By Dr. Shawna Darou, ND
As a past engineer, I tend to be very analytical in how I see health, wellness and trends. One thing that I often say to new patients, especially ones with complex health issues is that a big part of how I work is by pattern recognition. What this means is recognizing same constellation of symptoms or the way someone describes how they are feeling and being able to match that to other cases I have worked with. This is especially useful right now where it seems like the health landscape is changing. Often we are seeing things before they have a diagnosis or a name, and sometimes we are actually dealing with a functional imbalance rather than a disease or pathology.
Today’s article is a brief description of 6 patterns that I am seeing over and over again in my practice in 2023 so far. Perhaps you will see yourself in one or two of them.
(1) Food reactions
There are many ways the body can react to foods – classic ones like celiac disease and lactose intolerance, but also delayed food sensitivities, foods that increase inflammation. reactions to histamines, salicylates or oxalates. It’s important to note that food reactions are not limited to the gut, meaning you may not have significant digestive symptoms with certain types of food reactions. For some of these reactions, there are no adequate tests available so we rely on pattern recognition to match different types of foods with current symptoms. Here are some examples of food reactions:
- Delayed food sensitivities, or IgG reactions are associated with eczema, can aggravate autoimmune conditions, and can affect mood, energy and overall immune function.
- Foods that are generally inflammatory can aggravate any inflammatory condition, such as autoimmune condition, but also osteoarthritis, fibromyalgia, endometriosis and other pain-related conditions. This may include fried foods, pork, red meat, peanuts, sugar, and also
- Reaction to histamines in foods is associated with flushing, heartburn, migraines, hives, rosacea and also brain fog and dizziness.
- Reaction to salicylates in foods can cause significant sinus condition, nasal polyps and sometimes gastrointestinal symptoms too.
- Reactions to oxalates are associated with kidney stones, pelvic pain, joint pains and sometimes fibromyalgia pain.
Susceptibility to food reactions often stems from imbalances in the gut – for example a growing list of food sensitivities can be cause by intestinal permeability leading to more communication between the gut immune system and the rest of the body. Reactions to histamines can be triggered by an overload of histamine-producing bacteria in the small intestine with SIBO (small intestine bacteria overgrowth), and oxalate reactions can be triggered by high oxalates produced by intestinal yeast.
It’s important to note that identifying food reactions is the first step, but not the end of a treatment plan – we need to figure out why the body has started to react to the foods, and address the gut issues contributing to the reactions.
(2) Gut microbiome imbalances
Imbalances in the gut microbiome have been progressing over the past decades – due to changes in our food supply, changes in eating habits, especially less diversity in our diets, and widespread use of antibiotics, to name a few. When the gut is out of balance, it can impact any system in the body – the immune system, brain and neurological system, connective tissue and joints, reproductive system, and of course create digestive symptoms too. Any significant shift in the gut microbiome can trigger microbial lipopolysaccharides (LPS) production which in turn activates an inflammatory response. Cytokines can impact various systems, including the brain and can trigger inflammation.
Some conditions associated with imbalances in the gut micobiome:
- Persistent bloating, IBS, inflammatory bowel disease, chronic constipation.
- Any autoimmune disease may have gut and microbiome issues associated with it – Hashimoto’s thyroiditis, Lupus, rheumatoid arthritis, mixed connective tissue disease, multiple sclerosis, and more.
- Mood imbalances have been linked to the gut – depression, anxiety, OCD.
- Endometriosis has been linked to the gut and overgrowth of certain bacteria.
Any permutations in the gut microbiome composition trigger microbial lipopolysaccharides (LPS) production. It, in turn, activates inflammatory responses. Cytokines send signals to the vagus nerve, which links the process to the hypothalamic-pituitary-adrenal axis that consequently causes behavioral effects. Another school of thought suggests that the gastrointestinal (GI) tract’s inflammation leads to neuroinflammation.
(3) Insulin resistance and blood sugar issues
It’s no surprise after the past few years and the dramatic changes in lifestyle with more people working from home, more sedentary lifestyle habits, and changes in food habits that we are dealing with epidemic numbers of people affected by insulin resistance, pre-diabetes and diabetes. Chances are if you’re one of the millions of people who gained weight during the pandemic, you’re also switched on insulin resistance in that perfect storm of stress, reduced activity and comfort eating.
Symptoms of insulin resistance include:
- weight gain (often rapid in a period of two to three years)
- very slow and difficult weight loss
- intense cravings for carbohydrates or sweets
- increased appetite
- feeling tired or bloated after eating
- carrying extra weight in the central abdomen
- increased anxiety & interrupted sleep
- in women it is also associated with acne and hair thinning
Insulin resistance is also important to address as it creates a significant inflammatory state in the body, especially in the fat and liver with increased production of cytokines and other inflammatory chemicals. It is then associated with cardiovascular risk, chronic pain, depression, and fatigue.
