Primary Care in BC: NDs Help Patients Unable to Find a GP

There has been increasing public focus on the shortage of physicians to meet the health needs of the residents of British Columbia. By now, it is clear it’s not feasible to expect to hire enough medical doctors to meet demand. Moreover, there may be more realistic and more efficient ways to allocate resources that are already available. Health Minster Terry Lake has elaborated on this point by explaining that not every problem requires a medical doctor and many issues can be addressed by a “primary care team”. Naturopathic doctors can play an integral role in such a model of care.

 

Licensed naturopathic doctors in British Columbia are highly-trained medical professionals. While the profession has been regulated since 1923, in 2009 the B.C. Ministry of Health approved a new set of regulations which recognizes naturopathic doctors as primary health-care providers. The new regulations bestow on naturopathic doctors sweeping changes to their authority with respect to compounding, prescription authority, dispensing, ordering of laboratory and diagnostic services, and other privileges. This enables naturopathic doctors in British Columbia to have the widest scope of practice in Canada.  For nearly a decade, patients have been able to choose an ND for primary care—already reducing the burden on the medical system.

 

Many British Columbians chose to see naturopathic doctors because they enjoy the personalized care that they receive and alternative treatment options to conventional drugs or surgery. Because NDs mainly practice in private clinics where their services are not publicly-funded, these patients enjoy their preferred method of health care without requiring taxpayer dollars. Also, treatment plans emphasize preventative health and optimal wellness which further reduces the frequency of visits to the medical doctor or hospital.

 

While the government has recognized naturopathic doctors as primary health care providers, there are still some remaining obstacles that prevent NDs from being an even greater part of the solution to the doctors shortage. Of these, the two most significant are that naturopathic doctors are not permitted universal access to tests run at diagnostic facilities (a commitment made by Health Minister George Abbott 10 years ago and stated in the government’s 2008 Throne Speech) and access to information in PharmaNet.

 

BCNA has outlined the diverse and extensive primary care on offer, province wide, in a detailed report to government titled Supporting a Sustainable Health System.  A highlight of which is the collaborative, interdisciplinary support NDs bring to the provincial health care system, but which government has failed to capitalize on.

This post by BCNA Co-President, Dr. Victor Chan

5 Everyday Items Sneaking Carcinogens Into Your Household

These days it’s pretty much impossible to go 24 hours without exposing yourself to some sort of potentially dangerous substance or carcinogen. According to the American Cancer Society, carcinogens are the substances, situations, and exposures that can lead to cancer. Generally speaking, everyone’s risk of developing cancer varies, but the three main determinants are genetics, length of time you’re exposed to the substance, and the intensity of the exposure. Here are 5 carcinogen filled products that are better left on the store shelves:

1.Baby powder (Talcum powder)
Found in almost everyone’s bathroom cabinets, baby powder is widely used because of its almost endless possibilities. Not only can it be used as dry shampoo, deodorant, or a baby bottom refresher, but the main ingredient, Talc, is found in many cosmetic products. In Talc’s natural form, there is a chance it contains asbestos, a known carcinogen linked to lung cancer and rare cancer called mesothelioma when inhaled. Next time you’re picking up a bottle of baby powder, look for the words “Talcum free!”

2. Scented candles/air fresheners
This time of year, there’s nothing better than filling the house with the sweet aroma of pumpkin spice and peppermint candy cane, but think twice before dusting off the seasonal candles. Not only do burning candles release carcinogenic chemicals into the air, but there are studies stating chemicals can be absorbed by the body just by touching the candles. Fear not, candle lovers. Paraffin, a sludge waste from the petroleum industry, is the major ingredient in most candles but buying paraffin free candles means a cleaner burn!

3. Hot dogs
Yup, no surprise here. Most people accept the fact they don’t want to know what goes into a hot dog, but it’s more than just the rumored mystery meat. Highly processed hot dogs contain preservatives called nitrites, which when combined with amines naturally present in meat, form carcinogenic N-nitroso compounds. At your next barbecue, skip the hot dog line and add a veggie burger to your plate.

4. Laundry detergent
A lot of well-known detergents are also some of the most toxic. They might be the best at getting out those stubborn ink stains, but it comes at a price. The use of 1,4-dioxane (found in paints and varnishes) in some brands may trick you into thinking your laundry is clean, but that “fresh laundry” smell is just a bunch of chemicals sitting on your clothes waiting to be absorbed into your skin. Detergents with plant-based ingredients are not only safer for the whole family, but also a lot more eco-friendly!

