Dr. JoAnn Yanez on KCAA 05/08/19

Dr. JoAnn Yanez, AANMC executive director, joins KCAA’s NBC LA affiliate On the Brink to discuss spring-cleaning and de-cluttering your mental health.
 

Full Transcript of Interview Below.

Topics Include:

  • De-cluttering your mental health
  • Finding what works for you
  • Prioritizing tasks and asking for help when needed
  • Mental health statistics
  • Mental health stigmas
  • Expectations versus reality
  • 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 excited to welcome back to the show, Dr. JoAnn Yanez. She is the Executive Director of 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 Executive Director, Dr. Yanez oversees research, advocacy efforts, and the joint academic endeavors of the accredited colleges of naturopathic medicine. Dr. Yanez, welcome back to the show.

Dr. JoAnn Yanez: Oh, thank you so much! Hope you guys are well.

Erin Brinker: We hope you are well, too. It’s so beautiful outside. It’s just … you know, the weather where you just want to be outdoors. And it’s been very, very rainy. You know, this winter. So, the spring is much appreciated.

Dr. JoAnn Yanez: Yes, agreed. It’s really amazing how getting outside can make an impact in your mental health and in your health in general. And I think that’s what we were talking about today, right?

Erin Brinker: Absolutely. Absolutely. So, you know, everybody has seen or at least heard about Marie Kondo’s show about kind of spring-cleaning your house. Cleaning out closets and that sort of thing. And all of that really does impact your health, doesn’t it?

Dr. JoAnn Yanez: So, you know, it’s really funny. Folks will talk about the impact of clutter, you know, all the excess stuff that we accumulate through the course of our lifetime. And what that does to your mental health. I know personally for me, when my house is not organized, when it’s a disaster, it’s harder for me to concentrate. It’s harder to think straight. Even though cleaning is not the most fun thing in the world, you know, there is satisfaction in knowing that your space is organized. And I think that’s why so many folks have caught on to this one way of organizing. But I think it’s also important to think about the mental clutter. As a working mom myself, I think of all of the things that occupy my brain space. And how do you de-clutter, not only your personal space, but how do you de-clutter your thoughts? And by doing both of those, that definitely can have an impact in your mental health and in your stress level.

Erin Brinker: So, I have … and I’ve gone through periods of time where I do this, but I recently started really journaling. And it really does clear the cobwebs out of … you know, things that I’m kind of obsessing about. And I don’t really like that word. But it kind of describes things that are swirling around my head that I want to get rid of. And I find that when I write them down in a journal, then it clears all of that out. It’s like taking a Swiffer to the cobwebs.

Dr. JoAnn Yanez: It really is. And you know, I think that journaling … There are so many different tools out there to help you kind of manage those cobwebs. But, you know, journaling is one of them. Social support has been well documented to help people manage their stress. So, talking with a friend or a counselor, if that’s more helpful. I think all of those types of ways of having some sort of a release. For me, personally, it’s lists. Even if I don’t necessarily cross off everything on the list, it’s just knowing that I have everything down on paper that needs to happen so it doesn’t have to occupy the mental space of, “Oh, I’m going to forget this,” or, “Oh, I have to remember to do this.” Just putting it down. My calendar’s my bible. You know, I’ve got a calendar that’s chock-full of everything that I need to do, everywhere I need to be, everything I need to think of. Having that level of organization. I think more importantly, Erin, it’s finding the organization that works for you. For some people it’s writing down a handwritten list. Some people it’s a web app or tracker to help you stay organized. If the organizational tool becomes more stressful, then ditch it.

Erin Brinker: Absolutely. One more thing you have got to do is organize. So, I remember when I was very early in my career, I took a Stephen Covey class. You know, they had the Franklin planners, this was before people had the smartphones.

Dr. JoAnn Yanez: Oh, gosh.

Erin Brinker: And, you know, I found it so helpful as a way to kind of think about organizing your day. And I’ve thought recently that, “Well, maybe I need to take another one of those courses.” Because there’s a … obviously I don’t use a Franklin planner anymore, but you know, that maybe there are new ways to organize that would make life easier.

Dr. JoAnn Yanez: Well, there are. And you know, I think, again though, there are so many tools on cell phones, you can set reminders, you can have … You know, on my calendar, I have reminders that go off. They get sent to my email box and I get a little ping on my cell phone.  And that’s how I remember that, you know, Monday is spirit shirt day at my son’s school or, you know … All the random things that happen … you know, bring cans on Friday to school. In addition to work, all the extra stuff that would normally be like, “Oh, gosh, I’ve got to remember to, you know, to do this or to do that.” Or, “This is one extra thing.” Again, it’s having the organizational tools that work for you. I have found my system and I stick with it. And mayhem ensues when I don’t.

Erin Brinker: By the way, when your son hits middle school, you are going to find out about those special days about half an hour before he has to be at school.

Dr. JoAnn Yanez: Yes.

Erin Brinker: Oh, we were supposed to bring, you know, 150 cookies. Really?

Dr. JoAnn Yanez: Fabulous! But anyway, I think the spring-cleaning piece really does fit in to more of, “What are the things that clutter your mind? That stress you out?” And you know, if you … If having a messy kitchen doesn’t stress you out, then don’t worry about it. For me, it does. So, you know, I think it’s really what are the things that are stressing you out that are kind of leading to that, those little … you know, the little pins in the pin cushion? Like what are those little things that ultimately will add up? And if you can clear those out and kind of get those out of the way, then yes, it absolutely can help with mental health and with your overall stress levels. So, it’s really just knowing yourself and knowing what’s important, prioritizing the things that will help you feel better. And you know, and making that a regular part of your life.

Erin Brinker: So, one of the things that I hate doing is filing. I hate filing. And most of my … I generally don’t like paper. I want everything electronic. Because then it’s really easy for me to file. But like physically taking paper and putting in files, I hate that. Is there anything wrong with hiring people to do that for you?

Dr. JoAnn Yanez: There is absolutely nothing … if you have the means to do so. You know, I had a very smart mentor years ago who basically said, “Hire out the things you don’t like to do.” Because you will spend more time thinking about it, obsessing about it, stressing about it, than the $20+ you could have paid somebody to have gone and filed your stuff for an hour.  No, I definitely think that if you have the means or if you can, find a way without the means to enlist some help or have somebody there for moral support, that’s … The filing is one of my things, and so is when I’ve had to move, packing. For whatever reason I have this mental block on packing. And it stresses me to no end. And so, what I’ve found is if I can have music and some friends and make it fun that it goes by more quickly, it becomes less of that burden. And, you know, so I think again, asking for help is something that a lot of us don’t always do well. And whether that’s paid help or it’s a friend or whatever, asking for help and knowing when you need help is very important. And I think that’s one of the big messages in all of the mental health. If you look at Psychology Today or you look at any of the National Association of Mental Health and all of that, it’s all about knowing yourself, they have helpful self-assessment tools. And knowing when to ask for help. Knowing when you need professional help, knowing when you need a friend, or a spouse, or a partner, or family. And getting the help when you need it. And I think that’s the biggest piece. One out of five Americans struggles with some sort of mental health issue. And worldwide, the numbers are even one out of four. This is not something people … and we’ve talked about this before, have stigma about asking for help or saying they are said or saying they are anxious or angry or depressed. And we really should start to take that stigma away from people and make it safe to talk about things that are upsetting to you.

Erin Brinker: You know, it’s … I think that when expectations crash in to reality, it’s a tremendous … it’s a source of tremendous stress. And, you know, as you said, if you … having a messy kitchen doesn’t bother you, then don’t worry about it. And this idea that we have to have … everything has to be perfect and everything has to be just so. And that in itself causes us … can cause people significant mental anguish. And give yourself a break, cut yourself some slack, seems to be a really positive message.

Dr. JoAnn Yanez: Yes, you know, I think that striving for perfection and, you know, my husband will say, he would rat me out right now if he heard me talking about perfection. But you know, I think the striving for perfection and that extra pressure that you put on yourself, undue pressure. You know, I’ve heard folks talking, “Oh, well, you know, my house isn’t really ready yet. I don’t want to have people over.” I’m like, “Please. I don’t care what your house looks like.” Like don’t worry if your baseboards aren’t up or you haven’t finished your kitchen yet. I don’t care. You know. And frankly, anybody who will care shouldn’t be coming to your house.

Erin Brinker: Indeed. Indeed. Absolutely. So, is there any news on the naturopathic medical college front? Anything going on that you want to let the public know about?

Dr. JoAnn Yanez: Oh, gosh. There’s so much news. We have two states that have recently newly regulated naturopathic doctors – Idaho and New Mexico. The AANMC residency process has just finished up a cycle. We have our monthly free webinar series. I am actually getting ready to rehearse with the Naturopathic Medical Student Association president for his upcoming webinar on tips and tricks from a current ND student in a couple weeks.

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High Blood Pressure – How Naturopathic Medicine Can Have the Answer

High blood pressure (known in the medical world as hypertension) is a common diagnosis for many people, and is often seen in conjunction with heart disease, diabetes, strokes, and high cholesterol. According to the Center for Disease Control, about 1 in every 3 American adults has hypertension and roughly half of them have it under control. 1 Often described as the “silent killer” due to its general lack of symptoms, hypertension is a major risk factor for heart attack, stroke, heart failure, kidney failure, encephalopathy, and aneurysm.2 Blood pressure is the measurement of the force of blood flow against arterial walls both when the heart is contracting (systolic blood pressure), and when the heart is at rest and refilling (diastolic blood pressure). Below is chart from the American Heart Association explaining how blood pressure is categorized.

Luckily, the body is designed to control its own blood pressure based on the body’s needs. Several factors assist in regulating this process. Changes to the amount of blood pumped out of the heart with each contraction (known as cardiac output) can be impacted by factors such as heart rate and stroke volume. Additionally, variations in resistance in the blood vessels as determined by factors such as how wide or narrow the blood vessels are, how viscous (thick) the blood is, and alterations to the length of blood vessels (as is seen in weight gain) can also impact blood pressure.4 The sympathetic nervous system (SNS) stimulates release of chemicals like norepinephrine and epinephrine that act as vasoconstrictors and make the blood vessels smaller in diameter by attaching to alpha and beta receptors in the heart and blood vessels to increase heart rate and blood pressure in fight or flight situations, shunting blood to vital organs. They also stimulate aldosterone secretion from the adrenal glands, which leads to renal fluid retention and increased blood volume. Specialized baroreceptors (pressure receptors) in the carotid arteries and aorta monitor levels of pressure against them, and can decrease heart rate and cause vasodilation (widening of the blood vessels) by inhibiting the SNS in an attempt to lower blood pressure if it is too high, or increase heart rate if the pressure is too low.

