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Monthly Archives: August 2013
No doubt you have wondered if your thyroid is working properly. It’s more than just feeling sluggish and constipated. Here are some other symptoms that indicate low thyroid.
slow Achilles tendon reflexes, swollen eyelids, hands, lips, face and tongue, loss of the ourter third of the eyebrow, slow heart rate, dry scaly skin, cold hands, brittle nails, yellowing of palms and soles of feet. These people have intolerance to cold and heat and don’t sweat easily when it’s hot. They always seem to be cold and always have layers on. They can have joint stiffness and muscle pain especially in the morning. Leg cramps are often an issue with them and carpal tunnel syndrome is more common as can be low back pain. Hair loss can be common as well and headaches may develop. These patients don’t lose weight easily when they diet.
Keep in mind that as your TSH level creeps over 1.5 and 2.0 and beyond, it may be described as normal to you but an increase in TSH means your body is trying to tell you something. T4 is only part of your important levels to check. T3 is the active form of the thyroid hormone and should be determined as well. If you are able to determine the reverse T3 level as well then you have a large part of the thyroid story. High stress situations lead to T4 being converted to reverse T3 more and more instead of T3. Reverse T3 binds to the T3 receptor but has no biological activity. You can imagine the detrimental effect on the body when this happens. It’s like the body has low thyroid but is really just fine. In fact your doctor looks at the TSH and T4 and feels you’re fine. In fact you know something is wrong. You have a functional thyroid disorder. Small doses of T3 may help, perhaps 1% of the entire T4 dose. Not the 25 % that you have heard suggested at first.
The thyroid needs properly functioning Adrenal glands in order to function properly. We often determine adrenal health by taking a cortisol reading in the saliva 4 times during the day from am to bedtime. In testing these levels we often see low levels of cortisol all day. No nice peak in the morning and just flat all day. These people can hardly drag themselves out of bed in the morning, they start to come around around lunch but feel the need for a nap around 3 pm. They may feel more energetic around supper and feel normal tired around 11 pm and if they stay up they can get a second wind and feel they can stay up all night. Low cortisol from the adrenals can show other symptoms like nervous behaviour that is prone to emotional outbursts, melodramatic descriptions, allergic type reactions to everything, painful joints, skin disorders, rapid heart rate, low blood pressure, and unusual pigmentation of the skin. A common complaint is often cravings for sweets and intense and sudden hunger attacks. There may be cravings for salt and they don’t seem to tolerate medications very well.
I often see under responsive adrenals rather than over responsive ones. Either way there are effective therapies. There are numerous effective therapies for adrenal issues but they must be used in the right situation. hypo activation symptoms include fatigue, inflammation and autoimmune disorders, inability to cope or perform routine tasks, weight loss restless sleep, chronic pain and weakness, low libido asthma and allergies . Hyperactivation symptoms include anxiety, agitation, restless sleep, high cholesterol, triglycerides and blood pressure, insulin resistance, low libido, central obesity, bone loss, loss of muscle tone and GI disorders.
Examples of adaptogenic adrenal help for the adrenals include holy basil, ashwagandha, bacopa, cordyceps, asian ginseng (panax), rhodiola, and licorice root. For the thyroid we have T4 and T3, bladderwrack, iodine, selenium, vitamin E , vitamin A and D and Zinc.
Reference, The Hormone Book , Thierry Hertoghe, MD, SA Internationsal Medical Books, 2010
Arthritis affects millions of us. Most of the therapies I see in Pharmacy
include direct pain relief with anti-inflammatories (NSAIDS) or narcotics for
more severe cases. A few other therapies exist like hydroxychloroquine or
methotrexate or some new biologics. Regardless of the type of arthritis, osteo,
rheumatoid, juvenile, ankylosing spondylitis, or gout, there are therapies that
exist that may be more readily available and user friendly to the
Virtually all arthritis patients can have their symptoms
helped, or in some cases eliminated by eliminating the offending food or food
group from their diet.
For example the nightshade family (potato, tomato,
eggplant, bell pepper and yes – tobacco) have been implicated as one of the
biggest sources of inflammation in arthritis. Eliminating this from your diet
is not the end of the world for most of us and really needs a trial of at least
three months and maybe more to fully see benefits. Other common causes are
dairy (including eggs), and wheat. Eliminating the offending food can often
result in other issues resolving as well, such as dermatitis, psoriasis, eczema,
asthma, migraines, and mouth ulcers. Further testing is available to eliminate
these or other food allergens. I have rarely had a food sensitivity test come
back negative on everything.
