Fibrocystic Breasts

Fibrocystic breasts (also called cystic mastitis) is a common concern for pre-menopausal women and indicates palpable breast lumps that are non-cancerous and can be quite painful, especially when breasts become swollen premenstrually. Symptoms often disappear after menopause. A cyst is a fluid-filled sac that may feel firm or grape-like to the touch, is usually mobile with distinct borders. Cyst formation is influenced by lymphatic drainage and estrogen-sensitivity:

• Improper lymphatic fluid drainage within the breast can cause the excess fluid to be encapsulated by fibrous tissue.
• Breast tissue is sensitive to estrogen which stimulates tissue growth, and if overstimulated by estrogen (either produced by the body or ingested), there can be increased swelling and growth of fibrous tissue.

Coffee and caffeine, excess estrogens, insufficient anti-inflammatory fats, and excess weight are major influences on breast cysts and breast tenderness.

• Coffee is estrogenic and best avoided if fibrocystic breasts are a concern.
• Caffeine consumption causes magnesium to be excreted by the body and can be a factor  in fibrous breast cysts as well as contributing to osteoporosis, restless leg syndrome, urinary tract infections, and high blood pressure. Caffeine is found in: soda, black tea, chocolate, pain medications like Excedrin and Midol, and decaffeinated coffee (it’s true!). Green tea has caffeine but also contains L-theanine which modifies the effects of caffeine on the body, and may be well tolerated.
• Excess estrogens are due to hormonal imbalances (e.g. insufficient progesterone &/or excess cortisol) as well as ingestion of estrogens from the environment. Requesting a salivary hormone panel from your Naturopathic Doctor will help to determine hormone imbalances. Avoidance of plastics, pesticides and herbicides, dryer sheets, and fragrances (perfumes, cleaning products, laundry detergents) help to decrease the amount of estrogen ingested.
• Anti-inflammatory fats can aid in decreasing pain and swelling of breasts and include supplementing with Evening Primrose, Borage, or Echium oil. 
• Excess weight is often accompanied by estrogen excess, inflammation, and poor lymphatic drainage. Daily cardiovascular exercise, a diet rich in vegetables,  fruit, whole grains, and lean protein, and counselling or coaching if needed will help maintain a healthy body weight, balance hormones, decrease inflammation, and encourage lymphatic drainage and circulation.

Consult your physician if you notice lumps that don’t change with your menstrual cycle, discharge from your nipple, redness with swelling, severe breast pain, or dimpling or puckering of breast skin. Monthly self breast exams are recommended to familiarize yourself with what is normal for your breasts – click here for more information.

Peri-menopause – How Do You Know?

The average onset of menopause, when the ovaries cease to produce estrogen, is 52 years of age. Peri-menopause, the time span when hormone levels start to fluctuate and cycle abnormalities may begin, can start as early as 35 or as late as 50 years of age.

All hormones can be affected in peri-menopause including  thyroid and adrenal hormones. The most common complaints from women come from symptoms of fluctuating hormone levels and estrogen excess. These symptoms include night sweats (low thyroid function), heavy periods &/or prolonged periods (estrogen excess), hot flashes (estrogen surges), low sex-drive (low adrenal and thyroid function, estrogen excess), and abdominal weight gain (low adrenal function).

Other symptoms of peri-menopause include:

• breast tenderness or fibrocystic breasts – related to estrogen imbalances
• fatigue – related to low thyroid and adrenal function, and/or low iron stores
• uterine fibroid and endometriosis – related to estrogen excess
• thinning hair – related to low thyroid and anemia (due to prolonged periods)
• acne – related to excess estrogen &/or high testosterone
• joint pain – related to estrogen excess and poor liver detoxification of estrogens
• mood swings – related estrogen surges
• heart palpitations – related to estrogen surges
• sleep disturbances and insomnia – related to poor adrenal function

While menopause and peri-menopause are natural phases in a woman’s life, they do not need to be uncomfortable. Naturopathic Medicine provides a number of supportive therapies to help balance hormones and most importantly, ensure the adrenal glands, thyroid, and liver detoxification are functioning optimally.

