Archive for July 2013

Time

Sometimes time seems to fly by. Especially now, in the middle of summer. It seems it’s June one day, September the next.

For those suffering from pain or other health challenge, however, sometimes time drags. Though a health problem can happen in an instant–like a pulled muscle on a soccer field or whiplash from a car accident–most health conditions take time to build. They also take time to settle, improve, or resolve.

Of course we’d like our healing process to be as quick as a cheetah, instant coffee, and high speed internet–“faster is better,” the commercial tells us. But, this is not how the body–or nature–usually works.

Nature takes time. For example, in Hawaii I bought 2 sticks. The directions read that after cutting off the wax ends and placing them in water, these sticks would grow into the sacred Hawaiian ti plant called “Ki.” I placed one of the sticks in water and waited. A week later, added more water, and waited. Week after week I waited and watered, watered and waited. I started to think that all I was going to get out of this process was a wet stick.

Finally, a little green bud and a couple of skinny little roots emerged. Now, about 6 months later, I have a full Ki plant and a wonderful reminder of a wonderful place. But, if I had given up, I would have tossed the stick into the garbage and figured it would never have worked.

The body can be like this. Sometimes we need to pay careful attention to the small shifts, practice patience, give our bodies time. Then one day we might notice that eating more vegetables, getting acupuncture, getting more sleep, practicing a regular exercise program, meditating, and/or taking herbs really is making a difference.

 

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To Supplement, Or Not To Supplement

To Supplement, Or Not To Supplement

The following very LONG page is from 2 articles I wrote for a local magazine. I thought some might find it useful here:

Have you ever walked into a pharmacy or a nutrition store and gazed upon the bottle upon bottle of options for supplements? Perhaps you want to buy some calcium, but find it hard to pick out the best one. Price is certainly one thing to consider, but it is definitely not the most important thing to mull over when purchasing. You wouldn’t just pick the cheapest car when auto shopping, just because it’s the cheapest. That $200 “deal” might be trash on wheels and what a waste of your money it could be.

To Supplement, or Not to Supplement, That is the Question…(part 1)

The first question is whether you actually need to buy any supplements. Even the Canada Food Guide now recommends a multivitamin/mineral supplement. There are many reasons why a supplement may be useful or even essential.

  1. You don’t eat enough healthy, nutritionally balanced and varied meals. Broccoli, tomato, and lettuce are not good enough to cover your vegetable category. Can you try to guess the most consumed vegetable of North America? Potatoes. Usually in the form of French fries. Really not good enough.
  2. You have higher nutritional needs. Illness, stress, medications, and higher activity levels are examples of situations that cause a need for more nutrients. Some medications cause specific nutrient deficiencies. Ask your health practitioner or pharmacist about your medications and their impact.
  3. You have poor digestion/absorption. Just because you consume something does not mean that your body uses all those nutrients. We tend to produce fewer digestive enzymes as we age. Those with digestive issues such as irritable bowel syndrome, Crohn’s, colitis, indigestion, and others may not have good digestive absorption of vitamins, minerals, and other key nutrients from food. Also, as we age, we produce less stomach acid and fewer digestive enzymes. Even if you have heartburn or acid reflux, you may still have insufficient stomach acid. It may be that the problem is not enough of a protective lining of mucus to shield the stomach tissues or that the valve that stops stomach acid from rising is too loose and allows stomach acid to seep back and irritate the esophagus (the tube that brings food from your mouth to your stomach).
  4. Our food is less nutrient-rich than it once was due to nutrient-poor soils from over farming, early harvesting so that foods can be send on long journeys across the continent or from the other side of the world, pollution, and poor quality foods. We used to grow our own food or buy it from our neighbours. We used to pick up fresh foods daily. We now buy foods laden in preservatives. We add artificial or “natural” flavours to try to make them tasty again. We buy foods from the other side of the world. Try eating a banana in Thailand. It tastes totally different than what we eat here. Why? Because we don’t grow bananas here! Those bananas are picked long before they are ripe.

Some Basics

It is impossible for me to list all the supplements that you could or should consider, so we’ll just cover a few fundamentals about multivitamins/minerals in this article and expand on other important supplement categories next month.

