From a functional medicine perspective, postpartum cavities are not random. They are a predictable outcome of profound hormonal shifts, nutrient depletion, sleep disruption, and changes in oral and gut microbiomes that occur during pregnancy and the postpartum period. Understanding why postpartum cavities happen is the first step toward preventing and reversing them.

What Are Postpartum Cavities?

Postpartum cavities refer to tooth decay that develops during the months following childbirth. Some women notice sensitivity or pain shortly after delivery, while others discover postpartum cavities at their first dental visit after having a baby. In many cases, these cavities progress quickly and seem disproportionate to a woman’s oral hygiene habits.

This is often shocking, especially for women who brushed, flossed, and saw a dentist regularly before pregnancy. But postpartum cavities are usually less about hygiene and more about other aspects of biology.

Why Postpartum Cavities Are So Common

There is a perfect storm of factors that contribute to postpartum cavities, and they often overlap.

1. Hormonal Changes

Pregnancy and the postpartum period involve dramatic fluctuations in estrogen and progesterone. These hormones directly affect saliva production, blood flow to the gums, and the balance of bacteria in the mouth. Low estrogen postpartum can reduce saliva, and saliva is one of your primary defenses against cavities. Reduced saliva means acids linger longer on teeth, increasing the risk of postpartum cavities.

2. Mineral Depletion

Pregnancy places enormous demands on a woman’s mineral stores, particularly calcium, phosphorus, magnesium, and trace minerals. If these minerals are not adequately replenished postpartum, the body prioritizes survival and lactation over tooth remineralization. This creates a biological environment where postpartum cavities can form rapidly.

For several reasons, I usually recommend that my patients supplement with 1,000 mg of encapsulated calcium citrate beginning at 20 weeks gestation due to several studies indicating reduction in hypertension and pre-eclampsia risk in pregnant women. I recommend this practice continue for my patients who breastfeed their babies.

3. Changes in the Oral Microbiome

The oral microbiome shifts during pregnancy, often favoring more acid-producing bacteria. These changes don’t immediately reverse after delivery. When combined with lower saliva flow and mineral depletion, this microbial imbalance strongly contributes to postpartum cavities.

4. Increased Snacking and Nighttime Eating

Many new mothers eat more frequently (as well they should), often late at night (again, as well they should), to support breastfeeding and manage exhaustion. Unfortunately, frequent eating without immediate/adequate brushing increases acid exposure on teeth. This pattern is a significant driver of postpartum cavities, even when total sugar intake is not excessive.

Need an easy fix Pop a xylitol containing breath mint or chew a piece of xylitol-containing gum. Studies show that xylitol reduces the growth of cavity-forming oral bacteria. Xylitol consumption is considered safe during pregnancy (but check with your doctor) and studies even show that the children mothers who consume xylitol when pregnant themselves have lower risk of cavities.

Looking for an ultra-natural option? Underbrush Remineralizing Gum is a chewing gum made from natural tree sap with all natural ingredients and even nano-hydroxapatite which remineralizes teeth and stops decay.

5. Sleep Deprivation and Stress

Chronic stress and sleep deprivation elevate cortisol, impair immune function, and reduce the body’s ability to repair tissues. Teeth are living structures, and their ability to repair micro-damage is compromised in high-stress states. This is another underappreciated contributor to postpartum cavities.

I’ve said it before and I’ll say it again: sleep when your baby sleeps.

Why Traditional Dental Advice Falls Short

Most conventional explanations for postpartum cavities focus narrowly on brushing, flossing, and sugar intake. While these matter, they do not explain why so many women develop postpartum cavities despite good oral hygiene.

A functional medicine approach looks upstream. Postpartum cavities are a sign of systemic imbalance, not just local tooth decay. Addressing only the teeth without supporting the whole body often leads to recurring problems. Once again, a tooth problem is a gut problem, and we need to look inward to solve outward signs of toothe decay.

The Role of the Gut in Postpartum Cavities

It may surprise you to learn that postpartum cavities are closely tied to gut health. The gut microbiome influences mineral absorption, immune regulation, and inflammation throughout the body, including in the mouth.

Antibiotics during labor, C-sections, stress, and sleep deprivation all disrupt gut health postpartum. Poor mineral absorption and systemic inflammation increase susceptibility to postpartum cavities. Supporting gut healing is therefore a critical part of addressing postpartum cavities holistically.

Want to learn more about supporting your gut health Check out all the latest articles here.

Breastfeeding and Postpartum Cavities

Breastfeeding itself does not cause postpartum cavities, but it does increase nutritional demands. Producing breast milk requires significant amounts of calcium, magnesium, iodine, and fat-soluble vitamins. If intake does not meet demand, maternal stores are depleted, increasing the risk of postpartum cavities.

Based on his research in communities with little-to-no dental decay, Dr. Weston A Price (dentist) suggests a diet rich in whole foods, healthy fats, raw dairy and properly prepared (soaked, fresh-milled) grains. He also advocates for eating organ meats, bone broths, wild fish and fermented foods and avoiding processed foods. I will acknolwedge, postpartum is a time like no other to rely on prepared foods to support stress levels during the postpartum period. However, an ounce of prevention is worth a pound of cure. If you’re pregnant, check out this post about prepping nutritious meals for postpartum so that you are freed from so much reliance on food manufacturers to support your postpartum nutrition (seeing as they tend to be more concerned with their own profits than with your health, including your dental health.)

Nutrients That Protect Against Postpartum Cavities

One of the most powerful ways to prevent and heal postpartum cavities is by replenishing key nutrients.

• Calcium and phosphorus are foundational for tooth structure.
• Magnesium supports proper calcium utilization.
• Vitamin D regulates mineral absorption.
• Vitamin K2 directs calcium into teeth and bones rather than soft tissues.
• Vitamin A supports enamel integrity and immune defense.

Many women with postpartum cavities are deficient in one or more of these nutrients, even if they eat a generally healthy diet. All of these nutrients can be found in quality animal foods, like slow cooked meat on the bone. (And what postpartum mama doesn’t love a good crockpot meal?)

Blood Sugar Balance and Postpartum Cavities

Blood sugar instability is another overlooked contributor to postpartum cavities. Postpartum insulin resistance, sleep deprivation, and stress can all lead to blood sugar swings. Elevated blood sugar feeds acid-producing oral bacteria, increasing the likelihood of postpartum cavities.

Eating balanced meals with adequate protein, fat, and minerals helps stabilize blood sugar and reduce cavity risk.

What You Can Do If You Already Have Postpartum Cavities

If you’ve already been diagnosed with postpartum cavities, please know that this is not the end of the story. Dental treatment is sometimes necessary, but it should be paired with systemic support.

Addressing mineral repletion, gut health, hormone balance, and stress can slow or halt the progression of postpartum cavities and reduce future risk. Many women find that once these underlying issues are addressed, they stop developing new postpartum cavities altogether.

Practical Daily Habits to Support Oral Health Postpartum

Gentle but consistent oral care matters. Check out these tips:

• Use a soft toothbrush, particularly an electric one with a rotary head. We use the Oral B Pro 1000
• Avoid aggressive brushing (much easier with an electric brush), and consider remineralizing tooth powders or pastes. Rinsing with water after nighttime feeds or snacks can reduce acid exposure and help prevent postpartum cavities.

Avoid constant sipping on sweetened beverages, including juice and sweetened coffee drinks. Even “natural” sugars contribute to postpartum cavities when exposure is frequent.

Preventing Postpartum Cavities in Future Pregnancies

If you’ve experienced postpartum cavities once, you may be at higher risk in subsequent pregnancies. The good news is that prevention is possible.

Entering pregnancy with strong mineral reserves, supporting gut health, managing blood sugar, and prioritizing postpartum nourishment can dramatically reduce the risk of postpartum cavities the next time around.

Final Thoughts on Postpartum Cavities

If you are dealing with postpartum cavities, you are not alone, and you are not broken. This is a common and understandable outcome of the intense demands placed on the body during pregnancy and postpartum.

With the right support, education, and nourishment, it is absolutely possible to protect your teeth, restore balance, and move forward with confidence. Postpartum cavities are not just a dental issue—they are a whole-body message asking for care, rest, and replenishment.

And that message deserves to be heard.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post Postpartum Cavities appeared first on Dr. Alexandra MacKillop.

Things to Consider When Meal Prepping for Pregnancy

There are two types of meal prep you want to consider when getting food ready for yourself. This could include both 1) meal prepping for yourself when pregnancy leaves you too exhausted to pack a lunch and 2) meal prepping for postpartum so that food and nutrition is an easy, streamlined process.

The good news is that both of these meal prep goals involve the same strategies! Meal prepping for pregnancy or postpartum both involve the creation of easy, nutritious, low-toxin meals that are freezer-friendly and reheat with ease.

Two Types of Meal Prep

When meal prepping for pregnancy, you want to make two things happen. The first, is you need to make sure that you have something quick and easy on hand to grab and go when you only have a few minutes for a lunch or late dinner. The second is that you want a real, hearty meal available for when the whole family is sitting down to dine but you don’t have the time or energy to get out for groceries, assemble meals, and cook them all while holding a hungry, snuggly, and possibly crying newborn.

Whether you’re a busy pregnant mama or looking to the future after your little one arrives, you need both meals for yourself to grab and go as well as something that you don’t need to think about when it comes to a sit-down meal for everyone else, too.

Toxins When Meal Prepping for Pregnancy

Nobody wants to think that their food can be harming them, and the good news is that it isn’t, most of the time. Most foods are nutritious and beneficial to include in a well-rounded healthy diet. However, we can run into a few problems when considering toxins with our food, especially considering toxins that may be added to the food, or that may leach into the food through packaging.

Pesticides and Preservatives

The heart behind these food toxins is actually good. Of course we want pests to stay away from our crops, and we want our food to be protected from rot and degradation! However, the chemicals involved in accomplishing these tasks actually harm our health in doing so. In order to make sure that you family has the healthiest meals possible whether you’re eating for two or cooking when your arms are full, look for:

• Foods without preservatives addedd, like sodium benzoate, EDTA, potassium sorbate, nitrates and BHA, BHT or TBHQ
• Pesticides added to non-organic food and animal feed are a huge problem. Look for organic labeling whenever available.

Note: Other food additives, beyond preservatives, also can be harmful. I recommend avoiding artificial sweeteners like aspartame an acesulfame potassium, natural flavors, food dyes, and carageenan to name a few.

The good news is that apart from pesticides, if you are choosing whole foods to cook and meal prep with, you really don’t need to worry about the other additives.

Toxic Packaging Materials

Now, the downside about a grab-and-go meal strategy is that the packaging we sometimes use to do so can also pose risks to our health. Materials like plastic and aluminum leach into our food and can affect neurodevelopment of baby, hormone balance, cancer risks and more. Microplastics have been found in everything from the brain to the placenta, and it’s never something we want more of. Instead of disposable aluminum trays or plastic containers, consider the following ideas:

• Stainless Steel Casserole Dishes: This is the most cost effective product I’ve found on Amazon, comes in a pack of two, and can be reused over and over again. If you stock up on 8-10, you can easily prep several dinners that will last for multiple days for a meager investment and cultivate a habit of doubling any recipes you bake or cook going forward.
• Silicone Freezer Bags: Instead of meal prepping for pregnancy in Ziploc freezer bags, consider reusable silicone ones. While silicone is not ideal for hot food applications, they are safe for cold use, and provide a similar layer of freezer protection.
• Glass Jars: The standard for food preservation is usually Ball Jars, which are available in most grocery and home improvement stores. However, if you’re not actually using them for canning, the metal lids can easily corrode and stop being usable over time. These adorable freezer jars have plastic lids (which won’t be touching your food) and hold up better for repeated use. I recommend using individual serving jars like this for meal-prepped broths and soups. They also come in neutral colors.

