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26/Jul/2022

What is PCOS?

Finding an effective treatment for Polycycstic ovarian syndrome (PCOS) is important to me for two distinct reasons. 5-10% of woman are impacted by PCOS in their lifetime making PCOS a common and treatable condition in my Naturopathic practice. The second reason is that it is a condition that my wife has struggled with for many years therefore making it a syndrome that hits close to home.

PCOS is a bit of a misnomer as it is a continuum of symptoms and doesn’t necessarily have to include ovarian cysts. It is however characterized by several common objective findings including irregular periods, infertility, shifts in hormone balance (DHEA, Testosterone, LH, FSH), hirsutism (hair growth on the lip, chin and abdomen), Hair loss (Male pattern head hair loss), acne (typically on the lower jaw), high levels of insulin due to insulin resistance, and unexplained weight gain (especially around the abdomen).

Although we still do not know all the mechanisms involved as to why some women develop PCOS, there does seem to be a genetic component. Environmental toxins such as BPA seem to play a role, and gastrointestinal dysbiosis (unfriendly bacteria in the gut) plays a role as well.

Conventional Treatment for PCOS

Some of the more common conventional treatments of PCOS include birth control pill (to regulate irregular periods and hormone levels), metformin (a insulin sensitizing drug that helps to control blood sugar levels commonly used in diabetes), and spironolactone (a diuretic that also has the ability to block a type of testosterone formation called DHT). While these treatments can be helpful in the short-term they do not always address the root cause of PCOS and therefore ultimately fail in the long term. Some of these causes include hormone disrupters in the environment and diet, and gastrointestinal dysbiosis (leading to the production of inflammatory compounds that compromise insulin function).

Holistic Treatment for PCOS

Luckily there are relatively easy and low cost solutions to many of the fundamental causes of PCOS. As a Naturopathic Doctor I have the privilege and ability to take a detailed medical history. Doing so can point me in the direction(s) as to where these foundational imbalances are occurring. For instance if the patient has a history of gastrointestinal concerns, (constipation, diarrhea, gastritis, colitis) that informs me to focus investigation on the gastrointestinal tract. If a patients main concern is infertility and irregular periods I will shift focus into hormone balance. It may also be the case that a patient has several concern at the same time, which is not uncommon in PCOS. Once I know where to focus we can run specialized tests such as comprehensive stool analysis, female hormone panels, nutrient level panels, food sensitivity testing and environmental toxins. This aids in narrowing down where to implement the bulk of the treatment protocol. There are some general recommendations that are sure to aid all women with PCOS such as exercise, reduced carbohydrate diets and lowering exposure to petrochemicals. However, the medical history and specialized testing can be a guide for more specific recommendations.

Functional Testing for PCOS

A nutrients panel test can help determine if there are specific nutritional deficiencies such as low levels of vitamin D, vitamin A and omega-3 fatty acids, which tend to be common in PCOS. A female hormone panel can determine if there are specific imbalances with sex hormones. These imbalances can potentially be corrected with dietary recommendations, bio-identical  hormone replacement, and nutraceutical supplements. Evidence of dysbiosis in gut from a stool analysis can be reversed with dietary recommendations that promote colonization of helpful butyrate producing bacteria. Nutraceuticals containing antibiotic herbs can preferentially kill harmful bacteria while protecting good bacteria. Probiotic supplements containing specific strains of bacteria and prebiotic fibre can be very effective. Food sensitivity testing can help confirm if there are specific foods in the diet that are activating an immune response, causing further inflammation in the gut. Environmental toxin analysis would shed light on high levels of exposure to particular toxins, most of which are known hormone disruptors. Even the simple testing of insulin levels and blood sugar can lead to recommendations for easily accessible compounds like inositol, L-carnitine and chromium which can effectively increase insulin sensitivity.

Conclusions

The take home message is that PCOS is an extremely common and often disruptive condition for a significant amount of women worldwide. The conventional treatment of PCOS often does not provide long term solutions and can have significant side effects. Simple and inexpensive solutions through dietary, supplement and lifestyle recommendations can address the root causes of PCOS and bring about significant symptom relief with long-term sustainability. I therefore encourage anyone suffering from PCOS who hasn’t found an effective solution to contact a local Naturopathic Doctor or Functional Medicine Doctor for an assessment. If you would like to contact me, you can do so through the appointment page by clicking the link in the menu bar. The sooner you start to address the root causes the easier and quicker long lasting symptom relief can be achieved. That being said, implementation of a functional medicine approach to PCOS will undoubtably be helpful at any stage and at any age.


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03/Mar/2022

For the past 6-months I have been supplementing with collagen peptides in my morning coffee. I take relatively few daily supplements; Lions Mane mushroom for my brain, Vitamin D for my immune system and Collagen Peptides for my joints. I became focused on protecting my joints (especially my fingers, toes, knees and shoulders) a few years ago as I started training harder in rock climbing. I began to feel stiffness, soreness and occasionally pain after hard training sessions. I decided I needed to do something soon or I would lose the ability to climb at a relatively young age.

Instead of suppressing inflammation with compounds like curcumin, glucosamine and chondroitin I wondered if it would be possible to actually strengthen my tendons and ligaments. I had been aware of collagen supplementation through a number of patients taking it for hair and skin health. I had largely dismissed collagen as a beauty supplement and it was therefore not on my radar as a potential athletic enhancement.

Just over 6-months ago I had received a newsletter about of tendon health for climbers. The physiotherapist/climbing expert outlined specific exercises for warming up fingers and also mentioned the benefits of collagen supplementation for tendon health. At that moment I decided to re-visit the research on collagen, and I am glad I did!

Collagen peptides are small amino acid chains derived from collagen, which is the primary structural protein in ligaments, tendons, bones and skin. The research behind supplementing with collagen peptides seems to support three key areas.

Skin

A few studies, including randomized placebo controlled trials, have shown an improvement in skin moisture, elasticity and wrinkles with daily supplementation of Collagen Peptides. The daily dose ranged from 4-10 grams daily.

