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Archive for April, 2015

Bad Gut Health Symptoms

Bacteria in gut

BEST SELLING PRESCRIPTION DRUGS. These drugs are changing our gut bacteria. What does this mean when we’re after good gut healthEVERY YEAR there’s a list of the top selling prescription drugs. (Read on to find out what these are).

Nutrition expert Susannah assesses gut health  our gut health reflects our overall health.

At our London clinics we find patterns in YOUR HEALTH STORY. What does this mean exactly? Gut health and gut bacteria is a topic of overwhelming interest in functional healthcare right now.


The types of bacteria in our gut are summarised here. Gut bacteria are either growing in number or dying.
Our gut microbiome depends on 1) nutrition 2)lifestyle 3) environment. READ ON for 7 SIGNS we have an UNHEALTHY GUT
Gut bacteria rely on what we’re feeding them. The good bacteria we hear about is the one we try to cultivate. More about good and bad gut bacteria and gut health probiotics can be found here.

The top 25 best selling prescription drugs

The top drugs prescribed to the world include cholesterol-lowering drugs or statins. Also, drugs for chronic pain. Top of the chronic pain list are Humira an anti-inflammatory for arthritis   and oxycontin and vicodin. These tally high for pain relief consistently. Insulin glargine injection for type 1 diabetes, metformin for type 2 diabetes and asthma medications like albuterol also rank in the top ten. Several antacids like omeprazole and other drugs for indigestion always rank high.

Research firm IMS compiles a rolling 12-month history in the US. The pharmaceutical industry publication Genetic Engineering and Biotechnology News (GEN) do as well.

Gut Health

Gut health refers to the function or dysfunction of the gastrointestinal (GI) tract.

How do we maintain gut health? Any impairment of the Gut lining can increase the risk of developing infectious, inflammatory and functional GI diseases. An example of gut lining impairment is leaky gut syndrome.

As well, impairment can increase risk of extra-intestinal diseases, such as immune-mediated and metabolic disorders. GI barrier impairment can increase risk of immune-mediated & metabolic disorders.


Bad Gut Health

Bad Gut Health

Less clear, however, is whether GI discomfort in general can also be related to GI barrier functions. In any case, methods of assessing, improving and maintaining gut health -related GI functions are of major interest in preventive medicine. It is worth looking out for your body’s bad gut health symptoms.

A healthy gut

When we feel something’s not quite right, often it’s more than just a gut feeling. As powerful as those are, our precious health calls for understanding and finding solutions. The more we know, the more we can do. Signs of an unhealthy gut are below.

  1. You have a lowered immune response. 70-80% of our immunity to infection and disease is controlled by your gut microbiota.      [tweetthis]70-80% of your immunity to infection and disease is controlled by your gut microbiota[/tweetthis]      Your immune system launches a response, resulting in inflammation. This response might include recent developments of food allergies or food intolerances that you are experiencing later on in life.


  2. You experience unexplained changes in your weight. Bowel and bladder habits are affected. E.g. IBS, digestive issues such as gas and bloating.
  3. You suffer from tiredness that is unexplained. As featured by the Mayo Clinic, studies are connecting bacteria to its effect on energy absorption. “Researchers have identified a difference in the types of bacteria found in a lean person’s gut versus those that live in the gut of someone who is obese. The amount of energy is small, but researchers wonder if over time this could be a factor in weight maintenance.”
  4. You suffer from mood swings, anxiety disorders, depression, poor memory, poor concentration, ADHD or ADD. These may be due to inflammation in the gut. The gut-brain axis explains this.
  5. You have or have had autoimmune disease. Autoimmune diseases examples are alopecia areata, Coeliac disease, RA, MS, vilitgo, Raynauds, SLE, reactive arthritis, Addison’s disease, Psoriasis etc.
  6. You have skin conditions that are recurrent. Typically your skin issues are non responsive to medication. they don’t respond well to medical grade topical solutions and treatments. Or, they are a temporary solution, until the next outbreak. An example is adult acneacne vulgaris or eczema or rosacea
  7. You have diabetes or insulin resistance. This can be affecting your fertility, whether you are male or female.

DNA Test For Weight Loss – Results

Stubborn Belly fat

Why spend 5 hours in the gym? Imagine achieving your optimal MET (metabolic equivalent) taking the dog for a walk?!
Our laboratory DNA test analyses 4 genes that have been clinically proven to affect your response to diet and exercise.
Stubborn fat e.g. belly fat is a different kind of fat. The result of our DNA Diet may help you. Here’s how:

Is it safe?

YOU GAIN sensible advice so you won’t sacrifice important nutrients or indeed your own time by exercising unnecessarily.

Why are we storing fat around our middle, stubborn fat around our thighs, our hips or upper arms? Stubborn belly fat is a different kind of fat that leads to all kinds of health complications. Taking this DNA test doesn’t just highlight WHY diets have failed us in the past….

Belly fat is a more dangerous fat

Belly fat is a more dangerous fat


Feeling discomfort, low in energy, lacking confidence that comes with stubborn fat and being tired all the time?

DNA Test For Weight Loss

DNA Diet Test analyses for healthy weight loss at Susannah Makram Clinics gives clear:

(1) % values for optimal fats, carbs, proteins to consume daily for healthy weight loss.
(2) Suggestion for which proteins, carbs, fats you should consume daily for your healthy weight loss
(3) Clear instructions on how to achieve your optimal MET on a day by day, week by week basis

Our genes might hold the key to understanding why diets have failed in the past. We call the study of how this works epigenetics.

Why take the DNA Diet Test for Weight Loss at Susannah Makram Clinics

From your buccal swab sample we have used a process, called the Polymerase Chain Reaction (PCR). This copies the DNA of your genes many times over. This means we can generate sufficient quantities to analyse your genetic material. This is not uncomfortable at all and is all over very quickly!