Meal Prepping for Pregnancy Recipes

During the postpartum period, or even if you’re meal prepping to eat these dishes during pregnancy, nutrition is more important than ever. Consider the following strategies when meal prepping for pregnancy:

1. Lower Carbohydrate (In moderation)

• Blood Sugar Stability: After childbirth, many women experience fluctuations in blood sugar levels. A lower-carb diet can help stabilize blood sugar, preventing energy crashes and promoting consistent energy throughout the day.
• Avoiding Insulin Resistance: Some women may face insulin resistance or have higher blood sugar levels during pregnancy (e.g., gestational diabetes). Postpartum, focusing on lower-carb meals can support insulin sensitivity and help with long-term metabolic health.
• Weight Management: Postpartum weight loss or maintenance can be supported by consuming fewer refined carbohydrates, which can prevent fat storage and cravings. A more balanced approach helps maintain a healthy weight without drastic spikes or drops in energy levels. While weight loss should not be a top priority postpartum, eating nourishing meals will help your body naturally level out at the rate that is most appropriate for oyu.

2. High-Quality Animal Protein

• Muscle Repair & Recovery: Childbirth is physically demanding, and the body needs to repair and rebuild muscle tissue after the exertion of labor. High-quality animal proteins (like chicken, beef, turkey, eggs, and fish) provide essential amino acids that support muscle recovery and tissue healing.
• Breast Milk Production: Protein is also critical for producing breast milk. Amino acids from protein-rich foods are the building blocks of the milk, supporting both quality and quantity for breastfeeding moms.
• Hormonal Balance: Protein helps in balancing hormones, including the ones responsible for mood regulation (like serotonin and dopamine). Postpartum hormonal shifts can cause mood swings, so supporting hormonal health with protein is crucial.

3. Complex Fiber

• Gut Health: After childbirth, many women experience changes in digestion, including constipation or slower gut motility. Complex fiber (found in vegetables, legumes, and some whole grains) promotes regular bowel movements and supports gut health, which is vital for overall health during recovery.
• Blood Sugar Regulation: Fiber helps to slow the absorption of sugars in the bloodstream, preventing sharp spikes and crashes in blood sugar. This is important for postpartum recovery, especially if the body is recovering from insulin imbalances.
• Satiety: High-fiber foods also help keep you feeling fuller longer, reducing the tendency to snack on less nutritious foods or overeat. This is especially useful if you’re managing weight while also needing more energy for breastfeeding or caring for a newborn.

4. Slow-Cooked Meals

• Nutrient Retention: Slow-cooking, especially when using methods like stewing or braising, helps retain more nutrients in foods, particularly minerals and vitamins that are sensitive to heat. The longer cooking time at low temperatures allows for better extraction of nutrients, especially from tougher cuts of meat, bones, and fibrous vegetables.
• Digestibility: Slow cooking also breaks down proteins and fibers, making them easier to digest, which is helpful for a postpartum body that might be more sensitive to foods.
• Ease of Meal Prep: Slow-cooked meals are perfect for batch cooking, which is a huge benefit when you’re short on time during the postpartum period. A large pot of stew, soup, or curry can be made in advance, stored, and reheated as needed, saving time and effort. I recommend a slow-cooker with a latch-on lid for easy transport, and programming like this Crock Pot Cook & Carry.

5. Additional Benefits for Postpartum Health

• Anti-Inflammatory: Many slow-cooked dishes, especially those featuring bone broth or grass-fed meats, contain nutrients like collagen and gelatin, which help repair tissues and reduce inflammation. After childbirth, inflammation is common, and foods that support recovery can promote healing and comfort.
• Hydration: Slow-cooked meals like soups and stews can be rich in water, which is vital for hydration—important for breastfeeding and overall recovery.
• Comfort & Healing: Comfort foods are often slow-cooked, providing not only nourishment but also emotional support during a time of physical and emotional stress. The act of eating well-cooked, hearty meals can be soothing and help mothers feel nurtured during a challenging recovery period.

Meal Prepping Recipes

Here are some of my favorite recipes, to be prepared during pregnancy and enjoyed postpartum, or any time that you’re in need of a nourishing meal. Any soups or stews can easily be prepared ahead of time and frozen in individual servings, or ingredients can be stored together in freezer bags to easily throw in a pot or crockpot at a later time.

Breakfast

• Breakfast Burritos (make with almond flour or cassava tortillas)
• Low Sugar Baked Oatmeal (consider adding 1/2 cup collagen to the recipe)
• Paleo Banana Chocolate Chip Walnut Muffins (use unbleached muffin liners and a toxin-free, stainless steel muffin pan)
• Paleo Breakfast Casserole
• Almond Flour Cheddar Biscuits (high protein, low carb)

Lunch/Dinner

• One Pan Chicken Fajitas (prepare and freeze ingredients separately. You can even freeze a pack of tortillas together with the bag of chicken and veggies. Or, serve with rice)
• Veggie-Rich Taco Casserole (make with rice or quinoa)
• Ratatouille Soup (add diced grilled chicken)
• Pasta E Fagioli (omit pasta, if you wish)
• Instant Pot Rotisserie Chicken (serve with bagged salad)
• Beef Stew (sub tapioca starch for Paleo)
• Thai Chicken Curry Soup (store rice noodles separately in pantry, or serve with fresh rice/quinoa instead)
• Indian Curry Soup
• Chicken Potato Soup
• Zucchini Lasagne
• Chicken and Broccoli Casserole (no canned soup in this recipe! can omit cheese, and use bone broth instead of milk)
• Shepherd’s Pie
• Cabbage Roll Casserole (can substitute rice with quinoa for higher protein)

Snacks

• Protein Popsicles (made with silicone popsicle molds)
• Protein/Oat Balls
• Pistachio Date Balls (can omit oats)
• Low Carb Peanut Butter Bark

To sum it up, meal prepping for pregnancy is a smart, effective way to ensure that you and your growing family are nourished with wholesome, nutrient-dense meals. By focusing on simple, healthy recipes that are rich in high-quality protein, complex fiber, and slow-cooked goodness, you’ll be setting yourself up for smoother days, both during pregnancy and postpartum. Whether you’re meal prepping for pregnancy to manage your energy levels or preparing meals that support recovery after childbirth, the right foods will help you feel your best. So, take the time to plan ahead, minimize toxins, and create meals that are easy to grab, heat, and enjoy—your body and your baby will thank you.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

Become a Patient

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post Your Guide to Meal Prepping for Pregnancy appeared first on Dr. Alexandra MacKillop.

How GLP-1’s Work

In order to know how to increase GLP-1 naturally, we first need to understand what GLP-1 is and how it works in the body.

GLP-1 is a hormone. This means it travels in the blood stream after getting released by cells in the small intestine after eating. It also helps prompt the pancreas to secrete insulin, another hormone which functions to control blood sugar. Blood sugar fluctuations are a huge problem behind inflammation an weight gain, and subsequently is a major driver of interest in GLP-1’s.

GLP-1 slows digestion. GLP-1 delays stomach emptying, so food moves more slowly into the small intestine. The result: steadier blood sugar levels, fewer spikes, and a longer-lasting sense of fullness after meals.

GLP-1 lowers glucagon. Glucagon, another hormone, is designed to increase blood sugar under periods of stress, when food isn’t available. However, people desiring weight loss should not want their blood sugar to spike like this, especially without eating anything.

GLP-1 talks to the brain. GLP-1 receptors in the brain influence appetite and satiety. When GLP-1 activity rises, cravings diminish, meals feel more satisfying, and overeating becomes less likely.

What Are the Risks of GLP-1 Drugs?

The most common side effects include nausea, vomiting, diarrhea, constipation, bloating, and abdominal pain. Because GLP-1 slows gastric emptying, some people feel uncomfortably full or even experience reflux. For many, symptoms improve over time, but for others they remain disruptive. GLP-1 drugs are also associated with an increased risk of gallstones and gallbladder inflammation (cholecystitis), as well as pancreatitis and potentially even thyroid cancer (though there are few examples in humans; findings are primarily in animal models). Rapid weight loss using GLP-1 drugs often leads to muscle and nutrient loss, periods of blood sugar drops which can trigger fatigue and nausea, and some patients even report increased anxiety and depression symptoms.

These drugs are relatively new in the weight-loss world. While they have strong safety data for type 2 diabetes, the long-term impact of using them primarily for weight management — especially in otherwise healthy people — is still being studied. There’s a lot we still don’t know, which is why many are wondering how to increase GLP-1 naturally and avoid using them altogether.

How to Increase GLP-1 Naturally

The best and most direct substitutes for GLP-1 agonist drugs are other methods, like behaviors and evidence-based supplements that increase GLP-1 naturally. Here’s what the research can tell us:

• Nutrition: High-fiber foods (including resistant starch), healthy fats, protein and whole foods are an easy, nutritional answer for how to increase GLP-1 naturally. Mechanistically, fiber and resistant starch are fermented by colonic bacteria into short-chain fatty acids, which activate free fatty acid receptors 2 and 3 on L-cells, promoting GLP-1 secretion. Unsaturated fats stimulate GLP-1 via free fatty acid receptors 1 and 4.
• Glutamine: Dietary peptides like glutamine increase the levels of circulating GLP-1.
• Berberine offers a potent solution for how to increase GLP-1 naturally through modulation of the gut microbiome. However, please note that long-term use of berberine is not recommended as it can significantly affect the gut microbiome in negative ways.
• Curcumin directly stimulates GLP-1 secretion in the gut lumen (lining of the intestines.)
• Cinnamon is a food-based and delicious method for how to increase GLP-1 naturally. However, a large dose is needed—as many as 3 grams—to see an effect. Cinnamon also affects ghrelin, the hunger hormone.
• Resveratrol while human studies are limited on using this compound to increase GLP-1 naturally, it has been proven in mice. Additionally resveratrol can be a safe product to use in other health circumstances, so it has a strong case behind it for use as an answer to the question of how to increase GLP-1 naturally.
• Gardenia is a great option for the problem of leptin resistane, insulin resistance, and not having enough GLP-1. In particular studies have shown effectiveness of gardenia for specifically middle-aged obese women on hormoens regulating energy metabolism. This intervention works best in combination with exercise, as any weight-loss intervention does.

Other Ways to Lose Weight Related to GLP-1

It’s possible to find viable alternatives to GLP-agonist drugs without specifically asking how to increase GLP-1 naturally. Certainly, GLP-1 plays a huge role in appetite and body weight regulation, but other strategies that address the same mechanisms that GLP-1 agonist drugs (and GLP-1 agonists themselves) are also proven effective in supporting weight loss. To understand how to increase GLP-1 naturally (or rather, lose weight without doing so), let’s look back at how GLP-1 works.

Mechanistic Alternatives to GLP-1 Agonist Drugs

GLP-1 is a hormone that influences insulin secretion. Exercise after meals lowers insulin secretion by reducing total blood sugar. The kicker It also burns calories, and builds muscle, which boosts metabolism. You don’t need to ask how to increase GLP-1 naturally if you aren’t using it to moderate insulin.

GLP-1 slows digestion. Want to know what else does that Fiber. By slowing the rate of stomach emptying and gastrointestinal motility, you feel fuller longer. Additionally, slower movement of food through the intestines slows how quickly carbohydrates enter the blood stream, preventing blood sugar spikes.

GLP-1 lowers glucagon. Glucagon is notoriously released in response to stress, which is part of the reason that cortisol and stress increase blood sugar. Chlorogenic acid, found in coffee (a big reason I’m in favor of coffee for weight loss), reduces the glucagon response.

GLP-1 talks to the brain. Other ways to increase satiety through the gastro-neuro-endocrine feedback loops include a high protein diet, time-restricted eating, prebiotics, and green tea catechins.

Understanding how to increase GLP-1 naturally relies on lifestyle and dietary strategies that mimic the hormone’s mechanisms. High-fiber foods, resistant starch, healthy fats, protein, glutamine, berberine, curcumin, cinnamon, resveratrol, and gardenia have all demonstrated potential to stimulate GLP-1 secretion. Complementary approaches such as post-meal exercise, time-restricted eating, and high-protein diets improve insulin regulation, slow digestion, and enhance satiety through gut-brain signaling pathways. By understanding how GLP-1 works and leveraging these natural methods, you can achieve better appetite control, blood sugar balance, and metabolic health without relying solely on pharmaceutical interventions.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

Become a Patient

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post How to Increase GLP-1 Naturally appeared first on Dr. Alexandra MacKillop.