Niacinamide is one of the most overlooked
supplement in arthritis relief. In doses of 900-4000 mg per day, joint mobility
can increase within the first month. Further benefits are seen if taken for 1-3
years. This is a relatively safe supplement and should be taken 4-6 times daily
rather than once or twice, because of how quick it can be eliminated from the
Omega-3 supplementation can have anti-inflammatory effects. In
the standard North American diet we are overloaded with omega 6 and this puts
our bodies in a pro-inflammatory state. Sources are varied for omega 3. Fish
oils, flaxseed oil and EPA/DHA supplements are available quiet readily. Fatty
acids are also readily available. Olive oil, evening primrose oil, borage seed
oil all have shown anti-inflammatory activity. The Mediterranean diet is high
in omega 3 and has been implicated as an anti-inflammatory and arthritis
friendly way to eat. Vegan diets that are lacking in pro-inflammatory fatty
acids in meat are also worth a try in some patients.
chondroitin and MSM are not new to most self medicators with arthritis,
certainly those with osteoarthritis. We have had several patients tell us the
benefits they found from these supplements. They appear to be at least safe
when taken as directed and should be given 6 weeks of therapy to determine
effectiveness in osteoarthritis. Manganese is involved in the synthesis of
chondroitin sulfate and is taken to supplement arthritis treatments. As usual,
the western type diet is low in manganese as farming soil is low in more and
more nutrients. Fertilizers supply a few elements but dozens are needed for
nutrition in our food. Repeated farming can lower the levels of these elements
from the soil so supplementation becomes more necessary.
Zinc is one of
my favorite supplements I recommend for various reasons. Not just the common
cold. Zinc has been used in different types of arthritis and studies show its
effectiveness in reducing inflammation and pain in arthritis. Although other
studies have shown varied results, in my opinion zinc has anti-inflammatory
effects that can benefit arthritis patients. One drawback to chronic zinc
supplementation however is copper deficiency. Copper has been suggested as
another beneficial supplement in arthritis and is also thought to be
anti-inflammatory. Although copper bracelets are often looked at with
skepticism by many physicians, this is another self medication modality that is
easy to use and well received by those who use it. It has been determined that
the weight of these bracelets actually drops over time, suggesting absorption
through the skin of the element. Both of these elements deserve a closer look
by the public.
Bromelain is a natural enzyme found in some of our
anti-inflammatory products. Although not a product that is studied in many well
designed scientific studies, doses of 250-1000 mg daily have shown favorable
results and I have seen this in our own patients that have used it and is
relatively safe to use.
SAM-e is one of those supplements that hides in
the vitamin section and many wonder what it is used for. Although there are
various uses for this supplement, it actually has been found to be as effective
as many NSAIDs. Low in side effects, it is normally taken in doses of 400-1200
Other useful supplements used in arthritic conditions are
vitamin d (one of my personal favorites for pain control), folic acid, B
vitamins, vitamin C, vitamin K, vitamin E, and Quercetin, Devil’s Claw, Tumeric,
and Boswellia. As with any supplement, ask your pharmacist before starting or
stopping Rx or nonRx therapies.
Reference: Alan R Gaby, Nutritional
Medicine, FritzPerlberg Publishing, , 2011
A while back I posted a blog on why it is so easy to gain weight. Several, several responses resulted. Mostly split down the middle. Unfortunately that meant that 1/2 of them felt that the only reason we were overweight in North America was because we ate too much and exercised to little. Many simply felt that calories in and calories out was the sole responsible reason our population was so large.
Have a look at the percentage of the population that is overweight per decade since 1940 and you will realize how incredibly quick we have grown in the last 60 plus years. What happened at that point that changed the course of our health. Logic would conclude by the above paragraph that all of a sudden, the entire population of North America just said, “I’m going to be lazy now and just sit home and eat all day.” Do we really believe this? Was there some big meeting we had that decided this?
What happened at this point in our history that made this change in our health? If someone asks you what the most important historical event in the 40’s, what would you say. Probably the biggest is World War 2 and it’s completion in 1945. Anything else world wide happen then? Not to that scale.
