Dr. JoAnn Yanez on KCAA 06/12/19

Dr. JoAnn Yanez, AANMC executive director, joins KCAA’s NBC LA affiliate On the Brink to discuss naturopathic approaches to Post-Traumatic Stress Disorder (PTSD).

Full Transcript of Interview Below.

Topics Include:

  • PTSD statistics
  • No “statute of limitations” on trauma
  • Different ways symptoms may be presented
  • Coping mechanisms
  • Resiliency
  • Creating your safe space
  • And more…

Erin Brinker: Welcome back. I’m Erin Brinker.

Tobin Brinker: And I’m Tobin Brinker.

Erin Brinker: And we are On the Brink, the morning show on KCAA AM 1050, FM 106.5 and FM 102.3. I’m so pleased to welcome back to the show Dr. JoAnn Yanez. She is the Executive Director for the Association of Accredited Naturopathic Medical Colleges and the Chair of the Academic Collaborative for Integrative Health. She also serves on the Integrative Health Policy Consortium Education Committee. Weaving a passion for illness prevention into her professional life, Dr. Yanez’s career has spanned advocacy, academia, patient care and public health. As AANMC’s Executive Director, Dr. Yanez oversees research, advocacy efforts and the joint academic endeavors of the Accredited Colleges of Naturopathic Medicine. Additionally, she helps spread awareness of naturopathic medicine as a viable and satisfying career path. Dr. Yanez, welcome back to the show.

Dr. JoAnn Yanez: Good morning. Hi. How are you?

Erin Brinker: I’m good. Are you surviving this heat?

Dr. JoAnn Yanez: In the pool.

Erin Brinker: Yeah, because that’s really the only place where you can be comfortable.

Dr. JoAnn Yanez: It is, it is. California problems. I can’t complain too much.

Erin Brinker: No. You know, anywhere you live, there’s going to be a season that’s uncomfortable. It’ll be too cold or too hot or too sticky or too whatever. This is our uncomfortable season. But for nine months out of the year or eight months out of the year, it’s pretty awesome here, so we can’t complain.

Dr. JoAnn Yanez: Yes. Agreed.

Erin Brinker: So, one of the challenges that we’ve been talking about, the 9/11 responders and some of these diseases of despair that we’re seeing, so, depression and suicide and drug addiction and alcoholism. For many people, PTSD is the driver. So, some sort of trauma is the driver behind this. From a naturopathic standpoint, how do you treat PTSD?

Dr. JoAnn Yanez: It is so complex and comprehensive, Erin. It’s estimated that about 70% of adults in the U.S. have experienced some sort of traumatic event at least once in their lives, which… Just swallow that for a moment. 70% of adults.

Erin Brinker: 70%.

Dr. JoAnn Yanez: Yes, and when you look at the military, PTSD is a huge issue. And one, actually, that unequally impacts, women over men. 17% of the combat troops are women. However, 71% of female military personnel develop PTSD, commonly including because of the sexual assault as well as combat. And so, when you look at those numbers overall, it’s a military issue, it’s a civilian issue. And from the naturopathic approach, like we’ve talked about before, we take a whole-person approach. And oftentimes these traumatic events… Sometimes people will register that something as traumatic and sometimes they won’t even necessarily have processed fully, the event until much later.

Many, many times I’ve heard from people while we’re getting a history and we’re developing a relationship in that process of the naturopathic interview, which is extremely comprehensive, we will hear that folks may not have fully put the pieces together on a traumatic event. “Oh, man. You know, I had this teacher in college 30 years ago who was touching my thigh inappropriately. And ever since I’ve felt X,” and they may not have fully, in the moment, realized what was happening, but later on it starts to come to them. So, there’s no statute of limitations on trauma.

Erin Brinker: No.

Dr. JoAnn Yanez: And so, I think that what happens is… And that event, in and of itself, can become traumatizing and re-living things and thinking about it and processing it and what could I have done differently or what do I do about this? And so, with the ND approach, we take a very whole-person approach. We look to address the root cause.

I remember a patient I had had many years ago. She had chronic insomnia, she was in her 60s and had tried everything. Acupuncture, medication, counselors. You name it. And we did an approach, kind of modified cognitive behavioral therapy, that addressed the root of the issue, which for her, involved her parents… Her dad was in a cult and she had to not only watch things, but she would also stay hyper-alert at night to make sure her younger sister didn’t get taken. And so-

Erin Brinker: Oh my gosh.

Dr. JoAnn Yanez: Awful. Absolutely awful. And she had been to counselors and she’d worked through things, but the cognitive behavioral therapy helps people reframe and take the emotion and the fear out of the actual event. And she followed up the following week and shared that she had slept for the first time through the night. And this is a woman in her 60s who experienced this in childhood. And so, some of the mind-body approaches can be very helpful.