Why Women Seek Functional Medicine PCOS Treatment

Many of my patients come to me looking for an alternative to the birth control prescription given to them by their OB/GYN. Others have friends or family with a PCOS diagnosis, and are wondering if that’s the reason for their own irregular and/or painful cycles. Some ladies worry if they’ll ever be able to have children, since PCOS has complicated their fertility, and still more patients come to me out of desperation—they’ve already worked with another “natural doctor” who had put them on an extremely restrictive diet and told them to lose weight. I have even heard of PCOS patients being prescribed gluten-free, dairy-free, low-carb, sulfur-free diets. Functional medicine PCOS treatment offers hope of realistic, sustainable treatment where most other providers give a grim prognosis or simply leave patients feeling overwhelmed.

In this post, we’ll be diving into the details about PCOS: what it is, what it isn’t, how it’s managed by most healthcare providers, functional medicine PCOS treatment strategies, and more. As a starting point, I encourage you to check out my fertility overview post (Female Fertility 101) if you aren’t familiar with the ins and outs of your menstrual cycle. That post lays the groundwork for understanding the status quo of periods, hormones, women’s health, and it’s important to understand these topics before we start talking about with cycles that fall outside of the norm. [Although it’s the most common, it’s not the only period problem faced by women. To learn more about what your period can tell you about your health, check out this post.]

What Is PCOS, and How Is It Diagnosed?

PCOS stands for Polycystic Ovarian Syndrome, one of the most common endocrine and metabolic disorders in women of reproductive age. The syndrome is defined by hormonal imbalances and ovarian dysfunction, and it’s diagnosed only after other causes for the patient’s symptoms have been ruled out (such as hypothalamic amenorrhea). Because of this, many women have to go through a frustratingly long and drawn out process in order to get answers for their health struggles. However, functional medicine PCOS treatment offers faster results because it gets to the root cause.

Functional Medicine PCOS Diagnosis

The name “polycystic ovarian syndrome” is a bit of a misnomer, because although ovarian cysts are common in PCOS patients, they aren’t part of the diagnostic criteria—many women with PCOS don’t have any cysts on their ovaries at all. Rather, a PCOS diagnosis is given when at least two of the three following criteria are met: [Reference]

• Hyperandrogenism (elevated androgen hormones, assessed via lab work)
• Anovulation or oligo-ovulation (absence of ovulation or infrequent ovulation, usually leading to irregular cycle length)
• Polycystic appearance of ovaries (assessed via ultrasound imaging)

The general consensus in the medical community is that a PCOS diagnosis should be given when a woman has either polycystic ovaries and/or irregular cycles in addition to high androgen levels on her blood work. When making the diagnosis, doctors are careful to rule out other causes of high androgens, such as adrenal disorders, thyroid disease, drug-induced androgen excess, and other hormonal disorders, as well as alternative causes for irregular cycles.

Types of PCOS

PCOS patients typically fall into two different categories: insulin resistant, and non-insulin-resistant types. As is the case with most hormonal disorders, more than one level is out of balance. The vast majority of women who suffer from PCOS also present with insulin resistance, glucose intolerance, dyslipidemia, and elevated levels of inflammation. Part of what makes treating PCOS so complex is that these hormonal imbalances feed off of each other: elevated insulin levels trigger a feedback loop via the HPATG axis that leads to further androgen levels, and vise-versa. Apart from the insulin resistance piece, functional medicine PCOS diagnosis further divides PCOS into 4 separate categories which you can read about here.

Symptoms of PCOS

The symptoms experienced by women with PCOS vary because not everyone meets the same diagnostic criteria, and the extent of those experiences can vary too. Some women experience only mild elevations in androgens, and symptoms are consequently lesser. Women who have cysts on their ovaries often experience pain related to the formation and/or rupture of cysts, which are symptoms that wouldn’t be experienced by women who do not have cysts. Likewise, symptoms for women who concomitantly deal with insulin resistance face different symptoms than women who do not.

• Symptoms Related to Excess Androgens
  • Excessive hair growth (face, chest, back, buttocks)
  • Thinning hair
  • Oily skin
  • Cystic acne
• Symptoms Related to Anovulation/Olig-ovulation
  • Long cycles (more than 35 days) or irregular cycle lengths
  • Difficulty conceiving or repeated miscarriages
  • Abnormal uterine bleeding
• Symptoms Related to Polycystic Ovaries
  • Painful periods and/or pelvic pain
  • Sudden, intense abdominal pain resulting from ruptured cysts
• Symptoms Related to Insulin Resistance
  • High blood pressure and/or high cholesterol
  • Fatigue after meals
  • Weight gain, especially in the abdominal area
  • Dark patches of skin, particularly along neck creases, in groin and under breasts (this is called ancanthosis nigricans)
  • Skin tags

Due to the fluctuating hormones, many women also experience generalized symptoms related to hormonal imbalances, which include (but are not limited to): fatigue, insomnia, anxiety, depression, headaches, etc.

Functional Medicine PCOS (Causes and Treatment)

The root cause isn’t really known. The current understanding is that it’s a mixture of genetic predisposition and environmental triggers, but other theories include nutritional conditions in the uterus, prenatal exposure to androgens, insulin resistance on an and more [reference]. Because of this, most treatments focus on managing symptoms—painful periods, irregular cycles, insulin resistance, etc. Hormonal contraceptive use also can induce a reversible type of PCOS, but the symptoms can continue for months or even years (called “post-pill PCOS”).

On a physiological level, we know that elevated androgens and insulin resistance result from dysfunction in the hypothalamic-pituitary-adrenal-thyroid-gonadal axis. In women with PCOS, the pituitary gland releases higher-than-normal levels of luteinizing hormone (LH), which stimulates the ovaries to produce more testosterone than usual. (Ovaries normally produce some testosterone, but problems result when they produce too much.) This over-stimulation of the ovaries by luteinizing hormone also cancels out the mid-cycle LH surge that typically triggers ovulation.

Pituitary Hormones and PCOS

At the same time, the pituitary gland releases lower-than-normal levels of follicle-stimulating-hormone, which prevents eggs from reaching full maturity. When this happens, the follicle does not release the egg (ovulation does not occur, AKA anovulation). The immature egg either dissolves, or remains in the follicle, forming a cyst. Since the follicular remnant after ovulation (called the corpus luteum) is responsible for producing progesterone during the luteal phase, many women experience additional symptoms related to low progesterone levels. (Read more about luteinizing hormone, follicle-stimulating hormone, progesterone, and the luteal phase in this post: Female Fertility 101)

The Birth Control Pill and PCOS

Most OB/GYNs prescribe oral contraceptives as a first line of treatment for PCOS, because the artificial hormones suppress the natural cycling of luteinizing hormone, follicle-stimulating hormone, estrogen, progesterone, and testosterone. The simulated hormonal environment causes the endometrial lining to develop and shed as it would in a natural period, but it take the ovaries out of the equation: no egg matures, no egg is released, and fertility is not possible.

My goal as a functional medicine doctor is to promote the natural fertility of my patients, empowering them to have healthy cycles rather than suppress the normal functioning of their bodies. That being said, sometimes the healthiest thing for a patient and her values is to reduce the pain, control the hormonal dysfunction, and reach a place where she feels that her health is manageable. If that means medication, that’s okay—the most important thing is that she is able to manage her wellbeing according to her values.

Prescription Medications for PCOS

Another medication used in the treatment of PCOS is spironolactone, which is typically used as a diuretic drug for individuals with cardiovascular disease. However, this drug also has a secondary effect of reducing androgen levels in the body, which can be helpful in controlling irregular bleeding, hair growth, and other symptoms of high androgens in women with PCOS. Like birth control pills, using spironolactone targets hormonal pathways of PCOS without addressing the root cause. This is where functional medicine treatment for PCOS can fill a huge gap and meet a huge need.

The third medication that is used in the management of PCOS is metformin, which is a drug typically given to patients with diabetes. Metformin improves insulin resistance, which can be helpful in the treatment of PCOS because of the amplifying effect that insulin plays in the production of testosterone. When insulin sensitivity improves, often testosterone levels follow suit. You can read more about the use of metformin as a fertility drug (and natural alternatives) in this post.

Functional Medicine Treatment for PCOS: Lifestyle & Supplements  

Most of my patients come to me because they are looking to avoid the use of prescription drugs in managing their fertility. If that describes you too, keep reading!

1. Lifestyle Factors for Balancing Hormones: The #1 thing we can do to support hormonal balance is building a foundation for well-being. This means taking nutrition, rest, exercise, stress management, and psychological/emotional health into account. Neglecting even one of these areas can create huge interruptions in the HPATG axis, making symptoms of PCOS and other hormonal disorders so much worse. These lifestyle factors include eating enough (in terms of calories, macronutrients, and micronutrients) as well as eating frequently enough to keep blood sugar stable. It also involves balancing exercise and rest to prevent elevations in cortisol, the stress hormone, which interrupts the production of sex hormones like progesterone. This is part of the reason why stress management, sleep hygiene, and social support are so important.
2. Eating a Diverse Diet:Gut health is a huge topic in the media lately, and research continues to show that the best way to support GI health and microbiological diversity is to eat a varied diet, with many different types of plant foods and fibers. The more restrictive our diet (limiting the types of foods we eat to just a few varieties), the more likely we are to disturb our gut microbiome, which plays a huge role in balancing our hormones. (Did you know that bacteria both produce and metabolize hormones When we disturb our gut microbiome, it affects our bodies ability to make hormones as well as clean out the old, broken down ones.) Gut health also helps modulate blood sugar control, which is an important consideration in insulin-resistant PCOS. Check out this study to learn more about the relationship between PCOS and the gut microbiome.
3. Micronutrient Balance: Research has shown that women with PCOS tend to follow certain patterns of vitamin deficiencies, including vitamin D and B vitamins (especially folic acid). Vitamin D plays an important role in supporting the thickness of the endometrial lining, which is often depleted in women with PCOS due to low progesterone levels. Likewise, B vitamins such as folic acid play an important role in follicular maturation, and supplementing with elvels at 700 μg/day can support successful ovulation. Other nutritional deficiencies have also been identified in the majority of women with PCOS, including calcium, zinc, selenium, and chromium. [Reference] While the best way to prevent nutrient deficiencies such as these is to eat a varied and balanced diet (and avoid restriction of food groups of calories), some women may benefit from using supplements—especially Vitamin D. Studies have also shown that supplementing with omega-3 fatty acids, such as those found in cod liver oil, prevent excess inflammation, help manage dysglycemia, and support hormonal balance in women. [Reference]
4. Evidence-Based Supplements:
   1. Inositol: Inositol is a type of sugar alcohol that has been shown to improve insulin sensitivity, lipid synthesis, hormonal signaling, and maturation of oocytes (female eggs) during the follicular phase. Supplementation of inositol in women with PCOS lowers androgen levels, improves insulin sensitivity, and increases rates of ovulation in women with anovulatory cycles. Supplementation is effective when administered in ratios of 40:1 of myo-inositol to D-chiro-inositol, at levels of 4000 mg per day in conjunction with 400 μg of folic acid.
   2. Alpha-Lipoic Acid: This chemical is a free-radical scavenger, meaning that it prevents premature breakdown of biochemicals and hormones in the blood stream. Studies show that supplementation with alpha-lipoid acid decreases prevalence of ovarian cysts and increases progesterone levels in women with PCOS.
   3. Melatonin:While this hormone is typically thought of as a supplement for promoting sleep, it is not a sleeping pill, but rather a hormone. (There are many reasons to avoid using melatonin as a sleep aid, but that’s a topic for another post.) When used in women with PCOS, supplementation at night has been shown to improve ovulation rates, corpus luteum formation, progesterone levels, and pregnancy rates for those who are trying to conceive. Melatonin supplementation also decreases hirsutism and androgen levels when used at 10 mg/night.
   4. Black Cohosh: As described in this post about fertility drugs, research has shown that dosing 20 mg daily of black cohosh at the beginning of the cycle modulates the LH surge during the follicular phase, improving rates of ovulation. This supplement also results in higher progesterone levels during the luteal phase, improving the thickness of the endometrial lining and supporting a luteal phase that is long enough for implantation and pregnancy in women who are trying to conceive.

