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I am a 2012 Naturopathic Doctoral Candidate at National College of Natural Medicine in Portland, OR. I am excited to share and exchange knowledge about health and wellness on my journey to becoming a Naturopathic Doctor.

Monday, October 24, 2011

When Doing Nothing Is the Best Medicine


OCTOBER 20, 2011

When Doing Nothing Is the Best Medicine


By DANIELLE OFRI, M.D.
“Don’t just do something; stand there!”

It’s one of those phrases that attending physicians will spout off to their medical students while on rounds, trying to sound both sagacious and clever at the same time. It sometimes grates, but it does make a valid point, because so much of medicine is about “doing something.”

Sore throat? Prescribe an antibiotic.

New headache? Get a CT scan.

P.S.A. at the upper limit of normal? Get a biopsy.

Blood pressure still high? Add on another medication.

Doctors tend to want to “do something” whenever they note something amiss. And patients, by and large, want something done when they have a symptom. Few people like being told just to watch and wait.

Of course, every “thing” a doctor does also has side effects — rampant bacterial resistance from antibiotic overuse; major increases in radiation exposure from unnecessary CT scans; incontinence or impotence from prostate cancer treatments that may do nothing to prolong life; toxic drug interactions from multiple medications, particularly in the elderly.

The admonishment “Don’t just do something; stand there!” reminds us that we should stop and think before we act, that there are many instances in which doing nothing is greatly preferable to doing something.

In fact, there are some doctors for whom “doing nothing” is the dominant way of thinking, who are not reflex “do-ers.” They tend to lean toward the status quo: If the patient is doing fine right now, why rock the boat?

There’s a term for this in the medical literature — clinical inertia — a term with a distinctly negative connotation. It describes the doctor who, for instance, sees a patient with cholesterol levels that are not optimum but who does not prescribe a statin. Or the doctor who notices that a diabetic patient’s blood sugar levels are still not normal but refrains from increasing the patient’s medication.

Of course, this is not black and white: There is a continuum of practice styles, just as there is a continuum of personalities in general. At one end are doctors who jump on the merest hint of a borderline lab value; at the other are doctors who avoid making changes unless absolutely necessary.

I like to think of myself as perfectly balanced in the precise middle of this spectrum, but if I take a hard look in the mirror I can see that I tend toward the clinical inertia side, always hesitating before I write a prescription or order a test. I tell myself that this arises from the august wisdom of my clinical experience, from having witnessed my fair share of side effects and adverse outcomes due to medical meddling. But I have to be honest and recognize that it reflects my personal tendency to be slow in making major decisions of any sort, to need a strong sense of how things are likely to play out before I act.

Every time I prescribe a medication — or order an invasive test, or refer a patient to a surgeon — it always feels like I’m placing a stone on a balance scale. Intellectually, my goal is to place the stone on the side of the scale that benefits my patient. But in my heart, I fear that it could end up on the other side, the side that harms, and the weight and permanence of the stone give me pause.

Many make the argument that deciding not to act is as momentous as deciding to act. Except that it never feels that way. My hesitation induces guilt; it makes me ask myself if I am harming my patients by not acting as fast or aggressively as some of my colleagues would.

An essay I came across in The Journal of the American Medical Association called “Clinical Inertia as a Clinical Safeguard” offered some food for thought. The authors postulated that doctors who tend toward inertia might actually benefit their patients by protecting them from overzealous medical intervention.

They focused on three common medical conditions — diabetes, elevated cholesterol and hypertension — for which there are established clinical guidelines for doctors to follow and “quality measures” that evaluate medical care. For all three illnesses, “lower is better” is the dominant mantra.

But while “lower is better” is probably true for large populations, that is not always the case for individual patients. In fact, there are some clinical trials in which aggressively lowered blood sugar or blood pressure have been associated with higher rates of dying.

The authors weren’t saying that these medical conditions shouldn’t be actively treated, but they did caution that standard clinical guidelines tend to favor overaggressive treatment in pursuit of “good numbers.” In the stampede toward good numbers, individual patients can be harmed by the side effects of these treatments. Clinical inertia might actually act as a safeguard for such patients.

No one, of course, wants doctors who fail to act when action is necessary. And medical emergencies are a different story altogether. But most chronic illnesses, luckily, are not emergencies, so there is room for deliberation before action. And while insurance companies won’t reimburse for deliberation, and report cards pointedly penalize, it’s interesting to consider that there are many patients who may have been saved by inertia.

Danielle Ofri is an associate professor of medicine at New York University School of Medicine and editor in chief of the Bellevue Literary Review. Her most recent book is “Medicine in Translation: Journeys With My Patients.”

Copyright 2011 The New York Times CompanyPrivacy PolicyNYTimes.com 620 Eighth Avenue New York, NY 10018

Wednesday, October 12, 2011

Oregonian Coverage of Oregon Health Authority Public Meetings

The Oregonian yesterday reported on the Oregon Health Authority’s public meeting held in Portland yesterday (see my note from Sept. 28 below). The story reports that Dr. Dhai Barr (1998 NCNM graduate) wondered where ND care will fall in the new CCO plan—and it ends by noting a patient’s unfortunate health care experience—with a nod for naturopathic medicine. Here’s the story, “Oregon Health Authority meeting on health transformation packs the room in Portland.”

Here is the link to the story: http://www.oregonlive.com/health/index.ssf/2011/10/oregon_health_authority_meetin.html

Monday, October 3, 2011

Surgery Not 'A Magic Pill' For Obese Patients

While bariatric surgery has its place amongst the morbidly obese, this article points to the many reasons to go back to the basics and set the foundation for a healthy lifestyle with adequate nutrition and exercise. A Naturopathic Doctor is a great addition to your team if you struggle with weight loss and chronic health issues.


Original link:
http://www.npr.org/2011/10/01/140803898/surgery-not-a-magic-pill-for-obese-patients

Surgery Not 'A Magic Pill' For Obese Patients
by CARRIE KAHN

Listen to the Story
Weekend Edition Saturday [7 min 29 sec]


October 1, 2011
Part of an ongoing series on obesity in America

Losing weight in America is big business. Americans spend $61 billion a year on everything from diet pills and exercise videos to meal plans, health club memberships and medical treatment. One of the fastest growing and lucrative segments of the weight-loss market is surgery.

And if you want to learn about the risks and benefits of going under the knife to lose weight, there's a great place to go in Los Angeles — and it's not a Beverly Hills doctor's office. Check out Power 106, L.A.'s popular hip-hop station, and its larger-than-life DJ, Big Boy. The DJ — seldom referred to by his given name, Kurt Anderson — used to be really big.


Before getting bariatric surgery, Los Angeles DJ Big Boy posed for a photo promoting his radio station, Power 106. He weighed more than 500 pounds.
"I had gotten up to like an 8X shirt and size 66 pants. My whole life I've always been big. It just went from big to bigger till I got to my biggest," Anderson says.

He reached 520 pounds. At that weight, Anderson posed provocatively for a photo in his underwear. It was plastered on billboards all around L.A. But he says he knew he wouldn't last at that weight.

"I was 33 years of age, I was over 500 pounds, and you start to ask yourself, 'Do you have more years behind you than you have in front of you? Do you see any 66-year-old, 500-pound men?' You don't," he says.

Anderson says that after years of failed dieting, he decided on gastric surgery.

"There's really nothing in the field of medicine that can match what surgery can do for these patients," says Dr. Amir Mehran, the director of bariatric surgery at UCLA. He points out that there are many different types of bariatric surgery, from removing large portions of a patient's stomach to just restricting it so less food can get in. Mehran says each procedure has its risks and benefits.


Eight years after his surgery, Big Boy maintains his weight right around 200 pounds.
"The surgery is not a quick fix. It's not a magic pill at all. It's a very strong tool. And depending on the surgery, some are stronger and some are weaker," Mehran says.

