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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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11/Jul/2022

Fasting for six years

I thought it was a good time for me to personally reflect on the last six years of intermittent fasting. Yes, for the last six years I have been following a relatively strict program of fasting for 16-20 hours of the day. Usually this means having my last meal of the day around 6pm and my first meal the following day at 11am.

I remember first hearing about the benefits of intermittent fasting (IF) at a medical conference organized by the Association for the Advancement of Restorative Medicine back in 2016. After Dr. Denis Wilson M.D. spoke about all the clinically supported benefits of IF as well as his own personal journey with IF, I was sold!

Fasting and Climbing

That was around the same time I started to take rock climbing seriously. A was training 2-3 days per week and for around 2 hours each session. I decided it would be an interesting experiment to combine IF with my morning training. I was hitting the gym while in a fasted state (usually around 16 hours at that point) and would train as hard as I could.

When the body is in a post 14 hour fast it starts to convert fat into an energy source called ketones. This is because all the sugar stored in the body has been used up. Exercising while fasting speeds up this process. I was amazed to see how quickly this combination of fasting and exercise transformed my body and my health. Over the course of a year I lost 15lb and went up several grades in my climbing. My climbing partners couldn’t believe I was able to climb hard on an empty stomach, but I actually felt lighter and clearer. I would try to have my first meal of the day within an hour after workouts for optimal protein metabolism to build muscle. I would regularly get comments from familiar faces at the gym asking if I’m doing anything special outside of the gym. I simply told them that I’m fasting and climbing. Pretty simple but very effective.

Finding the right program

Over the following 5 years I had short 2-3 week periods where I would take a break from IF but would soon return as I felt my best, looked my best and climbed my best while on a pretty strict IF program. I have since recommended IF to dozens of patients, the majority of whom see results within a few months. One of my biggest supporters and now followers of IF is my dad. He saw such dramatic results that IF is now a regular lifestyle habit for him as well.

I dabbled a few times with doing pretty long fasts (20-23 hours) and eating only one meal per day but I found that this was a bit hard on my body. I was getting irritable and was not performing very well at the gym. I now have a pretty good understanding of how many hours my body likes to fast for and how many meals per day is best.

Everyone is going to find a sweet spot for themselves. I don’t recommend forcing the body into a particular program but to try fasting for different lengths of time and see what feels and works best. It does take a little getting used to at first but it is important to remember that this is a very natural state for the human body.

It’s only natural

Through most of human evolution humanity had to go for extended periods of time without food. In fact, an abundance of food at our beck and call is likely contributing to a lot of chronic disease in our modern way of living. Many religious traditions still practice fasting in order to clear the mind, body and spirit. Centuries of cultural practice as well as hundreds of recent studies are in support of fasting in one form or another. It is one of the cheapest, simplest and most effective medical programs I can recommend for a patient.

What lies ahead

Looking ahead to the next decade, I don’t see myself giving up IF anytime soon. There are a few other lifestyle changes I would like to implement but IF will continue to be the backbone of my personal health and wellness program. There are some individuals including in pregnancy where IF is not recommended. I encourage those of you curious about IF or trying it out, to at least have a consultation with a health professional like myself. The benefit of being supervised by a Naturopathic Doctor is the peace of mind that your are practicing something that is safe for your body, you have someone to answer questions as they arise and even to run blood tests if necessary. If I have inspired at least a few people to give IF a try then I have passed along a valuable lifestyle tool as it was passed to me six years ago. Happy fasting everyone!


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06/Jul/2022

What is NAD?

NAD IV therapy was described to me as a “game changer” while I was at a medical conference in Arizona. Up until then I had regularly treated my patients with vitamin and mineral infusions to help restore energy, sleep and manage the physical symptoms of stress amongst other things. I had come to terms with the fact that I could expect about a 60-70% response rate in my patients who were being treated for chronic fatigue. A colleague told me that NAD would be a game changer and that I could expect to see better and more consistent results. After my first NAD patient texted me the following day that they felt like a million dollars, I was sold to the idea.