So what effect did this have on us starting to die early in 2013? Well everyone came back home, baby boomers were born, businesses started, money was made, homes were built and bought, life’s pace gradually started to rev up. Mid 60’s early 70’s saw these baby boomers move out into the world. Things got busier and technology expanded. 1990’s saw the kids of these baby boomers moved out. We needed to drive more, move more, work inside more, eat faster, get back to work after babies were born. Companies capitalized on this and made food for us that would be ready instantly and everywhere. We were a dry cleaning, chemically cleaning, antiperspirant applying, sunscreen slapping, microwaving, teflon cooking, makeup using society. We made plastics that were cheap to make and distribute, microwaves to zap our food quickly, fertilizers to grow our food quicker, wheat that was modified to grow wherever we wanted, pop was invented, fruit drinks became popular, breakfast cereals were well into their prime, pesticides and herbicides became popular to grow everything more efficiently for a growing and prospering environment. Before we knew it we had completely changed our intake of food in just a few generations with just a handful of large corporations leading the way. We had never eaten this way before – ever. In fact, the most obese countries in the world are in North America, Europe, and Australia. How does this compare with their involvement in the war? Fairly close. How many people had gym memberships in the early 1900’s? We find them necessary now because of the lack of time available in the day to actually move.
Did you ever notice how most animals never really change their appearance? When was the last time you saw a giraffe? How different did it look from the last giraffe you saw? How does it differ from a picture from a giraffe from 100 years ago? They all look identical. Have your ever seen a fat giraffe? How about a squirrel? They’re all the same. Animals must look at humans in a strange fashion – “dude look at that human, he must be sick or something”. Do they think each person is a completely different species? It must be confusing. My point here is that the war had little effect on them. They continue to eat as they always they always did. A deer is a deer and they all weigh what we expect a deer to weigh. Why do humans have such a large range of weight? In fact most of the under or overweight animals we see are domesticated ones that are mistreated or over-treated by humans! Are human’s really that different from any other animal to someone looking down from space?
Of course overweight humans have always existed, but you cannot deny the change in the percentage of them. We eat more omega 6 and less omega 3, we spend less time in the sun and produce less vitamin D, we move more frequently and lose our close knit group of family and friends, our inflammation increases and we die earlier of various diseases (heart disease, type 2 diabetes, cancer and others). Before the war we were essentially living like countless generations before us, with some exceptions. We certainly not living like cavemen, they didn’t farm or raise cattle or chickens. This farming step was the first big change in direction for humans. The end of World War 2 was the second. If this war never happened, what would the health of industrialized countries look like today. We have the best medicine in history but our life expectancy is dropping. Even the Chinese who have such a low incidence of breast cancer start developing it when they move to our continent. Chinese and Indian cultures with low incidence of cancer undoubtedly eat a much more protective food than we do here. So much so that we feel we can catch up to them simply by supplementing with cur cumin or eating brown rice.
Until we learn to boost our diet with omega 3 and supplement with vitamin d the longstanding human threats of diseases will continue to catch up with us. Eating more fibre, reducing the chance of uncontrolled stress, eating lower glycemic index foods and realizing that supplements are necessary because it is difficult to get to where you need based on the amount of nutrients in your food. Cancer treatments can save lives but don’t prevent them from coming back. While I don’t believe meditation and green tea will cure cancer, I definitely see the benefit of changing your lifestyle once you get cancer. We all have cancer cells in our bodies, every one of us. It is what we do to keep those cancers from taking hold in our bodies that matters. Whether you are in relapse from a previous cancer or never had the disease – does it really matter? Some are satisfied to know that from their genetic test they are going to get cancer regardless or that they are in a low risk group and are safe. We all have a different chance of getting cancer with the lifestyle we have. The goal should be to change the lifestyle to someone in the 30% group that doesn’t get cancer.
So considering all of these changes that we have experiences seemingly as a result of the ending of World War 2, do you know anyone who has died as a result of this recently? Are you on your way to being a casualty of an event that happened nearly 70 years ago?
Most of us automatically think of a medication when we need something for pain. Certainly for a sudden onset acute type of pain that occurs infrequently, I recommend an NSAID or Acetaminophen to our patients who need some safe and quick relief for themselves to get on with their day or night. Most of the patients we see at Stone’s have no idea that nutrition (and diet) drastically influence pain management.
The standard American Diet drives people to a low omega3:omega6 ratio. The higher this ratio, the better outcome for just about any medical issue you can think of. Psychiatric, cardiovascular, dermatological, neurological and a myriad of other issues are helped or even cured it seems by increasing this omega-3 to our diet. The anti-inflammatory diet helps with this ratio.
Vitamin D. What a surprise. Vitamin D is good for something else. Shown time and time again to help with pain, vitamin D supplementation into target ranges is helpful to keep pain away. Overdoing it with the higher doses of vitamin D seem to very rarely cause adverse effects, but it helps to get your levels checked.
