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Healthy by Nature: Using ‘Therapeutic Order’ to Navigate Health Choices

By Dr. Marika Geis, BSc, ND

It starts out gradually enough. You hear that vitamin C is a good thing to take during cold and flu season or that as Canadians, we are deficient in vitamin D. The next thing you know you’re taking 20 different supplements every morning. Often, our clients will bring in their supplements to regain some clarity as to what they should take and why. Usually they’re unsure whether they need them anymore or are unclear as to their benefit. Using natural health products is certainly preferable to using harsh chemical treatments to manage troublesome symptoms, however, just like pharmacologic therapies, natural treatments need to be administered appropriately; the right supplement, in the right dosage for the right person at the right time via the right delivery method. The model that defines the naturopathic approach, the ‘Therapeutic Order’, takes this one step further by addressing the environment which created the dysfunction in the first place. Take, for example, a cut finger. We can either create the conditions required for healing or we can create the conditions that result in infection. Both are equally complex, however, as long as conditions that foster infection persist, no amount of medication will heal the cut. In the context of chronic diseases: adult onset diabetes, high blood pressure, elevated cholesterol, unexplained infertility, fibromyalgia, chronic fatigue syndrome or autoimmune disorders (to name a few), you simply cannot drug a body back to health. Dr.’s Pizzorno and Snider wrote: “We are natural organisms, our genomes developed and expressed in the natural world. The patterns and processes inherent in nature are inherent in us”. In the case of our cut finger, even in the presence of the proposed antibiotic ointment (natural or pharmacologic) which would push back the bacteria creating the pain, swelling, and inflammation, your body is ultimately responsible for the final step of healing. Naturopathic Medicine is fundamentally oriented to restoring health as opposed to ‘treating disease’. We tend to see illness as a process. Nature cure assumes, correctly, that illness manifests as a result of factors that disrupt health and that ‘symptoms’ are the body’s attempt to achieve equilibrium based on the conditions at the time. By creating the framework for health, we make it harder for ‘disease’ to manifest. To this end, we use Dr.’s Jared Zeff and Pamela Snider’s ‘Therapeutic Order’. This not only helps us prioritize which modalities would best serve our clients but also let’s us know when we can move on.

Chronic Illness generally takes hold when any or all three of the following conditions exist.

  • The persistence of so-called ‘disturbing factors’, most notably poor diet and long term stress,
  • The body’s reactive potential is blocked, usually by pharmacologic treatments (e.g.: acetaminophen for fever) and,
  • The body’s constitution is too weak in order to mount an appropriate response.

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The cumulative effect is such that our tissues sustain damage leading to chronic inflammation and possible scar tissue or tumor formation. Reversal of chronic conditions can rarely be accomplished through drugging the disease state. The more that you or your clinician can identify these ‘disturbing factors’ the more we can slowly peel back the layers that led to the development of the disease in the first place. We use every opportunity to establish the conditions for healing and tap into the body’s tendency to healthy balance. With this in mind the first step of the Therapeutic Order is to 1) remove obstacles to health, specifically, diet/sleep, stress and spiritual disharmony. How can we stand a chance at treating mental exhaustion and fatigue when we are eating whatever comes our way, falling asleep in front of the television and feeling isolated because we’ve moved away from our family home? An antidepressant can help with the symptoms of depression (a sometimes necessary respite) but we run the risk of ignoring the ‘disturbing factors’ that could lead to more serious consequences.

Next, we are tasked with 2) stimulating the body’s self healing mechanisms. Modalities such as hydrotherapy (various methods that combine the use of hot and cold water), movement (Tai Chi or Qi Gong), Traditional Chinese Medicine, and Homeopathy work with whatever vitality is present in order to augment the body’s response to the now absent obstacles to health. Given that we exist as complex patterns of matter, energy, and spirit, exposure to the appropriate rhythms and forces of nature strengthen our vitality, stimulates the healing power of nature and is thus a natural ally for our clients. Alerted to this momentum, our bodies are in a better position to respond to our attempts to 3) strengthening weakened or damaged systems. To this end, nutraceuticals, botanical medicine and glandulars, are indispensable resources when trying to restore function. Occasionally, attempts at restoring function are blocked by 4) derangements in structural integrity. Some ND’s, more so south-of-the-border, use ‘Naturopathic Manipulation’ or ‘Naturopathic Bodywork’ to address this issue. However, should this need attention, more often than not, clients will leave with a referral to a physiotherapist, osteopath, registered massage therapist, or chiropractor. At this point, many find that steps 1-4 are enough to bring our clients to a place of independence and flexibility, all with a minimum of supplementation. Additional treatments may be warranted though in which case we aim to 5) address true pathology. Natural health products provide a vast arsenal in which to treat everything from headaches to parasitic infections, to endometriosis, to allergies, but unless applied in the context of the Therapeutic Order, one cannot expect long term results. We would essentially be practicing what Naturopath’s call ‘green allopathy’, i.e.: using natural products as substitutes for pharmacologic intervention.

What comes next may surprise some of you. So long as steps 1-5 are addressed it can be further indicated to use 6) pharmacotherapy and/or surgery to preserve life and limb. This is the reasoning behind the expanding scope of Naturopathic Medicine in Canada. In fact, the original intention behind using drugs and surgery was only to use them when diet and lifestyle failed to yield results. In this limited context, one could say the naturopathic and allopathic models are aligned and that perhaps it isn’t necessary to differentiate between them. We could collectively refer to either of these models as ‘people medicine’ thus establishing the foundation for future collaboration among all professionals in the health care field. Lastly, at times it may be necessary to 7) supress the pathology altogether, in order to preserve life and limb, but as you may have already concluded, these methods keep you alive but with long term consequences (prednisone as an example).

So how do we decide which system to prioritize? In a society that routinely normalizes malaise and encourages us to ignore our instincts, deciding where to focus our energy may be the first hurdle. How much sleep is enough sleep? What makes a healthy diet healthy? Keeping true to the guiding principle of ‘docere’ or ‘doctor as teacher’, the Cathedral Centre for Wellness offers several courses to help guide you through the labyrinthine world of superfoods, supplements, detoxification, diets and even supports for the spiritual/emotional issues that impede the health strategies we know will serve us well. Throughout the year, I will be offering a curriculum that addresses the ‘whys’ and ‘wherefores’ of healthy living at every stage of life. The topics range from optimizing fertility, to the link between gut health and allergies, to bolstering immune function, to aging healthfully, and everything in between. Allopathic or Naturopathic, my newly coined ‘people medicine’ respects the individual’s unique healing order and their values as a context for applying the Therapeutic Order to clinical decision making. This, combined with a frame of reference that clarifies what optimal function looks like, you will become your own best advocate. You will know where you are in relation to healthful function, when to recognize disruptions in that balance and how to get yourself back on track. I look forward to sharing my evenings with you as we embark on your own unique, healing journey.

