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Fresh Start…? February 11, 2016

Posted by Dreamhealer in best vancouver naturopath, Healing, Naturopathic Doctor, Naturopathic Medicine.
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Somehow January is over. Have you gotten going on your 2016 new years’ resolutions? Are you feeling successful? Is the momentum petering out?

It’s easy to feel inspired at least for a little while by all the hype around a resolution at this time of year. It’s also easy to feel bombarded by pressure to be successful at this goal you set. Here are a few ideas to get you through the pressure and maybe even help you drop the resolution altogether!

  1. Intention is more powerful than resolution. 
    A resolution tends to carry power in the pressure department. Some people do well at them for a time because they feel the world is watching, holding them accountable and that’s exactly what they need. This may not resonate with everyone.

An intention comes from inside and acts more like scaffolding, helping to raise the structure of the things you want to bring into your life. It’s longer acting and gentle enough that you can revisit them easily if you find you have strayed.

  1. Winter is time for hibernation.
    I believe that one of the reasons resolutions set some up for failure is because some resolutions involve great action. Typical ones would be to exercise regularly, run more, eat less, eat better, etc.

If you are someone who needs a bit more meaning or connection to your goals, you’ll be interested to know that in the Shamanic world, winter is a time of stillness. It’s a time to go inside, hibernate, let go and clear space, letting the old stuff die and be removed to make room for the upcoming spring and return to life.

I find it’s the best time to take time and listen. To go with the natural tendency towards stillness. To allow in what is meant to come and to form intentions for the rest of the year from this place of quiet connection.

  1. Get clear and ask for help.
    What I love most about the idea of a fresh start with a new year is that it’s an opportunity to get really clear in what you want to call in this year. And sometimes that means simply asking and then letting go of the question.

If you have a resolution you already feel good about then re-examining what the intention behind it might help bolster you forward or tweak it to fit the big picture. Is losing that extra 10 pounds really about the exercise and food? Or can you also bring in the intention to work a bit less and give yourself more stress-free time for joy and sleep, removing a big obstacle to losing that weight.

If you’re at a loss, might I suggest making time for more TLC? It’s my favourite prescription, be it a massage, acupuncture, tea and a good book or a walk in the woods. TLC can also take on the form of asking for help more, giving yourself a break and recognizing that you don’t have to do it all.

Whatever you resolve to do or intend to bring in, remember to check in and to take yourself into account along the way.

A gentle and strong fresh start to you!

Is Your Gut Friend or Foe? January 28, 2016

Posted by Dreamhealer in Healing, Health, immunity, Integrative Medicine, Naturopathic Doctor, Naturopathic Medicine, nutrition.
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Reprinted by permission from the Gastrointestinal Society. Originally published in the Inside Tract® newsletter, Issue 193, 2015. ©Gastrointestinal Society

All disease begins in the gut

Hippocrates made this statement more than 2,000 years ago. Since then, much has changed in medicine. However, this theory remains of great interest in the medical community, especially when considering the terrain of the individual, how robust their immune system may or may not be, and determining ways to treat our modern day chronic illnesses.

We live in an age when having a diagnosis of some kind is almost as common as having a job. We hear the terms IBS, IBD, autoimmune disease, hormone imbalance, arthritis, allergies, migraines, MS, asthma, neurodegenerative disease, eczema, depression, obesity, and so on.

Having a definitive diagnosis can certainly be beneficial for us to have an understanding of what is going on in the body and how it might be causing symptoms, but none of these diagnoses actually tell us why.

What if understanding the gut is the key to understanding why disease occurs? What if Hippocrates was right? This would mean that for almost all diseases and diagnoses out there, the root cause is in the gut, that what is going on in the gut has ripple effects in the body and that the gut is always a factor in determining disease or health, either partially or completely.

In my practice as a naturopathic doctor, I see a wide variety of health conditions, and more often than not, when we treat the gut, along with making sure all other ‘pillars of health’ are in place, such as sleep, nutrition, exercise, stress management, etc., the symptoms of disease diminish and often go away altogether.

How can that be? What does your gut have to do with your headache or your skin rash or your joint pain?

The Importance of Having Guts: A Genetic Potluck

Not only is the gut our second brain (and some would argue it to be our first), due to the multitude of neurons in the enteric nervous system and the amount of neurotransmitter production that takes place in the gut,[1] it contains the majority of the microbial DNA that dictates our complex functioning as humans. That delicate balance of the good and bad bacteria in the gut, also known as the microbiome, plays a large role in the health of the whole person. We are even more aware of this since scientists mapped out the human genome early this century. Researchers were amazed at the unexpectedly small size of the human genome, which is roughly equivalent to that of a dragonfly. As it turns out, later research has shown that only 1 in 10 cells in the body are human. The other 9 (or 90%) are microbial. This 90% contains the DNA from the microbes that live in and on the body and provides essential functions for the human as a whole.

The Good, the Bad, and the Commensal

When talking about the balance of good (beneficial) and bad (pathogenic) bacteria in the gut flora, there is one more category of microbe to be aware of when thinking about the gut’s influence on the rest of the body and, prior to that, the influence of the environment on the gut. Commensal bacteria are those bacteria that can go either way; they are neither fully beneficial nor are they pathogenic, they act neutrally. This is where much of our own lifestyle influences come into play in the development of health or disease. If we eat a clean and healthy diet, manage stress well, get lots of sleep, fresh air and activity, these commensal bacteria are inclined to go over to the good side. If the opposite is true, then they can turn bad. The stronger one side is over the other, the more influence it has over these commensal microbes, just like a game of red-rover, the side with the strongest hold grows and wins.

To add complexity, we require all these types of microbes in the right amounts to benefit the body. The beneficial bacteria provide the body with nutrients and help remove waste. The pathogenic bacteria, in a balanced amount, train the immune system. When the pathogenic bacteria overtake and overwhelm the beneficial bacteria things can go awry in the body. Dysbiosis, or an imbalance in the microbiome, has effects on the gut such as increasing permeability and integrity of the gut lining, leaving the body more susceptible to autoimmunity and inflammatory disorders.[2]

In short, our microbiome influences our health, and we influence the health of our microbiome.1

From the Gut to Disease

So if something is going wrong or is out of balance in the gastrointestinal tract, how does this translate to symptoms in areas of the body that, seemingly, have nothing to do with the gut?

The common analogy I use to illustrate for patients how some health care professionals believe gut health affects health of the entire body is that of a clogged kitchen sink. Imagine the things that end up in your kitchen sink every day, and imagine it all building up. That drain eventually clogs.

In the body, the main drain is analogous to the gut and your liver, your main detox pathways and means for waste elimination. Should their function become impaired to some degree due to being overwhelmed with the quantity or quality of what it is trying to eliminate, the rate at which your body (the sink) can eliminate potentially toxic by-products of metabolism slows.

Now imagine this continues for years. The level in that clogged kitchen sink begins to rise, eventually reaching the point of spilling over. Each individual exhibits unique symptoms when this spillover occurs. Early research suggests that these symptoms of spillover can be anywhere from fatigue, mood disorders, developmental disorders, skin rashes, allergies, asthma, to serious complications such as multiple sclerosis (MS) or other severe immune dysregulation or autoimmunity.

This seems to depend on the degree of impairment in function of the drain, the quality of what is accumulating in the kitchen sink (what we put in and what we are exposed to, whether it be the food we eat, the medications we take, the environmental toxins we take in, or other factors), and what tools we use to assist the drain with the elimination of waste and toxicity.

