Root Functional Medicine

Functional Medicine for Sports Performance Optimization

Root Functional Medicine — Fri, 15 Jan 2021 00:00:00 -0500

Interested in how Functional Medicine can improve sports performance? In this article Dr. Slater talks about why this is something she is passionate about!

My interest in functional medicine for sports performance optimization stems from the fact that I’ve been an athlete my whole life. In my younger years I did gymnastics and competitive swimming. Later on, in high school I played tennis which I was then able to continue on a collegiate level. My husband also comes from a very athletic family, with some playing on a professional level. My kids play travel hockey and soccer. So, you can say that sports are an integral part of my life.

Advanced Functional Testing

Nutrition is particularly important for athletes due to the stress and high energy demands they put on their bodies. There are many basic and more advanced (functional) tests that we can check on our athletes.

For basic lab testing, both thyroid and iron stores testing are part of our standard new patient lab panel at Root. Over exercising combined with low calorie intake in athletes can lead to decrease thyroid function by increased conversion of T4 thyroid hormone to the storage form of thyroid hormone- reverse T3 (rT3). rT3 is the inactive form of thyroid hormone. It is produced in times of stress and leads to slowing down of our metabolism.

Iron deficiency is another common deficiency especially in endurance athletes. Iron is a key component of hemoglobin, which carries oxygen to muscles and other tissues. Low iron or low ferritin (a measure of iron storage) can manifest as decreased oxygen delivery to tissues, fatigue during exercise and increased risk for injury.

There are also many advanced (functional) lab tests we can do for athletes:

Full Micronutrient analysis includes everything from antioxidants to vitamins and minerals as well as fatty acids and amino acids. This can give athletes very valuable information as to what foods they should be concentrating on as well as possible supplement needs for their particular energy requirements.
Gut health and microbiome testing is another big area we can evaluate. We are not only what we eat, but we are what we can digest and absorb. So, if our gastrointestinal system is off balance due to, for example, low digestive enzymes or bacterial imbalances, such as small intestinal bacterial overgrowth, then we will not be able to break down and absorb food properly. This can lead to various nutrient deficiencies and issues with energy production/athletic performance.
Cortisol Measurements: We can measure salivary cortisol levels at 6 points throughout the day to determine if you have a proper circadian hormonal pattern. Normally your cortisol should be highest in the morning and then gradually drop throughout the day, with its lowest level being right before bedtime. This allows you to have energy throughout the day and the lower levels at nighttime allow you to relax and fall asleep. In the initial stages of high intensity training your cortisol can be high- this is your bodies normal response to stress. But over time, if you are overtraining, your adrenal glands can grow weaker, which can eventually lead to a condition called adrenal fatigue. In adrenal fatigue you can have depressed cortisol levels in the morning and throughout the day, leading to low energy.

I like to take a personalized approach with all my athletes and after listening to their full story, order appropriate testing and customize their nutrition plan to their individual needs.

Fertility Diet To Improve Egg Quality

Root Functional Medicine — Sun, 18 Apr 2021 00:00:00 -0400

Whether you are planning to get pregnant soon, working through fertility treatments, or have suffered multiple miscarriages, focusing on egg quality during the preconception period is critical for all women trying to conceive. In this article, we’ll discuss the best fertility diet to improve egg quality.

Why Does Egg Quality Matter?

Contrary to men who continuously generate sperm, women are born with all the egg cells they’re ever going to have, and this number slowly declines with age. The quality of your remaining eggs also decline which can increase the risk of fertility issues and miscarriage.

While you cannot change the number of eggs you have, you can influence egg quality.

Three to four months before ovulation, an egg cell (also called a follicle) matures and grows dramatically in size. The growing follicle requires nutrients and energy from the surrounding environment. By improving your diet and lifestyle during this approximately 90 day time period before ovulation, you can improve egg quality and increase your chances of a healthy and successful pregnancy.

Fertility Diet to Improve Egg Quality

Research largely supports a Mediterranean-inspired diet for optimal fertility. Many aspects of this diet may also improve overall egg quality. The Mediterranean diet is rich in fruits, vegetables, nuts, seeds, beans, whole grains, and lean protein.

Protein + Fat + Carbs

Eating for blood sugar balance is one of the biggest components of a fertility diet. When you eat a meal containing carbohydrates, your pancreas releases a hormone called insulin to lower blood sugar levels back to normal. A poor diet high in added sugar and refined carbs will eventually cause your cells to stop responding properly to insulin. This is known as insulin resistance and can increase blood sugar levels and overall inflammation in the body. High blood sugar is a big problem for egg quality and fertility because it disrupts the balance of other reproductive hormones.

By following a simple formula of protein + fat + carbs at every meal and snack, you can properly balance your blood sugar levels. Aim to fill half of your plate with non-starchy vegetables like broccoli, leafy greens, bell peppers, and more. Then, fill one quarter of your plate with fiber-rich carbs, and the other quarter with a high-quality protein. Finally, top off your plate with 1 to 2 tablespoons of healthy fat.

Our quick and easy, fully prepared, Root Farmacy Meals follow this PFC guideline to help balance your blood sugar levels.

Meal Plans

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Antioxidant Rich Foods

Antioxidants are molecules that protect your eggs from damage and oxidative stress. Unfortunately, women with conditions like polycystic ovary syndrome have higher levels of oxidative stress and lower antioxidant levels which may result in poor egg quality and fertility problems (1).

To improve egg quality and boost antioxidant levels, include a variety of antioxidant-rich foods in your fertility diet, like fruits and vegetables. Here are a few common foods containing high levels of antioxidants:

Berries (all kinds)
Apples
Dark leafy greens
Broccoli
Asparagus
Pecans
Walnuts
Red kidney beans
Spices (especially cinnamon, mint, oregano, and thyme)

The more colorful you make your plate, the better!

Seafood

The Mediterranean diet emphasizes multiple servings of seafood rich in healthy omega-3 fats. Omega-3 is an anti-inflammatory fat that is particularly beneficial for fertility and egg quality. In fact, some researchers have found that women with sufficient omega-3 levels typically have higher-quality embryos and are more likely to become pregnant (2).

Furthermore, most fish is rich in fertility-friendly nutrients like vitamin D, vitamin B6, iodine, and selenium.

To optimize omega-3 levels, aim to include two servings of fish every week in your fertility diet. The fish that are the highest in omega-3 (EPA and DHA) but lowest in mercury include: salmon, mackerel, anchovies, sardines, and herring.

Caffeine and Alcohol

Drinking large amounts of caffeine (> 400 mg or 4+ cups of coffee) per day may negatively affect fertility and even increase miscarriage risk (3). Plus, excessive caffeine can impact your sleep quality, so try to limit yourself to 1 to 2 cups of coffee per morning.

Heavy drinking is undeniably harmful for general health as well as egg health and fertility. Some studies found reduced fertility in women when consuming more than 14 drinks per week. However, there is less consensus on moderate alcohol consumption and its effect on fertility. Nonetheless, alcohol certainly does not promote egg health or fertility, so it’s best to limit alcohol intake or keep it to the occasional glass of wine to help set a romantic mood.

Take a High Quality Prenatal Vitamin

We believe in a food first approach, and this applies to fertility as well. However, while most women begin taking prenatal vitamins once they become pregnant, we recommend starting a prenatal at least three months before trying to conceive. If you were previously taking the birth control pill, start taking a prenatal as soon as possible, as the pill can deplete your body of many important nutrients needed for egg health and optimal fertility.

You can purchase our recommended prenatal vitamin here.

Another supplement, called coenzyme Q10, is critical for energy production inside the “power plants” i.e. mitochondria of your egg cells. If your egg can produce optimal energy, there is a greater chance for it to mature, fertilize, and successfully grow. In fact, one study found that a higher level of CoQ10 inside developing eggs was associated with higher-quality eggs and higher pregnancy rates (4).

You can purchase coenzyme Q10 from our Root Shop as well.

Best Fertility Diet for Egg Quality: Summarized

While your overall egg quantity declines as you age, eating a Mediterranean-inspired diet (especially in the 90 days before conception) may improve egg quality and optimize your fertility.

The Mediterranean diet is rich in vegetables, fruits, nuts, seeds, whole grains, and lean protein. Use the protein + fat + carb formula with lots of colorful non-starchy vegetables to balance your blood sugar and provide an antioxidant boost. Aim to eat at least two servings of fish per week to improve your omega-3 levels and lower inflammation.

Egg quality is particularly important for women in their late thirties to early forties; however, all women should focus on improving their diet and lifestyle in the preconception period to optimize fertility and future pregnancy outcomes.

Need more help? Our functional medicine dietitians offer various 1:1 fertility nutrition evaluations with personalized labs to develop a plan that best works for you. Learn more about our fertility consults.

IBS and PCOS

Root Functional Medicine — Mon, 30 Aug 2021 00:00:00 -0400

Irritable bowel syndrome (IBS) and polycystic ovary syndrome (PCOS) are two common conditions that affect many women around the world.

In this article, we’ll discuss how these two conditions are related and why identifying and addressing the root cause can treat both PCOS and IBS.

What is IBS?

IBS is a gastrointestinal disorder affecting up to 20 percent of all people. Individuals with IBS generally have abdominal discomfort multiple days a month for at least three months. The official diagnosis of this criteria also includes two or more of the following symptoms at least 25 percent of the time:

Improvement in pain when you have a bowel movement
Change in stool frequency (more or less than usual)
Change in appearance (watery or firm/hard)

Common symptoms of IBS include:

Diarrhea, constipation, or a combination
Abdominal pain
Bloating
Gas
Difficulty or straining with bowel movements

Some studies suggest that IBS is actually caused by dysbiosis— an imbalance of gut bacteria. Similarly, small intestinal bacterial overgrowth (SIBO) is also a suspected cause of IBS with one study reporting up to 78 percent of IBS patients also testing positive for SIBO (1).

What is PCOS?

PCOS is the most common metabolic and hormonal disorder in women of childbearing age. Some estimates suggest that PCOS affects up to 20 percent of these women. Individuals with PCOS generally have at least two of the following:

Biochemical and/or clinical hyperandrogenism (like high testosterone, acne, or facial hair)
Irregular or absent periods
Polycystic ovaries

Common symptoms of PCOS include:

Acne
Hair loss or thinning hair
Unwanted facial or body hair
Irregular periods
Long or absent periods
Weight gain
Difficulty losing weight
Infertility

PCOS is a complex syndrome with multiple root causes like insulin resistance, high testosterone, and dysbiosis. Learn more about PCOS here.

What is the relationship between IBS and PCOS?

An estimated 30 to 40 percent of women with PCOS also have IBS (2, 3). IBS is more common in PCOS than the general population because these two conditions share one major root cause: dysbiosis.

Dysbiosis is an imbalance of gut bacteria in which you have too many bad bacteria, not enough good bacteria, and/or not enough bacterial diversity. A variety of factors cause dysbiosis of the gut including: the standard American diet, alcohol intake, frequent antibiotic use, stress, limited exposure to germs/dirt, and various medications. Left untreated, dysbiosis can damage the gut lining and subsequently cause leaky gut and food sensitivities. Furthermore, some new research suggests that dysbiosis may even cause the insulin resistance, hyperandrogenism, and chronic inflammation seen in PCOS (4).

Some medications prescribed for PCOS, like metformin, cause side effects similar to symptoms of IBS. Interestingly, these side effects may be due to metformin’s influence on the gut microbiome, and some studies suggest this drug may also cause dysbiosis.

I have IBS and PCOS. What now?

Given the major role dysbiosis plays in various health conditions, especially IBS and PCOS, we assess digestion for every single client in our practice. Implementing interventions to treat dysbiosis is essential.

Reduce gut disruptors

Your diet has the largest impact on gut health because these foods come into contact with your gut bacteria multiple times per day. Added sugar disrupts your gut bacteria by feeding the harmful bugs and starving the good bugs. Too much added sugar can also exacerbate PCOS by raising your blood sugar levels and worsening insulin resistance.

Removing added sugar and artificial sweeteners from your diet is key in preventing and fighting against dysbiosis. The largest sources of added sugar in the standard American diet are sugar-sweetened beverages, pastries, and desserts. This is a great place to start. Aim to reduce or remove these items from your diet. Examples of sugar-sweetened beverages include sweetened coffee drinks, soda, juice, and sweet tea. Many beverages contain added sugar even if they are marketed as “healthy” options. Get into the habit of briefly scanning the ingredient label to look for these sneaky sources of sugar. New labeling requirements make this process easier by including a separate line on the nutrition facts label to clearly show how many grams of added sugar are in each serving of the product.

Consider trialing a low-FODMAP diet

If your IBS and gut symptoms are moderate to severe, you may need to trial a temporary low-FODMAP diet. A low-FODMAP diet is a short-term elimination diet that helps you identify which foods worsen your GI symptoms. FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides and polyols.” Essentially, certain foods contain higher levels of FODMAPs that cause your gut bacteria to release excess gas. By eliminating the foods highest in FODMAPs, you may experience less digestive symptoms.

Common foods high in FODMAPs to eliminate on this diet include:

Wheat
Dairy (lactose)
Garlic
Onions
High fructose corn syrup
Fruit juice

The low-FODMAP diet can provide fast relief from your symptoms. However, it is fairly difficult to follow on your own, as many foods contain varying levels of FODMAPs. Fortunately, our registered dietitians developed an online course to help you navigate this diet. Learn more about our Low-FODMAP Diet Course.

Eat a fiber-rich diet

While starving the bad bugs by reducing added sugar, we want to simultaneously feed the good bugs. This is where fiber comes into play. Fiber is the preferred source of fuel for your beneficial gut bacteria. Eating fiber-rich foods with your meals and snacks ensures the survival and growth of good gut bacteria which then provide benefits like reduced inflammation and regular bowel movements. Fiber is also essential in PCOS because it helps to balance blood sugar levels and increases satiety after a meal. You should aim to eat 25 – 35 grams of fiber per day.

Some individuals with IBS may experience worsening GI symptoms when increasing fiber in their diet. In this case, we recommend trialing a low-FODMAP diet or working with your doctor to obtain a test for small intestinal bacterial overgrowth(SIBO).

Start including some of these high fiber foods into your diet:

Non-starchy vegetables: broccoli, Brussels sprouts, cauliflower, carrot
Starchy vegetables: potato, sweet potato, winter squash
Fruit: apple, banana, blueberries, raspberries, pear, orange
Grains: quinoa, oats, brown rice
Legumes, nuts, and seeds: green peas, lentils, black beans, chia seeds, almonds, pistachios

Consider supplements to treat dysbiosis

Your overall diet, as in the foods you eat, plays the most important role in treating dysbiosis and therefore IBS and PCOS. However, we do recommend a few supplements which we have found extremely effective.

Our Gut Health Bundle includes digestive enzymes, a soil-based probiotic to support a healthy microbiome, and our Gut Health Rebalance powder to help reflux, reduce gut inflammation, and repair the gut lining.

Key Takeaways

Up to 40 percent of women with PCOS also suffer from IBS. Dysbiosis is a shared root cause of both of these conditions, and addressing this imbalance of gut bacteria is crucial to find true healing. Removing added sugar, eating a colorful and fiber-rich diet, and taking targeted supplements all help to reverse dysbiosis. Some individuals may also need to trial a temporary low-FODMAP diet to identify food triggers and achieve symptom relief from IBS symptoms.

What is Polycystic Ovarian Syndrome (PCOS)?

Root Functional Medicine — Fri, 20 Dec 2019 00:00:00 -0500

Last week we wrote about 5 common women’s health problems we frequently treat here at Root. Today, we are going to go more in depth about a condition mentioned in that post: Polycystic Ovarian Syndrome (PCOS).

How is it diagnosed?

PCOS is the most common metabolic and hormonal disorder in women of childbearing age, and is estimated to effect between 6-13% of women. It is the leading cause of female infertility in the United States. Per the Rotterdam Criteria, women must meet at least 2 of the following 3 criteria to be diagnosed with PCOS:

Absent or irregular menstrual cycles (Oligo- or amenorrhea).
Clinical or biochemical signs of hyperandrogenism (such as high testosterone)
Polycystic ovaries (confirmed via ultrasound)

There is also emerging research that elevated levels of a protein hormone secreted by the ovaries called Anti-Mullerian Hormone (AMH) might be indicative of PCOS, but this is not currently used for official diagnosis. You can read more about that here.

It often takes several years and visits to several healthcare practitioners before women are correctly diagnosed. According to this study, it took one-third of women over 2 years and visits to at least 3 healthcare professionals before a proper diagnosis was made. It’s possible that you or someone you know has PCOS and you don’t even know it. The study also reported that a large percentage of women were unhappy with the education they received around the diagnosis.

Signs and Symptoms

The vast majority of women (around 70%) with PCOS suffer from insulin resistance, and therefore have difficulty losing weight. Insulin is a hormone produced by the pancreas that is released when carbohydrates (sugar) are consumed. Insulin’s job is to help bring sugar of out the blood and into the cell, but when insulin resistance is present, the cell’s receptors don’t open up efficiently to let the sugar in for absorption. This leads to both elevated glucose in the blood and elevated circulating insulin. Insulin is a “fat storage” hormone and therefore elevated circulating insulin can make it challenging to maintain a healthy weight. Because the cells are not able to utilize the glucose efficiently, this often leads to severe sugar cravings as well.

Other symptoms associated with PCOS include skin problems (acne), hair loss, unwanted hair growth (hirsutism), irregular or heavy periods, and mood disturbances.

Treatment

Mainstream recommendations often tell women to lose weight and this alone will make their symptoms improve, but that is not necessarily the case, nor is it easy for women with PCOS to lose weight due to the insulin resistance described above. It’s also important to note that there is something called “Lean PCOS”, so giving the blanket statement that women with PCOS need to lose weight to improve their symptoms is incorrect again.

PCOS is an inflammatory condition. In order to effectively treat PCOS, it is essential to treat the root cause of the condition and work to reduce system-wide inflammation using a personalized approach.

Some women take the drug Metformin to help with insulin resistance and to improve their likelihood of getting a regular menstrual cycle, but this drug can come with many side effects. Hormonal birth control is often used as a treatment in traditional medicine, but this is more of a “band-aid” approach and isn’t truly getting to the root of the problem. Right when you go off birth control you will be right back where you started. It’s also important to note that the bleeding you get when you take the “sugar pills” in your monthly pack of pills is not truly a period. This bleeding is called “withdrawal bleeding,” meaning withdrawal from the synthetic hormones.

There are many diet and lifestyle changes that can be made to improve PCOS symptoms. One recent long-term study showed that 54% of women with PCOS were able to improve their menstrual cycle via lifestyle and behavior modification changes and 43% of women were ovulating regularly post intervention. It is interesting to note that these changes were with just a 2% loss of body weight, proving again that weight loss should not be the primary focus for PCOS treatment.

Dietary treatment is highly individualized and we always take into account a woman’s relationship with food and readiness to change when creating treatment plans. Some general recommendations often include:

– Eating a lower glycemic index diet

– Being mindful of the amount of carbohydrates you consume and balancing out meals with adequate protein and fat

– Including anti-inflammatory fruits and vegetables

– Eating adequate healthy fat

– Taking supplements proven to help with PCOS symptoms and cravings (these are discussed more in our 3-month program)

Resources:

Gibson-Helm M , Teede H , Dunaif A , Dokras A . Delayed diagnosis and a lack of information associated with dissatisfaction in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2017;102 (2): 375-378

Marsh KA, Steinbeck KS, Atkinson FS, Petocz P, Brand-Miller JC. Effect of a low glycemic index compared with a conventional healthy diet on polycystic ovary syndrome. Am J Clin Nutr. 2010;92(1):83-92.

Rashidi B, Gorginzadeh M, Aalipour S. Age related endocrine patterns observed in polycystic ovary syndrome patients vs. ovulatory controls: descriptive data from a university based infertility center.Arch Encocrinol Metab. 2016;60(5):486-91

Obert E, Gidlof S, Jakson I, MItsell M, Tollet Egnell P, & Hirschberg AL. Improved mennstrual function in obese women with polycystic ovarian syndrome after behavioural modification intervention-a randomized controlled trial. Clin Endocrinol (Oxf). 2018. doi: 10.1111/cen.13919.

PCOS and Constipation

Root Functional Medicine — Mon, 30 Aug 2021 00:00:00 -0400

Constipation is a fairly common symptom among women with polycystic ovary syndrome (PCOS).

In this article, we’ll discuss the relationship between PCOS and constipation, and how you can treat the root cause of both of these conditions with diet, lifestyle, and targeted supplementation.

What Causes Constipation in PCOS?

There are a few factors which may explain why an individual may suffer from both constipation and PCOS.

First of all, irritable bowel syndrome (IBS) is a GI disorder that causes painful digestive symptoms including diarrhea, constipation, or a mixture of both. IBS is more common in women with PCOS, especially the IBS-constipation subtype (1). Dysbiosis, or an imbalance of gut bacteria, may be to blame for the increased prevalence of constipation in women with PCOS. Dysbiosis occurs when you have too many bad bugs, too little good bugs, or not enough bacterial diversity. Women with PCOS are more likely to have dysbiosis of the gut than women without this condition (2).

Small intestinal bacterial overgrowth (SIBO) may also cause constipation in certain individuals. SIBO is a form of dysbiosis which occurs when too many bacteria end up in the small intestine. SIBO can cause hormonal imbalances, constipation, weight gain, acne, and more.