Support for liver detoxification includes adding supplements like Indole-3-Carbinol (I3C) & Calcium-D-glucarate which assist the detoxification of estrogens and encourage the formation of ‘good’ estrogens. Eating foods like berries, apples, carrots, evening primrose oil, beans, lentils, chickpeas, mung beans, fermented non-GMO soy products, flaxseeds, and pears keep estrogens balanced and discourage the inflammatory estrogens (16-alpha-hydroxy estrone) from forming.

Adrenal function can be optimized through the addition of Vitamin B5 and Vitamin C, and Siberian ginseng. Sipping licorice root tea throughout the day can also help to boost adrenals.

The thyroid is best boosted through herbs like  Ashwaghanda and Fucus vesiculosus (kelp), as well as amino acids like L-tyrosine, and minerals like selenium and zinc.

Using lab testing (salivary hormone panels, blood tests for TSH, ferritin) and symptoms your Naturopathic Physician will be able to determine which foods, supplements, and herbs are most appropriate for you.

Heart Healthy

Heart health means minimizing inflammation and cholesterol deposits in the arteries and in the heart, as well as lowering blood pressure to less than 140/90 mmHg.  Lately I’ve seen quite a few patients with high cholesterol “hypercholesterolemia”, and “dyslipidemia” (LDL and HDL cholesterol too high and low, respectively). Taking steps to prevent cardiovascular disease and improve quality of life starts with protecting your heart.

Your heart directs the flow of blood which feeds your body’s cells and tissues with life-giving oxygen. Fatty plaques can form on the inside of arteries and the heart due to inflammatory situations including:

• consistent high blood pressure
• poor diet (high in processed foods and saturated fats)
• poor liver function
• poor blood sugar control and Diabetes Mellitus
• smoking
• obesity

the heart is the epicentre of the body

Lowering blood pressure with medications like Beta-blockers, ACE Inhibitors, and diuretics may only decrease the overall risk of strokes, coronary heart disease  (CHD)events, and mortality by an average of 1%, according to numerous studies (JAMA 2002, N Engl J Med 2008, Lancet Oct 2005). The best defense against cardiovascular disease (CVD) appears to be lifestyle and prevention.

Heart Healthy foods include:

• onions and garlic – help prevent platelets from sticking together; support healthy liver function (liver makes cholesterol)
• apples – fibre content in the skin and pectin in the fruit help remove excess cholesterol
• ground flax-seed – binds cholesterol and toxins, removing them safely from the body
• berries (blueberries, blackberries, raspberries etc) – support blood vessel integrity and provide antioxidants, decreasing inflammation
• brassica family vegetables (broccoli, cauliflower, kale, brussel sprouts) – fibre binds excess cholesterol for removal from the body; supports healthy liver function
• nuts & seeds (walnuts, almonds, pumpkin seeds etc) – source of omega 3 fatty acids; low in sodium, high in potassium; provide vitamin E to decrease inflammation
• beans and legumes – high in potasium, low in sodium; excellent source of fibre
• omega 3 fatty acids (fish oil, fish, avocado, hemp seen, algae, green plants) – help lower cholesterol; help lower blood pressure; helps prevent platelets rom sticking together; decreases overall inflammation in the body

Other lifestyle considerations to help lower blood pressure, maintain healthy levels of cholesterol, regulate blood sugars, and maintain optimal body weight include:

• daily exercise – 30-60 minutes of moderate intensity cardiovascular exercise
• quit smoking – this is linked to cardiovascular disease as well as numerous other diseases
• stretch and breathe (e.g. yoga) – helps to calm the nervous system and lower blood pressure
• drink plenty of water – approximately 1 Litre per 100 pounds of body weight; allows for proper function of all cells in the body
• eat more vegetables – 60-75% of your diet from vegetable sources supports healthy body weight, healthy cholesterol, and regulates blood sugar
• rest – quality sleep is a foundation of health, wellness, and rejuvenation

Herbal supplements like motherwort, hawthorne, and bilberry have all been shown effective in supporting blood vessel and heart health. Prior to starting any herbal supplements, consult with your Naturopathic Doctor to ensure correct, individualized dosing and quality of ingredients.