coming-full-circle-the-enduring-beauty-of-bone-broth

Coming Full Circle: The Enduring Beauty of Bone Broth

By Dr. Marika Geis, ND

I’ve once heard it said that a good bone broth can bring someone back from the dead. After seeing a variety of conditions improve with this form of nutrition despite an entire arsenal of naturopathic therapies, I wholeheartedly believe it. In an age where we seek to understand our natural world by breaking down complex scenarios into increasingly smaller, simpler, and thus tractable units, we fail to appreciate the characteristics of the system being acted upon. Put another way, do we necessarily need to find the ‘magic bullet’ for those troublesome symptoms or can we get out of the way of our body’s attempts to heal and broaden our scope to include the system in question? The beauty of the naturopathic model is that it allows for exactly this type of approach and is central to many of our interventions. While bone broth lacks the specificity of being an agent to say, decrease inflammation or fight infection, the synergism of its compounds work to rebuild tissue (particularly our gut lining) literally from the ground up so that the system functions better as a whole regardless of how problems manifest. When used in conjunction with targeted dietary interventions we see our clients improve on a number of levels sooner than with foods and digestive aids alone. Further, in cases of severe inflammatory bowel disease, bone broth might be the only food our clients can tolerate without compromising nutrition. So what is it about bone broth that allows it to persist as a functional food?

You may already know that bone broths have been around for as long as anyone can remember. I personally recall the perpetual pot of chicken broth on my grandmother’s stove when I was a child. Nothing was left to waste! What you may not realize though is that bone broths have been around for as long as there have been people. Archaeological evidence reveals the use of animal stomachs stuffed with herbs, meat, bones and animal fat being placed over hot rocks to yield the first primitive bone broth. Over time the practice evolved and grew to touch every known modern culture. Meat and fish broths play a central role in French, Italian, Chinese, Japanese, African, South American, Middle Eastern, and Russian cuisines. References to its medicinal properties can be found as far back as 12th century Egypt when it was used to treat colds and asthma. In Traditional Chinese Medicine, bone broths were used to treat ulcers, tuberculosis, diabetes, infections, muscle diseases, jaundice and cancer. Babies were known to experience less digestive upsets when bone broth was added to milk. When meat and vegetables were scarce during the 4-month long siege of Paris in 1870, families were able to survive in good health with nothing more than bone broth and added fat. Formal research into its health properties started in 17th century France and persisted until 1950 when food producers found cheaper ways to duplicate meat flavours in the lab thus removing bone broth and all its health benefits from their cuisine.

One might think that the healing and immune enhancing properties of bone broths are attributable to its mineral content (why wouldn’t you? You’re boiling up bones after all), however the benefits derive mainly from the presence of collagen, our body’s most abundant protein; the principle building block of bones, cartilage, skin, arteries, corneas, placentas and just about every other structure in our body. It’s true that bone broth supplies easily absorbable minerals including calcium, magnesium, phosphorus, silica, and sulphur among others. However, they are not present in substantial amounts and yet bone broth is said to be beneficial for our bones and tissues. Why is this? Using bones as an example, these highly bioavailable minerals get woven into the greater collagen matrix that provides our bones with tensile strength and resists fractures (Think of collagen as the rebar in concrete). Research from the Czech Republic, Germany and the United States have verified this showing that collagen supplementation significantly reduced the rate of bone turnover and fracture risk in those suffering from osteoporosis and osteopenia. As an aside, one may ask whether or not there is something missing in so called ‘bone building’ supplements as the bigger issue seems to be the ratios/source and not the amounts of the minerals themselves that have the bigger impact on bone health?

When a bone broth is properly prepared the collagen present in joints, skin, meat and bones gets broken down into two principle amino acids: glycine and proline which ultimately serve as building blocks for our bodies own collagen production. They are not considered ‘essential’ amino acids but given the fact that most people cannot produce enough to keep up with the demand for tissue repair, think: big wounds, microscopic damage to the gut and vasculature by inflammation, infection and a disordered immune response, top researchers are opting to call them ‘conditionally essential’. Indeed, people falling into any of these categories (read: most of us) benefit greatly from supplementation of proline and glycine rich foods. This is especially true as we age when our tissues become drier, less pliant, thinner and weaker, all due to our body’s decrease in collagen production.

Beyond it’s effect on tissue repair, glycine has numerous other benefits. It aids digestion by regulating the production of bile salts and secretion of gastric juices likely contributing to it’s label as ‘the digestor’ in 17th century France. Further, glycine is required for glutathione production (the most abundant antioxidant in the body) by the liver in addition to regulating glucose production in the same organ. Low levels of glycine render the immune system more prone to activation (think eczema, allergies, and asthma along with autoimmune disorders). It has multiple effects on our nervous system. It calms our excitatory neurotransmitters, improves mental alertness, memory and mood thereby collectively reducing the harmful effects of stress. Additionally, while this discussion has focused mainly on the effects of glycine and proline, bone broths’ benefits can be extended to include joint repair due to the presence of glucosamine and chondroitin.

The successes of the reductionist model that characterizes modern medicine are undeniable. Where would we be without insulin for diabetes or epinephrine for anaphylactic shock? When the human body is viewed as a collection of components, the natural inclination of medicine is to isolate the single factor most responsible for the observed condition. Much like a mechanic who repairs a broken car by locating the defective part, physicians typically treat disease by identifying an isolated abnormality. Implicit within this practice is the deeply rooted belief that each disease has a single target for medical treatment. Without contextual information, one might see the folly of approaching all issues in the same fashion and say that we are attempting to understand the forest by studying the trees alone. Using bones again as an example, we see how the focus on mineralization has lead to over-supplementation of large, hard to digest and absorb compounds that fall short of their desired intent in the absence of a full complement of bone building trace minerals and collagen. Simply taking a small step back and understanding osteoporosis as a disorder of connective tissue and not the bone itself provided researchers the perspective that allowed them to confirm that something was missing from conventional approaches. Likewise, when it comes to seeking out therapies that are going to yield the maximum possible benefit to our bodies as a whole, they need to function on multiple levels. Looking to Mother Nature for solutions provides us time and again with remedies that do just that and bone broth is no exception. It reminds me of a comic that I often find hanging on the walls of labs and medical reception desks. You may have seen it?

medication-pills-and-the-such

A Short History of Medicine

I have a headache:

2000 BCE: Here, eat this root.
1000 AD: That root is heathen. Here, say this prayer.
1850 AD: That prayer is superstition. Here, drink this potion.
1940 AD: That potion is snake oil. Here, swallow this pill.
1985 AD: That pill is ineffective. Here, take this antibiotic.
2011 AD: That antibiotic is artificial. Here, eat this root.