NAD stands for nicotinamide adenine dinucleotide. It is a coenzyme that our body requires in order to convert food into energy and for facilitating many biochemical reactions. We need NAD to metabolize nutrients, proteins, carbohydrates and fats. NAD also impacts the functioning of cells, formation of muscle and regeneration of tissue. Studies have shown that low NAD levels are detrimental to muscle development, while elevated NAD levels could improve muscle health.

Like many fundamental nutrients and hormones, NAD levels decline as we age. This can prompt changes to our metabolism, energy levels, and our biochemistry over time. Low NAD levels can also make us more susceptible to age-related diseases and health concerns, such as Alzheimer’s, sarcopenia, and inflammation. NAD has even been touted as an anti-aging nutrient.

At my Toronto Naturopathic located in York MIlls,  between the Bayview village area and Leaside, we have started to incorporate NAD into many of our IV infusions. Here are some of the outcomes of NAD therapy backed up by clinical research:

Cognitive dysfunction

Boosting NAD intake can impact brain health by improving neuronal function, protecting brain cells from harm, and driving mitochondrial functioning. Animal studies have shown that a group of signalling proteins called sirtuins may be linked to memory and learning. Sirtuins protect the body from amyloid proteins, which are related to Alzheimer’s and other degenerative diseases. Sirtuin production relies on NAD. Boosting NAD levels may likely help protect the body from amyloid proteins via sirtuin production.

Recovery from substance abuse

Excessive consumption drugs and alcohol can cause damage to organs and tissues including the brain. Studies have shown that substance abuse can specifically cause a drop in NAD levels. NAD is fundamental in the repair and detoxification pathways engaged after consumption of drugs and alcohol. Boosting NAD levels with IV therapy can help with cravings while mitigating brain fog, anxiety and fatigue.

Athletic Recovery

Proper energy metabolism and inflammatory pathways are fundamental in athletic recovery from training and injury. NAD supplementation helps to optimize energy metabolism through mitochondria activity, increases blood flow and reduces inflammation. These benefits in turn help to hasten the recovery phase and lessen muscle pain.

Chronic Fatigue

If you’re struggling with Chronic Fatigue or Myalgic Encephalomyelitis (ME), NAD could offer some alleviation. One of the ways NAD works via the mitochondria is by  boosting the production of ATP. ATP is the primary energy source of all cells in the body.  Boosting NAD levels via IV infusion helps to increase ATP production thereby reducing the severity of chronic fatigue syndromes.

Wondering how you may benefit from NAD supplementation? Give me a call or email and we can discuss how NAD may help you reach your health and wellness goals.


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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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09/May/2022

The mind body connection

The mind and body are closely connected through thousands of chemical messengers. When we have a mental experience the brain sets off a cascade of neurotransmitters and hormones that affects our body. For instance when we experience joy, our body produces the hormone oxytocin. Oxytocin reduces blood pressure, stress hormone, anxiety and promotes growth and healing. Conversely, when we experience an emotion like sadness this can raise stress hormone, increasing blood pressure and eliciting negative effects on the immune system. Psychotherapy can therefore have a big impact on the health of our body by modifying mental outlook and thus inducing positive chemical messengers to the rest our body. An example is cognitive behavioural therapy, which has well documented success in the treatment of depression, anxiety and stress. https://pubmed.ncbi.nlm.nih.gov/ 31004323/

We can also treat conditions of the mind through our body. In pharmaceutical medicine, drugs like anti-depressants can block the breakdown of the neurotransmitter serotonin. Serotonin is involved in mood and therefore in some individuals boosting serotonin activity can improve mood and decrease anxiety. However, some short falls of pharmaceutical medicine is that it can often cause unwanted side effects and have a narrow therapeutic range; meaning that too little may have no effect and too much can be deadly. There are also issues with dependancy and addiction.

