New Beginnings

After 7 years in Airdrie, we have moved and expanded!  The last couple of years have been a tough go for many Albertans due to a sluggish economy that seems to be stuck in first gear.  Naturopathic medicine has had its challenges too as most patients rely on insurance coverage through employer benefits which seem to be continually shrinking.  And then I will never forget so much negative media coverage in Alberta erroneously linking Naturopathic Doctors to several traumatic cases of very unfortunate health outcomes.  During the last 2 years, I was focused on each patient that was in my office, ensuring they had the best experience possible.  I guess I was trying to change Albertans perspective of naturopathic medicine one patient at a time. 

We still have a long way to go as many people who see me for the first time do so on a referral from a friend regarding a chronic health problem and they do not realize that most of my training is conventional (I attended 2 universities and graduated from the University of Calgary).  As such, hesitant patients tend to be pleasantly surprised that naturopathic medicine builds on science and can be quite logical and effective when used properly.

I am very proud to be one of only a very few health clinics in Canada to have such a diverse team.  In addition to my amazing reception staff, we have 2 Naturopathic Doctors, 1 Psychotherapist, 2 Registered Massage Therapists, 1 Prenatal Course Instructor and 3 Midwives (2 people are were absent from the photo above).

Dying to Wait

Evidence Based Medicine.  A guide that all medical professionals are to aspire to.  But what exactly does evidence based medicine currently mean?  After listening to Timothy Caulfield's talk at the Perspectives in Exercise, Health and Fitness conference 2 weeks ago, I am left with the impression that there is absolutely no evidence for almost everything I do.  Not even supplementing vitamin D in the winter!

Mr. Caulfield is an author and professor of health law at the University of Alberta and he is a very outspoken critic of Naturopathic Medicine.  He was certainly entertaining to listen to and fortunately a lot of what he said about celebrity health fads was true.  Unfortunately, if there is not a body of research consisting of randomly assigned, double blinded, placebo group, clinical trails showing significant benefit, Mr Caulfield was quick to state, "no science".

This leaves no room for logical conclusions in the absence of clear research evidence.  Two of the many examples Mr. Caulfield cast away as, "no evidence" were: prostate cancer screening and cupping.  Delving into each more closely will demonstrate that concluding "no evidence" based on the results of research alone may be problematic.

Looking at prostate cancer screening, according to the research the net benefit is zero.  However, Ben Stiller may be right too.  Research tells us that if the lives of Ben Stiller and 100 other men are saved from early intervention from prostate screening (PSA) and the lives of 90 other men are lost (due to complications of prostate surgery for example) the net gain is small.  And yet logic concludes that the 100 men who's lives were saved by prostate screening are very happy for the PSA test.  So do we throw the test away?  This is one of the complexities of research guided medicine.  In this case, medicine does not have the tools to know which side of the fence each male tested will be on.  In the mean time, PSA screening may be better as an individual choice after the risks have been described but "no evidence" is an illogical conclusion.

Then we have Michael Phelps to thank for bringing cupping to the general public's attention.  How can a research trial with a placebo group ever be done on cupping?  It leaves circular marks!  Again, do we discard cupping as a celebrity fad?  I should hope not as cupping has provided some people benefit long before Michael Phelps used it.  In this case, I would propose we take a look at our scientific understanding of muscle physiology and fascia tissue structure and then connect that to the clinical effect we see after cupping treatments on patients.

I fail to see how this logical approach makes Naturopathic Medicine quackery (which was a term originally used for medical doctors who used mercury as a remedy).  As a Naturopathic Doctor, I do not always have the luxury of waiting for double blinded, randomly assigned, placebo group, clinical trials.  Suffering people are often in my office after being told there is nothing that can be done for them (except possibly manage symptoms like pain).  "Nothing that can be done" is another way of saying there is no studies to the standard Mr. Caulfield (and I suspect many conventional thinkers) deem as science.  In these cases, I could sit on my hands and do nothing.  Alternatively, I could use the best evidence available to me at the time which would include a mix of research, physiology, and clinical experience.  It would also be my responsibility to develop a common understanding of my assessment and arrive at a shared treatment plan with my patients.

There was "no evidence" that BPA was dangerous to our children for years.  Research demonstrated this.  And then Canada became the first country in the world to take BPA out of baby bottles and toys as BPA was finally recognized as a hormone disruptor.  What damage was done while the science finally caught up?  Science often just confirms what we already know to be true as there is still so much that science knows so little about.