The other thing about PTSD, like you were alluding to earlier, is that the symptoms can manifest in a lot of different ways. There can be cardiac symptoms like heart palpitations. There can be anxiety and depression. Folks may self-medicate with pharmaceuticals or prescription-

Erin Brinker: Or food.

Dr. JoAnn Yanez: … or nonprescription drugs or food or sex. And so, they will use, sometimes we call maladaptive coping mechanisms, to deal with the stressors and ultimately suicide as that last-ditch maladaptive coping mechanism, if you want to even call it that.

At the end of the day we really look to the whole-person approach and care. So, there may be supplementation and maybe addressing some of the other things that are manifesting while we’re getting to the root cause of the post-traumatic stress and working on some of the issues that way.

Erin Brinker: So, one of the challenges in low-income communities, communities of poverty, is that there very often are traumatic events, one on top of the other. You have incarceration, you have people who frequently have to move around because they have unstable housing. There may have been homelessness, there may have been addiction. And so, the kids who grow up in that environment-

Dr. JoAnn Yanez: Food insecurity.

Erin Brinker: Oh yeah, food instability, lack of healthcare. Very often, unstable family situations. There may be parental figures that move in and out of the child’s life or not there at all. There could be kids going into foster care. And so, how is a child who grows up in that environment? That’s got to impact them forever. And how do you overcome that from a naturopathic standpoint?

Dr. JoAnn Yanez: Again, it is so complex and it’s so individual. There are people… Some of this, and I hate to… Nobody is at fault here. I don’t want for one minute for any of this to be construed that, you know, a child who’s being bounced in and out of foster care or someone who has been placed in circumstances that they have no control over is at any way at fault. There is a resiliency. And I had a mentor years ago. There are a lot of euphemisms in this, but when you lose, “don’t lose the lesson” or when you fall, “it’s not about the fall, it’s about the get-up.” And so, the resiliency piece and fostering a spirit of resiliency is not… We’ve talked about positivity before, and not that any of those types of things are positive, but folks who are able to find their personal happiness and who are able to create some sort of a positive out of the situation are more resilient and less able to see the negative impact.

Resiliency has been studied quite a bit, and the types of personalities and traits that foster resiliency. And in and of itself, if a person is coming to see a naturopathic doctor for conditions like this, they’re obviously exhibiting that they want help.

Erin Brinker: Right.

Dr. JoAnn Yanez: Or any other practitioner for that matter. They’re saying that they want help. So, the first step is acknowledgement. The first step is saying, “Something not so great happened and I want to get help for this. I’m worth the help. I want to get better.” And so, that is the first step, is just identifying it and recognizing the need for care and committing to that. So, with naturopathic medicine, we will focus on mind-body medicine, there may be botanical medicine. Other types of therapies like acupuncture have been used.

I remember seeing a patient. You want to talk multiple traumas? He was a military vet who fell on homelessness, he got involved in some illegal activities, he was incarcerated. During his incarceration, he contracted hepatitis and HIV.

Erin Brinker: Oh, my gosh.

Dr. JoAnn Yanez: And so, he was homeless and he was surviving. And when he first came in, there was a huge bravado about him. He was talking about all the people he’d killed and how tough he was. And he was homeless, dirty. I laid him down. I said, “This is a safe place for you.” I was, honestly, a little scared myself.

Erin Brinker:  I bet.

Dr. JoAnn Yanez: I kept the door open, just a crack. But I sat with him and I listened and I did some acupuncture and I left. And came back to check on him, took the needles out. Didn’t see him again. And I figured, with his housing situation, maybe he’s moved or not able to get to the clinic or what have you. And I really didn’t give it too much more thought.

And then a few months later, my front desk person says, “Hey, Dr. Yanez, there’s somebody here to see you. They don’t have an appointment.” And I said, “Hold on a minute. I’m running in between, checking on patients.” And so, I went to the front and I didn’t recognize anybody in the waiting room.

And my front desk person said, “No, no, no. Come over here. This gentleman wants to talk to you.” And it turns out this was the homeless man. He was clean-shaven, he got into a halfway house and he had started counseling boys at risk and he wanted to come back and tell me thank you.

Erin Brinker: Oh, my goodness.

Dr. JoAnn Yanez: And so, it’s the type of thing that you never know. Sometimes you could see a patient for years and not get that kind of reaction or maybe all somebody needed was someone caring and showing that they cared. Very often in these types of situations when you’re dealing with homelessness or abuse, people feel un-cared for. They don’t feel safe. Creating a safe space is a very important.

I’ve learned a lot of different guided imagery/hypnosis therapies over the year. And one of the first things that I used to do with folks was to create a mental image of a safe place. Because as you’re going to ask them to go to those places that were not safe, you want to give them a tool to be able to feel safe when they start to feel scared.

Erin Brinker: Right.

