6 Reasons Why You Can Still Have Symptoms in Celiac Disease after Gluten Elimination

Celiac disease is an autoimmune disease where gluten consumption triggers an inflammatory response and damage to the intestines. It is caused by a complex interaction between genetic predisposition, intestinal microbiome, environment, and immune system.

Symptoms & Diagnosis
Symptoms can vary widely but can include gastrointestinal symptoms such as abdominal pain, diarrhea, bloating, and mouth sores, but can also lead to weight loss or failure to thrive, fatigue, dermatitis herpetiformis (a skin condition), neurological symptoms, hormone disruption such as irregular periods, infertility, and early menopause, and nutrient deficiencies leading to osteopenia/osteoporosis (bone loss).

Diagnosis is usually done by blood test but is confirmed by intestinal biopsy. The primary treatment is a gluten-free diet and occasionally corticosteroids. Because nutrient deficiencies are a concern it may be appropriate to do labs to evaluate levels of iron, folate, vitamin B12, carotene, albumin, prothrombin time, and calcium levels.

Many times people with celiac disease continue to experience symptoms (gastrointestinal or otherwise) despite the elimination of gluten from the diet. Here are 6 of the most common reasons that I see people with celiac disease continue to have symptoms: Continue reading “6 Reasons Why You Can Still Have Symptoms in Celiac Disease after Gluten Elimination”

How to Use Nutrition to Help Combat Addiction

Though the rates of cigarette smoking, alcohol abuse, and cocaine use have declined in recent years, addiction to these and other substances continue to be a serious problem.

Sometimes addiction can even start with a prescribed medication that may have been very beneficial to reduce symptoms and improve quality of life at the time. 2.5% of the population uses prescription drugs non-medically, such as pain killers, tranquilizers, and stimulants which can lead to a dependency and difficulty discontinuing. In an effort to end one addiction, people may jump to other substances in attempts to control cravings. What started as taking a prescription to control pain can end up in a cycle of dependency and drug use.

Nutrition is often not emphasized as a foundation of addiction treatment, but it should be seriously considered as a tool to provide comprehensive support and better recovery outcomes. There are many connections between substance abuse and nutrition, and if utilized correctly, diet can play a vital role supporting people in recovery. Continue reading “How to Use Nutrition to Help Combat Addiction”

Forest Medicine and The Science Behind Shinrin-Yoku

Less than 0.01% of our species existence has been in our modern, urbanized surroundings. (1) Throughout the 99.99% of our species’ time before this urbanization, we had many more interactions with nature and subsequent adaptations of our immune system, genetic expression, microbiota ecosystem, and stress response. Our bodies react to airborne plant compounds and work in symbiosis with microorganisms, primarily in our gut. Our gastrointestinal tract is a dynamic setting for immune processes, metabolism, and genetic expression and is the location of significant interactions with the outside environment. Even our DNA communicates with that of microbes here. These interactions help modulate our immune system and influence many aspects of human physiology.

We have also reduced our interactions with plant chemicals released into the air that are lacking in most modern indoor environments. Most people today have very different relationships with nature and this likely results in many implications on human health.

“Extricate yourself from the web of life in which you evolved, and the immune system loses its bearing.” – Moises Velasquez-Manoff, An Epidemic of Absence

We are only beginning to truly appreciate the influences of these interactions on health and the possible impacts our separation from the natural world may have.  As research continues to support these influences on nature and health, a field of study called Forest Medicine has evolved with an increase in research in therapies such as shinrin-yoku. Continue reading “Forest Medicine and The Science Behind Shinrin-Yoku”

How Reducing Toxin Exposure Can Promote a Healthy Weight

It may not surprise you that the majority of my patients come in with some level of concern about their weight. Even if it is not their primary concern, the issue is on their short list. Certainly part of that comes down to societal constructs of what we think we should look like, comparing perfectly healthy bodies to an image that isn’t necessarily right for all. There are, however, many people who are considered overweight or obese and would like to lose weight and these numbers are on the rise.

