This month Dr. Julie answers questions on:

Thank you for your question.  Cortisol is a stress hormone produced in the adrenal glands.  You have probably been reading about it in regard to its role in weight maintenance.  It is has been the focus of new weight loss products.  Let’s talk about cortisol’s functions, how you can find out what your own levels are and how to keep it’s level in the normal range. 

Cortisol has a number of functions but all related to keeping usable energy (glucose) in your blood stream.  The most important stimulus for the release of cortisol is stress because the body anticipates the need for energy to remove you from a threatening situation.   With regard to weight maintenance the most important function is the enhancement of gluconeogenesis.  This fancy word simply refers to your body’s ability to build glucose (sugar) to use as an energy source when blood sugar is low.  Thus the more you are under stress the more cortisol stimulates the liver to build sugar.  Blood sugar increases and if it is not used up then it is stored as fat. 

Other functions of cortisol are the building and breaking down of protein, fat breakdown and the release of fatty acids from fat tissue.  These functions are also important in weight maintenance and this is the reason why you should focus on keeping cortisol in a normal range rather than keeping it low.

Your body tends to release cortisol in a cyclical pattern, highest in the morning and decreasing gradually to the evening.  Stress of any sort, physical, mental or emotional cause spikes of cortisol that can be measured in the blood and saliva.  Patterns of high cortisol can also be coupled with times of low cortisol which is valuable to know when choosing therapies and dosing regimens.  The most specific way to measure cortisol is with multiple samples in a salivary hormone analysis.  Other hormones that can influence cortisol levels are commonly tested at the same time including DHEA, male or female hormones and possibly neurotransmitters.  For a less costly inference of cortisol levels the Konisberg test and symptomatology may be used.  I employ both methods in my Naturopathic practice.  See your integrative health professional to access these tests. 
   

Once you figure out how your cortisol levels are fluctuating supplementation can optimize it.  As always, seek guidance before starting supplementation, especially of you take prescription medication.  Some natural products to consider for low cortisol are vitamin C, the B complex vitamins, especially B5 and B6, and zinc.  Adaptogenic herbs support the adrenal gland and the body during stress.  They include licorice, the ginsengs, withania and sarsaparilla.  Glandular support with adrenal and pituitary extracts may be helpful.  Some natural products to consider for high cortisol are the same vitamins and minerals as mentioned above.  Other supplements include phosphatidyl serine, and calming herbs like St Johns wort, passionflower and valerian.  Adaptogenic herbs may be used in low doses for their regulating properties. 

Remember that none of these supplements are meant to replace a healthy diet, exercise and stress reduction techniques. 

I hope that this answers your question.  If you have any further questions please seek the advice of a Naturopathic Doctor.

I commend you for taking a proactive approach to improving your health.  Since the environment in which we live makes it impossible for us to maintain a pristine lifestyle, regular cleansing is essential to maintain health.

Before starting a detoxification, or cleanse, it is important that you undergo a physical examination and assessment from your health care provider.  Cleansing regimens are individualized based on organ health, medication use, toxin load and the individual’s lifestyle and time commitment.  

In my Naturopathic practice assessment includes a urine sample, in office lab tests and possibly blood, hair or stool tests to assess the functioning of the organs to be detoxified, most commonly the liver, kidneys and intestines.  In addition I assess the individual’s prescription medication to see which organs are involved in the metabolism and excretion of the medication. 

Detoxifying organs leads to an increase in their activity and can increase or decrease medication levels.  I assess an individual’s toxin load to suggest an appropriate duration and intensity of cleanse.  Finally I discuss how to best fit a detoxification into my patient’s lifestyle and what time commitment they can make.

Once it is determined that a cleanse is appropriate, natural remedies can be targeted to affect the desired organs.  Just as important as the remedies used, but often overlooked, are dietary and lifestyle recommendations.  These include a healthy diet, sufficient water, ample sleep and moderate exercise.  For more information on remedies and methods of detoxification read the article titled “detoxification” located on this website. 