Essentially, the integrity of the gut is analogous to the integrity of a drain, responsible for allowing everything to flow through the body with ease.

The Gut, the Brain, and the Gut-Brain Axis

Do you ever get a gut feeling: something you know in your gut even before your brain can explain it? What about butterflies in your stomach when you’re anticipating something? Perhaps when you experience stress you feel it in your gut without necessarily thinking about it.

Research continues to show us the strong links between the brain and the gut. For example, some small studies show that a leaky gut could imply a leaky brain. ‘Leakiness’, or hyperpermeability, in the gut, in part due to an imbalance in the flora, creates a playground for inflammation that cascades systemically throughout the body. Inflammation occurring in the gut might lead to inflammatory processes in the brain.[3] By the same token, what is occurring in the brain could affect the gut via the vagus nerve,[4] altering motility, function, and secretions.

In neurodegenerative diseases such as MS, one study identified hyperpermeability in the blood-brain barrier (BBB), as well as in the tight junctions of the intestinal wall.3 Another study linked this similar leakiness to the autoimmune response in the myelin sheath, or protective fatty layer wrapped around the nerves, causing a breakdown in function.[5]

The gut can also exhibit localized symptoms such as gas, bloating, diarrhea, and constipation among others, which can be transient and benign, or involve disease processes that penetrate deeper into the gut wall. “The clearest correlation between dysbiosis and disease has been found with inflammatory bowel diseases (IBD)…”,7 including Crohn’s disease and ulcerative colitis, in which strictures[6] and obstructions are among some of the serious complications.[7]

Effects on the gut-brain axis can cause changes to gut flora in conditions such as irritable bowel syndrome (IBS).[8] Recent research also links depression and anxiety to an inflammatory reaction in the gut.8,[9]

Individuals with obsessive-compulsive disorder (OCD), pediatric acute-onset neuropsychiatric disorder associated with streptococcal infections (PANDAS),[10] and neurodevelopmental disorders such as autism and attention deficit hyperactive disorder (ADHD) have all shown alterations in gut flora.1,[11]

Understanding the gut’s influence on the brain as well as the brain’s influence on the gut is a fascinating step toward treating the person as a whole, and not exclusively by symptoms.

The Gut, Allergies, and Atopic Disease

While an obvious allergic reaction or anaphylaxis clearly allows you to identify its cause, the increasingly more common delayed food sensitivities can cause an array of symptoms anywhere from local abdominal pain and bloating to migraines, body pain, skin issues like rashes or acne, and so on.[12] These symptoms may not show up for hours or even days, making it tricky to figure out what is causing the reaction.

In practice it is quite common to have patients test positive for a few-to-many food allergens, when testing for serum immunoglobulins, only to have them eliminate those foods and find that 3 to 6 months later, they now test sensitive to foods they did not initially test sensitive to. This leads some practitioners to suspect that intestinal hyperpermeability (leaky gut) is a factor and may play a role in developing food sensitivities.[13]

Dysbiosis might also be a contributing factor. In infants, the development of food allergies and sensitivities could be related to an overabundance of certain types of pathogenic bacteria, such asClostridiae along with fewer good bacteria.[14]

One study found that in atopic disease such as atopic dermatitis (eczema), the skin microbiome, which the balance of the gut microbiome indirectly alters, is very different from that of healthy skin. The study found the same to be true for psoriasis.[15]

Other symptoms of atopic disease, such as asthma, also relate to gut health. Functional and structural abnormalities, specifically in asthma, relate to persisting inflammation in the lungs and link to altered gut flora. This predisposes an immune response to occur when allergens are present, causing sensitization to these allergens and subsequent symptoms of asthma.[16]

The Gut and Joint Pain

Dysbiosis and intestinal hyperpermeability might play a role in joint inflammation. When an antigen, such as an offending food or toxin enters the blood stream from the gut, the immune system kicks in. An antibody, plus its target antigen, bind together to form a ‘complex’. This complex circulates, causing other cascades of inflammation as it goes, finally depositing in places like the joints. The joints are particularly susceptible because there is low blood circulation to flush the inflammatory complexes out.

A toxemic theory, proposed at the turn of the 20th century, alluded to a build-up of this toxicity in the body from infectious agents ultimately promoting joint inflammation.[17] In a recent study, researchers have correlated an overgrowth ofPrevotella copri to an increased susceptibility to rheumatoid arthritis.[18]

The Gut and Obesity

Alterations in the gut flora may play a part in the development of obesity.[19] (See the Inside Tract® issue 192.) Reduced bacterial diversity is common in obese individuals, which researchers believe may be interfering with metabolic pathways, since the gut harbours many microbes responsible for regulating metabolism and extracting energy from otherwise indigestible elements of the diet. One study reviewing the microbiome diversity of obese and lean mice suggests that microbes play a role in the efficiency of calorie use and calorie storage in the body.[20]

The Gut and the Immune System

Have you ever been the only person in your household who doesn’t get sick, or are you the first to get sick?

The gut is our main route of contact with the external world; 70% of the immune system is located in the gut. This is mediated through the gut-associated lymphoid tissue (GALT), which is responsible for orienting immune response to contents in the gut and for the production of 80% or our main first immune response, that of Immunoglobulin A (IgA) in the mucous layer.

In a study on the effect of the gut microbiome on the flu virus infection, the immune modulating effects stretch far beyond the gut to the respiratory mucosa, acting protectively.[21]

Increasingly, some health care professionals recognize that disruptions in the commensal microflora may lead to immune dysfunction and autoimmunity.[22]

So Is Your Gut Friend or Foe?

It’s your friend!

If the gut is the root of all disease, as Hippocrates suggested, then, it could also be the root of all wellness.

In other words, if it is true that disease does begin, or has something to do with some amount of disruption, in the gut environment, then this could mean that the root of all health also lies in the gut and in healing the diversity of this environment.

What to Do?

Thus begins your journey of healing the gut.

First, when looking to protect and nourish a healthy gut, think basics: think slow food, single ingredient, whole food, colourful food, and think fresh, unprocessed, and seasonal food, live and fermented foods, and nutrient-dense foods.

As for what to minimize or avoid as much as you can, think medications such as antibiotics, oral birth control, NSAIDs, caffeine, alcohol, processed and genetically modified foods, processed sugar, foods you are sensitive or allergic to, food dyes, packaged, and pasteurized foods.

There is also much talk around seeding the microbiome of a baby’s gut before, during, and after birth. This promotes the development of a healthy immune system, through prenatal health care and preparation of the mother and father, natural vaginal birth, and breastfeeding, along with ongoing exposures to the environment through childhood to train the immune system and increase the diversity of the child’s microbiome.[23]

These basic things are a great start to help the gut move to a state of greater health, and therefore help the whole person establish or maintain health.

Keep in mind that once a disease state is already in process, testing and stronger treatments are required. These might include high dose nutrient supplementation, medications, or natural methods of assisting the body with eliminating accumulated toxins. Naturopathic doctors and functional medicine doctors are the experts in holistic care to help get you on track, deal with the root cause of illness, and address your individual needs. We work closely with your conventional medicine team to ensure a smooth, effective treatment plan.

