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It doesn’t happen often I get to practice my newly acquired skills on my parents, since the Atlantic Ocean keeps us apart for most of the year. So when they came over this summer to travel British Colombia with me, I made sure I brought my equipment with me, including my acupuncture kit. You never know when an opportunity presents itself.

Having spent numerous vacations in the Alps, we are all avert mountain hikers, so we were excited to explore the Rocky’s with it’s famous crystal blue lakes and stunning views. Our first hike was supposed to be a warm-up – a gentle warning to our bodies about what was yet to come. Yet my mom was struggling to keep up with the rest, breathing heavily and frustrated with her perceived “unfitness”.

Something wasn’t right. My mother has climbed mountains for longer than I can remember and has an overall active lifestyle. The level of activity required for this hike just didn’t justify her struggle. What was going on?

Some background information: one year prior to this my mom experienced severe heart palpitations, and was diagnosed with atrial fibrillations. Her doctor prescribed Beta-blockers to slow down her heart rate. A common side-effect of this medication is fatigue, especially when the heart rate is kept so low that it’s unable to do its job when the bodies demand for oxygen increases – like during physical exercise.  Not only did my mom experience this debilitating side-effect, the palpitations persisted, though less severe. While she had tried discontinuing the drug on several occasions, the uncomfortable irregular heart beats several days later had forced her to comply.

Atrial fibrillations – some statistics

Atrial fibrillation is an heart arrhythmia that occurs when erratic electrical signals in the heart cause the atria to contract rapidly and irregularly. This prevents the smooth flow of blood into the ventricles, which can cause blood to pool in the atria, increasing the risk of a blood clots and stroke.

  • About 6% of the population over 65 years of age and older live with atrial fibrillation (Sacco et al, 1997).
  • After the age of 55, the risk of developing atrial fibrillation doubles with each decade of life (Sacco et al, 1997, Benjamin et al, 1994).
  • Individuals with atrial fibrillation have 3 to 5 times greater risk for ischemic stroke (European Heart Rhythm Association et al, 2010).
  • It is estimated that 20% of all strokes are caused by atrial fibrillation (European Heart Rhythm Association et al, 2010).

At first I felt slightly intimidated by this medical
Yin & Yang qualitiesdiagnosis and, being a beginner practitioner, not sure if I could help. But then it dawned on me that this diagnosis is just a label given to a symptom (heart arrhythmia’s). This same symptom is often part of a different type of diagnosis in Traditional Chinese Medicine (TCM). A TCM diagnosis is not based on just one symptom, but is based on a combination of symptoms and characteristics of the whole person. Depending on what else is going on in the body and mind, the TCM diagnosis can be further refined. For example, my mom being menopausal with hot flushes was another important aspect of her TCM picture.

Yin Yang balanceA quick Google search resulted in a number of studies supporting my thoughts. Atrial fibrillations have been successfully treated with acupuncture. And so have hot flushes and other menopausal symptoms, resulting from a deficiency of Yin (the female principle, which is cooling and lubricating), and a relative excess of Yang  (the male principle, which is warming and drying). Balancing  Yin and Yang is key to prevent illness. Yin can be depleted during menopause, but also by stress, worry, and long work hours with little time for self-care and relaxation – all too common in our contemporary societies. Besides heart palpitations and hot flushes, some other Yin deficiency symptoms include night sweats, thirst with no desire to drink (or just in small sips), a dry mouth and throat at night, mentally restless but tired, vague anxiety and fidgety, and frequent waking during the night.

Acupuncture can help restore this delicate balance by stimulating specific points on the meridians, and so can some simple lifestyle modifications.

