What is Your Poop Telling You?
We may all be adults here but there are some subjects we still feel embarrassed talking about, and bowel movements is one of them. The list of funny names we call our excrement is nearly as long as the things about us it may reveal. Some equate examining our poop to the ancient art of reading tea leaves. So, pull up a stool, have a seat and let’s get down to business.
Important stuff you need to know:
Stool color is important and can be an indicator of serious health conditions that may need immediate attention. For instance, if your stool is bright red or black this may indicate the presence of blood. Please seek medical attention. Your stool reflects what you eat and the color will change accordingly, but not all colors or changes are normal. Yellow means something different than green, which means something different than brown. Admit it, you peek in the bowl; please share the information with your health care provider. It’s significant.
It is not normal to not poop every day, after all, you eat every day. If you aren’t regular – and daily is regular- where is the poop hiding? You only have so many feet of intestines. The perfect poop is a well formed, golden brown stool and should make an appearance about 3 hours after a meal, but if you have a successful visit once per day most doctors would consider that to be in the normal range too. Ongoing constipation or diarrhea may be a sign of a more serious condition. Surprisingly, there are many non-gastrointestinal conditions related to irregular bowel movements. A common complaint of thyroid patients is digestive distress.
Shape matters. There is even an “official” identification chart used by practitioners called The Bristol Stool Chart. Pooping pebbles? Sounds like you may be constipated. The question you need to ask is why. Is it because of illness or are you eating an unhealthy diet? Pooping fluffy pieces or something closer to brown pee equals diarrhea. Again, the important question is why. Unfortunately, IBS patients suffer frequent bouts of diarrhea and are often afraid to engage in life because of the constant fear of embarrassing accidents.
Using the expression “I feel like crap” can actually be fairly accurate. Your brain and digestive tract are intimately related. As a matter of fact, the gut is often called the second brain. So when your emotional health is in the can it may very well have everything to do with your poopy poop process. By creating a sort of electrical circuit between your brain base and gut, your Vagus Nerve, the longest of your cranial nerves, tells your brain when food has been ingested and digested. Any interruption in this circuitry can cause serious problems like a loss of muscular function in the stomach and intestines, sending you running or doubled over in pain.
Although your body has many subtle ways of giving you signs about your health, your stool carries perhaps the biggest load of information. Color, consistency, sinking or swimming, all attributes are important. So, what is your poop telling you?
Trying to explain what peripheral neuropathy is, and how finding the cause of your peripheral neuropathy is essential to your successful treatment, may seem daunting in the space of a blog post. At times it can be a very easy condition to address and fix, but more frequently it is very complex.
Peripheral neuropathy means the nerves outside of your spinal cord are damaged. Although often related to diseases like diabetes, the nerve damage ultimately comes from one of five things.
Five common causes of Peripheral Neuropathy:
1. Nerves are not getting enough nutrients (fuel) to stay healthy.
2. Nerves are not being activated, or used enough to stay healthy.
3. Nerves are being deprived of oxygen.
4. Nerves are being compressed, and from the point of compression on down, they are dying because of a lack of fuel, oxygen or activation.
5. Or, you are suffering from a combination of all of the above.
Depending upon the cause of your peripheral neuropathy, and which nerves are affected, you will eventually have symptoms like pain, tingling and numbness predominately in your feet, but it may spread to your hands as well. As nerves continue to die these symptoms will worsen and start to affect other tissue. The most commonly affected is the cerebellum, the part of your brain that controls eye movement, balance, and coordination of movement, so it is not coincidental that along with your peripheral neuropathy you may also have trouble balancing.
Try this test: stand in a relaxed manner, putting more weight on your left foot, then try to place your right foot on the floor directly in front of the left, touching the right heal to the left toe. Were you able to keep your balance? Now switch sides and try again? You should not wobble.
