Ballard Naturopathic Blog | Supplements

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Stone Turtle Health Blog

Alternatives to Antibiotics?

March 29, 2015

The White House has just released a 63-page report that sets 1-, 3-, and 5-year goals for adderssing antibiotic resistance and overuse. The report focuses on slowing resistance, having a single point of integration for multiple health information networks, to accelerate research, testing, and treatments for current bacterial infections to stay a step ahead of the resistant bugs. By 2020, the report goals include a 50% reduction in inappropriate antibiotic use in outpatient settings, including family practices like ours. 

Where do antibiotics fit into naturopathic medicine and how does this plan affect naturopathic doctors? Any treatment, including antibiotics, vaccines, and surgery can be done "naturopathically" if it is utilized within our Hierarchy of Interventions (lowest to highest, as appropriate) and if it is performed in accordance with the tenets of our profession. These pillars, discussed in earlier posts, include "treating the cause" (something antibiotics do well) and "prevention" (vaccines, check!) as well as "first, do no harm", "treating the whole person", "doctor as teacher", "wellness" and the "healing power of nature". Naturopathic medicine is not a proscribed set of herbs or nature therapies to the exclusion of advances in medicine, it is a philosophy that takes these tenets into account when treating each patient as an individual. Sometimes, antibiotics are the right choice. Sometimes, an herbal remedy with antimicrobial properties would be a better, lower-level intervention for a less serious bacterial illness. NDs (naturopathic doctors) work to support the patient's own immune system in addition to appropriate interventions to address the cause of the illness, whether it is lifestyle-related, genetic, bacterial, viral, fungal, or environmental.

As a parent, it is difficult to take a sick child into the doctor and NOT come out with something tangible, like a prescription for antibiotics. Many doctors feel pressured to "do something" by the parents, aside from recommending rest and hydration. However, antibiotics do not address causes that are not bacterial, such as viruses, and should not be given unless there is a strong indication for need. In addition, there are a number of antimicrobial or antibacterial herbs that can be used in place of antibiotics in milder illnesses. Many viral illnesses are self-limiting and sometimes the best thing we can do is to support the immune system with natural antivirals (like elderberry and licorice) and help to relieve symptoms that are the body's way of attacking the virus (cough suppressants like cherry bark for example). Common hygiene practices, such as proper hand-washing technique, can slow or stop the spread of viruses and bacteria in many cases. Naturopathic medicine has multiple treatment choices that can help minimize our reliance on antibiotics, allowing them to be reserved for more serious bacterial infections and slowing the progression of antibiotic resistance. It is my hope that some of that research money will be used to replicate earlier studies on antimicrobial herbs as an alternative to antibiotics for resistant bugs. 

The Dark Night

October 27, 2010

We're entering the time of year when many people get up and dressed in the dark, drive to work in the dark, and then drive home in the dark, after sitting all day in an office with fluorescent lighting. Many of us are exhausted all the time, regardless of our sleep habits. We need sun, really need it. Our bodies use sunlight to activate vitamin D, which is used in so many chemical reactions, from absorbing calcium in the digestive tract to supporting immune function and brain health. Without vitamin D, we find ourselves lethargic, depressed, with poor digestion, low back pain, and not functioning at our best mentally.

In the state of Washington, something like 80% of people are clinically vitamin D deficient, the highest rate in any of the 50 states, including Alaska. Washington also has the highest rates of MS, depression, and certain kinds of cancers. Not only that, but in many cases, people who test within the normal range (lab values between 30-100 are a typical normal range), may still not be getting enough vitamin D to adequately absorb all their dietary calcium. Values greater than 50 are necessary to properly absorb calcium, which is used in bone health (as we all know), brain function and also in muscle contraction and relaxation (skeletal, smooth, and cardiac). Without adequate absorption, our bodies begin to break down bone cells to release calcium, leading to osteopenia and, in some cases, osteoporosis. This bone damage begins in our 20s and women are particularly susceptible although it can happen to men, too. Weight-bearing exercise, such as walking or weight training, is also important to help maintain healthy bones, but without the calcium to lay down over the lattice of bone cells, bones become brittle and more prone to fracture.

 The vitamin D test is a very simple, cost-effective blood test that can be performed at any time of day (you don't have to be fasting) and is covered as a standard laboratory test by almost every insurance plan. Supplementation with vitamin D is an essential tool for getting through the dark winters of the Northwest and should be done under a doctor's care. Most over-the-counter supplements are either in a poorly absorbable tablet or are in insufficient dosages to have any significant effect on vitamin D deficiency. It is a fat-soluble vitamin that should be taken with food to aid in its absorption. Adults, pregnant women, and children all have varying recommended dosages and should seek professional testing and advice from their family naturopath before beginning supplementation.

And the most important caveat: Don't use tanning beds to try to ramp up your D levels. They project both the vitamin D- enhancing UVB light as well as the skin cancer-inducing UVA. Stay out of the tanning beds!

Supplements

March 5, 2010

Today, I was given a link (via a FB friend and colleague) to what was termed "a visual representation of the research done on supplements". It's very pretty and interactive (you can click on a tab to gauge the benefits of a supplement as related to a specific category of illness). The link is here: http://www.informationisbeautiful.net/2010/snakeoil-scientific-evidence-for-health-supplements/

It's an interesting site, not just because of the visual qualities, but because they use interesting parameters to affect the size of the "balloons", each depicting a different supplement. The higher up the page, the more "large, human, randomized, placebo-controlled trials" were found in searches of two top search engines, PubMed and Cochrane. The size of the balloon reflects the number of Google hits for a supplement. I'm not entirely sure of the relevance of this, myself, since anytime a supplement comes into fashion, the number of websites and Google searches will correspondingly shoot up.

I look forward to seeing this specific illustration grow and change as the authors find more studies to validate or invalidate health claims made by people on both sides of the supplement argument. I would posit that, while many herbs, vitamins, and minerals have not been included because they have not been the focus of these large studies, there is something to be said for an herb with a 3000-plus year tradition of being used for a certain condition. This is termed "empirical evidence" (as opposed to evidence found using the scientific theory of forming a hypothesis, eliminating variables and testing the hypothesis) by people supporting a specific issue and "anecdotal evidence" by those opposing it. As humans, we have a wonderful capacity for assigning value to an object through spin, or, as I like to call it, creative wordsmithing.

For my practice, I will continue to suggest treatments that I've seen work, have been educated to understand why they work (what effect they have on the body physiologically), and have seen research on that is compelling enough for me to feel comfortable prescribing to my patients. Many, many of the treatments I use fall outside of the scope of this link and it's graphical representation, but I feel that they have a good grasp on the need to protect consumers from false health claims and a strong commitment to recommending demonstrably useful supplements. It's a great start to educating the public.