On the other hand nutritional and herbal supplementation can be an effective treatment for depression, stress and anxiety without the same safety concerns as drugs.

Supplementation for depression

Depression is both a physical and emotional condition. We know that depression can impact the reproductive system, immune system and our nervous system. Nutritional deficiencies can arise as a result of long standing depression and can be a precursor in the development of a depressive condition. Deficiencies in vitamin B12, vitamin D and protein are associated with depression. https://pubmed.ncbi.nlm.nih.gov/ 23377209/ In my Toronto clinic we can identify and correct nutritional deficiencies and make a big impact on depressive symptoms.

There is also a lot to be said about the impact of chronic inflammation on brain and mental health. Research has shown that chronic inflammation can increase susceptibility to depression. https:// pubmed.ncbi.nlm.nih.gov/32553197/ At the Toronto clinic we treat inflammation using supplements such as curcumin, omega-3 fatty acids and cannabidiol (CBD). These supplements can improve depressive symptoms through modulation of inflammation.

Furthermore many natural health products like CBD can also impact neurotransmitters (brain messenger chemicals) directly associated with depression. Through the interaction of cannabinoid receptors, 5-HT1A (involved in serotonin regulation) and neurogenesis factors CBD can act similarly to an anti-depressant medication but with less potential for adverse effects. At the Toronto clinic I offer cannabis education and counselling when cannabinoids would benefit a patients condition.

Supplementation for Anxiety

Anxiety disorders are the most common mental illness in the United States effecting close to 20% of the population every year. While genetics play a significant role in the development of an anxiety disorder, biological and environmental factors are pivotal as well. We know that there are often disruptions in serotonin and dopamine, cortisol and adrenaline in anxiety syndromes. A common class of drugs used in the treatment of anxiety are the benzodiazepines (Xanax, Valium, Ativan etc…). Although these medications can be very effective, they often have significant side effects (drowsiness, depression, constipation). Benzodiazepines can also be difficult to stop once started. One of the most significant mechanisms in which anti-anxiety medications work is through the GABA receptor system.

GABA is an inhibitory neurotransmitter, meaning that it helps to calm the nervous system and muscular skeletal system. Benzodiazepines have a very strong effect on GABA receptors making them effective but also potentially dangerous.

Many nutraceutical compounds activate the GABA pathway but with a gentler effect than benzodiazepines. Pharma GABA (GABA produced by bacteria), Passionflower, St. Johns Wort, Taurine, 5-HTP and CBD all have well documented effects on GABA and Serotonin. At the Toronto clinic we use these compounds successfully in the treatment of anxiety syndromes with less potential for adverse effects.https://pubmed.ncbi.nlm.nih.gov/ 11679026/

Supplementation for Stress

Every single human being experiences stress throughout their life. Stress can be a healthy natural process in the right circumstances and at the right time. Stress becomes pathological when it is experienced chronically and without appropriate instigation. Long lasting stress can have detrimental effects on multiple biological systems including the immune system, endocrine system (hormones) and cardiovascular system. https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC5137920/

There are no specific pharmaceutical interventions in the treatment of stress. Benzodiazepines are the most common class of drug prescribed for debilitating stress and as I mentioned in the section on anxiety, benzodiazepines can have significant side effects and issues with dependency.

Since there is a wide spectrum of factors that can cause stress a “one size fits all” approach is not always effective. The naturopathic approach is fundamentally holistic and therefore takes into account mental, emotional and physical stressors. For instance a change in work schedule may be contributing to sleep disruption, leading to insomnia, poor work performance and nutritional disruption.

Furthermore, there is an entire class of nutritional and herbal supplements called adaptogens. Adaptogens have the ability to modulate cortisol (stress hormone) preventing peaks and dips in cortisol levels throughout the day. Overtime treatment with adaptogens facilitate a more balanced cortisol output avoiding periods of hyperactivity and burnout. To my knowledge there are no pharmaceutical drugs that act in a similar way. Some common adaptogens are: Ashwagandha, Rodiola and Siberian Ginseng. Vitamins like Vitamin C and Magnesium can help support adrenal function further helping the body to avoid burnout in periods of prolonged stress. At the Toronto clinic I use these adaptogenic compounds in conjunction with other treatments to provide a safe and effective treatment plan for chronic stress.