I understand that there must be a balance between potentially risky early adoption of medical treatments and on the other side latent adoption where great numbers of people suffer unnecessarily and are dying to wait for the wheels of science to spin on and on.  It is equally as important to have this conversation as it is to know what current research evidence says.

Cowspiracy Movie

Cowspiracy Movie Review

As often is the case, things are just not as they seem.  This movie highlights the "elephant in the room" by demonstrating the devastating impact of modern day agricultural on our world.  Environmental and government agencies are seldom targeting animal agricultural practices that ultimately are causing climate change, huge water loss and destruction of the rainforests.  So why the silence?  This movie proposes a conspiracy with cows at the forefront.

Overall this movie highlights many important considerations despite its underlying goal of promoting strict vegetarianism.  However, to the movie's discredit, two major separate issues appear to be consolidated and presented as just one:

1.  Destroying the planet
2.  Feeding the planet

Destroying the planet by conventional animal agriculture is a huge legitimate concern.  Feeding the planet is a separate but equally legitimate concern that needs different solutions.  A strict vegan diet would extend the years that our planet could sustain its exponential population growth but the conclusion is still the same - we build houses over agricultural land until we run out of space to grow food.  Growing up on a farm where we had a large produce garden, I'm not convinced that a roof top garden on nearly every house in the mega cities of the future will feed our planet.

Feeding the planet is an economic problem where, at least in Canada, we encourage population growth and our economic development almost entirely hinges on the population growth of cities.  We indirectly encourage other countries to grow too beyond their means by opening our arms to immigration (our population doesn't grow fast enough on its own to continue economic growth so we import in from others' excess).

When both destroying the planet and feeding the planet are not distinguished as two separate issues, the strict vegetarian diet conclusion of Cowspiricy works.  When separated, what remains is yet another oversimplified answer to a complex problem.

Furthermore, Cowspiracy argues some other premises that need to be exposed.  First of all, the calculations the movie makes are made on the current USA average meat consumption which certainly needs to go down, and this would make space again for grass feed meat as a viable option.  More importantly though, comparisons between animal and vegetable agriculture are represented as a weight of food per acre.  This is quite problematic as 10 lbs of meat is significantly more protein and calorie dense than 10 lbs of any vegetable and 10 lbs of meat would feed a starving person for a lot longer period of time.  Calculating this way I suspect would put meat from grass fed animals significantly more comparable to vegetable produce on most aspects.

On this point of grass fed animals, the movie does not consider a land-food matching process either.  Some places can grow grass to feed cows but the soil constitution, including volume of stones in the topsoil, makes vegetable produce farming unsuitable.  Grassed sod is also a carbon sink and significant producer of oxygen just as forests are whereas vegetable agriculture has to be cultivated.

Finally, as a Naturopathic Doctor, I realize that most people eat significantly too much meat and meat from the wrong sources.  On a daily basis I am encouraging people to eat more vegetables and fruits.  At the same time, grass fed meat can be a very important medical food for many of my patients.

I'm not saying I agree with New Zealand professors Brenda and Robert Vale who propose it is time to "eat our pets" as we're all basically competing for the same land to grow our food.   However, strict veganism is not the answer for everyone either. 

Where are Alberta's priorities?

My grade 8 patients learn about ecosystems and their importance not only to the environment and wildlife but our health too.  In the real world in Alberta, it seems these grade 8 lessons are long forgotten.  As such, this brings to the surface the increasingly popular question of, "can we be healthy in a sick world?"

This example is highlighted right at the end of our street (click to enlarge photo below - taken March 1, 2015) where our town puts more priority on having 3 new houses built rather than preserving this aquatic habitat despite a research study that demonstrated its importance.  You can see the barrier wall of earth that was started last year dissecting the wetland shortly to be filled with earth.

On a similar note, how are we planning to feed a growing world with so much of Alberta's farmland for sale? I took these photos below last year as I was alarmed at the volume of agricultural land for sale.

Alberta is changing and I cannot see how we are heading in the right direction.  This will be a public health issue sometime in the near future if not addressed quickly.

Long Term Survival

Awareness has become a larger part of my practice than I expected and I fully embrace the magnitude of what it can, on occasion, involve.  Many times, I am reminded that despite having a strong commitment to evidence based practice, I can still be far from mainstream thought.  For example,  several years ago a public health nurse in Calgary was asked on the radio if there were any need to eat organic.  Her answer in summary was to the effect of, "in the last several years, I have only seen maybe one or two cases of acute toxicity from consuming pesticides or herbicides on fruits or vegetables.  So, there isn't really a safety issue."  My reply would have been, knowing how smoking causes cancer, how may times have you seen acute toxicity of cigarette smoking in the last several years?  So, is there a safety issue with smoking?

