all posts, eczema, nutrition

do you detox? (or fast? or supplement?)

“Hello darkness my old friend”… today’s post was started during the witching hours of the night, not because of insomnia (yay, progress!) but because of Fi-somnia… aka my 4.5 month old baby, Fiona. She’s a much cuter reason to have a disturbed REM cycle.

Anyway let’s talk about the health elephant in the room: detoxing. I have heard more and more talk about various detoxification methods and I am just not sure what it all means, so today’s post is about clearing my system (pun intended) of these questions.

First off, what are the theories around detoxification? One theory I have heard for those who have eczema goes as followed: our organs (specifically the liver and kidneys) become over-taxed by our modern diets and exposure to heavy metals and other toxins, and at some point it becomes all too much and our bodies cannot flush-out said toxins, so instead, the build-up of toxins show off their toxic love by wrecking our skin.

Now going by that theory, let’s quickly delve into the soup to nuts details of how detoxification works in the body in general by addressing (very quickly) specific organs.

  • Liver: works by changing toxins into less harmful substances and/or helping the body flush out toxins
  • Kidneys: remove waste and acid build-ups from blood into our urine to be flushed out of the body
  • Intestines: helps to remove toxins via waste or vomit
  • Lymph system: transports its white blood cells throughout the body
  • Respiratory tract: the lungs remove gases from our bodies
  • Skin: (when intact) prevents some toxins from penetrating into the body

So from there, let’s address some specific detox methods I’ve heard about including the watermelon detox, the lemon detox, etc. My internet researching first led me to a review done in 2014, which reported that there wasn’t much evidence to show that detox diets actually work. It indicated that studies that said otherwise usually had flaws in their methods or too few people tested (aka small sample sizes, which is a problem because then you can’t reasonably assume the results will work for a much larger group).

I then looked more for studies, but before I talk about them, let’s backtrack and talk about studies that investigated how detoxification naturally works in the human body (and/or animal bodies). First I wanted to figure out what organs have been studied to hold toxins. A study done in 2007 on African catfish showed how the livers, kidneys, and hearts of the fish ended up storing high concentrations of heavy metals (zinc, lead, arsenite, cadmium, and copper) presumably from pollution entering the water nearby. I’m not sure if the same organs are seen to hold toxins in the case with humans, but given how often we hear livers talked about in the same sentence as detox diets, I’d venture to say yes. I then actually looked up via the CDC, about organs and toxic exposures for humans, and apparently all organs can be affected. Well then, how do our bodies avoid full spectrum toxicity?

Well, bodies have some ability to create compounds out of heavy metals, to bind them chemically to make them less dangerous to the body (which is the function of the liver, remember?), as was supported in a study in 2004 on seals, porpoises, and albatross. Generally heavy metals can end up in cells in the body: in the cell’s fluid, mitochondria, nucleus, etc (in the case of the study, they were talking about liver cells). But how specifically do bodies deal with heavy metals; or in other words, what gets the liver to start neutralizing these toxins? A study done in 2004 on mice looked at something called the metal responsive transcription factor 1 (or MTF-1)Side note: a transcription factor is a protein that helps turn on/off genes. The study’s results showed that a developing fetus that lacks Mtf1 (the gene that MTF-1 can turn on/off) will die because its liver won’t be able to form properly, but an adult that lacks Mtf1 will have difficulty handling heavy metals and will have low lymphocytes (the cells that help clear bad germs and materials out of our blood). This MTF-1 also is used to deal with when the body has hypoxia (not enough oxygen) or oxidative stress (too many free radicals in the body). What this all means is that our liver is able to function properly because it has this protein that turns on whatever genes are needed to get the liver to deal with toxins (metals and free radicals).

Now let me also quickly talk about oxidative stress, which is important to note because heavy metals can cause oxidative stress. That may be why and where the idea of some detox diets came from: if you want to detox from free radicals in the body, doesn’t it seem logical to consume antioxidant-rich foods and nothing else for a few days to cleanse? And what foods are known to have good supplies of antioxidants? Watermelons, lemons, and many fruits and vegetables that we see juiced into detox juices. So using that line of thinking I now move on to trying to better understand the support behind specific cleanses.

First I searched for the lemon detox. There’s a study that was done in 2015 on overweight Korean women that tested the lemon detox drink (a lemon, maple syrup, and palm syrup combo) versus a placebo drink versus a normal diet for 7 days followed by 4 days of food transition. According to the abstract of the study (which was all I could access freely) both the placebo and lemon drink resulted in improved BMI, body weight and body fat, as a well as improved serum insulin levels and insulin resistance scores. Hemoglobin and hematocrit levels were unchanged for those on the lemon diet, while a protein called serum high-sensitive C-reactive protein (hs-CRP) was reduced. What I am unsure of, is if the hematocrit and hemoglobin levels were within a normal range to start for the participants (which is important to know because too low indicates issues like anemia/low iron in the blood; too high can be a signal of dehydration among other things). The researchers concluded that going on a lemon drink detox for 7 days improves body fat and insulin resistance. The reasoning behind why however, they said was because the lemon detox drink is low-calorie, so essentially you are just burdening your digestive system less. So it’s more likely the fasting component that helps rather than the lemon drink having a cleansing effect.

What about watermelon? A study done on rats in 2015 indicated that a diet of watermelon helped reduce the effects of laboratory-induced type 1 diabetes. The procedure involved the rats fasting for 24 hours before being injected with a solution (alloxan) to induce diabetes, and then being fed watermelon extracts for a week. The rats given the watermelon extract had improved weights and reduced blood glucose concentrations, among others changes that caused the watermelon-fed rats to more closely resemble the control (healthy) rats, than the diabetic rats.

Thus my overall concluding thoughts on detoxing so far, are that:

  1. If you are consuming fewer calories, innately you are taxing your digestive system less so you’ll have a natural “detox” effect,
  2. With fewer things in your digestive system, the effects of consuming foods that are rich in antioxidants probably does help remove free radicals. It also probably therefore lets your liver bind toxins and your kidneys remove waste more effectively, and
  3. If detoxing is therefore being used synonymously with fasting, then there is a lot of evidence that it works. Fasting has been studied to, when done safely, be beneficial for everything from diabetes and obesity to other autoimmune disorders.

The reason I brought up point number 3 is because there are studies done on lemon juice and other popular detox foods that don’t include fasting, but rather just adding said food to a person’s existing diet. One such study done in 2016 tried such an experiment, by adding lemon juice and garlic to participants diets, and their results included decreased cholesterol, reduced blood pressure, and reduced BMI. In Jason Fung’s book Obesity Code, he mentions how drinking two tablespoons of apple cider vinegar in water before bed helps lower your blood sugar levels while you sleep. So then one can beg the question of, are we seeing improvements to health more so because fasting allows our bodies to “catch up” and get rid of toxins, or because we are lacking nutrients and so when we supplement them we see positive outcomes to our health?

Backtracking for one last comment on juicing and raw vegetable/fruit detoxing. A study done in 2017 looked at the effects of a raw juice diet of 6 drinks a day for 3 days, varying the juices throughout, and saw a lot of positive results in changes to the gut microbiota, increasing microbiome species correlated with weight loss and other aspects. The issue still stands of whether or not it’s the food types themselves that are included in the juices, or the fasting aspect (as one consumes a lot fewer calories when juicing), that provokes said positive results.

Honestly, in my humble opinion, it doesn’t actually matter which answer is correct because if you are safely fasting on occasion (and/or reducing calories), and consuming healthy options with lots of vitamins and minerals while doing so, does it really matter which aspect is to praise for the good results?

Ending note: I hope this was apparent, but, the intention of this post isn’t to target people who do or don’t do detox diets but merely to satisfy my curiosity. I had heard a lot of anecdotal experiences on the matter and so I was curious to hear about the results from more formal studies as well. Whether or not you choose to detox is your own prerogative.

 

REFERENCES

Aslani N, Entezari MH, Askari G, Maghsoudi Z, Maracy MR. Effect of Garlic and Lemon Juice Mixture on Lipid Profile and Some Cardiovascular Risk Factors in People 30-60 Years Old with Moderate Hyperlipidaemia: A Randomized Clinical Trial. Int J Prev Med. 2016; 7: 95.

“Detoxification.” Partnership for Environmental Education and Rural Health, https://peer.tamu.edu/curriculum_modules/OrganSystems/Module_3/index.htm. Accessed 7 Nov 2018.

