Ayurvedic medicine, enriched with oriental wisdom and millenniums of experience, argues that “health” is defined primarily by the emission of one to two formed stools daily and a maximum of three stools per day at most.

Alas, many people do not meet this definition because of loose stools, or even liquid stools. This is not our topic for today: many people fall into the other extreme; they “skip” days and do not reach the required seven stools weekly. Below five, one must be concerned, and then what is there to say about exceptional cases of only one or two bowel movements per week? Personally, I have even seen patients who have complained of a period of two weeks and even up to four weeks without a bowel movement!

This seems unbelievable but it is the sad reality, made even more distressing because constipation involves undeniable toxicity and serious health risks. In addition to the conventional mechanical complications (haemorrhoids and anal fissure), we can include gallstones and cancers with hormonal involvements such as colon cancer and breast cancer. We cannot therefore leave constipation untreated.

We should also respond to people who complain of hard stools, painful passing of stools, or alas, daily stools obtained through the regular use of laxatives. The latter, if they are of the drastic kind, such as from the senna plant, or chemical drugs, should be avoided like the plague. They will ultimately end up damaging the intestinal mucosa and create a lifetime dependency. Of course, the occasional intake of such laxatives doesn’t generate such complications.

The first tip is to hydrate thoroughly, but how can you judge this accurately? You should produce 1.5 to 2 litres of urine per 24 hours; this urine should be pale yellow – not dark or brown. It is also clear that exercise, or even just an active life, promotes intestinal transit: drinking and moving are essential!

Methods that provide a mechanical stimulus using natural products, as long as they have no irritant effect, constitute good strategies. For example, one or two tablespoons of flaxseeds (linseeds) or psyllium seeds (also called ispaghul) soaked overnight in a glass of water. The seeds absorb water and swell, forming a tasteless gelatinous mass. This is not unpleasant to swallow and works wonders for intestinal transit.

If those don’t work I am also in favour of a few natural remedies. Magnesium ascorbate in powder form can solve difficult cases with the advantage of not adding the acidity of the classic vitamin C, which is nothing else than ascorbic acid. However one must be careful not to overdose otherwise the opposite symptoms can occur or at the very least cramps and bloating. Usually a few grams daily will suffice, sometimes less, with a tendency towards spontaneous improvement and dose reduction. Most magnesium salts give the same kind of benefits. One can easily combine vitamin C powder in the morning (tonic) and the magnesium at night (relaxing) to completely resolve the problem.

These products have the advantage of not inducing any toxicity because any excess will only result in exceeding the goal; loose stools. Probiotics and prebiotics are another means of treatment, which is remarkably effective, and I recommend trying different symbiotic mixtures designed for this specific purpose. Finally, I would be upset with myself if I did not mention that severe cases could be caused by mechanical obstructions or insufficiency of the thyroid gland, and need to be treated accordingly.

As is generally the case in these blogs, we are not talking here about serious diseases, but rather ‘functional’ disorders. This blog is therefore more about common headaches rather than true migraines…

Very simply, the first two tricks – and probably the most important ones of all - are to eat and drink often enough! Indeed, dehydration plays a catastrophic role in triggering headaches. We must therefore ensure that urine is pale, with a daily volume (24 hours) of at least 1.5 litres, and 2 litres if possible. One can find, if necessary, the correct way to collect 24 hour urine on my website www.gmouton.com (click on the tab “Consultations”).

Hypoglycaemia constitutes another powerful trigger for headaches. I can vouch for this when I give late appointments to patients that must be fasting prior to their blood test, (just because the agenda is full you understand; not because I didn’t get up early enough!). These patients make their case worse by wrongly believing that they cannot drink fluids before a fasting blood test when they can perfectly well drink water, black coffee or green tea – but without milk or sugar.