Pain is a normal, natural and essential sensation for your body to experience. It tells you something is wrong. Medications may truly give you relief from your pain symptoms, but relief only occurs while taking the medication; it masks symptoms for as long as you continue taking it. When you stop, you are still left with the underlying condition – your peripheral neuropathy. It has not been cured. And what’s worse, the entire time your symptoms and pain were being masked there is a good chance your nerves degenerated further. The purpose of medication is to change your brain chemistry NOT find the root cause of your symptoms. How will you ever regain healthy nerves if you don’t find which of the 5 causes of peripheral neuropathy you are suffering from?
Patient A and Patient B both suffered from peripheral neuropathy. Both had symptoms that were continuing to worsen. Patient A was 57 and Patient B was 62. Both were on Lyrica to minimize pain yet, their pain was slowly increasing, especially the burning foot pain at night.
Patient A suffered from diabetes and blood tests also revealed macrocytic anemia. Both conditions can deprive nerves of adequate fuel and oxygen. Knowing 2 of the causes of peripheral neuropathy are a lack of fuel (nutrients) and a lack of oxygen to the nerves, a fairly simple treatment plan was developed for Patient A. One which got his blood sugar under control and supported the efficient transport of oxygen rich blood. Within 4 months Patient A related that his peripheral neuropathy pain was gone, his use of Lyrica eliminated, and his blood sugar which was 160-180 with meds before treatment was reduced to 85-110 after treatment enabling him to decrease is diabetes medication by 75%.
Patient B, also diabetic, presented a more complex case. In addition to his diabetes, his initial examination showed he was suffering from loss of “wide diameter afferent neurons.” These nerves, when healthy, block pain. With this information treatment was directed to stabilize blood sugar and improve activation of these “wide diameter afferent nerves.” It was explained to Patient B that this treatment would take longer to see results. Five months into the care he related an 80% reduction of pain intensity and he was able to sleep at night with no pain.
Even though their peripheral neuropathy symptoms seemed the same, it took a careful individual assessment to find the underlying cause or causes in each case. Finding the cause of your peripheral neuropathy is the first step in a successful, drug free plan to improve nerve health and live a pain free life.
Why Are My Hands and Feet Always Cold?
It’s a warm and slightly humid 82 degree end of summer kind of day. Bright sun, kids heading back to school, thoughts of reorganizing and cleaning out the house are pervasive as we move from one season to the next. If you look carefully the outer tips of leaves are starting to change, some have even begun to fall bringing with them thoughts of apple picking, football and pumpkins. A wonderful stirring of emotions until you remember this seasonal change brings with it a drop in temperature and the longing for spring when your hands and feet will be warm again. Unfortunately, some of us don’t even enjoy the reprieve of summer; we spend our days wondering “why are my hands and feet always cold?”
Contrary to popular belief cold hands and feet don’t just happen, they are a symptom of something not working optimally in your body that the warmest of mittens won’t fix. Although there can be a number of CAUSES for your cold hands and feet, it’s important not to fall too quickly into the trap of focusing on one single thing as the culprit.
Possible causes of cold hands and feet:
Chances are you have been researching your condition and understand my caution when reading the above list. For those new to this information let me explain. All of the conditions listed have the ability to cause cold hands and feet on their own BUT they are most often intertwined with one another. We refer to this as a “web of physiologic dysfunction.” For instance, thyroid dysfunction occurs in approximately 30% of women, some will have anemia and cold hands and feet, or the autoimmune condition known as Raynaud’s and an inability to lose weight, others may be experiencing digestive disorders and depression along with their cold hands and feet. So, again it is essential to consider all the possible culprits.
Let’s look at some of the possibilities more closely starting with thyroid conditions.
As mentioned, 30% of women in the US suffer from thyroid related issues. Your thyroid gland controls your metabolism. Metabolism is your body’s process for turning food into energy. If your thyroid is sluggish your metabolism slows down and so do all of the systems of your body that depend upon it. Cold hands and feet can easily be attributed to poor blood flow to peripheral nerves as a result of faulty metabolism. Other metabolic break downs may appear as hair loss, weight gain, depression, fatigue and digestive disorders.
