17/Nov/2020

5 Tips for Boosting Productivity During PMS

Breast tenderness, bloating, and cramps make functioning at work difficult enough. Throw in cravings, low energy, mental fog, and mood swings, and you’ve got the recipe for feeling like an unproductive sludge. If you’re reading this right now, and you happen to be a female who menstruates/has previously menstruated, you know exactly what I’m talking about. Most of us have experienced these episodes before yet, know exactly how it can affect daily motivation. If this sounds like you, stay on with me as we uncover how to boost productivity during PMS. First, let’s talk about what PMS is and then some at-home remedies you can do to improve your productivity (especially during that week before your flow).

What is PMS:

Premenstrual syndrome, experienced by most women of reproductive age, has symptoms of irritability, mood swings, weight gain, water retention, breast tenderness, bloating, cravings, difficulty sleeping, and fatigue. Discomfort is characterized during the luteal phase (second half of the cycle. How (and how long) women experience PMS varies where some may have a few symptoms for a couple of days before their period to others who have increased discomfort that substantially affects their daily lives.

What is PMDD

Some women experience significant physical, mental, and emotional distress in the last few days to weeks before their period, known as Premenstrual Dysmorphic Disorder. Symptoms consist of marked depression, low mood, anxiety, tension or feeling on edge, moodiness, tearfulness, irritability, easily fatigued, low interested in usual activities, distinct changes in appetite and sleep patterns.

PMS (and/or) PMDD kick in during the luteal stage; some women may even experience symptoms or discomfort as early as 2 weeks before their expected periods. Mood swings, irritability, bloating, and fatigue can really derail the productivity train if a significant chunk of the month is spent feeling moody and unmotivated. Over my years in practice working with women with PMS and PMDD I discovered that rather than working against the symptoms, it’s easier to recognize the patterns of PMS and take steps to prevent life from drowning in symptoms. Here are my top 5 tips for improving motivation and productivity during PMS.

5 tips to reducing symptoms + improve productivity during the luteal days

EXERCISE! – Move that awesome, strong body of yours, girl! If you’re new to physical activity, or lack motivation, start with a 5 min walk break. Move around the room if you have to, get that blood flowing! Consistent aerobic exercise 3 times a week for 8 weeks reduces the severity of the physical symptoms of PMS. If aerobic exercise isn’t always your jam, yoga for 40 min a day 3 times a week for a month is another effective strategy to reduce symptoms of PMS.
CUT THE SUGARS: Specifically, maltose. A recent study suggests that increased consumption of maltose (formed when two glucose molecules come together) is associated with the risk of developing PMS. Maltose is naturally produced in plants and seeds but high amounts can be found in bread, cereals, burgers, pizzas, pies, and more. Sweet potato also has maltose but one can argue that the nutritional benefits of a sweet potato outweigh its risk. Another study found that western diet patterns consisting of processed fast foods and soft drinks were associated with PMS compared to diets that had more nuts, fruits, and low processed foods did.
VITAMIN D: Higher doses of vitamin D significantly reduced PMS in women as well as symptoms of dysmenorrhea like backache. **Note: Always talk to your naturopath or trusted health care provider before taking high doses of vitamin D! You can read more about vitamin D and hormones in my last article here!
MINDFULNESS: Mindfulness-based practices like mediation (and yoga!) is associated with the reduction of anxiety and depression experienced by women with PMS. Try journaling your feelings, emotions, and thoughts that come up for you during your luteal phase and note if any patterns surface. Check-in with yourself daily and remember to speak to yourself kindly – you deserve it!
SCHEDULE: But make it super easy and not hectic at all! Write out your top 3 priorities (or less) to complete in the day and break your day into small chunks of uninterrupted time, remembering to take breaks (to move around!) in between. Keeping your to-do list on the lighter side can offset some of the unmotivating effects of PMS (like fatigue, low energy, and irritability). Take naps when you need them because resting is okay! Try to schedule your busiest days for the first half of your cycle where you have the energy to effortlessly tackle your tasks.

PMS is experienced by many premenopausal women and symptoms range in severity as each woman endures a unique collection of symptoms. Being a woman doesn’t require that we put our lives and productivity on hold each month; re-inventing our schedules that support our health needs, eating well and consistent exercise helps us to be a productive badass woman! Try these tips yourself and when you notice improvement, share the article with other boss women in your life!

Dr. Anousha Usman

23/Oct/2020

Women with PCOS should get their vitamin D levels checked ASAP

(What is vitamin D?) Vitamin D or cholecalciferol is the active form of vitamin D (D3) in the body. The conversion of UVB rays from the sun with a form of cholesterol in the skin, form a precursor to active D3 in the body. Cholecalciferol (active vitamin D), is formed after some changes are made to the precursor vitamin D in both the liver and kidneys.

Vitamin D has many functions in the body; commonly known for its immune-supporting properties and ability to balance calcium in the blood (contributing to bone health), vitamin D levels have also been linked to women’s health and PCOS outcomes.

How does vitamin D levels in the body affect PCOS outcomes?

The short story is, the hormonal imbalances in PCOS contribute to the development of a lot of inflammation and oxidative stress in the body. Vitamin D helps to decrease this inflammation with its anti-oxidant effects.

