Events in 2020 have been anything but calming! Add to the mix an election where emotions are flying high with extreme anxiety and stress! Irrespective of  which party you vote for,  whether you have or haven't voted yet, it appears that almost everyone is experiencing anxiety over the anticipation of the final result. Therefore, I decided to share some of the calming remedies we often recommend for our patients who suffer from episodic or chronic anxiety. I doubt anyone is going to be away from social media  or news channels for too long tomorrow, but if and when you do feel like taking a break and a nap won't help (or won't happen due to your racing thoughts!), consider one of these remedies to take the edge off! 

1. Enjoy a cup of Chamomile tea (Matricaria recutita). A soothing herb that in tea form that has been shown in several studies to help with calming anxious thoughts. Tea bags are easily available in most grocery stores and the tea can be brewed in few minutes!
2. Spray or dab some Lavender essential oil around your home. Lavender (Lavandula angustifolia) has been documented to decrease anxiety, lower blood pressure and stabilize mood and heart rate in anxiety triggering situations like dental surgery! Is the fear of dental surgery comparable to the anticipation stress in an election? That's for you to decide!
3. Use Rescue Remedy! This wonderful Bach Flower essence mix is designed to calm an anxious mind and has been used for long time in the European countries, and research indicates that it is considered at some nursing centers as a less disruptive (due to less or no side effects) alternative to anxiolytic medications.
4. Listen to your favorite music! I know you do not need studies or any kind of research to confirm that your mind feels at ease as soon as you hear calming music or your favourite music. Several studies have been done to document the anxiety lowering effect of music in both pre and post surgical patients, women in labor, patients with Alzheimer's disease and even cancer patients; these are just few of the many areas of study between music and anxiety.
5. Step outdoors and go for a walk/hike/bike ride. Being in nature and away from constant updates on social media/news channels, just doubles the benefit of the exercise! Your heart and brain will thank you!
6. STOP! Don't grab that candy or chips!! or those cheesy, salty nachos! This wouldn't be my blog if the gut microbiome did not get at least a mention!! The salty and sugary cravings that you experience when under stress are nothing but a "short-cut" that your brain is seeking to feel comforted, as those foods will lead your brain's reward centers to light up instantly, covering up any underlying grief/ anxiety! What's the problem with that? More than one! Eating those foods may make your feel distracted (yes!) from your real emotions, but the high fat, sugar, salt will also wreak havoc on your gut, liver, kidneys and of course your heart health! So what can you snack on? All snacks that you keep at home or literally within arm's reach should be 'wise choices' and there are plenty to list. Have some salted nuts or pumpkin seeds if you like and many even a power bar sweetened with dates - this way you will leave out the deep-fried and sugar added packaged stuff filled with trans fats, additives and whole lot of things that will make your gut and then your brain, very unhappy! There is so much more to the gut-brain axis than what this blog can cover - more on this some other time. If you would like to learn more right away, check out this article.
7. Diaphragmatic Breathing. Research reveals that different types of breathing techniques can help calm an anxious mind, including just plain deep breathing. Here's how I have made the importance of deep breathing at least once a day obvious to my mind: Breathing is what keeps you alive, in short, 'breath is life' and if you can control your breathing pattern, it just begins to feel like you have control over your life (even if only for a few minutes)! 

There are several other herbs, teas and  lifestyle remedies that we could share but that would require writing a book rather a blog post as I wouldn't be able to fit it all here! We at Core Integrative, hope that these 7 simple strategies will help you get through the stress, anticipation and anxiety that comes with today's Election Day.

IMPORTANT REMINDER: If your anxiety and/or mood swings are not limited and attributed to anticipation on election day, but are present year long and are starting to affect your relationships, work productivity and other aspects of your life, it may be time to discuss these symptoms with your doctor. Mental health symptoms are often ignored or remain undiagnosed due to several reasons including but not limited to:

• social stigma
  
• inability to 'see' the symptoms, unlike physical symptoms such as a rash
  
• often insidious onset of symptoms.  

If you would like us to help with your symptoms, we are only an email or phone call away!

In our practice, we often see patients who are suffering from symptoms that seem to have no apparent cause, and even after extensive test and (somes painful!) procedures like endoscopies, colonoscopies etc., have no definitive diagnosis and/or answers!
Don't be spooked by such a scenario! For it is very likely that the answer lies in an area that has not been investigated and all pieces of your health puzzle haven't been put together yet!
Fortunately, with functional tests and a ‘patient-centered’ approach we are able to
de-mystify many such symptoms! It is best to have Functional tests done in addition to conventional lab tests since they can reveal malfunction and deficiencies in organ systems way before an overt disease states develops, i.e., at the onset of your symptoms. Did you know that it takes anywhere between 5-10 years from initial blood sugar disruption symptoms, for a patient to receive a diagnosis of diabetes? Another way to look at this fact is, that a person has several years to prevent getting diagnosed with diabetes, if appropriate early screening is performed and interventions such as lifestyle and diet modification are implemented right away!

In summary, many chronic diseases are preventable and being aware that ‘mysterious’ symptoms  maybe be the early signs of such diseases, should be investigated and addressed rather than being ignored. It is important to note that some symptoms may be occurring due to a combination of factors affecting a person's health.
 
