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30/Jun/2022

What is Long Covid?

Long Covid is defined as symptoms that present 12 weeks after infection and that persist for at least 8 weeks. The most common symptoms being: Fatigue, Shortness of Breath and Cognitive Dysfunction. There will be an estimated 150 million cases of Long Covid cases worldwide as of 2022. Long Covid has the potential to significantly impact the lives of a large portion of the population making day to day activities difficult or near impossible. Although there are ways to reduce the risk factors in developing long covid, there aren’t many proven conventional medications to treat Long Covid once symptoms set in.

We now know that viral fragments, lingering spike protein and persistent inflammation are all likely features of Long Covid. This chronic state of immune activation leads to heart and blood vessel abnormalities, lung impairment, neurological injury and autoimmunity. Luckily, functional medicine practitioners have been at the forefront in developing protocols that work to resolve the aftermath of COVID-19 infection.

Mitochondrial Dysfunction

There is evidence of mitochondrial dysfunction in Long Covid cases as seen through disruption in fatty acid oxidation and altered lactate production. This would also partially explain the chronic fatigue of Long Covid. Functional medicine has a long history of developing protocols to address mitochondrial dysfunction. Many of the compounds used have been showing promise in treating Long Covid. For example, there is evidence of reduced levels of Coenzyme Q10 in COVID-19 infection. CoQ10 is an important compound in mitochondrial function and energy production. Supplementing with this compound along with other mitochondrial supportive nutrients (Niacin, N-Acetyl Cysteine, Alpha Lipoic Acid) have been helpful in treating Long COVID associated fatigue.

Chronic Inflammation

We also know that there is a wealth of data to suggest high levels of inflammatory markers in Long Covid sufferers. Conventionally, steroids such as prednisone have been used to effectively treat Long Covid symptoms. However, steroids can not be used indefinitely as there are significant side effects associated with long term usage. In Naturopathic and Functional Medicine we have evidence of a number of naturally derived compounds that work to treat Long Covid associated inflammation including: Curcumin, Resveratrol, Cannabinoids, Luteolin, Omega 3, and Black Cumin.

Immune System Abnormalities

We also know that there is immune system dysfunction in Long Covid as evidenced in abnormal T-cell behaviour. One of the most important compounds regulating immune function is vitamin D. There is strong evidence that having adequate vitamin D status prior to Covid infection is protective toward Long Covid and giving large doses of vitamin D to both active Covid-19 cases and Long Covid sufferers can be therapeutic.

Gastrointestinal Symptoms

Long Covid cases also seem to have a higher incidence of prolonged gastrointestinal symptoms and intestinal dysbiosis with organisms that increase inflammation. One of the best ways to treat intestinal inflammation is by promoting the growth of intestinal organisms that produce the short chain fatty acid Butyrate. Food that is high in fibre typically help to promote beneficial species of intestinal organisms. Oats, Apples, Onions, Asparagus, Broccoli, Whole grains, underripe bananas, Legumes, and Berries are some excellent foods shown to promote butyrate production.

Cannabinoids

Cannabinoids, and more specifically cannabidiol (CBD) has been shown to have some interesting mechanisms in the treatment of Long Covid. Strains of cannabis containing high levels of CBD have been shown to block spike protein from entering the cell (via ACE-2 receptors), modulate ACE-2 receptor density on cell surfaces (less doors of COVID to enter) and reduce inflammation. Therefore cannabinoids are very exciting compounds currently being investigated for use in Long Covid therapy.

Conclusions

Long Covid is a multifaceted chronic disease with effects on various physiological systems. Drugs with a narrow therapeutic scope are not going to be as effective as complex compounds that effect multiple physiological processes at the same time. This type of therapeutic synergy is a hallmark of naturally derived medicines and therefore functional medicine is going to play a pivotal role in dealing with this prevalent and highly complex disease state. In my Toronto practice I have had several cases of long covid that only began to resolve once a functional medicine protocol was put into place. So if you know someone who is suffering from Long Covid I recommend connecting them with a local Naturopathic Doctor or Functional Medicine Practitioner.


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01/Feb/2022

Intro

Our world is facing an epidemic of Long COVID over the next decade. Assuming at least 10% of COVID-19 survivors develop long COVID, which is likely underestimated, it is estimated that 5 million people are facing long COVID globally. Long COVID affects multiple systems in the body and therefore requires a multidisciplinary approach. It is a shared opinion amongst several specialists that a functional medicine approach will be needed to rehab these patients back to health. While we are still in the beginning stages of understanding this chronic disease, there are some emerging ideas on how to treat Long COVID as well as some nutritional supplements that may offer a complete or partial solution.

