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Eat to beat depression

Eat to beat depression for World Health Day

Tackling depression naturally for World Health Day

Nutrition-related health issues seem to take an age to become part of accepted medical practice. The medical establishment requires comprehensive scientific evaluation, randomised trials and peer review before a new drug can be licensed, for instance. The pharmaceutical company has to weigh up the costs of research and development versus the potential profit to be made from launching a successful product that can earn a good return on their investment. (When you add in the factor that 80 per cent of their budget goes on marketing, it is clear the stakes are high indeed.) As real food is simply real food and can’t be licensed, branded or patented, there is little impetus for the medical community to fund costly research.

Medical research over the last couple of decades has, nevertheless, highlighted how an unhealthy gut can contribute to many physical diseases and these findings are becoming more accepted in mainstream medicine. Clinicians increasingly agree that the gut-brain axis also plays a crucial part in emotional wellbeing, including the development of conditions as diverse as chronic fatigue syndrome, depression and autism.

The Gut-Brain Axis

The gut-brain axis is a way of describing the interrelationship between gut health and brain health. The various aspects of digestion are controlled via the vagus nerves by a complex set of neurons embedded in the oesophagus, stomach, intestines, colon and rectum. The brain sends messages to all the nerves in your body, including the neurons that control digestion. All work efficiently enough until a person is anxious or stressed on an ongoing basis. You perhaps know for yourself that if you are feeling nervous your stomach can feel upset and queasy. The reason for this is that strong negative emotions, stress and anxiety increase cortisol and adrenaline, which then stimulate the sympathetic nervous system and shut down the parasympathetic system, which includes control of the gut. This causes a physical chain reaction:

* Reduction in pancreatic enzyme production

* Reduction in gall bladder function

* Reduction in the production of stomach acid

* Slowing down of peristalsis – the involuntary muscle movements essential for moving food efficiently through intestines for the absorption of nutrients

* Reduction in blood flow to the intestines

* Suppression of the intestinal immune system

In the short term, this allows the body to focus its resources on ‘fight or flight’ – a good survival mechanism. However, with ongoing stress and anxiety, this cumulative slowing down and suppression of the digestive process can, over a prolonged period, lead to a condition called ‘small intestinal bacterial overgrowth’ (SIBO). As the digestive process is compromised by stress and anxiety, the lack of stomach acid allows the stomach and small intestine – which should both be pretty much microbe free – to be colonised by unhealthy bacteria, and yeasts, causing foods to be fermented rather than digested. In addition to gas and bloating, compromised digestion leads to declining absorption of nutrients, which contributes to the loss of the co-factors needed for good digestion, and consequently further gut problems.

Now consider this situation lasting for extended periods of time. The integrity of the gut lining may be compromised, contributing to gut permeability (‘leaky gut’) that may be sufficient to produce chronic low-grade inflammation.

Chronic Inflammation

The inflammatory process includes the production of cytokines, chemical signals of inflammation that are carried by the blood to the brain. The cytokines can activate cells – so that the inflammation originating in the gut thereby causes widespread inflammation in the rest of the body, including the brain.

The impact of brain inflammation is that the brain has reduced nerve conductance which – guess what – shows up as depression, anxiety and stress.

This vicious circle can self-perpetuate and requires long-term changes to heal the gut, which in turn will help to heal the brain. This is done through changes in behaviour and improving levels of nutrition through changes to food choices. To improve your natural resilience to stress it is important to increase the amount of healthy polyunsaturated omega-3 oils in your diet, so look for oily fish, grass-fed meats and butter made from the milk of grass-fed dairy herds. Good plant sources include hemp seeds, linseeds, chia and some nuts and nut oils (macadamia, almond).

If you consider yourself to be depressed it will be helpful for your recovery to manage your stress levels, improve your sleep patterns and add nutritious and gut-healing foods into your regular eating plan.

Do bear in mind, however, that you may also need professional help if you have been suffering from this debilitating psychological disorder for some time. Please make sure you are accessing all the medical and psychological support you need. Try hard not to add isolation to an already challenging situation.

This blog has been taken from How to Feel Differently About Food by Sally Baker & Liz Hogon.