Osteoarthritis

Several studies have demonstrated a modest benefit in pain and function with daily supplementation of Collagen Peptides. Most studies focused on osteoarthritis (OA) in the knees but a couple also mention hip and hand. In general the improvement was modest (a little better than chondroitin) and took approximately 3-5 months to appear. Some studies used collagen peptides in combination with other compounds like chondroitin and hyaluronic acid. Most studies used a 10 gram daily dose.

Performance Enhancement

A great systematic review came out in 2021 that looked at the effects of collagen peptide supplementation on body composition, collagen synthesis and recovery from joint injury.

Five studies demonstrated a positive effect on reducing joint discomfort, knee pain , ankle and knee function and recovery from achilles tendinopathy. Those studies used 40 mg-10 grams per day over a 4-6 month period.

Four studies looked at the effects of collagen supplementation on body composition and muscle strength. The studies combined collagen supplementation (15 grams per day for 3-months) with resistance training.The studies, which were conducted on elderly men, active men and untrained pre-menopausal women, found an increase in fat free mass, a decrease in body fat percentage and an increase in hand grip strength.

Two studies assessed the effect of collagen supplementation on exercise performance and recovery from muscle soreness. The studies included recreationally active men, one used 3 grams per day for 6 weeks and the other used 20 grams per day for 7 days prior to intense exercise. There was a strong positive effect on pain with movement and muscle soreness.

Two studies assessed the effects of Collagen peptide supplementation on collagen synthesis. When taken 60min prior to exercise there was a significant increase in collagen synthesis markers following ingestion of 15 grams collagen enriched with vitamin C.

Conclusions

When it comes to preserving joint, ligament and tendon health for myself and my patients, collagen peptide supplementation is now a staple. The evidence in favour of collagen, along with a strong safety profile makes collagen peptides a valuable nutritional supplement in both sports medicine and anti-aging medicine. The recommended dose seems to be between 10-20 grams per day for 3-6 months.

References

Inoue N, Sugihara F, Wang X. Ingestion of bioactive collagen hydrolysates enhance facial skin moisture and elasticity and reduce facial ageing signs in a randomised double-blind placebo-controlled clinical study. J Sci Food Agric. 2016;96(12):4077-81.

Czajka A, Kania EM, Genovese L, et al. Daily oral supplementation with collagen peptides combined with vitamins and other bioactive compounds improves skin elasticity and has a beneficial effect on joint and general wellbeing. Nutr Res 2018;57:97-108.

Asserin J, Lati E, Shioya T, Prawitt J. The effect of oral collagen peptide supplementation on skin moisture and the dermal collagen network: evidence from an ex vivo model and randomized, placebo-controlled clinical trials. J Cosmet Dermatol. 2015;14(4):291-301

Sangsuwan W, Asawanonda P. Four-weeks daily intake of oral collagen hydrolysate results in improved skin elasticity, especially in sun-exposed areas: a randomized, double-blind, placebo-controlled trial. J Dermatolog Treat. 2020:1-6.

Benito-Ruiz P, Camacho-Zambrano MM, Carrillo-Arcentales JN, et al. A randomized controlled trial on the efficacy and safety of a food ingredient, collagen hydrolysate, for improving joint comfort. Int J Food Sci Nutr. 2009;60 Suppl 2:99-113.

Kumar S, Sugihara F, Suzuki K, Inoue N, Venkateswarathirukumara S. A double-blind, placebo-controlled, randomised, clinical study on the effectiveness of collagen peptide on osteoarthritis. J Sci Food Agric. 2015;95(4):702-7.

Trc T, Bohmová J. Efficacy and tolerance of enzymatic hydrolysed collagen (EHC) vs. glucosamine sulphate (GS) in the treatment of knee osteoarthritis (KOA). Int Orthop. 2011;35(3):341-8

Moskowitz RW. Role of collagen hydrolysate in bone and joint disease.Semin Arthritis Rheum 2000;30:87-99

Kalman DS, Schwartz HI, Pachon J, Sheldon E, Almada AL. A randomized double blind clinical pilot trial evaluating the safety and efficacy of hydrolyzed collagen type II in adults with osteoarthritis. FASEB Experimental Biology 2004 Abstracts, Washington DC, April 17-21, 2004; A90.

Amino Acids. 2021; 53(10): 1493–1506.Published online 2021 Sep 7. doi: 10.1007/s00726-021-03072-xPMCID: PMC8521576PMID: 34491424The effects of collagen peptide supplementation on body composition, collagen synthesis, and recovery from joint injury and exercise: a systematic review Mishti Khatri,1 Robert J. Naughton,1 Tom Clifford,2 Liam D. Harper, 1 and Liam Corr1


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21/Nov/2019

It was my hope to find an effective alternative to Cannabidiol (CBD) that wouldn’t land me in jail when I travel; so is PEA the new CBD?

PEA stands for Palmitoylethanolamide. It is a fatty acid that is found in Eggs, Cheese, Meats and Peanuts.  We also make PEA during stress, infections, inflammation, trauma, allergies, pain, cardiac disease, kidney disease and obesity. Much like our endocannabinoids, PEA is responsible for maintaining cellular homeostasis.

Naturopathic Treatment for Multiple Sclerosis

How does it work?

While PEA does not have a direct effect on Cannabinoid receptor (CB1 and CB2) it does have similar mechanisms of action to our endocannabinoids and cannabidiol (CBD). PEA looks very similar to our body’s own endocannabinoids (AEA and 2-AG). These similarities allow PEA to exert effects similar to our AEA and 2-AG.

PEA down regulates mast cells, which are responsible for the release of histamine and other inflammatory mediators. PEA can therefore be a powerful molecule for immune heath, inflammation, pain, neuro-protection and allergies. PEA has direct action on receptors GPCR55 and GPR119, which produce effects similar to activation of CB1 and CB2 by endocannabinoids, THC and CBD.  PEA also acts similarly to CBD by affecting the breakdown of endocannabinoids via inhibition of the enzymes FAAH and MAGL. 