The first time that you begin a cleanse it is important to remember the signs and symptoms that you may experience as your body moves and metabolizes toxins.  These include flu-like symptoms, fatigue, irritability, headache, diarrhea or loose stools or food cravings.  Some symptoms occur when too many toxins are liberated and overwhelm the metabolic and excretory pathways.  Consult your health care provider and discuss altering dosages or implementing other strategies to speed the excretion of toxins.

I hope that this has given you a start to understanding detoxification, good luck.

Thank you for your question.  It brings to attention an important difference in the way natural products can be used.  Symptomatically there are many things that can be used to decrease the allergic symptoms and fight infection.  We will talk about some of those first.  Treating symptomatically will address your concerns initially but for lasting relief you should assess your immune system and factors that are compromising its function.  We will touch on those issues at the end.
 

When the allergen contacts a mucous membrane inflammation occurs, due to the release of chemicals such as histamine.  It is characterized by redness, itching, swelling and the increased secretion of thin, clear mucous.  Allergic symptoms can occur any where in the body, for you the mucous lining of the sinuses are affected.  Irritation of the gastrointestinal lining may cause bloating, diarrhea or constipation.  Inflammation in other areas may lead to headache, joint pain, heart palpitations, mood swings, hyperactivity and hypoglycemia.  Chronic infections with fungus, often candida, are a common complicating factor. 
 

Reactions to allergens can be cumulative and occur well after the allergen contacts the mucus membrane (up to 72 hour after).  Therefore a thorough assessment of allergens in your environment and diet is very important.  This can be done with blood testing (IgG and IgE) and elimination testing.    

Symptomatic allergy relief is aimed at decreasing the histamine response.  Histamine is released by mast cells.  Supplements like Vitamin C, quercitin and methylsulfonylmethane (MSM) stabilize the membranes of mast cells so that it takes more immune cell stimulation to release histamine.  On the other side of the coin, vitamin B3, initiates the release of histamine.  The flushing form of the vitamin causes redness and swelling, thus depleting the body of histamine.  If it is taken for a period of time prior to exposure to an allergen there is less histamine to available during a reaction and the allergic symptoms are decreased. 

Standing out amongst the many botanical medicines for allergies is stinging nettle.  It heals mucus membranes and decreases histamine release, especially in the sinuses.  Additionally it is an antioxidant.  Immune responses produce free radicals as a way to neutralize allergens and infections.

To help with chronic sinus infections consider replenishing the bacteria that normally line the mucus membranes, probiotics.  Two of the better-known strains are Lactobacillus acidophilus and Bifidobacterium bifidus.  They produce chemicals that act as natural antibiotics to prevent other organisms from colonizing our mucus membranes.  A deficiency of Vitamin A can lead to inflammation of the mucus membranes, including the sinuses.  Echinacea and goldenseal are two well-known herbs that have antiviral and antibacterial properties. 

You may have heard Naturopaths or other integrative health care providers talk about the “root” of disease in the body.  In this case the infections and allergies are simply symptoms of an underlying or “root” concern in your body, an imbalanced immune system.  A TH1 immune response occurs when the stimulus is a piece of an invading virus, bacteria, fungus or parasite.  This response starts the cascade of immune activity that neutralizes an infection.  A TH2 response is an inflammatory response.  Inflammation is used by the body to breakdown unwanted or damaged tissue (wound repair) clearing the way for tissue rebuilding and remodelling to occur.  A misguided TH2 response occurs when the stimulus is a part of the body (auto-immune) or, in your case, when the immune system is sensitized to benign particle (allergy). 

The body is in a balanced state of immunity when it spends equal time in a TH1 and TH2 response.  Stress, exposure to chemicals and other immune upsetting agents act by chronically elevating the TH2 (pro-inflammatory) response.  Thus the body spends more time in TH2, and a TH1 to TH2 shift occurs.  Infections happen more readily because the immune system spends less time defending the body.  Allergic responses, autoimmune responses and tissue damage cause symptoms of ill health. 

A branch of homeopathy, called homotoxicology focuses on remedies to balance the TH responses in various tissues.  These remedies are available through Naturopathic Doctors.  Finding research on other natural remedies that specifically modulate the TH response is not as easy.  However some of the more widely available remedies are plant sterols and medicinal mushrooms.

If you have any further questions please seek the advice of a Naturopathic Doctor.