The mind can be treated through the body. Pharmaceutical interventions can be effective but often come with safety concerns around adverse effects and dependancy. There are many safe and effective natural approaches to mental health conditions through supplementation. At my Toronto clinic we specialize in developing an individualized plan to help achieve your mental health goals.


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13/Apr/2022

Intro

Let’s take a look at 5 of the most common chronic issues that we experience as a a result of modern living: Stress, Insomnia, Anxiety, Depression and Pain. While there are some pharmaceutical medications that can be effective, most individuals would rather seek a safe and effective alternative approach. Here I will outline these conditions individually and describe some of the most effective treatments that I use at my Toronto naturopathic clinic Physic-Logic.

Stress

Stress is an unavoidable biological response to a threat. The human body developed the stress response in order to escape immediately threatening situations like wild animals and hunting for food. The stress response evolutionarily developed to kick the body into high gear in particular situations and for relatively short intervals. Stress demands a lot from our body in order to perform at a very high level. An increased output of hormones, vitamins and minerals are utilized during the stress response.

The reality is that in modern day living we perceive stress from a variety of situations that are outside of our evolutionary makeup. For example, many if not all of us experience financial stress, workplace stress, relationship stress, medical related stress etc… If we do not have effective coping strategies these stressors, overtime, use up our bodies resources and lead to burnout.

Chronic stress can also be a trigger in the development and resurgence of chronic illnesses like autoimmune disease, allergies, gastrointestinal disease, migraine and skin conditions. At our Toronto Naturopathic Clinic we have several therapies that help to support the body through stress. Adaptogenic herbs like Rhodiola and Ashwagandha help to balance cortisol levels, evening out the highs and lows of a stress response. Magnesium, b-vitamins and vitamin C help to support the adrenal glands which can experience a state of fatigue when under prolonged stress. Acupuncture can help to bring the body into a calming parasympathetic state after prolonged periods in sympathetic fight and flight mode. All these holistic modalities work together to bring a patient out of stress induced fatigue while allowing a better more controlled stress response in the future.

Insomnia

One of the most important foundations for health is good sleep. Most adults require 8-10 hours of sleep for optimal performance whereas in reality 5-7 hours seems to be the norm for most many patients. Not only is sleep duration important but quality uninterrupted sleep is important as well. Our body will have trouble healing and functioning optimally without adequate sleep quantity and quality.

There are 3 types of insomnia that I typically see in my Toronto Naturopathic practice: 1. Sleep initiation insomnia (trouble falling asleep) 2. Sleep maintenance insomnia (trouble staying asleep) and 3. A combination of both initiation and maintenance insomnia. Some of the most common issues causing insomnia are due to anxiety, stress, pain and discomfort. Therefore a successful approach to treating insomnia needs to take into consideration the root causes of the insomnia and the type of insomnia.

Many of the pharmaceutical approaches to insomnia have issues with dependency, addiction and grogginess. The pharmaceutical treatments don’t typically consider the issues causing the insomnia or the type of insomnia either. At my Toronto Naturopathic clinic Physio-Logic I use a combination of time tested approaches to pinpoint the specific areas of sleep that have been disrupted. For instance melatonin can be a very effective treatment for insomnia but many patients don’t realize that there is more than one type of melatonin and that dosage is very important. A fast acting sublingual melatonin may be very helpful to initiate sleep but not effective at maintaining sleep throughout the night; whereas a prolonged release melatonin is often much more effective for sleep maintenance issues. Similarly Cannabis and cannabinoids can be used for insomnia but fast acting inhaled forms are better suited for sleep initiation whereas longer acting oral forms are more useful for sleep maintenance. At our Toronto Naturopathic clinic we take into consideration all the nuances in the diagnosis of insomnia to come up with the most effective and safest course of treatment.