Big Boy had what is known as the duodenal switch surgery. More than 70 percent of his stomach was removed, and his intestines were rerouted. Eight years later, he maintains his weight right around 200 pounds.

But Big Boy wasn't — and isn't — the only overweight personality at Power 106. Three others have had bariatric surgery. Joe Grande chose the Lap-Band. It's a trademarked device that is surgically implanted around the top of the stomach.

It's been four years since Grande, whose real name is Joe Lopez, had the gastric band implanted. When inflated, the gastric band restricts the stomach so only a small amount of food can get in.

"Everybody always said, 'Joe, you carry your weight well.' I always looked like a football player. It wasn't like I carried it in my stomach. My weight was all around me. I looked like Shrek, basically, and people loved Shrek."

But unlike Shrek, Lopez had diabetes, high blood pressure and gout. Both his parents died in their 50s from complications due to diabetes. Lopez says he tried dieting and exercise for years. The lowest he could ever get down to on his own was 285 pounds. Eventually, he would gain it back and more. He had a lot of long-learned bad habits.

"You know, eating that rich Mexican food — 10 carbs for dinner. It's like, 'OK, we are having beans, fideo [pasta] with rice and other rice.' You grow up going, 'My mom was the best cook ever.' Everything was wrapped in bacon," he says. "Thanks for the diabetes! Love you!"

Bariatric Surgery On The Rise

Within three weeks of surgery, Lopez's diabetes and high blood pressure were gone. After taking medication for five years, he threw out all his pills. Lopez lost 125 pounds and became a spokesman for several bariatric surgery centers.

Lap-Band Surgery

But not everyone is happy with the Lap-Band. At the UCLA surgery clinic, doctors won't use it. They say they don't like the idea of leaving a foreign object in the body indefinitely.

And there are objections to the aggressive advertising used by some surgeons.

For example, spots and billboards advertising 1-800-GET-THIN blanket L.A. Critics say the ads focus more on getting thin than getting healthy.

Some surgeons tied to the advertising campaign are being sued by relatives of patients who died after having the Lap-Band implanted. Other patients are suing, claiming false advertising. In the past two years, five Southern California patients have died after having Lap-Band surgery at clinics tied to the ads. The clinics deny any connection.

David Pyott, the CEO of Allergan, which manufactures the Lap-Band, said the company does not condone the ad campaigns.

"We don't always agree with the tone of some of those advertisements by our customer. But we're not the advertising police," Pyott tells NPR.

Pyott says thousands of Lap-Bands have been implanted in patients. It is a safe, simple and successful way for people to lose weight, Pyott says.

"It's a mechanical way of controlling hunger — after a couple of hundred of calories of food intake, to say, 'I am satisfied, I can take a break,' " he says.

Four Common Procedures
When it comes to bariatric surgery, there are four common procedures:

Duodenal Switch: A large portion of the stomach is removed and food is diverted from the small intestine. A smaller stomach means a patient eats less, and some experts see a link between the removal of the hormonally active portion of the stomach and the treatment of health issues like diabetes.

Gastric Bypass: Like the duodenal switch surgery, doctors create a smaller stomach. Food is also diverted from the small intestines. However, nothing is removed and the stomach is smaller than with the switch surgery. Diabetes patients have also been helped by the surgery.

Adjustable Gastric Banding: A doctor implants a silicone ring around the stomach that is connected to tubing that goes to a port that sits above the abdominal wall, underneath skin. Using a needle, fluid can be added through the port to make it tighter (so patients eat less) or removed (so patients can eat more).

Vertical Sleeve Gastrectomy: Roughly two-thirds to three-quarters of the stomach, including hormonally active portions, is removed, but unlike the duodenal switch and gastric bypass surgeries, the intestines are not rerouted. This is the newest of the four methods.

Source: Dr. Amir Mehran, Director of Bariatric Surgery at UCLA

Despite the safety reassurances, the American Society for Metabolic and Bariatric Surgery is also concerned that the message to obese clients overemphasizes cosmetics and appearance. Society President Robin Blackstone performs between 300 to 400 gastric surgeries a year at her Scottsdale, Ariz., clinic. But she says surgery should be the last resort — not something decided after seeing a billboard.

"It causes people to continue to have an image about thinness rather than about health," Blackstone says.

Blackstone says patients should be wary about going to a surgeon who only offers one type of surgical treatment.

Post-Surgery Struggles


For Big Boy, it's been many years of doctors' visits and dealing with side effects after he had most of his stomach removed in the gastric bypass. On the day he was interviewed for this story, he was struggling with edema. His lower legs were swollen.

"I'm still going through medical problems. I'm at the doctor all the time," he says.

And he says he's still tempted by fatty food. He said the big box of doughnuts that is frequently on the table at the radio station calls out to him.

Lopez, who lost 125 pounds with the Lap-Band, says he still has an eating problem, too. Lopez says once he even had the doctor loosen his band. He was going on his honeymoon and wanted to indulge.

"Because I went to an all-inclusive resort and I wanted to eat a little more, so I asked my doctor if I could get it adjusted. And I gained 20 pounds, and it shows that left to my own devices I can gain about 20 pounds in a couple of weeks," Lopez says.

Once back, he had it tightened and dropped the extra weight.

Such success stories have helped boost the number of bariatric surgeries performed every year — more than 200,000 annually, according to the American Society For Metabolic and Bariatric Surgery. And that number could grow higher. Lap-Band maker Allergan recently got FDA approval to market the device to people needing to lose as little as 50 pounds. And the company is waiting for approval for its use in another obese group — teenagers.

If obesity has touched your life, share your story with NPR and the Public Insight Network.

Tuesday, September 27, 2011

Water Fasting: Crazy or Cleansing?

Last week, I began a 21 day Elimination Diet. This diet excludes foods that are considered to be the most inflammatory and allergic, including corn, soy, wheat, any gluten containing grains, dairy products, eggs, peanuts, night shade vegetables (potatoes, tomatoes, peppers), sugar, coffee, alcohol, any condiments that contain sugar, high fructose corn syrup or hydrogenated vegetable oils or preservatives. The goal of completing a diet such as this is to allow the body to process all of these foods and excrete them from the body, which takes about 21 days. After this time, one food at a time is introduced slowly to determine if you react to the food or not. Reactions to foods span many different systems, from gastrointestinal discomfort, to skin eruptions, to mood changes. As a part of my personal Elimination Diet, I also added a 2 day Water fast to further my detoxification. I am completing my cleanse and water fast under the care of a qualified and licensed Naturopathic Doctor, as should anyone who is attempting to complete an Elimination Diet and water fast. I found I was able to complete the water fast relatively "pain free" as I had one week to prepare my body in terms of eliminating inflammatory and allergic foods. I also allowed myself more time to rest, digest, and including saunas as a part of my cleansing. Not everyone is in a state of health, or will ever be in a state of health conducive to water fasting. Working with a Naturopathic Doctor, however, can help you to determine your safe level of cleansing, whether it be beginning with removing a few foods commonly known to be problematic for many people, to a supervised water fast. I highly recommend Dr. Amy Johnson and her clinic, Blue House Holistic Health (www.bluehousehealth.com) where I am currently completing her 5 week Elimination Diet. Feel free to explore her clinic and links available, and please work with a licensed Naturopathic Doctor should you decide cleansing and fasting is a part of your journey to health.

Thursday, September 22, 2011

Weekly Health Quiz

Find out how much you know about current health happenings in the news with the New York Times weekly health quiz. Click on this link to access this week's quiz: http://www.nytimes.com/interactive/2011/09/23/health/20110923_healthquiz.html?ref=health

Monday, August 22, 2011

Protect Your Bones with Herbs


Protect Your Bones with Herbs

March/April 2004
http://www.herbcompanion.com/Health/Protec-Your-Bones-With-Herbs.aspx

By Cindy Jones, Ph.D.