Dr. JoAnn Yanez: And so, we would create this mental safe place. Some people would bring in Jesus, some people would bring in their teddy bear or some people will bring in their dog. It varied and there was no judgment. Your safe place is your safe place. And whatever it was that made you feel safe and secure.

And so, I think that there are so many different ways to approach it. Each patient’s going to be different. Each patient’s going to need something different. And the great thing about a naturopathic doctor’s education is that we learned so many tools and we can pull from those to find the appropriate ones for the patient at that moment in time.

Erin Brinker: Wow. Wow. So, we are just about out of time. How do people find and follow you and learn more about the AANMC?

Dr. JoAnn Yanez: Oh boy, we’re all over the interwebs! You can find AANMC all over social media. Just Google AANMC and we will pop up. We have a webinar next week led by a veteran, Dr. Radley Ramdhan, who’s going to be talking about his work with PTSD and veterans, and his own journey with PTSD. And so, he’s a naturopathic doctor. He’s a recent grad and wonderful guy, and is going to be leading our webinar next week on PTSD.

Erin Brinker: Well, Dr. Yanez, Dr. JoAnn Yanez, it’s always a treat to have you on the show. Thank you so much for joining us today. For those of you all who are interested in being a naturopathic doctor, maybe you’re kind of thinking, “Huh, that might be interesting,” you can go to AANMC.org for the Association of Accredited Naturopathic Medical Colleges to get more information. Dr. Yanez, thank you so much for joining us.

Dr. JoAnn Yanez: Thank you for having me. Have a great day.

Erin Brinker: Thank you. You too. All right, so with that, it’s time for a break. I’m Erin Brinker.

Tobin Brinker: And I’m Tobin Brinker.

Erin Brinker: And we are On the Brink, the morning show on KCAA. We will be right back.

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Brain Food: The Naturopathic Kitchen

When asked, many people would jump at the opportunity for a better memory into their aging years. “Cognitive impairment” is a common and can involve memory loss, trouble with learning, difficulty concentrating, and challenges with decision-making. Symptoms can range from very mild to more severe dementia type and may result in loss of independence. According to a MetLife Foundation survey, Americans over 55 fear getting Alzheimer’s more than any other disease!1 Similarly, according to an article published in the London-based newspaper, The Telegraph, two-thirds of people over 50 are scared of developing dementia, while just one in 10 were frightened about getting cancer.2

The number of people living with cognitive impairment in the US is equal to twice the population of New York City!3 The baby boomer population is most at risk as age is a considerable risk factor. Other risk factors include genetic predisposition, being diagnosed with diabetes, high blood pressure, or obesity, or lifestyle factors like being a smoker, not exercising, or not being socially active. But what if there was something that could be done to help preserve and protect brain function? What if that something was at the end of your fork?

Most of us are aware of the things we shouldn’t eat such as fast food, packaged foods, and refined sugar. We know the impact overindulging on these types of foods can have on our body. But what many are less aware of are the things we should eat.  That’s where The Naturopathic Kitchen resources are useful, to offer education on the health benefits of natural herbs and foods. When it comes to brain health and preserving important brain functions like memory, cognition, and concentration, the food we eat can play a big role in supporting both short- and long-term brain function. The brain requires a lot of energy to function optimally, using around 20% of the calories we eat each day to operate.4 The choices we make in the foods we consume each day can have a big impact on both the structure and health of our brains.

Some of the top plant-based foods to include in a brain-boosting diet include:

Nuts and Seeds

Nuts are low in saturated fats but contain higher levels of both monounsaturated and polyunsaturated fats. Scientific research has found that higher levels of nut intake were associated with better brain function as we age.5 Nuts and seeds are also rich sources of antioxidant powerhouses like vitamin E (found in higher amounts in sunflower seeds, almonds, and hazelnuts). Human studies have validated the critical role of vitamin E in protecting the central nervous system.6 Vitamin E has been shown to protect cognitive performance in terms of learning and memory as well as emotional response.6

Nuts and seeds are also important sources of minerals like selenium (especially high in Brazil nuts), zinc (found in pumpkin seeds), and many others. Selenium has shown to be involved in diverse functions of the central nervous system, such as motor performance, coordination, memory and cognition.7 Selenium is widely distributed throughout the body, however one particular attribute of selenium biology is that brain has the highest priority to receive and retain this nutrient even in cases of selenium deficiency.8 Studies have demonstrated the abilities of selenium to prevent oxidative damage, morphological changes, and cognitive decline.9


Berries such as strawberries, blueberries, raspberries, blackberries and others are very high in antioxidants. Berries have particularly high levels of a subclass of flavonoids called anthocyanidins (the compounds responsible for the dark blues, purples, and reds associated with various berries), that have the ability to cross the blood-brain barrier where they localize in areas of learning and memory.10 Substantial experimental data have established that berry supplementation enhances nerve cell function and survival, and effectively reduces age-related cognitive impairment in experimental models.10 Blueberries have demonstrated an ability to improve measures of memory such as word recall after just 12 weeks of consumption.11