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The Science of Stress Hormones

Stress Awareness Month

Exploring the role of hormones for Stress Awareness Month

There are two main hormones governing the stress reaction: cortisol and adrenaline. They work together to exert the ‘fear, fight or flight’ response that was first described in the scientific literature as long as 1936. This response gives a temporary increase in energy production, at the expense of processes that are not required for immediate survival. The resulting biochemical and hormonal imbalances should ideally resolve as soon as the danger is over, due to a hormonally driven negative feedback loop. The following is a typical example of how the stress response is supposed to operate as a survival mechanism:

* An individual is faced with a stressor

* A complex hormonal cascade ensures, and the adrenals secrete cortisol

* Cortisol prepares the body for a fight-or-flight response by flooding it with glucose, supplying an immediate energy source to large muscles

* Cortisol inhibits insulin production in an attempt to prevent glucose from being stored, favouring its immediate use

* Cortisol narrows the arteries whilst adrenaline increases heart rate, increasing the blood pressure and delivering more oxygen rich blood to the tissues

* The individual addresses and resolves the situation

* Hormone levels return to normal

Unfortunately, with our over-stressed, fast paced lifestyle, our bodies are pumping out cortisol almost constantly, which wreaks havoc on our health. In times of high stress the body will break down amino acids to form glucose through the process of gluconeogenesis (a physiological process via which proteins and amino acids are utilised, instead of glucose), to produce energy. Cortisol is the major stress hormone that promotes this process. Collagen, being a structural tissue made from protein, is one of the target areas for spare amino acids; the muscles are another. Chronically elevated stress levels increase collagen breakdown. Since collagen is the matrix upon which our bones are built, anything that is likely to break it down will have potentially serious consequences for the strength and integrity of the bones.

Cortisol primarily acts on the outer layer of the bone, known as the periosteum. Research has shown that elevated cortisol levels interfere with the formation of osteoblasts and cell proliferation. This dramatically decreases bone building and lowers bone density. Without adequate rest and repair, bone mineralisation and collagen formation will be reduced for the duration of the elevated stress.  The absorption of vitamin D is also adversely affected by high cortisol levels. This gives a double whammy in favour of bone loss.

Stress can rot your bones faster than a can of fizzy drink. Stress and the negative emotions that accompany it have been shown to have a chemical structure in our bodies. And guess what? That chemical structure is acidic! With all the emphasis I place on ensuring appropriate intake of alkaline minerals in earlier chapters, and the fact that increased acidity causes increased urinary calcium excretion, is it any wonder that for prevention and reversal of osteoporosis we absolutely have to take stress reduction seriously?

The power of exercise

My favourite way of combating the stress that often accompanies a bad day at work is to get out and go for a run, or go to a karate class. Both are also excellent ways of not only de-stressing the body but also improving bone strength. Exercise is a surefire way to de-fuse. It boosts the level of endorphins in the brain, morphine-like ‘happy hormones’ which are often depleted by our daily lives. Relaxation classes and guided meditation are well worth doing, as is a meditation based on love and compassion. Thoughts of love and compassion stimulate the production of a hormone called oxytocin, whose effects in the body work in the opposite way to those of cortisol. Oxytocin lowers the blood pressure and relaxes the walls of the arteries.

This blog is taken from Love Your Bones: The essential guide to ending osteoporosis and building a healthy skeleton by Max Tuck.

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Sleeping for Health

We love bed times. Nothing beats a good night’s sleep, but it isn’t always so easy to get one so we’ve put together some of our favourite sleep facts and tips from three of our health books. If you’re catching more AAAAAH!s than ZZZZZZs we hope this blog can help you find the sleep of your dreams.

 

Prepare to snooze or prepare to lose

Ensure that you don’t eat within three hours of bedtime – easy to say, possibly harder to do. I know many people who snack in front of the TV in the evenings. Watching TV late in the evening can interfere with your sleep patterns, and we need that surge of human growth hormone that occurs shortly after we fall into deep sleep. Reading, or meditation, to calm the mind prior to going to bed allows the body to go into sleep mode more naturally. Eating too close to bedtime also causes a surge in cortisol, the stress hormone that we know is bad for bones, so don’t fall into this trap. If you have trouble sleeping, try a camomile or valerian tea before bed. These herbs are non-addictive and have no adverse side effects.

– Love Your Bones: the essential guide to ending osteoporosis and building a healthy skeleton by Max Tuck

 

Food, water…sleep?

Humans evolved to sleep when it is dark and wake when it is light. Sleep is a form of hibernation when the body shuts down in order to repair damage done through use, to conserve energy and to hide from predators. The normal sleep pattern that evolved in hot climates is to sleep, keep warm and conserve energy during the cold nights and then to sleep again in the afternoons when it is too hot to work and to hide away from the midday sun. As humans migrated away from the Equator, the sleep pattern had to change with the seasons and as the lengths of the days changed.

After the First World War a strain of Spanish ‘flu swept through Europe killing 50 million people worldwide. Some people sustained neurological damage and for some this virus wiped out their sleep centre in the brain. This meant they were unable to sleep at all. All these unfortunate people were dead within two weeks and this was the first solid scientific evidence that sleep was as essential for life as food and water. Indeed, all living creatures require a regular ‘sleep’ (or period of quiescence) during which time healing and repair take place. You must put as much work into your sleep as your diet. Without a good night’s sleep on a regular basis all other interventions are undermined.