Finally, diet and lifestyle may also cause constipation. The standard American diet is rich in calories, inflammatory fats, and refined sugar while lacking in fiber, fruits, and vegetables. In fact, the average American only consumes about 14 grams of fiber per day—half of the daily reference value of at least 28 grams. This type of diet can cause dysbiosis and slow GI transit time.

How to Treat PCOS and Constipation

Daily bowel movements are crucial to effectively remove waste byproducts through the stool for detoxification and optimal health.

Rule Out Hypothyroidism

Hypothyroidism, not PCOS, may be to blame for your constipation. Women with PCOS are three times more likely to suffer from Hashimoto’s thyroid disease than women without PCOS (3). Hashimoto’s is an autoimmune thyroid disease involving chronic inflammation of the thyroid gland. It is also the most common cause of hypothyroidism in the United States.

In hypothyroidism, the movement of food through the GI tract is slowed, which is why many individuals with Hashimoto’s complain of constipation. Other symptoms of hypothyroidism include brittle nails, thinning hair, cold intolerance, weight gain, and more.

If you have PCOS and suffer from constipation, ask your doctor to rule out Hashimoto’s with a simple blood draw. More specifically, you will want to request a full thyroid panel (TSH, Free T4, Free T3, and thyroid peroxidase antibodies). A high TSH with or without a low free T4 first confirms the presence of hypothyroidism. The additional presence of high thyroid antibodies in your blood indicates Hashimoto’s.

Increase Daily Fiber

Fiber is a type of nondigestible carbohydrate that provides numerous health benefits for individuals with PCOS and constipation. First of all, fiber provides bulk to your stool and softens it for easier passage. Fiber is also the main fuel source for your healthy gut bacteria. Your gut microbiome needs enough fiber to help these beneficial gut bugs flourish and provide great benefits like reducing inflammation, improving insulin resistance, and promoting regular bowel movements. Furthermore, fiber slows the absorption of carbohydrates into your bloodstream which prevents blood sugar spikes after a meal. Aim for a goal intake of 25 – 35 grams of fiber per day. Some people may need to gradually increase their fiber intake over a few days or weeks to prevent side effects like bloating and gas. Read more about Bloating and PCOS.

Fruits, vegetables, nuts, seeds, and whole grains provide rich sources of fiber. Don’t be afraid of carbs! Instead, focus on prioritizing foods rich in complex carbohydrates (like those previously listed).

In our practice, we prescribe foods or recipes for our clients’ specific health needs. For example, if you have PCOS and constipation, we may suggest including a chia pudding as a snack or quick breakfast a few times per week (pictured above is a Dark Chocolate Chia Pudding—a delicious snack from our Root Farmacy Meals). Just two tablespoons of chia seeds offers 11 grams of dietary fiber! Chia seeds also provide antioxidants and healthy omega-3 fats to fight off inflammation.

Here are a few other high-fiber snack ideas to incorporate into your diet:

½ cup blueberries + small handful of almonds
½ cup raspberries + 1-2 hard boiled eggs
Carrots/pepper strips + hummus
Almond flour or seed crackers (we love Simple Mills) + guacamole
RX Bar or Epic Bar
1 clementine + small handful of walnuts

If you’re interested in more guidance for treating PCOS and constipation with food as medicine, check out our upcoming course!

Adequate Hydration

Constipation and dehydration are closely linked, so drinking enough water is crucial to promote regular bowel movements, especially as you increase the fiber in your diet. Aim to drink at least half of your bodyweight in ounces. For example, if you weigh 200 pounds, you should try to drink around 100 ounces of water each day. Tired of water? Try sparkling or mineral water, unsweetened coconut water, or unsweetened green tea. Alternatively, you could also try homemade infused water with fresh produce and herbs, like cucumber mint, orange lime, or strawberry lemon.

Daily Movement

Exercise is a great prescription for constipation as daily movement promotes optimal digestion and increases gut transit time. Exercise can also reduce insulin resistance, enhance sleep quality, and boost your mood. The best type of exercise is the one you will consistently maintain! Moderate walking, yoga, cycling, strength training, or swimming are a few great options.

Consider a Magnesium Supplement

Magnesium is one of the key supplements in our PCOS treatment plan because of the widespread benefits of this mineral. Taking a magnesium supplement for PCOS can improve insulin resistance, reduce inflammation, and ease PMS symptoms (4). Plus, magnesium citrate, a specific form of this mineral, has a gentle laxative effect when taken properly. If trying a magnesium supplement for constipation, aim for around 200 mg of magnesium citrate each day.

Key Takeaways

Women with PCOS often complain of constipation, which may be due to gut dysbiosis, bacterial overgrowth, or diet and lifestyle. Hypothyroidism can also cause constipation and is fairly common in PCOS, so ask your doctor to rule out a thyroid disorder. You can treat PCOS and constipation by increasing daily fiber, drinking at least half of your body weight in fluid ounces, incorporating daily movement, and considering a magnesium supplement.

Is Functional Medicine Covered By Insurance

Root Functional Medicine — Mon, 18 Mar 2019 00:00:00 -0400

Is functional medicine covered by insurance is a question we get often, and it’s a sensitive subject for many. As I do my best to explain this answer, please know that the model we’ve chosen was what we felt allowed us to provide the best individual care in a holistic functional medicine practice for each person. As with many things in medicine, what’s covered by insurance can change, but at the present time…

Is functional medicine covered by insurance?

Chances are, if you are in a true functional medicine practice where your doctor is practicing in a functional medicine model of care and not a conventional insurance model of care, the most likely answer is no, it’s not covered by insurance.

What’s the difference between the two models of care?

Conventional insurance-based medicine is built around the concept of labeling you with a reimbursable diagnostic code (diagnosis) and then finding the medications or a procedure to match.

A functional medicine model of care works through the functional medicine matrix, balances imbalances, considers the connection of mind-body-spirit and often can’t label your symptoms with a single diagnostic name because body systems communicate. We remove the artificial silos of body parts into specialty areas of conventional medicine and consider you as a whole person, mind and body, with communicating body organs/systems. The core of functional medicine is finding the why, or the root cause, and simply operating in a diagnosis to medication model doesn’t fit.

In addition, if your doctor is spending enough time with you (both in person and afterwards researching your unique case) to get to the root of your issue, using advanced testing that takes more time and knowledge to interpret, and then personalizing your treatment plan to include natural therapies, the most likely answer is no, it’s not covered by insurance.

Many treatments in functional medicine are considered “alternative” because they don’t involve a medication for symptoms, but rather supplement an individual’s unique needs. (Pictured below is our foundational bundle, vitamins we find the majority of our patients are deficient.) Functional medicine doctors understand that what works for you might not work for the other 99 people in the study, because you have a unique genome, microbiome, and lifestyle – factors that aren’t considered in mainstream medicine recommendations.

So true functional medicine approach doesn’t often work with insurance but, here’s

why that can be a good thing:

Insurance-free practices allows for:

Advanced care. Being “insurance-free” allows doctors to recommend the most advanced therapies and testing. One study showed that conventional doctors took an average of 17 years to change behavior, from the time of new scientific information. The insurance model keeps doctors stuck in the current “standard of care” because that is often what is reimbursed, even if that standard of care is outdated. Insurance covers what they can easily track (expense to benefit) and unfortunately one of the easiest things to track is medication. Medications are also easier to study because it’s one intervention and not a more difficult to measure multi-factorial approach of lifestyle and natural therapies. (Not to mention medication studies have more funding). Yes, medications can be life-saving and necessary and as an MD I still prescribe them, but it is only part of our treatment plan.
Personalized care. In functional medicine, we base treatments on the best possibilities for an individual with a unique genome, microbiome, and lifestyle, instead of basing our treatments simply on what the insurance company tells us they’ll pay for.
Time. Insurance reimburses doctors’ visits that typically last about 15 minutes. We often spend over an hour with our new patients, getting a comprehensive assessment. We have to know what is going on in your life before we can improve it.
Flexibility. There are no restrictions with where or how your care can be given – in office, home, phone, or video. We can meet patients where they are.
1:1 personal relationship. There’s no one in between your doctor and you. It’s a true partnership. Your doctor is only working for you. She’s not caught in a triangle between you, insurance, and administration.
Transparency. There’s no guessing game of what’s covered, surprise lab bills in the hundreds of dollars for necessary tests that you felt should be covered. We spell out lab costs, decide together which tests are important and let you know the worst case pricing if the insurance doesn’t cover. We also offer much lower, direct pay pricing on many common labs.
No barriers to seeking care and support when you need it. There are no penalties for seeing us (like co-pays). In our model, we expect to see our patients frequently so that we can help them through the healing process.

But, functional medicine is expensive, right?

First, we consider functional medicine an investment over an expense. Working to transform your lifestyle and health will continue to reward you over your lifetime.

Functional medicine is not more expensive than repeat colonoscopies, ongoing work-ups with no answers and expensive imaging, “blockbuster medications” that only increase in dose and number, or an emergency that could have been prevented.

We see people from all walks of life, including hard working people on a fixed budget. They are willing to invest in their health and to them, it’s more of a priority decision than a cost decision. They’d rather not wait and keep doing the same things, taking the same medications, but expecting a different result. The upfront investment they make both financially and effort-wise often completely change the course of their health over their lifetime.

We still absolutely encourage our patients to have insurance, especially for acute medical needs. And although we don’t work with insurance directly, there are still ways to reduce the cost of functional medicine:

Online programs. We created programs that not only mimic what we do in our in-person programs at a much lower cost, they explain in depth the reasons around why we do what we do to help our clients heal. You can access these here without needing to become a patient.
HSA/FSA dollars are often able to be used for our medical and dietician consults (check with your carrier). This can give you more control over your health care dollars. Now, as many insurance plans have higher deductibles, many employers offer HSAs as part of the health plan.
The savings we are able to pass on to patients on direct lower cost conventional labs can offset the total cost of functional care.

Turmeric for PCOS

Root Functional Medicine — Mon, 07 Jun 2021 00:00:00 -0400

Polycystic ovary syndrome (PCOS) affects up to 15 percent of women and causes many unwanted symptoms, like acne, unwanted hair growth or hair loss, and irregular cycles.

In this article, we’ll discuss the benefits of using turmeric for PCOS, turmeric supplements, and tips for incorporating turmeric into your meals at home.

Related Post: What is Polycystic Ovary Syndrome?

What is Turmeric?

Turmeric is an anti-inflammatory spice derived from Southeast Asia. Traditional Chinese medicine has used turmeric for thousands of years due to its anti-inflammatory benefits.

Curcumin is the active ingredient in turmeric that provides most of the anti-inflammatory benefits and gives turmeric its characteristic bright orange color.

For the purpose of this article, we will use turmeric and curcumin interchangeably.

Benefits of Turmeric for PCOS

Most of the benefits of turmeric stem from its powerful antioxidant and anti-inflammatory properties. While there are not a large amount of studies specifically assessing PCOS and turmeric yet, the few available show promising results.

May Decrease Insulin Resistance

Up to 70 percent of women with PCOS have some degree of insulin resistance (1). Insulin resistance occurs when your cells do not properly respond to insulin, leading to higher blood sugar and insulin levels. Insulin resistance worsens inflammation and causes the ovaries to produce more androgens (i.e. testosterone). Excess androgens cause unwanted PCOS symptoms like acne, facial hair, weight gain, or weight loss resistance.

Fortunately, turmeric may reduce insulin resistance. One review study following women with PCOS found that taking a range of 500 – 1500 mg of curcumin per day reduced fasting insulin levels and improved the cells’ ability to respond to insulin (2).

Improves Blood Sugar Levels

Insulin resistance leads to higher blood sugar levels. Left untreated, high blood sugar levels can eventually lead to type 2 diabetes and other chronic diseases. To reduce your risk of these complications and address this major root cause of PCOS, you must normalize blood sugar levels by modifying your diet and lifestyle. Improving blood sugar levels may also promote healthy cycles with regular ovulation and help you lose weight.

Because of its beneficial effect on insulin resistance, turmeric may also subsequently reduce fasting blood sugar levels in women with PCOS (2).

Increases HDL Cholesterol

Taking turmeric may increase your HDL levels (2). HDL is commonly known as the “good cholesterol”, because it absorbs cholesterol in the blood and carries it back to the liver for disposal. Higher levels of HDL cholesterol can lower your risk for heart disease and stroke. This is particularly important for women with PCOS as this condition raises your risk of high blood pressure, high cholesterol, and heart disease.

Lowers Overall Inflammation

Women with PCOS often have higher levels of inflammation and oxidative stress. Oxidative stress occurs when there are too many oxidants (molecules that damage cells) and not enough antioxidants (molecules that protect cells). Inflammation in PCOS leads to more insulin resistance, higher testosterone levels, and worsening symptoms.

Thankfully, turmeric has powerful antioxidant and anti-inflammatory properties that may lower inflammation and oxidative stress in women with PCOS (3). Although not specific to PCOS, a large review study found that taking turmeric reduced levels of major inflammatory markers like C-reactive protein (CRP) (4).

Taking Turmeric as a Supplement

Taking turmeric is most beneficial when using a concentrated dose of curcumin, the active ingredient in turmeric. Most studies investigating turmeric for PCOS used around 1 gram of curcumin per day. However, taking larger amounts of supplemental curcumin may cause nausea or GI upset in certain individuals, and hasn’t necessarily shown to provide more benefits than lower doses (5).

Buy Turmeric from our Root Shop

Turmeric Recipes

While a turmeric supplement gives the most bang for your buck in terms of reducing overall inflammation, including turmeric into an anti-inflammatory diet is beneficial as well. In fact, we always recommend using a “food first” approach!

Turmeric is commonly added to curry recipes and rice, but you can also toss it with roasted veggies, add it into your scrambled eggs, or even mix it into your morning oatmeal!

Golden milk, or a turmeric latte, is another popular way to include this spice into your diet. Golden milk generally contains ground turmeric, fats to stabilize blood sugar levels, and a dash of ground pepper to enhance the absorption of curcumin.

Our delicious Root Farmacy meals also include many anti-inflammatory recipes with turmeric specifically made for women with PCOS. Root Farmacy Meals are fully prepared and nutrient-dense meals you can reheat in under 3 minutes at home. Learn more about our Root Farmacy Meals here.

Turmeric for PCOS: Key Takeaways

Turmeric is an anti-inflammatory spice that contains a powerful compound called curcumin. If you have PCOS, taking turmeric may reduce insulin resistance, lower blood sugar levels, and increase your HDL or “good cholesterol” levels. All of these benefits stem from curcumin’s ability to lower inflammatory markers, like CRP.

The most effective turmeric supplements contain curcumin in doses of at least 1 gram per day. But remember, you cannot out-supplement a poor diet! Make sure to eat a variety of anti-inflammatory foods and include turmeric in your meals and snacks each week to reap all of the potential benefits of this unique spice.

As much as we wish turmeric could be a simple fix, PCOS is a multifaceted condition often requiring a deep look into root causes, like inflammation, gut health, and thyroid function.

Our PCOS Nutrition Program helps you get to the root cause of this condition and will determine if turmeric (or other supplements and interventions) can help you achieve your health goals.

Why we should take stress seriously and 5 tips to manage it

Root Functional Medicine — Wed, 10 Oct 2018 00:00:00 -0400

We are seeing an epidemic of stress. Even people who appear to have it all figured out are really struggling on the inside with chronic daily stress. Busy people with jobs, families, and a social life are risking their health by being 100% on all day long.

Our bodies weren’t designed to be in a constant “fight or flight” status all day everyday. There is a natural ebb and flow to what our bodies can do. For example, historically, we could use a spurt of energy to run away from a tiger, and then rest until the next threat approached.

Today we are bombarded with constant tasks and no built-in break time at work or even between work and home responsibilities to recharge. This chronic secretion of our stress hormones is putting us at risk for chronic disease in insidious ways.

Studies show that high social stress puts us more at risk for chronic disease mortality than smoking. And recently, JAMA published a study showing that life stressors increase our risk of developing autoimmune disease.

Stress leads to high blood pressure, trouble sleeping, weight gain, headaches, neck pain, interferes with our hormones balance, and it can even change the balance of gut bacteria.

The good news is that simple changes can help you get a handle on stress.

Here are 5 starting points:

Plan breaks. Maybe it’s a 5 minute break every hour (which has been shown to increase focus and productivity), or maybe it’s a break in between work and home, like low impact restorative Yoga to help you feel more present once your arrive home.
Schedule it out. Upgrade your to-do lists, which aren’t always helpful in actually accomplishing the to-dos. Instead, place each to-do item on your calendar, either on your daily, weekly, or monthly schedule with an assigned allotted amount of time that each task will take.
Breathe. Simply the act of slow deep breaths can calm stress in the moment. Try box breathing. Breathe in slowly through your nose for 4 count thinking about expanding your belly with your breath, hold for 4 count, breath out for 4 feeling your shoulders relax, and hold for 4 count. Repeat x 3.
Meditate. Studies have shown that spending 5-10 minutes can improve productivity for the day, and meditating twice a day can lower blood pressure by 5 points. Meditation can be as simple as sitting in a quiet room and listening to a meditation app like Headspace, Calm, Insight Timer, or 10% Happier.
Unplug. Disconnect from your devices to re-connect with yourself and your surroundings. Try putting yourself in airplane mode overnight or giving devices a rest for 24 hours over a weekend.

These tips don’t need a lot of effort or time, but they can require practice to get into the habit of doing. The health benefits are worth it as a simple daily habit can start to reverse the effects of stress.

References:

Song, H. Fang, F. Association of Stress-related disorders with subsequent autoimmune disease. JAMA. 2018; 319(23) 2388-2400.

5 Common Women's Health Problems That Can be Treated with Functional Medicine and Nutrition

Root Functional Medicine — Mon, 14 Jan 2019 00:00:00 -0500

Here at Root, we treat a variety of women’s health conditions with functional medicine and nutrition. Here is a list of 5 conditions we commonly work with:

#1 Hashimoto’s (and other thyroid conditions)

Approximately 10% of women suffer from hypothyroidism, or an underactive thyroid. The Autoimmune form of hypothyroid disease is known as Hashimoto’s Thyroiditis. It is estimated that around 90% of cases of hypothyroidism are actually Hashimoto’s. With Hashimoto’s, there is an autoimmune attack on the thyroid taking place and antibodies are present in blood work.

We also work to prevent thyroid issues from occurring by assessing full thyroid panels from a functional medicine perspective. Thyroid issues don’t happen overnight and there are many lifestyle and nutrition changes you can make to optimize thyroid levels before a problem occurs. For a variety of reasons, including issues with insurance billing, full thyroid panels often aren’t even offered in traditional medicine. At Root, we have access to affordable thyroid testing and we assess more than just thyroid stimulating hormone (TSH). We also look at free T3 and T4, and thyroid antibodies. We value looking at the full picture, and looking at just the TSH often doesn’t cut it. If you were told your TSH was normal in the past, but still feel like something is off, we would suggest getting a full panel done.

#2: Polycystic Ovarian Syndrome (PCOS)

PCOS is the most common metabolic and hormonal disorder in women, and is estimated to effect between 6-13% of women. To be diagnosed with PCOS, women must meet at least 2 of the following 3 criteria:

– Absent or irregular menstrual cycles (Oligo- or amenorrhea).

– Clinical or biochemical signs of hyperandrogenism

– Polycystic ovaries

The vast majority of women with PCOS suffer from insulin resistance, and therefore have difficulty losing weight. Other symptoms associated with PCOS include skin problems (acne), hair loss, unwanted hair growth (hirsutism), irregular or heavy periods, and mood disturbances.

We review PCOS, root causes, and natural treatment with nutrition, lifestyle and supplements in our course: The PCOS Symptom Reversal Method.

#5: Migraines

It is estimated that almost 30 million Americans experience migraine headaches and that 3 out of 4 sufferers are women. Migraine treatment is highly personal and can be approached in a variety of ways. We often look at diet, genomics, micronutrient levels, hormones, stress levels, and sleep, to name a few things.

There are also several herbal remedies for migraine prevention and treatment. Here’s a study comparing taking daily riboflavin (vitamin b2) 100mg to one of the most common migraine prevention medications, propranolol at 80 mg/day. They were equally efficacious at that dose, but the patients who took riboflavin had significantly less side effects. At Root, we are well versed in herbal medications, have access to high quality third party tested supplements, and review potential interactions between herbs and medications through a subscription database.

Though we can use functional medicine for most health conditions, the above are some of our special interest areas.

How is MRT different from other food sensitivity tests?

Root Functional Medicine — Tue, 09 Apr 2019 00:00:00 -0400

MRT + LEAP Elimination Diet

We use the MRT panel with an elimination diet protocol, called LEAP (Lifestyle Eating and Performance). Our dietitian is a Certified LEAP Therapist, which means she has specific training to interpret the MRT food sensitivity panel and guide patients through the LEAP elimination diet.

Treating food sensitivities is more than just avoiding your red and yellow (reactive) foods. Our dietitian works with you to develop a personalized food sensitivity elimination diet based on your MRT results and functional nutrition assessment.

The diet protocol is broken into phases over a 2 to 3 month period. For the first two weeks, you will eat roughly 30 of your lowest reactive “green” foods. In this time, many people experience a 50 to 75% reduction in their symptom frequency and/or severity.