Below is a list of some common symptoms that we have been able to ‘demystify’ for our patients who had been through extensive testing before coming into  our office and still did not have any answers:
 

• Irritable bowels of all kinds! This can cause restrictive food intake (patients are afraid to eat!) and lead to nutrient deficiencies.
• Fatigue. Sometimes fatigue maybe masked by a person’s excessive caffeine intake. Do you need 3-4 cups of coffee a day to get through?
• Numbness or tingling of fingers and/or toes. This can be sudden or slow onset and may have a structural or metabolic cause.
• Chronic headaches or migraines with or without triggers.
• Joint pain even without  excessive movement /force on joints.
• Rashes or Hives or Itching that appear without a trigger.
• Sinus pressure and fullness that does not resolve with over the counter or even prescription medications.
• Dizziness with or without change in position.
• Chest pain that persists even after cardiac and lung involvement has been thoroughly checked and ruled out.
• ‘Brain fog’ or difficulty focusing on tasks
• Mood swings/changes  that are affecting social and family interactions
• Excessive perspiration with or without odor
  
  

​If you are experiencing one or more of these symptoms, the best course of action is to  contact your current healthcare provider or our office so that we can “see the whole picture” and implement appropriate care as soon as possible! If you have been through several specialists and practitioners, and still haven't found answers, it is time to consider putting all the data together with a naturopathic medicine!

Why is it known as the "Silent Killer"?
Hypertension is often referred to as the ‘silent killer’ in the medical world, as many individuals, completely unaware of it prior to their diagnosis. It is ‘silent’ because symptoms may not always be present and when they do manifest, they may be occasional and mild, typically ignored and attributed to external factors for example, a stressful day, sinus congestion, dehydration, strenuous activity and such.
Elevated BP is often detected either when an individual without symptoms goes in for a routine visit at their doctor’s office or at the other extreme, when their symptoms are at the worst and they end up in the ER!

If it is silent, what can I do? How do I know when I need to be worried?
Though symptoms may not always correlate to elevated BP, presence of minor symptoms causing annoyance or discomfort warrants immediate monitoring, especially if one or more of the risk factors mentioned further below are present.
Being aware of your numbers and regular communication and check-ins with your doctors, can ensure early detection and appropriate management. And here’s the good news: Hypertension is preventable and in many cases, when detected early, can be stopped from getting worse! Hypertension has been classified as a lifestyle disease and can be successfully prevented and/or managed with the consistent implementation of dietary and lifestyle changes, with or without medication, depending on the complexity of the case.
 The symptoms that you should watch out for:

• Headaches
• Fatigue
• Dizzy spells
• Visual changes – blurry vision, floaters
• Racing heart with mild activity or palpitations at rest and activity
• Heavy sensation in chest or chest pain
• Anxious feelings
• Dark urine (may indicate blood in urine)
• Ringing in the ears

Remember that these symptoms may be indicative of other diseases such as thyroid issues, diabetes and or hormone imbalances. If you are experiencing these on a frequent basis, it is critical to go in and see your doctor to rule out hypertension as the cause.
 
What are the risk factors that I need to be aware of?
The following risk factors can affect your blood pressure levels and  are categorized as modifiable versus non-modifiable.
You CANNOT alter the following risk factors, however, being aware them is critical in assessing your susceptibility to hypertension:

• Family history – especially if either of your parents had hypertension, your risk is elevated
• Age-  the older you are the more regularly you need to be screened.
• Sex: Until the age of 64, men are at a higher risk whereas, beyond age 65, women are more likely to be diagnosed (Find out with us why!)
• Race: Multiple studies have indicated that African-Americans are at higher risk

 
The following are factors that you CAN change to put odds in your favor to prevent/manage elevated blood pressure:

• Eat Well.
  • The Mediterranean diet and DASH (Dietary Approaches to Stop Hypertension) have the most convincingly shown evidence to lowering blood pressure and improving all aspects of health related to the heart and circulatory system.
• Keep Moving!!
  • There is no dearth of research and cardiologists who support the fact that regular, consistent exercise is required to maintain a strong heart and lower your BP. Brisk walking is the most commonly recommended form of exercise with patients who have sedentary habits. It is also recommended that you discuss your exercise program with your doctor before you begin to avoid further risks or injury.
• Stop Smoking
  • Depriving your body of oxygen will only increase it’s need for higher blood pressure. If you need help quitting, work with a team of health professionals who can help you.
• Decrease Alcohol Intake
  • More than 2 drinks per day for men and more than 1 drink per day for women have been shown to increase risks for hypertension and cardiovascular events in general. Again, if you need help, work with a team of health professionals to help you wean off.
• Stress Management
  • Having an effective stress management technique for yourself, be it through spending quality time with loved ones, playing your favorite musical instrument or through meditation and breathing, is quite critical when it comes to keeping your BP under check. Online scrolling and playing digital games does not count!
• Sleep Apnea
  • This is a major risk factor that often gets ignored even though it is very highly correlated with hypertension. Even if you do not snore or have no lack of energy, ask your doctor about conducting a sleep study for you, especially if you have family history of cardiac events.
• Co-existing Conditions:
  • Diabetes, Obesity, Elevated cholesterol can all increase your risk of hypertension. The positive side is that lifestyle changes that help with treating hypertension, also help to address these & vice-versa.