The DNA Diet test for weight loss lets us identify unique DNA sequences in some of your genes. You get these results within 7-10 working days in hard copy or email, however you prefer to receive them.

Identifying unique DNA sequences

Certain changes (polymorphisms) in these genes have been studied in detail. Evidence correlates these polymorphisms with your weight management and response to specific food. See these in your DNA Test For Weight Loss Results. (e.g. below)


DNA Test For Weight Loss

Taking the buccal swab sample

  • The term ‘Buccal swab’ refers to a DNA collection process involving cells taken from the cheek (from the inside mouth area).
  • Buccal Swabs are sterile. Therefore, it is essential to preserve a sterile test environment. They are produced for medical use. Unless you are allergic to cotton, they should not cause an irritation.
  • An advantage of a Buccal swab is that it allows you to take a DNA sample, in a non invasive way, that is accurate.
  • Buccal swabs should be taken when your mouth is empty. It is best if you swallow first, then swab the inside of your cheek for approximately 30 seconds. The feel is an impression as hard as if you were brushing your teeth.
  • Having a cold should not cause contamination or interferences to your Buccal Swab Sample of DNA testing

Your DNA Test For Weight Loss Results Explained

Not only will the test determine the percentage quantity of fat, protein and the amount of carbohydrate you should be eating but also the type of fat exactly and what type of carbohydrate exactly.



Four primary diet and lifestyle factors

i) exercise, ii) obesity risk, iii) sensitivity to carbohydrates and iv) sensitivity to saturated fats.

Your DNA Test For Weight Loss makes a complete assessment of weight management, both environmental factors (diet and lifestyle) and previous medical history need to be considered in conjunction with the accompanying genetic profile.

Only gene variants that have a beneficial, moderate or high impact on metabolic processes are analysed. These are described in detail in your report. Your report is delivered to you once the laboratory investigation on your buccal swab test has been processed. These gene variants will have impact or a mild impact to your personalised nutrition The required alteration or tweaking is made to your Naturopathic Portfolio

Gene Name for each Area of Activity is reported. The areas of activity of interest in the DNA Test for Weight Loss are:

DNA Weight Loss

DNA Weight Loss

Metabolism and Absorption    FABP2 Ala54Thr PPARG Pro12Ala     ADRB2 Arg16Gly     ADRB2 Gln27Glu   APOA5 T>C
Fat metabolism, obesity and satiety    APOA2 -265 T>C
Regulation of metabolism and feeding behaviour    MC4R T>C
Insulin sensitivity and regulation of energy intake  FTO T>A   TCF7L2 C>T
Exercise responsiveness     ADBR3 Trp64Arg
Circadian rhythms     CLOCK T>C
Fat storage      PLIN G>A
Inflammation     TNFA -308 G>A
Taste sensitivity    TAS1R2       SLC2A2 (encoding GLUT2)
Addictions and Overeating      DRD2

Genetic variations for each named gene are stated. Your Results and Gene Impact are in printed out for you in the list above.

Each gene tested has an impact score in your DNA Weight Loss Report


These results are only a guideline. You are as unique as your DNA.  Eat. Drink. Take. Make. Your Naturopathic Portfolio is Safe, Clinical, Practical, Effective.

Vitamin D2 and D3

Vitamin D Guidelines

Should we all take Vitamin D tablets? As response to prevalent vitamin D deficiency signs seen globally Vitamin D from food is more readily available. This is mainly because it has been added. Vitamin D fortified food is plentiful because few foods are natural sources of vitamin D. There’s a vast array of vitamin D supplements on the market.

Giving obese teenagers extra vitamin D pills can elevate their cholesterol and fat-storing triglycerides levels.

Vitamin D, Obesity, Adolescence

Researchers from the Mayo Clinic conducted a study. The paper was published in the journal Pediatric Obesity. They investigated obesity and discovered that Vitamin D does not bring any benefits to obese teens when it comes to heart health or diabetes risk. Moreover Vitamin D can on the contrary be harmful, leading to increased levels of cholesterol and triglycerides.

The findings of the study could be influenced by the fact that the study involved only a small number of participants lasted for a short period of time. Larger, placebo-controlled studies are required to examine the long-term effects of vitamin D supplementation on teens and children, however.


Differences between D3 and D2 d Vitamins

The term “vitamin D” refers to several different forms of this vitamin. Two forms: Vitamin D2 and D3 are important in humans: vitamin D2 – which is made by plants – and vitamin D3, which is made by human skin when exposed to sunlight.

Vitamin D, Obesity

Vitamin D, Obesity

Foods fortified vitamin D2 and D3.

The process by which the body makes vitamin D is complex. It starts when the skin absorbs rays in the invisible ultraviolet B (UVB) part of the light spectrum. The liver and the kidneys also participate to make a form of the vitamin that the body can use.

Vitamin D Deficiency

Vitamin D deficiency — when the level of vitamin D in your body is too low — can cause your bones to become thin, brittle or misshapen. The role of vitamin D and insulin resistance, high blood pressure, and immune function — and how these relate to heart disease and cancer — is under investigation.

Vitamin D, Obesity, Adolescence

Vitamin D, Obesity, Adolescence

Although the amount of vitamin D adults get from their diet is often less than what’s recommended, exposure to sunlight can make up for the difference. For most adults, vitamin D deficiency is not a concern. However, some groups — particularly people with dark skin and adults older than age 65 — may not get enough vitamin D in their diet or get enough sunlight for their bodies to produce it.

RDA Vitamin D

The recommended dietary allowance (RDA) for adults is 600 IU of vitamin D a day. That goes up to 800 IU a day for those older than age 70.