Once you begin feeling better, we slowly add one food into your diet at a time, monitor for any reactions that may occur, and set you up for long term success.

MRT is a Personalized Tool For Healing

Functional medicine uses individualized protocols based on your unique symptoms, immune system, genetics, and more.

Functional lab testing, like the MRT food sensitivity panel, is an essential tool in our practice to personalize your care and help you find symptom relief and healing.

You can purchase an MRT test kit and a food plan specific to your results here: MRT and dietitian designed food protocol.

What is Functional Nutrition?

Root Functional Medicine — Mon, 11 Mar 2019 00:00:00 -0400

What is Functional Nutrition?

You are unique. You have your own genetic makeup, health history, and lifestyle. Your nutrition plan should be unique to your individual body, too! Here at Root, we use functional nutrition as a key part of treating the root cause of your symptoms.

But, what is functional nutrition, exactly?

In this blog, we’ll review functional nutrition, how it’s different, and how we use it to help you restore wellness, find balance in the body, and prevent disease.

First, Let’s Review: What is Functional Medicine?

To understand functional nutrition, we need to first quickly review functional medicine as a whole.

Functional medicine is an approach to treating health conditions and preventing disease by finding the root cause of your health issues. However, instead of stamping you with a diagnosis and only treating your symptoms, functional medicine doctors find out WHY you have the diagnosis. They will do an in-depth assessment to look at ALL of your body systems (not just the one causing symptoms), and evaluate how well your body is communicating.

Then, functional medicine doctors will recommend interventions to help restore balance by addressing factors such as nutrition, movement, stress, sleep, and relationships.

What is Functional Nutrition?

Functional nutrition is a powerful cornerstone to functional medicine. It uses food as a natural medicine to help restore balance, replete nutrient deficiencies, heal the gut, and more.

Here are a few ways in which functional nutrition is different from conventional practices.

Functional Nutrition is Personal

Personalization is the main difference between functional and conventional nutrition.

Functional nutrition focuses on the patient instead of the disease. It is a personalized method of optimizing your health based on your individual genetics, lab values, lifestyle, and more. There are no generic meal plans or handouts, because each individual person is different!

Let’s use a case study as a quick example. Imagine Mrs. M comes in to see the dietitian for nutrition counseling for her Irritable Bowel Syndrome (IBS). She suffers from bloating, indigestion, and occasional diarrhea. In a conventional nutrition setting, Mrs. M may receive a generic low-FODMAP meal plan, which is a standardized diet that eliminates foods that may worsen symptoms in IBS patients. However, the foods are not the direct cause of her IBS, and not all IBS patients have the same reactions to all foods.

Now, let’s imagine Mrs. M’s case from a functional nutrition perspective. While each treatment is different, a functional nutrition dietitian may order personalized lab testing, like the MRT food sensitivity test, to learn how Mrs. M’s individual immune system is reacting to specific foods. We may also request nutrition labs to assess for underlying vitamin or mineral deficiencies. From there, we would develop a personalized elimination diet based on Mrs. M’s lab results to reduce inflammation, heal the gut, and (of course) reduce her symptoms!

Functional Nutrition Uses Food as Medicine

A whole food diet rich in fruits, vegetables and minimal processed food is always a great foundation. However, some patients require more targeted interventions with specific foods in order to treat the underlying cause of their health issues.

Functional nutrition honors the fact that food is not only fuel for your body, but also an extremely useful tool to help us address the underlying cause of your condition. Let’s go back to Mrs. M’s story as an example. After 1-2 months of eliminating her food sensitivities, a functional medicine dietitian may want to use specific foods or supplements to further heal her gut. The dietitian may recommend certain anti-inflammatory foods, gut-healing compounds like glutamine or probiotics, or targeted supplements to replete any nutrient deficiencies found on her lab testing.

Functional Nutrition Is Not Just About Food

While functional nutrition honors the powerful nature of wholesome food, it also respects that there is more to health than what you eat.

For instance, a functional medicine dietitian may ask you about your stress levels, sleeping habits, and overall environment. Not only do these factors play a huge role in your overall health, but they also have a bidirectional effect on your nutrition. For example, chronic stress can worsen IBS symptoms, like in Mrs. M’s case. Additionally, your sleep habits and stress levels all affect how nutrition is digested and absorbed in the body. A functional medicine dietitian can help you establish a stress management routine to further reduce your symptoms. We may recommend various foods or nutritional supplements to help your body cope with the added stress as well.

We Embrace Your Uniqueness

With functional nutrition, we embrace your uniqueness and use it to tailor your individualized nutrition recommendations. We can use personalized lab testing, functional food as medicine, and lifestyle interventions to further your healing process. We work closely with you to find a nutrition plan that is realistic for your lifestyle, while also reducing unwanted symptoms and restoring balance in the body.

Prebiotics: What are they and why are they important?

Root Functional Medicine — Mon, 10 Dec 2018 00:00:00 -0500

We hear about probiotics, the “good bugs” in our digestive system a lot, but what’s all of the buzz about prebiotics?

Prebiotics are the fiber-rich foods that probiotics feed on. Taking probiotic supplements or consuming probiotic rich foods such as kefir, yogurt, kimchi, kombucha, and sauerkraut will only get you so far if you are not consuming enough prebiotic fiber for the probiotics to eat. We call this seed (taking probiotics or probiotic foods) and feed (giving food to the good bacteria to flourish).

When probiotics feed on and break down (ferment) these prebiotic foods in the colon, a beneficial short chain fatty acid called butyric acid is formed. Often used interchangeably with the term butyric acid when discussing gut health, butyrate is the preferred energy source for the cells in the colon. While more studies are needed, butyrate has been studied for its roles in colon cancer prevention, insulin resistance/diabetes, obesity reduction, atherosclerosis, and chronic inflammation. Remember that what happens in the gut, doesn’t stay in the gut. Low grade inflammation that starts in the gut, then circulates through the blood supply causing symptoms like fatigue, brain fog, aches and pains, and even skin rashes and acne.

Here are some foods that are some good food sources of prebiotic fiber:

o Asparagus
o Banana (especially green bananas = resistant starch)
o Barley
o Dandelion greens
o Eggplant
o Artichokes
o Leeks
o Legumes
o Oats
o Onions
o Peas
o Potatoes
o Whole grains

There are many other fiber-rich fruits and vegetables that are great to eat but the above stand out as good sources of prebiotics specifically.

If you are thinking, “hey I’d love to eat these foods, but these fiber-rich foods really cause me discomfort whenever I eat them”, there’s a good chance you have some level of Dysbiosis (microbial imbalance) going on in your gut. At Root, we do comprehensive stool testing to help you get to the root of your health concerns. Remember that even if you aren’t having digestive issues, other symptoms such as joint pain, fatigue, and brain fog could be due to imbalances in your gut microbiota.

We have many options to help you improve your gut health. Here are two favorites:

We can do a deep dive in our Get to the Root program (for members in Michigan)

You can access our most commonly used gut health supplements in our Gut Health bundle (available for shipping throughout U.S.)

Sources:

Wong, JM, de Souza R, Kendall CW, Emam A, & Jenkins DJ. Colonic health: fermentation and short chain fatty acids. J Clin Gastroenterolog. 2006;40(3):235-43.

Dahl WJ, Agro NC, Eliasson AM, Mialki KL, Olivera JD, Rusch CT, & Young CN. Health Benefits of Fiber Fermentation. J Am Coll Nutr. 2017; 36(2): 127-136. doi: 10.1080/07315724.2016.1188737

McNabney SM & Henagan TM. Short Chain Fatty Acids in the Colon and Peripheral Tissues: A Focus on Butyrate, Colon Cancer, Obesity, and Insulin Resistance. Nutrients. 2017;9(12). doi: 10.3390/nu9121348

Bloating and PCOS

Root Functional Medicine — Tue, 13 Apr 2021 00:00:00 -0400

As if irregular periods, acne, and hair problems weren’t enough, bloating is another surprising, yet common, symptom of polycystic ovary syndrome (PCOS), a hormonal disorder affecting up to 20 percent of women. You may be tempted to try various probiotics, diets, or tonics for your bloating; however, this article will explain how to identify and treat PCOS bloating by finding your true root cause.

What Causes Bloating in PCOS?

Dysbiosis

Your gut is home to 100 trillion bacteria and divided into three categories: beneficial bacteria, neutral bacteria, and harmful bacteria. Under optimal circumstances, your body maintains a delicate balance of these three groups to optimize function and prevent disease. However, a variety of factors like diet, antibiotics, and your environment can cause detrimental changes to gut bacteria and lead to a condition known as dysbiosis.

Dysbiosis occurs when you have an imbalance of bacteria in your gut. You may have too much bad bacteria, not enough good bacteria, and/or not enough diversity of bacteria. Unfortunately, women with PCOS are more likely to suffer from dysbiosis than women without PCOS (1).

Dysbiosis is one major root cause of abdominal bloating in PCOS. Dysbiosis may also worsen other PCOS symptoms like acne, unwanted hair growth or hair loss, and hormonal imbalances. Pictured below are supplements routinely use at Root to treat Dysbiosis and support gut health.

Hormonal Imbalances

In a healthy menstrual cycle, your estrogen and progesterone levels change throughout the month. Estrogen levels slowly rise and peak right before ovulation. After ovulation, estrogen levels drop and progesterone takes over. If your egg is not fertilized for pregnancy, progesterone levels eventually drop to trigger the beginning of your period bleed.

However, many women with PCOS have irregular cycles and do not ovulate or bleed each month. Without ovulation, your estrogen levels may be constantly elevated because you do not experience an opposing rise in progesterone. This is known as estrogen dominance, or an excess amount of estrogen in relation to progesterone. Estrogen dominance may also contribute to bloating in PCOS.

PCOS Medications

Conventional medications commonly used to manage PCOS symptoms can cause bloating as a side effect.

Metformin is a prescription medication that lowers insulin and fasting blood sugar levels. It is often prescribed to treat insulin resistance in PCOS. A benefit of metformin is that it does attempt to address insulin resistance as an underlying root cause, which is why some individuals experience positive results while taking it. However, metformin commonly causes symptoms of GI upset like nausea, diarrhea, bloating, and gas. These side effects may be due to metformin’s influence on the gut microbiome, and some studies suggest this drug may also cause dysbiosis (2).

The birth control pill is also commonly prescribed to women with PCOS to manage symptoms of acne, irregular periods, and unwanted hair growth. Unfortunately, many women find that the pill commonly contributes to abdominal bloating among other side effects.

How to Treat PCOS Bloating

If you have bloating and PCOS, you will likely require a multiple thronged approach to treat it for good.

Balance Your Hormones

A healthy menstrual cycle with regular ovulation can reduce bloating by supporting the natural balance of estrogen and progesterone. One way to encourage ovulation is by balancing your blood sugar levels and treating insulin resistance with diet and lifestyle. Here are a few tips to get you started.

Include a real food source of protein, fat, and carb with each meal and snack (see below image for ideas).
Limit foods high in added sugar, like sweetened beverages, cookies/candy, and other grain-based desserts.
Aim for 7-8 hours of sleep each night, and reduce sleep disruptors like caffeine or alcohol close to bedtime.

Note: The pill does not actually make your cycle “regular” as often advertised. Rather, it provides synthetic hormones that prevent ovulation completely. However, balancing your blood sugar levels is still beneficial whether or not you are taking the birth control pill.

Trial a Low FODMAP Diet

When you have dysbiosis, your gut may have difficulty digesting certain foods.

The FODMAP diet is a temporary elimination diet that helps you identify which foods worsen your bloating. FODMAP stands for “fermentable oligosaccharides, disaccharides, monosaccharides and polyols.” Essentially, certain foods contain higher levels of FODMAPs that cause your gut bacteria to release excess gas. By eliminating the foods highest in FODMAPs, you may experience less bloating.

Common foods high in FODMAPs to eliminate include:

Wheat
Dairy (lactose)
Garlic
Onions
High fructose corn syrup
Fruit juice

The low FODMAP diet can provide fast relief from bloating. However, it is fairly difficult to follow on your own, as many foods contain varying levels of FODMAPs. Fortunately, our registered dietitians developed an online course to help you navigate this diet. In the course, you will learn how to follow a low FODMAP diet correctly, receive a low FODMAP food plan, and learn how to use our Core Gut Health supplement regimen for further healing.

Learn more about our Low-FODMAP Diet Course.

Exercise

Introducing a regular exercise routine can help treat PCOS by balancing your hormones, controlling blood sugar levels, and reducing inflammation in your body (3). Exercise may also reduce bloating by promoting optimal digestion and growth of beneficial bacteria in the GI tract. However, avoid exercise that is too vigorous or intense as this may worsen GI side effects. Instead, choose moderate forms of exercise like walking, cycling, strength training, yoga, or swimming.

Bloating and PCOS: Key Takeaways

If you have PCOS, the root cause of your bloating may be due to:

dysbiosis, or an imbalance of gut bacteria;
irregular periods without ovulation;
and medications used to manage PCOS symptoms, like metformin or the pill.

You can encourage regular ovulation and treat dysbiosis by eating wholesome foods that are low in added sugar and rich in protein, healthy fats, and fiber. If you are looking for fast relief, a low FODMAP diet is a temporary elimination diet that helps you identify which foods worsen your bloating. Learn more about our low FODMAP diet online course. However, this diet is meant to act as a short-term solution while you work to fully address your dysbiosis and other root causes.

The low FODMAP diet works well when combined with the right supplements and lifestyle to treat the underlying imbalance, such as our Microbiome Balance supplement and Gut Health bundle.

CoQ10 and Fertility

Root Functional Medicine — Tue, 07 Sep 2021 00:00:00 -0400

Can certain supplements improve your fertility? In this article, we’ll review a nutrient called coenzyme Q10 (CoQ10), how it functions in the body, and potential benefits of CoQ10 for fertility.

What is CoQ10?

CoQ10 is a vitamin-like compound that is critical for energy production inside the mitochondria of your cells. Mitochondria are the “power plants” of your cells that transform fat, protein, and carbohydrates into energy that your body can use. The egg cells in your ovaries have more mitochondria than any other cell in the body (1). If your egg can produce optimal energy, there is a greater chance for it to mature, fertilize, and successfully grow into a developing embryo.

Your body makes CoQ10 in every cell. However, certain factors, like aging, taking cholesterol-lowering drugs, and oxidative stress, may lower your body’s ability to make enough CoQ10 to keep up with the demand.

Benefits of CoQ10 for Fertility

CoQ10 is a well-known supplement in the fertility industry due to its possible benefits for mitochondria function, egg quality, and inflammation. Let’s discuss a few of these benefits in more detail.

Can Lower Inflammation

CoQ10 is an antioxidant that can protect your cells from damage. Oxidative stress is a condition that occurs when there are too many oxidants (molecules that damage cells) compared to antioxidants (molecules that protect cells). Higher levels of oxidative stress may lead to inflammation, poor egg quality, and fertility problems.

Fortunately, CoQ10 supplements have shown to reduce oxidative stress in the body and significantly lower markers of inflammation, like C-reactive protein (CRP) (2, 3). This is especially beneficial for women with polycystic ovary syndrome (PCOS) who often have higher levels of oxidative stress and inflammation than women without PCOS.

CoQ10 May Improve Egg Quality

Egg quality is crucial for healthy ovulation, implantation, and embryo development. Poor egg quality may contribute to early pregnancy loss and/or infertility. Your egg cells have over 100,000 mitochondria; however, as you age, the mitochondria become damaged and less efficient at producing energy. This mitochondrial dysfunction results in lower quality eggs and likely explains why age can negatively affect egg quality and overall fertility. However, egg quality may also play a role in other fertility concerns, like premature ovarian failure.

CoQ10 improves mitochondria function and helps your eggs produce more energy. This may translate to improved egg quality and fertility. For example, one study found a higher level of CoQ10 inside developing eggs was associated with higher-quality eggs and higher pregnancy rates (4). Likewise, a separate and larger review study found an increase in pregnancy rates when women undergoing fertility treatments took CoQ10 supplements (5).

Your diet may also impact your overall egg quality. To learn more, read our other blog post: Fertility Diet to Improve Egg Quality

Lowers Blood Sugar and Insulin Resistance

Insulin resistance occurs when your cells do not properly respond to insulin, leading to higher blood sugar levels. Insulin resistance worsens inflammation and causes the ovaries to produce more androgens (i.e. testosterone). Excess androgens may prevent ovulation, cause longer cycles, and lead to difficulty conceiving.

In order to reduce androgens and promote ovulation, you must focus on balancing blood sugar and reducing insulin resistance, if present. Fortunately, CoQ10 can help. A review study evaluating the use of CoQ10 for women with PCOS found that taking CoQ10 significantly reduced fasting blood sugar and markers of insulin resistance (6).

CoQ10 May Improve Sperm Quality

Male infertility accounts for nearly 50 percent of all cases in which a couple has difficulty conceiving. Oxidative stress is the biggest factor impacting sperm quality. However, men with subfertility who take an antioxidant supplement may have a significantly higher chance of their partner conceiving and a higher chance of a live birth (7).

As we mentioned earlier, CoQ10 is an antioxidant that can lower oxidative stress. A large review study evaluated the effect of CoQ10 supplements in male infertility and found that CoQ10 did not significantly increase pregnancy rates but did increase sperm count and sperm mobility (8).

CoQ10 Supplements

While specific dosing of CoQ10 is often personalized based on your clinical history and fertility treatment plan, starting with 100 – 200 mg of CoQ10 per day is a great place to start. For best results, take CoQ10 with a meal to enhance absorption.

You can purchase Coenzyme Q10 from our Root Shop.

CoQ10 and Fertility: Key Takeaways

Taking CoQ10 is an inexpensive, promising, and safe therapy that may improve fertility outcomes by reducing oxidative stress, improving egg and sperm quality, and reducing insulin resistance in women with PCOS. Some studies have found higher pregnancy rates in women taking CoQ10 supplements compared to women who do not take this supplement.

You can also check out our PCOS Supplement Bundle or our Male Fertility Supplement Bundle.

Inflammation Evaluation and Dietary Approaches

Root Functional Medicine — Tue, 22 Jun 2021 00:00:00 -0400

Inflammation is a major contributor to many chronic diseases and in many cases a driver for autoimmunity, both of which are on the rise in this country.

An important thing to understand about inflammation is that it is not an on/off switch but more like a dimmer switch. Often there are many lifelong contributors that push the dimmer switch towards a full force inflammatory process. But the good news about that is once we understand these inflammatory drivers, we can work on reducing or eliminating them from our lives. At Root we spend time listening to every member’s story and identifying potential contributors to Inflammation throughout a person’s life time.

Testing

When it comes to laboratory evaluation, there are some conventional tests that can be helpful and then also specialized functional medicine testing that can be used to identify inflammation.

Some basic testing, which we include on our Root wellness panel for every new member in our Get to the Root program are:

hsCRP- which stands for high sensitivity C reactive protein. This marker increases in your blood when there’s inflammation in your body. It doesn’t tell us where the inflammation is coming from it just tells us there is general inflammation. This test is more sensitive than a standard C reactive proteins test. It can also be used to assess your risk of coronary artery disease
Ferritin- Traditionally we think of it as a test for low iron stores, but it is also something called an acute phase reactant. When it is elevated, it can be a sign of inflammation
WBC- White blood cell count is also an acute phase reactant. When elevated, it can be a marker of infection, ongoing inflammation or even allergic response.
Omega-3 index- tells us the ratio of anti-inflammatory fat stores which are the omega-3‘s, (found in cold water fish, flax, walnut and chia) to more inflammatory fats, which are the omega 6’s. Omega 6’s (which are found in vegetable oils, red meat, diary and shellfish amongst others) are a precursor to Arachidonic acid, which is a pro inflammatory ecosanoid. Ecosanoids are signaling molecules found in the cell membrane of all mammalian cells. Arachnoid acid in particular is the precursor to prostaglandins and leukotrienes- which are responsible for pain and allergic signals in the body. It’s actually the pathway on which Motrin and anti-allergy pills work. So limiting the amount of Arachidonic acid in the diet can be very helpful to modulate these pathways and shifting the balance away from inflammation. An ideal omega 6/Omega 3 ration is 4:1.
Fasting insulin is another test that is very helpful because insulin resistance is under diagnosed and can be a driver for inflammation. By checking a fasting insulin, we can catch insulin resistance in earlier stages and work on reversing it

We also have several advanced tests called functional tests in our practice that check for inflammation. One of the foundational tests we do is a stool microbiome test. It includes several inflammatory markers:

Fecal calprotectin- Is a marker of neutrophil driven inflammation. It’s produced in sights of inflammation in the colon and this biomarker has been useful in differentiating between inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS)
Fecal secretory IgA is a marker of gut secretory immunity and barrier function. This is your colon’s first line defense and mucosal lining support.

Dietary Approaches

Once we’ve identified Inflammation, the question is what can we do about it? Diet is a foundational tool by which we can dial back inflammation. But we must not disregard other important lifestyle factors, that are the pillars of good health. These include- sleep, stress reduction, movement and relationships. A good diet is a great starting point however.

