Alzheimer’s Disease and Dementia September 29, 2016Posted by Dreamhealer in Aging, best vancouver naturopath, Healing.
Tags: Aging, Alzheimer's, dementia
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Alzheimer’s Awareness Day is September 21st , so I wanted to take this opportunity to talk a bit about Alzheimer’s disease and how naturopathic medicine may provide the answer that has thus far eluded the pharmaceutical world.
There are many potential causes of dementia, which affects more than half a million people in Canada, and that number is forecast to double in the next 20 years. Alzheimer’s Disease accounts for approximately 60% of dementia patients, and has been called the “second-most feared disease in Canada”. This description will come as no surprise to anyone who has been personally involved in caring for a loved one with Alzheimer’s, as it can be heartbreaking to watch their personality vanish before one’s eyes.
When it comes to conventional treatment options, there are at least 4 different drugs approved for Alzheimer’s in Canada, which target either of the neurotransmitters acetylcholine or glutamate. These drugs do not cure the disease or slow its progress, but merely alleviate some of the symptoms. However, this can provide an improved quality of life for patients for several years, until they lose their efficacy.
As usual, prevention is still the best option. Research has long indicated that Alzheimer’s was associated with diabetes. However, new research is now indicating that Alzheimer’s may be related specifically to elevated insulin levels, as is seen in type 2 diabetes. Whereas type 1 diabetes (aka juvenile diabetes, as it is most commonly diagnosed in childhood) is an autoimmune condition in which the body’s immune system attacks and destroys the insulin-producing cells in the pancreas, type 2 diabetes is a progressive condition associated with cells becoming less sensitive to the action of insulin. This forces the body to produce more and more insulin until the pancreas simply gets burned out. While insulin levels are high, this puts people at significant risk of developing Alzheimer’s. Simply put, the enzymes that process excess insulin are the same ones responsible for breaking down amyloid-beta, the protein that forms the plaques and tangles seen in the brains of Alzheimer’s patients.
When you take in foods that are high in simple refined carbohydrates (sugar and starches), they are rapidly digested and absorbed into the bloodstream. Your body responds by quickly pumping out insulin to bring these blood sugar levels down. However, your pancreas evolved to operate in more of a slow and steady way, producing a trickle of insulin to carefully balance a gradual blood sugar increase. In time, forcing it to break into a sprint over and over takes a serious toll.
At the same time, your cells are becoming resistant to the signal from insulin telling them to take in sugar from the bloodstream. This is caused by a few things that are all related – obesity, increased fats circulating in the blood, and a diet high in fructose (yes, that wonderful sugar seen in things like pop, candy – and anything else that contains high-fructose corn syrup). As insulin resistance develops, more and more insulin is put into circulation to get the same effect. This is where the risk of developing Alzheimer’s increases, as those enzymes are being diverted away from breaking down amyloid-beta in favour of dealing with the elevated levels of insulin.
So what can you do about this? Type 2 diabetes is one of the most preventable and even reversible conditions out there, simply by following the basic diet and lifestyle advice that’s been around for decades. Diet-wise, you want to prevent blood sugar spikes that come from high-glycemic foods and drinks. The Mediterranean diet – promoted for years for its cardiovascular protection – is ideal for this purpose as well. More fruits and vegetables and whole grains, and limited simple carbohydrates; lean protein like fish, chicken and legumes with each meal slows digestion and absorption of carbohydrates, as do healthy fats like olive oil, avocados, and fish oils. Regular cardiovascular exercise is also critical to restoring insulin sensitivity.
Naturopathic medicine may also have the best options out there for treatment of Alzheimer’s. At least one doctor in the US has reported significant improvement in patients following his protocol – in some cases, symptoms improved by 70-80%, even allowing some formerly severely debilitated patients to return to work. Although results are still preliminary – considering the lack of other options, these developments are really exciting.
As we learn more about prevention, and treatment options become more promising, Alzheimer’s disease doesn’t have to be the frightening prospect it has been. If you have questions about how you can reduce your risk, make an appointment with one of our doctors at Yaletown Naturopathic Clinic.
We Need to Talk About Death December 14, 2015Posted by Dreamhealer in Aging, Healing, Naturopathic Doctor, Naturopathic Medicine.