Anxiety

Most of us have experienced anxiety at one point or another and like stress, anxiety in specific circumstances and in relatively short durations is perfectly normal. When anxiety becomes a daily or long lasting biological response we simply cannot function optimally and start placing our body at risk of chronic disease.

Stress and anxiety are closely related with anxiety being more of the mental emotional response and stress being more of the physical response to a perceived threat. A big issue with chronic anxiety is that it becomes a vicious cycle perpetuating itself; the experience of anxiety creates more anxiety and the fear of its return creates more anxiety. The brain, much like muscle has a memory and the more times specific pathways are engaged the harder it becomes to break those physiological habits.

Anti-anxiety medications often fail at producing long lasting results without side effects because they where often designed for treating other conditions; as is the case with anti-depressant medications. A recent breakthrough in anxiety medicine has revealed that our endocannabinoid system has a significant role in the maintenance of balanced mental emotional health. Therefore compounds like cannabidiol (CBD) which act to support the endocannabinoid system have been shown to be effective and safe in the treatment of anxiety with minimal side effects.

Promotion of a healthy lifestyle including daily exercise and a healthy diet can further support the endocannabinoid system and are therefore extremely effective strategies in their own rite. At my Toronto Naturopathic Clinic Physio-Logic we combine several strategies including cannabinoid education to formulate an effective strategy to break the anxiety cycle once and for all.

Depression

Depression is a spectrum ranging from mild symptoms to severe symptoms. While pharmaceutical medication is often necessary for more severe forms of depression, functional medicine can be very effective in treating mild to moderate depression.

Most anti-depressant medications work by keeping higher levels of serotonin in the brain and nervous system. There are many natural compounds that can achieve similar results with a less specific but more holistic mode of action. The net effect is something that is gentler than a pharmaceutical drug but with less potential for dependency and side effects. One example is the flower St. Johns Wort which s backed by several studies confirming its efficacy in treating mild to moderate forms of depression.

Nutrition and exercise are also fundamental in treating all forms of depression and unfortunately as symptoms get worse so do the potential for lassitude and malnourishment. Intervention at the early stages of depression can often allow the patient to utilize holistic therapies effectively and prevent the need for a more aggressive pharmaceutical approach. At my Toronto Naturopathic Clinic, we use functional and holistic medicines from both eastern western medical traditions to treat mild to moderate depression safely and effectively. Some of these treatments include: herbal therapy, acupuncture, intravenous therapy and lifestyle counselling.

Pain

One of the biggest obstacles to cure is pain. Chronic pain interfere with the activities of daily living, disrupting sleep and making exercise impossible. Chronic pain also places physical stress on the body, over time leading to physical burnout and deficiency. Unfortunately many of the most effective pharmaceutical strategies for pain management are linked to addiction and long term side effects. Gastritis (inflammation of the stomach) is a common condition I see in practice linked to long term use of Non steroidal anti-inflammatory medications like Advil and Naproxen. Fortunately there are many safe and effective treatment options within naturopathic and functional medicine.

Pain is often linked to a few common phenomena: lack of circulation, inflammation, tight muscles and neurological injury. Many holistic treatments such as acupuncture, cupping, moxibustion, laser therapy and massage work to improve circulation and loosen tight muscles. Many vitamin, mineral and herbal therapies are excellent for controlling inflammation. Curcumin is a compound derived from the spice turmeric and has years of scientific research demonstrating its strong anti-inflammatory properties without side effects. Using electric current in conjunction with acupuncture can be a safe and very effective treatment for neurological injury. At the my Toronto Naturopathic clinic we utilize many different tools and strategies to provide a safe, effective and individualize treatment for both acute and chronic pain.