Dietary interventions to reduce inflammation include:

Optimize blood sugar balance- by eating lower glycemic foods and balancing with fiber and healthy fat. Eliminate simple sugars and refined carbs. At Root we spend some time with each client talking about protein fat and carbohydrate balance PFC with every meal. We know that diets high in glycemic load are positively associated with inflammation by increasing plasma hsCRP. Hyperglycemia can actually overproduce oxidative stress in the body.
Eat an antioxidant rich diet found in plants- mainly deeply pigmented veggies but also fruit. At Root we have a 30 plant challenge for clients where we try to have people eat 30 different plant based colors throughout the week. Roughly 4-5 servings per day. Plants are rich in something called Phytonutrients, which are the natural components of plants and have powerful antioxidant properties. Each color group has its own health benefit. For example the red colored plants which include tomatoes, raspberries, pomegranate seeds are rich in lycopene which may protect against cancers of the prostate, breast & skin as well as reduce risk of heart attacks.
Increase the amount of omega-3 (EPA/DHA) fats in the diet (found in cold water fish, flax, walnut and chia) which are anti-inflammatory. In the Western diet, often people will need to supplement with fish oil, at least temporarily, to bring these levels up. Our favorite fish oil supplement is our Root Omega 3. EPA also blocks the metabolism of Arachidonic acid. Zinc, magnesium, vitamin C and B vitamins are important coenzymes for metabolism of omega3s so it’s important to get enough of these in diet as well.
Increase the amount of fiber you eat. Aim for 25 to 35 g of dietary fiber per day. All plants have fiber. Eat more nuts, seeds, whole grains, fruits and vegetables to achieve this goal. Fiber increases the energy density of the diet and slows absorption in the gut for a lower glycemic index. The chemical structures of fiber may have inherent anti-inflammatory activities. Fiber promotes the growth of the good bacteria in your microbiome resulting in decreased amount of bad or pathogenic bacteria, positive immune system regulation, and anti-inflammatory bacterial metabolites, such as butyrate. Butyrate is produced when good bacteria breakdown/ferment fiber into Short chain fatty acids that are anti-inflammatory for the colon.
Eliminate hydrogenated oils and trans fats.
Intermittent fasting- can reduce reactive oxygen species (free radicals) in your system and it’s free. Avoid fasting for more than 16 hour stretches as this can slow down your thyroid function and metabolism.

Root Farmacy's full prepared meal service meets all of our clinical requirements for an anti-inflammatory diet.

Supplements:

Supplements we use with our members to improve inflammation include turmeric, Omega 3s, and our Root Reset protein powder which includes fiber and anti-oxidants.

Conversion of t4 to t3 thyroid hormone

Root Functional Medicine — Mon, 20 May 2019 00:00:00 -0400

Do you have a thyroid disorder? Or rather, do you suspect you have a thyroid disorder, yet your blood work came back “normal”?

Testing only TSH to assess thyroid function is not enough.

During a comprehensive thyroid workup, we assess how well your body is converting the main thyroid hormone (T4) to the active thyroid hormone (T3). Your T4 hormone must be converted into T3 in order for your body to use it.This article will review the conversion of T4 to T3 and what you can do to optimize it!

Why Does Conversion of T4 to T3 Matter?

Traditional health practitioners screen thyroid function by looking at one main lab value called thyroid stimulating hormone (TSH).

The pituitary gland in your brain releases TSH which then tells your thyroid gland to make thyroid hormone (abbreviated T4).

However, your body must convert T4 into T3 (the active form) in order to use it. If the conversion of T4 to T3 is poor, then you may experience some of the common hypothyroid symptoms like fatigue, depression, sensitivity to cold temperatures, difficulty concentrating, and more.

Keep in mind, that this poor conversion can occur even if your TSH levels appear to be normal. So, it’s important to assess the conversion of T4 to the active form of T3 to find the root cause of your symptoms and optimize thyroid function.

Finding the Root Cause of Thyroid Issues

Trying to navigate health issues on your own can be overwhelming and frustrating. When it comes to optimizing the conversion of T4 to T3 and treating thyroid conditions, finding the root cause is essential.

Whether it’s poor gut health, nutrient deficiencies, or inflammation, we are here to support and guide you in your healing journey.

Learn more about our treatment programs here. All of our functional medicine plans include a thyroid lab panel which assesses this T4 to T3 conversion. Because we know that up to 60% of people with thyroid disease are unaware of their condition, we feel this is an important screening test! (5)

Folic Acid vs. Folate: What's the Difference?

Root Functional Medicine — Sun, 21 Jul 2019 00:00:00 -0400

Autoimmune Disease After Pregnancy

Root Functional Medicine — Sun, 18 Aug 2019 00:00:00 -0400

The postpartum period with a newborn is an exciting and joyful time. However, it can also be very exhausting and overwhelming!

A woman’s body goes through immense changes during pregnancy, and this is no different after delivery. It takes time for the body to return to “normal.” But even then, many women struggle with regaining optimal health in the years after pregnancy.

In our practice, we have noticed a pattern of autoimmune diseases developing in the year or two following pregnancy. This article will review autoimmune disease onset after pregnancy, why it’s more common, and what you can do to start feeling better.

What is Autoimmune Disease?

The immune system is designed to fight against unfriendly germs and bacteria. Typically, your immune system does a pretty good job at determining which cells are foreign (and dangerous) and which ones are your own cells.

However, an autoimmune disease is a condition in which your immune system mistakenly attacks your own body. Autoimmune diseases are usually the result of a genetic predisposition, an environmental trigger, and changes in gut permeability (leaky gut).

The most common autoimmune diseases we see in our practice include:

Hashimoto’s Thyroiditis
Celiac Disease
Rheumatoid arthritis
Inflammatory Bowel Disease, like Crohn’s Disease or Ulcerative Colitis

We are most commonly seeing autoimmune thyroiditis (Hashimoto’s) in the postpartum period.

Why Autoimmune Disease After Pregnancy?

Researchers aren’t 100 percent certain why women experience more autoimmune disease in postpartum. However, there are many complex hormonal and immune-related shifts that occur during pregnancy. Fetal cells make their way into the mother’s circulation during pregnancy, and may remain in circulation long after delivery. Some researchers believe that this transfer of cells may be the underlying cause of higher autoimmune disease rates postpartum (1, 2).

Genetic Predisposition

If you have a family history of autoimmune disease, your risk of autoimmune disease after pregnancy may be higher. Studies also show that people with one autoimmune disease are also more likely to develop a second autoimmune condition (3).

Environmental Trigger

Environmental triggers are another suspected cause of autoimmune disease after pregnancy. Triggers can include emotional stress, like depression, anxiety, or feelings of overwhelm, or they may include physical stress, like sleep deprivation and postpartum nutrient deficiencies.

Leaky Gut

Many factors may lead to increased gut permeability postpartum. Besides changes in the immune system, we may experience changes in the gut lining due to use of antibiotics, stress, lack of sleep, and nutrient deficiencies.

Hashimoto’s and Pregnancy

While autoimmune Hashimoto’s thyroiditis can show up for the first time during pregnancy, the risk of onset is especially increased postpartum. In fact, up to 9 percent of all pregnant women develop hashimoto’s after pregnancy, which can present as either hyper- or hypothyroidism (4).

What is Hashimoto’s Thyroiditis?

Hashimoto’s thyroiditis is an autoimmune condition in which your immune system produces antibodies that attack your thyroid, a butterfly-shaped gland located at the base of the neck. Autoimmune thyroid disease affects eight times more women than men (1).

Symptoms of Hashimoto’s may include:

Hair loss (more than what is normal postpartum)
Depression or anxiety
Extreme fatigue
Decreased milk production in breastfeeding women
Heart palpitations
Dry skin
Constipation
Weight Gain
Brain fog

Why is Hashimoto’s Often Missed?

A Hashimoto’s diagnosis after pregnancy can be missed because the related symptoms are often brushed off as normal postpartum stress, fatigue, and moodiness.

If your practitioner does run a thyroid screen, it will often only include one blood marker called Thyroid Stimulating Hormone (TSH). Unfortunately, testing only for TSH does not give us a full picture of how well the thyroid is functioning and does not test for thyroid antibodies (seen in Hashimoto’s).

Autoimmune Disease and Pregnancy: What Can You Do?

Many of the environmental triggers for autoimmune diseases postpartum are unavoidable with a newborn. However, there are a few things you can do to help your body heal postpartum and start feeling better.

First of all, continue taking your prenatal vitamin postpartum. Pregnancy is physically taxing and often depletes women of many important nutrients. Meal trains are a great way to take the pressure off making delicious meals when baby first arrives. We also love grocery pick-up or delivery! Furthermore, try to make self-care a higher priority as much as possible. Sleep whenever you can, delegate tasks, and take time to just rest. The laundry and cleaning can wait, mama! You deserve to take care of yourself. Don’t be afraid to ask for help.

If you feel like something is “off” since your pregnancy, do not be afraid to speak up. Ask your doctor if they can run a full thyroid panel (including TSH, T3, T4) with thyroid antibodies included to screen for Hashimoto’s after pregnancy.

Trying to navigate postpartum health issues and autoimmune conditions can be overwhelming and frustrating. At Root Functional Medicine, we address the root cause of postpartum thyroid and/or autoimmune disorders. We offer our gut health bundle protocol as well as our quality prenatal on our shop page here.

Genetic Predisposition

Environmental Trigger

Leaky Gut

Hashimoto’s and Pregnancy

What is Hashimoto’s Thyroiditis?

Symptoms of Hashimoto’s may include:

Hair loss (more than what is normal postpartum)
Depression or anxiety
Extreme fatigue
Decreased milk production in breastfeeding women
Heart palpitations
Dry skin
Constipation
Weight Gain
Brain fog

Why is Hashimoto’s Often Missed?

A Hashimoto’s diagnosis after pregnancy can be missed because the related symptoms are often brushed off as normal postpartum stress, fatigue, and moodiness.

Autoimmune Disease and Pregnancy: What Can You Do?

magnesium citrate vs. magnesium glycinate

Root Functional Medicine — Thu, 20 Jun 2019 00:00:00 -0400

Are you deficient in magnesium? It wouldn’t be uncommon, as nearly 50 percent of Americans fail to eat enough magnesium in their diet (1). On top of that, our stressful lives and other health conditions may deplete our body of this important mineral.

Magnesium is an essential mineral and electrolyte that we must obtain from our diet. It has over 300 functions in the body and plays a crucial role in hormonal balance. For example, magnesium affects thyroid function, estrogen detoxification, blood sugar, stress hormones, and more (2).

Magnesium is an important mineral that many women are significantly lacking. In particular, women with PCOS (polycystic ovarian syndrome) are 19 times more likely to have a magnesium deficiency. This is important because magnesium plays a key role in regulating insulin and glucose. In fact, having low levels of magnesium increases your risk of insulin resistance, weight gain, and type 2 diabetes.

Magnesium’s role in thyroid health is that magnesium is needed to make thyroid hormone. Studies have shown that replacing a magnesium deficiency lowers TSH (and improves thyroid function.)

Others at risk for magnesium deficiency include people who take certain medications like acid reflux medications or birth control pills, and people who have trouble absorbing magnesium due to gut health issues.

Are you getting enough magnesium in your diet?

The Recommended Dietary Allowance (RDA) for magnesium is 400 milligrams (mg) per day for men and 310 mg per day for women (3). Magnesium is commonly found in nuts, seeds, legumes (like beans and peanuts), and leafy green vegetables. For various reasons such as poor soil conditions or the abundance of processing to our foods which strips magnesium from foods, it can be difficult to solely rely on diet for this mineral.

Although we always support a food first philosophy, we recognize that many of our patients may require additional magnesium in supplement form.

In this article, we’ll review two types of magnesium supplements: magnesium citrate vs. magnesium glycinate. But first, let’s discuss how to determine if you have a magnesium deficiency.

How do you know if you are deficient in Magnesium?

Symptoms of a Magnesium deficiency include:

muscle cramping, pain
frequent headaches or migraines
mood changes like anxiety or depression
insulin resistance (& craving sweets, especially chocolate)
low energy
PMS
trouble sleeping

How to Test Magnesium Levels

The most common way to evaluate magnesium levels is to order a serum (blood) magnesium test. However, this does not give us an accurate picture of your whole magnesium status, because only an estimated 1 percent of magnesium in the body is found in the blood (4).

Additionally, the body tightly regulates magnesium levels in the blood by pulling from stores in your bones and other tissues when dietary intake of magnesium is inadequate. This means that your blood levels will be the last place to show a deficiency. By this point, your symptoms could be very serious.

Subclinical magnesium deficiency, however, may be more common, affecting up to 30 percent of people (5). Subclinical means that your blood magnesium levels may appear to be normal even though you have an underlying magnesium deficiency (4).

A more accurate way to test magnesium status (and the method we prefer at Root Functional Medicine) is to look at the amount of magnesium in your red blood cells. This way, we can evaluate the levels of magnesium in your cells and identify subclinical magnesium deficiency before your blood values even begin to drop. A normal range for RBC magnesium is 4.2 – 6.8 mg/dL, however, it’s important to work with a functional medicine doctor to determine an optimal range for you.

Best Types of Magnesium Supplements

There are many different forms of magnesium supplements. The most common type of magnesium used in conventional medicine is called magnesium oxide (found in Milk of Magnesia). Unfortunately, magnesium oxide is not well absorbed and can have a strong laxative effect leading to uncomfortable bloating and diarrhea. In fact, only about 5 percent of magnesium oxide is absorbed and used by the body (6).

Magnesium Citrate

Magnesium citrate is one of our top choices for magnesium supplementation. The magnesium is combined with citrate, an organic salt. It is relatively cheap and has a better rate of absorption than magnesium oxide (6).

Magnesium citrate is a great option for people with constipation, as it can have a gentle laxative effect. This supplement works by pulling water into the intestines to make your bowel movements softer and easier to pass. However, unlike magnesium oxide, the laxative effect is much more tolerable.

Magnesium citrate may also be recommended for migraine prevention.

Magnesium Glycinate

Our other preferred magnesium supplement is called magnesium glycinate. Magnesium glycinate (also called magnesium bisglycinate) is well-tolerated and absorbed in the body.

In this case, the magnesium is combined with an amino acid called glycine. Glycine works alongside many neurotransmitters (chemicals in your brain), like GABA, to promote feelings of calm. Glycine may also improve sleep quality and promote a healthy circadian rhythm (7).

Additionally, magnesium has strong anti-inflammatory benefits. We may use magnesium glycinate to improve blood sugar levels or to help reduce overall inflammation in the body.

This form of magnesium is less likely to have a laxative effect than magnesium citrate. Because it is bound to the amino acid glycine, it has a calming effect and can be used for stress relief, insomnia, anxiety, and more.

Magnesium Citrate vs. Glycinate: Concluding Thoughts

While there are many forms of magnesium available, we often prefer to use magnesium citrate and/or magnesium glycinate.

Magnesium citrate is most helpful for people suffering from constipation, while the glycinate form is more useful for conditions like anxiety, insomnia, chronic stress, and inflammatory conditions. Some supplements provide a combination of magnesium citrate and magnesium glycinate, which is a great option for people suffering from constipation among other conditions.

Although magnesium is a very safe supplement for most people, dosing and usage may depend on various factors such as dietary intake, symptoms, lab results, gut health, and more.

For this reason, it’s important to work with a functional medicine practitioner to optimize your magnesium status and help you get to the root cause of your health issues.

Our favorite quality magnesium supplements can be found on our online supplement store here.

Snacks for PCOS

Root Functional Medicine — Thu, 01 Aug 2019 00:00:00 -0400

If you have been diagnosed with PCOS, you likely have a lot of questions about what you should be eating for meals and snacks. If you are like many of the women we work with, you have likely already consumed a lot of information on the internet or via podcasts about eating for PCOS. You might even be feeling MORE confused, the more you research, due to information overload and all of the conflicting advice out there. Today we are going to break things down for you and discuss appropriate snacks for PCOS, while keeping in mind the importance of individualization.

Here are a couple of things to keep in mind when meal and snack planning for PCOS:

Insulin resistance is at the root of 70% of PCOS cases. Elevated insulin and blood sugar levels leads to food cravings, which can make it difficult to make good food choices. Your body wants sugar and it wants it now! Addressing this component with the right lifestyle changes is essential, and we help women with this in our personalized program.
Women with adrenal and inflammatory PCOS should still pay attention to blood sugar balance. Elevated cortisol levels can lead to elevated blood sugar because this helps our body survive and have immediate energy when in “fight or flight” mode.
Sometimes when we think “snack” we think foods with low nutrient density like chips & pretzels. We want to shift this mindset and think of snacks as being “mini meals” that are used to fill nutrient gaps via extra fiber, healthy fats, protein, and phytonutrients (from bright colored fruits & vegetables).

Do I need to snack?

Before reaching for a snack, ask yourself the following things:

Are you actually hungry, or are you just eating out of habit? Think of a hunger scale that goes from 0 to 10, where 0 is ravenous hunger and 10 is so full you need to unbutton your pants. To avoid cravings and overeating, it is helpful to try and keep your hunger rating between 3-7 throughout the day. This is going to require some experimentation for you to find what combinations of foods work best for you (hint: it’s going to be hard to stay in this range without the proper balance of macronutrients).
If you are hungry, is it because you didn’t eat enough protein and fat at breakfast or lunch? Eating pure carbohydrate (such as a breakfast of plain oatmeal + fruit + orange juice) is a sure way to be hungry and have food cravings throughout the day. Try experimenting with different food combinations and make note of how satisfied you feel afterwards.

Should certain women avoid snacking?

You are the expert of your own body and are the only one who knows exactly what your body needs. Some women with severe insulin resistance might do better eating 3 balanced meals per day with no snacks in between because this will give their insulin levels more time to be lower throughout the day. Getting to a point where you only eat 3 meals per day with no snacks can be challenging and might take time (for reasons listed above as well as the food cravings that come along with insulin resistant PCOS). To comfortably avoid eating snacks when you have PCOS requires careful planning and inclusion of healthy fats, proteins, and bright colored plant foods at each meal. The goal certainly isn’t for you to eat a super low calorie diet and feel hungry all day. Eating adequate calories, fat, and vitamins/minerals is actually essential to proper hormone production.

Snacks to avoid.

Avoid snacking on simple “naked” carbohydrates. For example: plain crackers, chips, popcorn, and pretzels generally don’t contain much protein, fat, or fiber. These snacks aren’t going to fill you up so you will be more likely to overeat or start searching for another snack an hour later. You might also gravitate towards eating plain fruits or vegetables for a snack because it seems like the “healthy” thing to do, but even eating produce by itself likely won’t be a satisfying snack in the absence of protein and fat. Read below for a better way to handle this.

Best snacks for PCOS

The best snacks for PCOS will check a few different boxes:

Complex carbohydrates (fiber)
Protein
Healthy fat
Bonus points for including a bright colored fruit or vegetable or Omega-3 fatty acids (such as walnuts, flax, chia, or sardines).
They are filling enough to tide you over comfortably for 2-4 hours

In summary, snacks for women with PCOS:

- Shouldn’t include simple “naked” carbohydrates
- Should include a combination of complex carbohydrates (fiber), protein, and fat to keep blood sugar (and thus insulin) from spiking.
- Should help fill nutrient gaps and include anti-inflammatory and gut-health promoting foods like bright colored fruits/vegetables and nuts/seeds when possible
- Should be eaten after assessing hunger.

For PCOS snacks and meals, check to see if we deliver our PCOS friendly, fully cooked PCOS meals to your area!

Meal Plans

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Curing Histamine Intolerance

Root Functional Medicine — Mon, 16 Sep 2019 00:00:00 -0400

Are certain foods triggering your unwanted symptoms?

Similar to allergies and food sensitivities, histamine intolerance may be another cause of your adverse food reactions. However, histamine intolerance is not well understood by most people and can be tricky to diagnosis.

In this article, we’ll explain this condition in simple terms and discuss if there is truly a method for curing histamine intolerance.

What is Histamine Intolerance?

Histamine is a chemical that has many functions in the body. It is found naturally in certain foods and is best known for its powerful actions during an allergic or inflammatory reaction.

However, what is histamine intolerance? Despite the name, histamine intolerance is not an “intolerance” to histamine. Rather, histamine intolerance occurs when you have too much histamine than your body is able to effectively break down (1).

The main enzyme in your body responsible for breaking down histamine is called diamine oxidase (DAO).

Symptoms of Histamine Intolerance

While symptoms of histamine intolerance vary, some common reactions as a result of this condition may include (1):

D-hist for Allergies

Root Functional Medicine — Sat, 28 Mar 2020 00:00:00 -0400

Seasonal allergies can be troublesome for many people. In this article, we’ll discuss histamine, the benefits of using D-Hist for seasonal allergies, and other functional medicine therapies for seasonal allergy sufferers.

Histamine and Seasonal Allergies

Histamine is a chemical messenger your body makes to carry out multiple jobs in the body. For example, histamine is involved in hormone regulation, smooth muscle contraction, digestion, and more (1).

Normally, your body is fairly effective at degrading histamine. However, certain scenarios may cause your histamine load to build-up and lead to symptoms of histamine intolerance. An increase in environmental pollen and dust during certain times of the year is one such example.

Common symptoms of seasonal allergies include:

Nasal congestion
Sneezing
Runny nose
Asthma exacerbations
Itchiness
Red or watery eyes

If you suffer from these symptoms year-round, there may be other root causes that need to be addressed. Read more about histamine intolerance here.