Tags: death, life, palliative care
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“To the well organized mind, death is but the next great adventure”- Albus Dumbledore
You don’t have to be staring down the barrel of a terminal diagnosis to understand that death is a scary subject. In sitting down to write this article I also came to realize that attitudes towards death can vary as much as attitudes to life. The obvious factors such as religion, culture, level of education, upbringing and past experiences of death (mostly the death of others around us but occasionally a near death experience) influence how we feel about our own mortality. Around the world and throughout history the place beyond death has been described as a land on the other side of a river we must cross, a place beyond the clouds where all our problems dissipate or simply a gateway to another life where the cycle continues. Most cultures incorporate a god of death or personification of death into their religion and mythology and of course we all have our own rituals surrounding death and dying.This is because death is as much a part of life as birth and everything in between. Many people find strength in defaulting to these rituals around death as it gives them purpose in a time of crisis. A sense of knowing what to do during a time of uncertainty and the unknown. This protocol helps the dying and their relatives to feel like they have some structure and control over the event and therein lies the key- control. Death comes to us all but we can feel slightly better about it when we have some sort of say in how or when it happens.
Attitudes towards death in our society have changed dramatically over time. Historically death was viewed as a natural event with the dying person in charge, no health practitioners no hospitalization. Most people died in their own home, in their own bed. More recently, death is something to be “managed” by a team of doctors and nurses in a hospital. These changes have both positive and negative aspects for the dying person. One could argue that the regulation or institutionalization of death i.e. moving death into a hospital setting, is perhaps just another way for us to feel that sense of control over a situation we really are powerless against. That somehow the “management” of death by a health care team and all the protocols that go with it fills the void left by the rituals and customs of religion and culture. There may be elements of truth to this. That being said, the ability of the health care system to improve the quality of life and the quality of death for the dying person is undeniable. Having worked closely with terminal patients of all ages for a number of years I can attest to the existence of a “good death”. Pain control, comfort measures and maintaining patient dignity are the cornerstones of palliative care. The hospice movement particularly has done a lot of great work in the last 60 years or so addressing these issues and improving standards of practice around end of life care. When terminal patients were asked what scared them the most, surprisingly, many of them did not say death itself. They said pain, loss of independence and loss of dignity. These are all things that quality nursing care and cognizant medicine can help to regulate. In this area of healthcare the focus shifts completely from quantity of life to quality of life.
What is palliative care?
The journal of clinical oncology says “palliative care means meeting the physical, psychological, social and practical needs of patients and caregivers”. Palliative care is not necessarily end of life care, rather it focuses on the relief of suffering throughout a patient’s illness. Typically palliative care is offered to patients with cancer, particularly those with metastatic cancer and patients with a high symptom load (Chronic obstructive airway disorder, congestive heart failure etc.) although it can be beneficial for patients of any age and even for those who do not have a terminal diagnosis. The American College of Physicians identifies the key areas of focus for palliative care as pain, dyspnea (trouble breathing) and depression. They recommend practitioners regularly asses these areas for the dying person and put interventions in place to alleviate them. The interventions recommended include medications such as opiates, oxygen and psychosocial interventions such as cognitive behavioural therapy, education and individual and group support for depression. There is varying evidence for some of these interventions and many of them produce side effects which the dying person and their families may wish to avoid. Opiate medications are extremely effective at controlling pain and dyspnea. They can be administered orally, intravenously or under the skin. Having an awareness of potential side effects of these medications such as respiratory depression, drowsiness and constipation can help patients and families make informed decisions with regard to these medications. It also helps them to be proactive in terms of managing these side effects. Oxygen therapy though it is often recommended in the final stages of life when patients can become hypoxic (low oxygen) has also been shown to have mixed effectiveness in terms of maintaining quality of life. While in theory administering oxygen to a patient who’s oxygen is low makes sense, in the dying patient priorities are sometimes different. Oxygen is typically delivered to the patents via nasal prongs or a mask. It should be humidified to avoid drying out the patients nose and mouth. Even with humidification it can still have this drying effect. Regular oral care (every few hours) is one way to counteract this. For the dying patient who is at high risk of developing pressure sores the nasal prongs or mask and tubing can cause painful cuts on the face, neck and ears. Many patients and practitioners may weigh up the benefits versus the drawbacks and decide against this therapy for the dying person. It is also important to add to these interventions the importance of regular oral care for all dying patients during the final stages of their journey once they are no longer eating. If the dying person can no longer reposition themselves they should be assisted to do so every two hours. This helps to prevent painful pressure ulcers or “bedsores”. Naturopathic medicine has other tools to offer in addition to the intervention recommended by the American College of Physicians.These include nutritional support, counselling, acupuncture and relaxation techniques such as guided meditation.
