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Archive for the ‘Natural Therapeutics’ Category

Supplement_Advice_in_Jackson

Once again nutritional supplements are in the news, this time the attorney general of New York State has threatened legal action against four leading chains (GNC, Target, Walgreens and Walmart) for selling mislabeled products.  According to the report from New York attorney general Eric Schneiderman, investigation of store brand herbal products revealed that only 21% of herbal products contained DNA of the plants purported by the label, including the commonly used herbs Echinacea, Ginseng and Ginkgo biloba.

Though supplement quality is known to vary widely, the New York investigation has been criticized for using potentially inaccurate assessment methodology.  In a formal statement by Council for Responsible Nutrition, president Steve Mister cites the methods favored by botanical scientists for detecting plant material in products, stating that “…different identification test methods, from simple titration to chromatography and mass spectrometry, are appropriate for different stages of the processing—from the whole plant to the extract, to the finished product.”  Measuring DNA of the finished product may not be an accurate method of detecting presence of plant material in supplements. Harvard expert on nutritional supplements, Dr. Pieter Cohen, commented that the investigation results were so extreme that they were likely inaccurate, and it was possible that the tests had failed to detect the presence of plants because the manufacturing process had destroyed their DNA.  There is a precedent for using DNA barcoding in investigation of herbal supplements from a 2013 Toronto study, which found below 50% accuracy in label claims for the products investigated.

While nutritional supplements in the United States are technically regulated by the FDA through the Dietary Supplement Health and Education Act (DSHEA) of 1994, the law is not fully implemented to regulate dietary supplements for quality.  As required by DSHEA regulations, dietary supplements are required to follow FDA Good Manufacturing Practices (GMP) guidelines, which apply to pharmaceuticals as well as supplements.  In the years since DSHEA was passed, legislation calling for more stringent quality control have been introduced and voted down.  Critics of amending DSHEA claim that regulation of supplements as drugs will restrict consumer access and drive up costs.  On the other side, critics of DSHEA cite the multitude of safety issues with supplements causing illness and even death, and the problematic atmosphere created by DSHEA which allows for a free-market with the onus for quality control and safety on the profit-driven manufacturer. In a recent article by Harvard’s Dr. Cohen: “DSHEA creates perverse incentives for unscrupulous manufacturers to out-compete legitimate companies by adding undeclared, illegal ingredients including prescription medications, banned drugs and even entirely novel chemical compounds.”  Advocates of greater implementation of DSHEA point out that the the regulatory processes created by the original legislation have never been enforced, and rather than amend the legislation it should be fully funded and implemented.  For example, DSHEA stipulates that for new products (introduced since 1994), manufacturers must provide the FDA with evidence supporting a “reasonable expectation of safety.” This aspect of DSHEA has never been enforced. 

There are several components of FDA regulation of nutritional supplements to consider.  First is the accuracy of labeling and whether the contents of the bottle match what the label claims.  Because the FDA does not have systems in place to implement DSHEA by regulating manufacturing content, there is little oversight beyond independent watchdog companies such as Consumer Labs analyze products and report on accuracy of labeling.  Consumer Labs leads the field in independent product analysis, primarily using chromatography and mess spectrometry to analyze nutritional supplements for content.  In addition to reporting on accuracy of label claims, Consumer Labs also reports on the presence of potentially hazardous substances like allergens and toxins.

Next, the role of the FDA (and potentially the DEA) is to ensure that no drug contaminants are incorporated in dietary supplements.  In 2004, regulations were passed to ban ephedra and anabolic steroids from dietary supplements.  An international study published in 2004 revealed that as much as 15% of dietary supplements contained pro-hormone, anabolic contents that were not declared on the label.  Because pre-approval is not required for supplement sales, these contaminants are not detected until products have already been available on the market.  Safety issues are only brought to light through consumer reporting or through medical intervention after serious adverse effects occur.

Finally, dietary supplement safety involves product efficacy, which is presently not required under DSHEA.  The FDA does restrict claims made for the health benefits of nutritional products but does not require pre-approval of sales based on efficacy data.  This matter was recently raised by the Federal Trade Commission against Dr. Mehmet Oz was for making unfounded claims about the health benefits of supplements.   While the body of data for evidence-based complementary and alternative medicine is growing, there is a relative lack of clinical evidence for herbal and nutritional supplements.  Without the support of clinical trials to verify safety and efficacy, any health claim made by a dietary supplement – especially the more fantastic the claim – might very well be too good to be true.