D-Hist for Allergies

D-Hist is a popular supplement containing various antioxidants, enzymes, and plant extracts. The ingredients in D-Hist are intended to degrade the histamine load, reduce inflammation, and thin mucous secretions. Many people use this supplement as a way to reduce seasonal allergy symptoms. Purchase D hist here.

Let’s review each of the ingredients in the D-Hist supplement:

Quercetin

Quercetin is an antioxidant from the flavonoid group found naturally in onions, broccoli, and certain types of tea. It is known to have anti-allergic benefits that include lowering inflammation and reducing histamine release from your cells (2).

Nettles Leaf Extract

Stinging nettles leaf is a natural herb that has significant anti-inflammatory and antihistamine properties (3). As an extract in the Ortho Molecular D-Hist supplement, this potent ingredient has many benefits for people with seasonal allergies.

Bromelain

Bromelain is a natural plant enzyme found in pineapple. This popular ingredient also has effective anti-inflammatory and antihistamine properties.

N-Acetyl Cysteine

N-Acetyl Cysteine (NAC) is a powerful antioxidant that can reduce inflammation and lower oxidative stress in the body. NAC also loosens and thins mucus secretions in your airways which may be helpful in reducing nasal congestion (4).

Vitamin C

Vitamin C is a well-known nutrient with strong antioxidant properties. Besides boosting the immune system and reducing oxidative stress, vitamin C is also required to produce diamine oxidase—the enzyme responsible for breaking down histamine in the body (1).

How to Take D-Hist for Allergies

D-Hist by Ortho Molecular is one of the most popular supplements for allergies. For effective use, begin a loading dose of two capsules of Ortho Molecular D-Hist three times per day for 1 to 2 weeks. From there, you may lower to a maintenance dose of one or more capsules daily based on your seasonal allergy symptoms. We include D hist in our histamine bundle with magnesium which is helpful for stress and sleep and DAO which breaks down histamine in the gut.

Other Considerations for Seasonal Allergies

Besides taking D-Hist for allergies, other functional medicine therapies may reduce your overall histamine load and treat seasonal allergies from the root cause.

Low-Histamine Diet

If you are experiencing seasonal allergies, you may want to consider following a temporary low-histamine diet. Eliminate foods high in histamines like fermented foods (kombucha, sauerkraut, wine/beer), aged foods (aged meats and cheeses, olives, vinegar, canned meats/fish), and other high sources like tomatoes, avocados, and spinach.

Improve Gut Health

Gut inflammation, small intestinal bacterial overgrowth (SIBO) and other imbalances of gut bacteria may worsen histamine intolerance and seasonal allergies. While you may be tempted to take a probiotic and call it good, many probiotic strains can actually increase your histamine load and worsen your symptoms. For this reason, it’s helpful to work with a qualified functional medicine practitioner to implement a personalized gut healing protocol.

Reduce Stress

Chronic stress increases histamine production in the body. For this reason, healthy stress management is key in reducing your overall histamine load and treating seasonal allergies. Implement a realistic stress-reducing activity every day and reduce stressful triggers in your life if possible.

Estrogen Dominance

Estrogen triggers histamine release from the immune cells (1). Too much overall estrogen—as seen in estrogen dominance—may overload your histamine tolerance and worsen seasonal allergies. One way to naturally reduce estrogen levels is to include more cruciferous vegetables into your diet like broccoli, cauliflower, Brussel’s sprouts, and cabbage. However, many women require accurate testing and individualized protocols to effectively balance estrogen levels.

D-Hist for Allergies: What You Need to Know

Histamine is a chemical made in the body that has many important jobs. Increased environmental pollen and dust at certain times of the year may lead to histamine overload and symptoms of seasonal allergies.

D-Hist is an anti-inflammatory supplement containing various antioxidants, enzymes, and plant extracts aimed to reduce your overall histamine load. While taking D-Hist alone helps many seasonal allergy sufferers, others may require a more in-depth functional medicine treatment to assess diet, stress, gut health, and hormonal balance.

You can purchase D-Hist here.

PCOS and Thyroid

Root Functional Medicine — Mon, 30 Dec 2019 00:00:00 -0500

Polycystic ovary syndrome (PCOS) and thyroid disorders are two of the most common hormone disorders in women.

At Root Functional Medicine, we often see women presenting with BOTH of these conditions. Is there a connection?

In this blog, we’ll discuss the relationship between PCOS and thyroid conditions (Hashimoto’s in particular) and what you can do to start feeling better.

What is PCOS?

PCOS is an inflammatory condition that affects your hormones and menstrual cycle. Some studies report that PCOS affects up to 15 percent of women (1). Although some women with PCOS have cysts on their ovaries, it is not a requirement for diagnosis.

Most women with PCOS have higher levels of androgens, i.e. “male” hormones, and insulin resistance. Symptoms of PCOS may include period irregularities, acne, infertility, hair loss, unwanted hair growth, and mood disturbances.

What is Hashimoto’s?

Hashimoto’s is an autoimmune disease in which your immune system mistakenly attacks your thyroid, a butterfly-shaped gland in your neck.

Hashimoto’s is the most common cause of hypothyroidism in the United States, and women are 10 times more likely to have Hashimoto’s than men (2). In fact, up to 9 percent of pregnant women develop Hashimoto’s after pregnancy. Read more about autoimmune disease after pregnancy here.

Symptoms of Hashimoto’s include period irregularities, dry/thinning hair, fatigue, sensitivity to cold temperatures, mood disturbances, and more.

PCOS and Thyroid

While researchers aren’t quite sure how these two conditions are related, it is clear that there is a bidirectional relationship. For example, women with PCOS are three times more likely to also suffer from Hashimoto’s thyroid disease than the general population (3, 4).

At the same time, polycystic appearing ovaries can be a clinical sign of hypothyroidism.
This is why your doctor should rule out hypothyroidism before diagnosing PCOS (5).

PCOS and thyroid conditions also share common characteristics, like period irregularities, increased insulin resistance, and dysregulation of the immune system.

What Can You Do?

PCOS and Hashimoto’s thyroiditis are both inflammatory conditions. In functional medicine we focus on treating root causes to reduce inflammation in the body. So, whether you have PCOS, Hashimoto’s thyroiditis, or both, here are a few ways you can start healing.

Improve Your Gut Health

Your gut plays a large role in balancing sex hormones, like estrogen, reducing overall inflammation, and creating a healthy environment for friendly gut bacteria to thrive. So, healing the gut is essential in treating the root cause of PCOS and Hashimoto’s.

Here are a few ways you can start improving your gut health at home:

Eat a variety of fiber-rich foods.
Include probiotic-rich foods as tolerated (kombucha, raw sauerkraut, kimchi, etc.)
Limit foods high in added sugar.
Limit gut irritants, like excessive caffeine and alcohol.
Spend time in and around nature/plants.

Sometimes, women require more interventions to truly heal their gut. This is where working with a functional medicine practitioner to guide you through a personalized treatment plan is key.

Balance Your Blood Sugar

Women with PCOS and/or Hashimoto’s thyroiditis can both benefit from balancing their blood sugar levels.

Insulin resistance is a hallmark feature of PCOS. Insulin is a hormone responsible for lowering your blood sugar levels after a meal. If you have insulin resistance, your cells do not properly respond to insulin. This causes your blood sugar levels to remain elevated for longer than normal, which can worsen inflammation and PCOS symptoms.

Likewise, some studies indicate a relationship between insulin resistance and Hashimoto’s thyroiditis as well (6).

To balance your blood sugar and reduce insulin resistance, include a protein, fat, and high-fiber food in all of your meals and snacks. Try to limit processed carbohydrates and foods high in added sugar (like soda, sweets, and pastries) that excessively raise blood sugar levels.

Our PCOS supplement bundle can help by reducing carb cravings, replacing vital nutrients for blood sugar balance, and promoting relaxation and hormone balance:

Balance Your Lifestyle

Your lifestyle has a tremendous effect on your health, especially with PCOS and thyroid conditions.

Use these tips to rebalance your lifestyle:

Aim for 7-8 hours of sleep per night (read our blog on insomnia here).
Find a healthy way to reduce stress, like meditation, yoga, therapy, or breathing exercises.
Move your body in whichever way you most enjoy. Exercise is important for overall health, but avoid vigorous or stressful exercise, as this may do more harm than good in these conditions.

Sometimes we try so hard to be healthy that we end up ignoring our body’s cues. Make sure to listen to your body, and be kind to yourself!

Eat an Anti-Inflammatory Diet

By now you probably know that chronic inflammation creates havoc in the body. Since PCOS and Hashimoto’s thyroiditis are both inflammatory conditions, following an anti-inflammatory diet is crucial.

An anti-inflammatory diet is rich in colorful, non-starchy vegetables, fatty fish (like salmon), nuts, seeds, and colorful fruits! Including a variety of healthy fats, like extra virgin olive oil, avocados, and coconut oil is helpful, too.

Meal Plans

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Why am I waking up at 3am?

Root Functional Medicine — Sun, 29 Sep 2019 00:00:00 -0400

Have you ever woken up at 3 am, heart pounding, sweating and suddenly wide awake? Only to continue to lie awake wondering if and when you might fall back asleep, and wondering what caused you to wake so suddenly.

Insomnia (including trouble falling asleep, waking up throughout the night, or early morning awakening) is a symptom of an underlying imbalance.

Instead of relying on sleep aid medications (which were found to be metabolized slower in women after being on the market!), we have a different approach to resolving insomnia at the root cause. Each person’s reason for insomnia may be different – 10 different people might have ten different reasons that they wake up at 3am. Finding and treating those root causes requires a whole body, personalized approach.

Here are some possible root causes of waking up at 3am:

HPA axis dysfunction

HPA axis stands for hypothalamic, pituitary, and adrenal axis. Your adrenal glands secrete cortisol in response to signals from your brain (hypothalamus and pituitary). In an idealistic situation we want to see your cortisol levels higher in the am (to get you up and ready for the day!) and lower at night so that you can fall asleep. If your cortisol is high before bed, you’ll have trouble falling asleep. If your cortisol does not stay low overnight, or if cortisol starts spiking early, you’ll likely have middle of the night awakening. The brain is very perceptive and it also likes patterns so if you’re subconsciously preparing for the next days’ stress (or if you had been exposed to stressful situations in the recent past), this will lead to HPA axis dysfunction and insomnia.

Melatonin imbalance

The next thing about cortisol is that cortisol and melatonin work oppositely of each other. Cortisol suppresses melatonin during the day and then melatonin suppresses cortisol levels in the evening and at night. But, if cortisol stays high before bed, your body won’t be functionally optimizing melatonin.

What else suppresses melatonin:

There’s light in your room at night. The best sleeping environment is a near pitch black room. This includes exposure to blue light from devices 1-2 hours before bed.

Or,

You’re not getting enough light during day. While blue light from devices may have the most pronounced suppressant effect on melatonin, recent studies show that full spectrum light throughout the day can counterbalance blue light exposure. As we head into fall and winter months, using a light box for 30-60 minutes in the morning can help to reset melatonin cycles.

Sleep Apnea

Sleep apnea is the most prevalent sleep disorder. Sleep apnea is also a common comorbidity of Hashimoto’s thyroid disease. Studies have found that 25-35% of people with hypothyroidism also have sleep apnea and that sleep apnea is a risk factor for Hashimoto’s.

Leaky gut

Leaky gut is a common root cause of inflammation. Just under the lining of the intestinal cells is the vast majority of the body’s immune system. When this gets activated, the inflammation does not just stay in the gut, it circulates throughout causing cortisol imbalances, and systemic symptoms. Newer studies show that anxiety, depression, and insomnia are actually disorders of inflammation.

Our favorite Gut Health Rebalance supplement can be taken as a powder in water, or added to your morning smoothie:

Anxiety

The gut-brain axis is complicated and we’ll plan on doing more posts on this in the future. Leaky gut can be both a cause of anxiety and a result of cortisol imbalance from stress. Anxiety most commonly occurs at night. When our minds are not occupied, they wander. Even when it seems impossible to be experiencing anxiety in the middle of the night when you are sound asleep, remember that 1: anxiety is often an underlying inflammatory issue and 2. Your brain likes patterns and will trigger the release of cortisol even when it might not be warranted for the situation if HPA axis dysfunction is present.

Environmental triggers

This is not an exhaustive list, but we’ll start with the most common ones:

Alcohol. Alcohol notoriously causes rebound anxiety and 3am awakenings for many people. Even though it might seem like a glass or two of wine helps with falling asleep, the quality of sleep is affected by alcohol, leading to middle of the night and early morning awakening.

Caffeine. The half-life of caffeine is 6-8 hours. That means if you drink coffee at 1pm, half of that caffeine may still present at 9pm, making it harder for you to relax before bed. Also, you may have a genetic SNP that makes it harder to metabolize caffeine. This SNP is part of what we can test for at Root – check out our shop page for a very comprehensive nutrition genome report!

Nutrient Deficiency

Are you lacking nutrients like the essential amino acid tryptophan, which is used to make serotonin and melatonin? We can test for this in our functional labs, as well as your gut health to be sure you are breaking down and absorbing proteins.

Magnesium deficiency is a common deficiency. Magnesium powers detox reactions (occurring mostly at night!), relaxes muscles, and helps anxiety. We wrote more about magnesium here. Our favorite highly absorbable magnesium supplement can be found here.

Blood sugar imbalance

Having an unbalanced plate without fiber, protein, and healthy fat can lead to a cycle of blood sugar spikes, then insulin spikes, then blood sugar drops. When blood sugar drops, your body’s protective mechanism is to secrete cortisol to bring your blood sugar back up.

Insulin resistance can also lead to after dinner food cravings and later evening snacking. Eating at night raises body temperature, which makes it harder to fall asleep.

Hormone imbalance

Estrogen/serotonin/melatonin are all related. Estrogen works throughout the body, including the brain. In the brain, estrogen can regulate serotonin. Serotonin is used by the body to make melatonin. Balancing hormones at Root is a multi-layered approach.

To balance hormones, we balance blood sugar with our meal plans, supplement important nutrients, and manage stress and sleep with some of the tips in this article.

PCOS Meals

Root Functional Medicine — Thu, 08 Jul 2021 00:00:00 -0400

Women with polycystic ovary syndrome (PCOS) may suffer from irregular periods, acne, unwanted hair growth, weight gain, and more. Unfortunately, conventional medicine does little to support those with PCOS and often relies on birth control prescriptions or general recommendations for weight loss.

Yet, losing weight with PCOS is not an easy task and the underlying causes of PCOS, like insulin resistance and inflammation, make it very difficult. Plus, general weight loss does not necessarily address the various root causes of PCOS and many people still suffer from symptoms like acne and hair loss. Here’s the good news: targeting the root causes of your PCOS with nourishing foods can help eliminate your symptoms without restrictive dieting. With our sustainable methods, some women may also find it is easier to lose weight.

In this article, we will explain how to make a PCOS meal plan and provide examples using our own Root Farmacy meals.

How to Plan a PCOS Meal

Optimizing your overall diet—as in the foods you eat—is foundational in treating the root cause of PCOS. A diet high in refined carbs, inflammatory fats, and added sugar worsens insulin resistance and inflammation.These types of foods are also much easier to overeat, which can lead to an overabundance of calories, frequent blood sugar imbalances, and weight gain. On the other hand, an anti-inflammatory diet improves your body’s sensitivity to insulin, reduces inflammation, and provides the necessary nutrients to optimize hormone function.

The PFC (Protein, Fat, Carb) Balance Method

Instead of cycling through unsustainable fad diets, we recommend a simple formula of making sure you have lean protein, fat, and fiber-rich carbohydrates (PFC) on each plate for your PCOS meals. This formula is best for balancing your blood sugar levels and offering the nutrients you need for hormone balance.

To breakdown the PFC method further, let’s review which common foods fall into each category:

Protein: beef, pork, seafood, poultry, eggs, tofu or edamame
Fat: olive oil, avocados, coconut oil, nuts, seeds
Carbs: fruit, sweet potatoes, corn, brown rice, quinoa, oats, winter squash, beans, lentils, whole-grain bread
Non-starchy vegetables: leafy greens, Brussel’s sprouts, broccoli, cauliflower, tomato, bell peppers, cucumber, zucchini, etc.

Keep in mind that many foods cross over into two categories. For example, beans contain both fiber-rich carbs and protein. We put beans in the starch (carbohydrate) category instead of the protein category because they are heavy in carbohydrates.

We teach how to create easy, PFC balanced meals and include a PCOS meal plan in our online PCOS Course, The PCOS Symptom Reversal Method.

Despite what you may read elsewhere, it’s important to include fiber-rich carbohydrates in your PCOS meal plan. Low-carb or ketogenic diets are popular recently and many people tout the benefits of these eating patterns for women with PCOS. It is true that a low carb diet may benefit PCOS by balancing blood sugar levels and aiding weight loss. However, we find that these diets are difficult to maintain, trigger sugar cravings, and often do not provide enough calories (which can actually worsen your menstrual cycle and ovulation).

Curious about whether you should include gluten and soy in your PCOS meals? We covered these controversial topics in our Soy and PCOS and Gluten and PCOS blog articles.

Vitamins & Minerals

By following the PFC formula, you are also providing a wide range of nutrients required for making, metabolizing, and balancing your hormones.

Vitamin B6, folate, and vitamin B12 are particularly important in optimizing hormonal balance in PCOS. These three vitamins help to lower inflammation by breaking down an amino acid, called homocysteine, which is commonly elevated in women with PCOS (1). Lowering homocysteine may reduce your risk factors for heart disease and other reproductive symptoms.

Folate: leafy greens, asparagus, avocado
Vitamin B6: chickpeas, salmon, chicken, potatoes
Vitamin B12: animal products only; especially beef, fish, and eggs

Two minerals that are also crucial in treating PCOS are zinc and magnesium. Eating enough zinc may help reduce symptoms of PCOS like hair loss, unwanted hair growth, and acne. Similarly, magnesium is involved in over 300 reactions in the body and influences hormone balance and signaling. Unfortunately, over half of Americans fail to meet the daily magnesium requirements with their diet! Eating enough magnesium may improve insulin resistance, reduce inflammation, and promote restful sleep.

Zinc: beef, pork, cashews, and chickpeas
Magnesium: pumpkin seeds, chia seeds, almonds, and edamame

Phytochemicals

Phytochemicals are compounds made by plants that provide desirable health benefits to humans. It is the phytochemical compounds that give plant-based foods their unique color! For example, lycopene and beta-carotene are phytochemicals found in red foods, like tomatoes. Anthocyanins are found in blue and purple foods, like berries, and quercetin is found in brown and white foods, like quinoa, onions, and beans.

Women with PCOS have significantly higher levels of inflammation and lower antioxidant levels than women of the same age and BMI without this condition (2). Phytochemicals are crucial for women with PCOS because they boost antioxidant levels in the body and provide anti-inflammatory benefits.

You don’t have to remember all of the different kinds of phytochemicals to follow a successful PCOS meal plan. Rather, focus on eating colorful and diverse meals with a variety of fruits and vegetables to obtain all of the phytochemical benefits.

Examples of PCOS Meals

Using the PFC Method may not come naturally to you at first. The more you practice these methods when planning your weekly meals, the easier it will become. Let’s review a few examples of the PFC Method in action! We’ll use our Root Farmacy meals to provide a delicious visual.

Overnight Oats

These overnight oats are soaked with chia seeds, almond milk, and coconut yogurt and layered with strawberries. Overnight oats are a perfect fiber-rich breakfast to promote bowel regularity and optimal gut health in PCOS. The various forms of fiber in this recipe also prevents your blood sugar from spiking (which can lead to sugar cravings and fatigue later in the day).

Protein: coconut yogurt

Fat: coconut yogurt, chia seeds

Carb: oats, strawberries

Salmon is an excellent protein and omega-3 fat source for PCOS meals to help reduce overall inflammation. Rainbow carrots are a good source of beta-carotene and potassium while purple potatoes are rich in polyphenols to support a healthy gut lining. The roasted broccoli in this dish also provides a powerful antioxidant called glucoraphanin which helps neutralize damaging free radicals in the body.

Protein: salmon
Fat: salmon, olive oil
Carbs: purple potatoes
Non-starchy vegetables: carrots, broccoli

Lamb is another excellent protein source containing nutrients like B12, selenium, and zinc to support thyroid function in PCOS and optimal fertility. Quinoa (which is technically a seed, not a grain) is rich in fiber, antioxidants, and contains all nine essential amino acids. The asparagus in this dish provides prebiotic fiber, which is the preferred fuel source of healthy gut bacteria. Gut health is particularly important in PCOS as women with this condition tend to have more imbalanced gut bacteria (dysbiosis) compared to women without PCOS.

Protein: lamb
Fat: olive oil
Carbs: quinoa
Non-starchy vegetables: red peppers, asparagus

Farmacy Meals for your PCOS Meal Plan

Managing your PCOS and cooking nutritious meals at home can feel impossible when combined with the rest of your daily responsibilities. However, we see everyday how the anti-inflammatory food plans in our PCOS programs completely change member health outcomes! We created our meal prep service, Root Farmacy, as a way to share this powerful tool with the community.

Farmacy Meals are designed by our own functional doctors and prepared by dietitian chefs. Our meals are fresh, free from refined sugar, anti-inflammatory, rich in organic and local ingredients, and perfect for balancing hormones in PCOS. Learn more about Root Farmacy Meals here.