A study demonstrated that, when compared to controls, women with PCOS had lower serum vitamin D. Lower levels of vitamin D are associated with higher HOMA-IR (a marker that denotes insulin resistance in the body), and less favourable lipid levels in the blood. Women with both PCOS and who were deficient in vitamin D are more likely to have glucose dysregulation, increased levels of fasting blood sugar, thus, poor insulin resistance outcomes.

Another study found that supplementing vitamin D in women with PCOS, improved their hs-CRP (a marker for inflammation) and TAC (total antioxidant capacity).

Supplementing with vitamin D can improve insulin sensitivity, antioxidant capacity, and decrease inflammation, in women with hormonal imbalance and polycystic ovarian syndrome.

Women with PCOS should get their vitamin D tested ASAP!

Now especially, as we head into the winter months, there is a lot less sun exposure (in the northern hemisphere) with the days becoming shorter. Individuals with high pigmentation in their skin produce less vitamin D and are prone to have decreased serum levels especially in the winter months. Women with PCOS, particularly those who live in climates with less sun exposure, should have their levels tested as soon as possible in the upcoming season. Knowing their patient’s serum levels helps the clinician adequately dose vitamin D such that a woman with PCOS may benefit from improved blood sugar control, less inflammation, and improved immune health.

Special considerations: A note on the dangers of overdosing:

Yes, it is totally possible to overdose on vitamin D. It is a fat-soluble hormone: it is stored in the body’s fat cells. (Unlike B-vitamins which are water-soluble and produce the most vibrant pee, one ever did see). Vitamin D toxicity (hypervitaminosis): the presence of vitamin D in serum is to increase the levels of calcium in the blood. Increased levels of vitamin D can lead to higher amounts of blood calcium which may cause symptoms of nausea, vomiting, urination, and weakness. It may also lead to kidney problems. This is usually rare but can be caused by significantly increased supplementation.

For the women who come see me in my practice, I run tests to assess their serum vitamin D levels prior to supplementing with higher doses (often when doing vitamin D injections). Knowing your levels is crucial in creating a treatment plan to replenish your stores, reduce your symptoms of PCOS, and improve your body’s insulin response.

Are vitamin D injections may be right for you? Book a virtual discovery session with me today!

Dr. Anousha Usman

17/Jun/2020

You’ve just been (or about to be) diagnosed with PCOS for your irregular periods, now what?

Why is lab work important in understanding the progression and underlying causes of PCOS and its symptoms?

Treating symptoms alone is a band-aid solution to correcting a problem. Treating symptoms without the necessary investigation is like blindly applying a band-aid to a boo-boo and hoping you get it in the right spot. Why would you do that?

Likewise, why blindly put a band-aid on your health? I see a lot of women in my practice who either have a PCOS diagnosis or symptoms of PCOS, with very basic or little to no investigative lab work. These ladies have irregular cycles, intense carb cravings, a mighty hard time to lose weight, hair loss, and acne, and a whole lot of feeling pretty low about their appearance, health, and self-esteem.

Though these signs can be a flaming red sign pointing to PCOS, there are other root causes worth exploring. Why? PCOS is more than just irregular periods; insulin, thyroid hormones, and inflammation all contribute to the pattern of symptoms present.

As a naturopathic doctor, I encourage the awesome ladies I treat in my practice to consider a COMPLETE hormone investigation. This takes out the guesswork in piecing together which hormones are triggering your PCOS symptoms (i.e.: is it adrenal or insulin triggered?) while also giving us a baseline to build their specific treatment plans on.

Here is a snippet of the hormone-related labs I like to run in my patients.

HbA1C: Marker for measuring how your blood sugar has been in the past 3 months. HbA1C value between 6.0%-6.4% indicates pre-diabetes. How well your body is at processing blood sugar reveals the risk of developing/already having insulin resistance; a key player in the worsening of PCOS symptoms, weight gain, and inflammation.
SHGB: Sex Hormone Binding Globulin (try saying that 10 times fast!) Produced in the liver, SHBG has a high binding affinity for DHT (the hormone that causes male-type symptoms) and Testosterone. SHBG is like a sponge soaking up all that excess testosterone, keeping it from floating around in the blood.
Androstenedione: Produced by the ovaries and adrenal glands, this steroid hormone marker is overproduced by the ovaries in PCOS.
DHT: Dihydrotestosterone is produced by the conversion of testosterone by 5-a-reductase (an enzyme). DHT binds much strongly to testosterone receptors, and high levels have been attributed to male pattern balding in men and women.
Ferritin: The storage form of iron. Some symptoms of low iron include fatigue, low mood, feeling cold, weakness, and hair loss*.
TSH: Thyroid Stimulating Hormone acts on the thyroid gland to tell it to produce thyroid hormones (T3 and T4). We Measure TSH, T3 and T4 to rule out thyroid issues that may be contributing to irregular periods, hair loss, weight gain (i.e. hypothyroidism can present with hair loss, weight gain, irregular menstrual cycles, coldness, fatigue).