Pain Management
Micronutrient Infusion

The Research

Several studies have shown that when PEA is used with opioid type drugs for low back pain, the dose of the opioids could be reduced significantly. PEA was found to exert pain relief animal models of inflammation and neuropathic pain. These analgesic effects are thought to be due to increasing endocannabinoid levels similarly to how CBD works. All in all many studies have revealed that PEA exerts similar effects to CBD.  So I thought I would give this supplement a whirl, as a alternative to CBD (especially for travel) would be an important option for patients using CBD. 

My 5-day Trial with PEA

I took the supplement P.E.A. Activate from AOR , which contains 600mg PEA per lozenge.  My daily dose was two lozenges per day and I did that for 5 days. I noticed a strange light-headed feeling about 5 minutes after chewing my first lozenge. The feeling lasted for a bout 30min. I was excited that I actually felt a bit different after that fist dose by unfortunately each dose produced a similar effect (a light relaxing feeling) that only lasted between 30-60min. There didn’t seem to be much carry over from one dose to another. The effects were always pretty fast acting but short-lived. Furthermore I had a return of some muscle soreness that was absent for most of the time that I was taking my CBD supplement.  So, it seemed like, for me, the PEA was not having the same effect that I had experienced while on CBD.

In summary, the effects that I experienced during my PEA trial were fast acting but short-lived. PEA may therefore be a useful tool for acute episodes of anxiety, pain etc… but it did not have the same accumulative and long term effects that I experienced with CBD. The research on PEA is compelling and it is possible that this supplement warrants a more long-term trial. According to the research PEA seems to be a potential alternative to CBD but from my experience it falls a bit short.  Check out my video review of PEA here. 

https://youtu.be/Yfr-Ma19gGk

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30/Oct/2019

“Let food be thy medicine, and let medicine be thy food”; a famous quote from the Classical Grecian physician Hippocrates. Lions Mane mushrooms are a perfect embodiment of this philosophy; as delicious as it is therapeutic. 

Lions mane (Hericium Erinaceus) is a white clumpy mushroom with long dangling spines that tends to grow in late summer/early fall on hardwoods.

I was first introduced to Lion’s Mane a few years ago when I had a few patients tell me they were using an extract of the mushroom to help with memory. Supplements that enhance brain activity, AKA Nootropics, have always tweaked my interest as one of my areas of clinical focus is in neurology. At first I thought that maybe this is the newest “superfood fad” but once I began to investigate the research on this mushroom my opinion quickly changed.

It was clear that Lions Mane had some legitimate therapeutic value in inflammation, the immune system, psychiatric conditions, cognitive enhancement, diabetes, heart disease, bowel disease and cancer.

Lions Mane Mushroom
Preparing Lions Mane Mushroom in my kitchen

Inflammation and Depression

A 2012 study demonstrated that Lions Mane mushroom contains several compounds that have moderate to high levels of antioxidant capacity. This translates into an anti-inflammatory effect in the body. A 2015 study demonstrated that participants who consumed Lions Mane had less depressive symptoms and improvements in blo-markers of depression which was attributed to it’s anti-inflammatory effects.  Another study demonstrated that Lions Mane can enhance immune function possibly by reducing inflammation and oxidative stress. 

Immune 

Not only does Lions Mane help boost immune function by reducing oxidative stress, it also seems to benefit intestinal immune function. A study on mice revealed that some of the proteins in the mushroom help encourage the growth of beneficial bacteria in the gut. 

Naturopathic Treatment for Multiple Sclerosis

Memory

Cognitive enhancement is the main reason that I see people taking this mushroom. It is possible that it does have some cognitive enhancement properties but all the research so far has been done on animals. One such study found that mice given a lion’s mane supplement had better object recognition and recognition memory. Other research suggests that Lions Mane may have the potential to prevent or treat conditions of cognitive decline like Alzheimer’s and Parkinson’s disease.

Heart Health

Heart Health

Research on rats has demonstrated that Lions Mane may have cholesterol lowering effects and blood pressure lowering effects. Compounds in Lions Mane may help in the production of Nitric Oxide, which helps keep blood vessels relaxed. 

Cancer

The antioxidant properties of Lions Mane may contribute to some anti-cancer effects seen in rat and in vitro studies. One in vitro study indicated that Lions Mane has activity against human leukemia cells. Another study showed that in mice, Lions Mane has activity against Liver, Colon and Gastric cancer cells. 

Diabetes

After 4 weeks of Lions Mane supplementation, rats with diabetes had lower blood sugar levels than those who did not receive the mushroom.  Diabetes can often result in life altering nerve damage. A 2015 study showed that diabetic rats given an extract of Lions Mane had reduced nerve pain and improved antioxidant activity after 6 weeks. 

Intestinal Health

Digestive Health

I previously discussed how Lions mane can have anti-inflammatory effect of the digestive tract, as well as benefitting the growth of “good” intestinal bacteria. Another study demonstrated that Lions Mane has some interesting antimicrobial effects. Notably, Lions Mane seems to inhibit the growth of H-pylori, a bacteria responsible for close to 80% of stomach ulcers.

Nerve Repair

One of the most fascinating health benefits of Lions Mane came out of a rat study. Rats with nerve damage who were given daily extracts of Lions mane had quicker nerve cell regeneration than those who did not. 

Culinary 

Up until a few weeks ago I thought Lions Mane was an exotic mushroom that was only used therapeutically as a supplement.  Recently, I found myself in a local Farmers Market and low and behold a mushroom farmer was selling fresh Lions Mane; I was amazed! I asked the farmer “how do I prepare this”? He told me to cut the mushroom in ½ inch slices and in a hot pan with butter, sear both sides. So, I bought some and followed his advice, and discovered that Lions Mane is absolutely delicious! It is now one of my favorite cooking mushrooms and I have since heard from many foodies and chefs that it is one of their favorites too. So let food be thy medicine everyone, and cook up some Lions Mane this fall!

Citations


Leonard, Jayne. “What are the benefits of lion’s mane mushrooms?.” Medical News Today. MediLexicon, Intl., 22 Oct. 2018. Web.
30 Oct. 2019. <https://www.medicalnewstoday.com/articles/323400.php>


Leonard, J. (2018, October 22). “What are the benefits of lion’s mane mushrooms?.” Medical News Today. Retrieved from
https://www.medicalnewstoday.com/articles/323400.php.