Reference

[1]       Hadhazy, A. Think Twice: How the Gut’s “Second Brain” Influences Mood and Well-Being. The emerging and surprising view of how the enteric nervous system in our bellies goes far beyond just processing the food we eat. Scientific American. February 12, 2010.

[2]       Cho I et al. The human microbiome: at the interface of health and disease. Nature Reviews Genetics. 2012;13:260-70.

[3]       Deretzi G et al. Gastrointestinal immune system and brain dialogue implicated in neuroinflammatory and neurodegenerative diseases. Current Molecular Medicine. 2011;11(8):696-707.

[4]       Fasano A. Leaky Gut and Autoimmune diseases. Clinic Rev Allerg Immunol. 2012; 42:71-8.

[5]       Nouri M et al. Intestinal Barrier Dysfunction Develops at the Onset of Experimental Autoimmune Encephalomyelitis, and Can Be Induced by Adoptive Transfer of Auto-Reactive T Cells. PLoS ONE. 2014;9(9):e106335.

[6]       Gumaste V et al. Benign and malignant colorectal strictures in ulcerative colitis. Gut. 1992;33(7):938-41.

[7]       Martin R et al. Role of commensal and probiotic bacteria in human health: a focus on inflammatory bowel disease.Microbial Cell Factories. 2013;12:71.

[8]       O’Mahonya S et al. Early Life Stress Alters Behavior, Immunity, and Microbiota in Rats: Implications for Irritable Bowel Syndrome and Psychiatric Illnesses. Biological Psychiatry. 2009;65(3):263-7.

[9]       Dinan T et al. Melancholic microbes: a link between gut microbiota and depression? Neurogastroenterology & Motility. 2013; 25(9):713-9.

[10]     Rees JC. Obsessive–compulsive disorder and gut microbiota dysregulation. Medical Hypotheses. 2014;82(2):163-166.

[11]     Gilbert JA et al. Toward Effective Probiotics for Autism and Other Neurodevelopmental Disorders. Cell. 2013;155(7):1446-8.

[12]     Gaby AR. The role of hidden food allergy/intolerance in chronic disease. Alternative Medicine Review. 1998;3(2):90-100.

[13]     Liu Z et al. Tight junctions, leaky intestines, and pediatric diseases. Acta Paediatrica. 2005;94:386–93.

[14]     Ling Z et al. Altered Fecal Microbiota Composition Associated with Food Allergy in Infants. Applied and Environmental Microbiology. 2014; 80(8):2546-54.

[15]     Zeeuwen P et al. Microbiome and skin diseases. Current Opinion in Allergy & Clinical Immunology. 2013;13(5):514-520.

[16]     Huang YJ et al. The microbiome and asthma. Ann Am Thorac Soc. 2014;11(1):48-51.

[17]     Brusca S et al. Microbiome and mucosal inflammation as extra-articular triggers for rheumatoid arthritis and autoimmunity. Curr Opin Rheumatol. 2014;26(1):101-7.

[18]     Scher J et al. Expansion of intestinal Prevotella copri correlates with enhanced susceptibility to arthritis. eLife Sciences, November 5, 2013.

[19]     Tsai F et al. The microbiome and obesity: Is obesity linked to our gut flora? Current Gastroenterology Reports. 2009;11(4):307-13.

[20]     Turnbaugh P et al. A core gut microbiome in obese and lean twins. Nature. 2009;457:480-4.

[21]     Ichinohea T et al. Microbiota regulates immune defense against respiratory tract influenza A virus infection. PNAS. 2011;108(13):5354-9.

[22]     Fung I et al. Do Bugs Control Our Fate? The Influence of the Microbiome on Autoimmunity. Current Allergy and Asthma Reports. 2012;12(6):511-9.

[23]     Torrazza R et al. The developing intestinal microbiome and its relationship to health and disease in the neonate.Journal of Perinatology. 2011;31:S29-S34.

Is the Antioxidant Melatonin Dangerous during Chemotherapy and Radiation? January 25, 2016

Posted by Dreamhealer in best vancouver naturopath, Chemotherapy, Healing, Integrative Medicine, Naturopathic Doctor, Naturopathic Medicine, stress.
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Written By: Dr. Adam McLeod, ND, BSc (Hons)

It is not unusual for patients to be intimidated by their medical oncologists to fear all natural therapies. They are told to specifically avoid all antioxidants because they will neutralize the effects of chemotherapy and radiation. This broad generalization that all antioxidants should be avoided is simply not supported by scientific evidence. On an intuitive level, it makes sense that if chemotherapy is creating oxidative damage as its mechanism of action then providing the body with antioxidants would theoretically neutralize this mechanism. There are legitimate concerns with specific chemotherapies and high doses of synthetic antioxidants. However, there are many double blind human trials which demonstrate that antioxidant supplementation at moderate doses decreases side effects without interfering with the effects of the chemotherapy12,13,14. There is also no debating that patients who consume natural sources of antioxidants respond better to chemotherapy and radiation with less side effects33,7. If antioxidants are to be feared, then why do patients with better antioxidant capacity in their blood respond better to these conventional therapies?

There are several things which must be considered. First of all this simplistic view that all antioxidants are bad has long been debunked and this is not supported in the scientific literature31. Secondly, not all chemotherapies work by creating oxidative damage so the argument against antioxidants in these cases is nonsense. Another important point is that antioxidants can help your healthy cells to recover from the residual toxic effects of chemotherapy28,29,30. To add to the hypocrisy of the “avoid all antioxidant stance”, it is not unusual for oncologists to administer powerful pharmaceutical antioxidants such as theophylline to reduce side effects from chemotherapy34.

The antioxidant capacity of your blood is a measure of how effectively your blood is capable of neutralizing free radicals. The consumption of antioxidant rich foods dramatically increases the concentration of antioxidants in the blood which consequently increases antioxidant capacity3. It is well known that patients who have lower antioxidant capacity in their blood have greater side effects to chemotherapy32.

The notion that all medical oncologists share this view of fearing antioxidants is simply not true. There are major integrative cancer centres in the US where naturopathic doctors work along-side medical oncologists and things like melatonin and Vitamin C are given as standard therapies to patients undergoing chemotherapy or radiation. Of course there are specific interactions that must be avoided and a Naturopathic Doctor who is skilled in oncology will be able to guide you to develop a safe and effective plan. You must have professional guidance when developing a treatment plan in the complicated clinical context of cancer.

One of the most common natural therapies given to patients undergoing chemotherapy is melatonin. I have heard on numerous occasions from patients who were warned from the cancer agency pharmacist that melatonin is contraindicated during chemotherapy and radiation because it is an antioxidant. What I find so bizarre about this statement is that virtually all of the available scientific literature literally says the opposite and strongly supports the use of melatonin with chemotherapy and radiation. The position of scaring patients about melatonin is not grounded in scientific evidence, they take this position because from a legal perspective it is easier to say avoid any and all antioxidants.

What does the research say about melatonin used in combination with chemotherapy? Several randomized double blind trials have tested patients with lung cancer who were treated with chemotherapy alone or chemotherapy in combination with melatonin. The melatonin group not only lived longer they also had significantly better quality of life when compared to the group not given melatonin15,16,17. Melatonin has been consistently shown to enhance the effects of chemotherapy while reducing side effects18,19,20,25. It is however important to point out that not all cancers are the same and melatonin is not indicated for all cancers. In fact, it is contraindicated with many blood cancers such as leukemia.