To meet this level, choose foods that are rich in vitamin D. For example, choose fortified foods such as milk and yoghurt and fatty fish such as salmon, trout, tuna and halibut.

Do not over do it, though. Very high levels of vitamin D have not been shown to provide greater benefits. In fact, too much vitamin D has been linked to other health problems.

The National Institute of Clinical Excellence (NICE) recommends supplements for pregnant or breastfeeding women and their children from six months to four years.

If you are concerned about whether you are getting enough vitamin D and whether this might be the cause of your health concerns you should discuss these with your health specialist. See what they can do for you straight away. If a vitamin supplement is be beneficial to you, the right supplement that is bioavailable, is prescribed as part of an up-to-date Naturopathic Portfolio.

10 Signs Vitamin D Deficiency

D Vitamin Deficiency

ARE MY VITAMIN D levels LOW? Signs aren’t obvious. “EVERYONE should take vitamin D PILLS”. In August 2015 BBC Health news reported this.

What’s our RDA of Vitamin D ? Is our D Vitamin RDA fixed? It’s a hot topic in functional health right now. So, London naturopath, osteopath Susannah breaks it down….

It’s surprising to hear some signs associated with lack of vitamin D. The RDA of vitamin D required for individual health isn’t the same for everyone. READ ON FOR D2 AND D3 VITAMIN REQUIREMENTS.

Living in sunny climate? Global warming affecting your City? Vitamin D not concerning you? Here at Susannah Makram Clinics we see clients from London for osteopathy and naturopathy. They come from all over the world.
We are showing signs Vitamin D deficiency, on a global scale.

Should I Take Vitamin D Supplements?

Pilot studies and regional monitoring suggests that vitamin D deficiency is likely to affect at least 50% white population in the UK. Also, up to 90% multiethnic UK population. 25% children living in Britain will show signs of vitamin D deficiency.

As a London osteopath and naturopath Susannah not only looks for signs of D Vitamin deficiency in clients she’s also interested in the story of our health. STOP BUYING THE WRONG SUPPLEMENTS.

Signs vitamin d deficiency

The same BBC health news article included a guideline. The draft Scientific Advisory Committee on Nutrition guidelines suggest, from the age of one, 10 microgram pills be taken to ensure people get enough. Find vitamin D2 and vitamin D3 and RDA here.


10 Signs of Vitamin D Deficiency

A recent study in Australia revealed that one-third under-25s are vitamin D deficient. Is this surprising given how much sunshine the country gets? It’s not as simple as that.

Government experts are proposing that everyone should consider taking vitamin D supplements to counter the lack of sunshine in the UK.

New estimates suggest one in five adults and one in six children in England may have low levels.


Signs  Vitamin D Deficiency

Sign 1. You Have Gut Trouble
Vitamin D is a fat-soluble vitamin, which means that…

If you have a GI condition that affects your ability to absorb fat, you may have lower absorption of fat-soluble vitamins, like vitamin D.

Gut Trouble: This includes gut conditions like Crohn’s, celiac and non-coeliac gluten sensitivity, SIBO and IBS.

Sign 2. You Are Frequently Unwell With Flu or The Common Cold 
The active form of vitamin D tempers the damaging inflammatory response of some white blood cells. It also boosts immune cells’ production of microbe-fighting proteins. Vitamin D may be the seasonal stimulus that informs us why the flu virus is predominant in the winter, abating in the summer months.

Hope-Simpson RE. The role of season in the epidemiology of influenza. J Hyg (Lond). 1981; 86:35-47.
Cannell JJ, Vieth R, Umhau JC, et al. Epidemic influenza and vitamin D. Epidemiol Infect. 2006; 134:1129-40.
Ginde AA, Mansbach JM, Camargo CA, Jr. Association between serum 25-hydroxyvitamin D level and upper respiratory tract infection in the Third National Health and Nutrition Examination Survey. Arch Intern Med. 2009; 169:384-90.

signs vitamin d deficiency

signs vitamin d deficiency

Sign 3. Unexplained Autoimmune Disease
Autoimmune disease not confined to Rheumatoid arthritis.  Autoimmune disease causing hair loss e.g. Alopecia Areata and  skin health concerns such as Vitiligo, are included. Also, autoimmune urticaria (hives), autoimmune thyroid disease – and many more. These all may be explained by assessment of your Vitamin D levels. Vitamin D may reduce inflammation. It may also help prevent autoimmune diseases, including rheumatoid arthritis, multiple sclerosis and Crohn’s disease. However, further high-quality research is needed to confirm these results. Some people may have overactive parathyroid glands due to low levels of vitamin D. Vitamin D is the first treatment for this disorder. Increasing calcium intake, with or without vitamin D, may reduce the risk of underactive parathyroid glands after surgery to remove the parathyroid glands.

Sign 4. Your Bones Ache or You Have Back Pain
This is one of the signs of Vitamin D Deficiency that commonly present in clinic. It is easily missed because low back pain is so prevalent or commonplace. In combination with fatigue misdiagnosis such as having fibromyalgia or chronic fatigue syndrome is common at Susannah Makram Clinics.

Vitamin D deficiency osteomalacia is different from the vitamin D deficiency that causes osteoporosis in adults. What’s happening is that the vitamin D deficiency causes a defect in putting calcium into the collagen matrix in your skeleton. So what you are experiencing is a throbbing, aching bone pain – typically back pain.

Signs Vitamin D Deficiency – Vitamin D deficiency has also been linked to muscle weakness and pain.


Back Pain – Signs of Vitamin D Deficiency

Signs Vitamin D Deficiency

Signs Vitamin D Deficiency. Sign 5. You Are Overweight or Obese (or Have a Higher Muscle Mass)
Vitamin D is a fat-soluble, hormone-like vitamin. This means body fat acts as a “sink” by collecting it. If you’re overweight or obese, you need more vitamin D than a slimmer person.

