An Integrated GP's Blog

Its that time of your life when you could be sailing through or when all hell breaks loose. Menopause (and perimenopause-the period leading to) can be a difficult time for many women who struggle with the myriad of symptoms that come with the package. Mainstream approaches involve use of pharmaceutical HRT to calm the symptoms down which works for some and not so much for others, even causing them to feel worse. Does this mean you are left to live the rest of the years of your life miserable and breaking down? I believe not. Optimal hormonal regulation and signaling keeps one's body and mind sharp and tuned and this is what we see when we are young but as we age, the declining levels of body hormones start to cause 'dise-ease'. Scientists and researchers are stumbling upon evidence upon evidence to suggest that people who live with restored hormone levels (through bio-identical hormones) with appropriate lifestyle interventions function better in every aspect of their health including cognition. This article should expand your knowledge on the 'change-over'.

vital.ly Commons | Menopause...the fourth phase of a woman's journey Brenda shares about menopause, the fourth phase in a woman's life......the 'Maga' wise woman and more

Ever heard of the term Social Jet Lag? It’s the lag that we feel after having a late night which various studies have now shown are comparable to travelling across time zones!

Do you know what is the number one cause of death and work disability for active duty firefighters? No, it is not fire or related accidents but it is heart disease which now studies link to a disruption of the body’s innate circadian rhythm.

Do you think you classify as a shift worker? Think before you answer….let me clarify this for you. According to the official European definition of the term, a shift worker is someone who stays awake for more than 3 hours between 10 pm and 5 am for at least 50 days in a year. Now let’s ask that question again…Are you a shift worker who inadvertently has a disrupted sleep routine? The World Health Organisation International Agency for Research on Cancer has now officially classified shift work as a potential carcinogen

We all know that sleeping is important but just how much sleep is considered to be healthy and how much can we get away with without causing a detriment to our mental and physical health? Its during a restful nights sleep that we reduce body inflammation, clear toxins and eliminate body waste, rid off/recycle dysfunctional cells, reset hormones while the body ‘grows’ through growth hormone production.

It is now well recognized that even short-term sleep deprivation (can be compared to flying from one continent to another causing jet lag and sleep deprivation that results in increased levels of stress hormone cortisol and adrenal dysfunction, dys-regulation of blood sugars, elevated blood pressure and increased inflammation.

When we are sleep deprived, our sympathetic (fight or flight) nervous system is activated which makes us wired and jumpy and without our knowledge causes elevated levels of stress hormone cortisol which impacts blood sugar regulation in the body which then leads to hyperinsulinemia and insulin resistance. Now hang on what does this all mean to the average lay person reading this?

Cut to the chase,let me give you a list of medical conditions that studies have now linked sleep deprivation to:
Increased risk of Type 2 diabetes & Insulin resistance
Increased risk of cancer
Increased risk of obesity
Increased risk for psychiatric disorders
Poor cognition, memory and concentration leading to impaired work ability, impaired driving ability etc
Impaired immune system function which increases your risk of catching colds,flu and other illnesses that are linked to poor immune system function
Increased leptin levels (the hormone that tells your brain that you are full and stop eating)
Increased gut permeability (aka Leaky Gut)
Increased fat mass
Increased inflammation

If you struggle with sleep, it maybe that you need a holistic & comprehensive look at the matter and not a magic bullet like a sleeping tablet. Most often, its not just a sleeping issue and will be intertwined with other facets of your health. If you would like to discuss and get help for this, please contact my rooms on 9754 7566 and ask to have an appointment with myself, the author of this article. Until then, stay tuned.

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Eat your fruit,don't drink it!

We all love fruits and fruits juices don't we? Today,I am going to dispel a myth that I hear my patients often spell back to me when I ask them how good is their diet? ‘Doc,I eat my fruits and veggies and if I can't for some reason, I make sure I pick up fruit juice on my way home to make sure I have had my serve for the day’!! My heart goes out to them as I can see them trying but with the wrong knowledge based on what they are being told is the right thing to do. Sadly this is far from the truth and further afar from human physiology.

To understand this,you have to know the sugars we are talking about. In this context,there are mainly two-Fructose & Glucose. Carbohydrates are mainly broken down into sugars of which glucose is predominant which gets used for energy in the cells and also gets converted into glycogen (stored form of glucose in muscle,liver etc). Fructose on the other hand is very much like alcohol;has only one organ to go to & this is your liver. The difference between fructose and alcohol only remains in the kick + hangover and are otherwise pretty much similar in their actions. The liver has very limited options to handle these two identical twins other than convert them to fat,mainly in the liver creating a situation of fatty liver disease which haunts 1 in 3 Australians today (if rightly screened and tested).