Multivitamins/minerals

If any of the four listed issues above are ones that you think affect you, then consider a multivitamin/mineral. As mentioned, not all supplements are created the same. When picking up a multi, read the label or ask someone to help you. These are some things to look for:

a) We all have different needs at different stages of our lives. Women are different than men. Age plays a factor. So, if you are over the age of 45 or 50, pick a multi that is designed and labeled as specific to your age group.

b) Some nutrients are trickier than others. Looking at a multi, one way to assess quality is to check out the vitamin E. Does it read dl-alpha-tocopherol? If so, then that company is using a synthetic vitamin E which is poorly absorbed. Make sure that it reads d-alpha-tocopherol. Note the missing l. If the multi has mixed tocopherols or, even better, includes tocotrienols, you are getting a leg up on your vitamin E source and that multi is likely a very good one.

c) Check out the “non-medicinal” list of ingredients. I recommend avoiding supplements that add in extras like aspartame (an artificial sweetener—more likely found in the chewable forms), hydrogenated palm or soybean oils (hydrogenation produces trans fats, that bad stuff you have been hearing more and more about), sodium benzoate (a preservative), and FD&C dyes.

d) Remember, multis are a mix of various vitamins and minerals. If your multi is a single colour (usually a bright reddish orange), then dyes and other coatings have been used. Multis also often smell bad. The B vitamins, in particular, smell bad. That’s normal. If you have to, plug your nose when you take them.

Here’s a hint about swallowing these usually large pills: Have a small mouthful of food, chew it well, and pop in 1 or 2 of the supplement tablets or capsules with the food. You will find it much easier to get down.

Supplement How-To, (part 2)

Last month I covered some basic things to consider for choosing and taking supplements to optimize your health. This month’s article will cover a few specifics about some particular areas of health, but do remember that these recommendations are still generalized and you may want to discuss your particular needs with your health care provider or qualified natural health practitioner as each individual’s needs will vary.

Essential Fatty Acids (EFA)

You’ve likely heard about the importance of essential fatty acids (EFAs). Some best sources are found in flax seeds, hemp seeds, chia seeds (yes, of the famously known “Chia Pet” plants), and fish such as salmon, tuna, sardines, herring, and mackerel. The merit of EFAs is not overstated. They are “essential” because your body cannot make them on its own and they need to be consumed in foods.

There are some supplements where the cheapest brand may be just as good as the most expensive. That is not the case with EFAs. While you don’t necessarily have to search out the most expensive one, quality of oil is important.

When choosing fish oils, the small fish are best, i.e. sardines, mackerel, herring, rather than the large salmon, tuna, halibut, and cod. This is because the larger fish, being higher up on the food chain, have potential for a higher accumulation of heavy metals such as mercury.

Flax seeds are a great source of omega 3 EFAs (and fibre), but in order to get the oils out, you need to either buy flax oil, flax oil capsules, or grind flax seeds. Once ground, the flax seeds need to be kept in the fridge. Another option is to buy husked flax seeds as the oils are readily accessible and they are shelf stable.

Hemp seeds and chia seeds are great snacks as they can be chewed to access the oils, protein, and fibre.

Digestive support

In order to properly absorb and utilize all nutrients, your digestive system has to be working well enough. You may not need any of these supplements, but if your digestive system is impaired, you can ask me which, if any, might be best suited for you and what others might you include that I haven’t written about here.

Some key digestive nutrients include the following:

a) Digestive enzymes: As we age, we produce fewer digestive enzymes, substances that our bodies need to break down the foods that we eat so their nutrients can be absorbed and used. Eating raw or lightly cooked (TCM prefers lightly cooked, steamed, slow cooked, and soups and stews) vegetables, fruits, grains (especially sprouted grains), and legumes will provide some enzymes. Supplemental enzymes in capsule format are also available. If you are lactose intolerant (problems digesting milk and dairy products), make sure your enzyme supplement includes lactase.