In future blogs,I will discuss supplements to discuss with your healthcare practitioner, for both prevention and management of hypertension. Naturopathic medicine through the use of clinical nutrition and lifestyle medicine, can be a safe and effective  way to address hypertension, and related lifestyle diseases. If you would like to find out more, you are always welcome to request a free health consult on our website or by contacting our office via email or phone.
Until next time...this year, take that leap towards a healthier YOU!

It's the season for new beginnings! And many of us are trying to start (and keep!) new habits. At this time of the year, many people decide to eliminate one or more foods or food groups from their daily diet; some do it in pursuit of good health trying to "undo" the holiday overeating, some to get rid of annoying gastrointestinal symptoms like bloating, gas, unpredictable bowels, some others because it's a fresh start to the year and they have been waiting to implement their doctors' recommendations and many others in the hope of losing some weight. No matter what the reason, after 3 weeks of an 'elimination diet', it can be frustrating if you do not notice any positive changes whatsoever! 
There can be multiple reasons why you aren't seeing changes in your health. These are important to consider and address. Here I have listed these reasons in the order of most likely to least likely as I have observed in our clinical practice:
 
Reason#1: The eliminated foods/food groups aren’t problematic for you
Though this may sound like a very obvious reason it can often get ignored. Most elimination diets require you to leave out the “usual suspects” including:
 

• Sugar
• Wheat/gluten containing grains
• Dairy
• Red meat

 
However, in addition to these foods there are other foods that can be potential troublemakers. Since each of us is a genetically unique individual, besides functional deficits, some people may not have the ability to process all components of even seemingly healthy foods like fruits, vegetables, whole grains, nuts and seeds.
Consider getting a food sensitivity panel through your doctor. Food sensitivities are very different than food allergies and the one we offer at our practice tests for over 85 different foods! The information from that the test results reveal can be used to design a more specific elimination diet beneficial for you.
 
Reason#2: Increased intake of processed foods
In an effort to eliminate specific foods, people often start buying packaged foods that are labelled as being compliant to their diet. Labels such as gluten-free, dairy-free, low-fat, paleo etc. are very attractive but it is important not to overlook the actual ingredients list in any packaged food. Multiple chemical additives and preservatives often make their way into “special” packaged foods to help these foods taste and stay good. This is not always the case, but be sure to read the actual ingredients and rely more on fresh foods than packaged foods.
 
Reason#3: Food elimination is not enough!
Let’s say that you have persisted at least 4 weeks with an elimination diet designed based on a food sensitivity panel and have minimized use of packaged foods, and even then, you see no benefit or positive change in your symptoms or overall health- this most likely indicates that food may not be the root cause of your troubles. It is time to look at other factors influencing your health.
A weakened, diseased or sub-optimally functioning digestive system, adrenal or other endocrine imbalances or nutrient deficiencies are important factors to investigate when an elimination diet fails. Once these other factors are addressed, your practitioner may recommend repeating an elimination diet to assess if specific foods can aggravate or cause your symptoms to revert.

As a continuation of my previous blog, here is part 2 of the home cooking series. As a refresher, my goal with this blog series was to provide ideas and suggestions that can help save both time and energy while still keeping your home cooked meals healthy and tasty! Planning your meals 1 or 2 weeks at a time and preparing ingredients for those meals ahead of time takes the stress out of cooking at home. You can schedule  your "meal prep time" on the weekends or on a day of your choosing based on these 2 factors:

1. Assess what's available at home: in the fridge/freezer/ storage/pantry
2. Assess what you need, make a shopping list & get your groceries!

In my practice, there is  chart that patients receive in their initial few visits that helps them write out their meals for the week. It also allows them to complete both 1 & 2 listed above in relatively short time. Though it sounds very intuitive, you may be surprised at your own efficiency when you write/type your grocery list before you venture into the stores! A side- benefit of this exercise is that you are less likely to spend money on items that are not on your list (impulse purchases are more likely to happen if you are at the grocery stores and "planning meals as you go"!). This chart is nothing fancy, but a great organizational tool that helps you visualize the number of meals that you need to prep for & therefore, shop accordingly. I generally recommend that you only prep for one week at a time, as this is generally how long fresh groceries tend to remain usable. Of course, you can prep for 2 weeks at a time, and use the freezer as part of your battle plan...I mean meal plan :)

The meal planning chart has all of the following information: 

• Number of people in the household
  • family member/ friends/ roommates
  • Kids/ adults/ seniors with special needs
• Days of the week 
• All the meals you are prepping, i.e. breakfast, lunch, dinner, snacks
  • Include names of recipes on the chart
• Foods to exclude for allergy, sensitivity, religious or philosophical reasons

Once you have written down your meals and have the ingredients you need, start the meal prepping process! Essentially, your meal prepping strategy will belong to one of these 3 categories:

1. Prepare ingredients & store them for cooking on the day the meal(s) will be eaten
2. Prepare the actual meals and store appropriately in the refrigerator or freezer & heat/defrost when ready to eat
3. A combination of 1 & 2

Your strategy may vary between these 3 types based on your assessment of each week's schedule.Let's discuss each of these in detail below where I have included my suggestions to optimize efficiency:
1) Chop/cut/marinate/prepare ingredients & store them for cooking

• In Part 1 of this series, I recommended a food processor as a 'must-have'. You can choose to use a food processor or cut/chop all your veggies with the old-fashioned knife & cutting board. Though I know the food processor saves time & energy, I do enjoy chopping my veggies and fruit manually when I have some extra time. This is a great activity to do as a family!

