Prebiotics & Metabolic Regulation Psychiatric Disorders

DOCERE US Cannabis Regulation: What It NATUROPATHIC DOCTOR NEWS & REVIEW Means for Naturopathic Doctors ...... >>10 VOLUME 15 ISSUE 1 JANUARY 2019 | GASTROINTESTINAL HEALTH / TOXICOLOGY / BARIATRIC Shaon Hines, ND Laws around marijuana and hemp are confusing. Dr Hines’ article helps to clarify the issues.

FUT2 Secretor Status: Tolle Totum Effects on Gut Health ...... >>16 Ginger Nash, ND The gene controlling secretion of ABO antigens into Prebiotics & bodily fluids highly impacts GI function. EDUCATION Medical Resources for NDs: Metabolic Regulation A Review of Current Publications for the Naturopathic Industry ...... >>13 Blaine Harbourne, ND, LDN, CNS, CSCS Benefits Beyond the Gut Dr Morstein’s book on diabetes is a valuable resource for both patients and practitioners.

Naturopathic Medical Education: ERICK R. CERVANTES, MPH, ND What a Russian Soldier Taught Me DALE PFOST, PHD About Its Value Proposition ...... >>28 David J. Schleich, PhD uman beings are host to a diverse Weaving traditional values into worrying trends will keep the medicine defined in tough terrain. Hecosystem known as the microbiome. Characteristic of our microbiome, among many other things, is its now well-known TOLLE CAUSAM diversity within the individual and from Autoimmunity & GI Disorders: person to person, as well as its vast array Sorting Out the Triggers ...... >>14 of elaborate influences on our physiology. Chad Larson, NMD, DC, CCN, CSCS Dr Larson reviews models of immune dysregulation Our scientific knowledge of this symbiotic and how to nail responsible triggers. ecosystem has grown tremendously, and its clinical significance and implications cannot Clostridia & Constipation: Using Organic Acid Testing in be ignored. This paper highlights how some Diagnosis & Treatment ...... >>18 microbiota within our intestinal tract, in Angela Knapp, ND particular the large intestine, influences Dr Knapp reviews an often overlooked cause of chronic constipation and how to identify it. Continued on page 3 NATUROPATHIC Student Scholarship Honorable Mention PERSPECTIVE SIBO as an Adaptation: A Proposed Role for Hydrogen Sulfide ...... >>20 Greg Nigh, ND, LAc Psychiatric Disorders Despite symptom-inducing, microbial H S might be 2 Targeting the Microbiome an important source of sulfate in the body. STUDENT SCHOLARSHIP Honorable Mention – The Carroll ALEXANDRA FRANCIS, ND, MS, CNS genes than the human genome. It is now bowel syndrome (IBS) and inflammatory Method: An Explanation ...... >>22 MARIE WINTERS, ND, FABNO widely considered that the gut microbiota bowel disease (IBD), as well as systemic Jared C. Pistoia should be considered an ‘exteriorized’ conditions such as diabetes mellitus, obesity, Sussanna Czeranko, ND, BBE All disease begins in the gut. organ placed within the body, which and cardiovascular disease. This bioelectric technique for identifying food intolerances is far underutilized by doctors. (Hippocrates) provides important physiological functions 1 and is indispensable for human life.” Psychiatric Disorders VIS MEDICATRIX NATURAE hen in doubt, treat the gut” is These microorganisms are responsible for About half of US adults will experience Wan excellent naturopathic rule of metabolizing dietary nutrients, xenobiotics, a mood or mental disorder consistent Gallbladder Disease: thumb that naturopathic doctors have and drugs, as well as maintaining the with the diagnostic criteria in the DSM- Not Just a Problem for Women...... >>24 Robin DiPasquale, ND, RH (AHG) relied on for decades. We have always integrity of the gut mucosal barrier, IV at some point during their lives.3 Dr DiPasquale reviews risk factors and treatment understood that symptoms and chronic immunomodulation, and protection The onset of these disorders is usually tips for gallbladder, including key herbs. diseases often improve when we focus against pathogens.2 during childhood or adolescence, which on treating the gut, but only recently has Our knowledge of the functions and suggests that treatment methods should NATURE CURE there been exploration into why this is roles the gut microbiome plays in our be directed at the younger population and so. We’ve been told that we have more health and physiology has been expanding. emphasize prevention.3 Use of conventional CLINICAL PEARLS microorganisms in our gut (meaning our The gut microbiome is a relatively new drug therapies for psychiatric disorders Dyspepsia ...... >>26 whole digestive system, but primarily exploration in the field of medicine, and has been on the rise over the last few Sussanna Czeranko, ND, BBE the small and large intestines) than we recent research has shed light on promising decades. Given the increasing rates of A century ago, Naturopaths were already successfully treating dyspepsia naturally. have cells comprising our bodies. “The new clinical applications of focusing mood disorders and drug dependence human gut microbiota consists of a treatment efforts on the gut microbiome. trends, conventional drug therapy appears NDNR.COM complex community exceeding 100 trillion Some of the conditions shown to benefit to have had relatively low efficacy in Register online to read web-only content and microorganisms whose collective genome from optimizing the gut microbiome include psychiatric patients, especially those with access archives. – the microbiome – encodes 100 times more several digestive disorders, such as irritable Continued on page 8 Available online at ndnr.com

Naturopathic Doctor News & Review PO Box 2968 Scottsdale, AZ 85252-2968 Phone 888.627.8677 Fax 480.275.7712 www.ndnr.com BioDisrupt™ Mechanisms of Action ∞ Promoting a healthy Triple Action Support extracellular matrix*

∞ Supporting ideal cellular communication*

∞ Reinforcing normal microbial balance*

BioDisrupt™ supports the healthy immune system’s ability to target the sophisticated self-defense mechanisms of unwanted extracellular organisms. These organisms have developed a series of advanced mechanisms which allow them to evade immune detection. As part of this system, these organisms assemble into clusters, surround themselves with protective physical matrices and communicate among themselves.

Each 2 capsule serving contains:

EnzymeDisrupt™ - Lysozyme, Serratiopeptidase, Beta-glucanase, Lipase, Protease, Celllulase, Hemicellulase HerbDisrupt™ - Cranberry fruit extract, Beberine, Rose-mary extract, Peppermint oil powder N-acetyl cysteine

BDNF Essentials™ Promote Healthy Brain Function

New research demonstrates the adult brain is capable of reorganizing its neural network by forming new connections —— and this is known as neuroplasticity. Neuroplasticity means the brain continues to generate new neurons & synapses throughout life, helping the brain heal from injuries.

KEY ACTIVITIES TO INCREASING NEUROPLASTICITY INCLUDE:

Physical Exercise Learning New Skills Increase BDNF (Brain Derived Neurotrophic Factor) Good Nutrition Sleep Intermittent Fasting

Brain Derived Neurotrophic Factor (BDNF) is one of the key proteins that promote the survival, development and function of neurons. BDNF promotes neuroplasticity, the repair and generation of new neurons as well as supporting healthy telomerase activity.

BDNF ESSENTIALS™, formulated to promote healthy BDNF levels, neuroplasticity and healthy cytokine function, includes the following researched-based nutrients: NeuroCyto Protect™ Blend: Lions Mane Mushroom, Skullcap, Bilberry, Bacopa, Ashwagandha Cognition Blend: CDP Choline, Phosphatidylserine Joseph Burrascano Jr., MD

“I am impressed with the formulas of BioDisrupt™ and BDNF Essentials™ - they each contain well researched nutrients to support the basis of each product.”

+1.800.755.3402 Tel: 805.693.1802 • Fax: 805.693.1806 • [email protected] www.ResearchedNutritionals.com | Available only through healthcare professionals

*These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.

AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

• Look over your project and check for errors; spelling, address, telephone numbers, copy or content. NDNR is not responsible for typos or incorrect information. AD APPROVAL: • Please note that due to differences in monitor calibration, colors on this digital proof ❑ Ad approved as is may not match actual printed colors. ❑ Corrections needed client will supply a correct ad file • Sign this page and email or fax it back to NDNR. ❑ Corrections desired • Any changes from this point forward may cost you in time and materials. client authorizes NDNR to make changes indicated; design fee applies. • NDNR cannot process your job until receipt of sign-off. EMAIL BACK TO: [email protected] or FAX BACK TO: (480) 275-7712 Tolle Totum

Continued from top of page 1 our health through its fermentation of dramatic effects on the composition of the prebiotic dietary fiber and polyphenols microbiota and consequently the type and and the resulting metabolite-driven amount of SCFAs produced. feedback mechanisms. In addition, this The health of our GI tract and the paper discusses the clinical implications of health of our microbiota are thus directly prebiotic (dietary fiber and polyphenols) correlated to our dietary intake of fiber. Our Western lifestyle plays a detrimental role in supplementation for various metabolic More specifically, daily intake of dietary syndromes in terms of its influence on prebiotics (polyphenols and non-digestible our health and well-being. Characteristic of a satiety and blood glucose regulation. complex carbohydrates, aka fiber) directly To illustrate, we present findings from affects the diversity of our microbiota, Standard American Diet (SAD) and Western 2 clinical studies examining the health our metabolism, and therefore our health. effects of a prebiotic blend referred to as a Prebiotics cannot be digested by humans lifestyle is a sedentary lifestyle and an increase Gastrointestinal Microbiome Modulator, or but are fermentable and serve as nutrients GIMM. Both studies were conducted under for the microbiota in the large intestine. the direction of Frank Greenway, MD, of the The SCFAs (the products of fermentation) in energy intake in the form of increased dietary Pennington Biomedical Research Center in are used by the cecal and colonic Baton Rouge, LA, one of the nation’s leading epithelium cells for energy production, and sugars and processed foods. centers for nutrition research. they lower luminal pH, which inhibits the In general, our Western lifestyle plays growth of pathogenic bacteria. a detrimental role in our health and SCFAs also have far-reaching actions well-being. Characteristic of a Standard beyond the intestine. For example, SCFAs American Diet (SAD) and Western lifestyle is a decrease in physical exercise (sedentary lifestyle) as well as an increase in energy intake in the form of increased dietary sugars and processed foods.1 Such diets have a high glycemic index, are high in calories, and contribute to both high blood sugar excursions and weight gain. Daily consumption of this type of diet has led to an increased incidence of complex symptoms collectively categorized as metabolic syndrome. The key characteristics of metabolic syndrome are obesity, loss of glycemic control, dyslipidemia, and hypertension.1 The relationship of these conditions with gut health and our microbiota is explained here. It is also important to note that associated luminal dysbiosis due to poor dietary choices and other factors – such as food sensitivities/allergies, exposure to pesticides in our food supply, alcohol abuse, and antibiotics – plays a major role in gut permeability and impaired gut-barrier function.2 The consequences are a variety of other associated clinical conditions: food sensitivities and allergies, allergic rhinitis, inflammatory bowel disease, celiac disease, autoimmune hepatitis, prediabetes, type 2 diabetes mellitus, multiple sclerosis, systemic lupus erythematosus, depression, and autism.

Prebiotics, SCFAs & Health Our gastrointestinal (GI) health is greatly dependent not only on the foods we eat, but also on the health of our gut microbiota. The human microbiome is the entirety of the environment of microorganisms living in and on our bodies.3 The majority of them symbiotically inhabit our GI tract. Diets that are high in fruit and vegetables are richer in fiber than the SAD diet. On average, Western diets provide approximately 20-25 grams of dietary fiber per day, while high fruit and vegetable diets provide approximately 60 grams of dietary fiber.1 Intestinal bacteria, specifically those residing in the cecum and large intestine, produce short-chain fatty acids (SCFAs) – key signaling metabolites from non-digestible nutrients, specifically fiber and polyphenols, that pass out of the small intestine unaffected.1 The major types of fiber that pass through the gut are plant cell-wall polysaccharides, oligosaccharides, and resistant starches (eg, inulin and beta-glucan). The relationship between the health of our microbiota and high-fiber diets has been well established. Interestingly, the amount and type of fiber consumed has NATUROPATHIC DOCTOR NEWS & REVIEW JANUARY 2019 3 AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

act as signaling molecules to G-protein the pancreas for glucose regulation; it also fungi (as determined by DNA analysis); expands the microbiota populations, receptors involved in satiety and glucose slows gastric emptying.4-7 SCFAs; markers for digestion, absorption, leading to an increased production of regulation, and they regulate the balance and inflammation; and secretory IgA SCFAs (Figure 1).14 With the growth between fatty acid synthesis, fatty acid Study #1 (sIgA) to assess immune function. This achieved by inulin, the second ingredient oxidation, and lipolysis. Specifically, fatty Prebiotic Effects on GI Microbes prebiotic blend was specifically designed – polyphenols extracted from blueberries acid oxidation is activated by SCFAs in & SCFAs to produce a greater yield of SFCAs in the – serves as a microbial substrate that is the liver and muscle tissue, while de novo In a placebo-controlled, double-blind large intestine by diverting biosynthetic acetogenic, ie, uses hydrogen to produce synthesis and lipolysis are inhibited. This randomized trial, 30 adults with a body pathways towards the SCFAs and shifting acetate, a key SCFA (Figure 2).15,16 This can results in a reduction of free fatty acids in mass index (BMI) >30 or a diagnosis of away from biosynthesis of methane and result in a competitive advantage for the the plasma and a decrease in body weight.1 prediabetes were administered either a hydrogen sulfide, gases that have been acetogens and helps shift the microbiome SCFAs inhibit fat storage in adipose prebiotic formulation or placebo for 4 associated with obesity,9,10 type 2 diabetes,11 activity from microbiota that would tissue by suppressing insulin signaling weeks. Stool and blood samples were irritable bowel syndrome and colitis.12,13 otherwise produce methane and hydrogen in adipocytes, while promoting lipid and collected at baseline and at 4 weeks, and The blend included inulin, beta-glucan, sulfide. The third ingredient, beta-glucan, glucose metabolism in other tissues.1 markers for intestinal microbiome health and polyphenols, totaling 8.8 grams of fiber protects the GI tract by triggering the Moreover, SCFAs trigger the release of gut and metabolic parameters were measured. in powdered form. A blend of xanthan gum release of sIgA and acting as a decoy hormones, peptide YY (PYY) and glucagon- For the GI portion of the study, a and cellulose was used for the placebo. substrate for microbiota to consume instead like peptide-1 (GLP1). PYY is known as a GIMM, a strategic blend of 3 prebiotic Participants were instructed to mix the of digesting the mucosal lining.15,17-21 satiety hormone, helping to promote the nutrients, was studied for its ability powder into 6 oz water and take it twice feeling of satisfaction and early cessation of to promote a healthy-functioning gut daily on an empty stomach. No changes Summary of Prebiotic Blend eating. GLP1 triggers the release of insulin microbiome.8 Fecal assessments included were made to their daily meal routine. • Inulin from agave promotes growth and decreases the secretion of glucagon by aerobic and anaerobic bacteria and yeast/ Inulin is a fermentable prebiotic that of microbial populations that produce SCFAs • Polyphenol antioxidants from blueberries provide a substrate for the growth and activity of certain MITOCHONDRIA microbiota that produce acetate, a key SCFA • Beta-glucan from oats protects the intestine’s mucosal lining and supports the immune system Integrative Solutions Prebiotic Effects on Glucose Regulation & Appetite This same study8 also assessed the X Mitochondrial Support effectiveness of GIMM on metabolic parameters, lipids, and satiety, at baseline and at 4 weeks. Evidence supports the X Cytokine Support significant role of the gut microbiota in N Phospholipid membrane repair* the biochemistry of satiety – the feeling of reduced hunger and desire for smaller X Antioxidant—Nrf-2 Support N Krebs cycle support* portions at mealtime.22 A validated Visual Analog Scale (VAS) was utilized to assess N Clinically researched satiety. Blood measurements included X Detox Support serum glucose and insulin (in a 3-hour oral glucose tolerance test [GTT]), hemoglobin CYTOKINE SUPPORT A1c, hs-C-reactive protein (hsCRP), PYY, ghrelin, lipids, and other blood chemistry. Compared to placebo, results for the prebiotic group showed reduced mealtime blood glucose measurements, as measured during the oral GTT (Figure Tel: 805.693.1802 • Fax: 805.693.1806 • [email protected] 3); increased satiety, as measured by www.ResearchedNutritionals.com | Available only through healthcare professionals the VAS (Figure 4); and increased levels of sIgA, a fecal biomarker for immune preparedness (Figure 5). ANTIOXIDANT Study #2 Effect of Prebiotics on DETOX Metformin Tolerability N Promotes healthy Not all drugs developed to be taken orally cytokine activity* are completely absorbed into the blood N Highly absorbable and thus remain in the GI tract where there is potential for interactions with the polyphenol blend* microbiota. Individuals with high blood N Nrf-2 support* sugar are commonly offered metformin, an effective glucose-lowering therapeutic that is generally well tolerated; however, the drug can occasionally lead to diarrhea, N Targets hydroxyl radical group* constipation, heartburn, or nausea. For some people, this is enough to make it a challenge N Crosses blood-brain barrier & cell for them to achieve the recommended membrane* dosing. This second study showed that the N Clinically researched same prebiotic blend (GIMM) provides N Nrf-2 support, which promotes N Supports detox pathways* nutritional support to counterbalance the healthy glutathione level* occasional gastrointestinal effects that can N Promotes healthy mitochondrial accompany metformin. function & NK cell function* Joseph Burrascano Jr., MD This placebo-controlled, double-blind, randomized, crossover study assessed type “Due to the research basis of these formulations, I think these products would be an important part of a practitioner’s arsenal.” 2 diabetics with documented metformin intolerance.23 Each of the 2 treatment periods lasted 2 weeks, with a 2-week *These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease. washout period between them. All subjects continued to take daily metformin. In 4 JANUARY 2019 NATUROPATHIC DOCTOR NEWS & REVIEW AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

Figure 1. Production of SCFAs from Prebiotics addition, subjects ingested either placebo (cellulose) or the GIMM. No changes were made to their daily meal routines. Frequency and consistency of bowel movements and metformin tolerability Volume 15 Issue 1 | January 2019 were assessed via questionnaires, and fasting blood glucose was monitored via Publisher Razi Ann Berry morning finger-stick tests. [email protected] Results showed improved tolerance Founders of metformin (Figure 6) in the prebiotic Razi Ann Berry group, as compared to the placebo group, David A. Tallman, DC, ND [email protected] as well as improved bowel movement regularity and consistency (loose-to- Medical Editor Mary James, ND firm stools), all without compromising Cross-feeding of microbiota: Use of hydrogen from an initial fermentation produces undesirable the drug’s usual therapeutic effect on Associate Medical Editor gases and more SCFAs through a competitive process David A. Tallman, DC, ND regulating glucose levels. In summary, the 2 clinical studies Associate Editor & Director of CE Node Smith, ND Figure 2. Polyphenols Shift the Competitive Balance of H2 Utilization discussed here demonstrate that this prebiotic blend was effective at reducing the Contributing Editor, Education David Schleich, PhD desire to eat and in reducing the amount of food anticipated or considered sufficient Contributing Editors, Botanical Medicine Jillian Stansbury, ND at the next meal, improving regularity Robin DiPasquale, ND, RH (AHG) from occasional GI disturbances, lowering Contributing Editor, Homeopathy mealtime blood sugar levels, protecting Joseph Kellerstein, DC, ND and preparing the GI immune system, and Contributing Editor, Oncology improving metformin tolerability. Jacob Schor, ND, FABNO Contributing Editor, Nature Cure Relevance of Prebiotics to Sussanna Czeranko, ND SCFA Production Contributing Editor, Functional Medicine Dietary choices determine substrates Mark Swanson, ND for gut bacterial species, providing a Editorial Coordinator competitive advantage to some microbes Vanessa Wiley [email protected] over others. As explained, dietary prebiotics (fiber and polyphenols) have Director of Sales and Marketing Matthew Knapp a major role in the diversification of [email protected] microbiota and those microbes’ subsequent Polyphenols serve as a key substrate for acetogens to produce acetate (thus reducing biosynthesis of Circulation Manager undesirable gases) role in host metabolism and overall health. Tara Hall The more diverse the diet, the more diverse [email protected] the microbiota, and the more adaptable it Creative Direction can be to disruptions. Jaclyn Threadgill [email protected] During the past 30 years, the prevalence www.jthreadgill.com of metabolic disorders has sharply 24-26 Foreign Correspondent increased while gut microbiome diversity S.A. Decker Weiss, NMD, FASA Dietary prebiotics (fiber and polyphenols) has decreased.27,28 Additions or losses of species with similar roles tend to only have a major role in the diversification of have small effects on overall microbiome ND News & Review function. However, domination by a few PO BOX 2968 Scottsdale, AZ 85252-2968 microbiota and those microbes’ subsequent species or a reduction in species diversity 888.627.8677 | 480.275.7712 www.ndnr.com can significantly impact physiological ISSN 2169-1614 role in host metabolism and overall health. functions, specifically those related to host Our printer utilizes wind-power metabolism and host defenses (ie, gut The more diverse the diet, the more diverse barrier function and immunity). Naturopathic Doctor News & Review As evidenced by both human and Copyright © 2018 Naturopathic Doctor News & Review. All animal studies, diet can cause a shift in rights reserved. No portion of this publication may be copied, the microbiota, and the more adaptable it reproduced, or redistributed without express written permis- microbial populations in as little as 3 sion from the publisher. Reprint information is available by contacting [email protected]. Naturopathic Doctor News 29,30 days. Although temporary dietary & Review reserves the right to edit or reject any submitted can be to disruptions. editorial or advertising. Opinions expressed by contributors and changes will only briefly reduce diversity, advertisers are not necessarily the opinions of Naturopathic some losses of microbiota may not be Doctor News & Review or its principals. reversible after a prolonged absence Naturopathic Doctor News & Review is published and circu- lated as a complementary annual subscription (12 issues) of nutrients. This was suggested in a to licensed naturopathic doctors (NDs) and students and graduates of CNME recognized naturopathic colleges in North study in which mice inoculated with America, and certain suppliers to the profession. human microbiota and fed a low-fiber Annual subscriptions (12 issues) are available to other health- diet experienced an irreversible loss care providers and NDs outside of North America: US $99; Canada & Mexico $129USD; Europe and Overseas $179USD. of microbial diversity over several generations despite a reintroduction of dietary fiber.31 In addition, human use of Article Submissions antibiotics, the use of antibiotics in meat Articles should be original, previously unpublished, and should cover a specific topic, protocol, modality, diagnostic, philosophy, production, and the use of pesticides in commentary, or case study pertaining to naturopathic medicine crop agricultural practices can narrow the rather than a general overview. Illustrations, photographs, charts and protocols are encouraged. Naturopathic Doctor News & microbiome.32-34 Pesticides can also subdue Review does not reprint articles from other publications except under unusual circumstances. Typical word requirements are the plant’s own defense system, as the 700 to 2000 words per article. Topics of interest include: • Clinical pearls plant has no need to produce phytoalexins • Case management/case studies (a plant polyphenol with antimicrobial • Naturopathic philosophy • Practice building and business management actions); the end result may be that key • Current trends and issues that affect naturopathic physicians in your area micronutrients that normally nourish the • News, announcements, and event notices gut microbiome are no longer available • Development of new techniques or protocols • Abstracts and reviews when these plants are consumed.35 • Discussions pertaining to diagnostics • Public/media relations and networking Such factors can jeopardize the • Using technology to make practices more efficient and profitable • Educational and grassroots programs that further the natu- microbial production of the SCFAs and ropathic cause thus affect host health. As the body of • Any other trend, event, or development you believe is pertinent to the profession evidence grows supporting the role For more information regarding article submission, or to receive a copy of submission guidelines, please contact [email protected]. of SCFAs as key mediators of host Opinions expressed in NDNR do not necessarily reflect those of metabolism, it becomes increasingly clear this publication and its publishers. NATUROPATHIC DOCTOR NEWS & REVIEW JANUARY 2019 5 ad form Must be coMpleted in full

client phone

contAct fAx

Authorized signAture dAte CheCk eaCh box as a guide: ❑ name correct? ❑ Address correct? ❑ phone # correct? ❑ Ad copy correct? ❑ offer correct, if any?