Then we now have John Schadan vice president of Sherritt Coal.  Recently one of Sherritt Coal's tailing ponds broke and spilled heavy metals into the surrounding streams west of Edmonton and now the toxic waste is entering the Athabasca River.  To my surprise, the vice president tells the reporter that he wanted to prove a point to himself so drank water directly from the contaminated stream (Click to watch CBC Sherritt Coal Tailing Pond Spill Interview).  I'll leave it to you to decide what point he just proved!

It is not just the world we are leaving for our children that matters but we need to empower our children with the survival skills to last for generations or the state of the world that we leave them will not matter.

Naturopathic Lawn Care

For many suburbanites, social pressure regarding those bright yellow flowers which relentlessly pop up in their yards drives people to spend a lot of time, effort and unfortunately resort to risky pollutants to eradicate them.

Recently, a salesperson from a popular "lawn care" company knocked on my door and informed me that there were some terrible plants growing in my yard and that he had the cure.  When I asked him to point out which plants he was referring to, he walked me over and pointed, "see this terrible broad leaf plant, we need to get rid of those."  "Taraxacum officinale" I asked?  "You mean Dandelions?"

Yes, it seems like Dandelions are the bane of some people's assistance!  And, the cure according to this salesperson was 2,4D (2, 4-Dichlorophenoxyactic acid) which he didn't know much about other than his company was 28 years old and they would not be able to sell anything that wasn't safe for the public - including his young daughter who he reportedly lets play on the lawn after applying 2,4D. 

Unfortunately, as with most lawn pesticides and herbicides, the track record for 2,4D is not so clear.  In addition to being a major ingredient in Agent Orange, there are several studies indicating cancer risk as well as ALS (Lou Gehrig's Disease).

The Dandelion may be better utilized as a barometer for the internal health of your lawn.  When present, they indicate that your soil is not sick, you are not polluting the groundwater and it is safe to enjoy walking on and touching the grass.  Otherwise, artificial turf seems to become a better option than chemically induced fields of green.

Or, if you really detest the Dandelions, how about eating them?!  After all, they are a tremendously healthy vegetable.  The young leaves in the spring, included in a salad, are part of an excellent cleanse that I often recommend to my patients.  Less healthy, but more tasty, how about Dandelion syrup made from the flowers?

Here is a Recipe:

Start by washing 250grams to 280grams (about two heaped double handfuls) of Dandelion flowers and cut their base to help detach the yellow petals from the green leaves.

In a saucepan, cover the dandelion petals with water 1 Litre of water. Mix well until all petals are covered. Bring slowly to a boil, remove from heat, cover and let infuse in the fridge overnight.

The next day, filter the mixture using a fine sieve or cheesecloth into a pot – be sure to get as much of the liquid as possible.  Add 1kg of raw sugar into the liquid and place the pot on the stove without a lid to simmer on low heat.  Simmer until the liquid is slightly thinner than maple syrup at approximately 219 degrees Fahrenheit (which when cooled will be the same consistency as maple syrup).  Half a sliced lemon may be added when the liquid is nearing the desired consistency.

Remove from heat and store in a glass bottle until the next occasion for use.

Enjoy!

Do Ion Footbaths Detox?

With spring approaching here in Airdrie, patients are already talking about detoxification.  And, of any time of year, spring is the most opportune time to kick-start the body's already functioning purification systems after a long winter.  Unfortunately, many popular "detoxifications" are either completely ineffective or only create temporary diarrhea thereby "cleansing the bowels."  Worse, several times last year I saw the effects of an "herbal detox" that was absolutely dangerous. 

Today I'm going to highlight a popular product recently shown to be under the completely ineffective category.  Two years ago, a very well ran study assessed the effectiveness of the IonCleanse footbath.  The conclusion?  "Contrary to claims made for the machine, there does not appear to be any specific induction of toxic element release through the feet when running the machine according to specifications."  Yes, the water usually changes colour (this study tracked potentially toxic elements not just colour change) whether your feet are in the water or not!

Here is the entire study for those interested in seeing the detail to which the authors thoroughly tested the IonCleanse machines.  Objective Assessment of an Ionic Footbath (IonCleanse): Testing Its Ability to Remove Potentially Toxic Elements from the Body

As Detox has become mainstream culture, so has the opportunities to take advantage of your time and money.  Please ensure you are doing a safe and effective detoxification this spring.  Even the necessity for all people to do a full-fledged detox is certainly a matter of debate.  As a naturopathic doctor with a keen interest in environmental medicine, I evaluate each patient on a case by case basis: there is no one size fits all approach. 