b) Probiotics: Probiotics are the “good bacteria” that you hear a lot about in yogurt commercials. Yogurt is an okay source, but if you are taking or have taken a lot of antibiotics, or if you have digestive issues (constipation, diarrhea, bloating, cramping, etc.), probiotic supplements are best as they contain much higher dosages of the good bacteria. There are many strains of these bacteria, so it may be best to talk to a natural health care practitioner to determine which is best for you. This is another category where quality makes a difference because if the quality is poor, not enough of the good bacteria will survive and live in your intestines.

c) Fibre: Most of us do not get enough fibre in our diets. Although many people think that we only need to worry about fibre if we are constipated, its benefits are many. Fibre does help with regulating bowel function, will not cause “too many bowel movements” when taken properly, helps keep blood cholesterol in check, helps regulate blood sugar levels, and may even help prevent cancer, kidney stones, and gallstones.

d) Senna: I want to mention this one because it is commonly taken to remedy constipation. Note, however, that it can become habit forming because the body can become dependant on it. Talk with your health care provider for other options so that you can limit or avoid senna.

Bone Supplements

Note that for this category, I didn’t simply label it Calcium. Many nutrients are key to good bone health.

a) Calcium: Calcium carbonate is commonly used, but it is generally poorly absorbed. Calcium carbonate is what antacids use to decrease stomach acid. The problem with that as a calcium source is that we need stomach acid in order to absorb calcium and our stomach acid tends to decline as we age (even if you have acid reflux, it does not mean you have too much acid, just likely not enough mucus to protect from the acid). Better options include calcium citrate, calcium chelate, and my preferred, calcium microcrystalline hydroxyapatite complex (MCHC). The last one can not only slow the rate of bone loss, but also reverse bone loss attributed to osteoporosis.

b) Magnesium: More than 60% of the body’s store of magnesium is in the bones. Sufficient magnesium is required for vitamin D and calcium absorption. In addition, magnesium on its own has been shown to slow the rate of bone loss. Magnesium oxide is a poorly absorbed form, so what you are best consuming in supplement form is magnesium citrate, magnesium chelate, or magnesium glycinate. Magnesium may also help reduce muscle cramps and help with relaxing for sleep.

c) Vitamin D: Vitamin D is essential for optimal calcium absorption. While your body can make this nutrient from exposure to sunlight, many of us do not get enough sun throughout the year to support our needs.

d) Others: Manganese, copper, zinc, strontium, boron, and phosphorous are other key bone nutrients.

Supplements is a huge topic and I’ve only covered a very small part of it, but some things to remember are that no supplement should be used to replace a healthy diet and lifestyle, that while generally safe you should make sure that the supplements that you take are suitable for you and in combination with any medications that you take, and that quality of product and an appropriate dosage will impact the effectiveness of any supplement.

 

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Digestion According to TCM

My article as printed in Inside Tract about TCM and digestion:

“What foods should I eat?” For my patients both with and without digestive health issues, this is a common question. My answer is not that simple. Traditional Chinese Medicine (TCM) principles have me change my recommendations from person to person as well as from season to season. This is because, of course, we are not all the same and because external environments affect our bodies. So, there is no ONE perfect diet for all.

TCM is the second largest and the oldest continuously practiced professional medicine in the world, used by one-third of the global population. Before we can discuss the treatments of TCM for digestive health, we need to understand the basics of digestion from a TCM perspective.

tongue TCM healthTongue/Mouth

Where does digestion start? In the mouth, of course. When you go for a TCM consultation, don’t be surprised when you are told to stick out your tongue. The tongue is the only internal organ that we, as TCM doctors, can ask to see. We certainly can’t ask you to pull out your liver or stomach!