Cleanses – are they necessary?

I often get questions like “Should I do a cleanse?” and “Which cleanse do you recommend?”. Both questions are valid, but my professional opinion is that cleanses aren’t always necessary. What matters most is the lifestyle habits of the individual and whether long-term dietary changes are likely.

Cleanses are meant to help the body rid itself of toxins in a shortened amount of time and at a rapid rate.

Toxins targeted by cleanses include:

• pesticides and herbicides
• toxic metals
• hormone metabolites

The method of removal of toxins in most cleanses is via supporting the liver with herbs like milk thistle, and eating an alkalinizing (high vegetable), high fibre, whole foods diet while avoiding sugar, yeast, processed foods, alcohol and inflammatory foods like corn, gluten, dairy, and soy. Often the diet is calorically restrictive which can cause an offloading of toxins from fat cells, which the liver picks up and eventually the bowels evacuate the toxins.

The other ‘support’ commonly added to cleanse kits is bowel support in the form of fibre and laxatives. Fibre is an excellent addition to cleanses because it prevents toxins and excess cholesterol from being reabsorbed, supports bowel flora, and bulks the stool allowing for a smoother ‘exit’. The laxatives added are usually herbal laxatives like Cascara or Senna. The laxatives support movements and elimination of toxins. Laxatives can be harsh and cause emergency trips to the bathroom that disrupt daily life, and are not always recommended.

Some cleanses also add herbs and nutrients to bolster kidney elimination. In general, the liver rids the body of fat-soluble toxins, and the kidneys help rid the body of water-soluble toxins, so support for both organs is important when you’re pushing the body to dump toxins.

Purchasing a cleanse can be a tricky endeavour, but health food stores usually have cleanse kits like Cleanse Smart, Bioclinic Naturals 7 day Detox, and Heel detox kit. Quality of all ingredients in a cleanse kit is important and it is helpful to ask the staff about quality and ingredients of various kits.

My personal philosophy on cleanses is that they are not necessary if you can manage to maintain a whole foods diet for the majority of the time and minimize processed foods, sugar, alcohol, and yeasts  in your diet. Your body will naturally detox if you support it’s nutrition.

Support for daily detoxification can include:

• drinking water with organic lemon slices (gently supports liver function; drinking 1.5-2 Litres a day helps to hydrate and move toxins through your kidneys and bowels)
• using turmeric on foods (has a compound called Curcumin which is a powerful antioxidant and assists liver detoxification)
• avoiding environmental toxins (pesticides, plastics, herbicides, refrigerants, industrial solvents, dryer sheets, perfumes/fragrance)
• eating plenty of leafy green vegetables, broccoli, cabbage, dandelion greens, watercress, onions, and garlic
• eating 2 tablespoons of freshly ground organic flaxseed daily – flaxseed provides lignans which decrease the amount of free estrogen in the body and provide a source of fibre to bind toxins in the gut for elimination)
• taking a high quality multivitamin-antioxidant supplement containing magnesium, selenium, Vitamin B6, and Vitamin B12 (these improve detoxification, improve function of all cells in the body, and protect against cancer)

If you do choose to go with a ‘cleanse’ regimen, you may wish to consult your Naturopathic Physician to tailor a program to your body’s needs.

Progesterone prescription

Progesterone (synthetic progestin or bio-identical progesterone) is often prescribed for women looking to balance their hormones. But is hormone replacement always necessary? Naturopathic Medicine uses foods, herbs, supplements and lifestyle changes to help normalize hormone levels and bring the body back to balance. Although Naturopathic Doctors can prescribe bio-identical hormones, adding new hormones into your body is often a last resort.