Lifestyle modifications to replenish Yin:

  1. Avoid foods that may over stimulate your Yang energy. These include stimulants like caffeine, herbs like Chinese ginseng, and foods that are too heating such as curries, hot peppers and deep fried or roasted foods. Instead eat foods that are moistening and lubricating, and use plenty of water when cooking. Soups and stews are a great way to replenish Yin.
  2. Sleep: Get to bed early (10pm) at least three times a week. How restful your sleep is depends on what you do before bedtime, for example eating large meals, or drinking alcohol late in the evening, creates heat while being metabolized, and can disrupt your sleep. Likewise, vigorous exercise, watching TV or reading just before bedtime can disrupt your sleep patterns.
  3. Learn how to meditate. Once learned, you can meditate while walking up and down in an airport departure lounge, or on a railway station, or while waiting to pick up your children from school.
  4. Learn a simple form of exercise that you can do daily.  A 10-minute exercise regime you can do every day and that keeps you fit without over-straining yourself, is better than busting yourself in the gym 3 times a week. Also try to take a 20 minute walk every day, during which you walk fast enough to get slightly out of breath, so that you can only just carry on a conversation.
  5. Treat yourself to body treatments such as a rejuvenating massage, sauna’s, and of course regular acupuncture sessions.

YIN_YANG_hmmm

Dietary changes for atrial fibrillations – a Western medicine perspective

  • coconut waterAvoid known triggers. Reduce or eliminate known triggers such as caffeine (coffee, tea, chocolate), alcohol, wheat and other gluten-containing grains, tyramine-containing foods (such as aged cheeses), sugar & artificial sweeteners and additives like aspartame and MSG.
  • Balance electrolytes.  An average Western diet contains more sodium (added to most packaged foods) and calcium (in dairy products), and less potassium and magnesium. A proper balance between sodium and potassium is essential for a regular heartbeat. To maintain this balance, sodium intake should be less than 2400 mg per day, and potassium intake should be increased, preferably through foods (two of the best sources are blackstrap molasses and coconut water. Others: prunes, oranges, tomatoes, raisins, apricots, etc.). Supplementing potassium is another option.  The calcium – magnesium balance also affects heart rhythm, and magnesium is often deficient. Calcium is required for muscle contractions, and magnesium for muscle relaxation. Food sources of magnesium include dark green, leafy vegetables and nuts, whole grains, and fruits, but most people would benefit from supplementation.
  • Stay hydrated. Dehydration can contribute to atrial fibrillation. Coconut water is the ideal beverage, which is high in potassium and magnesium, and low in sodium and sugars. Water and herbal teas are another way to ensure proper hydration.

All good end good?

My mom responded well to the acupuncture sessions and was able to stay off the Beta-blockers and hike with us the rest of the vacation. While she is still busy trying to wrap her mind around how the hell these funny little needles took care of her symptoms, she is now considering seeing an acupuncturist in the Netherlands.

And me? For me this was a great lesson of gaining confidence in myself and the treatment modalities I apply. And no better person to learn this with than my own mom.

mam

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121667-378x317-Raw-food-smoothieEver wonder how you’re supposed to get all your vitamins, minerals, essential fatty acids, amino acids, fiber, AND antioxidants in without having to spend you’re whole day thinking about organizing meals? The solution to your struggle is here: do the breakfast smoothie.

Whatever you do: don’t skip breakfast. A good breakfast fuels you up and gets you ready for the day. People who eat breakfast tend to have more energy, perform better and eat healthier throughout the day. Without breakfast, people can get irritable, restless, and tired, and are more likely to reach for unhealthy snacks before lunchtime.

I don’t have time is NOT an excuse!

The breakfast smoothie literally takes 5 minutes to make, and this can be done the night before if you’re mornings are hectic. Smoothies are a treat to the taste buds, can be taken with you to the gym, work or school and when made with the right ingredients can be the top of the line fuel your body will thank you for.

Speaking of ingredients: what do you need? This blog is not about providing recipes, of which there are already tons online – rather, I’ll provide you with a guideline on how to get the most out of your smoothie. Experimenting with different combinations of flavours and textures is fun and makes me feel like an alchemist.

Ultimate-Smoothie

Liquid base

Examples are almond milk, rice milk, and soy milk (NGM = Non Genetically Modified – this should be mentioned on the label), which are all, by the way, superb sources of calcium.

protein

Protein

Protein consists of amino acids, the building blocks for all important processes in the body: immune cells, hormones, neurotransmitters (serotonin, dopamine, etc), enzymes – to name but a few – are all build from amino acids.  Some good sources of amino acids are nuts & seeds, legumes (beans, peas) and quinoa. The best amino acid profiles (meaning: containing all essential amino acids) however, are obtained from protein powders, such as whey, pea, hemp or rice protein. Just be mindful that your powder is free of additives, artificial flavours and sweeteners cause that would mess up the purpose of your smoothie. You can add your own flavours, as described below.

matcha_raspberryAntioxidants

Antioxidants are substances that may protect your cells against the cell damage caused by free radicals by interacting with and neutralizing them. Free radicals are molecules produced when your body breaks down food, or by environmental exposures like tobacco smoke and radiation.

