I am guessing that you never expected to still have acne in your late 20’s and 30’s? Many of my patients sailed through their teens and early 20’s with perfect skin only to be saddled with what we call “late onset adult acne”. I have a confession to make, I am one of those people. I always had great skin, which is really helpful when you have a skincare line! Then suddenly when I started my practice, my face broke out and didn’t stop for close to 3 years. Why was this happening?!  There I was a “skincare expert” with a face full of acne. I needed this to get fixed, and fast.

My research into adult acne over the last 5 years has lead me to a few conclusions about adult onset acne. The most important of which are that it is either

• Hormone Related
• Food Related

Allow me to expand, hormones play a critical role in skin health and there are a lot of things working against women from a hormonal perspective in their late 20’s and early 30’s. This is often one of the most stressful times in their lives. They are either working their tails off to establish themselves in their career, having and raising small children, or doing both at the same time. There are often financial struggles that come from paying off student debt while trying to get your first mortgage. The bottom line is this additional stress wreaks havoc on hormones. The stress hormone cortisol rises when we are under stress, it is linked to the fight or flight response. Increased cortisol leads to increased insulin. If you are under chronic stress, then your cortisol is constantly elevated. This means your insulin frequently elevated, which in turn, elevates your testosterone. Testosterone increase acne by increasing oil production on the skin, the acne’s food source.

Acne that is related to increased testosterone tends to develop on the chin and jawline area. Think of the area of a man’s face that is covered by a beard, that is where your testosterone linked acne will be. If it is not bad enough that all this stress is increasing cortisol and increasing testosterone, in your late 20’s and early 30’s your progesterone levels start to naturally decline. When your progesterone levels decline, your estrogen levels “look higher” this also makes your insulin levels spike. Having your hormones starting to work against you makes it all the more important to avoid foods that aggravate acne prone skin.

I also see a number of women who are diagnosed with Polycystic Ovarian Syndrome in their late 20’s and early 30’s. Symptoms of PCOS include: acne, weight gain and hair growth. These are all symptoms of elevated insulin and testosterone. Your acne could be the first sign that you are headed down the path to PCOS. For more about PCOS and how to help reverse it, click here.

So how does food play into all of this? Well as I mentioned last week, foods that increase your blood sugar, increase insulin and increase testosterone. But that is not the whole story. When your body has been under stress for many years, this stress causes damage to your digestive system. There is a layer of cells that line your intestines that are supposed to keep proteins within the digestive track. Stress aggravates this layer, leading to it having gaps in it, known as “Leaky Gut”. When your gut is leaky, proteins that are supposed to stay in the digestive track make their way into the bloodstream. These proteins are very inflammatory and can lead to acne.

So What Should You Do

• Stress Reduction: this does not have to mean yoga and meditation. The best stress reduction is whatever works the best for you. That could be hiring a house cleaner, delegating certain tasks, a night out once a week or exercise. What’s most important is that you implement some strategy to lower your stress
• Eat the Right Foods: Food is fuel. Don’t give your body garbage
• Lift Weights: Weight bearing exercise is one of the only ways, besides eating better, to lower your blood sugar. This in turn lowers your insulin and testosterone levels.
• See a Naturopathic Doctor: I have helped many patients find the ideal eating patterns and exercise for themselves, as well as, prescribing targeted supplements for stress and hormonal balance. I also usually do acupuncture on these patients as it works quite well with helping to regulate hormones.

I hope you found this post helpful. Please share it with your friends and family who may be dealing with adult acne. It can be fixed!

Dr Alexis

Dr Alexis practices in Kanata, and is currently accepting new patients

Naturopathic Medicine is covered by most extended insurance benefits

For years we have been told that food has no impact on acne. Remember hearing when you were a teenager that eating chocolate and drinking pop would not make your skin break out? Well I am here to challenge those thoughts today. It’s not that simple. I am sure most of you know many people who eat or ate all kinds of “junk food” and had perfect skin! But like everything to do with the body, the way your body responds is unique.

Our skin is like a window that allows us to have a sneak peak at what is going on inside the body. Did you know that many cases of eczema are caused by eating a food that the body is reacting too? The same goes for acne. Acne is often the first sign that something is off balance within the body.

What causes Acne?