A second branch of the nervous system known as the parasympathetic nervous system (PNS) balances the SNS by causing vasodilation and slowed heart rate via the vagus nerve. The kidneys also play a significant role in blood pressure regulation by changing the amount of sodium and water retention via the renin-angiotensin-aldosterone system. When the kidneys note a drop in blood pressure or are stimulated by the SNS, they secrete renin, which converts angiotensin to angiotensin I, which is further converted by the enzyme ACE (angiotensin converting enzyme) into a potent vasoconstrictor known as angiotensin II. This chemical also stimulates aldosterone release from the adrenals, increasing sodium and water retention to improve blood volume. The blood vessels themselves also have tools for regulating their constriction and dilation. Substances such as nitric oxide are released by the endothelium to relax the blood vessels.

All of these regulatory systems can fail or become unbalanced by a number of factors, many of which are modifiable by lifestyle and diet changes. Primary or Essential hypertension is most responsive to diet and lifestyle changes, and makes up 90% of cases.4 Essential hypertension is currently understood as a multifactorial disease arising from the combined action of many genetic, environmental, and behavioral factors.5 Triggers for hypertension include the standard American diet high in saturated fats, trans fats, sugar, salt, and processed foods; obesity, sedentary lifestyle, alcoholism, stress/sympathetic dominance, overuse of stimulants, hypothyroidism, smoking, hyperinsulinemia, medications such as hormones, steroids, and NSAIDS; nutrient imbalance (high sodium, low potassium and magnesium), food allergies, and sodium sensitivity.5,6 Other factors may include oxidative stress, which causes inflammation in the blood vessels, resulting in endothelial dysfunction and autoimmune activation.

High blood pressure implications

Hypertension is usually asymptomatic, leading to its denotation as a “silent killer” and can be elevated for years without discovery unless the person regularly assesses it.7 Sometimes very high blood pressure can cause neurological symptoms such as blurred vision, headache, dizziness, ringing of the ears, and nosebleeds. Hypertension puts a huge strain on the heart, damages blood vessels in the brain and kidneys, and increases the risk of plaque rupture and blood clot formation. Sometimes the first diagnosis of hypertension may be made when the damage is already done and a stroke or heart attack has occurred.7 If a patient is being followed by a physician, diagnosis of hypertension will typically occur when several random blood pressure readings are over 140/90.

Naturopathic approaches to hypertension

Naturopathic approaches to treating hypertension focus on identification of the underlying cause and then the use of diet and lifestyle modifications, stress management, herbal supplements, and occasionally pharmaceutical medications to aid in its control. Testing for renal function, hyperparathyroidism, thyroid function, and inflammatory markers in the blood such as CRP as well as other factors like the aldosterone to renin activity ratio and homocysteine can indicate possible causes of high blood pressure. Urine testing may also be helpful. Patients’ cardiovascular risk factors must be assessed in depth, as these risk factors are generally associated with hypertension. Adiposity, sleep apnea, dyslipidemia, insulin resistance, and systemic inflammation should all be considered in this work-up.6

Some believe that high blood pressure is regularly mismanaged across medical paradigms and that the current trend of treating hypertension as a disease rather than a symptom is at the root of the problem.6 It is of the utmost importance that the true cause of hypertension be determined whenever possible in order for true curative measures to be taken. While the cause is being determined however, using pharmaceutical or natural management techniques can be implemented to preserve cardiovascular health and reduce risk of further end organ damage due to the elevated blood pressure levels. Among the most common naturopathic therapies used include dietary interventions, lifestyle modifications, and stress reduction as well as the use of herbs and supplements.

Dietary interventions

Dietary changes are among the most basic interventions for nearly all types of conditions and high blood pressure is no different. Specific dietary systems such as the Mediterranean diet and the DASH diet are among the most fundamental strategies to manage elevated blood pressure and many of the conditions that cause it such as insulin resistance, type II diabetes, and obesity.

The Mediterranean diet focuses on the consumption of vegetables, fresh fruit, whole grains, fish and seafood, legumes, nuts, extra virgin olive oil, and red wine, whereas red and processed meat are limited, and dairy foods are moderate. The Mediterranean diet is known to have a favorable effect on hypertension. A number of large scale observational studies have revealed significant negative associations with both systolic and diastolic blood pressure reductions.8

The DASH diet is a flexible and balanced nutritional system that helps create a cardio healthy lifestyle. The DASH system focuses on eating vegetables, fruits, and whole grains and includes fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils. The program limits foods that are high in saturated fat, such as fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils as well as sugar-sweetened beverages and sweets.9 When compared to other popular dietary systems such as paleo diet, low carb diet, low fat, and others, the DASH diet proved to have the greatest impact on blood pressure.10

Stress management

Since stress and sympathetic nervous system over stimulation appear to play a role in hypertension, it is important to keep stress under control. Stress can cause hypertension through repeated blood pressure elevations as well as by stimulation of the nervous system to produce large amounts of vasoconstricting hormones that increase blood pressure.11 A variety of non-pharmacologic treatments to manage stress have been found effective in reducing blood pressure and development of hypertension, examples of which are meditation, acupressure, biofeedback and music therapy.11 Exercise is also useful in stress management and plays a role in lowering blood pressure. A single exercise session evokes immediate blood pressure reductions that persist for at least 24  hours.12 Becoming more active overall can lower your systolic blood pressure by an average of 4 to 9 millimeters of mercury.13

Supplements

A number of herbs and supplements can also be used to aid in the management of hypertension. Nutrients from various categories including amino acids, vitamins, minerals, and herbs can be useful tools in keeping blood pressure within an optimal range. An important consideration however is that the effects of various nutrients or herbs can be cumulative and care must be taken not to drive blood pressure too low, particularly if combining herbs and supplements with pharmaceutical medications that lower blood pressure.

L-Arginine is a commonly used supplement for cardiovascular conditions. L-Arginine is an amino acid which is a precursor to nitric oxide (NO) production. Nitric oxide is a substance that stimulates vasodilation or widening of the arteries thereby reducing the necessary pressure to push blood through. Arginine produces a statistically and biologically significant decrease in blood pressure and improved metabolic effect in normotensive and hypertensive humans that is similar in magnitude to that seen in the DASH-I  diet.14 Human studies in hypertensive and normotensive subjects of parenteral and oral administrations of L-arginine demonstrate an antihypertensive effect as well as improvement in coronary artery blood flow and peripheral blood flow in peripheral artery disease.15 Doses of 10g of arginine daily have been shown to lower blood pressure by up to 6.8 mmHg.14 Further, similar results were obtained whether the arginine came from supplemental or food sources.14

Taurine is considered a conditionally essential amino acid. It is a sulfur-containing amino acid that is not used in protein synthesis. Taurine is found in high concentrations in the heart muscle itself.16  Taurine lowers BP and heart rate, decreases arrhythmias, CHF symptoms and sympathetic nervous system activity, increases urinary sodium and water excretion, increases atrial natriuretic factor, improves insulin resistance, increases NO and improves endothelial function.17 In a study of prehypertensive patients, it was found that taking 1.6 grams (1600mg) of taurine daily for 12 weeks led to a 7.2 mmHg drop in systolic blood pressure and a 4.7 mmHg drop in diastolic blood pressure.18

Beyond amino acids, other nutrients that can also benefit blood pressure include such nutrients as omega 3 fatty acids, fiber, and CoQ10. Research has shown that doses of 2 grams daily can produce reductions in blood pressure of up to 8 mmHg within a six-week time frame. Fiber, especially soluble fiber may also be helpful. Studies have shown that increased fiber consumption can support blood pressure through a number of benefits including improvement in insulin sensitivity, endothelial function, reduction in sympathetic nervous system activity and increase in renal sodium loss.17 CoQ10 is another nutrient that has shown significant benefit for those with high blood pressure, particularly essential hypertension. Compared to normotensive patients, essential hypertensive patients have a 6 fold higher incidence of coenzyme Q10 deficiency.17

Vitamins and minerals can also support the body in maintaining healthy blood pressure. In fact, clinical trials involving as little as 250mg of vitamin C twice per day over an eight week period have revealed drops in systolic blood pressure of 5-7 mmHg and 3-5 mmHg for diastolic hypertension.17 Vitamin B6 (pyridoxine) can also be helpful as low levels of B6 have been shown to be associated with the development of hypertension in humans.19 As far as minerals go, a high dietary intake of magnesium of at least 500-1000 mg daily reduces blood pressure in most of the reported epidemiologic, observational and clinical trials.17 Magnesium also increases the effectiveness of all anti-hypertensive drug classes.20

Botanical medicine

In the botanical realm, there are a number of herbs that can be helpful in promoting healthy blood pressure and cardiovascular health. When speaking of herbs and the cardiovascular system, the herb Hawthorn (Cartaegus oxycantha) is among the top contenders. Hawthorn belongs to the Rosaceae family and consists of bright green leaves, white flowers, and bright red berries. Hawthorn extracts exert a wide range of cardiovascular pharmacological properties, including antioxidant activity, anti-inflammatory effect, antiplatelet aggregation effect, vasodilating effect, endothelial protective effect, antiarrhythmic effect, lipid-lowering effect and decrease of arterial blood pressure effect.21

Garlic (Allium sativum) is another herb with significant blood pressure benefits. Meta-analysis studies of randomized, controlled trials concluded that garlic supplements can induce a significant reduction in both systolic and diastolic blood pressure by 3.75 and 3.39 mmHg, respectively.22  Garlic’s ability to regulate nitric oxide, reduce inflammation, and act as an ACE inhibitor have all been recognized.23

Rauwolfia serpentina, a common Auyrvedic herb, also has potent impact on blood pressure. The first study on the anti-hypertensive effects of rauwolfia were published in 1949 when a study showed that 40 out of 50 participants experienced a drop in blood pressure.24 Further, the hypotensive action of the drug was perceptible two weeks after stopping the drug in 91% of patients and in 75% of patients after four weeks of discontinuing the drug. No serious adverse side effects were noted.24

Next steps

The number of natural treatments available to aid in managing blood pressure are plentiful. The exact combination is best to treat the cause of any one specific individual’s blood pressure challenges should be determined by a naturopathic physician. Utilizing a proper diagnostic work up including both physical exam and a thorough medical history combined with diagnostic and laboratory testing to uncover the true cause of the hypertension, a naturopathic physician is uniquely qualified to develop an appropriate plan to address the true underlying cause of the problem. Click here to find an ND in the US and Canada.

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Coffee 101: The Naturopathic Kitchen

Welcome back to The Naturopathic KitchenLiving a healthy life has roots in the kitchen. This week we will focus on a morning favorite – coffee. Many people do not consider their day started until after they have enjoyed their first cup, but coffee has numerous health benefits. Let’s find out together!

