November 2010 Archives
Well, the holidays are right around the corner, along with its many reminders for our entry into hyper-drive mode. Stores are hanging up signs posting "The Holiday Rush" and "Hurry, these sales won't last long!" It's no wonder our minds quicken and impatience sets in:
"What's the hold up!? Why are these people blocking the entrance? Don't they know that I've got to finish wrapping these presents, cooking the turkey, get to the bank, pick up the dry cleaning, shovel the walk, and pick up little Jimmy from school in less than an hour! Ok, I'm doing my deep breathing, deep breathe, 1, 2, 3, FOUR!!! Auggh!!! Oh geez!! What's wrong with me! I'm stressing out my adrenals!!!!! Great, now I'm going to need more metabolic synergy!!!! Is that from Standard Process or Moss? Do I have to wait for the check to get to Dr. Sarah's, will she be around to order it??!! OH NO!!! More stress!!!"
It's no wonder we overeat Thanksgiving turkey and Aunt Edna's cookies, we need the relaxing serotonin boosts from that tryptophan and quick energy from the sugar!! But, may I present an alternative viewpoint to the mass hysteria and pushing to do more?
As your Naturopathic Doctor, with 8 years of post-graduate education on balancing the body and nature cure, I wish I could say I was immune to the stress response from sheer knowledge of its effects; however, I can completely relate society's hyper-drive, hyper-reactive, holiday rush mode. In fact, if it weren't for my adorable niece, little Anna, sometimes I would forget to breathe and smell the roses. (Kids can have that effect on us, can't they? The ability to pause, take a look around, enjoy just being with them, with ourselves).
I had such a good reminder of this on Monday. After a tough day at work (journal deadlines, presentations, and such) I needed an Anna fix. I walked into "Grandma's house" and heard the familiar foot stomping and giggling. Anna was chasing my not-so-patient- tortoise haired cat around the hard wood floors. She was delighted with glee at the cats annoyed response as she clanged around bottles of lavender and peace and calming, the scents of relaxation, presence, and self- reflection. Wake up call for me!
Alright, now before I lose too much of my fantabulous male audience, let's get to some science of feeling good and ignite the left and right sided brain...
As many of you are aware, I've been studying the work of Robert Holden, PhD, and have even had the pleasure of speaking to him personally a few times. (What a treat!) For some, I have recommended his work as a way to support your stress relieving and mood balancing protocols. Robert's focus has been on the Happiness Project, an 8-week happiness course, famously tested by independent scientists for a BBC's science documentary. How to be Happy was started in 1985 when Robert and his team began documenting how people who experience happiness, through self-acceptance and being less busy, create positive changes in their brain chemistry, without a pill or placebo. Robert is quoted as saying that most of aren't suffering from a psychology problem, but rather a lack of self-acceptance.
What has touched me about Robert's work is his commitment and dedication to the concept of the power of presence and the perfection of who we are, where we are, right now. This is an important key point for anyone who wishes to heal from a chronic disease, as unless one accepts accountability and acceptance of their diagnosis, they cannot truly heal. Robert speaks of the concept of "shifting from adrenaline to grace" and his use of science to back up and document the health benefits of his mind-body approach has been extraordinary! I encourage everyone to follow his link and see if Robert's work would be of benefit to you and your life.
And....with thanksgiving coming up, let's not forget to mention gratitude! Gratitude and happiness are often companions. Gratitude has been linked to not only overall health improvements, but also better quality of life. Take, for example, the following excerpt from the Research Project on Gratitude and Thankfulness by Robert Emmons:
Gratitude Interventions and Psychological and Physical Well-Being
- In an experimental comparison, those who kept gratitude journals on a weekly basis exercised more regularly, reported fewer physical symptoms, felt better about their lives as a whole, and were more optimistic about the upcoming week compared to those who recorded hassles or neutral life events (Emmons & McCullough, 2003).
- A related benefit was observed in the realm of personal goal attainment: Participants who kept gratitude lists were more likely to have made progress toward important personal goals (academic, interpersonal and health-based) over a two-month period compared to subjects in the other experimental conditions.
- A daily gratitude intervention (self-guided exercises) with young adults resulted in higher reported levels of the positive states of alertness, enthusiasm, determination, attentiveness and energy compared to a focus on hassles or a downward social comparison (ways in which participants thought they were better off than others). There was no difference in levels of unpleasant emotions reported in the three groups.
- Participants in the daily gratitude condition were more likely to report having helped someone with a personal problem or having offered emotional support to another, relative to the hassles or social comparison condition.