• Reduce the amount of chopping by buying some of your vegetables & salads in the pre-cut packages available in most grocery stores. Watch out for added ingredients such as sulfites that are sprayed on vegetables to increase shelf life! Added sulfites can especially be a problem for people with skin conditions such as acne & psoriasis.
• Make the marinades & marinate tofu, tempeh, meats 
• Be mindful that some veggies & fruits can brown or spoil easily once chopped. Some examples include potatoes, bell peppers, apples. Use these in the earlier part of your week.  Sprinkling lemon juice on apples will lengthen the time for browning & storing chopped potatoes in water will keep them usable for up to 2 days.
• DO NOT wash spinach, kale, cilantro - these veggies need to be stemmed & stored wrapped in paper bags or kitchen paper towels for best storage life. Wash & chop right before use.
• Soak your beans! And throw out the water before you use them in your recipe. This simple procedure decrease the gas-causing properties of beans by altering some  lectins. Sprouting is another way to get the most nutrients out of your beans- the Air fryer can be very useful in sprouting your beans overnight! Or use the old-school way - wrapped in a wet cheese cloth & left in the oven (ensure the oven is not on!)
  

2)Prepare the actual meals and store appropriately

• This is my second choice in meal prepping  since this method invariably leads to over-use of the microwave oven, plus, the food storage science needs to be followed accurately to avoid bacteria/ fungi growing in your foods! That being said, pick the option that's best for yourself & your family. And try to make at least some meals on the day that they will be consumed.
• ​If you choose to prepare ALL your meals ahead of time, you need to have plenty of containers to store them plus adequate room in your fridge/freezer.
• It is best to cool cooked foods  to room temperature before freezing them otherwise the condensation from the steam will freeze to ice & add extra water to your meals when you defrost them - leading to a soggy entreé!
  
• Be vary of texture changes in some foods when you re-heat before eating. This is especially true of beans & green leafy vegetables.
• If you have leftovers from a previously frozen meal, it is best not to re-use this especially when meat is part of the ingredients. Food wastage is another reason this is my second choice of meal prepping!

I hope by now you are excited about starting to cook at home! By using both meal planning, meal prepping and time-saving cooking gadgets, you will be dishing out delicious meals that you can enjoy in the comfort of your home. Do not be afraid  to experiment with new recipes! I often look at recipes in books and online but end up using them as inspiration, ultimately  modifying the recipes to meet the criteria that I consider most important in a meal: packed with nutrients, free of additives & unnecessary chemicals, tasty, can be made in 30 minutes or less!!

If you have enjoyed reading this series, please send me a note or add a comment to let me know! Until next time....hope you enjoy your home-cooked meals!

​One of the first recommendations you will typically receive in my practice, is to start cooking your own food! There are many reasons for this recommendation,the first and foremost being: you have full control of what you eat! And what you eat is what fuels your body, and if your body is receiving the right "fuel", it is most likely to function efficiently, without trouble i.e. symptoms or illnesses.  So if you are to take control of what you eat, you must put in the effort for making as many of your meals as possible. Of course, a trip to the restaurant  or ordering take-out can be left for special occasions or for long days that you could not anticipate or for which you could not prep ahead. Last September, even the American Medical Association (AMA) released recommendations for home cooking. Based on the American College of Preventive Medicine's (ACPM) guidelines, the AMA recommends  "prescribing" home cooking to patients to reduce the risk of obesity and type-2 diabetes since it helps with:

• portion control
• lower sugar and salt levels
• no or low artificial  additives and preservatives
• more choice with type of vegetables and fats

Needless to say, there are additional mental-emotional benefits of family members participating in shopping, preparations and the cooking process.  

Knowing all of this helps the patients get motivated but very often, when they are not used to cooking at home, this simple prescription can be very daunting and often can increase patients' anxiety around meal preparation and planning; and if not given the right tools/resources, can ultimately result in patients sliding back into old, comfortable but not healthy, eating habits.
In this 2 -part series, I am excited to share ideas that I commonly discuss with patients to alleviate this type of anxiety & get them settled into cooking at home with ease! I hope these will be helpful in your efforts towards a healthier lifestyle! Let's begin!

If you have ever tried opening a wine bottle without a wine bottle opener or cutting veggies with a blunt knife, you already know the importance of having the right tools for the right job! Today's fast paced kitchens need gadgets & tools that can save us time AND energy. Here are my 4 of my favorites and "must-haves" in any kitchen with a summary of their most important features:

1. The Instant Pot​  (aka IP) 

​          ​You  probably have heard raving reviews about it and are skeptical about it. So let
          me tell you this:  all my skepticism (and there was a huge chunk of it!) flew out the
          window from day one of using it!...and now I am the proud owner or not one but 
          two of Instant Pots! Here's why I highly recommend it:

• Requires minimal monitoring once program is selected (this is great win!)
• Safe pressure settings to cook lentils, beans, whole grains fast!  The cooking time is very short  compared to stove top cooking
• Can "do-it-all": Sauté, Simmer, Steam, Cook, Warm! Choose pre-set programs for specific foods that can also be modified based on your preferences
• Some models have delay start options 
• Can also work as a slow cooker for specific recipes
• Friendly for oil-free cooking and minimal loss of nutrients - It's great for soups, stews, bean chili, porridges, multi-grain nourishing recipes
• Many online IP enthusiasts have blogs, recipes dedicated to IP cooking & there is no shortage of ideas. Look for one-pot meal ideas!
• Saves: Time, Energy, Nutrients 
• Side note: Proud to boast that it was invented by a team of  Canadians :-) The goal was to reduce cooking time for busy professionals so as to decrease their dependence on fast food!  Isn't that the goal with home cooking for everyone? Suffice to say, this product  has met that goal! 