Observation of the colour of the tongue (should be pink), the coating on the tongue (should be thin and white), and the shape and size of the tongue reveal clues as to what is occurring in the body. If, for example, you have a swollen tongue with a thick coating on it, then perhaps some of the symptoms that you suffer from include bloating and borborygmus (a fancy name for rumbling tummy caused by intestinal gas). A TCM doctor would have you limit or avoid phlegm-producing foods like dairy, wheat, and even bananas. If your tongue is red, dry, and thin, your symptoms may include heartburn, constipation, or hemorrhoids, and a TCM doctor would advise you to avoid spicy foods.

digestion TCMStomach

Let’s follow the food down from the mouth to the stomach. TCM envisions the stomach as a cooking pot. When food reaches the “pot”, it is partly broken down by the “cooking” process. This is really not that far from the actual action of stomach acid continuing the digestive process that began in the mouth. Since a pot requires fire or heat to cook food, TCM recommends the avoidance of excess cold and raw foods, including ice, ice cream, and sushi (although remember that sushi is traditionally eaten with the warming foods ginger and wasabi). Instead, the emphasis is on lightly steamed vegetables, and during colder seasons, more soups and stews, for easier digestion.

If you do not have enough digestive fire, your metabolism may be too slow and symptoms may include bloating, undigested food in the stools, and pain that is improved by warmth. If you have too much digestive fire, you may suffer from heartburn, an insatiable appetite, or constipation. Because foods can have an innate warmth or coolness, you may want to eat foods appropriate to your constitution, as well as to the weather. For example, spicy foods are obviously heating, but too many or too hot can cause digestive irritation. More suitable warming foods include ginger, cinnamon, fennel, winter squash, sweet potato, kale, oats, spelt, and quinoa. If you have a tendency toward heat signs and symptoms (not necessarily just feeling hot), you could consider cooling foods like peppermint, dandelion greens, cilantro, apples, watermelons, citrus fruits, tofu, millet, barley, amaranth, lettuce, cucumber, and yogurt.

healthy food and digestionSpleen/Pancreas

The next organ involved in TCM digestion is the spleen. The spleen and pancreas together are termed the spleen system. So, if you suffer from bloating, soft stool/diarrhea, undigested food in your stools, fatigue, and/or poor appetite, your TCM practitioner will likely tell you that you have spleen energy deficiency. One of the spleen’s jobs is to transform food and fluid into useful nutrients and to transport those nutrients to where they are needed in the body. Try including foods like squash, carrots, yams, well-cooked rice, ginger, and small amounts of honey or molasses in your diet, while limiting or excluding dairy, citrus, fried or heavy foods, and too much sugar.

liver cleanse healthLiver

The liver is involved in helping to cleanse the blood and detoxify the body. It also secretes bile which is stored in the gallbladder. Bile is required for the proper digestion of fats. TCM’s liver system does have these functions, so poor quality fat, intoxicants, chemicals, and denatured foods all cause problems for the liver. In addition, the TCM liver soothes and smoothes the functions of the whole body, including the emotions. A person whose liver system is not functioning properly will likely have emotional struggles such as irritability, frustration, aggression, impatience, stubbornness, and anger. Dandelion root or greens, milk thistle, artichoke, and chlorophyll-rich foods such as spirulina, wheatgrass, and chlorella may be helpful. Because stress can particularly aggravate problems with this system, it is also important to find ways to relax and manage stress.

Intestines

The jobs of the small and large intestines are to absorb nutrients and eliminate digestive waste. In order for this to happen properly, the intestines must have healthy cells lining the walls and the muscles must be able to contract rhythmically (peristalsis) to move matter along. Sufficient fibre and water must be consumed to ensure proper elimination, but I’m sure you already know that. If you do suffer from constipation, then avoid alcohol, yeasted breads, foods with baking powder or baking soda, and refined ‘white’ foods such as white bread, white pasta, white sugar, and white rice. General foods to implement for chronic diarrhea are rice or barley broth, leek, eggplant, sunflower seeds, yam, and aduki beans.

While many of TCM’s wordings for how the digestive system works are different from conventional allopathic medicine, the basic principles are similar. Eat healthy, whole foods, limit junk foods, chew your food well, eat regular meals, and enjoy!

Inside Tract Digestion TCM

Inside Tract Digestion TCM

Inside Tract Digestion TCM

 

 

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What pharmacy students asked me about Chinese herbs

What pharmacy students asked me about Chinese herbs

I recently did a talk for a class of pharmacy students at the University of British Columbia. I was happy when they asked me lots of questions though and I thought you might have some of those same questions.