This is not a simple question to answer, as many things cause acne. In my practice the “Big 4” are:

• Hormonal Imbalance
• Food Sensitivities
• Inflammation
• Stress

With respect to hormonal imbalance, the hormone that is most often the cause of acne is testosterone. When we have too much testosterone, relative to estrogen and progesterone, it signals for the skin to make more sebum, which is the food source for the bacteria Propionibacterium acne, resulting in increased breakouts. There is so much to cover with hormonal imbalances and acne, especially acne that starts for the first time in your 30’s, that I will do another blog post on this next week.

So how does food play a role? We talked about how much of a role testosterone plays in acne. One of the ways testosterone gets increased is by eating foods that are high in sugar! When you eat foods that are quickly converted to sugar, it makes your body have to spike its insulin levels in an attempt to bring your blood sugar back down, as the body is always fighting to stay in a state of homeostasis or balance. When insulin increases, testosterone follows suit, which leads to acne.

The Worst Foods For Acne Prone Skin

• Sugar: causes an insulin spike, which increases testosterone. All sugar is not created equally. The worst offenders are simple sugars (candy, high fructose corn syrup, fruit juice/pop). These spike the blood sugar very fast, as they do not contain any protein, fat or fibre to slow the release of sugar. This is why eating the whole fruit is still ok for people with acne. The fibre provided in the fruit helps to slow the blood sugar spike. If you find yourself in a situation where you know you are going to be consuming a lot of sugar, make sure you at least eat protein and fat with it in an attempt to slow the insulin spike
• Simple Carbohydrates: things like white bread, pasta, rice, spike the blood sugar in pretty much the same way as eating sugar does. These foods should be removed from your daily diet.
• Dairy: this is a tricky one. Most dairy contains a decent amount of protein (cottage cheese, cheese, milk), but the proteins from dairy act like a carbohydrate in the body. What this means is they act like sugar! They spike insulin levels, which in turn increases testosterone. Dairy is an inflammatory food for most people, and contains natural growth hormones. The first thing I do with acne patients in my practice is take them fully off of dairy for 3-4 weeks. This resolves their acne in 70-80% of cases.
• Foods You are Sensitive To: If you have a sensitivity to a food, it is going to mount and inflammatory response in the body. This inflammatory response will increase insulin, and you guessed it, increase testosterone.

 The Best Foods For Acne Prone Skin

• Nuts/Seeds- provide healthy fats that help with the skin’s ecosystem to not allow the overgrowth of Propionibacterium acne. Their protein content helps to reduce insulin and testosterone spikes
• Avocados- also provide healthy fats and protein.
• Vegetables- eating a wide variety of different vegetable of varying colours (red, purple, green) helps to provide the skin with the antioxidants it needs
• Berries- a low sugar fruit that provides antioxidants, and do not spike insulin levels
• Water- dehydrated skin is more prone to acne

The biggest messages I want you to take away from today are

• Ditch the Dairy: if your skin is breaking out, this is the first thing to try
• If you must eat sugar, make sure to also eat protein and fat with it.

I hope this blog post helped with your understanding of the connection between food and acne. If you have any additional questions, feel free to email me or comment below

Dr Alexis

Dr Alexis practices in Kanata, and is currently accepting new patients. To schedule your appointment, click here.

Naturopathic Medicine is covered by most extended healthcare benefits.

PS: Our Oily Skin Moisturizer is designed specifically for acne prone skin!

I grew up in a family of dairy farmers, and was always a milk drinker. It’s hard to come of age during the “Got Milk” era and not think that dairy is the best thing since sliced bread. Back in 1994, if it was good enough for Doug Gilmour and his cow legs, it was good enough for me. I didn’t just have a little dairy. I was a 3-4 glasses of milk a day plus yogurt and cottage cheese kind of teenager. It wasn’t until I was in Naturopathic School that I started to question dairy. I had long standing sinus congestion and post nasal drip and when I stopped drinking 3-4 glasses of milk a day these symptoms magically disappeared.

Fast forward to today in my practice and the subject of “Is Dairy the Devil” is something that comes up on a daily basis. One of the first things I like to talk about with patients is the different components of dairy that people can be sensitive to. There is lactose intolerance and then there is sensitivity to the proteins in dairy; whey and casein.