Signs Vitamin D Deficiency. Sign 6. You Feel SAD
Some studies suggest an association between various mood disorders and low vitamin D levels in the blood. These mood disorders include depression, seasonal affective disorder (SAD) and premenstrual syndrome (PMS). Serotonin – the brain hormone associated with mood elevation – rises with exposure to bright light. Serotonin levels fall with decreased sun exposure. These signs Vitamin D Deficiency may creep up unexpectedly and are easily left untreated.

Should I take vitamin D supplements?

Should I take vitamin D supplements?

Signs Vitamin D Deficiency. Sign 7. You Have Darker Skin
Recognise signs vitamin d deficiency. Your skin pigment acts as a natural sunscreen. The more pigment you have, the more time is needed in the sun to make adequate amounts of vitamin D.

Signs Vitamin D Deficiency. Sign 8. Excessive Sweating
Excessive sweating in newborns due to neuromuscular irritability is an early symptom of vitamin D deficiency. One of the first signs vitamin D deficiency is a sweaty head. Recognise signs vitamin d deficiency.

Signs Vitamin D Deficiency. Sign 9. You Have Type 1 Diabetes 
Vitamin D may play a role in preventing type 1 diabetes. Evidence comes from a 30-year study that followed more than 10,000 Finnish children from birth. From this study it was found that children who regularly received vitamin D supplements during infancy had almost 90% lower risk of developing type 1 diabetes than children not receiving supplements.

Hypponen E, Laara E, Reunanen A, Jarvelin MR, Virtanen SM. Intake of vitamin D and risk of type 1 diabetes: a birth-cohort study. Lancet. 2001; 358:1500-3.

Signs Vitamin D Deficiency. Sign 10. You’re 50 or Older
As we get older our skin doesn’t make as much vitamin D in response to sun exposure. At the same time, our kidneys become less efficient at converting vitamin D into the form used by your body. Older adults tend to spend more time indoors than outdoors in natural sunlight.

The risk of getting too much vitamin D is considered to be extremely low. Vitamin D supplements are available from your GP. Over the counter is available but you should supplement with care. There’s no point in committing to poor quality nutritional supplements. That’s whether you’ve signs of vitamin d deficiency or not.


Vitamin D – 6 Factors Affecting Your Levels

The Sunshine Vitamin

Sometimes, even when our bodes make vitamin D it’s still not enough. Sunshine and vitamin D – how does it work? Whether sunlight hits our skin or not we should know these SIX FACTORS affecting our Vitamin D levels.

Latitude studies, Vitamin D Deficiency, the environment, your skin, your age and your weight.

Six Factors That Can Affect Your Vitamin D Level

 A number of factors influence a person’s vitamin D levels.  Here are six important ones.

  1. Where do you live? How far from the Equator do you live? That is the real question. The further from the equator the less vitamin D–producing UVB light reaches the earth’s surface during winter. Living in countries such as The UK, Russia and Sweden, Norway, the Nordic countries mean you are less likely to get enough vitamin D. If you live north of the line connecting San Francisco to Philadelphia and Athens to Beijing you too may not be getting enough either.
  2. Air Quality – What’s Yours Measuring Up To? Carbon particles in the air from the burning of fossil fuels, wood, and other materials scatter and absorb UVB rays, diminishing vitamin D production. In contrast, ozone absorbs UVB radiation, so pollution-caused holes in the ozone layer could end up enhancing levels. Air pollution is killing more people prematurely than obesity and alcohol combined – an estimated 29,000 every year, in the UK
    The Sunshine Vitamin

    The Sunshine Vitamin

  3. Do You Use Sunscreen? Sunscreen prevents sunburn by blocking UVB light. Theoretically, that means sunscreen use lowers vitamin D levels. But as a practical matter, very few people put on enough sunscreen to block all UVB light. Or they use sunscreen irregularly, so sunscreen’s effects on vitamin D might not be that important. An Australian study that’s often cited showed no difference in vitamin D between adults randomly assigned to use sunscreen one summer and those assigned a placebo cream.
    Vitamin D

    Vitamin D – are you getting enough?

  4. What Is Your Skin colour? Melanin is the substance in skin that makes it dark. It “competes” for UVB with the substance in the skin that kick-starts the body’s vitamin D production. As a result, dark-skinned people tend to require more UVB exposure than light-skinned people. This means to generate the same amount of vitamin D, you need more sunshine.
  5. What is your weight? Calculate your BMI here. What is your percentage body fat?  Body fat mops up vitamin D. Studies have shown that being obese is correlated with low vitamin D levels. Being overweight may affect the bioavailability of vitamin D.iStock_000001947476_Large
  6. Age. Compared with younger people, older people have lower levels of the substance in the skin that UVB light converts into the vitamin D precursor. Experimental evidence that older people are less efficient vitamin D producers than younger people.

Being “D-ficient” may increase the risk of a host of chronic diseases. These include brittle bone disease causing back pain. Heart diseasesome cancers, multiple sclerosis, as well as infectious disease risk increase.These infectious disease are tuberculosis and even the seasonal flu. Read more about the evidence linking vitamin D Deficiency to the following:

Vitamin D Deficiency Is Linked To The Following Diseases

Deficiency Phosphate
Kidney Disease – Fanconi syndrome,
Osteomalacia causing back pain
Rickets in Children
Thyroid Conditions
Autoimmune Diseases
Cognition HBP Mood Disorders
Multiple Sclerosis

The Contraceptive Pill, Myths

The Pill

Birth control pills or Oral contraceptives known also as the Pill, OCs, BCs, BC tablets contain two types of hormones, usually man-made oestrogens and progestins and, when taken properly, prevent pregnancy. FACT. Hormone therapy in pill form is commonly used in conventional medicine. 

