Mental Health

Vitamin D: Are You Deficient?

 Clinic lab test available to you!

Clinic lab test available to you!

This vitamin, or hormone to be exact, is known as the sunshine vitamin. But are you actually getting enough sun exposure to to produce optimal levels of vitamin D?

Vitamin D plays many vital roles in our body. Virtually every cell in the body has a vitamin D receptor, which, when bound to vitamin D, can influence the expression of more than 200 genes. It maintains normal blood levels of calcium and phosphorus, to support proper bone development, it modulates cell growth, support the immune system, reduces inflammation and much more!

Vitamin D Levels:

The optimal level of 25-OH D is 75-100 umol/L (recent research has shown a possible optimal range at 120-150 umol/L), however the current Canadian average of D3 levels is 67.7 nmol/L. This means more than 70% of Canadians are deficient. I have seen patients which much lower numbers than this. Even down to 23 nmol/L! (Higher is not always better though for this fat soluble vitamin. However, most cases of toxicity symptoms are at 25000-60000 IU/day for 1-4 months. This is much higher than the ND recommended dose.)

Where do we get vitamin D?

We synthesize most of our vitamin D from sunlight exposure. It is estimated that 20 minutes, with face and arms exposed, provides 200 IU for people with light coloured skin. A moderate sunburn can produce 10000IU per day. However, sunscreen and sunblocks over SPF 8 prevents formation of D3, and most of us are indoors often throughout the summer and get minimal exposure to sunlight on these darker days of fall and winter. We source some vitamin D from food, with seafood being the most significant source, sardines to be exact! Mushrooms and egg yolk also have small amounts.

This is why it is recommended that most Canadians supplement with vitamin D.

What does Vitamin D effect?

To display the vast effects vitamin D has on the body here is a list of conditions that have been linked to vitamin D levels:

  • Fractures and Osteoporosis - Vitamin D along with K2 if needed to increase calcium absorption - D3 supplementation is associated with a 22% decrease in risk of falls

  • Depression - D3 deficiency has been linked to increased incidence of depression 

  • Autoimmune conditions - D3 deficiencies have shown an increase risk of autoimmune diseases such as MS, psoriasis and rheumatoid arthritis 

  • Thyroid health - There is an association between low vitamin D status and autoimmune thyroid diseases such as Hashimoto’s thyroiditis and Graves’ disease

  • Poor immune system - Vitamin D helps the immune system adapt and ward off infection, beneficial in cold and flu season

  • Metabolic disorders - D3 helps restore beneficial gut bacteria which in these studies has shown to have a key role in diabetes and heart disease 

How much Vitamin D to supplement?

So with all that information you may be wondering how much to actually supplement. This really depends on your individual levels of 25-OH D. As stated early, I’ve seen a patient with levels in the 20s (nmol/L), so they would need a much higher dose of D3 to reach optimal levels, compared to someone that is slightly deficient, let’s say in the 60-70nmol/L range. If you suffer from any of the above health conditions, I advise to get your vitamin D levels tested. The quicker you raise D3 levels if you are deficient, the sooner symptoms will improve. The common recommended dose of 1000-2000IU may not be enough for you! That said, if we were to give higher levels of D3, a dose of 5000-8000IU, it is important to know D3 levels and assess the necessity of vitamin K2 and vitamin A supplementation - all these soluble vitamins play a role with each other to prevent toxicity. Sufficient levels of potassium and magnesium have also been suggested to protect against vitamin D toxicity.

So ask your doctor to test your vitamin D levels, 25-OH D levels to be exact. There is a simple blood test I do in practice to assess your levels. Book in for a blood test visit to get yours tested today!

In health & happiness,

Dr. Karen

September is RESET Time!

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Every year around this time is it a common theme that we need to reset after a summer of less routine. September 1st, or when the kids go back to school, is usually a set point to do so for many. So if you have fallen off any of your health goals this summer, remember there are many just like you and it IS possible to get back on track! 

With that said, I want to remind you of simple things you can do to optimize your routine, and ultimately your energy, sleep, weight and mood. 

1. Set a wake time and bed time:

There is much research on the benefits of getting up at the same time every morning and going to sleep at the same time every night. Our body LOVES routine so it thrives when this happens. You may notice that after waking at the same time for a couple weeks with an alarm, your body will then naturally wake on its own at that time. Try using the bedtime app on your iPhone, but then put it on the dresser across your bed (not beside your head!) so you have to actually get up to turn it off. Wear earplugs, or a face mask, if need be while you adjust to this schedule.