80% of thyroid related issues actually stem from an autoimmune condition call Hashimoto’s. What does that mean for you? Your thyroid symptoms, fatigue, depression, hair loss, dry skin, digestive disorders and yes, cold hands and feet are secondary to an autoimmune condition. Meaning you generally won’t have one without the other. The web of physiologic dysfunction is in play here. If your thyroid condition is treated without considering the autoimmune component or vice versa there is a high probability you will continue to suffer and allow the underlying cause to wreak havoc on your body.
Anemia, hormonal imbalances and nerve issues, all of which may be related to metabolic breakdown, are also listed above as possible culprits of your cold hands and feet. But as you are learning, these may be the primary problem causing your symptoms OR the secondary problem; remember the role the web of physiologic dysfunction plays in your health. The relationship of anemia in thyroid sufferers is well documented, with some studies claiming as many as 43% of hypothyroid patients having some type of anemia.
In reality you are suffering from two things: the SYMPTOMS – cold hands and feet, and the underlying CAUSES of your condition.
The biggest pitfalls in your care will be treating the symptoms as the problem, and focusing only on one possible cause. Avoid these pitfalls and stop asking “Why are my hands and feet always cold?” Get proper testing, including a complete thyroid panel (not just TSH) with thyroid antibodies, check Vitamin D levels, as low Vitamin D is a precursor for many diseases including autoimmune conditions, and when indicated, test for intestinal permeability, a condition that will cause significant nutritional deficits.
Wouldn’t it be a nice change to enjoy a mug of warm apple cider because of the sweet, spicy dance it performs on your tongue instead of holding onto it for dear life as your hand warmer?
One of the most commonly asked questions among IBS, Crohn’s & Colitis patients is “Why can’t I eat anything without feeling sick?” Typically when people are intolerant to may foods they will direct their attention to the “what” question. “What can I eat? What will calm down the reaction? What do I take to settle my stomach?” Answering the “what” question will lead to many “solutions” but will not uncover the underlying cause. “What” solutions are many: restrict your diet, take pills and acid blockers, get tested for food allergies. Or, you can start asking Why you can’t eat anything without feeling sick.
By asking why you can’t eat anything without feeling sick , you are seeking the root cause of your condition, not just a resolution to the effects or symptoms from your condition. Although there are other possible reasons you may be reacting to everything you eat, one of the most common causes is a condition called Intestinal Permeability, or Leaky Gut. Your digestive tract begins with your mouth and ends with, well, your other end. Each part of the system has a specific job, from ingesting food to excreting it, the system is finely tuned to keep your body functioning properly. The job of the small intestine, where Leaky Gut can occur is to breakdown the proteins, fats and carbohydrates from the foods you eat before they enter your blood stream to nourish all the cells of your body. A healthy small intestine is lined with densely packed cells that act as a filter for the broken down particles. The space between these cells are referred to as junctions. A healthy intestine will have tight junctions or a very fine filter. Like the screens in your house, the junctions create a barrier that are meant to let the good stuff in while keeping the bad stuff out. Large undigested particles of food, parasites, and bacteria are all able to pass through the weakened junctions of a leaky gut which alerts the body to a foreign invader causing an inflammatory reaction.
Systemic inflammatory reactions related to Intestinal Permeability:
Nonspecific joint pain
Without fixing this barrier, you will develop more food intolerances and more systemic inflammatory reactions.
Going back to the most important question-Why? Why would you have Intestinal Permeability? This question has many answers. Foods sensitivities, low Vitamin D, intestinal parasites, medications, stress, and hyperthyroid or hypothyroid are all known culprits. From these culprits your barrier system will be affected in stages, starting with localized inflammation of the intestinal lining. As the lining continues to degrade your whole immune system will join the battle and, even though the damage is confined to the gut, the whole body immune/inflammatory reaction may cause symptoms anywhere in the body. Brain fog, skin conditions like acne or eczema, headaches, joint pain, and of course food sensitivities are all inflammatory reactions to Leaky Gut. As leaky gut progresses even further you will develop an accumulation of lipopolysaccharides locally in the gut, which is basically an overgrowth of bad bacteria or sludge on the intestinal wall which further affects the inflammatory process and inhibits digestion, creating a state of malnutrition.