​     2.   Food Processor
​​           There are lot of choices when it comes to a good food processor. Choose one that
           suits your family's needs. It is great for meal prepping and when cooking large
           quantities. Here's what it can help with:

• ​Chops or Grates vegetables/ fruits
• Making dry or wet mixtures: Blends and/or mixes vegetables, fruits, nuts, seeds,    powders into batter for patties or baking
• Powders nuts and seeds for salads, gravies and gluten free baking
• Saves: Time, Energy
• Great for making a colorful salads &  blending leftover veggies for soup!

     3.  Hand Held Blender
​         Again, there are many choices with brands and additional attachments for          
        whisking, batter mixer etc. A simple one will suffice & here's why:

• Awesome device for  making soups, gravies, salad dressings and dips! Insert the blender in the cooking pot or serving bowl directly and blend!
• Most can be used in hot & cold foods  though watch out for the splatter!
• Much more convenient than having to transfer ingredients into a blender then transfer back into a cooking pot/ serving bowl. 
• Saves: Time, Energy, Spills (no transferring required!), Nutrients

     4.  Air Fryer
          This is a relatively new addition to my list of must-haves and I am still exploring  
          new recipes! Here are the main features:

• Cooks faster than conventional ovens with circulating hot air - not gas!
• Especially great for small batch cooking
• Great for oil- free or minimal oil cooking 
• Wonderful for making quick snacks and entrées - carrot/sweet potatoes chips,  crispy tofu, roasted potatoes, grilled chicken/fish
• Just like the IP, there is no shortage of recipes & ideas online through blogs, FB groups
• Saves: Time, Energy (yours & your home energy!), Gas (not a an oven!) 

As you probably noticed, there was a lot of repetition above that was intentional: "Saves Time & Energy". That is the recurring theme of this blogpost. Cooking at home should be enjoyable and not burdensome. After cooking a tasty, healthy meal, you should still have energy to enjoy it with your family; that's what makes it all worthwhile!
Empowering patients to help them take charge of their health is the goal of naturopathic medicine and the constant effort in my practice. Please note, that I do not have any financial gains in any of the appliances listed above! I am passionate sharing ideas that help with living a healthy lifestyle and have received a lot of feedback from my patients, that specific tips like these help them in transitioning to cooking at home.

Next week, in Part 2 of the home cooking series, I will share some tips & ideas for efficient meal planning & prepping. 
​
Please feel free to share your comments & feedback below!

The psychosocial impact of acne is well-known and is severe enough to be the subject of several major studies in prominent journals. Acne is THE most common skin condition in the US affecting approximately 50 million Americans each year.  Depression, anxiety and lack of self-confidence due to facial acne  leads to time-off from school and work and the costs associated with this loss of productivity has been estimated to be as high as $400million (Statistics 2013)!! If that number is not staggering enough on its own,  the total cost of acne treatments combined with the cost of lost productivity were approximated to be $1.2 billion!

Numbers aside, in my practice I have personally witnessed and documented the social difficulties experienced by patients suffering from varying degrees of acne. Besides the physical discomfort, the negative impact of persistent acne on a patient's overall well-being varies based on many factors including their perception and understanding of the disease, underlying self-esteem issues and extent of support from family and friends. In this era of social media, the age group of 10-20 years olds are affected the most. So while counseling and use of psychotherapy and can help with many of these self-esteem & confidence factors, it still remains important for the patient (in their own words) - to 'get rid of the acne'! Almost all these patients usually have been through some combination of the following conventional treatments for acne:

• Topical / oral high dose vitamin A 
• Topical/oral antibiotic 
• Topical salicylic or azelaic aid
• Topical/ oral steroids
• Oral contraceptives
• Oral anti-androgen

Though some or all of these treatments can be effective in suppressing new eruptions, upon termination of the treatment,  the acne returns and sometimes at an intensity worse than prior to the treatment! 

So what else can be done?
Most acne sufferers already know that acne is not just 'skin-deep' and there is more to it's story - i,e. cause and recurrence.There are many naturopathic herbal remedies that can help with acne  symptoms, but I have observed for  a long time now  that there is one thing that seems to be the underlying root cause for the presence and persistence of acne vulgaris. The one thing that can be linked to all of the factors  often listed as its cause such as:

• Excessive sebum production & faulty keratinization leading to clogged pores
• Presence of the bacteria  Propionibacterium acnes or P.acnes
• Excessive inflammation in the skin​
• Insulin-resistance 

​
What is that one thing?
If you follow my blog, it is likely that you have guessed the answer. It is in fact the state of your gut!

