Being adaptable, to bend and shift and shape and adjust to new environments and ways of being, is an important quality of any species in order to survive.  Our evolution, or progress, depends on our ability to grow and think in new ways.  Staying the same is not an option.  When I was a teenager I worked at a lovely local book store.  Posted behind the counter was a cutout cartoon, which we would now share in present day as a meme, depicting the words "this is how we've always done it" crossed out inside a box.  (I may have the exact description wrong, but the sentiment of thinking outside the box is accurate). 

Change can be inspired by pure love for innovation, or it can be directed from old systems that no longer, or never did, work.  This happens all the time in health care, as we learn and shift our practices to suit new knowledge.  Recently, we've seen some changes to some long-held standard practices and treatments that I wanted to share with you.  

Aspirin
For decades, 81 mg baby Aspirin (acetylsalicylic acid) was added to anyone's protocol when there was a cardiovascular concern, or someone reached a certain age.  I quickly learned when taking the case of anyone with heart disease to automatically add it to their list of medications.  The purpose was for a blood thinning effect, to reduce the risk of a vascular event.  Unfortunately, Aspirin is also hard on the stomach and can cause gastrointestinal bleeding.  It can also cause bleeding in other locations, and increases the risk of colon cancer.  In 2019 the American Heart Association (AHA) removed it from their guidelines based on research studies that challenged the assumption that daily Aspirin prevented primary heart attacks and strokes. (1)  The AHA recommendations for the prevention of cardiovascular disease strongly focuses on the importance of healthy lifestyle, including food, exercise, and avoiding smoking. (2) In the journal of the Canadian Medical Association it stated that, "clinicians are strongly encouraged to promote medical, lifestyle and behavioural changes that are more effective than ASA (aspirin) in preventing cardiovascular events." (3) The US Preventive Services Task Force (USPSTF) also updated their Aspirin recommendations more recently. (4)  Its use as a blood thinner is still officially recommended for prevention of secondary cardiovascular and cerebrovascular events. (5)

There are other ways to achieve blood thinning without the negative effects on the gastrointestinal system and bleeding.  Alternatives like Omega-3 as fish or krill oil, garlic, turmeric, ginger, grapeseed, and even regular blood donations can help to improve cardiovascular health outcomes.  And I often use marshmallow root,  deglycyrrhizinated licorice and other herbs to heal the esophagus and stomach lining.  Of course, each person has a unique health picture that must be considered before making specific recommendations - it's not one size fits all, and only the prescribing physician can adjust your medications.  Still, it's an important consideration since cardiovascular disease is still the worldwide biggest cause of mortality, so up to date considerations are extremely valuable.  Read more about caring for your heart health here.  

Zantac (Ranitidine)
1 in 3 people experience acid reflux and, as a result, antacids are an extremely popular over the counter and prescription medication.  (You can read more about heartburn and acid reflux here.)  We certainly don't want acid in the esophagus, because that can lead to damage, but we should also consider that antacids can interfere with digestion and nutrient absorption.  In 2019, several manufacturers recalled their Ranitidine (H2 blocker) antacid products (including over the counter no name brands like Exact, Compliments and Life) due to the presence of NDMA, a nitrosamine impurity, at unacceptable levels.  Health Canada has since permitted sales of ranitidine antacids as long as batches are tested, however, certain lots are still being recalled after making it onto the market in 2021 and 2022. (6)

So what's the problem with NDMA?  It's considered a probable carcinogen, with the risk increasing with prolonged duration of use (the more you take the higher your risk). (7)  Unfortunately, lots of people with heartburn take medications almost daily for years, which has led to ongoing lawsuits against the manufacturers.  In studies cited by those lawsuits, Ranitidine use has been considered linked to colon, liver, bladder, thyroid, breast, kidney and stomach cancers, with prosecutors claiming the companies withheld knowledge of these risks.  Yikes.  Since then, newer versions of the product are said to not contain any of this compound.  

Now What?
We can support healing of the esophagus, stomach, and replace depleted nutrients.  The history of Aspirin and Zantac are simply two examples of standard, decades long practice of treatment for extremely common health concerns, that were eventually discovered to be counter to the best interests of the patients.  As you know, I never share information out of fear, I outline these two circumstances to describe the ways in which we evolve in our treatment philosophies and understanding of health.  Being educated on our choices creates empowerment, and what was the right decision before might be different now.

Now that we know better, we can do better.  And yes, we can certainly do better when it comes to our wellness.

Fortunately, there are many incredible ways that we can support well functioning cardiovascular and digestive systems, and ultimately stimulate healing and maintain good health for years to come.  I love creating personalized strategies to achieve these goals.
In your corner,
Dr. Christa
 
Rest.  Eat well.  Move everyday.  Go into nature.  Connect.