Lion’s Mane Mushroom, <i>Hericium erinaceus</i> (Bull.: Fr.) Pers. Suppresses H<sub>2</sub>O<sub>2</sub>-Induced Oxidative Damage and LPS-Induced Inflammation in HT22 Hippocampal Neurons and BV2 Microglia.
Kushairi N, Phan CW, Sabaratnam V, David P, Naidu M.
Antioxidants (Basel). 2019 Aug 1;8(8). pii: E261. doi: 10.3390/antiox8080261.
PMID: 31374912 [PubMed] Free Article
Thirteen-Week Oral Toxicity Evaluation of Erinacine AEnriched Lion’s Mane Medicinal Mushroom, Hericium erinaceus (Agaricomycetes), Mycelia in Sprague-Dawley Rats.
Lee LY, Li IC, Chen WP, Tsai YT, Chen CC, Tung KC.
Int J Med Mushrooms. 2019;21(4):401-411. doi: 10.1615/IntJMedMushrooms.2019030320.
PMID: 31002635 [PubMed – indexed for MEDLINE]
In Vitro and In Vivo Inhibition of Helicobacter pylori by Ethanolic Extracts of Lion’s Mane Medicinal Mushroom, Hericium erinaceus (Agaricomycetes).
Wang G, Zhang X, Maier SE, Zhang L, Maier RJ.
Int J Med Mushrooms. 2019;21(1):1-11. doi: 10.1615/IntJMedMushrooms.2018029487.
PMID: 30806251 [PubMed – indexed for MEDLINE]
Dietary Supplementation of Lion’s Mane Medicinal Mushroom, Hericium erinaceus (Agaricomycetes), and Spatial Memory in Wild-Type Mice.
Rossi P, Cesaroni V, Brandalise F, Occhinegro A, Ratto D, Perrucci F, Lanaia V, Girometta C, Orrù G, Savino E.
Int J Med Mushrooms. 2018;20(5):485-494. doi: 10.1615/IntJMedMushrooms.2018026241.
PMID: 29953363 [PubMed – indexed for MEDLINE]
A Polysaccharide Isolated from Mycelia of the Lion’s Mane Medicinal Mushroom Hericium erinaceus (Agaricomycetes) Induced Apoptosis in Precancerous Human Gastric Cells.
Wang M, Zhang Y, Xiao X, Xu D, Gao Y, Gao Q.
Int J Med Mushrooms. 2017;19(12):1053-1060. doi: 10.1615/IntJMedMushrooms.2017024975.
PMID: 29431066 [PubMed – indexed for MEDLINE]
Anti-Inflammatory Effects of Ethanol Extract of Lion’s Mane Medicinal Mushroom, Hericium erinaceus (Agaricomycetes), in Mice with Ulcerative Colitis.
Qin M, Geng Y, Lu Z, Xu H, Shi JS, Xu X, Xu ZH.
Int J Med Mushrooms. 2016;18(3):227-34. doi: 10.1615/IntJMedMushrooms.v18.i3.50.
PMID: 27481156 [PubMed – indexed for MEDLINE]

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22/Sep/2018

Cold and Flu season is here! Now that kids are back to school and the season is changing we should start thinking about preventing colds and flu. As a Naturopathic Doctor part of my job is counseling parents on safe and effective ways to treat and prevent colds and flu for the whole family. Here are 5 things that will help prevent colds and flu and can even help to ameliorate symptoms and shorten duration of an active infection.

 

Probiotics

  1. Probiotics

Probiotics help boost the immune system – Studies have shown that probiotics affect immune cells throughout the body. When certain strains of probiotics are introduced into our intestine they help to repair intestinal cells and they boost production of antimicrobial substances. In one study, 326 children aged 3-5 years were randomly assigned to receive, in double-blind fashion, probiotic supplementation. Treatments were given twice per day in divided doses for 6 months, including the winter season. Compared with placebo, the probiotic group had the following results; fever reduction 53-73%, cough reduction 41-62%, decreased runny nose 28-59%, decreased need for antibiotics 68-82%, reduced absence from school 28-32%.

Elderberry

  1. Elderberry

Elderberry extracts inhibit bacteria and viruses – Not only does elderberry syrup taste great, studies have shown that it inhibits the bacteria and viruses associated with common colds and the flu. One study demonstrated that an elderberry liquid extract possesses antimicrobial activity against both streptococci bacteria and influenza viruses. Another study looked at 312 air travellers flying from Australia to an overseas destination.  Those travellers who took an elderberry extract before, during and after travel had fewer colds, less sick days and less symptoms.

Vitamin C

  1. Vitamin C

Vitamin C supports immune cells – Vitamin C is very important for optimal immune system functioning. Vitamin C helps immune cells get to where they need to be, kill pathogens effectively, protect the body from damage and clean up after battling infections. Studies have shown that adequate vitamin C in the blood helps prevent infections, is necessary to fight infections and helps with recovery. The recommended daily intake of vitamin C is 100-200mg/day; however during active infection, the metabolic demand increases and therefore the requirement for vitamin C is likely to be higher. Even in this day and age, vitamin C is the fourth leading nutrient deficiency in North America. Poor diet and increases in free radical exposure due to an unhealthy lifestyle may be contributing factors. Excellent sources of vitamin C are Broccoli, Citrus Fruits and Berries.

Zinc

  1. Zinc

Zinc is essential for immune system communication – The importance of zinc for proper immune function has been well established. Zinc deficiency undoubtedly causes immune system malfunction.  The cells of our body are in constant communication. During infection there is a need for effective communication between immune cells in order to get rid of the “bad guys”.  Communication happens in the form of chemical messengers and enzymes. Zinc is an essential component of these chemicals and enzymes. As with vitamin C, during active infection our requirement for zinc is likely to increase. Studies have shown that Zinc supplementation during infection can shorten the duration of the illness. Excellent dietary sources of zinc include: Meat, Shellfish, Legumes, Nuts and Seeds. Supplementation may be important with a vegan or vegetarian diet.