2. Lemon Water in the Morning:

There are two reasons I love this for my patients. One, the warm water and lemon are wonderful for gut health. It acts as a gentle detoxifier in the morning and stimulates digestive juices. This can initiate a bowel movement or simply prime the digestive system for food. Second, it forces you to sit and relax in the morning (yes, please set out time to do this and not while running to get the kids packed up, or during a workout). Taking a few minutes in the morning for calm sets the tone for the day. We want to carry that feeling throughout the day. Meditation could be this time of calm for you as well if that suits you. 

3. Exercise in the Am:

The best time in chinese medicine to exercise is between 9-11 in the morning. It is the time of the Spleen, which in chinese medicine controls the muscles. I understand this is unreasonable for most but the point to take here is the earlier the better for exercise, especially if you have trouble sleeping. We want to wind down and calm the nervous system in the evening so a gentle yoga class is fine but a vigorous one may not be helpful. I love getting up and working up a sweat in the morning and then be ready to take on the rest of the day without worrying about exercise. 

4. Greens, Greens, Greens:

I always like to challenge my patients to try and get at least one serving of greens in a day (getting two?...even better!). Add spinach to a smoothie, make a breakfast hash with kale, eat a big salad at lunch or roast broccoli for dinner. Just something green, once a day 🙂 

5. Roll Back on Sweets:

Ice cream galore, cold ciders or coolers a plenty…summer staples for some. Let’s roll back on the sweets this September to balance blood sugar and energy as the darker days approach. If you know me, I have a sweet tooth, but I try to limit myself to a healthier treat such as a couple pieces of dark chocolate, a energy ball with dates or a few chocolate chips in the evening or during that 3pm slump. Out of sight, out of mind right! 

6. Blood Work to check:

If you have been feeling sluggish or anxious even during these summer months, I suggest getting some blood work done to assess a couple things. Vitamin D is key to have in a healthy range as we move into fall, as well as thyroid levels (TSH). Both affect your mood and energy and your thyroid controls your metabolism. Hypothyroidism is often missed and TSH is often something I find can be out of an ideal range yet not actual out of range for your MD to catch it yet. 

There you have it, a few basic things to check in with for yourself as we RESET this month! Any questions, I am always here to help. 

In health & happiness, 

Dr. Karen 

Adaptogens for Healing Burnout

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Do you feel like you are running on empty but you can’t find the time to refuel and replenish? A feeling of overwhelm can eventually turn into burnout and it is an unfortunate epidemic in our society these days. We tend to have too much going on than our bodies can handle and we don’t take the time to recharge our batteries. Women are more likely to feel the impact of overwhelm and burnout on their mental and physical well-being but that doesn’t mean we don’t see it in men. You may be a nurse who does shift work, a police officer needing to pump out adrenaline on the job, a new mom getting little sleep, or a menopausal women taking care of both teenagers and elderly parents. It all leads to the same thing if we can’t take care of ourselves! 

Some mild symptoms you may commonly experience are fatigue, poor sleep, sugar cravings and irritability. It can eventually lead to symptoms you may not acknowledge as burnout such as anxiety or depression, insomnia, poor memory, low libido, muscle soreness, inability to lose that dreaded belly fat, and a poor immune system. What we really need to watch out for is when the body can’t support itself anymore and autoimmune conditions such as Hashimotos thyroiditis or rheumatoid arthritis occur or potentially blood sugar issues or chronic hives. Eekk!

What is burnout?

I have explained this in a few different blog posts, but basically burnout is when you have pushed your stress response system pasts its limit of resilience. Your body is putting on the brakes to protect itself as best it can, forcing you to take it easy. Its the little white flag saying “I surrender.” These are the clues for you to take a step back or support your way through it. This is where adaptogens come in! Thank goodness all is not lost! 

What are adaptogens?

Adaptogens are herbs and fungi that have been around for many years. They help us adapt and heal from stress, hence the name, and they definitely come in handy in my practice! There are a few categories of adaptogens - calming, nourishing and stimulating - therefore best to know where you're at in the “burnout phase” to get the most out of them. If you use something too stimulating when you need more nourishing you may be adding fuel to the fire and cause more anxiety. 

Stimulating: These are helpful when you aren’t quite burnt-out but need support to get through an intense time, eg. studying at medical school, meeting a work deadline or working a night shift. Examples - panax ginseng, matcha, rhodiola.