Contraceptive Pill, Facts

The Lowdown on the Contraceptive Pill, Myths i.e. What Every Woman Should Know       [tweetthis]The Lowdown on the Oral Contraceptive Pill, Myths i.e. What Every Woman Should Know [/tweetthis]

COC, combined pill, ‘The Pill’, COCP – The combined oral contraceptive pill (COCP) is a highly effective form of contraception and used to control fertility by almost 20% of women aged 16-49 years in the UK. Commonly used brand names (updated): Rigevidon, Microgynon 30, Gedarel 30/ 150 FACT.

Most women want their oral contraceptive to be a reliable and acceptable form of birth control that is convent and flexible and free from oestrogen related side-effects. FACT.

The Contraceptive Pill, Myths

Hormonal forms of birth control, such as the Pill, can improve hair health. FICTION. The American Hair Loss Association recommends that all women interested in using oral contraceptives for the prevention of conception should only use low-androgen index birth control pills, and if there is a strong predisposition for genetic hair loss in your family we recommend the use of another non-hormonal form of birth control. FACT. 

The Contraceptive Pill, Myths

The Contraceptive Pill, Myths


The Contraceptive Pill, Debunking Myths

All Oral contraceptives work by primarily inhibiting ovulation. FICTION. The Minipill works by thickening your cervical mucus, so that it is more difficult for sperm to get through. POP or progestin or progestogen only pills thin the lining of your womb, therefore making it much less likely that an ovum (egg) will implant there. This affects the motility in your Fallopian tubes, thus reducing the chances of fertilisation and in some instances, prevents ovulation (egg release) – this is particularly so with Cerazette.

Cerazette is an oestrogen-free, progestogen-only oral contraceptive pill (POP). FACT

The minipill is oestrogen free. Common brand names: Cerelle and Cerazette and Aizia and Nacrez and  Zelleta. It is also known as the progestin-only birth control pill, is an oral contraceptive that contains the hormone progestin. Unlike combination birth control pills, the minipill doesn’t contain estrogen. The progestin dose in a minipill is lower than the progestin dose in a combination oral contraceptive pill. FACT. 

Undesirable side-effects of the Pill occur only with COP. FICTION.

Undesirable effects reported by some women treated with Cerazette include: acne, breast pain, mood and libido changes, nausea and weight increase. FACT. 

Smoking cigarettes while using oral contraceptives has been found to greatly increase chances of serious side effects occurring. FACT. In particular, cigarette smoking increases the risk of serious cardiovascular side-effects from combined oral contraceptive use. The risk increases with age and with heavy smoking (15 or more cigarettes per day) and is quite marked in women over 35 years of age.

Contraceptive Pill Side Effects

Contraceptive Pill Side Effects

St John’s Wort (Hypericum perforatum) can speed up the breakdown of the hormones in Cerelle – progestogen only contraceptive – by the liver, which makes it less effective at preventing pregnancy. FACT. In fact, a list of medications that has a similar effect include aprepitant, bosentan, barbiturates, carbamazepine, crizotinib, dabrafenib, efavirenz,
eslicarbazepine, nevi rapine, oxcarbazepine, perampanel (12mg), phenobarbital, phenytoin, primidone,
rifampicin, rifabutin, ritonavir, rufinamide, topiramate, vemurafenib.

Cerelle tablets contain lactose and should not be taken by women with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency, or glucose-galactose malabsorption. FACT.

Common side-effect of Cerelle or desogestrel affect between 1 and 10 out of every 500 women. FICTION. Common side-effect of Cerelle or desogestrel affect between 1 and 10 out of every 100 women. These include: changes in menstrual bleeding, eg irregular bleeding or sometimes stopping of bleeding, mood changes, including depression, decreased sex drive, headache, nausea, acne, breast tenderness, weight gain. FACT. 

Selegeline used to treat Parkinson’s disease and also as an antiageing supplement and an antidepressant should be avoided with the pill. FACT. Other brand names include, Deprenyl, Eldapryl, Emsam.

While you are on the Pill and you wear contact lenses – should you notice a change in vision or an inability to wear you lenses, contact your doctor or health care provider. FACT. 

Side Effects Of

Side Effects Of

Combined birth control pills (oral contraceptives) can improve acne in women. FACT.  However, it should also be noted that melasma – a spotty darkening of the skin is possible – particularly of the face, which may persist.

Combination birth control pills and preston only birth control pills will not protect you from sexually transmitted infections. FACT. 

Monophonic and multiphasic are types of progestin only birth control. FICTION. Combination birth control pill can be categorised as i) monophasic: each active pill contains the same amount of estrogen and progestin and i) multiphasic: the amounts of hormones in active pills vary. FACT. 

Taking combination birth control pills or minipills (progestin-only birth control pills) during early pregnancy increases the risk of birth defects. FICTION. While some research has suggested a link between the use of birth control pills near conception and an increased risk of low birth weight, preterm delivery or congenital urinary tract abnormalities, these concerns generally haven’t been observed in clinical experience.

Combination birth control pills increase the risk of certain conditions. Some of these complications can be serious. They include the following: Blood clots in the legs, Gallbladder disease, Heart attacks and stroke (smoking greatly increases the risk of these complications), Liver tumours. FACT. 

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Bariatric diet

Bariatric surgery

Considering bariatric surgery? It’s likely someone we know has healthy weight loss success with this surgery. The most common bariatric surgery procedures are gastric bypass, sleeve gastrectomy, adjustable gastric band and biliopancreatic diversion with duodenal switch.

Weight loss surgery

Knowing health risks of obesity means offering patient choice. At Susannah Makram clinics we feel you should know about options available to you. Also, you should know what to expect by choosing your healthy weight loss route.