Naturopathic Immunity

I can't believe it has been so long since my last post.  I am pleasantly surprised at how many people are looking at this blog despite my lack of recent posts - thank-you!

Today's topic: immunity.

As of yet, I have never had a runny nose, sore throat, nor an arm with eczema walk into my office.  There is always a person attached!  Obvious as this sounds, too often patients come to see me after months of being treated as such.  I believe this is partly due to our overburdened social health care system in Canada which doesn't afford Medical Doctors enough time to dig beyond the obvious.  It is also likely due to nearly 100 years of the conventional medical paradigm being applied directly to chronic conditions.  Yes, the conventional medical system is excellent and I thank God for its acute life saving ability.  However, your immunity is one of those systems that often requires more than a "band aid" solution.  If you have ever found yourself on continual prescriptions of antibiotics or corticosteriods, maybe it is time to look beyond the symptom and investigate the root of the problem.

Acne and Rosacea: Only Skin Deep?

Guest Writer: Amy Kroeker (ND candidate 2013) 

Everyone loves a pale rosy glow on the cheeks but persistent redness and frequent breakouts are something we try to eliminate or hide. But what do these symptoms tell us about our health? Are they genetic or are there environmental triggers? Most commonly, acne and rosacea are treated by face washes that contain antibacterial ingredients or, if more severe, with antibiotic medications. Although these treatments are effective for many people, others see no difference or have side effects such as dry skin and skin irritation. So why are skin conditions so stubborn and what other therapies can help?

Naturopathic medicine seeks to investigate and understand the underlying causes of any condition and skin conditions are no different. Acne and rosacea are rarely seen in children and often begin in the teenage years with puberty as hormones begin to change. This indicates that hormones and hormone dysregulation are factors in skin health. However, many people do not begin to experience acne or rosacea until later in adulthood. Breakouts can occur not only on the face but also the neck, back, chest, arms, or legs. 

It is commonly said amongst Naturopathic Doctors that the skin reflects the health of the gastrointestinal tract or gut. Food allergies and sensitivities can cause a significant amount of inflammation in the body that often appears as skin redness and pimples. Since the skin and the gut are also two important routes of elimination in the body, symptoms in these two organ systems are often correlated to each other. Common symptoms that accompany acne and rosacea are gas, bloating, constipation, moodiness, and fatigue after eating. Other signs of inflammation in the body can even include joint and muscle aches. These symptoms, when combined with acne or rosacea, indicate that what is going on is more than skin deep. 

Treatment of acne and rosacea from a natural perspective often involves testing for food sensitivities and allergies using diagnostic laboratory testing and then treating the gastrointestinal tract using diet change and botanical plant-based formulas or supplements. In this way, acne and rosacea can be treated from the inside out to prevent the recurrence so common with treatment that is only skin deep. For more information on natural treatments for acne and rosacea that address these underlying symptoms consult your local Naturopathic Doctor.

Not just any Airdrie Naturopath

Last Wednesday's announcement by Alberta's health minister brought Naturopaths back into the spotlight in Alberta - at least until Canada's Olympic medals diverted the media's attention.  Yes, naturopathic doctors are now regulated under Alberta's Health Professions Act which now requires any person who calls themselves a "Naturopath" to have completed the correct schooling and also pass licensing exams. And, I'm very happy to be distinguished by this new regulation. 

What is still surprising to me is how some media still present naturopathic medicine to the public.  The National Post began its article on the new regulation by stating, "Homeopathy, chelation therapy and vitamin injections will soon be regulated procedures in the province of Alberta, which is rapidly becoming more friendly to alternative medicines that have little or no scientific backing."  Then, after acknowledging the extensive schooling required by ND's, the same article states, "almost without exception, [ND's] were advising controversial therapies and techniques such as homeopathy, vitamin supplements, colon cleanses, ozone therapy, hair analysis, chelation therapy and herbal remedies that insert lavages into the nasal canal."

Wow! Is this really what the "mainstream" Canadian public thinks naturopathic doctors do?!!  A brief read through the comments below the National Post article demonstrates how polar (and sadly misinformed) the public is about health care and this great disparity really doesn't do anyone any good.  Yes, not all naturopathic doctors are equal but that is a human characteristic that goes across any profession.

A student from the Arizona school (SCMN) was preceptoring at my clinic last week and reminded me that until ND's value themselves as more than just a "naturopath" and accept the responsibility that comes with Naturopathic Physician, it will be hard for the mainstream public to let go of some ideas about ND's.  Point taken.