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Naturopathic Medicine

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"Mind" Your Blood Sugar, Decrease Your Risk of Dementia

Dementia: the loss of mental functions such as thinking, memory, and reasoning to the point that it interferes with activities of daily living. Dementia is not a disease itself, but rather a display of symptoms that can have various causes including Alzheimer's disease.  With our aging population, Alzheimer's-related dementia is rising.  This rise, has far-reaching implications on our burdened health care system, not to mention the impact on countless family, friends and care-givers of those afflicted.  [1] The New England Journal of Medicine- the world's most prestigious medical journal- has recently published a study linking pre-diabetic blood sugar levels (fasting blood sugar levels of 6.4 mmol/L) to an increased risk of developing dementia later in life. [2]  A diagnosis of diabetes isn't made until fasting blood sugar levels reach 7.0 mmol/L.

This means that you do not have to have a diagnosis of diabetes to be at higher risk of developing dementia.

More than ever, there needs to be a greater emphasis placed on diabetes prevention and blood-sugar-balancing diet and lifestyle modifications.  It is clear that waiting for a diabetes diagnosis may already be too late.  The good news is a naturopathic doctor is trained to work with an individual to balance blood sugar levels gently, effectively and naturally.  We are also trained to recognize risk factors for diabetes and may ask you to have your blood sugar levels checked.  Naturopathic doctors can also work with people who have diabetes to lower requirements for drugs and reduce complications like dementia, heart disease and eye problems.

How do I know if I am at increased risk of pre-diabetes and diabetes? You are over the age of 40; you having a close relative (parent or sibling) who has type 2 diabetes;  you are of Aboriginal, Hispanic, Asian, South Asian or African descent; you have a history of impaired glucose tolerance or impaired fasting glucose; you already dislay some evidence of the complications of diabetes, such as eye, nerve or kidney problems; you have heart disease; you have a history of gestational diabetes mellitus;  you have high blood pressure or high cholesterol and/or you are overweight especially around your waist.

Use the on-line Diabetes Risk Calculator (CANRISK) here

When should I be checked for pre-diabetes/diabetes?

Your naturopathic doctor or medical doctor should check your fasting blood glucose levels and HbA1c levels every 3 years if you are over the age of 40 or if you are at high risk.  Your ND or MD will check your levels sooner or more frequently if you have additional risk factors or are at very high risk of developing diabetes.  Additionally, your naturopathic doctor may  check blood sugar levels as part of routine wellness testing to catch a problem before it starts.

Final Word: Elevated blood sugar levels raise the risk of a number of health problems including dementia.  Do not wait until you are given a diabetes diagnosis.  Take charge of your health to live life to the fullest rather than spend your golden years suffering.

References:

1. WebMD (Online). Dementia.  Available at: http://www.webmd.com/alzheimers/guide/alzheimers-dementia.  Retrieved August 12, 2013.

2. Glucose levels and risk of dementia. NEJM 2013. Available online: http://www.nejm.org/doi/full/10.1056/NEJMoa1215740.

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Acupuncture for Allergy Relief: A Review of the Research

'Tis the season....for allergies, that is.  It is estimated that roughly one in six Canadians suffers from seasonal allergies which can greatly impact quality of life and worker productivity. As a naturopath there are many tools I can use to help an individual prevent and treat allergies and acupuncture is one of them. Especially for seasonal runny noses we call allergic rhinitis.

This Monday May 6th, the clinic where I work will be having an Open House to celebrate naturopathic medicine week and the grand re-opening of the clinic (more info here: https://www.facebook.com/events/497737796951965/).  There, I will be talking about acupuncture as an effective treatment for allergies so I thought it would be a good idea to be up-to-speed on the latest research on the subject.  I thought I would I would take the time to share with you what I found.  But first, in case you are not familiar with acupuncture....

What is Acupuncture?
Acupuncture involves the stimulation of points on the body using a variety of techniques, such as penetrating the skin with needles that are then manipulated manually or by electrical stimulation. It is one of the key components of traditional Chinese medicine (TCM), and is among the oldest healing practices in the world. [1] Despite popular belief, acupuncture does not hurt, though insertion of the needles can feel like a pinch.  We love when patients feel sensations such as heaviness, itching, aching or groundedness.  Feeling nothing at all is fine too.  Naturopathic Doctors receive 4 years of training in asian medicine and acupuncture.

How Many Treatments are Required?
The number of treatments required to see significant improvement varies greatly depending on the individual and is determined by your naturopathic doctor.  In general, acupuncture is prescribed once weekly for a period of 6 to 12 weeks.

A Review of the Research

Now for the sweet stuff....Here is what I found in the research literature (as a side note, naturopaths take alot of flack for not being evidence-based.  Just so everyone understands, I search through pubmed, cochrane review, etc- the same databases that all other science and medical professionals use.  Also, I included my references in case you want to check out the papers yourself. :))

Acupuncture may help combat against allergic rhinitis (runny nose) and improve quality of life
Acupuncture is a relatively cost-effective treatment
Acupuncture is safe
Acupuncture may reduce the need for anti-histamine use.