Notice how many PCOS symptoms are also present in other conditions or are affected by several hormones? Testing estrogen, LH, and FSH aren’t enough to help us understand the full hormonal picture. Yes, the symptoms look a heck of a lot like PCOS and you may even have a polycystic ovarian syndrome diagnosis, but until we understand the root cause and other hormonal and organ involvements, management and treatments are just a shot in the dark or conventional birth control pills.

Think you have PCOS and want to know how your specific hormonal pattern is affecting your periods? Connect with me here and let’s talk about finally improving your hormones so you can finally have a happy period!

Dr. Anousha Usman

08/Jun/2020

What do acne, facial hair, erratic periods, and a cotton candy burrito have in common? Insulin resistance.

Wait, isn’t insulin that sugar-thing in diabetes?

Affirmative, insulin resistance is often a precursor to developing type 2 diabetes, its presence is also marked in PCOS. That sugar-thing in diabetes affects the progression of symptoms in women with polycystic ovarian syndrome. Foods like cotton candy burritos (and other desserts, treats, and carnival foods) burden the body’s ability to process all that sugar in a way that’s usable (and healthy).

Why you should care about insulin resistance.

Let’s start with, what the heck is insulin anyway and what does it have to do with my period? Insulin is a fat-storage hormone that is released in the presence of glucose (sugar) in the blood. Every time we eat something with glucose, the sugar goes from our gut to our bloodstream and insulin is released. Insulin has the great task of escorting that sugar molecule to a cell, where the cell responds by taking in the glucose and using it to make energy. Insulin resistance occurs when there is an abundant amount of insulin (to make up for the abundance of sugar intake) in the bloodstream trying to get cells to take in more sugar. Cells are smart, they don’t take on more sugar than they need; they resist when insulin comes knocking on their doors which is common in metabolic disorders, type 2 diabetes, and PCOS. So, what happens with all that excess sugar? Recall that insulin is a fat-storage hormone, adipose cells (fat cells) are ever-welcoming to insulin with an open-door policy for sugar.

How does all that insulin affect my period?

Excess insulin floating around acts on the cells of the ovaries leading to the release of immature egg cells resulting in anovulation (i.e. no ovulation=no release of an egg). Excess insulin also affects the ovarian cells to produce more androgens which contribute to the development of hirsutism, hair loss on the head, and acne. This is distressing to women who battle not only the discomfort of irregular, unpredictable periods, but also the added stress of acne reminiscent of her puberty days. Hyperinsulinemia amplifies inflammation in women with PCOS and this has a significant impact on women’s menstrual health; periods might be heavier, occur more/or/less often, or last longer.

Does everyone with PCOS have diabetes?

While not every woman diagnosed with PCOS has diabetes, it is estimated that up to 58% have insulin resistance and up to 10% have impaired glucose tolerance. Women with PCOS have an increased conversion rate of impaired glucose tolerance to type 2 diabetes.

“I think I may have PCOS, what are the first steps I should take?”

Step 1 is to monitor your symptoms- make note of the appearance of acne, increased amount or thickness of facial hair growth, are you losing more hair in the shower? How are your cycles? Are they showing up on time (every month or so) or are they slightly unpredictable? Symptoms and their frequency and severity are the way the body tells us if something is wrong. Take a good, hard, honest look at your diet: where are the sugars creeping in? Sugars are sneaky, they hide in breakfast cereals, granola bars, processed foods, even yogurt with fruit at the bottom! Awareness is the first step to wellness. It’s the key to understanding your body’s messages (symptoms) about the triggers (eg: food).

Reach out to a naturopathic doctor or GP for blood work to investigate hormone imbalance, insulin resistance, diabetes, or other underlying condition that may be contributing to your acne, hair growth, or variable periods. Understand the root cause of your symptoms is beneficial for two reasons: 1) You have actual lab values to monitor of what the heck your hormones are up to; 2) A naturopathic doctor or other health care professional can use this information to create a specific treatment plan for you based on your labs AND symptoms (AND goals).

PCOS is a common hormone condition that women have a unique degree of symptoms but it all boils down to inflammation, insulin resistance, and sex hormones. You don’t have to suffer in silence anymore, there’s a reason for your unwanted hair growth, acne, and erratic periods. Awareness is the first step to wellness!

Ready to get started and you don’t want to follow these steps alone? I am happy to help you untangle this maze of hormones so that you can get back to being your awesome, confident, self! Click here to book an appointment today!

*Appointments available for Ontario residents only. Out of province or country? No problem, contact me here and we can help you find a naturopath in your area!

Dr. Anousha Usman

02/Apr/2020

These are unprecedented times. Whether you’re working from home or just plain-stuck-in-the-house, the isolation can make it tempting to slip into unhealthy habits. Being cooped up inside all day really does test one’s sanity, as time becomes a blurry concept. What day is it?

Since we’re all home anyway, why not use this time to get a start on your health goals that were put off BC (before COVID).

📢Introducing The Social Distancing Detox: A hands-on, start-right-away detox for the mind, body, and soul.

Let’s break it down:

Detox For The Mind: Given that most of us are forced to slow down, we may be experiencing a heightened sense of discomfort and uncertainty. Feelings of low mood, or just a case of the blahs are pretty common right now. We haven’t yet found a routine that works for us to keep us motivated and stimulated.