Beyond the safety issues of quality control and the efficacy of nutritional supplements are concerns over herb-drug or nutrient-drug interactions with medications, and contraindications with other health conditions.  Safety warnings about known adverse effects, interactions and contraindications are required by the FDA regulations under DSHEA.  The burden of proof falls on the FDA to ensure that these requirements are being met, and due to inadequate resources this may not be upheld.

Fortunately, naturopathic physicians are experts in the field of dietary supplement safety and efficacy, and are an excellent resource for information about nutritional supplements as well as prevention of interactions and contraindications.  To address the many concerns about supplement quality, safety and efficacy discussed above, in my practice I almost exclusively recommend professional-line nutritional supplements that are manufactured with the highest possible standards.  This means that the supplement manufacturer meets the following criteria:

  • independent, third-party analysis of their product
  • verified analysis of the suppliers of their raw material
  • adherence to GMP
  • routine batch testing of their products
  • potency testing to verify dosing of label claim
  • sufficient testing to confirm absence of contaminants
  • verification of stability of shelf-life for their product
  • evidence of total quality
  • often, participation in clinical trials to demonstrate the efficacy of their product

Some nutritional supplements sold over-the-counter meet some of these criteria, but very few or none meet all of them.  The only way to guarantee product safety is to choose nutritional supplements that elect to uphold the highest standards of quality, not because they are required to so by the inadequate implementation of DSHEA, but because they prioritize scientific research and rigorous standards.

There are dozens of professional-line ‘nutriceutical’ manufacturers that meet these criteria, and many of them dispense only to licensed providers or natural pharmacies.  One such dispensary that only contracts with licensed providers and distributes top-quality nutriceutical products is Emerson Ecologics.  Their quality standards, the Emerson Quality Program requires all manufacturers to submit to third-party analysis of their products.  Beyond the basic quality standards, Emerson Ecologics also Silver and Gold Partner quality standards which meet the criteria listed above, which is what I look for in making recommendations for top-quality supplements for my patients.

As experts in nutritional supplement safety and efficacy, naturopathic doctors have long been involved with the political side of supplement regulation.  The American Association of Naturopathic Physicians has long advocated for the full implementation of DSHEA, but opposes legislation that would restrict access to supplements or regulate them as drugs.  Because nearly 70% of Americans are taking some form of nutritional supplement, we support the FDA to fully and appropriately regulate them according to the purview of this legislation.

 

Additional Resources:

Natural Product Association 

Council for Responsible Nutrition

National Institute of Health, Office of Dietary Supplements

 

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Supplement_Advice_in_Jackson

Yesterday on The Diane Rehm Show, Ms. Rehm and her guests discussed the safety and regulation of nutritional supplements.  The topic was recently brought to light by a Congressional hearing of the Federal Trade Commission (FTC) featuring the high-profile physician, Dr. Mehmet Oz, who was being questioned about making claims about dietary supplements on his television show.  The role of the FTC is to investigate “unfair or deceptive advertising and marketing practices that raise health and safety concerns,” and they have recently filed a suit against green coffee extract manufacturers for false advertising.

While nutritional supplements in the United States are technically regulated by the FDA through the Dietary Supplement Health and Education Act (DSHEA) of 1994, the law is not fully implemented to regulate dietary supplements for quality.  In addition to the DSHEA regulations, dietary supplements are required to follow FDA Good Manufacturing Practices (GMP) guidelines, which apply to pharmaceuticals as well as supplements.

There are several issues at hand with regard to supplement safety and regulation.  First is the accuracy of labeling and whether the contents of the bottle match what the label claims.  Because the FDA has failed to provide the full oversight to ensure that label claims are valid, independent companies such as Consumer Labs analyze products and report on accuracy of labeling.  One drawback of Consumer Labs’ publications is that they are not peer-reviewed, but they are leading the field in independent product analysis.