I call fatty liver disease ‘Diabetes of the liver’. This is where the car's breakdown begins as fatty liver then leads to a dysfunctional liver that then affects cholesterol production and metabolism, affects detoxification of toxins and waste and a myriad of other functions for which the poor liver is responsible for. The effects of this are downstream with metabolic diseases such as diabetes,pre-diabetes, cholesterol, heart & kidney disease, stroke etc. I am not saying don't eat fruit as fruit is a good source of fiber and as such has lower fructose content and the human gut absorbs the fructose much slower due to the fiber content. Depending on the fruit,it also has a lot of potent antioxidants and phytochemicals that help the human body in various biochemical reactions and processes. Now that you know what these sugars are and what they do inside your body, think again before you give your kids (or have them yourselves!) a glass of ‘healthy’ apple or orange juice or go to one of those juice bars in your local shopping center for your ‘healthy juices’. And remember to eat the right fruit in moderation in its season and avoid fruits not in season (as the human body is not built to work outside its seasons).

To summarize, eat your chosen fruit, in season,in moderation and just avoid drinking it.

Home - Upwey Doctors Where Care & Compassion Meet Book an Appointment WELCOME TO A HILLS FAMILY MEDICAL PRACTICE Our practice is located off Burwood Highway in the town of Upwey. It is housed in modern, state-of –the-art facilities serving a large community in Upwey but not limited to,seeing patients from all over the...

Exercise - A word loved by millions but yet dreaded and feared by million others. Why is there so much emphasis on ‘exercise’ and what does it really involve?

Many of us associate exercise with hard labour intense activity like going to the gym and power pumping through treadmills,cycles and hi tech machines, lifting barbells and heavy weights. As much as some of it is true,I believe this is not the true meaning or definition of exercise. The term exercise originated with a French gymnast in the 1800’s who started health clubs in Brussels and later in Paris with a view to having people come in for designated periods of time for targeted exercises to improve health and well being. The definition of exercise is bodily or mental exertion, especially for the sake of training or improvement of health. While the definition holds true for its purpose, for the sake of my discussion (medical wellness),I would like to coin a different term- EPA:Enjoyable Physical Activity.

I believe EPA is anything that one would consider enjoyable, rewarding & satisfying for the person who does it. The time limit for EPA will depend on each individual’s personal tolerances and circumstances and there is no set rule for this. This may mean that one person may only be able to walk around the block and be done while another can garden all day and as such is very personal.

Any activity as we know is good for our bodies. However let’s take a closer look at the true benefits of EPA:
-Improved Immune function
-Decreased body inflammation
-Increased energy and decreased fatigue
-Improved bowel function
-Increases Heart Rate Variability (the more variable,the better)
-Increased oxygen consumption by the body
-Decreases blood pressure and improved resting heart rate
-Improved cholesterol profile
-Improved blood vessel function
-Improved blood glucose and insulin regulation
-Improved hormone function
-Increased muscle mass and reduced body fat
-Reduced blood clotting and thickness of blood
-Strong positive influence on the gut microbiome
-Improved mood,decreased depression and anxiety,decreased stress
-Improved psycho-social well being and self efficacy
-Improved spiritual health
-Better memory & cognition (enlarges the memory center in the brain)
-Increases BDNF (‘fertilizer’ for the brain and nerves)

And the list goes on……..! No surprise these days as we see health clubs popping all over the country. Health coaches are surely onto something and I agree. Next week,we will delve further into the research and evidence that links exercise to disease and well being. For now, I’ll leave you to think about what your EPA is.

The revelations we are now seeing in research is shedding light on our chronic disease epidemics. Our struggles with deadly infectious diseases that killed thousands during the world wars and those decades was pretty much halted by the discovery of Penicillin by Sir Alexander Fleming which earned him and his colleagues the Nobel Prize in 1945. However,today, we are dealing with a different monster - Chronic diseases of diabetes,autoimmune diseases,heart disease,arthritis etc and the human microbiome is linked to most if not all. Here are a list of conditions that we now know are strongly linked to a dysbiotic gut microbiome (not limited to)

> Depression
> Autism Spectrum Disorder
> Anxiety Disorder
> Emphysema
> Asthma
> Skin conditions
> Obesity and weight issues
> Cancer
> Diabetes
> Heart and cardiovascular disease
> Oral infections
> Rheumatoid Arthritis
> Inflammatory Bowel Disease

Now that you learnt about your precious co-inhabitants, let’s briefly discuss what we can do to help these little ones. It's important to know that when it comes to your gut friendly bacterial colonies, rather than the richness of a particular species of organism in your gut,the focus of any treatment should be to promote diversity of the colonies. Why this is important is because it is the compounds that these bacteria make that have varying effects in our bodies. While some bacteria make vitamins like B and K, others make enzymes to digest foods while some others synthesize precursors to serotonin (the feel good hormone) and others make short chain fatty acids (fuel for the gut cells).

