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Archive for May, 2015

How to manage your temper at work


Aggressive behaviour can have a detrimental impact on your employees – so if you’re a manager who struggles to control your anger, what can you do when your temper flares in the office? Georgina Fuller finds out. Manager skills required? Most of us are probably guilty of losing our temper from time to time especially when we are stressed or tired but…

What if you are a manager and you start losing it at work and taking it out on your team?  [tweetthis]f you are a manager and you start losing it at work and taking it out on your team?[/tweetthis]


Read full article here

Testimonialswho is taking ownership at work?

FAQ – are you the right client?


Pregnancy Tips

We’re all trying to keep our bodies fit and toned. We all want a good sex life. Sometimes the best we can hope for is a sex drive. However, there comes a time when we start to think about the possibility of starting a family. Starting a family or adding to our small family. We might only be thinking about it but the thoughts are inevitable.

fertility nutrition

fertility nutrition


So, it is that we ask how our modern lifestyle – our environment and the choices we’re making are going to impact our fertility journey. Does it stop at our choices? 

Fertility nutrition is a lifestyle. Your fertility journey isn’t the same as every other couple. Susannah sees mothers who want to add to their beautiful and healthy family. She sees couples who’ve been through fertility testing and fertility treatment. This includes Assisted Reproductive Technology ART -most commonly IVFSusannah sees couples who place value on a holistic and natural approach. Balance within our bodies helps create the right environment to step into our life’s journey.


Trying To Get Pregnant

Trying To Get Pregnant

Being present in that health journey means offering functional and practical advice. Being relaxed is one of the things couples trying for a baby hear constantly. It’s also one of least helpful pregnancy tips!

Trying to get pregnant

Susannah answers readers and couples’  questions on fertility. Couples trying to get pregnant ask pertinent lifestyle questions. Wanting for a healthy pregnancy journey starts with questions. From ovulation to birth control to the most effective sex positions to “fertility windows”.

Getting pregnant can prove to be a minefield of facts, fads and questions. They can send our stress levels through the roof.  Ironically this can do more harm than good when it comes to improving chances of conception.

To help clear the confusion, Get The Gloss asked Naturopath and fertility nutrition expert Susannah Makram for her top tips for getting pregnant. Whether you are wondering when you are most fertile or how to work out the inner workings of your ovulation cycle, here are Susannah’s 15 key tips to bear in mind should you be on the path to pregnancy.

We spend our whole lives taking take of our body for us. Suddenly we consider another journey for this amazing biological wonder. It’s a life change that’s changing us and challenging us in different ways in modern times.

Read the full article here

Getting Pregnant – Facts For NOW

Diet for pregnancy

diet for pregnancy

diet for pregnancy

With 1 IN 6 Couples currently experiencing difficulty getting pregnant, Get The Gloss caught up with their Expert in Naturopathic Nutrition and osteopathySUSANNAH MAKRAM covers the facts we should all know before embarking on the road to fertility.

Infertility is a rising problem. According to recent statistics, ‘one in six couples has problems starting a family, with the number of couples seeking medical help having risen dramatically.’  [tweetthis hidden_hashtags=”#nutrition”]What you need to know now if you’re thinking about getting #pregnant[/tweetthis]

Fertility and lifestyle

Most experts suggest these increasing problems with couples trying to get pregnant are due to larger amounts of environmental chemicals. These chemicals affect the body’s hormones, in men and women. Also, societal and cultural changes see more women choosing to delay starting a family until established in their careers. The older both men and women become, the more likely it is to encounter difficulties conceiving, for the woman to become pregnant.

The problem however, is that unless specifically trying to get pregnant, most women don’t know enough about fertility and the factors that can affect our chances. So, with the aim of getting us all a little more clued-up we reached out to fertility and nutrition expert, Susannah Makram, for a little more information on the possibilities and problems getting pregnant.

Read the full article here

Tightening up the Kardashian way

Waist Shapers

Tightening up the Kardashian way



Khloe Kardashian’s dramatic before and after picture illustrating her impressive weight loss was not the only thing we noticed on her Instagram account last week.

Posing in her Nike workout wear in her shoe wardrobe mirror (as you do) we couldn’t help but notice her microscopic looking waist, held in by what could only be described as a corset.

Waist trainers or waist shapers, whatever you call them, they’ve all one thing in common. People are obsessed. You see them on celebs like Kim K and the Kardashians, Madonna, Jessica Alba.

Tightening up the Kardashian way

Having investigated Waist Gang Society a little further it appears that this ‘Waist Shaper’ isn’t just an extreme version of Spanx. It doesn’t just function to ensure you fit into that dress but… Waist shapers are actually a WEIGHT LOSS METHOD itself in themselves!

FOLLOW us and keep up-to-date with innovative and new beauty and weight loss methods of the stars. 

Known as PreMadonna87 to its 400k+ Instagram following, Waist Gang Society have gained a name for themselves as the go-to brand for people wanting to get a Kardashian-like waist. AKA tightening up the Kardashian way. Featured on a hat trick of Kardashian Instagram accounts – Kim, Khloe and Kourtney have all posted selfies wearing the brand – its founder is not shy of sharing the millions she has made via her social media account as a result. Kim even says she sometimes wear two body shapers when she’s feeling heavy.