Next, the role of the FDA (and potentially the DEA) is to ensure that no drug contaminants are incorporated in dietary supplements.  In 2004, regulations were passed to ban ephedra and anabolic steroids from dietary supplements.  An international study published in 2004 revealed that as much as 15% of dietary supplements contained pro-hormone, anabolic contents that were not declared on the label.

Finally, dietary supplement safety involves the avoidance of herb-drug or nutrient-drug interactions with medications, and the avoidance of contraindications with other health conditions.  This is not required by the FDA regulations, though many supplement manufacturers elect to include this information on their labeling.

The matter raised by the FTC with Dr. Oz was not concerned with any of these safety issues, however, but with making unfounded claims about the health benefits of supplements.   While the growing body of data for evidence-based complementary and alternative medicine is growing, there is a relative lack of clinical evidence for herbal and nutritional supplements.  Without the support of clinical trials to verify safety and efficacy, any health claim made by a dietary supplement – especially the more fantastic the claim – might very well be too good to be true.  Fortunately, naturopathic physicians are experts in the field of dietary supplement safety and efficacy, and are an excellent resource for information about nutritional supplements as well as prevention of interactions and contraindications.

In my practice, I almost exclusively recommend professional-line nutritional supplements that are manufactured with the highest possible standards of quality.  This means that the supplement manufacturer meets the following criteria:

  • independent, third-party analysis of their product
  • verified analysis of the suppliers of their raw material
  • adherence to GMP
  • routine batch testing of their products
  • potency testing to verify dosing of label claim
  • sufficient testing to confirm absence of contaminants
  • verification of stability of shelf-life for their product
  • evidence of total quality
  • often, participation in clinical trials to demonstrate the efficacy of their product

Some nutritional supplements sold over-the-counter meet some of these criteria, but very few or none meet all of them.  The only way to guarantee product safety is to choose nutritional supplements that elect to uphold the highest standards of quality, not because they are required to so by the lax implementation of DSHEA, but because they prioritize scientific research and rigorous standards.

There are dozens of professional-line ‘nutriceutical’ manufacturers that meet these criteria, and many of them dispense only to licensed providers or natural pharmacies.  One such dispensary that only contracts with licensed providers and distributes top-quality nutriceutical products is Emerson Ecologics.  Their quality standards, the Emerson Quality Program requires all manufacturers to submit to third-party analysis of their products.  Beyond the basic quality standards, Emerson also Silver and Gold Partner quality standards which meet the criteria listed above, which is what I look for in making recommendations for top-quality supplements for my patients.

As experts in nutritional supplement safety and efficacy, naturopathic doctors have long been involved with the political side of supplement regulation.  The American Association of Naturopathic Physicians has long advocated for the full implementation of DSHEA, but opposes legislation that would restrict access to supplements or regulate them as drugs.  Legislation introduced in 2010, the Dietary Supplement Safety Act, sought to impose greater restrictions on dietary supplements without first implementing the regulations DSHEA.  Because nearly 70% of Americans are taking some form of nutritional supplement, it would behoove the FDA to fully and appropriately regulate them according to the purview of this legislation.

 

Additional Resources:

Natural Product Association 

Council for Responsible Nutrition

National Institute of Health, Office of Dietary Supplements

 

