Heart rate variability - A valuable tool to track well-being

A healthy heart does not beat like a metronome, but actually changes its rhythm with each heart beat. The constant variation between each beat is called your heart rate variability (HRV). This is something I have been speaking about to several of my patients recently, as more people have smart watches and other health tracker apps that can measure this.

What affects HRV?

There are certain situations that result in a higher HRV and other situations resulting in a lower HRV, reflecting your hearts ability to respond to different situations. This ultimately reflects how your nervous system is responding. HRV can react to stress and/or illness before resting heart rate, which makes it one of your body’s most powerful signals—providing useful insights into your stress levels, recovery status, and general well-being.

Generally a lower HRV is associated with your “flight or flight” response, stress or illness. A higher HRV is associated with your “rest and digest” response, general fitness and good recovery. It is amazing how we can track how just a 5 minutes meditation exercise can improve your HRV.

There are some things we cannot control that affect HRV such as age, hormone cycles, illness and amount of stress we have. However, to improve HRV there are things we can control such as sleep routine, alcohol and caffeine intake, how we manage stress and fitness level.

Tracking HRV

A high or low HRV is relative to each person. It is therefore best to track your own HRV over time and generally aim for a higher level, or track what improves it and decrease it, instead of comparing to others. It can range from 20 to above 150 depending on the tracker. Also, sometimes it is ok to see a lower levels for a short period of time, eg. during a strenuous activity where our nervous system is working hard to increase our heart rate. It is then how we recover that matters.

HRV fluctuates often throughout the day so is is helpful to track it in a controlled setting like sleep. However, some trackers, like the smart watch may limit this if you don’t want to wear it at night.

I see a lot of digestive issues, fatigue, insomnia etc in my practice and it almost always has a component that connects back to the nervous system. If we can help manage our stress response and improve HRV, that can help us tremendously over time. Ultimately, you don’t NEED to track HRV to check in with how you are doing overall. However there are some pretty neat tools out there now that can track things like HRV that we can use to our advantage.

Thoughts? Check in with me if you have questions.

Dr. Karen

Burnout & Energy Crashes - Unpacking Reasons Why

Burnout or fatigue...a very common concern I see in practice. 😞😴 But I promise you don't have to feel like this forever! ⠀
If you have been feeling emotionally and physically drained for awhile now let's dig into some common reasons why this may be. ⠀

1. Nutrient deficiency

Have you had blood work done to check nutrient levels lately? Some common blood work I like to see for those who are struggling with energy are:⠀⠀

• ferritin (your iron stores)⠀

• B12⠀

• Thyroid panel - additional symptoms may point us to look into this⠀

• D3 - surprisingly common to be low in those that are struggling

This is often where I start because it may be the simple solution. Symptoms such a heavy periods, or poor digestion may push me to get these checked sooner rather than later as well. ⠀
If these look good, we dig a little deeper...

2. Adrenal insufficiency (aka burnout)⠀

This is the one of the most common causes of fatigue I see in practice. You may be or have been in "fight or flight" for awhile, bombarding your body with cortisol and adrenaline (those get up and go hormones). It's telling you it has had enough and won't be listening to the signals anymore. Your body has decreased its production of cortisol, affecting your circadian rhythm. ⠀
We need to support your body with adaptogen herbs such as rhodiola, ashwagandha and holy basil and vitamins such as vitamin C, magnesium and Bs to support cortisol production again. ⠀
OR....⠀
We need to calm down your nervous system with nervine herbs such as passionflower or lemon balm to decrease the "fight or flight" response. ⠀
Is this you? 

3. Female hormone imbalances

This is a big topic itself so I'll just be brushing the surface here, but hormones can definitely affect your energy level. ⠀
Do you see a cycle to your fatigue? This could mean it is related to your menstrual cycle and therefore related to imbalances in estrogen and progesterone levels. ⠀
This is normal to see happen to some extent but not to the extent it interferes with your life. I’ve touched on this before but typically we see an increase in energy the week before ovulation (we are more extroverted) and then it decreases before your period (and we are more introverted). But if you feel so wiped several days before your period we assume either progesterone is low (do you also have spotting before your period?) or estrogen is too high (crazy mood swings or breast tenderness as well?) creating an imbalance. ⠀
What is great is that we can test these hormones through blood or urine with the DUTCH test and there are many great herbs and more natural modalities such as acupuncture that can help balanced it all out. 

Any of these signs common to you? Let’s explore together.

In health & happiness,

Dr. Karen

Leaky Gut - Yes there could be "holes" in your gut!

As a Naturopathic Doctor who sees a lot of gut issues, I get questioned often by people who have heard the term leaky gut, wondering what it is and if it could be the cause of their health issues. This is something I do see often in practice and I find very important to fix in order to treat a number of different issues, such as IBS, eczema, depression and most autoimmune disorders.