Coffee 101

For many, the day would feel incomplete without a morning cup of Joe. Simple as they may seem, coffee beans are extraordinarily complex fruits which contain over 1,000 different compounds within each tiny package.1 It is estimated that 2.25 billion cups of coffee are consumed every day around the world.2 French writer and philosopher Voltaire was rumored to have drunk 40 – 50 cups per day.3

Before becoming the popular morning beverage it is today, coffee was utilized in a variety of different preparations. In its natural and unprocessed state, coffee is actually a cherry-like fruit that becomes bright red when ripe. The famed coffee bean is actually the seed found at the center of the red coffee fruit. Initially, the fruits were mixed with lard to create a snack bar.2 Later on, the fermented pulp of the coffee fruit was used to make a sort of wine-like drink. Around 1000AD a drink appeared that was made from the bean and hull. In the 1400s, people began to roast the coffee beans – becoming the first step in the process we know today.2

Where does coffee come from?

According to the National Coffee Association, no one knows exactly how or when coffee was discovered, though there are many legends about its origin.4 The discovery of coffee is attributed to an Ethiopian goat shepherd named Kaldi. Kaldi had sent his goats to graze and when he found them, they were leaping and frolicking around with energy.  He noticed that they had been grazing on the red fruits of the coffee shrub so he decided to try the fruit for himself. After consuming the fruits, he too noticed a similar reaction. A monk who also witnessed the goats’ behavior took some of the coffee fruits back to his monastery and shared them. He and his fellow monks were alert and awake for evening prayer.2 It is likely they were all reacting to the caffeine content of the coffee fruit. Caffeine is a stimulant that is present in the plants as a natural pesticide.2

Though the quality and selection may vary greatly, coffee can be found at nearly any retail establishment. Health food stores are more likely to carry a wide variety of beans from various geographic regions around the world. Different regions offer growing conditions that contribute to the nuanced flavors of the beans that grow there.Coffee is among the most highly sprayed crops when it comes to pesticides and other chemicals so choosing an organic variety is extremely important to avoid taxing the body with added harmful chemicals.

How does coffee help my health?

Coffee is a potent source of antioxidants. Scientists have identified approximately 1,000 antioxidants in unprocessed coffee beans, and hundreds more develop during the roasting process.6 On average, a US coffee drinker consumes about 3.1 cups per day.7 However, research has shown that higher intakes, in the range of three or more cups per day may help prevent certain medical conditions.8,9 For example, although coffee can raise blood pressure immediately after consumption, a majority of research evidence suggests a longer term protective effect on cardiovascular health. In fact, daily coffee consumption over eight weeks was shown to have a lowering effect on blood pressure.11 Further research has shown the ability of regular coffee consumption to dampen inflammation, improve cholesterol profiles (specifically increasing the HDL or “good” cholesterol fraction) as well as decrease calcification of the coronary arteries.12,13

Beyond the cardiovascular system, coffee has also been shown to benefit the brain. A large study found that consuming one to four cups of coffee daily cut the risk of Parkinson’s by 47% and adding a fifth cup decreased the risk by 60%.14  Research has also found that consumption of coffee compounds like caffeic acid and caffeine can slow multiple classes of enzymes responsible for causing neurodegenerative processes in the brain.15

What medical conditions/symptoms is coffee used for?

When should coffee be avoided?

The caffeine in coffee may have a negative impact on certain people and may worsen certain health conditions like insomnia, anxiety, headaches, and high blood pressure. Those with health concerns like migraines (which can be induced by caffeine) or menstrual cramps may also need to avoid coffee. Decaffeinated coffee may be a good substitute for some, however ascertain that the methods employed to decaffeinate the beans are not relying on chemical processing. Additionally, the acidic nature of coffee may cause or exacerbate stomach discomfort and various gastrointestinal conditions. Because coffee constituents like caffeine are metabolized through specific liver enzyme pathways, those with sluggish liver detoxification may need to avoid consuming coffee.

 

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

 

Greek Yogurt with Coffee and Fig Compote

INGREDIENTS

1 1/4 c brewed coffee
7 oz pkg dried mission figs, stems removed and figs quartered
1/4 c honey (preferably local)
1/2 t cinnamon
1/8 t cardamom
1/8 t cloves
1/8 t nutmeg
1 t orange zest
24 oz plain Greek yogurt

INSTRUCTIONS

  1. In a medium-sized saucepan, combine the coffee, figs, honey, spices, and orange zest. Bring to a boil, reduce heat and simmer covered for 20 minutes.
  2. With a slotted spoon, remove figs from pan. Simmer liquid an additional 5 minutes, uncovered, over medium heat until reduced and syrupy. Combine figs and syrup and allow to cool to room temperature on the counter. Then cover and refrigerate until ready to serve.
  3. Spoon 6 oz. of the Greek yogurt into each of four serving dishes. Top each generously with the coffee fig compote.

Thank you to Foodtastic Mom for this wonderful recipe!

Carrots Slow-Baked on Coffee Beans

INGREDIENTS

1 lb thin carrots (no thicker than 1/2 in in diameter), peeled
1 t olive oil
1 small garlic clove, minced
Coarse sea salt and ground black pepper
1 c medium-roast coffee beans, preferably decaf

INSTRUCTIONS

Preheat the oven to 225°F. Place a cast-iron skillet over medium heat to heat for about 5 minutes.

In a large bowl, combine the carrots, olive oil, and garlic and toss until the carrots are slicked with oil and the garlic bits are distributed evenly. Season with salt and pepper; set aside.

Add the coffee beans to the hot skillet and remove from heat. Shake until the coffee is aromatic and the beans look a bit oily, about 3 minutes. Scatter the carrots over the beans in a single layer and cover the pan with a lid or a sheet of heavy-duty aluminum foil. Bake until the carrots are fork-tender and infused with coffee oil, 2 to 3 hours.

Lift the carrots from the bed of coffee beans and serve immediately. Discard the coffee.

Thank you to Splendid Table for this great dish!

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Asthma, Allergies, and Naturopathic Medicine

“I’m okay, it’s just my allergies,” is a phrase heard all too often. Allergic symptoms and allergic disease are among the most common, yet most often disregarded symptoms. Allergies and allergic diseases such as allergic rhinitis, atopic dermatitis, food allergies and allergic asthma are extremely common, impacting tens of millions of American men, women, and children each year.1 Asthma Canada reports 1 in 5 Canadians suffer from respiratory allergies. The symptoms associated with allergies occur when the body is exposed to something that the immune system over-reacts to.  The appearance of allergy symptoms can be associated with any number of triggers such as foods, creams, touching certain materials (even other people!), insects, pets, pollen, dust, and mold. The body’s immune response causes the symptoms we commonly refer to as allergies. The immune response results in effects on the body which can be mild or severe and can range from sneezing, coughing, itchy eyes, watery eyes, runny nose (often called rhinitis), and a scratchy throat, to rashes, hives, swollen respiratory passages, lowered blood pressure, breathing difficulty, asthma and even death in the most extreme cases.

What causes allergies and asthma?

The cause of this immune overreaction is largely unknown, but we have noted both genetic susceptibility as well as environmental influences.2 Heritability rates for susceptibility allergic disease can vary but have been found as high as 95% for asthma, 91% for allergic rhinitis, and 84% for atopic dermatitis.3 It is clear that genetics only account for an increase in susceptibility, and cannot be attributed fully for the dramatic increase in allergic disease worldwide.4 Food Allergy Research and Education reports a CDC statistic showing a 50% increase in food allergy prevalence in children between 1997 and 2011, and a 300% increase in peanut allergies during 1997-2008. 5 Environmental influences and triggers must also play a role. Large studies such as the International Study of Asthma and Allergies in Childhood and the European Community Respiratory Health Survey Study have revealed striking patterns showing increased prevalence of asthma in first world, English speaking countries and non-English speaking Western European countries over developing nations. These studies have further shown that asthma incidence increases in developing nations as they begin to embrace more “Westernized” lifestyles.4 All of these factors combined make it clear that lifestyle and environment play a role in the development of allergic disease and asthma.

Naturopathic approaches to allergies and asthma

From a naturopathic medical perspective, allergic symptoms are quite often associated with disruption to the microbiome in the gut, as well as to dysfunction of other systems including the adrenal glands, digestive disturbance beyond the microbiome, and altered immune responses. Determining the cause of a patient’s allergic symptoms including allergic asthma is at the forefront of a naturopathic treatment protocol and may involve laboratory testing combined with diet-symptom tracking via logs and observations as well as special diets called elimination and challenge diets. In terms of management and treatment, dietary avoidance, environmental modifications such as home air purifiers and specific cleaning routines, as well as a variety of herbs and supplements may be implemented.

“Allergies and asthma arise from a complex interplay of genes, food introduction, breast feeding or not, the gut and of course the greater environment. Some patients are hard-wired to develop allergies to pollen and mold. This can cause miserable symptoms, and is sometimes the real culprit driving asthma, but not always. It’s important to keep in mind that diet, home environment, stress, hydration, sleep and chemical exposure all play a role in how reactive someone is. Although allergy is definitely mediated by the immune system in well understood ways, we also want to examine someone’s toxic burdens in terms of how highly fired their system is from day to day. The Environmental Protection Agency has more than 85,000 chemicals listed in its registry, and processed foods contain many of them. Without oversimplifying matters, we do have to think about the impact of all this on someone’s allergic experience. As a naturopathic doctor I think about the whole person and how to restore health and, in that sense, allergies as sometimes a symptom of deeper problems I can help someone with.”

Fraser Smith, ND, MATD

Assistant Dean of Naturopathic Medicine and Associate Professor, AANMC President, National University of Health Sciences

Diagnostic testing

Uncovering the root cause of allergic symptoms is imperative,  and at the same time, can be challenging. There are several testing methods that are commonly employed to assess what a person’s specific allergies are. These include blood testing using various techniques to assess antibodies and immune reactions, testing blood levels of biomolecules associated with allergic responses such as allergen-specific IgE, histamine, and tryptase, scratch testing, and others. The type of testing most appropriate can also vary by the type of allergy being tested for.

When examining aeroallergen sensitization, testing is often done in a combination approach to ensure all sensitized allergens are accounted for. Although there have been many recent advances in testing allergen specific IgE levels, it has been found that using only one testing method may lead to a misdiagnosis with every fourth allergically sensitized patient as being found non-reactive.6 Many studies show that there is discord between testing for serum-specific IgE and skin testing results suggesting that the two methodologies act in a complimentary manner and should not be used interchangeably.

