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Naturopathic Medicine- Naturopathic Medicine- Treating the Whole Treating the Whole
Scleroderma PatientScleroderma Patient
Dr. Sara Korsunsky, B.Sc., N.D.The Centre for Natural Medicine1218 Lorette Avenue
www.naturalmedicine.mb.ca
WHAT IS WHAT IS NATUROPATHIC NATUROPATHIC MEDICINE?MEDICINE?
What is Naturopathic What is Naturopathic Medicine?Medicine?
A primary health care professionCombines effective traditional therapies with current advances in modern medicineFocuses on prevention and treatment of illness
What is a Naturopathic What is a Naturopathic Doctor?Doctor?Licensed Naturopathic Doctor's
(ND's) are the most highly trained practitioners in the broadest scope of natural medical treatments. ND's are required to complete at least 3 years of standard pre-medical studies at a recognized university before going on to 4 years at an accredited Naturopathic medical school.
Principles of Naturopathic Principles of Naturopathic MedicineMedicine
First, do no harm. Address the causes of disease. Heal the whole person. Cooperate with the healing
power of nature. Teach the principles of healthy
living and preventative medicine.
Naturopathic Medical Naturopathic Medical TrainingTrainingBasic medical sciencesMedical diagnosticsFull physical examsLaboratory diagnosticsPhlebotomyPharmacologyRadiology
Naturopathic Treatment Naturopathic Treatment OptionsOptions
◦Herbs ◦Clinical Nutrition & Neutraceuticals◦Homeopathy
symptom specific, no interactions with medications
◦Acupuncture◦Lifestyle Coaching
stress reduction, balance, wellness◦Prevention
early screening and education, proactive medicine
The Naturopathic ProfessionThe Naturopathic Profession
Today:Increased demand
For supportive medications and alternatives
Treatments for stress related illnessesPreventative medicine
Covered by private health insuranceRegulated, safe
◦ Canadian Association of Naturopathic Doctors (CAND), Manitoba Naturopathic Association (MNA)
What is Health?What is Health?- Health IS NOT the absence of dis-ease- Having a diagnosis does not exclude health
• Physical• Mental• Emotional• Energetic
BALANCE
What is Health?What is Health?
A state of balance and good function that permits a person to achieve their ultimate purpose of existence. A place where there is spiritual fulfillment. It is a changing process that requires persistent effort to maintain.
Education,
Commitment,
Choices
HEALTH AND HEALTH AND DISEASE- A NEW DISEASE- A NEW PARADIGM FOR THE PARADIGM FOR THE 2121STST CENTURY? CENTURY?
TM
The River of Health The River of Health ProgramProgramHealth and wellness is a process
1-The Source- optimal physical, mental, emotional health, healthy lifestyle and self care
2- Upstream- good physical health, underlying mental or emotion issues, lacking in some self care and healthy lifestyle habits
The River of Health The River of Health ProgramProgram3- Mid stream- moderate physical health with several symptoms, mental or emotional issues, poor mood or energy, unhealthy lifestyle choices
4- Down stream- polluted body, many symptoms, unhealthy lifestyle choices
5- End of the river- degeneration or death, body cannot cope
The Source of the River:Clean, clear, ideal terrain
Midstream- Impurities, toxins
Downstream- Polluted waters
End of the River
Where are you….Where are you….
In the River of Health?
Where would you like to be?
The Foundations of HealthThe Foundations of HealthProper HygieneRegular Movement/ ExerciseAdequate Rest & Quality SleepHealthy Nutrition & DigestionEffective Stress ManagementFunctional Organs = Anti-inflammatory lifestyle
Factors that Contribute to Disease
◦ Poor digestion (malnutrition) and elimination
◦ Immune system malfunction or suppression
◦ Toxic exposure◦ Unhealthy lifestyle ◦ Genes◦ Stress
Factors that Contribute to Disease◦ Poor digestion and elimination
Bad breakdown- bloating and promotion of unhealthy microbes
Bad absorption- low levels of nutrients, weight loss or obesity
Bad bowel movements- toxins reabsorbed or nutrients blood lost, pain.
◦ Immune system malfunction or suppression Poor recovery, autoimmunity, sclerosis,
◦ Both can present through skin
Factors that Contribute to Disease
◦ Environmental toxins Chemical, pollution, pesticides, etc.