What you can do right now to detox a cluttered mind:

Read! Pick up that book you’ve been promising yourself you’d finish for months. Dedicate an hour of your day to just reading for fun!
Connect with friends and loved ones and do fun things (virtually)! Have a virtual games night! Some of my favourite games apps are Jackbox.tv and House Party App. (Let me know in the comments what your favourite virtual games apps are!)

Detox Your Body: Okay it’s been about 2 weeks, this is a PSA: hun, it’s time to get off the couch! Being home all day makes it easy and tempting to just grow roots in whatever chair or bed you spend most of your time in. Don’t do it! Side effects of moving your body include: feeling energized, motivated, and accomplished. While you’re at it, why not put that bowl of chips into its own isolation for a while.

What you can do right now to detox a cluttered body:

Exercise! (How surprised were you that this was the first tip?) Go for a walk, get some sunshine! Work out! You don’t need a gym to get your sweat on: stand up and do some jumping jacks! Drop and give me 20! How about 10 burpees? Full disclosure: I’ve started working out on the driveway. Pretty sure all my neighbours can see me struggling through my push-ups, but whatever! Exercise + sunshine? Winning combo!
Socially distance yourself from junk food (lol). All hope is not lost and we’ll be able to be out in society again. Continue eating healthy as to not feel the sluggishness. A clean diet doesn’t have to be fancy, why not try switching your commute-to-work-pastry with a fresh piece of fruit in the morning? Delicious!

Detox Your Space: Time to Mary Kondo and spring clean! Out with the winter baggage, all the stuff that’s cluttering up your space (and also your mind), in with the tidying up! If we’re gonna be cooped up all day, might as well have a nice space right?

What you can do right now to detox your space:

Clean/organize your space! Try starting with one small project and dedicate half an hour a day just to organizing that space, and then another space, and then another, and then… Woah! It’s like a whole new room!
Add some comforting additions like pants to the areas you spend much of your time in. Enjoy the nature indoors

There you have it! Quick and easy tips for detoxing while social distancing! If you liked this article, share it with 2 of your friends who are at home feeling the cabin fever too! We’re all in this together!

Stay healthy, stay safe!

I compiled a short list on how you can stay motivated and energized during these times.

Dr. Anousha Usman

12/Feb/2020

Hair loss.

Pain points

Losing hair. Shedding a lot
Can see bald spots
No one is taking hair loss seriously
Bad hair days. Low self-esteem

Causes:

PCOS: androgenic alopecia.
Autoimmune: alopecia areata
Hypothyroid
Nutrient-related
Tension alopecia traction alopecia
Telogen effluvium
Side effects of medications like the pill

Conventional therapies

Rogaine/minoxidil
Transplant
PRP
Drugs
Birth Control

Other therapies (that are currently being explored)

Acupuncture
Essential oils like rosemary (find research if it helps)
Topical melatonin
Correcting nutritional deficiencies!
Herbs that correct the imbalance of hormones
Scalp massage: to improve blood flow and decrease inflammation

Hair loss is a distressing symptom of a deeper imbalance in the body and is one of the symptoms that present in women with PCOS.

Hormonal dysregulation in PCOS presents with an increased amount of testosterone and androgens in the blood Which clinically manifests as acne, hirsutism (the growth of darker, more coarse hair on the chin, neck, and maybe cheeks), and alopecia.

Androgenic alopecia or female pattern hair loss (FPHL) is often experienced by women who have PCOS, but also by women who have a genetic sensitivity to testosterone and DHT (the more potent product of testosterone metabolism).

Understanding Hair loss Causes

Female pattern: alopecia in women is seen as the loss of occipital hair and thinning on the vertex/crown area of the head. Often the thicker terminal hairs fall out and are replaced by thinner, lighter, and sparser vellus hairs. Unlike men who suffer from androgenic alopecia, women retain their frontal hairline. A current understanding of the mechanism of action for this pattern of hair loss, especially in men, is that the circulating testosterone gets converted to DHT by an enzyme called 5-a-reductase; DHT then acts on the hair follicles to minimize them. Research now suggests this is only part of the problem, as there is inflammation in the scalp about the follicles that also contributes to miniaturization.

Alopecia Areata: present in both sexes, this type of hair loss presents as patchy spots of loss over the scalp. It is often worsened or triggered by stress, and some of my patients have also reported a tingling feeling in the scalp right before they notice the hair fall. This is an autoimmune type of hair loss.
Hypothyroid hair loss: diffuse hair loss or hair that is dry, brittle, and breaks easily is a common symptom in those who also have an underactive thyroid.
Nutrient deficiencies: Iron-deficiency (more common in menstruating women), presents with diffuse hair loss and low energy. Low levels of zinc, vitamin B1, biotin have also been linked to hair fall, while vitamin A toxicity can also contribute to alopecia.
Tension or Traction alopecia: Tight ponytails, buns or updos pull on the root of the hair and subsequently lead to hair fall. This type of hair loss is usually noticed in the frontal hairline (where ever the hair is pulled the tightest).
Telogen Effluvium: A non-inflammatory (and non-scarring) form of hair loss that occurs after an event (usually due to medications). This alopecia alters the growth cycle of hair, where the hair remains in the resting phase for longer periods of time. Hair shedding is noticed after medications like chemotherapy and generally begins to grow back after 2 months.
Side effects of medications: Specifically, the birth control pills. Some BCPs are made with progestins (synthetic, almost-progesterone, which binds to progesterone receptors), that are more androgenic. Progestins such as Methyltestosterone, Gestodene, Levonorgestrel, -Norgestrel, and Desogestrel, contribute to the worsening of androgenic activity like hair loss, hirsutism, and acne.