1.  https://www.heart.org/en/news/2019/03/18/avoid-daily-aspirin-unless-your-doctor-prescribes-it-new-guidelines-advise
2..  https://www.washingtonpost.com/lifestyle/2021/10/12/low-dose-aspirin-heart-attack-stroke/
3.  clinicians are strongly encouraged to promote medical, lifestyle and behavioural changes that are more effective than ASA in preventing cardiovascular events.
4.  https://www.ahajournals.org/doi/10.1161/CIR.0000000000000678 
5.  https://www.cmaj.ca/content/192/12/E302
6.  https://recalls-rappels.canada.ca/en/alert-recall/ranitidine-products-recalled-because-nitrosamine-impurity
7.  https://www.health.harvard.edu/blog/popular-heartburn-drug-ranitidine-recalled-what-you-need-to-know-and-do-2019092817911
 
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​Leaky GutThe term 'Leaky Gut' is used to describe intestinal damage, where the cells are no longer doing their job as well as they should be.  There aren't a lot of great statistics on the prevalence of this condition; however, from experience I will tell you that a large percentage of the patients I see have health concerns resulting from poor digestive function.  This is because digestive health affects EVERYTHING - from memory, to the thyroid, brain function, mood, the immune system and the liver.

Health Issues Stemming from a Leaky Gut

• fatigue
• slow metabolism
• nutrient deficiency (like iron, vitamin B12)
• thyroid conditions
• eczema
• allergies
• joint pain/arthritis
• bloating
• hives
• brain fog
• acne and rosacea
• migraines
• IBS
• psoriasis
• autoimmune conditions

How does this happen?
     It doesn't occur overnight, but the progression of improper digestion may sneak up on you since the signs are easy to ignore.  The cells that line your gut are meant to be tight together and act as a barrier blocking bacteria, toxic waste, undigested food proteins, and anything else that might be in your digestive tract, from passing through into the blood or lymphatic system.  Ideally, your intestinal lining should act like a net, allowing water and nutrients to pass through, while blocking larger items from entering the body.
     The reasons the cells spring a leak, allowing unwanted stuff into the body, could be many but here's a list of possibilities:

• antibiotics
• infections
• blood sugar imbalance
• low stomach acid or digestive enzymes
• stress
• medications
• yeast/fungi or bacterial overgrowth
• hormone imbalance
• toxins
• constipation
• food sensitivities
• eating too many inflammatory foods (gluten, dairy, sugar, alcohol, GMOs)

How does a Leaky Gut cause disease?
     Whenever anything enters the blood or lymphatic system that isn't supposed to be there, the immune system will attack it.  Just as it's designed to fight any virus or bacteria that you might breathe in on a daily basis, the immune system will try to fight off any foreign invader to protect you.
     The trouble is, when the gut is leaky, the immune system is constantly being exposed to and attacks food proteins, toxins, or other particles that shouldn't be there in the first place.  This leads to chronic inflammation in the body, and results in any large number of health conditions or symptoms listed above.

How will we heal it?
1.  Remove 
Take any food triggers, sensitivities or inflammatory foods out of the diet.  Some of the foods may be reintroduced in smaller amounts after healing has occurred.  We can find out your specific food triggers through an Elimination Diet or by doing an IgG food sensitivity blood test.

2.  Replace
Saturate your body with delicious and nutritious healing foods like bone broth soups, coconut oil, fruits and vegetables, and sauerkraut or kimchi. Within a couple of weeks you should no longer be craving unhealthy foods, and your energy will have increased dramatically.  Any pain you may have experienced should also be reduced within that timeframe.

3.  Repair
In order to repair the damage, or speed up the healing, individualized treatments like herbal remedies, acupuncture, or supplements can be used.  My favourites are digestive enzymes, quercetin and L-glutamine to help the gut relearn its job and heal, plus licorice root and aswhaghanda if stress or the thyroid are implicated.  

4.  Rebalance
The neat thing about the gut is that it's not just the complex system of cells and enzymes that digest food, but there's also good bacteria that help us to breakdown food and absorb nutrients, keeping our digestion working at its best.  Once we've repaired the digestive tract, it's time to repopulate it with these good bacteria, especially to help crowd out the bad bugs.  The bacterial balance in the gut is affected by external factors like antibiotics, but also the foods we eat can cause certain types of bacteria to thrive over others.  Having the right ratios and balance of bacteria can be supported with probiotics and fermented foods, a higher dose is typically suggested initially.

I hope I've helped bring some clarity over this popular yet confusing topic, plus given you some insights as to why it's important to heal your digestive system and change your eating habits as part of your treatment plan.  

Enjoy the summer weather! :)
Dr. Christa