Another important link with insulin resistances is Alzheimer’s disease, which is sometimes termed “type 3 diabetes” occurring when neurons in the brain become unable to respond to insulin which then impacts memory and learning.
The good news is that insulin resistance and prediabetes are fully reversible with changes in nutrition especially, but also exercise, stress and sleep, which will then also turn off the inflammatory changes.
I’ve written about burnout many times over the years, and in 2023 I am seeing a tremendous amount of it, resulting in stress-leaves, poor mental health and significant fatigue. It’s not surprising after the past few years, and it always seems to catch up to us after the acute stress has passed – when it’s safe to take a break. Think about any major stressful event you have been through, where you’re able to cope and function at high capacity during the event itself, and then feel exhausted and worn-out afterwards. Now, this is stretched out over years – where we were living in a state of acute stress and hypervigilance for a long period of time – months or years, and now are feeling the impact of it.
Most of you have heard me say is that our bodies heal in a state of rest. If you haven’t been able to rest because of stress, a busy home life, high workload, anxiety, menopause disrupting your sleep, frequent illness, or anything else, fatigue builds and new health issues begin. The starting signals that your body is not coping well with stress and not healing fully are fatigue, body aches and low motivation. After a period of time, you’ll develop a flare-up wherever your health weak spot is – digestion is extremely common, but also hormones, joints, mood, sleep, or other systems.
The very first signs that you might be heading towards burnout are actually very consistent. They include:
- A change in your sleep patterns, especially waking up frequently in the night and having a restless sleep.
- Feeling unmotivated at work.
- Being very irritable with a short fuse.
Burnout doesn’t go away with a week off work and few days of sleeping in, in fact you often feel worse when you finally start to rest. It takes time for your nervous system to rebalance, and often requires some extra support with nutrition, gentle exercise and mental health therapy. You can also read more about some tips for burnout here: https://drshawnadarou.com/2023/01/10/steps-you-can-take-to-prevent-burnout-in-2023/ and https://drshawnadarou.com/2021/07/13/are-you-close-to-burnout/
(5) Very low nutrient levels
I am repeatedly seeing very low nutrient levels on bloodwork in the past months, and suspect it’s simply because many of us are a couple of years behind on routine blood tests and simple testing for nutrients got missed. Most common are low levels of iron, vitamin B12 and vitamin D, which can all have a tremendous impact on energy, mood, and overall health resilience. Any significant nutrient deficiency can make you feel really tired, and also more prone to illness.
Iron deficiency is extremely common, and women are especially prone to low iron levels with heavy menstrual cycles, or simply not paying attention to intake of iron-rich foods, Low iron can cause fatigue, hair thinning, dry skin, chills, and also low mood, anxiety and night-time waking.
Vitamin B12 deficiency can also be caused by heavy menstrual cycles, and also poor absorption due to gut issues, a plant-based diet without supplementation, and also certain medications especially Metformin. Low levels cause fatigue initially, but over time can affect the nerves causing numbness and tingling, and also brain fog, depression, anxiety, headaches and palpitations. (Read more here: https://drshawnadarou.com/2021/05/24/anxiety-tingling-and-palpitations-could-be-a-vitamin-b12-deficiency/).
Vitamin D is an essential fat-soluble vitamin, which all of us become deficient in the winter months living in Canada unless we supplement regularly. Low vitamin D levels can cause fatigue, depression and increased incidence of respiratory illness, and also muscle pain, bone pain, tingly sensation in hands or feet, and muscle weakness. Dosing and absorption of vitamin D varies tremendously, so it is important to test your levels to see if your dosage is adequate. Too much vitamin D creates a toxicity in the body and kidney stress, so more is not better here.
If you are supplementing with any of these nutrients to correct a deficiency, it is important to test regularly to confirm you are taking the correct dose for optimal absorption.
(6) Recurrent infections
It’s been a particularly bad year of upper respiratory infections especially, with the flu, many cold viruses, COVID-19, sinus infections, Strep throat and more. I am hearing many people getting sick over and over again this year, and not only ones with children in daycare or preschool. Perhaps this is from not being exposed to seasonal viruses for 2 years, or in many cases the immune system becomes more vulnerable after exposure to one significantly strong virus with a long recovery time. Regardless of the cause, our immune systems need support, and any one of the 5 patterns above can be contributing too. If you have also had a bad year with respiratory infections, you’re not alone.
If you recognize any of the common patterns mentioned above and are looking for support, please ask at your next visit. It is interesting that the patterns do shift and change over time, and we often experience common issues at the same time.