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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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30/Oct/2019

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

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

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

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

Lions Mane Mushroom
Preparing Lions Mane Mushroom in my kitchen

Inflammation and Depression

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

Immune 

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

Naturopathic Treatment for Multiple Sclerosis

Memory

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

Heart Health

Heart Health

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

Cancer

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

Diabetes

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

Intestinal Health

Digestive Health

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

Nerve Repair

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

Culinary 

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

Citations


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


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

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

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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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21/Jul/2018

It’s the summer of 2018 and it’s a hot one. Having fun in the sun is what we dream about all winter long and while we do benefit from some sun exposure (boosting levels of vitamin D and serotonin) we must also balance sun exposure with sun protection. In this article I will outline some general guidelines with reference to safe sun exposure, getting enough vitamin D and how consuming certain foods may help further protect us during recommended exposure times.

Exposure

According to recent research we now know that vitamin D is not only important for strong healthy bones but also plays a role in preventing some chronic diseases like Multiple Sclerosis and Cancer. So we need to know some general guidelines for getting the right amount of sun exposure while helping protect ourselves from damaging UV radiation.

In 2001 the Australian Radiation Protection and Nuclear Safety Agency set out to determine daily UV radiation levels in major cities across Australia. How much sun was needed to produce adequate levels of vitamin D and how much exposure could produce damage to the skin was investigated. The general guidelines to come out of the report were as follows: In the peak of the summer, July and August in North America, “2 to 14 minutes of sun three to four times per week at midday will give fair-skinned people with 15 per cent of the body exposed the recommended amount of Vitamin D. However, redness (skin damage) can occur in only eight minutes in these conditions.

So in peak summer times from 10 am to 3pm, you should use protection against the sun; shade, hats, clothing, sunglasses and sunscreen.

But earlier in the day and later in the afternoon, for a similar period of sun exposure and vitamin D manufacture, you get much less skin damage.”(http://www.abc.net.au/health/thepulse/stories/2006/04/05/1609208.htm)

For the months just before and after the peak summer months (June and September) the study revealed that the time of sun exposure needed for adequate vitamin D levels increases to 10 to 15 minutes 3-4 times per week. In the fall, winter and early spring months we need short periods of exposure during peak times of the day 10am-3pm in order to make enough vitamin D.

Sun-Blocking Foods

The question then becomes; in those times of recommended sun exposure how do we further protect ourselves from the damage of UV radiation? Part of the answer may be in the food we eat and beverages we drink. UV radiation helps us to make important compounds such as vitamin D but it can also cause damage to our cells. Cellular damage occurs via the production of inflammation and damaging compounds called free radicals. Some important compounds in our diet that combat inflammation and free radicals are: Omega-3 fatty acids and Antioxidants.

Antioxidants are compounds found in fruits and vegetables that serve to protect the plant against the harmful effects of its environment, including UV radiation. Many of these antioxidants incur the vibrant colors we associate with fruits and vegetables onto them.

Lycopene is a powerful antioxidant found in red colored fruits and vegetables such as: Tomatoes, Watermelon, Guava, Grapefruit, Papaya and Red Peppers including Chili Pepper. Lycopene is most easily absorbed when it has been cooked, making tomato paste and cooked tomatoes an excellent source of bio-available lycopene. Not only does this antioxidant protect the fruit/vegetable from UV damage, when we consume lycopene, it protects our body as well.

Anthocyanidins are a group of antioxidants that incur free radical protection and have a dark red or purplish color. Rich sources of anthocyanidins include: Blueberries, Acai, Pomegranate, Blackberries and Cherries.

The flavonoid antioxidants in green tea include the very powerful polyphenol EGCG. EGCG has not only been shown to inhibit tumor cells in some cancers but has also been shown to protect cells from the aging effects of UV radiation. Particularly matcha green tea (pulverized powdered tea leaves) can be 137 percent higher in EGCG than regular water infused tea leaf. Dark chocolate is also very high in phenols and can incur a 25 percent increase in sun tolerance at 2 ounces of over 70% cacao per day.

