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Health and Wellbeing Podcast #12 with Guest Kellie Holland from Tonik Health

In the first of two sections on a Naturopathic approach to pregnancy, Kellie Holland from Tonik Health and I chat about some of the most common issues that pregnant women deal with including morning sickness, stretch marks, gestational diabetes, pre-eclampsia and fluid retention. We also discuss some things it’s important to start doing with as soon as possible during pregnancy, and go into detail about the nutrients we need most during pregnancy.

Podcast Breakdown: 

0:00 Intro and disclaimer
0:59 Meet Kellie, and I talk a bit about what we will cover in these pregnancy episodes
3:10 Morning sickness, nausea in pregnancy and hyperemesis gravidarum.
4:06 Ginger for nausea: doses and the different forms you can take it in
5:15 Vitamin B6 for morning sickness
5:48 Keeping your blood sugar levels stable can help reduce morning sickness
6:59 Other factors which can contribute to morning sickness, stress and digestive problems, and dealing with these issues before you conceive.
9:42 Stretch marks
10:39 The oil I’ve been using: Vanessa Megan Mummy’s Tummy Pregnancy Oil 
11:29 Nutrients needed to reduce/prevent stretch marks
13:00 Gotu kola and diet for stretch marks
13:33 Exercise during pregnancy
15:00 Things to get started with early during pregnancy : yoga, flossing, nutrition, probiotics
17:35 Probiotics in pregnancy in helping prevent eczema, management of Group B Strep, digestive health, candida
19:01 Folate (folic acid, folinic acid) – important before conception as well as during pregnancy
19:50 Other essential nutrients for pregnancy
21:31 Iodine
22:05 Vitamin B12
22:51 The different forms of folate (vitamin B9/folic acid/folinic acid)
23:50 Iron
26:49 Selenium
27:19 Calcium
28:52 Vitamin K2
29:29 Vitamin D
32:31 Magnesium
33:46 Pre-eclampsia
35:16 Stress
36:30 Gestational diabetes
41:08 Fluid retention

Click here to subscribe on youtube 

Connect with Kellie

Kellie is a naturopath, clinical nutritionist and medical herbalist based on the Central Coast of NSW where she lives with her husband and daughter. She runs a successful blog on her website at www.tonikhealth.com.au where she also has free healthy and delicious recipes available.

Website: http://www.tonikhealth.com.au/
Facebook: http://www.facebook.com/tonikhealth
Instagram: http://instagram.com/tonik_health#
Twitter: https://twitter.com/tonikhealth

See other videos and podcasts I’ve done with Kellie :

Kid’s Immunity

The post Naturopathic Approach to Pregnancy (Video) – Part 1 appeared first on Alison Mitchell Naturopath.

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Guest Post by Katarina Mitrovic

Being vegan or vegetarian is usually considered as a healthy lifestyle. And why shouldn’t it? Avoiding meat and dairy, food groups which are increasingly being associated with an increased cancer risk and hormonal imbalances while eating only plant foods of which we are constantly reminded that we should be eating a lot off, surely is the best thing we could do for our health. Or is it? Vegetarian diet is cleansing, alkalizing, and can be therapeutic, however it requires a lot more effort and planning than just simply avoiding meat. On a long term, it can be inadequate in several essential nutrients of which vitamin B12 is one. So let’s talk about deficiency of B12 vitamin in Vegetarian/Vegan diet and how to best avoid it.

What is vitamin B12?

Vitamin B12, also known as cobalamin is the largest and has the most complex chemical structure of all vitamins. Vitamin B12 is made by certain bacteria in gastrointestinal tract of animals and is then absorbed and concentrated in the body tissue. Hence, vitamin B12 is only found naturally in foods of animal origin. Unfortunately, plants can’t produce vitamin B12, although some microorganisms on plant material may do so to some extent, which we will cover further down.

Why is this vitamin so important?

Well, B12 is essential in several very important processes in our body: DNA synthesis, synthesis of myelin sheath (a fatty, neuron-enwrapping sheath that serves to speed up neural conduction), it is also essential for energy production in ‘mitochondria’ our furnaces within the cells, as well as making red blood cells in the bone marrow. As you can see, a big job for our largest vitamin.

How much do we need?