The king of antioxidants is matcha powder, a type of green tea. Other excellent sources of antioxidants that make great additions to your smoothie are:

–       Pomegranate

–       Berries (acai, goji, blue, strawberries) & cherries

–       Vitamin C: citrus fruits, kiwi, mango, papaya

–       Vitamin E: seeds, nut(butter)s, peanut butter

–       Dark chocolate (cacao)

–       Cinnamon

raw-green-smoothie-recipe

Vegetables

You probably know that you need to eat your vegetables, because they are little bombs of nutrients which is why they are at the bottom of the food pyramid, in other words: the food group of which we need the most daily servings.

What you may not know (yet), is that vegetables taste deliciously refreshing when blended into a smoothie. By adding them to your breakfast smoothie you can tick off at least 1 or 2 of these daily servings.

Dietary fiber from vegetables helps reduce blood cholesterol levels and may lower risk of heart disease and colon cancer. Folate (folic acid) and iron help the body form healthy red blood cells and prevent anemia. Potassium may help to maintain healthy blood pressure. Calcium helps with the formation of strong bones. Magnesium is involved with many important processes and chemical reactions in the body. And so the list goes on: in other words – there’s a reason why you have always been told to eat your vegetables!!

Fresh smoothie of avocados, vanilla, walnuts and limes.

Essential Fatty Acids

Important for a thousand and one things as they surround every cell in your body with a protective fatty bilayer, maintain the right balance between pro- and anti- inflammatory processes and between ‘good’ and ‘bad’ cholesterol, support brain and heart function, decrease depression, etc, etc.  This is why everyone should be taking a fish-oil supplement. In addition, you can enrich your smoothie with:

–       Extra Virgin Olive Oil

–       Coconut oil

–       Avocado

–       Nuts (you need a strong blender for these, unless you use nut butters or oils) & seeds/ seed oils (hemp, flax, chia, sunflower, pumpkin, sesame)

 cinnamonFlavours

If you must use sweeteners, you could use some honey, maple syrup, or other natural sweetener – I prefer not to use them as they are still high on the glycemic index, which causes your blood sugar levels to spike, followed by a crash (which is experienced as drowsiness or a foggy head). And I don’t need them, as the ingredients described above are already yummy on their own! But I do like to add a bit of spices commonly used in herbal medicine for their many health benefits:

–       Sweet: cinnamon, nutmeg, cacao, cardamom, ginger

–       Spicy: cayenne

And finally: banana. Tastes good with just about anything and gives your smoothie a more creamy texture

ENJOY!!!

smoothies-for-seniors-004

out of order

Fibromyalgia (FM) and Chronic Fatigue Syndrome (CFS) are complex conditions that are often misdiagnosed, disregarded and misunderstood. At the Toronto based Robert Schad Naturopathic Clinic  (RSNC), we know that these conditions are not just ‘between the ears’, that they are not mood-disorders and – although rarely demonstrated by blood tests – that there is something very real going on in the bodies of these people. People affected are often times people who used to be very driven, ‘type A’ personalities who‘s busy lives have abruptly come to an halt and they no longer are able to the things they loved to do. Work, hobbies, and social life all pose way too many demands on the limited energy reserves available, causing dramatic changes to the lives of these people. No wonder that many experience grief and depression over the loss of the life they once lived and even the person they used to be.