Closing thoughts…

As if the symptoms of PCOS aren’t difficult enough, the journey towards a diagnosis to explain the symptoms, and finding a treatment strategy that works for you in the context of your own life can add enormous loads of stress to an already challenging life experience. There is a whirlwind of information out there, which only adds to the confusion and frustration of trying to manage your health. It can be a lonely and scary place, but I want you to know that you’re not alone. Consider making an appointment with a functional medicine doctor who can deliver personalized care and help you achieve your health goals.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

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Resources abound for hypothyroidism online. After all, it is one of the leading hormonal imbalances affecting women, and rates are rising faster than ever. But for those dealing with a different condition—or really, quite the opposite condition—of hyperthyroidism caused by Graves’ Disease, it can feel lonely and isolating when nobody is talking about, or offering help for you.

Well, you’re in the right place.

Doctors use the term hyperthyroidism to refer to a condition in which the thyroid gland is producing too much thyroid hormone, increasing metabolic rate to debilitating and sometimes dangerous levels. There are classically two main autoimmune conditions that can cause this: Graves’ Disease and Hashimoto’s Disease. While both Graves’ Disease and Hashimoto’s Disease are autoimmune conditions affecting the thyroid, they are different from each other. They are diagnosed differently, treated differently, and have different long-term health implications.

Let’s start by explaining autoimmunity.

Autoimmunity refers to the abnormal immunological process of producing antibodies against a person’s own self. Antibodies are like little soldiers made by the immune system for the purpose of fighting off foreign invaders like germs. If the body starts mobilizing soldiers against itself, that leads to problems ranging from inflammation to organ damage and even death. Graves’ Disease and Hashimoto’s Disease both involve the abnormal production of antibodies targeting the thyroid gland, but they produce hyperthyroidism in different ways.

What Is Hashimoto’s Disease?

Hashimoto’s Disease is the most common autoimmune diseases affecting the thyroid. Classically, however, it is thought of as causing hypothyroidism, and that’s because most cases do eventually result in a hypothyroid state. However, in the early stages, it can cause hyperthyroidism, or an overactive thyroid, too.

In Hashimoto’s Disease, the body makes antibodies (anti-thyroglobulin and anti-thyroperoxidase antibodies) that destroy elements of the thyroid gland. This causes swelling and inflammation of the thyroid gland. The inflammation itself is what can cause periods of thyroid overactivity because the provocation from the antibodies and resultant inflammatory processes may trigger the thyroid gland to produce even more hormone.

However, over time, as enough damage is wrought on the thyroid resulting from this autoimmune-driven inflammation, the thyroid may stop functioning as well as it should, or perhaps even may stop functioning altogether. As a result, hypothyroidism develops and while it can sometimes be improved through functional medicine, Hashimoto’s Disease that is diagnosed too late may lead to permanent hypothyroidism.

What Is Graves’ Disease?

Graves’ Disease is very different. Whereas Hashimoto’s Thyroiditis is the most common cause of hypothyroidism (ultimately), Graves’ Disease is the autoimmune disorder that is the most prevalent cause of hyperthyroidism. It occurs when the immune system produces antibodies that bind to the thyroid-stimulating hormone receptor (TSHR), leading to excessive thyroid hormone production. Under normal circumstances, the brain makes TSH (thyroid-stimulating hormone) for the purpose of binding to these receptors and stimulating the thyroid to produce thyroid hormone. In Graves’ Disease, thyroid-stimulating immunoglobulins (antibodies) bind to these receptors. In other words, the immune system mimics the brain and triggers the thyroid to make antibodies.

How Does Graves’ Disease Cause Health Problems?

Overproduction of thyroid hormone in Graves’ Disease accelerates metabolism and can result in symptoms such as weight loss, rapid heartbeat, anxiety, tremors, and eye problems like bulging eyes (Graves’ orbitopathy). Additionally, Graves’ Disease poses risks for people who are trying to get pregnant (or stay pregnant,) who struggle with anxiety, or who have cardiac conditions. It also may be challenging to function with Graves’ Disease because it often also brings other symptoms that affect quality of life, like body aches, sleep problems, and panic attacks. The immune side of Graves’ Disease is also problematic, as it can bring on episodes of full-body hives. If you’ve ever experienced this, you know just how overwhelming it can be.

How Is Graves’ Disease Diagnosed?

Diagnosis typically involves:

• Blood Tests: Measuring levels of thyroid hormones (T3 and T4), thyroid-stimulating hormone (TSH), thyroid-stimulating immunoglobulin (TSI) and thyroid-stimulating hormone receptor antibodies (TRAb) is an essential piece of diagnosing Graves’ Disease.
• Ultrasound: Assessing the size and texture of the thyroid gland. Thyroid nodules can also produce thyroid hormone, so it’s important to understand the root cause of hyperthyroidism and not simply assume that the root cause is Graves’ Disease.
• Radioactive Iodine Uptake Test: Determining how much iodine the thyroid absorbs, which is often elevated in Graves’ disease.

The Role of Gut Health in Graves’ Disease

Emerging research indicates a significant connection between gut microbiota and Graves’ disease. Studies have shown that individuals with Graves’ disease exhibit reduced gut microbiota diversity compared to healthy controls. Specifically, there is a decrease in the abundance of Firmicutes and an increase in Bacteroidetes, suggesting an imbalance in gut bacteria that may influence autoimmune responses.

Furthermore, certain gut bacteria have been found to share structural similarities with thyroid proteins, potentially triggering immune responses that lead to autoimmune thyroid diseases like Graves’ disease. The functional medicine perspective recognizes that gut health, and balancing the gut microbiome, is essential for managing Graves disease.

Functional Medicine Strategies for Managing Graves’ Disease

Functional medicine emphasizes a holistic approach to managing Graves’ disease, focusing on diet, supplementation, and lifestyle modifications to support thyroid health and overall well-being.

1. Functional Medicine Testing

• Gut Health: Gut health plays a crucial role in regulating the immune system, as a large portion of immune activity occurs in the gastrointestinal tract. An imbalanced gut microbiome or increased intestinal permeability (“leaky gut”) triggers immune dysregulation, contributing to autoimmune reactions like Graves’ disease by allowing toxins or antigens to enter the bloodstream and provoke an inappropriate immune response. Functional medicine offers testing methods for identifying the status of the microbiome including specific strains of microbes that are or are not present, allowing tangible, specific tests for treatment and rebalancing.
• Food Sensitivities: Food sensitivities overstimulate the immune system by triggering chronic, low-grade inflammation each time reactive foods are consumed. In individuals with autoimmune conditions like Graves’ disease, this constant immune activation may exacerbate symptoms or contribute to flare-ups by increasing the overall inflammatory burden. Identifying and eliminating trigger foods can help reduce immune system stress and support more balanced immune function. Functional medicine offers testing methods for IgG and IgA-mediated food sensitivies as well as Ig-E mediated food allergies.
• Histamine:Histamine intolerance occurs when the body cannot properly break down histamine, leading to an overload that triggers inflammation and immune system activation. This heightened immune response worsens symptoms in autoimmune conditions like Graves’ disease by increasing systemic inflammation and aggravating thyroid dysfunction, especially symptoms like heart palpitations, hives and anxiety. Histamine is a routine part of functional medicine testing, as well as other pathways of the body involved in histamine production and detoxification.

2. Dietary Strategies

• Anti-inflammatory Diet: Incorporate whole foods rich in antioxidants, such as fruits, vegetables, and fatty fish, to reduce inflammation. Many patients also experience food sensitivities to eggs, gluten or dairy, so testing and elimination of these reactive foods is also important.
• Limit Iodine Intake: Excessive iodine can exacerbate hyperthyroidism; it’s important to limit high-iodine foods unless testing demonstrates that you’re deficient in iodine.
• Avoid Stimulants: Reduce or eliminate caffeine and high-sugar foods to prevent overstimulation of the thyroid.
• Regular Meals: Eating at consistent times helps stabilize blood sugar levels and support metabolic function. It also helps prevent exacerbation of Graves’ symptoms, like anxiety, racing heart, or feeling dizzy.

3. Herbal and Supplement Support

• 1. Bugleweed (Lycopus europaeus)
  Action: Inhibits thyroid hormone synthesis and reduces TSH receptor activity.
  Evidence: Shown to reduce thyroxine (T4) levels and may help manage mild hyperthyroidism.
  
  2. Lemon Balm (Melissa officinalis)
  Action: Competes with TSH for receptor binding and may help reduce symptoms like anxiety and palpitations.
  Evidence: Traditionally used to reduce hyperthyroid symptoms; more robust human trials are limited.
  
  3. L-Carnitine
  Action: Acts as a peripheral antagonist of thyroid hormone activity and may relieve symptoms like muscle weakness and fatigue.
  Evidence: Effective in reversing hyperthyroid symptoms in both overt and subclinical cases.
  
  4. Selenium
  Action: Antioxidant that protects thyroid tissue and modulates autoimmunity.
  Evidence: Supplementation improves quality of life and reduces thyroid autoantibody levels in Graves’ disease.
  
  5. Vitamin D
  Action: Modulates immune function and lowers autoimmunity risk.
  Evidence: Low vitamin D is associated with increased thyroid autoimmunity and more severe Graves’ disease.
  
  6. Omega-3 Fatty Acids
  Action: Anti-inflammatory effects and immune modulation.
  Evidence: Helps regulate immune response and may reduce autoimmune thyroid inflammation.
  
  7. Ahnjeonbaekho-tang (AJBHT)
  Action: Traditional Korean herbal remedy shown to reduce thyroid hormone levels.
  Evidence: Clinical trials demonstrate improvement in T3/T4 levels and TSH normalization.
  

4. Lifestyle Modifications

• Stress Management: Chronic stress can exacerbate autoimmune conditions; practices such as meditation, yoga, and adequate sleep can help manage stress levels.
• Regular Exercise: Engaging in regular physical activity can improve cardiovascular health and support metabolic function.
• Avoid Environmental Toxins: Limit exposure to environmental toxins that may trigger or worsen autoimmune responses. It’s also important to avoid using hormonal contraceptives, as in my experience, these are a common trigger for new onset of Graves disease.

Graves’ disease is a complex autoimmune disorder with significant implications for thyroid health. Understanding its pathophysiology, recognizing the role of gut health, and implementing functional medicine strategies can provide a comprehensive approach to managing the condition. Always consult with a healthcare provider before making significant changes to diet, supplementation, or lifestyle to ensure safety and efficacy.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

Become a Patient

Don’t miss out! Join the email list.

Sign Me Up!

Love this post Share it!

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Want more Grab a copy of my new book, The Postpartum Check-In !

Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

References

1. ZUFRY H, ZULFA PO, HARIYANTO TI. The gut microbiota and its role in Graves’ Disease: a systematic review and meta-analysis. Biosci Microbiota Food Health. 2024 Jun 7;43(4):300–308. doi: 10.12938/bmfh.2024-020. PMID: 39364132; PMCID: PMC11444861.
2. Kiseleva EV, Kiseleva EV, Kiseleva EV. Gut Microbiota May Play a Significant Role in the Pathogenesis of Graves’ Disease. Front Endocrinol (Lausanne). 2020 May 5;11:301. doi: 10.3389/fendo.2020.00301. PMID: 32416683; PMCID: PMC7210420.
3. Lee YJ, Lee YJ, Lee YJ. An alternative therapy for graves’ disease: clinical effects and mechanisms of an herbal remedy. J Ethnopharmacol. 2008 May 28;118(3):409-13. doi: 10.1016/j.jep.2008.04.014. PMID: 18479224.
4. Komosinska-Vassev K, Olczyk K, Kucharz EJ, Marcisz C, Winsz-Szczotka K, Kotulska A. Free radical activity and antioxidant defense mechanisms in patients with hyperthyroidism due to Graves’ disease during therapy. Clin Chim Acta. 2000 May;300(1-2):107-17. doi: 10.1016/S0009-8981(00)00306-5. PMID: 10727685.
5. Ross DS, Burch HB

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In this post, we’ll explore the most important foods to avoid for each type of PCOS from a functional medicine perspective, while also offering evidence-based supplements and beneficial foods to help balance your hormones naturally.