Still wondering about taking ownership of your health? Think you’re too young, healthy, don’t qualify?
We’ve made it easy for to break down the routes of obesity treatment.

-> Fast Fact: Did you know that it may be advisable to seek a two week low calorie and mostly liquid diet to prepare you for your surgery?

Q. 1) Which Bariatric surgery for weight loss is right for me?

  • SAFE The safety of bariatric surgery varies considerably. It depends on your personal health and medical history. Safety varies based on the type of operation you have and the experience of both surgeon and hospital.
  • CLINICAL Speak frankly to your specialist. Don’t rely on previous experience of others or information on the internet.
  • PRACTICAL Measure your perceived success with that of your surgeon’s. Re-assess these when your are ready to take responsibility for your current lifestyle. Your nutritional habits and lifestyle need assessment first. This helps you make an informed decision, that is both realistic and optimistic. The right bariatric diet is crucial at every stage.
  • EFFECTIVE Only you can answer this important question. After you consider the medical evidence for surgery and facts. Look at the facts regarding risks and benefits of each procedure.

Q. 3) Is bariatric surgery the solution to Type 2 Diabetes and Obesity?

Bariatric surgery is also known as Obesity surgery. These include: gastric banding, gastric bypass, sleeve gastrectomy and duodenal switch. It is usually undertaken laparoscopically. The most commonly used method in the UK is a gastric bypass.

NICE Guidelines offer an expedited assessment for bariatric surgery. This is to people with a BMI of 35 or over who have recent-onset type 2 diabetes. The GDG considered that recent-onset type 2 diabetes would include those people whose diagnosis has been made within a 10-year time frame.

Classification of Obesity. Note: if you are of Asian origin, you may be considered for weight loss surgery at a lower BMI. This is because the risks of being overweight kick in at a lower BMI in people of Asian origin.

Bariatric Diet

Q. 4) Why are the first two years of bariatric diet after bariatric surgery important?

You will not absorb certain vitamins and minerals in the same way after your operation. You’ll need to take some supplements as advised by your specialist team.
The levels of these will be monitored for the rest of your life. This includes blood tests for your levels of iron, calcium, copper, zinc, vitamin D, and vitamin B12.

bariatric diet

bariatric diet

Q. 5) What the risks or complications of bariatric surgery for weight loss?

Weight loss surgery carries real risks. As many as 10% of people have complications afterward. Unpleasant side-effects include: Nausea, vomiting, diarrhoea.  3% of the time serious complications that are life-threatening occur: blood clot to the lungs -pulmonary embolism, heart attack, leaks in new surgical gut connections, bleeding ulcers. This is higher for people over 60. Even after successful weight loss surgery, other problems are common. These include gallstones often requiring gall bladder removal. Vitamin deficiencies from malnutrition or malabsorption – poor absorption of nutrients, sagging skin requiring body contouring surgery. WHAT’S A FUNCTIONAL BARIATRIC DIET EXACTLY? –> Read on to find out…

-> Fast Fact –  The best way to summarise the pros and cons of bariatric surgery are here     [tweetthis]-> Fast Fact -The best way to summarise the #pros & #cons of #bariatric surgery[/tweetthis]

Q. 6) What makes bariatric surgery successful for some not for others? Success depends on your ability to follow.  Keep reading to find out about the functional bariatric diet.

Weight loss surgery is not a cure for obesity. Rather it can be a tool to help you lose weight. Losing weight for many is about living a healthier, longer and more fulfilling life.

Long-term effects of bariatric surgery are still being studied. Nutritional deficiencies can arise over time. Periodic blood tests are required to help ensure nutritional balance. It is recommended that you do a series of tests every three months for the first year. Annual tests should follow for the rest of your life.

In addition to a complete blood count (CBC), other tests will measure levels of: alanine aminotransferase (ALT). albumin. alkaline phosphatase. aspartate aminotransferase (AST). calcium, cholesterol panel. direct and total bilirubin. electrolytes. fasting glucose. ferritin. folate. hemoglobin A1c. iron saturation and transferring magnesium, phosphorus, total protein and vitamin B12. You may have tests to measure your levels of thiamine and vitamin D.

Q. 7) Does functional nutrition for weight loss work with bariatric surgery? What’s a bariatric diet? 

Yes. Your Naturopathic Nutritional Portfolio For Weight Loss is in the four phases. Your portfolio is:

  1. SAFE. Depends on our health story. 
  2. CLINICAL.  For best possible short and long term outcome for: Biliopancreatic Diversion with Duodenal SwitchAdjustable Gastric BandRoux-en-Y Gastric Bypass, Sleeve Gastrectomy
  3. PRACTICAL. We don’t live in a spa. So let’s be realistic. Local, minimal lifestyle changes for maximal health and comfort.
  4. EFFECTIVE. Eat. Drink. Take. Make. Personalised nutrition around your lifestyle.
  • PHASE ONE – Preparation is key to lower the chances of complications that can arise with surgery & to improve rate of recovery
  • PHASE TWO – Adapting to your new gut environment
  • PHASE THREE – Making your microbiome and DNA markers for obesity work to improve metabolic function & energy levels
  • PHASE FOUR – Performance, endurance, perceived capability of body & mind is enhanced for prevention of illness & so that your surgery is a continued success

Weight Loss DNA Test

Gene Mapping

THE FAT GENE: Gene mapping for weight loss is a science. DNA fit for healthy weight loss uses data in our fat cells. These play a role in how food gets used. Since 2007, researchers have known that a gene called FTO was related to obesity. What they didn’t know, was how the fat gene was linked to obesity.. Do you have the fat gene? Keep reading…

So, researchers couldn’t tie the FTO gene or fat gene to appetite or other known factors. Now experiments reveal that a faulty version of the gene causes energy from food to be stored as fat rather than burned.