Conventional Therapies

Medications are used to treat the underlying root cause of hair loss. In patients suffering from hypothyroidism, treatments involve medications such as levothyroxine to replace thyroid hormones not produced by the gland. Hair transplants are available for moderate to severe hair loss patients.

Topical conventional treatments include Rogaine (minoxidil), that can be purchased at the pharmacy and applied to the scalp twice a day. A reported side effect is increased hair growth on the face.

Women with androgenic alopecia (with or without PCOS), are often prescribed a mix of birth control pills (with the least androgenic activity) along with spironolactone. Drugs that block the activity of 5-a-reductase are used to decrease the conversion of testosterone to its more potent form, DHT. Commitment to conventional medications is often life-long, once stopped, the hair fall returns.

Other therapies like PRP, protein-rich plasma, are cosmetic procedures that aim to stop hair shedding by decreasing inflammation in the scalp and stimulating new hair growth.

Alternative Therapies

Acupuncture: Done locally in the scalp, acupuncture causes a micro-trauma which stimulates blood flow to the area. Increased blood flow brings nutrients for the follicles, and may stimulate new hair growth while also decreasing local inflammation.
Topical essential oils: Rosemary essential oil also may support new hair growth by improving circulation to the scalp.
Topical Melatonin: Research suggests that a 0.1% melatonin solution applied nightly to the scalp improves hair growth in the occipital area of the scalp. It is suggested that melatonin may also act as an anti-inflammatory in the area. The same research finds that applying melatonin to the scalp did not affect blood concentration levels.
Correcting nutritional deficiencies: while low levels of biotin are typically seen in rare genetic conditions, it is also present in patients taking medications for epilepsy, in those who consume large amounts of alcohol (also causes vitamin B1 deficiency), and smokers. Iron deficiency is common amongst menstruating women; while the range for “normal” ferritin levels is great, as a naturopathic doctor I like to see serum ferritin greater than 70 ng/mL.
Herbs that may improve hair growth include those that support the elimination of excess testosterone and DHT from the body and others that block the conversion of testosterone to DHT. These include reishi, saw palmetto, nettle, licorice. Other herbs that support the production of estrogen and progesterone, like vitex and white peony may also help correct the hormonal imbalance in some women.
Scalp massage stimulates blood flow to the hair follicles. Massage may also decrease inflammation. While more research needs to be conducted into the exact techniques, when and how often, massaging one’s scalp can relax the mind and decrease stress – win!

Female pattern hair loss (FPHL)/androgenic alopecia is a distressing symptom of hormonal imbalance and PCOS. FPHL may even trigger psychological symptoms of low mood and depression. In fact, hair shedding is often overlooked by many professionals as a reaction to stress or a short-term change in diet and lifestyle habits. Some women may not even notice that hair loss has occurred until at least 25% has fallen/not grown back. In my practice I focus on uncovering the root cause of hair fall, be it thyroid-related, hormonal, or even autoimmune; no one-size-fits-all approach is going to stimulate every patient’s hair growth. This process may take longer for some, but treating the appropriate root cause is worth it.

Note from Dr. Usman, ND

Please share this article! I personally know just how hard it is to find the right (and relevant) information out there. A lot of androgenic alopecia studies are conducted in men, and there isn’t enough evidence to support female hormonal balance and hair growth – yet. The more we talk about hair loss and natural therapies in women, the more we can support those experiencing female pattern hair loss.

If you’d like to book in with me to discuss hair shedding solutions, please click here.

Dr. Anousha Usman

28/Jan/2020

Irregular menstrual cycles are frustrating!

A young woman recounts her experience with irregular periods:

“The hardest part was knowing when it [her period] would come and understanding where the heck my emotions were at. I was tired in school and didn’t have much focus [around menstruation]; the emotional instability really rocked me..”.

Irregular, out-of-whack menstrual cycles are common in PCOS. This could look anything like periods that show up twice in a month, or once every month and a half; some periods just change it up each cycle to keep you on your toes. So much for tracking your cycles and planning out safe days to wear white jeans because the irregularity makes Aunty Flow’s next visit unpredictable.

Nearly 20% of women of reproductive age have PCOS and almost 70% of women with symptoms of PCOS remain undiagnosed in Canada. That’s a lot of women living with the discomfort and mental stigma of irregular periods, acne/hair growth, infertility. This article focuses on irregular cycles and how unpredictable menstruation affects the lives of SO MANY WOMEN.