Read the full article at Get The Gloss

Horse Fertility Nutrition, Personalised


Horse Fertility Nutrition, Personalised

The horse genome was sequenced in 2007 with the final report published in late 2009.
This research enables scientists to better understand the molecular and biological processes responsible for equine health and performance. As a Naturopath and as an osteopath, I use a functional approach that resonates with my equine osteopathic and veterinary colleagues.

Horse nutrition

Horse fertility nutrition, is personalised as it is for humans. It teaches us a lot about this exact science of eating for health. This approach enables us to learn from research. We can apply what we learn accordingly for personalised fertility nutrition for humans.

Treating the cause of reproductive challenges or fertility concerns, as with complex cases treated at Susannah Makram clinics, requires an integrative healthcare approach. It is also how I came across special laboratory investigations or tests that we now use to choose the best treatment and optimise efficacy of treatment. This functional healthcare model relies on careful use of accurate methods of laboratory investigations when results impact nutritional therapy. Good nutrition is the cornerstone to healthy weight management in pre-conceptual care and treatment of factors affecting fertility in males and females and throughout pregnancy.

I was introduced to the latest advancement to male fertility testing by an avid horse breeder in Sussex, where I went to boarding school, enjoyed the stables and grounds. For many hours I blissfully recreated my childhood in Dhahran, Saudi Aramco horse riding at the Hobby Farm.

Semen Analysis And Stallion Fertility

The Society for Theriogenology has established guidelines for classifying stallions as to breeding potential. For a satisfactory rating, the Society requires that light-breed stallions ejaculate at least four billion total sperm in the first ejaculate after a period (typically one week) of sexual rest. The second ejaculate, collected about an hour after the first, should contain at least two billion total sperm.

Semen analysis
Sperm count
Sperm motility
Sperm morphology

These have typically been carried out on male human patients whereby; the results of the above show good fertility readings, the partner is similarly ‘fertile’ and after the couple undergo IVF cycles they are couple are given the diagnosis of: ‘unexplained infertility’.

My interest in treating the cause of infertility led me to this discovery – Sophisticated tests that can be performed on stallions:

Karyotype Analysis
Chemical Analysis of Seminal Plasma
Transmission Electron Microscopic Analysis of Sperm
Sperm Chromatin Structure Assay–The sperm chromatin structure assay is a procedure that has been developed to evaluate the structural integrity of sperm chromatin. This assay defines abnormal chromatin structure as a heat- or acid-induced susceptibility to DNA denaturation (destruction of the substance). Lower fertility occurs when greater sperm denaturation is found. The sperm chromatin structure assay may have potential for identifying some stallions as subfertile when routine breeding soundness examination fails to do so.
Antisperm Antibody Tests
Hormonal Assays

Sperm Chromatin Structure Assay is of interest to me as it offers information regarding the quality of sperm and this can only be improved upon by lifestyle changes. The right nutrients taken through diet and supplementation (for the first 2-3 months, dependent on the percentage of sperm DNA damage) reverse the damage.
Fish oil, for example, improves the quality of shipped semen in horses. Supplementing with natural-source vitamin E, a potent antioxidant, improves sperm quality also. There are several types of antioxidants: enzymatic antioxidants that are synthesized in the body and non-enzymatic, or nutritional, antioxidants like vitamin E, vitamin C, and selenium that are provided in a horse’s diet. Such antioxidants increase libido and semen quality in stallions and positively affect fertility in mares.

The genomic revolution has propelled the development of several new technologies in science and in the health industry. The data such technology provides is game changing in our industry when knowledge is effectively and is used to its full potential to translate science into practical and effective clinical nutritional therapy.
For horses this means that a report can be produced that measures the bioavailability of various nutrients to find out what works best for the animal.
Measuring the bioavailability of nutrients, as this is as unique to every human as is their DNA, is an invaluable tool we are using now at Susannah Makram Clinics to improve quality of life in humans. Prevention is better than cure.
Genetic screening tests for mares can account for primary infertility and reduced fertility rates.

Primary infertility in mares

The most commonly encountered chromosomal abnormality in horses, XO Gonadal Dysgenesis, was first described 1975. The condition is similar to Turner syndrome in human females. Prognosis for fertility is extremely poor. The syndrome has been diagnosed in diverse horse breeds throughout the world including Thoroughbred, Arabian, Welsh Pony, Tennessee Walking Horse, Standardbred, American Saddlebred, Paso Fino, Belgian, Quarter Horse, Appaloosa, as well as in grade horses.
The second most common finding in infertile mares with inactive gonads is the karyotype of a male horse (64,XY)(XY Gonadal Dysgenesis, XY Sex Reversal, Testicular Feminization). The problem may have a genetic origin. It has been encountered in Arabians, Thoroughbreds, Quarter Horses, Appaloosas, Morgans, Standardbreds and a pony of unknown pedigree. Fertility has been reported in XY mares, but is extremely infrequent.
Reduced fertility
The first example – that has been associated with chromosomal rearrangements called balanced reciprocal translocations – has been described in a mare and it is anticipated that others will be identified as the power of karyotyping tests to diagnose the basis of certain kinds of infertility becomes more widely known.