Progesterone can be low due to relative excess of estrogen – including exposure to environmental estrogens such as those found in plastics, cleaning & beauty products, and pesticides. Other factors contributing to low progesterone include high stress levels, low thyroid function, and blood sugar regulation dysfunction.

Low progesterone can lead to a number of symptoms including:

• headaches
• poor management of stress
• high cortisol levels
• estrogen dominant conditions (fibrocystic breasts, ovarian cysts, endometriosis, some breast cancers)
• heavy periods
• abdominal weight gain
• osteopenia (low bone density)
• recurring miscarriage
• bloating or water retention

Options for enhancing progesterone levels naturally include:

• Chaste tree berry (Vitex agnus-castus) – works to support progesterone production at the level of your pituitary gland
• Vitamin B6 – helps to balance estrogen and progesterone levels
• Cruciferous vegetables: broccoli, cauliflower, kale, cabbage, Brussels sprouts – all help to get rid of excess estrogens
• Omega 3 fatty acids: flax-seed oil, fish oil, hemp seed – support hormone function
• Eating organic meats – avoid ingesting hormones from food sources
• Eating organic fruits and vegetables – minimize pesticide exposure that can add estrogens and cause progesterone imbalance
• Use natural beauty products and cleaners – if you can read and understand the ingredients on the label, then it’s likely okay to use. Environmental Working Group has a site called Skin Deep that allows you to see the toxicity level of your beauty products.
• Use spices like nutmeg and turmeric to help protect your current progesterone levels
• Enjoyable activity or exercise for at least 30 minutes a day – helps decrease stress levels and promotes hormone regulation

Regulating hormones starts with lifestyle and nutrition. If you give yourself a good foundation for health, your body often does the rest on its own.

Coconut Chicken Curry – gluten-free, dairy-free recipe

This recipe (adapted) for Coconut Chicken Curry comes from the Anti-Inflammation Diet and Recipe Book by Jessica K. Black, ND. It’s a really creamy delicious sauce – excellent combined with the Lemon Vegetable Rice.

Sauce:

4-5 cloves garlic, minced

1 Tbsp olive oil (or use coconut oil which is heat-stable)

1 13.5 ounce can of coconut milk

2 Tbsp almond butter

4 tsp curry powder

1 Tbsp wheat-free tamari (or Bragg’s soy)

1 tsp fish sauce

2 tsp honey or maple syrup

Method:

Bake chicken breasts and pieces in oven at 400 F.

In a saucepan over medium heat, sauté garlic in oil. Stir in all other ingredients and bring to a simmer, then reduce heat to low. Continue cooking, stirring occasionally, until chicken is done.

Pour the sauce over chicken (& rice) when done.

Lemon Vegetable Rice

juice of 2 lemons

2 Tbsp maple syrup

2 1/2 cups chicken broth

1 1/2 cups short grain brown rice

1/2 tsp sea salt

1 cinnamon stick

5 whole cloves

2 Tbsp olive oil or coconut oil

1 tsp cumin seeds

1 small onion thinly sliced

2 small zucchinis sliced

1/3 cup roasted cashews, whole

2 Tsp fresh sweet basil, chopped

Method:

Pour lemon juice, maple syrup, and chicken broth into a saucepan; add rice, sea salt, cinnamon stick, and cloves.

Cover, bring to a boil, and boil for 2 minutes. Reduce heat and simmer for 25-30 minutes or until all liquid has been absorbed.

In a large skillet, sauté cumin seeds in oil until they begin to pop. Add onion and cook for another 5 minutes over medium heat.

Add zucchini and cashews, and sauté until zucchini is tender.

Stir in the basil and the rice, heat for another minute or two, and serve.

Immune system strengthening

As I sit here with my nose running and my head and throat aching, I feel inspired to discuss immune function. Yes, tonifying and strengthening your immune system is as essential as supporting liver and digestive health.

What are my favourite options for immune strengthening?

1. A diet high in antioxidants and trace minerals: Vitamin C, Vitamin A, Vitamin E, Zinc and Selenium are all essential for optimal immune function. Eating a wide variety of organic fruits, vegetables, and nuts & seeds will help with nutritional needs.