Types of PCOS

1. Adrenal PCOS

Adrenal PCOS is driven by excess androgen production from the adrenal glands. This type of PCOS is typically associated with high stress levels, poor adrenal function, and imbalances in cortisol. Women with adrenal PCOS may experience symptoms such as excess body hair (hirsutism), scalp hair thinning, acne, and irregular periods.

Foods to Avoid for Adrenal PCOS

• Caffeine: Excessive caffeine can stimulate cortisol production, exacerbating adrenal stress. It’s best to avoid caffeinated beverages like coffee and energy drinks.
• Refined Sugars: Refined sugars and processed carbs cause blood sugar spikes and crashes, which can lead to further cortisol imbalances.
• Alcohol: Alcohol places additional stress on the liver, impairing its ability to detoxify and regulate hormones.
• Processed Foods: These often contain trans fats and additives that may disrupt hormone function and contribute to inflammation.

Beneficial Foods for Adrenal PCOS

• Adaptogenic Herbs: Foods like ashwagandha, maca root, and holy basil can help regulate cortisol levels and support adrenal health.
• Healthy Fats: Avocados, olive oil, and omega-3-rich foods (like salmon and flaxseeds) nourish the adrenals and promote hormone balance.
• Leafy Greens: Rich in magnesium, spinach, kale, and Swiss chard help calm the nervous system and reduce stress.

Supplements for Adrenal PCOS

• Ashwagandha: Known for its adaptogenic properties, ashwagandha can help lower cortisol and support adrenal function.
• Vitamin C: High-dose vitamin C can reduce cortisol levels and improve adrenal function.
• B Vitamins: B5 and B6 are especially helpful for adrenal support and stress management.

2. Post-Pill PCOS

Women with post-pill PCOS develop symptoms of PCOS after discontinuing birth control pills. The synthetic hormones in birth control pills can suppress natural hormone production, and once the pill is stopped, the body may take time to rebalance itself. Common symptoms include acne, hair thinning, and irregular cycles.

Foods to Avoid for Post-Pill PCOS

• Soy: While soy is a good source of plant-based protein, it can interfere with estrogen levels and disrupt hormonal balance, particularly in women who have just stopped taking the pill.
• Dairy: Some women find that dairy exacerbates acne and hormonal imbalance due to its potential to increase androgens.
• Refined Grains: White bread, pasta, and other refined grains can spike blood sugar, which in turn elevates insulin levels and can worsen hormonal imbalances.

Beneficial Foods for Post-Pill PCOS

• Cruciferous Vegetables: Broccoli, cauliflower, and Brussels sprouts help the body detox excess estrogen and promote hormone balance.
• Flaxseeds: Rich in lignans, flaxseeds help balance estrogen levels by supporting estrogen metabolism.
• High-Fiber Foods: Fiber-rich foods like oats, quinoa, and chia seeds can help regulate insulin levels and improve digestive health.

Supplements for Post-Pill PCOS

• Inositol: A combination of myo-inositol and D-chiro-inositol can help improve ovarian function and regulate insulin.
• Zinc: Zinc supports healthy skin and can reduce acne related to hormonal imbalances.
• DIM (Diindolylmethane): Found in cruciferous vegetables, DIM supports the body’s ability to detoxify estrogen and may help with hormonal acne.

3. Inflammatory PCOS

Inflammatory PCOS is marked by chronic low-grade inflammation throughout the body. This type of PCOS is often associated with symptoms like weight gain, acne, fatigue, and insulin resistance. Chronic inflammation can exacerbate the symptoms of PCOS and interfere with hormone regulation.

Foods to Avoid for Inflammatory PCOS

• Fried Foods: High in trans fats, fried foods can increase inflammation in the body and contribute to insulin resistance.
• Sugar-Sweetened Beverages: Sodas, energy drinks, and even sugary fruit juices can spike blood sugar and increase inflammation.
• Processed Meats: Bacon, sausages, and hot dogs are often high in inflammatory omega-6 fatty acids and preservatives.
• Artificial Sweeteners: These can disrupt gut microbiota and promote inflammation.

Beneficial Foods for Inflammatory PCOS

• Turmeric: Contains curcumin, a potent anti-inflammatory compound that can help reduce inflammation in the body.
• Berries: Blueberries, strawberries, and raspberries are packed with antioxidants that reduce oxidative stress and inflammation.
• Omega-3 Fatty Acids: Fatty fish like salmon, sardines, and mackerel are rich in omega-3s, which help reduce inflammation.

Supplements for Inflammatory PCOS

• Curcumin (Turmeric): An anti-inflammatory powerhouse that can help reduce systemic inflammation and improve ovarian function.
• Omega-3 Fatty Acids: Supplements like fish oil can significantly reduce inflammation and support overall hormone balance.
• Vitamin D: Low levels of vitamin D have been associated with inflammation and insulin resistance in PCOS.

4. Insulin-Resistant PCOS

Insulin resistance is one of the most common underlying factors in PCOS. When the body becomes resistant to insulin, it leads to higher levels of circulating insulin, which can worsen hormonal imbalances, increase androgen production, and contribute to weight gain, fatigue, and acne.

Foods to Avoid for Insulin-Resistant PCOS

• High Glycemic Index Foods: Foods that spike blood sugar, such as white bread, pastries, and sugary cereals, should be avoided.
• Trans Fats: Found in many packaged snacks and fried foods, trans fats can worsen insulin resistance and increase inflammation.
• Refined Grains: These foods cause rapid spikes in blood sugar and insulin levels, exacerbating insulin resistance.

Beneficial Foods for Insulin-Resistant PCOS

• Low-Glycemic Index Foods: Non-starchy vegetables, legumes, and whole grains help stabilize blood sugar levels and improve insulin sensitivity.
• Magnesium-Rich Foods: Spinach, pumpkin seeds, and almonds are great sources of magnesium, which can help improve insulin sensitivity.
• Cinnamon: Known for its ability to improve insulin sensitivity, cinnamon can be added to smoothies or oatmeal.

Supplements for Insulin-Resistant PCOS

• Berberine: An herbal supplement that has been shown to improve insulin sensitivity and regulate blood sugar.
• Magnesium: Magnesium supplementation can help improve insulin sensitivity and reduce the risk of developing type 2 diabetes.
• Alpha-Lipoic Acid: A potent antioxidant that can enhance insulin sensitivity and improve metabolic function.

Personalizing Your Diet for PCOS

Whether you have adrenal, post-pill, inflammatory, or insulin-resistant PCOS, a functional medicine approach focuses on addressing the root causes of your hormonal imbalance through diet, lifestyle, and targeted supplementation. By avoiding inflammatory foods, refined sugars, and processed carbs, and by incorporating hormone-balancing foods, you can help mitigate the symptoms of PCOS and support long-term health.

Remember that everyone’s experience with PCOS is unique, so it’s important to work with a functional medicine practitioner or healthcare provider to customize your diet and supplement plan for optimal results.

By understanding the type of PCOS you’re dealing with and adjusting your diet accordingly, you can reclaim your health, balance your hormones, and feel empowered to manage your symptoms effectively.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

Become a Patient

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Sign Me Up!

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post How to Use Supplements for PCOS appeared first on Dr. Alexandra MacKillop.

If you’re unfamiliar with Invisalign, they are clear, plastic, molded retainers that are designed to shift teeth over the course of time. As a teenager, I had some mild crowding on the top and bottom, so my dentist recommended a 9-month course of using these dental trays to gently shift my teeth instead of having metal orthodontic braces put in. My dentist counseled me about the importance of keeping my teeth clean so that food particles didn’t get trapped underneath, and I took him seriously. But what he failed to mention and what I failed to realize is that the Invisalign trays were also keeping important things out, and that is how my cavity developed: saliva and oxygen.

Our mouths are living ecosystems. Just like “bad bacteria” causes cavities, good bacteria produce beneficial chemicals that protect our teeth and keeps our mouths functioning normally. Healthy saliva continually bathes our teeth and gums, protecting the enamel and maintaining an optimal chemical environment so that good bacteria can grow and bad bacteria cannot. When I was wearing the Invisalign, the saliva in my mouth was blocked from reaching my teeth, which influenced the type of bacteria that were able to grow. Without that natural cleansing, bad bacteria developed.

In addition to saliva, oxygen exposure is essential for a healthy mouth. Oxygen allows certain types of beneficial bacteria to grow and kills bad bacteria, which tend to die when exposed to air and oxygen. This is also part of the reason that flossing is important because in addition to removing stuck food, flossing introduces oxygen between teeth so that bad bacteria can’t grow, and so that saliva can get in to bathe and protect our teeth. My Invisalgn dental trays were also blocking my teeth from oxygenation, which favored the growth of anaerobic species of bacteria, which ferment and produce acid as byproducts, eroding enamel and leading to cavity formation and rot.

Obviously, it’s bad news when cavities form. A generally healthy lifestyle is needed for good dental health, and it’s also important to take steps to preserve the dental microbiome. Here are some strategies from functional medicine that you can take to help support your dental health and preserve your oral microbiome.

Here’s How to Support Your Oral Microbiome through Functional Medicine

1. Stop using plastic dental trays. As I outlined above, plastic dental trays prevent oxygen and saliva from reaching your teeth which leads to unfavorable shifts in the dental microbiome. It also damages gums and can worsen receding and inflammation. Instead of Invisalign and related products, opt for traditional wire braces. Likewise, instead of plastic retainers, use either a wire retainer or consider palate expansion so that the teeth naturally stay in place without the need for the constant pressure of a retainer.
2. Ditch sugar. Sugar favors the growth of bad bacteria in your mouth. It also is the fermentable substrate that bacteria consume, converting into acid and alcohol byproducts that erode enamel. You should also be mindful of foods that break down into sugar, like crackers which become wet and form a paste, sticking to teeth and holding sugar against them over the course of time. These pasty carbohydrates can get wedged into small grooves and cracks in teeth and contribute to cavity formation over time, even if they aren’t sweet foods with sugar added.
3. Use hydroxyapatite toothpaste. This is a natural way to rebuild enamel and protect your teeth if you have had exposure to damaging substances over time. Avoid toxicants like fluoride, which harm the balance of good and bad bacteria in the mouth (fluoride is toxic to good bacteria.) You should also avoid products like hydrogen peroxide which can damage enamel and harm the microbiome by killing beneficial bacteria.
4. Consume probiotic foods. Fermented foods like yogurt, kombucha, kimchi and natural pickles seed the mouth with beneficial probiotics. They also naturally stimulate saliva production which helps keep teeth and gums clean and moistened. You should have probiotics foods with every meal.
5. Avoid alcohol-based mouthwash. Alcohol-based mouth washes are not only drying, but they also kill beneficial bacteria in the mouth. This is a problem because the oral microbiome is there for a reason! Instead, use herbal mouth rinses like the Tooth & Gums Tonic from Dental Herb Company.
6. Fix mouth breathing. When we are sleeping (or awake), we should be breathing through our noses, with our mouths shut, unless we are eating, drinking or talking. Mouth breathing dries out the mouth and contributes to decay by shifting the oral microbiome and drying out teeth. This can worsen gum inflammation, lead to break down of enamel, and disrupt the oral microbiome. Mouth breathing can be challenging to fix, but I recommend having a comprehensive evaluation of why your body tends to use that method of breathing. Are you dealing with undiagnosed allergies Do you have a restricted airway Do you need dental expansion I recommend working with an airway dentist to have a thorough examination.
7. Take oral probiotics. In my functional medicine practice, I have somewhat of an eclectic approach to gut health and proboitic use. I am absolutely an advocate for consuming probiotic foods when appropriate (individuals with some histamine problems and overgrowth patterns may not tolerate probiotic supplementaiton.) In general, I prefer for people to not need to take probiotics in order to be healthy. However, as a consequence of our food system and because of some of the problems outlined in items 1-6 on this list, sometimes probiotic supplementation is necessary. Apart from correcting imbalances as outlined in functional medicine stool microbiome testing, I often recommend the E.N.T. Biotic from Protocol for Life Balance or Adult ENT-Pro from Biotics Research Company. What’s unique about both of these formulations is that they are not capsules; rather, they are lozenges that are meant to slowly dissolve in the mouth and “seed” the oral and sinus cavities with beneficial bacteria.
8. Use Red Light Therapy. If you are dealing with chronic imbalances in your oral microbiome or chronic problems with gum inflammation (gingivitis), consider using red light dental trays to administer red light therapy to your gums to facilitate healing and reduce cavity formation. Red light limits the growth of harmful bacteria and facilitates the growth of beneficial bacteria to balance the microbiome. This strategy is also a natural method for tooth whitening that does not use harsh chemicals or erode enamel like peroxide does.