Weight of horse

Overweight mares have reduced fertility just as overweight stallions do. This is why DNA testing for weight management improves the overall health of humans and horses alike. Obesity increases risk of cardiovascular disease and can lead to insulin re that affects the male’s ability to maintain an erection for example.
Obesity can lead to insulin resistance in females that has correlations to PCOS that can cause fertility concerns or infertility.

For both horses and humans a bristle style cheek swaps is sufficient to collect the required DNA sample to test for the genes that impact metabolism and exercise.
A tailored nutritional plan that prescribes the right amount of food energy sources in the right measure in order that body fat composition is reduced in cell size and number than then be applied accurately.

Potential Future Applications
Sequencing the horse genome is just the start. The future will be how to use it in more and more effective ways for the benefits of the horse, the overall health and wellbeing.
The science of nutrigenomics looks to find out how diet affects gene expression and hence metabolism. Reversing (sperm) DNA damage using nutritional therapy and supplementation improves fertility rates, offers reason for previously diagnosed ’unexplained infertility’ and guides humans to the right fertility treatment where they have the best chances of conceiving.
It is already known that food components like fats, vitamins or minerals not only provide vital nutrition for the body but also affect the way genes are expressed. Selenium, for example, a trace mineral, is known to be essential for fertility. This would be a very useful area for equine science to investigate, in light of how this has progressed fertility rates and outcomes in other species, to include humans.

Susannah is a Naturopathic Doctor of Nutrition with a clinical background in osteopathy

PCOS and Weight

How to eat for PCOS

Concerned with PCOS related weight struggles? Knowing how to eat for PCOS (today) begins with taking a hormone profile. Balancing hormones with nutrition helps with lots of PCOS symptoms. It’s frustrating when you try things without knowing if they’ll work for you. We take healthy weight loss seriously and here we focus on safe, practical solutions for you.

Follow @susannahmakram if you haven’t met her yet here

We  have knowledge that is not known to the medical community as to how we can improve quality of life. Weight gain and PCOS and not the end of the story. They can be the start of your health journey.

PCOS stats: 25% of perfectly normal women display polycystic ovaries at one time or other (1)Polycystic ovary syndrome (PCOS) is a common endocrine system disorder among women of reproductive age. PCOS affects us in a variety of ways. First, it’s important to understand how diagnosing PCOS is not enough by ultrasound alone. At Susannah Makram Clinics we use a functional approach, integrated care pathways, functional nutrition.

Diagnosis of PCOS

In some cases, PCOS develops later during the reproductive years. For instance, in response to substantial weight gain so we need to look closely at both PCOS and weight gain in context.

PCOS and weight gain – all of the signs and symptoms of PCOS can worsen with obesity.
When do we notice signs of PCOS typically? After a woman first begins having periods is typically the time that signs and symptoms of PCOS begin.

Signs and symptoms of PCOS

Signs and symptoms of PCOS

Diagnosis of PCOS is too often misunderstood. So, it’s best to get the right information. We outline these in your consultation.
Irregular periods. This is the most common characteristic. Examples include menstrual intervals longer than 35 days; fewer than eight menstrual cycles a year; failure to menstruate for four months or longer; and prolonged periods that may be scant or heavy. Ask us how you can obtain a more conclusive diagnosis of PCOS – how is it made and can we help you?
Excess androgen. Elevated levels of male hormones (androgens) may result in physical signs, such as excess facial and body hair (hirsutism), adult acne or severe adolescent acne, and male-pattern baldness (androgenic alopecia).
Women with PCOS may have enlarged ovaries that contain small collections of fluid — called follicles — located in each ovary as seen during an ultrasound exam.

How to clear pcos

Irregular ovulation is usually detectable by a long history, usually dating back to when your periods first began, of irregular cycle length or unpredictable menstrual bleeding. Some women with PCOS however, will begin their reproductive lives with regular cycles and then have the cycles become irregular during their early 20’s.

PCOS and weight gain

PCOS and weight gain

PCOS and weight

A big clue to possible PCOS is a history of abnormal male hormone production in a woman. Male type hormones are known medically as androgens. All women normally make a small amount of these androgens. The most common androgen that is found elevated beyond the normal low female levels in women with PCOS is Testosterone. Testosterone is a very potent male hormone. And this elevation of male Testosterone hormone in women with PCOS helps explain many of the “clinical findings” (what we see) found with PCOS shown below and separate to or in conjunction with PCOS and weight gain:

  1. ‘Androgen driven hair loss’ which is responsible for the majority of inherited hair loss in men (androgenetic) and for the hair loss in women who have PCOS.
  2. Facial or body hair growth – hair growth on the upper lip, on the chin, in the “sideburn” areas, in the middle of the abdomen, in the area around the nipples and in on the fingers or toes
  3. Pigmentation of the skin, especially on the neck – excess brownish pigmentation on the neck or behind the ears “acanthosis nigricans”
  4. Acne resistant to the usual treatment methods or persisting beyond age 15. Acne is the skin’s reaction to sebum or oil production where the excess oil blocks the normal drainage channels of the skin causing inflammation and pimples. At puberty, many boys develop acne from their sudden rise in testosterone production. Boys make far more testosterone than the girls, so the boys tend to get far more acne than the girls. Acne in an adolescent female is also the result of a (normally) small amount of testosterone arising from the awakening ovary. Girls normally make very little testosterone, so their skin conditions and associated acne are usually far less severe than that seen in the boys. A sign of underlying excess male hormone production in a female may be excess or severe acne.
  5. Weight gain and the inability to lose weight with normal weight loss measures

To summarise, irregular menstrual cycles can be monitored personally and self-screening for possible excess male hormone production means looking for any or all of the following as possible evidence of PCOS related excess hormone production

Noticing signs at an early stage to help identify PCOS and get the right care and treatment.

Facial hair growth   –   Hair growth on the upper lip  –   Hair growth on the chest   –   Hair growth on the arms and legs   –   Hair growth on the back –   Excess skin oiliness –   Resistant Acne –   Weight gain that   “won’t come off”   –   Pigmentation of the skin on the neck or behind the ears –   Social aggression or seclusion –   Increased libido


How To Treat Psoriasis

Psoriasis Facts

Here’s how to treat psoriasis by treating its cause. Natural remedies can work if we start at the root of the problem, there’s no point chugging celery juice if you’ve got a leaky gut. Psoriasis affects 2% – 3% of the UK. Psoriasis is an inflammatory skin condition that causes thickening, redness, scaling.

Psoriasis Triggers

The causes of psoriasis remain unknown but it can run in families. It can be precipitated by illnesses. Psoriasis, therefore, is believed to be linked to problems with the immune system. Stress or even some medications may trigger psoriasis. When you have psoriasis, your body starts producing too many skin cells. Although there is no cure, per se, the condition can be well controlled using the Susannah Makram Clinics functional care approach.

Celebrities With Psoriasis

Cara Delevingne – model, Hollywood actress – revealed her psoriasis trigger – stress. Catwalk modelling made her ‘hate herself and her body’. Kim Kardashian suffers with psoriasis and dedicated time on Keeping up With The Kardashians to showcase her psoriasis symptoms and shame.

Psoriasis can affect the whole of the skin including the scalp and nails. Occasionally it can be associated with arthritis – characterised by remission and ‘flare ups’.

Many diseases that seem totally unrelated to the gut, such as eczema or psoriasis or arthritis, are actually caused by gut problems

So if you have to get you gut working properly, how do you get good gut health? Here’s how to treat psoriasis…

Gut Health and Psoriasis

1) EAT 2) DRINK – what food should I cut out for good gut health? gluten, dairy, yeast, corn, soy and eggs yeast, corn, soy and eggs? – e.g. irritants associated with food intolerance or (common) inflammatory triggers.

ASK the questions. Ask why before you do decide to go gluten free and dairy free. Understand why you are advised to avoid yeast, corn, soy and eggs. If asked to go sugar free, is this sugar or specifically high fructose corn syrup?
Safe, Clinical, Practical, Effective management of food intolerance or suspected allergies is a process. PHASE 1 and PHASE 2 use elimination of the suspected food. If indicated this will confirm your diagnosis so your Naturopathic Portfolio treatment works for you.

How To Treat Psoriasis

3) TAKE 4) MAKE – functional laboratory testinggut health analysis. e.g. testing for SIBO To treat the right, if any, infections or overgrowth of bugs like parasites, small bowel bacteria, or yeasts. This is part of PHASE 1-2. You might not need any special tests at all.

psoriasis and nutrition

how to treat psoriasis 

E.g. Taking digestive enzymes with food or taking the right probiotics as recommended for you. Susannah takes care to consider the right dosage when treating psoriasis. How to treat psoriasis properly factors dosage into your 4 PHASE Portfolio due to timing and bioavailability. These are tailored to have the best possible effect on your overall health. Your Naturopathic Portfolio is an unique as your DNA. Our body systems are complex. Nutrition is an exact science. Your Portfolio is simple. EAT DRINK TAKE MAKE for you only. Taking extra omega 3 fat supplements may help cool inflammation in the gut.
Gut-healing nutrients such as glutamine and zinc may work for you but it depends on what exactly needs healing, requires attention.

There is no trial and error in the functional medicine method. You have to treat the cause to get the result. 

What does Psoriasis look like?

There are several clinical patterns of psoriasis:
Chronic Plaque– The commonest variant, it tends to occur on the extensor aspects of the elbows and knees and in the scalp. Skin changes include pink or red inflamed, thickened plaques with copious white scale (see image).
Sebopsoriasis – similar to scalp psoriasis but can occur on the face, chest, armpits and groin
Flexural – raw, red areas in the groin, armpits or under the breasts
Guttate – multiple small spots of psoriasis that erupt on the trunk following a sore throat or illness (see image).
Erythrodermic – extensive disease covering more than 90% of the body surface area.
Palmoplantar pustular – pus-filled inflamed spots and the palms and soles
Pustular – the most severe form of psoriasis, skin lesions are red, tender and filled with pus spots

Psoriasis Treatment

Psoriasis Treatment


Psoriasis Treatment

Conventional treatment of psoriasis can be divided into three basic strategies depending on severity, namely creams, phototherapy (ultraviolet/sunlight) or systemic medication (oral or injectable drugs). Creams include emollients, soap substitutes, vitamin D, tar, steroids. Phototherapy involves precise doses of ultraviolet light being delivered by a medical UV-machine. Systemic medications include tablets such as acitretin, methotrexate and ciclosporin or injectables such as etanercept, adalimumab or ustekinemab. These powerful drugs are reserved for severe or life-limiting psoriasis.