• Look over your project and check for errors; spelling, address, telephone numbers, copy or content. NDNR is not responsible for typos or incorrect information. AD ApprovAl: • Please note that due to differences in monitor calibration, colors on this digital proof ❑ Ad approved as is may not match actual printed colors. ❑ Corrections needed client will supply a correct ad file • Sign this page and email or fax it back to NDNR. ❑ Corrections desired • Any changes from this point forward may cost you in time and materials. client authorizes NDNR to make changes indicated; design fee applies. • NDNR cannot process your job until receipt of sign-off. email baCk to: [email protected] or fax baCk to: (480) 275-7712 Tolle Totum

that SCFAs represent a key molecular link is implied or made reference to in this Figure 3. Serum Glucose After 4 Weeks of Prebiotics paper and all study materials or related between diet, microbiota, and health. supplements are not intended to diagnose, Studies designed to improve treat, cure, or prevent any disease. microbial diversity using prebiotics have Financial Disclosures: Dale Pfost demonstrated some success, suggesting is the founding CEO of MicroBiome that high levels of non-digestible Therapeutics, the company that carbohydrates may be needed in Western provided the prebiotic blend used in the 2 studies discussed in this article. diets to produce relevant changes in Dr Erick Cervantes is an ambassador SCFA production, along with nutritional for MicroBiome Therapeutics, and counseling and behavior modification recommends a proprietary version of the surrounding dietary choices. GIMM to appropriate patients. Fortunately, the increase in prevalence Acknowledgments: The authors wish to of type 2 diabetes, obesity, inactivity, and the acknowledge the primary contribution ubiquitous SAD diet has led to an increasing to the research and development of the GIMM described here by Mark focus on disease prevention. Prebiotics Heiman, PhD, who is the CSO emeritus have been proven in numerous studies to Note: Blood glucose excursion was significantly improved after 4 weeks. There was a significant of MicroBiome Therapeutics. Dr Heiman postprandial effect and greater effect in diabetic subjects (those with A1c >6.5%). Fasting blood alter the gut microbiome in favorable ways, and Dr Frank Greenway are both scientific glucose normalized to 0. and continuing research is now illustrating advisors to MicroBiome Therapeutics. (GIMM = Gastrointestinal Microbiome Modulator) the power of prebiotics to impact health beyond the gut as well, especially metabolic Erick R. Cervantes, MPH, ND, is a Figure 4. Increased Satiety After 4 Weeks of Prebiotics disorders. SCFAs’ ability to affect appetite 2011 graduate of NCNM in Portland, OR. Dr Cervantes is currently Program and glucose regulation suggests that they Chair and Assistant Professor of the may play an important role in protecting Complementary and Alternative Health undergraduate program at Ashford the body against the deteriorating metabolic University in San Diego, CA. He has control and inflammation associated with taught within and led the program and has been practicing naturopathic medicine since 2011. Western lifestyles. Dr Cervantes joined the integrative health center, Body Craft, in October 2017. He uses an array of successful Nourishing the gut microbiota treatment interventions that include: Western herbs, through diet and simple and cost-effective homeopathy, massage, behavioral modification, nutrition, German bio-therapeutic drainage therapies, home- interventions such as prebiotics, including opathy, tissue cell salts, herbal stem-cell therapies, and dietary fiber and polyphenols, offers micro-current therapy. significant promise in the prevention of Dale Pfost, PhD, has 25 years of metabolic syndrome and in slowing the experience as a serial entrepreneur progression of prediabetes to diabetes. As we and executive in life sciences. He has A Validated Visual Analog Scale (VAS) was used to measure appetite. Data shown are from the final been the founding CEO of 5 biotech- visit (Week 4). all know, far more important than treating nology companies – achieving 3 IPOs, 3 trade-sales and 3 companies with (GIMM = Gastrointestinal Microbiome Modulator) the symptom is to treat the cause.* market capitalizations of over $2 billion. These include: Oxford GlycoSciences (IPO 1988); Orchid Biosciences (IPO 2000); Acuity References available online at ndnr.com Pharmaceuticals (now OPKO Health, 2007); and NuMe Figure 5. SIgA After 4 Weeks of Prebiotics Health (founded 2010, now MicroBiome Therapeutics). Dale is also the US-based General Partner of the * The statements in this paper have not London venture capital firm, Advent Life Sciences. Dale been evaluated by the FDA. No product holds a BS degree from the University of CA and a PhD in physics from Brown University.

The intestinal antibody sIgA normally defends against food allergens and pathogens. Study showed significantly increased sIgA at the final visit (Week 4). (GIMM = Gastrointestinal Microbiome Modulator)

The Wise Choice Figure 6. Metformin Tolerability After 4 Weeks of Prebiotics For digestive health • Supports normal digestion, motility and the healthy absorption of nutrients* • Promotes healthy production of stomach acid and enzymes* wisewomanherbals.com (800) 532-5219

Tolerability Score is a symptom composite of bloating, urgency to evacuate, stool consistency, and flatulence. *This statement has not been evaluated by the Food & Drug (GIMM = Gastrointestinal Microbiome Modulator) Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

6 JANUARY 2019 NATUROPATHIC DOCTOR NEWS & REVIEW AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

Authorized signAture dAte CheCk eaCh box as a guide: ❑ name correct? ❑ Address correct? ❑ phone # correct? ❑ Ad copy correct? ❑ offer correct, if any?

Continued from bottom of page 1 depression.4,5 Possibly in response to this, precursor, tryptophan, compared to control there has been increasing research into mice.8 This could be due to the elimination the composition of the gut microbiome in of pathogenic or inflammation-inducing individuals with mood disorders. Many bacterial and/or fungal species in the gut. people with psychiatric illnesses have been When in excess, some of these pathogenic found to have an altered gut microbiome enteric microbes can trigger inflammatory Many people with psychiatric illnesses have composition and compromised integrity processes in the CNS. Acutely depressed of the gut lining, and these patterns are patients have been shown to have higher been found to have an altered gut microbiome theorized to affect the functioning of the gut levels of Bacteroidetes, Actinobacteria, nervous system.6 and Proteobacteria, as well as lower levels composition and compromised integrity of the Ever since the 1950s, the only therapy of Firmicutes, compared to patients with widely used to treat mood disorders are milder depression.7 Children with autism gut lining, and these patterns are theorized to pharmaceutical agents that target the spectrum disorder (ASD) have been shown monoamine neurotransmitters in the to have less gut microbial diversity and central nervous system (CNS) – serotonin, lower levels of Prevotella, Coprococcus, and affect the functioning of the nervous system. norepinephrine, and dopamine.7 Recent Veillonellaceae compared to controls.9 research has established a strong Spore-forming anaerobic bacteria and connection between physiological microaerophilic bacteria have also been health and mental health, including found in gastric and duodenal samples from the extensive therapeutic potential of children with ASD, whereas control children cytokines by acting on monocytes, the epithelial lining of the small intestine manipulating the gut microbiome in showed no presence of these microbes.9 macrophages, epithelial cells, peripheral that allow for translocation of partially individuals with mood disorders. blood mononuclear cells, and dendritic digested food products and bacterial toxins The way that the gut communicates Probiotics & Prebiotics cells.10 The eradication of “bad” species of into the bloodstream, often triggering a with the brain is likely the underlying factor The main immunomodulatory actions gut bacteria and the addition of beneficial low-grade immune response through the in this relationship. Extensive research has of probiotics and prebiotics include probiotic species may provide novel interaction of T-cells and compromised been conducted on mice that has included modulating the immune responses from avenues for treatment of mood disorders. epithelium. It has been shown that manipulating their gut microbiota and the gut mucosa, enhancing the integrity “Live bacteria that have a positive mental intestinal hyperpermeability often coexists observing their consequent behavioral of the epithelial barrier in the gut, and health benefit have been defined as with altered gut microbiome composition changes (eg, increased or decreased priming adaptive responses via antigen- psychobiotics.”7 and activity.1 depression and anxiety).8 Findings from presenting cells.10 Disorders characterized by a deviation Immune system hypersensitivity this research strongly support the theory Immunomodulation is primarily from normal gut bacteria include small should also be explored as a possible that these behavioral/mood changes result carried out through regulation of T-cell intestinal bacterial overgrowth (SIBO), contributing factor in the gut-brain from aberrant neurochemical transmission maturation, which is highly implicated in dysbiosis, IBS, and more. It should connection. While the immune system is from the gut microbiome.8 When mice are inflammation and autoimmune disease.10 come as no surprise that there is a high not usually occupied with reacting to non- treated with oral neomycin (antibiotic), The 2 dominant genera of gut bacteria that prevalence of psychiatric illness among harmful antigens, it can start to overreact bacitracin (antibiotic), and primaricin are considered beneficial probiotics are patients with IBS, including panic disorder, to a normally harmless antigen; this is (antifungal), their anxiety is reduced.9 It Lactobacilli and Bifidobacteria.11 Research generalized anxiety disorder, social referred to as an immune hypersensitivity has also been demonstrated that germ-free has demonstrated that Lactobacillus and phobia, posttraumatic stress disorder, reaction. There are several types of mice (mice devoid of gut microorganisms) Bifidobacterium species modulate the and major depression.12 Probiotics hypersensitivity reactions, and they all have higher concentrations of the serotonin production and secretion of various can competitively inhibit disease- and promote inflammation that may affect inflammation-causing pathogenic mood and behavior. It has been found bacteria by blocking attachment sites on that germ-free mice have an increased epithelial cells. Lactobacillus plantarum and stress response, higher cortisol levels, and Lactobacillus rhamnosus upregulate the lower levels of cortical and hippocampal production of intestinal mucins, which brain-derived neurotropic factor (BDNF) greatly reduces the adherence of Escherichia compared to control mice; furthermore, coli O157:H7 and its damaging effects.13 these effects are no longer present when the It has been demonstrated in humans mice are recolonized with Bifidobacteria Mood Support™ Formula that administering a combination of the species.14 Lactobacillus strains have also probiotics Lactobacillus helveticus and been shown to trigger increased levels Bifidobacterium longumhas an anxiolytic of 2 key anti-inflammatory/suppressive effect and reduces serum cortisol.14 cytokines – transforming growth factor- Lactobacillus reuteri is another highly beta (TGF-ß) and interleukin-10 (IL-10) effective probiotic that modulates immune via interaction with dendritic cells.10 system functioning, reduces stress-induced This produces a tolerogenic state such S u p p l e m e n t F a c t s increases in corticosterone, and reduces that immune cells do not hyper-react to Serving size: 3 capsules Servings per container: 30 anxiety by altering the mRNA expression non-harmful antigens (ie, they tolerate Amount per serving %DV Vitamin B1 (as Thiamine HCl) 75 mg 250% of GABAA and GABAB receptors in the them), thereby keeping inflammation Vitamin B2 (as Riboflavin 5' Phosphate) 30 mg 500% 14 10 Vitamin B3 (as Niacinamide) 45 mg 225% CNS. Bifidobacterium infantis has been low. TGF-ß has major regulatory activity, Vitamin B6 (as Pyridoxine HCl) 75 mg 3400% Vitamin B12 (as Methylcobalamin) 1200 mcg 2000% found to have antidepressant effects, induces peripheral antigenic/immune Folinic Acid (as Calcium Folinate) 2400 mcg 600% St. Johns wort (Hypericum) (aerials) (0.3% hypericin) 900 mg * via suppression of stimulation-induced tolerance, and suppresses cells of the L-Tyrosine 750 mg * 16 Skullcap extract (Scutellaria baicalensis) (root) (4:1) 90 mg * elevations in proinflammatory cytokines as innate immune system. Because of its 5-HTP (5-Hydroxytryptophan) 60 mg * well as increasing tryptophan levels.14 broad anti-inflammatory effects, TGF-ß L-Theanine 60 mg * Rhodiola rosea extract (root) (4% rosavins) 108 mg * has been considered a possible therapeutic Ginkgo biloba extract (leaf) (24% ginkgoheterosides and 6% terpene lactones) 45 mg * The Gut-Brain Connection for inflammatory diseases, autoimmune Percent Daily Values are based on a 2,000 calorie diet. * Daily Value not established. There have been rapidly coalescing disease, cancer, and Alzheimer’s disease; it Other ingredients: vegetarian capsules (cellulose and water) clusters of evidence related to the gut-brain might also be considered in the treatment connection, with special focus on potential of severe mood disorders.16 etiologies of anxiety, depression, behavior, and other mental or emotional disorders. Nutritional Impacts “…[I]llnesses such as major depressive on the Gut disorder are disproportionately prevalent The first time nutrition is thought to in patients with gastrointestinal illnesses impact the gut microbiome is shortly after Mood Support™ formula contains highly effective ingredients such as inflammatory bowel disease, which birth. Early life (the weeks and months that nutritionally alter brain chemistry in order to address the pathologically has been strongly linked to following birth) serves as a critical window physiological causes of depression, promote positive mood microbiome function.”15 of opportunity for the development of the regulation and encourage normal neurological function. Intestinal hyperpermeability is a very core microbiome from diet.10 Human breast important pathophysiologic mechanism milk has profound beneficial effects on Learn more about MPN Condition Specific Formulas® implicated in dysbiosis and mood the gut microbiome and is considered the and view full ingredients lists at www.mpn8.com disorders. The hyperpermeability is optimal source of nutrition for newborns. To order call toll free (877) 686-7325 characterized by weakened tight junctions Breast milk contains several components between the enterocytes of mainly the that are essential for a maturing *These statements have not been evaluated by the Food and Drug Administration. Products are not intended to diagnose, treat, cure or prevent any disease. small intestine. This creates “gaps” in immune system, including colostrum, 8 JANUARY 2019 NATUROPATHIC DOCTOR NEWS & REVIEW AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

immunoglobulins, lysozyme, lactoferrin, resabsorption and decrease fecal pH, which psychiatric and developmental disorders is highly recommended for increasing Lactobacillus acidophilus and L gasseri, both beneficially affect bacterial growth that are increasingly affecting young the concentrations of beneficial gut Bifidobacterium bifidium and B breve, and in the colon.9 Levels of SCFAs (butyrate, children are postulated to result from microbes. The current average American human milk oligosaccharides (HMOs).10 acetate, propionate), along with levels of nutrition and diet during infancy and diet is pro-inflammatory by promoting Some of the general dietary changes different phylogenic microbial strains, can be childhood – factors that significantly affect overgrowth of pathogenic microorganisms, that have occurred in the United States measured via a comprehensive stool analysis. the composition of the gut microbiome. both bacterial and fungal. Enhancing over the past 3 decades include higher Strong but complex connections exist patients’ dietary patterns can serve to caloric intake, higher proportion of Conclusions between the gut microbiome, the immune balance their gut microbiome, decrease calories derived from refined grains/ Anxiety disorders, depressive disorders, system, CNS activity, mood, and behavior. inflammation, optimize nutrient absorption carbohydrates, and increased intake of and autism spectrum disorders have been Research is just beginning to reveal how and utilization, and modulate their corn-derived sweeteners (ie, corn syrup).17 rapidly increasing in prevalence over the these systems interact with each other. immune system. All of these effects should These poor dietary patterns are likely past few decades, especially in the United Although clinical applications are not significantly decrease their symptoms a major culprit in the development of States. Causes of this increase are still yet well supported, it is likely that the of anxiety and depression, and help to psychiatric disorders, mood disorders, largely unknown, but etiologic factors are growing interest in the gut microbiome stabilize their mood. and developmental disorders. A significant beginning to be considered at a deeper will propel further investigation into more amount of evidence exists that shows how level. This fact highlights the need for more specific medical treatments that optimize References available online at ndnr.com dietary interventions (especially gluten-free effective intervention strategies, which can the microbiome. Probiotics are already a and casein-free diets) that help optimize be accomplished through research studies useful clinical tool in the treatment of a the gut microbiome and reduce levels of and clinical trials. Most studies of the gut wide variety of health problems, including inflammation also effectively improve microbiome to date have been conducted psychiatric disorders. Diet therapy, behavioral and digestive symptoms in on mice, which only minimally translate to functional foods, nutritional supplements, Alexandra Francis, ND, MS, CNS, autistic children.18 Foods shown to foster human health. antimicrobial agents, and probiotic therapy was a 4th-year naturopathic medical student at the University of Bridgeport gut bacterial imbalances include sugar, Today, there is a clear need for are all avenues of treatment that have been College of Naturopathic Medicine when eggs, soy, gluten, and dairy.19 These foods alternative treatment strategies for several shown to be highly effective in healing the she wrote this article; she graduated in May 2018. She is also pursuing a trigger some of the most common food common psychiatric conditions including gut, including balancing enteric bacteria, master’s degree in Human Nutrition at the University of Bridgeport Nutrition sensitivities in individuals with intestinal anxiety and depressive disorders. improving the integrity of the epithelial Institute. Alexandra has given several lectures on hyperpermeability (“leaky gut”). Food Pharmaceutical therapy has demonstrated lining, and modulating the activity of subjects including naturopathic medicine, nutrition, therapeutic diets, lifestyle, and wellness. Alexandra sensitivities can be the root cause of many limited efficacy in the general population gastrointestinal immunity. We now plans to start consulting on nutrition, diet, and lifestyle, to complement her clients’ medical treatment in Long common inflammatory manifestations, of psychiatric patients. Many patients know that all of these factors are central Island, NY. including mood disorders. with psychiatric illness are prescribed to the functioning of the CNS and the Short-chain fatty acids (SCFAs), such indicated medications and become reliant pathophysiology of psychiatric disorders. Marie Winters, ND, FABNO, received her ND degree from Bastyr University in as butyrate, acetate, and propionate, have on them for a significant portion of their Nutritional therapy is one of the 2006. Dr Winters is the former director of been shown to positively impact the gut lives, despite their often-minimal efficacy most powerful tools for altering the gut the Naturopathic Medicine Department at Cancer Treatment Centers of America microbiota and exert modulatory effects on and the fact that they are often intended microbiome. It has been shown that even in Philadelphia. She is also a Fellow of the immune system.17 Increased fiber intake to be used only for a short period of short-term dietary changes significantly the American Board of Naturopathic Oncology, sits on the Board of Medical can enhance SCFA status, since SCFAs are time. As an alternative to pharmaceutical affect (positively or negatively) the Examiners for the American Board of Naturopathic Oncology, and is currently President of the PA products of anaerobic microbial fermentation therapy, treatment designed to reduce populations of microorganisms in Association of Naturopathic Physicians. She is an of non-digestible macronutrients (mostly CNS inflammation and optimize the gut the GI tract. In general, a high fiber, adjunct professor at Bridgeport University’s College of Naturopathic Medicine and maintains a private practice plant polysaccharides and resistant microbiome may be a novel and highly plant-based diet, in conjunction with in Philadelphia. Dr Winters has spoken at several medi- starches).17 SCFAs promote colonic water effective form of therapy. Many of the fermented foods containing probiotics, cal conferences across the country.