For most people weight loss is incredibly challenging, even when they do have a healthy lifestyle. Many of these patients wonder if there is something else going on. Why do their bodies respond differently?

There are many nuances to nutrition, nutrient timing, exercise type and intensity that may affect one’s success with body composition goals, but there are also many other factors at play.

Metabolic abnormalities, total cortisol (the stress hormone) and its daily rhythm, the microbiome, genetic differences in how we respond to nutrients, sex hormone imbalances, inflammation, and more can play a part in determining your body weight. Another less commonly discussed factor is toxin exposure.

What is a Toxin?

Hearing the word “toxin” I can’t help but cringe. This term is abused by advertisers that tout products that have vague claims about ridding your body of unnamed toxins without really explaining which toxins they are referring to or how exactly their products work.

I whole-heartedly agree that we are excessively exposed to toxins and that limiting this exposure and supporting our bodies to process them is important, but I’d like to be more specific. In the following paragraphs I hope to put a name to a few of those toxins, inform you of how they can affect body composition, and give you real world examples of what to do about it.

The “Toxins”

There are numerous chemicals potentially involved here, some causing larger problems than others. A large systematic review of studies from 1995-2016 indeed showed a significant positive correlation between pollution exposure and obesity. This study looked at many chemicals, and showed that not all pollutants have the same level of effect on obesity risk, and they influence weight in different ways. Here are a few you should know about:

BPA (and other bisphenols)

One that is associated with higher risk for obesity is BPA. BPA stands for Bisphenol A and is found in plastic water bottles, lining aluminum cans, and even on receipts. Higher urinary BPA levels have been associated with greater risk for abdominal obesity, diabetes, and hypertension. (1) Be careful about trying to bypass this compound by buying “BPA-free” bottles however. There are other bisphenols in plastics that may be just as bad, if not worse, that BPA is replaced with.How Reducing Toxin Exposure Can Promote a Healthy Weight


Phthalates are another component of many plastics that correlate with obesity and insulin resistance. (2) Phthalates are also found in cosmetics, soaps, paint, lubricants, and pesticides. Like many other pollutants, phthalates are known endocrine disruptors. This means they influence hormones like testosterone and estrogen. Phthalates, for example, reduce testosterone contributing to obesity in men. There is even a term for these endocrine disrupting chemicals that cause obesity: obesogens.

Air pollution

Another major consideration is air pollution which can consist of many different chemicals. Several studies, often done in Los Angeles, describe the effects of air pollution on weight and blood sugar control. They found that even ambient air pollution can cause an increased risk of obesity and contribute to insulin resistance, a precursor to type 2 diabetes. (3) (4) (5)

In fact, simply living closer to a major roadway is associated with higher BMI, subcutaneous adipose tissue (fat just under the skin), and visceral adipose tissue (deeper abdominal fat), even when they adjust for lifestyle factors, socioeconomics, demographics, and other factors that could influence these results. (6)How Reducing Toxin Exposure Can Promote a Healthy Weight


POP stands for Persistent Organic Pollutant, or a pollutant that stays in the environment and builds up over time. POPs are created in some manufacturing processes, industry (including booms like during WWII), agriculture, and more, and are transported around the planet by wind and/or water. Because POPs build up over time they can have significant impacts on human health. For example, the pesticide DDT which was unregistered from use in the United States in 1972, still persists in our environment. Some people believe that exposure to POPs may one day be considered an additional official risk factor for developing type 2 diabetes. (7)

A specific POP, dioxin, has been shown to increase risk for obesity, insulin resistance, and heart disease. (8) Inflammation is one of the primary features of obesity and is one of the mechanisms in which POPs like dioxin increase risk for weight gain as well as associated metabolic conditions. They do this at the genetic level, inducing pro-inflammatory gene expression in fat cells.

We are primarily exposed to POPs in our food, especially meat, because it accumulates in animal tissues.