Increased consumption of herbs may be a useful approach to reducing the risk of osteoporosis. Researchers have found that common herbs, including sage, rosemary and thyme, can inhibit the breakdown of bone that contributes to osteoporosis.

Because these herbs are rich in essential oil components, the researchers also looked at essential oils and specific components of these essential oils to inhibit bone breakdown. We have known for some time that minerals found in plants, such as calcium, potassium and magnesium, are important to bone health. Plants also contain vitamins K and C, as well as phytoestrogens, that may contribute to bone health. But substances other than these that are found in essential oils may be equally important.

Testing the Theory

In their experiments, researchers from the University of Bern in Switzerland used a model of osteoporosis in rats. Rats were fed a diet containing powdered herbs, essential oils or purified monoterpenes from these essential oils for a period of 10 days. Bone breakdown during this time was measured by the release into the urine of bone breakdown markers.

Besides the powdered whole herbs sage, rosemary and thyme, the essential oils that inhibited bone breakdown included sage, juniper, pine, dwarf pine, eucalyptus and rosemary. Pine oil was discovered to be the most potent. Protective effects were seen as early as two days following treatment. Orange peel, fennel and cumin were the only oils tested that did not inhibit bone breakdown.

Researchers investigated further to determine what components of essential oil were responsible for this inhibition of bone breakdown. They found that the essential oil components thujone, eucalyptol and camphor all had inhibiting activity. Borneol had limited activity and only at a higher dose. These components are all monoterpenes found in sage oil. Components of pine oil — alpha-pinene, beta-pinene and bornylacetate—also were inhibitors of bone breakdown. Additionally, menthol, thymol and medicinal turpentine were found to inhibit bone breakdown.

Take Them or Cook Them
In the study, the dried herbs were given in the food at a dose of 1 gram per day. To scale this up to human proportions, this would mean about 150 grams per day, or 10 tablespoons of dried herb. The essential oils were active between 30 to 100 milligrams per day, pine being the most active. Again, to scale this to proportion for a human would mean about 15 grams of oil, or about 3 teaspoons per day. It is not advised that you take these very large amounts because toxicity studies and clinical trials have not been conducted on their safety. However, since these are culinary herbs, there is no reason not to increase the use of sage, rosemary and thyme in cooking or in teas.

Bone breakdown that leads to osteoporosis is, unfortunately, a normal event that occurs in humans as we age. To slow its progression, medical science has suggested a regular exercise routine and ingestion of calcium-containing foods or supplements. A diet rich in vegetables, including onions, has been found to decrease bone loss, as well. This research further expands the list of foods known to prevent bone loss.
Reference
Muhlbauer, R.C., et al. “Common herbs, essential oils, and monoterpenes potently modulate bone metabolism.” Bone 2003; 32: 372 – 380.
________________________________________________________________________________________
Cindy L. A. Jones, Ph.D., Sagescript Institute (www.sagescript.com).

Sunday, August 21, 2011

Care Package for a Breast Cancer Patient

Well - Tara Parker-Pope on Health
August 18, 2011, 9:00 am
Care Package for a Breast Cancer Patient
By TARA PARKER-POPE

How do you support a friend or loved one with breast cancer?

Frozen casseroles and offers to shuttle children to activities can be tremendously helpful, but many people want to do more. This weekend I stumbled across one of the best columns I’ve seen on the topic, written by a 32-year-old woman named Nicole who last summer opted for a prophylactic mastectomy after learning she had the BRCA2 genetic mutation, which put her at high risk for breast cancer.

In her blog, Losing My Boobs, Nicole, who asked that her last name not be used, offered a list of recommendations for women heading to the hospital for breast surgery. It contains a number of great suggestions for anyone wanting to prepare a care package for a woman they know.
Tony Cenicola/The New York Times

Comfy button-front pajamas: The softer the fabric, the better, said Nicole. She couldn’t raise her arms after surgery, so she lived in these pajamas for two weeks.

Soft, fuzzy socks: “I was freezing in the hospital all the time,” she said.

Dry shampoo: A woman can’t shower for days after surgery, but a dry shampoo can lift her spirits. Nicole said she will always be grateful to the friend who gave her a dry shampoo and braided her hair while she was recovering in her hospital bed.

Baby wipes: An important item for the bedside table of any woman stuck in a hospital bed.

Lip balm and moisturizer: During her stay in the hospital, Nicole said, she constantly felt parched and kept her lip balm and moisturizer close at all times.

Mineral water spray: Water sprays, like the brumisateur sold by Evian, can be particularly refreshing.

Mints: A box of Altoids is an essential for a hospital patient who can’t get out of bed to brush her teeth in time for visitors, says Nicole.

A battery-powered toothbrush: This gift from a doctor friend was surprisingly useful, said Nicole. Even a movement as small as brushing your teeth is too painful after surgery. “You can’t move your arms, so you need something that can do the work for you,” she said.

A soft blanket: Work friends gave Nicole a super-soft blanket and pillow from Brookstone, and she treasured it during her hospital stay. “Anything soft is good,” she said. “That soft material was so comforting . No position you get in after that kind of surgery is comfortable. You can’t move, you can’t sleep, so anything that can be the least bit comforting is wonderful.”

Entertainment: An iPod or MP3 player loaded with music and a few magazines or books that can be flipped through with minimal effort are a good idea. Nicole said she brought a laptop but never used it “because I felt so terrible, not to mention mentally foggy from all the drugs.”

Waxing: Before surgery, a wax treatment, particularly under the arms, is a good idea, said Nicole. With all the tubes and pain, the patient won’t be able to shave for a while, so a pre-surgery gift certificate would be a welcome treat.

To learn more about Nicole’s experiences, you can read her blog, or follow her on Twitter.

* Copyright 2011 The New York Times Company
* Privacy Policy
* NYTimes.com 620 Eighth Avenue New York, NY 10018

Monday, June 20, 2011

Think Yourself Out of Your Hot Flashes

Apparently mainstream medicine is catching on: if we think we have control over our lives, our health and well-being, it seems to have a beneficial impact on the actual outcome of our health. Imagine that.
Have a look at what this interesting Portuguese study found regarding women and their perceived control of hot flashes.

Perceived control, lifestyle, health, socio-demographic factors and menopause: Impact on hot flashes and night sweats.


Maturitas. 2011 Jun 14;

Authors: Pimenta F, Leal I, Maroco J, Ramos C

OBJECTIVE: To develop a model to predict the perceived severity of hot flashes (HF) and night sweats (NS) in symptomatic middle-aged women. METHODS: This was a cross-sectional study of a community-based sample of 243 women with vasomotor symptoms. Menopausal status was ascertained using the 'Stages of Reproductive Aging Workshop' criteria. Women's 'perceived control' over their symptoms was measured by a validated Portuguese version of the Perceived Control over Hot Flushes Index. Structural equation modelling was employed to construct a causal model of self-reported severity of both HF and NS, using a set of 20 variables: age, marital status, parity, professional status, educational level, family annual income, recent diseases and psychological problems, medical help-seeking behaviour to manage menopausal symptoms, use of hormone therapy and herbal/soy products, menopause status, intake of alcohol, coffee and hot beverages, smoking, physical exercise, body mass index and perceived control. RESULTS: Significant predictors of perceived severity were the use of hormone therapy for both HF (β=-.245; p=.022) and NS (β=-.298; p=.008), coffee intake for both HF (β=-.234; p=.039) and NS (β=-.258; p=.029) and perceived control for both HF (β=-1.0; p<.001) and NS (β=-1.0; p<.001). The variables explained respectively 67% and 72% of the variability in the perceived severity of HF and NS. Women with high perceived control had a significantly lower frequency (t(235)=2.022; p=.044) and intensity of HF (t(217)=3.582; p<.001); similarly, participants with high perceived control presented a lower frequency (t(235)=3.267; p<.001) and intensity (t(210)=3.376; p<.001) of NS. CONCLUSION: Perceived control was the strongest predictor of the self-reported severity of both HF and NS. Other causal predictors were hormone therapy and caffeine intake. All three were associated with less severe vasomotor symptoms.