- In a sample of adults with neuromuscular disease, a 21-day gratitude intervention resulted in greater amounts of high energy positive moods, a greater sense of feeling connected to others, more optimistic ratings of one's life, and better sleep duration and sleep quality, relative to a control group.
- Children who practice grateful thinking have more positive attitudes toward school and their families (Froh, Sefick, & Emmons, 2008).
So, let me close by saying that I am extremely grateful to all of you. I am truly thankful for the emails, updates, and good news, joys, sorrows, and healing we have shared on your journey. You have all helped me grow as a practitioner and a person, thank you.
I wish you all a wonderful holiday, in which you can not only nourish your adrenal glands with herbal supplements and B-vitamins, but also with pausing before you eat your organic turkey (J). May you take time to be grateful for quiet moments in the midst of the holiday craze and experience the true art of happiness and being present!
Happy Holidays, everyone!!
PS...Don't forget that extra diaplex if you partake in organic, or non-organic, sugary treats....or to use the pause before you make the decision to pick up the sugary treat!
Finding the right product for your skin can be boiled down to one word: ingredients.
Drugstores, supermarkets, department stores, specialty stores or spas: one thing they have in common is that they all sell skin care products. So, what's your best bet and why?
In Part I, we boiled good skin care down to the necessities and answered the question, "What product do I need?" But, as home care is only 40% of the equation, let's move on and discover what is the basic treatment must have.
I recently listened to various speakers addressing the subject of the use of evidence based medicine (EBM) for assessing efficacy of treatment parameters in nutritional and plant based medicine. In these presentations, various research experts in the field of integrative medicine discussed the latest studies in natural medicine and funding grants along with the pros and pitfalls of using a conventional model of assessment in natural medicine.
The concept of EBM is based on the idea that in a specific controlled environment, one and only one intervention is responsible for producing a positive or negative effect over a given placebo treatment. The results are compiled, peer reviewed, and confounding factors (such as experimenter bias and expectations of participants) are controlled for. Based on how well the design of the model is, sample size, and clinical efficacy, clinicians use these results to adjust their therapeutic protocols.
While, this can be helpful to learn new information and address various disorders, there are a variety of issues when using this model for natural medicine.
Issue 1: Most clinicians don't find these studies relevant to their clinical practice or review the articles properly to interrupt the results outside of the researcher's conclusions. Due to this fact, they rely on summaries from drug companies or other biased sources.
Issue 2: Data is usually skewed in favor of the company funding the study (see the last three references below).
The British Medical Journal's "Clinical Evidence" analyzed common medical treatments to evaluate which are supported by sufficient reliable evidence (BMJ, 2007). They reviewed approximately 2,500 treatments and found: (Note the link to BMJ shows different numbers, actually less favorable, please cross-reference!)
· 13 percent were found to be beneficial
· 23 percent were likely to be beneficial
· Eight percent were as likely to be harmful as beneficial
· Six percent were unlikely to be beneficial
· Four percent were likely to be harmful or ineffective.
· 46 percent were unknown whether they were efficacious or harmful"
Issue 3: In real life, people are not in a controlled environment with confounding factors taken out and only using one medication.
Today in America, every man, woman, and child is prescribed around 13 prescription drugs per year (and this doesn't count the many over-the-counter drugs that doctors prescribe and that patients take on their own) (Kaiser, 2006). Just 12 years earlier, Americans were on average prescribed less than eight drugs per person, a 62 percent increase! The fact of the matter is that drugs are not tested for approval in conjunction with other drugs, and the safety and efficacy of the use of multiple drugs together remains totally unknown.
According to a 2008 nationwide survey, 29 percent of Americans used at least five prescription medications concurrently. (BMJ)
Issue 4: My recent blog on hormesis explained the importance of how dosage affects clinical outcomes. In other words, a constituent found in a plant can have therapeutic, neutral, or toxic effects depending on how it's used in the body and at what level of imbalance the body is in. This concept makes it hard to translate evidence based models (EBM) of placebo, randomized controlled studies in clinical practice to a synergistic interactive model.
Issue 5: With drugs you have two very controllable factors; the impact of the actual intervention vs. no intervention. With nutritional interventions, it is not that easy. Why? There are two phases of extreme nutritional intervention factors-complete deficiency and resultant death vs. toxicity from over dosage and resultant death.
Most clinical trials for nutrition don't take into account if a person is deficient in the nutrient or phytochemicals to begin with when they are testing a particular constituent in their study. Therefore, mixed results will occur. If the intervention was applied to people who were deficient and needed the nutrient, the results will likely be positive. If those tested were already above the threshold for the nutrient or compound, the results would be skewed to negative effects.