Chances are, we’ve come across some one who is suffering from psoriasis. They’re likely being treated using methods of conventional medicine. This means their psoriasis is being treated symptomatically. Have we ever wondered why they’re still suffering from psoriasis? By pioneering and pushing the boundaries of functional healthcare in UK at Susannah Makram Clinics we’re dedicated to achieving excellence in healthcare by managing chronic conditions, treating he cause of dysfunction. We’re documenting successful treatment outcomes daily.

When we want to heal our skin we need to heal our gut. When we have knowledge we have power. When we take ownership of our health, we see and feel changes in every aspect of our lives. In the four phases. 

SUBSCRIBE to Susannah Makram TV for our unique video mini series on naturopathic skincare In The Four Phases.

Cholesterol – Debunking Myths

High fat diet cholesterol

HIGH FAT DIET – What’s this? HIGH CHOLESTEROL DIET works by lowering intake of dietary fat – true or false? High fat diets like paleo or bullet proof, low carb or Atkins cause cholesterol problems, correct? Not true, entirely. One of the biggest cholesterol myths out there has to do with dietary fat. READ ON AS WE BREAK THIS DOWN…Susannah debunks cholesterol myths.
✗ Trans fats or hydrogenated fats and saturated fats promote abnormal cholesterol, whereas…

✔ Omega-3 fats and monounsaturated fats actually improve the type and quantity of the cholesterol your body produces.          

LOW fat diet

LOW fat diet

Cholesterol Level – What is cholesterol?

Cholesterol is a fatty substance produced by the liver. The body uses it to help build your cell membranes, the covering of your nerve sheaths, and much of your brain. It’s a key building block for our hormone production: testosterone, oestrogen, progesterone and cortisol. 

✔ The biggest source of abnormal cholesterol is sugar and specifically High Fructose Corn Syrup.

✗ “Corn sugar” or High Fructose Corn Syrup HFCS and cane sugar are essentially the same

HFCS and cane sugar are NOT biochemically identical or processed the same way by the body.     

“The digestion, absorption, and metabolism of fructose differ from those of glucose. Hepatic metabolism of fructose favors de novo lipogenesis (production of fat in the liver). In addition, unlike glucose, fructose does not stimulate insulin secretion or enhance leptin production. Because insulin and leptin act as key afferent signals in the regulation of food intake and body weight (to control appetite), this suggests that dietary fructose may contribute to increased energy intake and weight gain. Furthermore, calorically sweetened beverages may enhance caloric over-consumption.” (i)

✔ HFCS contains toxic levels of mercury because of chlor-alkali products used in its manufacturing.

✔ Consumption of high fructose corn syrup, which is present in soft drinks or fizzy drinks, many juices, and most processed foods, is the primary nutritional cause of most of the cholesterol issues

Harmony & Sensuality. Romantic Blond Female in Black Dress resting in Armchair. Satisfaction


✔  Total cholesterol is not as critical as the following:

  • Your levels of HDL “good” cholesterol vs. LDL “bad” cholesterol
  • Your triglyceride levels
  • Your ratio of triglycerides to HDL
  • Your ratio of total cholesterol to HDL

✗ Your lipid profile as often requested by your GP will indicate levels of LDL – keeping this in check is enough to keep you off statins e.g. Lipitor

✗ It is not important to know that there are different sizes of cholesterol particles.

✔ There are different sizes of cholesterol particles. There are small and large particles of LDL, HDL, and triglycerides. The most dangerous are the small, dense particles that act like tiny bullets, easily penetrating your arteries. Large, fluffy cholesterol particles are practically harmless–even if your total cholesterol is high. They bounce off the arteries like beach balls and cause no harm.

✔ The risk of arterial plaque is the more accurate heart attack risk assessment

✔ CVD – as with all disease states – can be prevented or targeted treatment can be administered only by determining the cause; examination and assessment of overall health, the interaction of your genes, lifestyle, and environment that ultimately determines your risks — and the outcome of your life. We practice this functional approach here

Rancid or oxidised cholesterol results from oxidative stress and free radicals, which trigger a vicious cycle of inflammation and fat or plaque deposition under the artery walls.        [tweetthis]Rancid or oxidised #cholesterol results from oxidative stress and free radicals[/tweetthis]    That is the real danger: When small dense LDL particles are oxidised they become dangerous and start the build up of plaque or cholesterol deposits in your arteries.