Another compound important for protecting our body against the potentially harmful effects of sun exposure are omega-3 fatty acids. These fatty acids help to drive an anti-inflammatory pathway in the body. Radiation and chronic disease induces inflammation which can lead to cellular damage and premature aging. Fish is an excellent source of omega-3 fatty acids, particularly Salmon, Herring, Mackerel, Trout and Sardines. It is recommended to eat at least 2 servings of high omega-3 fish per week or to take a fish oil supplement daily.

Another good source of omega-3 fatty acids are flaxseeds. Flaxseeds also contain compounds called lignans which may protect against the development of some cancers. It is recommended to have a half teaspoon of ground flaxseeds per day or a flaxseed oil supplement.

Although these are all specific examples of foods rich in sun protecting compounds, a good general rule of thumb is too eat plenty of vibrantly colored fruits and vegetables which will undoubtedly be rich in antioxidants. It is also just as important to limit foods which can cause free radical damage and inflammation, these include: sugar and red meats.

Equip your body with sun protecting foods and follow the guidelines as to when to allow for uninhibited sun exposure. By doing so you will make the D and be problem free.

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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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16/Mar/2018

Why get a license?

I want to tell you how to obtain a license for Medical Marijuana. Every month I see a handful of patients who are trying to medicate with unregulated cannabis obtained either through “a guy” or a local illegal dispensary. The problem with this approach is that you are buying an unregulated product, meaning you cannot guarantee its purity, quality, potency, and cannabinoid profile.

There are some decent products out there but largely its hit and miss and perhaps the most frequent complaint is a lack of consistency from batch to batch. Its funny how patients will be shy about discussing use of medical marijuana with me and yet will go to a complete stranger for their medication. A growing part of my practice is convincing patients to transition from their “street weed” to a proper regulated medical marijuana product.

Although, as a Naturopathic Doctor, I am not able to directly prescribe medical marijuana in Ontario, I am fortunate to have a good professional relationship with a licensing clinic and am writing an average of 3-5 patient referrals per week. Most licensing clinics will require a referral from a healthcare professional.

How to get a license

The process is quite simple: a patient will come in either having experience with cannabis or will be curious as to whether cannabis can help them. I will then preform an assessment, including a health history and short physical exam, in order to determine if they would benefit from cannabis. A referral is then made to the licensing clinic. The licensing clinic then calls the patient to setup an appointment to get a license for access to medical marijuana. Once setup with an account the patient then does all their ordering online through a regulated distributor such as Tweed, Aphria, Tilray or MedRelief.

These regulated grower/distributors have an excellent selection of strains and oils with varying cannabinoid concentrations and terpene profiles. Most importantly, the purity and potency are guaranteed and there is very high consistency from batch to batch. Therefore, if you find a strain or oil that works for you, you can pretty much guarantee it will work the same way every time you order it.

Common conditions for referral

The most common conditions I write referrals for are: Insomnia, Multiple Sclerosis, Chronic Pain, Migraine, Irritable Bowel Syndrome, PTSD, Inflammatory Bowel Disease, Cancer, Fibromyalgia and Neurological Conditions with painful spasms.

The environment in Canada with regard to cannabis is going to change as we approach legalization, but until that happens I would advise you that it is usually better to consume regulated medicines, this medication just happens to be marijuana.

 

For more great articles and information on cannabis and CBD check out the link below:CBD Oil Room


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31/Oct/2017

Clinical Endocannabinoid Deficiency

Clinical endocannabinoid deficiency, (CED), was first introduced by Dr. Ethan Russo M.D. a neurologist, psychopharmacology researcher and former advisor to GW pharmaceuticals. The theory of CED is based on the concept that many neurological conditions are associated with neurotransmitter deficiencies, for example, a deficiency in dopamine with Parkinson’s disease. Subsequently, an endocannabinoid deficiency might be present in some disorders sharing predictable clinical features.

