Dr. Shawn Reviews...Cannabis: Tweed Argyle Spray
Cold and Flu season is here! Now that kids are back to school and the season is changing we should start thinking about preventing colds and flu. As a Naturopathic Doctor part of my job is counseling parents on safe and effective ways to treat and prevent colds and flu for the whole family. Here are 5 things that will help prevent colds and flu and can even help to ameliorate symptoms and shorten duration of an active infection.
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Probiotics
Probiotics help boost the immune system – Studies have shown that probiotics affect immune cells throughout the body. When certain strains of probiotics are introduced into our intestine they help to repair intestinal cells and they boost production of antimicrobial substances. In one study, 326 children aged 3-5 years were randomly assigned to receive, in double-blind fashion, probiotic supplementation. Treatments were given twice per day in divided doses for 6 months, including the winter season. Compared with placebo, the probiotic group had the following results; fever reduction 53-73%, cough reduction 41-62%, decreased runny nose 28-59%, decreased need for antibiotics 68-82%, reduced absence from school 28-32%.
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Elderberry
Elderberry extracts inhibit bacteria and viruses – Not only does elderberry syrup taste great, studies have shown that it inhibits the bacteria and viruses associated with common colds and the flu. One study demonstrated that an elderberry liquid extract possesses antimicrobial activity against both streptococci bacteria and influenza viruses. Another study looked at 312 air travellers flying from Australia to an overseas destination. Those travellers who took an elderberry extract before, during and after travel had fewer colds, less sick days and less symptoms.
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Vitamin C
Vitamin C supports immune cells – Vitamin C is very important for optimal immune system functioning. Vitamin C helps immune cells get to where they need to be, kill pathogens effectively, protect the body from damage and clean up after battling infections. Studies have shown that adequate vitamin C in the blood helps prevent infections, is necessary to fight infections and helps with recovery. The recommended daily intake of vitamin C is 100-200mg/day; however during active infection, the metabolic demand increases and therefore the requirement for vitamin C is likely to be higher. Even in this day and age, vitamin C is the fourth leading nutrient deficiency in North America. Poor diet and increases in free radical exposure due to an unhealthy lifestyle may be contributing factors. Excellent sources of vitamin C are Broccoli, Citrus Fruits and Berries.
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Zinc
Zinc is essential for immune system communication – The importance of zinc for proper immune function has been well established. Zinc deficiency undoubtedly causes immune system malfunction. The cells of our body are in constant communication. During infection there is a need for effective communication between immune cells in order to get rid of the “bad guys”. Communication happens in the form of chemical messengers and enzymes. Zinc is an essential component of these chemicals and enzymes. As with vitamin C, during active infection our requirement for zinc is likely to increase. Studies have shown that Zinc supplementation during infection can shorten the duration of the illness. Excellent dietary sources of zinc include: Meat, Shellfish, Legumes, Nuts and Seeds. Supplementation may be important with a vegan or vegetarian diet.
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Vitamin D
Vitamin D is the supervisor of the immune system –Vitamin D has many functions in the body, and receptors for vitamin D can be found on many different tissues. One important function for vitamin D is in the modulation of our immune system. Studies have suggested that vitamin D is able to both calm down and rev-up the immune system according to what our body needs it to do. This is why Vitamin D is thought to be as important in autoimmune disorders as it is in infections.
Vitamin D deficiency can cause the immune system to behave erratically. Unfortunately in Canada we have one of the highest incidences of vitamin D deficiency in the world. Our primary source of vitamin D is from sunlight and therefore supplementation becomes important especially during the winter months. Studies have shown that there is a higher incidence of upper respiratory tract infections in athletes who are deficient in the vitamin and who train in the wintertime. Supplementation had preventative and symptom reducing effects. Aside from sunlight, some dietary sources of vitamin D are: fortified foods, fatty fish, beef liver, egg yolks and cheese.
Even vitamins and minerals at high dosages can be dangerous, especially in children. It is always recommended to consult with a health care professional, such as a Naturopathic Doctor, before supplementing on your own.