Meal Plans

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Tea for PCOS

Root Functional Medicine — Fri, 01 Nov 2019 00:00:00 -0400

Green Tea

A study published in 2017 showed that the consumption of 500 milligrams of green tea extract twice daily for 12 weeks led to weight loss, decreased fasting insulin levels, and lower levels of free testosterone in overweight women with PCOS (3). Animal studies have also shown the positive effects of green tea extract in subjects with PCOS. One study found a significant reduction in insulin resistance index as well as reduced body weight in rats with PCOS (4).

How does 500 mg of green tea extract translate to cups of green tea? One would probably have to drink at least 64 oz of green tea per day to reach that level, so about 128 oz per day to reach the therapeutic dose in the human study above. Is this realistic for most people? Probably not. Taking a supplement of green tea extract, such as this one or doing a combination of the tea and the extract supplement, would be an easier way to achieve that dose for most people.

Other teas and beverages

Drinking adequate water and a good variety of herbal teas, even those not studied for PCOS, is a good way to stay hydrated and get anti-inflammatory benefits from the polyphenols and antioxidants in tea. You can read more about healthy drinks other than water and some of our favorite tea options here.

What should you do with this information?

More studies are certainly needed to prove the anti-androgenic properties of spearmint and green tea for PCOS, but consuming more tea is a good option to try for women struggling with symptoms from the high androgens that come along with the condition.

If you are a more than 1 cup per day coffee drinker, start off by replacing your second cup of coffee with tea and see how it goes. Consider using decaffeinated green tea if you are drinking it in the afternoon. Working towards an intake of 2-6 cups of spearmint or green tea per day is a reasonable goal for most people. You can find one of our favorite spearmint teas here.

If you are looking for more guidance for treating PCOS, check out our online PCOS program.

Intermittent Fasting and Hypothyroid

Root Functional Medicine — Tue, 28 Jan 2020 00:00:00 -0500

The popularity of intermittent fasting has grown tremendously over the past few years. Benefits of intermittent fasting may include weight loss, reduced inflammation, and improved blood sugar balance.

Yet, how do intermittent fasting and thyroid health fit together? Is it safe to practice intermittent fasting if you have hypothyroidism?

In this article, we’ll review the pros and cons of intermittent fasting, how it may affect thyroid function, and discuss whether or not you should practice fasting if you have hypothyroidism.

What is Intermittent Fasting?

Intermittent fasting is the term used to describe various fasting patterns, in which individuals purposefully fast for a specific amount of time (except for water). Please note, this article is not referring to religious fasting, which some cultures practice during certain times of the year. There are many different types of intermittent fasting, but some of the most common include:

Alternate Day Fasting

In this practice, a person would completely fast for alternating days throughout the week.

Alternate Day Modified Fasting

This is similar to the above method with the distinction that you can eat a small amount of food (usually less than 25% of calorie needs) during the fasting days.

Time-Restricted Fasting (16:8)

We all practice some form of time-restricted fasting when we sleep. However, the 16:8 fasting method limits food intake to 8 hours per day. People often compress their eating window by eliminating breakfast or eating an earlier dinner to allow for a 16 hour overnight fast.

Periodic Fasting

A periodic faster would eat normally most days of the week, and fast for 1 to 2 days. Another form of this fasting schedule includes the 5:2 method. For this practice, individuals eat 25 percent of their calorie needs on two scheduled fasting days and eat normally for the other 5 days.

Pros and Cons of Intermittent Fasting

Many health professionals and celebrities tout the benefits of intermittent fasting. Some research studies also show potential benefits. But, are there any drawbacks to intermittent fasting?

Benefits of IF

The main benefits of intermittent fasting found in human research so far include weight loss (with fat loss), improvements in fasting blood sugar, and reduced insulin resistance (1, 2). Intermittent fasting may also reduce levels of inflammation within the body (3, 4, 5).

Drawbacks of IF

The main drawbacks of intermittent fasting for certain individuals include the potential for disordered eating behaviors, hunger, sustainability, and nutrient deficiencies (6).

Let’s discuss the potential impact of intermittent fasting on hypothyroid conditions.

Intermittent Fasting and Thyroid Health

Limiting your eating window often results in lower calorie intake. While this may be helpful for weight loss, calorie restriction has a significant impact on your thyroid.

For example, your inactive thyroid hormone, called reverse T3, increases with dieting and competes with your active thyroid hormone (T3) to bind to your receptors. Both short and long-term dieting can result in up to a 50 percent decrease in your active T3 hormone (7, 8). Increased reverse T3 and reduced active T3 may result in a worsening hypothyroid condition.

Despite these findings, some studies show that your thyroid hormones return to pre-fasting values after breaking your fast with a meal, indicating that some prolonged fasting may not be detrimental to individuals without a hypothyroid condition (9, 10).

Intermittent Fasting and Cortisol

Long periods of fasting can also lead to low blood sugar levels and cause your adrenal glands to release a hormone called cortisol.

Cortisol is a steroid hormone that has many important functions in the body, like reducing inflammation during an acute injury, helping your body adapt to dangerous situations, and regulating blood sugar levels. Yet, when cortisol is chronically elevated, we can experience negative side effects. For example, chronically elevated cortisol levels can impair thyroid hormone production and function (11).

If you struggle with adrenal issues, like elevated cortisol levels, intermittent fasting may worsen cortisol balance and subsequently hinder your thyroid function.

Fasting aside, many Americans do not meet the recommended daily amounts for nutrients like vitamin A and iron. What’s more, a whopping 95 percent of people fail to meet the recommended amounts of fiber (12). Fiber has a vital role in maintaining optimal gut health which then indirectly affects your thyroid health! Skipping meals or fasting for multiple days during the week may create nutrient deficiencies that can ultimately worsen a hypothyroid condition.

Intermittent Fasting and Hypothyroid: Is it Safe?

Intermittent fasting is one tool that may be beneficial for some individuals.

However, fasting with a hypothyroid condition should be carried out carefully. As always, focus on eating an unprocessed, whole-food diet that is rich in fiber. Listen to your body, and stop any practice that may make you feel worse, mentally or physically. Because of the clear connection between low-calorie diets and reduced thyroid function, we usually recommend against full-day fasts. A safer alternative may be to extend your overnight fast by eliminating late-night snacking (which tends to involve low-quality foods anyway!).

Prolonged fasting is not for everyone. Along with hypothyroid disorders, intermittent fasting is not recommended during pregnancy, for women with eating disorders, or those with unresolved adrenal issues.

If you have a thyroid condition (or suspicions for one), check out our individualized Functional Medicine Program to help you find healing.

SIBO and Acne

Root Functional Medicine — Mon, 20 Jan 2020 00:00:00 -0500

If you suffer from acne, you’ve probably investigated tons of potential causes and treatments. But, in this article, we’ll explain why you must address gut health in order to truly heal your acne, and how a gut condition called SIBO may be the root cause of your acne struggles.

How does gut health affect acne?

The gut is responsible for much more than digestion and nutrient absorption.

It’s an ecosystem! Like any other ecosystem, your gut needs the right environment to flourish. Through a healthy diet and lifestyle, the collection of bacteria, viruses, and fungi (your gut microbiome) can thrive.

Your gut and skin communicate with each other through what is called the gut-skin axis.

Since the majority of your immune system cells are actually located in your GI tract, your gut microbiome largely influences your immune system (1, 2). By influencing your immune system, the health of your gut microbiome also affects your skin health.

Imbalances in your gut bacteria can lead to leaky gut and inflammatory responses which may eventually present as acne on the skin.

What is SIBO?

SIBO stands for Small Intestinal Bacterial Overgrowth and occurs when too many bacteria end up in the small intestine.

Normally, the small intestine is home to a relatively small number of bacteria. Most of your gut bacteria are supposed to live in your large intestine. When too many bacteria start to colonize in the small intestine, you can experience unpleasant symptoms, like acne, leaky gut, and inflammation.

SIBO and Acne

A lot of people with SIBO suffer from GI symptoms like gas, bloating, diarrhea/constipation, and heartburn.

However, this isn’t the case for all women. Some people with SIBO also (or only) present with non-GI symptoms like acne, eczema, fatigue, or nutrient deficiencies. In fact, one study reported SIBO is 10 times more prevalent in those with acne versus healthy controls (3).

What causes SIBO?

One of the main causes of SIBO is called hypochlorhydria, or low stomach acid. Without enough acid in your stomach, microbes can survive digestion, camp out in the small intestine and feast on your partially digested food. Many people with acne also have low stomach acid (4). Coincidence? We don’t think so!

SIBO can also be triggered from an episode of food poisoning or the stomach flu.The bacteria or virus from the illness releases a toxin into the GI tract that can damage the cells that control your “cleansing waves.” These cleansing waves are muscular contractions responsible for sweeping away debris from the small intestine. When the cleansing waves are disrupted, you can develop an overgrowth of bacteria.

Some conditions may not directly cause SIBO but are associated with it: irritable bowel syndrome, gastroparesis, celiac disease, Crohn’s disease, and hypothyroidism.

How to test for SIBO

The main test to diagnose SIBO is a breath test. For this test, you drink a specific syrup and then provide breath samples at various time intervals. The bacteria in your small intestine feed on the syrup and produce hydrogen and/or methane gas. If the levels of gas are higher than the provided threshold, this may indicate a SIBO diagnosis.

A stool test can also be helpful in looking at the microbiome of the large intestine. This stool sample tells us if there are other issues in the gut like candida overgrowth, dysbiosis (an imbalance of good to bad bacteria), or parasites.

How to treat SIBO and acne

We use an individualized approach with all patients, including those who may be suffering from SIBO and acne. This may include personalized lab tests, like food sensitivity testing, a full thyroid panel, and/or a comprehensive stool test.

However, whenever addressing acne, we implement a targeted gut health program using what is called the 5R approach. Let’s review what this 5R approach for natural treatment of SIBO and acne may include:

Remove

The first step aims to reduce bacterial overgrowth and remove pathogens (the bad guys) with targeted supplements, like antimicrobials. This step also removes food sensitivities and foods that compromise gut health (added sugar, refined grains, alcohol, etc.). An anti-inflammatory diet is crucial to starve the bad bugs while feeding the good bugs. A Low FODMAP diet, specifically for SIBO and IBS symptoms, may also be beneficial.

You can learn how to do a Low FODMAP diet here.

Replace

The second step restores everything your body needs for optimal digestion and health. We may replace stomach acid, digestive enzymes, and address any nutrient deficiencies at this time. We also want to optimize your cleansing waves which may include implementing set meals and time-restricted eating at nighttime.

Repair

The third step of the 5R process is repairing damage to the intestinal wall. Diet, lifestyle, and SIBO may lead to leaky gut which worsens acne. To address the root cause of your acne for good, we need to repair the gut wall to treat leaky gut and reduce whole-body inflammation. In this step, we may recommend helpful supplements like gelatin, bone broth, colostrum, or L-glutamine.

Reinoculate

Once we have removed the excess bacterial overgrowth in the gut, we reintroduce beneficial bacteria to maintain a healthy balance. In this step, you may include fermented foods into your diet, like raw sauerkraut, kimchi, and kombucha. We may also recommend targeted probiotic supplements.

Rebalance

In the final step of the 5R gut health process, we aim to rebalance all aspects of your life to promote whole body health. We’ll address physical stressors, like lack of sleep, stress, and exercise. We’ll help you implement lifestyle interventions and may recommend supplements, like magnesium or adaptogens, that can help you relax and rebalance your life.

This bundle includes support for the 5Rs.

Treating SIBO and acne requires a whole-body approach.

While it can be tempting to try random acne therapies and quick-fix creams, treating the root cause of acne with a gut healing protocol will ultimately save you lots of time, energy, and money. Plus, it may address other health issues at the same time!

Here are photos of the transformation of one of our Root clients who improved her acne through following a personalized gut health and hormone balancing approach. Shared with permission. This is over a period of 3-4 months:

Here are the following resources that will help you treat your Root cause: our Acne bundle with important nutrients for skin health and our favorite probiotic for SIBO, Gut Health Bundle helpful for SIBO, Low FODMAP diet course and food plan.

NAC for PCOS

Root Functional Medicine — Tue, 11 Feb 2020 00:00:00 -0500

Polycystic ovarian syndrome (PCOS) affects up to 15 percent of women and is the leading cause of infertility due to chronic anovulation—a lack of ovulation (1).

Various interventions are used to promote regular, ovulatory cycles in women with PCOS. In this article, we’ll review a supplement called N-acetyl-cysteine (NAC) for PCOS, how it may improve menstrual cycles, fertility, and other PCOS symptoms.

Related Post: What is Polycystic Ovarian Syndrome?

What is N-Acetyl-Cysteine (NAC)?

NAC is a powerful antioxidant that works to reduce inflammation and oxidative stress in the body. Oxidative stress occurs when you have an imbalance of antioxidants and free radicals, which causes toxic and damaging effects to your cells.

NAC promotes antioxidant activity by increasing the production of glutathione, one of the most important and naturally occurring antioxidants.

By raising glutathione levels, NAC helps reduce inflammation and protects your tissues and cells from damage. NAC is also known for its ability to loosen and thin mucus secretions in your airways and other parts of your body (2).

NAC for PCOS: How Does it Work?

Women with PCOS often have higher levels of inflammation and oxidative stress. In fact, studies show that women with PCOS have almost 50 percent lower glutathione levels compared to controls (3, 4).

Through its powerful antioxidant benefits, NAC may help treat the root cause of PCOS in a few ways.

Improves Insulin Sensitivity

Insulin resistance is a common underlying cause of PCOS and affects up to 70 percent of women with this condition (5).

Insulin is a hormone released by the pancreas after eating a meal containing carbohydrates. Insulin’s job is to lower your post-meal blood sugar levels by moving the sugar from your blood into your cells to be used for energy.

Insulin resistance occurs when your cell receptors do not properly respond to insulin, leading to higher blood sugar and insulin levels.

Fortunately, supplementing with NAC can improve insulin resistance in women with PCOS. In fact, one study showed that NAC reduced fasting insulin to a greater degree than Metformin, a drug commonly used to treat PCOS (6, 7).

NAC may also improve cholesterol and fasting blood sugar levels.

NAC Lowers Androgens

Hyperandrogenism—or high androgen levels—is common in women with PCOS and is one of three criteria for a PCOS diagnosis.

Testosterone is the main androgen often elevated in women with PCOS. High testosterone levels can cause symptoms like acne, facial hair, and hair loss.

Using NAC for PCOS may reduce testosterone levels (1, 8).

Improves Fertility

Taking NAC for PCOS can greatly increase your chances of getting pregnant.

A large study showed that women taking NAC with PCOS were 3.5 times more likely to become pregnant. What’s more, the NAC group also had a greater likelihood of having a live birth and a reduced risk of preterm delivery (1, 9).

Fertility doctors often prescribe Clomid to women with PCOS to achieve ovulation and pregnancy. However, up to 40 percent of PCOS patients may be resistant to Clomid. Fortunately, using NAC for PCOS in combination with Clomid considerably increases both ovulation and pregnancy rates. Clomid can negatively affect cervical mucus, but taking NAC may also improve cervical mucus quality and create a better environment for conception (2, 10).

NAC Regulates Menstrual Cycles

Normalizing your period is key to optimizing fertility and getting pregnant with PCOS. However, if getting pregnant is not your health goal at this time, it is still crucial to regulate your menstrual cycle because fertility is a sign of optimal health.

NAC can help regulate your menstrual cycle by reducing testosterone levels, promoting ovulation, and improving liver detoxification.

Dosing and Safety of NAC

Most of the studies assessing NAC for PCOS use dosing between 600-1800 milligrams per day. Thankfully, NAC is considered very safe and tolerated by most people (2).

NAC can be purchased over-the-counter; however, it’s important to recognize that many supplements are not regulated, so it can be difficult to know what is actually in them.

It’s important to purchase high quality, professional-grade supplements from a trusted company. This way, you know that what you’re purchasing and taking is true NAC and free from harmful additives.

We offer high quality, professional-grade supplements, like NAC, through our Root shop. Shop NAC from our Root Shop here.

Using NAC for PCOS

NAC has impressive benefits for women with PCOS thanks to its powerful antioxidant activity. It can reduce insulin resistance, lower testosterone levels, improve fertility, and regulate your period.

As much as we wish NAC could be a simple fix, we know that PCOS is a multifaceted condition requiring a deep look into root causes, like inflammation, gut health, and thyroid functioning to find true healing.

Our PCOS Nutrition Program helps you get to the root cause of this condition and will determine if NAC (or other supplements and interventions) can help you achieve your health goals.

We also included NAC in our most frequently recommended PCOS supplements in our programs here.

PCOS and Insulin Resistance

Root Functional Medicine — Mon, 24 Feb 2020 00:00:00 -0500

Insulin resistance is one underlying root cause of polycystic ovarian syndrome (PCOS). In fact, some studies report that up to 70 percent of all women with PCOS have some degree of insulin resistance (1).

In this article, we’ll define insulin resistance, how to test for it, and how we treat insulin resistance and PCOS from a root cause and functional medicine approach.

What is Insulin Resistance?

Insulin is a hormone made by the pancreas that helps to regulate your blood sugar levels.

After eating a meal, your pancreas releases insulin into your bloodstream. The insulin binds to receptors on your cells which allows glucose (broken-down carbohydrates) to move into your cells to be used for energy. By moving glucose into your cells, insulin lowers your blood sugar levels back to baseline after a meal.

Insulin resistance occurs when your cells do not respond properly to insulin binding. As a result, your blood sugar remains elevated (sugar stays in blood instead of going into the cell) and your pancreas over secretes insulin in an attempt to normalize blood sugar levels and fuel your cells.

In simpler terms, when insulin isn’t doing its job to direct sugar into the cell, this is called insulin resistance. Your body thinks more and more insulin is needed to do the job so the pancreas secretes more insulin. This is why we see high insulin levels in early stage insulin resistance.

For optimal health, we want to reduce insulin resistance and improve insulin sensitivity—your cells’ ability to bind to insulin.

PCOS and Insulin Resistance

Many women with PCOS have insulin resistance, even if their body mass index (BMI) is categorized as “normal.” Diet, lifestyle, and genetics can all affect insulin resistance.

How does insulin resistance affect PCOS?

Insulin resistance leads to high insulin levels in the bloodstream, which worsens inflammation and causes the ovaries to produce more androgens (i.e. testosterone). Excess androgens are often the cause of unwanted PCOS symptoms like acne, facial hair, weight gain, or weight loss resistance. Chronic low-grade inflammation and high androgen levels subsequently worsen insulin resistance creating a vicious cycle for women with PCOS (2).

The combination of insulin resistance, excess androgens, and inflammation can prevent ovulation and lead to irregular menstrual cycles.

Fortunately, we can lower androgen levels and restore ovulatory menstrual cycles in women with PCOS by treating insulin resistance.

Testing for Insulin Resistance

There is no one test that can directly screen for insulin resistance. Here at Root, we look at the entire clinical picture along with a few lab tests to assess insulin resistance in our patients with PCOS.

Fasting Blood Glucose

This is a measure of how much glucose (sugar) is in your blood after an overnight fast. A fasting blood sugar level between 70 and 85 mg/dL is ideal. However, we cannot rely on a fasting blood glucose level alone to screen for insulin resistance.

Hemoglobin A1C

Hemoglobin A1c is a blood test that measures your average blood sugar levels over the past three months using a percentage point. An ideal a1c level is below 5.4 percent. While A1C is a helpful tool for an overall picture of your blood sugar levels, solely relying on A1C can significantly under-diagnose insulin resistance.

Fasting Insulin

Insulin resistance is characterized by increased insulin levels in the blood, so we also test for fasting insulin levels to give us a more complete clinical picture (2, 3). At Root, we consider an ideal fasting insulin level to be below 7.

How to Treat Insulin Resistance

Treating insulin resistance in women with PCOS can lower androgen levels and promote normal, ovulatory menstrual cycles (4).

Eating for Blood Sugar Balance

The food you eat plays a vital role in treating insulin resistance and PCOS. The goal is to fill your plate with colorful and anti-inflammatory foods rich in protein, fat, and fiber to support blood sugar balance.

By using this simple formula (protein + fat + fiber) when planning meals and snacks, you can normalize blood sugar levels, lower insulin release, and reduce inflammation.

We provide easy PCOS snack ideas using this formula in our Snacks for PCOS blog post.

You can also sign up for Root Farmacy meals for PCOS balanced meals delivered to your doorstep.

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Balance Your Lifestyle

Poor sleep, high-stress levels, and a sedentary lifestyle can all worsen insulin resistance (5).

We believe in supporting the whole body, which is why we work with our patients to balance lifestyle and establish healthy habits to create whole-body health.

Assess your lifestyle quality by looking at your sleep habits, stress levels, and exercise routines. Aim for 7-8 hours of sleep each night, and reduce sleep disruptors like caffeine or alcohol close to bedtime. Additionally, try to engage in a stress-reducing activity each day. This may include yoga, meditation, reading, deep breathing, or walking.

Exercise is another powerful tool that can effectively reduce insulin resistance. Even a short 15-minute walk at lunch makes a difference in the long run!