                                    ~anon

 

Chicken Stock

(Both recipes excerpted from Sally Fallon’s Broth is Beautiful article for the Weston A Price Foundation)

1 whole free-range chicken or 2 to 3 pounds of bony chicken parts, such as necks, backs, breastbones and wings*
gizzards from one chicken (optional)
2-4 chicken feet (optional)
4 quarts cold filtered water
2 tablespoons vinegar
1 large onion, coarsely chopped
2 carrots, peeled and coarsely chopped
3 celery stalks, coarsely chopped
1 bunch parsley

*Note: Farm-raised, free-range chickens give the best results. Many battery-raised chickens will not produce stock that gels.

If you are using a whole chicken, cut off the wings and remove the neck, fat glands and the gizzards from the cavity. Cut chicken parts into several pieces. (If you are using a whole chicken, remove the neck and wings and cut them into several pieces.) Place chicken or chicken pieces in a large stainless steel pot with water, vinegar and all vegetables except parsley. Let stand 30 minutes to 1 hour. Bring to a boil, and remove scum that rises to the top. Reduce heat, cover and simmer for 6 to 8 hours. The longer you cook the stock, the richer and more flavorful it will be. About 10 minutes before finishing the stock, add parsley. This will impart additional mineral ions to the broth.

Remove whole chicken or pieces with a slotted spoon. If you are using a whole chicken, let cool and remove chicken meat from the carcass. Reserve for other uses, such as chicken salads, enchiladas, sandwiches or curries. Strain the stock into a large bowl and reserve in your refrigerator until the fat rises to the top and congeals. Skim off this fat and reserve the stock in covered containers in your refrigerator or freezer.

 

Beef Stock

About 4 pounds beef marrow and knuckle bones
1 calves foot, cut into pieces (optional)
3 pounds meaty rib or neck bones
4 or more quarts cold filtered water
1/2 cup vinegar
3 onions, coarsely chopped
3 carrots, coarsely chopped
3 celery stalks, coarsely chopped
several sprigs of fresh thyme, tied together
1 teaspoon dried green peppercorns, crushed
l bunch parsley

Place the knuckle and marrow bones and optional calves foot in a very large pot with vinegar and cover with water. Let stand for one hour. Meanwhile, place the meaty bones in a roasting pan and brown at 350 degrees in the oven. When well browned, add to the pot along with the vegetables. Pour the fat out of the roasting pan, add cold water to the pan, set over a high flame and bring to a boil, stirring with a wooden spoon to loosen up coagulated juices. Add this liquid to the pot. Add additional water, if necessary, to cover the bones; but the liquid should come no higher than within one inch of the rim of the pot, as the volume expands slightly during cooking. Bring to a boil. A large amount of scum will come to the top, and it is important to remove this with a spoon. After you have skimmed, reduce heat and add the thyme and crushed peppercorns.

Simmer stock for at least 12 and as long as 72 hours. Just before finishing, add the parsley and simmer another 10 minutes. You will now have a pot of rather repulsive-looking brown liquid containing globs of gelatinous and fatty material. It doesn’t even smell particularly good. But don’t despair. After straining you will have a delicious and nourishing clear broth that forms the basis for many other recipes in this book.

Remove bones with tongs or a slotted spoon. Strain the stock into a large bowl. Let cool in the refrigerator and remove the congealed fat that rises to the top. Transfer to smaller containers and to the freezer for long-term storage.

Mom’s To Be- Don’t Forget Your Probiotics

Mom’s To Be: Don’t Forget Your Probiotics!!

By: Dr. Marika Geis BSc, ND

Breastmilk is widely acknowledged as being the most complete form of nutrition for infants. Beyond the perfect combination of proteins, fats, carbohydrates, and nutrition that change continuously according to the needs of a growing baby – it is responsible for several significant outcomes regarding immune function. In infancy these will manifest as:

  • A threefold decreased risk of respiratory infection
  • A three to fourfold decreased risk of diarrheal disease
  • A decrease in the incidence of SIDS (Sudden Infant Death Syndrome)
  • A decrease in the incidence of atopic conditions (eczema, asthma and allergies)
  • Cumulatively, in developing countries, breastfeeding appears to be a critical factor in a baby’s survival. Infants in Brazil are fourteen times more likely to die if not breastfed.

Later in life, the immunological benefits of breastfeeding for 6 months or more are associated with:

  • Decreased incidence of food allergy/sensitivity
  • Decreased incidence of ear infections
  • Decreased incidence of obesity
  • Decreased risk of developing autoimmune disease
  • An eightfold decreased risk of developing cancer prior to the age of 15

While conventional wisdom attributed the majority of these effects to the various compounds present within human breastmilk, namely immunoglobulins (antibodies derived mainly from maternal gut and lungs), lactoferrin (inhibits growth of bacteria, viruses and fungi) and lysozymes (directly toxic to pathogenic organisms), little thought was given as to whether or not commensal (symbiotic) or beneficial bacteria could be a factor since breastmilk was thought of as sterile. However, in 2003, a Spanish study published in the Journal of Pediatrics revealed breastmilk to be a major source of lactic acid bacteria for the infant gut. Beyond the vital exposure to commensal/beneficial bacteria that babies receive as a result of a vaginal birth (vagina/rectum/skin), it appears that babies consume as much as 100,000 to 10 million bacteria daily (based on an average consumption of 26 ounces daily).  This is hardly surprising given that non-human micro-organisms greatly outnumber our own cells; three to one by some estimates.

Breastmilk is widely acknowledged as being the most complete form of nutrition for infantsBreastmilk is widely acknowledged as being the most complete form of nutrition for infants

If one were to take a cursory look at the available research on the benefits of probiotics, they would likely find a striking similarity between their supplementation and the effects observed above among many others. Yet while the research shows that breastfeeding and probiotics (and even probiotics during pregnancy) reduce the likelihood of developing the conditions listed above, to date, research linking the two variables is sparse. This is presumably due to the fact that up until recently, researchers had yet to explain how something residing solely on the so-called external environments of our body (gut, lungs, genitals, oral, skin), made their way into breastmilk.

What the research suggests is something of a pathway that exists between the maternal gut and mammary glands via the immune system. Firstly, white blood cells that normally serve a ‘Pac Man’-like function (engulf and destroy foreign material) alter their activity and instead ‘sip’ the environment of the maternal gut, take samples of the resident bacteria, travel through the bloodstream, and deposit their contents in the mammary glands. Indeed, small numbers of bacteria can reside inside these cells for several days prior to reaching their destination. Changes to maternal physiology, specifically, weakness in the gut wall, increased permeability of the gut wall, and decreased motility allow for this incredible process starting in the third trimester and continues up until the point of weaning. Once these bacteria reach the infant gut, there are literally no barriers to colonization. It’s warm and moist with an endless supply of food- the complex sugars of the mother’s breastmilk.