In regard to food allergies, there are numerous laboratory assays that can be performed such as radioallergosorbent tests (RAST), immunoblotting, basophil activation (BAT), leukotriene LTC4 release, cellular allergen stimulation tests (CAST), and others. Other methods such as skin prick testing and fecal testing are also common. Skin prick tests are quite common as they are inexpensive, and relatively low risk, however skin prick testing to foods has a low specificity with a low positive predictive value.7 This means that a positive result, unless confirmed by other clinical data such as a diet-symptom log, does not allow for a definitive diagnosis food allergy. There is also a non-standardization of measurement of positive reactions as evidenced by the identification of cut-off values for the SPT reaction diameter for certain food allergens (milk: 8 mm, egg: 7 mm, peanut: 8 mm) but not their universally acknowledgement.7 Allergen specific IgE testing is also common, but can be extremely costly. Specific IgE levels exceeding a certain value (considered a “diagnostic cut-off”) showed a 95% predictive value for a symptomatic allergy.7 When combined with compatible clinical history, this gives this type of testing the advantage of being able to confirm a diagnosis of food allergy without the need for further challenge testing. However, it is important to note that there are a number of variables that can impact the outcome of such testing such as age and the length of time the person has been avoiding the food. Not all food reactions are mediated by IgE as is true of many cases of sensitivities to foods. In these cases, an elimination diet followed by a re-challenge phase are critical for the identification and proper treatment of food sensitivities.8 This type of testing is considered the gold standard for diagnosis of food allergy.9

“The goal of naturopathic medicine is to reduce the exaggerated immune response to allergens, and bring tone to the mucus membranes of the respiratory and digestive systems. The side effects of the naturopathic treatments include increased energy and nutritional status, greater resistance to colds and flus, and increased cardiovascular health. The side effects of conventional treatments commonly include drowsiness and diminished sense of taste, smell, and sight, rebound congestion leading to dependency on medications, and progression of inflammatory disease processes (especially eczema and asthma). The naturopathic approach is more complicated, and can, in some cases be more expensive, so it is up to the allergy sufferer to decide which is better for them. Often, people elect to manage symptoms for a short transitional period while beginning the naturopathic treatments, just to find they no longer need the antihistamines after a few days or a week and feel more energetic than anticipated.”

Jenn Dazey, ND, RH (AHG)

Core Faculty in the Department of Botanical Medicine, Bastyr University

Naturopathic treatment of allergies can involve multiple pathways including treating alterations to the gut micro biome, using supplements, instituting sublingual immunotherapy, implementing dietary considerations, and environmental modifications.

Balancing the gut microbiome

In humans, the gastrointestinal tract is inhabited by a large, complex group of microbes that play a distinguished role in maintaining health. Collectively, this group includes trillions of bacteria, fungi, parasites, and viruses that are known as the microbiome. A person is first exposed to microorganisms as an infant, during delivery in the birth canal and through the mother’s breast milk.10 As time goes on, the microbiome evolves with the individual and exposures to various environmental factors as well as variations in diet can impact the microbiome leading to improved health benefits or increased risk of disease. The microbiome has numerous important functions including producing various nutrients such as vitamin K, prevention of colonization by intestinal pathogens, and modulation of the immune response to name a few.11 The diverse role of the micro biome has led to the idea that its modification may be a target used to restore and maintain balance of the overall individual. Introducing probiotics and prebiotics are a means to accomplish this. Probiotics and prebiotics may be consumed in the form of raw vegetables and fruit, fermented pickles, or dairy products. Another source may be supplemental formulas and functional food. Studies examining the use of probiotics in patients with allergic rhinitis (hay fever) found that adjuvant use of probiotics resulted in improvement in quality of life.12 Probiotic use has also resulted in increased symptom control as evidenced by decreasing scores on questionnaires designed to assess control of allergic rhinitis and asthma symptoms.12 Additionally, a meta study examining the use of probiotics in the treatment of allergic rhinitis examined 22 double-blind, placebo-controlled studies. Seventeen trials showed significant benefit of probiotics clinically, whereas eight trials showed significant improvement in immunologic parameters compared with placebo.13 All five studies with Lactobacillus paracasei strains demonstrated clinically significant improvements compared with placebo.13

Using supplements

Supplements can provide targeted therapeutic options for the treatment and prevention of allergies. Supplements can address many different factors involved in the expression of allergies and asthma including immune system dysregulation, high levels of inflammation, and oxidative stress among many others. Some examples of supplements commonly used in treatment of allergies and asthma include:

Stinging nettles

Stinging nettles (Urtica dioica) is also commonly called simply “nettle.” Nettle has a significant research profile as a treatment for allergies and allergic rhinitis.14 National College of Naturopathic Medicine (now National University of Naturopathic Medicine) published a double-blind, placebo-controlled randomized study examining the use of freeze dried nettle leaf for treatment of hay fever, asthma, and seasonal allergies found that the freeze-dried preparation was rated higher than placebo in relieving symptoms after just one week’s time.15 Further studies on the use of nettle in preventing the lung inflammation associated with asthma have also been promising. Studies using an experimental model of allergic asthma have shown positive benefit in both immune modulation as well as reduction in inflammatory markers with administration of an aqueous extract of stinging nettle.16

Omega 3 fatty acids

The omega 3 fatty acids docosohexaenoic acid and eicosapentaenoic acid, better known as DHA and EPA respectively, are found in fish oil and are known for their anti-inflammatory properties and protective effects in inflammatory diseases including asthma and allergies.17 Studies examining fish oil supplementation during pregnancy and lactation have shown to reduce both the prevalence and severity atopic dermatitis and food sensitization during the first year of life for the offspring with a possible persistence until adolescence with a reduction in eczema, hay fever, and asthma.17 A six month study conducted by Johns Hopkins University examined the role of omega 3 fatty acids in the prevention of environmentally triggered asthma symptoms and found that having more omega-3 fatty acids in the diet results in fewer asthma symptoms triggered by indoor air pollution.18

Quercetin

Quercetin is among the most abundant polyphenols representing the flavonoid subgroup. It is naturally occurring in plant foods such as onions (the most studied quercetin containing food), broccoli, capers, apples, berries, and grapes, herbs like dill and is also found in tea and wine.19 Quercetin has been utilized in a number of studies examining factors underlying the development of allergies. Quercetin is known for many different properties including its anti-allergic properties such as inhibition of histamine release, decrease in pro-inflammatory compounds, immune system modulation, and inhibition of antigen-specific IgE antibody formation.19 All of these mechanisms can contribute to addressing the underlying cause of allergy symptoms and asthma. In an experimental model of allergic rhinitis, quercetin has been shown to reduce antigen specific IgE levels and well as mitigate the expression of allergic rhinitis symptoms.20

Sublingual immunotherapy

In years past, allergy sufferers were often subjected to extensive series of allergy shots. These were injections designed to aid in reducing the expression of allergy symptoms. Sublingual immunotherapy is a method of allergy treatment that does not involve injections, rather small tablets or liquid drops containing small amounts of specific allergens to build up tolerance and reduce symptoms. This type of immune modulation aims to decrease the pathologic immune response rather than to cause a return to an immunologically naive or unresponsive state.21 Numerous studies have shown that sublingual application of allergen specific immunotherapy is an adequate, safe and efficient substitution to the injection route of allergen administration in the treatment of IgE-mediated respiratory tract allergies.22 Meta analysis studies have shown that sublingual immunotherapy reduces both the symptoms of allergic diseases and the use of medications, and improves the quality of life of children with the diseases.22

Dietary considerations

The diet constitutes an important source of nutrients and non-nutrient components with multiple properties that present a potential opportunity to modulate the risk of asthma and allergies. Elimination diets wherein the offending food is completely avoided can be difficult to follow long term. Contemporary studies have shown that nutrition trends during the early childhood years may produce changes that have a lasting impact on human health at later ages particularly on the respiratory, GI, and immune systems.23  Western diets are characterized by the consumption of highly refined, overly processed, energy-rich foods and beverages, typically high in fat, sugar, and salt but low in dietary fiber and other nutrients. Changes in dietary habits mainly the decreased intake of fresh fruit and vegetables and a higher intake of processed foods have previously been linked to an increasing prevalence of asthma and allergies.24Multiple studies have highlighted evidence of a beneficial effect of fresh fruits, and antioxidant vitamins on asthma.25 Additional studies have specifically looked at the quality and quantity of dietary fats as a source of allergenic response. Research has shown that a high fat diet potentiates food-induced allergic responses associated with dysregulated intestinal effector mast cell responses, increased intestinal permeability, and gut dysbiosis.26 The quality of fat has also been shown to play a role in increased risk of allergenic response. In a pediatric asthma study, researchers found that for each additional gram of omega 6 fats consumed, children had a whopping 29% increased risk of being in a more severe asthma category.18 Fiber is another nutrient that is consistently lacking in the standard American diet as well as many dietary patterns of many other developed/“Westernized” countries.27 Consistent with the reported health benefits on other immune cells, dietary fiber (especially polysaccharides and oligosaccharides) and its metabolites (SCFAs) have been shown to regulate mast cell function and mast cell activation can be downregulated by pretreatment with these substances.27 Mast cells play a central role in initiating and maintaining inflammation, particularly in allergies and asthma.28

Environmental modification

Some parts of our environment are out of our control, particularly outside the home. We cannot control the amount of mold, pollen, or other allergenic inhalants that are in outdoor air. But there are steps we can take inside the home to manage our exposure indoors.

  • Rugs, drapes, wall-to-wall carpet, and even overstuffed, upholstered furniture are tremendous collectors of dust and pollen. Removing them or changing styles can help reduce exposure.
  • Using specialized air filters like HEPA filters particularly in the bedroom can be helpful. In some cases, whole house filtration systems may also be recommended.
  • Avoiding toxic inhalants like perfumes, body sprays, scented candles, room sprays, air fresheners, dryer sheets, and other scented products, especially those with synthetic ingredients.
  • Have your home tested for the presence of mold and remediate the source if mold is detected and found.
  • Use zippered, allergen resistant covers on mattresses and pillows. According to the Asthma and Allergy Foundation of America, encasing mattresses works better than air cleaners to reduce allergy symptoms.28

Dr. Dazey shares a patient success story

“One of my patients suffered from severe, debilitating spring allergies that started each April, and lasted until the end of August. Since he was a young boy, he used an inhaler for asthma, antihistamines daily, and avoided physical activity and being outdoors. This was not enough to stop the symptoms, as he still suffered miserably with irritated eyes, constant dripping nose, sneezes, headache, and generalized fatigue. His allergy symptoms became inseparable from his moderate depression. As an adult, he began looking forward to a Prednisone prescription each June, but dreaded when the effects wore off. He began to notice changes to his body, his mood, and how less effective and long-lasting it seemed each time. When he learned about the long-term health risks of Prednisone, he sought alternative management approaches. He came and saw me at age 55. The first thing I did was to let him know he could continue using all the conventional medications he needed to function and feel comfortable. He was about 50 pounds overweight, with high blood pressure, high cholesterol and triglycerides, high fasting blood sugar, and mild benign prostatic hypertrophy (BPH). We began with the standard protocol of fish oil, nettles, and quercetin, as well as soup broth that was simmered with Astragalus membraneceus root, Ganoderma lucidum powder, and Pacific bull kelp. Since he was a regular soup eater, this was more agreeable than tea, and he was motivated to use the broth in a variety of different soup recipes. The first season that he tried this protocol, he reported much reduced symptoms in April and May. When June came, he got his prescription for Prednisone but later decided it was not needed – he never filled his prescription! He also used an herbal tincture formula that relaxes the airway and found it unnecessary for weeks at a time to use his inhaler. (I am reluctant to list the herbs in the formula because they should be dispensed correctly and used under a physician’s care). He began walking outdoors with his dogs every day and eventually did not need the inhaler at all.”