Why Does This Matter?

Imagine you have access to why your healthy weight loss goals are hindered. Sound too good? KEEP READING….
We’ve a far greater chance of success following our personalised care pathway. With a healthy weight loss goal we help you reach your target.

The faulty gene doesn’t explain all obesity. It was found in 44% of Europeans but only 5%of blacks. So, other genes are clearly at work. Food and exercise still matter.

Read a break down of genetics factors affecting weight loss here in this sample DNA Diet report.

Keep reading to see how your result at Susannah Makram Clinics is shown on your DNA Weight Loss Test Report. READ as No Impact, Low Impact, Medium Impact, High Impact.

What’s the Real Story?

Possessing this ‘glitch’ doesn’t determine whether we are obese but may predispose us to obesity. Those of us with two faulty copies of the gene (one from our mother and one from our father) weighed an average of 7lbs more than those without them.

Genetic Testing For Weight Loss – Weight Loss DNA Test

Genetic testing is said to predict our chances of getting sick with critical illness. Weight Loss DNA Test reports are for healthy weight loss. Functional testing provides an algorithm that regular blood work does not. It’s hard to know how effective these tests are when we haven’t seen many long-term studies on DNA testing by laboratories up and down the country.
This is why, when it comes to offering you a personalised care service, sometimes conventional medicine alone just doesn’t work.

  • The Weight Loss DNA Test for healthy weight loss. What is this? We elect to use gene mapping at Susannah Makram Clinics that has been designed to assist health practitioners in effectively managing our body weight. The results provide guidelines we can use in your Naturopathic Portfolio for Weight Loss. Diets, in general, do not always target specific body fat or belly fat loss. There are health reasons to avoid body fat accumulation in these areas. Your test results help us identify what we need to do to burn fat in these areas.
  • The Weight Loss DNA Test is based on genetic differences in nutrient metabolism and body fat regulation.
  • Genes involved in regulation of energy expenditure, appetite, and fat metabolism, all play an important role in weight regulation.
  • 40% to 80% of the variance in body weight is due to genetic factors. This helps to explain why not everyone becomes obese even though people may be exposed to similar environments.

    Weight Loss DNA Test

    obesity gene

    Weight Loss DNA Test

  • From your buccal swab sample taken in for laboratory testing at the clinical consultation rooms we collect DNA accurately. This sample is used in a process, called the Polymerase Chain Reaction (PCR). This copies the DNA of your genes many times over so that we can generate sufficient quantities to analyse your genetic material. You can see this in action when you subscribe to Susannah Makram TV
  • Four diet and lifestyle variables are analysed for the role they play in your weight management. These are your:
    i) Obesity Risk
    Research has clearly shown that individuals respond differently to carbohydrate in the diet. For some, reducing carbohydrate intake improves weight loss and prevents weight gain.
    ii) Saturated Fat
    Individually, we differ in our response to the quantity and quality of fat in our diet. Our genes may influence how we absorb fat. Not just that. Also our ability to burn up fat.
    iii) Carbohydrate
    Research has clearly shown that individuals respond differently to carbohydrate in the diet. For some, reducing carbohydrate intake improves weight loss and prevents weight gain.
    iv) Exercise
    Exercise is an important part of weight loss. However, some individuals require higher exercise intensities. Some of us need greater time spent exercising to mobilise their fat stores.
Complete Care System

Weight Loss DNA Test

    • Weight Management Genetic Testing has been all over the news in the US – The Today ShowThe Wall Street JournalCBS Morning News – In America they are calling it personalised medicine.
    • All genes tested meet the following stringent criteria for utility in genetic screening tests, including that they:
      • Have proven biological function. Many of the genetic variations in the test panel produce a change in the amino acid structure of the protein and change theactivity of the protein. Other variations in the panel affect transcription factors in DNA-based communications.
      • Have a plausible biological role in weight management. For example, some of the gene variations produce a change in the amount of fat absorbed from a meal or alter carbohydrate metabolism.
      • Have evidence from clinical studies, that individuals with different genotypes have a differential response to either certain diets or different levels of physical activity.

Nutrigenomics – Weight Loss DNA Test

  • Genotype Results show a break down of every genetic variation tested for with the impact of this gene on you as an individual. The gene is measure with regards to how it affect your weight loss by nutrient metabolism and body fat regulation. Your result for each variable tested is shown on your DNA Weight Loss Test Report as No Impact, Low Impact, Medium Impact, High Impact. On your report the genes identified and their role is explained. As shown in 9. and 10. below the areas of genetic activity are broken down into Absorption and metabolism
    Fat metabolism, obesity and satiety
    Regulation of metabolism and feeding behaviour
    Insulin sensitivity and regulation of energy intake
    Exercise responsiveness
    Circadian Rhythms
    Fat Storage
    Taste Sensitivity
    Addictions and Overeating 
  • An example of one of the genes test is CLOCK – Circadian Locomotor Output Cycles Kaput (CLOCK), an essential element of the human biological clock, is involved in metabolic regulation. Carriers of the C allele are less successful losing weight than the TT genotype. In addition, those with the C allele have reduced sleep, report morning fatigue and show an evening preference for activities. They also have higher ghrelin levels which regulates appetite, potentially altering eating behaviour and weight loss.
  • ADRB2 Arg16Gly This ADRB2 receptor protein is involved in the mobilisation of fat from fat cells for energy in response to catecholamines, and modulates lipolysis during exercise. The G allele has been associated with obesity, and G allele carriers are more likely to gain and regain weight and lose weight more slowly. These carriers are less able to mobilise fat stores in response to exercise. In these individuals it is important to emphasise diet for weight management as exercise may be less effective.