MODULATING THE GI MICROBIOME

GASTROINTESTINAL MICROBIOME MODULATOR - GIMM – NOW BIOMEBLISS

• BiomeBliss is a next generation prebiotic optimized for metabolic productivity in the gut

• BiomeBliss is a prebiotic blend, clinically tested in two studies at Pennington Biomedical Research Institute (double-blinded, placebo-controlled and randomized trial)

Our clinical results show BiomeBliss: • Helps control hunger • Promotes regularity Available on naturalpartners.com • Supports overall gut health • Manages healthy mealtime blood sugar when already within normal range

BIOMEBLISS.COM These statements have not been evaluated by the FDA. Product is not intended to diagnose, treat, cure or prevent disease. BERRY-FLAVORED PREBIOTIC BLEND

NATUROPATHIC DOCTOR NEWS & REVIEW JANUARY 2019 9 AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

SHAON HINES, ND (which is known for its euphoric or CSA defines marijuana as all parts of the psychoactive properties), whereas hemp Cannabis plant except for the mature stalks uch confusion exists regarding has a very low THC content and is non- and sterilized seeds.3 MCannabis, marijuana, and hemp. A psychoactive. The varying amounts of THC (16) The term “marihuana” better understanding of the terminology are accomplished by growing different means all parts of the plant Cannabis manufacture, salt, derivative, mixture, will help you to understand the legality. varieties of the Cannabis plant to be either sativa L., whether growing or not; or preparation of such mature stalks The terms “Cannabis” and “medical low-THC hemp or high-THC marijuana. the seeds thereof; the resin extracted (except the resin extracted therefrom), marijuana” are often used interchangeably. The 2014 Agricultural Act, also known as from any part of such plant; and fiber, oil, or cake, or the sterilized seed Cannabis, however, is both marijuana and the 2014 Farm Bill, originally separated every compound, manufacture, salt, of such plant which is incapable of hemp. For example, marijuana and hemp marijuana from hemp by the amount of derivative, mixture, or preparation of germination.3 belong to the Cannabaceae family, genus THC within the plant. To be considered such plant, its seeds or resin. Such term Cannabis L, and to the species Cannabis hemp, the amount of THC in the plant does not include the mature stalks of Fortunately, due to the 2018 Farm Bill sativa.1 The difference between marijuana must be less than 0.3%.2 Prior to December such plant, fiber produced from such that was passed in Congress in December and hemp is that marijuana has a higher 2018, the Controlled Substances Act (CSA) stalks, oil or cake made from the seeds 2018, the definition of marijuana and hemp tetrahydrocannabinol (THC) content did not separate marijuana and hemp. The of such plant, any other compound, have been officially separated, making hemp no longer a “controlled substance.”

Can NDs Prescribe Medical Marijuana? Marijuana (Cannabis) is classified as a Schedule I Controlled Substance.4 Such substances are not allowed to be prescribed by any type of physician in the United States. According to the Drug Enforcement Administration (DEA)’s Practitioner’s Manual,5 All drugs listed in Schedule I have no currently accepted medical use in treatment in the United States and therefore may not be prescribed, administered, or dispensed for medical use. In contrast, drugs listed in Schedules II through V all have some accepted medical use and therefore may be prescribed, administered, or dispensed for medical use.5

In states where medical marijuana is legal, physicians are allowed to recommend, certify, or authorize, but not prescribe.

• In the United States, medical marijuana is currently legal in 33 states and the District of Columbia (see Figure 1)6 • Naturopathic doctors are currently licensed or registered in 20 states, the District of Columbia, and the United States territories of Puerto Rico and the US Virgin Islands7 • Of the 20 states and the District of Columbia, naturopathic doctors have prescribing rights in 11 of those states and the District of Columbia.8 Please note that a few states are awaiting regulation, so this could change. • Of the 11 states with prescribing rights and the District of Columbia, only 2 states – Arizona and Washington – allow for naturopathic doctors to recommend, certify, or authorize for medical marijuana9,10

If you have prescribing rights and wish to recommend, certify, or authorize for medical marijuana, it is recommended that you contact your state medical board for the most current status to see if naturopathic doctors are eligible in your particular state.

Pharmaceutical Cannabis Synthetic THC cannabinoid formulas that are available for prescription include Cesamet, Marinol, and Syndros. Epidiolex is a cannabidiol (CBD) product available 10 JANUARY 2019 NATUROPATHIC DOCTOR NEWS & REVIEW AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

6 for prescription. Cesamet and Syndros where it was passed by 369 Yea vs 47 Nay. Figure 1. Marijuana Legality in the United States are Schedule II; Marinol is Schedule III; Upon passage by both the Senate and the and Epidiolex is Schedule V. Sativex (THC House, the bill was sent to the President & CBD) is another formula but is not of the United States and signed into law. currently approved for use in the United History was made, ending the federal States.11 prohibition on hemp and establishing it as Naturopathic doctors are able to an agricultural commodity. prescribe these substances, depending Before the passage of this bill, hemp on their individual state’s formulary was still considered a controlled substance and whether they are able to prescribe and was federally illegal. Previously, controlled substances. hemp and marijuana both fell under the Controlled Substances Act because they The End of Hemp are both Cannabis and the CSA’s definition Prohibition of marijuana included all parts of the The Agriculture Improvement Act of Cannabis plant except for mature stalks and 2018, also known as the Farm Bill, was sterilized seeds.3 Hemp was only able to be passed in December 2018. This was a legally distributed within the United States monumental victory in the United States. if it represented the mature stalks and/or Hemp cultivation and processing has been sterilized seeds and products made thereof restricted since the Marijuana Tax Act of or if it was imported from a different 1937. Prior to that, the hemp industry in country, just as long as the products the United States was encouraged between didn’t fall within the CSA’s definition of the 1600s and the late 1800s. It wasn’t marijuana. until the 1930s that the industry started The definition of hemp per the to get demonized by powerful American 2018 Farm Bill is stated as: the plant industrialists that wanted it prohibited. Cannabis sativa L and any part of that Image courtesy of ProCon.org. Back then, hemp was used to make sails, plant, including the seeds thereof and (Source: ProCon.org; https://tinyurl.com/ya6y9xyc) rope, and clothing.12 Bringing hemp all derivatives, extracts, cannabinoids, back as an agriculture commodity will isomers, acids, salts, and salts of isomers, commodity products can have separate restrictions present many opportunities for farmers, whether growing or not, with a delta-9 • Interstate commerce of hemp can no mandated by individual states and manufactures, and retailers. We will see tetrahydrocannabinol concentration of not longer be interfered by the DEA. This tribes. They cannot, however, interfere more hemp nutraceuticals, personal care more than 0.3% on a dry weight basis.13 allows for e-commerce, banks, and credit with interstate transport and commerce. products, textiles, biofuels, paper, and card processors to conduct business • The US Food and Drug Administration much more. Hemp also has the ability to What Did the 2018 Farm Bill freely. (FDA) will continue to regulate detoxify soil and can be used to produce Change?14 • Hemp farmers, processors, and retailers ingestible and topical hemp products non-toxic building materials; thus, its uses • The definition of hemp asw separated will now be able to get insurance are truly endless. from that of marijuana • Hemp farmers will be able to participate The most important aspect regarding In December 2018, the Senate passed • Hemp is no longer a part of the in USDA programs for certification and hemp in the 2018 Farm Bill was separating the 2018 Farm Bill by a vote of 87 Yea vs 13 Controlled Substances Act competitive grants it from the definition of marijuana. This Nay. The bill was then moved to the House, • Hemp is now considered an agricultural • Growth and sale of hemp and hemp alone created many changes, removed

Why don’t we use antibiotics to treat sinusitis anymore? Because they make the problem WORSE.

Try the products recommended by ENT specialists! Sinus Relief – eliminate bacteria & fungus Sinus Support – relax, moisturize & heal damaged nasal tissues Congestion Relief – clear congestion & relax inflamed membranes Super Neti Juice – deep antimicrobial cleaning Herbal Neti Soother – soothe & restore the sinus tissues

with coupon 20%OFF code SINUS20 We get calls every day from sinus sufferers like you thanking us for bringing them our fine products. Nothing makes us happier than hearing our customers proclaim, “I can breathe again”. Check-out our website & see all of the wonderful products that we offer to help you maintain your health naturally. Here at Nature’s Rite, we’re ridding the world of sinusitis… one nose at a time. Why don’t we heal yours next?

Order online at MyNaturesRite.com or call 800-991-7088 NATUROPATHIC DOCTOR NEWS & REVIEW JANUARY 2019 11 ad form Must be coMpleted in full AD FORM MUST BE COMPLETED IN FULL

client phone CLIENT PHONE

contAct fAx CONTACT FAX

Authorized signAture dAte AUTHORIZED SIGNATURE DATE CheCk eaCh box as a guide: CHECK EACH BOX AS A GUIDE: ❑ name correct? ❑ Address correct? ❑ phone # correct? ❑ Ad copy correct? ❑ offer correct, if any? ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

• Look over your project and check for errors; spelling, address, telephone numbers, • Look over your project and check for errors; spelling, address, telephone numbers, copy or content. NDNR is not responsible for typos or incorrect information. AD ApprovAl: copy or content. NDNR is not responsible for typos or incorrect information. AD APPROVAL: • Please note that due to differences in monitor calibration, colors on this digital proof ❑ Ad approved as is • Please note that due to differences in monitor calibration, colors on this digital proof ❑ Ad approved as is may not match actual printed colors. ❑ Corrections needed may not match actual printed colors. ❑ Corrections needed client will supply a correct ad file client will supply a correct ad file • Sign this page and email or fax it back to NDNR. • Sign this page and email or fax it back to NDNR. ❑ Corrections desired ❑ Corrections desired • Any changes from this point forward may cost you in time and materials. client authorizes NDNR to make changes • Any changes from this point forward may cost you in time and materials. client authorizes NDNR to make changes indicated; design fee applies. indicated; design fee applies. • NDNR cannot process your job until receipt of sign-off. • NDNR cannot process your job until receipt of sign-off. email baCk to: [email protected] or fax baCk to: (480) 275-7712EMAIL BACK TO: [email protected] or FAX BACK TO: (480) 275-7712 Docere

only parts per million) that may be Table 1. FDA & Marijuana: 18 found where small quantities of resin Questions & Answers adhere to the surface of seeds and mature 15. Will FDA take enforcement action stalk. Thus, based on the scientific regarding THC and CBD products that Now that hemp has been separated from literature, it is not practical to produce are marketed as dietary supplements? extracts that contain more than trace What about foods to which THC and the definition of marijuana, hemp is no longer amounts of cannabinoids using only CBD has been added? the parts of the cannabis plant that are excluded from the CSA definition of A. When a product is in violation of the FD&C Act, FDA considers many factors under strict regulation. marijuana, such as oil from the seeds. in deciding whether or not to initiate an The industrial processes used to clean enforcement action. Those factors include, cannabis seeds and produce seed oil among other things, agency resources and would likely further diminish any trace the threat to the public health. FDA also may amounts of cannabinoids that end up consult with its federal and state partners in making decisions about whether to initiate a restrictions, and opened many doors for confusion in the United States. The in the finished product. However, as federal enforcement action. hemp agriculture in the United States. confusion lies in the terminology of indicated above, if a product, such as oil The development and sales of hemp Cannabis, hemp, and marijuana; differences from cannabis seeds, consisted solely of nutraceuticals will soon be bigger and between federal and state regulations; parts of the cannabis plant excluded from Table 2. FDA & Marijuana: better than what it seems to be today. whether CBD is derived from hemp vs the CSA definition of marijuana, such Questions & Answers19 marijuana; and the percentage of THC in product would not be included in the 12. Can products that contain THC or Hemp was Previously the plant. new drug code (7350) or in the drug code cannabidiol (CBD) be sold as dietary Federally Illegal CBD can be derived from hemp or for marijuana (7360), even if it contained supplements? Many people have been under the marijuana. CBD derived from marijuana is trace amounts of cannabinoids.20-22 impression that the 2014 Farm Bill still a controlled substance but can be sold A. No. Based on available evidence, FDA made hemp legal in the United States. in dispensaries in states where medical Many of the hemp extracts on the has concluded that THC and CBD products Unfortunately, this was not the case. In marijuana is legal. CBD derived from hemp shelf that claim to be derived from stalks are excluded from the dietary supplement definition under sections 201(ff)(3)(B)(i) the Statement of Principles on Industrial was previously federally illegal, just like and seeds are hemp oil products with and (ii) of the FD&C Act, respectively. Under Hemp, the 2014 Farm Bill did not remove CBD derived from marijuana; however, other beneficial ingredients, but not the those provisions, if a substance (such as industrial hemp from the CSA; as a result, the passing of the Farm Bill has changed sought-after cannabinoids. The companies THC or CBD) is an active ingredient in it was still federally illegal prior to the that. Prior to the 2018 Farm Bill, hemp still will definitely change production now to a drug product that has been approved current 2018 Farm Bill.15 fell within the Controlled Substances Act’s include the whole hemp plant; however, under 21 U.S.C. § 355 (section 505 of the FD&C Act), or has been authorized Section 7606 did not remove definition of marijuana. Therefore, hemp if you are buying a product manufactured for investigation as a new drug for which industrial hemp from the controlled was still considered a Schedule 1 Controlled prior to the passage of the 2018 Farm Bill, substantial clinical investigations have been substances list. Substance. Now that hemp has been I would be wary of its true ingredients if instituted and for which the existence of separated from the definition of marijuana, what you are looking for is cannabinoids. such investigations has been made public, The Farm Bill of 2014 simply defined that problem has been solved and hemp is then products containing that substance industrial hemp as containing less than no longer under strict regulation. Choose Products Wisely are outside the definition of a dietary supplement. FDA considers a substance to 0.3% THC and also authorized institutions Another problem with CBD legality The FDA is going to strengthen regulation be “authorized for investigation as a new of higher education and state departments exists, though. This problem arises with for hemp products, but it will take some drug” if it is the subject of an Investigational of agriculture to grow and cultivate hemp the Food, Drug and Cosmetic (FD&C) Act. time to get things totally under control. New Drug application (IND) that has gone for research under state laws.16 According to the FD&C Act, “an active Right now, it is the Wild West out there; into effect. Under FDA’s regulations (21 CFR The FDA was sending warning letters ingredient in a drug product that has been millions of people have jumped at the 312.2), unless a clinical investigation meets the limited criteria in that regulation, an IND to many companies, and many consumers approved under 21 U.S.C. § 355 (section 505 chance to get involved with the CBD and is required for all clinical investigations of and retailers got in legal trouble; we just of the FD&C Act), or has been authorized Hemp Extract market, which has resulted products that are subject to section 505 of didn’t hear about it. The law enforcement for investigation as a new drug for which in thousands of less-than-optimal products. the FD&C Act. was minimal and mostly concentrated substantial clinical investigations have been Make sure your products are sourced in states that didn’t have laws regarding instituted and for which the existence of from the whole hemp plant; have been There is an exception to sections 201(ff) CBD. Some of the states that were such investigations has been made public, properly tested for exact ingredients (ie, (3)(B)(i) and (ii) if the substance was “marketed as” a dietary supplement receiving enforcement action for CBD then products containing that substance cannabinoids and terpenes), potencies, and or as a conventional food before the were California, Wisconsin, Indiana, are outside the definition of a dietary contaminants; and ensure they are organic drug was approved or before the new North Carolina, Texas, Wyoming, Arizona, supplement.”19 Since THC and CBD are and were extracted using safe methods. drug investigations were authorized, as Alabama, Montana, Ohio, Iowa, North both active ingredients in FDA-approved applicable. However, based on available Dakota, South Dakota, and Missouri.17 drugs (ie, Cesamet, Marinol, Syndros, Cannabis Law: Helpful Resources evidence, FDA has concluded that this is not the case for THC or CBD. For more These states had varying reasons for Epidiolex), they cannot be sold as dietary 1. National Conference on State information on this provision, including an enforcement. Here are a few examples: supplements. (Please read the full excerpt Legislatures- State Medical Marijuana explanation of the phrase “marketed as,” 19 CBD could not be contained in food from the FDA’s website in Table 2.) Laws: http://www.ncsl.org/research/ see Draft Guidance for Industry: Dietary products (California); CBD from other health/state-medical-marijuana-laws. Supplements: New Dietary Ingredient states could not be sold in dispensaries What About Hemp Extracts aspx#4 Notifications and Related Issues. (Arizona); CBD with any amount of THC and Hemp Oil? 2. FDA and Marijuana: Questions FDA is not aware of any evidence that was not allowed (Texas); the purchase Many companies have started to use the and Answers: https://www.fda.gov/ would call into question its current of CBD oil in another state led to felony term “Hemp Extract” instead of “CBD.” NewsEvents/PublicHealthFocus/ conclusions that THC and CBD products charges (Wyoming); and retailers selling Since hemp was previously not exempt ucm421168.htm#dietary_supplements are excluded from the dietary supplement CBD were sent “cease and desist” letters from the CSA and CBD cannot be sold as a 3. NORML: https://norml.org definition under sections 201(ff)(3)(B)(i) and (Alabama).17 The lack of widespread dietary supplement per the FD&C, many 4. ProCon.org (ii) of the FD&C Act. Interested parties may present the agency with any evidence that enforcement by the FDA throughout the companies started to sell “Hemp Extracts” a. Legal Marijuana States and they think has bearing on this issue. Our https://medicalmarijuana. United States was most likely due to the instead. The problem with this approach is D.C.: continuing review of information that has lack of resources in the FDA as well as the that prior to the passing of the 2018 Farm procon.org/view.resource. been submitted thus far has not called our fact that CBD and hemp extracts are very Bill, the only legal way to form the product php?resourceID=000881 conclusions into question. safe and don’t pose a public health threat.18 was to extract it from the mature stalks b. States with Laws Specifically (See the FDA’s statement on this in Table 1.) and sterilized seeds of hemp plants. The for Cannabidiol (CBD): https:// Another reason the FDA was sending mature stalks and sterilized seeds only medicalmarijuana.procon.org/view. warning letters out and will continue contain trace amounts of cannabinoids.20 resource.php?resourceID=006473 to send those letters out is there is a The excerpt regarding this from the DEA’s 5. US Hemp Roundtable: https:// widespread problem with false claims in website is below. Please note that at the hempsupporter.com regards to product descriptions and also time of this statement, hemp was still 6. Hoban Law Group: https://hoban.law/ frontpage what ingredients are actually in the bottles. included in the definition of marijuana; Shaon Hines, ND, is a licensed natu- This is a problem that will continue until thus, any mention of “marijuana” also 7. Kight on Cannabis: https:// ropathic doctor and a US Air Force veteran. Dr Hines is originally from more regulations are made. It’s important means hemp: cannabusiness.law Wisconsin, joined the Air Force right to stay informed on what products you are According to the scientific literature, out of high school, and did tours of duty in Saudi Arabia and Qatar. She also using and where they came from. cannabinoids are not found in the parts References available online at ndnr.com served as Flight Sergeant for the MacDill AFB Honor Guard. Dr Hines earned her of the cannabis plant that are excluded Doctor of Naturopathic Medicine degree from National CBD Legality Explained from the CSA definition of marijuana, Disclaimer: The information presented here is University of Health Sciences in Lombard, IL. She is not meant to constitute legal advice. Consult also a certified personal trainer, behavioral change spe- The legality of CBD has drawn much except for trace amounts (typically, your attorney for advice on specific situations. cialist, master speed reader, and raw foods chef. 12 JANUARY 2019 NATUROPATHIC DOCTOR NEWS & REVIEW Education Medical Resources for NDs A review of current publications for the naturopathic industry

is the naturopathic doctor’s backbone. : Key supplements 7. Supplementation Title: Master Your Diabetes: A Repairing the gut and balancing the provide essential cofactors for multiple Comprehensive, Integrative Approach for microbiome helps optimize digestion and biological pathways in the body. Dr Both Type 1 and Type 2 Diabetes absorption of key nutrients. Dr Morstein Morstein does a wonderful job of Author: Mona Morstein, ND, DHANP provides enough detail to facilitate a full explaining exactly how they fit into the Publisher: Chelsea Green Publishing understanding of this area. management of diabetes. Available from: All major book sellers 6. Environmental Detoxification: Our 8. Medications: The book provides Pages: 560 environment is toxic. Understanding how a comprehensive overview of all to avoid these toxins and remove them medications available to diabetic Style: Trade Paperback helps patients select specific avenues in patients, including how to utilize each Copyright: 2017 their lives for reducing their toxic load. drug to its full potential. MSRP: $21.73