Then it is clear that stress constitutes another major trigger of headaches via cervical muscle contraction, those of the neck and in particular those at the base of the skull. I am especially referring to the deep muscles that are at the base of the skull on the perimeter of the posterior skull, behind the left ear lobe and going across to the right ear lobe… Various specialized techniques can be used by professionals from diverse fields, but one should not disparage an amateur masseur that has “good hands” and is capable of relaxing those muscles…

We can even help ourselves! Start by identifying the most pressure sensitive spots in this area. You need to apply enough pressure to feel the pain, preferable with the thumb. Inhale deeply by using abdominal breathing (inflate the abdomen, not the chest) and exhale very slowly, until the last bit of air has been exhaled. Repeat the exercise three times consecutively then, and only then, release the pressure of the thumb. By doing this you will have released the contracted muscle, which should immediately ease your tension headaches.

Still in the category of headaches with a mechanical trigger, besides the muscular contractions described above, there are also the problems of minor intervertebral dysfunction (that is to say, one or two vertebrae misaligned) that can affect the cervical spine. In this area, I love the image of a stack of plates where, if there are anomalies at the top of the pile (the cervical region) the equilibrium will only be maintained if another anomaly –“mirrored”- exists at the bottom of the pile (lumbar region). We must therefore examine the whole spine.

Still under the umbrella of mechanical problems, let’s not forget the enormous consequences of an imbalance of the static jaw (disruption of the temporomandibular joint or TMJ), a major source of headaches! Let’s also mention imbalances of the pelvis; for example due to one limb being shorter than the other: this is another major cause of headaches! The evaluation of these problems along with their resolution should always be referred to professionals who are experienced in this field.

Finally, I refer you back to Blog 8 for everything related to IgG food allergies, often the cause of headaches. I also refer you to future blogs dealing with hypothyroidism. Even in its moderate form, a weakness in the thyroid can constitute the cause of headaches that cannot be cured until the thyroid is dealt with.

Laboratories always indicate, for every requested parameter, a range of reference values. The norms are defined to include 95% of the “healthy” population within this reference range, with 2.5% of subjects above and 2.5% under the proposed range. It is simply a general rule!

We begin by questioning this so-called “normal” reference population. The use of these standards doesn’t cause me concern in the vast majority of cases; however we must keep in mind a few epidemiological hitches. For example, it should be noted that that various nutrient deficiencies affect a large proportion of the population of Western Europe: vitamin D (lack of sunshine); selenium, iodine, and sulphur (poor soil quality); iron (heavy periods, lack of proteins)…

An excellent example of the inadequacy of relying on the reference values can be seen with Thyroid Stimulating Hormone (TSH) secreted by the pituitary gland to increase hormone production by the thyroid gland. The higher the TSH, the weaker the thyroid gland is. A longstanding controversy with the standard ranges concerns the upper limit of references ranges for TSH, classically defined between 4 and 5. It now seems likely that the sample Caucasian population that was used to establish the "healthy” range of TSH was actually significantly “contaminated” by subjects with low-grade thyroid disease. People suffering from a goitre (swelling of the thyroid gland) and also people with thyroid autoantibodies (an auto-immune disease affecting the thyroid - often seen in the Caucasian population) were part of that sample group.

By introducing into the sample reference population a significant proportion of subjects who were slightly hypothyroid – the typical consequence of autoimmune thyroid disease and the main cause of goitre – the reference values were thus biased. Since then, calculations performed on a population pre-selected by a blood test and screened for auto-antibody carriers, and an ultrasound of the thyroid gland to detect goitre, resulted in quite different values. These results suggest that the upper limit for TSH should be brought down to 2.5 instead of the 4.5, which is still used to this day by most laboratories.

Of course, this doesn’t mean that any person with a TSH above 2.5 is suffering from hypothyroidism, but that such a possibility should be considered by comparing the results to other suspect laboratory findings and the potential symptoms. In the so-called “grey” area of TSH between 2.5 and 4.5 we can assert: no symptoms, no treatment. We must simply monitor the biological evolution from time to time.