The Recommended Dietary Intake (RDI) for an adult is 2.4 µg/day and it is slightly higher during pregnancy 2.6 µg/day and lactation 2.8 µg/day. Now, that doesn’t sound like much but to obtain it from vegetarian sources isn’t that easy, even for lacto-ovo-vegetarians. For example, a whole egg = 0.9-1.4 µg/100g (one egg is 50-60g) so we are looking at 4-6 eggs – however the problem is that it is poorly absorbed (3.7% – 9.2%); Milk = 0.3-0.4 µg/100g (glass of milk is 250mls) so you looking at 3-4 glasses but again, a lot is lost during processing of the milk; cheeses are a bit better as a lot of B12 lost in milk processing is then recovered during chees making process (i.e. cottage cheese, hard cheese, and blue cheese are good sources). Plant sources unfortunately either don’t contain any B12 or if they do as a result of microorganism action, the amounts are variable in amount and form and hence rendered unreliable. There are few sources that can be considered useful to some extent. More on that later.
So, this is how much you need daily when your stores of B12 are full, however if deficient – it will take much more than the RDI to replenish the stores. Initial supplemental dose is usually 1000-2000 µg/day for week or two and then 1000 µg/day for life.

Obtaining vitamin B12 from vegetarian food sources. Is it possible?

Dietary sources of B12 as mentioned are mainly meats and dairy. In a typical Western diet approximately 5-15 µg of vitamin B12 is easily obtained daily. This is much more than recommended daily intake of 2-3 µg/day. However for Vegetarians and Vegans sources of B12 are scarce.

These are some of the sources, although none are very reliable and adequate. In most cases supplementation is usually recommended.
Fortified foods i.e. commercial cereals, soy milk and soy meat substitutes, however these are highly processed foods and the B12 contain is variable. I would not recommend them as a good source of B12. Another one is fortified nutritional yeast specially targeted for vegans, with 2 tablespoons typically containing recommended daily intake amount.
Fermented beans i.e. tempeh = 0.7-8.0 µg/100g although there is a concern about absorb-ability.
Shiitake mushrooms may contain between 1.3-12.7 µg of B12 per 100g of dry weight but consuming this amount of mushrooms daily is not possible and you still don’t know how much you are getting as B12 content varies a lot.
Some algae may contain considerable amounts of B12. And to the surprise of many it is not Spirulina or Chlorella, it is Nori which is used in making sushi. Green and purple nori contains approximately 63.6 µg/100g & 32.3 µg/100g dry weight respectively. (Watanabe et al 2014) Who would have known? One Nori sheet is approximately 2.1 g so it would take 2 green nori sheets or 4 purple nori sheets daily to achieve required daily requirement. This may be manageable on some days but perhaps used in a soup or stir-fry rather than 4-8 sushi rolls with tone of carbs in between. Other algae including spirulina are not a reliable sources. They have a form of B12 which is an analogue or pseudo vitamin, it is biologically inactive in humans.
For lacto-ovo-vegetarians, milk, cheese and eggs are a source although not very significant as mentioned earlier.
Also it is interesting to know that organic vegetables get some B12 producing bacteria through fertilization with manure, and hence choosing organics may contribute to your vitamin B12 intake ever so slightly.

For the rest of us who consume animal products clams and beef liver are the highest sources of B12, containing about 84 and 71 µg/100g of B12 in a serving of 85g. Other good sources are chicken liver, pork liver and salmon.

B12 absorption, getting it into our body and cells.

Getting enough B12 through food is one challenge, but being able to then absorb it is a whole new one. B12 is the hardest to absorb nutrient. It has very complex absorption process. It depends on salivary glands to produce R-Protein for temporary binding to B12, stomach acid and pepsin to help break down protein bonds, stomach parietal cell function to produce intrinsic factor for binding, functional pancreas to produce proteases and functional illium for proper absorption. So in addition to not being readily available in plant foods there are so many areas with absorption that can also go wrong. For example, use of antacids suppresses stomach acid production. The elderly can often have reduced parietal cell function and pancreatic cell function. Inflammation in small intestines can reduce absorption. These are very common scenarios and are especially concerning if a person is long term vegetarian or vegan. (http://www.aafp.org/afp/2003/0301/afp20030301p979-f2.gif)

How would I know if I am deficient?

Well, you may not know if you are deficient for several years. B12 can be stored in the liver for many years, and therefore deficiency symptoms may not be apparent for some time. When symptoms do occur, and they can occur rapidly, you have well and truly depleted your stores.

