puts major strain on our bodies that are made mostly of water.  The winter months are particularly challenging as the air is dry from furnaces and defrosters.  We also get chilly and lack desire for cold drinks.  Even though drinking water isn't always as intriguing at this time of year, it's still just as important to stay well hydrated.

Of course, drinking plain water is THE BEST option.  However, I totally understand that it doesn't always happen, or sometimes we need to switch things up.  Some people don't always absorb the water they are getting, and need electrolytes, or other adjustments to help get the water into their cells.
How to stay hydrated without water:

Foods

• soups - they have a high water content compared to other foods, and are often high in vegetables so the nutrients help the water get absorbed by the body
• vegetables and fruits - cucumbers, celery, blueberries, pineapple, lettuce, strawberries, spinach, bok choy, zucchini, tomatoes, swiss chard....
  - most vegetables are 90% water by weight 
• smoothies - liquid meals help get more water into the body by replacing dry foods
  - try 1 cup frozen fruit with 1/2 avocado and cover with liquid of your choice
  - add boosters like protein powder if desired

Drinks

• herbal teas - they can also provide the benefits of whatever herbs they contain
• sparkling mineral water - contain minerals to help with absorption
  - I really like Gerolsteiner for the high magnesium content -> very helpful for relaxation if you have a glass in the evening (hint: extra beneficial for hydration if you replace dehydrating alcohol for a mineral water)
• lemon water or other infused waters to improve flavour and absorption
  - lemon or lime (can serve warm like tea)
  - a few cucumber slices
  - a few raspberries or strawberries
  - a sprig of mint or rosemary
• coconut water
• maple water (found at Zehrs in the natural health section)
• RHD Milieu by Physica Energetics (purchase at the clinic)
  - homeopathic drops that you put into your water to help with absorption of water into the cells, works very very well

Lifestyle

• we lose a lot of water through our skin so if you have dry skin, ensure you protect the barrier function of the skin by using coconut oil or other natural oil moisturizers
• watch caffeine and alcohol
• start the day with one glass of water to begin the day in a positive water ratio
• try to have 1 litre of water by noon to stay on track and stay out of the bathroom at night
• humidify - set your furnace (purchase a humidifier) and set it to the upper end of the recommended 45-55% humidity level
  - (fun fact:  studies show that humidity above 43% keeps the flu virus from spreading as easily)

I hope this helps to encourage you to become more hydrated!

Take good care,
Dr. Christa

This time of year is a huge challenge for some people.  Many people feel the pressure to do more, buy more, give more, eat more, drink more (nevermind the Elf on the Shelf!) - and do it all with grace and joy.  It's a recipe for disaster.  It makes me happy that some of you have figured out a way to divide the work, once you learned that doing it all yourself was just WAY too much.

The ideas I've heard from patients are awesome:

• making all get-togethers potluck
• getting children involved with housework and wrapping
• opting for family experiences as gifts instead of toys and other "stuff"
• purchasing baked goods (Try: Shine Baking Co. - allergy friendly options for those who are gluten free, dairy free, egg free etc.)
• pre-cooking the meal to avoid spending the day in the kitchen
• serve a buffet
• 3 gifts only: something you want, something you need, something to wear
• keep up or start the adrenal support for stress now to improve resilience
• make time for yourself too

So, it sounds like in general things have been scaled back in terms of gifts and cooking, but what about the other expectations?

The holiday season is a huge test for your new and hard-earned lifestyle changes.  I totally think it's a time to enjoy some indulgence, but I don't believe that you need to feel gross for the next 4 weeks straight either.  If you find yourself thinking that it's a good thing you got new track pants or pajamas then it might be time to reassess your tendencies.  If you are eating a whole tray of baking at a time, if you're stress eating, if you're feeling pressured to eat foods that you know don't agree with you then we need to reevaluate (and maybe even in person).  In the meantime, here are some great tips for staying on track.