 

All humans possess an underlining endocannabinoid system governed by two primary compounds; Anandamide (AEA) and 2-Arachidonoylglycerol (2-AG). These are compounds naturally made in our body that interact with the same receptors marijuana and associated cannabinoids act upon. It is known through various studies that when endocannabinoid tone is decrease there is a lower pain threshold, disrupted digestion, mood and sleep disturbances. A deficiency of endocannabinoids can be caused by genetics, injury or disease.

Migraine

There is evidence for CED in several treatment resistant syndromes, most notably in Migraine, Fibromyalgia and Irritable Bowel Syndrome. All three present with: heightened pain sensitivity, mood disruption, and comorbidities. One study in chronic migraine sufferers discovered a statistically significant difference in endocannabinoid concentration within the cerebral spinal fluid of chronic migraine sufferers vs. non-migraine sufferers. With migraine there is a strong association between endocannabinoids and blood vessel dilation, a key component of the propagation of migraine. Furthermore activation of the CB1 cannabinoid receptor decreases pain fiber activity in the sensory nerves of the face and head.

Endocannabinoid levels in Migraine Cerebral Spinal Fluid

It is worth noting that Cannabis was a mainstay treatment of migraine for a century between 1843 and 1943. A study from 2016 looked at the effects of medical marijuana on migraine headache frequency in adults. Headaches diminished from 10.4 to 4.6 attacks per month and overall 85.1% had decreased migraine frequency.

Fibromyalgia

Much like Migraine, Fibromyalgia is associated with hyperalgesia. In an uncontrolled trial of nine patients Tetrahydrocannabinol (THC) was administered in doses of 2.5-15mg a day for 3 months. Unfortunately 5 patients left the study early due to secondary THC side effects but those completing had marked reductions in subjective pain visual analog scales (VAS) 8.1 at start to 2.8 after 3 months. A survey of 1300 respondents called the National Pain Report from 2014 demonstrated that marijuana was the most effective treatment for Fibromyalgia compared to Duloxetine, Pregabalin and Milnacipran.

Cannabis treatment in Migraine

Cannabis most efficacious in Fibromyalgia

Irritable Bowel Syndrome

Another syndrome suspected of CED is Irritable Bowel Syndrome (IBS). The role of the endocannabinoid system in the gut is to regulate propulsion, secretion and inflammation. Cannabis was one of the first medications used for secretory diarrhea associated with cholera. A study done in 2007 demonstrated that endocannabinoids AEA and 2-AG influences the contractile force in the muscle fibers of the gastrointestinal tract. Studies also have demonstrated that there are increased levels of immunoreactive nerve fibers (TRPV1) causing pain and hypersensitivity in IBS. Cannabidiol (CBD) seems to increase AEA, which in turn reduces the activity of TRPV1. In 2007 a randomized control trial of 52 normal patients were given a single dose of 7.5mg THC. The outcome on the gastrointestinal tract was increased colonic compliance, inhibited postprandial tone, and a trend toward relaxation of fasting colonic tone.

There are a number of other conditions demonstrating evidence for CED, including motion sickness, Multiple Sclerosis, Huntington’s disease, Parkinson’s disease and Post Traumatic Stress Disorder (PTSD).

Conclusion

There is good evidence for disruption of the endocannabinoid system in Migraine, Fibromyalgia, IBS and many other neurological and psychiatric syndromes. Besides a wealth of anecdotal benefit, there exists some clinical evidence to support cannabinoids as a safe and effective treatment in these conditions. We also need to come to terms with the fact that effective medications are lacking in these conditions. An obvious shortcoming of past studies is the use of single cannabinoids for treatment such as THC. I am certain that future studies incorporating a more complete cannabinoid profile, including CBD, as a treatment approach will have far better outcomes and far fewer side effects. Lifestyle choices also play an important role in endocannabinoid function, specifically low-impact aerobic exercise. Multimodal approaches including diet, lifestyle and cannabinoid therapy will ultimately be the best approach in CED syndromes.

