Naturopathic medicine has long espoused the connection between digestive health and overall wellness. The internal ‘terrain’ of the body determines susceptibility to illness and the general state of health, and has everything to do with the ecosystem of the gut. The term ‘dysbiosis’ refers to an imbalance of this internal ecosystem, a complex environment of microflora, chemical signaling, and immune activity. Disturbances of the gut can have far-reaching effects including digestive symptoms, immune issues like allergies or autoimmunity, and mood or neurological conditions. Fortunately, naturopathic medicine specializes in identifying and resolving imbalances of the gut.
Acupuncture and Traditional Chinese Medicine is based on the theory of “Qi Energy”. Qi energy is what guides all functions in our body – breath, movement, reproduction, digestion are all functions of qi. In TCM, every organ has Qi energy and each organ’s qi oversees different functions of the body. Every organ has a season in which the functions of that organ are “in the spotlight”. The organ (and qi) associated with the spring is the Liver.
Spring is a good time for rejuvenation and change. It is a also good time to think about supporting the Liver. In TCM, the Liver Qi regulates the flow of qi throughout the whole body. There are over 20 kinds of qi that the Liver QI keeps flowing smoothly. Stress in our life tends to effect the Liver qi. When this happens, the Liver qi does not flow smoothly, and it gets stagnant. Headaches, PMS, Irritable Bowel Syndrome, Depression, Irritability are all thought to be associated with Liver Qi stagnation. There are many ways we can support the Liver and assist it in its job. [Read more…]
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.
We’re now a week into the new year and some of us are beginning to realize that things aren’t panning out as we’d intended. We aren’t zooming around on hover boards as predicted back in 1985, and the perennial commitments to hit the gym every day may not have come to fruition. Some will be discouraged by this and decide to throw in the towel with guilt and dismay. Others will pledge to ‘try harder’ and compel themselves even more earnestly to do more, do better, be more.
What if there were another option?
What if, rather than fervently throwing ourselves into yet another rapid weight loss plan or heroic detox regimen, we shifted the focus toward greater self-acceptance and compassion? Would health goals be easier or more likely to attain if the motivating factor were self-love and commitment to our primary relationship with ourselves for the long haul? The research suggests this to be true.
Begin with self-compassion and gentleness
Why do you have goals for wellness and health in the first place? Hopefully because you care about yourself and want to take good care of yourself! When the motivator is self-care rather than on self-criticism, sticking with your plan and feeling good is much more likely. Positive regard for oneself leads to self-efficacy, the belief that you can achieve your goals in a specific area, which is a predictor of effective health behavior change and maintenance.[i]
Self-compassion is good for your health
Having compassion, whether for ourselves or for others, increases our production of a hormone called oxytocin which creates positive feelings such as love and trust, and also helps lower blood pressure and heart rate. Conversely, self criticism activates a fight-or-flight response in the body with increased adrenaline, cortisol and blood pressure.[ii] The long-term effects of cortisol are very damaging and lead to insulin resistance and diabetes, fatigue, brain fog, hormonal imbalance, sleep disturbance and many more of the chronic ailments prevalent today. Dr. Hans Selye coined the term ‘General Adaptation Syndrome’ to describe the effects of chronic adrenal stress.
Often times, there are good reasons why people rely on the less-than-healthy habits in their lives. Perhaps you suffer from adrenal stress and fatigue, and can’t imagine getting through the day without a triple espresso. Maybe your sleep is poor, and you have an extra glass of wine in the evening to try to get some sleep. Or perhaps your carb cravings are absolutely unmanageable in the afternoon when your blood sugar and serotonin levels dip and you just have to have that chocolate chip cookie. In all of these scenarios, underlying metabolic and neuroendocrine issues set the stage for reliance on a ‘crutch’ to keep functioning. The problem isn’t faulty will-power, but an actual physiologic imbalance, and when resolved, the cravings simply fade away. A naturopathic consultation for wellness and prevention can help identify obstacles to achieving your goals and get you on the right path.
Identify what you really want and begin where you are
Would you like to lose 20 lb, get in good enough shape to run a half marathon this spring, take up yoga, and do a complete nutrition overhaul? It’s possible that you could achieve all of these goals, but a realistic strategy is to identify what you really want and break it into manageable steps, centered around self-acceptance rather than perfectionism. In addition to self-compassion and gentleness, support can help clarify your goals and identify obstacles in your path. Whether you seek more radical changes or simply to fine-tune your nutrition or supplement regimen for optimal wellness and prevention, the tools you need to get there with gentleness are available.
Keep the focus on what you will add, rather than take away
Instead of focusing on the things you want to cut from your diet, begin by building a relationship with the things that you’ll add. For example, if you’ve vowed to cut out sugar from your diet, begin by gathering recipes calling for natural sweeteners and exploring new healthy treats. You need not feel deprived to reach your goals. In addition to the nourishing additions to your life, practices such as Emotional Freedom Technique are helpful for reinforcing your commitment to self-care and let go of attachment to the old habits that no longer serve you.
Wellness & Prevention Offering
In the spirit of supporting self-compassion in our patients wellness goals, we’re offering a special naturopathic wellness & prevention package for 2015. This one-hour intake session is designed to help clarify wellness goals, identify obstacles, and offer tools to support you on your path to greater health. Happy new year!
[i] Stretcher V. The role of self-efficacy in achieving health behavior change. Health Education Quarterly. Spring 1986 Vol 13(1):73-91.
[ii] Neff Kristen. Self-Compassion: Stop Beating Yourself Up and Leave Insecurity Behind. 2011
As Acupuncturists, we sit with many of our clients and talk with them about their emotions. Emotions are an important part of the intake process for Traditional Chinese Medicine. Emotions affect our physical health and physical health affects our emotional well-being.