What does the scientific literature actually say about combining melatonin with radiation therapy? Patients who concurrently take melatonin during radiation therapy for glioblastoma live significantly longer than those who just received radiation therapy21. Melatonin helps to protect damage to the immune system during radiation22,23,24. Although melatonin is a well documented antioxidant, there are numerous studies which demonstrate that melatonin actually makes cancer cells more sensitive to the effects of radiation26,27.

When used appropriately certain antioxidants such as melatonin can reduce side effects from conventional cancer therapies without interfering with their effectiveness. Healthy cells need antioxidants too and when you consume natural sources of antioxidants the net effect is that it protects healthy cells much more than cancer cells. Ultimately this makes the drugs work just as well and the healthy cells are less damaged from the drug. When you consume a diet rich in antioxidants, the antioxidant capacity of your blood increases dramatically and the research clearly demonstrates that this is a good thing during chemotherapy and radiation.

Lets take a moment to look at the data about melatonin and its activity as an antioxidant. After consuming 80mg of melatonin the serum levels peak at approximately 100,000 pg/mL before rapidly dropping by the end of the day2. The standard dose of melatonin given during chemotherapy or radiation is 20mg. Based on this number it is fair to assume that the amount of melatonin in the blood would be approximately 25,000 pg/mL. At first glance this seems like a shockingly high number. It is well documented that when patients eat a diet high in antioxidant rich foods, that the antioxidant capacity of their blood increases and some of this is due to the melatonin in the food3. In one well controlled study after consuming approximately 1L of orange juice the participants had serum melatonin levels rise from 40 to 150 pg/mL1. This is still 150 times less than values that would be expected after consuming 20mg of melatonin.

The data must be taken into the proper context. True antioxidant capacity in the blood is never determined by one single molecule. It is the entire antioxidant network that gives the blood the capacity to neutralize free radicals. There is a potent synergy between hundreds of different antioxidants which counteracts oxidative damage in a balanced way. Each molecule on its own is only one small piece of the complicated antioxidant network. The mechanism by which melatonin neutralizes free radicals is very different from that of Vitamin C and Vitamin E5. Melatonin is often described in the literature as a terminal antioxidant which distinguishes itself from so called opportunistic antioxidants. The bottom line is that the addition of a single antioxidant does not necessarily impact the entire antioxidant capacity of the blood in a linear fashion.

This next section is a bit heavy in math but I feel that it is important to break down these details. Melatonin is approximately 2.04 times more potent of an antioxidant than a molecule called Trolox. This molecule Trolox is often used as a standard to measure the antioxidant capacity in the blood. Blueberries, which are best known for their antioxidant capacity have an ORAC value of 6552. This means that 100g of blueberries will have the same antioxidant capacity as 6552 micromoles of Trolox. Based on this information it is easy to calculate that 15.26mg of blueberries is the equivalent antioxidant capacity of 1 micromol of Trolox. If you convert these values to make it relevant to melatonin, each mg of melatonin is equivalent to 31.13g of blueberries. The standard dose of 20mg of melatonin during chemotherapy is the equivalent of a patient eating 622.71g of blueberries. In other words, if you eat a little over 1 pound of blueberries this should have the equivalent antioxidant effect as 20mg of melatonin.

There is no evidence to suggest that antioxidants from natural sources are dangerous during chemotherapy or radiation. In fact, virtually all of the literature clearly states that it is beneficial to get antioxidants from natural sources. By consuming antioxidant rich foods, patients have fewer side effects during conventional cancer treatments. Many studies have also clearly demonstrated that these foods do not interfere with the effectiveness of these therapies6,7,8,9,10,11. The debate is around synthetic supplementation with high doses of antioxidants during chemotherapy and radiation. Natural sources are well established as beneficial in these cases, as they protect healthy cells without interfering with the effects of conventional therapies9.

Blueberries are a great source of nutrients and they provide a balanced antioxidant support that is synergistic with chemotherapy and radiation. What is particularly interesting is that wild blueberries are much more effective at neutralizing free radicals than cultivated blueberries. Depending on which measurements you use, in some cases the wild blueberries have almost double the antioxidant capacity. So make sure you eat your blueberries and give your cells the nutrients they need!

Dr. Adam McLeod is a Naturopathic Doctor (ND), BSc. (Hon) Molecular biology, Motivational Speaker and International Best Selling Author. He currently practices at his clinic in Vancouver, British Columbia where he focuses on integrative oncology. http://www.yaletownnaturopathic.com

References:

1) Sae‐Teaw, Manit, et al. “Serum melatonin levels and antioxidant capacities after consumption of pineapple, orange, or banana by healthy male volunteers.” Journal of pineal research 55.1 (2013): 58-64.

2) Waldhauser, Franz, et al. “Bioavailability of oral melatonin in humans.” Neuroendocrinology 39.4 (1984): 307-313.

3) Cao, Guohua, et al. “Increases in human plasma antioxidant capacity after consumption of controlled diets high in fruit and vegetables.” The American journal of clinical nutrition 68.5 (1998): 1081-1087.

4) Pieri, Carlo, et al. “Melatonin: a peroxyl radical scavenger more effective than vitamin E.” Life sciences 55.15 (1994): PL271-PL276.

5) Tan, D-X., et al. “Significance of melatonin in antioxidative defense system: reactions and products.” Neurosignals 9.3-4 (2000): 137-159.

6) Moss, Ralph W. “Should patients undergoing chemotherapy and radiotherapy be prescribed antioxidants?.” Integrative cancer therapies 5.1 (2006): 63-82.

7) Simone, Charles B., et al. “Antioxidants and other nutrients do not interfere with chemotherapy or radiation therapy and can increase kill and increase survival, part 1.”Alternative therapies in health and medicine 13.1 (2007): 22.

8) Drisko, Jeanne A., Julia Chapman, and Verda J. Hunter. “The use of antioxidant therapies during chemotherapy.” Gynecologic oncology 88.3 (2003): 434-439.

9) Moss, Ralph W. “Do antioxidants interfere with radiation therapy for cancer?.” Integrative cancer therapies 6.3 (2007): 281-292.

10) Conklin, Kenneth A. “Cancer chemotherapy and antioxidants.” The Journal of nutrition134.11 (2004): 3201S-3204S.

11) Block, Keith I., et al. “Impact of antioxidant supplementation on chemotherapeutic toxicity: a systematic review of the evidence from randomized controlled trials.” International Journal of Cancer 123.6 (2008): 1227-1239.

12) Weijl, N. I., et al. “Supplementation with antioxidant micronutrients and chemotherapy-induced toxicity in cancer patients treated with cisplatin-based chemotherapy: a randomised, double-blind, placebo-controlled study.” European Journal of Cancer 40.11 (2004): 1713-1723.

13) Drisko, Jeanne A., Julia Chapman, and Verda J. Hunter. “The use of antioxidant therapies during chemotherapy.” Gynecologic oncology 88.3 (2003): 434-439.

14) Conklin, Kenneth A. “Dietary antioxidants during cancer chemotherapy: impact on chemotherapeutic effectiveness and development of side effects.” Nutrition and cancer 37.1 (2000): 1-18.

15) Lissoni, P., et al. “Five years survival in metastatic non‐small cell lung cancer patients treated with chemotherapy alone or chemotherapy and melatonin: a randomized trial.” Journal of pineal research 35.1 (2003): 12-15.