Issue 6: Nutrients work in synergism. Meaning, if you take too much of one nutrient, a deficiency in another can ensue. For example, too much zinc depletes copper. Therefore, you take another drug or another supplement to deal with the side effect of the previous drug or previous supplement when basing treatment on symptoms verses on a therapeutic protocol.
How does all this information affect you, the consumer of supplements? For the above reasons, I've become increasingly concerned with the use of self-prescribing and the continued use of therapeutic, high potency or unregulated supplements without being evaluated as to if the supplement is still needed. There is also the misconception that because a supplement worked for one person with the same symptom it will work for someone else with the same symptom, without looking at the cause. For example, what if Aunt Martha needed magnesium and that's why she's not constipated anymore; whereas, you needed fiber to cure your constipation woes?
I believe it's important to check back in via testing or with the practitioner who made the recommendation when one is on therapeutic protocols of supplements. This is because the biochemistry of how the product or supplement works in the body is well understood by the practitioner. For Naturopathic Doctors and Functional Medical Practitioners, the use of nutraceuticals and herbals is a form of medicine! Symptoms and effects are expected through the use of these interventions. The Practitioner will know based on what is occurring in your body and how the supplement works when to discontinue the supplement, increase it, or change to a more maintenance-based protocol.
And....Here's the even more exciting part!! Today, Integrative and Functional Medicine can assess nutritional deficiencies through various testing methods and case history and detect exactly which interventions are needed and for how long. Furthermore, testing can assess biochemical individuality versus randomly assigned RDAs which are based on the minimal amount of nutrients needed to prevent disease, not establish health. This extra tool is very helpful for when case histories or clinical symptoms aren't changing.
I view it as my job to make sure that my patients get the best results based on their individual issues. My job as a doctor is a teacher. I love it when I can get a patient to understand what their symptoms mean, how their specific protocol works in their body, and what different cues on their supplements mean. Eventually, when the patient fully understands their body, predispositions and risk factors, armed with a maintenance protocol, they are empowered to go it on their own and check in if needed when things pop up they don't understand. However, as one is healing, I believe it's a good idea to follow up and make sure everything is still needed and dosages are absolutely optimum for healing. Otherwise, "side effects" could occur that could be prevented. I do ultimately believe in the body's innate ability to heal and I feel it's my job to get people back in tune with this.
Kaczor, T. The Pros and Cons of Evidence-based Medicine as It
Relates to the Practice of Natural Medicine. Clinical Roundtable Interview with Dr. Shoa and Dr. Barrett (Audio). Natural Medical Journal. November 2010.
Gazella, K. A Conversation With Bastyr University Researcher Leanna Standish, ND, PhD, LAc, FABNO, About Naturopathic Research and Her Two NIH Funded Clinical Trials. Reseacher Interview (Audio)Natural Medical Journal. November 2010.
Moss, J. Entry Level Clinical Nutrition: A cost effective, practical and simple addition to the functional medicine repertoire Part I: Introduction. Moss Nutrition Webinar. November 2010.
Jones, D. & Quinn, S. (ed). Changing the Evidence Based Model. Textbook of Functional Medicine. IFM. Gig Harbor, WA. 2006
Evidence based medicine--selective reporting from studies sponsored by pharmaceutical industry: review of studies in new drug applications. BMJ. 2003 May 31; 326(7400): 1171. doi: 10.1136/bmj.326.7400.1171. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC156459/
Systematic review of the empirical evidence of study publication bias and outcome reporting bias. PLoS One. (abstract) 2008 Aug 28;3(8):e3081. http://www.ncbi.nlm.nih.gov/pubmed/18769481?ordinalpos=1&itool=PPMCLayout.PPMCAppController.PPMCArticlePage.PPMCPubmedRA&linkpos=2
Clinical Evidence. BMJ. 2010. http://clinicalevidence.bmj.com/ceweb/about/knowledge.jsp
With so many treatment and product choices available today, how do you know what you really need? Here's some sound, professional advice from the heart of an aesthetician.
Oh geez, guys, I hate to do this to you, scare you after Halloween, but I think it's important. I've been diving into toxicity and environmental issues the past few weeks. I think some of you have noticed. It's not that I want to scare myself, or you, really it isn't. It's because I've seen clinically many patients who have been brushed over as "psychosomatic" that really aren't. I've seen people who have questioned their own sanity, because no one believes they can "be that sensitive." Well, these people could actually be our saving grace in an environment where new chemicals are introduced every year without needing to prove safety or long term consequences.