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Leyer, GJ et al. Probiotic effects on cold and influenza-like symptom incidence and duration in children. Pediatrics 2009; 124-179. Walker, WA. Mechanisms of action of probiotics. Clin Infect Dis. 2008; 46 (Suppl2): S87-91.
Curr Opin Gastroenterol. 2011 October ; 27(6): 496–501. doi:10.1097/MOG.0b013e32834baa4d. Probiotics and immune health Fang Yana and D.B. Polkb,c,d
Elderberry Supplementation Reduces Cold Duration
and Symptoms in Air-Travellers: A Randomized,
Double-Blind Placebo-Controlled Clinical Trial Evelin Tiralongo 1,2, *, Shirley S. Wee 2,3 and Rodney A. Lea 4 Received: 8 February 2016; Accepted: 18 March 2016; Published: 24 March 2016
Krawitz et al. BMC Complementary and Alternative Medicine 2011, 11:16
http://www.biomedcentral.com/1472-6882/11/16
Inhibitory activity of a standardized elderberry
liquid extract against clinically-relevant human
respiratory bacterial pathogens and influenza A
and B viruses Christian Krawitz1†, Mobarak Abu Mraheil1†, Michael Stein2, Can Imirzalioglu1, Eugen Domann1, Stephan Pleschka2*,
Torsten Hain1*
Vitamin C and Immune Function Anitra C. Carr 1, * and Silvia Maggini 2
1 Department of Pathology, University of Otago, Christchurch, P.O. Box 4345, Christchurch 8140, New Zealand
2 Bayer Consumer Care Ltd., Peter-Merian-Strasse 84, 4002 Basel, Switzerland; silvia.maggini@bayer.com* Correspondence: anitra.carr@otago.ac.nz; Tel.: +643-364-0649 Received: 21 September 2017; Accepted: 31 October 2017; Published: 3 November 2017
Biofactors. 2014 Jan-Feb;40(1):27-40. doi: 10.1002/biof.1114. Epub 2013 Jun 27.Zinc signals and immune function. Haase H1, Rink L.
Cochrane Database Syst Rev. 2013 Jun 18;(6):CD001364. doi: 10.1002/14651858.CD001364.pub4. Zinc for the common cold.
Vitamin D3 Supplementation Reduces the Symptoms
of Upper Respiratory Tract Infection during Winter
Training in Vitamin D-Insufficient Taekwondo
Athletes: A Randomized Controlled Trial Hyun Chul Jung 1 , Myong-Won Seo 2 , Sukho Lee 3 , Sung Woo Kim 2 and Jong Kook Song 2, * 1 Department of Kinesiology, College of Health Sciences, University of Louisiana at Monroe, 700 University
Avenue, Monroe, LA 71209, USA; jung@ulm.edu
2 Department of Taekwondo, College of Physical Education, Kyung Hee University, 1732 Deokyoungdaero, Giheung-gu, Yongin-si, Gyeonggi-do 17014, Korea; smilly1004@khu.ac.kr (M.-W.S.); kswrha@khu.ac.kr (S.W.K.)
3 Department of Counseling, Health, and Kinesiology, College of Education and Human Development,Texas A&M University-San Antonio, One University Way, San Antonio, TX 78224, USA; slee@tamusa.edu* Correspondence: jksong@khu.ac.kr; Tel.: +82-31-201-2708 Received: 2 August 2018; Accepted: 10 September 2018; Published: 14 September 2018
Mechanisms Underlying the Regulation of Innate and
Adaptive Immunity by Vitamin D Ran Wei and Sylvia Christakos *
Received: 25 June 2015 ; Accepted: 15 September 2015 ; Published: 24 September 2015 Department of Microbiology, Biochemistry and Molecular Genetics, New Jersey Medical School, Rutgers, the State University of New Jersey, 185 South Orange Ave, Newark, NJ 07103, USA; weira@njms.rutgers.edu
* Correspondence: christak@njms.rutgers.edu; Tel.: +973-972-4033; Fax: +973-972-5594
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.