Nourishing: When you need to fill the bucket up again and refuel these come in handy. They acts as building blocks lets say to boost cortisol. Most of the adaptogens fall into this category. Examples - ashwagandha, rhodiola, holy basil, licorice (not advised for high blood pressure), medicinal mushrooms. 

Calming: When someone is feeling anxious and their body needs to hit the reset button, these calming adaptogens are very helpful. They slow down the output of cortisol. Examples - schizandra (calms the mind), avena sativa, holy basil, motherwort. 

A reminder that adaptogens should not replace nourishing lifestyle habits that support a calm and relaxed state, such as meditation, sleep, nourishing food, time in nature and time with loved ones. Adaptogens are also not suitable during pregnancy. 

If you are feeling burnt-out and need a reset come chat! I’d love to help pick the right adaptogen for you. 

In health & happiness,

Dr. Karen 

The Winter Blues: 5 Ways to Beat Seasonal Affective Disorder and Depression

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It always surprises me after the time change in November how dark it can get in the evenings. Every year around this time I have to check in with myself and how I am feeling and every year I realize, after a gentle reminder from those around me, that the darker days do affect my mood. Living in Vancouver for 4 years, where it is raining most of the winter, I would forgot how much happier people were with the sun out, until the skies opened and you get a glimpse again of sunny summer days. The same goes for most of Canada however. When a patient comes to me concerned about their mood, I always ask whether they notice a more depressed mood in the winter...most say yes! 

An important point is that there could be a easy explanation as to why you are feeling depressed and ruling these out first is key. There are a few common reasons I see in my practice, for why people feel depressed. They are vitamin D deficiency, adrenal fatigue, hormone imbalances, hypothyroidism and food allergies/sensitivities. Simple blood work, a health history and/or elimination diet can help decipher if your mood is affected by one of these issues.  However these simple tips can make a drastic change in your mood.

1. Light Exposure:

As the day shorten our circadian rhythm adapts and melatonin production increases. This in turn decreases serotonin production. Unfortunately this combination doesn’t improve sleep. Getting some light exposure in the morning, helps to keep our circadian rhythms in check. Suggestions for this are going for a 20 minute walk in the morning when it is brighter out, in nature is an added bonus, or investing in a sunlamp. I recently learned that the Public Libraries around HRM have these on loan!

2. Vitamin D3:

One of the first vitamins I think about when it comes to mood is vitamin D. It plays an important role in many things, including bone, skin and immune health, but it also contributes to improving mood. There are several studies that show an association with low vitamin D status and mood disorders, including seasonal affective disorder. 30 minutes of full-exposure to sunlight, without sunscreen, can provide between 10,000 to 20,000IU of vitamin D. In the winter, or if we work in an office all year, it is difficult to get enough D3, therefore we need to supplement. I suggest 2000-5000IU/day for mood disorders, however it is recommended to have your vitamin D levels checked to avoid toxicity. 

3. Increase Endorphins:

On these cold darker days we tend to sink into the couch. Exercise, even moderate amounts, have been proven to increase endorphins and serotonin production, ultimately improving your mood. Start by walking 20 minutes in the morning or at lunch if you are just getting back into it, or increase the intensity with HIIT workouts. Massage also has been studied to increase endorphins, or any physical touch for that matter! Our testosterone levels have been shown to increase in the winter so take advantage of the increased sex drive. 

4. B Vitamins:

These vitamins are also important to regulate mood. B vitamins are necessary for every energy reaction in your body, including the production of hormones and neurotransmitters mentioned above. Women on oral contraception become deficient in B6 (and magnesium), therefore it is even more important to supplement in these women. I recommend a multi-B vitamin, with higher amounts of certain Bs depending on the person. 

5. Decrease Sugar Intake:

When our blood sugar spikes then crashes it stimulates a stress response in our body. An increased cortisol level in turns affects other hormones and neurotransmitters and ultimately affects mood. If you are having energy crashes or bouts of fatigue or depression take inventory at how much sugar you are eating in a day. The recommendation is no more than 6g/day! Good quality protein, fat and fibre in the morning will set your day off right so you won’t be craving that 2pm sugary snack. 

 

As you can see there are many tools to consider to help with SAD and depression. There are other nutrients and botanicals that I would consider in my practice, depending on the person and if they are on medication or not. For a more individualized approach consider booking an appointment with me or your local ND.

In health & happiness,

Dr. Karen

p.s Check out these posts if interested - PMS: Recognizing the SignsAnxiety: Tried & Tested Tools, Adrenal Fatigue