 

So what are the implications of this profound relationship between mother and baby? It’s important to realize that the first month of breastfeeding is a critical period for establishing the bacterial profile of the infant gut. Samples taken from eight and nine year olds show that the streptococcus and staphylococcus profiles established within the first month of life remain intact. This finding lends new insight to the negative impact that antibiotic use, modern diets, and stress have on the maternal microbiome and the potential for chronic disease in children. Given what we know of the benefits of probiotics and that breastfeeding is a principle source of beneficial bacteria for the newborn, the utmost care must be taken to protect this sensitive and diverse ecosystem. As naturopaths, we often talk about the healing power of nature. While conception, pregnancy, and birth aren’t necessarily conditions that require healing, this is just one more example of how the wisdom of Mother Nature manifests to ensure that we are able to survive the environment we’re born into.

 

Progesterone: Too Much of a Good Thing?

Bio-identical progesterone isn’t without risk

By: Marika Geis, ND

Ask anyone suffering from extreme PMS or early menopause if they’ve benefited from bio- identical hormones and they’ll tell you that along with B vitamins, Fish oil, Chaste-tree, seed rotations, calcium/magnesium, liver and adrenal support, bio-identical progesterone was a game changer. The benefits of bio-identical progesterone don’t stop there. In women with PCOS, progesterone can lower the male type hormones responsible for some of their symptoms along with balancing the pituitary hormones that help regulate their cycle. While the processes that contribute to the above conditions are complex, the one common denominator is the relative excess of estrogen, a hormone, which if left unopposed, can have a significant impact on our health. Nowhere was this made clearer than with the Women’s Health Initiative in 1991. Of the 3 interventions, one sought to determine which would have the greater benefit on reducing cardiovascular risk, cancer and osteoporosis: estrogen only therapy or estrogen in combination with progesterone. Women with intact uteruses given ‘estrogen only’ therapy were at significantly greater risk of developing uterine cancer, a risk that was reduced when estrogen was given in combination with progesterone. As a result the study ended in 2004, two and a half years early.

In a world that seems determined to ensure that we are swimming in vast amounts of estrogen, both from the environment: plastics and their petrochemical cousins, pesticides and herbicides etc…and internally: lack of ovulation (a process that produces progesterone), compromised liver function (which will hold onto estrogen as opposed to eliminating it) and excessive stress (a process that sequesters progesterone to make more stress hormone), progesterone might seem a likely antidote for all this exposure given its role in balancing the effects of estrogen. This of course, after liver function has been corrected and balance has been restored to the nervous system, right? For the most part this is true but what happens when we’re given too much of a good thing? What might present as a baffling array of symptoms apparently implicating the thyroid gland, the nervous system and cardiovascular system, could actually have their roots in supra-physiologic amounts of progesterone as we shall soon see.shutterstock_90840794

Lucy, a 47 year-old mother of 3 children, experiencing increasingly irritable episodes prior to her cycle along with night sweats that leave her sleepless and drained of energy went to her doctor’s office asking for advice on how to handle this new development. She has a good rapport with her physician and reports that she has also been experiencing frequent headaches, some flushing during the day and increasingly irregular periods that are quite heavy and painful. Her intrepid doctor, resisting the urge to recommend antidepressants and/or birth control pills, and having just read Dr. John Lee’s ‘What Your Doctor May Not Tell You About Menopause’, correctly sees this as the relative imbalance of estrogen and progesterone that occurs in early menopause and goes about prescribing her the standard dose of bio-identical progesterone to be taken during the last 2 weeks of her cycle. Lucy left relieved and began taking her medication at the appropriate time. Well, she was astonished. Most of her symptoms had disappeared, she felt more like her old self and life went back to normal. After about 6 months or so she found herself back in the doctor’s office with the same symptoms. What happened? More progesterone is prescribed except this time the symptoms aren’t getting any better. In fact, Lucy is now experiencing heart palpitations, hair loss, extreme fatigue, depression, low libido, cravings and weight gain. Some preliminary blood work by her doctor showed a normal value for thyroid function but a high fasting blood sugar along with a cholesterol profile that increased her risk of having a cardiovascular event in the future. Perhaps Diabetes? Maybe.

Lucy decided to take matters into her own hands unwilling to accept the fact that within 6 months she went from a healthy 47 year old woman to one that could potentially be taking 4-5 different medications to mitigate the cardiovascular risks associated with Type 2 Diabetes. She had some brave friends that had seen Naturopathic Doctors with some encouraging results and decided to make an appointment. During the course of the interview, her naturopath suggested something called ‘salivary hormone testing’ to see where her levels of estrogen and progesterone were at given that her decline started with common peri-menopausal symptoms. They decided on a hormone panel that included the hormones in question in addition to assessing the status of her nervous system. The results clearly indicated where the problem was. Estrogen was within the normal range for a woman her age but her progesterone was clearly out of balance. And not by a little. The normal reference range for this particular test for progesterone is 0-50. Her result came back as

Lucy decided to take matters into her own hands unwilling to accept the fact that within 6 months she went from a healthy 47 year old woman to one that could potentially be taking 4-5 different medications to mitigate the cardiovascular risks associated with Type 2 Diabetes. She had some brave friends that had seen Naturopathic Doctors with some encouraging results and decided to make an appointment. During the course of the interview, her naturopath suggested something called ‘salivary hormone testing’ to see where her levels of estrogen and progesterone were at given that her decline started with common peri-menopausal symptoms. They decided on a hormone panel that included the hormones in question in addition to assessing the status of her nervous system. The results clearly indicated where the problem was. Estrogen was within the normal range for a woman her age but her progesterone was clearly out of balance. And not by a little. The normal reference range for this particular test for progesterone is 0-50. Her result came back as 3200!!

When the body encounters an agent that is in excess of what it needs, it will attempt to protect itself from its effects by down regulating the number of receptors on the target organs that respond to the agent in question.

Take adult onset Diabetes as an example. In response to chronically high blood sugar, the pancreas makes more and more insulin in an attempt to keep levels with range. However, when the body registers that too much is being made, the number of receptors to insulin is reduced and the body secretes even more insulin to achieve the same blood sugar lowering effect. This is what is known as insulin resistance – the precursor to Type II Diabetes. Progesterone receptors will act in much the same way in that once the body is flooded with progesterone and all receptors are saturated, the body will make less receptors available because it no longer needs to maintain sensitivity. Since the target tissues no longer need progesterone it is often repurposed to other systems.

One common fate of excess progesterone is cortisol. Anyone with a history of PMS that was improved by including adrenal support to their health regimen can attest to this. When the body is under chronic stress, it will sequester progesterone to make more cortisol leaving the patient with a relative excess of estrogen. But what happens when there’s a relative excess of progesterone? The same thing, although the stimulus won’t be excessive long term stress. Excess progesterone will be shunted to making additional cortisol. Excess cortisol can have a suppressive effect on the thyroid gland – the metabolic powerhouse of the body. The end result is a spectrum of symptoms that involve the pancreas, adrenals, thyroid and ovaries: extreme fatigue, depression, low libido, hair loss, weight gain, palpitations, insomnia, cravings and perhaps more troublesome is the potential to precipitate progesterone receptor positive cancers.

