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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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18/Apr/2018

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

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

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

 

Sugar

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

 

Diet

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

 

Nerve Pain

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

 

Cramps and Spasms

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

 

Nerve-Protection

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


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29/Nov/2013

Garlic (Allium Sativum) is an ancient therapeutic food that has been in use since the dawn of medicine. It is mentioned in the bible and has been used by all the great forefathers of modern medicine such as: Hippocrates, Galen and Dioscorides. Garlic is mentioned several times in the Ebers Papyrus, an ancient Egyptian medical text written circa 1550 B.C. Garlic was used topically and internally to treat ailments of the respiratory tract, digestive tract and for infection. Men and women would consume large quantities of garlic to prevent illness and improve endurance. Garlic bulbs have even been found buried in the tombs of Egyptian royalty, such as King Tutankhamen. Garlic continues to be one of the most powerful remedies in the modern day alternative health care practitioner’s toolbox. Fortunately, it has worked so well for so many thousands of years that a significant amount of funding has gone into researching the particular constituents contained in Garlic that lend it its medicinal properties.

Research has shown that sulfuric compounds in garlic are effective at lowering blood pressure, lowering LDL cholesterol, exploding certain cancer cells, and killing some strains of harmful bacteria. The following is an overview of some of the most compelling research on Garlic as a medicinal supplement over the past few years.

In ancient times Garlic was viewed as a tonic of the respiratory and digestive tract, however; persuasive evidence based research demonstrates that it is also a tonic for the cardiovascular system. In 2010 a double-blinded randomized placebo-controlled trial was performed on 51 coronary heart disease patients to determine the effect of time-released garlic powder tablets on the risk of heart attack and sudden death. It was demonstrated that after 1 year on the garlic supplement, men had a 1.5-fold reduced risk for serious cardiovascular disease and women had a 1.3-fold reduction in risk. The reduced risk was extrapolated through the finding that men had on average a decrease in LDL-cholesterol by 32.9 mg/dl and women had a 27.3 mg/dl decrease on the garlic supplement.

Besides high LDL-cholesterol, another marker of risk for cardiovascular disease is hypertension. A Meta-analysis that looked at 1994 randomized placebo controlled trials using garlic preparations as intervention for hypertension found that garlic was significantly more effective than placebo. In hypertensive patients garlic preparations produced an average of an 8.4 mmHg drop in systolic blood pressure and a 7.3 mmHg drop in diastolic blood pressure. A research article published in 2007 demonstrated that the polysulfuric compounds in garlic are converted into hydrogen sulfide by red blood cells. In turn, hydrogen sulfide has the ability to relax blood vessels, therefore decreasing blood pressure.

Over the past decade there have been numerous studies looking into garlic as a potential anti-cancer medicinal food. Studies, which looked at the correlations between garlic consumption and incidence of cancer, haven’t been extremely convincing in either direction. Some correlations do exist, however, which has spawned further investigation into the anti-carcinogenic properties of Garlic. A 2009 study in the journal of Clinical Cancer Research demonstrated that one of the sulfuric compounds in garlic, diallyl trisulfide, may have a beneficial effect on prostate cancer cells. Just like some breast cancers are sensitive to estrogen, some prostate cancers are sensitive to androgens, like testosterone. Bicalutamide is a drug given to some patients with prostate cancer in order to block the effect of testosterone on cancer cells. The diallyl trisulfide found in garlic has a similar effect to this medication, causing a decrease in androgen receptor protein, leading to a decrease in prostate specific antigen levels (PSA).

One of the most fascinating articles that I came across was an article published in 2008 in the Journal of Biologics: targets and therapy. The study looked at the treatment of childhood Pre-B Acute Lymphoblastic Leukemia (ALL) with preparations of garlic extracts compared to common chemotherapeutic agents used in the treatment of this illness. One of the most concerning side effects in chemotherapy treatment, especially of leukemia, is a decrease in white blood cell count and therefore a susceptibility to infection. While both the chemotherapeutic drugs and the garlic extract caused a destruction of cancerous cells, only the garlic extract was reported to not have any detrimental effect on non-cancerous white blood cells. The authors also comment on the fact that garlic is known to be an effective (around 10% the effectiveness of the antibiotic vancomycin) antimicrobial agent against many hospital acquired infective organisms.