Most people will likely be able to tell you that green vegetables are good for you, but fewer may be able to explain why they are great for the brain! Greens such as kale, chard, spinach, bok choy, and broccoli are rich in vitamins and nutrients, many of which have demonstrated remarkable influence on brain structure and function. Green vegetables are a good source of vitamin K. While vitamin K may be most well-known for its role in blood coagulation, research has shown it also has an emerging role in brain health. Vitamin K is involved in the production of a specific type of fat-based molecule called a sphingolipid that is part of the cell membrane of all nerve cells in the brain.12 Other protein-based biomolecules that depend on vitamin K are also being discovered. These molecules play a number of roles in cellular communication as well as roles in the growth and survival of nerve cells and the specialized glial cells that are responsible for surrounding neurons and providing support for and insulation between them.13 Emerging data also point to unique actions of the K vitamer menaquinone-4 (MK-4) against oxidative stress and inflammation.12

Dark Chocolate

Believe it or not, chocolate contains many compounds that are of important biological activity. Dark chocolate is a particularly rich source of antioxidants. The brain is highly susceptible to oxidative stress, which increases during aging and is considered a major contributor to the degenerative breakdown of nerve cells so having adequate antioxidant support available is vital to preserving health and function.6 Dark chocolate is a particularly rich source of antioxidants and may be uniquely helpful in supporting brain health. Research shows that consuming dark chocolate (at least 70% cacao) may improve brain plasticity, which is crucial for learning, and may also provide other brain-related benefits.14  Further research suggests that the flavonoids contained in chocolate may encourage neuron and blood vessel growth in areas of the brain involved in memory and learning as well as stimulate blood flow in the brain.15

Let’s try out some brain-healthy recipes!

For more tasty recipes and to learn more about the health benefits of natural foods, visit The Naturopathic Kitchen!

Summer Berry Salad


12 c mixed organic lettuce
1 c organic strawberries (sliced)
1 c organic blueberries
1/2 c organic raspberries
1/2 c organic boysenberries
1 1/2 c slivered almondS


1/2 c extra virgin olive oil
1/4 c organic rice vinegar
1/3 c organic raspberries
sea salt to taste

*Non-organic berries are often highly sprayed with pesticides. Choose organic berries whenever possible.


Chop lettuce into small bite-sized pieces and place in a large bowl. Mix in berries and almonds. Top with raspberry vinaigrette dressing.

Thank you to Like Mother Like Daughter  and The Healthy Home Economist for theses delicious recipes!

Nut and Seed Granola


¼ c pure organic maple syrup
2 T extra virgin olive oil
1 c slivered almonds
½ c pecans, roughly chopped
¼ c unsweetened shredded coconut
3 T sunflower seeds
1 T sesame seeds
1 T ground flaxseed
¼ t sea salt


  1. Position an oven rack at the bottom of the oven and preheat to 325 degrees F.
  2. Whisk maple syrup and oil together in a large bowl. Add the almonds, pecans, coconut, sunflower seeds, sesame seeds, flaxseed and salt then toss to coat.
  3. Spread the mixture out on a baking sheet and bake for 20 minutes. Remove from the oven, then scrape and toss mixture around and continue to bake until golden and still slightly sticky (about 10-12 minutes more) or for a deeper, toasted version, bake until deeply golden (about 13-15 minutes more).

Thank you to Food Network for this wonderful recipe.

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Naturopathic Approaches to PTSD

Post-Traumatic Stress Disorder (PTSD) is a growing concern in America. Experiencing trauma can be a life changing event, one that can impact an individual’s ability to experience a joyful life and participate in normal daily activities. Experiencing a traumatic event is not rare. Approximately 70% of American adults have experienced at least one traumatic event in their lifetime.1 It is perfectly natural to feel fear during a traumatic event and nearly everyone will experience some degree of reaction afterwards. Of course, not everyone who experiences a traumatic event has lasting challenges as a result of it. Approximately 20% of those who experience a traumatic event will go on to develop PTSD.1

Many people associate PTSD with military personnel who have been in combat situations. Although PTSD is common in this population, it certainly does not discriminate. PTSD can impact children and adults, old and young, male and female (though women are twice as likely as men to develop the condition).1 Those who develop PTSD may feel frightened, anxious, or stressed even when there is no inherent danger. People who develop PTSD may feel very “on-edge” and may react strongly to noises, sights, and situations. They may have trouble sleeping, have unsettling memories, and avoid anything that reminds them of the event (even if that thing was something they once enjoyed.)2

PTSD is an extremely complex condition which requires an equally comprehensive treatment plan in order to offer the best chance of permanent recovery. 39%  of people diagnosed with PTSD seek out complementary and integrative health approaches.3 Naturopathic physicians are uniquely trained to offer PTSD treatment options that span a variety of therapeutic options. A naturopathic approach to managing and treating PTSD may include:

Mind-Body Medicine

Mind-body medicine contains among the most well-researched means of managing PTSD. There are a number of therapies that could fall in this category, however not all have been proven empirically effective. Some techniques, proven to help PTSD, include Cognitive Behavioral Therapy (CBT) and Eye Movement Desensitization and Reprocessing (EMDR), both of which are utilized by the US Department of Veterans Affairs as treatment options for service members with PTSD.4

Cognitive Behavioral Therapy

Cognitive Behavioral Therapy (CBT) is, at its core, a combination of the fields of cognitive and behavioral psychology. It is based on the idea that psychological concerns are often manifested and maintained through distorted thoughts and maladaptive behavior. Sessions are focused on current problems and encourages the development of solutions to those problems. the goal of the therapy is to support the client in developing and implementing effective strategies to reduce psychological distress. Research has shown that CBT has the ability to significantly reduce the symptoms of PTSD.5

Eye Movement Desensitization and Reprocessing

Eye Movement Desensitization and Reprocessing (EMDR) was developed as a means of helping people deal with the emotional distress that often accompanies a traumatic event.6 The goal of EMDR therapy is to impact the negative feelings about the event by focusing less on the traumatic event itself and more on the disturbing emotions and symptoms that result from the event.7 The Research on EMDR is plentiful. Scientific evaluation has shown that after just three 90-minute EMDR sessions, 84-90% of single trauma PTSD sufferers no longer had the condition.6 Further research reported that 100% of single-trauma victims and 77% of multiple-trauma victims no longer had PTSD after a mean of six 50-minute EMDR therapy sessions.8

Botanical Medicine

The current understanding of the development of PTSD involves dysregulation among a branch of the nervous system known as the autonomic nervous system (ANS). The ANS has a direct role in how the body responds to stress.9 There are a number of botanical medicines that can impact the stress response (adaptogens) and the balance of the nervous system (nervines). Though certainly not an exhaustive list, herbal formulas containing herbs such as eleuthero (Eleutherococcus senticosus), licorice (Glycyrrhiza glabra), wild yam (Dioscorea villosa), Schisandra (Schisandra chinensis), oats (Avena sativa), Holy Basil (Ocimum sanctum), and Rhodiola (Rhodiola rosea) may be particularly useful.

Energy Alignment Therapies

Therapies that utilize and seek to align and balance the energetic pathways of the body can also be useful in the naturopathic management of PTSD. Among the most common are craniosacral therapy, homeopathy, and acupuncture.

Craniosacral Therapy

Craniosacral therapy is a gentle, hands-on treatment that is focused upon the removal of restrictive forces within the meningeal membrane system and all of the bones of the skull and vertebral column, including the sacrum and coccyx to which these membranes attach.10 This technique is essentially risk-free in terms of potential hazards or negative side effects. Studies have been conducted specifically evaluating the effectiveness of craniosacral therapy in the treatment of PTSD. Research shows that craniosacral therapy has the ability to make a positive impact on PTSD symptoms.11


Homeopathy is actually a discrete system of medicine that was developed by German physician, Samuel Hahnemann over 200 years ago. Homeopathic medicine has its own diagnostic methods and prescriptive methods. The homeopathic approach takes into account every available indication related to the possible troubles in the whole person.12 There are hundreds of potential remedies that could benefit someone with PTSD. Prescription of a homeopathic remedy is very individualistic and relies on the totality of the individual and not just specific symptoms related to the condition being treated.


Acupuncture as a medical treatment is thousands of years old. It involves inserting very fine needles into specific points in the body for therapeutic or preventive purposes. Acupuncture has been widely used for a number of psychiatric conditions.13 Preliminary results for the use of acupuncture in the management and treatment of PTSD are encouraging. Clinical trials in combat veterans with PTSD are currently underway.14

Naturopathic physicians are uniquely trained to use a multitude of techniques and therapies to manage conditions like PTSD and work with patients to address the root of the issue. Click here to find an ND near you in the US and Canada.

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Dr. Lisa Ghent – BINM

“I thrive on helping people feel better, not just for a few months, but for the rest of their lives. Often it’s about helping people to discover what is most important to them and showing them ways they can prioritize differently.”

Laying the groundwork to become an ND

Frustrated with the lack of help she was receiving from conventional medicine, Dr. Lisa Ghent discovered naturopathic medicine as a patient struggling with fertility. With a background in the medical field, she saw medicine in a new light, and was inspired by the holistic approach to patient care. “Considering everything about a patient – mind, body, soul –  was so different than what I had previously been exposed to. Something just felt right about naturopathic medicine.”

BINM as a springboard

Following her gut instinct, Dr. Ghent took the leap of faith and completed her naturopathic medical degree at the Boucher Institute of Naturopathic Medicine, while working full-time and having three kids throughout the program. “The experienced and caring faculty took an interest in helping me hone my skills. I wouldn’t be where I am today without them.”