16) Lissoni, P., et al. “A randomized study of immunotherapy with low-dose subcutaneous interleukin-2 plus melatonin vs chemotherapy with cisplatin and etoposide as first-line therapy for advanced non-small cell lung cancer.” Tumori 80.6 (1994): 464-467.

17) Lissoni, P., et al. “Randomized study with the pineal hormone melatonin versus supportive care alone in advanced nonsmall cell lung cancer resistant to a first-line chemotherapy containing cisplatin.” Oncology 49.5 (1992): 336-339.

18) Govender, Jenelle, Ben Loos, and Anna-Mart Engelbrecht. “Melatonin: a protective role against doxorubicin-induced cardiotoxicity.” Future Oncology 11.14 (2015): 2003-2006.

19) Tavakoli, Maryam. “Kidney protective effects of melatonin.” Journal of Nephropharmacology3.1 (2015).

20) Mills, Edward, et al. “Melatonin in the treatment of cancer: a systematic review of randomized controlled trials and meta‐analysis.” Journal of pineal research 39.4 (2005): 360-366.

21) Lissoni, P., et al. “Increased survival time in brain glioblastomas by a radioneuroendocrine strategy with radiotherapy plus melatonin compared to radiotherapy alone.” Oncology 53.1 (1996): 43-46.

22) Thomas, Charles R., Russel J. Reiter, and Terence S. Herman. “Melatonin: from basic research to cancer treatment clinics.” Journal of Clinical Oncology 20.10 (2002): 2575-2601.

23) Srinivasan, Venkataramanujan, et al. “Therapeutic actions of melatonin in cancer: possible mechanisms.” Integrative Cancer Therapies 7.3 (2008): 189-203.

24) Blask, David E., Leonard A. Sauer, and Robert T. Dauchy. “Melatonin as a chronobiotic/anticancer agent: cellular, biochemical, and molecular mechanisms of action and their implications for circadian-based cancer therapy.” Current topics in medicinal chemistry 2.2 (2002): 113-132.

25) Conti, Ario, and Georges JM Maestroni. “The clinical neuroimmunotherapeutic role of melatonin in oncology.” Journal of pineal research 19.3 (1995): 103-110.

26) Alonso‐González, Carolina, et al. “Melatonin sensitizes human breast cancer cells to ionizing radiation by downregulating proteins involved in double‐strand DNA break repair.”Journal of pineal research 58.2 (2015): 189-197.

27) Alonso-González, Carolina, et al. “Melatonin enhancement of the radiosensitivity of human breast cancer cells is associated with the modulation of proteins involved in estrogen biosynthesis.” Cancer letters 370.1 (2016): 145-152.

28) Ladas, Elena J., et al. “Antioxidants and cancer therapy: a systematic review.” Journal of clinical oncology 22.3 (2004): 517-528.

29) Kasapović, Jelena, et al. “Antioxidant status and lipid peroxidation in the blood of breast cancer patients of different ages after chemotherapy with 5-fluorouracil, doxorubicin and cyclophosphamide.” Clinical biochemistry 43.16 (2010): 1287-1293.

30) Chen, Yumin, et al. “Collateral damage in cancer chemotherapy: oxidative stress in nontargeted tissues.” Molecular interventions 7.3 (2007): 147.

31) Moss, Ralph W. “Should patients undergoing chemotherapy and radiotherapy be prescribed antioxidants?.” Integrative cancer therapies 5.1 (2006): 63-82.

32) Kennedy, Deborah D., et al. “Low antioxidant vitamin intakes are associated with increases in adverse effects of chemotherapy in children with acute lymphoblastic leukemia.” The American journal of clinical nutrition 79.6 (2004): 1029-1036.

33) Russo, Gian Luigi. “Ins and outs of dietary phytochemicals in cancer chemoprevention.”Biochemical Pharmacology 74.4 (2007): 533-544.

34) Benoehr, Peter, et al. “Nephroprotection by theophylline in patients with cisplatin chemotherapy: a randomized, single-blinded, placebo-controlled trial.” Journal of the American Society of Nephrology 16.2 (2005): 452-458.

Neural Prolotherapy – Treatment for Chronic Neurogenic Pain December 30, 2015

Posted by Dreamhealer in best vancouver naturopath, Chronic Pain, Healing, Naturopathic Doctor, Naturopathic Medicine, prolotherapy.
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Written by Dr. Reuben Dinsmore, ND

There’s a very good chance that you or someone you know suffers from chronic pain. It is one of the most common complaints that cause people to seek treatment. Almost one in five adult Canadians report having a chronic pain condition; prevalence increases with age, and is more common in women than men. Treatment may be in the form of massage therapy, physiotherapy, acupuncture, chiropractic, over-the-counter painkillers, prescription-strength analgesics, or various other treatment modalities. Depending on the root cause of the pain, these treatment methods can bring varying degrees of relief.

What is pain?

At the most basic, pain is simply an unpleasant sensation carried by specific nerve fibers to the central nervous system, where it is registered as what we all understand as pain. The source of the pain may be a muscle or other soft tissue, internal organ, or from the nerve itself. Large nerves are themselves innervated by small nerve fibers that carry sensory signals that relate to the stimuli affecting those nerves.

What is Neural Prolotherapy (NPT)?

I recently had the opportunity to study with Dr. John Lyftogt, a medical doctor from New Zealand who is pioneering neural prolotherapy (NPT), a novel treatment in chronic neurogenic pain – that is, pain that originates in the nerves themselves (as opposed to pain that originates in another tissue which is then simply carried by nerves). This neurogenic pain has various causes – nerves can be constricted as they pass through, under or over muscles, fascia or other soft tissues, or as they pass over bony prominences (a well-known example of this is when you hit your “funny bone”, which is actually pressure on the ulnar nerve as it crosses the elbow). These constrictions can cause the nerves to become inflamed and swollen, thus exacerbating the original constriction.

Short-term relief for neurogenic pain can be obtained through the use of nerve blocks – an injection of a local anaesthetic that temporarily changes physiology of the nerve, and therefore the way the nerve conducts its signals. In very general terms, this means affecting the sodium and potassium channels that are at the heart of every signal carried by our nervous system. But when the anaesthetic wears off, the pain returns as before.

How does Neural Prolotherapy cure pain?

NPT involves injections of a dextrose solution just under the skin, along the path of affected nerves. It is proposed that this sugar solution acts in a similar way to an anaesthetic nerve block – it prevents the nerve from undergoing “repolarization”, which is necessary for generating the pain signal. Furthermore, it actually has a direct effect on the inflammation seen in the nerves, allowing them to return to a healthy state. The treatment itself is quite well-tolerated; a very small needle is used to inject small amounts of fluid just under the skin. A whole treatment session may involve anywhere from a few to twenty or more of these injections, and can take from 10 minutes up to 30 minutes.

Patients feel immediate relief from pain – within seconds. Prior to treatment, points on the skin would elicit pain from the slightest pressure. In less than a minute following treatment, often patients aren’t even able to localize where the pain used to be.

How long this relief from pain lasts is variable – from a few days to even a week or two. Almost always, the pain returns – but typically it is less severe. After another treatment, the same relief is felt, which then lasts a bit longer than following the first treatment. After a course of treatment, many patients have been able to be completely pain-free after years of living with debilitating pain.

If this description of chronic pain sounds like what is experienced by you or someone you know, consider looking into NPT. It may turn out to be the treatment modality that ends your suffering and allows you to return to your active lifestyle, pain-free.