2. Hydration – drinking plenty of fluids daily (1.5-2 Litres of water for most people)

3. Supplementing with immune tonifying herbs: Astragalus is great prior to cold/flu season, Echinacea is fantastic as it strengthens the White Blood Cell response

4. Exercise – cardiovascular training, yoga, and breath work all help to improve your body’s immune function

5. Supplementing with a good quality multivitamin/mineral will help maintain nutritional status (most foods do not have adequate nutrients due to poor soil mineral content).

6. Sleep 8-10 hours a night in a dark room allows for melatonin to rejuvenate your cells while you sleep.

Super foods, herbs, and supplements  that help when you’re getting sick:

1. Garlic – has the widest spectrum antibiotic, antifungal, antiviral activity of all foods. Chop it into manageable pieces for swallowing it raw – in its raw form it maintains its active properties.

2. Echinacea – a good quality Echinacea like MediHerb will help improve your body’s defense reaction to the virus or bacteria.

3. Homemade organic chicken broth will help to thin mucous.

4. Vitamins A, C, E, and zinc and selenium in high doses help to decrease the life of a cold/flu virus, repair mucous membranes, and support immune and detoxification.

5. Complex homeopathics are beneficial – GUNA & Boiron are companies that have remedies specific for flus. These can safely be taken every 20-30 minutes at the onset of a cold/flu.

Getting sick with a cold or flu 1-2 times a year is a sign that your immune system is alert and able to recognize and respond appropriately to foreign viruses and bacteria. So if you do find yourself coming down with a cold or flu, embrace the time off of your busy schedule and take time to care for yourself.

Liver Detoxification of Estrogens

Full detoxification of estrogen by the liver is essential for hormonal health and prevention of disease and hormone-sensitive cancers. The liver uses 2 pathways to detoxify, called Phase I and Phase II.

Phase I detoxification is called the “hydroxylation” phase – which means that the estrogen is made more water-soluble. Intermediate estrogen metabolites are the product of Phase I and include 2-OH and 16a estrogens. These intermediates are biologically active and are potentially damaging to the body’s tissues if reabsorbed (this usually happens with poor Phase II detoxification). 2-OH estrogens are weaker ( the preferred metabolite) than 16a estrogens which is linked to breast cancer. The balance of estrogen intermediates from 16a estrogens to 2-OH estrogens is shifted with dietary and lifestyle changes.

Phase II detoxification involves “methylation, glucuronidation, and sulfation”, meaning that various molecules are added to the estrogen intermediates to make them easily and safely excreted. Ensuring enzyme pathways are active allows for proper excretion of estrogens and decreases prevalence of estrogen-dominant conditions and cancers.

Disorders related to incomplete estrogen metabolism or estrogen dominance include:

• uterine fibroids
• endometriosis
• fibrocystic breasts or painful breasts
• PMS
  

  Lemon water gently supports liver function

• cervical dysplasia
• Systemic Lupus Erythematosis (SLE)

Options for improving estrogen detoxification:

• drinking water with organic lemon slices (gently supports liver function)
• use turmeric on foods (has a compound called Curcumin which is a powerful antioxidant and assists liver detoxification)
• avoid oral contraceptive pills and hormone replacement therapies (these increase your body’s burden of estrogen)
• avoid environmental toxins which resemble & act as estrogens in your body (pesticides, plastics, herbicides, refrigerants, industrial solvents, dryer sheets, perfumes/fragrance)
• eat plenty of leafy green vegetables, broccoli and cabbage (these increase the 2-OH metabolite and protect estrogen-sensitive tissues like the breast and uterus)
• eat 2 tablespoons of freshly ground organic flaxseed daily – flaxseed provides lignans which decrease the amount of free estrogen in the body and formation of estrogen in breast tissue)
• try a high quality multivitamin-antioxidant supplement containing magnesium, selenium, Vitamin B6, and Vitamin B12 (these improve estrogen detoxification, improve function of all cells in the body, and protect against cancer)
• try Calcium-D-glucarate as a supplement (it directly enhances Phase II detoxification of the liver)

Enjoy your health, treat your liver!