Conclusion

Many of the health concerns that we experience in modern society can be safely and effectively treated with a Naturopathic approach. I would encourage anyone experiencing stress, insomnia, anxiety, depression or pain to have a consultation with a Naturopath or other functional medicine doctor. Unfortunately it is all too common for patients to first step into my office after years of trying to manage symptoms using only a pharmaceutical approach. It is never too late to try a more holistic approach. You will be surprised at how effective these treatments can be.


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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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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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25/Jun/2021

Traumatic brain injury is damage to the brain that is the result of a head injury. Quality of life is greatly diminished for those living with a traumatic brain injury. Even fatal results can occur. As the quantity of study devoted to CBD develops, there is the rise in the query that whether CBD can help in treating brain injury or not. Currently, the research indicates that CBD possesses neuroprotective properties. Such effects can include mitigating the effect of head injuries.

A flexible and effective anti-inflammatory cannabinoid that has few to no adverse effects is known as cannabidiol or CBD. The number of conditions treatable with CBD increases daily with the introduction of fresh scientific information. There is emerging evidence that CBD is starting to be used as a treatment for severe traumatic brain injury.

TBI can happen to anyone who suffers from brain trauma, and it can affect every aspect of life.

What Do We Understand from Traumatic Brain Injury?

Any brain injury merits serious concern. The brain goes through a cascade of reactions after sustaining a significant injury. Inflammation, edema, and immunological activation are included in this list.

Though this is a usual and helpful set of reflexes in response to a break or fracture. Additional neurological damage might result from this set of events. 

When brain cells die, the damage to the brain as a whole will soon follow. Common TBI patients include people who have served in the military, professional athletes, and victims of motor vehicle collisions. TBI can have enduring and crippling repercussions, and might manifest emotionally, physically, behaviorally, and socially.

A lot of the time, these impacts are life-altering. As well as cognitive deterioration and impaired motor function, depression and anxiety are common side effects. Severe symptoms among certain people with TBI can also result in seizures. Conventional medicine currently lacks effective treatments for minor TBI, which is an underreported and frequently misdiagnosed condition.

Scientific Evidence Which Says CBD is Effective for TBI

CBD is showing some evidence of usefulness in reducing some of the harmful effects of TBI, specifically in the areas of inflammation and neurological complications.

A paper published in Frontiers in Pharmacology claims that “The Endocannabinoid System Possesses Potentially Drugable Receptor and Enzyme Targets for the Treatment of Varying TBI Pathology.”

In addition, there are numerous studies which suggest that in combination with THC, CBD is neuroprotective, indicating that regular ingestion of cannabinoids reduces the likelihood of a catastrophic brain injury.

More and more research about TBI is becoming available with each passing year. A variety of research studies agree that the ECS plays a major role in the development of mental, bodily, and behavioral responses after a TBI. 

Although further study is needed to produce precise protocols that may be accessible and recommended by mainstream medicine, some preliminary research has already been done. Each example is adding information to the outlook for the condition treated with cannabinoids.

Anecdotal Support for Using CBD as a Treatment for Brain Injury

It takes years for new scientific information to be studied and released. To draw a conclusion, you first must subject the drug being investigated, in this case CBD, to rigorous testing.

While scientific studies take time, evidence exists for the benefits of cannabis in treating brain injury based on anecdotes from patients.

CBD has the potential to improve the quality of life for people who have suffered a brain injury by allowing them to increase their quality of life. 

Final Words

CBD’s brain-healing qualities are not yet fully understood and must be investigated further. Much research is being conducted regularly, and soon we will get a clearer understanding of the role of CBD in TBI. The current research suggests that CBD has some properties which can help increase quality of life in brain injury, but we cannot be sure how effective it is or if it has any side effects. We have to wait for more research to be conducted and results to be announced; only then can we be sure about how effective it is to use CBD as a treatment for brain injury. 

About the author:

Sean Roberts is a writer by profession. He is a full time writer working with NY Marijuana Card, a leading clinic that provides medical marijuana recommendations. He aims at educating people about the medicinal use of cannabis https://nymarijuanacard.com/


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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

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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