I wished I could say we offer the magic pill that many have been hoping to find in their search for a cure. We don’t. But we do offer hope and support to gradually move towards a better quality of life, ultimately a life with less pain, better sleep quality, more energy, and improved cognitive and physical function. If you don’t live in the Toronto area, I hope you can benefit from some of the resources I included below.

factors-present-in-complex-pain-syndromes

In recognition of the complexity of FM/ CFS, the specialty shift at the RSNC offers personalized holistic treatment plans, utilizing a wide variety of natural therapies. Depending on each patients’ individual needs, interventions are chosen from clinical nutrition, intravenous therapy, herbal medicine, homeopathic medicine, Asian medicine (acupuncture, herbs), mind/body medicine, hydrotherapy (the RSNC has a hydrotherapy facility with infra-red sauna’s and peat baths), lifestyle counseling and education. In addition to individual services offered at the RSNC, there is a weekly educational support group. The next series of sessions runs from  09/14/2013 – 11/23/2013.  You can register here. The aim is to identify and remove aggravating factors, while at the same time supporting and strengthening the body’s functions. Multifaceted conditions require a multifaceted treatment, which approaches the issue from many different angles. Examples of common area’s that might be addressed are discussed below.

Diet & Nutrition

Diet is a vital component of the treatment plan. While certain foods can enhance inflammation, others are essential for the body’s systems to perform. Whether it is the immune system, the neurological system, or other systems, without the right levels of vitamins, minerals, amino acids, essential fatty acids, anti-oxidants, or other essential nutrients, those systems and processes can’t function optimally. To fully appreciate the importance of the things you feed your body with, imagine what would happen to a machine that is not given the right fuel – everything will just stop working! The human body is much more complicated than any machine, and its ‘fuel’ mostly comes from the foods we eat.

diet or drugs

What is considered healthy food by most people may not always be the right choice for you. There are certain common irritating foods (including vegetables from the nightshade family, dairy, wheat, gluten, sweets and processed foods) that can contribute to inflammation in the body. Removing these foods from the diet can lead to a significant decrease in pain, stiffness and inflammation (see study). While the elimination diet might seem challenging at first, it is helpful to focus on those things you can eat, rather than on those you can’t. Cookbooks like The Fibromyalgia Cookbook and Meals that heal inflammation can help to get inspired and develop new ways of cooking.

In addition to eating a healthy diet, food intake can be complimented with supplements (specific to each persons individual needs) and high dose intravenous nutrients, for example the Meyers cocktail. In a small study  on people with fibromyalgia who did not improve with standard medical interventions, a weekly ‘modified Myers Cocktail’ was given for eight weeks.  By the end of the study, pain levels were reduced by 60%, and energy levels were improved by 80%. Meyers cocktails are available at RSNC.

 

Improving circulation

Studies have shown that many people with FM/ CFS have reduced blood flow to the part of their brain that controls sleep, pain signal processing, temperature control, cognitive function, etc. This may explain why some sufferers of fibromyalgia experience ‘brain-fog’, where they find it difficult to think or concentrate. Ways to improve circulation include hydrotherapy and exercise. It is important to start with very gentle forms of exercise, such as restorative yoga, to prevent exercise induced setbacks. In addition to the impact on the brain, improved blood flow throughout the body can help reduce inflammation, pain and stiffness.

Reducing toxic burden

Environmental toxins can interfere with various tissues in the body, of which some of the most sensitive types are the neurological tissues and hormonal glands. The first thing to do is identifying and removing toxic elements from the environment (home, work, etc). There are numerous environmental exposure questionnaires available online that can give you an idea of past and current sources of exposure to toxic chemicals. In addition we can test for certain toxins, like heavy metals. The next step is to address any nutritional deficiencies and ensure proper organ function. Organs of elimination, such as the liver, kidneys, lungs, skin, lymphatic system and bowels, are responsible for removing toxins from the body and thus need to be in optimal condition before starting on a detox regimen. If accumulated toxins are being mobilized before ensuring proper organ function, they might lead to worsening of symptoms, also known as ‘healing crisis’.

Stress & energy management
pacingStress management is important for anyone, but particularly for people with chronic pain and fatigue. Stress costs a lot of valuable energy and stress induced hormones exacerbate inflammation. Likewise, when you do have some energy it might be tempting to immediately start doing all those things you are dreaming of doing, resulting in a big crash that might leave you with even less energy and more pain than before. Pacing is key to recovery. Pacing is about finding the right balance between spending enough time on an activity to enjoy it, without pushing yourself so hard that it causes you to crash the next day. Some resources and worksheets to help you find the right balance can be found here. Cognitive Behaviour Therapy and/ or mindfulness based techniques can help cope with the emotions & stress resulting from having a chronic condition.