Other Strategies for Dental Health

In addition to maintaining the above strategies to support the dental microbiome, an overall health lifestyle is essential for good oral health. It’s not just as simple as brushing and flossing, though those are obviously important too.

In order to maintain your dental health, I also recommend eating a low glycemic index, nutrient-dense diet. Dental health requires micronutrients like chromium, copper, zinc, selenium, magnesium, calcium, vitamin D, vitamin C, and B vitamins. While you could certainly supplement these factors, there are additional nutrients far too numerous to list in a blog post that can only come from a diverse and abundant diet. Please also be sure to include quality animal products in your diet to support your long-term health.

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post Dental Probiotics: How Good Bacteria Can Transform Your Oral Health appeared first on Dr. Alexandra MacKillop.

Prior to becoming a functional medicine doctor, I started my career in the field of food science working as a flavor chemist to make natural flavors. Frankly, I loved it, but much of what I learned and saw there ultimately led me to exit the field and transition to working in natural health.

How can both of those things be true How can I love something that ultimately led me away?

Read on to learn the story of how I entered, and then left, the field of food science to become a functional medicine doctor.

I chose to study food science in college because it seemed like the perfect mix of science, creativity and fun. I mean, who doesn’t love the idea of “playing with food” all day and calling it science

For much of my adolescent life, I was already doing food science on my own. I was interested in eating healthy and cooking, and certainly appalled by the diversity and breadth of food items on the market that were completely unhealthy. It was not hard to see, even as a young person, that ultra-processed food items were not the way to long, vibrant life. As a teenager and athlete, I enjoyed concoting “alternative” recipes for “healthified” versions of common processed foods, inlcuding those that had taken on nostalgic appeal.

Sometimes I was successful, sometimes I wasn’t, but I learned a lot and had a lot of fun.

After starting my college career in engineering and quickly learning that the computer programming lifestyle was not for me, I took a turn in my study of science to pursue food science. I describe food science as a specialized form of chemical engineering that is focused on food. Food scientists, I’d explain, were responsible for finding recipes to keep cereal crunchy longer in milk, and come up with new, alternative protein sources. I was a vegan at the time, so I loved to wax poetic about meat alternatives.

Oh, how the times change.

As a hopeful young person, I envisioned myself working in R&D at a food company, designing formulations for healthier versions of popular products. I daydreamed about the next fast company like Annie’s Organics, or Morningstar Farms. I got involved in the local food office and connected with farmers and those who shared my passion for sustainable food growing practices. I interned in a lab where we used blueberry-derived antioxidants to kill cancer cells. I entered into R&D food competitions and won awards for “functional foods,” like a pea protein-based sausage alternative and a color-changing salt for those with hypertension. I was on a roll, and nothing was going to stop me. That is, until I graduated.

Through the end of my senior year and after graduation, I started working for a flavor company. First of all, I want to be clear that I have very fond memories of my time there, think well of the company owners/my bosses, and value the relationships I formed. It was a wonderful experience, I was treated very well, and I learned so much. The criticisms I carry from my time there have nothing to do with my team in flavor chemistry and everything to do with government regulations, marketing, and the food industry as a whole.

There are a few things to understand about flavor chemistry that I also want to cover, first. Food flavorings are built by mixing together individual chemicals to round out a flavor, kind of like how we combine rosemary, thyme, sage and oregano to make “poultry seasoning,” for example. It’s like filling in pieces of a puzzle to round out the flavor of a food. The chemicals chosen for this come from a process called gas chromatography, which is a chemical testing method that detects the presence of volatile compounds in food to figure out what is contributing to the flavor profile. These are complex processes and the gas chromatographer (GC) can’t do it all on its own; a trained flavorist fills in the gaps by identifying what might be missing from what the GC reports. Think about this role as like a sommelier who can identify the “grassy notes” in a young Pinot Grigio or “black pepper flavor” in a spicy zinfandel. The chemicals we mix together are ingredients, not reactants, meaning that they retain their characteristics and form even after being mixed together. They don’t form a chemical reaction like what occurs when mixing baking soda and vinegar; it’s more like, as I mentioned, mixing spices. They’re all there, together.

What goes into natural flavors?

And that is precisely the problem. My job in the lab involved making samples of these natural flavors sold by our company for manufacturers to try out before buying. Our flavorist-formulated flavors were built by yours truly and sent off to see if someone wanted to buy them. When they did, the warehouse guys would mix up large-scale portions of the flavors to send out for industrial use in everything from fizzy drinks to soft serve ice cream, to candy, popcorn and more.

My first problem with the job was that it was kind of boring. The end product was fun (mixing up two different types of strawberry flavoring was a fun experience for sure) but I didn’t love the solo work in a lab, with goggles and a ventilation hood and gloves to avoid chemical burns.

But, the second problem which ultimately led me out of food science was that when I traveled into the warehouse to refill my sample bottles in the lab, I was met with alarming warning labels on the drums of “natural” acetaldehyde and “natural” furfural. They said things like “do not ingest,” and “harmful if swallowed” and had skulls and crossbones on them. And there I was, using a pipette to mix them into a solvent (alcohol or MCT oily, or propylene glycol, for example) and then literally spooning it into my mouth to taste test the final product. Was I poisoning myself? I wondered.

The tipping point came when, while in the warehouse, I accidentally spilled natural methyl butyric acid on my shoe. It was so extraordinarly potent! It made my eyes water and my lungs spasm just being around my own foot. But the bottle in warehouse carried those alarming labels: “harmful if swallowed,” and “do not ingest.” If the spill on my shoe was making my eyes water, what was it doing to my insides? I wondered. My questions became even more important when I went home to where I was staying, with my pregnant sister, and I became concerned that I could potentially be exposing her and her unborn baby to harmful volatile chemicals.

I’d thought that by entering the food industry that I would be doing something good. After all, I was working with “natural” flavors, and wasn’t natural supposed to be better But I also knew that alcohol can be considered “natural” even though it’s a carcinogen. Aspirin is naturally occurring in plants but can permanently damage children through Reye’s syndrome. Was my work with “natural chemicals” really in line with my desire to make healthier products to feed the world?

The problem with natural flavors

The more I looked into these chemicals, the more I became aware that they were not safe, not at all. Sure, I was diluting them down in the lab, but I also knew that the chemicals I was mixing up to make, say, strawberry flavoring were not the same as eating a fresh strawberry that grew in the ground. Moreover, I was starting to experience some concerning symptoms for myself, like weight gain, acne, and bloating. I also started experiencing cramping with my periods, which I had never dealt with prior.

Unsurprisingly, these symptoms disappeared when I left the office and entered graduate school instead. It wasn’t stress because again, the job was low-key and pretty fun. But chemical toxicants profoundly influence hormones, liver health, and inflammation, which were all systems of my body that were struggling because of my job.

Moreover, “natural” flavoring is exactly the same as artificial flavoring, which most consumers are already plenty wary of. The only difference is that the consitutent chemicals, such as furfural, for example, are derived from “natural” starting materials rather than synthesized through chemical reactions in a laboratory. Natural furfural comes as a byproduct from the biodiesel industry, derived from chaff. Synthetic furfural, on the other hand, is synthesized using catalysts like sulfuric acid in a laboratory setting. Regardless of formation, however, both are distilled and purified to be, truly, pure furfural. It’s the same thing just a different origin.

The flavor industry isn’t the only defunct area of our food system that concerns me, however. Even starting in my college program, our professors were honest about the fact that money, not consumer wellbeing, drives the industry. If we were to work in R&D, the #1 thing our bosses would be asking us to do was cut costs to cheaper ingredients. To model this, our capstone design project involved our professor immediately handing the projects back to us after submission, and instructing us to reformulate to cut costs by 30%. The way to do that was to transition to ultra-processed, refined, shelf-stable ingredients like corn and soy derivatives instead of fresh ones sourced from whole foods.

Why

They’re cheap. They don’t “go bad.” They can be used as fillers to crowd out the expensive ingredients, only they come at the cost of diluting the flavor, too. They’re subsidized by the government and there are incentives for food companies to use them.

Well, friends, that’s where flavoring comes in. And coloring. “Natural” aside, those colors and flavors are designed to cover up the cover up. The food industry, contrary to what I was hoping to do, was all about tricking consumers into eating “junk food” and truly, toxic chemicals rather than helping to bolster up the health of Americans. Nobody was working to clean things up and make it healthier. Going agains the status quo would invariably get me fired. Yikes.

So, where does that leave us?

I personally consume processed foods still, from time to time. Even as a functional medicine doctor who has had personal experience working in the food industry and knowing all the crazy things that go on behind-the-scenes. But I try to strike a balance, for both myself and my family, between pursuit of “perfection” which does not exist, and enjoyment of life and novelty. That being said, I try not to let those ultra processed foods make up too teribly great of a proportion of my diet, instead emphasizing whole foods and fresh ingredients whenever I can. Not only do I feel better this way, but I’m naturally minimizing and displacing ingredients like those used to produce flavoring, which are truly harmful.

But what about you How can you know what goes into these flavoring ingredients How do you know what harm can be caused by them

This is what natural flavors are made of, straight from my work in food science:

Natural flavoring is made from volatile organic compounds, things like aldehydes and -enols and -enals and other types of carbon-based molecules that can get really toxic, really quickly. The exact chemicals in different food items differ based on the construct of the flavor, whether the food has been cooked, etc.

Food companies don’t list out the ingredients in their flavoring because these recipes are considered to be “proprietary.” McDonald’s Vanilla Ice Cream has its own distinct flavor profile, separate from Breyer’s Vanilla Ice Cream, or what the food would taste like if you made dessert yourself from real cream and vanilla beans. However, many of the fundamentals are the same.

To find out what might be individual flavorings, start with Google. Search “VOC chemicals in __________” and fill in the blank with the food you’re looking for. Take strawberry flavoring, for example:

Then you’ll want to get the industrial-level safety information on these individual chemicals, such as furaneol, mesifurane, linalool, ethyl butanoate and more.

I recommend searching the database of real US flavor ingredient suppliers, such as Advanced Biotech, which offers a database of hundreds if not thousands of different chemicals that fall under the guise of “flavoring” ingredients. This is one of the major suppliers of industrial-level fragrance and flavoring chemicals that are food-grade, which I personally worked with when I was working as a food scientist in the flavor industry. Navigate to their website, hit the search function, and search these compounds by name. Here’s an example for the safety data sheet for acetaldehyde, which is found in many fruit flavors, especially citrus:

Keep in mind that if you don’t have a chemistry background, this can be confusing at times because the same chemicals can go by different names. For example, mesifurane which is listed as a VOC in strawberries, does not show up on the Advanced Biotech database. However, mesifurane also goes by the name 2,5-DIMETHYL-4-METHOXY-3(2H)-FURANONE. So, if you can’t find a particular chemical, look up (Google can again be a resource for this) other names for that chemical.

At the end of the day, you’re the one who ultimately gets to make the decision about what you put in your body. And, when food companies hide the ingredient list under the guise of “natural flavors,” it’s hiding information and getting in the way of informed consent. I take issue with that, which is why I’m sharing my experience and knowledge here, today.

Let me know in the comments: Did you know the truth about natural flavors What are you comfortable consuming when it comes to natural flavors

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post The Truth About “Natural Flavors” appeared first on Dr. Alexandra MacKillop.