PMID: 21680119 [PubMed - as supplied by publisher]

Wednesday, June 15, 2011

Deoderant may not be coming up not smelling like roses afterall....

Deodorants are the leading cause of allergic contact dermatitis to fragrance ingredients.

Contact Dermatitis. 2011; 64(5):258-64 (ISSN: 1600-0536)

Heisterberg MV ; Menné T ; Andersen KE ; Avnstorp C ; Kristensen B ; Kristensen O ; Kaaber K ; Laurberg G ; Henrik Nielsen N ; Sommerlund M ; Thormann J ; Veien NK ; Vissing S ; Johansen JD

Department of Dermato-allergology, National Allergy Research Centre, Gentofte Hospital, University of Copenhagen, 2900 Hellerup, Denmark. mavohe01@geh.regionh.dk

BACKGROUND: Fragrances frequently cause contact allergy, and cosmetic products are the main causes of fragrance contact allergy. As the various products have distinctive forms of application and composition of ingredients, some product groups are potentially more likely to play a part in allergic reactions than others.

AIM: To determine which cosmetic product groups cause fragrance allergy among Danish eczema patients.

METHOD: This was a retrospective study based on data collected by members of the Danish Contact Dermatitis Group. Participants (N = 17,716) were consecutively patch tested with fragrance markers from the European baseline series (2005-2009).

RESULTS: Of the participants, 10.1% had fragrance allergy, of which 42.1% was caused by a cosmetic product: deodorants accounted for 25%, and scented lotions 24.4%. A sex difference was apparent, as deodorants were significantly more likely to be listed as the cause of fragrance allergy in men (odds ratio 2.2) than in women. Correlation was observed between deodorants listed as the cause of allergy and allergy detected with fragrance mix II (FM II) and hydroxyisohexyl 3-cyclohexene carboxaldehyde.

CONCLUSION: Deodorants were the leading causes of fragrance allergy, especially among men. Seemingly, deodorants have an 'unhealthy' composition of the fragrance chemicals present in FM II.

PreMedline Identifier:21480912

Tuesday, June 14, 2011

Q: I’ve heard a lot about fish oil? Is it something I should take?


A: Fish oils contain omega-3 essential fatty acids which help to reduce blood viscosity, increase good cholesterol (HDL) and lower triglycerides. Essential fatty acids cannot be made by the human body but are ‘essential’ for normal metabolism. Therefore, we must acquire them in our diet. Omega-3 fatty acids are often lacking in the modern diet, which is instead higher in omega-6 type fatty acids. Omega-6 fatty acids are found mostly in animal products and contribute to the body’s inflammatory response, vital for our immune system. The problem is not the omega-6 fatty acids, but rather that our diet provides us with too much omega-6 and not enough omega-3. The idea behind supplementing with fish oil is to provide the body with a healthy amount of omega-3 oils, and to create a more appropriate balance between omega 6 and 3 fatty acids in the body. Because fish oils are so beneficial in this aspect, they are an appropriate supplement for many people.

If you are vegetarian, vegan or opposed to animal supplements, you can also consider other oils that contain healthy amounts of omega 3 oils. Fish oils are often the first choice because they provide the greatest amount of omega 3 oils per serving. There are, however, many other non-animal sources of omega 3 fatty acids including flax seeds, hemp, canola, walnut, pumpkins, soy, algae, and purslane.

Talk to your Naturopathic Physician about whether a fish oil supplement is a good choice for you and what to look for in selecting a supplement. It is important to read all labels and look for certified products tested for Mercury and other contaminants and is guaranteed to be shelf-stable (to not turn rancid).

References
Marz, Russell B. Medical Nutrition from Marz. 2nd ed. Portland: Omni-Press, 1999.
Thom, Dick. Notes from “Clinical and Physical Diagnosis.” National College of Natural Medicine. 2009-2010.

Thursday, June 9, 2011

Dr. Mercola's Tips for Keeping Joints and Muscles Healthy

What strategies can you use to help keep your joints healthy and flexible?
  1. Exercise. There's a common urban legend that exercise is bad for your joints.Woman Stretching to promote Healthy Joint Most people have little appreciation for how powerful exercise can be in supporting joint function. Vigorous low-impact exercise is beneficial for your joints, as well as for cardiovascular, pulmonary, and other systems in your body.
    It's simply a myth that you can 'wear down' your knees just from average levels of exercise  and/or normal activity. In fact, inactivity causes your muscles to become weaker and actually works against optimal joint flexibility and comfort.
    One caution, however when using this valuable tool, you need to start slowly if you have not been exercising regularly, and build up to higher activity levels otherwise you risk incurring an injury that could cause really set you back..
    If typical vigorous exercise is not easy for you, try walking, tai chi and yoga  as they are very low impact, yet offer many health benefits.
  2. Achieve your optimal weight to improve your bio-mechanic function. One of the outstanding benefits of exercise is its ability to help you achieve and maintain your ideal weight which is highly beneficial to your joints.
    Overweight and obese people compromise joint comfort more than those who are carrying their ideal load. Each additional kilogram (2.2 pounds) of body mass increases the compressive load over your knee by roughly 4 kilograms (nearly 9 pounds).
    Research shows that a weight loss of as little as 11 pounds can have a positive effect on joint function. And those who are at their optimal weight experience increased joint health as compared to those who are obese or overweight.
    So you go full circle losing weight reduces the load on your joints and makes it easier to exercise, and exercising helps you lose weight and supports your joint health.
  3. Eat a higher quality diet. Eliminate sugar and starchy carbs from your diet. And definitely stop drinking soda. These foods do absolutely nothing to support healthy joints or a healthy body. In fact, their potential for damage is well documented.
    I believe you should limit your total fructose from ALL sources to no more than 25 grams per day, as it raises uric acid levels, which is hard on your joints. Now, chances are, you consume substantially more than 25 grams per day. Approximately of Americans consume a whopping 134 grams of fructose every day!
    Within your 25 grams of fructose, you could consider including some tart cherries or concentrated tart cherry juice. They contain anthocyanins and bioflavonoids, which help support a healthy immune response for your joints and whole body health.
    Also, in my opinion, you should base your food choices on your nutritional type to ensure you optimize your ideal macronutrient ratios.
  4. Optimize your vitamin D levels. Vitamin D also supports a healthy immune response. Please recognize that during the fall, winter and early spring in most of the U.S., Canada, and Europe, your vitamin D levels can drop precipitously. If your levels fall, you give up the support this vitamin offers for your joints and your whole body.
  5. Get plenty of omega-3 fatty acids from krill or high quality fish oil. Omega-3's support your joint health.
  6. Try EFT Emotional Freedom Technique. EFT is an energy psychology tool that uses tapping and acupuncture meridians to help resolve the emotional factors that contribute to less-than-optimal health.
If you’re already using the above six strategies, and still want additional support for your joints, consider using a ‘joint-specific’ supplement.* I’ll talk about the one I recommend in a moment.
But first, allow me to discuss the joint support supplement everyone talks about – which many believe is not effective.

What You Should Know About Glucosamine and Chondroitin

For the past decade, people have been rushing on board the glucosamine and chondroitin train for joint care.
Yet, many are unhappy with it, or experience health problems from it.
Why? Learn more at http://products.mercola.com/joint-support/?source=nl

Wednesday, May 11, 2011

Cardiovascular Benefits of Vitamin D

1. J Clin Lipidol. 2010 Mar-Apr;4(2):113-9. Epub 2010 Feb 6.

Vitamin D is associated with atheroprotective high-density lipoprotein profile in postmenopausal women.