To learn about natural approaches to combating allergies and asthma, contact your local naturopathic doctor. Click here to find an ND in the US and Canada.

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Naturopathic Approaches to Women’s Health

May is Women’s Health Month, an opportunity to remind women of the importance of screening, health education, and preventative care.
The AANMC shares resources that are important for women, not just in May, but all year long.

Heart Disease

25% of female deaths are attributed to heart disease.1 64% of women who die suddenly from coronary heart disease have no symptoms.Watch naturopathic cardiologist Dr. Decker Weiss’ webinar on naturopathic approaches for women with heart disease.

Osteoporosis

Approximately 25% of women will develop osteoporosis in their lifetime.1 The National Osteoporosis Foundation reports that approximately half of women over the age of 50 will break a bone because of osteoporosis.2 Lifestyle factors such as exercising, specifically weight bearing, and maintaining a nutritious diet with vitamin D and calcium are critical to bone health.

Stress

Stress can ripple through all aspects of our mind and body. Dr. Brad Lichtenstein shares how NDs help patients identify and prevent stressors, teaching them simple techniques to manage stress, and how to avoid situations that may lead to negative impacts on health and well-being.

Infertility

12% percent of women have difficulty getting pregnant or carrying a pregnancy to term.1 Naturopathic approaches to improved fertility help couples conceive quickly and safely while addressing the root cause of conception issues.

Cancer

Over 1.5 million people are diagnosed with cancer every year in the Unites States. 38% of women will develop cancer in their lifetime.1 Drawing on decades of combined experience in naturopathic oncology, Dr. Marcia Prenguber and Dr. Marie Winters review the role of a naturopathic physician from risk reduction to survivorship.

Pain Management

Millions of American are prescribed opioids to cope with chronic pain. It’s estimated that 21-29% of patients will misuse them, and  8-12% will develop an abuse disorder.1 46 people die every day from overdosing on prescription opiods.2 Dr. Tyna Moore discusses the opioid crisis and non-pharmacological approaches to pain management.

PCOS

Polycystic Ovarian Syndrome (PCOS) affects 1 in 10 women of childbearing age.1 Dr. Jamine Blesoff discusses the impacts on long-term health and how naturopathic medicine can make a difference.

Depression and Anxiety

Women are nearly two times more likely to be diagnosed with depression than men.1 Studies show that anxiety and depression are related to our genetic tendencies and exposure to stressors. Dr. Peter Bongiorno explains how naturopathic medicine can help resolve mood-related issues.

Irritable Bowel Syndrome

Most people are embarrassed to talk about problems they experience in the bathroom. With a worldwide prevalence of 10-20%, it’s time to start talking about irritable bowel syndrome (IBS).1 Hear from four NDs about why naturopathic medicine may hold the key to uncovering the root cause of IBS.

Endometriosis

200 million women worldwide and 1 in 10 women in the United States suffer from endometriosis.1 Dr. Alison Egeland discusses naturopathic approaches to women’s health and a tricky case of endometriosis.

Weight Management

Greater than 2 out of 3 women in the United States are either overweight or obese.1 Dr. Afsoun Khalili reviews natural approaches to weight loss and healthy weight maintenance.

PMS

Over 90% of women experience some form of premenstrual syndrome (PMS).1 Dr. Ellen Lewis shares how NDs guide patients to combat PMS and irregular periods, naturally.

Diabetes

1 in 9 women in the Unites States has diabetes.1 Learn how naturopathic approaches to diabetes treatment can relieve symptoms, help patients manage blood sugar levels better, and in some cases reverse disease progression.

Learn More About Becoming a Naturopathic Doctor

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Gluten – What’s All the Buzz?

If it seems like everyone and their dog is avoiding gluten lately, rest assured, it’s not all in your head. The food market is exploding with gluten free alternatives from shampoo, body care, and cosmetics to gluten free bread, cereal, and vodka. Even the Girl Scouts have joined in with the release of a gluten free chocolate chip shortbread cookie! The food industry reports that the gluten-free market is projected to balloon from about $7.28 billion in 2016 to over $16 billion in 2025.1

The exact reason for the increasing numbers of gluten intolerant people is unknown but there are several theories as to why the prevalence has increased so much, including hypotheses like the so-called “old friends” theory where it is believed that the loss of contact with the very bacteria, fungi, parasites, and other microbes that humans evolved with has resulted in intolerance to natural compounds like gluten. Research with celiac patients found that those who were intentionally infected with hookworms could then tolerate digestive exposure to gluten without problems.2 Other hypotheses include the presence of too much wheat in the diet, overuse of antibiotics, treatment of conventionally grown wheat with pesticides, and of course misdiagnosis of the problem altogether.

To gain more complete understanding of gluten and its potential impact on health, there are a few questions that must be answered.

What is gluten anyway?

Gluten is a general term for a large family of proteins found in several types of grains like wheat (all types including wheatberries, durum, semolina, spelt, faro, graham, etc.), rye, and barley. Gluten can also be found in derivatives of these grains like malt and brewer’s yeast. It is used by the plant as a source of nourishment during seed germination. Gluten acts as a glue helping foods maintain their shape and elasticity, and also allows bread to rise during baking. Gluten is often found in unexpected places like soy sauce, pickles, cosmetics, medications, supplements, and even in naturally gluten free products like rice, oats, or French fries via cross-contamination.

What does it mean to be “sensitive” or “intolerant” to gluten?

People that are sensitive or intolerant to gluten are those who develop any number of symptoms when they consume gluten or gluten containing products. Often termed, non-celiac gluten sensitivity, these people may experience many of the same symptoms such as brain fog, gas, bloating, constipation, headaches, joint pain, etc. as someone with celiac disease yet they do not test positive for the condition. Such individuals may see benefit including resolution of symptoms from adhering to a gluten free diet.

What is the difference between a gluten “sensitivity” or “allergy” versus an “intolerance”?

An allergy to a particular food happens when the body produces an immune response upon exposure to that food. The resulting symptoms can be mild like a stuffy or runny nose and/or headache to moderate symptoms like hives, itchy mouth, or a rash, to severe reactions like throat tightening, difficulty breathing and even life-threatening anaphylactic reactions. Researchers estimate that 32 million Americans have food allergies, including 5.6 million children under age 18 – that’s roughly two people in every classroom!3 Further, the Center for Disease Control reports that the prevalence of food allergies among children increased by 50% between 1997 and 2011.3

Another type of food reaction is an intolerance (though people often mistakenly call these allergies). This type of reaction is not initiated by the immune system and does not result in anaphylactic reactions. Food intolerances are often related to the absence or decreased activity of specific chemicals or enzymes that are required to digest certain substances. A classic example of this is lactose intolerance. People who suffer from lactose intolerance lack sufficient amounts of the enzyme lactase which is needed to digest lactose resulting in digestive disturbance.

In conclusion, the difference between an allergy and an intolerance comes down to the type of biochemical reaction that drives them within the body. The treatment in many cases may be the same (avoidance) regardless of the type of reaction causing the symptoms.

What are the signs and symptoms of gluten sensitivity/intolerance?

The reactions an individual has to gluten consumption can vary. This is by no means an exhaustive list, and not every person will have every symptom, but typical symptoms include:

  • Bloating
  • Flatulence
  • Constipation
  • Diarrhea
  • Irritable Bowel Syndrome (IBS)
  • Iron deficiency anemia
  • Joint pain
  • Skin problems
  • Asthma
  • Mood imbalance
  • Fatigue
  • Weight loss
  • Delayed puberty (in children)
  • Slowed growth (in children)
  • Infertility
  • Osteoporosis

What is celiac disease?

The most well-known and serious type of gluten reactivity is an inflammatory gut disease known as celiac disease. Celiac disease is often thought of as a food allergy, but since celiac is a genetic autoimmune disease caused by activation of certain genes, this is an inaccurate representation. About 33% of people in the Western world, carry the gene for celiac disease.4 But since celiac disease has a prevalence of only about 0.5-1%, the cause is beyond simple genetics and disease manifestation in susceptible individuals likely must also include an environmental trigger.5

As in other autoimmune diseases, people with celiac disease may have periods of exacerbation of symptoms or remission, when they are asymptomatic.6 However, celiac disease is chronic. If someone with celiac disease consumes gluten, an abnormal immune response is triggered that causes significant inflammation that damages the villi of the small intestine.5 The villi are finger-like projections found in the small intestine whose function is to increase the surface area of the small intestine to facilitate absorption of nutrients as food moves through. The damage to the villi and inflammation of the intestinal lining can lead to malabsorption and malnutrition which can lead to osteoporosis, anemia, and delayed growth.

Are celiac disease and gluten intolerance the same thing?

No. Although the symptoms can often be the same, celiac disease and gluten intolerance are driven by different biochemical processes within the body. Celiac disease is an autoimmune condition that results in an immunologic response to gluten in the intestines. An intolerance is not immune mediated and may be related to lack of key enzymes or chemicals required for digestion of gluten.

Can a gluten free diet help?

Yes! In the case of celiac disease, a strict gluten free diet is an absolute must. A gluten free diet means that the protein gluten is excluded from all foods consumed. Label reading is very important when taking on a gluten free diet. Some people are exquisitely sensitive to gluten and may not see improvement of symptoms with a gluten-free diet if they are exposed to even small trace amounts of gluten. For this reason, some people may need to be very conscientious of hidden sources of gluten as well cross contamination of typically non-gluten containing foods. Such individuals would need to consume gluten free products from facilities and growers who are strictly dedicated to being gluten free.

Be sure to consult your naturopathic doctor if you are considering switching to a gluten free diet. Click here to find an ND in the US and Canada.

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Ashwagandha 101: The Naturopathic Kitchen

Welcome back to The Naturopathic KitchenAs always, our focus here is to learn more about bringing new, fun, and healthy foods into our home kitchens. Today we will take a closer look at a lesser known powerhouse called ashwagandha!

Ashwagandha 101

Ashwagandha (Withania somnifera) may be a relative newcomer to the Western world, but this herb has a long and distinguished history of use. It has been in use in Ayurveda (the traditional system of medicine used in India) for 6000 years, with a wide range of health benefits.1 Ashwagandha is a member of the nightshade family and is commonly known as “Indian Winter Cherry” or “Indian Ginseng.” Rooted in Sanskrit, Ashwagandha literally means “smells like a horse.” It has been suggested that the herb was given this name because taking it can provide one with the strength and stamina of a horse.2 Ashwagandha has been used medicinally in the treatment of a list of conditions in infants and the elderly. Overall, ashwagandha is considered an adaptogen, meaning it helps the body cope with stress. Ashwagandha is known to tonify and regenerate the entire system, especially the endocrine and immune systems.3

Where does ashwagandha come from? Where can I find it?

