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:
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.
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.
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.
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.
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.
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.
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/
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.
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.
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.
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.
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.
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.
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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.
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.
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.
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.
“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.
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.
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.
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.
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.
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.
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.
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.
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.
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!
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Anti-Inflammatory Effects of Ethanol Extract of Lion’s Mane Medicinal Mushroom, Hericium erinaceus (Agaricomycetes), in Mice with Ulcerative Colitis. |
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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.
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.
Exercise 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 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.
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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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.
[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.