Deficiency symptoms may be mild or severe. Mild symptoms, such as lethargy or forgetfulness are so general that often are associated with other issues. Other symptoms of Vitamin B12 deficiency can range from skin pallor, lowered energy and exercise tolerance, shortness of breath and palpitations which are generally associated with anaemia. Most of these effects are indistinguishable from another vitamin deficiency – folate deficiency. Neurological symptoms are present in about 75-90% of people with frank deficiency and are more severe with vitamin B12 than in folate deficiency which helps to set them apart. They include sensation of tingling, tickling, pricking, or burning of hands and feet, movement and gait changes, mood changes and memory loss which can progress to dementia. There may also be visual disturbances, impotency and impaired bowel and bladder control. These are some serious effects not to be laughed off. So let’s pay attention to our body and if in doubt test.

How can I test it

The most common test is blood test, that is, total serum B12, however research has shown that it doesn’t accurately represent the levels of B12 within the body tissue. Testing for blood Homocysteine and Methylmalonic acid levels is a more sensitive method for testing as these parameters are increased early in Vitamin B12 deficiency, even before red blood cell changes occur. If we only use low blood vitamin B12 level to diagnose B12 deficiency, observational studies show that we would miss up to one half of people with actual B12 deficiency. (Oh & Brown 2003) Hence, Homocysteine & methylmalonic acid represent a more functional tests for B12 deficiency. If in doubt, ask your doctor for these tests.

Supplementation

B12 can be supplemented in few different forms. Doctors can prescribe B12 via intramuscular injections, however for those who cringe at the thought, there are also oral sprays and tablets. Luckily, oral vitamin B12 has been shown in several studies to be as effective as injections in treatment of B12 deficiency states. (Oh & Brown 2003).

There are several different forms of this vitamin but not all are biologically active. The best forms to look for in the supplement are “methylcobalamin” and “adenosylcobalamin” as these are most natural forms referred to as “activated B12”. They are in the form ready to be used by the cells, however these forms are not yet approved by TGA (Therapeutic Goods Administration) and hence cannot be found in supplements manufactured in NSW. The methylcobalamin form is becoming available in some other regions like in US.

The most commonly used form however is synthetically made Cyanocobalamin form. It is the form used in most supplements and B12 fortified foods as it is more stable and of course cheaper to make. This form has raised some concerns as it contains a molecule of cyanide, but the amount of cyanide in cyanocobalamin supplements is small and we are told physiologically insignificant. According to research, the amount of cyanide in 1,000 micrograms of cyanocobalamin is about .6% of the amount that is thought to be the lower level that causes harm. (http://veganhealth.org/b12/toxicity)

The bottom line

B12 is essential nutrient that is hard to obtain from vegetarian/vegan diet. Although there are several vegetarian sources, none are very reliable or available in adequate amounts. You could possibly try increasing intake of Nori, Shiitake mushrooms, tempeh or fortified nutritional yeast, however I would still suggest supplementing especially if you have already depleted your Vitamin B12 stores. Another reason why supplementation is better in this case, it is because of numerous issues with absorption of this vitamin.

Resources:

• Oh & Brown 2003,’Vitamin B12 Deficiency’, American Family Physician, Vol 67, No 5, page 979-986
• O’Leary & Samman 2010,’Vitamin B12 in Health and Disease’, Nutrients, 2010, 2 ,299-316
• Watanabe et al 2014,’Vitamin B12-Containing Plant Food Sources for Vegetarians’,Nutrients, 2014, 6, 1861-1873
• Pawlak et al, ‘How prevalent is vitamin B12 deficiency among vegetarians?’, Nutrition Reviews, Vol. 71(2):110-117
• Braun & Cohen 2010, Herbs & Natural Supplements An evidence-based guide, 3rd edn, Elsevier, Syd, Page 957-963
• http://veganhealth.org/b12/toxicity
• http://www.aafp.org/afp/2003/0301/afp20030301p979-f2.gif

Katarina Mitrovic, Nutritionist

Adv. Dip. Nut

Katarina is a Nutritionist with an interest in family and children health.

You can connect with her on her Facebook page

The post Vitamin B12 in Vegan/Vegetarian diets appeared first on Alison Mitchell Naturopath.

Perhaps you’ve heard about one of the latest health buzzes when it comes to mental health – a cheeky enzyme known as MTHFR (methylenetetrahydrofolate reductase).

If you have a mutation in this gene then it can cause your methylation processes to work too much, too little, or not enough at all.  Methylation is essentially a process that occurs where DNA gets tagged with a ‘methyl group’ which lets the rest of the body know not to read that particular bit of DNA.  It’s also involved in the production of neurotransmitters, detoxification of chemicals, nerve health and processing of certain hormones and nutrients, to name just a few.

When the MTHFR genes work properly, you have adequate enzyme activity and that means you can more efficiently make proteins, use antioxidants, metabolize hormones, enjoy more stable brain chemistry, better eliminate toxins and heavy metals, and manage inflammation.  So if you’ve got a problem with this gene, it really can be a bugger.