To explain this in simple terms, if you were at a musical show and there were just a couple of instruments used to create sound such as a drum and a guitar,you would pretty much call it a poor show as it had only two sounds and got boring. However,if the musical had a wide array that included a singer, a choir, guitarist, a drummer, a pianist, a violinist, a tambourine,flute,sitar etc,how melodious would all of these different sounds playing in symphony be? In the gut,this is called symbiosis (working together for betterment) as opposed to dysbiosis (operating in ways that cause dysfunction).

Fixing a dysbiotic gut is of prime significance when it comes to treating chronic disease. As Hippocrates said centuries ago ‘All disease begins in the gut’. Specialised laboratories across Australia, US & Europe now have the capability to test for dysbiosis (Microbiome Analysis) but can be costly (not medicare funded) and generally beyond the scope of mainstream medicine. Nevertheless,the test provides vital information that then helps your integrated practitioner tailor your treatment plan.

Once the pattern of dysbiosis is determined,treatment involves a process of weeding and feeding using an approach of
> Dietary modification that removes foods that affect your gut and promote the use of microbiome building foods
> Changes in food cooking practices that reduce/avoid gut damage
> Amendments to eating patterns including time restricted eating
> Good hydration through consumption of non caffeinated sugar free drinks,mainly water
> Addition of probiotic rich foods to the diet
> Targeted supplements to heal the gut lining and support the microbes
> Specific strains of probiotics with or without herbal/conventional antibiotics as part of a schedule of treatment
> Regular exercise to improve the wellness of your gut ecosystem
> Restful sleep (believe it or not...your gut microbiome has a circadian rhythm too!) and stress reduction which all helps with the healing process

Gut bacterial ecosystems shift in 2-3 days when we change lifestyle and dietary habits and maintaining good gut health thereafter requires persistence and ongoing awareness. You are unique and so is your gut microbiome and any treatment needs to be personalised to your specific needs.

If you are sick with no light at the end of the tunnel and need a different set of lenses,you need to talk to an Integrated Medical Practitioner who will be able to look at these and other factors that have led to your ill health.

MICROBIOME FACTS
Would you do anything different if you knew that your gut holds the key to preventing you from becoming sick? What if I told you that the size of your entire gut when laid bare out for measuring is around 40 square metres,the equivalent of half a badminton court. Or if I told you that 70-80% of your immune system is housed in your gut. What if I told you that the antibiotic prescription you are about to take does not pick and choose the bugs to suppress but instead works like na**lm on your gut and the friendly inhabitants living there,that restoring them back may take upto 12 months if ever or worse…….Never.

The Father of Medicine Hippocrates said a long time ago that ‘All disease begins in the gut’ and he did not need modern contraptions, inventions or tests to say that. He was a clinician who knew from the patterns of diseases he saw and his vast clinical experience. Today,as we stand, gut disorders account for the vast majority of our ill-health,directly or in-directly. Our gut was made to be a fortress being the biggest interface we have with our environment as opposed to skin etc and this is why it houses the largest part of the human immune system called the GALT (Gut Associated Lymphoid Tissue).

With our modern day lifestyle (which includes foods,consuming medicines,toxin exposure etc), our immune system is always on the alert and doesn't get a moment of rest. It's akin to an army on patrol duty 24/7 with no rest and this creates a hypervigilant state within the immune system. Ever wondered why auto-immune disorders like Psoriasis, Crohn’s disease, Multiple Sclerosis etc are on the rise?

You’ve already heard the term ‘Gut Microbiome’ from me (or even a zillion times before) and it refers to the trillions of healthy bacteria that reside within our gut,the average total weight of which exceeds 2.25 kgs (To bring perspective,the average weight of the human brain is 1.3 kgs). We knew little about this ‘organ’ of our body until the last 20 years or so when research exploded rising from a mere 74 published articles in 2000 to a whopping 9600 in 2017 and I would imagine it would a lot more today in 2020.

We humans are predominantly microbes taking the combination of skin,gut and others and the right term is a Holobiont (a discrete ecosystem of human genomes and that of various other species that is a functional unit). The DNA of the microbiome outnumber our own by 10:1 and includes viruses,bacteria,fungi,parasites etc that run various operations from a command center that is based in the intestines. Scientists are essentially calling this ‘the second brain’ with the knowledge that there is 10 times more communication heading up from the gut to the brain than the opposite direction. Have I caught your attention now? If so, watch this space over the next few days as I share more gut truths.