However, if the TSH is reaching the grey area and if the thyroid hormones come close to the bottom of the reference range, we can deduce that the pituitary gland is stimulating the thyroid without a sufficient response. We therefore conclude that there is, at least, a certain laziness of the thyroid gland. In cases where the TSH is rather high and within the grey area, along with hormonal levels in the upper half of the reference range, we may conclude that the thyroid gland is responding to the pituitary gland and therefore there is no need to worry.

The details of the scientific references explaining this controversy can be found in the conference “Thyroid”, heading “Functional Hormonology” in the tab “Conferences” on my website www.gmouton.com. You can download the PDF folder free of charge.

Generally speaking, any biological test result should always be assessed in relative terms. There is nothing worse than a binary response qualifying the result as “normal” or “abnormal”. Rather, we must really visualize the result and put it on an imaginative graphic scale going from the minimal reference to the maximum (without forgetting any alterations utilised to optimize the reference range). The ideal way would be to always represent results graphically; a few laboratories sometimes do it, but this should become the norm for all the current biological parameters.

We would then avoid the ridicule of successive assessments where two almost equal values are categorized in totally conflicting ways: “normal” if just above the reference limit, and "abnormal" if just below this threshold. It is in reality perfectly identical results if we take into account the systematic measurements errors…

I would like to return to the important principle that we must always strive to consume seasonal products. In my opinion it is a fundamental concept from which many other food rules should also be respected to promote good health.

When you stop and think about it, everything is seasonal food! I have already discussed the subject of eggs, whereby if you halt the consumption of eggs in the winter it should protect against developing IgG allergy (birds do not lay eggs in winter, do they?). Then there is that ridiculous idea that you should eat an apple a day all year long (this will supposedly keep the doctor away?). Another example is to consume strawberries in winter (even in February when they come from Spanish hot houses, with no flavour or nutrients, but covered with a lot of pesticides). Here's how to get rid of allergies to fruit and vegetables: eat them in their normal season.

I encourage everyone to download from my website www.gmouton.com your list of seasonal foods: click on “seasonal” then click on the tab “English” and you are there!

If we look more closely, nearly all food should be rotated with their normal seasons. Take East Africa for instance, where the people are no longer nomadic hunter- gatherers. They now practice subsistence agriculture ("food to mouth agriculture") and do not care for intensive production for sale. In their environment it is all that is possible on extremely arid and stony land. There, I have observed that the herds are systematically heterogeneous: one or two zebras, several cows, goats and sheep. Hence they are benefiting from a good form of natural food rotation. And when they consume dairy products they do not do it all year round or from the same species….

Maybe you are going to tell me they do so given the chronic lack of food affecting these populations. The fact is quite different as these people recognize how important it is to interrupt their milk consumption while the mother is breastfeeding its newborn. In these regions, they require all the maternal milk to grow and develop, especially in this particularly harsh environment where there is not much other food available. So, they create a cycle and benefit from this seasonal interruption so essential for the immune system to rest, thus avoiding the development of unwanted reactions.

For further proof, let’s look at the traditional farms within European counties where animals were raised to feed the families. On these farms they did not sacrifice an animal at any time of the year: there was generally a season for everything!

When one respects the seasons it carries with it many other advantages beyond the avoidance of any adverse food allergies. First of all, there is the obvious freshness of the foods. In addition you also avoid the abomination of long-haul transport, where fruit is picked while still “green” and sprayed with chemicals to prevent too rapid ripening, held in refrigerated conditions for the same reason (but this process leads to a degradation of the flesh of the fruit and reduces the shelf life once the warming up takes place), without ignoring the huge wastefulness that this practice entails.

The intercontinental export of perishable goods is only possible thanks to cheap oil, which are the result of the US-Saudi agreements following the end of the Second World War. Alas, the price of oil doesn't reflect its rarity and pushes us to excessive consumption, while oil reserves are being rapidly depleted.