Farombi EO, Adelowo OA, Ajimoko YR. Biomarkers of Oxidative Stress and Heavy Metal Levels as Indicators of Environmental Pollution in African Cat Fish (Claris gariepinus) from Nigeria Ogun River. Int J Environ Res Public Health. 2007; 4(2): 158-165.

Henning, SM, Yan J, Shao P, Lee R, Huang J, Ly A, Hsu M, Lu Q, Thames G, Heber D, Li Z. Health benefit of vegetable/fruit juice-based diet: Role of microbiome. Scientific Reports. 2017 May 19; 7.

“How does the liver work?” Informed health Online, Institute for Quality and Efficiency in Health Care, https://www.ncbi.nlm.nih.gov/books/NBK279393/. Accessed 6 Nov 2018.

Ikemoto T, Kunito T, Tanaka H, Baba N, Miyazaki N, Tanabe S. Detoxification Mechanism of Heavy Metals in Marine Mammals and Seabirds: Interaction of Selenium with Mercury, Silver, Copper, Zinc, and Cadmium in Liver. Archives of Environmental Contamination and Toxicology. 2004 Sep; 47(3): 402-413.

Kim MJ, Hwang JH, Ko, HJ, Na, HB, Kim JH. Lemon detox diet reduced body fat, insulin resistance, and serum hs-CRP level without hematological changes in overweight Korean women. Nutrition Research. 2015 May; 35(5): 409-420.

Klein AV, Kiat H. Detox diets for toxin elimination and weight management: a critical review of the evidence. Journal of Human Nutrition and Dietetics. 2015 Dec; 28(6): 675-686.

Oseni OA, Odesanmi OE, Oladele FC. Antioxidative and antidiabetic activities of watermelon (Citrullus lanatus) juice on oxidative stress in alloxan-induced diabetic male Wistar albino rats. Niger Med J. 2015 Jul-Aug; 56(4): 272-277.

“Taking an Exposure History: Which Organ Systems Are Affected By Toxic Exposure(s)?” Agency for Toxic Substances & Disease Registry: Environmental Health and Medicine Education, https://www.atsdr.cdc.gov/csem/csem.asp?csem=33&po=6. Accessed 6 Nov 2018.

“Transcription factors.” Khan Academy, https://www.khanacademy.org/science/biology/gene-regulation/gene-regulation-in-eukaryotes/a/eukaryotic-transcription-factors. Accessed 7 Nov 2018.

Wang Y, Wimmer U, Lichtlen P, Inderbitzin D, Stieger B, Meier PJ, Hunziker L, Stallmach T, Forrer R, Rülicke T. Metal-responsive transcription factor-1 (MTF-1) is essential for embryonic liver development and heavy metal detoxification in the adult liver. The FASEB Journal. 2004 Jul 1; 18(10). 

“Your Kidneys & How They Work.” National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/kidneys-how-they-work. Accessed 6 Nov 2018.

all posts, eczema, nutrition

why you might want to follow news on filaggrin

I mentioned in a post last week that I was reading a book called Living with Itch by doctors Gil Yosipovitch and Shawn G. Kwatra. Well I’ve since finished it and determined it’s another book that I think everyone should read.

While reading said book I came to the following image:

2018-10-28 09.50.04

As I stared at my own palms, which do look remarkably like that illustration (as in I would make a palm reader dizzy trying to interpret all my lines), I pondered about this protein, filaggrin, and about all of us filaggrin-lacking individuals. This led me to wonder if there were existing treatments out there to replace filaggrin in those deficient.

But first, I had to understand what filaggrin does. Cue google scholar searching for studies! Filaggrin is a protein that binds keratin fibers together. Keratin is the protein that helps create the structure of the outer layer of our skin (and nails and other things). So not having functioning filaggrin means that outer skin barrier is not as strong and impervious to the external environment (germs, mechanical stressors like scratching, chemicals, temperature, water retention, etc).

Armed with that knowledge I did a cursory search which brought me to two studies, one in 2014, and one brand spanking new one done this year. The 2014 one looked into filaggrin injections, but I’m getting ahead of myself. To start, the study (done presumably in Europe as it talks about Europeans in particular and as I could only access the study’s abstract) gives background information that 1 in 10 European people have this filaggrin (FLG) loss of function mutation (or what they call a LOF mutation) and that so far this LOF mutation is the biggest genetic risk of atopic dermatitis. They also give other fun likelihoods like that someone with said mutation is more likely ” to develop asthma, to have more severe and more persistent disease, to have allergic sensitizations, and to develop eczema herpeticum”. At this point you may be thinking, ‘all of us FLG LOF’ers are off to a rough start!’ The study then went on to describe why they think filaggrin replacement therapy may help with eczema management (specifically atopic dermatitis, but I’m going to continue using the blanket term of eczema from now on). Basically they talk about how gene replacement therapy of this protein is difficult because the protein is so large and they need to get it through the stratum corner layer of the skin into the cytoplasmic space for it to work. So instead of trying to inject the big protein into the skin, they did some science-magic and used some mouse genetic material linked to a compound that could penetrate cells (a peptide) to make a recombinant protein (which can help get a mutant gene to express the normal function, in this case getting filaggrin to bind keratin fibers together). They tested their work on cell cultures, flaky mice tails, and human skin equivalents and results showed that the flaky tails’ stratum corneum (the outermost layer of the skin) seemed to be restored. They ended the study by saying that there would need to be further studies to determine how safe this would be for humans, as well as things like how much to use, how well it works, and how long to use it, etc. They also noted that though mice didn’t have any problems with the foreign protein injected into their tails, that there is still a possibility that humans’ skin/immune system could reject the forgiven material.

The newer study, rather than trying to inject filaggrin into the skin, took the approach of trying to create a nutritional supplemental to ingest (as they were particularly interested in making a convenient and safe treatment, especially for children). They noted that an amino acid called L-histidine gets used in filaggrin production, and when the filaggrin gets broken down, the L-histidine is released and used as a natural-moisturizing factor (or NMF) and is said to “contribute to barrier function through skin hydration and maintenance of stratum corneum acidity” (hey look, skin acidity mentioned once again). This study also goes on to mention how eczema may be caused by either the FLG mutation or messed up profilaggrin processing but either way can lead to the skin barrier issues we see with eczema, and for either issue the L-histidine amino acid has a beneficial effect. Their overall results were that an L-histidine supplement once a day for 4 weeks showed positive changes to eczema and those benefits lasts even when the L-histidine was discontinued. They even said that their results indicated using the L-histidine was on par with using a mid-potency topical steroid while being steroid free (so none of the side effects)!

Both the L-histidine supplement and the filaggrin injection sound extremely promising and exciting for the world of people living with eczema, though I, in particular am leaning towards the supplement, if I had my pick (I would love to be part of the study for L-histidine, but that will have to wait until I’m done breastfeeding).

 

REFERENCES

Irvine AD. Crossing Barriers; Restoring Function? Filaggrin Protein Replacement Takes a Bow. Journal of Investigative Dermatology. 2014 Feb; 134(2): 313-314.

Sandilands A, Sutherland C, Irvine AD, McLean WHI. Filaggrin in the frontline: role in skin barrier function and disease. J Cell Sci. 2009; 122: 1285-1294. 

Tan SP, Brown SB, Griffiths CEM, Weller RB, Gibbs NK. Feeding filaggrin: effects of L-histidine supplementation in atopic dermatitis. Clin Cosmet Investig Dermatol. 2017; 10: 403-411.

all posts, eczema, miscellaneous, nutrition

what on earth is seed cycling?

Today’s post may feel a bit out there, but that’s why it’s also nestled under my “miscellaneous” category. So, having absolved myself of all guilt for anyone who misinterprets this post as hard fact, I begin.

I recently saw the term ‘seed cycling’ used on social media and became intrigued as to one, what it meant, and two, what benefit it had (if any).

A quick Google search led me to both answers. Seed cycling is somewhat literally what it sounds like (although my first guess as it was 4am as I wrote this, involved interpreting cycling as bicycling). You cycle between seeds in your diet, consuming specific ones at specific types during your menstrual cycle (and supposedly it can be use for peri-menopausal and post-menopausal women as well).