The gastrointestinal tract, the source of your nutrients also harbors a large percentage of your immune cells and major immune modulators - your intestinal flora of bacteria, archae and viruses. This microflora (also known as the microbiome) can change based on a person's diet, environmental factors, disease states, toxin exposure and yes, hormonal changes. The influence of the microbiome on our hormones  and vice-versa is a major field of study in the scientific world right now and even though its implications are yet to be fully understood, current studies have sufficient data to define what a  healthy microbiome constitutes and it's potential impact of an unhealthy one on various systems of your body. 

In 2017, an interesting study by Clarke et al. was published in the International Journal of Molecular Sciences. It summarized how plant-based herbal supplements can influence the microbiome, which in turn influences the levels of inflammation and androgen production leading to a targeted impact on the skin.  Following a diet that includes low-glycemic foods and lots of fiber rich plant-based foods does not just influence blood glucose levels, but also shifts the microbial balance in favor of lower inflammation and therefore, lower permeability of the gut. With a gut lining that is very selective about what is being absorbed into your bloodstream and then being transported to various organs including the skin, the rate of new lesions goes down significantly. Plus, older lesions and scars heal much more rapidly with the use of appropriate non-toxic cleansers and healing agents, when the gut microbiome is truly balanced- that is, topical treatments are more effective when combined with the treatment of the underlying cause.

The diagram below from the study mentioned above, provides an insight into the interconnected process :
​

Like each year, January is the month when we set our health goals for the year and are determined to follow through until...life's gets busy again! End of January is typically the time when your resolutions are being tested and how the rest of the year goes depends on what choices you make now. To help you with just one aspect of this year's resolution, that is, eating healthy, here is a checklist of 5 things to avoid when we must rely on processed and packaged foods, especially for snacks. 

As a reminder, healthiest options such as fruits, veggies, nuts and seeds for snacks should be at the top of the list and processed & packaged foods should be used occasionally when hosting an event, travelling or just needing a change in taste. If you have children, you know the need to have a huge stack of snacks available at short notice for those sudden hunger pangs, last minute play dates or times when fruit just won't satisfy those tiny taste buds!
 
The golden rule when choosing packaged foods is of course: Read the Ingredients! Not just how many calories, fats or sugar is in each serving size. Know what exactly you are eating. To make this process quick and efficient (and less confusing) here are the 5 main ingredients/ingredient categories that should watch out for and avoid when choosing your packaged snacks:

• Artificial colors and flavors
  • Multiple studies have confirmed the negative effects of artificial food coloring and revealed a link between the chronic consumption of these with conditions such as ADHD, dermatitis and other neurological and inflammatory conditions. Yet, since these additives are currently FDA approved and they continue to be present in snacks. 
• High-fructose corn syrup (HCFS)/Corn syrup
  • The strong link between the consumption of foods with HFCS and obesity, insulin resistance and high triglyceride levels  has now been very well established (Review in 2018). The risk is higher when its consumption is on a regular basis. A note of caution here: whether the syrup is derived from organic, non-GMO corn or conventionally grown corn, it still has the same negative effect. 
• Chemical preservatives or stabilizers
  • These are added to many packaged foods to increase shelf-life and enhance the taste of the food product.They possess zero nutritional value! Often with some reading you will be able to tell chemical yet benign ingredients, for example, baking soda (listed as sodium bicarbonate) from other risky chemicals such as added  sulfites, nitrates and nitrites.These have been linked to many types of gastric and colorectal cancers, though some studies question the direct correlation. Monosodium glutamate or more commonly known as MSG or Ajinomoto has been commonly associated with triggering headaches and migraines, and it’s full impact on the gastrointestinal and neurological systems is yet to be understood.
• Artificial sweeteners/low glycemic sweeteners
  • Aspartame was under scrutiny for a long time due to its potential carcinogenic effects. Though many food companies and large studies claimed that there was 'no direct link’ with consumption of aspartame and specific types of cancer, many major food industry giants have recently decided against it’s use. In many patients it has the ability to trigger headaches & migraines.
  • Other low glycemic sweeteners such as sorbitol and mannitol can trigger gastrointestinal side effects such as severs bloating, gas and abdominal pain in some patients with IBS  or SIBO
• Hydrogenated or partially hydrogenated fats
  • These are more commonly known as Trans Fats and have adequate research to support their ill-effects on cardiovascular health. Since the 1990s, Denmark and Netherlands have reduced  the amount of trans fats in processed foods, including popular foods such as french fries and other European countries are following this trend. In the US, starting in 2006, only foods containing 0.5g or less  could be labelled as ‘"Not a significant source of trans fat".​

In naturopathic medicine, since the the focus the is on treating the root cause instead of symptom relief, I always begin with investigating these three main factors that may be responsible for irritating your bowel system:
 
1) Anything coming in contact with the lining of the bowels
Investigating foods that you eat on a regular basis to check for food sensitivities and delayed allergic reactions is critical. Most common culprits in this arena include dairy, gluten containing grains, corn, nuts, soy but you maybe sensitive to a food that is generally considered healthy and nutrition packed. Examples of such foods include:

• Nightshades such as tomatoes, potatoes, egg plant, bell peppers.
• Foods with naturally occurring/added sulfites such as sauerkraut, wine, dried fruits

Besides food, medications, supplements and unfiltered tap water are other causes for     
irritating the intestinal lining and are reviewed as well.
 