Vitamin D from Sunlight

  1. Vitamin D

Vitamin D is the supervisor of the immune system –Vitamin D has many functions in the body, and receptors for vitamin D can be found on many different tissues. One important function for vitamin D is in the modulation of our immune system. Studies have suggested that vitamin D is able to both calm down and rev-up the immune system according to what our body needs it to do. This is why Vitamin D is thought to be as important in autoimmune disorders as it is in infections.

Vitamin D deficiency can cause the immune system to behave erratically. Unfortunately in Canada we have one of the highest incidences of vitamin D deficiency in the world. Our primary source of vitamin D is from sunlight and therefore supplementation becomes important especially during the winter months. Studies have shown that there is a higher incidence of upper respiratory tract infections in athletes who are deficient in the vitamin and who train in the wintertime. Supplementation had preventative and symptom reducing effects. Aside from sunlight, some dietary sources of vitamin D are: fortified foods, fatty fish, beef liver, egg yolks and cheese.

 

Even vitamins and minerals at high dosages can be dangerous, especially in children. It is always recommended to consult with a health care professional, such as a Naturopathic Doctor, before supplementing on your own.

 

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Leyer, GJ et al. Probiotic effects on cold and influenza-like symptom incidence and duration in children. Pediatrics 2009; 124-179. Walker, WA. Mechanisms of action of probiotics. Clin Infect Dis. 2008; 46 (Suppl2): S87-91.

Curr Opin Gastroenterol. 2011 October ; 27(6): 496–501. doi:10.1097/MOG.0b013e32834baa4d.  Probiotics and immune health Fang Yana and D.B. Polkb,c,d

Elderberry Supplementation Reduces Cold Duration

and Symptoms in Air-Travellers: A Randomized,

Double-Blind Placebo-Controlled Clinical Trial Evelin Tiralongo 1,2, *, Shirley S. Wee 2,3 and Rodney A. Lea 4 Received: 8 February 2016; Accepted: 18 March 2016; Published: 24 March 2016

 

Krawitz et al. BMC Complementary and Alternative Medicine 2011, 11:16

http://www.biomedcentral.com/1472-6882/11/16

Inhibitory activity of a standardized elderberry

liquid extract against clinically-relevant human

respiratory bacterial pathogens and influenza A

and B viruses Christian Krawitz1†, Mobarak Abu Mraheil1†, Michael Stein2, Can Imirzalioglu1, Eugen Domann1, Stephan Pleschka2*,

Torsten Hain1*

 

Vitamin C and Immune Function Anitra C. Carr 1, * and Silvia Maggini 2

1 Department of Pathology, University of Otago, Christchurch, P.O. Box 4345, Christchurch 8140, New Zealand

2 Bayer Consumer Care Ltd., Peter-Merian-Strasse 84, 4002 Basel, Switzerland; silvia.maggini@bayer.com* Correspondence: anitra.carr@otago.ac.nz; Tel.: +643-364-0649 Received: 21 September 2017; Accepted: 31 October 2017; Published: 3 November 2017

 

Biofactors. 2014 Jan-Feb;40(1):27-40. doi: 10.1002/biof.1114. Epub 2013 Jun 27.Zinc signals and immune function. Haase H1Rink L.

 

Cochrane Database Syst Rev. 2013 Jun 18;(6):CD001364. doi: 10.1002/14651858.CD001364.pub4. Zinc for the common cold.

Singh M1Das RR.

 

Vitamin D3 Supplementation Reduces the Symptoms

of Upper Respiratory Tract Infection during Winter

Training in Vitamin D-Insufficient Taekwondo

Athletes: A Randomized Controlled Trial Hyun Chul Jung 1 , Myong-Won Seo 2  , Sukho Lee 3 , Sung Woo Kim 2  and Jong Kook Song 2, * 1 Department of Kinesiology, College of Health Sciences, University of Louisiana at Monroe, 700 University

Avenue, Monroe, LA 71209, USA; jung@ulm.edu

2 Department of Taekwondo, College of Physical Education, Kyung Hee University, 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014, Korea; smilly1004@khu.ac.kr (M.-W.S.); kswrha@khu.ac.kr (S.W.K.)

3 Department of Counseling, Health, and Kinesiology, College of Education and Human Development,Texas A&M University-San Antonio, One University Way, San Antonio, TX 78224, USA; slee@tamusa.edu* Correspondence: jksong@khu.ac.kr; Tel.: +82-31-201-2708 Received: 2 August 2018; Accepted: 10 September 2018; Published: 14 September 2018

 

Mechanisms Underlying the Regulation of Innate and

Adaptive Immunity by Vitamin D Ran Wei and Sylvia Christakos *

Received: 25 June 2015 ; Accepted: 15 September 2015 ; Published: 24 September 2015 Department of Microbiology, Biochemistry and Molecular Genetics, New Jersey Medical School, Rutgers, the State University of New Jersey, 185 South Orange Ave, Newark, NJ 07103, USA; weira@njms.rutgers.edu

* Correspondence: christak@njms.rutgers.edu; Tel.: +973-972-4033; Fax: +973-972-5594


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31/Aug/2018

Multiple Sclerosis is a complex disease; those living with it need a simple approach. A treatment approach should appreciate the physiology of the disease process without neglecting the human body as a holistic system, and the patient as a person.

Naturopathy is an ideal philosophy of medicine for the treatment of M.S. as it aims to address disease processes and symptoms without loosing sight of the patient as an individual.

I chose to focus in neurological disease early into my professional career and as a result I have come across many complex chronic diseases of the nervous system including all subtypes of M.S. When patients come for their initial visit it is not uncommon to be privy to a long list of life events that have impacted the disease, symptoms that have evolved over years and medications that have been tried, stopped and tried again.

It’s easy to see why the practitioner on the other end of the patient with M.S. can become overwhelmed and confused, loosing sight of the big picture, dismissing the patients needs and goals. Unfortunately, this medical tunnel vision re-aimed at addressing each and every concern translates into complex and confusing treatment plans that most patients cannot comply with. I sympathize with these patients who have to remember to take dozens of pills while also dealing with a life altering condition.