Anyway, the theory is that a menstrual cycle is most naturally working if it is within the 28-day cycle, and anything else indicates some sort of imbalance of estrogen. The seeds chosen during the two phases of the menstrual cycle (when estrogen is decreasing and when it is increasing) are chosen specifically to help balance out the estrogen in each phase to allow the person to resume the natural cycle duration.

At this point you may be wondering why am I posting about this on my eczema blog? Well, you may recall from my post on pregnancy, that one of the factors believed to provoke eczema in pregnant women is the surge of estrogen. So my hypothesis is that if one’s cycle is off, and they experience larger ranges of estrogen surges during phases of their cycle, perhaps that would increase the intensity of an eczema flare.

Here’s a quick overview about the menstrual cycle (I previously worked as a women’s health consultant, so I both enjoy this kind of knowledge and could use the refresher myself). We have 4 phases: menstruation, the follicular phase, ovulation, and then the luteal phase.

  • MENSTRUATION – This is the phase in which the lining of the uterus (or the endometrium), which has thickened over the month, comes off and there is bleeding from the vagina.
  • FOLLICULAR PHASE – This phase starts on the first day of menstruation. The pituitary glands, triggered by the hypothalamus, release follicle stimulating hormone (FSH), and FSH in turn causes the ovaries to release a few follicles, each of which has an egg. One of these follicles’ eggs will start to mature, while the others die (around day 10). The uterine lining starts to thicken during this phase too due to follicular stimulation. The follicular growth also causes a surge in estrogen, which the body compensates for by the hypothalamus releasing gonadotrophin-releasing hormone (GnRH), which gets the pituitary gland to release lutenizing hormome (LH) and FSH.
  • OVULATION – During this phase, the high levels of LH triggers the release of the mature egg from the ovaries in two days. The egg is propelled by little hair-like structures through the fallopian tube into the uterus. Once there, it can survive for only about 24 hours. During this process, the egg has “hatched” out of the follicle, and the follicular remnant that gets dragged along outside the egg becomes the corpus luteum. The corpus luteum releases progesterone and a little estrogen, a mixture that helps keep the uterine lining thickened.
  • LUTEAL PHASE – During this phase the corpus luteum releases progesterone and a little estrogen, a mixture that helps keep the uterine lining thickened. When no pregnancy occurs, the corpus luteum falls off and dies (around day 22), causing a drop in progesterone. The progesterone drop triggers the uterine lining to fall off (aka menstruation), hence the cycle repeats.

So how does one do this seed cycling, you ask? Well, during the follicular phase (day 1 when you start to bleed to day 14) you take a daily dose of 1 tablespoon of ground flax/pumpkin/chia seeds. From days 15-28 you take a daily dose of tablespoon of ground sunflower/sesame seeds. That’s all there is to it.

But why is this supposed to work? I couldn’t find any rigorous studies on seed cycling, but came upon a blog post written by a naturopathic doctor (Dr. Lindsey Jesswein). She explains that the seed hulls have chemicals called lignans, which help “modulate hormone pathways”, and the seed oils (made of omega fatty acids) help “provide the building blocks for steroid hormone synthesis”. Jesswein then describes each seed (minus chia) a bit more by what they provide:

  • Flax – vitamin B, manganese,  and magnesium
  • Pumpkin – iron, magnesium phosphorous, zinc
  • Sesame – vitamin E, vitamin B1, manganese, irin, magnesium, copper, sesamin
  • Sunflower – vitmin E, linoleic acid, magnesium, potassium, zinc, calcium

The Herbal Academy (which was how I came to Dr. Jesswein blog post) goes into a bit more detail about the various benefits of each of these seeds and provided studies, but noted that the information was on individual seeds and not their impact with seed cycling.

A few of the studies they included (and some additional ones I found) found that:

Overall the evidence of large changes for the menstrual cycle is not huge, but at the same time, it generally doesn’t hurt to consume seeds in one’s diet so it may be worth trying if you want to play around with your nutrition (though always seek advice from a medical professional first, especially if you have a specific condition you are trying to treat!).

I’m curious to apply seed to myself so I might give it a trial for a few months and report back. Maybe. I’m also incredibly fickle, so probably not. I generally eat flax anyway with breakfast and the like, but I wouldn’t be able to notice if there were any changes because I’m still breastfeeding and thus not getting my period anyway.

Also I do understand that engaging in many different eczema projects simultaneously results in confounding the data as to which project individually helps my eczema, but it is my belief that eczema cannot be managed by just one miracle solution (though diet is a huge one) and so enacting multiple positive changes and approaches, so long as they are sustainable to myself lifestyle, I view as being the most maximally beneficial.

 

REFERENCES

Gossell-Williams, M., Hyde, C., Hunter, T., Simms-Stewart, D,. Fletcher, H., McGrowder, D., Walters, C.A. (2011). Improvement in HDL cholesterol in postmenopausal women supplemented with pumpkin seed oil: pilot study. Climacteric. 2011 Oct;14(5):558-64.

Hall, Annie. “Seed Cycling for Hormonal Balance.” Herbal Academy, https://theherbalacademy.com/seed-cycling-for-hormonal-balance/. Accessed 22 Oct 2018.

“Menstrual Cycle.” Better Health Channel, https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/menstrual-cycle. Accessed 24 Oct 2018.

Phipps WR, Martini MC, Lampe JW, Slavin, JL, Kurzer MS. (1993). Effect of flax seed ingestion on the menstrual cycle. Journal of Clinical Endocrinology & Metabolism. 1993 Nov;77(5):1215 – 1219.

Somwanshi SB, Gaikwad VM, Dhamak KB, Gaware VM. Women’s Health Issue: A Brief Overview on Irregular Menstruation. IJNRD. 2017 May;7(5):2456-4184.

Troina AA, Figueiredo MS, Moura EG, Boaventura GT, Soares LL, Cardozo LFMF, Oliveira E, Lisboa PC, Passos MARF, Passos MCF. Maternal flaxseed diet during lactation alters milk composition and programs the offspring body composition, lipid profile and sexual function. Food and Chemical Toxicology, 2010 Fed;48(2):697-703.

Zaineddin AK, Buck K, Vrieling A, Heinz J., Flesch-Janys D, Linseisen, J, Chang-Claude J. (2012). The association between dietary lignans, phytoestrogen-rich foods, and fiber intake and postmenopausal breast cancer risk: a German case-control study. Nutrition and Cancer. 2012;64(5):652-65.

all posts, eczema, miscellaneous, nutrition

waiting on time is so friggin’ stressful!

Today’s post starts off as a bit of a downer. I have been feeling a bit trapped lately.

First off (and I’ll need to go back and do some searching because I’m genuinely curious), of all the people out there going steroid-free/not on biologics who have eczema covering over 50% of their body (and all the concurrent fun symptoms that entails), did this degree of eczema impede or otherwise alter your life plans (specifically career goals and things of that nature)?

I ask because lately I have fallen into a rut where I feel like I am failing. I left a planned career behind because a continuously flare was deteriorating my lifestyle and because of the nagging fear that my flares would always be there holding me back, making me miserable in my field of choice (physical therapy at the time). So there I was, feeling grumpy, and wondering  how others with severe eczema who work in health professions do it. But then I talked to my husband about my frustrations, which, to be fair were compounded by the worries and stress I’ve had with breastfeeding.

So let me foray into that realm now. In a nutshell, the current issue is that Fi sometimes has blood in her stool (poop) and most doctors tell me to use formula, in lieu of focused elimination diets. This stresses me the f*ck out because one, the pediatricians have been inconsistent in their reasoning. When Fi was less than 2 weeks old I was told to use formula because Fi wasn’t gaining “enough” weight (which is pretty subjective especially since their measurements haven’t been the most accurate… but that’s a rant for another time). Instead of teaching me about different ways to entice a baby to eat more or about potential reasons why she might not be eating, I was told to try pumping once to see how much I make in a sitting, and then supplement with formula with however much I pumped to make 3 ounces. The logic was clearly my body was failing to produce enough milk. So I pumped and only made about half and ounce and I diligently tried to feed her 2.5 ounces formula. You know what happened? She only drank half an ounce of formula and then didn’t want to eat anymore. The second reason I get stressed by this push towards formula now is that initially when Fi wasn’t eating I was told to eliminate dairy and soy from my diet. When I asked three doctors about how to reconcile the fact that formula (including the hypoallergenic ones) have dairy derivatives and soy I was told 3 different things:

  • Doctor 1. The hypoallergenic formula doesn’t have dairy or soy. But it does.
  • Doctor 2. It (this was around day 10) is more important for Fi to gain weight than whether or not the formula has allergens. That’s great and all, but Fi wouldn’t take more than an ounce of formula or breast milk at a time.
  • Doctor 4: This particular other hypoallergenic formula (being prescribed at around 3.5 months due to the blood in Fi’s stool) has hydrolyzed milk protein (basically pre-digested milk proteins, in that they are broken down so supposedly easier for the baby’s digestive system to handle), while the brand prescribed to me at 10 days was partially hydrolyzed. Okay sure, but then there was no mention of the fact that the third ingredient in said formula is still soy oil.