Personalized Supplementation

We use our patients’ health history, lab results, and overall lifestyle to formulate individualized supplement recommendations.

However, there are a few supplements for PCOS that can generally reduce insulin resistance in PCOS. For example, we may recommend supplements like N-acetyl-cysteine (NAC), green tea extract, or magnesium.

You can find many of these supplements in our Root Shop.

Metformin and PCOS

Metformin is a prescription medication that lowers insulin and fasting blood sugar levels. It is often prescribed by conventional doctors to treat insulin resistance and PCOS.

In women with PCOS, Metformin may improve insulin sensitivity and increase ovulation rates. However, it does have some negative side effects.

First of all, there is a clear association between Metformin use and subsequent vitamin B12 deficiency (6). Vitamin B12 has many important jobs in the body like forming red blood cells, nerve functioning, and optimizing energy levels. What’s more, Metformin commonly causes GI upset such as nausea, diarrhea, bloating, and gas (7). These side effects may be due to Metformin’s influence on the gut microbiome. Some studies suggest this drug may cause dysbiosis—an imbalance of the gut bacteria (8, 9).

While we recognize that Metformin can be a useful medication, we prefer to treat insulin resistance in PCOS at the root cause with diet, lifestyle, and targeted supplementation.

PCOS and Insulin Resistance

Insulin resistance is one underlying cause of PCOS and may affect up to 70 percent of all women with this condition. Fortunately, we can reduce insulin resistance, lower inflammation, and normalize your menstrual cycles with a targeted functional medicine approach.

Our PCOS Nutrition Program can help you reduce insulin resistance through nutrition, meal plans, and education from doctors and dietitians with extensive PCOS training and experience.

Soy and PCOS

Root Functional Medicine — Tue, 26 May 2020 00:00:00 -0400

Have you heard conflicting information about which foods you need to avoid with polycystic ovarian syndrome (PCOS)? Soy is particularly controversial in the PCOS community with some praising its benefits and others claiming it could be bad for your health.

This blog will review food sources of soy, explain what the research says about soy and PCOS, and share our stance on this topic at Root Functional Medicine.

Related Post: What is Polycystic Ovarian Syndrome?

What is Soy?

Soy comes from a soybean plant, which pods produce a type of legume. Like other legumes, soy is a nutrient-dense source of plant protein. In fact, one cup of shelled edamame (immature soybeans) contains 19 grams of protein and 8 grams of fiber! Soybeans are also rich in important nutrients for women like iron, magnesium, folate, and vitamin K (1).

Food Sources of Soy

Soybeans
Edamame
Tofu
Soy Milk
Tempeh
Miso
Natto

Soy is eaten in many different forms. The least processed forms of soy include soybeans (brown or tan in color) and edamame (immature soybeans that are green in color). Foods like soy milk and tofu are made by soaking and grinding soybeans into either a liquid or pressed block. Some soy products, like tempeh, miso, and natto, are made by fermenting soybeans. These fermented options are particularly popular in Asian cuisine.

However, manufacturers often use other types of soy-based additives in packaged food products like soybean oil, soy lecithin, and soy protein isolate. These types of foods are less healthy because many of the natural nutrients found in soy have been stripped and processed away.

Why Do Some Recommend Avoiding Soy?

Like other common foods, some people may develop a food sensitivity to soy. This isn’t necessarily related to the food itself, but rather the health of your gut and overall immune system. We may recommend short-term elimination diets, when indicated, to assist in healing the gut, reducing inflammation, and improving food tolerance.

Growing conditions is another concern for consuming soy. More than 90 percent of the soy grown in the United States is genetically modified (2). These GMO crops are sprayed heavily with a weed-killing chemical called glyphosate (i.e. Roundup) that may affect reproduction, hormone balance, and the gut microbiome (3, 4, 5). You can easily reduce and/or eliminate glyphosate residue by only choosing organically grown soy.

Lastly, soy contains higher concentrations of isoflavones, a phytoestrogen that has similar functions to human estrogen but with much weaker effects. A diet excessively high in soy may lead to hormonal imbalances in certain cases. However, when combined with a balanced and varied diet, the level of phytoestrogens present in most soy foods is not likely to cause hormonal disruption (6). In fact, many studies suggest that eating unprocessed soy may improve hormonal function in women with PCOS!

Health Benefits of Soy for PCOS

Despite what you may hear on social media, research suggests that eating soy may be beneficial for women with PCOS.

Improving Metabolic Health

Women with PCOS are more susceptible to metabolic disorders, like high blood pressure, heart disease, and type 2 diabetes. These conditions can further exacerbate your symptoms of PCOS.

Fortunately, studies looking at soy and PCOS found that soy intake reduces metabolic markers for these conditions. For example, soy intake may reduce both LDL cholesterol and triglyceride levels (7, 8, 9).

Insulin resistance is another hallmark feature of PCOS. Insulin is a hormone responsible for lowering your blood sugar levels after a meal. If you have insulin resistance, your cells do not properly respond to insulin signaling, which leads to high levels of both insulin and sugar in your bloodstream. Soy supplementation may reduce free insulin levels and improve the cells’ ability to properly respond to insulin (7, 8). This can make it easier to lose weight, normalize your cycle, and reduce common PCOS symptoms, like acne.

Soy May Lower Androgen Levels

High levels of androgens, like testosterone, are one marker of PCOS. High androgens worsen common PCOS symptoms like acne, facial hair, or hair loss.

Soy has shown to significantly reduce androgen levels in women with PCOS (7, 8, 9). This may be thanks to soy’s favorable effect on insulin levels, as reducing insulin can reduce androgens and associated symptoms.

Furthermore, soy may also beneficially increase the level of sex-hormone-binding globulin (SHBG) in your bloodstream (8). SHBG is a protein that binds tightly to hormones, like testosterone. By binding to testosterone, SHBG reduces the effects of free testosterone in women with PCOS, which then reduces unwanted symptoms, like acne and facial hair.

Improving Fertility

Improving metabolic health, insulin sensitivity, and lowering high androgen levels can all improve ovulation and overall fertility.

One large study also found that increasing plant proteins, like edamame or tofu, in the diet significantly lowers the risk of infertility due to ovulatory disorders, like PCOS (10). Soy intake may also benefit women undergoing assisted reproductive therapy, like IVF, by improving implantation rates and live birth rates (11).

Our Stance on Soy and PCOS

We use an individualized approach in helping women treat the root cause of their PCOS in our clinic. As such, we recognize that some people may not tolerate soy products (at first or at all). However, when considering the research and our clinical experience, we believe that many women with PCOS may tolerate, and even benefit, from including occasional whole food sources of soy into their diet. This is why we do include organic edamame in one of our PCOS Farmacy meals.

Currently, our meal program is for local pick up. Join our PCOS email list to find out when we can ship our meals, plus get premium PCOS content.

When including soy into your diet, keep these things in mind:

Choose whole food sources, like soybeans or edamame, to get the most benefit. Avoid processed versions like soy protein isolate or soybean oil.
Choose organically grown, non-GMO soy to significantly reduce glyphosate residue.
Avoid eating soy every day. We always encourage eating a diverse diet with many different types of foods! If you include soy into your diet, include no more than 2-3 servings per week.

Interested in learning more, we offer a PCOS Nutrition Program for women all over the world.

Best Supplements For PCOS

Root Functional Medicine — Sun, 19 Jul 2020 00:00:00 -0400

Diet and lifestyle make a huge difference in treating the root cause of PCOS. However, we also use targeted supplementation with our PCOS clients based on their clinical history and individualized labs.

In this blog, we’ll review the best supplements for PCOS, how they help treat hormonal imbalance, and which dosage to consider for best results.

Inositol

Inositol is one of the best supplements for PCOS due to its benefits in controlling blood sugar.

Up to 70 percent of women with PCOS have some degree of insulin resistance (1).

This occurs when your cells become resistant to insulin, a hormone responsible for controlling blood sugar levels. Fortunately, inositol may lower high insulin levels and improve blood sugar control in women with PCOS (2). Read more about PCOS and insulin resistance.

By improving insulin resistance with inositol, you may experience more regular ovulatory cycles and improved fertility. In fact, one study found that myo-inositol was more effective in restoring ovulation than metformin, a drug commonly used to treat insulin resistance in PCOS (3). Another smaller study found that taking myo-inositol reduced testosterone levels and symptoms of hirsutism (excessive hair growth) in women with PCOS (4).

Dosing of Inositol

The two main types of inositol effective for PCOS are called myo-inositol and D-chiro-inositol. We recommend taking a 40:1 combination of myo- and D-chiro-inositol to mimic the ratio of these molecules naturally found in the body (5, 6). Typical doses of myo-inositol in this ratio range from 2 – 4 grams per day.

N-Acetyl Cysteine (NAC)

NAC is a powerful antioxidant that reduces inflammation and oxidative stress in the body. Oxidative stress occurs when you have too many free radicals and/or too little antioxidants. Women with PCOS tend to have higher levels of inflammation and oxidative stress, which is why NAC may be one of the best supplements for this condition.

Other benefits of NAC include:

Lowering testosterone levels (7).
Improving insulin resistance; NAC may reduce fasting insulin effectively more than metformin (8).
Boosting fertility by optimizing ovulation and improving cervical mucus quality (9).

Read more about using NAC for PCOS here.

Dosing of NAC

NAC is safe and well-tolerated. We may recommend between 600 – 1,200 mg of NAC per day. Purchase NAC from our Root Shop.

Fish Oil

Fish oil is the healthy omega-3 fat derived from oily fish like salmon, herring, and anchovies.

Fish oil is one of the best supplements for PCOS because of its powerful anti-inflammatory benefits. For example, taking a fish oil supplement may improve insulin resistance and lower cholesterol numbers in women with PCOS (10).

Dosing of Fish Oil

Fish oil, or omega-3 supplements, should contain the two key omega-3 fats derived from fish: EPA and DHA. In addition to eating fish at least twice per week, we may recommend taking about 1,000 mg of total fish oil (EPA + DHA) per day. Purchase Fish Oil from our Root Shop.

Magnesium

Magnesium is involved in over 300 reactions in the body, many of which affect hormone balance and signaling. Unfortunately, over half of Americans fail to meet the daily magnesium requirements with their diet (11).

Taking a magnesium supplement for PCOS may improve insulin resistance, reduce inflammation, and ease PMS symptoms (12).

Magnesium can also be calming and helpful for restful sleep.

Dosing of Magnesium

Magnesium supplements are available in a variety of forms, including magnesium oxide, citrate, or glycinate. Magnesium oxide is not well absorbed and may cause diarrhea or GI upset. Magnesium citrate, however, is much better tolerated and has a very gentle laxative effect which may help if you also suffer from constipation. Magnesium glycinate is the most universal form that is well absorbed and tolerated with minimal GI effects.

Appropriate dosing of magnesium supplements ranges from 200 – 350 mg per day.

Purchase Magnesium Glycinate from our Root Shop.

Zinc

Women with PCOS tend to have lower zinc levels than women without this condition.

Some researchers suggest that zinc deficiency may be partly to blame for the insulin resistance and abnormal cholesterol levels often seen in PCOS (13). Fortunately, taking a zinc supplement may help to treat these underlying conditions (14).

What’s more, a zinc supplement may reduce unwanted symptoms of PCOS like hair loss, unwanted hair growth, and acne (15).

Dosing of Zinc

You can safely take between 10 – 30 mg of zinc per day in the form of zinc picolinate, glycinate, or citrate. Make sure you also take a multivitamin that contains copper, as taking too much zinc for longer periods may cause a copper deficiency.

Purchase zinc from our Root shop.

B-Complex Vitamin

A general B-complex vitamin is one of the best supplements for PCOS because of the wide range of benefits these nutrients provide. Plus, some medications often prescribed for PCOS (like birth control and metformin) can actually deplete your body of many of these B vitamins (16, 17).

Vitamin B6, folate, and vitamin B12 are particularly important in optimizing hormonal balance in PCOS. These three B-vitamins help to lower inflammation by breaking down an amino acid, called homocysteine, which is commonly elevated in women with PCOS (13). Lowering homocysteine may reduce your risk factors for heart disease and other reproductive symptoms.

Dosing of B-Complex

Choose a B-complex vitamin that contains the methylated forms of folate and vitamin B12. These methylated forms (named methylfolate and methylcobalamin, respectively) are the active version of these vitamins and more effectively used by the body, especially in women with MTHFR genetic mutations.

Purchase B complex from our Root shop.

Probiotics

The gut plays an important role in controlling inflammation, balancing hormones, and promoting overall health.

Inflammation is a key driver of insulin resistance seen in PCOS. Likewise, insulin resistance worsens inflammation. A probiotic supplement is one tool we may use to optimize gut health in our PCOS patients to lower inflammation and disrupt this vicious cycle.

Taking a probiotic supplement may also normalize your menstrual cycle, lower androgen levels (like testosterone), and improve insulin resistance (18).

Dosing of Probiotics

There is a wide range of probiotic dosing used in research and on the market today. For example, most probiotic supplements contain between 10-30 billion colony forming units (CFU) per capsule. Other probiotics, like spore-based probiotics, may only need to contain a few billion CFU because of how they function in the gut. A good rule of thumb is to look for a probiotic supplement that contains multiple (5-10) probiotic strains for the most benefit.

Vitamin D

Up to 85 percent of women with PCOS have a vitamin D deficiency (19). Unfortunately, lower vitamin D levels are significantly associated with worsening insulin resistance in PCOS, independent of your weight, ethnicity, or season of the year.

Since vitamin D is not commonly found in the foods we eat, we must rely on adequate sunshine or supplementation. Supplementing with vitamin D may improve insulin resistance, lower inflammation, and help to normalize your menstrual cycle (20).

Dosing of Vitamin D

Vitamin D dosing should be personalized based on your own lab results. For example, if your vitamin D levels are adequate (50-70 ng/mL), a maintenance dose of about 2,000 units per day may be most appropriate. However, you may require higher doses (5,000 units per day) if your blood levels indicate a vitamin D inadequacy or deficiency. If you are severely deficient, you may require a short term prescription for a megadose of vitamin D. We check vitamin D levels and provide personalized recommendations for all of our clinical program members here at Root.

Ideally, your vitamin D supplement should also contain vitamin K2, which helps direct calcium and vitamin D to your bones where it can be used and stored.
Purchase Vitamin D with K2 from our Root Shop.

Individualizing Your PCOS Supplements

Feeling overwhelmed? We’re here to help. Our PCOS Nutrition Program includes supplement recommendations based on your individual needs and budget!

Get Started with our core recommended PCOS supplement bundle!

Good Food Good Mood

Root Functional Medicine — Thu, 09 Apr 2020 00:00:00 -0400

The foods you eat play an important role in supporting a healthy and happy mood.

This article explains how food affects your mood, which mood-enhancing foods we recommend, and how to best individualize your “good food, good mood” diet.

How Does Food Affect Your Mood?

Your brain is a complex organ. It communicates with the rest of your body and receives feedback communication from other organs, like the gut.

Put simply, nutritious food benefits your mood by supporting healthy communication in the brain and reducing chronic inflammation. For instance, certain nutrients increase the production of a protein in the brain called Brain-Derived Neurotrophic Factor (BDNF).

BDNF is like a fertilizer for the brain and can promote the growth of new brain cells (1).

Secondly, chronic inflammation is a major root cause of mood disorders, like depression (2). So, the diet pattern that most supports a good mood is rich in anti-inflammatory foods!

What Nutrients Support a Good Mood?

There are twelve nutrients that seem to play the biggest role in benefiting mood disorders, according to a large study published in 2018 (3).

One dietary pattern seems to most effectively encompass all of these nutrients. The Mediterranean diet is an anti-inflammatory eating pattern that has been found to improve mood disorders like depression or anxiety (4, 5, 6). A Mediterranean diet is rich in fruits, vegetables, nuts, seeds, legumes, and seafood.

Seafood

Seafood is one of the best food categories for a good mood thanks to rich amounts of omega-3 fats, vitamin B12, selenium, and zinc.

Omega-3 fats have loads of research backing them as a brain-boosting and mood-enhancing nutrient. Fatty fish are particularly rich in two omega-3 fats commonly known as EPA and DHA (i.e. fish oil).

The best sources of EPA and DHA with the lowest amounts of mercury include salmon, mackerel, anchovies, herring, and sardines. These types of fish are also rich in selenium and vitamin B12 to further support a good mood!

Other types of seafood, like oysters and mussels, are particularly rich in zinc. In fact, six cooked oysters provide over 600 percent of your daily zinc requirements (7).

We recommend including low-mercury seafood into your meals at least two times per week, if not more!

Leafy Greens

Leafy greens—like spinach, kale, chard, and bok choy—are rich sources of good mood nutrients like folate, vitamin A, and vitamin C. Both vitamins A and C have antioxidant properties to fight off free radicals, or molecules that can harm your body and cause oxidative stress. This is important because oxidative stress may be another root cause of mood disorders, like depression (8).

Additionally, the folate in leafy greens supports methylation and the production of neurotransmitters, like serotonin, to improve your mood (9).

Here are a few different ways to eat more leafy greens:

Add bok choy to an Asian stir-fry
Throw spinach into a morning smoothie
Mix chopped spinach into an egg omelet
Add spinach to homemade pesto sauce
Roast some kale chips
Use chard leaves to wrap up sandwich contents

Cruciferous Vegetables

Cruciferous vegetables are a diverse group of veggies like broccoli, cauliflower, Brussel sprouts, and cabbage.

Crucifers are packed with nutrients like folate and vitamin C. However, the mood-enhancing benefit of cruciferous veggies is also due to their role in estrogen detoxification. Crucifers are rich in phytochemicals (like DIM) that help your liver metabolize estrogen. This is key for a good mood because too much estrogen may lead to symptoms like depression or anxiety (10).

Use cauliflower rice in your Asian dishes, add chopped cabbage to tacos, or shred Brussel sprouts as an alternative salad base. You can also use foods like broccoli slaw with tuna salad or in recipes like “egg roll in a bowl.”

Nuts and Seeds

We include nuts and seeds in our good food, good mood diet because they contain high amounts of magnesium, zinc, and selenium.

Zinc and selenium are particularly important in maintaining optimal thyroid health, a butterfly-shaped gland in your neck. The thyroid has many jobs in the body, one of which is balancing your overall mood. Eating sufficient amounts of selenium and zinc ensures that your body makes enough active thyroid hormone to support a good mood. Did you know? Just one brazil nut per day meets your daily requirements for selenium!

Magnesium also plays a critical role in supporting a good mood by promoting hormone balance and the production of brain chemicals like serotonin and GABA (11).

Here are a few ways to eat more nuts and seeds:

Make breakfast quinoa with slivered almonds and pumpkin seeds
Throw a tablespoon of ground flaxseed into your smoothie
Spread your nut butter of choice on apple slices for a filling snack
Try a recipe for nut-crusted fish or chicken
Sprinkle walnuts onto your salad for a satisfying crunch

What Foods Should I Avoid?

Reducing highly processed foods—like commercial baked goods, sugar-sweetened beverages, and fast food—can also improve your overall mood.

However, instead of focusing on the foods you must eliminate or reduce from your diet, we recommend focusing on all the colorful, wholesome foods you can ADD to your plate! By eating more fruits, vegetables, legumes, nuts, seeds, and seafood to your diet, you will naturally eat less of the highly-processed food items.

Individualizing Your “Good Food, Good Mood” Diet

In this article, we covered the best foods for a healthy and happy mood: seafood, leafy greens, cruciferous vegetables, and nuts/seeds. While these foods benefit most people, we recognize that everyone’s body is different!

A “food and mood journal” helps you determine which foods make you feel great and not-so-great. In the journal, loosely record your meals and snacks for the day. But most importantly, record how you are feeling (mentally and physically) before and after each meal. This way, you adjust your diet to include more foods that make you feel great every day.

We love that food can support our overall mood each day. However, avoid overly-restrictive diets and remember that factors like adequate sleep, stress reduction and social connection also support a healthy and happy mood.

Check out our meal prep service, Root Farmacy!

Choose 6 or 10 meals a week to incorporate everything mentioned in this article into your life!

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Best Soil Based Probiotics

Root Functional Medicine — Tue, 13 Jul 2021 00:00:00 -0400

Soil-based probiotics are bacteria found in the soil that provide health benefits to humans.

In this article, we’ll explain the benefits of soil-based probiotics and share our opinion on what we believe is the best soil-based probiotic on the market.

What are Soil-Based Probiotics?

As the name implies, soil-based probiotics are bacteria found in the soil which generally contain bacteria strains from the Bacillus family. These bugs are commonly referred to as spore-forming probiotics because they are encapsulated with a hard shell, or endospore, making them very stable and highly resistant to extreme conditions. Unlike traditional probiotics, soil-based probiotics are more likely to survive the harsh environment of your GI tract that would otherwise destroy bacteria. They are also shelf-stable and do not require refrigeration. Once these soil-based probiotics reach the large intestine, the spores can change into their active form to begin colonizing the gut.