To make matters worse, these confusing treatment plans hardly ever work because they tend to forget that the human body is not a series of islands, rather it’s a society striving to work in harmony and balance. The key to developing a simple, understandable and effective treatment plan is to figure out what is out of balance and how do we bring it back.

A typical treatment plan for M.S. has three parts: Foundations, The Immune System and Specific Symptoms. Since we are working toward bringing the body back into balance it is important to take the time to hear the full story and timeline of how the condition started and progressed. Often during the initial consultation it will become clear as to what type of events precluded the first attack and how these events triggered a physiological imbalance.

Diet therapy in multiple sclerosis

Foundations

It’s a futile effort to try and treat symptoms while the very basics of health and wellness are not fortified. The foundations of health can be summed up into three parts: Sleep, Diet and Exercise.

Sleep is the healing chamber for the body. Recently studies have shown that the brain undergoes a type of detoxification process while we sleep. Many neurodegenerative diseases have been correlated to poor sleeping habits. It is common to see sleeping issues in patients with M.S. In fact I have had a few cases where years of terrible sleep may have contributed to the patient experiencing their first symptoms related to M.S. This makes sense in the light of the new research demonstrating how important sleep is in clearing neurotoxic compounds from the brain.

One of the most important protocols I put together for my M.S. patients is aimed at improving sleep. This is achieved through sleep hygiene education and supplements that have been carefully vetted over my years in practices for their effectiveness in improving sleep initiation and maintenance.

Diet is important for a number of reasons, some are general and some are specific to M.S. The food we eat and its relation to our digestive tract determines our nutritional robustness.

M.S. is a chronic neuro-inflammatory state and therefore patients with M.S. will be using up vitamins and minerals involved in inflammatory processes at a greater rate than in a healthy control group. Therefor it’s important to determine what the nutritional status is of the M.S. patient (through consultation and specific lab tests), bring it back into balance and correct deficiencies. Otherwise the body will be unable to cope with the inflammatory process and the disease will progress.

It is also important to identify any food allergens, intolerances and sensitivities in the M.S. patient for these will perpetuate the inflammation. Chronic inflammation has a detrimental effect on the immune system, which I will discuss further in the next part of the treatment plan.

Another aspect related to diet is the health of the gastrointestinal tract and more specifically the micro-biome (the bacteria of the gut). A healthy micro-biome is important for detoxification, nutrient absorption and immune system regulation. A protocol addressing diet will focus on testing for nutritional deficiencies, food sensitivities, specific dietary guidelines for M.S. and supportive supplements where necessary.

A good dietary resource specific to M.S. is The Wahls Protocol.

physiotherapy for Multiple SclerosisExercise is a powerful health modulator and is under-appreciated for its importance in chronic disease and specifically M.S. Often exercise comes in the form of physiotherapy in progressive M.S. and the first thing I will do with a patient is set them up with one of the physiotherapists in my clinic (if they don’t already have a physiotherapy program). Often patients newly diagnosed with M.S. are neglected by the medical system in terms of exercise. In-patient rehab programs are inadequate, scooters and wheelchairs are promoted over therapy. Exercise and physiotherapy are instrumental in promoting neuroplasticity, decreasing inflammation, improving energy metabolism, maintaining and improving upon range of motion.

My clinic specializes in neurological rehabilitation using the Bobath Physiotherapy approach. Physio-Logic

The Immune System

Multiple Sclerosis is an autoimmune condition and therefore one cannot overlook the role of the immune system. Autoimmunity basically translates to a confused immune system that has targeted healthy cells and tissues rather than disease. The philosophy behind this part of the treatment plan addresses two questions: how the immune system became confused and how to bring it back into harmony.

There are many theories as to the cause of M.S., to name a few: Genetics, Vitamin D deficiency, Environmental Toxin Exposure, Candida Overgrowth, Dairy Protein Antigen Confusion and Leaky Gut Syndrome. There are truths to be told within many of these theories but in reality we just don’t know exactly what causes M.S. Some things we do know are the triggers for symptom activation, and things that reduce the risk of developing M.S. We know that stress (physical and/or emotional) often precipitate symptom relapse and progression. We also know that having adequate vitamin D levels are protective toward the development of M.S.

Vitamin D from SunlightVitamin D is not longer thought of as merely a bone-building vitamin. In reality it is more of a hormone and has a very important role in maintaining the health of the immune system. Step one of addressing the immune system is making sure the patient has optimal levels of vitamin D and if not, to adjust those levels using specific supplemental doses of vitamin D along with calcium and regular follow-up blood work.

Stress, whether it physical or emotional, causes a burden on the body. Most of the time we are able to cope with short durations of stress; however, when the stressful event is severe enough or lasts long enough it can impact the immune system in a negative way. Chronic stress can affect the immune system in two ways: Creating chronic inflammation that harms tissues and suppressing immune cells needed to fight infection.

When the immune system is under prolonged stress it becomes tired and makes mistakes, much like how we feel when under stress. One of these possible mistakes is mounting an autoimmune attack, harming normal healthy tissue rather than disease. Prolonged stress also depletes natural anti-inflammatory compounds like cortisol, allowing inflammation to run amuck. Therefore the protocol built around the immune system is aimed at decreasing stress on the immune system and bringing the immune system back into balance.

Anything that can be causing unnecessary inflammation needs to be dealt with and therefore chronic infections and food sensitivities must be addressed. Specific lab testing is used to investigate infections and sensitivities. Common food sensitivities in M.S. patients include: Dairy, Gluten, Yeast and Egg.

Once the major obstacles to a healthy immune system are removed we can work toward assisting the immune system back into a balanced state. The most important cells involved in bringing the immune system back into balance are “regulatory T cells” also known as “T suppressor cells”. These cells maintain tolerance in the immune system preventing autoimmunity. Part of the protocol is therefore aimed at supporting these cells. Some compounds that influence regulatory T cells are: probiotics, vitamin D, vitamin A, Omega 3 fatty acids and food sensitivities.