5. Whole Milk
Didn’t our mothers make us finish our glass of milk before we could even leave the dinner table? Unless you’re getting milk from the neighbor’s grass-fed cow down the road, chances are the gallon of whole milk sitting in your fridge contains a handful of carcinogens and growth hormones like bGH (some studies show a possible link to breast cancer.) Try organic almond or coconut milk next time you’re pouring yourself a bowl of cereal!

Foods to Fend Off Flu

Dr. Rigobert Kefferputz discussed foods with important immune-enhancing properties.  Watch the CTV video here.

 

What Your Reaction to Coffee Says about Your Liver and Why You Should Be Concerned

What Your Reaction to Coffee Says about Your Liver and Why You Should Be Concerned

Olisa Mak, ND

I have a guilty pleasure: I love coffee, the smell of it, the bitter taste of it. Nothing wakes me up on a day off more than a fresh cup of dark roast coffee. I usually drink anywhere from two to four cups of coffee a week, but never more than one a day. Yesterday, I drank two cups of coffee, a latte that was quite strong and a dark roast two hours apart. The effect? A coffee overdose. For the rest of the day, I was restless, experienced chest pains, had chattering teeth, hands that were shaking, a headache and was unable to sleep. I was buzzed and overly stimulated. It wasn’t until five in the morning, roughly 14 hours after my second cup of coffee, that I stopped feeling the buzz. Although, this morning, I woke up feeling completely hungover like I had a night out drinking.

Although most people do not experience such an extreme reaction, it isn’t uncommon to hear people say that they can’t handle coffee, that they feel “jittery” after drinking it. On the other end of the spectrum, there are people who simply do not feel anything after drinking coffee; they can have several cups a day with no after effects.

So what does all of that mean? Why do some people, like myself, have such extreme reactions to coffee whereas other people feel nothing?

First we have to understand how coffee is metabolized in the body. When we drink coffee, it reaches our digestive tract where the coffee is modified and individual chemical constituents of coffee are absorbed by our small intestines. Once in the small intestines, the various chemical compounds found in coffee are absorbed and circulate throughout the bloodstream and reach the liver and other organs.

The liver metabolizes coffee in a step-wise manner and in each step, the compounds are chemically modified to become more and more water-soluble, to ensure proper elimination by the kidneys and bowels. here are two general steps in the liver detoxification process, which I’ll call phase one and two. When you’re overly sensitive to coffee, your phase one is sluggish whereas if you don’t feel anything from coffee, your Phase one is too active.

So how can you bring these two steps back into balance? If you’re overly sensitive to coffee, you need to give your phase one a boost. Phase one relies mainly on B vitamins (amongst other nutrients) whereas phase two mainly relies on amino acids from protein sources like good quality meat and fish. A diet abundant in colorful fruits and vegetables, rich in vitamins is key. There are also supplements that have been especially formulated to support liver function when changing your diet isn’t enough. Certain foods, especially cruciferous vegetables like kale, cabbage, broccoli and Brussels sprouts, are also great for giving your phase one a boost. If your phase one is overactive and you don’t feel anything from coffee, then you need to slow down phase one. You can do this with herbs, such as Calendula officinalis, or spices such as turmeric (in a supplement form it is sold as curcumin).

Other than feeling “jittery” after drinking coffee, why is it important to correct an imbalance between the two phases? At the end of phase one, reactive oxygen species are produced. If phase one is overactive or faster than the phase two pathway, you ultimately get an accumulation of reactive oxygen species because your phase two just can’t keep up with phase one. Reactive oxygen species are chemically reactive molecules known to cause inflammation and damage throughout the body, including cellular DNA damage. Reactive oxygen species or high oxidative stress have been implicated in chronic conditions including cancer, diabetes, atherosclerosis and aging, Having signs of an imbalance between both phases has long term consequences and should be addressed.

Figure 1. Your liver and Phase 1 and Phase 2.

liver diagram

Diagram created by Dr. Olisa Mak

Although the body naturally produces reactive oxygen species, the body has protective mechanisms in place to protect itself. By eating a diet rich in antioxidants such as vitamin C, zinc and thiols (e.g., NAC) which can be found in garlic, onions and cruciferous vegetables, the body neutralizes these harmful, reactive oxygen species.