Although ashwagandha is sometimes referred to as Indian Ginseng because of its revitalizing and energizing properties, it is not a ginseng at all and is actually more closely related to  tomato or eggplant. The herb itself is a leafy shrub with yellow-green flowers and orange-red berries that is native to Pakistan, India, and Sri Lanka.4 Ashwagandha is not typically found in a supermarket but may be found at health food stores available as a fine powder or tincture extract. The herb has a bitter taste and has been added to things like ghee, honey, chocolate, baked goods, and smoothies.

How does ashwagandha help my health?

Ashwagandha is known for its ability to enhance the function of the brain and nervous system and improves the memory.5 It is an essential for support of the reproductive system, aiding in infertility.6 As an adaptogen, Ashwagandha has the profound ability to help the body handle stress. It has been shown to reduce cortisol levels and improving quality of life.7 Ashwagandha also benefits the immune system and strengthens resistance to disease.1 Its powerful antioxidant capacity makes it very effective in guarding against cellular damage due to free radicals.8 Ashwagandha should be avoided in people with allergies to nightshades.

What medical conditions/symptoms is ashwagandha used for?

Promotes insulin sensitivity

Supports hormone balance

Protects brain health

Enhances muscle size and strength

Improves endurance and athletic performance

Multiple pathways of anticancer activity

When should ashwagandha be avoided?

Ashwagandha has a long history of use and a good safety profile. Most people can safely take ashwagandha, however minor side effects such as headache and digestive disturbance have been reported in some clinical studies.

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

 

Ashwagandha Gingerbread Cookies

INGREDIENTS

2 c organic oat flour
1/2 c coconut oil, melted
2 t ashwagandha powder
2 T ground ginger
2 T ground cinnamon
1/2 T ground cloves
1/2 t sea salt
3 T maple syrup
2 T blackstrap molasses

INSTRUCTIONS

Preheat oven to 375 degrees and grease a cookie sheet with coconut oil. In a large bowl, whisk together flour, ashwagandha, ginger, cinnamon, cloves, and sea salt. Add coconut oil, maple syrup, and molasses into the dry ingredients bowl. Knead the mixture with your hands until it is a soft dough. Roll about a tablespoon of dough and place onto the cookie sheet, and continue for each cookie. Take the back of the spoon and lightly press down on the top to soften the cookie. Bake for 15 minutes or until crispy.

Thank you to Moodbeli for this fabulous recipe!

Comforting Cashew Night Tonic

INGREDIENTS

1 c cashews, soaked overnight
2 c filtered water
1 t maple syrup
½ t vanilla bean, ground
1 t cinnamon powder
¼ t nutmeg, grated
½ t ashwagandha powder
Pinch of sea salt

INSTRUCTIONS

Make homemade cashew milk by adding soaked cashews to a blender with enough filtered water to fill one inch above cashews. Blend until smooth. You will use 8 ounces of the milk in your recipe and any extra will keep for a few days in an airtight jar or bottle in your refrigerator. Add cashew milk, maple syrup, vanilla bean, cinnamon, nutmeg, ashwagandha, and sea salt to a small pot. Heat on high, removing before it comes to a boil. Stir using a spoon, whisk, or milk frother to be sure everything is combined. Relax and sip away once cool enough to drink.

Thank you to Banyan Botanicals for the amazing recipe!

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How Do YOU Take Care of Your Mental Health?

With the hustle and bustle of the 24/7 news cycle, family, and work/school responsibilities seemingly adding more to our to-do lists than there are hours in the day – we thought we would compile some of AANMC’s favorite ways to recharge and unplug from day-to-day stresses.

Laugh

Laughter is medicine, so let yourself enjoy a good belly laugh! Get together with friends and family, go to a comedy show, or simply watch a silly show…whatever tickles your funny bone!

Exercise

Move that body! Walk, dance, play a team sport, swim. The ‘what’ doesn’t matter as much as long as you are making it happen. Shoot for at least 30 minutes daily.

Meditate

People often associate meditation with a long and intricate process. It can be as easy as practicing clearing your mind of active thoughts before bed. Letting whatever does come to mind quietly float away. It doesn’t need to be complicated. Start out small and work your way up.

Unplug

Literally. If you are constantly tethered to a mobile device or screen, free yourself by spending some time away and ‘off–the-grid.’ Try to do this for 1-2 hours before bed at a minimum, and if you can – schedule a weekend a month and a week a year, completely tech free!

Spend Time in Nature

Don’t have time to enjoy nature every day? Bring the outside, in. Open a window or try to work where you can see the beauty of your natural surroundings. Invest in a houseplant. Grow window herbs. And when you can, and as often as you can, make an effort to walk, hike, play, or swim to realign yourself with nature.

Socialize

When was the last time you had a heart to heart with a loved one? Are your personal relationships filling or emptying your cup? If more are emptying – then it may be time to reassess who you allow in your sacred circle of friends. Social support is a vital component in the ability to adapt to stressors. Make sure you take time to nurture your relationships.

Spend Time with Pets

Pets are often responsible for filling their owner’s heart with love, but studies have also demonstrated that pet ownership can positively impact your overall health.

Get Organized

Sometimes being a little proactive and cleaning your space or organizing the day can help minimize the stress that comes with clutter of both your mind and surroundings. While cleaning may not be everyone’s favorite activity – there is a good amount of satisfaction that comes with a tidy and organized space. Pencil it in on the calendar if you have trouble making it a regular habit.

Sleep

How long has it been since you slept like a baby? Sleep is an important factor in supporting overall balanced mental, emotional, and physical health. Getting too few hours of sleep can contribute to any number of health crises. Practicing good sleep hygiene can get you back to catching those restful Zzzzs.

Eat Well

The foods we eat on a daily basis can have important effects related to disease susceptibility, proper physical, mental, and intellectual development, inflammation and immunity. Whether these effects are taking us in a positive or a negative direction depends on the choices we make. Educate yourself on what you eat and get tasty recipes with The Naturopathic Kitchen.

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Stinging Nettle 101: The Naturopathic Kitchen

Welcome back to The Naturopathic KitchenAs always, our efforts are centered on introducing ways to bring new, fun, and healthy foods into our home kitchens. Today we will take a closer look at a delightful green with a scary sounding name – stinging nettles!

Stinging Nettle 101

Stinging nettle (Urtica dioica) is commonly called “nettle.” In modern times, stinging nettle is often considered a nuisance weed, popping up in gardens, flowerbeds, and yards every spring. However, stinging nettle has a rich history of varied uses across many cultures. Chief among the oldest uses of stinging nettles is as a fiber for fabric, sail cloth, cordage and fishing nets. In Denmark, burial shrouds made of stinging nettles date back to the Bronze age some 4000 plus years ago.1 Similarly, stinging nettle was used by Europeans and Native Americans as material for sailcloth, sack material, cordage, and fishing nets.1 The cloth produced from stinging nettle is called “nettle cloth” with a silken, linen-like quality.2 During wartime, raw textile material shortages were quite common. German military uniforms worn during World War I were 85% nettle fibers.1 The fibers of the nettle plants were not the only part used in textile production. Decoctions of the nettle plant’s rich chlorophyll are used to produce green dye used for clothing as well as a food coloring agent.1

Stinging nettle has also been traditionally used as food for livestock. In fact today, stinging nettle is often fed to chickens to increase egg productivity.3 It is also used as a source of vegetarian rennet during the cheese making process and is still included in Passover herbs. Nettle is a very popular wild edible plant in some developing countries and contributes to both community food security and in some cases, the local economy.4 Nettle is often used in curries, soups, and vegetable dishes as well as an additive to breads and pastas. In Georgia, a former member of the Soviet Republic, boiled nettle with walnuts is a common meal.

From the leaves to the seeds, stinging nettle plants have been used medicinally throughout history. Nettle leaves have traditionally been used for scurvy, anemia, arthritis, seasonal allergies, wound healing, and general fatigue, and as a diuretic and to stimulate pancreatic secretion.4 Stinging nettle tea has been used historically as a cleansing spring tonic and blood purifier. The juice of nettle leaf has been used as a hair rinse to control dandruff and to stimulate hair growth.1 Among the oldest medicinal uses of stinging nettle is in the process of urtication. Urtication involves flogging the skin with a frond of a fresh nettle, allowing the tiny hairs or trichomes to pierce the skin. The trichomes are tiny, hair-like projections that cover the leaves and the stem of the plant. They have a bulbous tip that breaks off when touched, revealing needle-like tubes that pierce the skin and inject their serum of acetylcholine, formic acid, histamine, and serotonin resulting in an itchy, burning red rash that can last for half a day.5 This practice has been documented by many cultures and has been in use for thousands of years. Urtication was prescribed for a variety of maladies from chronic rheumatism, lethargy, coma and even for infectious diseases such as typhus and cholera.1 Additional uses of nettle have included soaking the stems and leaves in water then applying the water as an organic/natural pesticide to plants that are infected with mites or aphids. Nutrient-rich nettle also helps to restore the vitamin and mineral content of soil used for growing crops which can help enhance the vitality of the plants. It also helps to speed along the composting process.

Where do stinging nettles come from? Where can I find it?

Nettle is native to a large region spanning northern Africa, Europe, and Asia but has been found widespread across the Western world as well from northern Mexico to northern Canada for hundreds of years.3 Nettles are reported to be among the tastiest cooked greens with a flavor similar to spinach but a bit sweeter. Nettle is a good source of several vitamins and minerals including vitamins A and C, iron, potassium, and calcium as well as a balanced source of omega 3 and omega 6 fatty acids. 3

Fresh nettle can be difficult to find commercially; however, you may be able to find them at farmers markets, local food co-ops, or online. Also, they grow wild in abundance, and the tender young tops can be gathered for free, particularly during the early spring months. If foraging for nettle though, be sure to wear gloves to avoid the “sting!” It is important to note that once dried, wilted or cooked, the trichomes become denatured and are no longer capable of stinging.3 Fresh nettles can be boiled, steamed, stir-fried and consumed as a standalone vegetable or they can be added to any number of savory dishes including baked goods.

How do stinging nettles help my health?

Stinging nettle has long been recognized for its medicinal qualities. Hippocrates utilized 61 different remedies that contained nettle.1 Nettle is an extremely valuable medical herb that is often used in the spring months as a gentle detoxifying agent.6 Among the most recognized benefits of nettle is its benefit for benign prostatic hyperplasia (BPH), commonly known as an enlarged prostate.7 There have been multiple studies examining the effects of nettle on the prostate and all produced favorable results in terms of symptom reduction as well as safety when compared to placebo.8,9,10

Nettle has a significant research profile as a treatment for allergies and allergic rhinitis.11 Portland, Oregon based National College of Naturopathic Medicine (now National University of Naturopathic Medicine) published a double-blind, placebo-controlled randomized study examining the use of freeze-dried nettle leaf for treatment of hay fever, asthma, and seasonal allergies found that the freeze-dried preparation was rated higher than placebo in relieving symptoms after just one week’s time.12

Osteoarthritis is the most common form of arthritis and is a debilitating and painful condition impacting the lives of millions of Americans.13 Nettles can also help alleviate the symptoms of osteoarthritis and ease joint pain.7 Studies also show that consuming nettle can reduce the need for NSAID type pain medication by producing a synergistic effect.14

What medical conditions/symptoms are stinging nettles used for?