My complaint with this process is that the pediatricians have no advice about nutritional or dietary changes. Doctor 1 told me to give up dairy and soy, and then try gluten and eggs too if that didn’t work, but openly admitted to not knowing much about how diet affects breast milk or if foremilk/hindmilk imbalances have an effect. The same doctor told me that we had to keep getting diapers tested for occult blood (invisible blood in the stool). Doctor 2 was more like “look she’s a baby. These things happen. She’s gaining weight now so we are good.” And doctor 4 was like “occult blood doesn’t matter, we only care about visible blood”. I have a hard time trusting my baby’s doctors if they are all giving wildly different advice. Oh, and another point I have to make. I didn’t seek out 4 different doctors. The practice Fi goes to usually just sticks us with whoever is available so we have seen 5 different doctors/nurses there and gotten wildly different advice from each one. Doctor 4 I mentioned was a GI specialist, which we went to see as per doctor 1’s advice.

As for Fi’s inability to gain weight fast enough from day 10? She started gaining weight (still exclusively breastfed) after we had her treated for reflux, (which I had noticed because she made gagging faces whenever she ate, and doctor 3 confirmed my suspicions go be correct). After a few weeks, the reflux abated and she was fine on that front.

My problem with this process is it feels extremely similar to how doctors treat things they can’t solve, such as with eczema. I’ve gone to state-of-the-art facilities, told a dermatologist my background including about having horrible topical steroid withdrawal symptoms, and been either convinced or scared into using steroids again (the scaring came from being told my organs would all be inflamed if I didn’t use steroids). None of them addressed diet, none of them offered any alternatives to steroids, though one did say if steroids didn’t work we would move to cyclosporin (an immunosuppressant drug used for people who get organ transplants so that their body can’t reject the new organ). That option was on the table so long as I was ready to get frequent check-ups for my kidney* to make sure it was functioning well, and so long as I knew I would be at risk for getting sick more easily. It felt like an extreme option to say the least.

*(I previously wrote liver but meant to write kidney!)

This constant push towards formula without trying less invasive means first, disturbs me. Formula and breast milk are very different. Breast milk gives Fi a better chance of not getting eczema (which she sorely needs given that both Jake and I have it) as well as helps her fight off colds by producing antibodies when either one of us is getting sick. Breastfeeding also releases oxytocin and other calming hormones to make us both happy mellow and sometimes sleepy lovelies when I nurse her (a nice boon!).

This is not to say I wouldn’t use formula if I knew it would solve her problems. But so far the evidence indicates that it may not. Her weight gain issue resolved without formula, despite it being implied over and over that my body was to blame for the issue in the first place. She could only be having weight gain trouble if I was underfeeding her, because my supply was too low, right? Imagine if I hadn’t thought to inquire about her reflex symptoms.

And if doctor 2 is right and this is stool issue just part of her developing digestive system, then we have cut her off breast milk for no reason. Plus the formula doctor 4 prescribed? It’s so expensive that there’s a black market demand for it, despite it being pretty much identical to the formula doctor 1 prescribed. What?

So anyway I have this constant lingering fear that my body is poisonous and killing my baby, so therefore I’m failing being a mother, and I can’t work first because of skin and now also because of my tenure as a failing mother, so I’mm failing as a working adult, hence the added stress of being a useless human.

I should probably qualify to say that despite Fi’ s ever fluctuating stool contents, she is quite a happy baby, still slowing gaining weight, and hitting milestones as she goes. She is  also a crazily active baby, which may be the reason she gains weight slowly as she does spend cumulatively hours a day flail kicking whatever comes her way and smiling about it.

I don’t know. I guess the problem is that I straddle unknowns so often that they are starting to get to me. It just sucks to feel like my body is constantly to blame. It feels like my skin is a fluctuating erratic b*tch and now my breast milk is too?

Another qualifier I have to add. After all these diet changes I’ve been doing, I have noticed that my skin is much less terrible this cold season than previous ones. So clearly something I’m doing is helping a little. And the same can be said about Fi. The blood on her stool has lessened so much from when we saw doctor 4 and I just started avoiding rice (which I ate all the time) and oatmeal (which I realized I wasn’t eating notably gluten-free ones (oats are commonly contaminated with wheat during processing)) and cocoa/chocolate (which has caffeine and historically I’d eat a lot of it at one time). But the other problem is all these factors take time. There’s always potentially a quick fix medication to mask the symptoms, but to actually suss out what works and prevent it from happening again takes time. And what’s more nerve-wracking then sitting around waiting to see if your changes help or hurt your baby?

And then I’ll think, well maybe it’s not my diet at all, but the fact that I have so much systemic inflammation living with eczema, and that’s affecting Fi (despite not being able to find scientific proof or any doctor that believes that that happens). I don’t know. There’s no worse feeling than the lingering doubt and insecurity that you are f*cking up your baby.

Anyway that’s the basic hum of stress I have undertoning my life lately.

To combat that hum, I have been trying to augment lived with things I know have always made me happy and continue to do so: books, and more specifically, library books. I am forever taking out book after book on all manner of subjects, to consume like it’s my calling, like ants to sugar. To this day I know I would love working in a public library; I have so many ideas swirling in my head about improvements to various existing ones to help further user accessibility and build community. I just love libraries and books. So much information right there, and for free! You don’t need WiFi or a smart phone or anything. It’s a relic of a bygone era that I think is so important for today, as it provides so many underappreciated values. You can go to most libraries, in most towns, without being a patron, and sit down and enjoy their services including free internet. Lots of libraries have free events from book clubs to baby hangouts to beer nights. Every library has its own history and is usually shaped by its community, so you can get a glimpse of what a town is like by just walking through its library doors. Plus most libraries have interlibrary loan systems where they are partnered with other libraries to make sure they can continue to supply their community with a wide array of materials. There are also some funky libraries out there including Bookmobiles or libraries with novel services like American Girl doll rentals or art and tech supplies (like with Maker spaces). Libraries are actually one of the coolest inventions mankind has created. I just can’t get over a system that lets me borrow so many stories (I think I currently have 11 out, 7 on their way through the ILL system, and 21 more on my radar to take out once I make a bit more headway with my current batch).

I frequently find myself singing to Fi (completely randomly as I haven’t seen this show in years), “Butterfly in the sky. I can fly twice as high. Take a look, it’s in a book. Reading rainbow. Reading rainbow!”

eczema, nutrition

“and now for something completely different”

Remember how I did a post yesterday about my skin care regime? Yeah ignore that. Much like how lives change, the way I take care of my skin is almost as fluid as my skin itself. Let me explain.

Yesterday I was talking about how I was using two products (Eczema Honey Co.’s Nut-Free Natural Healing Cream and Chuckling Goat’s Calm Down Kefir Lotion), and talked a little about them both. Well last night, Fi was fighting the sleep hard and I couldn’t get her down until around 11pm (after trying for 3 hours!), which meant that I didn’t get to catch up on the massive sleep deprivation from the night before. While I was trying to get her to calm down and sleep through various means, I was using the Chuckling Goat lotion on some dry areas (hands, feet, knees) to help work through some light itching. Finally, the little piglet stayed asleep when I put her down and I thankfully succumbed to my own exhaustion, only to be woken up around midnight by myself scratching the sh*t out of my hands, arms, and feet. It was so bad I could feel my skin starting to weep. Here’s a picture of the aftermath on my hand:

2018-10-17 20.21.01.jpg

When I woke up enough to realize what I was doing, I took some Benadryl and waited for it to kick in and knock me out. But then I had to wake up at around 3am because Fi has been big into not sleeping through more than 4 hours at a time lately, which was rough (I don’t know if you’ve ever tried to cut your sleep short when taking Benadryl, but it is hard to mentally function afterwards).