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Last weekend I was thrilled to attend an intensive training with Julia Ross MA of the Recovery Systems Clinic in Santa Rosa, CA.  A psychotherapist and nutritionist, Julia has pioneered the field of neuronutrient therapy for the natural treatment of depression, anxiety, ADD, addiction, eating disorders and much more.  Her book, The Mood Cure, was published in 2003 and describes her clinical experience using amino acid therapy to effectively treat the core chemical imbalances behind mood disorders and addiction.  In 2012, she published The Diet Cure, which elucidates the problem of addictive foods in the Standard American Diet – sugar, refined flours and wheat, high-fructose corn syrup, caffeine – and provides an alternative ‘good mood’ diet to repair the neurological damage caused by dependence on toxic foods. My own practice has been informed by Julia’s work since I read her book as a naturopathic medical student and she delivered a Grand Rounds lecture for upper class students.  I’ve seen first-hand the benefit of incorporating neuronutrients in a comprehensive plan alongside traditional diet and herbal medicine, in a wide variety of patients I’ve worked with over the years.  As my practice evolves toward a greater emphasis on emotional wellness and holistic support for the mind, body and spirit, I felt called to deepen my understanding of neuronutritional medicine.  The weekend intensive was the first step in a year-long certification training through Julia’s NeuroNutrient Therapy Institute, an enterprise dedicated to training practitioners around the country to apply these therapies clinically.  As an apprentice to Julia, I will have the opportunity to work closely with her and other mentors from the Institute to review cases from my clinic and get feedback from the expert herself. I’m very excited about pursuing this training to hone the use of neuronutritional therapy in my practice.  On a personal level, I had the opportunity while working with Julia to do a self-assessment and trial the amino acids to replenish my own deficits, and experienced profound results within minutes.  If I wasn’t already a believer in nutritional therapy to restore neurotransmitter balance, I sure am now! I’d like to offer a one-hour neuronutritional evaluation intake to the community at a reduced rate to encourage others to experience the benefit of simple amino acid therapy to correct the nutritional imbalances connected to many of our every-day sufferings.  For example, dependence on caffeine to improve concentration and combat fatigue; insomnia with racing thoughts or frequent nighttime waking; low level depression that presents as irritability; anxiety with the inability to fully relax; the feeling of being ‘on the outside’ and inability to fully engage with life confidently; cravings for alcohol, sweets or other drugs to relax or ‘take the edge off’…. The naturopathic precept of ‘Identify and Treat the Cause’ asks us to locate the source of the imbalance contributing to the symptoms of dis-ease, and I have found neuronutrient therapy to be a profoundly effective, safe and non-invasive way to achieve both the relief of symptoms and addressing the causal imbalances that underlie them. A neuronutrient evaluation and recovery plan can help you with:

  • Mood enhancement
  • Psychological healing
  • Alternatives to antidepressants and anti-anxiety medication
  • Relief from insomnia
  • Improved energy
  • Greater attention, focus and clarity
  • Addiction recovery
  • Cessation of cravings for foods and other substances

Until August 1st, Dr. Quinn will be offering one-hour neuronutrient assessments for $98.  These consultations can take place in person, or via phone or Skype for long-distance clients.  Please schedule by calling (734) 769-6100 or emailing welcome@hygeiacenter.org. 

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Seasonal Affective Disorder, or SAD, affects roughly 6% of adults in the US.  Defined as annual depression occuring the winter months and lifting with seasonal change, SAD is a more severe form of the “winter blues.”  Over 25% of Americans report some sensitivity to the decrease in light during the fall and winter.

The specific cause of SAD is not fully understood, but it is believed to be caused by a confluence of factors including: age, gender, genetics and individual brain chemistry.   SAD is more common in women, and in young adults to mid-life.  It is also more common in those living in northern states with reduced sunlight exposure in the fall and winter months.

The symptoms of SAD are due to a chemical imbalance marked by a decline in serotonin, a neurotransmitter that governs mood, and melatonin, the hormone responsible for sleep/wake cycles.  Production of both melatonin and serotonin depends on exposure to UV light, and the absense of light exposure is a key factor in the decline of levels.

The symptoms of SAD may include:

  • Mild to moderate depression in the fall and winter
  • Fear, worry, anxiety
  • Loss of energy
  • Social withdrawl
  • Oversleeping
  • Aggravation in the afternoon
  • Pain – fibromyalgia, TMJ, migraines
  • Difficulty concentrating
  • Appetite changes, cravings for sweets and carbs, especially in the afternoon and evening
  • Weight gain
  • Sleep problems, insomnia
  • If untreated can lead to serious problems including suicidal thoughts and behavior, school or work problems, social withdrawal and substance abuse

The most common treatment for SAD is light therapy with full-spectrum light bulbs or lightboxes.  Full-spectrum lightboxes come in a variety of designs, the Ott light and the Verilux products are two quality brands with affordable lamp options.  Medical research typically cites results from light therapy with 30 minutes of exposure to 10,000 lux daily.  Lux is a standard measurement of luminescence; on a typical overcast day one would be exposed to 10,000 -25,000 lux.