 

Just Make Sure You Eat A Vegetable: A Holiday Survival Guide December 24, 2015

Posted by Dreamhealer in Healing, Health, holidays, Naturopathic Doctor, Naturopathic Medicine, stress.
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Many of my patients have recently been telling me they know their progress will go out the window, now that the holidays are coming. For some of them, they’re excited to give themselves permission to indulge. For the others, they strongly judge themselves for being “weak” and they worry about the consequences.

And their worries are not just about the food! They also worry about the stress. House guests, parties, dinners to plan and prep for, travel, traffic, shopping, late nights and little sleep, responsibilities, keeping everyone happy, getting all the right gifts, and, most importantly, not getting any time for themselves.

Here’s my simple guide to treating yourself well during this season:

DON’T OVERPLAN

It can be tempting to say yes to every invitation that comes along. If you thrive on this, great! If you’re like me, you love the idea of getting cozy at home and staying there. Be aware of what the right amount of planning is ok for you, and what amount is too much. Maybe you pick your top 1,2 or 3 events to attend (again, how many is the right number for you?). Maybe you do say yes to every invitation, but only commit to staying for a short time. Maybe you plan your own event that allows all your loved ones to come to you. Whatever you decide, be ready to say a wholehearted yes or no and keep the overwhelm off the table.

SLEEP AND PLAY

The best medicine. This probably goes hand in hand with not over-planning. Take the opportunity to sleep in, laze around in bed, snuggle with the kids for long mornings, have leisurely breakfasts and coffee that take you well into the afternoon. There’s no need to be productive. Put that urgency down and pull out the board games, the Wii, run through the park, play in the snow (or rain, that is, if you live in Vancouver), laugh lots, catch up on movies, dance just because the family is all in their pj’s and the music is on loud. Shake off the end of this year, shake off work and shake off the “shoulds”.

GO OUTSIDE

Rain or shine or snow or sleet. Get out into the fresh air every day. Get in some long or short walks and keep the blood flowing. You may not be able to honour your regular gym or yoga class schedule, but that’s ok. Work in a brisk walk to the store, take a detour into the mountains and woods if you can, or just wander through your neighbourhood with a hot chocolate and your loved ones. Then get right back to the wintry festivities once refreshed.

SNEAK AWAY TO TREAT YOURSELF!

This could entail a number of things. My favourite thing to do is finally schedule that much needed massage or sauna session. Take the opportunity to use up your extended medical benefits if you have them! This means paying your naturopathic doc a needed check in for acupuncture, a nutrient IV (we may have something for that hangover) or a plan for the new year. Give yourself a gift or two by getting some TLC. You’ve taken care of so many and so much all year, it’s your turn too.

SCHEDULE RECOVERY DAYS

This is planning at its best. For those with food restrictions, it’s probably inevitable that you’ll get gluten-ed or dairy-ed or sugar-ed… or all of the above. A recovery day for this kind of offence can involve doubling those probiotics and digestive enzymes, keeping meals light and easy to digest, like broths and smoothies.  For recovery from everything else, sleep, rest, play and do all the other things you need.

DON’T SHOW UP HUNGRY

If you’re worried about packing on those holiday pounds, showing up famished will likely work against you. Have a smaller meal before you show up to that dinner party so that you can still enjoy the treats without overdoing it.

JUST MAKE SURE YOU EAT A VEGETABLE

If all else fails, let go and enjoy fully what you have in front of you. Just make sure you also do some of the things that help your body feel good and recover well, like eating as many vegetables as you can. Make sure that plate of turkey and potatoes slathered in gravy also includes many colors of the rainbow, particularly green.

Warm Holidays to you!

To book an appointment contact info@yaletownnaturopathic.com

We Need to Talk About Death December 14, 2015

Posted by Dreamhealer in Aging, Healing, Naturopathic Doctor, Naturopathic Medicine.
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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.

References

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.

A Naturopathic Approach for Attention Deficit (Hyperactivity) Disorder (ADD/ADHD) December 10, 2015

Posted by Dreamhealer in ADHD, Cancer, cancer therapy, integrative cancer care, Naturopathic Doctor, Naturopathic Medicine.
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Attention Deficit (Hyperactivity) Disorder (ADD/ADHD) is a term that covers a wide variety of symptoms. The most common ones include decreased concentration, poor organizational skills, decreased attention, impulsivity, learning difficulties and restlessness, to name a few.

Many children diagnosed with ADD/ADHD are treated with various medications. Side effects of these types of drugs may include abdominal cramps, insomnia, depression, headache, dizziness, high blood pressure and appetite suppression. Additionally, medication such as Ritalin which is a common stimulant used to treat ADD/ADHD can make patients prone to dependence on the medication.

Naturopathic medicine approaches the treatment of behavioural challenges in children for a holistic point of view. The naturopathic approach to ADD/ADHD may involve establishing optimal nutrition, supplementing where necessary and identifying any food sensitivities/allergies or irritants that could be instigating the symptoms.

While the goal of treatment is not to change who they are as people, there are treatment options to help ease symptoms such as learning difficulties, impulsivity, digestion issues, inattention, difficulty focusing, anxiety, as well as eating habits, coordination, mood and sleep, and finally to help them function optimally.

Contact us today to book an appointment and begin your healing journey with the Yaletown Naturopathic Clinic

What You Need to Know About Your Immune System November 30, 2015

Posted by Dreamhealer in Healing, immunity, Naturopathic Doctor, Naturopathic Medicine.
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Days are getting shorter and we have all noticed the drop in temperature even on sunny days. Fall is here! Thanksgiving, pumpkins and beautiful foliage are all part and parcel of the coming season. Autumn is historically a time for harvest, taking stock and preparing for the coming hardships of winter. This principal can also be applied to your health. Now is an ideal time to take stock of your body and help set yourself up to fight off that winter virus or even avoid it completely. In order for you to help maintain and improve your body’s defence system it may be helpful for you to have a better understanding of how it works.

Your body is constantly bombarded by bacteria, fungi and viruses, amongst other things. They are in your home, on your skin and even in the air you breathe. While quite a number of these are harmless, many of them are potentially dangerous to us. The name given to these infectious agents (including bacteria, virus, prion, fungus, or parasites) is pathogen. If you think about it, the human body is a perfect home for these pathogens. A warm moist environment such as that found in the human respiratory tract is exactly what they need to grow and multiply . Luckily for us, the human body has evolved a number of ways to protect us from an invasion. As with all parts of the human body and its inner workings, the immune system is incredibly complex. For the purposes of this article we will try to keep things as simple as possible.

The immune system is not a combination of organs such as the digestive system or the nervous system. Rather is it functional system that involves a number of organs, molecules and immune cells. Many of the organs involved in the immune system have other functions too. The immune cells (of which there are trillions) live in the lymphatic system and the blood and other body fluid.

Skin and Mucosa – Innate Physical Defence

The skin is the largest organ of the human body. It provides a physical barrier between the outside world and your body. The epidermis or outermost layer of the skin is made up of highly keratinized cells. This layer is resistant to most bacteria enzymes and toxins. Mucous membranes line all body cavities that open to the exterior. Examples of these are the digestive system and the respiratory system, reproductive tracts and urinary tracts. The lining inside your mouth is an example of a mucous membrane. Apart from physical barriers these organs also produce secretions such as sebum on skin, hydrochloric acid in the stomach, saliva in the mouth and tears in the eyes, which contain enzymes and chemicals to inhibit or destroy bacteria. The skin and vaginal mucosa maintain their PH at a level that also makes it difficult for pathogens to survive. Sticky mucous at the body’s orifices traps pathogens and prevents them from entering the body. Along the upper respiratory tract you will find tiny hair like structures known as cilla which sweep dust and mucus towards the mouth thus preventing it from traveling further into the body.