Today I started the day off (once the Fi routine was completed) with another bleach bath to help level out my skin, followed by rinsing off using the Chuckling Goat Calm Down soap bar, and then using the Eczema Honey Co cream again. I am still very much enjoying it, in fact, it’s time for a mini review!

Eczema Honey Co is a company where the founders live with eczema themselves (always a plus because you know they are actually experiencing the condition they are treating). They currently have 4 products: their original cream, their nut-free (no almond oil) version, an oatmeal scrub, and cotton gloves, and the cool thing about their line is that they have a monthly subscription, which is lovely because when you have eczema all over your body, you know that you’ll need a lot of product. The one I am using is there nut-free cream and so far I love it. It’s only got a few ingredients (Organic Pure Honey, Grapeseed Oil, Organic Grated Beeswax, Organic Sunflower Oil, Colloidal Oatmeal, Pure Spring Water, and Optiphen), which makes it easier to understand what I’m putting on my body (aka looking up the studies on how specific ingredients affect skin). This is an important factor to consider because our skin is quite absorbent and things we put on it can end up in our hypodermis and/or our blood stream (and this is even more true for people with compromised skin like those of us with eczema). Of note: optiphen is a chemical made of Phenoxyethanol, Caprylyl Glycol, and Sorbic Acid, and the biggest concern with it seems to be that it can be a skin irritant according to EWG Skin Deep Cosmetics Database. My opinion on the product overall is that it seems to be the best thing I have tried up to now. I put it on after baths or showers and it tends to hold in the moisture best like I mentioned in my post yesterday, and it smells nice and seems to be helping reduce the major TSW signs: the redness, the dryness, etc. Jury’s still out as to whether it is helping with the itch (currently it seems my itching is worst 11pm-4am and nothing can fix that minus taking Benadryl to knock me out). All in all I think for now, especially given that I have only used it for a few days now, this is the product I am going to stick with and see where it takes me and my skin. The only less than positive comment I have is that it is a bit sticky, but it’s mostly made of honey, so that’s expected. All in all I’m giving it two thumbs up so far.

Now why do I think I am enjoying this Eczema Honey Co product? It may jusr be because their first ingredient is honey, and honey historically has been used topically to treat wounds. The evidence is still a bit iffy on how effective honey really is on wounds other than partial thickness burns, with some studies toting the antibacterial properties when used for wounds (studied on the wound of a stumptail macaque), and other saying that honey can slow healing (of venous ulcers in particular). But all in all, as with most things, I think it comes down to using what you feel is comfortable (and consulting an open-minded medical professional who you can discuss your concerns and questions) to determine what you want to use for your care.

Speaking of skin (which I almost always am), I am currently reading The Little Book of Skin Care: Korean Beauty Secrets for Healthy, Glowing Skin by Charlotte Cho. So far I’m enjoying it immensely, as it goes into detail about how the Korean skincare regiment works in a nutshell, as well as how the mentality of it differs (Cho says that Koreans enjoy their skin care and don’t think of it as a chore). I am trying to think about how those of us living with eczema/TSW could learn to love our skincare regimes. It feels like such a foreign concept, but I can see how it would be an immensely helpful part of healing. So, I am thinking about how to apply what I’m reading in the book to myself and if it works, subsequently to the eczema/TSW community. Keep your eyes posted for that in a bit!

I also wondered if there are estheticians that specialize in eczema/TSW, because that would be awesome. Another idea I had was that if in some world I could learn Korean, it would be awesome to go to South Korea (with my sister who has been studying Korean for years) and experience their skin care ways for myself. But that’s a pipe dream.

On a complete and utter tangent, all I dream about lately is eating That’s It Bites, the blueberry ones in particular. But actually. I go to sleep wanting them, I wake up wanting them, and then when I am sitting around during the day, especially if I get a little bit hungry, I crave them so badly. I think I’ve latched onto them because:

  1. That’s It bars are so good
  2. blueberries are some of my favorite berries
  3. the chocolate truffle version is delicious, particularly the blueberry one
  4. they don’t have any other ingredients in them besides blueberries, apples, and dark chocolate (cocoa, cane sugar  and cocoa butter), and I’m not eating sweets with ingredients I can’t track

So basically if you are ever feeling like you want to send me something nice… send me those – insert winking face here – !

Anyway, in regards to the title of today’s post, what I meant by taking a new direction is that I am trying to figure out what my focus, both hobby and career-wise, will be. I am accepting that my skin is going to be the limiting factor for a while to come and in that interim I am trying to figure out what I can do, not just in the meantime, but potentially forever. I want to be able to start to commit to things again and know that I’ll still be able to do them even with the worst of flares. I know I’ve dabbled with writing for a while, but now I am thinking of taking it seriously (Glob help me!). If you know of any opportunities, let me know (this is my desperate reach out to the universe)!

Tangential parting thoughts: Did anyome know the reference I made with the post’s title? I credit my dad for why things like that are still stuck in my head today.

 

REFERENCES

Jull AB, Cullum N, Dumville JC, Westby MJ, Deshpande S, Walker N. Honey as a topical treatment for acute and chronic wounds. Cochrane Database of Systematic Reviews. 2015 Mar 6;(3):CD005083.

Jull AM, Walker N, Deshpande S. Honey as a topical treatment for wounds. Cochrane Database Syst Rev. 2013 Feb 28;(2):CD005083.

“Optiphen.” EWS Skin Deep Cosmetics Database, https://www.ewg.org/skindeep/ingredient/732140/OPTIPHEN/. Accessed 17 Oct 2018.

Staunton CJ, Halliday LC, Garcia KD. The use of honey as a topical dressing to treat a large, devitalized wound in a stumptail macaque (Macaca arctoides). Contemp Top Lab Anim Sci. 2005 Jul;44(4):43-45.

all posts, eczema, nutrition

my new(est) regimen

I successfully (so far at least) staved off a flare! Generally as the seasons change towards their colder demeanor, my skin freaks out. As I have gone through topical steroid withdrawal for about 4 of the last 5 winters, I’ve learned that this time of year includes symptoms such as:

  • a baseline of my skin getting redder,
  • little pimple-looking marks on my arms and legs especially,
  • thermoregulation issues at night especially, which start with what I liken to non-menopausal hot flashes of the skin while my core feels freezing,
  • a thickened and discolored layer of skin developing all over, and
  • an insatiable itch thats origin is probably more related to the inflamed nerves as the itch can travel.

On worser years there was also skin weeping and other gross exudate but luckily this time around, as I haven’t used steroids in about 11 months (and when I was using them they were not a strong), this flare’s symptoms seemed to be more benign. That being said, I also am a seasoned TSW sufferer now so I know more or less how to handle the onset of a flare.

Firstly, diet. I luckily am in the midst of multiple dietary changes for the sake of Fi and her developing digestive system, and so I have already been avoiding dairy, soy, gluten, and eggs (all as per suggestion of the pediatrician), and coconut and corn for good measure.  Then I recently eliminated rice and oats, which apparently are other common allergens a breastfeeding baby can have (which I learned by word of mouth from a physicians assistant’s coworker). I’m at the stage where everyone, especially pediatricians, joke about how I have nothing left to eat but air, and it’s getting old. Essentially my diet just means I have to (aka Jake has to) cook all my food at home. My meals have become neither meat- or carb-based, which completely confuses the majority of people I meet. Here’s an example of what I ate yesterday. I had 6 separate food dishes that I rotated around to make 3 meals. They were as followed:

  • a cold salad of chickpeas, cucumbers, red cabbage, vinegar, and some peppers
  • a pulled chicken with a graoefruit sauce in lieu of BBQ, cooked with onions, kale and other spices
  • a quinoa dish with poblanos, dried apricots, and spices
  • braised rosemary potatoes
  • baked and salted chickpeas
  • chorizo, “riced” cauliflower,  pinto beans, onions, garlic, kale and other spices, and
  • a warmed apple with cinnamon for a sweet treat

So clearly I still have plenty I can eat. But I digress! My point is, my diet is currently avoiding a number of inflammatory and common eczema-inducing foods.

So now that we’ve gotten past food, the next factor in my skincare during a flare (that rhymes!) is figuring out the topical stuff. First, I end up taking much more frequent baths. The pimple looking stage is what triggers me to take a bleach bath, the redness drives me towards Epsom salt baths, and the residual heat or skin discomfort and dryness warrants apple cider vinegar baths. Epsom baths tend to dry me out so I use them after bleach baths when I know the bacterial overload has been decreased and now I need something to dry out the dead crusty exudate layer.