How does it affect your mood?

Many people with the MTHFR gene experience mood imbalances.  This gene affects your mood in a few ways.

Reduced MTHFR enzyme means that you cannot make and recycle a very important antioxidant, glutathione effectively.  Glutathione is responsible for a vast array of activities in the body and low levels have been associated with conditions such as depression, inflammation, bipolar, chronic fatigue syndrome and autism.

If your body cannot methylate the chemical homocysteine (you can find out if this is too high via a blood test) that results in decreased production of SAMe.  This leads to decreased production of dopamine, serotonin and norepinephrine, neurotransmitters all responsible for mood balance.

If there is a reduced ability to detoxify chemicals and heavy metals (which is a factor for those with the MTHFR gene) this can also affect your mood.  Digestive and liver health can have an indirect affect on your mental health, for several reasons such as the health of your gut flora, increased inflammation and an impact on your neurotransmitters.  Digestive health problems have been linked to mental health problems in several studies.  Click here to read more.

A lot of people with MTHFR gene also have a condition called Pyroluria (also known as Pyrolle disorder, Mauve factor, Kryptopyrrole, Kryptopyrroluria.  People with this condition produce excess amounts of a substance called Pyrolles which bind to certain nutrients such as Vitamin B6, Biotin Zinc and GLA (an essential fatty acid).  There are several conditions associated with this disorder but namely it is involved in several mental health conditions such as Bipolar, Schizophrenia, Manic depression and ADD/ADHD.  This condition is also strongly linked to the state of the digestive system.

MTHFR and Folate

One of the main issues we have come to understand with MTHFR is that people with this gene cannot process folic acid into folate effectively and so cannot handle synthetic forms of the nutrient.  This can become a bit of an issue because synthetic folic acid is in pretty much every multi-vitamin, and a lot of foods are fortified with it.  If you are consuming synthetic folic acid and you can’t process it, it clogs up a lot of the pathways that require folate and as a result a lot of health complications arise.  You can also be prone to problems relating to deficiencies of folate, such as miscarriage and neural tube defects.

Photo by Braňo on Unsplash

People with MTHFR require a special activated form of this nutrient, the type found naturally in some foods.   How much depends on the level of the gene mutations present (there’s a lot of variety that you can have) and your diet and lifestyle can have a big impact on it as well – it’s completely possible to have this gene and be symptom free and healthy if your diet and lifestyle is fine, and the gene hasn’t been ‘switched on’ (usually by stressful events).  In Australia the closest to natural folate that we have available is folinic acid (calcium folinate) supplements, however this may still be difficult to metabolise for those who have very poor methylation.

Getting tested

If you suspect that you have this gene, then you can easily get yourself tested via labs such as Healthscope, Nutripath or 23 and Me.  You may like to get this organized with a health practitioner who is knowledgeable in the realm of MTHFR, so they can guide you with treatment if needed.

Learn more: MTHFR_Related_Health_Problems

The post MTHFR and your Mood appeared first on Alison Mitchell Naturopath.

All the work that you have been doing in pre-conception care, eating well and taking your supplements doesn’t stop now, but it does change slightly.

Nutrition and Supplements

Your body has a high demand for nutrients during pregnancy.  You are the only source of nutrition for your growing baby. The baby is growing inside your womb and it forms its whole body from yours.  The baby will take what it needs and whatever is left the mother then uses (getting you ready for the selflessness of motherhood).

Some factors such as stress, inadequate diet, the effects of morning sickness, undiagnosed allergies, heartburn, constipation, long term deficiencies, stress or other pre-existing conditions may mean your intake of essential nutrients is inadequate to cope with the needs of both you and your growing baby.

If you are low in nutrients your baby will take what it needs from you, often leaving you in a deficient state.  Many conditions that occur during pregnancy (e.g. pregnancy brain, leg cramps, constipation) are caused or worsened by nutritional deficiencies, so it makes sense that ensuring you have ample supplies of nutrients not only means your baby is getting everything they need, but so are you.

When breastfeeding nutritional demands are as great, and sometimes even higher than during pregnancy.  It can take 2 years to nutritionally recover from a pregnancy!  If you are planning to concieve again during this time, then it isessentialto ensure you are stocked up well.

Did you know that during your pregnancy, you will create several extra kilograms of your own uterine muscle, as well as the nerves, bones, organs, muscles, glands and skin of your baby? In addition, you will make several kilograms of amniotic fluid, a placenta and produce a significant increase in your own blood volume. In addition, your own kidneys and liver have to work overtime, as they have to process the wastes of you and your baby!