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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One goal of Naturopathic pediatrics is to use natural therapies to prevent and treat mild to moderate conditions, resorting to pharmaceutical and surgical interventions as secondary options or in emergency situations. The core belief in Naturopathic pediatrics is to encourage the body to heal itself. This is achieved through supporting the immune system, addressing nutritional deficiencies, promoting a healthy diet and lifestyle; including exercise, sleep and mental habits.
Disease as a Process
Fever is an excellent example of how a naturopathic approach may differ from a conventional approach. A fever is our natural defence mechanism against a pathogen. By raising the temperature of the body a few degrees many pathogens (viruses, bacteria) stop functioning optimally and the body activates inflammatory immune cells and enzymes to destroy the invading organism. While conventional medicine often sees disease symptoms, like a fever, as something to be suppressed, naturopathic doctors often see them as something to be promoted.
It has become commonplace to try to intervene in the disease process too swiftly, taking medications to decrease fever and inflammation prematurely. The Naturopathic Doctors role is to recognize the stages of the disease process, closely monitoring a fever, knowing when a fever should be left alone and when intervention is necessary. All the while helping the child feel better without interfering in the healing process.
There are generally 5 stages of the disease process: Incubation, Aggravation, Destruction, Abatement and Reconstruction.
Incubation is where the invading organism is accumulating in certain areas of the body. This process can take hours to days to weeks to months. The immune system reacts and either removes the organism or the organism replicates too quickly and the body moves to the next stage. It is common to not have any obvious signs of infection during this stage.
Aggravation includes the usual signs of inflammation, replication of immune cells, fever, redness, pain, malaise, loss of appetite and fatigue. These are signs that the immune system is hard at work and should be encouraged. This is where suppression commonly occurs with fever reducing medications, and anti-inflammatories, which can revert healing back to the incubation phase.
Destruction is the peak of inflammation and results in the destruction of one organism or another.
Abatement occurs when the fight is over and it’s time to clean up the debris. The immune cells, dead organisms and inflammatory fluids must be removed by the body. The fever “breaks” and sweating begins. Coughing up phlegm, runny nose, diarrhea and other discharges remove the debris from the body. In conventional medicine, cleanup is often viewed as an additional set of annoying symptoms that need to be suppressed by drugs, often impeding on the “cleanup” process.
Fever reductions after administering fever reducing medications should not be confused with abatement. The fever will often spike again. The immune system is trying to do its job but is being suppressed.
Reconstruction happens next. The body is reconstructing damaged tissue, the body is attempting to reset back to its original state.
Most pediatric infections will run their course, and the child will heal themselves. The Naturopathic Doctor watches the disease process closely, waiting to see if the body will heal or get worse requiring intervention. Besides making this decision, it is also the Naturopathic Doctors role to encourage processes like fevers, rather than suppress healing and teach parents to save fever reducing medications until necessary.
Intervention
The Naturopathic Doctor monitors the inflammatory process, only intervening to prevent a severe state of aggravation. Mild interventions such as cooling baths, friction rubs, warming socks can often lower a high fever and help the child feel better. These therapies have their limits and are not always sufficient. It is also the Naturopathic Doctors role to recognize an emergency situation that requires pharmaceutical intervention and to educate the family with regard to monitoring the disease and recognizing an emergency situation.
Safety
The first principle of Naturopathic Medicine is “primum non nocere” first, do no harm. Safety is a combination of good diagnostics, good choice of treatments, prevention, and physician intervention when necessary. The properly trained, properly regulated Naturopathic Doctor should be able to guide the family through a confusing landscape of both conventional and non-conventional medicine by knowing which “alternative” approaches are safe and effective and when referral to another integrative professional or physician will be in the best interest of the infant, child or adult.
Dr. Shawn is now at KidCrew Fridays from 10am-6pm
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.
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:
How to Cook With Cannabis
Dr. Shawn demonstrates how to make edibles with medical marijuana. He’s talking CBD, THC, Terpenes, Cannabutter, Brownies and Pancakes.
Check out this “highly” informative instructional video.
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.
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.
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).
Patient focused integrative health care. Utilizing effective natural approaches designed to be used alone or to compliment conventional medical care.