Kazlauskaite R, Powell LH, Mandapakala C, Cursio JF, Avery EF, Calvin J.

Source

Department of Preventive Medicine, Rush University Medical Center, 1700 W. Van Buren St, Ste 470, Chicago, IL 60612, USA. rasa_kazlauskaite@rush.edu

Abstract

BACKGROUND:

Low vitamin D has been associated with low levels of high-density lipoprotein (HDL) cholesterol, a marker of coronary risk. Whether atheroprotective HDL particle composition accounts for this association and whether fat affects this association is not known.

OBJECTIVE:

To explore the association between HDL particle composition and 25-hydroxy vitamin D (25[OH]D) in post-menopausal women.

METHODS:

Vitamin D levels and lipoprotein composition were assessed in fasting blood samples of apparently healthy women from a diverse Chicago community. Visceral (VAT) and subcutaneous (SAT) abdominal fat area were assessed using computed tomography. Total body fat mass was measured by dual-energy X-ray absorptiometry.

RESULTS:

We enrolled 78 women (50% black; 50% white), age 48 to 64 years, all of whom were participants in a longitudinal study of fat patterning. They had a mean 25[OH]D of 31 ± 15 μg/L, HDL cholesterol 57±11 mg/dL, and large HDL particle subclass 8.6±3.4 μmol/L. In a multivariable-adjusted regression model, each 5 μg/L higher 25[OH]D predicted 0.57 μmol/L (95%CI 0.20-0.95) higher large HDL particles, independent of race, season, and total HDL particle concentration. This association was only partially confounded by total body fat mass (0.49, 95%CI 0.10-0.89), SAT (0.50, 95%CI 0.11-0.90), or VAT (0.37, 95%CI 0.01-0.74). Age did not significantly influence the strength of associations.

CONCLUSIONS:

Higher 25[OH]D levels are associated with large HDL particles. This association is stronger than that of HDL cholesterol and only partially confounded by body fat. Theoretically, vitamin D may protect against cardiovascular risk by promoting formation of large HDL particles, affecting reverse cholesterol transport.
Copyright © 2010 National Lipid Association. Published by Elsevier Inc. All rights reserved.



PMID:




21122638
[PubMed - indexed for MEDLINE]

Monday, May 9, 2011

Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds.


The New York Times


  •  
    Many studies have shown the benefits of a salt-restricted diet in treatment of hypertension. The study mentioned in this article examined patients who did not have a pre-existing diagnosis of hypertension. Though it has its flaws, it is certainly interesting to read up on what the investigators found in terms of salt restriction and hypertension. Happy reading!
    Brooke H


    This copy is for your personal, noncommercial use only. You can order presentation-ready copies for distribution to your colleagues, clients or customers here or use the "Reprints" tool that appears next to any article. Visit www.nytreprints.com for samples and additional information. Order a reprint of this article now.


    May 3, 2011 
    Low-Salt Diet Ineffective, Study Finds. Disagreement Abounds. 

    A new study found that low-salt diets increase the risk of death from heart attacks and strokes and do not prevent high blood pressure, but the research’s limitations mean the debate over the effects of salt in the diet is far from over.

    In fact, officials at the Centers for Disease Control and Prevention felt so strongly that the study was flawed that they criticized it in an interview, something they normally do not do.
    Dr. Peter Briss, a medical director at the centers, said that the study was small; that its subjects were relatively young, with an average age of 40 at the start; and that with few cardiovascular events, it was hard to draw conclusions. And the study, Dr. Briss and others say, flies in the face of a body of evidence indicating that higher sodium consumption can increase the risk of cardiovascular disease.
    “At the moment, this study might need to be taken with a grain of salt,” he said.
    The study is published in the May 4 issue of The Journal of the American Medical Association. It involved only those without high blood pressure at the start, was observational, considered at best suggestive and not conclusive. It included 3,681 middle-aged Europeans who did not have high blood pressure or cardiovascular disease and followed them for an average of 7.9 years.
    The researchers assessed the participants’ sodium consumption at the study’s start and at its conclusion by measuring the amount of sodium excreted in urine over a 24-hour period.  All the sodium that is consumed is excreted in urine within a day, so this method is the most precise way to determine sodium consumption.
    The investigators found that the less salt people ate, the more likely they were to die of heart disease — 50 people in the lowest third of salt consumption (2.5 grams of sodium per day) died during the study as compared with 24 in the medium group (3.9 grams of sodium per day) and 10 in the highest salt consumption group (6.0 grams of sodium per day).  And while those eating the most salt had, on average, a slight increase in systolic blood pressure — a 1.71-millimeter increase in pressure for each 2.5-gram increase in sodium per day — they were no more likely to develop hypertension.
    “If the goal is to prevent hypertension” with lower sodium consumption, said the lead author, Dr. Jan A. Staessen, a professor of medicine at the University of Leuven, in Belgium, “this study shows it does not work.”
    But among the study’s other problems, Dr. Briss said, its subjects who seemed to consume the smallest amount of sodium also provided less urine than those consuming more, an indication that they might not have collected all of their urine in an 24-hour period.
    Dr. Frank Sacks of the Harvard School of Public Health agreed and also said the study was flawed.
    “It’s a problematic study,” Dr. Sacks said. “We shouldn’t be guiding any kind of public health decisions on it.”
    Dr. Michael Alderman, a blood pressure researcher at Albert Einstein College of Medicine and editor of the American Journal of Hypertension, said medical literature on salt and health effects was inconsistent. But, Dr. Alderman said, the new study is not the only one to find adverse effects of low-sodium diets. His own study, with people who had high blood pressure, found that those who ate the least salt were most likely to die.
    Dr. Alderman said that he once was an unpaid consultant for the Salt Institute but that he now did no consulting for it or for the food industry and did not receive any support or take any money from industry groups.
    Lowering salt consumption, Dr. Alderman said, has consequences beyond blood pressure. It also, for example, increases insulin resistance, which can increase the risk of heart disease.
    “Diet is a complicated business,” he said. “There are going to be unintended consequences.”
    One problem with the salt debates, Dr. Alderman said, is that all the studies are inadequate. Either they are short-term intervention studies in which people are given huge amounts of salt and then deprived of salt to see effects on blood pressure or they are studies, like this one, that observe populations and ask if those who happen to consume less salt are healthier.
    “Observational studies tell you what people will experience if they select a diet,” Dr. Alderman said. “They do not tell you what will happen if you change peoples’ sodium intake.”
    What is needed, Dr. Alderman said, is a large study in which people are randomly assigned to follow a low-sodium diet or not and followed for years to see if eating less salt improves health and reduces the death rate from cardiovascular disease.
    But that study, others say, will never happen.
    “This is one of those really interesting situations,” said Dr. Lawrence Appel, a professor of medicine, epidemiology and international health at Johns Hopkins Medical Institutions. “You can say, ‘O.K., let’s dismiss the observational studies because they have all these problems.’ ” But, he said, despite the virtues of a randomized controlled clinical trial, such a study “will never ever be done.” It would be impossible to keep people on a low-sodium diet for years with so much sodium added to prepared foods.
    Dr. Briss adds that it would not be prudent to defer public health actions while researchers wait for results of a clinical trial that might not even be feasible.
     Dr. Alderman disagrees.
    “The low-salt advocates suggest that all 300 million Americans be subjected to a low-salt diet. But if they can’t get people on a low-salt diet for a clinical trial, what are they talking about?”
    He added: “It will cost money, but that’s why we do science. It will also cost money to change the composition of food.”


    Saturday, May 7, 2011

    So You Want to Be a Doctor?