Studies have shown that the involvement of palliative care earlier on in a patients illness can improve outcomes significantly for both patient and care givers. Improvement in quality of life, reduction in symptoms, reduced caregiver burden and also reduced costs to the health care system have all been demonstrated as positive outcomes with earlier referrals to palliative care. Many patients are not referred to palliative care until quite late in their journey (less than three weeks prior to their death) and of course this limits the benefits they can gain from this service.
Importance of Communication
The shift of focus from quantity to quality is something healthcare practitioners and caregivers can sometimes struggle with. Health care practitioner’s instinct is to preserve and maintain life for as long as possible.The importance of advanced care planning is emphasized by much of the literature around palliative care and dying. In palliative and end of life care, treatment decisions are often group decisions and the input of caregivers and family is important. It is essential that relatives and health carers have open communications with the dying person and clearly understand their wishes when it comes to their own death. A “good death” may be different for each person. Understanding what a good death means to the dying person enables the healthcare team to navigate care in a way that finds the correct balance between quality and quantity for that individual. It is important to discuss what measures the dying person would like to be taken in terms of medical interventions like medication, intravenous therapy, surgery, ventilation, resuscitation.
Openness about a diagnosis and about death have increased in recent years in the medical model of end of life care. In the past, patients were often not told about their terminal diagnosis as families and doctors felt they were protecting them. This is a phenomenon known as “closed awareness”. Thankfully this is quickly changing as patients gain more autonomy around their care. One study which interviewed patients with brain tumours and their relatives identified some interesting facts around communication in these unique situations. In the interviews family members felt that they should protect the patient from bad news and they felt that the patient didn’t want to know. However when patients themselves were interviewed most of them expressed that they did indeed want information and even if it was bad news they wanted to know. Of course patients are individuals. The individuality of death and dying is the same as the individuality of life. No two people are the same in their approach. For some patients their interest in information was affected by their coping strategies. For instance, patients who were going to have certain types of treatment simply did not want to read anything negative about that treatment.
Death is something we can all be afraid of certainly. However, we shouldn’t be afraid to talk about it. Many studies identify that talking is helpful for the dying person and their relatives/caregivers. Meaningful communication surrounding death or a serious diagnosis was shown to help people identify the positive things about their situation. Many people identified their situation as a challenge and opportunity to grow. They said it taught them to prioritize their lives and do things like focus on family and themselves. Dying people or those facing a frightening diagnosis also said that they were able to find a strength within themselves that they never knew they possessed. Frank and open discussion regarding diagnosis and the practicalities of end of life care hands that control back to the dying person. This can be done at any stage of a person’s life. After all, none of us know what is around the corner for us. Thinking about our death not only helps us to prepare and potentially improve the quality of that death it also enriches our life.
“Of all mindfulness, and of all awareness, mindfulness of death and impermanence is the most important”- Buddha.
Evidence-Based Interventions to Improve the Palliative Care of Pain, Dyspnea, and Depression at the End of Life: A Clinical Practice Guideline from the American College of Physicians. Annals of Internal Medicine January 2008.
American Society of Clinical Oncology Provisional Clinical Opinion: The Integration of Palliative Care Into Standard Oncology Care. Thomas J. Smith, Sarah Temin, Erin R. Alesi, Amy P. Abernethy, Tracy A. Balboni, Ethan M. Basch, Betty R. Ferrell, Matt Loscalzo, Diane E. Meier, Judith A. Paice, Jeffrey M. Peppercorn, Mark Somerfield, Ellen Stovall and Jamie H. Von Roenn. Journal of Clinical Oncology. February 2012.
Communication and awareness about death: A study of a random sample of dying people. Social Science & Medicine, Volume 32, Issue 8, 1991, Pages 943-952
Pain and Palliative Care Service, Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA. Accepted: April 13, 2006;
Cancer patients’ information needs and information seeking behaviour: in depth interview study. The BMJ. April 2000.