Because Vitamin D is produced in the skin cells upon contact with sunlight, many people in northern climates can be deficient or insufficient in Vitamin D and require supplementation.  This important nutrient helps maintain mood, immune function, and hormone balance.  Because Vitamin D is a fat-soluble nutrient that can accumulate in the body, it is recommended that one test blood levels of Vitamin D (a test known as 25-hydroxy-vitamin D) prior to supplementation.  This can help determine what dosage of supplementation would be ideal; in some cases of extreme deficiency, your doctor may recommend weekly megadoses to help bring the level up to the optimal range, then switch to a lower maintenance dose.

Other natural treatments for SAD are aimed at increasing serotonin and melatonin levels.  One option is the herb St. Johnswort, which has been extensively studied for the treatment of mild to moderate depression, and is useful for SAD.  St. Johnswort should not be used by patients who are already taking anti-depressants, as it works similarly to the medications and can potentiate their effects.  Another option might be 5HTP, a natural substance which is a precursor to both serotonin and melatonin.  This can help naturally increase serotonin levels and boost mood.

Lifestyle modification is also an important part of coping with SAD or other forms of depression.  Counseling or psychotherapy, stress management and mind-body techniques may all be helpful.  Additionally, a balanced whole-food diet high in vegetables, fruit, whole grains, beans, nuts, seeds and fish is optimal for maintaining overall health.  Avoiding sugar, alcohol and caffeine is key as these substances can aggravate a depressed mood.

Finally, exercise and time spent in nature are important ways to elevate mood and promote health.  Exercise naturally raises serotonin levels, helps improve sleep and maintains physical health.  Many studies demonstrate that time in nature also brings a sense of well-being, in addition to some sunlight exposure even during the winter months.  Dressing warmly and taking a brisk walk every day can help beat the winter blues.

For more information please see the following resources:

WebMD – Seasonal Affective Disorder

Mayo Clinic – Seasonal Affective Disorder

Dr. Julia Ross’ book The Mood Cure

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The Environmental Working Group (EWG) has recently shed light on the dangers of sunscreen.  Most commercially available sunscreens contain two major toxic chemicals; Oxybenzone, a hormone-disrupting chemical, and retinyl palmitate, a form of vitamin A that has been shown to accelerate the growth of skin tumors.  The EWG recommends that consumers avoid sunscreens with vitamin A (look for “retinyl palmitate” or “retinol” on the label).  Unfortunately, many of the safer sunscreens recommended by EWG contain forms of zinc and titanium, which can have their own health risks in high doses. Most of the non-toxic sunscreens are all-natural or organic. 

Ultimately,  the EWG states that the best protection from the harmful UVA rays of the sun is a physical barrier  such as clothing or shade.

Below is a list of EWG-recommended sunscreen brands.  For the complete list of specific products and ratings visit the EWG website at: www.ewg.org/2010sunscreen.

Safe Sunscreens:  Avoid These:
Badger Coppertone
California Baby Hawaiian Tropic
Jason Kiss My Face
Loving Naturals Neutrogena
Soleo Organics No-Ad

Thanks to Anna Weaverdyk and Rachel Hasse for their contribution to this article.

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Chocolate l photo by ParsecTraveller

February is Heart Health Awareness Month, a great opportunity to explore preventive measures for maintaining cardiovascular health.  While hereditary risk factors are not modifiable in preventing heart disease, many lifestyle and nutritional choices have been shown to reduce risk and to strengthen the heart.  Fortunately, many of these options don’t require self-denial, and in fact some can be rather indulgent and may fit in well with your plans this Valentine’s Day: dark chocolate, red wine, and loving relationships.

Chocolate is cardioprotective is due to antioxidant, anti-inflammatory, and anti-atherogenic  compounds called polyphenols in cocoa .  Polyphenols in dark chocolate have been shown to reduce LDL cholesterol, the “bad” form that causes the cholesterol deposits in blood vessels and leads to atherosclerosis, and increase the “good” HDL cholesterol.  Chocolate was also found in one small study to inhibit platelet activity, reducing blood clotting.  It also appears to help lower high blood pressure by triggering the release of nitrous oxide in the blood, which relaxes blood vessels. 