So what’s the bottom line? As a naturopath, I can’t say that bio-identical progesterone is my first choice when it comes to treating things like PMS, peri-menopause, PCOS or some other kind of estrogen dependent condition. I usually try and support the systems whose dysfunction is lending the body to manifest those particular symptoms. This can go a very long way! However, when my patients are doing their very best to support healthy blood sugar levels, manage their stress and take their supplements and things are still just not quite right, I have no qualms about recommending bio-identical hormones. But, and a very BIG but, it is usually done with appropriate testing to ensure that the recommended dosage actually reflects what their body needs. A good rule of thumb is to start low and go slow. Test every 2-3 months for the first 12 months to ensure that your levels are within range and make corrections accordingly. A good compounding pharmacist is a crucial ally when a patient’s needs go beyond the standard available dose. Avoid unintended consequences….test don’t guess!

Happy summer ?

Genetic Roulette

Film Review: Jeffrey Smith’s Genetic Roulette

By Dr. Marika Geis, BSc, ND

A couple of months ago I came across a film that can only be described as a public service announcement. The spirit of common sense that keeps us wearing our seatbelts andfrom getting behind the wheel while under the influence will be the same that makes your resolution for 2013 an easy one, or so I hope. The argument is so compelling that it leaves you with little choice. The Institute for Responsible Technology’s founder, Jeffery Smith expertly distills an overwhelming body of research against the use of Genetically Modified foods into a relevant, accessible and impassioned plea to those that would do right by themselves and their children. The documentary, “Genetic Roulette”, systematically exposes the astonishing truth behind the consumption of genetically modified foods. From the manipulation of the legislative process that deems these products ‘safe’, to the repeated and ostensibly successful attempts to paralyze the research engine that overwhelmingly concludes that genetically modified foods pose a significant health risk, to farmers observing dramatic changes to the health of their livestock after stopping GM feed for just three days, to the dismantling of the GMO myths claiming that genetically modified food are the only way to meet the ‘world food shortage’ and the more than 40 health risks associated with GM foods, Jeffrey Smith provides a clear and comprehensive body of work that leaves little doubt in the viewer’s mind that the only way to reclaim control of your body is to be selective about what you put in it.

I have to admit that before seeing this film, my decision to avoid GM foods was largely emotional. I remember an interview with David Suzuki many years ago. He was asked whether or not GM foods were safe to eat. His response was something along the lines of “We have no idea how these organisms will behave in nature because they’ve never existed before now”. Made sense; it was good enough for me. As a physician, I was more concerned with avoiding commercial foods because of the health risks associated with the chemicals used in industrialized agriculture and how they affected overall toxicity. But after seeing this film, not only am I more vigilant about what I bring into my home for my family, I have now begun to refine my prescriptions to my patients, particularly those who are just experiencing naturopathic medicine for the first time ; “Don’t worry about the wheat, dairy and sugar just yet, we’ll have time for that later. Eliminate processed foods from your diet”.

In clinical practice the GM issue is particularly relevant to our pediatric genetic_roulettepatients in that we see time and time again  health concerns stemming from ‘Leaky Gut Syndrome’: allergies, eczema, allergies, autoimmune and neurological disorders and immune dysfunction all have their roots in a compromised digestive tract. When we see so many systems affected in a single individual, it seems obvious that one must consider the ‘source’. In Chinese medicine, one of the sources of our life force or Qi comes from the food we eat. Likewise, when the parents, veterinarians, and farmers that were interviewed in this film, stopped to consider why their children and animals were so ill they too had no choice but to question the food they were eating. When people found out about how Bt toxin contributes to gut permeability or how RoundUp ready crops contribute to malnutrition and therefore make us more vulnerable to virulent diseases, there was never really any choice for them except not to look back. Of all the allergists, immunologists, pediatricians, registered dieticians, hematologists, oncologists,naturopaths and internal medicine specialists who commented on the rise of the conditions listed above, every one stated that when GM foods were eliminated from their patient’s diets their health improved.

When you experience this film, there may be the tendency to despair. Indeed the problem of GM foods is global leaving no one, not even our infants, untouched. However, as Jeffery Smith describes, it is possible to reverse the damage done. You have a choice about where you spend your money. You have a choice about what you eat. Avoiding GM foods is far from impossible. The ‘Genetic Roulette’ website has a vast number of resources that you can access to ensure that you avoid GM foods. An epiphany takes only a moment of clarity, a resolution, only the sincere intention of doing better. If you haven’t already, know that when you make your resolution this year that you will not only be benefitting yourself but your family and generations to come.

Juvenile Rheumatoid Arthritis: Naturopathic Medicine in Action

A Case of Juvenile Idiopathic Arthritis AKA Juvenile Rheumatoid Arthritis.

By Dr Marika Geis, ND

When I think of two years old’ a vision of the Merry Melodies Tasmanian Devil comes to mind: A screaming whirlwind of dust leveling everything in its path or in the case of my own children, launching themselves off the couch and flushing my watch down the toilet along with a whole roll of toilet paper. The last thing I would imagine would be a child cautious about moving too fast because their joints were hot and swollen, or having to take breaks several times throughout the day to recharge because it takes so much to work through the discomfort and stiffness of juvenile idiopathic arthritis (JIA). Yet this was exactly the case when I met little Katie in August of last year. Her parents had noticed that her big toe was quite swollen and didn’t seem to be going away on its own. Two weeks later her parents noticed that Katie would move carefully in the morning and take her time initiating movement. To them it seemed as she was moving like someone sore and stiff. A week after that her knees became involved; they were swollen and warm to touch. Her mother, a registered nurse, promptly took her daughter to the doctor and did some preliminary bloodwork. The results showed that inflammation was present but did not point to a cause. Treatment options at the time were to prescribe Naproxen (a non-steroidal anti-inflammatory or NSAID associated with bleeding in the digestive tract), to do cortisone shots in the affected joints which, with repeated use, degrades connective tissue and lastly to prescribe prednisone, a steroid drug associated with several damaging side effects. The parents opted for the naproxen with the intention of buying a little time before the other treatments became necessary. At this point they came to our clinic looking for ways to augment her treatment given that, despite the naproxen, the number of joints involved was growing.shutterstock_296807261

It’s important to understand the prognosis of kids with JIA/JRA as these children are at increased risk for the
involvement of other organ systems, have mobility issues stemming from chronic inflammation and potential joint deformities. Conventional treatment is ‘comprehensive’ in that it involves pharmacotherapy, physical therapy, academic counselling, occupational therapy and psychological counselling. For kids with more than one joint involved complete remission is rare. Although Katie’s parents were absolutely prepared to do whatever was required of them they couldn’t help but wonder if there wasn’t something that was being overlooked.