Death and dying in the intensive care unit. J.L. Epker. Erasmus MC:University of Rotterdam. September 2009.
The Attitudes of Cancer Patients and Their Families Toward the Disclosure of Terminal Illness. Young Ho Yun, Chang Geol Lee, Si-young Kim, Sang-wook Lee, Dae Seog Heo, Jun Suk Kim, Keun Seok Lee, Young Seon Hong, Jung Suk Lee and Chang Hoon You. Journal of Clinical Oncology. January 2004.
Healthy lifestyle ‘slows cellular ageing’ September 25, 2013Posted by Dreamhealer in Aging, Alternative medicine, Dreamhealer, Energy Healing, exercise, Experiments, Healing, Health, Integrative Medicine, Naturopathic Medicine, Research.
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Written by: Nick Collins
Healthy lifestyle changes such as eating whole foods and practising yoga could reverse the ageing of the body’s cells, a new study suggests.
The type of change seen in their chromosomes, the structures which house our genetic code, has previously been linked to a lower risk of age-related disease and greater life expectancy.
The findings, from a pilot study of prostate cancer patients, could equally apply to women and healthy men although larger studies are needed to confirm the results, researchers said.
They studied data on 35 patients who had a non-aggressive form of prostate cancer and had chosen to be regularly assessed by doctors rather than undergoing conventional treatment.
Ten of the men adopted a “lifestyle change intervention” which included eating a plant-based diet of whole foods, moderate exercise, stress management and regular group support classes, while the other 25 made no change to their lifestyle.
The scientists, from the University of California, San Francisco, examined changes in the men’s telomeres, structures which sit at the ends of chromosomes like the protective caps on the end of a shoelace.
Telomeres prevent the DNA within our chromosomes from being damaged, but as we grow older they become shorter and cells begin to age and die more rapidly.
Previous studies have linked the shortening of telomeres to a decrease in life expectancy and a greater risk of age-related diseases such as heart disease, vascular dementia, obesity, stroke, diabetes and various cancers.
But the new research found that in the group who adopted strict and comprehensive healthy changes to their diet and lifestyle, telomeres lengthened by an average of 10 per cent over five years.
The more positive changes the men made, the greater the increase in telomere length. In contrast, among those who did not alter their way of life, telomeres decreased in length by three per cent on average.
Although it is well known that a healthy diet and plenty of exercise can result in a host of medical befits, the findings published in The Lancet Oncology journal, are the first evidence of such an effect on telomeres.
Prof Dean Ornish, who led the study, said: “The implications of this relatively small pilot study may go beyond men with prostate cancer.
“If validated by large-scale randomised controlled trials, these comprehensive lifestyle changes may significantly reduce the risk of a wide variety of diseases and premature mortality. Our genes, and our telomeres, are a predisposition, but they are not necessarily our fate.”
Dr Lynne Cox, a Biochemistry lecturer at the University of Oxford, who was not involved in the study, said the findings “support the calls for adoption of and adherence to healthier lifestyles”.
It is “perhaps too soon to judge whether this increase in telomere length will correlate with increased longevity or healthspan”, she added.
Four lifestyle improvements which could lengthen telomeres
Participants adopted a diet high in whole foods such as fruit, vegetables, pulses and grains. They cut down on refined carbohydrates, such as white bread, and lowered their fat intake to less than 10 per cent of all the calories in their diet.
The men were asked to undertake “moderate” levels of aerobic exercise for the duration of the study, for example walking for half an hour a day, six times per week.
Exercises participants carried out to lower their stress levels were gentle yoga-based stretching routines, breathing exercises, meditation and “progressive relaxation”, a technique which involves tensing and relaxing different muscle groups in turn.
The men were asked to attend one hour-long group “social support” session each week, led by a clinical psychologist.
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Lifestyle changes may delay aging, study says March 23, 2009Posted by Dreamhealer in Aging, Diet, exercise, Healing, Health.
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American researchers may have found the fountain of youth. But it will take major lifestyle changes for the average person to get there. A radical diet and exercise plan, which includes following a vegan diet and exercising nearly every day, increases the levels of a protein that may delay aging and increase life expectancy, the new research suggests. Read More…