Then comes the moisturizing stage. Lately I have been using two products. Eczema Honey Company’s product Eczema Honey Original Natural Healing Cream, and Chuckling Goat’s kefir lotions (first the rosemary, now the lavender one). I think the Eczema Honey Co works a bit better. It tends to provide a better barrier and seal in moisture better, plus the honey works as a light and natural antiseptic. It’s downside is that it separates from the oil in the mixture pretty quickly so I have to stir it a bit before use, and that it is so sticky! The Chuckling Goat lotions are better for the inflamed days as it seems to help dry out the excess heat and redness.

Lastly, there is the stress factor. I have gotten pretty good at distraction (as mentioned in one of my previous posts), which truly does help keep my flares under control. I just don’t let them get to me for very long. It’s really a godsend right now because I haven’t been sleeping so well (partially because I’ve been under the weather, partially because my skin heats up like crazy when I’m under a blanket, and partially because a few days ago Fi started randomly waking me up every 2 hours to feed. Apparently it’s possible that I was producing less milk while sick and so she needed more feeds in to get the same amount as usual. Anyway, the point is that my sleep has been compromised.

Instead other things I’ve done to try to help my skin include drinking a lot more water (something I am historically terrible at), and taking probiotics and the daily prenatal. I have also been making sure to do some kind of physical activity, usually the True Blood Fitness Game (see the post here), but also yoga when my insomnia gets bad, and generally just passing around the house holding Fi for “cardio”.

It’s slow going, but I seemed to have been able to skip over most of the worst of the inflammation phase, save for a few elephant skin wrinkles and the telltale cuts in my hands as they dry out. I’m hoping the difficulty with sleep (and the whole aggressive skin heating up in bed) dissipates. Work in progress with that.

Ugh. Overall my feelings (mostly formed based on how my skin reacts) are that I am not a fan of when the cold seeps in and it feels like nothing can stay warm. Until I can consume copious amounts of hot tasty beverages and treats for fall and live dressed in a thick comfy blanket, this time of year is bleh! Sometimes I think I was meant to be a bear because hibernating through the cold months seems ideal.

all posts, eczema, miscellaneous, nutrition

herbaceously delicious: herbs for eczema

I have decided to start a new series within the blog. I have had a deep and abiding love for herbs and gardening since I was a wee one (I used to try to collect dandelion roots to make my own coffee around age 12, despite the fact that I didn’t drink coffee. Anyway, I digress). As a result of said love, I have decided to really delve in and learn about an herb, and then I’ll hopefully try to use that herb to create something (be it edible, a body product, incense, or other) to use to help manage my eczema.

Currently, my garden looks like this below, so I’ve got a lot to work with (basil, wood sorrel, marshmallow, licorice, oregano, sage, thyme, rosemary, raspberry leaves, chives):

2018-08-05 19.54.04

To start off this series, I collected basil from my garden last week. I have two types, sweet basil, and English basil, but I only used the sweet type.

Screen Shot 2018-08-08 at 12.24.10 PM

Sweet basil, or (ocimum basilicum), is an edible herb of which we eat the leaf and flowering top. It’s other names include St. Joseph wort, arjaka, and luole.

  • ocimum = ‘smell’
  • basilicum = ‘kingly’

Historically in Europe it was a symbol of love/romance and of grief, and it has associations with the Basilisk (it was thought to be poisonous in the past).

To grow it you need rich, well-draining but moist soil, and full sun. It can grow well in containers too if you don’t let it flower. The season to grow it is in summer.

For food: It’s usually used in soups, salads, with eggs, most red meats, in tomato sauces, or in general cooking. I’ve also heard of it being used in ice cream though I have yet to see or try it. It combines well with vegetables such as zucchini, beans, and mushrooms.

It’s key constituents include:

  • essential oils
  • caffeic acid
  • tannins (estragole and eugenol)
    • estragole can have a sharp/hot and numbing effect
    • eugenol is in cinnamon and cloves; it imparts a spiciness
  • monoterpenes
  • beta-carotene
  • vitamin C

It can be used to make teas, tonics, poultices, etc.

It is used to help with:

  • itches and pain (of bug bites and other small wounds)
  • removing heavy metals and toxins from the body
  • promoting the growth of hair, specifically oily types
  • melancholy/low spirits and headaches/stress (due to its antispasmodic properties)
  • fatigue if it’s steeped in wine (so if you are going for a glass anyway, might as well add some basil in there)
  • deterring flies (though I am not sure how well that works)
  • indigestion, stomach cramps, relieving nausea and vomiting, and easing gas (because it’s an aphrodisiac)

Given that basil is a pretty frequent herb in our savory meals already, (and because I can’t eat dairy currently for Fiona, so alas no basil ice cream), I decided I wanted to use it in a non-edible manner. As I’m always thinking about my skin, I decided to make it into a skin toner. I talked about it a bit in a recent post (korean skincare for eczema), but here’s a picture of it again:

Screen Shot 2018-08-03 at 8.56.26 AM

The final product was lovely. It was refreshing and smelled delightful. The recipe I used is here, and I did add a little witch hazel. It’s fairly gentle on my skin and in the future I may try it without any witch hazel.

Just in case the above link ever gets taken away, the recipe was as followed:

  • bring 3 tbsp freshly crushed basil leaves to a boil for 4-5 minutes
  • remove from heat and let cool to room temperature
  • strain leaves from mixture
  • add teaspoon of witch hazel (optional)
  • place liquid in a bottle (glass preferred)
  • store in refrigerator for one week

To use:

  • pour about a teaspoon onto a cotton ball and gently dab onto face as wanted, or
  • freeze and then use the cubes on face as a pore minimizer after a wash

 

And that’s it!

all posts, eczema, nutrition

the magic of medicinal ideologies

Something that has always fascinated me has been the underlying ideologies behind medicine of different regions/cultures, be it modern western science, naturopathic medicine (which can blend a lot of the holistic and western medicine practices), traditional Chinese medicine, Ayurveda, or yoga.

As western medicine is the most familiar, I will talk about that briefly at the end.

The other day I went to a Qi Gong and Tai Chi school where I talked with one of the instructors about the concepts behind medical Qi Gong. We talked a little bit about my skin and the instructor mentioned how the skin and the liver are connected in the Chinese ideology and so if the skin is showing lots of signs of disease, there may be an issue with the liver’s digestion. She also mentioned that I would be a person expected to have an imbalance of yang over yin. Yin and yang are seen as complimentary energies that keep the body in balance, with yin being the cooler, more feminine energy, and yang being a hotter, more masculine one.

In regards to nutrition, when I was seeing an acupuncturist a few years ago, she also talked about the dietary components that might be causing my skin issues. She also believed that I had an imbalance of yin and yang, (in that again I had more yang), hence the inflammation. Her advice to me was to eat less spicy food, avoid sugars, and have more bitter herbs in my diet, as well as continuing the treatments I was getting from her in acupuncture, cupping, and massage.

The National Eczema Associate interviewed Dr. Xiu-Min Li (a Professor of Pediatrics in the Division of Pediatric Allergy and Immunology at the Icahn School of Medicine at Mount Sinai) who studies asthma and allergies (including AD) and went on to explain about traditional Chinese medicine and how it fits into the treatment of eczema. The article provides more insight into how TCM is starting to be incorporating into mainstream western medicine, with the goal of having an alternative to use before topical steroids. It would seem that many people currently turn to try traditional Chinese medicine when standard western medicine practices of topical/oral steroids and other topical medications don’t do the trick.

When I was doing my yoga teacher training a while back they talked about chakras. Chakras are energetic points of the subtle body and there are 7 of them that line the spinal column, and they each are meant to represent a basic level of human consciousness. According to what I learned during the training, when the third chakra (Manipura) is unbalanced, one can expect to see eczema and other stress-related skin conditions. This may be because the third chakra is connected to the detox related organs (like the liver) as well as the abdominals, obliques, etc.

Nutrition based in the Ayurvedic ideology talks about balancing the Pitta dosa (doshas are energies that control how we act, think, move, etc), and to do that they advise avoiding eggs, wheat, milk, nightshades, spicy foods, corn, shellfish, and overly sugary foods. Eczema is seen to be more of an excess of Pitta dosha, or more fire, hence trying to eliminate inflammatory foods.