– Prevent and Cure Diabetes: Delicious diets, not dangerous drugs by Sarah Myhill and Craig Robinson

 

Sleep and mental health

When sleep requirements are not being met on an ongoing basis, teenagers will present with fatigue, low energy, exhaustion, and a lack of motivation. It is generally recommended that teenagers get eight to 10 hours’ quality sleep a night. This is vital for the body to relax, repair and refuel. Lack of sleep has a domino effect and impedes mental and physical wellbeing, inviting the onset of self-defeatist syndrome. As I have said already, parents are advised to take their child to a GP to rule out any organic causes of fatigue. In instances where no organic cause is established it is highly likely that the Gremlin has moved in. The Gremlin loves and thrives on the darkness. It becomes alert and active, coming out to play its evil games at night when we are programmed to relax, unwind and fall into a peaceful slumber. The Gremlin is very powerful and demanding, wanting to keep us awake, bolstering and encouraging negative thinking, which leads to rumination, tossing and turning and feeling like our head is going to explode! Thoughts are negative, racing and exhausting. It is vital that teenagers who have been taken hostage by the Gremlin receive appropriate support and professional intervention so they may be facilitated in developing the tools and techniques needed to evict the Gremlin.

– Overcoming Self-Harm and Suicidal Thoughts: a practical guide for the adolescent years by Liz Quish

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Super Fruity Flapjack Recipe

Fruit is a great cleanser of the liver and blood and provides many essential nutrients, such as Vitamin C, which is required on a daily basis. Fresh or home-juiced fruit will aid in weight loss and improve metabolism and the immune system. Juicing one lemon and consuming the juice throughout the day in teas, on fish and salads and in drinks will give the system an enormous cleansing boost. Berries are also highly nutritious. Cherries are anti-inflammatory so can provide pain relief.

Most fruits are diuretic and have antibacterial, antifungal and antiviral properties so can relieve many ailments. They will also clean the blood, kidneys and liver, protect the heart, lungs and eyes, and clear the skin. Tangerines and raspberries possess properties which metabolise fat so can help with losing weight. Pineapple rehydrates the system so is good to consume after sweating or during fever. Try to eat at least three fruits of different colours every day.

Dried Fruit

This is an important part of the diet as it provides a concentrated form of fresh fruit’s nutrient and mineral content. Dried fruit can help avert cancerous tumours and aid digestion. One tablespoon of powdered maqui berry, from a reliable source, per day can help protect against cancer as it is very high in antioxidants. All dried fruits replenish energy and should be added to breakfasts, meals or eaten as snacks throughout the day instead of unhealthy, processed, sugary food bars. Making flapjacks with oats, honey, coconut, nuts, seeds and dried fruit can provide a way to stop hunger and revitalise the body instantly during the day. Consume a small handful of different dried fruits or a mix of them once or twice a day.

Healthy Heart Flapjacks

Flapjacks are a great way to gain the fibre and nutrients required throughout the day and this version also helps lower cholesterol, improve the digestive and immune system and nourishes and protects the bones, brain, eyes and heart. Because flapjacks take time to be digested, they will also stop hunger for a long time after consumption. They make a great breakfast, mid-morning or evening snack. Ingredients do not need to be measured exactly. Experiment and mix and match fruit, nuts and seed ingredients for personal taste and availability.

Ingredients

  • 500g porridge oats (other grains can also be added if required)
  • One table spoon of honey
  • One tablespoon of rapeseed oil
  • Juice of half a lemon
  • Quarter of a teaspoon of cinnamon
  • Quarter of a teaspoon of nutmeg
  • One tablespoon of maqui berry powder
  • Pinch of ground unrefined sea salt
  • Five stoned and chopped dates
  • One handful dried chopped apricots
  • One medium peeled mashed banana
  • One small handful of raisins
  • One tablespoon of dried goji berries
  • One small handful of chopped nuts (almonds, hazelnuts, walnuts etc.)
  • One small handful of mixed seeds (flaxseeds, hempseeds, poppy, pumpkin, sesame, sunflower and watermelon)
  • One tablespoon desiccated coconut

Any or all of the following but add more oats to the mixture so it is not too wet

  • One handful of stoned cherries
  • One handful of raspberries
  • One handful of cranberries or blueberries

Method

  • Preheat the oven to 350°F 180°C/160°C fan, Gas 4
  • Place all ingredients (except berries and cherries) into a food processor and mix to a very stiff paste-like consistency
  • If too dry add a little water and mix further
  • If too wet add more oats
  • Then add the cherries and berries gently folding them into the mixture
  • Press the mixture into a non-stick (rapeseed oil greased) shallow baking tin or tray
  • Bake for 30 to 45 minutes until set with a brown crispy top. Use a skewer to test the middle. It may take longer if fresh fruit has been added
  • Take out of the oven and cool slightly before cutting into portion sizes then leave to get cold in the tray. Store in a sealed container in the refrigerator.