The tradition use of cocoa originates in Mayan and Aztec culture in the form of a blended drink of fermented and crushed cocoa beans called xocoatl, which lacked the saturated fat and refined sugars of modern chocolate products that may do more harm than good.  The amount of cocoa used in clinical trials is roughly 100 g, which is a fairly high daily dose even for chocoholics.  The downside of obtaining this amount of cocoa daily is of course the increased caloric intake that comes from consuming chocolate bars containing sugar and cocoa butter, between 200-400 extra calories daily and containing over 1/3 of the daily recommended limit for saturated fat.  The “darkness” of the chocolate or cacao content doesn’t necessarily reflect the polyphenol content, although dark chocolate may have less added sugar and saturated fat than milk chocolate. 

Antioxidant polyphenols are found in many foods besides chocolate, of course, which brings me to our next indulgence, red wine.  The benefits of red wine have been known for quite some time and have been written about extensively in both medical literature and books on diet and health.  An 8 oz glass of red wine contains over 600 mcg of resveratrol, a potent antioxidant that supports blood vessel health.  The alcohol content of red wine is an unnecessary element of the beverage for conferring the health benefit, and many people choose to obtain the beneficial constituent resveratrol in supplement form rather than imbibe daily.  Alcohol can have an unfavorable effect on blood sugar, and again there are the extra calories.  Like chocolate, the benefit of red wine is probably best as an occasional indulgence.  Fortunately, many other foods that we can consume every day contain polyphenols and other beneficial nutrients, such as tea and fresh, brightly colored vegetables and fruits. 

Finally, an essential way to care for your heart is by managing stress and maintaining healthy relationships.  Many studies document the impact of stress on cardiovascular risk factors like high blood pressure and cholesterol.  Dr. Dean Ornish, a physician specializing in the reduction of coronary heart disease risk through lifestyle modification, emphasizes the need for love and intimacy in our lives. In his book Love and Survival, he writes: “I am not aware of any other factor in medicine – not diet, not smoking, not exercise, not stress, not genetics, not drugs, not surgery – that has a greater impact on our quality of life, incidence of illness, and premature death from all causes.”

Wishing you a heart-healthy Valentine’s Day,

Diana Christoff Quinn, ND

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Seasonal Affective Disorder, or SAD, affects roughly 6% of adults in the US.  Defined as annual depression occuring the winter months and lifting with seasonal change, SAD is a more severe form of the “winter blues.”  Over 25% of Americans report some sensitivity to the decrease in light during the fall and winter.

The specific cause of SAD is not fully understood, but it is believed to be caused by a confluence of factors including: age, gender, genetics and individual brain chemistry.   SAD is more common in women, and in young adults to mid-life.  It is also more common in those living in northern states with reduced sunlight exposure in the fall and winter months.

The symptoms of SAD are due to a chemical imbalance marked by a decline in serotonin, a neurotransmitter that governs mood, and melatonin, the hormone responsible for sleep/wake cycles.  Production of both melatonin and serotonin depends on exposure to UV light, and the absense of light exposure is a key factor in the decline of levels.

The symptoms of SAD may include:

  • Mild to moderate depression in the fall and winter
  • Fear, worry, anxiety
  • Loss of energy
  • Social withdrawl
  • Oversleeping
  • Aggravation in the afternoon
  • Pain – fibromyalgia, TMJ, migraines
  • Difficulty concentrating
  • Appetite changes, cravings for sweets and carbs, especially in the afternoon and evening
  • Weight gain
  • Sleep problems, insomnia
  • If untreated can lead to serious problems including suicidal thoughts and behavior, school or work problems, social withdrawal and substance abuse

The most common treatment for SAD is light therapy with full-spectrum light bulbs or lightboxes.  Full-spectrum lightboxes come in a variety of designs, the Ott light and the Verilux products are two quality brands with affordable lamp options.  Medical research typically cites results from light therapy with 30 minutes of exposure to 10,000 lux daily.  Lux is a standard measurement of luminescence; on a typical overcast day one would be exposed to 10,000 -25,000 lux.

Because Vitamin D is produced in the skin cells upon contact with sunlight, many people in northern climates can be deficient or insufficient in Vitamin D and require supplementation.  This important nutrient helps maintain mood, immune function, and hormone balance.  Because Vitamin D is a fat-soluble nutrient that can accumulate in the body, it is recommended that one test blood levels of Vitamin D (a test known as 25-hydroxy-vitamin D) prior to supplementation.  This can help determine what dosage of supplementation would be ideal; in some cases of extreme deficiency, your doctor may recommend weekly megadoses to help bring the level up to the optimal range, then switch to a lower maintenance dose.