Benefits of Soil-Based Probiotics

When your grandparents ate an apple, it was probably full of soil-based probiotics. However, as society moves away from local farming, spends less time in nature, and becomes hyper aware of hygienic practices, we are less exposed to these beneficial bacteria. Here are a few ways in which supplementing with soil-based probiotics may benefit your health:

Balances your gut microbiome

Spore-forming bacteria may regulate your gut microbiome and reduce dysbiosis—which is an imbalance in gut bacteria. This is one big difference between soil-based and conventional probiotics. For instance, taking 20 billion colony forming units (CFU) of a traditional probiotic is simply a drop in the ocean compared to the rest of your estimated 100 trillion gut bacteria. What’s more, typical probiotics do not usually eliminate or prevent the growth of harmful bacteria. Spore-forming probiotics, however, can distinguish between “good” and “bad” bacteria and may reduce dysbiosis by crowding out and even secreting antimicrobials to kill off the bad bacteria.

Dysbiosis is present in numerous conditions, like polycystic ovary syndrome (PCOS) and autoimmune diseases. Dysbiosis is also suspected to play a role in the development of irritable bowel syndrome (IBS). One study investigated the role of soil-based probiotics in patients with IBS and found that the patients in the probiotic group reported a significantly higher quality of life and lower symptom scores than those who received typical antibiotic treatment (1).

Produces natural antioxidants

One of the main Bacillus strains in our favorite soil-based probiotic is known for its antioxidant producing abilities. Antioxidants are molecules that fight off damaging free radicals. If there are too many free radicals and not enough antioxidants, oxidative stress can occur and eventually lead to various chronic diseases. Studies have linked conditions like PCOS, mood disorders, and Hashimoto’s thyroid diseasewith increased levels of oxidative stress (2, 3, 4).

May reduce leaky gut

Soil-based probiotics may help repair the gut lining and reduce leaky gut. In fact, one study found that taking a soil-based probiotic for 30 days reduced leaky gut by up to 42 percent (5).

Your intestines contain a protective barrier, or lining, to prevent uncontrolled entry of undigested food, bacteria, and toxins from entering the body. It also prevents loss of water and electrolytes while allowing for proper absorption of nutrients. The gut lining contains a single layer of cells linked together by proteins called “tight junctions” which control what can or cannot enter the intestinal cells.

When the integrity of the gut lining is compromised through dysbiosis, inflammation, or infection, larger food proteins or harmful bacteria may enter into the cell. This is known as a “leaky gut.” Leaky gut is associated with many conditions, like polycystic ovary syndrome, acne, irritable bowel syndrome, and even depression (6, 7).

Lowers inflammation

When leaky gut is present, your immune cells produce more pro-inflammatory chemicals. These chemicals can cause widespread inflammation throughout the body and may even trigger autoimmune disease. However, in addition to reducing leaky gut, a different study found that taking a spore-forming probiotic for eight weeks reduced these inflammatory markers by up to 55 percent (8).

The Best Soil-Based Probiotic

We believe that MegaSporeBiotic from Microbiome Labs is the best soil-based probiotic on the market. First of all, Microbiome Labs has conducted numerous research studies on their specific probiotic blend (many of which were referenced above). This is essentially unheard of in the supplement, and especially probiotic, industry! MegaSporeBiotic contains five different strains of Bacillus which all provide different health benefits.

MegaSporeBiotic also functions to address the root causes of most gut related issues: dysbiosis, leaky gut, and inflammation. When we address these root causes with our patients, we see more positive clinical outcomes and reduction (or elimination) of their symptoms.

Purchase MegaSporeBiotic from our Root Shop.

Because soil-based probiotics can benefit a wide variety of conditions outside of gut-related conditions, we also include MegaSporeBiotic in our acne supplement bundle.

Dosing

The dosing of MegaSporeBiotic as per their company instructions:

Week 1: take 1 capsule every other day
Week 2: increase to 1 capsule daily
Week 3+: take 2 capsules daily

Work with your doctor to find the right dosing for you.

Key Takeaways

Soil-based probiotics are bacteria found in the soil that have shown to balance gut bacteria, produce antioxidants, improve leaky gut, and lower inflammation in the body. Unlike traditional probiotics, these spore-producing bacteria survive the harsh conditions of digestion making them much more effective.

MegaSporeBiotic is the best soil-based probiotic on the market because it is backed by research, contains five different strains, and may benefit a variety of health conditions.

Purchase MegaSporeBiotic from our Root Shop.

Anti-histamine Foods

Root Functional Medicine — Tue, 29 Sep 2020 00:00:00 -0400

Antihistamines are substances that treat allergy symptoms by blocking the effects of histamine in the body.

While fairly effective for seasonal allergies, these pills or capsules usually fail to address the root cause of these symptoms and may result in unwanted side effects. In this blog, we’ll discuss anti-histamine foods, low-histamine diets, and finding the root cause of your symptoms.

What is Histamine?

Histamine is a chemical messenger produced by the body that is typically associated with allergy-type symptoms. However, histamines also have other jobs in the body related to digestion, blood pressure regulation, and hormone balance.

Typically, the body does a great job of effectively degrading histamine. However, some susceptible individuals may struggle with histamine breakdown due to high levels of pollen, leaky gut, genetics, hormones, or diet. DAO enzyme helps break down histamine in the gut. People who are deficient in DAO enzyme will be more prone to trouble breaking down histamine.

Purchase DAO enzyme from our shop.

When the body is unable to effectively degrade histamine, you may experience symptoms of histamine intolerance. These symptoms vary widely and can cause typical allergy symptoms, fatigue, anxiety, and even menstrual cycle irregularities.

Anti-Histamine Foods

While no single food matches the antihistamine strength of over-the-counter drugs, there are some nutrients, antioxidants, and extracts that contain natural antihistamine properties.

Quercetin

Quercetin is an antioxidant found naturally in onions, broccoli, green or black tea, berries, and grapes. It is known to have anti-inflammatory benefits and may reduce histamine release (1).

Vitamin C

Vitamin C is a well-known nutrient that can strengthen the immune system and reduce inflammation. Vitamin C is also required to produce the necessary enzymes for histamine breakdown making it a crucial anti-histamine nutrient.

The foods containing the highest amounts of vitamin C include (2):

Red bell pepper
Oranges
Kiwi
Green bell pepper
Broccoli
Strawberries
Brussels sprouts
Grapefruit

Make sure you’re eating a diet rich in vitamin C for a healthier immune system and effective histamine breakdown.

Nettles Leaf Extract

Stinging nettles leaf is an herb that also has anti-inflammatory and antihistamine benefits (3). You can buy the dried leaves or flowers of stinging nettle and steep them into an herbal tea or add them to a bowl of soup.

Bromelain

Bromelain is the natural plant enzyme found in pineapple that is said to possess antihistamine properties. While pineapple is a nutrient-dense and delicious fruit, this anti-histamine food may be more effective for histamine intolerance when taken in higher amounts, as found in supplement form.

D-Hist Supplement

D-Hist by Ortho Molecular is one of the most popular supplements for histamine intolerance and allergies because it contains all of these beneficial anti-histamine food ingredients and more! You can learn more about this effective supplement in our D-Hist for Allergies blog or purchase D-Hist from our online store in our histamine bundle.

Is summary, foods with anti-histamine properties include:

Apples
Onions
Pineapple
Parsley
Blueberries
Olive oil

Low-Histamine Diet

While anti-histamine foods have properties that may reduce histamine release or promote proper breakdown, the most effective overall diet for histamine intolerance is a low-histamine diet. Many foods contain various levels of natural histamine. These levels tend to increase in leftovers, fermented foods, and certain alcoholic beverages.

The foods to avoid on a low-histamine diet include:

Kombucha
Sauerkraut
Wine or beer
Aged meats or cheese
Olives
Vinegar
Canned meats/fish
Tomatoes
Ketchup
Avocados
Spinach

Besides the ones listed above, almost all fresh fruits, vegetables, meats, nuts, and seeds are safe to eat on a low-histamine diet plan. However, it’s best to eat leftovers within 24 hours or less as histamine content may increase the longer food sits. Cooking from home is also most effective as you can control which high-histamine ingredients to avoid in your recipes.

A low-histamine diet isn’t meant to be followed forever. Rather, it is meant to act as an elimination diet while you determine your own personal histamine threshold and work to address the root cause of your symptoms.

Finding the Root Cause

If you suspect that your symptoms may be triggered by histamine, you’ll want to investigate further to find the root cause.

Since there is not an overall test to diagnose histamine intolerance, it’s important to rule out other health conditions first, like autoimmune diseases or gut infections. Some of these conditions may be the underlying cause as higher levels of inflammation and leaky gut can impair your ability to breakdown histamine. A hormonal imbalance may also lead to histamine intolerance as estrogen is thought to activate histamine release from immune cells. As such, an estrogen imbalance may cause the body to release more histamine and lead to worsening symptoms.

Treating the root cause of your symptoms, especially if histamine related, may also include stress and lifestyle management, and eating an anti-inflammatory diet low in overall histamine content.

Zinc for PCOS

Root Functional Medicine — Wed, 07 Oct 2020 00:00:00 -0400

Polycystic ovarian syndrome (PCOS) affects up to 15 percent of women and involves many different parts of the body. Diet plays a significant role in treating PCOS with many nutrients being particularly helpful. Taking zinc for PCOS may help reduce common symptoms of this condition like unwanted hair growth and/or hair loss, acne, high blood sugar, and more.

This blog explains the benefits of zinc for PCOS, food sources, and how to properly use zinc supplements.

Related post: What is Polycystic Ovarian Syndrome (PCOS)?

What is Zinc?

Zinc is a mineral found naturally in various foods and often added to dietary supplements. It also acts as an antioxidant, meaning it helps prevent cellular damage and has anti-inflammatory benefits.

As an essential nutrient, zinc has many important functions in the body including:

Immune function
Protein synthesis
Wound healing
Growth and development
Thyroid health
Blood sugar regulation

Women require about 8 milligrams (mg) of zinc per day, unless pregnant or breastfeeding, in which the body requires closer to 12 mg of daily zinc.

While most people meet the recommended daily allowances for zinc, there are some groups more prone to zinc inadequacy than others. For example, people following a vegetarian/vegan diet may have lower levels of zinc because the zinc in plant foods is harder for the body to absorb and use than zinc from animal sources. Interestingly, new research suggests that women with PCOS may also be at a higher risk of zinc inadequacy or deficiency.

PCOS and Zinc Deficiency

Zinc deficiency is more common in women with PCOS than those without the condition. This is especially true in cases of insulin-resistant PCOS. In fact, one study found that zinc levels were the most accurate predictors of PCOS even more than body mass index (BMI) or cholesterol levels (1).

Zinc deficiency and PCOS have an intricate relationship. To further explain, first consider one of the most common conventional treatments for PCOS: oral contraceptives. Women with PCOS are often prescribed the birth control pill to manage PCOS symptoms. Unfortunately, the pill does not treat the root causes of PCOS but rather covers up symptoms that will likely return if and/or when a woman decides to come off the pill.

What’s more, these oral contraceptives can deplete the body of important nutrients, like folate, vitamin B12, and zinc (2). Zinc insufficiency can then increase your risk of diabetes, obesity, and glucose intolerance which are key players in the vicious cycle of worsening PCOS.

Blood Test for Zinc Deficiency

Zinc nutritional status is difficult to measure using lab tests due to its distribution throughout the body.

However, the concentration of zinc in blood plasma or serum is currently the best available test for zinc deficiency (3). This is why we include a plasma zinc test for every member in our Get to the Root Program.

Benefits of Zinc for PCOS

Since women with PCOS are more likely to have inadequate zinc levels, there are some research-based benefits of using zinc supplements for treating PCOS.

Improves Blood Sugar Control

Zinc is required to make and store an important hormone called insulin. This hormone is released from your pancreas in response to a meal containing carbohydrates. Insulin lowers your blood sugar levels back to normal by signaling the cells to allow glucose (broken-down carbohydrates) inside to be used for energy. Insulin resistance occurs when your cells have difficulty binding to insulin causing both insulin and glucose to build up in the blood for longer periods of time.

Related Post: PCOS and Insulin Resistance

When zinc levels are inadequate, your risk of diabetes and high blood sugar increases. In fact, some researchers suggest that zinc deficiency may be partly to blame for the insulin resistance often seen in PCOS (4).

Thankfully, supplementing with zinc may reduce your fasting blood glucose and insulin levels and improve your cells’ response to insulin (5, 6). When your blood sugar is better controlled, you may see other secondary benefits like improved fertility, regular menstrual cycles, and fewer sugar cravings.

Reduces Hair Loss and/or Unwanted Hair Growth

Hair loss and/or unwanted hair growth (hirsutism) are two common PCOS symptoms that are both caused by excess androgens, i.e. male hormones.

However, zinc has shown to block these excess androgens. For instance, one study found that taking a zinc supplement significantly decreased both PCOS-related hair loss and hirsutism in just eight weeks (7).

Improves Skin Health

Acne is another common symptom of PCOS that is often related to excess androgen production. While not specific to PCOS, zinc levels may correlate with the severity of acne, and taking zinc supplements may be useful in treating moderate to severe acne (8, 9).

Reduces PMS Symptoms

Premenstrual syndrome is a common occurrence in women who may report symptoms like breast tenderness, abdominal bloating, depression, and anxiety before their period. Zinc may play a beneficial role in reducing these common PMS symptoms.

Similar to the PCOS connection, women with PMS were also found to have lower zinc levels than women without PMS (10). Fortunately, taking a zinc supplement may significantly reduce PMS symptoms within three months (11). Some studies have also found benefits in zinc supplementation to reduce symptoms of depression (12).

Supports Thyroid Health

Finally, zinc is a very important nutrient in supporting overall thyroid health.

Women with PCOS are three times more likely to also suffer from thyroid autoimmune disease (Hashimoto’s) than the general population (13, 14). These two conditions share common characteristics like period irregularities, insulin resistance, and infertility, so it’s important to rule out thyroid disease before assuming you have PCOS. Read more about the connection between PCOS and thyroid disorders.

Zinc is required to convert thyroid hormone into the active version that your body can use to carry out important jobs, like making reproductive hormones and promoting healthy ovulation! So, ensuring you have adequate zinc levels is beneficial for both thyroid health and PCOS.

Foods High in Zinc

PCOS is highly responsive to positive changes in diet and lifestyle, which is why we always encourage a “food first” approach with our patients.

Not only do these foods contain rich sources of zinc that may be beneficial to treating PCOS, but they also contain other important minerals for whole-body health, hormonal balance, fertility, and more. Try to incorporate a variety of these zinc-rich foods into your everyday meals and snacks (15):

Shellfish: oysters, crab, lobster
Meat: beef, turkey, pork, chicken
Legumes: soybeans, chickpeas, kidney beans
Nuts and seeds: pumpkin seeds, pecans, cashews, almonds
Whole grains: oats

Dark chocolate also contains a fair amount of zinc, so you can happily choose a few squares of dark chocolate for a sweet treat!

Zinc Supplements for PCOS

Most studies showing the benefits of zinc for PCOS used around 50 mg of supplemental zinc per day. However, the upper limit for zinc is set at 40 mg, and taking too much of this mineral may cause GI upset or a subsequent copper deficiency. While more may be recommended to treat a deficiency, we generally recommend supplementing with around 15mg – 30 mg of zinc per day.

Purchase zinc from our Root Shop.

Should I take Zinc for PCOS?

Zinc has many benefits for women with PCOS including blood sugar balance, optimizing hormone production, and decreasing PCOS symptoms, like unwanted hair growth or acne.

Taking a zinc supplement can be a very helpful factor in treating the root cause of your PCOS. However, for the best results, we also recommend a solid foundation of an anti-inflammatory diet and a balanced lifestyle to include stress management, movement, and sleep hygiene. Some people may also require more personalized treatments or additional supplements for PCOS.

Gluten and PCOS

Root Functional Medicine — Tue, 01 Dec 2020 00:00:00 -0500

If you have polycystic ovary syndrome (PCOS), chances are you may have considered following a gluten-free diet. Gluten and PCOS is a hot topic among the internet and social media. Some websites warn against eating gluten and claim it may cause hormone imbalances, inflammation, and worsening insulin resistance. Others argue that there is no research to support a gluten-free diet for women with PCOS.

In this article, we will discuss the controversial topic of gluten and PCOS and whether or not you need to follow a gluten-free diet if you have this condition.

What is Gluten?

Gluten is the name for a group of proteins found in grains like wheat, barley, and rye. Gluten provides texture, retains moisture, and promotes elasticity to bread and other baked goods.

Everyday foods that commonly contain gluten include:

Pasta
Bread
Crackers
Cookies
Pastries
Cakes or Pies
Cereal
Beer

Because of its unique properties, gluten is also used as an additive in processed foods like gravy, condiments, soup, and lunchmeat.

Gluten-Related Disorders

There are two main types of gluten-related disorders: celiac disease and non-celiac gluten sensitivity.

Celiac Disease

Celiac disease is a serious autoimmune condition in which a person’s immune system mistakenly attacks the lining of their small intestine after eating gluten-containing foods. The only treatment for celiac disease is a strict and lifelong gluten-free diet. Only an estimated 1 percent of the population has celiac disease, although experts suspect that many people remain undiagnosed. Your doctor can screen for celiac disease with a blood test to look for antibodies called anti-tissue transglutaminase (tTGA).

Gluten Sensitivity

Gluten sensitivity is a condition in which a person experiences a variety of symptoms after eating gluten-containing foods, but does not have celiac disease or a wheat allergy. Symptoms of gluten sensitivity vary and may include gastrointestinal upset, brain fog, anxiety, headaches, or skin disturbances. Gluten sensitivity is thought to affect up to 13 percent of the general population and may be more prevalent in women than men (1). There is no one overall test to diagnose gluten sensitivity. Rather, health providers may recommend omitting gluten as part of a short-term elimination diet and/or food sensitivity tests to screen for this condition.

Benefits of a Gluten-Free Diet for PCOS

Although there are no studies specifically looking at the relationship between gluten and PCOS, many women report a reduction in symptoms after eliminating gluten from their diet. How could this be?

Lower Refined Carbohydrates

Most gluten-containing foods in the American diet are also higher in refined carbohydrates and/or added sugar. Eating less of these foods can improve blood sugar levels in women with PCOS. This is helpful because an estimated 70 percent of women with PCOS have some degree of insulin resistance, a condition that reduces your body’s ability to breakdown carbohydrates. Insulin resistance is responsible for many common PCOS symptoms like acne, unwanted hair growth or hair loss, irregular periods, and infertility. By eating less refined carbs and added sugar, women with PCOS may experience improved blood sugar levels, less insulin resistance, and overall symptom improvement.

Gut Health

If you are one of the individuals with PCOS who also has a gluten sensitivity, you may experience benefits from eliminating gluten from your diet. Food sensitivities occur when your immune system overreacts to a particular food which can then trigger more inflammation, leaky gut, and an imbalance in gut bacteria. These three factors largely affect PCOS and overall health. In fact, women with PCOS are more likely to have leaky gut and dysbiosis—an imbalance in gut bacteria—than women without this condition (2). Temporarily eliminating food sensitivities as part of a gut healing protocol can reduce inflammation, heal leaky gut, and rebalance your gut microbiome to treat PCOS from the inside out.

At Root Functional Medicine, we offer personalized testing to identify food sensitivities and develop a short-term elimination diet based on your individualized results. Learn more about our food sensitivity test and elimination diet.

Thyroid Health

Women with PCOS are three times more likely to also have an autoimmune thyroid disease called Hashimoto’s thyroiditis (3). With Hashimoto’s, the immune system mistakenly attacks the thyroid gland causing progressive damage and inflammation which eventually leads to hypothyroidism. Some studies have shown benefits in using a gluten-free diet with Hashimoto’s and other autoimmune conditions (4, 5, 6).

Cautions with a Gluten-Free Diet

If you suspect that you may have celiac disease or gluten sensitivity, check with your doctor before eliminating it. Otherwise, the blood test used to screen for celiac disease can result in a false negative if you have already eliminated gluten from your diet.

What’s more, many gluten-free food items have poor nutritional value, are high in added sugar, and can worsen insulin resistance and PCOS symptoms. If you decide to try a gluten-free diet, focus on eating whole and unprocessed foods that are naturally free of gluten like fruits, vegetables, nuts, seeds, lean protein, and gluten-free whole grains (i.e. brown rice or quinoa).

Learn more about our naturally gluten-free and anti-inflammatory Root Farmacy Meals.

Gluten and PCOS: Key Takeaways

Currently, there are no research studies to support a blanket gluten-free diet recommendation for all women with PCOS. Many women with PCOS report feeling better on a gluten-free diet; however, this may be related to eating less refined carbohydrates, a gluten sensitivity, or an underlying Hashimoto’s diagnosis. If you have celiac disease, following a lifelong gluten-free diet is required.

While gluten sensitivity does not cause PCOS, it is often a symptom of an underlying imbalance, like poor gut health. In fact, some food sensitivities can be reversed after properly healing the gut!

When it comes to gluten and PCOS, we practice individualized functional medicine and take each patient’s story and experiences into consideration when making recommendations. That being said, we may suggest a temporary elimination of gluten while working with you to address the underlying causes of your PCOS.

Our Get to the Root Program offers individualized support.

Anyone in our delivery area can order meals from Root Farmacy! You do not need to be in any clinical program to enjoy delicious gluten-free meals.

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Root Functional Medicine — Wed, 17 Nov 2021 00:00:00 -0500

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We empower you with the right information for a healthy lifestyle and healing from the inside out. We support you through our online community, our healthy ready-made meals, and tried and true supplements straight from our own clinical protocols.