New patients

Due to increased capacity on the FM/ CFS shift, there are currently openings for new patients. To book an appointment with me or one of the other interns on this shift, call the RSNC at 416-498-9763. Make sure you mention you want to be booked on the FM/ CFS shift.This shift runs on Fridays from 9 A.M. till 1 P.M. The supervisors are Dr McCrindle and Dr Prince. The RSNC being a teaching clinic, rates are very reasonable (about 1/3 – 1/4 of regular rates). 

RSNC

It is amazing that so many skeptics are so misinformed about homeopathy, and it is ironic (to be diplomatic) that these skeptics hold themselves out as “defenders of science,” while being embarrassingly ignorant of the “body of evidence” that verifies the efficacy of homeopathic medicines and the biological activity of its doses. (Dana Ullman, MPH)

Ask any skeptic of homeopathic medicine what they know about homeopathy and they will tell you that they are sugar pills with some substance that is so diluted that there is nothing left of it. Therefore it can’t work. Therefore it has to be placebo when it does work.

Think again.

Why do highly educated physicians, with many years of training (including medical, naturopathic, and osteopathic physicians), use homeopathy in clinical practice? What is their motivation? It is not exactly a money making business we are talking about here. And I promise, it has nothing to do with a spiritual practice or a belief system either. As you will read below, homeopathy requires a very systematic approach in order to determine the right remedy (a homeopathic medicine).

Was it placebo that cured patients who were treated with homeopathic remedies during pandemics (typhus fever, cholera, influenza, yellow fever, diphtheria, Spanish flu, etc) of the 19th and 20th century, and that kept their mortality rates far below the number of patients dying while receiving allopathic treatment?

              Source: Homeopathy in Epidemics and Pandemics.

What about the body of evidence that has been published in peer reviewed medical journals? Doesn’t this at the very least make you a little curious? Doesn’t it make you wonder if maybe, there could potentially be a possibility that you too can benefit from homeopathic treatment?

True science begins with observation. Although it is valuable that the body of accepted evidence in support of homeopathy is growing, it is also worth noting that homeopathic medicine is already at its very roots based on scientific enquiry. Students of homeopathy know that their Materia Medica contains over 2500 remedies, which are based on a huge collection of observations (called provings), that have been repeated over and over again to verify the accuracy of each individual remedy’s description. Publications in peer reviewed journals are great for gaining acceptance by the mainstream, but large clinical trials (the golden standard in evidence based medicine) are not always suitable to measure a treatment as individualized as a homeopathic remedy, given that each prescription is based on the totality of a person’s symptoms, rather than an isolated symptom or disease. For example, while conventional medicine treats most coughs alike, in homeopathy, how you uniquely express the cough is important to your treatment as are the other symptoms associated with your cough.

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How is it possible that ever so diluted doses are still effective?

This is the big question, and the reason homeopathy receives so much resistance. It may have proven to be effective, but that doesn’t explain how it works, thus causing mainstream science to remain skeptical. Not unlike the tragic story of the Hungarian physician Dr. Semmelweis, who was ostracized from the medical community and committed to an insane asylum in the mid 1800’s for proposing the idea that disease was caused by invisible microorganisms. Then the microscope was invented and the germ theory gained widespread acceptance.   As I described in my blog “The science delusion and its implications to our healthcare”, science is not without its own dogma’s and it requires an open and curious mind to further scientific enquiry. Just because we are not able to explain how something works, does not mean it doesn’t work and does not justify labeling hard working, highly educated and skilled practitioners who want the best results for their patients, as ‘quacks’. We don’t call a medical doctor who prescribes a drug of which the mechanism of action is unclear, but which has demonstrated clinical efficacy, a quack either.

One possible theory is offered by the idea that water (which, by the way, also encompasses 60-70% of our body’s composition) has a memory and takes on the qualities of the substance dissolved in it, even when diluted to the point where atoms are no longer measurable.  In order to demonstrate this, a study published in the journal Inflammation Research was conducted with highly diluted histamine (without any molecules left) – and still elicited the typical immune response to histamine when given to a biological system (e.g. a person or animal).

In his book ‘The hidden messages in waterMasaru Emoto shows with pictures how water molecules are reshaped by different energetic vibrations.