✔ What is the point in discovering that this is the case by targeted testing if there is no solution? The solution is your Naturopathic Portfolio: Safe, Clinical, Practical, Effective management of this cause or the causes of this type of inflammation. If oxidative stress is a factor then the right antioxidant therapy will play a part – at the right time – in the right way, that is bioavailable and therefore taken up and used by your body to eradicate this issue.

✗  By the time there is inflammation it is too late 

✔ As discussed, cardiovascular illness results when key bodily functions go awry, causing inflammation, imbalances in blood sugar and insulin and oxidative stress

✔ We use the science of nutrigenomics, or how food acts as information. This can be used to stall or totally prevent some predisposed disease risks by turning on the right gene messages with our diet and lifestyle choices. That means some of the factors that unbalance bodily health are under your control, or could be given the right test and therefore, treatment.genetic-makeup

✗ Diet, nutritional status, stress and activity levels cannot be assessed accurately.

✔ The right tests can reveal problems with a person’s blood sugar and insulin, inflammation level, level of folic acid, clotting factors, hormones, and other bodily systems that affect your risk of cardiovascular disease.

What do we mean by inflammation and how do we reduce it?

We test for inflammation  here Cardio C-reactive protein. This is a marker of inflammation in the body that is essential to understand in the context of overall risk. Your C-reactive protein level should be less than 1.

Inflammation can arise from poor diet (too much sugar and trans and saturated fats), a sedentary lifestyle, stress, autoimmune disease, food allergies, food intolerance, hidden infections such as gum disease, and even toxins such as mercury. All of these causal factors need to be considered anytime there is inflammation. We conduct clinical consultation and examinations to evaluate these in order to target your treatment effectively.
Safe, Clinical, Practical, Effective 

✗  Cholesterol levels are the best indicator to predict Coronary Heart Disease

✔A major study done at Harvard found that people with high levels of a marker called C-reactive protein (CRP) had higher risks of heart disease than people with high cholesterol. Normal cholesterol levels were NOT protective to those with high CRP. The risks were greatest for those with high levels of both CRP and cholesterol. (ii)

✔ Metabolic Syndrome or Insulin Resistance can be tested and treated to manage pre-diabetes (typically in middle age and in PCOS patients) before full blown DM2 takes over. This can prevent or slowly reverse reliance on blood-sugar regulating medication, commonly Metformin 

✔ The side effects of statins have been called to question recently in a research study by the Cleveland Clinic. Problems including muscle pain and weakness have been called to question in this recent study. Statin intolerance is real. (iii)

Elevated levels of a substance called homocysteine (which is related to your body’s levels of folic acid and vitamins B6 and B12) appears to correlate to cardiovascular illness. We measure Homocysteine. Your homocysteine measures your folate status and should be between 6 and 8. Where problematic levels occur, they can be easily addressed by adequate folic acid intake, along with vitamins B6 and B12.

(i) Bray, G.A., Nielsen, S.J., and B.M. Popkin. 2004. Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. Am J Clin Nutr. 79(4):537-43. Review.

(ii) Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ; JUPITER Study Group. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008 Nov 20;359(21):2195-207.

(iii) Steven E. Nissen, MD et al Efficacy and Tolerability of Evolocumab vs Ezetimibe in Patients With Muscle-Related Statin Intolerance. JAMA. Published online April 03, 2016. doi:10.1001/jama.2016.3608

Cholesterol and Heart Attack Risk

High Cholesterol

Cholesterol is bad; lowering cholesterol is good for our health. So, we’re led to believe. Low and high cholesterol levels are perceived to reflect our diet or genes, to one extent or another. Chances are we know at least one person on cholesterol lowering drugs  e.g. lipitor or atorvastatin.

Fast Fact: 75% OF PEOPLE who have a HEART ATTACK have NORMAL CHOLESTEROL     [tweetthis hidden_hashtags=”#heartdisease”]75% of people who have a heart attack have normal #cholesterol [/tweetthis]

Liposcan HDL & LDL Subfractions is a new procedure that determines actual heart attack risk by means of differentiated analysis of HDL and LDL subfractions.

Cholesterol Levels

The clinical value of the Liposcan Test lies in the readings it gives you.
Liposcan is a unique fat metabolism test. It identifies and differentiates all cholesterol particles quantitatively by their size. This is the first test of its time.

Liposcan tells us for the first time:

  • Small, dense LDL – are they high? If you lower bad cholesterol (LDL) but have a low HDL (good cholesterol) there is no benefit in your taking statins. (i)
  • Differentiations between IDL and LDL and the large, less artherogenic LDL and VLDL
  • Subfractions of LDL1 LDL2 LDL3 LDL4 LDL5 LDL6 LDL7
  • These are non-pathogenic/pathogenic – by size, the small particles  LDL3-7 carry a significant heart attack risk potential. This is due to their higher content of polyunsaturated fatty acids meaning  they can be oxidised easier, which further increases their aggressiveness.
  • The protective HDL as LDL/HDL quotient i.e. indicates actual protective effect of the HDL

If high quantities of atherogenic LDL particles have actually been found, there will be the possibility to identify the cause of these findings. Nearly half of patients without heart attack have high cholesterol levels. Which type of cholesterol is elevated and which size the distribution particles have give us parameters for risk assessment and will tell us what is the best therapy for you.