In light of the recent cholera outbreak in Haiti, I decided to include the following study published in 2009 in the journal of Bioscience, Biotechnology and Biochemistry. In this study garlic oil was studied for its diallyl sulfide content and its antimicrobial activity against V. cholerae. The in-vitro study found the oil to have bacteriocidal effect against all tested strains of V. cholerae. It was also demonstrated that the garlic oil had an inhibitory effect on the growth of V. cholerae in contaminated food. In my opinion, it wouldn’t be a bad idea for the Centre for Disease Control and Prevention to add regular consumption of garlic to its cholerae prevention protocol in Haiti.

On a final note, I came a cross an article published in 2009 in the Journal of Agricultural and Food Chemistry that confirms the notion that fresh crushed garlic has a greater therapeutic benefit than processed garlic. This is due to a higher concentration of the sulfuric compounds that have been previously mentioned in fresh garlic. Like all food, garlic is potentially aggravating for some individuals and can cause allergic reaction in individuals with an allergy to the Alliaceae family. Be diligent when consuming garlic, especially when adding garlic to the diet of children. I have used garlic in numerous home remedies for cardiovascular health, and for upper respiratory and gastrointestinal infection. The most common complaint I get is the smell. Since the unpleasant odor of garlic is actually emitted from the inside out, it is very difficult to conceal. I have heard that consuming milk with garlic is the best way to cover it up. Cooking the garlic also helps but this greatly diminishes its therapeutic benefit. I now look at this odor as the odor of a healthy heart, and most likely, the distinguished odor of Egyptian royalty.


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29/Nov/2013

One of the key ingredients for a healthy heart is keeping cholesterol under control. Decreasing dietary cholesterol intake can reduce blood cholesterol levels; however, the magnitude of this effect is relatively small. It has been estimated that only 25% of the population will have significant increases in their cholesterol levels in response to increase in cholesterol in their diets. Cholesterol does have a role to play in cardiovascular health but what may be most important is how our cholesterol is handled rather than how much of it we consume. When exposed to oxygen, heat and other forms of processing, cholesterol becomes more of a risk factor for atherosclerosis.

Atherosclerosis

Atherosclerosis, or plaque in the arteries, develops when damaged “oxidized” cholesterol comes into contact with the delicate lining of our blood vessels. Our immune system, in an attempt to fix the damaged cholesterol, sends out white blood cells. When these white blood cells come into contact with the damaged cholesterol they create abnormal frothy cells called “foam cells” which stick to the inside of the blood vessel and can eventually cause a plaque to form. In order for this cascade of events not to occur we must take care of our blood vessels by living a healthy lifestyle and we must avoid subjecting our body to unnecessary oxidized cholesterol.

Oxidation

Oxidation is a chemical reaction where a molecule will loose electrons in the presence of oxygen. A mixture of oxygen exposure and heat can cause this to occur. The “oxidized” molecule will now do anything to get those electrons back, including stealing them from healthy tissues. These oxidized molecules are sometimes referred to as “free radicals” and as the name suggests can wreak havoc on healthy cells.
The way we cook and store our food can prevent unnecessary oxidation of fats and cholesterol, therefore dramatically improving our cardiovascular health.

Cooking Temperature

Most chemical reactions require a catalyst in order to take place. Heat is often the catalyst in the chemical reactions that take place in food. Fats and cholesterol are very sensitive to heat and will become oxidized when exposed to high temperatures. A study in the Journal of Agricultural and Food Chemistry looked at the oxidation of cholesterol under different cooking temperatures. Cholesterol was found to be relatively stable at a temperature of 100 degrees celsius for 24 hours. Temperatures in excess of 120 degrees celsius produced oxidized derivatives of cholesterol within one hour. Oxidation of cholesterol was at a maximum at temperatures in excess of 150 degrees celsius. These results demonstrate that the level of heat at which we cook our cholesterol containing foods (meats, fish, eggs, dairy etc..) will impact the potential for that food to be healthful or harmful.

Cooking Time

Perhaps one of the most interesting studies I came across on this subject was comparing the effect of different cooking methods on the fat quality and cholesterol oxidation of salmon. When comparing steaming to pan-frying it was found that steaming produced twice as many cholesterol oxidation products as did pan-frying. The authors conclude that this is likely due to longer cooking time during steaming, and therefore longer heat exposure. It seems that a delicate balance between time and temperature must be obtained for the healthiest results.

Cooking Method

Not only does the temperature and time affect the quality of the fats we cook, but there is evidence to suggest that the device used to cook may contribute as well. A study done in 2003 looked at the oxidation of cholesterol in microwave cooking and in pan-frying. The results indicated that in beef and chicken patties, microwave cooking produced 3 times as many cholesterol oxidation products as did pan-frying. As an aside, chicken patties had twice as many cholesterol oxidation products as did beef patties.