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I have tried homeopathy, but it didn’t do anything for me

It is possible that you will not notice immediate benefits of homeopathic treatment. This doesn’t automatically mean that homeopathy is useless. Instead, consider any of the following:

1)      Unlike pharmaceutical drugs, homeopathic remedies might take time before they start to take effect. It can be a slow and gradual process, with very subtle changes – especially with long standing chronic symptoms. See the list below for examples of changes to look for.

2)    Your homeopath didn’t find the right remedy for you yet. To help identify the appropriate homeopathic medicine, accurate observation and reporting of your symptoms is essential. Here are topics that you can think about before your next visit:

      •  Unusual symptoms and the characteristics of your illness
      • The pattern of your symptoms and the cause of your illness
      • Anything that makes your symptoms better or worse (other than drugs)
      • Your level of energy and what effects it
      • How your energy changes during a normal day
      • Your body’s response to weather
      • Your sleep position and patterns
      • Recurrent dreams
      • Foods that you especially like, dislike or that affect you
      • Your thirst and fluid intake
      • Your bodily functions (menses, elimination)
      • Your personality

3)    Level of expertise. Because certification is not presently required to practice homeopathic medicine, there are great differences amongst practitioners’ level of expertise. A good homeopath will ask you to describe each of your symptoms in exquisite detail. The initial intake will be at least one hour in length, but could easily be longer. Questions will not be limited to your physical symptoms, but will include your psychological state.

antacidsThey look so innocent, those pink colored tums, or antacids. But in reality they might be the cause of many of your health concerns, including maldigestion, irritable bowel syndrome (IBS), and even depression.  Not only do they not cure the cause of your symptoms (they just suppress them), they also create a whole list of new problems, especially when used on a regular basis. Let me explain this before talking about natural treatment options. First of all – and contrary to popular belief – heartburn, or acid reflux, or GERD is not caused by too much stomach acid, but rather by stomach acid in the wrong place, and potentially too little acid.

Why is my stomach acid in the wrong place?

When you experience heartburn, the acid from your stomach has traveled up into your esophagus, which doesn’t have the protective layer against acid the stomach has. The reason it is in the wrong place is that the lower esophageal sphincter (LES), the muscle that separates the stomach from the esophagus, is not closing properly, it is too relaxed. When the LES is working properly, it doesn’t matter how much acid you have in your stomach: it will not regurgitate up into your esophagus.

The pathophysiology of GERD

How is too little stomach acid a bad thing?

The stomach needs stomach acid to do its job. By suppressing the acid your stomach naturally secretes, you stop it from doing its job properly. It might go in overdrive and start secreting more acid to compensate for what was lost, thus creating a vicious cycle and making it more and more difficult to get off antacids. But most importantly, it interferes with a cascade of processes in your body that are important for good health. Stomach acid is the “turn on switch” to start the entire digestive cascade, which determines how much of your nutritional intake is actually taken up and used by your body. For example, stomach acid aids in:

  • Absorbing minerals (iron, calcium, zinc)
  • Absorbing vitamin B12
  • Resisting infection and preventing bacteria overgrowth (e.g. H. pylori)
  • Communicating satiety to the brain
  • Breaking down protein by activating pro-enzymes
  • Facilitating the closure of the LES

No matter how healthy your diet is, if the food is not broken down and absorbed, it will remain useless for your body. Thus, low stomach acid can cause nutrient deficiencies, which can disrupt your health in many, many ways. For example, proteins are required to manufacture hormones and neurotransmitters such as dopamine and serotonin, which are important for the regulation of mood. Hence the relationship to depression I mentioned earlier.

Protonpump inhibitors have been linked to bone fracturesIn addition to nutrient deficiencies and increased risk of infections, low stomach acid can increase the risk of stomach or esophageal cancer and other diseases. Long term use of antacids can cause diarrhea, altered calcium metabolism, and buildup of magnesium in the body.

Dr Wright, author of Why Stomach Acid is Good For You, has been measuring stomach acid in people suffering from heartburn and GERD for 25 years, and found that it is almost always low, especially with increasing age (Fig 1).  Yet the incidence of heartburn and GERD increases with age, simply because the LES tone decreases as we get older. If this did not convince you yet, I should mention that Dr Wright, and many other clinicians (including naturopathic doctors) supplement with hydrochloric acid (HCl), which often cures the problem – again demonstrating that low acid is the real problem.
Why stomach acid is good for you
A naturopathic approach to the treatment of heartburn/ reflux/ GERD

The good news is that, when adhered to faithfully, diet and lifestyle changes work exceptionally well for the treatment of GERD.