BLAINE HARBOURNE, ND, LDN, CNS, CSCS

Master Your Diabetes: A Comprehensive, Integrative Approach for Both Type 1 and Type 2 Diabetes

orldwide, there are 350 million Wpeople diagnosed with diabetes. In the United States, alone, there are an estimated 120 million prediabetic and diabetic patients (29 million diagnosed diabetics). The diabetes epidemic is growing and is no longer affecting just adults; diabetes is increasingly occurring in children and adolescence. Providing insight into the pathology and the IT’S HEMP. ONLY BETTER. physiology of diabetes is of paramount importance, not only for managing the disease but also for halting the epidemic. After 25-plus years of practice in dealing with diabetes, Dr Mona Morstein provides us with a comprehensive resource that combats diabetes and helps patients understand their unique circumstances. With her “8 Essentials,” Dr Morstein offers a thorough explanation for each aspect of diabetes as well as instructions in to manage it. At Aceso, we are pairing plant science with

food science, designing nutritional supple- The 8 Essentials For Managing Diabetes ments that set the precedent for whole plant, 1. Diet: Diabetes at its core is a condition of dysfunctional carbohydrate metabolism. hemp-derived cannabinoids. We are pushing This book delivers an exceptional new boundaries, using the latest technologies amount of nutritional information to patients, helping them to select what can to extract and blend full-spectrum hemp oil work best for them. 2. Exercise: The prescription of exercise with time-tested botanicals and terpenes. Our cannot be overlooked, as it is an highly-targeted formulations offer enhanced important component of the diabetes management puzzle. bio-availability, uptake and impact. 3. Sleep: This is a frequently overlooked and underrated part of the diabetes Our Calm line combines hemp-derived CBD puzzle. Knowing that sleep plays a role in key biological processes should with passionflower, grapefruit and lavender. be enough to convince us to engage in proper sleep hygiene. Restorative sleep helps manage cravings, blood sugar, CALM | SOOTHE | WELLNESS appetite, and a slew of other challenges associated with this disease. Take 20% off your first order 4. Stress Management: Stress plays a pivotal role in lifestyle management, and and Learn about our Wholesale Program not just for the diabetic patient. All of us at MyAceso.com/NDNR are constantly faced with stressors in our lives. Learning how to deal with those stressors is crucial for keeping patients on their path toward optimal health. 5. Healing the Gut and Microbiome: This NATUROPATHIC DOCTOR NEWS & REVIEWACESO_NDNR_Fullad_Final.indd 1 JANUARY 11/20/182019 12:5113 PM AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

CHAD LARSON, NMD, DC, CCN, CSCS main trigger categories that we need to consider when evaluating for non-self re you noticing the growing antigens that are causing immune system Aepidemic of autoimmunity? As the dysregulation. These trigger categories number of Americans suffering from include dietary proteins, chemicals, When dysregulation of the immune system autoimmunity has reached 25-50 million1 and pathogens. There is actually a very and that figure continues to climb, we important fourth trigger that the science causes autoantibodies to be developed, the goal must consider new approaches for has added more recently, which we’ll managing these patients. The evolution of discuss toward the end of this discussion. should be identification of the non-self antigen laboratory science has provided new tools to help us investigate causes of immune Models of Immune Dysregulation dysregulation that can eventually manifest Before we get to that, I’ll mention as a causing the dysregulation. in autoimmune disease. It is generally quick reminder something about why accepted that autoimmunity is a result of the immune system dysregulates by an abnormal interplay between genetic misinterpreting a non-self antigen (such as predisposition and immune reactivity a bacterial toxin or a dietary protein like is dietary proteins. We know that certain to start. Working with a lab that features to non-self antigens (ie, environmental gluten) as a self-antigen (such as your gut foods, eg, wheat and dairy, are more the most common pathogens known to be triggers). Since the gastrointestinal (GI) cells) and then attacking it. Since nearly immunogenic than others, especially related to autoimmunity is recommended; tract is such a key focus in naturopathic the beginning of our understanding of when it comes to autoimmunity. The examples include Klebsiella, Epstein-Barr medicine, let’s focus on that organ system autoimmunity, we’ve known that infections immunogenicity of different food virus, and Mycoplasma, to name a few. in our discussion of how environmental can trigger this process. There are 3 models constituents varies between individuals. Some labs also make it possible to evaluate triggers induce autoimmunity and how that explain this. Therefore, to decrease the chance of these different pathogens in 1 panel from we can test for them. potential false-negative results, it’s best a single blood draw specimen, which can Are you checking your GI patients for Molecular Mimicry to evaluate these foods comprehensively. save your patients time, money, and the autoimmunity? I’m not just talking about The idea associated with the first model is For example, instead of just evaluating necessity of multiple needle sticks. the biggies like celiac disease, Crohn’s, that a part of the pathogenic antigen looks for wheat antibodies, it’s recommended and ulcerative colitis (although make enough to the immune system like a piece to look at multiple components of wheat, Intestinal Permeability (Leaky sure that you are ruling these out); I’m of self-antigen that the immune system eg, alpha-gliadin, gamma-gliadin, omega- Gut)18,19 also talking about polyarteritis nodosa starts to attack the self-antigen with gliadin, glutenin, wheat germ agglutinin, A more recently identified autoimmunity (PAN), autoimmune hepatitis, diabetes, the same antibodies used to attack the and even non-gluten wheat proteins. trigger is leaky gut. A breakdown of the eosinophilic esophagitis (EoE), and maybe pathogenic antigen. Once the self-antigen We also know that when a food is tight junctions along the gut barrier causes even small intestinal bacterial overgrowth is on the radar of the immune system, cooked or modified in some way, the increased intestinal permeability, which (SIBO) and irritable bowel syndrome the immune system keeps targeting it. immune-triggering antigens in that food serves as a gateway through which a wide (IBS). Having said that, it’s less about Over time, this can lead to destruction can change. For example, an individual variety of immunogenic antigens can naming the autoimmune condition and of the tissue and organ system. This might be reactive to cooked salmon but enter the circulation superhighway that more about understanding the process. concept of immune dysregulation is called not uncooked salmon. Not all laboratories otherwise would not, including undigested Discovering that a patient’s condition is “molecular mimicry.” test for both cooked and raw foods. How dietary proteins, pathogens, and other related to autoimmunity creates a valuable often do your patients consume uncooked toxins. Multiple labs now test for these therapeutic branch point – one that helps Bystander Effect grains, beans, and meat? Not often, so we tight-junction gut-barrier proteins. open up other clinical opportunities. The second model suggests that the should not only be testing for immune When dysregulation of the immune immune system’s reaction to a non-self reactions to raw foods. Conclusion system causes autoantibodies to antigen (such as a pathogen) becomes so I’ll leave it to Alessio Fasano, one of the be developed, the goal should be overzealous while working to destroy the Chemicals4,8-10 top researchers in this area, to put it most identification of the non-self antigen pathogen that it inadvertently destroys Multiple chemicals have been implicated succinctly: causing the dysregulation. If we can some of the surrounding self-tissue as well. in GI dysfunction, including styrene, Genetic predisposition, identify and remove the auto-antigen, the This is referred to as the “bystander effect.” molds (eg, aflatoxin), formaldehyde, miscommunication between innate autoantibodies will decrease. I believe it’s tetrachloroethylene, and heavy metals. and adaptive immunity, exposure to inappropriate to claim that autoimmunity Hygiene Hypothesis Chemicals can covalently bind to human environmental triggers, and loss of the can be cured; however, if we can identify The third model basically suggests that tissue. When this happens, the immune intestinal barrier function secondary and remove the environmental trigger our overly antibiotic, antimicrobial, system will recognize it a problem and to dysfunction of intercellular tight that is causing the immune system to and anti-bacterial society eradicates the develop antibodies against the now- junctions, seem to all be key ingredients hyper-react, and bring about a decrease or microbes that normally upregulate the combined chemical and host tissue. This involved in the pathogenesis of normalization of the autoimmune markers, Th2 immune response in childhood. is an example of the “bystander effect” autoimmune diseases.18 signs, and symptoms, this would be This results in a more aggressive Th1 that can lead to autoimmunity. Many labs considered a successful clinical outcome. immune response, which is associated evaluate levels of chemicals in the body, The pharmaceutical model of symptom So, what kind of environmental triggers with predisposition to autoimmunity which can be relevant in certain clinical suppression in autoimmune diseases is cause the immune system to dysregulate, and chronic inflammation. This model is situations; however, when it comes to outdated and should be replaced by, or potentially leading to autoimmunity? referred to as the “hygiene hypothesis.” autoimmunity, our main interest should be at least added to, an approach that aims antibody reactions to chemicals or metals. to identify the environmental triggers It’s Just Genetic, Right? With this information serving as a The immune system’s reaction to such for different individuals. This will allow If you have been in clinical practice for backdrop, we can better understand chemicals with IgG, IgA, or IgM antibodies physicians and patients to better manage any amount of time, you’ve undoubtedly how environmental triggers cause the indicates loss of immune tolerance, and these conditions, thereby minimizing noticed that autoimmunity can run in immune system to initiate an attack on in susceptible individuals can result in the abnormal interplay between genetic families. Typically, family members aren’t self-tissue. Whether it’s through molecular autoimmunity. Make sure that you test predisposition and environmental triggers. necessarily suffering from the same mimicry, the bystander effect, or the through a laboratory that evaluates for condition. For example, your patient hygiene hypothesis, once an immune immune reactions to chemicals/metals, not References available online at ndnr.com may have Hashimoto’s thyroiditis, and system reaction is blended with genetic just their presence. her mom has rheumatoid arthritis, her predisposition, autoimmunity can result. Chad Larson, NMD, DC, CCN, CSCS, 3,11-17 holds a Doctor of Naturopathic Medicine sister has multiple sclerosis, and her Lab testing is the best way to take the Pathogens degree from Southwest College of son has celiac disease. There is clearly a guesswork out and identify which triggers Pathogens are ubiquitous in the GI tract, so Naturopathic Medicine, and a Doctor of Chiropractic degree from Southern genetic predisposition; however, the latest are stimulating the immune system. should be considered in every case of GI California University of Health Sciences. estimate suggests that only about one- dysfunction, especially GI autoimmunity. Dr Larson is an advisor and consul- tant on the Clinical Consulting Team third of an individual’s risk of developing Autoimmune Triggers Viruses, bacteria, parasites, and molds for Cyrex Laboratories. He is also a certified clinical 2 3-7 nutritionist and a certified strength and conditioning autoimmunity comes from genetics – Dietary Proteins can all trigger autoimmunity. Many labs specialist. Dr Larson particularly pursues advanced which leaves almost 70% of other stuff. The most common environmental trigger evaluate for these pathogens, but the developments in the fields of endocrinology, orthope- dics, sports medicine, and environmentally-induced So, what’s the other stuff? There are 3 that constantly drags across the GI tract clinical challenge is determining where chronic disease. 14 JANUARY 2019 NATUROPATHIC DOCTOR NEWS & REVIEW Meet our HMF Intensive Probiotics Research-driven support for gastrointestinal health‡

Daily probiotic supplementation is considered a necessary component of any healthy diet. That’s why Genestra Brands® has expanded the HMF Intensive family, which provides clinically studied probiotics for the rapid replenishment of an optimal gut flora composition. There is a probiotic formula suited for each of your patients. ‡

• HMF Intensive 500, our highest-potency probiotic

• HMF Intensive 50, a delayed-release, shelf-stable formula

• HMF Intensive, formulated to support intestinal comfort‡ (also available in a powder format)

Non GMO Gluten Free Soy Free Dairy Free No FOS Vegan

For more information, visit GenestraBrands.com or contact Customer Service at 1.888.737.6925.

Tried, tested and true.

‡These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease.

AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

GINGER NASH, ND health of the gut, most of us are well aware of the intensive research being conducted he significance of the on the gut microbiome. We know that the Tfucosyltransferase-2 (FUT2) gene and composition of our gut microflora affects More work and attention may be required on “secretor status” has been written about our ability to metabolize, digest and by Dr Peter D’Adamo for over 20 years. absorb nutrients, and to regulate immune Dr D’Adamo’s research into ABO blood function and defend against a multitude the part of non-secretors to maintain or restore type led him to see a connection between of pathogens. Indeed, it is our first “line the gene that codes for blood type and the of defense” against our environment, a healthy balance of commensals as well as FUT2 gene, which determines secretor including the food we eat. The FUT2 status. Specifically, the FUT2 gene is secretor status gene is responsible for the adequate diversity in their GI tract. responsible for the expression of our ABO synthesis of the type-1 H antigens, which blood-type antigens into all of our bodily act as precursors for the ABO blood-group fluids. Individuals who carry at least 1 antigens expressed on intestinal mucosa functional allele are known as “secretors,” and deposited into digestive secretions Certain strains of bacteria have a greater various gut bacteria, they also provide a whereas individuals who are homozygous (among individuals who are secretors).1 affinity for the different carbohydrates, or level of protection against the adherence for loss-of-function mutations are known Considering its significance, it is essential blood-type antigens, found throughout of certain pathogenic bacteria. Several as “non-secretors.”1 to understand a little bit about the the gut. Translation: your gut bacteria studies have shown that secretor status Non-secretors do not secrete blood-type relationship between ABO and FUT2 gene eat certain foods based on your blood type. affects susceptibility to infection by antigen into bodily fluids, ie, saliva, sweat, function with regards to intestinal health. Because secretors have blood-type antigen Norwalk and respiratory viruses, Vibrio tears, vaginal secretions, semen, or digestive The ABO antigen is a carbohydrate plentifully distributed throughout their cholera, Campylobacter jejuni, rotavirus, juices. Secretor status is completely food source for many bacteria and thus digestive secretions in the intestine, the and Helicobacter pylori.8 In some cases, independent of ABO status, so an individual influences commensal bacterial levels.2,3 beneficial bacteria have a constant supply FUT2 non-secretor status confers an can be a Type O secretor or non-secretor, The FUT2 gene plays such an important of food! Non-secretors, on the other hand, advantage.8 Remember, ABO expression Type A secretor or non-secretor, etc. It is role in the composition of gut bacteria, do not have such a plentiful food supply. is heavily dependent on the inheritance of estimated that about 18-20% of the general that authors of a study from 2014 stated, As a result, more work and attention may the Secretor/FUT2 gene. population are non-secretors, and this has “secretor status and FUT2 polymorphism be required on the part of non-secretors an impact on various aspects of human are associated with the composition of to maintain or restore a healthy balance of The Role of Lectins physiology.1 It is the impact of secretor human intestinal microbiota, and appears commensals as well as adequate diversity Another important factor in the status on gut health that will be the focus of thus to be one of the key drivers affecting in their gastrointestinal tract.5-8 relationship between diet, blood type, the remainder of this article. the individual variation of human Because our ABO blood-group and secretor status is the role played by intestinal microbiota.”4 To understand antigens are a source of food for various lectins. These are sugar-binding proteins Secretor Status & the Gut why this is so, it is helpful to examine the bacteria, the presence or absence of these that are found in abundance throughout NDNR 2019-01 (Focus on Gastrointestinal Health-Toxicology-Bariatrics) - half page .pdf 1 20/12/2018 4:52:59 PM As naturopathic physicians focused on the role of ABO antigens in the gut mucosa. antigens not only affect the population of the plant and legume world. Lectins are

Nutritional Fundamentals for Health Inc.

Paving the Path to Optimal Health

CM Focus on MY Gastrointestinal Health, CY Toxicology, and Bariatrics CMY

K Ginger SAP™ Berberine SAP™ Science-based digestive and pain support.* Science-based berberine for optimal metabolic function.* Ginger SAP™ is a standardized extract of Zingiber officinale that can be used to help Berberine SAP™ supports healthy cholesterol levels and promotes healthy glucose prevent nausea and vomiting associated with motion sickness and/or seasickness, and metabolism.* Berberine SAP™ supports healthy intestinal microbial activity.* Berberine relieve digestive upset including conditions like dyspepsia and flatulent colic, lack of SAP™ provides 300 mg of berberine hydrochloride and 150 mg goldenseal root per appetite, and digestive spasms.* In addition, Ginger SAP™ can assist in reducing symptoms non-GMO vegetable capsule.* associated with primary dysmenorrhea and migraines, and can also act as an expectorant and antitussive to help relieve bronchitis, coughs, and colds.* Artemisinin SAP™ Probio SAP™ Science-based Artemisia annua extract for optimal health.* 10 billion live cells per pH-activated enteric-coated capsule.* Each non-GMO vegetable capsule of Artemisinin SAP™ provides 500 mg of high quality Probio SAP™ supplies a comprehensive, high-dose, multistrain probiotic blend in an Artemisia annua extract standardized to 10% artemisinin.* Artemisinin SAP™ provides enteric-coated capsule to promote a wide spectrum of gastrointestinal and immune health digestive support and exerts anti-bacterial, anti-helminthic and anti inflammatory effects.* effects.* Artemisia annua apart from artemisinin, contains other bioactives such as sesquiterpene lactones that have antihelminthic properties.* Artemisinin SAP™ also helps regulate cancer cell growth and has anti-tumor properties.* All ingredients listed for these product lot numbers have been validated by a third-party ISO 17025–accredited laboratory for identity, potency, and purity. *These statements have not been evaluated by the Food and Drug Administration. Our products are available through these distributors. Please contact This product is not intended to diagnose, treat, cure or prevent any disease. them about availability. www.emersonecologics.com | 800.654.4432

Nutritional Fundamentals for Health Inc. • 3405 F.-X.-Tessier, Vaudreuil, QC J7V 5V5 • Tel. 1 866 510 3123 • Fax 1 866 510 3130 • www.nfh.ca OUR PRODUCTS ARE PROUDLY CANADIAN

16 JANUARY 2019 NATUROPATHIC DOCTOR NEWS & REVIEW AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

highly specific to their sugar moieties. infections. Antibiotic treatment in non- absorption and distribution of lipids such overall gut health for non-secretors. It After all, the word “lectin” comes from secretors appears to promote easier as cholesterol after the ingestion of a fatty would be appropriate and important the Latin word legere, meaning “I choose.” overgrowth of known gut pathogens meal, so there are implications far beyond for any practitioner making dietary Your ABO “blood type” is a sugar antigen such as Salmonella and Clostridium difficile, the gut as well. recommendations to his or her patients to – a carbohydrate structure found on making these enteric pathogens more identify their patients’ secretor status and the surface of many cells, not only in difficult to treat in the non-secretor Treatment Considerations have a basic understanding of its impact on the blood. Blood-type antigen is found population.14-18 FUT2 gene expression is fairly individual, health. After all, true health, as we know, extensively throughout the lining of your The activity of an important enzyme especially based on the presence of various begins in the gut! gut and all your digestive secretions if in the gut is also affected by FUT2 secretor other genes, including ABO. Nonetheless, you are a secretor.9 When you consume status. It has been estimated that non- there are various therapeutic measures References available online at ndnr.com incompatible lectins for your blood type, secretors have only 20% of the enzyme, that are generally reliable for non-secretor they can bind to your particular blood- intestinal alkaline phosphatase (IAP), that individuals. Beta-glucans, a type of type antigen and damage your intestinal secretors possess.9 IAP plays an essential beneficial fiber, have been shown to help lining; this in turn diminishes your ability role in intestinal homeostasis and health. protect the intestinal wall in non-secretors, Ginger Nash, ND, is an expert in the and several strains of “probiotics,” most field of women’s health and hormone to digest food and lays the foundation for This enzyme interacts with the resident balance, having lectured to both women inflammation in the gut. microbiota and with our dietary intake notably Bifidobacterium, will also enhance and practitioners of natural medicine 6 across the United States and Canada Generalized “low-lectin diets” of certain foods. One’s secretor status the expression of FUT2. In addition, for 20 years. Dr Nash taught at the continue to be espoused by various health will mightily influence the ability of this certain nutrients, eg, vitamin B12 or University of Bridgeport’s College of Naturopathic Medicine clinic for 6 years practitioners. D’Adamo’s work, however, enzyme to protect us from both infectious picolinic acid, may alter the activity of and has also had a thriving practice in New Haven, 19-23 24,25 CT, since 1999. She is a sought-after speaker and has looks at the specificityof lectins for each agents and chronic inflammation. the FUT2 gene. Dietary modifications recently launched a comprehensive online program for person, based on his or her blood type. Lastly, IAP also plays a role in the proper can make a tremendous difference in menopausal women. This is really the key to understanding any lectin-host relationship. In fact, some lectins are beneficial for certain individuals, in that their immune systems are more able to identify pathogens and, in some cases, defend against cell changes that might lead to cancer. This is because the lectins can cause aberrant cells to stick together, creating clumps of cells that are now more “visible” to the immune system. If an individual is a non-secretor, the potential for damage wreaked by FOR THOUSANDS OF PATIENTS, adverse lectin relationships is much higher. This is because non-secretors lack that RELIEF STARTS WITH NEPRINOL. extra layer of protection afforded by ABO antigen in the digestive secretions whereby See for yourself online at ArthurAndrew.com certain lectins can attach to “decoy” molecules instead of doing damage to the mucosal lining of the gut. In this way, blood groups can serve as false receptors, preventing binding to various target CONTINUED USE FOR ENDOMETRIOSIS tissues. Consuming incompatible lectins By Freya S. for your genetic individuality promotes a My Dr. prescribed Neprinol for my endometriosis. It really seems to be making a difference. My proinflammatory state in the intestinal tract pain level is down. Bloating of the abdomen is down. My digestion has improved, and overall as a whole. health and well-being continues to improve!