Lactose Intolerance vs Dairy Sensitivity

• Lactose Intolerance- happens when people are deficient in the enzyme lactase making them unable to properly break down lactose, the sugar in milk.
• Whey and/or Casein Sensitivity- Casein is the main protein found in dairy products. When someone has a sensitivity, the proteins can get through the permeable and inflamed gut wall and the body attacks the protein, as it is not supposed to be there

One of the most common misconceptions I find with my patients is they think that by switching to lactose-free dairy they can negate any of the sensitivity issues with dairy. This is not the case, as both whey and casein are still present in lactose-free products.

Dairy and Calcium

In North America we have been told for years that we need to consume dairy to make sure we have adequate calcium intake and to reduce the risk of osteoporosis, especially for women. While dairy does contain a good amount of calcium, the correlation to reduction in fractures and osteoporosis has not been seen. In the Nurse’s Health Study the opposite effect was observed. Those who consumed the most dairy had 50% more fractures. From an epidemiological standpoint, countries with the lowest rates of dairy intake, like those in Africa and Asia, also have the lowest rates of osteoporosis. You may have also noticed recently or been told by your doctor, naturopathic doctor or pharmacist to reduce the amount of supplemental calcium you take on a daily basis. This is due to a study released in 2013 by the National Institutes of Health showing that taking more than 1500 mg of calcium/day was associated with an increased risk of cardiovascular disease. The current guideline is supplementing with no more than 1000 mg/day.

Bone Health

Dairy and calcium are not the be all and end all for bone health either. Newer research has shown that Vitamin D (which many people are deficient in in Canada), Vitamin K2, and magnesium all work together with calcium to support bone health.

Dairy, Calcium and Cancer

The research on whether having a high intake of dairy increases your risk of cancer has been mixed. Dairy contains relatively high levels of Insulin Like Growth Factor 1, (IGF-1), which is a known cancer promoter because it is a stimulus for high cell growth rate. Recent studies have shown that dairy may be linked to hormonal cancers such as prostate, testicular, breast and ovarian.

Calcium Alternatives

Once my patients have been determined to be sensitive to dairy, the next question is always about other ways to get their calcium. Foods that are good sources of calcium are:

                -Dark Leafy Green Vegetables

                -Sesame Seed and Tahini

                -Salmon with the Bones

                -Sea Vegetables

Aside from all we have already talked about regarding dairy, it is a food that many people are sensitive to. For those who are lactose intolerant, they usually experience digestive symptoms like bloating, cramps, gas and diarrhea. The symptoms however of a sensitivity to whey or casein (the proteins in dairy) are much more varied.

Signs You Could Have a Dairy Sensitivity

• Gas/Bloating- Can happen with both dairy sensitivity and lactose intolerance
• Post Nasal Drip- Dairy is a mucous forming food
• Sinus Congestion/Infections- From the increased mucous production
• Acne- Dairy contains IGF-1 which increases insulin and inflammation. People will often get acne around their mouth and on their chin with a dairy sensitivity
• PCOS- IGF-1 increases insulin which causes the ovaries to make androgens like testosterone
• Eczema- Dairy is inflammatory, and can cause eczema flares
• Insomnia- This is especially common in children

Everyone responds a little differently to dairy. To find out how your body is responding, remove all forms of dairy for one month and see how you feel.

Do you consume dairy? Share in the comments below

Talk Soon,

Dr Alexis

Dr Alexis practices in Kanata and is accepting new patients. To schedule your appointment, click here.

Naturopathic medicine is covered by most extended health care benefits. 

Many people think that losing weight is a simple matter of taking in less energy (calories) than you expend. While calories consumed and used are a key to weight loss they are not the only factors. Hormonal balance is key to help achieve lasting weight loss. One of the key hormones involved in weight loss are regulated by the thyroid gland.

It’s Not You, It’s Your Thyroid

Thyroid disorders are the second most common endocrine (hormonal) disorder after diabetes. It is estimated that 10% of the North American population is suffering from a thyroid condition. The news only gets worse for post menopausal women, when rates go up to 20%. This increase is post menopausal women is likely due to the influence of estrogen and progesterone on thyroid hormone. Post partum is also a trying time for the thyroid, and many women will experience symptoms of hypothyroidism.