Defining Long Covid

The now accepted technical name for Long Covid is Post Acute Sequelae of CO-V-2 (PASC). While a widely accepted definition is lacking, there seems to be some consensus on the approximate timing of symptoms and the type of symptoms common to a diagnosis of PASC. Onset is typically anywhere from 2-8 weeks after a confirmed or suspected COVID-19 infection and may persist up to 6-months or more. Common symptoms include: fatigue, dyspnoea (shortness of breath), cognitive dysfunction, headache, myalgia, chest pain, joint pain, smell and taste dysfunction, cough, hair loss, insomnia, wheezing, rhinorrhea, autonomic dysfunction (POTS), cardiac and gastrointestinal issues.

Risk Factors

Some of the clearly defined risk factors for developing long COVID include: More than 5 initial symptoms, initial disease severity, female sex, pre-existing comorbidity, prior psychiatric disorder, and old age. There are also certain biomarkers in blood samples that appear to have a correlation with Long COVID including: Increased levels of D-dimer, CRP, IL6, procalcitonin, troponin-1, BUN, neutrophils and decreased levels of lymphocytes.

Pathophysiology

Although the exact mechanisms behind what causes PASC in not completely understood recent research has pointed towards a few mechanisms. For some Long Covid sufferers there seems to be evidence of long term tissue damage in the cardiovascular, pulmonary and neurological systems. There is also prevalence of unresolved inflammation, viral persistence, gut dysbiosis and autoimmunity.

Treatments

The obvious question that everyone would like know is if there are treatment interventions to both prevent and alleviate the symptoms of PASC. The most conventionally accepted treatments thus far are: Personalized rehabilitation programs (light aerobic and breathing exercises), analgesics, antidepressants, ivabradine (for POTS like symptoms) and antihistamines. It is also accepted that treatment to regulate immune and mitochondrial function would be useful. This is perhaps where naturopathic and functional medicine can make an enormous impact.

There is emerging research looking into nutraceutical compounds to help prevent and treat PASC, here is an overview:

Mitochondrial Support: The mitochondria is an energy producing organelle within every cell of our body. In high school science we are taught that the mitochondria is the “power plant of the cell”. Disruptions in mitochondrial function can lead to fatigue, muscle pain, headache and immune dysfunction. COVID-19 infections seems to disrupt mitochondrial function through mechanisms still being investigated but include oxidative stress and alterations in genetic mutation.

Co-factor nutrients that help support mitochondrial function are being investigated for use in treating COVID-19 infection and PASC. These nutrients include: L-Carnitine, Alpha lipoic acid and Coenzyme Q10. A CoQ10 deficiency has been reported in COVID-19 patients and therefore supplementation with this particular compound is of great interest amongst researchers.

Inflammation: Inflammation seems to be driving a lot of the symptomatology in PASC. Inflammatory compounds have been identified in multiple organ systems including the brain, lungs, pancreas and heart. As such one natural anti-inflammatory compound has been identified as being a possible adjuvant therapy in both COVID-19 infection and PASC.

Curcumin is a compound derived from Turmeric and has anti-inflammatory, anti-viral, anticoagulant, anti-platelet and cytoprotective properties. There has been some evidence to suggest that 1000mg of a turmeric supplement restored smell and taste in individuals who lost these senses following COVID-19 infection. Furthermore in vitro studies have demonstrated that curcumin can inhibit coronavirus from entering the cell, and can disrupt some of the signing processes of the virus.

Immune System: Many of the complications of COVID-19 can be attributed to a dysfunctional response of the immune system, either over-reactive or under-reactive. Many compounds that have a direct and indirect role in proper immune system activity are showing promise in treating COVID-19 infection and PASC.

Vitamin D acts as an immune activity regulator, helping to both increase and decrease immune activity as is appropriate to the situation. Some studies have demonstrated that vitamin D supplementation after COVID-19 infection is associated with less ICU admissions and decrease mortality. Another study demonstrated that a combination of vitamin D, selenium and zinc was able to mitigate the course of respiratory complications with COVID-19 infection. It is likely that co-factors and nutrients which help support normal immune activity can shorten the duration of PASC and alleviate symptoms.

Gastrointestinal: Symptoms affecting the gastrointestinal tract are both common in COVID-19 infection and PASC. There is evidence that COVID-19 and its associated spike protein can persist in the gastrointestinal tract for months after confirmed infection.

Autoimmune type syndromes are commonly seen with PASC. One hypothesis for this outcome is a type of molecular mimicry between spike protein and healthy tissue. Spike protein can enter through a compromised digestive tract into the blood stream. Once in the blood stream the immune system can create auto-antibodies in response.

Maintaining a healthy gut/body barrier is emerging as a possible area of treatment in COVID-19 infection and PASC. A healthy environment of commensal bacteria strengthens the gut/body barrier as well as driving the production of healing compounds such as butyrate.