    May 5, 2011, 12:01 am  
    original link: http://well.blogs.nytimes.com/2011/05/05/a-better-medical-school-admissions-test/?ref=health

    A Better Medical School Admissions Test

    Jesus Jauregui/Getty Images
    Recently the college-age daughter of a friend talked to me about her dream of becoming a doctor. She was doing well as a psychology major and in her pre-medical courses, was working as a research assistant for a pediatrician at a nearby medical school and volunteered on the cancer ward at a children’s hospital.
    I was impressed.
    But her enthusiasm dipped sharply when she told me she was preparing for the MCATs, the Medical College Admission Test, the required standardized test that measures mastery of the pre-medical curriculum. She was putting all her extracurricular work on hold so she could focus on reviewing biology, physics, chemistry and organic chemistry for the exam. “Does my ability to memorize the Krebs cycle and Bernoulli’s equation really have anything to do with what kind of doctor I’ll be?” she asked.
    The answer, it turns out, is yes — and no.
    The first MCAT, then referred to as the Scholastic Aptitude Test for Medical Schools, was administered in 1928 and represented an effort to address the significant medical school dropout rates of the time. Up until that point, medical school applicants had been evaluated, and accepted, on the basis of stray bits of biographical information, random letters of endorsement, a few prior grades or the existence of a high school diploma. As many as half of those accepted eventually quit, resulting in huge losses of time, energy, educational resources and money. But thanks in part to the MCAT, by the mid-1940s the medical school attrition rate had plummeted to less than 10 percent, even as the standardized exam was becoming a much-maligned rite of passage for aspiring young doctors.
    Over the years, the MCAT has gone through four major revisions and has only strengthened its ability to predict success in medical school, particularly when evaluated in combination with grades. Each year more than 70,000 students take the exam, vying for a little more than 19,500 medical school slots. These days, fewer than 4 percent of those finally accepted drop out.
    But the MCAT has had one major failing in its otherwise brilliant performance: It has been unable to consistently predict personal and professional characteristics. As early as 1946, medical educators were trying to design the MCAT in a way that might tease out such information, but they, and those who followed, were unable to succeed.
    Now the MCAT is about to undergo its fifth revision, the first in nearly 25 years. Last month, the Association of American Medical Colleges, the national organization that administers the MCAT, released the preliminary recommendations of a 22-member advisory committee that has been studying the issue for the last three years. They recommend, among other things, lengthening the four-and-a-half hour exam by 90 minutes and adding questions on disciplines like sociology and psychology. The new exam would also test analytical and reasoning skills in areas like ethics, philosophy and cross-cultural studies, which could include questions about how someone living in a particular demographic situation, for example, might perceive and interact with others.
    Despite what some view as a long overdue re-examination of this linchpin of medical school admissions, many medical educators, including members of the advisory committee, remain cautious about tampering with a test that has proved successful so far.
    “It’s like trying to improve a Honda,” said Dr. Ronald D. Franks, vice chairman of the committee and vice president of health sciences at the University of South Alabama College of Medicine in Mobile. “When you’ve got something that’s working extremely well, you can make improvements, but you’ve got to be mindful of the services it has rendered.”
    Those services can be gargantuan. Jefferson Medical College in Philadelphia, for example, receives almost 10,000 applications each year and must whittle those numbers down to 800 for interviews for the 260 available slots in each class. In combination with grades, the MCAT can help admissions officers eliminate a quarter of the applications.
    “But we and other medical schools have so many great applications from the standpoint of just numbers that we usually also need to go through other parts of the application as well,” said Dr. Clara A. Callahan, dean of student affairs and admissions at Jefferson and the lead author of one of the largest longitudinal studies on the predictive validity of the MCAT. “You want to make sure someone isn’t just saying that he or she wants to help people.”
    It’s likely that Dr. Callahan and other medical school admissions officers will have to continue to look beyond the MCAT to learn more about their applicants’ personal qualities. The science of personality testing has advanced tremendously over the last 25 years, but the committee felt it was still unclear how accurately a test could predict traits like integrity, altruism and the ability to collaborate. Some members were uncomfortable, too, with the long-term implications. “Will we end up labeling someone forever with a 9.2 for their personality?” Dr. Franks asked.
    Only time will tell whether this newest version succeeds where earlier ones have not. But one thing is certain: Taking the MCAT is likely to remain a rite of passage for doctors-to-be for years to come.
    “The reality is that we doctors are taking standardized tests – in-service exams, board exams, recertification exams – all our life,” Dr. Callahan said. “It’s something people have to master in medical school and beyond, so it’s nice to be able to accurately predict at the outset how someone will do with them in medical school and beyond.”
    The MCAT advisory committee is continuing to solicit opinions through its Web site until February. The new exam will be administered beginning in 2015.

    Monday, May 2, 2011

    CranioSacral Therapy

    I just completed CranioSacral Therapy I training through the Upledger Institute, http://www.upledger.com

    This powerful modality offers practitioners and patients alike a different approach to working with physical restrictions in the body. There are a lot of differing opinions on the validity of CranioSacral Therapy, as its mechanism of action is not fully understood.

    Though the best place to read about CranioSacral Therapy is from the leaders in training themselves at Upledger Insitute, even Wikipedia has something to say about it!  I found some of this information helpful in understanding the history and basics of this modality.
    Original Link: http://en.wikipedia.org/wiki/Craniosacral_therapy



    Craniosacral therapy (also called CST, also spelled Cranial Sacral bodywork or therapy) is an alternative medicine therapy used by osteopaths, massage therapists, naturopaths, and chiropractors. A craniosacral therapy session involves the therapist placing their hands on the patient, which allows them to tune into what they call the craniosacral rhythm. The practitioner claims to gently work with the spine and the skull and its cranial sutures, diaphragms, and fascia. In this way, the restrictions of nerve passages are said to be eased, the movement of cerebrospinal fluid through the spinal cord is said to be optimized, and misaligned bones are said to be restored to their proper position. Craniosacral therapists use the therapy to treat mental stress, neck and back pain, migraines, TMJ Syndrome, and for chronic pain conditions such as fibromyalgia Several studies have reported that there is little scientific support for the underlying theoretical model for which no properly randomized, blinded, and placebo-controlled outcome studies have ever been published.

    History 

    Cranial Osteopathy was originated by physician William Sutherland, DO (1873-1954) in 1898-1900. While looking at a disarticulated skull, Sutherland was struck by the idea that the cranial sutures of the temporal bones where they meet the parietal bones were "beveled, like the gills of a fish, indicating articular mobility for a respiratory mechanism."


    Sutherland stated the dural membranes act as 'guy-wires' for the movement of the cranial bones, holding tension for the opposite motion. He used the term reciprocal tension membrane system (RTM) to describe the three Cartesian axes held in reciprocal tension, or tensegrity, creating the cyclic movement of inhalation and exhalation of the cranium. The RTM as described by Sutherland includes the spinal dura, with an attachment to the sacrum. After his observation of the cranial mechanism, Sutherland stated that the sacrum moves synchronously with the cranial bones. Sutherland began to teach this work to other osteopaths from about the 1930s, and continued to do so until his death. His work was at first largely rejected by the mainstream osteopathic profession as it challenged some of the closely held beliefs among practitioners of the time.

    In the 1940s the American School of Osteopathy started a post-graduate course called 'Osteopathy in the Cranial Field' directed by Sutherland, and was followed by other schools. This new branch of practice became known as "cranial osteopathy". As knowledge of this form of treatment began to spread, Sutherland trained more teachers to meet the demand, notably Drs Viola Frymann, Edna Lay, Howard Lippincott, Anne Wales, Chester Handy and Rollin Becker. The Cranial Academy was established in the US in 1947, and continues to teach DOs, MDs, and Dentists "an expansion of the general principles of osteopathy" including a special understanding of the central nervous system and primary respiration. Towards the end of his life Sutherland believed that he began to sense a "power" which generated corrections from inside his patients' bodies without the influence of external forces applied by him as the therapist. Similar to Qi and Prana, this contact with, what he perceived to be the Breath of Life changed his entire treatment focus to one of spiritual reverence and subtle touch.This spiritual approach to the work has come to be known as both 'biodynamic' craniosacral therapy and 'biodynamic' osteopathy, and has had further contributions from practitioners such as Becker and James Jealous (biodynamic osteopathy), and Franklyn Sills (biodynamic craniosacral therapy). The biodynamic approach recognizes that embryological forces direct the embryonic cells to create the shape of the body, and places importance on recognition of these formative patterns for maximum therapeutic benefit, as this enhances the ability of the patient to access their health as an expression of the original intention of their existence.