Other natural treatments for SAD are aimed at increasing serotonin and melatonin levels.  One option is the herb St. Johnswort, which has been extensively studied for the treatment of mild to moderate depression, and is useful for SAD.  St. Johnswort should not be used by patients who are already taking anti-depressants, as it works similarly to the medications and can potentiate their effects.  Another option might be 5HTP, a natural substance which is a precursor to both serotonin and melatonin.  This can help naturally increase serotonin levels and boost mood.

Lifestyle modification is also an important part of coping with SAD or other forms of depression.  Counseling or psychotherapy, stress management and mind-body techniques may all be helpful.  Additionally, a balanced whole-food diet high in vegetables, fruit, whole grains, beans, nuts, seeds and fish is optimal for maintaining overall health.  Avoiding sugar, alcohol and caffeine is key as these substances can aggravate a depressed mood.

Finally, exercise and time spent in nature are important ways to elevate mood and promote health.  Exercise naturally raises serotonin levels, helps improve sleep and maintains physical health.  Many studies demonstrate that time in nature also brings a sense of well-being, in addition to some sunlight exposure even during the winter months.  Dressing warmly and taking a brisk walk every day can help beat the winter blues.

For more information please see the following resources:

WebMD – Seasonal Affective Disorder

Mayo Clinic – Seasonal Affective Disorder

Dr. Julia Ross’ book The Mood Cure

Read Full Post »

A Naturopathic Perspective on the H1N1 Flu

By Dr. Diana Christoff Quinn

The H1N1 virus, also called the swine flu, is of great concern to many as we enter the early stages of cold and flu season. The swine flu is a strain of the influenza A virus that typically causes flu-like symptoms including fever, cough, runny nose, sore throat, headache, muscle aches, and sometimes nausea, vomiting and diarrhea.  The swine flu is a composite of four different flu viruses – North American swine, Eurasian swine, North American avian, and human[i].

The swine flu is transmitted by respiratory droplets in the air, from coughs and sneezes.  Transmission requires fairly close contact to the sick person, as the virus can’t travel more than 6 feet and does not remain airborne for long.  The typical incubation period for the virus is 1-7 days after exposure, but more likely 1-4 days.  People infected with the flu are contagious at least one day prior to the outbreak of symptoms and up to five days after.

thermometerHow serious is the swine flu?

At this time, the World Health Organization considers the overall severity of the influenza pandemic to be moderate.  The moderate assessment reflects that:

  • Most people recover from infection without the need for hospitalization or medical care.
  • Overall, national levels of severe illness from Influenza A (H1N1) appear similar to levels seen during local seasonal influenza periods, although high levels of disease have occurred in some local areas and institutions.”[ii]
  • According to the CDC, there have been roughly 400 deaths in the US reported to date attributable to the H1N1 flu; many estimate a million cases of infection or more are probable, given that mild cases are not reported and routine testing is no longer being performed.

Are there ways to prevent the flu?

Using basic hygiene is often our best defense. Everyone is advised to wash their hands regularly, use a tissue to cover mouth and nose during a cough or sneeze, and stay home if they are ill.  Getting adequate rest and nutrition are also very important for maintaining good immune defenses.  For hand washing, consider using essential oil antimicrobial hand sanitizers such as CleanWell[iii].  This product does not contain alcohol, and is therefore gentler on hands while still being 99.9% effective in killing germs.

Natural remedies to help with prevention include probiotics, healthy gut bacteria including Lactobacilus acidophilus.  A recently published study in the journal Pediatrics demonstrated that “daily dietary probiotic supplementation for 6 months was a safe and effective way to reduce fever, rhinorrhea, and cough incidence and duration and antibiotic prescription incidence, as well as the number of missed school days attributable to illness, for children ages 3 to 5.”[iv]

Who is at risk of complications from the flu?

Most people will not experience severe symptoms or complications from the flu.  Those who may be at higher risk of complications and hospitalization include:

  • Children less than 5 years old
  • Persons aged 65 years or older
  • Children and adolescents under 18 who are receiving long-term aspirin therapy and who might be at risk for Reye syndrome after influenza virus infection
  • Pregnant women
  • Adults and children who have chronic pulmonary, cardiovascular, hepatic, hematological, neurologic, neuromuscular, or metabolic disorders
  • Adults and children who have immunosuppression (including immunosuppression caused by medications or by HIV)
  • Residents of nursing homes and other chronic-care facilities.[v]

When is it important to get medical attention?