Estrogen excess?

Excess estrogen, or ‘estrogen dominance’ refers to a state of hormone imbalance often due to stress, toxins, or poor detoxification. Excess estrogen causes a lot of uncomfortable symptoms  in women including:

• uterine fibroids, fibrocystic breasts, ovarian cysts, breast cancer, PCOS, endometriosis (all estrogen-dominant conditions)
• fatigue
• bloating and fluid retention
• gallstones
• decreased sex drive
• PMS
• long, short, heavy or irregular periods
• hot flashes and night sweats
• weight gain
• acne
• depression &/or irritability

Usually, the body isn’t deliberately producing too much estrogen, rather it’s an imbalance in our internal or external environment that leads to estrogen dominance. Many chemicals in our environment mimic estrogens in our bodies (xenoestrogens). Stress can act as an internal toxin and alters your body’s production of hormones. Finally, poor detoxification (liver, bowels, kidneys) can lead to a build up of estrogens.

So what are your options?

1. Eat organic, download the Environmental Working Group’s ‘dirty dozen’ and ‘clean fifteen’ lists:  pesticides are hormone disruptors, estrogenic, neurotoxic, and reproduction-impairing (60% of pesticides currently used are hormone disruptors)
2. Drink water from glass or steel bottles: bottled water is less regulated than tap water; plastic bottles leach Bisphenol-A (BPA) which is a hormone disruptor; water filtered at home is a good place to start
3. Do laundry differently: laundry soaps contain phthalates, artificial dyes, perfumes and petroleum-based chemicals; fabric softeners and dryer sheets contain chloroform, benzyl acetate, and toluene; Try Biovert, Ecover, Soap Factory Laundry Miracle, Nature Clean, Seventh Generation and a reusable dryer cloth such as Static Eliminator.
4. Yoga, enjoyable activity or exercise, breathing, meditation, talking, journaling, and sex can all reduce your stress levels.
5. Support your detoxification by: drinking hot water with a slice of lemon in the morning, adding ground flax seeds to your diet, eating dandelion greens, onions, garlic, broccoli, watercress, and artichoke, drinking plenty of water, and eating a whole foods diet.

You may also choose to consult your Naturopathic Doctor to consider a salivary hormone panel (assesses your estrogen, progesterone, cortisol, testosterone and DHEA levels throughout the month), or supplements to support hormone balancing (e.g. Vitamin B6, Magnesium, Chaste Tree berry, milk thistle).

Lemony Lentil Soup

This is a new favourite in our house – Lemony Lentil Soup!  A – I love lemons and lemon-flavoured dishes, B- I love dill!  Both flavours transport me to sunny summer days.  I found this recipe in  Whitewater Cooks  by Shelley Adams.

Ingredients:

Spices & herbs:

2 tsp salt

Lemony Lentil Soup

6 garlic cloves, minced

1 large onion, diced

1 tsp pepper

1/4 tsp red chili flakes

1 Tbsp oregano

1 Tbsp fresh rosemary, chopped

2 bay leaves

2 Tbsp fresh dill, chopped

The rest of the goods:

2 cups red lentils

2 Tbsp olive oil

3 carrots, diced

8 cups vegetable or chicken stock

juice of 2 lemons

2 tsp lemon zest

1 cup feta cheese crumbled (I use goat feta)

Method:

– rinse lentils and allow to drain

– heat olive oil (or you can use coconut oil for a more heat-stable oil) in a large pot, and add onions; sauté until translucent

– add carrots, garlic, salt, pepper, chili flakes, rosemary, oregano, and bay leaves

– stir and sauté until the carrots are tender

– add the stock and lentils and bring to a boil

– reduce to a simmer for 25 minutes or until the lentils are soft

– remove the bay leaves and purée if desired (I prefer the purée)

– add the lemon juice and zest

– to serve: sprinkle feta and dill on top

Enjoy!