High Cholesterol

Cure For Cholesterol

Our functional approach to treatment is your Naturopathic Portfolio. This is  personalised nutrition. Susannah takes the effect of lipid lowering drugs or statins. She uses your lifestyle as the canvas for change. Your routines and your habits are reformed. Your work other life demands will not change. Life is not a luxury spa. Our modern environment needs to work for us. This does not happen overnight. Our time the food you eat and the choices you make become easier. It is encouraging that you feel and see results from the start.

Low Cholesterol

Get the right treatment. Prevent disease. Prevent this disease from being passed on to future generations. Do you think you have true High Cholesterol levels that predispose you to myocardial disease? First, understand the physiological process that links high cholesterol to a heart attack.

What is cholesterol?

Cholesterol is a fatty substance produced by the liver that is used to help perform thousands of bodily functions. The body uses it to help build your cell membranes, the covering of your nerve sheaths, and much of your brain. It is a key building block for our hormone production. Without cholesterol we are not be able to maintain adequate levels of testosterone, oestrogen, progesterone and cortisol.

People with the lowest cholesterol as they age are in fact at highest risk of death. Under certain circumstances, high cholesterol or higher cholesterol can actually help increase life span.

Think there is 36% reduction in risk of having a heart attack using lipid lowering drugs or statins ..? Think again. The touted “36% reduction” actually means a reduction of the number of people getting heart attacks or death from 3% to 2% (or about 30-40%)
If you are a healthy woman with high cholesterol, there is no proof that taking statins reduces your risk of heart attack or death.(ii) If you lower bad cholesterol (LDL) but don’t reduce inflammation (marked by a test called C-reactive protein), there is no benefit to statins. (iii) Keep reading…

Heart disease is not only about cholesterol. It is important to look at many factors that contribute to your overall risk. And it seems that insulin and blood sugar imbalances, and inflammation are proving to be more of a risk that cholesterol.                         At Susannah Makram Clinics our CardioMetabolic Profile Panel provides an assessment of: Disease risk for diabetes, cardiovascular disease (myocardial infarction, stroke, peripheral arterial disease), metabolic syndrome.

Low Cholesterol Diet

The Right Test = The Right Treatment.

High Cholesterol

High Cholesterol

Total cholesterol, HDL cholesterol, LDL cholesterol, and triglycerides. Your total cholesterol should be under 200. Your triglycerides should be under 100. Your HDL should be over 60. Your LDL should be ideally under 80. Your ratio of total cholesterol to HDL should be less than 3.0. Your ratio of triglycerides to HDL should be no greater than 4, which can indicate insulin resistance if elevated.

Cardiometabolic Combination Panel – Blood Sugar 

Haemoglobin (Hb)A1c – DBS.  measures whether target levels of blood sugar control have been achieved and your average blood sugar level over 6-12 week period. Anything over 5.5 is high. Glycated haemoglobin indicates poorly controlled blood sugar.

Glucose Insulin Tolerance Test. Testing your blood sugar levels are not the same thing. Most clinics just check blood sugar and not insulin, which is the first thing to go up. Measurements of fasting and 1 and 2 hour levels of glucose AND insulin helps identify pre-diabetes and excessively high levels of insulin and even diabetes. By the time your blood sugar levels go up, you have missed the boat which is why we measure:

Fasting Insulin – DBS. At Susannah Makram clinics this is an assessment of insulin resistance, diabetes and heart disease risk (via a measure of insulin resistance).

Cardio C-reactive protein. This is a marker of inflammation in the body that is essential to understand in the context of overall risk. Your C-reactive protein level should be less than 1.
Inflammation is a key contributor to heart disease. A major study done at Harvard found that people with high levels of a marker called C-reactive protein (CRP) had higher risks of heart disease than people with high cholesterol. Normal cholesterol levels were NOT protective to those with high CRP. The risks were greatest for those with high levels of both CRP and cholesterol.

Homocysteine. Your homocysteine measures your folate status and should be between 6 and 8.

(i)Barter P, Gotto AM, LaRosa JC, Maroni J, Szarek M, Grundy SM, Kastelein JJ, Bittner V, Fruchart JC; Treating to New Targets Investigators. HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events. N Engl J Med. 2007 Sep 27;357(13):1301-10.

(ii) Abramson J, Wright JM. Are lipid-lowering guidelines evidence-based? Lancet. 2007 Jan 20;369(9557):168-9

(iii) Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ; JUPITER Study Group. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008 Nov 20;359(21):2195-207.

Hormone reset diet

Hormone Imbalance Hormone reset diet

Hormone reset diet for hormone imbalance alleviates the symptoms associated with hormone imbalance. For men and women, as we age, the decline in certain hormone secretion affects our quality of life. How can we manage this? With a simple hormone reset diet.

FAQs at Susannah Makram clinics — do hormones cause acne? Adult acne and hormone balance are part of the adult skincare naturopathic screening.
Typically, acne or excessively oily skin and changes in hair distribution: the first signs people relate to a hormone imbalance. Here are several other warning signs.