How to Navigate Eating Over the Holidays

1.  Eat your regular meals - sometimes we want to skip meals if we know we have a big feast coming (or we get busy and forget), try to just eat lighter and focus on veggies, healthy fats and protein at your regular mealtimes to keep your blood sugar stable (and prevent you filling up on appetizers when you arrive at your event).
2.  Get some activity - whether it's the gym or a snowball fight or public skating, move your body to keep your mood up and burn some calories.
3.  Eat before you leave - having a small meal before you go will prevent you from being tempted by foods you know aggravate your health.  (Just like grocery shopping when you're hungry leads to a cart full of junkfood).
4.  Make special requests - everyone is entitled to feel good, but sometimes we hesitate to inform our hosts of food sensitivities which can make them feel just as awkward when you can't eat the food they've prepared.  This likely won't go over as well for people with multiple sensitivities - dairy free, gluten free, egg free only please ;) 
5.  Bring things you can eat - bring your own safe foods so that you know you have an option: crackers, dip, salad, etc.  You can always warn your host privately ahead of time - I know that many of you aren't comfortable asking for special accommodations, so this is a way around that.
6.  Beverages - keep hydrated to stay energetic and also prevent cravings.  For every alcoholic drink, have one glass of water.  Minimize sugary alcohol drinks like egg-nog which have a lot of extra calories.  White wine spritzers can be a good alternative, also gin & tonic or vodka & soda.  As long as you have something in your hand, you will generally be left alone (sad but true!).  I've been loving the flavoured sparkling waters lately.
7.  Arm Yourself - if you have a food sensitivity or trigger that causes immediate symptoms, you can arm yourself with digestive enzymes and probiotics to prevent some of the side effects. The same is true if you experience anxiety in social situations or with family stress, we can discuss your best remedy choice.
8.  Don't be afraid to stand up for yourself - if someone is trying to pressure you into eating a second serving of dessert, just say no (politely) and excuse yourself from the conversation.  If you actually want the item that's being offered, that's ok - enjoy it.  Check in with yourself and decide if you are making the best choice for you, or are you being driven by other feelings like guilt?
9.  Focus on People - get-togethers are about enjoying the company around you.  Position yourself away from the buffet table and use smaller plates to prevent overeating, then enjoy catching up with friends or family.
10.  Sleep - just as it's important to stay on routine with foods, keeping your regular sleep schedule will help control stress (cortisol) and regulate blood sugar (AKA cravings!).
11.  Be kind to yourself - relax and have fun because a healthy lifestyle is about what you choose each and every day of the year, not in one meal.  At this time of year we aren't judging others on what they're eating, and we shouldn't judge ourselves either.  Start the next day fresh and let go of guilt.
12.  Remember your why - remind yourself of why you chose a healthier lifestyle in the first place.  Was it to lose weight, feel better in your own skin, be energetic, have less pain, stop feeling bloated?  It's easier to stay focused and avoid de-railing your lifestyle if you remember why you're doing it in the first place.

Take care of yourself and each other this season,
Dr. Christa

Iron deficiency, or anemia, is a very common diagnosis for women.  It's so common, in fact, that we often accept it as 'normal' or no big deal.  Well, guess what?  Yet again, just because something is common does not make it normal.

The symptoms of iron deficiency are: fatigue, exhaustion, pale skin, frequent colds or other infections, feeling cold, shortness of breath, noticeable heartbeat, dizziness, headaches, swollen tongue, trouble swallowing, spoon-shaped or brittle nails, leg pains, hair loss, or a desire to eat non-food items like ice.

As with most of the vitamins, the common lab reference ranges (the range which is considered acceptable) do not reflect optimal nutrient levels.  This means, that when you have bloodwork done, you may be told that everything is normal - and yet you are one point away from being deficient.  As you know, to me that one point is significant.  There is no imaginary line that defines when we have symptoms and when we do not because health is a continuum.  This explains why many women can be diagnosed with iron deficiency on and off throughout their lives.  The other reason is that the cause of the deficiency has not been addressed.  Let's go through some of the reasons why you might have low iron.

1.  Blood Loss
- Whether you have heavy periods or a hemorrhoid (both are treatable, by the way), it's important to first consider any reasons why you might be losing blood.  Blood loss through the colon, even if you can't see it, is a huge red flag for colon cancer and must be treated urgently.  A bleeding ulcer is another origin for digestive blood loss, and could be caused by pain medications irritating the stomach. 

2.  Not Getting Enough Iron in Your Diet
- When we think of Iron, we often think of red meat but there are plenty of other foods that contain iron as well:
spinach, shellfish, lentils, pumpkin seeds, quinoa, broccoli, dark chocolate, tofu, turkey  Here's a great reference
- Women who are menstruating need at least 18mg of iron per day, while Men & menopausal Women require a minimum 8mg/day.  The need for pregnant women is much higher at 27mg/day.

3.  Not Absorbing Iron
- Plant sources of iron are not as well absorbed by the body as animal sources, so you need to consider this if you are following a vegetarian or vegan style of eating.
- Vitamin C helps to improve the absorption of iron and you will notice that some iron supplements suggest taking it with a glass of orange juice or else they contain Vitamin C right in the capsule.
- Many different medications interfere with our digestive processes.  Our stomach acids start the process of protein digestion, and iron is absorbed in the first part of the small intestine.  Stomach acid levels are interfered with by antacids including TUMS or other prescription Proton-Pump Inhibitors.  Furthermore, pain medications like Aspirin or Ibuprofen are known for irritating the stomach lining, and consequently the stomach cannot efficiently do it's job to break down proteins, which leads to poor iron absorption as well.
- the heavy metal lead competes with iron, and so a lead toxicity can lead to iron deficiency
- Drinking tea with meals because the tannins in tea block iron absorption (a trick to use if your iron levels are too high)
- Any digestive condition that leads to poor digestive ability or inflammation in the digestive tract like Celiac disease, food sensitivities, irritable bowel diseases like Chron's or Colitis
- Chronic infection
- Iron absorption is tightly regulated by the body, so we can only absorb so much each day.  Eating a ton of iron one day and none the rest of the week will not maintain iron stores in the body.  Just like taking huge doses of an iron supplement will only lead to constipation since the majority of the iron simply passes through.

4.  Other Conditions to Think About
- We know that having low iron often goes hand in hand with low thyroid function.  The symptoms of each are very similar, and both should be considered if you have been diagnosed with one or other
- Kidney disease can impair the ability to make Red Blood Cells, which will show up as anemia in lab work

To me, the why is just as important as the diagnosis.  I like to understand where things are going wrong so that we can fix it for good. Your body deserves to be working at it's best, and by healing the root cause of your issues we can make that happen.