Nutrients and Benefits of The Flapjack Ingredients

  • Apricots (protects the heart and eyes)
  • Bananas (adds fibre and potassium)
  • Cherries (adds anti-inflammatory pain relief especially sour cherries)
  • Coconuts (adds lots more fibre and has antimicrobial, antifungal, antivirus and rehydrating properties)
  • Cranberries and blueberries (protects the eyes, liver and the whole body against arthritis, cancer and urinary tract infection)
  • Dates (protects against heart and eye diseases)
  • Lemon (adds vitamin C, cleanses the liver, pancreas and intestines and helps with weight loss)
  • Raisins (protects against heart disease and arthritis)
  • Raspberries (increases metabolism of fats)

This recipe and blog is taken from Nature Cures: The A to Z of Ailments and Natural Foods by Nat H Hawes. For more natural nutrition and home remedies from Nat visit Nature Cures.

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World Book Day special offer: 75% off all our ebooks

World Book Day

To celebrate the joy of reading, we’re giving you the chance to download all of our ebooks with 75% off, for today only.

We have self help books on everything from chronic fatigue and invisible illnesses to vegan food and natural health. Our latest release, How To Feel Differently About Food was featured in Healthista, Women’s Fitness, Marie Claire and Rude Health. You can browse all our titles here or search the categories below.

Caring

Chronic Fatigue

Dieting and Weight Loss

Mental Health

Wellbeing and Illness Prevention

Just enter the following code at checkout to receive your 75% discount.

WORLDBOOKDAY17

To find out more about World Book Day and see how you can get involved visit www.worldbookday.com.

 

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Self Injury Awareness: Getting to know the ‘Self-Defeatist Gremlin’

Understanding ‘Self-Defeatist Syndrome’

A person whose head is bowed and whose eyes are heavy cannot look at the light.

Christine de Pizan

What I will term ‘self-defeatist syndrome’ is the uninvited Gremlin that moves into young minds, metaphorically speaking. The Gremlin is STRESS that leads to DISTRESS, an unruly tenant that is powerful, deceitful and controlling. Its ultimate goal is to take control of a teenager’s life in a destructive manner causing him/her to feel alone, depressed, angry, afraid, hopeless and anxious. The Gremlin’s goal is to isolate the teenager from family and friends, thus making itself even more powerful. It wants to make the teenager feel lonely and powerless, surrendering to the darkness, diminishing his/her light and self-esteem, distorting his/her belief system and sense of self.

The sense of self

The ‘self’ relates to our uniqueness and individuality, our thoughts, feelings, perceptions and sense of worth, and how we view ourselves. The self also relates to our sense of identity, our belief system and values.

A teenager with a healthy sense of self will:

  • feel confident and competent
  • feel a sense of belonging and acceptance
  • feel secure, safe and valued
  • have self-discipline and self-control
  • learn from and move on from mistakes with new awareness
  • value his/her strengths and accept his/her weaknesses
  • have a healthy set of core values

These are all the traits that the gremlin of self-defeatist syndrome despises and wants to eliminate. The Gremlin does not want the teenager to have a healthy sense of self; a healthy sense of self is its enemy. Its wish and desire is for the teenager to have a defeatist view of him/herself. In achieving this, the Gremlin has accomplished its objective and is actively compromising the wellbeing of teenagers, who are not strong enough to evict the Gremlin on their own.

The defeatist attitude

The ‘defeatist attitude’ refers to an attitude or view of oneself which is negative, pessimistic and unforgiving. A teenager with a defeatist view of him/herself will present with low self-esteem and a noticeable and ongoing lack of motivation, generally deriving little pleasure from life, with a distinct lack of belief in his/her abilities. This is a clear sign that the Gremlin has moved in and taken the teenager hostage. Teenagers in this situation will often use phrases like:

  • What’s the point?
  • It won’t work for me
  • They would all be better off without me
  • It’s just one thing after another
  • I couldn’t be bothered
  • I can’t manage this anymore
  • I am no good
  • No one cares about me
  • I can’t do it

Syndrome

A ‘syndrome’ refers to a combination of signs and symptoms that are indicative of a particular condition. A teenager in midst of self-defeatist syndrome will generally present with:

  • Low energy
  • Low self-esteem
  • Depression
  • Anxiety
  • Anger
  • Self-harming
  • Suicidal ideation (thinking)

Low energy

A teenager can experience low energy for a number of reasons. Adolescence is a period marked by a rapid increase in physical and emotional development. Puberty, hormonal changes and the soaring growth of bones and muscles can have a temporary effect on energy levels, causing many teenagers to feel fatigued from time to time; this is totally normal and to be expected. However, if low energy persists and negatively effects the quality of life of a teenager, a detailed and comprehensive medical investigation is warranted and strongly advised. A full medical investigation should uncover any organic reasons for fatigue and low energy; then, the right treatment can get a teenager’s energy levels back on track and prevent the onset of self-defeatist syndrome.