The Epigenetic Effect

A group at Columbia University studied pregnant women who were exposed to high concentrations of air pollutants and the effects on their children. They found when the mothers were exposed to high levels of these pollutants their children were more than twice as likely to suffer from obesity by the age of seven. This is likely due to a process called epigenetics. (9)How Reducing Toxin Exposure Can Promote a Healthy Weight

Epigenetic changes happen on top of your DNA that essentially turn genes on or off. You inherit your DNA from both of your parents, and you can’t change that, but you can change the way your DNA is expressed through lifestyle factors that affect your epigenome.

One comparison that some people find helpful for understanding this concept is to think of your DNA as your hardware and your epigenome as the software, where the epigenome tells your DNA what to do.

The pollutants the previously mentioned study looked at are known as polycyclic aromatic hydrocarbons (PAHs) which are created when different materials are burned (such as cigarette smoke, forest fires, grilled foods, and car exhaust). How could these products of burning result in obesity? There are likely multiple mechanisms. Alteration in the epigenome is certainly one way, but also via estrogenic activity of PAHs, and by causing fat to accumulate by blocking the breakdown of fats in the body.

The good news is the process of epigenetics can also have your back. It is the reason why your DNA is not your destiny.  Epigenetic changes are not only caused by harmful things like pollution, but can be positively influenced by lifestyle factors like a healthy diet, regular exercise, and avoiding pollutants.

Where Are We Exposed to Chemicals & Pollutants?

We’ve answered this throughout, so you know the short answer is “everywhere.” There are chemicals in mattresses, laundry detergents and dryer sheets, plastics, hair products, cosmetics, air pollution, cigarette smoke, preservatives, in our food, our water, and our lawns. You cannot avoid them completely, but you can do a few things to reduce exposure and support your body’s ability to handle them.

Reducing Your ExposureHow Reducing Toxin Exposure Can Promote a Healthy Weight

  • Avoid microwaving in plastic and drinking out of plastic water bottles.
  • Use good air filters in your home, car, and office.
  • Eat organic.
  • Eat cruciferous vegetables. Cruciferous vegetables like broccoli contain a compound called Sulforaphane which has been shown to increase air pollution excretion from the body like benzene by up to 61%! (9)
  • Eat a plant-based diet. 90% of our exposure to Persistent Organic Pollutants like dioxin is through food. POPs  accumulate in animal tissues, increasing our exposure when we eat more meat. If and when you do eat meat, removing the skin from fish and chicken and checking local water advisories if you catch your own fish can help reduce exposure. (10)
  • Keep air-purifying plants around your home and office. NASA did a study that showed that certain plants are effective at reducing airborne benzene, formaldehyde, and tricholorethylene to near zero in 2 hours and is enhanced by carbon filter systems. (11) Check out a compiled, easy-to-use list at Wikipedia here.
  • Check your cosmetics and other personal care products at the Environmental Working Group’s Skin Deep site for potentially harmful chemicals.
  • See www.EWG.org or their Healthy Living app for more resources.