Uncovering the cause of irregular periods

PCOS: Polycystic ovarian syndrome is the amalgam of an imbalance of hormones, also known as an endocrinopathy (fancy word for, an issue with the endocrine – hormone – system). We know that PCOS presents with irregular periods and increases the risk of developing type 2 diabetes, metabolic syndrome, and cardiovascular issues. The natural cycle of hormones stimulates ovulation which contributes to the balance of estrogen and progesterone with which (if no fertilization) brings about a period. In PCOS, this delicate cycle is thrown off contributing to the lack of regular menstruation.
Stress is another factor that affects the cycle of hormones (mentioned above). If your body is under extreme or chronic stress, it wants to survive first. The body uses any and all of its resources to make sure you’re safe and sound. I.e. the body takes resources away from your digestion and reproductive organs, ultimately affecting your cycles.
Thyroid dysfunction causes a variety of menstrual-related problems as abnormal levels of thyroid hormones affect the release and amount of sex hormones available to bind and act on the body.
Weight: Extreme weight changes disrupt the balance of hormones. Crash diets, malnutrition, anorexia can all lead to irregular periods or amenorrhea (no period). Obese women also demonstrate abnormal hormone profiles; in obese women with PCOS (or at risk of PCOS) tend to carry extra fat around the waist and abdomen rather than the hips.

Do I have PCOS?

While irregular cycles (short: less than 21 days or longer: more than 35 days between periods) are one symptom of PCOS, menstrual irregularities are also present in thyroid dysfunction, periods of stress, and extreme changes in weight or diet. Speak to your doctor/naturopathic doctor about further testing to confirm a diagnosis of PCOS.

Management

Treatment for regulating periods always start with diet and lifestyle interventions. If PCOS is the likely cause, cutting out sugar and increasing exercise (more HIIT training!) are my favourite places to start. The less sugar a woman is consuming, the less her insulin levels will spike and the less fat she will store on her body. This is especially important for obese women. If I suspect an underlying thyroid dysfunction, after a thorough investigation, I’ll recommend specific herbs and supplements to help support natural thyroid hormone balance.

Some of my favourite herbs for treating irregular periods:

Vitex: Also known as Chasteberry, acts on the hypothalamus-pituitary system by slightly elevating LH and decreasing FSH in favour of producing more progesterone.

Black Cohosh: Traditionally used for treating menopause symptoms and painful periods, this herb is estrogenic and helps balance hormones to support menstrual regularity.

Rhodiola: A herb that helps the body deal with stress effectively.

Dong Quai, Alfalfa, Flaxseed, Licorice: which all help to balance hormones

Our young woman with the irregular cycles on her menstrual experiences after making dietary and lifestyle adjustments:

“Having regular periods helps me have regular emotions and I can plan out my outfits”

If these symptoms sound like you, or someone you know, book in an appointment with me to uncover the root cause of your irregular cycles and how naturopathic medicine can support your hormones and regulate your periods. Life is unpredictable, periods shouldn’t have to be!

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Dr. Anousha Usman

20/Jan/2020

Improving pregnancy outcomes for expecting mothers

Pregnancy is a major life event for nearly all women. What a woman puts into her body before, or during this time can greatly impact both hers and the health of her fetus. Whether meticulously planned or otherwise, there is a ton of information out there for maternal health during pregnancy and sifting through all that information can easily become overwhelming and stressful.

Why is it important to prepare for pregnancy anyway?

Pregnancy, birth outcomes, and the future health of the child are all impacted by the mother’s mental/emotional and physical health both before and during gestation. If the expectant mother has underlying health conditions such as diabetes, thyroid disorders, or blood pressure issues, or even being older than 40 at the time of pregnancy, she may be monitored and treated as a high-risk pregnancy. High-risk pregnancies require more diligent care from health providers, physicians, and naturopathic doctors.

This post breaks down the prenatal vitamin and the purpose each nutrient serves for both baby and mama.

When to start taking a prenatal:

As soon as you find out your pregnant, but even starting a couple of months before you are planning to conceive all the way up to the postpartum period is encouraged. Ontario standards of practice for perinatal care advise women to take a folic acid supplement (or in their multi) prior to conception.

Vitamins:

Vitamin A

Required for the healthy development of vertebrae, spinal cord, limbs, heart, eyes, ears, and regulating the health of genes. Be careful though; vitamin A in doses of 10,000IU or more it can be toxic to the developing fetus (especially in the first trimester), causing malformations and defects in the heart and genitourinary systems. Better to stick with B-carotene.

Vitamin B

Also known as pyridoxine, helps with nausea and vomiting experienced by the mother during the first trimester of pregnancy.

B12

This vitamin comes in a few forms, methylcobalamin, hydroxycobalamin, and cyanocobalamin. Methylcobalamin is used by individuals who have impaired methylation while cyanocobalamin breaks down to cyanide and cobalamin in the body. Naturopaths and health-care providers prefer the first two forms of vitamin B12 when supplementing their patients, which helps with nausea/vomiting and low energy.

Vitamin C

Ascorbic acid supplementation may help prevent the rupturing of membranes by stimulating collagen synthesis. Vitamin C is also associated with a lessened risk of pre-eclampsia (a disorder of pregnancy, associated with marked high blood pressure and increased protein in the urine).