2) Imbalance in the gut flora
Whether it is due to a recent course of antibiotics or an extended period of stress, the balance of normal friendly bacteria in the digestive system can be greatly affected.  There are multiple species and strains of bacteria, viruses, fungi and archaea that live in the digestive tract and some have a much more beneficial presence than others. The beneficial strains assist in functions such as digestion, absorption, immune signaling and even neurotransmitter balance. The non-beneficial strains may not be pathogenic (i.e. disease causing) but still be contributing to IBS symptoms by competing for resources with the beneficial bugs.
 
3) Lack of adequate enzymes leading to improper digestion
Chronic stress, antimicrobials and medications can negatively affect the production of the natural digestive “juices” such as enzymes and hydrochloric acid (HCL), that are crucial for the appropriate break down of foods into the macro and micro nutrients. These macronutrients such as carbohydrates, proteins and fats need to be further broken down into the building blocks for our body to assimilate and utilize for its various functions. When foods are improperly digested, symptoms such as gas, bloating, pain can result in the short-term but can have a much more serious long-term impact due to resulting nutrient deficiencies and chronic disease.
 
Identifying and correcting these three factors frequently result in both immediate symptom relief and the long lasting benefit of ‘calmer’ and ‘not so irritable’ bowels. With such a multifactorial approach, patients often report that their bowels appear to be less affected by their mental-emotional state, indicating a much more resilient digestive system.
 
If you or someone you know, suffer through the inconvenience and social withdrawal associated with  IBS, please contact our office to set up a free consultation. 

Continuing my series of blogs on the principles of naturopathic medicine, our next principle, which explains why NDs make an effort at every single visit to educate their patients: Doctor as Teacher.
 
The origin of the word ‘doctor’ comes from the Latin word ‘doctor’ which means ‘teacher’, which in fact originates from the Latin verb ‘docere’ = “to teach”. I was not aware of this fact until my undergrad years, when I chose a course purely out of interest, about the Latin and Greek origins of English words. What a fascinating fact this was! However, I only truly understood the meaning of the word doctor and this principle, once I had joined naturopathic school.
 
Now, having been in clinical practice for over 10 years, it is obvious to me why my duties as a doctor are intertwined with that of an educator. And for you see it as obviously as me, I just listed the primary responsibilities of a traditional teacher inspired from my daughter’s wonderful school teachers:

• Communicate & teach new ideas in an effective way so students are able to learn the information and skills
• Allow students to think independently, ask questions and help them find answers
• Educate students about various tools and resources and how to utilize them
• Provide support to students when facing challenging situations either with their assigned work and/or life situations
• Monitor students’ progress and make necessary recommendations to rectify poor performance in specific areas, while acknowledging their hard work
• Cheering students when they accomplish their goals!

Now, if you were to go back and read those responsibilities and replace the word ‘student’ with ‘patient’, it easily explains the why the Doctor is also a Teacher. The curriculum and goals are unique to each patient!
 
As a naturopathic doctor, I educate my patients about their health, actions they can take to correct a deficiency, to improve their energy, to reduce the risk of a heart attack or stroke and sometimes about something as simple as home care remedies for fighting off a cold. I allow them to ask questions and provide answers when I can, or refer them to specialists when necessary. I make them aware of various health resources available to them and how they can be used to their benefit. It is also my role to monitor their progress and explain what they need to change. Besides providing a treatment solution, I also provide ongoing support and coaching, so they can implement their treatment plans and achieve their health objectives.
 
I would like to end this blog, with a special note for my patients. As much as I am a ‘teacher’ for them, each & every patient has been a teacher for me! I have learned from my patients about resilience, inner strength, happiness, the ability to fail and yet keep going and most importantly, the importance of being compassionate and need for constant learning. Thank you for giving me an opportunity to be part of your healthcare team.
 
Sign off for today – the real Day# 4 (yesterday was a typo!)
​

The above quote gives an insight into the next two principles of naturopathic medicine: Treat the Whole Person and Treat the Root Cause.
The same disease can manifest as different symptoms for different patients. If you identify why the patient has a particular disease, that is, why this patient and not another, you may be able to treat them much more effectively. I thought the best way to illustrate these two principles would be through patient stories as case examples.
 
Both patients A & B in the stories below had identical major concerns and official diagnoses at their initial intake visits but since the root cause of the problem and the patients were very unlike each other, so were their treatment plans and corresponding results:
 
MAIN CONCERN: Difficulty losing weight and keeping it off, tried many diets/ programs
MAIN DIAGNOSIS: Obesity
Other official diagnosis common to both cases: Type 2 Diabetes, Hypertension, High Cholesterol

Patient A:

• 51 year-old single male weighing 340lbs.
• Lives alone, does not like to get out of the apartment for any reason except for work and to pick up food when not ordering pizza
• Diet: Fast food – delivery and drive-thru places only. Mainly pizzas, burgers, fries. Fruits: maybe an orange occasionally. Vegetables: potatoes. Microwavable TV dinners.
• Lifestyle: sedentary, hates to move as joints hurt, does not have any friends and does not like to interact with people as self-conscious about his overweight appearance
• Medications: many!