In Traditional Chinese Medicine – most organ systems have an emotion associated with them. When someone is angry or irritable, we think of the Liver and how to work to balance the flow of Liver Qi. Fear is associated with the Kidneys, Grief, the Lungs, Heart = joy and the emotion associated with the Spleen is worry. Since we so often experience many emotions, one can only predict the effect the emotions have on our health.
I want to make a pitch for starting to make friends with our emotions. So often, we try to push our feelings away. This may be done through drugs and alcohol, food and other addictions, exercise or medications. An informal industry has been developed in order to support us in NOT FEELING. What this ultimately does is add an additional layer to our pain and suffering. We still feel the emotions we don’t want to feel and we self medicate ourselves to get away from the feelings we still feel! [Read more…]
In early January, on a beautiful winter day, I broke my collarbone while enjoying an afternoon of snowshoeing. What I learned after visiting the ER is that the collarbone cannot be casted or set. It is in a precarious place with interdependency on many other bones and ligaments. It has to heal by itself. I was given a necessary prescription for medication and told to rest and come back in 3 weeks.
Fortunately I knew better and knew, through a combination of modalities, I could do a lot better than “just resting”. Don’t get me wrong – rest is critical when you are recovering from an injury! However, I knew it alone would not be enough help me heal. [Read more…]
Natures First Aid Kit
Our health food and grocery stores shelves are lined with many different supplements and medicines – trying to determine what to take can be overwhelming. There are many choices that extend beyond the supplement aisle! There is much to learn about the food universe – even plants, herbs and spices have medicinal benefits!
Tea Tree Oil is an essential oil. Essential oils are the oil of a plant from which it is extracted from. The usually carry a specific scent or “essence” of the plant. When used topically, tea tree oil is thought to have anti viral, antibacterial, anti-inflammatory and anti-microbial benefits. To this end, tea tree oil can be very helpful in treating fungal infections (athlete’s foot), acne, dandruff (when added to shampoo), and yeast infections. I experienced the benefits of Tea Tree Oil personally during a recent beach trip. My legs were bitten over 100 times by sand flees and I found recently found the topical application of tea tree oil to be very effective in reducing itching and swelling. Tea Tree Oil is also good for inflammation and as an assistant in recovering from injury.
Turmeric , a spice (often used in curry) has widespread use in preventative medicine. According to the American Cancer Society, “Some proponents believe turmeric may prevent and slow the growth of a number of types of cancer, particularly tumors of the esophagus, mouth, intestines, stomach, breast, and skin.” Turmeric’s active ingredient is curcumin and both are thought to have anti-inflammatory and anti-oxidant properties. In addition, the American Cancer Society’s web site states that “ Early research has suggested that curcumin may help lower “bad” cholesterol, reduce inflammation, help ulcerative colitis, and reduce arthritis symptoms, although more reliable human studies are still needed”. Turmeric can be used liberally in one’s daily diet and can also be taken as a supplement at a dose of 500 mg 1-4 times a day. [Read more…]
As acupuncturists, we sit with our clients and talk with them about their emotions. Emotions are an important part of the intake process for Traditional Chinese Medicine. Emotions affect our physical health and physical health affects our emotional well-being.
In Traditional Chinese Medicine – most organ systems have an emotion associated with them. When someone is angry or irritable, we think of the Liver and how to work to balance the flow of Liver Qi. Fear is associated with the Kidneys, Grief, the Lungs, Heart – joy, and the emotion associated with the Spleen is worry. Since we so often experience many emotions, one can speculate the effect the emotions have on our health.
I want to make a pitch for making friends with our emotions. So often, we try to push our feelings away. This may be done through drugs and alcohol, food and other addictions, exercise or medications. An informal industry has been developed in order to support us in NOT FEELING. What this ultimately does is add an additional layer to our pain and suffering. We still feel the emotions we don’t want to feel and we self medicate ourselves to get away from the feelings we still feel! Doesn’t make sense! [Read more…]
As women, we are pressured to keep our figures intact and the world around us supports our desire to be thin and svelte. At the same time, we are watching our bodies change – most of which is beyond our control. Midlife hormonal changes take precedent to our old ways of eating what we want and being able to exercise a few times and “work it off”. Our mind and body are in conflict and there is no sense of balance between the two. In addition, the images we see in the media feed our desire to keep youthful and fight creating a healthy state of balance.
For the past 10 years I have been working in the field of Traditional Chinese Medicine. TCM looks at our body (and our world) from a viewpoint of balance. It is the goal of TCM to support our body in achieving a healthy state of balance. Balance does not mean perfection. We are conditioned to think of the perfect body as the images that we see in the media. In TCM, balance means a harmonious way of feeling, being and thinking. Everybody (and body) has their own natural state of balance and every body’s balance is different. My balance is different than your balance. I remember once, in my early days of acupuncture school, some of the senior students telling me that, after learning about TCM, I would “never look at my body the same way”. And they were right. [Read more…]
Good health, according to Traditional Chinese Medicine (TCM) is dependent on four major foundations. These include diet, exercise, adequate rest and relaxation, and a good mental attitude. Acupuncture reaches it’s full and lasting effect when lifestyle changes are made where all four foundations are attended to. Diet, while not more important than the other three, contributes mightily to many health related issues. The following article shall discuss Damp and its relationship to digestion and health.
In TCM the energies (qi) of organs are paired in a yin and yang fashion. Very briefly, yin and yang are distinct entities yet dependent on each other, with yang found in yin and yin found in yang. Qi, the life force, is found in every organ and in the body overall. Diseases and digestion are therefore a result of excessiveness or deficiencies in qi, as related to the yin and yang organ pairs. This principle is the foundation of TCM. The goal of Acupuncture is then to restore the balance of the organ pairs within the body. [Read more…]