Sleep

Specific Symptoms

Treating foundations and immune system irregularities take time, therefore it is almost equally important to address the specific symptoms of the patient. Fatigue, weakness and pain are often obstacles to important foundational concerns like sleep and exercise.

Fortunately, there are many great strategies within Naturopathic medicine to help address the most common symptoms in M.S. namely: Weakness, Spasticity, Fatigue, Pain, Bowel and Bladder issues. There are dozens of supplements that have shown promise in treating the common symptoms of M.S. The art of the practitioner is in choosing the right compounds for the right patient. As an example, medical marijuana can be very effective for spasticity, pain, bladder dysfunction and sleep but can exacerbate weakness. A good practitioner with experience in treating M.S. will know how to choose the appropriate medications for the patients needs.

Multiple Sclerosis is a complex condition with many subtypes and many different ways it affects the individual patient. Naturopathic medicine aims to treat the root cause of disease while also addressing the individual concerns of the patient. The treatment plan can be summed up into three areas: Foundations, Immune System and Specific Symptoms. This helps direct the practitioner toward the right approach and simplifies the philosophy behind the treatment, improving upon compliance and therefore patient outcomes.

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09/Aug/2018

Do you give your kids probiotics?

Every year it seems like the back to school commercials start to pop up earlier and

earlier in the summer months. Although these commercials are aimed at bringing

parents into office supply and clothing stores in prep for their kids returning to

school, as parents we can also use this time to implement nutritional strategies to

help our kids excel during the school year.

Besides the obvious beneficial lifestyle approaches like eating a balanced nutrient

rich diet and daily exercise, there are a few specific recommendations that may help

your kids have the edge when it comes to starting school.

Probiotics Kids Back to School

[banner ]Probiotics[/banner]

Probiotics are live bacteria cultures that seem to have varying health benefits when

introduced into our gastrointestinal tract. Probiotics are naturally found in many

fermented foods such as yogurt, kefir, miso, tempeh, sauerkraut and kombucha. It is

believed that as a species, fermented foods played a larger role in our diet as we

evolved and our bodies have grown to rely on these bacterial cultures for optimal

health and wellbeing. Our modern “western” diet has been relatively low in these

fermented foods and there have been hypothesis relating many chronic diseases of

the gastrointestinal tract and immune system back to imbalanced gut bacteria.

Subsequently we have witnessed a surge in probiotics being offered in supplemental

form as a way to help restore this balance. It is important that I stress the fact that

probiotics alone are not the complete picture with regard to a healthy

gastrointestinal and immune system but research has suggested that they do play a

part.

 

Probiotics help boost the immune system – with kids heading back indoors and

spending large amounts of time in classrooms with each other (including daycare),

there is a dramatic increase in germ exposure and potential for kids to fall prey to

illness. In one study, 326 children aged 3-5 years were randomly assigned to

receive, in double-blind fashion, probiotic supplementation. Treatments were given

twice per day in divided doses for 6 months, including the winter season. Compared

with placebo, the probiotic group had the following results; fever reduction 53-73%,

cough reduction 41-62%, decreased runny nose 28-59%, decreased need for

antibiotics 68-82%, reduced absence from school 28-32%.

 

Probiotics help with allergies – Heading back indoors can trigger many kids who

are especially allergic to dusts and molds. With regard to asthmatic children with

allergic rhinitis, studies have shown the use of probiotics resulted in a significant

reduction in the inflammatory immune chemistry produced by peripheral blood

mononuclear cells. Further studies have shown specific down-regulation of T cells

(immune cells), which beneficially alter the balance of pollen specific antibodies in

seasonal allergic rhinitis. In short – probiotics lower the allergic load and decrease

inflammation.

 

Probiotics help with mood – Recent research is showing new gut-brain

connections as happy gut ecology seems to make for happier brains. In one

particular study, anxious mice dosed with probiotics showed lower levels of anxiety,

decreased stress hormones, and even increased brain receptors for

neurotransmitters vital in curbing worry, anxiety and fear. With better mood comes

greater ease and ability to learn in school settings and beyond.

Stay tuned for part 2 which will focus on cold/flu prevention and treatment.

Book a consultation with our Naturopathic Doctor Shawn Meirovici for

more information on child-friendly probiotic strains and dosages.

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Leyer, GJ et al. Probiotic effects on cold and influenza-like symptom incidence

and duration in children. Pediatrics 2009; 124-179.

Walker, WA. Mechanisms of action of probiotics. Clin Infect Dis. 2008; 46 (Suppl

2): S87-91.

Yang, G et al. Treatment of Allergic Rhinitis with Probiotics: An alternative

approach. N Am J Med Sci. Aug 2013; 5 (8): 465-68.

Javier, AB, Forsytthe, P & Cryan, J. Ingestion of Lactobacillus strain regulates

emotional behavior and central GABA receptor expression in mice via the vagus

nerve. Proc Natl Acad Sci USA. Sep 20, 2011; 108(38): 16050-55.


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06/Jul/2018

One goal of Naturopathic pediatrics is to use natural therapies to prevent and treat mild to moderate conditions, resorting to pharmaceutical and surgical interventions as secondary options or in emergency situations. The core belief in Naturopathic pediatrics is to encourage the body to heal itself. This is achieved through supporting the immune system, addressing nutritional deficiencies, promoting a healthy diet and lifestyle; including exercise, sleep and mental habits.

 

Disease as a Process

Fever is an excellent example of how a naturopathic approach may differ from a conventional approach. A fever is our natural defence mechanism against a pathogen. By raising the temperature of the body a few degrees many pathogens (viruses, bacteria) stop functioning optimally and the body activates inflammatory immune cells and enzymes to destroy the invading organism. While conventional medicine often sees disease symptoms, like a fever, as something to be suppressed, naturopathic doctors often see them as something to be promoted.

It has become commonplace to try to intervene in the disease process too swiftly, taking medications to decrease fever and inflammation prematurely. The Naturopathic Doctors role is to recognize the stages of the disease process, closely monitoring a fever, knowing when a fever should be left alone and when intervention is necessary. All the while helping the child feel better without interfering in the healing process.