By allowing the condition to persist you are seriously hindering any chance of regaining health. There are tests available to determine if you have Intestinal Permeability and what type you may have. Uncovering this roadblock will help to answer the question “Why can’t I eat anything without feeling sick?”
Dr. Kirshner holds Free Workshops where you can learn more about your condition and how to control it without medication.
Probiotics are live bacteria and yeasts that are called “good” microorganisms because they benefit the body, specifically the digestive system. Your gut has more bacteria then total human cells in the body. There are over 500 different strains, or types of bacteria in your gut and each of these live strains, just like you, wants to survive, thrive and multiply. So, should you take probiotics? How does your Gut Health Affect Your Brain Health?
Think of all the bacteria in your gut as being embattled in a world war. Many of these strains are fighting for your benefit by making vitamins, detoxifying, and repairing cells. Some bacteria even create healthy neurotransmitters, the brain chemicals that communicate information throughout your brain and body, hence the term “Gut-Brain Connection.” This explains studies showing that an improvement of good bacteria often results in a positive emotional benefit. Because your gut and brain have this connection, the opposite will also hold true – bad bacteria may create negative emotional and neurologic effects. Therefore, supporting our allies, the beneficial bacterial is critical.
The Power of Sauerkraut
Across enemy lines lie those bacteria that have little benefit and in fact may cause harm. These bad strains are known to create bloating, inflammation, depression, reduction of healthy vitamins, and reduction of healthy neurotransmitters. This may sound familiar to you as the symptoms of Irritable Bowel Syndrome. For you to win the war, it is important to send in reinforcements to support the healthy troops. This is the role of probiotics. It is also just as important to feed the troops. This is done by taking prebiotics. The stuff that healthy bacteria feed off of, prebiotics are non-digestible foods that make their way through our digestive system and help good bacteria grow and flourish. One of the healthiest categories of prebiotics can be found in fermented foods like sauerkraut, and kimchee.
One thing that all bacteria have in common, both good and bad, is their food source; carbohydrates. Carbohydrates can be classified loosely into two groups: Simple Carbohydrates which are found in unhealthy forms like refined sugar, and candy, and healthy forms like those in fruits. Complex Carbohydrates, also called starches can be found in less healthy refined forms like pasta, bagels, and bread or their healthier forms found in vegetables, beans and legumes. By eliminating specific carbohydrates you are limiting the fuel source for bacteria. This is the premise of many so called gut health diets like FODMAP, SCD and GAPS. But…
“A diet that significantly reduces carbohydrates can reduce the number of BOTH good and bad bacteria.”
A recent study found that low-carbohydrate weight loss diets reduced the number of certain kinds of bacteria in your intestines. One kind of beneficial bacteria, bifidobacteria, were particularly affected. This is a problem because beneficial bacteria in your gut produce butyrate. Butyrate is a short chain fatty acid that serves as an anti-inflammatory and “fuel of choice” for the cells lining the colon. It is vital for your intestinal health and helps prevent colon cancer. Doctors are concerned that people on low-carb diets may not have enough good bacteria in their intestines to produce protective butyrate, possibly putting them at risk for cancer.
An effective tool to deduce the health of your gut bacteria is a Functional Stool Test. This 3 day test will check gut bacteria count, it will look for an overgrowth of bad bacteria, and check for imbalances between good and bad bacteria. The findings from this test help determine the necessity of taking probiotics.
Why do you want to take Probiotics?
Should I take probiotics? Let’s answer that question with a question. Why would you take them to begin with? What problem are you trying to solve? The answer is, you are hoping to improve gut health; your health. Given this answer taking probiotics may be an important component for improving gut health but to improve overall health it is often prudent to defend your assets using all the forces available in your arsenal.
If you are trying to improve health, taking probiotics along with other strategies may be a good course of action. If you are suffering from the results of your internal bacterial war, then your best chance of success is consulting with someone who is familiar with the intricacies of this problem and how best to navigate your way to better health.
This is a question I am frequently asked by thyroid patients. As with most questions of this nature the answer isn’t a simple yes or no, additional questions need to be addressed.