◦ Unhealthy lifestyle Lack of movement, poor mental health,
drugs, alcohol Unhealthy diet- low in nutrients, high in
fat/ sugars/ salt, skipping meals or overeating
Factors that Contribute to Disease
◦ Lack of rest or quality sleep Affects adrenal stress glands Increases inflammation
◦ Genes Not a definitive outcome, can be turned
on or off
◦ STRESS! Contributes to every single disease Is inflammatory
The Root Causes of The Root Causes of SclerodermaScleroderma
Genetics (HLA) Infections Toxins (environmental) Stress- oxidative, other?
Scleroderma Problems and Scleroderma Problems and ImmunityImmunity Overactive T- lymphocytes- T helper,
CD +, IL-2 (infections and self- non-self)
Fibroblasts display cell growth abnormalities- proto oncogene c-myc
Platelet derived growth factor alpha receptors are increased (accelerates growth of collagen, regulator of cell division)
Natural medicines can influence these
Infections & Poor Infections & Poor Microbiology (Microbiome)Microbiology (Microbiome)Bacteria VirusesParasitesFungiLack of healthy levels of good bacteria/
overgrowth of poor microfloraVery commonDiagnosis by stool culture (CSDA) or ELISA/ PCR bloodwork
Infections & Poor Infections & Poor Microbiology (Microbiome)Microbiology (Microbiome)Research shows distinct improvement
using probiotics in Scleroderma◦ After 2 months use, significant
improvements were seen in scores of total gastrointestinal symptoms, reflux, and bloating/distention.
Frech TM, Khanna D, Maranian P, Frech EJ, Sawitzke AD, Murtaugh MA. Probiotics for the treatment of systemic sclerosis-associated gastrointestinal bloating/distention. Clin Exp Rheumatol 2011;29(Suppl 65):S22-S25.
Nutritional Medicine, a textbook by Dr. Alan R Gaby M.D.
InfectionsInfectionsRelease inflammatory toxins Steal nutrientsBlock immune systemSuboptimal bacterial levels lead
to greater risk for infections
Immune support is important
ToxinsToxins Environmental Chemicals Ingested Medications
◦Detoxification to relieve the body of toxins and impurities can benefit pathophysiology of autoimmunity1
1. Crinnion WJ. Results of a decade of naturopathic treatment for environmental illnesses: a review of
clinical records. J Naturopathic Med 1997;7:21-27.
StressStressAdrenal gland- deals with stress
dailyDysfunction caused by chronic:
◦Anger, sadness, grief◦Insomnia◦Overwork◦Surgery◦Trauma, injury, chronic illnesses
Symptoms of Stress Gland Symptoms of Stress Gland DysfunctionDysfunctionFatigue, Sleep disturbancesAnxiety/ low moodOverweightHeart palpitationsPoor memory/ focusHeadachesDizziness standing upLow blood pressurePropensity for autoimmune and liver
diseases
Naturopathic Approach to Naturopathic Approach to HealthHealthNo referral needed60-75 minute initial visit
◦Thorough history◦Physical Exam◦Review records ◦Appropriate laboratory testing◦Diagnosis
TreatmentsVisits may be weekly, monthly,
seasonally
Clinical Nutrition- Why?Clinical Nutrition- Why?Better function (enzymes, energy)Malnutrition in Scleroderma
Of 160 consecutive Italian patients with systemic sclerosis, 15% had evidence of malnutrition. Malnutrition was significantly associated with disease activity, and was nonsignificantly associated with gastrointestinal involvement. Caporali R, Caccialanza R, Bonino C, Klersy C, Cereda E, Xoxi B, et al. Disease-related malnutrition in outpatients with systemic sclerosis. Clin Nutr 2012;31:666-671
Vitamins, minerals, other nutrientsOral or injected
Nutritional Tips for HealingNutritional Tips for HealingAvoid inflammatory foods
◦Trans fats, deep fried foods, charred foods
◦Sugar- stops white blood cell response- The Loma Linda study
◦Refined grains and flours (ie Not WHOLE)
◦Red farmed meats◦Secondarily: dairy, nightshades
(tomatoes, potatoes, eggplants), corn◦Food sensitivities or intolerances
Nutritional Tips for HealingNutritional Tips for HealingWhole GrainsHealthy fats and oilsNatural sugars onlyFish, lean meats, vegetarian
proteinIncreased organic vegetable
intakeWater, water, waterGreen or herbal teas
Nutritional Tips for HealingNutritional Tips for HealingDiets rich in bioflavonoids
benefit inflammation, immunity, blood vessels◦Virtually all fruits, vegetables, herbs
and spices contain antioxidants◦Non-toxic, best absorbed with food◦Avoid overcooking foods◦Examples: quercetin, carotenoids,
isoflavones◦Caution with high fiber diets!!