Following graduation, Dr. Ghent opened a small private practice where she saw patients on evenings and weekends while working a corporate day job. She admits that it was challenging to balance family, school, and a full-time job, however her determination and hard work paid off after two years when her patient base was established enough to allow her to practice full-time.

Dr. Ghent opened a clinic earlier this year, offering family-focused and community-oriented care. “For me, running a business has always been about staying true to my core values. It’s always been incredibly important to me to provide practical and affordable healthcare. I am blessed to work with other like-minded local health care practitioners and I can’t wait to see what the future holds.”

Finding fulfillment as an ND

As a naturopathic doctor, “I thrive on helping people feel better, not just for a few months, but for the rest of their lives. Often it’s about helping people to discover what is most important to them and showing them ways they can prioritize differently.”

As a mother of three, and the wife of a pilot, career flexibility was big component to pursuing naturopathic medicine. “When things with my kids are really important, I can be there, and that is important to me.”

Advice for aspiring NDs

“This is a profession that requires you to be all in if you want to be successful, so your why has to be meaningful.” Pursue your passion by taking time to shadow or interview a local naturopathic doctor, and visit the naturopathic medical schools you are interested in to determine the best fit for you!

Learn more about Dr. Ghent



Learn More About Becoming a Naturopathic Doctor

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Naturopathic Approaches to Skin Care

The condition of our skin can make a tremendous difference in how others perceive us as well as how we perceive ourselves and has been linked to profound impact on psychological health. According to Psychology Today, Americans spend more on their appearance than on social welfare, health, and education combined.1 While many people may scoff at this as pointless and tragically shallow, the desperation to look good may be rooted in something much deeper than vanity. Body image accounts for about one-quarter to one-third of your self-esteem, a major influence on your overall psychological health.1

The connection between skin and psyche is so deep that multiple studies have shown significant associations between skin disorders and psychiatric based conditions like depression, anxiety, and even suicidal ideations.2 What is interesting however, is that the severity of the skin condition is only weakly related to the severity of the psychological condition.1 This means that someone who has a relatively mild skin condition may take a deeper psychological hit. Large-scale international studies have shown that those with skin conditions such as eczema, acne, psoriasis, have higher incidences of depression, with 10% of those with psoriasis carrying the more severe diagnosis of clinical depression.2.3 Similar large-scale population studies have further shown significant associations between acne, eczema, and psoriasis with suicidal thoughts. In fact, a German study showed that 16% of patients with atopic dermatitis had suicidal ideation compared with 1% of the controls.4 The psychological scars can remain even after the skin condition has resolved.1

The naturopathic approach takes into consideration the mind, body and spirit. NDs will work with patients to uncover the root of skin issues and to mitigate impacts in other organ systems.

Uncovering the root cause skin issues

Naturopathic physicians have many tools to aid in the treatment of skin conditions and its overall cause and effect on the whole person. Because the practice of naturopathic medicine is rooted in finding and removing the cause of the problem, the issue of chronic and ongoing “flares” and “break outs” may be less common with a naturopathic approach. Utilizing a holistic, whole-person perspective means that the entirety of the individual will be addressed, not just the symptomatic area of concern. Some of the most common ways that naturopathic physicians approach treating skin conditions include:

Support digestion and gut health

Most people have heard of the “mind-body connection” but what about the “gut-skin connection?” The gut and skin are uniquely related in structure and function. Serving as our primary interface with the external environment, both have a dense vascular network and extensive nerve supply that is core to its role in neuroendocrine and immune function.5 A mounting pile of scientific evidence has confirmed the depth of the connection between the gut and skin, and multiple studies link GI health to skin health, particularly for inflammatory skin conditions like acne, eczema, and psoriasis.5 Naturopathic physicians have long been aware of this link and will take steps to assess, measure, and treat gut health as part of the approach to dermatological care.

Address food allergies and sensitivities

The digestive tract is home to about 80% of the human immune system.6 Since the gut regularly interacts with bacteria, yeast, viruses, and other microbes from the external environment, the job of this immune system is to help protect us from the onslaught of microbial invaders. Sometimes the immune system can become a little too vigilant in its protective role and can mistakenly start to attack normal food that we have eaten, resulting in food allergies and food sensitivities. This immune reaction sets off an inflammatory cascade that can manifest on the skin in the form of various breakouts and blemishes as well as inflammatory skin conditions like acne, rosacea, and eczema. Fortunately, there are blood tests that can assist in the identification of foods that may be causing the body to mount an inflammatory response. Knowing which foods are problematic and avoiding those foods in the diet for a time can help control a variety of skin conditions and allow the skin to heal.