3 most important questions to ask before taking any supplement:
What problem are you trying to solve?
Can the “solution” actually make the problem worse?
Why would you be deficient in iodine and need to consider supplementation?
What are thyroid hormones T4 and T3 and why are they significant?
First a little background. Your thyroid makes many hormones but the two most commonly talked about are T4 and T3. The numbers 4 and 3 refer to how many iodine molecules are on the thyroid hormone. T4 means there are four iodine molecules, T3 means there are 3 molecules.
Your body has roughly 100 trillion cells, all vying for hormones and to be metabolically active. Cells have receptor sites which are specific to the hormones needed like T4 and T3. Metabolic activity occurs when T4 and T3 successfully enter the cell. If the cells are not functioning well, tissues, organs, your whole body in fact begins to degrade. You may feel this as thyroid symptoms including: fatigue, weight gain, hair loss, brain fog, depression, constipation, and infertility to name a few.
When you are healthy and your thyroid is functioning properly it will predominantly produce T4, then the T4 will travel through the body on a mission to be converted to T3 to maintain the correct hormonal balance. Some T4 will be converted to T3 in the liver, more will be converted in the small intestines, and yet more T4 will be converted to T3 by tissue it passes along the way. This conversion process is critical; remember the thyroid predominantly produces T4 but the more active form of thyroid hormone is T3.
And one more important consideration before I discuss iodine and the need for iodine:
“70% to 90% of hypothyroid patients are actually suffering from an autoimmune condition called Hashimoto’s.”
This is a condition where the body is destroying its own thyroid gland. The point is, even though you might be suffering from the results of a hormonal (endocrinological) issue, the underlying cause may actually be an immunological issue.
4 Groups of people who usually consider taking iodine supplements.
1) People with no known thyroid problem who “just want to supplement.” For this group adding foods to the diet with naturally occurring iodine, like fish, some dairy products, sea vegetables, kelp, dark leafy greens like Swiss chard, mustard greens and spinach should be more than adequate to maintain health.
2) People who have developed or are at risk for developing goiters because of an iodine deficiency. The deficiency may cause the thyroid to enlarge and in turn develop nodules. Many people with goiters will have an enlarged thyroid with few “thyroid” symptoms and should consider taking iodine in combination with Selenium to mitigate adverse reactions to the iodine.
3) People with hypothyroid conditions not related to an autoimmune condition often consider supplementing with iodine, but this can become complicated. Your thyroid condition may be the result of underactive thyroid, problems with converting T4 to T3 including stress induced under-conversion of T4 to T3, hormonal imbalances which will down regulate conversion of T4 to T3 or will deregulate transportation of T4 and T3 through the body. Just taking iodine may not be the answer to your problem. But once again should you decide to supplement with iodine a healthy suggestion would be to include a selenium supplement to mitigate adverse reactions to iodine.
4) If you have an active autoimmune condition like Hashimoto’s Thyroiditis, taking iodine will create more activity in the thyroid gland. The body may see this increased activity as an increased attack on the body. The body’s response will be to increase an immune reaction thereby causing more inflammation. Even though you might be deficient in iodine, the supplementation may cause more harm than the iodine deficiency alone. Once again, if you consider taking iodine, a healthy addition might be to add selenium. But an even healthier alternative would be to investigate a whole body approach that looks for the cause of your iodine deficiency. Do you have Intestinal Permeability? Do you suffer from food sensitivities? Are you reacting to other triggers that might be the cause of an autoimmune condition?
There is no simple answer to the question “Should I take iodine if I have a thyroid problem?” All aspects of your health should be taken into consideration before taking any supplement. A truly heathy diet should be sufficient to maintain health; however a body in crisis needs to be addressed using different criteria that should include consideration of all systems of the body.
If you have been dealing with Irritable Bowel Syndrome you know how frustrating it can be. Always plotting out where the next bathroom will be or knowing when “it” will strike, dealing with countless doctors, enduring invasive tests, trying multiple medications to “fix” the problem- none of it is fun and it doesn’t yield the results you are looking for. After helping hundreds of people overcome IBS by finding the underlying cause, I know there is a different approach that works. I like to call it “Big Rocks Before Small Rocks.”