 
Root Cause Assessed to be:

• Partially loneliness, zero social interaction compounding the problem of sedentary lifestyle with no desire to move/walk/ exercise.
• Classic “overfed but undernourished”- excessive intake of carbohydrates, dairy and animal fats, trans-fats, additives, flavorings with little nutritional value

 
Initial Recommendations:

• Gradual lifestyle and dietary changes with weekly check-in visits.
  • These  changes included incorporating fresh fruits and vegetables daily
  • Eliminating animal proteins & fats except fish
  • Cooking food at home with recipes provided as a starting kit,
  • Adopting a dog with the 2 fold  intention of providing a companion and encouraging him to get 30 minutes of exercise  by walking the dog twice daily.

 
Result in 6 months:

• Patient A** lost significant amount of weight (almost 80 pounds) and had sustained the weight loss rate at >10lbs per month.
• He was no longer diabetic and did not need his blood pressure medications. Cholesterol was normal!
• He was now a proud dog parent and had made friends and was beginning to consider a relationship.
• His self-esteem had improved dramatically and was considering other forms of exercise
• Decided he would like to be 100% vegan long-term and had no desire or temptation to add animal products back to his diet, even occasionally. YAY! 

 
**He went on to lose over 200lbs by the end of his complete treatment and is now an animal rights activist and marathon runner. Yes, you read that right- not a typo, You can read more about him and his complete weight loss journey in his book named, Walking with Peety.

Patient B:

• 57 year old female in steady long-term relationship,no children weighing 360lbs
• Proud owner of 2 cats
• Diet: vegan by choice with occasional intake of eggs/fish/ice cream. Craves sweets especially after dinner; sometimes craves dairy
• Both her and her partner cook at home, and try new vegan recipes, eats out occasionally. Does not eat too many processed foods except the vegan ice cream. Skips breakfast, eats healthy lunch & dinner.
• Lifestyle: sedentary now, used to be very active in sports when younger. Stopped playing after knee injury. Likes to meet with friends and travel.
• Medications: None- Does not like to take medications.

 
Root Cause Assessed to be:

• History of “yo-yo” dieting and lack of regular exercise due to knee pain and work hours.
• Tests revealed hormonal imbalance with estrogen dominance, adrenal fatigue, a sub-optimal thyroid function and possible gluten sensitivity

 
Initial Recommendations:
Counseling provided on healthy, balanced vegan diet and frequency of visits set at every 2 weeks.

• Eliminate all gluten containing foods. Ok to eat fish and eggs but no milk products.
• Digestive enzymes and probiotics to optimize nutrient absorption from food and rehabilitate gut from years of gluten exposure
• Must have regular eating patterns especially follow the rule: do not skip breakfast
• Anti-inflammatory supplements to decrease inflammation & pain in knees.
• Thyroid  hormone prescription and appropriate adrenal support
• For Exercise: Swimming 2-3x/week and or stationary bike 2x/week for at least 30 minutes

 
Result in 6 months:

• Patient B lost 15 lbs with average loss of 2.5 - 3 lbs per month
• Her energy was improved and she was wearing clothes 2 sizes down!
• Not diabetic anymore, but still prediabetic.
• Blood pressure was still slightly elevated
• Cholesterol was lower than when she stated but still higher than normal
• Cravings for ice cream & sweets still present but has better awareness of eating patterns.
• Exercise was regular at 2x/week swimming only due to extended work hours
• Wants to continue on current program i.e off gluten, reduced sugar, healthy meals at regular intervals and will work on adding exercise to her routine.

 
Patient B is still an active patient is continuing to lose weight at her steady rate of 3 lbs/month. She has recently been diagnosed with Sleep apnea and upon correcting that she lost > 5lbs in one month and no longer has elevated BP.

As you realized, both patients were very different: male vs. female, single vs. in long term relationship, lonely  vs. socially active and more. Therefore, the investigation was very different for both even with the exact same diagnoses! Both had positive outcomes, though with varying degrees, and were content with their results. That is the power of Naturopathic Medicine!
 
Signing off for today! Day4 #NatMedWeek.
Be sure to call us if you  need help with your weight loss journey

​As you can see, even our smartest devices are unable to repair themselves for smallest of problems. Whereas the human body has a tremendous capacity fro healing and full recovery, when given the adequate support and care. There are limitations of course and the extent  recovery depends on several factors including, genetics, a person’s nutritional status, ability to follow self-care instructions and follow through with rehabilitation.
 
Naturopathic Doctors focus on removing any obstacles to full recovery such as improper diet, lack of sleep routine and lifestyle modifications and providing additional support with healing herbs and supplements. Symptomatic relief such as for pain in the case of injuries, is given equal importance and typically treated with homeopathic and herbal supplements that are more effective, not addictive and have less side-effects than OTC or prescription medications. Pain or symptom relief is particularly important from the perspective of supporting mental-emotional health that can contribute majorly to the healing power of the body.
 
As a Naturopathic Doctor, when I think about the healing power of the body, elaborate diagrams of immune cells, long lists of  pro-inflammatory versus anti-inflammatory cytokines and all the nutrients involved in the process that we studied in naturopathic medical school, flash across my mind all at the same time. Yet, for the human body, it is a simple, well-defined process. 
My respect for this healing power increases daily as I  realize that all of that "simple complexity"  has not yet been duplicated in man-made devices even with seemingly rapid progress in the field of AI (Artificial Intelligence).
 
Leaving you with those thoughts, until tomorrow, Happy Day2 of  #NatMedWeek2018!