There are generally 5 stages of the disease process: Incubation, Aggravation, Destruction, Abatement and Reconstruction.

Incubation is where the invading organism is accumulating in certain areas of the body. This process can take hours to days to weeks to months. The immune system reacts and either removes the organism or the organism replicates too quickly and the body moves to the next stage. It is common to not have any obvious signs of infection during this stage.

Aggravation includes the usual signs of inflammation, replication of immune cells, fever, redness, pain, malaise, loss of appetite and fatigue. These are signs that the immune system is hard at work and should be encouraged. This is where suppression commonly occurs with fever reducing medications, and anti-inflammatories, which can revert healing back to the incubation phase.

Destruction is the peak of inflammation and results in the destruction of one organism or another.

Abatement occurs when the fight is over and it’s time to clean up the debris. The immune cells, dead organisms and inflammatory fluids must be removed by the body. The fever “breaks” and sweating begins. Coughing up phlegm, runny nose, diarrhea and other discharges remove the debris from the body. In conventional medicine, cleanup is often viewed as an additional set of annoying symptoms that need to be suppressed by drugs, often impeding on the “cleanup” process.

Fever reductions after administering fever reducing medications should not be confused with abatement. The fever will often spike again. The immune system is trying to do its job but is being suppressed.

Reconstruction happens next. The body is reconstructing damaged tissue, the body is attempting to reset back to its original state.

Most pediatric infections will run their course, and the child will heal themselves. The Naturopathic Doctor watches the disease process closely, waiting to see if the body will heal or get worse requiring intervention. Besides making this decision, it is also the Naturopathic Doctors role to encourage processes like fevers, rather than suppress healing and teach parents to save fever reducing medications until necessary.

Intervention

The Naturopathic Doctor monitors the inflammatory process, only intervening to prevent a severe state of aggravation. Mild interventions such as cooling baths, friction rubs, warming socks can often lower a high fever and help the child feel better. These therapies have their limits and are not always sufficient. It is also the Naturopathic Doctors role to recognize an emergency situation that requires pharmaceutical intervention and to educate the family with regard to monitoring the disease and recognizing an emergency situation.

Safety

The first principle of Naturopathic Medicine is “primum non nocere” first, do no harm. Safety is a combination of good diagnostics, good choice of treatments, prevention, and physician intervention when necessary. The properly trained, properly regulated Naturopathic Doctor should be able to guide the family through a confusing landscape of both conventional and non-conventional medicine by knowing which “alternative” approaches are safe and effective and when referral to another integrative professional or physician will be in the best interest of the infant, child or adult.

 

Dr. Shawn is now at KidCrew Fridays from 10am-6pm



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18/Apr/2018

A Naturopathic Doctor can play an important role in managing CMT through dietary counseling, specialized testing and by offering relevant integrative therapies.

CMT is a hereditary disorder affecting the motor and sensory nerves.  It’s characterized by progressive loss of muscle tissue and sensation in various parts of the body. Currently CMT is incurable and is the most common inherited neurological disorder and affects approximately 1 in 2,500 people.

In terms of managing CMT, by far the most important goal is to maintain movement, muscle strength and flexibility. Often overlooked is the role diet, pain management and antispasmodics can play in CMT. Having a naturopathic doctor familiar with neurological conditions can be a valuable part of a healthcare team.

 

Sugar

Although sugar is sweet and delicious, at high concentrations it can become a poison for the nervous system. Uncontrolled blood sugar, including diabetes, will exacerbate nerve damage and peripheral neuropathy in CMT. A naturopathic doctor can test blood sugar in order to determine if it poses a risk. Dietary counseling, such as education around glycemic index and glycemic load, can help balance blood sugar levels. There are also effective strategies that can boost insulin sensitivity thus lowering blood sugar. These include; low impact exercise and supplements like chromium, berberine, agaricus mushroom, american ginseng, and vitamin B3.

 

Diet

A diet rich in antioxidants and anti-inflammatory compounds can greatly improve neuromotor and locomotor performance. Curcumin and vitamin C are two natural compounds that have been and are currently being investigated as potential therapeutic agents for CMT. One study demonstrated a decrease in neuron death and an increase in size and number of nerve sheath cells after administration of curcumin. Intermittent fasting is a diet strategy that promotes a 16 hour fasting period each day and has been shown to improve locomotor functioning in CMT patients after 5-months.

 

Nerve Pain

Nerve pain and neuropathy can be addressed through a few different approaches. Application of topical counterirritants such as capsaicin and menthol can work by overriding pain signals. Peripheral pain blockers work by re-routing pain signals locally at the source of the pain. Effective peripheral pain blockers include: acupuncture, electro-acupuncture, moxabustion and transcutaneous electrical nerve stimulation (TENS).  Central pain blockers block or override pain signals where they are interpreted, in the brain. Central pain blockers include cannabis, wild lettuce and california poppy.

 

Cramps and Spasms

There are many effective integrative therapies for cramps and muscle spasms. These therapies work by balancing electrical conduction at the muscle and stimulating inhibitory neurotransmitters. Some of the most effective therapies are: magnesium, acupuncture, GABA, valerian, cramp bark, skullcap, passionflower and cannabis.

 

Nerve-Protection

One of the largest areas a naturopathic doctor can serve as a crucial part of the integrative healthcare team is in offering strategies to prevent further nerve damage, and in some cases reversing existing nerve damage. Neuroprotectants generally belong to two main categories: antioxidants and anti-inflammatories. Neuroprotectant antioxidants include: alpha lipoic acid, glutathione, resveratrol, EGCG, flavonoids, Co-Q10, CBD and THC. Anti-inflammatory strategies include testing for food sensitivities, hormone levels and environmental toxins.  Anti-inflammatory supplements include Omega 3 fatty acids, curcumin, boswelia, and CBD.


dr_shawn

Patient focused integrative health care. Utilizing effective natural approaches designed to be used alone or to compliment conventional medical care.


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