A randomized, controlled clinical trial by Xue, et.al. (2002) compared 4 weeks of acupuncture using Chinese Medicine Theory versus sham acupuncture.  They showed that there was a significant improvement in nasal and non-nasal symptoms associated with seasonal allergies.  There were no side effects reported in either group suggesting that acupuncture is a safe alternative treatment. [2]
Another study by Witt, et.al (2008) showed that 10 treatments of acupuncture improved quality of life measures and was a relatively cost-effective treatment for allergic rhinitis when it was added to a routine treatment approach (ie. meds). [3]
After 8 weeks of acupuncture, Brinkhaus et.al. (2013) found that there was a statistically significant improvement in quality of life scores and anti-histamine use compared to those receiving sham acupuncture.  This was a multi-center, randomized, controlled trial using individuals with proven allergy (IgE-mediated) to birch and grass pollen. [4]

See you at our Open House!

References:
1. "What is CAM?". N.I.H. Retrieved 8 March 2013.
2. Xue C.C. et al. Effect of acupuncture in the treatment of seasonal allergic rhinitis: randomized controlled clinical trial.  Amer J Chin Med. 2002; 30(1): 1-11.
3. Witt C.M. et al. Cost-effectiveness of acupuncture in women and men with allergic rhinitis: a randomized controlled study in usual care.  Amer J Epi. 2008; 169(5): 562-571
4. Brinkhaus B, et.al. Acupuncture in patients with seasonal allergic rhinitis: a randomized trial. 2013 Feb 19;158(4):225-34.

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3 Common Misconceptions About Naturopathic Doctors

MISCONCEPTION #1: "I didn't know you offered acupuncture"

Don't feel bad if you didn't know we offer acupuncture as part of our scope of practice. It can be confusing as to who does and who doesn't practice based on their schooling, their area of practice and their desire to practice this particular modality.

In Canada, Traditional Chinese Medicine (TCM) and acupuncture are offered as part of the 4 year full-time Naturopathic Program whereas in the U.S TCM and acupuncture are not offered as part of the 4 year full-time program.  This means that if an ND graduated at either the Canadian College of Naturopathic Medicine (CCNM) in Toronto or Boucher Institute of Naturopathic Medicine outside of Vancouver they have been fully educated in TCM and acupuncture. Additionally, a ND can practice acupuncture only if their province, territory or state allows it.  Here in Ontario, acupuncture is part of an ND's scope of practice.  All practicing ND's must be licensed by the Board of Directors Drugless Therapy- Naturopathy (BDDT-N).  The BDDT-N requires all NDs to demonstrate competency in acupuncture via a written and practical exam before licenses are granted (In addition to two North America-wide standardized tests known as NPLEX I & II).  If a ND is practicing in an unlicensed province or territory they may practice acupuncture because they are still licensed by the BDDT-N or the BC equivalent. To make matters somewhat more confusing, a ND may have all his/her educational and licensing requirements but not practice acupuncture.  Though it is in our scope of practice, ND's can choose not to utilize this modality (though the board encourages us to use our full scope).

The simple solution to all of this? Just ask your Naturopathic Doctor whether this is a service they offer or check out their website.  In my practice, I use acupuncture for a myriad of conditions from hormone balancing, fertility, pain, digestive issues, mood disorders and stress relief.  Again, if you are seeing a licensed ND here in Ontario they will have the skills required but may choose not use it.

***As a side note: NDs are trained to use acupuncture using the the Traditional Chinese theory of practice similar to a Licenced Acupuncturist (L.Ac) but can also use it as "medical acupuncture" like a chiropractor, medical doctor or physiotherapist.  In this way, it is most used for pain relief and musculoskeletal issues.

MISCONCEPTION #2: "I'll wait to see a naturopath as a last resort" Although I am happy to see you even when I am your last resort (and there are still ways to help you at this point) preventing you from getting there should not only be my goal but everyone's goal.  Currently, Naturopathic Doctors are the only regulated health professional that are experts in preventative medicine.  We are trained to treat patients on all spectrums of health and can meet you where you are at.  We use a thorough medical history including family history, relevant lab work and physical exam findings to assess your health and address current as well as future problems. More and more I am thrilled to report that I am seeing patients who are interested in improving their overall health, even when they have a pretty good health profile.  The bottom line: there are always aspects of our busy lives that could use some focus and naturopaths help you zero in on what is most important at that given moment and help educate you on areas that might become issues down the road.

MISCONCEPTION #3: "I can't afford your services" Naturopathic medicine can be expensive but anything will seem expensive when we are used to free.  I could write all day trying to convince you why paying to have a naturopathic doctor as part of your health team is important but I'll let one of my colleagues do that instead.  He says it better than I ever could.  Check out this blog post by Dr Justin Gallant ND

http://www.drjustingallantnd.com/2/post/2013/01/why-should-i-pay-for-naturopathic-medicine.html

The good news is many private health plans now cover naturopathic SERVICES up to a certain amount. Admittedly, this amount is usually only enough to get you started with your naturopath.  Lab work and prescribed remedies are not covered.  With this in mind, I always do my darndest to ensure I am working within your means. Though my service fees are fixed for the time being (some NDs do sliding scale or take on a few patients a year at a reduced rate) I will always let you know where you can buy things the cheapest, offer alternatives or space out visits.  I am also in the process of starting community acupuncture to make it more cost effective for patients.  Don't be afraid to let your naturopathic doctor know that finances are tight, in fact we want to know these things.

Do you have questions about naturopathic medicine? You are most welcome to ask (there are no stupid questions) and I will be happy to answer in another blog post

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