Secretor Status & Intestinal Disease Secretor status effects on GI inflammation, THE BEST DISCOVERY EVER!!! By Jason C. in conjunction with its effects on host gut microbiome bacterial populations, likely I have severe daily joint discomfort, contributes to the higher number of non- and this is the best thing I’ve ever secretors among individuals with Crohn’s happened upon. This product has disease.10,11 All chronic inflammatory bowel rid me of the constant call of PAIN every day. diseases (IBDs) should be more extensively LOVE THIS PRODUCT researched with an eye toward secretor By Katherine M. status. Although the precise etiology of It helped remove scar tissue, IBDs is not yet fully understood, abnormal boosted my immunity, and made BEFORE NEPRINOL host-microbial interactions have been my body feel better, as in no Subject has high levels implicated in the pathogenesis of IBD.11-13 physical issues, pains, etc. I of blood contaminants and reports stiff, Mucosal and fecal bacterial analyses have recommend this product to all! uncomfortable joints after revealed that patients with IBD have less exercise (from overuse). diverse normal flora, and it has also been shown that non-secretors have less overall AFTER NEPRINOL diversity in their microbiomes compared Subject’s blood is to secretors. This is one of the most cleansed and reports important factors in overall gut health: no joint discomfort or a diverse bacterial population. Small tenderness. intestinal bacterial overgrowth (SIBO) likely has connections to secretor status as well, if we consider the ability of certain bacteria to migrate into the small intestine more easily and propagate due to less mucosal layer protection. More research is Learn more about the benefits of Neprinol and read needed in this area. reviews from real customers at ArthurAndrew.com A review of the scientific literature will show definitive associations or call 800-385-2091. between non-secretor phenotype (or the FUT2 genotype AA) and celiac *These statements have not been evaluated by the Food and Drug Administration. disease, peptic and duodenal ulcers, type This product is not intended to diagnose, treat, cure, or prevent any disease. 1 diabetes, primary sclerosing cholangitis, vaginal candidiasis, and urinary tract NATUROPATHIC DOCTOR NEWS & REVIEW JANUARY 2019 17 AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

in impaired B12 metabolism, resulting in Clostridia & Constipation anemia.2 The short-chain fatty acid, butyric acid, is generally considered beneficial to the Using Organic Acid Testing in Diagnosis & Treatment health of the gastrointestinal tract. In the case of clostridia overgrowth, however, butyric acid (along with propionic acid) ANGELA KNAPP, ND OR may help diagnose bowel obstruction or may induce sodium and water absorption • Loose stools are rarely present without gallbladder sludge that reduces digestive in the colon, furthering the solidity of the lthough Clostridium species are the use of laxatives function. Food sensitivity testing can stool.2,4,5 Atypically present in the large intestine identify food triggers of constipation. Once constipation has worsened, as a beneficial part of the gastrointestinal Constipation is not only a symptom Additionally, there are gastric emptying backup of clostridia into the small intestine flora, the word clostridia generally elicits of an underlying problem; it also has the tests and tests for neuropathy, though these can allow for the sequestration of vitamin thoughts of intractable diarrhea and potential to create further dysfunction if are rarely used to evaluate constipation. B12 prior to its absorption in the terminal Clostridium difficile. However, despite the not treated properly. Getting to the root ileum.6 Resulting B12 deficiency may common association between clostridia cause of constipation requires identifying When Clostridia lead to anemia and eventual neurological and diarrhea, an imbalance of multiple contributing factors. Causes Problems damage by demyelination.6 Clostridium species can result in chronic The first step in uncovering the root of a This particular article focuses on the constipation. patient’s constipation is an in-depth history use of organic acid testing to help Organic Acid Testing and physical exam. A proper physical identify clostridia as a causative factor Organic acids are byproducts of Constipation: exam includes listening for the sounds of in a patient’s constipation. Clostridia’s metabolism in the body that can be easily A Brief Review digestion, percussing or drumming on the presence in the colon is generally not measured in a urine specimen. Levels Constipation is a digestive complaint abdomen, and feeling for gas or impacted problematic. However, when the bacteria of different organic acids can provide that runs rampant in the United States stool. While no sounds may indicate regurgitate into the small intestine, information about various functions and and perhaps worldwide. It can cause obstruction or slow motility, too much clostridia can wreak havoc on the digestive organ systems in the body, including the enough discomfort to result in irritability. sound, aka borborygmus, suggests gas tract, resulting in systemic imbalances. gastrointestinal tract. Constipation is defined as incomplete from offending foods, deficient digestive Clostridia’s access to nutrients in the ileum Research since 1955 has shown or infrequent stools, as well as difficulty enzymes, lactose intolerance, or celiac allows the microbes to produce short- that certain Clostridium species (and passing stool. To diagnose constipation, disease. Additionally, assessing reflexes chain triglycerides that promote water enterococci) are capable of bile salt at least 2 of the following symptoms must and motor strength is important in order to absorption, which dries up intestinal deconjugation via the bacterial enzyme be present over a 3-month period. This is identify any potential nerve dysfunction. waste.2 Clostridia are also capable of cholylglycine hydrolase.7 Deconjugation according to the Rome-III criteria1: The next steps in uncovering the reducing fat absorption by deconjugating of bile salts prevents the breakdown of • Fewer than 3 bowel movements per root of constipation are lab tests and bile and consuming available lecithin.2 fats, resulting in lipid malabsorption and week imaging. These are not always necessary Tryptophan – one of the most-scarce fat-soluble nutrient depletion. Remaining • Straining to diagnose the cause of constipation, amino acids3 and which is required for fats in the intestine serve as a food source • Lumpy or hard stools but can be helpful in some cases. For the production of 5-hydroxytryptophan for pathogenic bacteria, producing • Sensation of anorectal obstruction example, an organic acid test or microbial (5-HTP), serotonin, and melatonin – may malodorous gases from putrefactive fatty • Sensation of incomplete defecation stool testing can point towards particular be metabolized by clostridia, reducing acids such as putrescine and cadaverine. • Manual maneuvering required to microbial disparities, such as clostridia bioavailability.2 Finally, clostridia’s On an organic acid test, elevated levels defecate overgrowth or yeast excess. Imaging presence in the small intestine may result of suberic and adipic acids indicate a

NorthAmerican

Swiss-Biomedicine.com EventCalendar WestPalmBeach,FL byDr.Rau AdvancedBiologicalMedicineforDifficultDisease MODULE3 Jan23&24 MODULE4 Jan25&26 CEPrograms byourNorthAmericanteam. AttendModulesinanyorderoraccordingtointerest. Seattle,WA byDr.Stills MODULE1 Feb27&28 MODULE2 Mar1&2 Toronto,ON byDr.Roberts MODULE1 Apr3&4 MODULE2 Apr5&6

Scottsdale,AZ byDr.Stills MODULE3 Apr17&18 MODULE4 Apr19&20 NewYork,NY byDr.Bethge MODULE1 Apr30-May1 MODULE2 May2&3 Dr. Thomas Rau M.D., past 27-year Medical Director of Switzerland’s famous Paracelsus Clinic, leads the new teaching and treatment clinic, Swiss Biological Medicine Center at Teufen. NewYork,NY byDr.Rau MODULE3 June4&5 Who attends? Holistic-Minded Biological, Functional and Naturopathic Medical Doctors, Holistic MODULE4 June6&7 Dentists, Nurses and support staff. Participants are now from 19 Countries! AcademyFellowsareinvitedtojoinourInternationalTreatmentNetwork Register! SwissBiologicalMedicineCertificateProgram 2-dayAdvancedNatural MODULE1- IntroductiontoSwissBiomedicine MODULE4- 2nd&3rdPillars-Intestinaland * MedicineSeminars GreatOrientationfor acompleteprogramoverview ImmuneFunctionRestoration;Regeneration allStaffMembers * TakeModulesinany MODULE2- The1stPillar-Detoxification MODULE5- ApplyingtheSBM Approachto order,atyourconvenience IdentifyingandRemovingToxicBurdens DifficultDiseaseSituations;CaseExamples Info:1-778-847-3243 MODULE3- Hyperacidityand Associated MODULE6- SwissBiomedicineCancerPrograms 3AANPCEperseminar. DiseaseConditions;TreatmentsandExamples Modules5&6aretaughtatTeufen.SWZ $628ea-order2andsave$60 18 JANUARY 2019 NATUROPATHIC DOCTOR NEWS & REVIEW AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

reduction in the breakdown of fats. This, Management of chronic constipation in combination with elevated levels of requires a complete work-up. Organic Clostridium metabolites, such as 4-hydroxy- acid testing can help identify clostridia phenylacetic acid, HPHPA, 4-cresol, and Clostridia has been shown to cause tryptophan as a possible contributing factor in a 3-indolacetic acid, supports a link between patient’s constipation. It can also help reduced bile function and clostridial deficiency via 2 mechanisms. assess how clostridia may be affecting deconjugation of bile.8-10 nutrient absorption, lipid breakdown, and Tryptophan metabolism is one of neurotransmitter balance, as well as the the more well-researched aspects of use of probiotics comprised of Lactobacillus canadensis (goldenseal), shiitake, Salix alba severity of these imbalances. clostridia metabolism. Clostridia has been species, particularly Lactobacillus (white willow bark), garlic, grapeseed shown to cause tryptophan deficiency rhamnosus.12 In combination or individually, extract (minimum 90% polyphenols), References available online at ndnr.com via 2 mechanisms. Firstly, Clostridium research has also supported the clostridia- Juglans nigra (black walnut) hull and leaf, can consume the sugar necessary for inhibitory effects of Saccharomyces raspberry, Fumaria officinalis(fumitory), Angela Knapp, ND, believes in the 13 symbiosis of humanity and the envi- tryptophan’s absorption, which can then boulardii. Gentiana (gentian), Melaleuca alternifolia ronment. It was during her work as a result in preferential absorption of other One of the most popular botanical (tea tree oil), Ferula spp (galbanum) oil, small farmer after college that Dr Knapp recognized her goal to heal the earth amino acids, such as tyrosine. Secondly, approaches to dysbiosis that among lavender oil (plant and flower), and by helping its inhabitants heal themselves. In 2013, Dr Knapp received her Clostridium can metabolize tryptophan. The clinicians is a proprietary blend of Origanum vulgare (oregano) oil (plant and doctorate from NCNM, with a specialty resulting deficit in available tryptophan Vaccinium myrtillus (bilberry) extract flower). Pulsing doses of this tincture may in Natural Childbirth. She currently practices at the Peirson Center for Children, in Portland, OR. Dr Knapp may cause niacin deficiency, due to (25% anthocyanosides), Morinda citrifolia reduce clostridial burden similar to pulsing is Staff Physician at Kashi Clinical Laboratories. She tryptophan’s role in niacin metabolism. (noni), Silybum marianum (milk thistle), doses of antibiotics like vancomycin and enjoys spending time with her family, preparing meals with locally procured foods, and grounding herself by Niacin as NAD plays an important role in Echinacea (purpurea & angustifolia), Hydrastis metronidazole.14 getting her feet wet in any nearby body of water. oxidation-reduction reactions as well as non-redox reactions.11 On organic acid testing, urinary levels of tryptophan metabolites such as 5-hydroxyindolacetic acid (5-HIAA), quinolinic acid, kynurenic acid, and the ratio of quinolinic acid to 5-HIAA, can ORAL TO OVERALL HEALTH indicate a possible tryptophan deficiency and potential neurotoxicity (Figure 1). STARTS WITH GOOD NUTRITION. Along with markers for Clostridium, these tryptophan markers may suggest Clostridia involvement. Low serotonin levels, indicated by low 5-HIAA, can play a role in reduced peristalsis, further “Fermented Cod Liver Oil and X-Factor High Vitamin Butter complicating constipation. Extract are excellent sources of unadulterated fat soluble vitamins, Omega oils, and coenzymes.” Treatment Options Behrooz Tahririha, DNM Management of clostridia-mediated constipation can take any number of directions: diet, supplements, botanical “Thank you for working hard to benefit mankind. My family medicine, or antibiotics. Lactobacillus is doing well with your fermented cod liver oil. Our doctor species are known to be health-promoting suggested it especially for the good health of our eyes. gastrointestinal bacteria. Because We love taking the tasteless capsules daily.” lactobacilli balance and counter many of Linda A. the actions of clostridia, a diet supporting lactobacilli and inhibiting clostridia can help prevent and reverse dysbiosis. Lactobacillus requires little iron and is unable to digest cellulose, many proteins, and lipids, whereas Clostridium can digest most foods other than lactulose and some proteins and lipids. Therefore, a diet low in protein and iron can help support lactobacilli species while at the same time reducing clostridia species. It has also been suggested that conservative use of lactulose can help alleviate constipation while also promoting growth of lactobacilli. Just as a Lactobacillus-promoting diet can benefit the balance of the gut flora and “I am happy that there is a brand of fermented cod inhibit Clostridium overgrowth, so can the liver oil I can trust. I look forward to giving this to my entire family to improve our oral and overall health.” Megan S. Figure 1. Tryptophan Metabolism

Dr. Weston A. Price discovered that cod liver oil combined with butter oil was even more beneficial than either one on its own!

Learn more about our products at greenpasture.org or call 402-858-8139

SAVE 10% EXTRA! Practitioners initial order coupon code: GPP12019NDNR *THESE STATEMENTS HAVE NOT BEEN EVALUATED BY THE FOOD AND DRUG ADMINISTRATION. THIS PRODUCT IS NOT INTENDED TO DIAGNOSE , TREAT, CURE, OR PREVENT ANY DISEASE. CALL 402-858-8139 TODAY

NATUROPATHIC DOCTOR NEWS & REVIEW JANUARY 2019 19 AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

hydrogen producers, while at the same SIBO as an Adaptation time supplying the body with a crucial gasotransmitter.

A Proposed Role for Hydrogen Sulfide H S as a Sulfate Substrate 2 Aside from its role in both health and diseases of the gastrointestinal tract,21

GREG NIGH, ND, LAC day of altering the macronutrient content because we’re thinking about it wrong. there is another crucial role for H2S in of the diet. It will revert back to its original Maybe the problem with the durability the body, a role that I believe is central

We can not solve our problems with the composition within 2 days of ending the of our therapies is that SIBO is not the to SIBO’s adaptive function: H2S is a 9 same level of thinking that created them. trial diet. There are numerous examples of problem. Rather, maybe SIBO is actually an substrate for sulfate (SO4) production. (Albert Einstein) the microbiota remodeling itself in order to adaptation, a symptom-laden solution to a Activated neutrophils can generate sulfate 22 utilize dietary constituents for the benefit of different problem. Bear with me. from H2S, while virtually all cells contain t is an understatement to say that the the host.10,11 SIBO is as much a clinically diagnosed the enzymatic machinery to oxidize microbiome is not what we thought it The picture that has emerged is one of condition as it is diagnosed through H S to thiosulfate in a 3-step process I 2 was. In the past decade we have seen an shocking complexity: these trillions of non- testing. Patients with the standard SIBO in which sulfite is an intermediate.23 explosion of information regarding the self organisms are sensing the changing symptoms but without a positive SIBO Sulfite can also likely be generated 12 multiple regulatory roles the gut bacteria nutritional environment and constantly breath test are, in my experience, generally from H2S via endothelial nitric oxide play in the body. Almost every major producing signaling molecules,13 and fine- classified as hydrogen sulfide-type SIBO. I synthase (eNOS).24 Sulfite, wherever it organ in the body is now understood to tuning and adjusting our entire physiology am not doing SIBO testing in my practice, is generated, can be acted upon by the function within an “axis” with the gut. accordingly. It all works brilliantly until, it but this is how patients commonly arrive ubiquitous enzyme, sulfite oxidase, to 1 These include a gut-brain axis, gut-heart would seem, it doesn’t. at my office. I don’t doubt that hydrogen generate SO4. Given the body’s constant 2 3 4 25 axis, gut-kidney axis, gut-lung axis, sulfide is behind symptoms in those cases, need for SO4 to build heparan sulfate, diet-microbiota-immune axis,5 gut-liver An Alternative View and in fact I suspect it goes much further carry out phase II detoxification, maintain axis,6 gut-joint axis,7 and others. To During my first year as a student at the than that. Let’s consider the prime suspects proper blood viscosity,26 and many designate an axis is to recognize the active National College of Naturopathic Medicine behind SIBO. other actions, any reduction in sulfate role the microbiome plays in the beneficial (NCNM), I made it a habit to regularly As much as 1 liter of hydrogen is availability necessitates a “work-around,”

modulation of these varied organs. meet with Dr Jared Zeff over lunch. During produced by bacteria of the microbiome a compensatory shift. 2H S produced in The case has been made that the those walk/talk sessions I would pepper each day. It is important to keep in mind the gut via SFB, symptomatic though it microbiome constitutes an endocrine him with as many questions as I could. that molecular hydrogen plays a strong may be, will diffuse into the blood and a organ in itself due to its ability to produce Once I naively asked, “How do you treat anti-inflammatory role in the body.14 In portion of it will ultimately be oxidized a wide range of compounds that regulate a common cold?” His reply was quick and fact, the antioxidant properties of lactulose to sulfite and then sulfate via these distant cells, organs, and systems. These has stuck with me since: “A cold isn’t the have been attributed to its ability to mechanisms just described. compounds include neurotransmitters problem; it’s the cure.” promote bacterial production of molecular There are many reasons that sulfate and short-chain fatty acids, in addition Regarding the microbiota, I would hydrogen,15 and the cardioprotective effect might be in short supply, most of to regulators of cortisol, ghrelin, leptin, not suggest that there is no such thing of alpha-glucuronidase inhibitors has them, I believe, being environmental. secondary bile acids, and others.8 Further, as dysbiosis. However, when it comes been attributed to their ability to increase Glyphosate, the active ingredient in the microbiome can make changes in its to small intestinal bacterial overgrowth hydrogen production in the microbiota.16 many commercial herbicides, can chelate composition that are adaptive for the host – (SIBO), in particular, I do want to suggest Numerous articles have postulated molybdenum and iron and can also changes that can take place within a single that perhaps it is such a tenacious problem beneficial effects from the molecular impair heme synthesis – 3 consequences hydrogen produced by the microbiome. that would have profound impacts on the

Methane (CH4) has been proposed sulfate-generating heme enzyme, sulfite ACTIVATED CHARCOAL as meeting all 6 requirements to oxidase (SUOX).27 Sunlight exposure 17 560 MG/SERVING be a “gasotransmitter.” While the is another important source of sulfate

physiological role(s) of CH4 is unclear, it production within the skin. The dramatic is well-established that microbial methane increase in UV-blocking sunscreens production acts as a sink for hydrogen would be expected to significantly reduce produced “upstream” by the hydrogen- the average daily sulfate production in producing bacteria.18 the population.24

Hydrogen sulfide (H2S) has its Heavy metals, such as tungsten, own interesting history. Regarded for copper, cadmium, and arsenic, have also over a century as simply a noxious been shown to insert themselves into the gas, it eventually joined carbon molybdenum cofactor within SUOX.28 monoxide and nitric oxide as the third Sulfur-containing products (eg,

gasotransmitter in the human body. 2H S methionine, methylsulfonylmethane has a wide range of functions, including [MSM], lipoic acid, glutathione, DETOX SUPPORT* cognitive, neurological, gastrointestinal, N-acetylcysteine [NAC], and others) ALLEVIATES GAS & BLOATING* cardiovascular, and others. Interestingly, its are used as detoxification therapies for MADE FROM physiological effects are often opposite at a reason. Sulfur binds, and this includes COCONUT SHELLS low and high concentrations.19 the sulfur in the amino acid, cysteine, NON-GMO PROJECT VERIFIED When healthy cells are put under stress, found within serum albumin, the sulfate

the H2S-generating enzyme cystathionine- in heparan sulfate, and elsewhere. It will gamma-lyase (CSE) translocates from bind metals29 as well as various other HOW IT WORKS the cytosol to the outer mitochondrial pollutants.30 An unfortunate result is that Activated charcoal powder has been traditionally used to support membrane, where it uses the high the heparan sulfate proteoglycans sustain healthy digestive function.* Its porous texture allows it to attract and mitochondrial concentration of cysteine damage when assaulted by byproducts trap toxins and gases that are typically present in the GI tract and carry them safely out of the body.* In this way, activated charcoal can help to alleviate to generate H2S. The H2S then acts within of modern life such as reactive oxygen uncomfortable gas and bloating caused by gas-producing foods.* Our Activated the electron transport chain to improve and nitrogen species, heavy metals, and Charcoal is derived from non-GMO coconut shells. efficiency of ATP production.20 The point is aberrant copper and iron metabolism.26,31 that H S production is vital to the cellular Genetics comes into play in this as CLINICAL VALIDATION 2 In a one-day randomized, double-blind, placebo-controlled trial adaptation to physiological stress. well, though my clinical experience on healthy volunteers (n=62 in India, n=30 in the USA), subjects H S is also generated by the suggests that outside of polymorphisms received 1,040 mg Activated Charcoal (AC) or placebo; 30 2 minutes later they were given one dose of lactulose microbiome through the action of the in the SUOX gene, the polymorphisms (15 ml) as a gas-inducing compound, and after an additional 30 minutes, a second intake of 1,040 mg AC or placebo was sulfur-fixing bacteria (SFB). As with associated with cystathionine-beta- scheduled. The number of volunteers who experienced bloating and abdominal cramps was signi cantly lower in the AC group. CH4 production, H2S production is a synthase (CBS) and CSE are usually The score for each of these two GI discomforts was signi cantly means of trapping molecular hydrogen playing a relatively minor role in sulfate lower as well.* ( gure 1) produced upstream. In fact, the SFB production and processing. have a substantially stronger affinity It is within this context that hydrogen for molecular hydrogen than do the sulfide comes to the ironic rescue. facebook.com/ProtocolForLifeBalance

linkedin.com/company/protocol-for-life-balance methanogens, which means that H2S is Although linked to various symptoms, more likely to be produced than CH . In its ability to be oxidized to sulfate fills a *These statements have not been evaluated by the Food and Drug Administration. 4 This product is not intended to diagnose, treat, cure or prevent any disease. this way, the methanogens and the SFB biological vacuum that must be filled for maintain a functional balance with the sustained physiological functioning. In this 20 JANUARY 2019 NATUROPATHIC DOCTOR NEWS & REVIEW AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

adaptation model, the many sulfur-fixing Hydroxocobalamin specific low-sulfur diet that is customized struggle with recurrence; a body’s gotta bacteria – which can convert sulfated This particular form of vitamin B12 is able to each patient. The common goal of do what a body’s gotta do, and producing steroids, sulfomucins, dietary cysteine, and to bind H2S and render it less biologically all therapies is to reduce the need for sulfate is what a body’s gotta do. other dietary sulfur into hydrogen sulfate – toxic.35 Clinically, I’m using this both SFB and reestablish healthy sulfate Viewed in the light of sulfate-producing proliferate in order to supply this much- intramuscularly and as oral therapy. production. Most patients have had adaptation, I believe it is not only SIBO needed sulfate substrate. The sulfur fixers years or decades of inflammatory bowel that becomes more understandable, but are not just in the genus of Desulfovibrio, Korean Red Ginseng issues that have to be repaired, so it a wide range of modern maladies also but also include Staph aureus, E coli, This form of ginseng has been shown to takes time before dietary sulfur can be become less mysterious. Campylobacter jejuni, Klebsiella species, suppress the activity of the CBS and CSE brought back in as a standard part of the