What is leaky gut?

Your gut is actually quite fragile as the lining of your intestines is made up of only 1 layer of cells, called enterocytes, lying between your gut lumen and the blood vessels. A border of microvilli on top increases the surface area to aid in absorption of nutrients, water and electrolytes. The intestinal lining also regulates the trafficking of environmental antigens (1) . These enterocytes are held together by tight junctions, like water-way locks, preventing the cells to come apart when inappropriate. Remember the childhood game red-rover? This is the game your gut is always playing. However, damage to the gut lining from inflammation and stress, releases a protein called zonulin which weakens these tight junctions making the lining more permeable (2) and ultimately creating small gaps between the enterocytes that cannot close up. Food particles, or antigens get absorbed between the cells now instead of through the cells, activating an inflammatory and/or immune response in the gut and blood stream.

What health issues can this cause:

• Local inflammation - IBS symptoms such as bloating, cramping, diarrhea, constipation

• Autoimmune conditions (1) - Hashimotos thyroiditis, Rheumatoid arthritis, Lupus and IBD, MS

• Systemic conditions - eczema, psoriasis, acne, joint pain, headaches, seasonal allergies

• Mental/emotional issues - depression and anxiety, chronic fatigue

What causes leaky gut:

• Gluten - this was the first thing found to increase zonulin levels

• Bacteria and infections - or bacterial endotoxins also found to increase zonulin levels

• Stress - this decreases stomach acid and digestive enzymes leaving larger particles of food to descend into the intestines which irritate the gut lining

• Medications such as proton pump inhibitors, antibiotics and NSAIDs

• Simple sugars and food additives

How to fix leaky gut:

If you haven’t read my blog post about the 4Rs in gut health, I’d lead you there to shed a little more light on my whole gut healing protocol. Ultimately we need to reestablish the zonulin-dependent intestinal barrier function to close up those gaps between the cells. There are a few favourites of mine that been shown to be very effective at REPAIRING the gut, but don’t forget to REMOVE, REPLACE and REINOCULATE as well.

• L-glutamine - this is my go-to for any gut issues, from mild to major. Always given in powder form to ensure a high enough dose.

• Collagen - helps to support and strengthen the gut lining like glutamine. I love the brand Sproos that I carry in my practice.

• Zinc carnosine - studied to heal the gut, including the stomach lining after H.pylori or an ulcer or after NSAID use

• Mucilaginous herbs - marshmallow, aloe vera, DGL, slippery elm

If you struggle with any of the conditions listed above do not hesitate to reach out to discuss the best treatment options for you! Heal your gut to heal your body and start feeling yourself again.

In health & happiness,

Dr. Karen

References:

1 - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3384703/

2 - https://www.ncbi.nlm.nih.gov/pubmed/21248165

How are you? No, but for real. Uncovering anxiety and depression.

How many times have you asked that question yet are not quite ready to hear the full answer? Are you asking to be polite or out of habit or are you truly there to listen. Of course no one is being rude when they ask that question out of habit. Sometimes this question can open up a can of worms and in my opinion, this is where the good comes. This question, "How are you?", if you have more than a second to listen, or more importantly to answer, is a time to get real, to allow those feelings and emotions to come boiling up instead of being suppressed, which can eventually cause physical or mental health issues.

There was a recent study that showed the connection between Alzheimers and stress. This proves, yet again, the connection between the mind and the body. We also hear heart-wrenching stories of those taking their life due to depression, when no one around them knew they were suffering.  I see this mind-body connection every week, both personally and professionally. 

Professionally I ask the question “How are you?", usually hoping for more detail, to figure out if there is an emotional connection to the root of my patients concern. Time and time again there is! Because I understand the mind body connection I ask these questions first before doing any extra testing or giving supplements. I love taking the time to listen. Most people aren’t given that time or space and it can be very therapeutic. 

Personally, building a practice and understanding how to structure it to best suit my needs is hard. I have learned this since I started and still struggle to find the right balance. I can suffer health wise myself because of stress and worry. No job is perfect but being the perfectionist that I am I can’t seem to settle for anything else. I want to help you, I want you to heal, I want to give you that space and be open to truly listening to your answer when I ask how you are. In order to do that I need to find time to answer that question myself, to breath, to meditate, to talk. Practice what I preach. 

Are you feeling overwhelmed, anxious or depressed? Don’t hide it. Find people that can support you. That could be family and friends or it could be someone with an unbiased approach or simply a sounding board; a counsellor, a therapist or me, an ND. We are all happy to listen and to help. It’s time to talk.  

In health & happiness,

Dr. Karen

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