Common organic reasons for low energy uncovered through a medical investigation in teenagers include:

  • Infection
  • Virus
  • Iron-deficiency anaemia
  • Low thyroid function
  • Vitamin B and C deficiencies
  • Allergies

Harder to diagnose, and more unusual in younger people, are underactive thyroid (hypothyroidism) and pernicious anaemia/vitamin B12 deficiency.

If after a full medical investigation no organic causes for low energy and fatigue can be detected, then lifestyle needs to be further scrutinised and addressed as the Gremlin may be actively trying to move in.

Please share this blog to raise awareness of Self Injury Awareness Day (SIAD).

This blog has been adapted from Overcoming Self-harm and Suicidal Thoughts: A Practical Guide for the Adolescent Years by Liz Quish.

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Spotting the Signs of Emotional Eating

For many who are compulsively driven to eat for emotional reasons, not hunger, food has become a manifestation of self-loathing and a complex method of self-harming, or even a way of failing to thrive. These people crave food, avoid food, binge on food and obsess about food. Thinking about food fills their every waking moment. Food has become a way to celebrate and commiserate with themselves. In fact, it is their everything – except a natural way to sate hunger or be a source of healthy nourishment.

Typically, emotional eaters feel their appetite for food is out of their control and is counter to their heart’s desire to be slimmer than they are. They feel their inability to resist their food cravings proves how worthless they are as they trade their dreams of being slimmer for swallowing down foods they consider to be ‘bad’ or ‘forbidden’. They also often believe that the excess weight they carry is their own personal failing and visible proof for all to see that they are weak, inadequate or just plain greedy. The story they tell themselves continues with the common beliefs that if they were stronger, or had more will-power, or were simply just ‘better people’, then they would find it easy to manage their weight-versus-food-intake without the daily time-consuming over-thinking that they endure.

Every emotional eater has his or her own unique set of circumstances and history, but there are often similarities in thinking and in the belief system that defines each emotional eater. For instance, emotional eaters judge themselves harshly and their self-talk – the quiet voice that everyone hears within their own mind – is particularly critical and unforgiving. We also understand that emotional eaters can be triggered to binge eat when experiencing negative or challenging emotions, such as loneliness, sadness or anger.

Disordered thinking around food that emotional eaters may experience makes it particularly challenging to establish a nutritionally balanced way of eating that can be sustained for the long term. This is particularly true for those who are attempting to stabilise their weight after years, or possibly even decades, of yo-yo dieting.

Emotional eaters do not generally fare well following a type of diet that brings any of the following circumstances into play:

1. Diets that promote low-calorie eating to a level that induces hunger can quickly feel unendurable and trigger strong self-sabotaging behaviour.

2. Diets that rely on low-fat foods to restrict calorie consumption can increase the occurrence or severity of low moods, even to the risk of increasing the incidence of depression.

3. Diets that replace foods containing real sugars with chemical sweeteners can still spark compulsive sugar cravings and out-of-control bingeing.

4. Diets that replace meals with fake-foods, such as shakes, snack bars, instant soups or variations on this theme, often fail for emotional eaters when they are challenged with the inevitable reintroduction of real food.

5. Diets that promote or exclude whole groups of food, impose excessive or irrational rules or demand a specific cooking methodology can all help encourage unhelpful over-thinking about food that emotional eaters are already prone to. This includes the eating of only ‘free-from’ foods, including gluten-free (without a confirmed medical need), or following a strict macrobiotic diet, or eating only raw foods.

Do you obsessively follow all the latest healthy eating crazes, or recognise other symptoms of emotional eating? Read more from Sally Baker and Liz Hogon in their books How To Feel Differently About Food and 7 Steps to Stop Emotional Eating.

Sally Baker will be speaking at The Best You Expo at ExCel in London on 4th March 2017.

This blog is adapted from How To Feel Differently About Food by Sally Baker and Liz Hogon.

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Invisible Illness: recognising the symptoms of Pernicious Anaemia

Invisible Illness: recognising the symptoms of Pernicious Anaemia

Pernicious Anaemia (PA) is an invisible illness caused by deficiency in vitamin B12 owing to problems absorbing it from food.

Everyone is different and sufferers of pernicious anaemia will experience the symptoms of the condition to varying degrees. Some patients will have all of the symptoms listed below while others will recognise only a few. This list has been compiled over a number of years and shows what a wide range of symptoms there can be. There are two problems with this wide range. First, many of the symptoms listed below are associated with other medical conditions, which often leads to confusion with other invisible illness and misdiagnosis. Secondly, because there are so many symptoms associated with pernicious anaemia, it makes it difficult for doctors to identify the symptoms specific to the disease – thus making an early diagnosis even less certain.