Up until Katie, I had never treated anyone with JIA/JRA but as naturopaths we routinely treat multiple manifestations of autoimmune disease of which JIA/JRA is one. The working naturopathic theory behind autoimmunity is one that I am sure you’ve heard of before although perhaps in different contexts. Leaky gut syndrome or gastrointestinal permeability is a process by which material from the cavity of the intestines enters into the bloodstream through the tissue wall before it’s intended to. Once in the bloodstream, the regional lymphatic tissue, correctly recognizing it as foreign, begins making an abundance of antibodies in an attempt to neutralize this ‘threat’. The problem is that in certain populations where the genetic susceptibility exists, those antibodies, having a similar structure to some of our bodies own tissues will now go and attack various systems throughout the body. The thyroid in Hashimoto’s hypothyroidism, the myelin sheath in Multiple Sclerosis, the joint capsule in Rheumatoid Arthritis, the colon in Crohn’s Disease, The liver in Autoimmne Hepatitis….the list goes on. From a naturopath’s point of view, it matters less how it manifests and more that it’s autoimmune in nature.

There are several ways by which permeability in the gut arises. In children, one of the more common ways is through foods. At birth and by design, babies are born with several gaps in the tissue lining the intestines as this is how babies absorb proteins and fat from mom’s breast milk. As baby grows and their intestines mature they can gradually begin to tolerate different foods provided that the food matches their capacity to digest it. In many cases however, foods, often allergenic foods, get introduced too early, are recognized as ‘foreign’ and the above process of antibody production begins. In Katie’s case it wasn’t so easy to pinpoint possible food sensitivities given that gluten, a common allergen wasn’t introduced until 8 months of age and dairy wasn’t introduced until 12 months of age. She did not present with any significant digestive concerns although she did manifest eczema, a classic sign of ‘leaky gut’. This, despite the parents having done all the right things.

We discussed the possibility of starting a hypoallergenic diet prefaced by a Food Sensitivity test for what’s called an IgG response (or ‘delayed’ immune response) to 96 different foods. This, in addition a small number of supplements to help heal the gut and modulate the immune response. They did the test and began the dairy, soy, corn, egg, gluten, and sugar free diet in earnest. What they noticed initially was that the swelling was on its way down. However, Katie was also still taking Naproxen so it was difficult to tell what was helping. When the results came back it allowed Katie’s family to further refine her diet. As it turned out grapes and citrus were high on the list as were the foods she was already avoiding. Remarkably, her eczema disappeared indicating to her mother that her gut was indeed permeable and in the process of healing. Another significant development was that Katie was able to have a fever during a cold without aggravating her joint symptoms, something that previously went hand in hand. Slowly but surely the swelling was going down and her range of motion was improving. Finally, to do away with the residual inflammation, Katie’s parents opted to proceed with the cortisone shots allowing for full recovery of her range of motion. To date, Katie is now in complete remission, off the Naproxen, bouncing off the walls and threating to flush her mother`s watch down the toilet. There have not been any further flare ups in her joints or skin, she is sleeping better, has more energy and is fearless in her exploits.

This story has a tremendous ending. It`s a testament to what children can endure and how well and completely they can heal once the true cause has been found. These parents have literally changed the trajectory of their daughter`s life. I feel so fortunate to have participated in this family`s journey and witness our body`s innate wisdom and the healing power of nature. Thank you Katie!

The Benefits of Water in Your Life

By: Marika Geis, BSc, ND

Beverage wars. With the multitudes of choices out there, sodas, ‘vitamin water’, sugar laden antioxidant juices, white teas promoting ‘anti-aging’ benefits, it’s a safe bet that water remains the healthiest choice. However, when it comes to water, consumers often are faced with mixed messages. You’re making a healthier choice sure, but at what expense? Each time we dispose of a plastic bottle, we are told that it remains in a landfill for a minimum of 700 years before it begins to decompose. Coupled with the fact that 80% of bottles are not recycled, the environmental impact is significant to say the least. Space in the landfill is not the only issue. 24 million gallons of oil are needed to produce a billion plastic bottles.

The average Canadian consumes approximately 167 bottles per year. So what to do? According to David Suzuki, who insists on drinking municipal water wherever he goes, drinking bottled water is an unimaginable waste not to mention a significant health hazard, and that the only way to mitigate the damage is to drink tap water. Increasingly, Canadians fear that their water is unsafe. The Environmental Working Group states that there are over 315 pollutants in municipal tap water. More than half of the chemicals detected are not subject to health or safety regulations and can legally be present in any amount. While the federal government in the United States has health guidelines for some, at least 49 of these contaminants have been found in one place or another at levels above those guidelines, polluting the tap water for 53.6 million Americans. Despite these infractions, at least the United States Environmental Protection Agency’s (USEPA) guidelines for maximum contaminant levels in water are standards enforced by law. In Canada, our water quality guidelines are at best, recommendations which do not necessarily have the force of law behind them; responsibility for water quality rests with the administrators of the myriad local and municipal water systems across Canada. One only need be reminded of the May 2000 Walkerton E-coli outbreak that resulted in seven deaths and 2000 illnesses, to want to take control of their water quality.

Water filters are becoming an increasingly popular way to reconcile the need for less waste with healthier and safer water. But how to choose? Just like the myriad of choices available to you when choosing a beverage, choices of water filters are equally overwhelming not to mention the confusing selection criteria. What follows is an attempt to demystify the selection process and give you a few guidelines to begin choosing which filtration system is right for you.

The first step is to choose a filter that is shutterstock_141717046independently certified. At a minimum filters (available in two types: point of entry or point of use) should meet NSF 53 (National Sanitation Foundation) certification. NSF 53 is designed to reduce specific health-related contaminants, such as Cryptosporidium, Giardia, lead, volatile organic chemicals (VOCs), MTBE (methyl tertiary-butyl ether), that may be present in public or private drinking water.

The second step is to choose your filtration process. There are a variety of ways to meet or exceed the NSF 53 standard although only 4-5 options are available to the general public. Activated carbon filters are positively charged and highly absorbent. They reduce bad tastes and odors, including chlorine. NSF 53 activated carbon filters can substantially reduce many hazardous contaminants, including heavy metals such as copper, lead and mercury (although it should be mentioned that a solid carbon block cannot achieve this – it must be combined with a KDF, see below); disinfection by- products; parasites such as Giardia and Cryptosporidium ; pesticides; radon; and volatile organic chemicals such as methyl-tert-butyl ether (MTBE), dichlorobenzene and trichloroethylene (TCE). The advantage of using activated carbon as a filter is that it retains all the positively charged minerals (what makes water ‘hard’ or ‘alkaline’) such as calcium, magnesium potassium and sodium; minerals necessary to maintain optimal health.

KDF resin filtration has limited utility in that it needs long exposure to untreated water and large amounts of the resin in order for it to exert its effects; mainly to remove chlorine. As such, KDF resin is usually applied in point of entry systems and in some cases shower heads to reduce chlorine exposure. One of the disadvantages of using KDF resin as a filter is that in some cases it can leach copper and zinc into the water as both minerals are used to reduce bacterial growth within the filter itself. KDF filters also clog fairly easily and require huge amounts of hot water to decongest the apparatus with no way to stem the flow of the dislodged pollutants into the treated water.