Here’s an anecdotal story published by the National Eczema Association a while back about a family that turned to Ayurveda when the western medicine wasn’t helping their daughter’s eczema.

In regards to modern western medicine practices, a few comparison points are developing that reflect the more holistic ideals in the ideologies mentioned above. For example, added sugar is more or less nationally seen as being inflammatory, and many doctors will caution against having a diet that includes too much of it. There are also more practices such as taking bleach baths to help reduce infection risk and other treatments that can be done at home without a prescription that a western doctor will recommend now. And the recommendations around lotions and moisturizers (over the counter) are more prevalent, though the brands which are suggested still vary. Light therapy/phototherapy is also recommended to help increase vitamin D exposure, and more and more doctors are also advising getting moving more to help with healing, as well as different solutions to try at night to help with sleep- from stress relieving techniques like meditation or taking a bath at night, to antihistamines.

I personally however, have not yet had a doctor who engaged me in a conversation that got more specifically into nutrition (minus not eating a lot of sugar or junk food). I am not sure if it is out of their scope of practice, but it has not come up in 26 years of seeing doctors, which surprises me. Many doctors, as far as I can tell, still think eczema is not really related to food, but as I do have food allergies I was born with, I would probably be a prime candidate to test for new allergies. The rub there is that generally doctors will prescribe getting a patch test done- but you have to have cleared up skin for the test results to be more or less accurate, and you can’t be on steroids at the time (and I haven’t had clear enough skin in about 3 years).

There is also the holistic medicine movement we see that is not specifically tied to any of the above ideologies. It includes more of western herbalism, often crossed with different nutrition changes and protocols, like the autoimmune protocol, or the elimination diet, or other variations to help with what is called the “leaky gut” syndrome. There are tons of resources from bloggers, nutritionists, doctors, etc about how to go about a nutritional change to heal whatever ailments you are undergoing with food, and I’ve also noticed a lot of sufferers of eczema have gone into nutrition after having success controlling their conditions with their dietary changes (one example being Prime Physique Nutrition). There are also movements to changing the whole lifestyle to be more holistic (like making your own cleaning products as well as skin creams, moisturizers, body wash products. A lot of this new movement is grounded in taking control of your health, often after having tried working with doctors in modern western practices for long periods of time unsuccessfully.

A health resurgence in America has been in herbalism. Some famous members of the community include Rosemary Gladstar (author of Herbal Healing for Women), Susan Weed (author of Wise Woman Herbal for the Childbearing Year), Aviva Romm, Mark Blumenthal (founder of the American Botanical Council), Christopher Hobbs, and many, many others. Of note, I am usually deep into researching about women’s health, hence the references above. Gladstar does have a book on men’s health called Herbal Healing for Men.

From Gladstar’s book Herbal Recipes for Vibrant Health (which I own) she briefly talks about her general advice as an herbalist for how women can keep balance in the bodies by doing “good living practices”, which she notes as having proper nutrition, ample enough rest, joyful exercise, self connection, and tonic herbs. Delving deeper into nutrition she says to eat foods close to their natural states (which also means eat what grows seasonally), pay attention to how you feel while eating and afterwards, eat organic when you can, and eat  alkalizing foods. She notes about the latter that a lot of the disorders women have thrive in acidic conditions (aka when we eat too many sweets and carbs).

Personally, I have found relief from the most extreme symptoms by modifying my diet (I usually avoid eating wheat products and sugar because I tend to over consume foods containing them), and by using products approved by the NEA that avoid parabens, alcohol, and other chemicals that can be irritants for people with eczema. Acupuncture did seem to help- though I can’t say it was in isolation, since I did get massaged each time (which is also known for helping eczema). I tend to only bathe in a diluted bleach bath when I feel like my skin is getting close to infection (not sure how to explain how I know when that point is), otherwise this winter I did take a lot of baths with either apple cider vinegar (works similarly to bleach) or epsom salt (tends to calm me down and works well for helping me get through the dry out phase of TSW faster). I generally avoid using topical steroids when I can because I have gone through withdrawals before, and because I don’t like the reliance on something that doesn’t fix my issue (usually starting on steroids means I have to stay on them because I flare back up as soon as I start a taper).

All in all it does feel like there are more overlaps occurring over time in these differing ideologies, and we are seeing them sort of blend together in effort to figure out how to deal with chronic non-fatal diseases such as eczema. Whether or not they work still mostly seems to comes down to a person-by-person basis.

 

REFERENCES

“Ayurvedic Medicine and Eczema.” National Eczema Association, https://nationaleczema.org/ayurvedic-medicine-eczema/. Accessed 14 May 2018.

Berzin, Robin. “The Simple Elimination Diet that Could Change Your Life Forever.” Mind Body Green, https://www.mindbodygreen.com/0-12540/the-simple-elimination-diet-that-could-change-your-life-forever.html. Accessed 14 May 2018.

“The Effects of Traditional Chinese Medicine on Eczema.” Pacific College of Oriental Medicine, https://www.pacificcollege.edu/news/blog/2016/08/19/effects-traditional-chinese-medicine-eczema. Accessed 14 May 2018.

Ehrlich, Henry. “Traditional Chinese Medicine and Eczema: An Interview with Xiu-Min Li, M.D.” National Eczema Association, https://nationaleczema.org/traditional-chinese-medicine-and-eczema/. Accessed 14 May 2018.

Gottfried, Sara “Is the Autoimmune Protocol Necessary?” Sara Gottfried MD, https://www.saragottfriedmd.com/is-the-autoimmune-protocol-necessary/. Accessed 14 May 2018.

“The Three Doshas: The Keys to Your Individual Nature.” Eat Taste Heal, http://www.eattasteheal.com/ayurveda101/eth_bodytypes.htm. Accessed 14 May 2018.

“Yoga for Skin Diseases”, Yoga India, http://yoga-india.net/wp-content/uploads/2014/04/Yoga-for-Skin-Diseases-Anna-Mayer.pdf. Accessed 14 May 2018.

 

all posts, nutrition

skin deep it’s not so sweet: all about sugar

[For background context: I am currently still interning with EChO-Eradicate Childhood Obesity Foundation, and so I spend a lot of time thinking about and researching sugars].

Ask anyone- I love sweets. I’m pretty indiscriminate about what types (though I tend to prefer baked goods to pure candy). At either rate, one thing I have worried about over the years (and not necessarily due to any scientific reasoning) was that my previously very high sugar consumption as a child/teen had somehow contributed to my global body eczema flares now (despite not eating as much sugar these days). This has led me to be particularly interested in researching more about sugar, and it’s potential links with eczema.

So let’s get into the nitty-gritty about sugar. The term sugar, much like the term bacteria, often gets a bad rep. Sugar is a type of carbohydrate (the others being polysaccharides and oligosaccharides), that is best defined as either monosaccharides or disaccharides (‘saccharide’ means ‘sugar’). Monosaccharides include simple sugars like glucose (dextrose), fructose (levulose), and galactose. Disaccharides includes sucrose (or what we know as table sugar) which is made of glucose and fructose, maltose (a sugar from grains made of 2 glucose molecules), and lactose (a sugar from milk and made of glucose and galactose). You may have heard fructose (the sugar that makes fruit sweet) getting a bad rap, and that’s because the way the brain processes fructose versus glucose differs. Studies done on rats show that when glucose was consumed, a “satiety” response eventually kicks in because glucose triggers the hormone insulin to be released, but when fructose was consumed, there wasn’t enough of an insulin response to cause the same feeling of satiation. What does this mean globally? Well, consuming fructose sugars may take longer for you to feel full or done eating, and so as a result you are more likely to eat/consume more of whatever food/drink it’s in before you feel done. But why are fruits okay to consume (in moderation)? Because they are packaged naturally with fiber and other nutrients and are not just added fructose (think like how many products, like sodas, often have/had high fructose corn syrup, or extra fructose in them but no fiber or other healthier aspects to balance them out).