Magnesium. This quickly emerging star in the supplement world has shown several benefits, including pain relief from migraine, fibromyalgia, sciatica, muscle cramps, back pain, dysmenorrhea issues and more.
B vitamins are important for pain relief. Especially, a mixture of pyridoxine, B12 and thiamine have been used in patients with vertebral pain and nerve related pain with much success.
What else deserves mention, boswellia, curcumin, green tea, gamma linoleic acid, 5-hydroxytryptophan, zinc/copper, and bromelain have shown promise for antiinflammatory and pain relief.
A patient comes into my pharmacy and asks what they can do to beat breast cancer. They aren’t particularly interested in me quoting a list of studies proving what I am telling them, or getting a sworn statement that this is a guarantee that this will enable them to live to be 100. There is a reason they have this disease and their neighbour doesn’t (yet) have it. Everything comes down to the nucleus of the cell. The nucleus that contains the genes and chromosomes that act like the king on the throne dictating everything that will happen to that cell. Sometimes the king is attacked by another party, sometimes the king unzips mentally and goes amok – running things in ways that make sense only to them and ultimately results in the kingdom falling.
While we can do very little to change the genetic makeup in an individual that result in the path to cancer so easily compared to other individuals, we can act on this part of the cell head on to protect the rest of the cell from a wrong decision by the nucleus. What is it an individual can do to protect themselves at such a microscopic level to grab control over the nucleus and cells of the body.
What type of breast cancer is this? This helps me understand what is feeding the tumor. Does it grow in response to estrogen? Progesterone? Overproduction of HER2 protein? Or perhaps none of the above. The hormone didn’t necessarily cause the tumour to occur in the first place, it just caused the tumour to grow faster. Treatment by your physician is particularly important. Following the medication plan outlined is the foundation of the treatment. What can you do on top of this treatment to make it more successful? Here are some of my recommendations based on literature:
Vitamin D supplementation. You cannot go very far in searching in this topic before you come across vitamin D levels and cancer prevention. If you are serious about it check your blood levels and supplement accordingly. If you don’t take vitamin D or take only 800 IU per day or less you are most likely in need of bringing your levels up. vitamin D toxicity is rare even at doses of 10,000 IU per day. Still, check your levels.
Indole-3-Carbinol (I3C) or Diindole Methane (DIM) help to funnel estrogen down into favorable metabolites. Research abounds on these supplements that are found in nature through cruciferous vegetables.
Omega 3 consumption. Here’s another bucketful of discussion that lies at your fingertips. Bottom line for me is that this does help to prevent, if it turns out to be false, at least we know we are healthier taking it.
Ketosis – before you slam the idea of consuming healthy fats, low carbs and low calories and eat a restricted amount of protein per day (1mg/kg of protein per kg of lean body weight), keep in mind that the idea that cancer cells are damaged enough to keep them from burning fat is an advantage to the rest of your cells. Starving your cancer cells by keeping glucose from them and getting your energy via ketosis makes sense. Eating a well balanced diet with everything in it may sound wholesome, but killing off cancer and preventing its metastasis is serious business. Calorie restriction may sound crazy at a time when you are fighting cancer, but trying to build up your body while fighting a tumor is like climbing a greased rope. Deal with the tumor first. Branched chain fatty acids, coconut oil, avocado, nuts, and other sources of healthy fat are easy to obtain. Too much protein is only converted to glucose.
ALKALINE DIET – There are lots of arguments as to the resilience of the human body to buffer itself against acid or base conditions. Again though, the idea that an acid environment promotes cancer and an alkali environment does not is attractive. You can wait for further studies if you have time but there seems to be little harm in adopting this eating style.
Cleanse – Another topic that divides many. What harm do you bring yourself in a cleanse program that clears toxins from the colon, liver and kidney? Therapeutic drainage of the lymphatic system is worth investigating as well. Start off with as little resistance as possible in your body, especially if you are taking a chemotherapeutic agent.
Previous blogs ad to these suggestions. whether or not you feel they sound hoaky or not, antioxidants, curcumin, green tea, resveratrol, quercetin, fiber, stress reduction, sleep and probiotics can benefit. Keep clean from contaminants in the environment. And remember hormone therapy can protect you when used properly – as long as they are not from a horse or have a similar structure to your own hormone and claim to be the same thing. Most importantly, complimentary therapy means going along with your doctor and helping it along a bit further.