Bilophila wadsworthia, Helicobacter pylori, enzymes, thus reducing production of H2S diet. Gut rebuilding protocols have to References available online at ndnr.com and over a dozen others.32 Each of these can internally.36 This can obviously play an be utilized incrementally, and only after convert different sulfur substrates into 2H S, important dual role in those SIBO patients sulfate-supporting nutrients have been and H2S can be transformed into SO4. who struggle with fatigue or who manifest brought into the program and biologically I believe this is the reason that SIBO other low-adrenal symptoms. available sulfate has been supplied. treatment that focuses on eradication Greg Nigh, ND, LAc, is naturopathic physician and acupuncturist, graduating of the bacteria causing the symptoms Miscellaneous Conclusion from NCNM (now NUNM) in 2001. Dr Nigh is co-owner of Immersion Health is doomed to fail, or at least has a high In addition to these basic therapies, I SIBO is a sign of the times. The modern in Portland, OR, where he has a prima- probability of failure. One study showed utilize a wide range of homeopathics, world is built in a way that impairs sulfur ry-care practice as well as a specialty in naturopathic oncology. He has done a 44% recurrence of SIBO 9 months after other nutrients (as indicated per case), metabolism, and SIBO is a reflection extensive research, writing, and speak- successful rifaximin treatment.33 ing on the relationship between dysfunctional sulfur Patients and with the assistance of the nutrition of that problem. If we treat SIBO as metabolism and the development of SIBO, inflammato- who take the best herbal and prescribed therapist in my office, recommend a the problem, then patients are likely to ry diseases, cancer, and other chronic conditions. antibiotic protocols, eat the right diets, and take all the indicated probiotics and kyowa-sustamine-ad-hcp.pdf 1 12/13/18 4:53 PM nutrients have a tragically high probability of symptoms resurfacing. It doesn’t make sense. However, this should be expected if the underlying issue is a sulfate deficiency, and if access to biologically useful sulfate has been limited. For improved I came to this adaptationist opinion rather incidentally. I was studying sulfur metabolism, seeing its connection to many compliance, maladies, and was working with sulfur issues as it related to hives, hot flashes, recommend the dermatitis, brain fog, inflammatory bowel disorders, and many other conditions. glutamine that's Then patients with a SIBO diagnosis started showing up to my office. I didn’t know what the breath tests meant, but better absorbed. with the help of the nutrition therapist I work with, I put these patients through Glutamine begins to degrade when a protocol designed to “unlock” sulfur mixed with liquids, but Sustamine® is metabolism. Lo and behold, regardless of a unique dipeptide form of glutamine their SIBO test results, a large majority of that's been designed for optimum these patients felt dramatically better, often absorbtion, stability and solubility.* for the first time after years of “standard” So when you recommend Sustamine, naturopathic SIBO diet and treatment. I don’t claim any universal cure; however, you can be confident your patients I think that a significant number of SIBO will get the amount listed on the label. An absorbable, clinically tested form patients are significantly lacking in sulfate,C and therapies to restore sulfate will reduceM of glutamine, Sustamine supports the need for those sulfur-fixing bacteria,Y hydration and other recovery functions and thus reduce or eliminate symptoms.CM in the body.* Sustamine is also MY

CY tasteless, colorless, odorless and Unlocking Sulfur Metabolism CMY dissolves completely in hot or cold K Restoring metabolic sulfate production liquids – so there is no gritty texture. can be a tricky business in patients with an Vegetarian, allergen-free and GRAS, established dysbiosis, but a few therapies Sustamine is an ingredient designed are almost universally helpful. to deliver optimal glutamine benefits to your patients.* Epsom Salt Baths RH Waring conducted a study34 with 19 healthy subjects. He found that using 400 grams (about 4 cups) of Epsom salt and soaking for 20 minutes nightly for 7 nights in a row increased sulfate levels .sustamine.com in the blood to a steady state. I have recommended this protocol for many patients and found that this alone can sometimes dramatically improve digestive symptoms in SIBO patients. A shower rinse after the bath is recommended.

Molybdenum *These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease. This trace mineral is crucial, though it is important to keep in mind that more is not always better. Molybdenum should be dosed in an organic form, and no more than 150 mcg twice daily with food should be taken. In my practice I have tried many supplemental forms, and only a few have worked. NATUROPATHIC DOCTOR NEWS & REVIEW JANUARY 2019 21 AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

thereby confirming that morbid matter The Carroll Method is a veritable concern and not merely a concept. Toxemia is concerning because it increases the toxic load in the blood An Explanation and taxes the organs of elimination. These disturbances can then manifest as inflammatory symptoms in the patient JARED C. PISTOIA application of the results has anecdotally The Carroll Method and disrupt normal bodily functions. SUSSANNA CZERANKO, ND, BBE been a key step in preventing toxemia, Morbid Matter The ill effects of consuming intolerable ie, the buildup of toxic digestive The primary aim of the Carroll method foods is not unlike other forms of toxicity. he Carroll method is a technique byproducts, historically referred to is to reduce the production of morbid For example, chronic lead exposure in Tperformed to identify food as morbid matter by Henry Lindlahr.1 matter. Food that is incompletely broken children results in systemic symptoms intolerances. Traditionally oriented When used in conjunction with the other down is destined to be digested by in those children.4 In this way, lead can naturopathic doctors rely on the Carroll available dietary evaluation tests, the bacteria in the large intestine. Bacterial also be thought of as morbid matter. The method in conjunction with other widely result is a highly personalized diet that metabolism of meat, eggs, and dairy same principle applies to the internal implemented dietary evaluation tests to helps minimize the creation of morbid products increases the level of morbid environment of the body when it is identify foods that may be problematic matter and ingestion of inflammatory matter (such as trimethylamine N-oxide) exposed to intolerable foods. for a patient. This method is especially or metabolically inefficient foods – a and the risk of developing its associated important because there are very few necessary first step in the naturopathic diseases.2 Through simple urinalysis, Vibratory Properties of Food available tests that can reliably identify therapeutic order of cure. a practitioner may detect levels of In the early 1900s, naturopaths wrote food intolerances, also because clinical morbid matter in a patient’s body,3 about the vibratory properties of food and theorized that disturbances in harmonious vibration were a chief cause of disease.5 The theoretical basis for such an idea is entirely plausible, considering that all material objects are composed of elementary particles that are neither stationary nor obey the known laws of physics6; light, sound, and all other detectable waves follow these same principles. Harmonious vibration refers to unimpeded cellular function and is therefore a governing concept of health. Of chief importance is understanding the precise cause of impeded cellular function. In clinical practice, a correlation between food intolerances, symptoms, and the disappearance of symptoms after removing the offending foods can be observed. In the same way that a lactose intolerance test implies a genetic lactase deficiency,7 results of the Carroll method may imply enzyme deficiencies.

Methodology The Carroll method uses an electrical device and glass rod to detect subtle electrical change at an acupuncture point (Stomach 25). The electrical device is used as a means of capturing and oscillating current sourced from the practitioner’s electric field.8,9 The field is honed by fastening a headband with a small conductive plate against the patient’s forehead and then plugging the headband directly into the machine. Once the circuit is established, dials on the device are adjusted to manipulate the frequency of the established circuit to match that of the large intestine’s frequency. Before the technique is performed, a sample of the patient’s blood is drawn onto a small piece of filter paper; this sample is allowed to dry, and then placed between 2 metallic surfaces on the electrical device. This modifies the circuit and personalizes the results for the patient rather than the practitioner. Finally, a sample of dehydrated food – typically dairy, egg, potato, meat, or fruit – contained within a glass jar is placed individually on top of the metallic surface to detect any change in current. The glass rod is the primary instrument used to detect changes in current. Before being used, it is briefly and vigorously rubbed with a wool cloth to temporarily transfer electrons from the wool onto the glass rod, much in the same way that one might rub a balloon on a shirt, essentially “charging it.” The glass rod acts as a detector of current over the acupuncture point and will be met with a small level of resistance if the practitioner 22 JANUARY 2019 NATUROPATHIC DOCTOR NEWS & REVIEW AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

gently and skillfully drags it upward past Conceptual Plausibility of food or is not physically present for the potentially be the cutting edge of the acupuncture point. If the patient is the Carroll Method test? Clearly, there is another force or factor medicine – a new wave of powerful intolerant to dairy and a sample of dairy The rationale behind the Carroll method is at play that is not well understood and healing methods. The ability of the Carroll is introduced to the current, current can currently theoretical because the technology requires further study. method to identify a food intolerance, no longer be detected and the glass rod required to fully understand bioenergetics based presently on underdeveloped or will thus slide over the acupuncture point. either does not yet exist or is ignored by Present-Day Bioelectric unexplored principles of bioenergetics, If the person is not intolerant of dairy, the scientific community. Therefore, it’s Techniques is a phenomenon that cries out for the glass rod will be met with resistance, helpful to consider known principles The Carroll Method is but one means attention in the scientific community. It resulting in a slight sticking phenomenon. of electromagnetism and physiology to of obtaining information coded in is well worth exploring, considering the Such a reaction establishes dairy as a facilitate an understanding of the potential electromagnetics. Presently, the study positive clinical outcomes of applying this compatible food. mechanism of the Carroll method. and application of harmonious vibration technique. Dismissing such claims and Although the mechanism of the Carroll The technique can be understood falls under the category of bioenergetics. devices as “pseudo-scientific,” and eagerly method has no unanimous explanation conceptually by likening the body to that There are several modern-day techniques dismantling the theories, does little to in the medical community, it is theorized of a simple electric circuit. Imagine a circuit that seek to restore normal, harmonious explain the clinical success, turns a blind to be a bioenergetic phenomenon and consisting of 2 wires, 1 bulb, and 1 battery. cellular vibrations to the various organs of eye to the essence of scientific inquiry, is perhaps best explained by the late Dr The battery is the source of electrical current the body. Savely Yurkovsky, MD, utilizes a and potentially limits advancements in Albert Abrams in his work, The Electronic – the electromotive force. The bulb is the technique called “Field Control Therapy,” medicine, our understanding of health, and Reactions of Abrams. In the “Conceptual resistor of current, and the wires transport proclaiming that it’s a form of targeted our evolution as a species. Plausibility” section below, we offer a basis the current. Under normal circumstances, homeopathy.13 His method employs a for understanding the technique based current flows from the battery through machine that identifies disturbances References available online at ndnr.com on known principles of physiology and the wire until it meets the light bulb, in cellular frequency and then applies electromagnetism. which resists the current as it converts a homeopathic dose of electricity to electrons into heat and light. In the body, draw out toxins from that organ.14 Method Reliability the bulb’s conversion of energy is similar to Similarly, Pierre Nicolas created a form Jared C. Pistoia is a 2nd-year medical Typically, if more than 1 trained mitochondrial conversion of electrons into of energy medicine called Biosyntonie, student at the National University of practitioner performs the Carroll method heat and ATP. The large intestine and food capable of normalizing biorhythms and Natural Medicine (NUNM). He earned 15 a bachelor’s degree in Health Science on a patient, the results will be the same. sampled together can be likened to the bulb. neuroendocrine functions. Both methods from Stony Brook University and has a Although the execution of the method Like bulbs of differing resistance, food likely of bioenergetic medicine are based on the strong interest in vitalism and traditional naturopathic philosophy. is subjective, its ability to reproduce the also has a resistance value depending on the concept that harmonious vibration is a same result across multiple practitioners individual’s ability to assimilate that food. function of unimpeded cellular function, Sussanna Czeranko ND, BBE, a natu- demonstrates objectivity. However, the More resistance results in decreased ability and the varying forms of impedance ropathic physician licensed in Oregon, has been practicing since 1994. She method’s objectivity can be undermined to assimilate the food, which translates include exposure to deleterious electric incorporates nature-cure approaches such as balneotherapy, hydrotherapy, if the practitioner is incompetent in into decreased current flow. Since the large frequencies, ie, radiation, the internal and breathing therapy into her practice. terms of skill or knowledge. There are intestine is ultimately digesting food as a effects of wrongful eating. Other Dr Czeranko is a faculty member and works as the Rare Books Curator at several physical or energetic factors means of accessing electrons to be packed techniques, such as music therapy, NUNM. She has completed the 11th book in a 12-vol- that can interfere with the practitioner’s into ATP molecules, the liberation of these employ the use of sound waves to restore ume series, The Hevert Collection, based upon Benedict Lust’s original journals. She is also the founder of the performance, such as body temperature, electrons theoretically creates a detectable harmonious vibration.16 Breathing Academy, which trains NDs in the breathing therapy, Buteyko. She is a founding board member of moisture at the site of testing, or a flow of current. The concept of harmonious vibration, the International Congress of Naturopathic Medicine. negative mental state, which also has been In this way, intolerable foods can be bioelectric fields, and bioenergetics Dr Czeranko has established a traditional naturopathic clinic, Manitou Waters, in Manitou Beach, Saskatchewan, shown to induce both tissue-specific and thought of as strong insulators. Thus, all seems to point toward what could which is scheduled to open in August 2019. generalized cellular changes over time.10 when tested, the glass rod will slide over The practitioner should regularly practice the acupuncture point, unable to detect a the fundamental tenets of health to achieve flow of current. This simple explanation physical and mental competency. is plausible by considering Ohm’s law, Though empirical evidence is limited, or I = V/R, where I is current flow, V is studies support the Carroll method as a voltage, and R is resistance. Accordingly, highly specific method for determining more resistance decreases current output. food intolerances. One double-blind A closer look at physiology helps one to study determined the Carroll method to understand the processes occurring at the have comparable specificity and positive cellular level. predictive value as IgE/IgG/IgG4 testing for Each cell in the body has a resting foods.11 Further studies with larger sample membrane potential. The cells are populations are needed to help determine constantly exchanging ions, in different large-scale clinical efficacy, although the concentrations and rates of exchange. aforementioned study is consistent with Different cells comprise different tissues anecdotal evidence from naturopathic with distinct functions, ultimately forming doctors who utilize the Carroll method organs. The fact that different types of ions in conjunction with other traditional exist in the various tissues of the body naturopathic modalities. allows for a reasonable assumption that The specificity of the method is each organ has a numerically dissimilar, revealed clinically when the test results summed electric field frequency. The value are applied to the patient. After the patient of organ frequencies has previously been is directed to avoid their intolerable produced by the late Bruce Tainio, whose food(s), a series of treatments beginning original work is missing. Other work with constitutional hydrotherapy involving organ frequencies and diseases, are employed on a routine basis to discovered by the late Royal Raymond Rife, facilitate the eliminative faculties of showed promise but was harshly criticized, the body. According to the Therapeutic rejected, and later tarnished by the AMA, Order, the order of treatment to and his Rife machine was confiscated by assist in toxin elimination begins the Department of Public Health.12 Rife with constitutional hydrotherapy was the highly acclaimed inventor of the and is followed by choice herbs first universal microscope, which at the and homeopathic remedies, etc, time was considered a modern marvel and determined on a case-by-case basis. earned him the title of “scientific genius.”12 The protocol is considered successful if Although these explanations offer patients avoid their intolerable foods, an idea of the potential mechanism of resulting in restoration of tissue function the technique itself, 2 key questions and symptom dissipation. The use yet remain: 1) What is the relationship of diagnostic techniques such as iris between the blood sample, the device, examination or Chapman reflex points and the practitioner? and 2) How does the can also be performed to gauge the technique provide information about an effectiveness of the healing protocol from individual’s digestive capabilities if that an objective standpoint. individual is not currently digesting that NATUROPATHIC DOCTOR NEWS & REVIEW JANUARY 2019 23 ad form Must be coMpleted in full

client phone

contAct fAx

Authorized signAture dAte CheCk eaCh box as a guide: ❑ name correct? ❑ Address correct? ❑ phone # correct? ❑ Ad copy correct? ❑ offer correct, if any?

who was in the middle of a gallbladder Gallbladder Disease episode (milder than an attack) while traveling on a plane, and she appeared to resolve the spastic squeezing sensation Not Just a Problem for Women by eating an apple. For anyone with GBD, castor oil packs ROBIN DIPASQUALE, ND, RH (AHG) with GBD by ultrasound. Of those, 150/198 risk for GBD, whereas the opposite was combined with 30 minutes of heat over the were women, 144/198 were fair, and observed in men.10 liver and gallbladder several days per week t is estimated that 15% of the US 135/198 were fertile, ie, of child-bearing Hormones appear to be another gender will help to decrease inflammation, soften Ipopulation – about 20 million people – age. Interestingly, although we often think difference in terms of GBD risk, as there any stones, and support the flow of bile. In have some degree of gallbladder disease of overweight and obesity as a contributing seems to be a direct relationship between my clinical experience, the essential oil of (GBD). The prevalence of GBD increases factor to GBD, only 56/198 had a BMI >30. GBD and estrogen. The rates of GBD are rose geranium is a valuable addition due to with age and can often be asymptomatic, And while the study found that 82/198 2-3 times higher in women compared to its antispasmodic action. If patients are not until it isn’t anymore. were over 40, those with a family history men, but primarily during the childbearing keen on the idea of the castor oil pack, or When a gallbladder attack comes on, of at least 1 first-degree relative with GBD years.11 Pregnancy is a major risk factor say they don’t have time for it, I often have there is often extreme and unrelenting was 78/198 – close to the same number as for gallstone formation. Higher estrogen them massage the castor oil over the liver/ pain, which can last for hours. People the over-40 group.4 levels increase biliary cholesterol secretion, gallbladder area, put on an old T-shirt, and often go to the emergency room looking While Bass et al showed overweight causing cholesterol saturation of bile and climb into bed. The heat of their bodies will for relief. Analgesic medications such as and obesity to be a contributing factor reduced gallbladder motility.11 help with the absorption of the castor oil acetaminophen or codeine may decrease for developing GBD in only 28% of If this is the case, that estrogen is linked throughout the night. pain. Anticholinergics, such as hyoscine participants, other studies have confirmed with the increased risk of GBD for women, butylbromide, may decrease the spasms. the correlation with weight. Radmar then GBD risk should go down as women Herbal Solutions But nobody wants to experience this et al, for example, looked at the ability move into menopause and estrogen levels The Eclectic literature doesn’t speak again… which is why cholecystectomy, ie, of abdominal/visceral fat to predict decline. Estrogen replacement therapy directly about GBD; however, discussions surgical removal of the gallbladder, has gallbladder disease.5 Of 1494 participants, should restore that risk. It is also possible of the herbs that act on the liver make become the gold standard of treatment for 51.4% were men over 50 years of age. that as men age, and their estrogen levels reference to it in several books. Following GBD. Out of every 100 people diagnosed Their research found a significantly increase through the aromatization of are a few pearls. with biliary colic, 22 are referred for increased risk of GBD among men with an testosterone to estrogen, their own risk of cholecystectomy.1 People are increasingly elevated waist:hip ratio. For women, the GBD would increase. Chelidonium majus choosing elective cholecystectomy as a BMI and waist:height ratio were found to Felter11 holds Chelidonium majus (celandine) preventative measure against the severe be more significant in determining GBD Treatment Considerations as a top choice of herbs for this condition. complications of acute cholecystitis, acute risk.5 In a prospective study of 29 847 men Diet can be the most significant contributor Felter’s key notes include the following: biliary pancreatitis, or acute cholangitis.2 with no prior history of gallstone disease, to GBD, and the most potent path to 1. Biliary catarrh resulting from hepatic But is this really the best choice, to lose 1117 new cases of symptomatic gallstone resolving it. A plant-based diet may be congestion an organ when the condition might be disease were documented over a 2-year optimal for patients, including plenty of 2. Jaundice due to swollen bile ducts as a managed more conservatively? Brazzelli period, linked to increased waist:hip ratio vegetables, some fruits, legumes, grains, result of subacute sluggish liver action reviewed 2 Norwegian studies including a and waist circumference.6 In other words, nuts, and seeds. Lean meats can be 3. Light, pasty stools total of 201 participants with symptomatic among these men, increased abdominal included in small portions. High-quality 4. Throbbing pain of the hypochondrium, GBD.3 During the 14 years of the study, circumference was a more significant oils, in small-to-moderate amounts, are an with dull pains extending to beneath the 88% of the patients who had been contributing factor to GBD symptoms important source of fatty acids; examples right shoulder blade randomized to surgery, and 45% of those than was BMI. include olive, avocado, flax, walnut, 5. This herb can prolong the intervals who had been randomized to observation, We know that a primary contributing coconut, and sesame oils. Eating smaller between attacks of gallstone colic underwent cholecystectomy. That meant factor to abdominal adiposity is metabolic meals overall can reduce the burden on the that 12% of the surgery-randomized syndrome, which can be a precursor to digestive system. The caffeine in coffee, Ellingwood13 wrote about Chelidonium group, and 55% of the observation- type 2 diabetes. A population-based study tea, and chocolate can trigger contraction being used for the treatment of biliary randomized group, did not require of 1250 men and 1656 women showed that of the gallbladder, so have your patients calculi, and comments that many surgery.3 So perhaps there are other the odds of developing GBD was 1.6 times be mindful when eating or drinking physicians consider it superior to any other options, but patients have to be willing to greater when type 2 diabetes was present.7 caffeinated products. agent known for preventing gallstone make changes in their lifestyle and diets – A retrospective cohort study, including Bitter herbs are useful in GBD because formation. not always an easy sell. 337 067 type 2 diabetics and the same of their ability to prime the entire digestive Matt Wood, in The Book of Herbal number without diabetes, produced similar system, including the release of bile from Wisdom,14 reports that Chelidonium is used Contributing Factors to GBD findings: the type 2 diabetes cohort had both the liver and the gallbladder and the almost the same way in both homeopathy Everyone remembers the “5 Fs” mnemonic a 1.91-fold greater risk of biliary disease thinning of bile throughout the system. and herbalism – as a liver remedy with for cholelithiasis as a rule-out in upper compared to the non-diabetic cohort.8 A comprehensive plant-based digestive an affinity for the bile. He also notes that abdominal pain: fair, fat, female, fertile, Although dietary fat intake may not enzyme taken with meals can be useful, Chelidonium is a very important herb for and forty. In a 2013 study, Bass et al contribute to increased GBD prevalence in as amylase, protease, and lipase will “gallbladder headaches,” and includes it confirmed most of these parameters, women, it might in men. In a population- contribute to the breakdown of all 3 major on the list next to Sanguinaria. Its bright and included an additional parameter based study of Mexican Americans (who macronutrients, including fats. Plant- yellow/orange sap exemplifies the doctrine that begins with the letter F, that being have a higher prevalence of GBD9), the based enzymes are more easily digested of signatures. family history.4 Of 398 patients with upper women reporting the highest intake of and absorbed compared to pancreatin, Ellingwood13 writes about herbs to abdominal pain, 198 cases were diagnosed total fat and linoleic acid showed reduced thus useful for a person with an already prevent gallstones, listing Chionanthus compromised digestive system. virginica, Iris versicolor, Leptandra virginica, There are 2 specific drinks that can and Podophyllum peltatum. He doesn’t be a supportive component of treatment mention Fumaria officinalis,but I’m adding for GBD. One of them is simply a cup of it to this list. Plant tannins warm water with the juice of one-half lemon, to be sipped each morning. This Chionanthus virginica GI Support drink will engage the liver, enhance bile Chionanthus virginica (fringe tree) is a flow, increase metabolic rate, and help cholagogue cathartic; however, its best effects maintain a balanced pH. This is actually are seen in acute congestion of the liver, for over 30 years a good idea for anyone, not just those with imperfect discharge of bile or catarrh with GBD. The second drink contains 8 of the common bile duct.13 Chionanthus oz water and 2 tsp apple cider vinegar conquers catarrh, liquifies the bile, prevents (ACV), also to be sipped. Some people the formation of calculi, and promotes the love this; some people hate it. discharge of stones that have formed. It is not I had one patient add the ACV to indicated for impacted gallstones. a glass of apple juice every morning, Tanalbit & Viracin plant tannins are just two of our science based formulas hoping the malic acid in the apple juice Iris versicolor available directly to health professionals. Experience superior products, would soften and dissolve his gallstones. Ellington’s key notes for Iris versicolor (blue stellar customer service and better savings for your business or oﬃce. I’m not sure about the effectiveness of flag) are as follows13: this approach, since he wound up having 1. When the stools are clay colored, the his gallbladder removed a few months urine scanty, and the skin inactive and later. I did, however, have another patient jaundiced 24 JANUARY 2019 NATUROPATHIC DOCTOR NEWS & REVIEW AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