How many Chinese herbs are there?

There are more than 6000 herbs–including plants, minerals, and animal parts–with 600 used commonly.

Do you prescribe things like tiger bone, bear gallbladder, and rhinoceros horn?

NO! A big emphatic NO! Though they have been used traditionally in TCM in the past, they are illegal in Canada. Not only that, but they are not necessary to use. There are many substitutes that are effective and ethical to use.

What herb is best to treat…[fill in the blank, e.g. headaches]?

In TCM, the key is to obtain a TCM pattern diagnosis. Everyone is different, so 10 people with a headache might all have different herbs and treatments. Not only that, but Chinese herbs are almost always prescribed in combination, almost never as single herbs.

How do you make sure that herbs you prescribe are safe?

An herbal prescription is chosen with safety at top of mind. We consider the length of time that the herbs will be prescribed, the quantity of herbs prescribed, the methods of processing the herbs, whether there’s any risk of conflicting with any pharmaceuticals or other nutraceuticals, each individual’s health issues, and allergies and sensitivities.

Do the herbs come from China? Is the quality safe?

Some of my patients are concerned about the quality of the herbs I prescribe as they hear about quality issues with come products and foods that come from China and other countries. Some problems include that poor quality herbs can low quality or incorrect herbs; can be adulterated with pharmaceuticals; laden with heavy metals, pesticides, fungus, molds; and manufactured in substandard facilities.

But, not all herbs can be painted with this same brush! The herbs I use go through rigorous testing. They are extremely high quality herbs that much attain a Certificate of Analysis (COA). They must pass the strictest criteria of standards from U.S., Singapore, Japan, and E.U. Herbs go through a process of identification that includes selection by qualified professionals, microscopic inspection, chemical identification, and chemical “fingerprinting” (thin layer chromatography) to make sure that the right herb is chosen. Herbs are cleansed of dirt and other foreign particles, prepared with traditional methods, and extracted while making sure to maintain the integrity of the volatile essential oils. They are then concentrated with low temperature methods so as to not destroy any of the components. Every batch is tested with microbiological assays to make sure there is no e.coli, salmonella, molds, yeast, or other contaminants. Gas Chromatography tests for safety, making sure there are no pesticides, fungicides, and herbicides. High Performance Liquid Chromatography measures for key active ingredients while Inductively Coupled Plasma – Mass Spectrometer tests for heavy metals.

Phew! So, as you have learned, there is a lot that goes into the selection of each herbal formula that I create!

Any questions? Ask me!

 

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Planning for the Worst

Planning for the Worst

Don't stress acupncture fear.jpgThis is a change for me. It’s not that I don’t sometimes find my thoughts spinning me around in worst case scenarios. I do worry sometimes, though it seems less and less over time. However, I have never recommended actually trying to imagine and think out all the ways that things could go wrong.

I started this blog by writing about people’s fear of needles. If you want to read how I normally address people’s fear of needles, read here. But then thought that fear stops so many other things as well. Fear stops many from stepping onto the paths that would bring them greater happiness, health, wisdom, or other positive trait. Fear leaves people wondering “what if”. Fear freezes people. So, fear needs to be addressed on its own, not just in relation to needles.

I usually think that fear can be overcome by looking toward the positive. If I am afraid of flying, but really want to visit Japan (my husband’s situation), then the positive of travel experiences can drive me to get on a plane regardless of my fear.

What I find happens more often is a choice between a lesser of two evils. People come in for acupuncture despite their fear of needles because something that they are experiencing now is worse than the worst they can imagine acupuncture will deliver. Physical pain or discomfort or emotional turmoil are strong incentives to push ones’ boundaries.

A third way of thinking about how to move past fear is something that I have never done myself: Planned Pessimism. Tim Ferriss, author of “The 4-Hour Workweek” and “The 4-Hour Body” discussed this.

The basics of Planned Pessimism are:

1. Write down worst case scenarios

2. In a column next to each of those situations, write out what you can do to resolve or avoid those possibilities.

For example:
If you have a fear of needles.