Macrophages

These are a type of white blood cell that essentially guard and patrol every border of the body. If the skin and mucosa are breached these cells are usually the first to come upon the pathogen. They work by engulfing the pathogen and secreting enzymes, free radicals and even hydrogen peroxide (bleach) in some cases. Sometimes the chemicals secreted depend on the type of pathogen. If the pathogen is too big for the macrophage to engulf it will secrete it’s chemicals into the area surrounding the pathogen in order to kill it. Often macrophages can handle the pathogen on their own as they are capable of engulfing up to 100 pathogens each. Macrophages will also communicate to other immune cells to bring them to the area. They can also cause the cells of the surrounding blood vessels to flood the area with fluid making it easier for the immune cells to work in the area. This is part of what causes swelling and inflammation in an area where the immune system is at work.

Neutrophils

Neutrophils are another type of white blood cell very similar to macrophages, these cells are found in the blood. Once alerted to the presence of an intruder (usually by a macrophage) neutrophils will travel to the area. They are very aggressive and will often kill healthy cells and themselves while in the process of removing a pathogen. They engulf and kill in a similar way to macrophages and they also create barriers around pathogens to prevent it spreading. They will also trigger the next line of defence. Neutrophils will commit suicide after 5 days to prevent them becoming too prolific and causing damage within the body.

Natural Killer Cells

Once the pathogen has managed to infect a healthy cell, the healthy cells send out a stress signal. The natural killer cells, found in the blood and lymph, recognize that this cell is infected and kill it. Unlike the previous cells they do not engulf the cell but attach to it to induce apoptosis (cell suicide). The infected cell dies and takes the pathogen along with it. Natural killer cells also act to enhance the inflammatory response first triggered by the macrophage.

Inflammatory Response

This response is activated when any trauma occurs to the body e.g. a blow, a burn, a cut or an infection. The signs of inflammation are redness, heat, swelling and pain. This is a normal part of the healing process and not always indicative of an infection. Heat and redness are caused by increase blood flow to the area which brings more immune cells to fight any potential infection. There is also an increase in fluid surrounding the cells in this area, leading to swelling. This fluid contains chemicals to promote inflammation and draw more immune cells to the area. It also contains interferon and complement which kill virus infected cells, and helps the healthy cells resist infection and intensifies the body’s response. The build up of fluid causes swelling which presses on nerve endings in the area and can cause pain. Pain may also be caused by the pathogen itself releasing toxins. The increase in fluid in the area helps to dilute any harmful chemicals a potential pathogen may produce and the fluid also contains important chemicals such as clotting factors which help to form a protective barrier and contain the area. The pain and swelling also restrict movement in the area forcing us to rest it and allow for healing to occur.
All these factors can occur before the body has even worked out what it is defending itself against. These responses happen regardless of the pathogen and are known as the nonspecific immune response.

B-Cells, T- Cells and Dendritic Cells- Adaptive immunity

Antibodies found on B-cells (another white blood cell) activate the complement that in turn interferes with the pathogens ability to function. The antibodies are made by the B-cell from pieces of the pathogen. The dendritic cell, sometimes known as the brain of the immune system, eats part of the pathogen and decides what kind of cells are needed to fight the infection. It then calls on the appropriate cells to the area.

Helper T cells release chemicals which aid antibodies and call more macrophages and neutrophils to the scene.

Cytotoxic T cells also receive the signal and secrete chemicals to get the infected cell to die and take the pathogen with it.

Regulatory T Cells are the cells which slow the immune response by releasing chemicals. These are the cells responsible for calming down the immune response once a threat has been overcome. These cells also play an important role in preventing autoimmune reactions.

Memory Cells (which can be made from B-cells or T-cells) are produced by the body during the course of an attack on the immune system.

They can remain in the body for years after the infection and enable our bodies to mount an even faster response in the event of another attack by the same pathogen. Often they will enable the body to react so quickly that you will never even know your body is under attack.
Other areas of the body involved in our immunity include the bone marrow where blood cells including those discussed are made, the thymus gland which produces hormones involved in the immune response, and the lymphatic system which is closely related to the circulatory systems and drains into it. Many white blood cells are found in the lymphatic system and during an immune response they travel from here to the site of infection. This is why during an infection you may notice swelling in the areas where lymph nodes are present such as neck and underarms.

Fever

Part of the body’s immune response may include a fever. It was previously thought that a rise in temperature simply aided the body to defend itself by making it difficult for bacteria to replicate and grow. However, new research is now showing that an increase in body temperature may actually help the cytotoxic T-cells (which kill infected and cancerous cells) to carry out their work more effectively. Some experts now believe that allowing the body to go through a mild fever may actually enhance the immune systems response and we should reevaluate how we treat mild fevers in the future. It is important to note that while a mild fever may be helpful, a very high body temperature can be dangerous. The normal range for your body temperature should be between 97.8 and 99.0F (36.5-37.2 C).

Your immune system can be a good indictor of your overall health. Contrary to popular belief, getting cold when wet will not make you more likely to catch a cold or flu this winter. However, things like stress, lack of sleep, poor diet and generally being run down could contribute to a less effective immune system. As such, maintaining a healthy happy lifestyle can help you to avoid becoming unwell this winter. Talk to your Naturopathic Doctor at Yaletown Naturopathic Clinic for advice on optimizing and boosting your health and immunity.

References
Human anatomy and physiology 7th ed. 2007. E. N. Marieb and K. Hoehn.
Fever Plays Vital Role in Immune Response. Infection Control Today. Nov 2nd 2011. Accessed on September 7th 2015.http://www.infectioncontroltoday.com/news/2011/11/fever-plays-vital-role-in-immune-response.aspx

Top 5 Medications You Shouldn’t Take Without Trying the Natural Alternative First November 18, 2015

Posted by Dreamhealer in Healing, Medication, Naturopathic Doctor, Naturopathic Medicine, Supplements.
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Natural supplements, or nutraceuticals, have been given a bad rap lately – which, in some cases, has been absolutely warranted. But natural formulas that actually contain what they claim to contain, and that are formulated to have maximal efficacy can be equal to their pharmaceutical counterparts – but without the laundry list of side effects.

1. Statins (the class of drugs prescribed to lower cholesterol) accounted for 3.8% of all money spent on prescription drugs in Canada in 2013. High cholesterol is blamed for heart attacks and strokes via formation of arterial plaques. But the real culprit is inflammation, without which the plaques wouldn’t form in the first place. Bottom line – you can lower cholesterol all you want, but as long as there is inflammation present, plaques can still form.

Some common side effects of statins: muscle pain, cognitive impairment, sexual dysfunction, and increased risk of cancer and diabetes.
Nutraceutricals: Omega-3 fatty acids (best sourced from wild-caught fish oils) and curcumin (the active component in turmeric) are two excellent supplements to lower inflammation. Garlic extracts have been proven to improve cholesterol levels. As well, red rice yeast extract is the natural compound statins were derived from, and works in a similar manner – however, it has been suggested that because of this, some of the same side effects may be seen.