    From 1975 to 1983, osteopathic physician John E. Upledger and neurophysiologist and histologist Ernest W. Retzlaff worked at Michigan State University as clinical researchers and professors. They set up a team of anatomists, physiologists, biophysicists, and bioengineers to investigate the pulse he had observed and study further Sutherland's theory of cranial bone movement. Upledger and Retzlaff went on to publish their results, which they interpreted as support for both the concept of cranial bone movement and the concept of a cranial rhythm. Later reviews of these studies have concluded that their research is of insufficient quality to provide conclusive proof for the effectiveness of craniosacral therapy and the existence of cranial bone movement.

    Upledger developed his own treatment style, and when he started to teach his work to a group of students who were not osteopaths he generated the term 'CranioSacral therapy', based on the corresponding movement between cranium and sacrum. Craniosacral therapists often (although not exclusively) work more directly with the emotional and psychological aspects of the patient than osteopaths working in the cranial field.

    Craniosacral Therapy Associations have been formed in the UK, North America, and Australia

    The primary respiratory mechanism

    The Primary Respiratory Mechanism (PRM) has been summarized in five ideas.

    Inherent motility of the central nervous system

    The inherent motion of the brain is described as a "dynamo," beginning with the cerebellum. The postulated intracranial fluid fluctuation can be described as an interaction between four main components: arterial blood, capillary blood (brain volume), venous blood and cerebrospinal fluid (CSF). The function of such a mechanism is postulated by Lee as being based on a fulcrum created by the root of the cerebellum and its hemispheres moving in opposite directions, resulting in an increase in pressure which squeezes the third ventricle. The pulsation is described as essentially a recurrent expression of the embryological development of the brain.

    Fluctuation of the cerebrospinal fluid

    Sutherland used the term "Tide" to describe the inherent fluctuation of fluids in the Primary Respiratory Mechanism. Tide alludes to the concept of ebbing and flowing, but also the contrast between waves on the shore having one rhythm, with the longer rate of lunar tides below. The Tide incorporates not only fluctuation of the CSF, but of a slow oscillation in all the tissues of the body, including the skull.
    Practitioners work with cycles of various rates:
    • 10-14 cycles per minute - the original "Cranial Rhythmic Impulse" (CRI) (also described as 6-14 times per minute)
    • 2-3 cycles per minute - the "mid-Tide"
    • 6 cycles every 10 minutes - the "long Tide"
    In 1960 Lundberg made a continuous recording of intracranial activities of traumatised patients, finding three waves, one of which Lee believes resembles the CRI. There is research which demonstrates examiners are unable to measure craniosacral motion reliably, as indicated by a lack of interrater agreement among examiners. The authors of this research conclude this "measurement error may be sufficiently large to render many clinical decisions potentially erroneous". Alternative medicine practitioners have interpreted this result as a product of entrainment between patient and practitioner, a principle which lacks scientific support. Another study reports craniosacral motion cannot be reliably palpated.

    Mobility of the intracranial and intraspinal dural membranes

    In 1970, Upledger observed during a surgical procedure on the neck what he described as a slow pulsating movement within the spinal meninges. He attempted to hold the membrane still and found that he could not due to the strength of the action behind the movement.
    It has been theorized that during[who?] craniosacral treatment the membranes act as a fulcrum for fascial restrictions throughout the body, and craniosacral therapists may perceive a change in quality as a result of disturbance such as infection or allergic irritation.

    Mobility of the cranial bones

    Cranial sutures are almost immobile after fusion, inhibiting movement between cranial bones. According to Lee (2005), this understanding arose in the mid-1900s and was misinterpreted from the work of authors hoping to correlate suture closure with the chronological age of a skull in archaeological specimens. Lee suggests the authors found there was no correlation between suture closure and the chronological age of the individual, and also most skulls demonstrated no suture closure at all except as structural evidence of pathological physical trauma. Lee cites many references giving evidence for mobility in human skulls, and modern anatomy books suggest incomplete fusion of some sutures. According to Gray's Anatomy, "[w]hen such sutures are tied by sutural ligament and periosteum, almost complete immobility results."

    Cranial textbooks propose that motion of the skull is possible during flexion and extension because the sutures are mobile. The sphenobasilar synchondrosis (SBS) - the junction between the base of the sphenoid and the occiput- is thought to fuse by the mid- to late twenties, but still retain limited mobility . An alternative theory to SBS Motion taught in craniosacral training suggests that sutures are "lines of folding", like pre-folded marks on cardboard, rather than necessarily being fully open.

    Craniosacral Treatment

    A typical craniosacral therapy session is performed with the client fully clothed, in a supine position, and usually lasts about one hour. In the Upledger method of craniosacral therapy, a ten-step protocol serves as a general guideline, which includes (1) analyzing the base (existing) cranial rhythm, (2) creating a still point in that rhythm at the base of the skull, (3) rocking the sacrum, (4) lengthening the spine in the lumbar-sacral region, (5) addressing the pelvic, respiratory and thoracic diaphragms, (6) releasing the hyoid bone in the throat, and (7-10) addressing each one of the cranial bones. The practitioner may use discretion in using which steps are suitable for each client, and may or may not follow them in sequential order, with time restraints and the extent of trauma being factors.
    The therapist places their hands lightly on the patient's body, tuning in to the patient by ‘listening’ with their hands or, in Sutherland's words, "with thinking fingers". A practitioner's feeling of being in tune with a patient is described as entrainment. Patients often report a sense of deep relaxation during and after the treatment session, and may feel light-headed. This is popularly associated with increases in endorphins, but research shows the effects may actually be brought about by the endocannabinoid system.
    There are few reports of Adverse side effects from CST treatment. In one study of craniosacral manipulation in patients with traumatic brain syndrome, the incidence of adverse effects from treatment was 5%.

    Criticisms

    There are extensive criticisms of cranialsacral therapy from the scientific and health care professions as to the validity and efficacy of Cranial Type techniques and principles. The following criticisms are cited against this form of therapy.
    • Lack of evidence cranialsacral therapy provides a therapeutic benefit
    • Lack of evidence for the existence of "cranial bone movement":
    Scientific evidence does not support the theories for cranial bone movement claimed by craniosacral practitioners. This research shows that partial fusion between cranial bones occurs during growth and development.
    • Lack of evidence for the existence of the "cranial rhythm":
    While evidence exists for cerebrospinal fluid pulsation, one study states it is caused by the functioning of the cardiovascular system and not by the workings of the craniosacral system.
    • Lack of evidence linking "cranial rhythm" to disease:
    Research to date to support the link between the "cranial rhythm" and general health is cited as "low grade" and "unacceptable to meet scientific measures".
    • Lack of evidence "cranial rhythm" is detectable by practitioners:
    While studies have reported evidence of the existence of the primary respiratory rhythm, the link between any such mechanism and states of health or disease has also been contested. One meta-analysis from the British Columbia Office of Health Technology Assessment (BCOHTA) concluded that "there is evidence for a craniosacral rhythm, impulse or 'primary respiration' independent of other measurable body rhythms", however it was noted that "these and other studies do not provide any valid evidence that such a craniosacral 'rhythm' or 'pulse' can be reliably perceived by an examiner" and that "The influence of this craniosacral rhythm on health or disease states is completely unknown." The examiners concluded (1) there is little science in any aspect of cranial of the PRM; (2) the only publication purporting to show diagnostic reliability with sufficient detail to permit evaluation is deeply flawed and stands alone against other reports that show reliabilities of zero; and (3) there is no scientific evidence of treatment efficacy.
    Operator interreliability has been very poor in studies that have been done. Five studies showed an operator interreliability of zero. In a report to the British Columbia Office of Health Technology Assessment one study in this report shows some operator interreliability but has been criticized as deeply flawed.