Worst Case Scenario Resolve or Avoid
It will hurt Tell Acupuncturist to stop if it does hurt.Breathe through thoughts about discomfort.Tell Acupuncturist that I’m concerned about how it will feel.Ask for smallest needles.Note: Acupuncture is not painful.
I may get an infection from the needle Make sure that Acupuncturist is using sterile disposable needles, one-time-use.
I may get injured Choose a qualified professional. Acupuncture training varies in different provinces and states, but if there is a licensing board, make sure that Acupuncturist is registered and licensed. (In British Columbia this requires a minimum of 1900-3250 hours of acupuncture study, including 450-1050 hours of practicum training, as well as completing written and practical licensing examinations and ongoing continuing education)Tell Acupuncturist about your concerns so they can explain what they are doing.
I don’t like needles of any kind Don’t watch. Close my eyes. Breathe.Don’t think of them as needles. They don’t feel like needles.Daydream about something else during treatment. Use distraction.

I’m still not sure that planned pessimism is the best way for me to get through any fears or worries, but if you have trouble finding that silver lining or looking at the bright side of things or perceiving the glass as half full, this may be another way to move forward.

As Yoda said: “Named must be your fear before vanish it you can”.

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But I’m afraid!

But I’m afraid!

Are you afraid to give acupuncture a try?

woman screaming

My first response is that acupuncture is not painful, as that’s what most fear. I call it ahhhhhcupuncture, said with a sigh, because most fall asleep during their treatments. But, if saying that doesn’t help, I suggest to have that person contact me. Maybe there’s a non-needle approach I can suggest: herbs, supplements, lifestyle changes, dietary recommendations, etc. Maybe they’ll be willing to try just one needle.

That’s something I’ve done with a number of patients. I’ve asked them if I could try just one acupuncture needle with them. I said that if it hurt or they didn’t like it, I would immediately take it out and not continue. Everyone has let me continue. Because acupuncture should not be painful. One of my acuphobe patients now calls the acupuncture needles “happy sticks” as she doesn’t think of them like needles.

For some, explaining the difference between an acupuncture needle and a hypodermic (injection) needle makes it less scary. An average hypodermic needle could fit 10-40 acupuncture needles inside. An acupuncture needle does not push in or pull out any fluid (that is often what you feel more than the injection needle itself). An acupuncture needle is shaped differently. This shape allows it to glide easily through tissue with less disruption and thus less (or no) pointy needle sensation. An acupuncture needle is very, very, very thin.

woman relaxing on tableThis is why some of my patients fall asleep before I’ve even finished putting in their acupuncture “happy sticks”!

This convinces most people that an acupuncture needle experience is different from an injection needle experience and turns acuphobe to acuphile. But, still not everyone is convinced that it’s not scary.

It was a 5-minute video that I just watched that made me think that there’s another way to approach people’s fears. It’s called “Practical Pessimism”. Tim Ferriss is author of “The 4-Hour Workweek” and “The 4-Hour Body”. I haven’t read the first book, but I’m being open-minded in reading the latter. If you want to read more about how I can link Yoda, Tim, and acupuncture, click here for my blog on “Planning for the Worst”.

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Name This Cooling Food

This food is about 92 percent water.

This food has just 48 calories in 1 cup.

This food provides 19.5 percent of the daily value of vitamin C and 13.9 percent of vitamin A through its beta-carotene.

This food is also a rich source of vitamins B1, B5, B6, biotin, magnesium, potassium, and fibre.

This food is a summer favourite for many!

If you didn’t know which food from the first hint–it’s name includes the word “water”–perhaps you recalled that beta carotene colours foods red or orange.

Did you know that this food can help lower your blood pressure, improve heart function, support healthy muscles and nerves, enhance your immune system, improve your skin, and boost brain function?

Check it out, it’s watermelon.

Try Chef Luisa Rios’ Watermelonade:

In a blender, combine 4 cups of chopped water­melon with half a tray of ice and the juice (about 4–5 table­spoons) and grated zest of 1 lemon. Pulse for 2 minutes or until smooth. Garnish with a slice of watermelon. www.cookingjourneys.ca

 

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