Vitamin D3

Deficiency is associated with low birth weight and pre-term birth, as well as a higher risk of developing MS or diabetes later on in life. Vitamin D is important for the development of a healthy immune system and lungs in utero. When expectant mothers increased their intake of D3, a decreased risk of asthma in 40% of children between the ages of 3 and 5 was observed. Vitamin D3 is important for bones and teeth development. Recommended dose: 400-1000 IU daily.

Vitamin E

Vitamin E does thin the blood, so your naturopathic doctor or MD will note to monitor the dose. This vitamin helps with the formation of cells and is used as an antioxidant.

Vitamin K

Important for making the components that develop into blood clots.

Zinc

Decreases risk of low birth weight (especially in malnourished women). Zinc important for protein synthesis and nucleic acid metabolism, and RNA. This nutrient may prevent congenital malformations. Recommended dose: 10-25mg/day.

Iodine

Expecting mothers require more to meet the demands of fetal needs. Maternal thyroid hormone decreases slightly during the first trimester to meet the needs of the fetal thyroid hormone and to make up for the increased excretion. Too much or too little iodine may contribute to the development of congenital hypothyroidism.

Calcium

Important for the development of the skeleton, tissues, and hormones. Usually given up to 1000 mg daily.

Magnesium

Magnesium is required for building body tissues and preventing the uterus from contracting prematurely. 500 mg daily.

Iron

Iron is imperative for hemoglobin production and is sourced from our diets (red meats and plant sources such as dark green leafy vegetables. Hemoglobin carries oxygen in the blood for all of the tissues in the body throughout life. The growing fetus accumulates iron from their mother, who then experiences a decrease in her own iron stores. Iron-deficiency anemia is pretty common in pregnancy for this reason and these women may have a desire to chew on ice. Ferrous fumarate is a form of iron that is commonly used in over-the-counter prenatal vitamins however, it is not very well tolerated by the GI system. Some iron supplements like ferrous fumarate and succinate tend to also cause or worsen constipation. The most bio-available form of iron is iron glycinate.

Speak to your naturopath about how much iron is right for you.

Omegas and Essential Fatty Acids

DHA (an essential fatty acid) is important for the development of the brain and nervous tissue which is most significant from the 3^rd trimester to the first 3 months of breastfeeding and early childhood.

Working with the naturopath:

Pregnancy is an exciting and overwhelming time for most women so choosing the right prenatal vitamin shouldn’t be. While there are a lot of options out there, I focus on selecting vitamins that specifically provide therapeutic doses to best support the health of mama and baby throughout all stages of pregnancy. (Not all vitamins are created equal and it’s important to keep in mind that some may cause more harm than good).

As a naturopathic doctor, I always ensure that my patients are up to date and aware of which vitamins and supplements they should (or should not) be on, what lifestyle factors and other wellness habits can improve their health outcomes, and any other naturopathic modalities might best support them.

If you found this article informative chances are it’ll resonate with someone else too! So please share it with your friends and family, and comment below what other topics you’d love to learn more about!

Dr. Anousha Usman

14/Nov/2019

Anxiety is characterized as a state of hyperarousal. present in other anxiety-type disorders such as generalized anxiety disorder, mania or bipolar disorder, personality disorders, PTSD, or phobias to name a few. Emotional symptoms of anxiety include nervousness, irritability, dream, insomnia or trouble sleeping, easily startled/distracted and difficulty in concentrating. Physical symptoms of anxiety are often overlooked; these include muscle twitching, restlessness, shakiness, fatigue, muscular aches or tension.

How does your body experience anxiety?

Anxiety is the heightened response of the Autonomic nervous system; the ANS controls the heart, gastrointestinal and genitourinary systems (including sexual health and libido), and parts of the Neurologic system. It is quite possible to suffer from heart palpitations (a fluttering feeling in your chest), shortness of breath, chest pain, sweating, a sensation of choking, heartburn/nausea/vomiting, stomach aches, frequent peeing, dizziness and or headache, while experiencing anxiety or an anxious episode.

Canadians are anxious.

In 2016, nearly 4 million Canadians had been diagnosed with a mood and/or anxiety disorders

In Ontario, about 10% of the population has a mental illness and receives only about 7% of health care funds

Don’t Panic! Anxiety is manageable and treatable. Check out these tips for managing grounding and managing anxiety:

Diet

Avoiding stimulants like coffee, caffeinated drinks, stimulating drugs
Stabilize blood sugar levels. Low blood sugar can trigger feelings of anxiety. Eat a meal or small snack every 2 hours if you find that feelings of “hanger” trigger anxiety.
Removing other foods that trigger anxious feelings

Mindful Activities

4-7-8 Breathing

Inhale for 4 seconds. Pause for 7 seconds. Exhale for 8 seconds. Closing your eyes if you feel comfortable, practice this type of breathing throughout the day and during periods of anxiety and stress, starting with 3-5 cycles. Exhaling for twice as long as inhaling reminds us that no matter how much we take in, we must always let go of more.

Toe Wiggling

In a standing, seated, or laying down position. Wiggle your toes; focusing on how they feel in your shoes or socks. Are you bare foot? How do they feel rubbing against each other? By bringing your attention downwards to your feet, you are bringing attention from your thoughts and into your body.