The balance between both phases is important to understand as it plays a key role in the metabolism of everything that our bodies comes into contact with—not just coffee but alcohol, medications, supplements, pesticides on our foods, even chemicals we absorb through our skin from personal health care products. The rate at which these two phases function ultimately defines how well our liver protects us from everything that we are exposed to. The chronic illnesses associated with high oxidative stress may not appear right away but ultimately affect our ability to live healthy and happy lives. Love your liver by eating a well-balanced, organic diet, rich in antioxidants and nutrients.

My ordeal from drinking only two cups of coffee one after the other brought to my attention the imbalance between my liver’s phase one and phase two. I too will examine my diet and find a way to improve my liver’s functioning. Will you?

If you’re concerned about your liver function, book an appointment to see how your liver function can be improved. Make better, more informed, decisions about their health. Come in for an appointment and get started with an individualized treatment plan just for you.

Dr. Olisa Mak ND is at Inspirit Clinic in Yaletown, Vancouver, BC.

GERD and Protein Pump Inhibitors: Seeking Alternatives

GERD and Protein Pump Inhibitors: Seeking Alternatives
Ingrid Pincott, ND

Proton  pump inhibitors (PPIs) are one of the ten most prescribed drugs in North America. PPIs are used in the treatment of acid reflux or GERD. I see at least one patient every week who is taking PPIs and wanting to get off them.

Bob, age 45, is a typical example. He has been taking PPIs for years and his GERD symptoms were not completely under control. He also had developed a rash he could not get rid of through conventional treatment so he is ready to try and improve his health. Certainly if a person is in severe gastric pain due to hyper-secretion of stomach acid, these drugs are useful to treat the acute phase. The side effects of long term treatment include: Decreased blood flow to the stomach, bacterial overgrowth in the stomach, hyperplastic polyp formation in the stomach, increased bile reflux and increased food allergy because food is not digested properly. Hypersensitivity reactions that can occur include urticaria, contact dermatitis, and drug rashes.

One of the reasons an MD might recommend a PPI for life is due to Barrett’s esophagus which increases the risk of developing esophageal adenocarcinoma (EAC).  However, in some recent research published by F. Hvid-Jensen, 2014, the risk of developing EAC increased with PPI use due to the increased formation of polyps while taking the drug!

Other complications of long term PPI use include: gastrin secretion increases, contributing to the risk of colon cancer, and esophageal adenocarcinoma; women taking PPIs have an increased risk of hip fracture, and reduction in bone density; there is also an increased risk of developing community acquired pneumonia especially in the elderly; and, finally, there is an increased risk to developing C. difficile as well as an increased risk of having a heart attack.

I recommended to Bob to come off PPIs gradually over six months to avoid rebound excess stomach acid. Some patients I have seen come off a lot faster than that because they did many other changes at the same time. For example removing wheat from their diet, eating a low carb diet, and eating food in proper combination helps a great deal to reduce GERD symptoms quickly. I put Bob on my candida program which addressed a lot of these recommendations in one protocol. The “yeast” killers help to kill off harmful bacteria and taking a strong probiotic away from the “yeast” killers helps establish a healthy microbiome. I told Bob this treatment program has helped many with chronic GERD.

I also have great success with a digestive aid containing  licorice, marshmallow and slippery elm that is aimed to heal the  stomach and help digest starches and fats without the use of protease, which can aggravate these cases in the early phases of treatment.

I saw Bob one month later. He was using the PPIs much less and was amazed. His skin was beginning to clear and he was much less itchy. He continued on the candida program for another two months and once he was off the PPIs I recommended a slightly stronger digestive enzyme. During this time I noticed on his blood work results that his liver and gallbladder were abnormal so I added a bile thinner and detoxifier for at least three months.

At the six month mark, Bob had lost 20 pounds due to the diet changes, his liver enzymes were back to normal and the only digestive aid he needed were the probiotics and the digestive enzyme. Often the symptoms of too much stomach acid are the same as too little stomach acid. The rest of his maintenance health program included B complex, vitamin B12, omega-3 essential fatty acids, vitamin D and a calcium magnesium complex. PPIs deplete magnesium and B12 so we had some catching up to do because he had been on them for so many years.

[A version of this article originally appeared in the Campbell River Mirror, March 25, 2016.]