Common general symptoms of Pernicious Anaemia

  • Shortness of breath – ‘the sighs’
  • Extreme fatigue
  • Brain fog
  • Poor concentration
  • Short-term memory loss
  • Confusion (‘handbag in the fridge syndrome’)
  • Nominal aphasia (forgetting the names of objects)
  • Unaccountable and sudden bouts of diarrhoea, often following a spell of constipation
  • Clumsiness/lack of coordination
  • Brittle, flaky nails; dry skin anywhere on body
  • Mood swings, ‘tear jags’, heightened emotions
  • Sleep disturbance
  • Even though patient is exhausted, is unable to sleep
  • Waking up still tired, even after many hours’ sleep

Neurological symptoms of Pernicious Anaemia

  • Balance problems
  • Dizzy/faint
  • ‘Shoulder bumps’ – frequently bumping into or falling against walls
  • General unsteadiness, especially when showering and dressing
  • Inability to stand up with eyes closed or in the dark
  • Vertigo – inability to cope with heights, linked to the need for a visual reference as compensation for damage to the brain’s balance mechanism
  • Numbness/tingling – especially in hands, arms, legs, feet
  • Burning sensation in legs and feet – Grierson-Gopalan syndrome
  • Tinnitus – ringing/screeching/howling in the ear or ear
  • Neuropathic pain/fibromyalgia – often on only one side of the body
  • Irritability/frustration/impatience; desire for isolation, quiet and peace; aversion to bright lights and crowded spaces

Skin problems associated with Pernicious Anaemia

  • Hair loss – can range from moderate to sever; premature greying of hair
  • Psoriasis/eczema/acne
  • Rosacea – reddening of the skin around the nose and cheeks
  • Vitiligo – white patches that develop on the skin

Other medical problems associated with Pernicious Anaemia

  • Poor digestion
  • Arrhythmia – irregular, fast or slow heartbeat

Autoimmune conditions associated with Pernicious Anaemia

  • Rheumatoid arthritis
  • Hypo- or hyper-thyroidism – almost exclusively among females
  • Coeliac disease – sensitivity to wheat and/or wheat products
  • Myasthenia gravis – weak muscles leading to problems swallowing, chewing and opening eye(s)
  • Psoriatic arthritis

Vitamin B12 deficiency can be detected with a blood test, and if this deficiency is then determined not to be caused by diet it may be a clue that Pernicious Anaemia is the underlying invisible illness.

To learn more about Pernicious Anaemia diagnosis and treatment read What you need to know about Pernicious Anaemia and Vitamin B12 Deficiency by Martyn Hooper, founder of The Pernicious Anaemia Society.

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Is it ‘just’ indigestion?

Indigestion is that uncomfortable feeling most of us have experienced at some point in the upper abdomen or lower part of the chest – usually after eating or drinking (but not always). The official medical definition is upper abdominal discomfort or pain that may be described as a burning sensation, heaviness or an ache. It is often related to eating and may be accompanied by other symptoms, such as nausea, fullness in the upper abdomen or belching. It’s usually worse if you lie down directly after eating a heavy meal.

Other names for indigestion include dyspepsia and acid reflux or heartburn. It is basically an inflammation of the gullet (oesophagus) – the long pipe that runs from the mouth to the stomach. Indigestion is so common most people will have experienced it at some time and it’s usually more of a fleeting inconvenience than a major health problem. Most people don’t see their doctor about it and either grin and bear it or simply treat it themselves with remedies they can buy over the counter from a chemist. Only a quarter of people who suffer indigestion see their GP about their symptoms and about 10 per cent of these consultations will be referred for further investigations.

Indigestion is rarely a symptom of a serious underlying medical condition (but if you are worried check out our list of reasons for an urgent referral, below). In people who have an endoscopy to investigate their indigestion, 30 per cent will have no abnormal findings and 10 to 17 per cent will have oesophagitis (inflammation of the oesophagus) and the rest will have gastric or duodenal ulcers, gastritis, duodenitis (inflammation of the duodenum) or hiatus hernias, according to the British Society of Gastroenterology.

But, having said that, we’re not saying indigestion can’t still affect your quality of life and be a pain to deal with. If you’re one of the unfortunate ones who suffer from recurrent severe bouts of indigestion, Chapter 8 in What’s Up With Your Gut may help you get to the root of what’s causing your symptoms, help you find some long term relief and enable you to enjoy your food again.

Symptom Checker

If you have one or more of the following symptoms, you may have one of the conditions discussed in this blog.