Distillation is an expensive process that heats the water to the vapor point and aids in removing some impurities from the water. The process itself requires electricity and adequate water, since it wastes gallons of water for every gallon produced. However the main disadvantage is that it leaves the water ‘soft’ or mineral free. If drunk over a long period the body tends to lend its own minerals to balance the effect on the body’s pH. Bones and teeth get weak with time. Another disadvantage is that distillation is not effective at removing VOC’s because many of them re-condense back into liquid just like water does. For this reason, a distiller is usually combined with a carbon filter to remove additional chemicals.

Reverse osmosis was developed to remove salt from sea water for military submarines. The reverse osmosis process draws water through a membrane. Salt water is put on one side of the membrane and pressure is applied to stop, and then “reverse,” the osmotic process. It generally takes a lot of pressure and is fairly slow removing all minerals in the process (similar to distilled water). For every one gallon of water produced, 10 gallons of water is used in the RO process. It does however get rid of most contaminants such as Cryptosporidium and Giardia; heavy metals: cadmium, copper, lead, mercury and other pollutants including arsenic, barium, nitrites, perchlorate and selenium.

UV Disinfection uses ultraviolet light to kill bacteria and viruses. Class A systems protect against harmful bacteria and viruses, including Cryptosporidium and Giardia, while Class B systems are designed to make non-disease-causing bacteria inactive. Unfortunately, it is not effective against parasites, heavy metals and VOC’s. Because of this it is often used in combination with a carbon filter and sediment screen.

Once you have decided on your filter, it’s important to maintain it properly as its performance will decrease over time as contaminants build up and potentially back up into your ‘treated’ water. Make sure to follow the manufacturer’s maintenance directions. Some filters only require a cartridge change, while others are better maintained by a certified professional. Many filter distributors offer maintenance and service contracts for their products. Before buying any water treatment system, compare not only filter prices, but also operating and maintenance costs for the different units.

Here’s to your good health! Dr. Marika Geis, ND

Chronic Yeast: Why Does This Keep Happening?

The impact of hormones on vaginal immunity.

By Dr. Marika Geis

For most women, yeast infections are nothing new. We know that if we take a prescription of antibiotics for a sinus infection that just won’t go away, we run the risk of getting a yeast infection. As doctors, we also know that those who use steroids regularly, have Diabetes, or are immunocompromised also have a greater likelihood of developing vaginal yeast infections. However, there are women out there who suffer from this minor annoyance, monthly or worse yet- constantly, often for years. The pattern usually presents as gradually getting worse prior to menstruation followed by relief for up to 10 days afterwards before the whole cycle starts again. These women know about the role of antibiotics and how they disrupt the healthy balance of bacteria in the body leaving yeast the opportunity to grow and proliferate. They are often aware that sugar, breads, dairy and alcohol feed yeast and will mostly be avoiding these. Often times women will report taking “yeast busting” cleanses that temporarily relieve their symptoms for a month or two only to have it return. So why does this keep happening? The timing of the infections is our clue. While optimal hormone balance rarely leaves us susceptible to this type of chronic infection, a relative excess of estrogen has an enormous impact on the immune micro-environment of the vagina. It not only allows the vulnerability to the yeast in the first place but goes on to feed it throughout the cycle.shutterstock_152301968

Besides the relative acidity of the vagina created by the presence of Lactobacillus (the main factor protecting us from infection), there are several types of immune cells that reside within various zones of tissue that provide further protection. Through a complex interplay of chemical messages and interactions, these cells essentially reveal microorganisms to other cells that will then ingest them. There is also a formidable complement of something called ‘secretory IgA’, a type of antibody that: neutralizes viruses, blocks the adherence of microbes to the tissue wall and enhances the microbe eating activity of other immune cells. Under normal conditions, secretory IgA begins to increase during the second half or luteal phase of a woman’s cycle and is lowest at ovulation thus allowing for insemination and possible conception. This leaves a woman vulnerable to infection for the first two weeks of her cycle which is typically when we start to see the symptoms returning.

Where we see problems is when a woman expresses an excess of estrogen relative to progesterone during the last half of the cycle. While estrogen can lower the amount of secretory IgA, it can also decrease the ability of certain immune cells to present microbes to the other types of cells that would otherwise engulf the pathogen. Furthermore, excessive estrogen shifts the immune response from one that is cell mediated to on that is antibody mediated. In other words, the simple ingestion of a foreign invader vs a more specialized approach which requires an initial exposure, an initial exposure that leads to symptoms; symptoms that would not have manifested had the microbe been dealt with by cells that just eat what’s not supposed to be there in the first place. Once an organism has overwhelmed the local immunity, estrogen makes things worse by allowing more vaginal epithelial cells (skin cells) to slough off and provide a food source (glycogen) for the growing microbes. Normally this food source would be reserved for the Lactobacillus that maintain the acidic pH of the vagina, however given the balance in favor of the invading microbe, the glycogen stored in the skin cells of the vagina actually contribute to their proliferation.

Dealing with excessive estrogen can be tough. Poor liver function caused by stress and poor diet, the exposure to environmental estrogens, the relative estrogen excess that comes with peri-menopause from lack of ovulation, oral contraceptive pills and under-function of the adrenal glands can all tip the scales overwhelmingly in favor of estrogen. Luckily, this pattern seems to be quite amenable to naturopathic interventions. Our strategies usually involve enhancing elimination by the liver and gall bladder, improving nutrient status, reducing exposure to petrochemicals and correcting adrenal function. Correcting adrenal function, by the way, is extremely important in that high levels of stress in and of themselves can drive down overall secretory IgA levels. So in addition to using the herbs, glandulars and vitamins available to us, outlining a stress management program is essential to minimizing the impact of stress on our immunity.

The occasional yeast infection is usually just a transient shift in the body’s ecology and is quite responsive to dietary changes, probiotics, antifungals a sitz bath and even a garlic clove suppository. However, when the infections are chronic and sometimes constant one must consider that the yeast itself isn’t the cause but rather the consequence of a greater imbalance – beyond slips in diet or taking prescription medications. Exploring the relationship between estrogen balance and secretory IgA levels in the vagina provides one possibility for treatment and has implications beyond yeast in that maintaining robust immunity in this area can protect us from all manner of infections including the possibility of cancer.

Japan Does Not Want Any More American Wheat

More Questions Raised About the Modern-Day ‘Staff of Life’:

Japan Refuses to Import US Wheat By: Dr. Marika Geis, ND

The future of the U.S. wheat industry looks a bit uncertain as of the end of May, 2013. Japan, upon the discovery of a genetically modified strain of ‘white wheat’ coming from Oregon, announced that all wheat imports coming from the United States were to cease immediately; this pending a thorough investigation as to the extent of the contamination and an assurance by the USDA that no such GM strain will ever make it into U.S. exports again.