2. Gastralgia and gastrodynia with For these symptoms, Ellington offers Gemmotherapy peltatum; Dioscorea and Lobelia are vomiting or regurgitation of food, the following formula, warning the reader I always like to bring up the specifically antispasmodic.13 especially after eating fats or rich pastry that it will not taste good13: gemmotherapy remedies whenever One of our brilliant colleagues has 3. Diarrhea, with a burning sensation after • Podophyllum tincture: ½ dram they might be indicated for a condition, formulated an antispasmodic combination the passage of stool • Leptandra tincture: ½ dram as they work to bring drainage to that includes Viburnum opulus, Actaea 4. Jaundice arising from duodenal catarrh • Capsicum tincture: 20 minims specific organs and systems. In the racemosa, Petasites, Valeriana, Matricaria, and obstruction of the biliary ducts • Syrup of licorice: ½ oz case of GBD, the most indicated of all Mentha piperita, Viburnum prunifolium, • Port wine, to make 4 oz total gemmo remedies is Rosmarinus officinalis Glycyrrhiza, and Atropa belladonna.16 Matt oodW writes this about Iris: Directions: Take 1 tsp every 2-3 hours (rosemary). Rosmarinus is specific for liver Lastly, keep in mind the emotions ”Causing a liquidification of the bile, and gallbladder drainage, it regulates related to the liver and gallbladder so that it flows freely from the hepatic For removal of gallstones, Ellington motility of the gallbladder, and it acts as (per TCM), including anger, irritability, structures, producing yellow to orange recommends ½ to 1 grain dose of a cholagogue and choloretic, helping to frustration, resentment, jealousy, and diarrhea with itching of the anus, which Podophyllum, repeated once or twice, move bile and stimulate its production, envy. Whether you work with Family showed up in the homeopathic proving.”14 followed by ½ pint of olive oil.13 He says respectively. Constellation Therapy, EMDR, EFT, flower the results may be painful, but the patient Here are some additional gemmo essences, hypnosis, or some other modality Leptandra virginica will have subsequent relief. remedies that have been found useful: when working with your patients, Here are Ellington’s key notes for Leptandra • Fraxinus excelsior (ash): helps with remember to work holistically by also virginica (Culver’s root)13: Fumaria officinalis drainage of liver and kidney; reduces attending to the mental, emotional, and 1. Pressure in the right hypochondrium Fumaria officinalis (fumitory) is a plant in the cholesterol spiritual aspects of gallbladder disease – or 2. Torpor of the liver Fumariaceae family, which used to be the • Acer campestris (hedge maple): regulates any disease, for that matter. It’s essential. 3. Jaundice Papaveraceae family; other useful members the saturation of bile with cholesterol, of the Fumariaceae family include Corydalis preventing the formation of sand and References available online at ndnr.com Podophyllum peltatum (turkey corn) and Dicentra (bleeding heart stones in the gallbladder Ellington lists these key notes for and Dutchman’s breeches). All of these • Prunus amygdalus (sweet almond): Podophyllum peltatum (May apple),13 many herbs work to diminish gallbladder pain. reduces lithiasis in the bile ducts of which you will recognize as signs and Here are Felter and Lloyd’s key notes • Secale cereale (rye): supports drainage symptoms of GBD: for Fumaria,15 which are not so specific and decreases inflammation in the liver 1. This remedy is demanded in inactive about GBD: • Corylus avellana (hazel): helps regulate conditions of the gastrointestinal tract 1. Used in jaundice cholesterol metabolism in the liver 2. Heavily coated tongue, thick and broad 2. Obstruction of the abdominal viscera • Juniperus communis (juniper): supports

and pale, with a coat of dirty yellow 3. In cases of debility of the digestive liver and kidney drainage Robin DiPasquale, ND, RH (AHG), color, especially at the base organs has been practicing in the healing arts for over 30 years. Dr DiPasquale served 3. Biliousness with inactive liver, sallow Closing Comments as faculty at Bastyr University for 15 skin and conjunctiva, constipation, and Other Considerations As gallbladder disease involves a great years where she chaired the Botanical Medicine department, was a clinical highly colored urine Herbal formulas for GBD can also include deal of spastic action, remember to include supervisor, and taught botanical medicine and homeopathy. After moving to 4. Enlargement of the liver with general these liver herbs: Cynara scolymus (globe antispasmodic herbs in your formulas. Madison, WI, she opened a family practice, Red Lotus indisposition, soreness over the liver, artichoke), Taraxacum officinalis (dandelion Ellingwood writes about herbs for pain Healing Arts. She was also the first ND to work directly in patient care through the U of WI Integrative Medicine and pain through the right side and root), Mahonia spp (Oregon grape), during the passing of stones, listing Clinic. Dr DiPasquale now lives and practices in Fort Collins, CO. She has been teaching on-site and on-line under the right scapula Silybum marianum (milk thistle), and Dioscorea villosa, Hydrastis canadensis, Lobelia courses in Gemmotherapy for over 10 years. Her new- Arctium lappa (burdock). inflata, Piscidia erythrina,and Podophyllum est passion is Family Constellation Therapy.

Practitioner ® Formulated

TCMCEUTICALS ® PRODUCTS ARE TCMZONE’S NEW CONDITION-SPECIFIC HERBAL FORMULAS DEVELOPED BY LEADING TCM DOCTORS IN THEIR SPECIALTY AREAS

Digestive Health Guru Esophageal Balance: Maintain Healthy Levels of Esophageal & Stomach Acid* Digestive Support: Help Enhance Healthy Digestive Function* Colon Harmony: Help Support Healthy Colon Function*

Fertile Wisdom Series Fertility Phase 1: Natural Follicle & Egg Quality Support* Fertility Phase 2: Natural Ovulation & Fertilization Support* Fertility Phase 3: Natural Luteal & Implantation Support*

Gluten Dairy Non- Vegan Free Free GMO

Also Available Through:

For Samples & Catalog: 888-788-8086, www.TCMzone.com DIETARY SUPPLEMENT *These statements have not been evaluated by the Food and Drug Administration. These products are not intended to diagnose, treat, cure or prevent any disease. 健康

NATUROPATHIC DOCTOR NEWS & REVIEW JANUARY 2019 25 AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

SUSSANNA CZERANKO, ND, BBE dyspepsia, the numbers are escalating. alimentary canal, not only in the stomach, The early Naturopaths of that era giving rise to flatulence, but also in the There are probably more persons in the were quick to recognize symptoms of small intestine, particularly in the colon, world today suffering from indigestion dyspepsia, and treated their patients resulting in the formation of poisonous than from any other known ailment. without drugs. Then, as now, allopathic substances which thin the blood and And so long as people eat too much, medicine was often successful at permeate the tissues, interfering with all too fast, and improperly, they will have eliminating the symptoms of indigestion the vital functions, giving rise to a variety stomach troubles. while completely overlooking why of chronic diseases.” (Lust, 1905, p.56) The William James Cromie, 1902, p.506 these very symptoms arose in the first multitude of chronic diseases listed by place. The early Naturopaths, on the Fletcher continue to plague society. Should you suffer from indigestion, fast other hand, studied closely the causes of Fletcher differentiated between awhile and take physical exercise. Eat indigestion; as a result, their treatment cravings and hunger. He emphasized that only when hungry. plans were multifaceted. one “be sure he or she is really hungry Benedict Lust, 1908, p.149 and not pampering a false appetite.” (Lust, 9 Rules to Prevent 1905 p.54) Fletcherism entailed chewing Never eat to satiety. Eat only when Indigestion one’s food until it is virtually liquefied, Cromie was Physical Director of the YMCA, in hungry, never because it is meal time, William James Cromie (Figure 1) was and then swallowing. This practice became Easton, PA or because invited to eat. one such Naturopath very interested in common and was adopted by Naturopaths, John Harvey Kellogg, 1908, p.320 indigestion. He was one of Benedict Lust’s persisting long after Fletcher’s book Figure 2. Horace Fletcher students, and he specialized in Physical retreated into the shadows. John Kellogg (1849-1919) igestive disorders are on the rise. Culture. Cromie published often in Lust’s also instructed patients to chew their DFunctional dyspepsia is widespread magazine, The Naturopath and Herald of food well. He wrote, “Chew every morsel – 20% prevalence worldwide – and despite Health. In a 1902 article (Cromie, 1902, until reduced to liquid in the mouth … extensive research, “the underlying causes p.506), he compiled a list of 9 causes of thorough chewing develops appetite juices of dyspepsia in a majority of patients indigestion that included: [hydrochloric acid] in the stomach.” remain [elusive and] unknown.” (Addula 1. eating too fast (Kellogg, 1908, p.321) et al, 2018, p.831) Full-blown indigestion in 2. drinking too much fluid J. Devereux summarizes the importance the form of GERD (gastroesophageal reflux 3. mental effort of mastication and saliva: “To those disease) is increasing globally. According to 4. fatigue suffering from acidity and flatulence, the World Health Organization, more than 5. eating too much denoting forms of indigestion or dyspepsia, $10 billion was spent on antacids alone in 6. sedentary habits it should be carefully noted that the natural 2017. (Marketwatch, 2018) More money 7. tight clothing antacid is the alkaline saliva.” (Devereux, is apparently spent on antacids than on 8. alcohol 1926, p.327) Thorough mastication creates politics in the United States. The significant 9. irregular eating habits the conditions for the correct balance of economic burden due to healthcare costs gastric juices, thus preventing indigestion. and constraints on daily activities of Eating quickly resulted not only in After eating a meal, Cromie patients remains a challenge for those food being poorly masticated, but also recommended giving the brain a rest so afflicted with indigestion. in preventing enzyme production by the that blood is available for the stomach While proton-pump inhibitors (PPIs) salivary glands; this, in turn, resulted in to digest. “There is not enough blood in are the first line of drugs used, the unwanted fermentation in the digestive the body to supply muscles, mind and over-reliance on these drugs and their tract. stomach, or any of the two organs at the increased unsubstantiated long-term same time.” (Cromie, 1902, p.507) Orison use have become a concern. Importantly, Fletcherizing, by Horace Marden adds, aside from side effects, taking medications Fletcher Many intelligent people do not has not resolved the inherent problem of The man whose namesake became know that the reason for being so sleepy stomach juices.” (Luntz, 1921, p.94) Cromie indigestion. associated with chewing was Horace and dull after a hearty meal is because continues: “Too much liquid taken at meal A century ago, Edwin Ross noted, Fletcher (Figure 2). He wrote the book, The Nature has sent just as much blood as time tends to dilute the gastric juice and “Great industries the world over are A B Z of Our Own Nutrition (1903), which possible to the digestive organs, and thus weakens its power in the process of kept busy producing ‘cures’ and the revolutionized the act of eating. Fletcher the brain is left without stimulation. digestion.” (Cromie, 1902, p.507) On the newspapers, magazines and other declared that “Americans eat too much and Nature makes it difficult for us to work other hand, J. Neff counseled against any avenues of publicity are cluttered with unwisely. The result … is a loss of energy right after a meal by withdrawing from drinking of liquids during meals. He wrote, their advertisements.” (Ross, 1922, p.65) and an invitation to disease.” (Lust, 1905, the brain the blood, which supplies the “Never, never drink a drop of any liquid Indigestion is as old as history, and yet p.53) Fletcher observed that when “food thinking forces. (Marden, 1915, p.177) at meals. … It only prevents digestion and despite the well-oiled scientific machinery [is] properly chewed, there is marked causes ill health.” (Neff, 1911, p.381) of the American medical industry, absence of fermentations and putrefactions Naturopaths would counsel patients “Nervous dyspepsia” was common rather than seeing any improvements in which are so often present in the to sit down to eat, focus on chewing their and seen as a diagnostic category of its food thoroughly, and on being patient and own. People who were seen as nervous or aware of the digestive process. suffering from “neurasthenia,” or what Drinking too fast and consuming too we today call stress, would be prone to much fluid during meals reduces the dyspepsia. “Mental exertion, haste of our amount of saliva to mix with foods and busy life, mental disturbances of all kinds, drink, and also leads to fermentation. J. such as anger, sorrow, the constant fear Neff described drinking during meals of the future and all sorts of excesses may as “one of worst acts of gluttony.” (Neff, bring about nervous diseases,” leading to 1911, p.181) He writes, “When you drink dyspepsia. (Lust, 1900, p.38) at meals, you wash the food down long When stressed or exhausted, eating before it is chewed finely enough, or should be postponed until a feeling of before it has received half of the saliva repose returns. When agitated, digestive needed to prepare the food for the gastric processes are impaired, the early operation [of digestion].” (Neff, 1911, Naturopaths contended, and gastric p.181) The presence of saliva in the mouth secretions thus decrease. Emotions determines the secretion of gastric juices to such as “worry, fear, anger, discontent, be produced in the stomach. Harris Luntz jealousy, malice,” (Cromie, 1902, p.507) writes, “Digestion, as we all know, begins also contributed to dyspepsia. These in the mouth, that of mixing the food with same naturopathic pioneers also felt that saliva.” (Luntz, 1921, p.94) Mastication digestion began in the brain. We only need increases the flow of saliva and enzymes, to say “lemon juice” to feel the salivary which “stimulates the flow of the acidic glands activated, they would declare. 26 JANUARY 2019 NATUROPATHIC DOCTOR NEWS & REVIEW AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