 

At my clinic I have repeatedly seen the benefits of cannabinoid therapy in these syndromes. After an initial assessment, if indicated, patients are referred to a medical cannabis clinic for registration under a licensed producer under the Access to Cannabis for Medical Purposes Regulations (ACMPR).


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12/Sep/2017

Intermittent fasting is a different way of thinking about eating.

I’m suggesting that the majority of people have been eating too much and too often. I’m suggesting that breakfast is not the most important meal of the day. By following a few simple guidelines my readers can  loose weight, feel great and be healthier than ever before. The guidelines are:

 

  1. “6 to 8 and feel great”
  2. “Eat what you need”
  3. “Respect your food, respect yourself”

 

6 to 8 and feel great

Everyday eat within a 6 to 8 hour time frame. If you eat breakfast at 7:00am then your last meal of the day should not be later than 3:00pm. If you eat lunch at 12:00pm then your next and last meal should be no later than 8:00pm. In the first scenario you are basically skipping dinner and in the second scenario you are skipping breakfast. Water, tea, and even coffee are allowed outside of the 6-8 hour allotted time frame as long as there is no added calories, i.e. sugar, milk and or cream. There is also no snacking outside of your 6-8 hour window.

Now let me tell you why and how intermittent fasting works. Immediately after eating, a hormone in your body called insulin rises. Insulin tells your body to burn carbohydrates (sugar) for energy and to store whatever hasn’t been used in your liver and fat cells. This process continues for approximately 4 hours after eating. After 4 hours insulin drops and your body begins to dip into stored sugar and fat reserves for energy; or in other words that’s when you start burning fat.

It’s common practice for most people to eat 3 times a day with snacks in between, this means that we almost never dip into our fat stores. Therefore you would have to do some intensive daily exercise or eat incredibly small portions to loose weight. By following the 6-8 rule; you can almost be certain that you will be burning fat for approximately 10-12 hours per day. The only thing keeping you from shedding excess pounds is by being excessive with portion size and calorie intake, which brings us to the next guideline “eat what you need”.

 

Eat what you need

This guideline basically translates to portion control. One advantage about using the 6-8 methodology is that you will start becoming more in tune with your body and more aware of hunger and satiety. It is a great feeling to eat when you are actually hungry rather than out of habit. When we experience hunger, food is digested better. Hunger causes your gastrointestinal tract to prepare for food, including ample amounts of stomach acid aiding in the proper breakdown and absorption of nutrients.

Pay close attention to the point at which you no longer feel hunger and you are adequately satiated. Do not overeat. Eat to a point that you feel satisfied but not heavy and bloated.  You may notice that portion sizes become smaller. Now, because we are eating only two meals per day, it is also important that when we eat, we eat nutritious food and a variety of foods. Which brings us to the next guideline.

Respect your food; respect yourself

This guideline is about what kind of food you eat and how you eat it. As mentioned in the previous section, since we are essentially eating only twice per day, we want to be putting high quality foods into our body. Fresh, local and organic foods are what you want to focus on. The great thing about this diet is that it there are no restrictions on foods, it’s more about quality. Try to have meals that have a good quality protein, and complex carbohydrates such as veggies and whole-grains.

While making healthy choices is very important, it is also just as important not to stress over your food. Do your best to cook healthy while acknowledging that sometimes you will find yourself eating out, ordering fast food, and having desserts. Don’t beat yourself up about the choices you make, love whatever it is your eating, own it and do your best to eat healthy most of the time. Love your food and love yourself.

 

Final Thoughts

The guidelines I have purposed, although expressed in an original way, are not new concepts. Eating within a 6-8 hour window is also known as intermittent fasting; a lifestyle and medical intervention that shown to have a multitude of health benefits including lowering blood pressure, staving off cardiovascular disease and improving longevity. Presenting these ideas in away that is easy to incorporate into a daily routine can help to improve the lives of many people. I encourage you to try it out, give it a few weeks and let me know how you feel.

Fitness trainer Mike O’Donnell (2 meal mike) does a great job of further explaining intermittent fasting and how to easily incorporate it into your daily routine. I encourage you to visit his site http://www.theiflife.com


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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