Works Cited

  1. Bisphenol A and the risk of cardiometabolic disorders: a systematic review with meta-analysis of the epidemiological evidence. Rancière, F, et al., et al. 46, s.l. : Environ Health, 2015, Vol. 14.
  2. Phthalates and metabolism: exposure correlates with obesity and diabetes in men. Phillips, Melissa Lee. 6, s.l. : Environ Health Perspect, 2007, Vol. 115, p. A312.
  3. Longitudinal associations between ambient air pollution with insulin sensitivity, beta-cell function, and adiposity in Los Angeles Latino children. Alderete, TL, et al., et al. s.l. : Diabetes, 2017.
  4. Effects of air pollution exposure on glucose metabolism in Los Angeles minority children. Toledo-Corral, CM, et al., et al. s.l. : Pediatr Obes, 2016.
  5. Ambient air pollutants have adverse effects on insulin and glucose homeostasis in Mexican Americans. Chen, Z, et al., et al. 4, s.l. : Diabetes Care, 2016, Vol. 39, pp. 547-54.
  6. Residential proximity to major roadways, fine particulate matter, and adiposity: the framingham heart study. Li, W, et al., et al. 12, s.l. : Obesity (Silver Spring), 2016, Vol. 24.
  7. Study links exposure to environmental pollutants to obesity, diabetes. American Diabetes Association. Alexandria, Virginia : http://www.diabetes.org, 2014.
  8. Abdominal Obesity and Insulin Resistance in People Exposed to Moderate-to-High Levels of Dioxin. Chang, Jung-Wei, et al., et al. 1, s.l. : PLOS ONE, 2016, Vol. 11.
  9. Association of Childhood Obesity With Maternal Exposure to Ambient Air Polycyclic Aromatic Hydrocarbons During Pregnancy. Rundle, Andrew, et al., et al. 11, s.l. : Am J Epidemiol, 2012, Vol. 175, pp. 1163-1172.
  10. Rapid and sustainable detoxification of airborne pollutants by broccoli sprout beverage: results of a randomized clinical trial in China. Egner, Patricia, Chen, Jian-Guo and Zarth, Adam. 8, s.l. : Cancer Prev Res (Phila), 2014, Vol. 7, pp. 813-823.
  11. Dioxins. National Institute of Environmental Health Sciences. [Online] June 2012. https://www.niehs.nih.gov/health/materials/dioxins_new_508.pdf.
  12. Interior landscape plants for indoor air pollution abatement. Wolverton, BC, Johnson, Anne and Bounds, Keith. s.l. : National Aeronautics and Space Administration, 1989.

Struggling with weight loss? Lipedema may be the reason why.

“It all started in menopause. The weight started to come on gradually, primarily in my arms and legs, and I couldn’t seem to get it to go away. I tried everything. I eat a super clean diet and I work out religiously. The weight barely budges. I feel like something is wrong with me. I just don’t understand it!”

I hear this and similar stories from patients pretty regularly, with slightly different renditions. Sometimes it starts in puberty. Sometimes body pain is the chief concern. Although it isn’t always lipedema, I have to ask myself – could it be?

Obesity Rates 2009-2010 Data

According to the National Institutes of Health, 68.8% of the United States is overweight and 35.7% are considered to be obese and the numbers are rising. Obesity is not just one condition, however. It has different causes.  Lipedema, Dercum’s disease, Madelung’s, and Familial Multiple Lipomatosis are 4 specific examples, but lipedema in particular appears to be far more common.

Lipedema is an under-recognized condition that may affect as many as 11% of women according to lipedema expert, Dr. Etelka Földi. One of its striking features is that the fat, primarily in the lower extremities, does not go away despite very good diet and exercise habits. Continue reading “Struggling with weight loss? Lipedema may be the reason why.”

10 Things You Can do to Help Control Healthy DNA Expression

If you have a parent or other family member with a health condition like high cholesterol or cancer you’ve probably considered you may have a genetic predisposition for those conditions. Though this may be true, it doesn’t mean you can’t influence your risk. It’s no secret that diet and exercise can have positive influences on your health and risk for disease, but now we know it is even affecting how your DNA is expressed.

A little DNA refresher…

You inherit your DNA from each of your parents. Your DNA carries the instructions that determine your growth and development, and produces proteins that are necessary for everyday functioning. Genes are basic units of DNA that interact with each other and the environment.

Epigenetics & Why Your DNA Isn’t Your Destiny

Your DNA isn’t necessarily your fate when it comes to health and disease. The way our DNA is expressed depends on certain modifications that determine if the gene is turned on or off. These are called epigenetic modifications which occur “on top of” the DNA, not to the DNA itself. Diet, lifestyle, and environmental factors can influence genetic expression through epigenetic changes. Continue reading “10 Things You Can do to Help Control Healthy DNA Expression”

Getting the Most out of Weight Lifting: An Introduction to Protein, BCAAs, and Nutrient Timing for Optimizing Athletic Performance


This article was originally published at Whole Health Associates’ website

By Aylah Clark, ND

The exercise supplement industry is thriving as the popularity of weight lifting in particular has increased. I love that weight-lifting is becoming more popular, especially among women, but there is a lot of misinformation out there. This doesn’t mean you should avoid exercise supplements completely however because some do have a lot of evidence behind them.