Do you remember my past reference to the CDC 's Fourth National Report on Human Exposure to Environmental Chemicals of 2010? Now, within its 529 page "summary" of how different aspects of environmental chemicals harm our health, in just two years 75 new chemicals are listed. The scary thing is that the average volunteer of this study had over 200 chemicals found in their blood and urine samples!
The patients that are "oversensitive" are truly "canaries in the gold mine", warning us that the environment isn't as safe as we think it is. They probably have changes in their genetic sequences relating to liver detoxification, single nucleotide polymorphisms (SNPs), regarding phase I and phase II detoxification pathways, such as in the enzymes of Cytochrome P450, COMT, GST, and NAT. When someone has a SNP, they could clear toxins less effectively and react more profoundly than your espresso-drinking, not touched by midnight chocoholic friend.
What does this mean? It means that your friends who have "an overreaction" to the bright lights in the mall, who experiences chronic fatigue from normal day activities and "extreme" headaches from being near a cell phone, is a yellow light warning to you. They are signaling that although your liver may not be overload yet by this environmental trigger, there's something present that isn't so liver loving.
Anyone been over the Rexford Bridge lately on 146? I'm concerned. Did you see the signs, "Toxic: lead poisoning?" Lead is number two behind arsenic and in front of mercury for the top 3 toxic metals. Signs and symptoms include anemia, peripheral motor neuropathy, anorexia, vomiting, abdominal pain, growth delay (children), hypertension, renal insufficiency, fatigue, myalgias, etc. Who knows how far that lead can travel, in our water, etc.?
Ok, I'll stop here. I don't want to blow your adrenal glands, or mine! I want to empower you. If you notice symptoms coming on, what can you do to protect yourself? First, avoid that bridge whenever possible. I spoke with a certified chelation specialist, Dr. Gogenheim from CT, and told her of our local situation. Besides doing some clinical testing to assess your blood and urine, she gave me some basic suggestions:
· Take a good source of calcium and magnesium
· Oxygenate your body with supplements such as essential oils (I like frankincense because it's also anti-inflammatory), green drinks, DIM from broccoli and green leafy vegetables
· Consider basic liver supporting herbs such as milk thistle and anti-oxidants/ liver detoxification support such as NAC, glycine, and glutathione
· Drink plenty of water
If you think that you may be a canary that needs more than home remedies, you may want to consider contacting a specialist in chelation or make an appointment with someone versed in environmental toxicity. I know of some basic protocols that have assisted chemically sensitive individuals. As a Naturopathic Doctor, I feel it's vital to find someone who will follow your body's signals, go slow, and build you up first.
So, let me leave you by saying, trade in those leftover PB cups for broccoli....at least until they are done with that bridge!
Department of Health and Human Services. CDC's Fourth National Report on Human Exposure to Environmental Chemicals. Accessed March 2010. http://www.cdc.gov/exposurereport/
Baker, S. Canaries and Miners. http://www.scribd.com/doc/31217217/Canaries-and-Miners-by-Sidney-Baker-MD
Rountree, R. Toxicity, and Biotransformation. Applying Functional Medicine in Clinical Practice. Portland, OR. September 29, 2010.
Cline, J. Assessing Toxic Overload and Impaired Biotransformation. The Institute for Functional Medicine. Applying Functional Medicine in Clinical Practice. Portland, OR. September 29, 2010
Chemoprotective glucosinolates and isothiocyanates of broccoli sprouts: metabolism and excretion in humans. Shapiro TA, Fahey JW, Wade KL, Stephenson KK, Talalay P. Cancer Epidemiol Biomarkers Prev. 2001 May;10(5):501-8.PMID: 11352861
Don't be fooled by low price tags for services; they can be disguising a lack of experience, proper sanitation procedures or low quality products. Many times, when something appears too good to be true, that's because it is! Choosing an experienced practitioner who uses high quality product can make the difference between a wonderful or terrible experience.
Picking an appropriate time of year to work on your skin care goals can be crucial to your overall success.
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As a New York State Licensed Aesthetician, New York State Licensed Nail Specialist, and the Director of Living Well Healing Arts Center & Spa, Reisa combines her love of spa services and healing arts to achieve optimum skin and nail health, create greater overall wellness and bring forth our optimal, individual beauty.
"I believe that the day spa should be an instant getaway; a place that is quiet without being stuffy, relaxed, elegant and yet entirely comfy. You should feel warm and welcome, surrounded by people who care about you and what they are doing. This is the environment we strive to create at Living Well Healing Arts Center & Spa. Here, you are never just the "next" number; we allow ample time for your services, offer a flexible schedule and can be reached after hours. After all, to me, spa craft is not really a business, it's a lifestyle."