Mitigate inflammation pathways

Inflammation is a normal and beneficial facet of immunity. In the short term, it helps drive the appropriate cells to the area where they are needed, supports removal of damaged tissue components, and advances the healing process. However when inflammation becomes long-term and chronic, the consequences can be quite serious.7 Inflammatory conditions of the skin can be impacted by local inflammation and reactivity of the cutaneous immune system as well as to inflammation in other areas such as the gut and overall systemic inflammation. Taking steps to minimize inflammatory activity in the body through any number of means can be a key feature of managing skin conditions. Moving to a more plant-based diet, avoiding food sensitivities, utilizing anti-inflammatory herbs, spices, and other nutrients are all ways that naturopathic physicians seek to curb inflammatory activity.

Balance detoxification pathways

There are multiple pathways by which the body utilizes to eliminate waste and toxins. Collectively, these organs and body parts are known as emunctories. Among these are the lungs, liver, kidneys, GI tract, and of course, the skin. A pace of detoxification commensurate with the ability of the emunctories to freely discharge toxins is essential for efficient elimination of toxins.8 When any one of these pathways is blocked or impeded, the others must take up the slack. The result is that they can become congested and overloaded from managing the increased workload. This can lead to the skin becoming a veritable wasteland for excess toxins and blemishes, rashes, acne, and inflammation can increase. Naturopathic physicians are well-versed in the emunctory system and in how to encourage its proper and balanced function through a variety of methods that promote elimination of toxins and toxic metabolic byproducts.

Utilize herbs and supplements

Naturopathic physicians are experts in the use of supplements and herbs as therapeutic agents in disease management. The internal and external use of nutrients can also be an important part of the management of skin conditions like psoriasis, eczema, and acne. Vitamins such as A, D, and E play crucial roles in skin health, integrity, and immune function. Low levels of some vitamins, such as vitamin D have consistently been observed in serious skin conditions like psoriasis.9 Other fats like omega 3 and gamma-linolenic acid (GLA) can also be important supplement considerations. Omega 3 fats have been shown to mitigate inflammatory pathways in the skin and aid in balancing an overactive immune response in cases of psoriasis.10,11 GLA is found in high concentrations in evening primrose oil as well as borage oil. Research has revealed that supplementing with evening primrose oil standardized to contain 40mg GLA led to significant improvements in eczema severity scores.12

Many minerals are also important for skin health. Deficiencies in minerals such as zinc, copper, selenium, and iron may result in cutaneous abnormalities. For example, scientific research has revealed a correlation between low serum zinc levels and the severity and type of acne lesions.13 Further research demonstrated that deficiencies in zinc and selenium could exacerbate eczema lesions.14

Herbs can also play a vital role in supporting skin health. Studies of multiple botanical acne treatments have reported favorable results, and several showed equal or superior treatment to standard therapies.15  Herbs like Curcuma longa have also been found to significantly inhibit inflammatory factors as well as reduce T cell proliferation in cases of psoriasis.16 Topical botanical therapeutics are also an option. Studies have shown topical application of Mahonia aquifolium, indigo naturalis, and Aloe barbadensis to be among the most efficacious in the treatment of psoriasis lesions.17

The skin is the largest organ of the body, with a total area of about 20 square feet. It protects us from microbes and the elements, helps regulate body temperature, and permits the sensations of touch, heat, and cold. The skin can also be the site of a number of medical conditions and clue us in to other underlying conditions. Dermatology and the treatment of cutaneous conditions can be extremely complex and notoriously difficult to treat. In conventional care, individualizing therapies can be extremely challenging, and pharmaceutical regimens may confer side effects that may be more unpleasant than the disease itself. Naturopathic physicians are uniquely trained to use a multitude of techniques and therapies to manage health. Click here to find an ND near you in the US and Canada.

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Swiss Chard: The Naturopathic Kitchen

Welcome back to The Naturopathic KitchenThe kitchen is the heart of healthy living. This week we will learn more about a wonderful leafy green known as Swiss chard. Read all the way through where we share a couple amazing recipes for you to test out!

Swiss chard 101

Swiss chard is a plant grown for its green leaves and edible stalks. It is a member of the same family as the sugar beet (bearing the same scientific classification but lacking the enlarged bulb root), spinach, and amaranth.1 Swiss chard is quite cold-tolerant and can be grown and harvested from mid to late spring until the first few frosts of fall.

Swiss chard is a biennial plant meaning that its growth cycle spans two growing seasons. It can grow to a height of about 28 inches and has a bitter flavor due to the presence of oxalate in the leaves. Young leaves (baby Swiss chard) that are harvested at a height of four inches or less are lower in oxalate and can be eaten raw in salads or other dishes. Larger, more mature leaves and their stalks are typically cooked which causes the bitterness to fade and results in a flavor that is delicate and more mild than that of cooked spinach.