Food Processing

The processing of food which often includes high heat, high pressure, freeze drying, dehydration, irradiation and chemical additives contributes to the formation of toxic derivatives of cholesterols and fat. Studies have indicated that powdered dairy products, powdered egg products, and smoked meats are some examples of prepared foods that have high potential for toxic derivatives.

Food Storage

Factors which can contribute to cholesterol oxidation during storage are: light, air, temperature, pre-cooking and freeze-drying. As a general rule of thumb it is always best to prepare fresh unprocessed food daily. The following tips will help in the healthful storage of food items. Protect oils and fats (such as olive oil, vegetable oil, fish oil, butter, dairy, meat and fish) from light (use dark glass containers, store in dark environments), heat (store in cool environments), and oxygen (use airtight containers or vacuum sealing).

Conclusion

It is popular knowledge that dietary cholesterol intake has a role to play in cardiovascular health. The common belief is that, with regard to cholesterol, limiting intake is the primary method toward reducing cardiovascular disease risk; however, the amount of cholesterol may be just as important as the type of cholesterol when it comes to cardiovascular disease risk. Proper preparation and storage of oily foods is a disease prevention strategy that can have profoundly beneficial effects on health, and for the most part, is lacking in public awareness.


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29/Nov/2013

Lentinula Edodes is a mushroom native to East Asia which is now cultivated worldwide for culinary and medicinal purposes. This mushroom is usually referred to as Shiitake, which is its Japanese common name based upon the “Shii” tree that the mushroom grows on.

Shiitake has been cultivated for over 1000 years. During the Ming Dynasty (AD 1368-1644) Chinese physician, Wu Jue, wrote that the mushroom could be used medicinally as a remedy for: upper respiratory tract infections, poor circulation, liver pathologies, exhaustion, premature aging and as a Qi (life-force) tonic.

Shiitake has a nutty and earthy taste making it a common delicacy of the culinary world. Many chefs prefer to use sun-dried Shiitake, the drying process seeming to enhance the flavour. Interestingly, the effect of UV light on the mushroom converts ergosterol into vitamin D making the sun-dried variety a significant dietary source of this vitamin. Shiitake is often sauteed in Chinese cuisine, used to flavour soup in Japanese cuisine and steamed, simmered or fried in Thai cuisine.

From a Naturopathic perspective, Shiitake is a fascinating mushroom due to its application in health care, ability to be easily incorporated into the diet and excellent safety profile. Current research is discovering that certain extracts of this mushroom have immune system regulation properties, antibacterial and anti-viral properties, and blood clot inhibiting properties.

A study published by the Journal of Microbiology and Biotechnology in 2009 discovered that polysaccharide extracts of Shiitake were shown to stimulate the function and activation of macrophages. Macrophages are white blood cells that are involved in the body’s initial response to infection (destroying pathogens and sending out chemical signals to the immune system to mount an attack on invading organisms).

In 2006 the Biological Pharmacology Bulletin published a study that examined the efficacy of a hot-water extract of Shiitake on protecting hepatocytes (liver cells) from the hepatotoxic agent D-galactosamine. The result was that 0.5 mg/ml of the Shiitake extract completely suppressed the cytotoxic (liver cell death inducing) effects of D-galactosamine. The study continued to examine the effect of injecting the Shiitake extract into rats treated with D-galactosamine. The result was less leakage of AST and ALT (both chemical markers of liver cell injury).

Lentinan, a common extraction of Shiitake used for medicinal purposes, was researched with regard to its immune regulatory applications in people with HIV. In 1998 the Journal of Medicine (AIDS Activities Division, San Francisco General Hospital) conducted a double blind placebo control trial on 98 patients with HIV. Patients were administered either 2, 5, or 10mg of Lentinan or placebo via I.V. once a week for eight weeks. Side effects of the I.V. administered Lentinan were generally mild when administered over a 30-minute period. The patients in the study receiving Lentinan demonstrated a trend toward increases in CD4 cells (these are the white blood cells that are targeted for destruction by HIV) and in some patients, increased neutrophil (the primary white blood cell involved in the acute response of the immune system to infection) activity.

Like all things we ingest, there is potential for allergic reaction to Shiitake. Be careful and observant when ingesting crude Shiitake or Shiitake extract for the first time.


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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