2. Antacids 5 million Canadians suffer from heartburn symptoms weekly. Prescriptions for the acid-blocking drugs PPIs (proton pump inhibitors) accounted for $24 million in BC alone in 2013. Risks of taking these mostly involve nutrient deficiencies from poor absorption DUE TO LOW STOMACH ACID (see the problem here?). Examples include bone fractures from poor calcium absorption or anemia from decreased levels of B12 or iron. B12 deficiency can also cause dementia and neurological damage. There has also been a correlation shown between PPI use and C. difficile infection, which causes life-threatening diarrhea.

Nutraceuticals: long story short, most people don’t have too much stomach acid. The problem is the acid they have is getting into the wrong place (the lower esophagus) where it burns. This can be from the muscle between the esophagus and the stomach not closing properly, either from poor tone or insufficient stomach acid, which is the signal for the sphincter to close. Limonene (an extract from citrus peel) helps strengthen this muscle and promotes movement of food downward to the stomach. DGL (an extract from licorice root) stimulates mucus production in the stomach, which acts to coat and protect the sensitive lining of the esophagus.

3. SSRIs (selective serotonin reuptake inhibitors) are the most common class of anti-depressant drugs. One in twelve Canadians will experience major depression in their lifetime, but it’s still one of the most poorly understood conditions. Standard treatment protocols typically target neurotransmitter activity (most commonly serotonin). However, new research indicates the underlying cause may actually be inflammation. Either way, natural medicine has you covered.

Nutraceuticals – 5-HTP is used to make serotonin, with the help of vitamin B6. The herb St. John’s Wort has been studied extensively and appears to work in the same way as SSRIs. Both 5-HTP and St. John’s Wort have shown similar efficacy to SSRIs when given for mild to moderate depression. And as I mentioned earlier, omega-3 fatty acids and curcumin decrease inflammation throughout the body, including the brain.

Side effects of SSRIs include sexual dysfunction, weight gain, and worsened/chronic depression. St. John’s Wort also has a side effect which should be considered if taking other medications – it affects liver function, which can result in either higher or lower blood medication levels.

4. Anti-hypertensives Hypertension (also known as high blood pressure) affects 6 million Canadians, and is responsible for approximately 13% of all deaths. Various classes of anti-hypertensives include diuretics, ACE inhibitors, angiotensin II receptor blockers (ARBs). Diuretics increase urine output, which can negatively affect sodium and potassium levels, which can cause muscle cramps. ACEIs and ARBs may both cause a chronic dry cough. All anti-hypertensives can cause dizziness, headache and low blood pressure.
Nutraceuticals – CoQ10, magnesium, garlic extracts, omega-3 fatty acids, L-arginine and vitamin C have all been shown to lower high blood pressure by various means. Dandelion leaf is an effective diuretic that doesn’t lower potassium levels.

5. Benzodiazepines are a class of drugs most often prescribed for anxiety disorders and insomnia. They work by binding to receptors for GABA, a neurotransmitter in the brain that calms activity of the nervous system. Interestingly, this is the same mechanism by which alcohol acts in the brain. One obvious effect of benzodiazepines is sedation – great when the treatment target is insomnia. Not so great when you just want to decrease your anxiety but still function. Other side effects include dizziness, loss of balance, and even cognitive impairment at higher doses. They also have a significant risk of developing physical or psychological dependence and rebound anxiety when discontinued.
Nutraceuticals – you can take GABA itself (but there’s mixed evidence on whether or not it actually gets into the brain), or herbs such as passionflower (same mechanism of action as benzodiazepines), valerian, chamomile, kava – the list goes on.

So now you think you’re ready to ditch all your pharmaceuticals and go natural? Not so fast – the examples used above are by no means the only supplements that have been used effectively for these conditions. And equally as important are diet, exercise, sleep habits, relaxation techniques and other lifestyle factors. The next step – sit down with a naturopathic doctor and work together to develop a personalized approach that takes all your health concerns into consideration.
Written by: Dr. Reuben Dinsmore BScH, ND

Neural Prolotherapy – Treatment for Chronic Neurogenic Pain November 5, 2015

Posted by Dreamhealer in Naturopathic Doctor, prolotherapy.
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There’s a very good chance that you or someone you know suffers from chronic pain. It is one of the most common complaints that cause people to seek treatment. Almost one in five adult Canadians report having a chronic pain condition; prevalence increases with age, and is more common in women than men. Treatment may be in the form of massage therapy, physiotherapy, acupuncture, chiropractic, over-the-counter painkillers, prescription-strength analgesics, or various other treatment modalities. Depending on the root cause of the pain, these treatment methods can bring varying degrees of relief.

What is pain?

At the most basic, pain is simply an unpleasant sensation carried by specific nerve fibers to the central nervous system, where it is registered as what we all understand as pain. The source of the pain may be a muscle or other soft tissue, internal organ, or from the nerve itself. Large nerves are themselves innervated by small nerve fibers that carry sensory signals that relate to the stimuli affecting those nerves.

What is Neural Prolotherapy (NPT)?

I recently had the opportunity to study with Dr. John Lyftogt, a medical doctor from New Zealand who is pioneering neural prolotherapy (NPT), a novel treatment in chronic neurogenic pain – that is, pain that originates in the nerves themselves (as opposed to pain that originates in another tissue which is then simply carried by nerves). This neurogenic pain has various causes – nerves can be constricted as they pass through, under or over muscles, fascia or other soft tissues, or as they pass over bony prominences (a well-known example of this is when you hit your “funny bone”, which is actually pressure on the ulnar nerve as it crosses the elbow). These constrictions can cause the nerves to become inflamed and swollen, thus exacerbating the original constriction.

Short-term relief for neurogenic pain can be obtained through the use of nerve blocks – an injection of a local anaesthetic that temporarily changes physiology of the nerve, and therefore the way the nerve conducts its signals. In very general terms, this means affecting the sodium and potassium channels that are at the heart of every signal carried by our nervous system. But when the anaesthetic wears off, the pain returns as before.

How does Neural Prolotherapy cure pain?

NPT involves injections of a dextrose solution just under the skin, along the path of affected nerves. It is proposed that this sugar solution acts in a similar way to an anaesthetic nerve block – it prevents the nerve from undergoing “repolarization”, which is necessary for generating the pain signal. Furthermore, it actually has a direct effect on the inflammation seen in the nerves, allowing them to return to a healthy state. The treatment itself is quite well-tolerated; a very small needle is used to inject small amounts of fluid just under the skin. A whole treatment session may involve anywhere from a few to twenty or more of these injections, and can take from 10 minutes up to 30 minutes.

Patients feel immediate relief from pain – within seconds. Prior to treatment, points on the skin would elicit pain from the slightest pressure. In less than a minute following treatment, often patients aren’t even able to localize where the pain used to be.

How long this relief from pain lasts is variable – from a few days to even a week or two. Almost always, the pain returns – but typically it is less severe. After another treatment, the same relief is felt, which then lasts a bit longer than following the first treatment. After a course of treatment, many patients have been able to be completely pain-free after years of living with debilitating pain.

If this description of chronic pain sounds like what is experienced by you or someone you know, consider looking into NPT. It may turn out to be the treatment modality that ends your suffering and allows you to return to your active lifestyle, pain-free.

Written by Dr. Reuben Dinsmore, ND

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