    Regulation

    In the United Kingdom, resulting from a regulation programme facilitated by The Prince's Foundation for Integrated Health, craniosacral therapy is to be regulated on a voluntary basis by the Complementary and Natural Healthcare Council (CNHC) from late 2009 onwards. The standards of competence required for registration are craniosacral therapy techniques plus hands on practice, anatomy and physiology, business, legal and ethical issues. Registrants must have full public and professional liability insurance and annual continuing professional development is a condition of re-registration.

    Monday, April 25, 2011

    North Dakota Licenses Naturopathic Doctors!

    Thanks to much hard work and committed individuals, Naturopathic Doctors will now be licensed to practice medicine in my home state of North Dakota. This process of introducing the bill to the legislature began just a short few months ago at the beginning of 2011, and is now a reality!

    Read about the amazing work of doctors, students and helpful and willing individuals!

    North Dakota Licenses Naturopathic Doctors!   
    By Gene McGill, Director of State Government Relations

    The North Dakota Legislative Assembly has passed SB 2271 for the licensure of naturopathic physicians and, as of this printing, the bill has made its way to the governors office and is schedule to be signed by North Dakota Governor Jack Dalrymple.

    Congratulations to all involved in this tremendous accomplishment!

    There is a saying that to get legislation passed you need a good sponsor, a good grassroots operation, and a good lobbyist. All those things were present in the passage of SB 2271. Senators Margaret Sitte and Tim Mathern worked in a bipartisan manner to move the legislation through the chambers. Upon passage, Senator Sitte said, “I’m so happy for our state that we have a new tool in medical care.”
    North Dakota Association of Naturopathic Doctors President Faye Johnson, Treasurer Lezlie Link and Beth Allmendinger, ND Candidate (Bastyr), were crucial in the grassroots operation of finding additional sponsors, gathering community support, and the executing the email campaign. Also lending support were Kathleen Allen, ND, and Stephanie Nishek, ND. Special thanks to the other students who joined in the grassroots organization Sara: Christopherson (Bastyr), Brooke Halgren (NCMN), Scott Just (SCNM), and Sara Larson (NCMN).

    The lobbying, planning, and organizing the push for licensure was all the work of Beth Allen, ND. Beth also serves as the secretary of NDAND. She worked tirelessly over the past several months to defend the bill, present testimony, and work with the legislature to ensure changes did not compromise the final legislation. Beth personally spent in excess of four hundred hours this year working on licensure.

    SB 2271 will create “the state board of integrative health care.” The board will consist of a minimum of five members. Each profession regulated by the board must have one member on the board. Additionally, the board will consist of an MD or DO, a pharmacist, an advanced practice nurse, and up to two laypersons. A subgroup must be established for each profession being regulated with three to five members, all licensed or licensable in the regulated profession. The board as a whole may take no action that impacts a regulated profession unless they first consult with the subgroup.

    The practice of naturopathic health care in North Dakota will permit nonprescriptive natural therapeutic substances, food, vitamins, dietary supplements, topical drugs, health-care counseling, nutritional counseling, and barrier devices for contraception. Naturopathic doctors may also perform or order for diagnostic purposes a physical or orificial examination, ultrasound, phlebotomy, clinical laboratory tests, and any other noninvasive diagnostic procedure commonly used by physicians in general practice and authorized by the board.

    SB2271 offers NDs in North Dakota a very solid base to build upon. Congratulations again to everyone that that worked so hard to make it happen.

    http://ndsfornys.com/blogs/blog/2011/04/23/north-dakota-licenses-naturopathic-doctors/


    Friday, April 22, 2011

    Published on Environmental Working Group (http://www.ewg.org)
     
    Prenatal Pesticide Exposure Linked to Diminished IQ

    Some Popular Fruits and Vegetables Contain Highest Levels

    Published April 21, 2011
    Washington, D.C. – Arriving at stunningly similar conclusions, a trifecta of studies published today (April 21) have each shown a connection between prenatal exposure to organophosphate pesticides and diminished IQs in children between the ages of 6 and 9.
    Researchers at Mt. Sinai School of Medicine, University of California Berkeley’s School of Public Health and Columbia University’s Mailman School of Public Health separately recruited pregnant women and tested either their urine during pregnancy or umbilical blood after birth. The Columbia researchers measure levels of the pesticide chlorpyrifos in cord blood samples, while the teams from Berkeley and Mt. Sinai tested urine for metabolites of organophosphate pesticides.
    All three studies are available for free and online at the Environmental Health Perspectives website [1].
    Between 1999 and 2003, EPA put in place restrictions on the most toxic organophosphate pesticides on crops and in homes. In 2006 the Agency concluded those restrictions would be sufficient to protect children’s health, but these studies show further restrictions over the use of organophosphates in agriculture may be necessary to protect kid's health.
    “For years, EPA used complex models to assure us that pesticide exposures were safe,” said Environmental Working Group senior scientist Sonya Lunder. “These studies strongly suggest that kids remain at risk. The next time EPA and the pesticide industry tell you all is well with the food system, don’t rush to believe them.”
    “Organophosphates have been associated with learning delays and ADHD in children,” Lunder added. “But the fact that three separate studies arrived at such similar conclusions is overwhelming evidence that this family of pesticides presents profound and very serious health risks to children before they’re even born.”
    Each year, the U.S. Department of Agriculture extensively tests fruits and vegetables for pesticide residues. The tests are conducted after each sample has been washed as if being prepared to eat or cook. Environmental Working Group (EWG) compiles USDA’s [2] data and ranks the most popular fruits and vegetables according to the levels of overall pesticide residues. Here are the 12 with the highest and lowest levels of pesticide residues From EWG’ 2010 Shopper’s Guide. The 2011 Guide will be out soon once USDA releases its latest round of produce testing.
    Highest Levels Lowest Levels
    Celery
    Peaches
    Strawberries
    Apples
    Blueberries
    Nectarines
    Bell Peppers
    Spinach
    Cherries
    Kale/Collard Greens
    Potatoes
    Grapes (imported)
    Onions
    Avocado
    Sweet Corn
    Pineapple
    Mangos
    Sweet Peas
    Asparagus
    Kiwi
    Cabbage
    Eggplant
    Cantaloupe
    Watermelon

    Some tips to avoid or reduce exposure to organophosphate pesticides:
    1. Organic produce is becoming much more available and the price gap between it and conventionally grown fruits and vegetables has narrowed somewhat, but buying organic can be a burden on families on tight budgets. EWG’s online Shopper’s Guide to Pesticides [3] provides an easy-to-use list of non-organic items that have the lowest levels of pesticide residues. EWG recommends sticking to those fruits and vegetables whenever possible.
    2. Wash, wash, wash: Washing conventional produce won’t remove all of the residues, but it does make a difference. Wash all fruits and vegetables before serving.
    3. Eating fruits and vegetables is an essential part of a healthy diet, but we recommend women who are pregnant choose organic produce or conventional fruits and veggies with the lowest levels of pesticide residues.
    4. Eat food that is in season. It is more likely to be grown domestically where there are tighter restrictions on organophosphate pesticide use (as opposed to abroad).
    EWG is a nonprofit research organization based in Washington, DC that uses the power of information to protect human health and the environment. http://www.ewg.org [4]