When should stinging nettles be avoided?

Outside of outright allergy or sensitivity to the plant itself, nettle is very safe and has been consumed for thousands of years with no issues. However, while nutrient-rich dried nettle and nettle infusions are often recommended as a nourishing tonic during pregnancy, fresh nettle has been reported to have stimulatory action on the uterus and should be avoided. 15

Let’s try out stinging nettles with these delicious and nutritious recipes!

Stinging Nettle Pesto

INGREDIENTS

Salt and freshly ground black pepper
1/4 lb. stinging nettles
1/4 c fresh mint leaves
1 clove garlic, minced
1/2 c pine nuts, toasted
2 T lemon juice
1/3 c olive oil
1/4 c firmly packed grated Parmigiano Reggiano cheese (can omit for vegan pesto)

INSTRUCTIONS

Fill a large pot halfway full with water. Add 1/4 cup salt and bring to a boil. Fill a sink or a large bowl with cold water. Using gloves or tongs, submerge the nettles in the water and let them sit for 5 minutes. Remove the nettles and discard the water. Wearing rubber gloves, pull the leaves from the stems and discard the stems. Put the nettles in the boiling water and boil for 1 minute. Drain and spread the nettles on a baking sheet. Let cool completely. Squeeze out as much of the water as possible and coarsely chop. Place the nettles in the bowl of a food processor with the mint, garlic, pine nuts, and lemon juice. Process until the mixture has formed a paste. With the machine running, pour in the olive oil. Transfer to a bowl and fold in the cheese. Taste and adjust the seasoning with salt and pepper.

Thank you to SplendidTable.org for this wonderful recipe!

Chicken Nettle Soup

INGREDIENTS

6-7 c bone broth
3 large handfuls of cubed or shredded chicken
4 T grass fed butter (or substitute with olive oil)
1 large onion, diced
4-6 large carrots, diced
2 large ribs of celery, diced
6-8 cloves of garlic, chopped
1/4 c dried nettle
Fresh flat leaf parsley, chopped for garnish
Fresh scallion, chopped for garnish
Salt and pepper to taste

INSTRUCTIONS

  • Add the butter to a pot and swirl around the bottom until it foams
  • Add the onion, garlic, carrot, and celery and sauté for 5 minutes on med heat
  • Add chicken and cook for one minute
  • Season with freshly cracked black pepper and sea
  • Add the bone broth and dried nettles to the pot and turn up the heat until the soup begins to simmer
  • Turn the heat down and gently simmer for 10-12 minutes until the carrots are fork tender
  • Serve and garnish with fresh parsley and scallions

Thank you to holistichelathherbalist.com for this tasty recipe!

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Naturopathic Doctors as Part of the Health Care Team

While many naturopathic doctors work in private, solo practices, there is increasing demand for NDs as vital members of the health care team. Interprofessional healthcare occurs when different disciplines collaborate to collectively provide patient care. Patients benefit by having the right expert advice at the right intervention point. Improved cross-profession communication also decreases care delays, medication interactions, and promotes team members working together for optimal patient care. Naturopathic doctors are an integral part of interprofessional healthcare delivery in many types of patient care settings. We speak with nine naturopathic doctors in various interprofessional healthcare settings to learn how they work to uncover the root cause of illness, coordinate care with numerous professionals, and ultimately educate and empower patients toward wellness.

One of the nine doctors we interviewed is Dr. Arvin Jenab, a naturopathic doctor at the Susan Samueli Center for Integrative Medicine (SSCIM) at the University of California-Irvine Health. He serves as the Medical Director of Naturopathic Medicine and the Director of the Naturopathic Residency Program. He works directly with medical residents and patients and is actively involved in research and education. Dr. Jenab also works to develop new programs to increase access to integrative medicine by underserved communities across Orange County, California.

Interprofessional healthcare benefits patients and doctors alike – the days of one doctor treating one condition are behind us – we have moved into an era where patients need a village of doctors and doctors need a team of colleagues!  Interprofessional healthcare results in team-based, patient-centered, compassionate care. Patients feel heard and more extensive efforts and resources go into determining the cause of illness and developing the most effective treatment plan. With the complexity of chronic diseases and overwhelming number of influences that impact health, it is increasingly important to create opportunities for interprofessional healthcare whereby both patients and doctors can engage in meaningful exchanges aimed at changing the context of health.”

Arvin Jenab, ND

Graduate, Canadian College of Naturopathic Medicine

Uncovering the Root Cause

Naturopathic medicine is grounded in the inherent belief that is better to prevent illness and get to the root cause than to suppress symptoms. This is why initial visits with naturopathic doctors are likely to last between 60-90 minutes. Topics such as nutrition, digestive health, family history, stress, sleep, and mental health will be addressed regardless of the issue presented with the understanding that the body functions as a complete system, and that each of these pieces are components and contributors to overall health.

Dr. Sunita Iyer is the Clinic Director and Founder of Eastside Natural Medicine, PLLC where she and her colleagues see primarily perinatal and pediatric patients, offering midwifery care, mental health care, acupuncture, lactation management, minor surgery, and primary care for all ages. Dr. Iyer’s specialties are the Five Ps: preconception, pregnancy, postpartum, parenting, and pediatrics.

“When patients have each part of their body addressed by a separate health care provider, there is a presumption that health and well-being happen in isolated systems.  We know this isn’t true. When working as an integrated and interdisciplinary team, we can better understand our roles, contributions, and limitations to communicate more effectively about the person we are treating rather than the systems. Patients know that we are all working toward their health together, and that when something isn’t working, we will all problem solve together.”

Sunita Iyer, ND, LM

Adjunct Faculty and Graduate, Bastyr University

Dr. Tegan Moore is the Executive Medical Director and Co-Founder of WHEELHOUSE Center for Health and Wellbeing. Her practice sees a variety of patients from pediatrics to oncology who are looking for a team-based approach and personalized healing solutions for chronic illness. Dr. Moore’s team works together to provide a one-stop-shop for genomic and microbiome analysis, personalized nutrition and lifestyle interventions, acupuncture, and cognitive/behavioral health.

“Naturopathic doctors are trained to search out and address imbalances in the body that cause symptom patterns—a method of doctoring that often requires unique treatment strategies catered to the needs of the patient. This approach to treatment often stands in contrast to allopathic protocol-based treatment plans and can act to augment care plans and improve health outcomes.”

Tegan Moore, ND

Graduate, University of Bridgeport School of Naturopathic Medicine

Many times, these conversations with patients reveal symptoms or health issues that may have not otherwise been addressed, and can act as a first line of defense against chronic disease, greatly reducing the need for future healthcare intervention.

Dr. Lisa Taulbee is a primary care provider who specializes in women’s health and gynecology. She works for ZoomCare, which is an on-demand interprofessional health care clinic with specialists who are available to see patients without referrals seven days a week .

“Patients often require multiple approaches and therapies to best manage health conditions.  All the providers on a patient’s care team are able to provide input in regards to their own specific areas of expertise, including naturopathic doctors.  Natural therapies can augment conventional therapies and even prevent the need for conventional therapies that may have adverse risks associated.”

Lisa Taulbee, ND

Graduate, National University of Natural Medicine

Dr. Jacob Wolf serves as a naturopathic provider at Lake Health Integrative Medicine, a practice which consists of osteopathic physicians, medical doctors, and chiropractors.

“With current heavy reliance on opioids and polypharmacy, a growing number of patients are looking for non-drug alternatives that an ND can offer.”

Jacob Wolf, ND, LAc, Dipl. OM

Graduate, Southwest College of Naturopathic Medicine

Furthermore, “NDs are investigative diagnosticians. They take the time to gather a fair amount of information including labs and imaging, analyze and interpret based on defining and guiding principles of naturopathic medicine, develop hypotheses, and follow through with sometimes complex treatment strategies.  Our uniqueness is our systems-based approach to health and disease, and our consideration of the mental and emotional factors that influence patients’ health,” adds Dr. Jenab.

Dr. Dawn Siglain specializes in autoimmune, pulmonary, and renal health at Inner Source Health in New York City. She also is trained as a Reiki instructor and acupuncturist.  Dr. Siglain describes a visit at Inner Source as unlike any other doctor appointment, with an in-house variety of providers for women’s health, pediatrics, mental health, chronic pain, neurodegenerative disease, cardiovascular health and metabolic syndromes, Chinese Medicine, Lotus Physical Therapy, Pelvic Floor Therapy, and massage therapy.

“Naturopathic medicine extends beyond what labs may reveal about a current physical state.  Using a preventative eye, I assess labs with a narrower reference range which allows for detection of imbalance in the body before symptoms of discomfort may arise.”

Dawn Siglain, ND, LAc

Graduate, University of Bridgeport School of Naturopathic Medicine

Doctor as Teacher

The first step to treatment is providing patient education with medical professional insight. Naturopathic doctors take the time to explain how factors could be contributing to illness so that the whole person is treated, not just the symptoms. In doing so, naturopathic doctors may collaborate with other medical professionals to provide the most comprehensive care available. Most importantly, the patient is involved and given options in each step of the process.

Dr. Dan Rubin is a board-certified naturopathic oncologist, founding president of the Oncology Association of Naturopathic Physicians, and Medical Director at Naturopathic Specialists, LLC., where many of his oncology patients are sent to him on referral from medical doctors. His team of interprofessional healthcare providers sees patients for pain management, diet and nutrition, IV therapy, and more.

“As part of an interdisciplinary team, each physician is presented with the same patient, but each physician, given their specialty, is going to see the patient a little bit differently. NDs are very attuned to identifying the cause of illness rather than just addressing the symptoms.  This focus on asking “Why did you become ill?” rather than jumping straight to “do this to get better,” helps to facilitate patient education and draw attention to the patient’s accountability in maintaining their own health.  It’s that vital step that makes personalized medicine and care possible.”

Dan Rubin, ND, FABNO

Graduate, Southwest College of Naturopathic Medicine

Dr. Heather Bautista is a naturopathic provider at Edward-Elmhurst Integrative Medicine Clinic. She works alongside medical providers to offer holistic patient care.

Simply put, interprofessional healthcare gives patients options. Being in an outpatient hospital setting, I often get statements like ‘I don’t want to go on medication’ or ‘I don’t want to be on this certain medication’ followed by ‘What can I take instead?’  It is not about replacing a medication with a supplement, but giving the patient options of what they can do at home with their lifestyle, food choices, possibly looking into environmental exposures, stress levels, detoxification pathways, etc.”