Global agriculture is thereby upset because we grow anything anywhere (roses in Kenya!) by using very intensive methods, most often with very destructive consequences for the environment. In addition people are exploited by this system: emerging market farmers are under-paid by multinationals, while in Europe the produce bought out of season is over-priced versus produce bought in season and locally grown….

We must buy locally: virtually everyone knows this but who actually does it? One extremely good reason is the superior taste of fresh foods locally produced and in season. These foods are far superior in comparison with the expensive altered products that are imported and transported from afar. A good flavour always reflects the presence of abundant alkaloids, these precious phytonutrients that are crucial to our health. What are you waiting for? Please download the list of seasonal foods from my website now!

As usual, we are discussing relatively benign forms of functional anaemia because what we are describing doesn’t require a specialist, namely a haematologist, to treat these conditions. A diagnosis of anaemia implies a lack of haemoglobin, which implies a deficiency of red blood cells that are necessary to transport haemoglobin, which results in less oxygen supply to the tissues. You may not be surprised to learn the typical symptoms associated with anaemia: pale skin, fatigue and rapid shortness of breath even with only a moderate level of effort.

Essentially, the synthesis of haemoglobin requires three basic components: iron (4 atoms for each molecule of haemoglobin), folic acid (or vitamin B9) and vitamin B12 (or cobalamin). Just missing one of the so-called “anti-anaemic” nutrients and the production of haemoglobin by the bone marrow could be diminished or blocked. We always thinks first of iron deficiency and often not of the B vitamins even though they are also essential.

Vitamin B12 has a remarkable feature: you can only find it in foods of animal origin and therefore vegetarians will most likely be deficient and of course vegans even more so. However it is not sufficient to just consume products rich in vitamin B12 - meats, fish, and shellfish - as with all nutrients they need to be properly absorbed! This implies a good digestive system. I have examined with great detail the complex physiology of vitamin B12 absorption in an article in English posted on my website: www.gmouton.com: click on “Articles” then the heading “Nutrition and Function” and you will access the article in question (“Elevated Vitamin B12 Blood Levels"), which is fully referenced.

The title of the article may surprise you but it refers to an interesting phenomenon involving patients suffering from Small Intestinal Bacterial Overgrowth (or SIBO). This is the invasion of the small intestine by bacteria that are normally confined to the large intestine and the colon and which have the ability to produce vitamin B12. Please note that all of these remarks are also true for vitamin B9 (folic acid). These differing physiological results derive from the fact that the end part of the small intestine is precisely where vitamin B12 and B9 are absorbed. We find, therefore, in the majority of subjects with a SIBO, abnormally high blood levels of vitamin B12 and / or vitamin B9.

Any person not taking B-vitamin supplements who has an excess of vitamin B12 and / or B9 automatically implies this form of intestinal dysbiosis. It is in fact a common cause of what is labelled Irritable Bowel Syndrome (IBS), although it is of course not the only possible explanation. Please note that the long term use of proton pump inhibitors (omeprazole, lansoprazole, pantoprazole) promotes this disease through the suppression of gastric acid and the consequent increase in pH of the small intestine that results. A favourable environment for bacterial overgrowth is therefore created, perfectly similar to what happens in the colon. Gas, bloating, abdominal cramps and loose stools reflect these digestive disorders and an increased blood level of vitamin B12 is biological evidence.

Measuring vitamin B12 levels therefore offers important data concerning whether a person should be considered as a perfect omnivore, or as a carnivore (B12↑), or as a vegetarian (B12↓). Any distortion of these results compared to what might be expected implies a digestive malabsorption (level of B12 lower than expected) or a bacterial overgrowth of the small intestine (level of B12 higher than expected). There is, to my knowledge, no other biological parameter, which by its mere interpretation implies such an ability to provide key diagnostic insight.