It is also worth noting about polyols. Some sources consider this to be a type of sugar (such as the World Sugar Research Organization), while others say it is not a sugar, but it is a carbohydrate (Polyols Organization). Polyols can sometimes be called ‘sugar alcohols’ because their structure looks somewhat like a sugar molecule and somewhat like an alcohol molecule. Polyols include: erythritol, hydrogenated starch, hydrolysates, isomalt, lactitol, maltitol, mannitol, sorbitol, and xylitol. They are seen as a new alternative to sugar because they don’t spike blood glucose levels, and they generally have fewer calories per gram. Currently the warning with them is that they may make still be addictive and cause people to consume larger quantities of foods that contain them and/or start to dislike products that don’t have them. The adverse side effect listed by the FDA of excess consumption of polyols is usually related to digestive issues (gas, bloating, diarrhea, etc). Anyway…

The function of sugar in our bodies is to produce energy. When we eat carbohydrates our body breaks it down into glucose and uses those molecules to do important functions like activating our muscles. However, the rates at which sugar affects our blood sugar levels varies. Simple carbohydrates (like sucrose, or table sugar) increases our blood glucose levels quickly, while complex carbs (whole grains, beans, etc) affect blood glucose levels more slowly. In this case we have another example of how slow and steady wins the health race- fast blood glucose level spikes means insulin is released quickly (insulin is used to help cells take in glucose), as a result, you’ll want more sugar again more quickly after eating a blood glucose spiking diet and also, diseases like diabetes and heart disease are related to blood glucose level spikes.

So why are some sugars considered worse than others? The term “added sugars” is a more recent addition to our nutrition world vocabulary and is used to talk about when products include sugars that are not naturally in food (such as when we add a table sugar to the cake batter we are making for a birthday). For example as mentioned before, fruits contain the sugar fructose, but it is considered a natural sugar because one, it is naturally created by the fruit, and two, because it is packaged in the fruit with a balance of fiber and other micronutrients. The problem is that a lot of our processed foods have more added sugar than we think, and dietary guidelines about how much sugar we should maximally eat in a day are being exceeded (according to the American Heart Association, women should eat no more than a total of 6 teaspoons of added sugar a day, and men no more than 9 teaspoons). So if you had a seasonal tall (aka a small) Starbucks Pumpkin Spice Latte this fall with 2% milk and no whipped cream, you consumed about 37 grams of added sugar, or 7.4 teaspoons, exceeding the max a women should have in a day and getting close to the men’s max as well, with one beverage.

But how does sugar impact skin? It affects it in a few ways: by causing inflammation, by aiding candida infections (people with eczema often have a higher risk of candida infections), via glycation, and by messing up our sleep.

When it comes to inflammation, the issue tends to be that sugar (fructose in particular) as its metabolized by the liver can cause free radicals to be made, which are known to cause inflammation. Inflammation results in cell damage, and with a condition such as eczema where your body is already in hyperdrive of attacking its own cells, increasing cell damage is the last thing you want. Interestingly enough, studies on rats have shown that strength training helps to control inflammation even with a high-fructose diet, but I’ll talk about exercise and activity in another post.

Candida albicans is a type of yeast (or fungus) that many healthy people carry orally, and can be non-pathogenic if there is not an overgrowth of it. When there is too much (or any other type of Candida yeast), the condition is called candidiasis. Though there are many reasons for why we’ve seen an increase in candida infections, some of the major culprits are increases in antibiotic use, use of topical or oral corticosteroids (or other local immune suppressors), as well as refined sugars changing our pH, and allowing for easier growth of this yeast. The problem with candidiasis is it can lead to bloodstream infections, and it can cause increased production of acetaldehyde, a chemical that breaks down DNA and impairs cellular repairs. Now it stands to say again that sugar isn’t the only cause for increased risk of candidiasis, but in tandem with taking corticosteroids and antibiotics, it doesn’t help.

Glycation (or more technically described as advanced glycation end products, or AGEs), are products created by a reaction called the Maillard/browning reaction- a reaction that occurs in normal metabolism, but if too many AGEs are made that’s when it becomes a problem because they can increase inflammation and oxidation stress in the body. Usually, AGEs are released by cooking animal-based foods at high heats, more so than by cooking fruits, veggies, whole grains, etc (unless the fruits/veggies/whole grains are made with added fats, in which case the dietary AGEs are also drastically increased). Increased AGEs can also impact collagen and elastin production (due to the oxidation effects), which would impair wound healing. So how does this relate to sugar? Well sugars such as fructose, in combination with some animal protein components heated together increases the dietary AGE production. A low dietary AGE intake, much like a low sugar diet, can help fix insulin sensitivity and improve wound healing (especially with the subsequent decrease of inflammation that occurs). But if your snack/sweet of choice are baked goods made with animal/protein-rich products and includes fructose, chances are you are upping your AGEs, therefore decreasing wound healing, increasing inflammation, and impairing insulin sensitivity.

And lastly, sleep. Simply put, if you eat a lot of sugar, your body has to spend more time trying to convert it into energy and/or store it as fat, and so if you are eating enough to have the ‘food coma’ effect at night, chances are you are slowing your body’s recuperating abilities as it spends the time trying to handle sugar, instead of focusing on general repairs (such as healing eczema rashes and cuts). When we ultimately hit the sugar crash point, our bodies produce cortisol, which results in a higher heart rate, and subsequently less good sleep. Ironically it’s a cyclical pattern. The more you lose good sleep, the more likely you may be to crave sweets!

So the takeaway? Sugar (and specifically added sugars) definitely don’t help eczema, especially when eaten in excess.

 

REFERENCES

Aubrey, Allison. “Sugar and Sleep: More Rest May Dull Your Sweet Tooth.” National Public Radio: The Salt, https://www.npr.org/sections/thesalt/2018/01/18/578604700/sugar-and-sleep-more-rest-may-dull-your-sweet-tooth. Accessed 12 Apr 2018.

Botezelli JD, Coope A, Ghezzi AC, Cambri LT, Moura LP, Scariot PPM, Gaspar RS, Mekary RA, Ropelle ER, Pauli JR. Strength Training Prevents Hyperinsulinemia, Insulin Resistance, and Inflammation Independent of Weight Loss in Fructose-Fed Animals. Scientific Reports. 2016 Aug 4;6(33106).

Gainze-Cirauqui ML, Nieminen MT, Novak Frazer L, Aguirre-Urizar JM, Moragues MD, Rautemaa R. Production of carcinogenic acetaldehyde by Candida albicans from patients with potentially malignant oral mucosal disorders. J Oral Pathol Med. 2013 Mar;42(3):243-249.

“Healthy Eating Tip of the Month: Does Sugar Feed Cancer?” University of Michigan, https://www.med.umich.edu/pfans/_pdf/hetm-2016/0416-sugarcancer.pdfAccessed 12 Apr 2018.

Lawson M, Jomova K, Poprac P, Kuča K, Musílek K, Valko M. Free Radical and Antioxidants in Human Disease. Nutritional Antioxidant Therapies: Treatments and Perspectives. 2018 Mar 11;283-305.

Ott C, Jacobs K, Haucke E, Santos AN, Grune T, Simm A. Role of advanced glycation end products in cellular signaling. Redox Biology. 2013 Dec 19;2():411-429.

Page KA, Chan OC, Arora J, Belfort-DeAguiar R, Dzuira J, Roehmholdt B, Cline GW, Naik S, Sinha R, Constable T, Sherwin RS. Effects of Fructose vs Glucose on Regional Cerebral Blood Flow in Brain Regions Involved with Appettite and Reward Pathways. JAMA. 2013 Jan 2;309(1):63-70.

Patil S, Rao, RS, Majumdar B, Anil S. Clinical Appearance of Oral Candida Infection and Therapeutic Strategies. Front. Microbiol. 2015 Dec 15.

“Sugar 101.” American Heart Association, https://www.heart.org/en/healthy-living/healthy-eating/eat-smart/sugar/sugar-101#.Ws9onWbMzowAccessed 12 Apr 2018.

“Sugar Alcohols.” FDA, https://www.accessdata.fda.gov/scripts/InteractiveNutritionFactsLabel/sugar-alcohol.html. Accessed 12 Apr 2018.

Uribarri K, Woodruff S, Goodman S, Cia W, Chen X, Pyzik R, Yong A, Striker GE, Vlassara H. Advanced Glycation End Products in Foods and a Practiacl Guide to Their Reduction in the Diet. J Am Diet Assoc. 2010 Jun;110(6):911-916.e12.

“Your Questions Answered.” Polyols, https://polyols.org/frequently-asked-questions/. Accessed 12 Apr 2018.