Heather Bautista, ND, CNS, LDN

Graduate, National University of Health Sciences

If the patient desires care outside the specialties or training of one health care provider the naturopathic doctor will make referrals to another.

Dr. Erica Joseph is a naturopathic oncologist at Seattle Integrative Oncology. In this busy practice, naturopathic doctors offer patients additional care in addressing symptoms and side effects from their treatments – a service that other providers do not have time to offer.

“Within the realm of oncology, each practitioner has a very specific role that they play and the different modalities can be quite separate, from radiologists who provide imaging, to surgeons who perform biopsies or curative surgeries, on to medical oncologists or radiation oncologists who provide their respective treatments. As a naturopathic doctor, I work with patients through each of these different stepping stones and help them to have a cohesive and optimal health care plan. By having the option to see multiple providers, patients gain more knowledge about their health and are given more options for treating their health conditions.”

Erica J. Joseph, ND, LAc, FABNO

Graduate, Bastyr University

Many times, naturopathic doctors can work with patients to incorporate lifestyle changes such as exercise, diet, nutrition, and stress management that provide a more natural approach to healing and longevity.

“From a family medicine perspective, the interdisciplinary model is priceless. Being able to see a child, and also take care of the parents, and even grandparents, provides insight not only into the symptoms in that moment; we gain a critical view of all of the social dimensions of health which often supersede the healthcare encounter in terms of effects upon a child’s or family’s health,” Dr. Iyer adds.

Interprofessional Feedback

Naturopathic doctors share the feedback that they have received about their naturopathic approach from their interprofessional team members.

Intrigued by whole-person approach

Dr. Jenab states, “My colleagues are intrigued and interested in learning more about the naturopathic approach to patient care.  Specific feedback is that we are thorough, hold a lot of information in context, are effective at engaging patients, and create a therapeutic space that encourages patients to speak openly about their health including their emotions, thoughts, and beliefs.”

Open to new approaches

As a licensed naturopathic doctor who practices in a pre-licensed state, I am always surprised by the positive feedback I get. My day-to-day interaction in my practice is with osteopathic physicians, medical doctors, and chiropractors who fully understand and appreciate the training of naturopathic doctors and value my approach to patient care. Other colleagues outside of my practice have occasionally been skeptical of treatment or diagnostic techniques that I have used, but have been open to trying new approaches,” says Dr. Wolf.

Surprised by extent of patient care

Dr. Iyer provides a different context on feedback she’s received. “I have a lot of friends who are other healthcare providers: nurse practitioners, surgeons, dentists, and physical therapists.  When they heard that I am a naturopathic physician and midwife, they hesitated.  They aren’t sure what that means.  Do I run wild in the countryside with scissors? Am I anti-vaccine? Am I anti-medicine altogether?  The way I describe my approach is as ‘natural-lite.’  Which isn’t to say that I don’t find natural therapies incredibly powerful or effective in my practice.  What I mean is that my approach is very much a marriage of methods.  All are welcome. Over time, I subject both natural and conventional therapeutics to scrutiny.  I don’t think one side is ‘better’ than the other.  I don’t think that there are sides.  We live, as do our patients, in a system. For our patients to be healthy but also well-resourced, we must work within the system to get their needs met.  Other providers are surprised that the naturopathic approach and the holistic approach involves the larger healthcare context of our patients, and not just using herbs or supplements to treat symptoms.”

Patient Success Stories

Naturopathic doctors share success stories of interprofessional patient care.

Cancer

“As a cancer specialist, I see the benefits of interprofessional healthcare firsthand. I really believe that ‘it takes a village’ when it comes to the treatment of a person with cancer.  If a patient only sees one physician, there’s realistically only so much care that they can receive. By involving medical, surgical, radiation, and naturopathic oncologists, the care they receive is more rounded and the patient is well-supported; it’s a team effort to provide the best care possible. I also believe the principle that ‘iron sharpens iron.’ The interactions and experience that I’ve had with my multidisciplinary colleagues over the years has made me a better physician, and enhanced the care that I provide by expanding my own knowledgebase.”

Dan Rubin, ND, FABNO

Graduate, Southwest College of Naturopathic Medicine

Breast Cancer and Hypothyroid

“I am treating a patient with metastatic breast cancer who has been on a trial drug for about two years. During this time, she has had multiple joint pain, severe fatigue, as well as insomnia. We had been attributing her fatigue to treatment side effect, however upon deeper investigation we found that she was hypothyroid, likely due to the variety of treatments she has received. By improving her thyroid function, she has regained significant energy as well as improved sleep. She was also starting to develop elevated liver enzymes due to her treatment and although she has been responding well, there was concern she might not be able to continue. Working together with her medical oncologist, we were able to come up with a plan to stabilize her liver enzymes which has allowed her to continue treatment. Additionally, I provided her acupuncture, which has greatly improved her pain level and daily functioning.”

Erica J. Joseph, ND, LAc, FABNO

Graduate, Bastyr University

Lower Back Pain

“A patient came to me for acute low back pain on referral from a neurologist. His symptoms were initially concerning for a potentially emergent condition, cauda equina syndrome, but there was no evidence on MRI. Since a surgical treatment was not an option, he was referred for acupuncture. I used a combination acupuncture techniques and targeted supplements to resolve the majority of symptoms including peri-anal numbness, thigh and groin pain, and low back pain. However, he still had a “stuck” feeling in his right sacro-iliac joint when moving from seated to standing. He began a series of biweekly manipulation sessions. Additionally, he began treatment with a massage therapist available in our practice. He now has complete resolution of symptoms and is back to full function.”

Jacob Wolf, ND, LAc, Dipl. OM

Graduate, Southwest College of Naturopathic Medicine

Women’s Health

“A 39-year-old female patient presented initially for an evaluation of acute abdominal pain. She was ultimately diagnosed with NSAID-induced gastritis.  After questioning the patient, she revealed that her high NSAID use was due to severe dysmenorrhea from stage 4 endometriosis.  She had previously desired to preserve her fertility and declined contraceptive options and hysterectomy for treatment.  We initiated numerous natural therapies to help control her pain as well as counseling her on all options, including surgery.  Her pain was so severe and limiting her life to such a degree that ultimately, she made the decision to move forward with hysterectomy.  I referred her to a surgeon I frequently work with who was able to perform the surgery. Though it was not natural therapies that ultimately resolved her issue, I believe that having the time to try multiple options as well as counsel her on the risks associated with surgery and answer her questions as well as address her fears, she was able to make the decision that freed her from the excruciating pain she had been dealing with for decades.”

Lisa Taulbee, ND

Graduate, National University of Natural Medicine

Weight Loss

With hopes of making a full recovery after a work-related back injury, my patient considered the advice of his physical therapist to start exercising and lose weight and was referred to me to help with this lifestyle change. After four months, he lost 84 pounds. You may learn more about his weight loss journey here. Since this story was published, this patient has started intermittent fasting with continued weight loss.

Heather Bautista, ND, CNS, LDN

Graduate, National University of Health Sciences

Pregnancy and Birth

“One of my favorite stories is of a new mother that was in the care of a midwife at my clinic. During her care, she came to me for management of her thyroid with medication, lifestyle, and nutrition, which was very different than what her prior primary care physician was able to offer.  Given the nature of my working relationship with her midwife, we were able to jointly manage her care plan, labs, and follow up.  In the course of her pregnancy, she required a TDaP vaccine, which she was then able to walk right upstairs and receive with our team.  After her baby was born, she was having lactation difficulties.  I was able to step in to help with some botanical lactation support, she was able to see our acupuncturist for milk supply augmentation, and was able to connect with our mental health counselor and psychiatric nurse practitioner to assist with her postpartum anxiety and depression.  I was able to work with both her mental health team members to offer nutritional and supplemental support, and to ensure that her treatments were synergistic, not overlapping, and certainly not antagonistic and causing harm.  Most importantly, she was able receive all of this care in one place. She came in with her baby and was able to move between appointments seamlessly, with each of us shifting rooms to accommodate her while she breastfed or pumped.  While there are so many stories like hers, what we have created in our clinic in terms of interdisciplinary and integrated care that holds families is an incredible experience for us as providers, and for the families that we care for.”

Sunita Iyer, ND, LM

Adjunct Faculty and Graduate, Bastyr University

Psoriasis

“A recent success was the complete remission of an intractable case of psoriasis that presented in the ear canals and genitals and produced chronic and constant itching and irritation that was very distressing to the patient. The team approach included naturopathic internal medicine techniques including specialized genomic analysis of the patient’s inherited gene single-nucleotide polymorphisms that were potential contributors to immune dysregulation, genomic analysis of the patient’s microbiome to address inflammation that could be contributing to the immune activation, personalized nutrition offered by our skilled nutritionist as well as process cognition sessions with our hypnotherapist to support anxiety and improve the patient’s stress management skills. I am happy to report that the patient’s skin lesions healed within six weeks after treatment began and they are still symptom free to this day!”

Tegan Moore, ND

Graduate, University of Bridgeport School of Naturopathic Medicine

Mental Health

“I had a patient suffering from mental health concerns which were severely impacting his personal and work life.  He wanted only all-natural treatment; however, he was taking medications to keep his mood stable.  He had an appointment with his prescribing physician, but told me that he wasn’t going.  I strongly advised him that it was in his best interest to go to the appointment, explain his desires to his medical doctor and continue taking the medication as prescribed.  For him, naturopathic medicine could only work in conjunction with conventional medicine.  With the patient’s consent, I reached out to his psychiatrist and sent him my recommendation plan for this patient’s naturopathic appointment. It was so important in this case to have continuity of care including clear communication with his prescribing physician.  We were both concerned for the patient’s well-being.  In addition, this patient needed the support of naturopathic medicine combined with allopathic care to achieve his optimal state of mental wellness.”

Dawn Siglain, ND, LAc

Graduate, University of Bridgeport School of Naturopathic Medicine

Continuous Learning and Excellence in Patient Care

Naturopathic medicine serves as a key component to interprofessional patient care. With the collaboration of health care professionals, naturopathic doctors serve as a teacher and guide in navigating patients through their healthcare options. Furthermore, interprofessional care encourages open-mindedness and continued education between providers to establish the best care possible for each unique patient.

I consider myself an idealist and hold a personal vision for an integrated model of care where the naturopathic paradigm helps to inform the overall team approach. Although many integrative health settings currently offer naturopathic care as a ‘supportive’ or ‘complementary’ modality, it is my hope that the heightened interest in holistic and functional approaches to healing makes room for naturopaths to act more often as the central hub in integrated clinical settings.”

Tegan Moore, ND

Graduate, University of Bridgeport School of Naturopathic Medicine

In the words of Dr. Rubin, “In the end it’s all about the medicine and supporting the patient in a positive way. Having a community of health care providers, each with their own perspective and experience, looking at one person and weighing in on what options they have while supporting and enhancing treatment is a wonderful standard of care to aspire to.  In my opinion that’s how medicine should be delivered and exactly the care I would want to receive.”

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