But, what’s to be done about it? You’ll find answers to that question and more in this post, which discusses the differences between diagnosis and management of eczema and psoriasis.

Two of the most common categories of skin rashes include eczema and psoriasis, and these categories both include several different subtypes within them. However, all of these subtypes share certain etiological similarities and have similar approaches to treatment even though they are individual types of eczema and psoriasis. At the same time, psoriasis and eczema share similarities, such as the inflammatory and immune components, but they are, of course, different things.

In this post, we’ll explain how psoriasis and eczema are similar but also how they’re different, so you can get a better understanding of the Psoriasis vs. Eczema equation and know how to best work with your doctor in approaching the issue, whether it’s you, your child, or someone else you know who is suffering.

Psoriasis vs. Eczema: Types of Conditions

Types of Eczema

Eczema on it’s own is not fully considered an autoimmune disease, though it is closely related to a dysfunctional immune response, and many of the treatments both in Functional Medicine and the traditional medical model treat it as though like an autoimmune condition. Eczema commonly accompanies other autoimmune condition. However, while autoimmunity involves the immune system attacking the self, with eczema, the response is more like an allergy, with the immune system inappropriately attacking allergens and irritants due to a compromised skin barrier.

1. Atopic Dermatitis (Atopic Eczema)
   • Chronic condition, often begins in childhood. May even appear on babies, and many often confuse it with “baby acne.” (Baby acne typically appears within a few days of birth and resolves by 3 weeks, whereas rashes that persist or appears for the first time after 6 weeks of age are more likely to be eczema.)
   • Itchy, red, and inflamed skin, typically on the face, hands, and behind the knees. Underarms are a less frequent location for eczema, and may be more likely to be a yeast rash, such as Candida.
   • Linked to genetics and environmental factors (allergies, asthma, antibiotic use and other gut-related conditions).
   • Skin may also become “weepy,” or crusted from dried, oozing lesions.
2. Contact Dermatitis
   • Triggered by contact with irritants or allergens. When severe, contact dermatitis may closely resemble atopic dermatitis, and doctors easily confuse the two if the causative agent is not obvious.
   • Irritant Contact Dermatitis: Caused by direct irritation from substances (e.g., chemicals, soaps).
   • Allergic Contact Dermatitis: Caused by an allergic reaction to substances (e.g., poison ivy, nickel).
3. Seborrheic Dermatitis (“Cradle Cap”)
   • Red, scaly patches on oily areas of the body, such as the scalp, face, and chest.
   • Often associated with dandruff or oily skin.
   • Often appears on newborn babies and may persist for years if untreated. Because this is a type of dermatitis, if other irritants contact the inflamed skin, it may progress to other forms of dermatitis such as atopic dermatitis.
4. Dyshidrotic Eczema
   • Small, itchy blisters on the hands and feet.
   • Often linked to stress, allergies, or sweating.
5. Nummular Eczema
   • Coin-shaped, deep red patches of irritated skin, usually on the arms, legs, or torso.
   • Often triggered by dry skin or winter weather.
6. Stasis Dermatitis
   • Occurs on the lower legs due to poor circulation.
   • Common in people with venous insufficiency or varicose veins. May also be accompanied by the appearance of bruising, spider veins and possibly even bleeding from ulcerations over veins.

Types of Psoriasis

We consider psoriasis a true autoimmune disease, and sometimes is accompanied by other autoimmune symptoms like joint arthritis. With psoriasis, the immune system attacks itself, creating thickening and reproduction of skin cells which form the inflammatory plaques.

1. Plaque Psoriasis
   • Most common type, characterized by raised, red patches with silvery scales.
   • Typically affects elbows, knees, scalp, and lower back.
   • Tends to be worsened by certain medications, like beta-blockers and lithium. It’s also worsened by stress, infection, and injury.
2. Guttate Psoriasis
   • Small, drop-shaped, red lesions, often triggered by infections (e.g., strep throat, COVID).
   • Common in children and young adults.
   • May be worsened by puberty and other hormonal shifts.
3. Inverse Psoriasis
   • Red, shiny lesions that appear in skin folds (e.g., armpits, groin, under breasts).
   • Triggered by friction and sweating.
4. Pustular Psoriasis
   • Characterized by white pustules surrounded by red skin which eventually pop and flake/itch.
   • Can occur on any part of the body, but most common on hands and feet.
   • Easily confused with infectious rashes.
5. Erythrodermic Psoriasis
   • Extremely rare, severe form with widespread redness and peeling of the skin, often across the whole body.
   • Can be life-threatening and requires immediate medical attention.
6. Nail Psoriasis
   • Affects the nails, causing pitting, discoloration, and thickening. May affect one nail or multiple nails, as well as the nail bed.
   • Often seen with other types of psoriasis.

Differences Between Eczema and Psoriasis

It’s important to note that eczema and psoriasis are similar, but their differences are significant enough that they need to be treated differently. However, before we dive into the differences, it’s important to remember what is similar about them.

Both eczema and psoriasis are immune-mediated conditions, meaning it’s wrongful activity of the immune system that drives the condition. Both create inflammatory skin changes, which influence the microbiome of the skin, favoring the growth of inflammatory bacteria. This bacteria, typically related to Strep and other species, further triggers the immune response and worsens the condition. Because the gut microbiome also influences both the immune system and the skin microbiome, gut health plays a strong role in controlling both eczema and psoriasis.

Although the types of eczema and psoriasis are varied, in this discussion we will be focusing on the most common types, which inclue atopic dermatitis (eczema) and plaque psoriasis.

• Cause (Psoriasis vs Eczema):
  • Eczema: Primarily linked to allergies, immune system dysfunction, or environmental factors that trigger an overreactive immune system. Eczema may also be triggered by food sensitivities as well as allergies and problems with gut health.
  • Psoriasis: Caused by a self-reactive immune system, leading to rapid skin cell turnover and skin thickening. Psoriasis is not as closely linked to allergies as eczema, and is more likely to exist concomitantly with other autoimmune diseases. May be triggered by food sensitivities.
• Appearance (Psoriasis vs Eczema):
  • Eczema: Typically presents with red, inflamed skin, and sometimes blisters that weep and form yellow crust.
  • Psoriasis: Characterized by raised, thickened, scaly, and often silvery patches.
• Itchiness (Psoriasis vs Eczema):
  • Eczema: Often intensely itchy.
  • Psoriasis: May or may not be itchy, but can cause discomfort, pain or physical dysfiguration.
• Triggers (Psoriasis vs Eczema):
  • Eczema: Allergens, stress, temperature extremes, and irritants. May also be paradoxically triggered by moisture and sweat, such as in the summer, or dry air as in the winter. In children, teething may worsen eczema.
  • Psoriasis: Infections, stress, injury to the skin, and certain medications.
• Location (Psoriasis vs Eczema):
  • Eczema: Commonly affects the face, hands, feet, and behind the knees.
  • Psoriasis: Commonly affects the scalp, elbows, knees, and lower back.
• Chronicity (Psoriasis vs Eczema):
  • Eczema: Often a long-term condition, that may flare up seasonally or when exposed to certain triggers.
  • Psoriasis: Also chronic and can have periods of flare-ups.
• Traditional Treatment (Psoriasis vs Eczema):
  • Eczema: The traditional medical model treats eczema with moisturizers, such as colloidal oatmeal to reduce itching and petroleum-based skin protectants. Severe cases may be treated with corticosteroids such as (short term) hydrocortisone/clobetasone butyrate or (longer term) fluocinolone. Antihistamine medications may also be prescribed. Some providers may recommend skin-prick allergy testing. More recently, biologic medications such as Dupixent and Adbry have been approved for adults and children with eczema.
  • Psoriasis: Treated with topical steroids, phototherapy (including UV light exposure), and systemic chemotherapy (methotrexate) or biologic (Humira, Enbrel, Cimzia) medications for severe cases.

Psoriasis vs. Eczema: Functional Medicine Treatment

Through functional medicine, treating psoriasis and eczema both emphasize the same principles of building a foundation of health upon which the immune system can function normally. This necessitates overall good nutrition, exercise, sleep and stress management practices, control of exposure to environmental toxins, and accurate diagnosis of the underlying root causes of immune dysfunction.

Here’s the thing about immune dysfunction, whether overreactive to self or overreactive to triggers: it all depends on exacerbation of the Th2 division of the immune system, meaning the division of the immune system responsible for “fighting” and “killing” invaders. For both psoriasis and eczema, the Th2 division becomes overreactive, “fight” and “killing” things it shouldn’t. At the same time, there develops a relative deficiency in the activity of the Th1 immune system, which is responsible for cleaning up damaged cells. When these cells fail to be cleaned up properly, the Th2 immune system ends up creating an inflammatory response against those cells, too, snowballing the problem.

The Functional Medicine Basics for Psoriasis vs. Eczema

Gut Health: The gut mediates the immune system. Everything that enters our ears, eyes, nose, mouth and stomach ultimately gets to our digestive tract, where our bodies need to decide whether what we’ve swallowed is COVID, a turkey sandwich, or ourselves. Bacteria play a tremendous role in informing our immune systems in this way. In my practice, the starting point for all skin conditions is the gut: testing for the microbiome (probiotics, commensals and pathogens), as well as screening for intestinal permeability (“leaky gut”), the ability to break down protein, carbohydrates and fats as evidenced by stool residues, as well as screening for inflammatory markers like calprotetin, lactoferrin, lysozyme and changes in pH. I also look for chemicals that play a role in maintaining the gut barrier like butyrate.

Stress: With all immune-reactive conditions, stress makes matters worse. This is a highly individualized situation, and I cannot diagnose a person’s stress the way that they themselves can. I do screen for cortisol and DHEA on blood work as well as other markers of a chronic, dysfunctional stress response. But only a person themselves (or the person’s parent, in the case of a pediatric patient) can evaluate for stress. (Stressors in children often relate to moving homes, starting daycare or school, family conflict, teething, addition of new siblings, potty training, teething, and more.)

Nutrition: Micronutrient deficiencies as well as deficiencies of essential amino acids impact the skin barrier and immune system. I test patients in office for zinc, selenium, omega-3 fatty acids, vitamin D and ensure that their diet contains animal foods. It is nearly impossible to have enough healthy protein while maintaining carbohydrate intake on a vegan or vegetarian diet. It’s also essential to limit sugar, to avoid immune-reactive foods, and to treat insulin resistance if it is present.

Exercise: The benefits of exercise for stress reduction and immune system modulation are innumerable. That’s all I will say here. Adults and kids both need to move their bodies daily.

Sleep: Adults need 8-9 hours of sleep and children need 10-16, depending on their age. Screening for sleep problems is beyond the scope of this post but if you are concerned you may have sleep apnea, or that your child may be struggling with sleep, please have an evaluation done.

Toxins: This is the big one. The term “toxins” refers to chemicals (biological, synthetic or otherwise) that enter the body or come into contact with the skin and drive a dysfunctional immune response. These may include additions to personal care products, ingredients in medications or injected pharmaceuticals, pesticides, food additives, exposure to environmental toxins in air or water, and even household cleaning chemicals. If it triggers inflammation or an immune response, it will invariably trigger the eczema, or the psoriasis, of any sort. I recommend using the Environmental Working Group and Yukka apps as starting points for eliminating toxins.

Functional Medicine Treatment for Eczema

Beyond a firm foundation outlined above, functional medicine also offers specific strategies for treatment. In eczema, the keys are allergies, inflammation and supporting the skin barrier.

Allergies: I recommend blood testing for allergens and the foods you most commonly consume if you are an adult. Skin-prick allergy testing done by an allergist is not sufficient, and does not translate to eczema because these aren’t typically contact allergies driving the eczema response. It’s oral tolerance, or lack thereof. In my office, I run IgE blood test. For children, watch them like a hawk. Pay attention to any signs of redness, itching, hives, scratching, fussiness, reflux, vomiting or abdominal pain in the 3-6 hours following consumption of a particular food. If it happens more quickly, it is much more likely to be related to an IgE-mediated allergy. Then, when these foods have been identified, confirm the suspicion with an IgE blood test for each food. (Note: for milk, eggs, soy, peanut and certain other high-risk allergens, I recommend a “component panel” rather than just the IgE. Some foods have multiple identified immunogneic proteins, i.e. “Milk Component Panel” rather than “Milk, IgE.”)