  • Burning sensation, fullness, heaviness or ache in upper abdomen or lower chest
  • Burning, griping pain in the abdomen, lower gut and back
  • Sharp, persistent pain at the top of the stomach or above ribs on right
  • Bitter taste in the mouth
  • Nausea, vomiting
  • Bloating
  • Belching and burping
  • Lump in your throat
  • Tickly cough

What causes indigestion?

Diet

Most people associate indigestion with overdoing it, with a big meal, sometimes with a high fat or spice content – creamy curry sauces and dishes containing chilli for instance. You might also notice that particular foods can trigger your symptoms, including curries, fatty foods, citrus fruits, bananas and cucumbers – it’s very individual though. Sometimes however, it can be down to something simple such as eating too fast or too close to bedtime. Drinking too much alcohol, or caffeine in coffee, tea and chocolate may have a similar effect.

Drug side effects

There are many other causes of indigestion and sometimes the cause isn’t so obvious. These other causes include the side effects of drugs, including non-steroidal anti-inflammatory drugs (NSAIDs) taken to relieve the pain of arthritis (such as ibuprofen and aspirin) and nitrates prescribed for angina for instance.

Acid reflux or GORD

A major cause of recurring indigestion is acid reflux, or gastro-oesophageal reflux disease (GORD), which is caused by the sphincter in the oesophagus failing to close and prevent

large amounts of stomach contents, including acid, moving back up from the stomach and causing irritation and inflammation in the oesophagus. The inside of the oesophagus has a protective lining but it can become irritated and inflamed by stomach acid. If the lining becomes ulcerated by the stomach acid, it causes a condition called oesophagitis. Sometimes stomach acid can escape back up from the stomach to the oesophagus due to gastric and duodenal ulcers (known collectively as peptic ulcers), which are sores which develop in the lining of the stomach or duodenum. Peptic ulcers can be caused by a bacterial infection called Helicobacter pylori.

Another cause of GORD is hiatus hernia – where part of the stomach pushes up through the diaphragm (the sheet of muscle between the abdomen and the chest, needed for breathing), partially blocking refluxed stomach acid in the oesophagus. Being overweight or obese (including weight gain due to pregnancy) will make it more likely you’ll suffer from acid reflux – obesity causes more pressure in the abdomen which forces acid back up into the gullet. This is also true if you are constipated or wearing clothes with a tight waistband. Chemicals in cigarette smoke can also relax the ring of muscle that divides the stomach from the oesophagus and make it easier for stomach acid to escape back into the gullet, causing acid reflux/heartburn symptoms. Stress and anxiety are also believed to play a part in indigestion, as is increasing age.

If you have some of the ‘alarm bell’ symptoms described below you should be considered for urgent endoscopy referral rather than taking any prolonged treatments which may mask the symptoms of a more serious illness.

Reasons for an urgent referral

NICE advises that:

  • people with an upper abdominal mass require urgent referral for endoscopic investigation (an appointment within two weeks) [National Collaborating Centre for Cancer, 2015].
  • urgent direct access upper gastrointestinal endoscopy should be performed within two weeks to assess for stomach cancer in people with dysphagia (swallowing problems) or aged 55 and over with weight loss and any of the following: upper abdominal pain, reflux, dyspepsia.
  • referral for non-urgent direct access upper gastrointestinal endoscopy should be considered to assess for stomach cancer in people with haematemesis (vomiting blood) and in people aged 55 or over with treatment-resistant dyspepsia, upper abdominal pain with low haemoglobin levels, or raised platelet count with any of the following: nausea, vomiting, weight loss, reflux, dyspepsia, upper abdominal pain; or nausea or vomiting with any of the following: weight loss, reflux, dyspepsia, upper abdominal pain [National Collaborating Centre for Cancer, 2015].

If you’re struggling with indigestion don’t panic, but don’t let it ruin your life. If you have any doubts at all about whether your indigestion might be something more serious, visit your doctor and tell them ALL the symptoms.

What’s Up With Your Gut is available now as paperback and ebook.

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CFS/ME – Vicious circles and multitasking

As co-admin of Dr Myhill’s Facebook groups, I often see members asking what the single most important intervention in a person’s recovery from CFS/ME has been. I totally understand the reasoning behind this question – having limited funds where should attention be directed first to achieve the best results? Where does one find the most bang for one’s buck!

Dr Myhill instinctively takes this approach too, preferring her patients to do the ‘easy’ cheaper things first because these interventions are often enough on their own to elicit recovery. So, correcting sleep, doing the right diet and taking nutritional supplements are right at the top of the list. This is laid out in her CFS/ME checklist.

However, for some this is not enough and it is then that we must face the complexity of our intricate biological system with its many feedback loops and synergistic effects.