Hormonal imbalance in men and women refers to either a deficit or an excess in levels of certain hormones in the body. The hormone reset diet reflects the need in modern times for us to address this. It’s a guide. Types of hormonal imbalances include progesterone deficiency, oestrogen dominance, testosterone deficiency, excessive oestrogen and thyroxine deficiency or hypothyroidism. DHEA, cortisol, aldosterone and Melatonin. Other hormones secreted by glands can be overproduced or underproduced. These hormones lead to hormone imbalance symptoms.

Hormonal imbalance symptoms

We have all heard of  hormone imbalance symptoms like:

1. Weight gain

2. Insomnia 

3. Hormonal Acne

Chronic insomnia is one of the most debilitating symptoms of perimenopause for a lot of women. In addition to an imbalance of the sex hormones oestrogen and progesterone during perimenopause, a lot of women suffer with high levels of another hormone. High levels of the stress hormone cortisol can contribute significantly to chronic insomnia. Chronic Insomnia is one of the hormone imbalance symptoms that is overlooked typically before clients arrive at Susannah Makram Clinics.

Hormone Imbalance

Hormone Imbalance

Released by the adrenal glands during the “fight or flight” response, cortisol, is a powerful chemical. Cortisol, along with adrenaline, is highly effective in preserving and protecting the body during times of stress.

High levels of cortisol interfere with restorative REM sleep and interrupt sleep rhythms. This is why so many women in perimenopause report that they are able to fall asleep, but they cannot stay asleep.
High cortisol levels can also cause racing, panicky thoughts, heart palpitations, and even panic attacks.  Even if you are suffering from exhaustion and burnout, with high levels of cortisol in your body, you will not be able to sleep. Women often describe this feeling as “tired but wired.”

3. Hot flashesnight sweats, hormonal migraines, PMShigh blood pressure, dizziness, excessive facial hair, are all hormone imbalance symptoms.

Restoring adrenal function is a pre-requisite for hormonal balance. The adrenals are involved in manufacturing numerous hormones. The adrenal gland makes hormones involved in the following:
Blood sugar regulation
The regulation of the body’s minerals
Producing and maintaining the body’s energy levels in conjunction with the thyroid
Producing stress-monitoring hormone

Most hormonal imbalance symptoms are experienced because of underlying health issues.  


Maintaining healthy adrenals, thyroid, colon etc is fundamental to hormonal well being at any age with a hormone reset diet.

Which hormone causes acne?

Hormone reset diet


Hormone reset diet

Nutrition to maintain healthy adrenal gland function begins by unravelling your hormonal history. One this is decoded we can see if you have been tested for the right things that can be reversed by diet alone. Your personalised Naturopathic Portfolio for balancing Hormones Naturally is tweaked throughout the FOUR PHASES.

As indicated.
Without veering away from your day-to-day current lifestyle.

When it come to hormone imbalance symptoms, treating the cause or causes in the 4 Phases is necessary. This is so we  carefully select nutritional supplements if need be. From PHASE ONE to PHASE FOUR personalised nutrition targets primary and secondary reasons for experiencing hormone imbalance symptoms. Nutritional supplements may or may not support your personalised nutrition Naturopathic portfolio treatment. Extra care is taken in instances when considering hormone imbalance symptoms. This is because as they have special importance to the adrenals, are bioavailable and it is not possible for your individual body’s dietary uptake alone to fully support adrenal gland function. the is hy we place emphasis on this careful selection for consistent and successful hormonal balancing.

Our hormones have a complicated relationship with our Central Nervous System as well as our Cardiovascular Systems.

4. Burning Tongue Syndrome

You probably will not have any physical signs of a burn in your mouth, but your mouth might feel dry, sticky or itchy and you might even have a metallic taste in your mouth.  Interestingly, for some women this gets worse throughout the day and feels better at night.

5. Formication – Skin Crawling Sensation

This is the sensation of having the feeling of small insects crawling on or under your skin that results in itchiness and scratching that can lead to skin damage.

6. Carpal Tunnel Syndrome +/- sudden muscle weakness – carpal tunnel syndrome – what’s causing it?

7. Many factors contribute to headaches for both men and women, including family history and age. Women, however, often notice a relationship between headaches and hormonal changes. The drop in oestrogen just before your period may contribute to headaches. Many women with migraines report headaches before or during menstruation.

8. Electric Shock Sensation

9. Frozen Shoulder – adhesive capsulitis – Like many musculoskeletal or jot problems/pain adhesive capsulitis can also have a hormonal cause

iStock_000001550919_Small9. Tingling Extremities – Paraesthesia – In certain cases, numbness and tingling sensations can be explained by natural hormonal changes and fluctuations. This is because oestrogen has a complex and widespread effect on the nervous system. Thus, when oestrogen levels vacillate it can sometimes produce symptoms such as, tingling extremities.

Numbness and tingling in the feet, hands, legs, and arms can be an indicator of more serious problems like diabetes, vitamin, and calcium deficiency, potassium depletion, or blood circulation problems so you should be be able to have causes or the cause of your discomfort, health concern or complaint correctly identified at your consultation at Susannah Makram Clinics in order that you receive the right treatment.


Safe, clinical, practical and effective.

Call  020 7060 3181