Butyrate is a short chain fatty acid that is produced by beneficial bacteria in our gastrointestinal tract. Butyrate can cross the blood brain barrier and influence regeneration of damaged nerve cells. Probiotic strains belonging to the Lactobacillus and Bifidobactrium categories are

essential for Butyrate production. While probiotic supplementation can assist in developing a healthy gut environment most of the benefit comes from eating foods which help these probiotics thrive. A diet rich in fibre and polyphenols is therefore essential in influencing the growth of beneficial butyrate producing probiotics. Fruit, veggies, and polyphenols like curcumin, luteolin and resveratrol are likely an important part of what will be a holistic approach to treating PASC.

Conclusions: The COVID-19 virus has turned out to be a multifaceted disrupter of homeostasis in a large percentage of those who have been infected. A functional medicine approach to treatment is likely going to have the most profound impact in addressing PASC. We are already starting to see some natural compounds (L-Carnitine, Alpha Lipoic Acid, Coenzyme Q10, Curcumin, Vitamin D, Selenium Zinc and probiotics) having an impact of this ill defined syndrome. More properly funded research in the area of nutraceuticals and functional medicine for treatment of PASC is much needed. In the meantime Naturopathic Doctors and Functional Medicine Physicians have many tools to start treating PASC with safe and effective protocols.

References

Rattis BAC, Ramos SG, Celes MRN. Curcumin as a Potential Treatment for COVID-19. Front Pharmacol. 2021 May 7;12:675287. doi: 10.3389/fphar.2021.675287. PMID: 34025433; PMCID: PMC8138567.

Zahedipour F, Hosseini SA, Sathyapalan T, Majeed M, Jamialahmadi T, Al-Rasadi K, Banach M, Sahebkar A. Potential effects of curcumin in the treatment of COVID-19 infection. Phytother Res. 2020 Nov;34(11):2911-2920. doi: 10.1002/ptr.6738. Epub 2020 Jun 23. PMID: 32430996; PMCID: PMC7276879.

Chabot AB, Huntwork MP. Turmeric as a Possible Treatment for COVID-19-Induced Anosmia and Ageusia. Cureus. 2021 Sep 8;13(9):e17829. doi: 10.7759/cureus.17829. PMID: 34660038; PMCID: PMC8502749.

Alexander J, Tinkov A, Strand TA, Alehagen U, Skalny A, Aaseth J. Early Nutritional Interventions with Zinc, Selenium and Vitamin D for Raising Anti-Viral Resistance Against Progressive COVID-19. Nutrients. 2020 Aug 7;12(8):2358. doi: 10.3390/nu12082358. PMID: 32784601; PMCID: PMC7468884.

Pal R, Banerjee M, Bhadada SK, Shetty AJ, Singh B, Vyas A. Vitamin D supplementation and clinical outcomes in COVID-19: a systematic review and meta-analysis. J Endocrinol Invest. 2022 Jan;45(1):53-68. doi: 10.1007/s40618-021-01614-4. Epub 2021 Jun 24. PMID: 34165766; PMCID: PMC8223190.

Ouyang L, Gong J. Mitochondrial-targeted ubiquinone: A potential treatment for COVID-19. Med Hypotheses. 2020 Nov;144:110161. doi: 10.1016/j.mehy.2020.110161. Epub 2020 Aug 5. PMID: 32795832; PMCID: PMC7403158.

Theoharides TC, Cholevas C, Polyzoidis K, Politis A. Long-COVID syndrome-associated brain fog and chemofog: Luteolin to the rescue. Biofactors. 2021 Mar;47(2):232-241. doi: 10.1002/biof.1726. Epub 2021 Apr 12. PMID: 33847020; PMCID: PMC8250989.

Crook H, Raza S, Nowell J, Young M, Edison P. Long covid-mechanisms, risk factors, and management. BMJ. 2021 Jul 26;374:n1648. doi: 10.1136/bmj.n1648. Erratum in: BMJ. 2021 Aug 3;374:n1944. PMID: 34312178.

Mercola J, Grant WB, Wagner CL. Evidence Regarding Vitamin D and Risk of COVID-19 and Its Severity. Nutrients. 2020 Oct 31;12(11):3361. doi: 10.3390/nu12113361. PMID: 33142828; PMCID: PMC7692080.

Yong SJ. Long COVID or post-COVID-19 syndrome: putative pathophysiology, risk factors, and treatments. Infect Dis (Lond). 2021 Oct;53(10):737-754. doi: 10.1080/23744235.2021.1924397. Epub 2021 May 22. PMID: 34024217; PMCID: PMC8146298.


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


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