Thyroid Problems Commonly Present in the Postpartum Period

The thyroid is a butterfly shaped gland that is at the base of throat, approximately just below the Adam’s apple on a man. It’s main function is to be the master controller of the metabolism.  The thyroid works in a feedback loop process. The thyroid gland gets a signal from the brain (Thyroid Stimulating Hormone- TSH) to release it hormones, primarily thyroxine (T4) and also some Triiodothyronine (T3). The T4 that was released than travels in the blood and gets back to the brain to tell it that the thyroid is responding and it can stop releasing TSH. If for some reason the thyroid gets the “message” from the Thyroid Stimulating Hormone but doesn’t release T4 and T3, then the brain keep pumping out more TSH to try and make the thyroid listen up and respond. This is what is happening when someone has Hypothyroidism. It can be confusing because even though it is HYPOthyroidism, the TSH is high. It is considered to be hypothyroidism because the levels of the thyroid hormones T3 and T4 are lower than they should be. This is the most common kind of thyroid disorder.

Lab Tests:

TSH: first line testing, done to try and determine is the thyroid is responding properly to its stimulus.

T3 and T4: the “active” forms of thyroid hormone, T3 is much more active than T4

Reverse T3:  Sometimes, especially when the body is under stress instead of converting T4 to the more active T3, it will convert it to reverse T3, an inactive form of T3.

Thyroid Peroxidase Antibodies (TPO): These are antibodies present within the body that work against the enzyme that helps convert T4 to T3. These are commonly seen when someone has an auto immune destruction of the thyroid gland (called Hashimoto’s disease) or post partum.

Symptoms of Hypothyroidism

There are many symptoms, but the most common are:

-weight gain

-fatigue

-constipation

-dry skin/hair, thinning hair

-depression and decreased concentration/memory

-irregular periods

-cold hands and feet

-elevated cholesterol

Treatment Options

1) Synthroid/Levothyroxine: Supply the body with the inactive hormone T4. This is a good solution if your problem is that your body is not responding to its TSH stimulus and releasing T4. If however, your problem is with the conversion of T4 to T3, this will not be of much help. This is the reason that many people who are on synthroid do not find an improvement in their symptoms, even though their TSH levels improve

2) Iodine: is a nutrient essential in the product of thyroid hormone. Three iodine molecules are addd to make  T3 (Triiodothyronine) and four are added to make T4 (thyroxine). Iodine deficiency can lead to hypothyroidism. In many areas of the world, particularly the Great Lakes region, the soils are deficient in iodine. This is the reason salt was iodized. However, many people are now eating sea salt, which is not iodized. On the contrary too much iodine can also be harmful to the thyroid, leading to hyperthyroidism. For this reason, iodine supplementation should be done under the supervision of your Naturopathic Doctor.

3) Selenium and Zinc: trace minerals required in the production of thyroid hormone. Slenium is required for the conversion of T4 to T3

4) Tyrosine: an amino acid that is necessary for thyroid hormone synthesis. Tyrosine is also required for cortisol synthesis, which the body selectively makes over thyroid hormone. This is one of the biochemical links between stress and thyroid dysfunction

5) Botanicals: There are many herbs that can help with thyroid function including but not limited to Bladderwrack, Blue Iris, Guggul, Nettle, and Ashwagandha

6) Food Sensitivities: sensitivities to foods create an auto immune reaction in the body which can be detrimental to the thyroid. People with thyroid problems should avoid goitrogens (cauliflower, broccoli, Brussels sprouts, cabbage, millet, soy). Gluten has also been shown to be linked to hypothyroidism.

7) Adrenal Health: Stress has a negative impact on the thyroid gland, and also on the adrenal glands. IN practice, it is often seen that once someone’s adrenal glands are well supported that their thyroid starts responding better

8) Hormonal Balance: progesterone makes thyroid receptors more sensitive to thyroid hormone. It is essential to establish the proper balance between estrogen and progesterone for thyroid health. PCOS can also throw off hormonal balance. Not sure if you could have PCOS? Check out my blog post.

Naturopathic Doctors can help getting you feeling better especially if you are already on Synthroid and not seeing a change in your symptoms

Talk Soon,

Dr Alexis

Dr Alexis practices in Kanata and is accepting new patients. To schedule your appointment, click here.