Swiss chard is well-known for its nutrient content, ranking among the top three most nutrient-dense by World’s Healthiest Foods behind broccoli and spinach.1 It contains many beneficial nutrients in the forms of vitamins and minerals as well as an array of important phytonutrients. Swiss chard is an especially rich source of Vitamin K, as well as vitamins C, E, B2 (riboflavin) and B6.2 In terms of minerals, it provides ample amounts of calcium, iron, magnesium, potassium, copper and manganese.2 Other nutrients include choline, biotin, and fiber. In addition to these traditional nutrients, Swiss chard is also rich in phytonutrients including carotenoids (which the body can convert to vitamin A), flavonoids, and phenolic acids.

Where does Swiss chard come from?

The first uses of Swiss chard date back about 2,500 years ago. Interestingly, it is not native to Switzerland as the name would have you believe. Swiss chard is actually a derivative of the wild sea beet and is native to the Mediterranean region, growing along the border of the Mediterranean Sea in countries along the northern coast of Africa, the Middle East, and southern Europe.1 Once people learned of its culinary uses, it quickly became a domesticated crop grown in many geographic regions around the world and can now be found virtually everywhere in many different types of cuisines.

Swiss chard is widely available in grocery stores. It is common to find organic varieties in conventional supermarkets. When purchasing Swiss chard, it is important to choose chard that is held in a chilled display as this will help to ensure that it has a crunchier texture and sweeter taste.1 The leaves should be bright green in color with no browning, yellowing or wilting. The leaves also should not have tears or tiny holes in them. The stalks come in a variety of colors including white, red, pink, purple, orange, yellow, and silver. They should appear firm and crisp without blemishes, bruises, or marring. Swiss chard is highly perishable. It should not be washed before storing and is best stored in a cool environment such as the refrigerator.

How does Swiss chard help my health?

Swiss Chard is worthy of the classification as a nutrient powerhouse vegetable whose vitamins, minerals and phytonutrients promote a number of health benefits. Swiss chard is rich in the carotenoid pigments lutein and zeaxanthin. Both of which have been proven to improve visual memory, visual processing speed and more in older adults.3 The combination has also been shown to significantly improve other measures of cognitive functioning such as complex attention and cognitive flexibility.4 Swiss chard is also particularly rich in a phenolic compound called syringic acid. Research has found that syringic acid inhibits the formation of new fat, prevents fat accumulation, and acts as an antioxidant.5 Kaempferol and quercetin are two flavonoid phytonutrients found in Swiss chard. Recently published research has revealed that these two compounds have anti-fungal activity and the ability to slow the growth of and decrease the size of fungal biofilms.6

What medical conditions/symptoms is Swiss chard used for?

When should Swiss chard be avoided?

Barring an outright allergy or sensitivity to the plant itself, Swiss chard can safely be consumed by most people. Some people however, particularly those on blood thinning medications like Warfarin/Coumadin, should consult with their physician before consuming Swiss chard. It is also high in oxalic acid which can be problematic for those with gout or kidney stones.

Let’s try out Swiss chard with these delicious and nutritious recipes!

Sautéed Swiss Chard with Golden Raisins & Pine Nuts


1 1/2 lbs. Swiss chard, stalks cut crosswise into 1-inch pieces, leaves torn into 2-inch pieces (keep stalks and leaves separate)
2 T pine nuts
2 T olive oil
1/3 c golden raisins
2 cloves garlic, minced
1 T balsamic vinegar
Coarse salt and ground pepper


    1. Wash chard, leaving some water clinging to stalks and leaves; set aside. In a large saucepan with a lid, toast the pine nuts over medium-high heat, shaking pan to brown evenly, 2 to 4 minutes. Remove from pan; set aside.
    2. In same saucepan, heat oil over medium-high. Add stalks, and cook until beginning to soften, about 4 minutes. Add leaves, raisins, and garlic. Cover, reduce heat to medium-low, and cook until tender, 6 to 10 minutes, stirring occasionally.
    3. Pull lid back slightly, and tilt pan to pour off water. Stir in vinegar and pine nuts; season with salt and pepper.

Thank you to Everyday Food for this great recipe.

Lemony Chicken and Rice Soup with Swiss Chard


2 T olive oil
2 lbs. boneless skinless chicken breasts, cut into 1/2-inch pieces
5 cans (14-1/2 ounces each) chicken broth
8 c coarsely chopped Swiss chard, kale or spinach
2 large carrots, finely chopped
1 small onion, chopped
1 medium lemon, halved and thinly sliced
1/4 c lemon juice
4 t grated lemon zest
1/2 t pepper
4 c cooked brown rice


  1. In a large skillet, heat 1 tablespoon oil over medium-high heat. Add half of the chicken; cook and stir until browned. Transfer to a 6-qt. slow cooker. Repeat with remaining oil and chicken.
  2. Stir broth, vegetables, lemon slices, lemon juice, zest and pepper into chicken. Cook, covered, on low until chicken is tender, 4-5 hours. Stir in rice; heat through.

Thank you to Taste of Home for this great recipe!

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