Nutrition:http://www.med.umich.edu/scleroderma/patients/nutrition.htm
Scleroderma SpecificsScleroderma SpecificsVitamin D: often low in scleroderma,
autoimmunity and MB. Vitamin E supplementation resulted in
improvements in the skin of scleroderma patients, including morphea, calcinosis cutis, and Raynaud’s phenomenon.
Zinc improves MorpheaDon’t self- prescribe high doses. ND’s check interactions with
medications!!!
Natural TreatmentsNatural TreatmentsTREATMENT DOSAGE RATIONALE
Fiber Use with cautionDecreased colonic motility
Para-aminobenzoic Acid (PABA)
12 g/day KPABA (potassium-PABA)
Anti-fibrotic
Vitamin E200-1,200 IU/day orally; topical application
Antioxidant; anti-fibrotic, dermatologic improvements
Vitamin D0.25-1.25 mcg/day calcitriol OR 1,000-4,000 IU/day D3 (not studied)
Immunoregulatory; inhibition of fibroblast growth and collagen synthesis
GLA (sources; black currant, borage, or evening primrose oil)
540 mg/day GLA (evening primrose oil used in the studies)
Converts to prostaglandin E1 to increase capillary flow and decrease inflammation; especially for patients with concomitant Raynaud’s phenomenon.
Estriol2 mg/day orally OR 10-20 mg/week subcutaneously
Mechanism unknown
N-acetylcysteineIV infusion of 15-150 mg/kg/hour for five days.
Mechanism unknown
S-adenosylmethionine (SAMe)
IV infusion of 600 mh/day followed by 400mg three times daily
Mechanism unknown
Bromelain50-160 mg/day enterically coated
Mechanism unknown
Avocado/Soybean Extract (unsaponifiable)
300-600 mg/day Mechanism unknown
Zinc/copper15-60 mg/day zinc; 1-4 mg/day copper
Correct a deficiency, aids morphea
Stop inflammation Stop inflammation Fish oils- high dosageTurmeric- bonded to a lipid (fat)Boswellia, cayenne, licoriceFlaxseed, hempGingerStress management- counselling,
spirituality, energy medicineMeditation
Improving Energy and Improving Energy and SleepSleepTreat Adrenal gland dysfunction
◦Testing- Adrenal Stress IndexTreat AnxietyCorrect dysfunction (gut, brain)Natural options:
◦Lifestyle◦Herbs, vitamins◦Homeopathy◦Acupuncture
Why Consult an ND?Why Consult an ND?Integrative
◦ Science, medical technology and nature◦ Work with MDs to support health
Safe ◦ NDs do not remove medications◦ NDs know interactions and side effects◦ Standardized training, licensure
Options ◦ where possible, fewer medications is
advantageousImproved lifestyle
◦ Improved body physiology means reduced symptoms
Naturopathic MedicineNaturopathic Medicine
IS IT FOR ME?A medical process, not a magic quick
fixReduces toxins and harm from
medicationsPatient-centered care & participationWhole person focusedTime taken to listen, discuss
Naturopathic medicine Naturopathic medicine treats all health concerns:treats all health concerns:
from pediatric to geriatric, from irritating symptoms to chronic
illness and from physical to the psychological.
ND’s attend to your individual physical, mental & emotional harmony
Optimal Health CareOptimal Health CareND’s work with you to meet your
health goals
Results:◦Better energy◦Fewer symptoms◦Treatment options◦Empowered patients◦Reduced disease
Contact InformationContact Information
Dr. Sara Korsunsky BSc, N.D.The Centre for Natural Medicine
1218 Lorette Avenuewww.naturalmedicine.mb.ca