When I say “Big Rocks Before Small Rocks” what I mean is before you try a potentially harmful drug, or the latest and greatest supplement you need to address the big issues first. The reason why this approach is important stems from two lines of reasoning:
1) Most patients find a successful resolution to their IBS concerns by handling the “Big Rocks” first.
2) Handling the “Big Rocks” is a process of creating a healthy foundation within your body. If this doesn’t completely resolve your problem, then you will still benefit from that healthy foundation when tackling the “Small Rocks.” This will greatly enhance your success.
What Does Your Gut Do?
Now when I talk about the big issues first, it’s best to have a basic understanding of the many jobs of your gut. This basic understanding will lay the groundwork of why my approach works.
Your mouth is the beginning of the GI tract and the entryway for food.
I know this sounds stupidly simple but think about just that one statement. Your mouth is the entryway for food. Food is nutrition for the body. Are you eating FOOD that nourishes or are you eating things that appear like food but have no nutritional purpose and may actually be harmful? I mean everything you eat. Even your multivitamin may be filled with stuff that might be causing more harm than good.
What is the Underlying Cause of Your Irritable Bowel Syndrome?Next along the GI tract in our discussion is the stomach. The stomach has many important roles, but two of the most important are to break foods down, especially protein, and to prepare food for further digestion by killing off pathogens (harmful bacteria) before entering the small intestine. The secretion of hydrochloric acid is one of the many processes the stomach employs to break down food. That’s right; your stomach needs an acidic medium to function properly. Not only will acid blockers (known as proton pump inhibitors) hinder your digestion, they may actually cause you more harm in the long run. Many studies have linked these drugs to kidney disease, b-12 deficiencies, magnesium deficiencies, to name a few.
The 23’ long small intestine is next. I am in awe of this area of the GI System, especially a 6’ long layer that is only as thick as one microscopic human cell. This one layer allows broken down food to be absorbed. This one layer, where 80% of our immune system resides, is vigilantly stopping food pathogens from crossing the intestinal barrier. This one layer is beginning to carry waste products out of the body. This one layer is breaking foods down further. This one layer, with connections we are still leaning about, is in direct communication with your brain affecting everything from moods and emotions, to memory and intelligence.
The Large Intestine is where something called your microbiome resides. Your microbiome is a two pound mass consisting of trillions of microorganisms living in your gut. These organisms are vitally important to your health. The disruption of the microbiome has been implicated in a variety of conditions including IBS, Diabetes, Alzheimer’s, Depression, Mood Disorders, and skin conditions like Eczema. It would be nonsensical to discount the importance of the health of this very important ecosystem if you are having GI distress.
What Can You Do?
What’s the point of all this information? A sensible, successful approach to overcoming life with Irritable Bowel Syndrome must include the examination of all segments of the GI tract. Who is qualified to do this? A doctor who practices Functional Medicine and has seen hundreds of patients and has had the experience of helping patients navigate through this process.
The next best approach is to educate yourself, as you are doing now, and adopt an approach that takes all these systems into consideration.
It all starts with a healthy diet; remember, your mouth is the beginning of the GI tract and the entryway for food. There are many “diets” to choose from: Paleo, Micobiome, Ketogenic, FODMAP, Cellular Healing. It has been my experience that not everyone will respond the same way to each diet. Without knowing which one is best for you (based on blood tests and functional tests), you may consider a simple approach that has only six instructions:
1. Eliminate ALL grains
2. Eliminate all BAD fats
3. EAT HEALTHY FATS
4. Choose free range eggs and grass fed beef
5. Eliminate all processed foods
6. Eat a variety of vegetables (French fries are not a vegetable)
Supplementing with digestive enzymes, probiotics, CoCurcumin, fish oil (unless eating fresh fish twice a week) has also been found to be helpful in some patients.
These simple steps may help, and if they do that’s great. Please let me know your success story. If they don’t, maybe its time to seek expert advice to uncover the underlying cause of your IBS.