5 Senses

Name 5 things you can SEE.

Name 4 things you can TOUCH.

Name 3 things you can HEAR.

Name 2 things you can SMELL.

Name 1 thing you can TASTE.

Supplements, Vitamins, Minerals

Dr. Usman takes extra care when it comes to your health. She may recommend specific supplements or nutrients (individualized to your treatment plan) that will help you to manage your symptoms and to improve your mood and energy. Note: any botanical, herb, supplement, or vitamin that Dr. Usman prescribes, is specific to your health needs and takes into account any medications you’re currently on or underlying health conditions. Self medicating can be dangerous; just because its natural, doesn’t always mean its safe. Consult Dr. Usman, ND, prior to trying any new supplement, herb/botanical.

Acupuncture

Dr. Usman may recommend a course of an acupuncture treatment weekly for 4-8 weeks to help improve and stabilize mood, improve energy, and lessen symptoms of anxiety.

Yes, when anxiety happens it can feel like your thoughts, emotions, and sometimes your bodily functions are running away without you. There are effective ways to manage the underlying root cause while improving the uncomfortable symptoms. If this article resonated with you and/or you think someone else may benefit from it – please do not hesitate to share this blog! The better we understand anxiety and mood disorders and how they fit in the greater scheme of wellness.

Ready to take the next step in your health journey? Get back to feeling great, book an appointment with Dr. Anousha Usman today!

Dr. Anousha Usman

19/Sep/2019

I love a good grocery store, it’s like being a kid in a candy store for me! Whenever there is a new grocery store that pops up, I go check it out and always come out with something new! Especially going to the states, where they have difference products than Canada. Would you believe me if I told you that when I travel my carryon is full of American products (I swear, it’s true)? I get pulled over to be searched, Every. Single. Time. But I do realize not everyone is like me who loves to grocery shop, so here are the grocery store hacks to make it easy!

Never shop hungry. You know what I’m talking about – it leads to buying way more than you need, and more snacking too.
Make a list before you go of the must-haves and what you are planning to prep for that week. This way you don’t over or under buy. Pro Tip – organize your list into the sections of the grocery store so you are in and out quicker.
Go early in the morning, fresher produce + less people (win-win)
Shop the perimeter of the store first. Produce and meat (the essentials) then the other stuff you may need in the isles.
Don’t be afraid of the frozen fruits + veg, it makes it more affordable to buy organic
Shop the seasonal fruits and veg, that’s what our body craves.
Read the labels! Low fat, gluten free, sugar free – this doesn’t mean healthy! Read the ingredients and make sure you understand what is listed.
Use the dirty dozen and clean 15 list to buy organic foods. It can be costly, so don’t forget about the frozen option.
BYOB – bring your own bag.

Let’s break down a general grocery list. This will give you options of proteins, vegetables, condiments, etc. but is definitely an elongated list!

Meat based proteins:

Organic chicken and turkey. If you’re craving turkey slices, go for the nitrate free
Atlantic salmon or smoke salmon
White fish, shrimp, scallops if they are looking fresh
Grass fed beef/ burgers, but not very often (1 X per week)

Dairy and eggs:

2% plain Greek yogurt
Organic eggs
Cottage cheese
Feta/ goats milk cheeses
Grass fed butter/ ghee (I love Lee’s ghee)
Almond, cashew or oat milk – all unsweetened

Fruits and veg

Avocado
Carrots
Cucumber
Tomato
Broccoli
Cauliflower
Apples
Berries
Banana
Japanese sweet potato (can also do regular sweet potato)
Spaghetti squash
Zucchini
Your choice of greens (I prefer spinach and arugula)
Onions and garlic
Ginger
Lemon/ lime

Frozen foods

Berries
Avocado (for smoothies)
Stir fried veggies of your choice (stay away from corn)
Shrimp

Grains

Wild/ brown rice
Ezekiel bread
Mary’s crackers
Nuud crackers
Chickpea/ lentil pasta

Other fridge

Hummus
Sauerkraut
Mustard
Mother Raw dressing

For more information, Consult our best naturopathic doctor in toronto now!

Dry foods

Natural nut butters
Almond flour
Whole gluten free oats
Stock
Coconut milk
Spices
Coconut oil, avocado oil, olive oil
Raw, unsalted nuts

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Hair loss.

Hair loss is a distressing symptom of a deeper imbalance in the body and is one of the symptoms that present in women with PCOS.

Hormonal dysregulation in PCOS presents with an increased amount of testosterone and androgens in the blood Which clinically manifests as acne, hirsutism (the growth of darker, more coarse hair on the chin, neck, and maybe cheeks), and alopecia.

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Conventional Therapies

Alternative Therapies

Irregular menstrual cycles are frustrating!

Improving pregnancy outcomes for expecting mothers

Why is it important to prepare for pregnancy anyway?

Vitamins:

How does your body experience anxiety?

Canadians are anxious.

Diet

Mindful Activities

Supplements, Vitamins, Minerals

Acupuncture

Meat based proteins:

Dairy and eggs:

Fruits and veg

Frozen foods

Grains

Other fridge

Dry foods

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