Emergency warning signs in children:

  • Rapid or difficult breathing
  • Fever with a rash and/ or bluish skin
  • Lack of thirst resulting in not drinking enough fluids
  • Being so irritable that the child does not want to be held
  • Flu-like symptoms improve but then return with fever and a worsened cough


In adults, emergency warning signs requiring urgent medical attention include:

• Difficulty breathing or shortness of breath

• Sudden dizziness or confusion

• Severe or persistent vomiting

Are there natural remedies to help treat the flu?

It is important with the treatment of the flu to keep hydrated and to rest.  Because the flu is a virus, antibiotics are not an effective treatment.  Many holistic doctors recommend using the homeopathic remedy Oscillococcinum[vi] at the first sign of symptoms.  This remedy has been shown to shorten the duration and severity of flu symptoms.  Additionally, one study of Elderberry syrup demonstrated its efficacy for shortening the duration of the flu.[vii]

The H1N1 virus was initially thought to be very dangerous, but now the severity has been updated to moderate.  With basic hygiene and self-care the flu virus may be prevented, and common natural remedies can help decrease the symptoms and duration of a flu infection.

Dr. Diana Christoff Quinn, ND is a licensed Naturopathic doctor specializing in women’s health and chronic illness.  She maintains a private practice in Ann Arbor as well as in Beaumont Hospital’s Integrative Medicine clinic in Royal Oak.  For more information or to schedule an appointment call (734) 769-4981.


[i] http://www.infectiousdiseasenews.com/article/39389.aspx

 

[ii] http://www.who.int/csr/disease/swineflu

[iii] http://www.cleanwelltoday.com/

[iv] http://pediatrics.aappublications.org/cgi/content/abstract/124/2/e172

[v] http://www.cdc.gov/h1n1flu/identifyingpatients.htm

[vi] http://www.oscillo.com/

[vii]http://www.ncbi.nlm.nih.gov/pubmed/15080016?ordinalpos =13&itool=EntrezSystem2.PEntrez.Pubmed.PubmedResultsPanel.Pubmed_ DefaultReportPanel.Pubmed_RVDocSum

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As there are no upcoming classes scheduled for July and August, we at Naturopathic Women’s HealthCare send our wishes for a safe and healthy summer with some tips for fun in the sun.  Everyone needs a good natural first aid kit to take to the beach, camping in the woods, or even in your own backyard.

Do-It-Yourself Natural Insect Repellant

A study published in the New England Journal of Medicine (see article) found that soybean oil insect repellant was effective against biting mosquitos for over 90 minutes.  Although the formula below needs to be reapplied every couple of hours for optimal protection, and is not designed for use in areas where insect-born illnesses are a high risk, it is an effective means for preventing mosquito bites without the exposure to neurotoxic compounds like DEET.

1 c. soybean oil

10 drops each of Geranium, Eucalyptus, Lavendar and Lemongrass essential oil

Mix and place into clean spray bottles.  Reapply every 1.5-2 michigan-beacheshours while outdoors for maximum protection.

Homeopathic First Aid Kit

Aconite 30C: shock and trauma

Apis 30C: stings or bites, swelling, allergic reactions

Arsenicum 30C: vomiting and diarrhea, anxiety

Arnica 200C: bruising, injury, swelling

Belladonna 30C: fever, injuries with red,

hot swelling; acute ear infections

Bryonia 30C: flu, cough, gastritis

Cantharis 30C: mild burns, sunburn

Gelsemium 30C: flu symptoms

Ledum 200C: puncture wounds or cuts

Nux vomica 30C: nausea, headache

Rhus Tox 30C: poison oak or ivy, joint pain

All-Purpose Salve: topical healing aid for minor cuts and bruises.

Kits are available for sale through Naturopathic Women’s HealthCare.  The homeopathic first-aid kit  is meant for use in conjunction with medical care for minor ailments and is not intended to diagnose, treat or prevent illness.

Enjoy the summer, and be well!

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