Why all the uproar? Well, no country in the world has ever approved genetically modified wheat for sale. What’s more is that the strain found in Oregon, developed by the biotechnology giant, Monsanto, between 1998 and 2005 was never approved for sale because growers and buyers opposed Monsanto’s intent to seek approval to market the seeds.

People are right to be leery of GM foods. GM soy and corn are implicated in a number of human and livestock illnesses that literally leave no part of the body untouched (gut, liver and kidney function, the immune and endocrine systems, blood composition, allergic response, effects on the unborn, the potential to cause cancer, and impacts on gut bacteria). What’s even more concerning is that over 80% of processed foods contain GM foods with no labelling to identify products as such. However, despite their presence in processed foods, and the effects notwithstanding, GM soy, corn and more recently hay (alfalfa), are largely intended for animal feed. Wheat would be the first GM crop ever to be consumed en masse by people directly.

According to the U.S Food and Drug Administration policy statement on the safety of GMO’s, they are essentially equivalent to heritage seeds and crops and need no government regulation. It went on to say that the food producer bears responsibility for assuring safety. This is problematic as government officials from other countries often use FDA assessments to inform their own policies. If it’s happening south of the border it’s likely happening here.

The concern regarding GM wheat is compounded by the problems surrounding the hybridized varieties already being used. Driven by a mandate to combat world hunger, wheat went through a rapid period of cross-breeding resulting in thousands of varieties that dramatically increased yields from 8 to 65 bushels per acre. With each stage of hybridization (repeated thousands of times), 5% of the proteins are new and may have novel characteristics. Gluten seems particularly vulnerable to these structural changes and is therefore inherently more allergenic given that these new proteins have never existed before today. Clinically, we see time and again how symptoms ranging from total debility to softer syndromes improve with the elimination of wheat. Celiac disease is four times more common today than it was 65 years ago.

The average person eats 133 pounds of wheat per year, up 26 pounds from 1970. 99% of that wheat is the modern day, high yielding ‘dwarf’ and ‘semi dwarf’ variety containing ever changing gluten proteins. This coupled with the discovery

of GM strains of wheat making their way into our food supply presents a potentially dangerous combination and necessitates serious examination of our food’s safety. Until an unbiased consensus is reached, I think the precautionary principle exercised by Japan is an essential move. The best way to avoid wheat/gluten is simply to avoid using recipes that call for it or provide suitable replacement flours. Better yet, avoid recipes that call for any kind of flour. Eating seasonally and locally is the healthiest way to support your own health, your family’s health and the longevity of our environment.

Ever Our Faithful Servant: The Liver

Where would we be without you?

Dr. Marika Geis, BSc, ND

The natural medicine of today is a far different animal than it was a generation ago. In a society hungry for alternatives to conventional medical practices, ‘natural medicine’ has come to include any method that avoids the use of pharmacotherapy. With Dr. Oz touting the latest and greatest natural health phenomenon, detox foot baths, oil pulling, and so on, it can be easy to lose sight of the conceptual model that make natural medicine so effective. It’s not unusual for people to come to their appointments with their entire arsenal of supplements hoping for some clarity as to what they need to be taking. When asked why they are taking supplement ‘x’ I often hear “That’s agood question! I’m not actually sure. I think I read it somewhere in a magazine”. As naturopaths, a big piece of the education we offer to our patients is providing the framework with which to interpret their symptoms and decide on an appropriate course of action. This framework, regardless of how your naturopath formulates their assessment or the modality used, ultimately works on a ‘systems based’ approach in that our symptoms are the result of an issue ‘upstream’. Support the weakened system and the ‘downstream’ issues get resolved. It’s this ‘systems based’ approach that provides the direction necessary to focus on the remedies needed and hold off on others even though they might be ‘good for you’.liver

One such ‘upstream’ system is your liver. To those of you who have been receiving this newsletter for a while, this may seem like old news. So old in fact that it is often forgotten when attempting to figure out, as a for instance, why at the age of fifty, you’re all of a sudden constipated, bloated, fatigued and having the worst hot flushes of your life. It can be easy to think of all the herbs and vitamins that are involved in balancing out hormones like estrogen and progesterone or to make dietary changes that avoid the inflammation associated with troublesome hot flushes. But what’s to be done when these interventions don’t quite deal with the problem as you had hoped? Have we forgotten that a well-functioning liver is essential for optimal hormone balance? As another ‘for instance’, what if all of a sudden you are beset by a rash so itchy that you can’t sleep at night and you’re wearing socks on your hands to protect yourself for scratching yourself to infection? Have we forgotten that toxic compounds not eliminated by the liver and kidneys will look to the skin as a way to be eliminated?

“But I detoxify twice a year” you say. Detoxifying semi-annually and annually is certainly helpful in mitigating the toll of modern life on your liver but it is not a guarantee that your liver will never be impacted and in need of support outside those times. Excessive stress, pharmaceutical drugs, alcohol and sugar consumption, nutritional deficiencies, processed food, environmental chemicals, plastics in the home, the list goes on, can all potentially compromise liver function. Signs of dysfunction go beyond jaundice, pain in the upper right hand side and abnormal liver function tests. They can also include: lowered immunity, headaches, trouble balancing blood sugar, poor metabolism of fats (LDL will go up and HDL will go down), digestive issues (bloating, constipation, IBS, heartburn), rashes, bad breath, difficulties absorbing nutrients from our food (liver has a role in making the nutrition from our food bioavailable) which impacts mood, memory and concentration, keeping anger in check, and premenstrual symptoms such as breast tenderness, cramping and a heavy flow with clotting. The Chinese take it further implicating the liver in such things as sleep patterns (anyone out there consistently get up between 1 and 3 am?), the quality of your sight and health of your nails.

As naturopaths, we often see the chronic issues that the conventional model is at a loss to deal with. At times pharmacotherapy is needed to help manage symptoms that are intolerable. Life may become more manageable but the underlying cause goes unaddressed. Using a ‘systems based’ approach provides a broader framework with which to interpret symptoms and offers a direction in terms of treatment. Treating the liver is not the answer to all chronic health issues but it is certainly a key player in maintaining our overall health. It’s a little like a rain barrel: try never to let it get too full by keeping the spigot open at the bottom. Our humble liver is the spigot and our bodies, the rain barrel. Provided we have a little room at the top to collect rainwater, we’ll never spill over.

For more information on how liver health might relate to your specific health concerns, your naturopath is a wealth of knowledge. In the meantime (especially over the holiday season) you may want to incorporate the following:

  • A little lemon juice first thing in the morning (helps stimulate the flow of bile)
  • 1-2 tablespoons of non-GM soy or sunflower lecithin (helps the flow of bile)
  • Turmeric daily
  • Castor oil packs nightly
  • A good quality greens powder daily
  • A diet full of dark, leafy and bitter greens
  • Keep caffeine, alcohol and sugar to a minimum.