Polycystic Ovarian Syndrome is a complex endocrine disorder that affects 5-10% of reproductive aged women. As surprising as the name is you can have PCOS without even having polycystic ovaries! In order to be diagnosed with PCOS you have to have 2 of the following 3 findings

1) Oligomenorrhea or anovulation (meaning long cycles, 35 days plus, or not ovulating)

2) Hirsutism and/or hyperandrogenism

3) Polycystic Ovaries

Another hallmark of PCOS, although not included in the diagnostic criteria, is insulin resistance. Insulin resistance happens when the cells of the body do not respond well to insulin, causing the body to have to produce even more of it. If the body is unable to utilize its insulin properly it can lead to high blood sugar, and if this goes on for a long period of time can lead to Type 2 diabetes.

PCOS is often undiagnosed, as there is not one lab test or imaging that can be done to either rule it in or out. One of the big misconceptions is that you have to be overweight to have PCOS. This is absolutely not true! There are many normal and underweight women who also suffer from PCOS. If you are having difficulties with infertility it would be good to get a throughout work up from your doctor and/or naturopathic doctor to rule out PCOS, as it is the leading cause of female “sub fertility”.

Signs and Symptoms of PCOS

-irregular periods

-head hair loss (male pattern baldness)

-acne

-infertility

-hypo or hyperglycemia

Conventional Treatment

1) Birth Control Pills. If fertility is not desired at the moment, birth control pills are prescribed. Birth control pills act to cease ovulation, thus preventing the formation of ovarian cysts. However this is just masking the problem, not helping to correct, as when you stop taking the pill the cysts will return. They also give the body more estrogen, which helps to lower the relative effect of the excess testosterone that is typically seen with PCOS.

2) Spironolactone. This drug is an androgen receptor antagonist. It helps by blocking androgen receptors and in effect reduced hirsutism. Spiro cannot be taken by anyone with a chance of becoming pregnant, as it can cause birth defects.

Naturopathic and Lifestyle Treatment Options

1) Reduce intake of refined carbohydrates/high sugar foods. A paleo style diet, with a very high vegetable intake may be best for PCOS

2) Exercise!! Especially exercises that use your big muscle groups. Strength training is great for PCOS as when we strength train the muscles can use up excess glucose, by shunting it directly into the muscle. It is important to do resistance based training a minimum of 3 times a week to help regulate blood sugar levels

3) Cinnamon: can help balance blood sugar levels

4) Ground Flax Seeds: can help increase elimination of excess hormones

5) Inositol: a nutritional supplement that can help reduce testosterone levels

6) Herbs: There are plenty of herbs that can help balance testosterone levels, reduce luteinizing hormone, encourage ovulation and balance estrogen and progesterone. It is not wise to try and treat yourself with herbs as one herb can have many different actions/effects on the body. Speak to your naturopathic doctor.

I hope this gave you some good information on what PCOS is and what can be done about it. PCOS is quite common and can be successfully managed with the help of your naturopathic doctor

Talk Soon,

Dr. Alexis

Dr Alexis practices at Living Science Wellness Centre in Stittsville. Call 613.836.7901 to schedule your appointment.

 Naturopathic Medicine is covered by most extended health insurance benefits

Most people think of acne as a teenage problem, this is not so. Many adults suffer from acne well into their 50’s and some of them never even had it as a teenager! While it can be frustrating and hurt your self esteem there is plenty that can be done to get to the root of the issue! Keep reading to learn why acne happens, and what you can do about it.

Physiology of Acne

The physiology of acne is quite similar in most people who experience the condition, what differs is what causes the skin to go haywire. Acne occurs when the pilosebaceous gland get inflamed. When this gland is inflamed it produces and secretes more sebum. When more sebum is being produced it is easy for the pore to become blocked. Excess sebum production excites the bacteria Propionibacterium acnes. We all have low levels of these bacteria on our skin, but seeing as they feed off of sebum, if sebum production is low then the bacteria are kept in check. However, if sebum levels become higher the bacteria are essentially at an all you can eat buffet….and they invite their friends! The bacteria cause the body to mount and immune response. This is what is happening when you have acne that gets red, sore and pus filled. Conventional acne treatments aim to target the bacteria and kill them off. This can help reduce the amount of acne you are getting but it is not getting to the bottom of the issue.