Although getting nutrients from food is ideal, sometimes supplementation around exercise can actually be very helpful in optimizing the right nutrients at the right time. If you are supplementing are they working for you? Are you taking the right ones? Are you taking enough or even at the right time?Weight Lifting

Foundationally, the right diet with appropriate proportions of macronutrients (protein, fats, carbs) in the form of healthful foods, adequate sleep and recovery, and good exercise techniques are essential. As we get those ducks in a row, we can also move toward optimizing specific nutrients and their timing which I focus on here. Continue reading “Getting the Most out of Weight Lifting: An Introduction to Protein, BCAAs, and Nutrient Timing for Optimizing Athletic Performance”

8 Reasons Your Probiotic Isn’t Working

Probiotics have become enormously popular, expected to reach $42 billion dollars in global sales this year. [1] This is due largely to our rapidly expanding knowledge of our microbiome and the impacts of gut bacteria on aspects of our health ranging from body composition, mood, genetic expression, immune response, and beyond. There is even a growing field of neurogastroenterology studying the bidirectional communication of the brain-gut axis.

Many of the benefits people report from probiotic use have evidence showing they may indeed be beneficial including relief from antibiotic-associated diarrhea in children [2] and other causes of diarrhea such as C. difficile infection, [3] improved bowel movement and consistency, reduced inflammation associated with the intestinal tract, decreased symptoms of allergy and eczema, and aiding immune function to name a few. [4] Sometimes, however, probiotic supplementation fails to meet expectations. Why is that? Continue reading “8 Reasons Your Probiotic Isn’t Working”

5 Nutrients for Men’s Health You Don’t Want To Miss

This article was originally published on Whole Health’s website.

Men’s health can mean a lot of things but this discussion will primarily center around 5 key nutrients that support cardiovascular health, sexual health, and muscle mass– topics we find are important to many of our male patients.

When we talk about men’s health, it’s worth mentioning vascular health for a few reasons. One reason is to support cardiovascular function for a healthy heart, but also to address and prevent erectile dysfunction which can be caused by sub-optimal health of blood vessels. The cells lining blood vessels are called endothelial cells. Endothelial cell dysfunction is a primary contributor to atherosclerosis (plaque forming in blood vessels). Endothelial dysfunction increases with age but can be exacerbated by high blood sugar, inflammation, and oxidative stress.

Effects from nitric oxide will come into play below so here’s a little background. Nitric oxide is released from the endothelial cells lining your blood vessels and results in vasodilation. In men who have erectile dysfunction associated with arterial origins, increasing nitric oxide and therefore dilating blood vessels can result in improved erectile function. These effects on blood vessels can result in other cardiovascular benefits and potentially play a role in exercise performance.

Now let’s get on with it! Continue reading “5 Nutrients for Men’s Health You Don’t Want To Miss”

Quercetin & Nettle Pops to Support Allergy-Prone Kids (5 recipes)

This article was originally published on Whole Health Wellness Center’s website.

We hope you enjoy these 5 recipes for frozen pops containing quercetin and nettle! This was a collaboration between Dr. Aylah Clark and Dr. Sally Machin.

Frozen pops

This article was written to inform. The article and its contents are not intended to treat, diagnose, prevent, or cure any disease.

It’s that time of the year again when the antihistamine medications come out and tissues are always in arms reach for allergy-sufferers. Here in Connecticut the trees are budding, flowers are blooming, and there’s a thin yellow coating over the entire Farmington Valley. It seemed like a good time for us to come up with some recipes for popsicles that contain quercetin and nettles, both of which have been shown to support a more balanced immune response. If you want to get into the research behind these two ingredients, scroll past the recipes for more information. For kids who aren’t allergy-sufferers, quercetin and nettles can be taken out of the recipes and the pops can be used as a delicious, fun-to-make, and healthier alternative to frozen treats with a lot of added sugar and artificial flavors. Continue reading “Quercetin & Nettle Pops to Support Allergy-Prone Kids (5 recipes)”