When allergens have been confirmed via blood work, or even if the IgE is negative but the skin reaction is apparent, eliminate all sources of these foods for 6 months minimum. One skin is clear, reintroduce one-by-one to evaluate for tolerance. If IgE levels were detectible, re-test the IgE level after 6 months and consider reintroducing in your pediatrician or allergist office. Always consult with a physician when conusming allergenic foods.

Skin Barrier: Babies have thin skin with a poorly formed moisture barrier, making them more susceptible to irritants, especially chemical toxicants, abrasion, irritation, moisture, dryness and other triggers. I recommend using a thick, water-protective barrier ointment on all diaper changes, as well as a lotion containing saccharomyces ferment medium/filtrate such as Tubby Todd AOO. The chemicals in this fermentation filtrate protect the skin and calm inflammation, and also play a role in inhibiting the growth of inflammatory bacteria (see below.) Food-based oils do not make a good moisture barrier because they absorb quickly and are also likely to stain clothing. Instead, I recommend using either beef tallow or a beeswax-based non-petroleum product. That being said, I’m also okay with recommending Aquaphor, which contains petroleum and also castor oil, simply because it works really well and is much safer than steroids in the grand scheme of things.

In addition to topicals, supplementing with the amino acid L-Histidine upregulates the production of fillagrin, a protein that plays an extremely important role in mintaining the skin barrier. I recommend that my adult patients take 3-6 grams daily and pediatric patients somewhere between 0.25 and 1 gram depending on age and stature (capsules can be opened up and mixed with food). This needs to be supplemented long-term, for months or years, and takes time to create change so it should be combined with other strategies listed here. I also recommend my patients take an oral prescription of the probiotic saccharomyces boulardii as well as humic acid taken three times daily before meals to prevent overgrowth of commensal bacteria.

Inflammation: Inflamed skin favors the growth of inflammatory bacteria and that bacteria, in turn, worsens the immune response. It goes like this: eczema breaks out, and the skin barrier is compromised. Staphylococcus and other skin-dwelling bacteria take advantage of the situation and enter the cracks in the skin, triggering a worsened immune response, which worsens itching, prompts scratching and the eczema snowballs. This needs to be interrupted.

In extremely acute cases of eczema, I prescribe a triple-action ointment prepared using anti-fungal medication, antibiotic ointment and topical corticosteroid to be applied to the affected areas as follows: 4 times daily for 4 days, followed by 3 times daily for 3 days, twice daily or 2 days and then once daily for 1 additional day. This will help the itching/inflammation initially calm down, control infection and allow healing to begin. You can prepare this ointment at home using a 1:1:1 ratio by weight of Polysporin Ointment, Hydrocortisone 1% Ointment, and Miconazole 2% Ointment. Note that where indicated, you must use ointment rather than “cream.”

Once the skin has begun to calm down, or even if it hasn’t, I recommend my patients utilize a twice daily application of ozonated olive oil. The ozone in the olive oil produces reactive ozonides that kill bacteria, destroying their cell wall. They also stimulate the Th1 (healing) division of the immune system to clear infection, close wounds and restore the skin barrier. The OOO should not be used as a preventative, but should only be applied to areas of redness with limited spots of broken skin.

Functional Medicine Treatment for Psoriasis

Beyond a firm foundation outlined above, functional medicine also offers specific strategies for treatment. In psoriasis, the keys are prebiotics and oxidative control.

Prebiotics: Prebiotics are the precursor fibers to the growth of probiotics. Without enough “food” to keep them growing, probiotics will die off and not stick around long enough to do anything for the skin in terms of calming the immune system. Fructooligosaccharides tend to work best for psoriasis, but note that they will flare up individuals sensitive to FODMAPs or who are struggling with SIBO.

Oxidation: In addition to the benefits for eczema in controlling bacterial colonization, the Th1-stimulating properties of ozonated olive oil work tremendously well for psoriasis. OOO should be applied in a thin layer, twice daily, to any area that shows a flare. Take caution with areas of the scalp because the oil may create unfavorable changes to hair. For a standard shampoo, I recommend using a tar-based product. Coal-Tar Shampoo suppresses skin cell growth by preventing abnormal differentiation. It also helps calm inflammation and pain, and can be used as a topical wash for non-scalp areas. Coal-Tar ointment works well for non-scalp areas.

Moreover, UV exposure is essential for controlling psoriasis, as it has a similar effect to coal tar in controlling abnormal skin cell differentiation. We often think of UV exposure as a danger or risk but it provides tremendous benefits to the skin, especially inflamed skin such as in the case of psoriasis. I recommend my patients receive 30 mintues of direct sunlight exposure twice daily, or supplementation with a UV lamp or other at-home device. Note that UV lights are not the same as black lights, “blue lights,” or “sun lamps” used for reptiles.

A third factor in controlling psoriasis is omega-3 fatty acids which, when taken above daily requirements, control inflammation, immune reactivity and abnormal growth of tissue. I recommend a minimum of 4,000 mg daily for adults (often up to 8,000 mg daily) and a minimum of a standard adult dose for my pediatric patients. Be aware that doses this high might have a blood-thinning effect which can be dangerous when taking blood thinners, if having surgery, during injury or with those at risk of stroke.

Overall, skin conditions like eczema and psoriasis can be tricky to treat, and it can be very disheartening when seeing a PCP or dermatologist and receiving a lifelong steroid prescription.

That being said, functional medicine has so much to offer, wether for psoriasis vs. eczema. Natural healings can literally be in your hands!

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

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Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post Psoriasis vs Eczema: Functional Medicine Treatment appeared first on Dr. Alexandra MacKillop.

The Gut Microbiome

The word “microbiome” refers to the microbial colonies that live in, on and around the human body. [Microbes = bacteria and yeast] Modern researchers estimate that as few as 30% of our cells are actually human, which means the remaining 70% are actually bacteria. This is an incredible number, but when we factor in all the functions of these bacteria, it’s not that surprising. See, the vast majority of the cells in our digestive tracts—an estimated 39 trillion—are bacterial cells responsible for clearing up waste products. Not only do these bacteria clear up our own waste after we’re finished with the food we eat, but they also get rid of all the contaminating chemicals we come into contact with throughout our lives…things like pollution, plastics and more. Our bacteria help break these chemicals down so that they don’t wreak havoc on our health. They also break down our own bodily chemicals, like old, broken-down hormones that are past their prime, and red blood cells that are no longer functional. Our liver filters our blood of these toxins and deposits them into our intestines where it then becomes the job of our bacteria to take care of the rest.

Unfortunately, we don’t always have enough of the right kind of good bacteria; and sometimes those good bacteria are crowded out by bad bacteria. This isn’t necessarily pathogenic bacteria, like E. coli or Salmonella, though those too can be problematic. Dysbiotic and inflammatory bacteria like Group B beta-hemolytic streptococcus are also of concern. These dysbiotic bacteria take advantage of us if we consume something contaminated, if we take antibiotics, if we don’t have a diet that is adequate in diverse types of fiber, and more. Even stress can shift our microbiome and make us worse for the wear.

Our gut microbiome is also closely connected to our skin microbiome. That’s because, in all actuality, the human body is rather hollow. We are an open tube from the points of input (eyes/ears/nose/mouth) to the point of output (rectum) and those openings seamlessly blend into the exterior epidermis—that is, our skin. In this way, the microbial populations of our gut hold a profound influence over the microbial populations of our skin. Yes, our skin has a microbiome too, and it plays a big role in preventing and mitigating disease.

Inflammation

When we have an imbalance in good and bad bacteria, our good bacteria is no longer sufficient to do the job of “cleaning” up inflammation in our bodies. Our good bacteria produce anti-inflammatory chemicals like butyrate which help protect our bodies from inflammation. Likewise, overgrowth of inflammatory bacteria produce additional inflammation. Inflammation in the gut becomes inflammation in the blood and on the skin and feeds forward into flare ups of chronic skin conditions. These can include psoriasis, eczema, acne and rashes like those seen in autoimmune diseases. From hives and itching to flaking and dryness, the microbioe plays a role. If you have any of these chronic skin conditions and notice flare ups in periods of stress it’s because inflammation increases in response to chemical stressors in the body, and stress likewise affects the function of our microbiome!

Immunoreactivity

Another way that the microbiome affects skin is because of how those bacteria control inflammation: through the immune system. The good bacteria in our skin and our gut stimulate anti-inflammatory divisions of our immune system such as interleukins (i.e. IL-10, IL-17 and IL-22) which protect us from infection. Our microbiome also helps teach our immune system to distinguish between self and non-self as in the case of autoimmunity, and to develop tolerance to benficial exposures like food and food allergens. Breakdown of the microbiome, or a microbiome that doesn’t have the chance to develop properly early in life can all lead to immune system problems that may manifest as skin reactions. These can include the rashes seen in autoimmune diseases (malar rash) or skin-related allergic and intolerance reactions (hives, itching, swelling, redness.)

Toxins

A third way that the microbiome affects skin is through toxins. Here’s a somewhat unrelated example to illustrate the point: sometimes newborn babies develop jaundice which involves a yellowing of the skin. This is because at birth, new babies are filled with extra red blood cells from their mothers. These red blood cells die off rather quickly and if they aren’t broken down and cleared away through the (you guessed it) GI system, chemicals from the old cells such as bilirubin will build up in the blood stream and cause damage to other organs in the system. This bilirubin chemical is yellow which is why the skin begins to look yellow when it isn’t cleared away properly. Otherwise healthy babies who drink lots of milk and have frequent bowel movements in the early days are typically able to clear away this waste product in their stools no problem. But if they aren’t digesting and metabolizing properly, and if their gut microbiome is malfunctioning, the bilirubin and toxin buildup could become fatal.

Adults process bilirubin too, as we all make new red blood cells every 3 months. However bilirubin is far from the only toxin we need to clear out of our bodies. We make new hormones every day, and consume food that needs to be broken down every couple hours. All of these processes involve waste products that need to be cleared away from the gut. Breakdown in that clearance system due to imbalances in bacteria easily leads to problems like hormonal imbalances, which can manifest on the skin as redness, acne, and other blemishes.

Let’s take a closer look at eczema, for example. Eczema is very similar to an autoimmune disease, in that the immune system creates localized inflammation on the skin which worsens in response to different immunological triggers. Exposure to irritants and toxins, such as fragrance or detergents, may flare up the skin, inflammation tumbles out of control, and the immune system reacts all the more aggressively to the now broken-out skin. It tends to create a snowball effect once bad bacteria start colonizing the breakouts—namely Staphylococcus species which are responsible for the angry, rashy redness we so often associate with eczema. Treating a condition like eczema necessitates a combination strategy that is anti-inflammatory and immune modulating, but also requires a deeper look at toxic exposures and immune triggers which are all mediated by the GI tract.

In the early stages of a flare-up, however, sometimes a topical solution is necessary to calm things down enough to get to the root cause. Ozonated oils kill inflammatory bacteria like Staphylococcus and also directly stimulate immunological healing of damaged skin. This buys the time to figure out the root-cause trigger and treat it holistically.

If you loved what you read here, check out these related posts:

• Diets and the Gut Microbiome
• Natural Eczema Treatment

I’m Dr. Alexandra MacKillop, a functional medicine doctor, food scientist and nutrition expert.

I specialize in women’s nutrition & hormonal health, addressing concerns like longevity, fertility, postpartum, PCOS, endometriosis, and gut symptoms like bloating, constipation, diarrhea and more.

If you’re looking for a new way to approach your health, I’m here to help you through it.

Become a Patient

Don’t miss out! Join the email list.

Sign Me Up!

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Want more Grab a copy of my new book, The Postpartum Check-In !

Reminder: The information on this post or anywhere else on this blog or other writing is purely educational, and is not intended to diagnose, treat, prevent, or cure any health condition.

The post Here’s How Your Gut Health Affects Acne, Eczema, Hives and More appeared first on Dr. Alexandra MacKillop.