Why Does Acne Happen

So what is causing the excess sebum production in the first place? The short answer, lots of different things! The liver is the hormone processing factory in the body. If the liver is not functioning optimally hormone levels can get out of balance. Androgens, the male hormones, increase the thickness and quantity of sebum, leading to an increase in acne. This is why acne is a common symptom of PCOS, where women have elevated androgens. The stress hormone cortisol is also well known to increase sebum production. Think back to times when you were very stressed (exams, your wedding day) chances are your skin wasn’t looking its best. Foods that are high in sugar help to feed the Propionibacterium acne, increasing the amount of acne. A lesser known cause of acne is dehydration. When we are dehydrated the sebum gets more sticky in quality and gets trapped in the pores, triggering an inflammatory response.

How to Make it Better

The only way to improve acne for good is to get to the root cause of the symptoms. Treatment will differ greatly if your acne triggered by a food sensitivity versus a hormone imbalance. If you have been suffering from acne for some time and it just doesn’t seem to be getting better consider booking an appointment with your naturopathic doctor. A naturopathic doctor will help you figure out what is causing your acne and then design a treatment plan for you that gets to the bottom of the problem. Skin improvements can take time so it important to be patient and really give your treatment plan time to fully work, typically 3 months.  Here is a list of some natural therapies that can help to reduce your acne

1) Reduce your stress! Getting your cortisol under control is one of the best ways to reduce acne. Ways to reduce cortisol include: abdominal breathing, meditation, yoga, regular moderate physical exercise, and going to bed at a decent time (before 11 pm). Cortisol is a double edged sword as when it is increased it can increase your androgens, especially in women

2) Increase your elimination: Make sure you are eating plenty of fiber (25 g/day). The liver is also an organ of elimination and helps to process hormones properly. Foods that are good for keeping the liver in tip top shape are: cruciferous vegetables (broccoli, cauliflower, brussel sprouts, kale), beets, dandelion and milk thistle tea, apples (with the skin) and B vitamins.

3) Keep hydrated: being dehydrated slows elimination and it also can cause a thickening of the sebum, making it more likely to get caught in the pores. Aim for 2 L of water and/or herbal tea per day. Keeping hydrated also makes the skin look better in general, giving it more of a glow and plumping up wrinkles

4) Eliminate Sensitive Foods: Common food sensitivities include gluten, dairy, soy and corn. If your body is sensitive to a food, when you eat it, it causes an inflammatory response, which can be manifest in the pilosebaceous glands of some people. Try eliminating these common allergens for 3 weeks and see if you notice a change in your skin. Alternatively, if you do not feel that you can eliminate these foods, you can see your naturopathic doctor for IgG food sensitivity testing.

5) Hormones: hormonal imbalance of both female and male hormones can wreck havoc on the skin. Many women will know that fluctuations in their hormones throughout the course of their menstrual cycle can trigger acne. This is a common problem, but is in no way NORMAL. Working on getting the liver functioning optimally can help with hormone regulation, however it may not be enough for everyone, There are many herbs that help modulate hormones, and salivary hormone testing is available, where hormone levels are measured every 3 days over the course of the month, to help pin point which hormones are causing the problem. Learn more about the basics of hormones and how they work?

6) Products: many people with acne tend to use products that are drying in an attempt to remove excess sebum. This can have the opposite effect. If you are using products that dry the skin out too much, then the body makes even more sebum to compensate. Benzyl peroxide can often cause this problem. Try to stick to products that contain natural astringents (reduce oil without being too drying) like witch hazel and tea tree oil. Aloe vera and rose water can also help to rebalance the sebum levels on the skin. Use a mild, castile soap based facial cleanser. People with acne are also typically afraid of putting oil on their skin. Oils that are of an astringent nature and are good for people with acne include macadamia and grapeseed oil. Staying away from synthetic products is important, as they can cause inflammation in the skin.

Eco Chic Movement’s Oily Skin Moisturizer is specially formulated for acne prone skin

I hope you found this description of why acne happens and the tips for how to reduce it helpful. As always post any questions or comments in the comment section and I will be sure to get back to you!

Talk Soon,

Dr Alexis

Dr Alexis practices in Kanata . To schedule your appointment, click here

Naturopathic Medicine is covered by most extended health insurance benefits.