Epigenetics, Epigenome – Intro


Epigenetics is the study of changes in organisms. These changes are caused by modification of gene expression rather than alteration of the genetic code itself.

What does this mean exactly? The epigenome dynamically responds to the environment. Stress, diet, behavior, toxins, and other factors regulate gene expression.
As an organism grows and develops, carefully orchestrated chemical reactions activate and deactivate parts of the genome. this occurs at strategic times and in specific locations. Epigenetics is the study of these chemical reactions and the factors that influence them.

Epigenetics has transformed the way we think about genomes”      [tweetthis]#Epigenetics has transformed the way we think about #genomes[/tweetthis]

Epigenetics & The Epigenome

Epigenetics & The Epigenome

Biological change and what we eat, our nutrition our food. The right food turns on the right genes. These in turn create biological signals that create health. The wrong foods turn on genes that cause disease and create biological chaos.

Recent discoveries in the field of genomics, epigenetics and nutrigenomics provide a new paradigm for understanding how to treat disease. This is an exciting time for pushing functional healthcare boundaries.

Your body is a system, an ecosystem where everything is connected. When that system is out of balance, diseases arises.

Disease goes away as a side effect of getting healthy. You do not have to treat the symptoms. Treat the cause and the symptoms vanish. Treat the system.

Nutrigenomics teaches us how to prevent, treat and reverse almost every chronic illness. Chronic disease include diabetes, high blood pressure, depression, allergies, asthma, IBS, reflux, migraines, acne, low sex drive, fatigue and more.

Aging and nutrition

Our chromosomes are shortening. This inevitably happens over time. We can accompany this sign of aging by eating a whole-foods, personalised diet. Telomeres are the little end caps on your chromosomes. Telomeres get shorter as we age. Eating real food lengthens them. There is no drug or any intervention other than food that has ever been shown to stop or reverse this. This inexorable shortening of chromosomes is lowering our quality of life.


Gut Microbiome and Fertility

Gut Microbiome and Fertility

Recap then gut microbiome and fertility. The human microbiome consists of the microbes living on and within our human bodies. Most of these bugs inhabit our large intestine. There, a few pounds’ worth of bacteria, yeasts, archaea and even viruses. These help digest food, calibrate our metabolic and immune function and hold off would-be invaders.

There’s growing evidence that the pathogenic effects of bacterial vaginosis may not be confined to the lower genital tract.

Fertility Nutrition

Most studied is how gut microbiota affects an individual’s risk of obesity and other metabolic conditions. In both men and women weight management plays a pivotal role in reproductive heath, pre conceptual care, without and throughout use assisted reproductive technologies.      [tweetthis]In men & women weight management is crucial to reproductive heath, pre-conceptual care[/tweetthis]

Much more attention should be paid to the impact of obesity on fertility in both women and men. This appears to be particularly important for women before assisted reproductive technologies are used. Treatment of obesity may improve androgen imbalance and erectile dysfunction, the major causes of infertility in obese men.

Gut Microbiome and Fertility

Gut Microbiome and Fertility

Female Fertility – The Vaginal Microbiome

A special subset is the vaginal microbiome. The vaginal microbiome inhabits the vagina and successful reproduction, as it turns out, owes an immense debt to this microbial community.

A healthy vaginal microbiome produces lactic acid and hydrogen peroxide. These maintain a level of acidity that keeps troublemaking microbes at bay. When the vaginal community becomes unbalanced, on the other hand, acidity decreases. The wrong microbes may then invade or, if they’re already present, bloom. How does this happen?

The Role Of The Vaginal Microbiome In Fertility – Reproductive Health & Beyond

This disturbance can cause bacterial vaginosis—not really an infection, but an out-of-whack ecosystem. It sounds like a trifling problem, and half of women with vaginosis may display no obvious symptoms. But this minor-seeming imbalance can have major consequences.

Vaginosis increases the risk of contracting secondary infections, from herpes to HIV. But even on its own, the microbial shift may prompt low-grade inflammation that can derail reproduction. It can prevent fertilisation in would-be mothers, prompt spontaneous abortion in pregnant women, and increase the risk of preterm birth later in pregnancy.

Many factors affect the vaginal ecosystem—smoking, stress, diet, the number of sexual partners, and obesity. One of the most direct ways to upset the vaginal microbiome may be douching.

The Role Of The Vaginal Microbiome In Fertility – Bacterial Vaginosis & Miscarriage

The consequences of bacterial vaginosis can be devastating. In a study of 1,950 urban women in Philadelphia, for example, vaginosis in the first trimester more than doubled the risk of spontaneous pregnancy loss in the second. In Belgium, vaginosis more than quintupled the risk of early preterm birth.

Vaginosis-related microbes have been implicated in roughly one-quarter of all preterm births. For the most vulnerable group of children, those born extremely preterm, or before 25 weeks, the number perhaps doubles.
Studies in Kuopio Finland by this Finnish group have since replicated the finding among 15-to-17-year-olds, implying that the consequences of prenatal inflammation persist into adolescence and probably adulthood.

Does the vaginal microbiome play a role in IVF?

personalised nutrition

personalised nutrition


Influence of bacterial vaginosis on in-vitro fertilisation and embryo implantation during assisted reproduction treatment.

Although an altered vaginal microbiota has been demonstrated to affect parturition, its role in assisted reproductive technologies is uncertain.
Clinical findings suggest that routine screening for bacterial vaginosis in the hope of improving the success of IVF treatment is not justified. The prevention of complications in pregnancy associated with bacterial vaginosis might be a more relevant indication for screening at the time of IVF treatment, in particular patients with tubal disease, if treatment were shown to be effective for that particular purpose. However, antibiotic treatment before IVF has been shown to be positively disadvantageous for IVF by encouraging other organisms.

Safe, clinical, practical and effective.

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