A balanced diet should include a good variety of foods and provide all nutrients the body needs. The emphasis should be on eating a higher quality diet rather than simply eating more.   We can provide you with nutritional education and advice specific to you and provide meal suggestions or plans to support you and your baby.

All pregnant women require nutritional supplementation to some extent, due to the lack of essential nutrients in our soil and food supply.

The most well known nutrient that we require during pregnancy is folate, however it’s not that simple.  A lot of pregnancy multi-vitamins you can find in supermarkets and chemists contain plenty of folate, but lack or are extremely low other nutrients essential in pregnancy.  We can assess your individual requirements and recommend the right supplements for you.   It is important not to self medicate, especially during pregnancy.

Click here to read about some of the key nutrients required in pregnancy

Not only does nutritional supplementation help to prevent and manage deficiencies, it is also helpful in managing conditions.  Some nutritional supplements such as probiotics have been shown to be beneficial in preventing allergies in eczema in the newborn.

Some general tips during pregnancy:

• Avoid junk food and refined sugar and food completely.
• Avoid raw eggs, meat, chicken and seafood
• Avoid foods which you are allergic or intolerant to.
• Avoid foods high in mercury or other heavy metals such as swordfish, shark, tuna.
• Eat LOTS of fresh fruit and vegetables.
• Eat legumes and beans for fibre and protein.
• Eat foods rich in calcium and iron.
• Eat lots of foods containing soluble fibre, rather than insoluble fibre (such as wheat bran) as this can worsen constipation.
• Aim to have at least 2 serves of protein each day.
• Make sure you are hydrated, drink plenty of clean filtered water and avoid using water bottles which contain BPA.
• It is best to avoid caffiene during pregnancy.  Some women can be particularly sensitive to this, so should avoid tea, coffee, dark chocolate and soft drinks.  Caffiene can decrease blood flow to the baby and regular intake has been associated with low-birth weight.
• Avoid alcohol, cigarettes, recreational drugs and any unnecessary medications.

Common Conditions during Pregnancy

There is much that naturopaths can offer to women during pregnancy.  Conditions such as leg cramps, morning sickness, pre-eclampsia, reflux, colds, sinusitis, constipation and more can be managed with natural medicines.

Click here to read more about the common conditions of pregnancy and what we can do.

Pregnancy Program

Continued naturopathic care throughout pregnancy will help to ensure a healthy pregnancy and a healthy, happy outcome.  The pregnancy program is designed to support you and your baby during this time of rapid growth and change.  The emphasis will be on your nutritional status and your changing nutritional requirements through each trimester, while addressing any queries, complaints or issues that may arise.  Towards the end of the pregnancy we can begin to introduce remedies which prepare for your for labour, as well as providing you with your tool kit for after the birth.  Regular massage throughout the pregnancy is also recommended.

A typical pregnancy program includes:

During the 1^st Trimester we will address

• Giving suggestions for good dietary and lifestyle habits and continuing clean, toxin free environment
• Advice on a nutritious and individualised food plan for your pregnancy to support you and your baby
• Optimising your nutritional status,  promoting and nurturing a lush and healthy environment in which your baby can grow
• Reducing any uncomfortable symptoms of early pregnancy that may arise such as morning sickness
• Treating any threat to the pregnancy such a bleeds or threatened miscarriage
• Acupuncture is fantastic during this time for helping to manage morning sickness

2^nd Trimester

• Continue to monitor your nutritional status with particular emphasis on iron and blood nutrients as well as zinc status
• Treat any pregnancy problems that may be arising
• Review your activity and exercise

3^rd Trimester

• Prevent or treat any problems typically related to the later stages of pregnancy, such as gestational diabetes, pre-eclampsia, constipation, and oedema (fluid retention).
• Begin birth preparation.  Specific nutritional and herbal treatments are introduced to support labour, delivery and lactation.  Herbal medicine has a long history of use in the last trimester of pregnancy.  Specific nutrient supplementation and individualized herbal homoeopathic formulations will promote a more comfortable birth, post natal and breastfeeding experience as well as reducing likelihood of complications and improving recovery.

Post-partum

• Herbs to improve healing, reduce inflammation
• Support breast-feeding if there is any issues with flow, failure to thrive, mastitis or cracked nipples
• Giving suggestions for a healthy, nutrient dense diet for breastfeeding as well as advice on introduction to solids and management of common conditions for infants such as colic

The post Naturopathic support in pregnancy appeared first on Alison Mitchell Naturopath.