I am a mathematician and so the assumption is that I like linear arguments progressing from one irrefutable logic step to another, and so on, until we arrive at the ‘answer’! In my case, nothing could be further from the truth. For example, when first introduced to James Watt’s centrifugal governor, I was fascinated. This governor is essentially a continuous feedback system that controls the rate of a steam engine so as to maintain a near-constant speed, irrespective of the load or fuel-supply conditions. The constant speed of the engine achieved in this way is the mechanical equivalent of a well-functioning biological system. I enjoyed learning about these feedback systems but never had a chance to study the many biological examples because aged 12, I chose Latin and Ancient Greek over Biology for my school options.

However, life, and more specifically CFS, has forced me to become more acquainted with these biological systems because I am one of those for whom the ‘easy’ cheaper things have not fully worked.

As laid out in much more detail in Dr Myhill’s upcoming and fully revised book, Diagnosing and Treating CFS/ME – It’s mitochondria, not hypochondria and in Sustainable Medicine, there are many vicious circles in CFS/ME and these make the recovery process so much harder.

For example, if mitochondria go slow then the heart, being a muscle and so dependent on good mitochondrial function, will also go slow. The heart delivers fuel and oxygen to all cells in the body and so, if fuel and oxygen delivery is impaired then this too further impairs mitochondrial function. This can be seen below:

cfs-myhill-mitonchondria-vicious-circle

As further illustration, magnesium is of central importance for mitochondria. Having low levels of magnesium inside cells and mitochondria is a symptom of CFS but also a cause of it. This is because 40 per cent of resting energy simply powers the ion pumps for sodium/ potassium (Na/K) and calcium/magnesium (Ca/Mg) across cell membranes. When energy supply is diminished, as in mitochondrial dysfunction, there is insufficient energy to fire these pumps, and so magnesium cannot be drawn into the cells for oxidative phosphorylation to work. If there is insufficient energy to drag magnesium into cells, then there is a further diminishing of energy delivery, because of the lack of magnesium, and hence we have another vicious circle.

But all is not lost! We have at least two things in our favour – we now understand these vicious circles, and so can ‘break’ them, and many of the nutritional interventions we use can ‘multi-task’.

So, considering the two examples above, we can ‘break’ those vicious circles and so restore mitochondrial function by using Dr Myhill’s standard mitochondrial package of supplements, and by supplementing with magnesium we can further support the ion pump:

  • Coenzyme Q10 as ubiquinol – 200 milligrams
  • Vitamin B3 as niacinamide – 500-1500 milligrams – slow release
  • Acetyl-L-carnitine – 1-2 grams
  • D-ribose – up to15 grams
  • Vitamin B12 – 5 milligrams sublingually or ideally B12 by injection
  • Magnesium – ½ ml 50% magnesium sulphate, ideally, or 300mg orally

So, what of this multi-tasking then? Many interventions multi-task. High-dose vitamin B12 may be used to improve mitochondrial function, for detoxing via the methylation cycle, as an antioxidant and for its anti-inflammatory properties by damping down the pro-inflammatory fire of the NO/ON/OO cycle. This makes correcting multiple co-existent problems that much ‘easier’!

And then we have a ‘lovely’ example which I came to learn through both my own experience and also very many questions on Dr Myhill’s Facebook groups, essentially asking the same thing:

Why is it that when I have a sudden energy dip, I also feel weepy and emotionally fragile, weepy beyond what I would expect to feel?

Well, here is one way of looking at it – ATP is not only the energy molecule but also a neurotransmitter – to be precise, a co-transmitter. Other neurotransmitters, such as serotonin, dopamine, GABA and acetylcholine, will not work unless they are accompanied by a molecule of ATP. So, if ATP levels fall precipitously low, then one feels dreadfully fatigued [ATP as the energy molecule] and simultaneously one feels very low emotionally [ATP as co-transmitter]. To mitigate this ‘double whammy’ effect, I carry a bottle of water with D-Ribose dissolved in it and this works as a great ‘rescue remedy’ for when I experience these sudden ATP dips.

So, I suppose what I am saying is that CFS/ME sufferers should try the ‘easy’ things first but that if these don’t work out for you, then don’t despair. We know the circles that must be broken and we have some great helpers, like Vitamin B12 and D-Ribose, which can multi-task and solve more than one problem at once! Never ever give up!

Craig Robinson first met Sarah in 2001, as a patient for the treatment of his CFS, and since then they have developed a professional working relationship, where he helps with the maintenance of www.drmyhill.co.uk, the moderating of Dr Myhill’s Facebook groups and other ad hoc projects, as well as with the editing and writing of her books.

A fully revised and expanded 2nd Edition of Dr Myhill’s book Diagnosis and Treatment of Chronic Fatigue Syndrome: it’s mitochondria, not hypochondria will be published in January 2017.