Eating when emotionally charged or famous Hydrotherapist of Battle Creek, “should live on a light vegetarian diet, the which was used to wet the sheets. Lust stressed is a sure recipe for indigestion. counseled against condiments as well, use of butter and eggs is also permitted.” provides clear instructions on how the wet including sugar, which he considered very (Lust, 1907, p.289) packs were applied: Evils of Overeating irritating for the digestive tract, causing Lust considered rice an easily digestible The wet linen, wrung out well, Excessive consumption of food not indigestion. (Kellogg, 1908, p.320) food, requiring only 1 hour to digest, must cover the whole abdomen. This only leads to weight problems; it is also unlike other foods that required hours. linen, which must reach around the reasonable to conclude that there is a Medications Shorter digestion times allowed the whole body, must be covered with limit to the amount of digestive fluids The effects of medications upon the stomach to have a rest. (Lust, 1905, p.271) a woolen cloth to produce the heat our bodies can produce so that food can digestive tract were also recognized The early Naturopaths knew about necessary to create that beneficial effect be digested. The digestive fluids must by the early Naturopaths. Benedict food combinations too. Morgan writes, which will cure. The packings will stop permeate the contents of the stomach Lust writes, “In our increasingly “Some fruits have acids that hinder the that painful pressure in the abdomen, to complete the digestive process; degenerated conditions, the sins of the digestion of starch.” (Morgan, 1901, remove the gas and help the stool. otherwise, the “parts of the mass which fathers are visited on the children more p.305) Another early Naturopath, Eugene (Lust, 1900, p.39) are not digested will soon decompose, often than ever.” (Lust, 1901, p.298) Christian, was an important author of producing acidity and a pressure Vincent Priessnitz, in his lifetime, had books and home courses on diet. He Once patients were accustomed to these of gas.” (Cromie, 1902, p.507) Lust successfully treated a multitude of comments, “About 90% of all human preliminary cold-water treatments, other suggested taking a break from eating: patients who were ravaged by the golden disease originates in the stomach caused applications such as gushes, sitz baths, and “People who are in the habit of gorging standard of care used by doctors of his by errors in eating.” (Christian, 1912, p.6) half-baths were given. A combination of themselves every day should better fast day. The medical doctor would have He believed that people should “know these would be applied 3 or 4 times a week. one day in each week and thus give their relied upon calomel, considered as the how to select [and combine] food that (Lust, 1900, p.39) overworked digestive organs a little rest very best that medicine offered to sick would remove causes of indigestion and so that many diseases, beginning with people. Patients, invariably heavily dosed constipation.” (Christian, 1912, p.7) Closing Comments stomach troubles, can be prevented.” with mercury or calomel, sought out Many of the Naturopaths spoke The Naturopaths understood dyspepsia or (Lust, 1901, p.27) Eating too often also Priessnitz and others using hydrotherapy. about the merits of a vegetarian diet for indigestion and were successful in not only contributed to indigestion. In this regard, Cold water cured these patients, not only indigestion. Louisa Lust herself published treating the symptoms but also in teaching Lust remarked, “Many diseases are of their mercury toxicity but also of their a cookbook that became a valuable source their patients preventative measures. In caused by eating a second meal before original diseases. book for those initiating into vegetarianism. the next issue, we will explore some of the first has been fully digested.” (Lust, Lust writes, “Father Kneipp … could She writes, “Such vegetarians should the roots of naturopathic thoughts on the 1905, p.271) distinctly trace in children that their father remember that the secret of physical health theories of nutrition based upon Louis Cromie made his living teaching people had been treated for a length of time lies just as much in discarding sugared Kuhne (1835-1901). to exercise. He counseled that when people with mercury, and had still in his system beverages and starchy, devitalized foods as adopt a sedentary lifestyle, peristalsis also the poisoned blood which had naturally in leaving out the meat.” (Lust, 1921, p.323) follows suit. “General exercise is effective been transmitted to the poor innocent Continuing, she adds, in the cure of indigestion as it increases the offspring.” (Lust, 1901, p.298) These early Green and root vegetables are Sussanna Czeranko ND, BBE, a natu- circulation of the blood and this in turn hydrotherapists recognized that offspring antiseptic. They neutralize poisons ropathic physician licensed in Oregon, has been practicing since 1994. She stimulates the stomach, and … all [organs]. from parents treated with mercury and toxins as well as stop gaseous incorporates nature-cure approaches such as balneotherapy, hydrotherapy, (Cromie, 1902, p.509) Luntz adds, “Most inherited poor digestive organs. fermentation and eradicate poisons and breathing therapy into her practice. of us suffer from lack of exercise. We sit in from the walls of the bowels. Any Dr Czeranko is a faculty member and works as the Rare Books Curator at chairs and work with our heads. Nature Symptoms treatment for indigestion must NUNM. She has completed the 11th book in a 12-vol- made our body for muscular work.” be directed toward cleansing the ume series, The Hevert Collection, based upon Benedict Patients suffering from nervous dyspepsia Lust’s original journals. She is also the founder of the (Luntz, 1921, p.95) Accordingly, Luntz had a variety of symptoms that included stomach and bowels of their poisonous Breathing Academy, which trains NDs in the breathing therapy, Buteyko. She is a founding board member of included poor posture as a factor in poor “bad taste in the mouth, gaping, belching accumulations. (Lust, 1921, p.323) the International Congress of Naturopathic Medicine. Dr digestion. He summarizes many of the of wind, and sometimes intense pain.” Czeranko has established a traditional naturopathic clinic, Manitou Waters, in Manitou Beach, Saskatchewan, previous causes of indigestion identified by (Lust, 1900, p.38) The presence of gas or In her view, adopting a healthy which is scheduled to open in August 2019. Cromie: bloating did not come immediately after a vegetarian diet was the ticket to heal Habit comes in as another meal but “often appeared one-half or three- indigestion. important point in digestion. By habit, quarters of an hour later; … with others, I mean, how we dress, how we walk, they occur upon an empty stomach.” (Lust, Fiber how we breathe, the amount of exercise 1900, p.38) Naturopaths also emphasized the inclusion REFERENCES we take, and generally our amount of of fiber or cellulose in the diet to counter Addula, M., Wilson, V. E. D., Reddymasu, S., Agrawal, D. K. (2018). Immunopathological and molecular basis of willpower and poise. (Luntz, 1921, Dietary Counsel indigestion and its sequela, constipation, functional dyspepsia and current therapeutic approaches. p.94) Lust commented that “the treatment of that often accompanied indigestion. Fiber Expert Rev Clin Immunol, 14 (10), 831-840. nervous dyspepsia should never be a mere was recognized as one of the constituents Christian, E. (1912). The food we eat and the food we should eat. The Naturopath and Herald of Health, XVII (1), Alcohol was on Cromie’s list of dietetic one, but must be directed more of foods that stimulated “proper peristaltic 6-7. digestive culprits because alcohol caused at the improvement and strengthening activity.” (Ross, 1922, p.65) Foods that Cromie, W. J. (1902). Indigestion cured by exercise. The Naturopath and Herald of Health, III (12), 506-510. inflammation and ulceration … and of the whole organism and especially the contained fiber included “apples, oranges, Devereux, J. R. (1926). Digestion and indigestion. Nature’s changed the gastric fluids. Alcohol was nervous system of the patient.” (Lust, lettuce, celery, spinach, etc., [and] are in Path, II (7), 325-327. often lumped together with spices and 1900, p.38) He emphasized individualized reality far superior to concentrated foods Kellogg, J. H. (1908). The simple life in a nutshell. The Naturopath and Herald of Health, IX (10), 319-323. condiments such as pepper, catsup, and dietary recommendations tailored to the such as grains, cereals, beans, peas, lentils, Luntz, H. H. (1921). Indigestion. Herald of Health and mustard. (Cromie, 1902, p.508; Kellogg, conditions of each patient. (Lust, 1907, eggs, cheese, meats or nuts.” (Ross, 1922, Naturopath, XXVI (2), 94-95. 1908, p.320) John Harvey Kellogg, the p.290) Those with nervous dyspepsia p.65) Naturopaths taught their patients that Lust, B. (1900). Nervous dyspepsia. The Kneipp Water Cure Monthly, I (3), 38-39. fruits and vegetables contained more water Lust, B. (1901). Diet treatment. The Kneipp Water Cure than legumes and helped lubricate the Monthly, II (1), 27-28. digestive tract. Lust, B. (1901). Diseases. The Kneipp Water Cure Monthly, II (11), 298. Lust, B. (1905). New theory on eating. The Naturopath and Water Applications Herald of Health, VI (2), 53-56. Cold-water applications had the primary Lust, B. (1905). A sure cure for indigestion. The Naturopath and Herald of Health, VI (10), 271. purpose of strengthening the whole body. Excessive consumption of food not only leads Lust, B. (1907). Nervous dyspepsia and its treatment Special considerations for weak patients according to Kneipp’s methods. The Naturopath and included beginning with a washing or Herald of Health, VIII (10), 289-290. to weight problems; it is also reasonable to Lust, B. (1908). Vegetarian method of life. The Naturopath affusion, using a small amount of vinegar and Herald of Health, IX (5), 148-149. mixed with water. One part vinegar to Lust, L. (1921). Some thoughts on the value of conclude that there is a limit to the amount of 2 parts water was the preferred ratio vegetarianism and raw foods in health and disease. Herald of Health and Naturopath, XXVI (7), 323-324. for vinegar used in bathing. (Lust, Marden, O. S. (1915). Diet and digestion. The Naturopath digestive fluids our bodies can produce so that 1907, p.290) Patients who suffered from and Herald of Health, XX (3), 177. anemia, or chlorosis, especially needed Marketwatch. Press Release: Global antacid market growth is expected to be driven by increasing incidence to be warm before and after any cold- of gastroesophageal reflux disease globally. March 14, food can be digested. 2018. Available at: https://tinyurl.com/yaj69gvw. Accessed water treatment, and these patients were December 3, 2018. advised to rest in bed until their bodies Morgan, J. (1901). Scientific cooking and eating. The warmed up. (Lust, 1900, p.39) Kneipp Water Cure Monthly, II (11), 304-305. Neff, J. H. (1911). Drink at meals. The Naturopath and Wet wraps were also used as one of Herald of Health, XVI (6), 381. the hydrotherapies to begin with. Again, Ross, E. J. (1922). The life worthwhile. The Herald of vinegar would be added to the water, Health and Naturopath, XXVII (2), 65-67. NATUROPATHIC DOCTOR NEWS & REVIEW JANUARY 2019 27 Education Naturopathic Medical Education What a Russian Soldier Taught Me About Its Value Proposition

DAVID J. SCHLEICH, PHD by the robust, resilient people who made their living there. There too were the aturopathic educators toil with peculiar and wonderful cries of cuckoo Nthe right language and content birds, distinct among the meadow pipits, to describe the value proposition for dunnocks, and reed warblers sharing the It was when one male tourist handed her some the medicine for students. In an era of terrain. In the late afternoon, the bubbly, confusing messages flying hither and chuckling calls of the cuckoos didn’t fool money that the soldier barked his admonition. thither among naturopathic doctors, the locals, like Irene. She lived in one of holistic medical doctors, functional the larch-built cabins – of mostly a chill medicine doctors, holistic nurse jade color – that peppered the slopes professionals, and – in recent years – descending to the lake. by a very late train. I was standing at the into a prolonged delay. It was when one integrative medicine doctors, a calming, Irene had rented me a room near the Mikrorayon Batareynaya station with male tourist handed her some money guiding framework for action is in order. church. She warned me that the cuckoo my backpack, waiting for the decrepit that the soldier barked his admonition. I’d like to invite you back to the wild is clever (in mimicking sparrowhawks), transcontinental Trans-Siberian train, The uniformed boys and girls quickly east of former Soviet Russia in 1983, and proffered wisdom about those birds. which I could see wending its way scurried away to and boarded a white where I found such counsel about value They are, after all, she said, nest parasites. westward along the Angara River. It and orange Liaz 5256 bus (that model was propositions in professional medical Know who’s doing what and why, she was finally arrived 3 hours late on its way all over the Soviet Far East, sometimes in education even before I knew I would telling me. to Krasnoyarsk and other points west, the most unlikely of places). I watched need to know about such things, and Her pretty little village had an such as Krosnoyarsk, Omst, Perm, and the whole thing uncomfortably. The old which insight has helped me navigate impossible name (see below) that not only eventually Moscow itself. On the platform soldier sensed my minor chagrin about through today’s brave new world of ROI Irene, but also an old Russian soldier I on that very hot August afternoon, his officious behavior. He commented (return on investment) in post-secondary met a few days later, challenged me to I happened to take up a spot on the in elegant Russian, “They should not be and higher education. pronounce properly. Irene had been a crowded platform near a severe, tall, old bothering Intourist guests.” “But they fisher’s wife in the village for decades. The soldier who suddenly began scolding enjoyed it,” I countered, in poor Russian. Siberian Mentors solider turned out to be a retired history a group of a dozen cadet pioneers to It all began after a midsummer fortnight professor at the Irkutsk State Technical “priderzhivat’sya vyazaniya” (“stick to A Russian Hit Song up at the top end of Lake Baikal in Siberia University of Siberia. When I met him he the knitting”). Angling for tips among the The young girl had been singing a popular 35 years ago. There I was in a remote was retired from both the military and disembarking travelers, one of the young Latvian hit song, “Million Alyh Roz,” eastern USSR village surrounded by the the university, but now had a volunteer women in the group played her guitar or “million red roses,” immortalized magnificent hinterland of Siberian taiga security job at the Irkutsk railhead. I and sang, surrounded by several of the everywhere that year in the Soviet Union (forest), smitten by rhododendrons and learned that village name with difficulty. train workers, performing for the Eastern by Alla Pugacheva. I later bought an old wildflowers profuse and cascading down As I passed through Irkutsk, en route European and Japanese “intourists” Russian equivalent of a 45 record, which to the shores of that unique, deep, deep slowly back home to North America via who had descended from the heat of I have to this day. In any case, he stared lake. And in that village, I was charmed Leningrad and Helsinki, I was delayed the train during what soon developed down right into my face, probably surprised

28 JANUARY 2019 NATUROPATHIC DOCTOR NEWS & REVIEW AD FORM MUST BE COMPLETED IN FULL ad form Must be coMpleted in full

CLIENT PHONE client phone

CONTACT FAX contAct fAx

AUTHORIZED SIGNATURE DATE Authorized signAture dAte CHECK EACH BOX AS A GUIDE: CheCk eaCh box as a guide: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any? ❑ name correct? ❑ Address correct? ❑ phone # correct? ❑ Ad copy correct? ❑ offer correct, if any?

• Look over your project and check for errors; spelling, address, telephone numbers, • Look over your project and check for errors; spelling, address, telephone numbers, copy or content. NDNR is not responsible for typos or incorrect information. AD APPROVAL: copy or content. NDNR is not responsible for typos or incorrect information. AD ApprovAl: • Please note that due to differences in monitor calibration, colors on this digital proof ❑ Ad approved as is • Please note that due to differences in monitor calibration, colors on this digital proof ❑ Ad approved as is may not match actual printed colors. ❑ Corrections needed may not match actual printed colors. ❑ Corrections needed client will supply a correct ad file client will supply a correct ad file • Sign this page and email or fax it back to NDNR. • Sign this page and email or fax it back to NDNR. ❑ Corrections desired ❑ Corrections desired • Any changes from this point forward may cost you in time and materials. client authorizes NDNR to make changes • Any changes from this point forward may cost you in time and materials. client authorizes NDNR to make changes indicated; design fee applies. indicated; design fee applies. • NDNR cannot process your job until receipt of sign-off. • NDNR cannot process your job until receipt of sign-off. EMAIL BACK TO: [email protected] or FAX BACK TO: (480) 275-7712 email baCk to: [email protected] or fax baCk to: (480) 275-7712 Education

by my awkward Russian, and ready to “What matters for them?” I asked him. I first became president of CCNM in doctors not being the same as medical coach me in pre-perestroika politics. “What matters is only what we decide Toronto. He understood what naturopathy doctors in North America. Krispin passed “Where do you come from, that you are to teach them and only what they decide was and sent me a parcel of information in 1997 at age 92. waiting here for a train to go to Moscow?” to learn,” he said. The implied transaction about Russian botanicals and the medical “I am from North America. I was in a was clever. “And if what they learn are system in Siberia. More than once I have Value Proposition in little town up north.” pretty songs only,” he went on, “that is thought about his counsel. I have thought Naturopathic Medical “Which town?” not enough. They must know where it all about what value propositions we have for Education I tried my best at the name. He came, even the sad painter soldier’s lament new naturopathic doctors. How have they I’m embellishing what Krispin said here, laughed. He then said the name correctly. from the song, and why he and they are arrived at where they are? but a Krispin-approved model, had I I imitated his pronunciation, repeated it where they are this day.” I think Krispin would have said that been able to run it by him, likely would twice, and later successfully did it again I have remembered that conversation our model for naturopathic medical involve 3 simultaneous variables: customer after we had a few hours together. I can say from so long ago, not just because of the education must assume what matters (student or patient) buy-in to the value it right even today, but still have to break exotic, faraway city where it took place, for health for all people. “So, the doctors proposition, a value chain in the delivery it down into syllables to make it through: but because Krispin’s words stuck and of your country do not agree among of education and licensing, and a realistic Baykalo-Lenskiy Gosudarstvennyy made sense in many contexts. He and I themselves and they fight about who is revenue formula. He would never have Priorodnyy Zapovednik. became pen pals (the best one could do the boss of the patient? Is a doctor not used that language. We are asking a great What he also said, in addition to back then). We kept up our conversations a doctor? Why do you have different deal of our ND programs, just as the pre- straightening me out on the village name – discretely about many topics over the doctors? What fuss and rattle is that?” Gorbachev leaders in the USSR were asking and what is most relevant here – has stuck next 20 years. His country collapsed in he asked me in bold letters in the French a great deal of the newest generation of with me for a quarter-century. He said, 1989 and he went silent for some months. language in one of his letters, reacting to “pioneers” in the crazy end-game of the more or less, pointing at my backpack with Krispin last wrote me in 1996, the year a comment I made about naturopathic Cold War. Those young Siberians had its big maple leaf, “My friend, you are a guest in our fatherland Soviet Union. We are in perilous times, and the future lies with our children. They cannot waste time with foolish songs about a million scarlet roses and a lovesick painter. They must stick to the knitting.” “But,” I protested, presumptuously, when I should have known better, “should they not be permitted to be young?” “They are not young. Russians cannot be young for more than a moment in this world,” he said slowly. We were still standing on the platform, his assigned post. Many travelers were waiting to hear about the train’s likely departure time. Eventually, an announcement from the monstrous loudspeaker over the station next to a huge clock with 3 hands (the third hand always pointing to Moscow time), declared that the train would leave the following day at 2 PM. We were both standing in the shade of a massive billboard blasting red and green letters to all and sundry about a sprawling monument behind it that honored Russians killed in what the sign proclaimed as “The Great Patriotic War.” Every quarter-hour in the time we had been standing there, a phalanx of young students in dark-blue uniforms oddly goosestepped up to the monument to salute its eternal flame. In those hours we talked about many things: the compromises of the vanguard of the proletariat, my assertions about the impossibility of central planning, awful consumer reports on the Lada, and good ones on Soviet tractors. NATURAL IMMUNE SUPPORT The soldier’s name was Krispin. He had served many years in the Red Army in the Combining seven unique immune enhancing herbal Soviet Far East and had been among the 4 extracts with Berberine and 7.5 mg of Zinc per waves of very young Russian soldiers who serving, Viracon’s synergistic formula helps increase occupied South Sakhalin and the Kuril cytokine production and other important immune Islands in 1945. Early into our conversation, I discovered that he spoke excellent French, factors to support the body’s natural defenses.* This which allowed me to abandon my terrible gentle vegetarian formula also helps promote normal Russian and he, his labored English, and respiratory function and energy, and is a must for we were away to the races. The lessons everyone’s home during times of seasonal challenges.* came quickly.

“What we value in Soviet Russia is what PRODUCT CODE: VNVRC120 lasts,” he said. “These young pioneers you like can have their songs, but they must stick to what matters,” he insisted. Later he repeated these same aphorisms in a pub where we retreated once we knew the train was not going anywhere. I drank tepid Kalinkin pivo and he swilled back long funnels of alcoholic fermented milk, which I did not favor as an afternoon repast. He 888.328.9992 | vitalnutrients.net chomped toothlessly on black bread and *This statement has not been evaluated by the Food & Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease. natural butter. I kept drinking pivo. NATUROPATHIC DOCTOR NEWS & REVIEW JANUARY 2019 29 AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

never experienced a German invasion or detractors have an edge; social connection, however achieved, and old people alike squatted on their a Stalinist pogrom, and were expected to • faculty workload and employment whether via blogs, wikis, visualizations, hams eating discarded vegetable rinds and understand and honor the traditions that model issues; digital information, simulations, or scraping hopefully on the discarded bones preceded them. • credentialing challenges; MOOCs. Those are not necessarily massive of other people’s soups. “We were crafty Our value propositions might be these: • financial models that address student disrupters if they too can convey the back then,” he said. “We had eyes like the • A credential that is accredited and debt; and traditional into the contemporary and fox.” The naturopathic profession is not in valued by a growing community • persistent cash flow vulnerabilities both can propel forward the profession in starvation mode, but it is in scarcity mode • A credential that is convenient and fairly the volatile terrain of health care and the in many jurisdictions. priced Our students are not only experiencing militant politics of health, not to mention As we continue to refine our • A credential that emphasizes the the confusion of terminology and tight timing and cash flow realities. naturopathic programming, adjusting to the experience of getting it, and not the philosophy in the marketplace, but are complex interprofessional interplay before course installments or final degree also bringing their digital skills and habits Sticking to the Knitting us means contending with a confused credential into the equation at the same time as During some breakfasts and evening meals identity, along with a checkered, messy • A credential that the experience of many of them continue to demonstrate with Irene and her family, and during marketplace. We need elders like Krispin getting motivates lifelong learning and great respect for the traditions and elders that delightful afternoon and evening of and Irene who can remind us about what the commitment to solve crucial health of the profession in a pre-digital age. The conversation and feasting with Krispin, to value most in our educational product problems on the planet “revitalization” efforts at NUNM, SCNM, along with our many letters over a number and processes. Our graduates can emerge • A credential that leads to work and and Bastyr, and the recent growth of the of years, I learned how concerned they confident that way, and anchored to a long income every time because it is NMI (Naturopathic Medicine Institute), both were about keeping the values and history of value-added contributions to civil grounded in the integration of content indicate the persisting interest from what priorities of the past robust in the face of society. Throughout it all, though, Krispin with real-world experience some would depict as a less complex era. new challenges and priorities. Krispin, for (and Irene too, probably) would insist that • A license that works where the licensee Krispin would disagree. He would have example, worried that even though his we have to stick to the knitting. wants to work with what s/he has said that all eras have their complexities. country had emerged after the war as one learned for a long, long time We know that smartphones, tablet of the world’s 2 great military powers, there • A credential recognized and honored by computers, and lightweight laptops in our was a solemnity and seriousness about the individuals and by third-party payers lecture halls are replete with conflicting work at hand that was not embraced with • A growing profession on all fronts David J. Schleich, PhD, is president messages and data about the location of the same conviction by the young people and CEO of the National University (numbers of states and provinces, naturopathic medicine in the healthcare around him. I think of our contemporary of Natural Medicine (NUNM), former president of Truestar Health, and former cohorts in training, and clinical and terrain. All eras have their tools, but naturopathic students who don’t understand CEO and president of CCNM, where residential venues in which to work) underlying everything are resilient values. their mission as particularly solemn and he served from 1996 to 2003. Previous posts have included appointments as The ROI our students expect includes serious, tinged as it is with the practicalities vice president academic of Niagara College, and administrative and teaching positions at In a world of integrative medicine, learning what Oblinger characterizes of licensing and making a living. St. Lawrence College, Swinburne University (Australia) holistic medicine, and functional medicine as “experiential, socially constructed, Krispin once wrote to me about the and the University of Alberta. His academic creden- tials have been earned from the University of Western – variegated forms with a similar core and interdisciplinary” (2012, p.14). infamous Zhdanovshchina Campaign Ontario (BA), the University of Alberta (MA), Queen’s content – the values we attribute to our Furthermore, she contends, “[In the post- (think McCarthyism, Soviet style) and how University (BEd), and the University of Toronto (PhD). educational efforts must address what our course era], our classrooms may no longer the answer to going forward was not by deans and faculty are dealing with: be the place where the most significant adopting an adversarial posture, but by • the need for a strong, consensual learning takes place.” (2012, p.14) She focus and hard work that is grounded in REFERENCES definition of naturopathic medicine; emphasizes – in a way that reminds me shared values. He went on to talk about Oblinger, D. G. (Ed). (2012). Game Changers: Education and Information Technologies. Louisville, CO: Educause. • a hotly competitive landscape where of Irene and Krispin – participation and the days after the war when young people Fuco-Immune with Immuno-LP20® & Maritech® Synergy Fucoidan

• Supports healthy respiratory function, healthy gut lining and immunity, and antioxidant activity* • Contains Maritech® Synergy, a fucoidan seaweed extract, and Lactobacillus plantarum L-137 (Immuno- LP20®), a stable, heat-treated immunobiotic* • Maritech® Synergy has been shown to increase T-cells and activity of monocytes and granulocytes* • Immuno-LP20® has been shown in human clinical trials to significantly support respiratory function and shorten recovery time from respiratory immune challenges* Maritech® is a registered trademark of Marinova Pty Ltd Australia.

Immuno-LP20® is a registered trademark of House Foods Group Inc. *This statement has not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.

800.545.9960 30 vegetarian [email protected] capsules www.allergyresearchgroup.com Item #77150

30 JANUARY 2019 NATUROPATHIC DOCTOR NEWS & REVIEW AD FORM MUST BE COMPLETED IN FULL

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?

CLIENT PHONE

CONTACT FAX

AUTHORIZED SIGNATURE DATE CHECK EACH BOX AS A GUIDE: ❑ Name correct? ❑ Address correct? ❑ Phone # correct? ❑ Ad copy correct? ❑ Offer correct, if any?