General tips

Dietary recommendations for heartburn and GERD

  1. Avoid foods and drinks that weaken the LES: coffee, alcohol, chocolate, (pepper) mint and fried foods.
  2. Avoid substances that can irritate a damaged esophageal lining: citrus fruits & juices, tomato products, spicy foods, pepper, carbonated drinks, NSAIDs/ Aspirin.
  3. Quit smoking: cigarette smoking weakens the LES.
  4. Relax while eating: sit down, eat slowly and deliberately, without distractions such as TV or reading.
  5. Eat small meals, e.g. 4-5 per day, with the last meal at least two hours before bedtime.
  6. Avoid drinking during meals, to avoid diluting the concentration of stomach acid.
  7. Take demulcents. Demulcent herbs, such as Althea officinalis or Ulmus vulva, are rich in mucilage and can soothe and protect irritated and inflamed mucosal tissue. In addition, chamomile tea, sipped throughout the day can be helpful to reduce inflammation.
  8. Raise the head of the bed: using gravity to minimize reflux of stomach contents into the esophagus
  9. Decrease intra-abdominal pressure (IAP): Avoid stooping, tight clothes, etc; Increase fiber intake; Weight loss (if overweight).

If that’s not enough….

If diet and lifestyle changes are not sufficient to resolve your symptoms, there are several supplements that have shown to be effective in the treatment of GERD. Please consult with your ND or other qualified medical practitioner for more information.

  • Melatonin and phosphatidylcholine supplementation have been shown to enhance LES tone and protect the esophagus.
  • Betaine hydrochloride: if your stomach levels are low (which was the case in over 90 percent of people tested in Dr. Wright’s clinic), supplementation with HCl will almost always solve the problem. Before supplementing HCl, testing should be done to confirm low stomach acid; otherwise supplementation can cause harm.
  • Bitter herbs: another way to stimulate acid production in the stomach.

References

  1. Greenblatt, J. Integrative Medicine for the treatment of depression. An evidence based orthomolecular approach. CSOM seminar 2012
  2. Wright JV, Lenard L. Why Stomach Acid Is Good For You. New York, NY: M. Evans and Company, Inc, 2001
  3. Prousky J. Textbook of Integrative Clinical Nutrition. Toronto: CCNM Press Inc, 2012
  4. Hoffmann D. Medical Herbalism. The science and practice of herbal medicine. Vermont: Healing Arts Press, 2003
  5. Shehab El-Hashemy. Family Medicine & Integrative Primary Care. Toronto: CCNM Press Inc, 2011
  6. Konturek SJ, Zayachkivska O, Havryluk XO, Brzozowski T, Sliwowski Z, Pawlik M, Konturek PC, Cześnikiewicz-Guzik M, Gzhegotsky MR, Pawlik WW. Protective influence of melatonin against acute esophageal lesions involves prostaglandins, nitric oxide and sensory nerves. J Physiol Pharmacol. 2007 Jun;58(2):361-77. http://www.ncbi.nlm.nih.gov/pubmed/17622703
  7. Pereira Rde S. Regression of gastroesophageal reflux disease symptoms using dietary supplementation with melatonin, vitamins and aminoacids: comparison with omeprazole. J Pineal Res. 2006 Oct;41(3):195-200. http://www.ncbi.nlm.nih.gov/pubmed/16948779
  8. Eros G, Kaszaki J, Czobel M, Boros M.Systemic phosphatidylcholine pretreatment protects canine esophageal mucosa during acute experimental biliary reflux. World J Gastroenterol. 2006 Jan 14;12(2):271-9. http://www.ncbi.nlm.nih.gov/pubmed/16482629
  9. de Oliveira Torres JD, de Souza Pereira R. Which is the best choice for gastroesophageal disorders: Melatonin or proton pump inhibitors? World J Gastrointest Pharmacol Ther. 2010 Oct 6;1(5):102-6. http://www.ncbi.nlm.nih.gov/pubmed/21577303

Research, consciousness, science

The ancient oracle said that I was the wisest of all the Greeks. It is because I alone, of all the Greeks, know that I know nothing (Socrates)

There has been a lot of discussion lately about the (ironically) biases within contemporary science: a discussion I embrace wholeheartedly, as it seems to be particularly relevant to the future of our healthcare.  The discussions show how even science, known for its unbiased and objective methods of enquiry, can develop preferences for certain worldviews over others, without evidence to uphold these views. Thus, the pursuit of knowledge can be influenced, and even held back by biases existing within the scientific and medical community.

