Dr. Shawn Reviews...Cannabis: Tweed Argyle Spray
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
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:
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).
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:
- “6 to 8 and feel great”
- “Eat what you need”
- “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
Relax an let go
We need to learn how to relax. Many great spiritual teachings and teachers have at some point arrived at a similar insight. At its essence it’s the importance of relaxation and letting go. A Chinese proverb states “Tension is who you think you should be, relaxation is who you are”. We spend an awful lot of time in a state of tension and many believe this to be a productive state, describing it as “good stress”. In reality, tension of the body and mind is a great inhibitor of creative thought and positive emotions.
Recently I underwent a quest of sorts with a good friend of mine in the wilderness of northern Ontario. We were both very lucky to have walked away from that experience with several insights. The most important lesson was that ones true self and ones ability to act with creativity, love and insight is most possible when the mind is able to let go and the body is able to relax.
Health
It is a fact that stress can negatively impact health if left unchecked. Stress affects the body, mood and behavior; it can cause headache, fatigue, insomnia, anxiety, depression and overeating. A Japanese study from 2002 examined 73,000 Japanese men and women, age 40-79, for two years. Men and women who reported a high level of perceived mental stress had between a 1.5 and 2 fold increase in the risk of stroke and congestive heart disease. [1]
In Kompier and Coopers 1999 publication, “Preventing Stress, increasing productivity: European case studies in the workplace”, the impact of stress related illness in the UK is estimated at an economic cost of 2.5-10 percent of the gross national product, with an estimated 30 million days lost due to stress related illness every year.[2] One can easily see that stress is an impeder rather than a supporter of productivity. Kompier and Coopers publication outlines a very technical analysis of strategies for preventing stress in the workplace; however, as a healthcare practitioner I see and understand the need for a simplified strategy that one can implement anywhere and at anytime.
Training
Thus I return to the idea expressed at the beginning of this article, namely to relax and let go. I can predict that many of you reading this are probably muttering to yourself “easier said than done” or something along that line, and you would be absolutely correct; it is! Experience has taught me that in order for the mantra “relax and let go” to stick it helps to have experienced a prolonged state of mental and physical stillness, awareness, or expanded consciousness. By sampling an elevated state of being one is able to better understand the benefit of a stilled mind and better equipped to return to awareness. Unfortunately it is one of those things that as Morpheus told Neo “you must see… for yourself”.
Many of you that have practiced meditation, living in the moment or even a transcendental occurrence through a near death experience or psychedelics may have a sense of what I am talking about. For the rest, step one is to capture a moment of stillness in order to sew the seed of relaxed awareness. For this I can suggest a few things:
- Go into nature (nature emits a certain vibration that facilitates meditation, or at least filters out the hustle and bustle of modern mechanistic living).
- Practice meditation (for centuries this has been the primary tool used to quiet and focus the mind and body)
- Practice a paradigm shift (try to gain a new perspective on yourself and life by pondering a night sky, life itself and trying to live within the moment).
- Respectfully and responsibly participate in a traditional healing ceremony (A sweat lodge or a ceremony incorporating herbal medicine, often psychedelics, is a centuries old practice traditionally lead through ritual. Psychedelics are traditionally used to promote expansion of consciousness and are gaining favor in modern medicine as possible treatment for PTSD and depression.) http://www.mwikwedong.com/?page_id=131 http://www.rollingstone.com/culture/features/how-doctors-treat-mental-illness-with-psychedelic-drugs-w470673
In order to train a muscle to act in a certain way you must implement repetition, a process known as muscle memory. It is the same with the mind, in order to train the mind to relax and let go you must repeatedly remind yourself to do this. I want to clarify that it is possible to practice this without prior experience in achieving states of expanded consciousness, it is just more difficult to maintain because you may lack the frame of reference as to what to return to and why to return to it. The persistent reminding of yourself to relax and let go may be facilitated with a strategy such as setting an alert on a phone, calendar or clock every 30 or 60 minutes. Ultimately you will find a method that works best for you.
The take away message from this discussion is that we can all be more productive, better listeners, more creative, more loving and more aware when we relax and let go. The “relax and let go method” is simple and can be practiced anywhere, you just simply have to remind yourself to relax and let go. It helps when you have a frame of reference as to what a truly relaxed state of mind and body is; however, it’s not necessary and with enough practice you will get there. There is no trying with this method, it is in essence the complete opposite of trying, one just has to remember, over and over, to relax and let go, relax and let go. https://doctorshawn.ca/about-me/
[1] https://doi.org/10.1161/01.CIR.0000028145.58654.41
Circulation. 2002;106:1229-1236
Originally published August 12, 2002
[2] https://books.google.ca/books?id=OFsSz45OxewC&lpg=PR11&ots=S64R_GVnY2&dq=stress%20and%20productivity%20in%20the%20workplace&lr&pg=PP1#v=onepage&q=stress%20and%20productivity%20in%20the%20workplace&f=false
Patient focused integrative health care. Utilizing effective natural approaches designed to be used alone or to compliment conventional medical care.