On January 13 2013, Rupert Sheldrake, a renowned member of the scientific community, gave a provocative talk titled the science delusion on TED, whose conferences attract worldwide attention to new, cutting-edge ideas.  Sheldrake proposed that modern science is being held back by ten assumptions that have hardened into dogmas. He states that, when you subject each of these to scientific scrutiny, you see that they are not actually true. The science delusion is the belief that science already understands the nature of reality, in principle. The fundamental questions are answered, leaving only the details to be filled in. Sheldrake argues that science would be better off without its dogmas: freer, more interesting and more fun. The dogma’s he challenges in his talk  are:

1. Nature is mechanical or machine like

2. All matter is unconscious

3. The laws or constants of nature are fixed

4. The total amount of matter and energy is always the same

5. Nature is purposeless

6. Biological heredity is material

7. Memories are stored inside your brain

8. Your mind is inside your head

9. Psychic phenomena like telepathy are not possible

10. Mechanistic medicine is the only kind that works: that’s why governments only fund mechanistic medicine and ignore (or minimally fund) complementary and alternative therapies.

The talk was subsequently banned from the TED site, with the criticism that Sheldrake misinformed the public since several of these dogmas are already active areas of science. And this is true! Many scientists have challenged the above mentioned dogmas with their findings. But how many people, including scientists, are aware of this? How many medical doctors apply the findings from neuroscience, quantum physics, and epigenetics – and utilize the power of the mind, for example, in their daily practice with patients? This is the message Sheldrake tried to convey: to challenge mainstream science with findings from not so mainstream science. Findings that could have huge implications to the way we practice medicine, especially when treating chronic conditions.

Another important talk, also on TED, was delivered by Ben Goldacre, on what he as a medical doctor, finds to be the “biggest problem in medical science today”: publication bias – “a problem so prevalent that it reaches the core of evidence based medicine.”

In his talks “Battling bad science” and “What doctors don’t know about the drugs they prescribe”, Goldacre outlines the many different ways in which pharmaceutical companies that fund medical research distort evidence. For example, positive findings are twice as likely to be published, while negative findings tend to disappear, thus distorting the overall outcomes on a certain drug. New drugs are compared to placebo rather than a drug that is already on the market to show its superiority. Or when compared to the old drug, the old drug is subscribed in such high end range dosages that it will almost certainly cause adverse effects. What is most significant about Goldacres talk is the acknowledgement that many scientists and medical doctors involved in medical research know this, but blindly accept this ‘minor’ shortcoming of evidence based medicine. “This is a disaster. We can’t prescribe if we don’t have access to all the information.”

The above discussions reflect the fragmentation that can be observed within science, the medical profession, as well as the general public. There are those who are skeptical of anything that is ‘non-scientific’, yet are unaware of the supporting evidence of non-mainstream medicine. On the other hand, there are those who have lost all faith in science, given the biases described earlier. And of course there is a group that walks the middle path and that embraces the best of both worlds, which is seen in integrative medicine. Whichever group you identify with, staying in one box is almost always limiting your views. If we want to provide people with the best healthcare available for their specific individual needs, and if we want science to stay true to its original purpose (to enquire) we have to distinguish good science from bad science, and accept that there are alternatives to mainstream medicine that haven proven to be more effective for certain conditions, or equally effective but less toxic and/or invasive. Being critical, not blindly accepting the status quo, is important to the generation of new knowledge and growth. Being skeptical based on set worldviews is not.

 Few people are capable of expressing with equanimity opinions which differ from the prejudices of their social environment. Most people are incapable of forming such opinions. (Albert Einstein, 1953)

For this reason alone I find Sheldrakes talk a valuable contribution, which is certainly worth sharing with the world.

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